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More on Xiaflex Phase IIb Clinical Trial Results  

Peyronies is essentially a collagen disturbance. (See the photo
below for a contrast with the collagen in a normal penis and one
with Peyronies.)  The hope is that the enzyme, Xiaflex, will
chemically reconfigure the collagen in the penis and allow it to
expand normally.  

Although I believe the Xiaflex only approach can be beneficial,
there may be a way to augment and improve this approach. For
illustration, let's say I took your left arm and constricted with rope
for a period of 6-18 months and then cut the rope. It would be
unreasonable to expect this arm to regain its former shape and
functionality without significant exercise. This is essentially is what
we are expecting from the penis after treatment with Xiaflex.  
Unlike the arm or fingers in the case of Dupuytren's Contracture ,
the penis is not frequently moving and flexing. In like manner, the
penis would need “help” in the form of stretching and exercise in
order to regain its former shape and functionality. In my opinion,
one approach that may achieve a better gain is to use Xiaflex in
combination with a stretching device for an extended period.  Think
of this as a modeling approach on steroids. It is reasonable to
assume this would have a cumulative effect resulting in maximum
improvement.

In 2007, Dr. Lawrence Levine, a Peyronies expert, reported that
men who used only a traction device achieved an average 33%
reduction in curvature.  If we could combine this stretching
approach with Xiaflex and achieve a cumulative improvement, this
would be approaching the hoped for cure.
Collagen in normal tunica of the
penis: Note the organized fibers
arranged in sheets that can
slide past each other  during
penile expansion and
contraction
Collagen in Peyronie's Disease:
Note the densely packed
collagen fibers; this will prevent
normal collagen sliding during
penile expansion and
contraction
Disease and current treatments.