The collagenase injection is a non-surgical, high-cost approach that is not authorized in Brazil for treating Peyronie’s disease.
Collagenase treatment for Peyronie’s—often referred to as the Xiaflex injection—is considered a non-surgical alternative in some settings. However, its high cost and questions about effectiveness make its use impractical in Brazil.
This approach aims to act on the fibrotic plaque that drives the condition—with the objective of favoring tissue elasticity and potentially assisting penile alignment when appropriate.
Although some studies report improvements, there are international critiques regarding data clarity and consistency.
Learn more about this option and how to seek professional help for penile curvature:
What is the role of collagenase and when is it considered?
The collagenase injection is an injectable formulation intended to break down collagen fibers.
In Peyronie’s disease, when applied directly into the plaque, this injectable treatment seeks to expand tissues with the intent of reducing penile deformities, depending on fibrosis extent and individual response.
This treatment is not registered in Brazil and lacks ANVISA authorization for commercialization. Therefore, it cannot be indicated within Brazilian territory.
Dr. Paulo Egydio interviewed Turkish urologist Dr. Ege Şerefoğlu, editor-in-chief of the International Journal of Impotence Research, who also noted the treatment is not used in Türkiye.
According to Dr. Şerefoğlu, in U.S.-based studies he joined, collagenase trials showed controversies. Publications did not clearly report dropout rates or reasons, which limits reliability for broad indication.
How the application works
The protocol for using collagenase injection should be defined by a urologist.
In general, treatment may involve up to four cycles, with at most three applications per cycle, and six-week intervals between cycles.
Between cycles, clinicians may associate specific penile physiotherapy—under medical guidance—to help tissue remodeling.
How long does collagenase take to show an effect?
The plaque may begin to soften during the first cycle; many men, however, require additional cycles.
Total treatment can take about 4–5 months, when the planned number of applications is reached and response is reassessed.
What is the price of Xiaflex?
Because the medication is not registered in Brazil, a price in BRL cannot be estimated.
In the United States, where it is used, costs are high. Per-injection pricing can approach US$ 4,000, as reported by MedPage Today.
Considering that a collagenase application cycle often ranges from four to eight injections, total costs may reach around US$ 48,000 for injections alone.
How effective is collagenase injection?
Collagenase injection does not work for all patients. Effectiveness depends on plaque features—location and stage among them.
Very rigid, calcified plaques tend to respond poorly; thus, this option is usually not recommended in established calcification.
If curvature is near the urethra, injections may not be advisable due to risk of urethral injury.
When considered for Peyronie’s, protocols report curvature improvement in the range of about 15° to 30° in selected cases.
For mild deformities, this non-surgical alternative may yield noticeable improvement in some individuals; results are typically less favorable when there is shaft narrowing, length loss, or erectile dysfunction.
Talk to a urologist about the best approach for your case
Because collagenase for Peyronie’s is not available locally and has variable responses, seeking medical evaluation is important to guide care for penile curvature.
Given the high cost and heterogeneous outcomes, careful assessment helps align expectations and treatment options.
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