Traction and Traction Devices for Correcting Peyronie’s Disease

Peyronie’s disease is a curvature abnormality of the male penis that is marked by a multitude of disturbing symptoms such as; curvature deficits, painful penile spasms, erectile dysfunction and a reduction in the overall size of the penis.
Several pharmacological and invasive procedures are available to manage the symptoms of this condition; however, conservative remedies such as traction devices are considered superior owing to minimal risk of adverse effects and long term disabilities.
 

What are Penile Traction Devices?

Penis elongating devices (also known as penile traction devices) constitutes of a plastic ring (that fits at the base of the penis) and two metal rods that holds the ring in place via adjustable fitting. The aim of this arrangement is to maintain optimal traction of the penile shaft in order to build adequate pressure outwards, for meaningful support.
It is imperative to keep in mind that the intensity of the applied traction is mild to allow the elongation of penile tissue as a result of high rate of production and deposition of tissue matrix to ensure optimal remodelling of penile muscular components
The rationale behind the use of traction devices in the management of Peyronie’s disease is the fact that persistent force over the curved, deformed pat of the penile shaft can help in the activation of remodelling and reconstruction mechanisms to restore normal anatomy and physiology.
 

Efficacy of Traction and Traction Devices

Research and clinical data indicates that controlled use of traction devices help in the growth of penile tissue (both in transverse as well as linear fashion). It is indeed the cheapest and most effective remedy that helps in reversing the curvature abnormalities without aggravating the risk of adverse effects. Most importantly, the patient satisfaction scores and compliance rate is also excellent with traction devices; since individuals are not required to go through embarrassing physical examinations and long hours of waiting at doctor’s office. The economic cost of therapy is lower with no heavy consultation charges and cumbersome cost of expensive medications.
Although these devices are designed to augment the girth of the penis but elongation of linear penile shaft is the mainstay of intervention goal. The added benefit of improvement in girth is considered a good combination for most users. After all, thick and long penis is a blessing for many especially in a complicated Peyronie’s disease in which penile shortening is a chief complaint.
 

Some Tips to Improve the Quality of Results

Experts believe that traction is an excellent modality of care in individuals with mild disease such as curvature abnormality of no more than 50 degrees, with minimal ED and otherwise stable disease. The quality of results can be enhanced by:

• The frequency of the device application and the quantity of the force applied determines the outcome of the treatment.
• The device should not be used for longer periods than advised and strength of traction force should be tapered to higher strengths in a gradual manner.
• For best results, start slowly and gradually increase the duration of traction (for up to 8 to 9hours/ day); however, single episode of traction application must not exceed 2 hours.
• There should be a minimum of 20 minutes break between two consecutive sessions. Traction should be started from mild and can be increased gradually or as instructed.

What are the Disadvantages?

The biggest drawback of this treatment modality is long term usage and strict adherence to the treatment and usage plan. The frequency and duration of traction greatly determines the quality of results.
For example, according to a new study published in The Journal of Sexual Medicine (3), investigators reported that an improvement in the curvature of penis (from 31 degrees to 27 degrees) was observed in patients who used traction devices for at least 5 hours/ day over a period of 6 months. In addition, a mean improvement of 0.83 cm in the length of flaccid penis and an increase of 1.3 cm in the length of extended/ erected penis was also observed in the 15 subjects who used traction for 6 months. Investigators also reported that the results were maintained at 12-month follow-up visit; suggesting long term efficacy of traction.
However, nonetheless application of an apparent penile extenders is an awkward situation and most men would like to avoid it especially those who are involved in physical work. In such cases, use of penile extenders should be combined with vacuum devices. Individuals can wear traction devices in the evening or on weekends and holidays while relying on vacuum device at other times.
 

Adverse Effects of Penis Traction Devices

Based on clinical data, most penile traction devices are mostly well tolerated but the safety and long term benefits are mainly dependent upon the individual’s use and compliance to instructions. After applying the device, it should be taken out after maximum of two hours. Most frequently reported adverse effects with poorly regulated use are itching and soreness of the head of the penis.
 
References:

1. Levine, L. A., Newell, M., & Taylor, F. L. (2008). Penile Traction Therapy for Treatment of Peyronie’s Disease: A Single‐Center Pilot Study. The journal of sexual medicine, 5(6), 1468-1473.
2. Ralph, D., Gonzalez‐Cadavid, N., Mirone, V., Perovic, S., Sohn, M., Usta, M., & Levine, L. (2010). The Management of Peyronie’s Disease: Evidence‐based 2010 Guidelines. The journal of sexual medicine, 7(7), 2359-2374.
3. Gontero, P., Di Marco, M., Giubilei, G., Bartoletti, R., Pappagallo, G., Tizzani, A., & Mondaini, N. (2009). Use of penile extender device in the treatment of penile curvature as a result of Peyronie’s disease. Results of a phase II prospective study. The journal of sexual medicine, 6(2), 558-566.