Professor Knigavko’s Collagenase+ Protocol

A more biocompatible, more comprehensive, and more affordable alternative to standard Xiaflex injections for the treatment of Peyronie’s disease in Dubai end Europe

We do not copy the American method.
We have enhanced and adapted it for patients in Europe and Asia, focusing not only on plaque breakdown but also on proper tissue healing, stabilization of results, and preservation of erectile function.

The Collagenase+ protocol is more effective than standard Xiaflex injections

Classic Xiaflex is an injectable collagenase used for enzymatic breakdown of pathological collagen in the plaque. This is an important step, but on its own it does not address all treatment objectives.

We have gone beyond the standard American approach

The Knigavko protocol includes:

  • precise assessment of the plaque and the degree of calcification,
  • targeted action on pathological collagen,
  • tissue remodeling,
  • biological support of healing,
  • stabilization of results,
  • rehabilitation and support of erectile function.

Xiaflex vs Collagenase+
Stages of the Collagenase+ Protocol

What Is Xiaflex and How Collagenase Works

Xiaflex is the original brand name of collagenase clostridium histolyticum (CCH), previously known in Europe as Xiapex.
It is an injectable enzymatic drug administered directly into pathological tissue to break down excess collagen.

The active component of Xiaflex is a combination of two purified bacterial enzymes:

  • collagenase AUX-I
  • collagenase AUX-II

These enzymes work synergistically and degrade collagen at specific sites within its triple helix.
Since collagen is the main structural protein in the pathological plaque in Peyronie’s disease, its enzymatic breakdown weakens the tissue and allows curvature reduction after subsequent modeling.

In other words, the basis of the method is controlled enzymatic action on pathological collagen.

According to the product information, Xiaflex is FDA-approved for adult men with a stable form of Peyronie’s disease, with a palpable plaque and a curvature of at least 30°.

The standard regimen includes up to 4 cycles, each consisting of an injection followed by modeling 1–3 days later.
Classical Xiaflex was originally designed within the American treatment model for the stable phase of the disease, rather than as a comprehensive protocol with anti-inflammatory, regenerative, and rehabilitation support.

Key Differences

In our clinical model, different forms of injectable collagenase are used, applied outside the United States, including collagenase derived from human stem cells.

According to the protocol concept, this provides several important advantages:

  • higher biocompatibility
  • less swelling and tissue reaction
  • the possibility of combining with PRP in a single syringe
  • more seamless integration into a comprehensive regenerative protocol

Biological support after injection

The standard approach usually ends with injection and modeling.
In the Knigavko protocol, the most important part begins afterwar- how the tissue heals following plaque treatment.

To reduce the risk of re-scarring, support erectile function, and improve the durability of results, biological support methods are used during the recovery period.

What this provides:

  • reduced risk of recurrence
  • support for healthy tissue regeneration
  • preservation of elasticity
  • improved chances of a more stable result
  • support of erectile function

The Collagenase+ Protocol Is Especially Relevant Outside the USA

As of today, there is no FDA-approved generic or bioequivalent alternative to collagenase clostridium histolyticum in the United States.
At the same time, access to the original injectable collagenase outside the U.S. is limited.

For this reason, our clinics use alternative forms of collagenase derived from human stem cells as part of a proprietary enhanced protocol for the treatment of Peyronie’s disease.

This makes the treatment not only more accessible but also more flexible in terms of clinical customization for each patient.

Cost of the Collagenase+ Protocol

The estimated cost of the Collagenase+ protocol (2 cycles) is approximately €2,500.

The exact price is determined after consultation (online consultation is available) and depends on:

  • stage of the disease
  • size and density of the plaque
  • presence of calcification
  • degree of curvature
  • previous treatments
  • required level of support and rehabilitation

Guarantees and Realistic Expectations

We guarantee adherence to the protocol and achievement of the improvement predicted during the consultation after thorough diagnostics.