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Penile Traction Therapy and Vacuum Erection Devices in Peyronie's Disease

Published on Apr 1, 2019in Sexual medicine reviews
· DOI :10.1016/j.sxmr.2018.02.005
R. Avant3
Estimated H-index: 3
(Mayo Clinic),
Matthew J. Ziegelmann9
Estimated H-index: 9
(Mayo Clinic)
+ 3 AuthorsLandon Trost16
Estimated H-index: 16
(Mayo Clinic)
Abstract
Abstract Introduction Peyronie's disease (PD) has historically been managed by at least 1 treatment, including oral supplements or medications, intralesional injections, or surgery. Adjunctive mechanical therapies also have been described, including penile traction therapy (PTT) and vacuum erection devices (VEDs), although relatively limited data are available on their use with PD. Aim To review and summarize the published literature on the role and efficacy of PTT and VED in men with PD. Methods A PubMed search was performed of all publications on PTT and VED in men with PD from inception through September 2017. Main Outcome Measures Changes in penile curvature, length, girth, erectile function, and adverse events with PTT or VED. Results PTT and VED exhibit mechanisms to improve aspects of PD, although clinical outcomes data are limited. Based on current data, PTT likely has a potential role as a primary lengthening therapy (modest improvements), in curvature correction (acute phase; unclear role in chronic phase), before penile prosthesis insertion, and after surgical correction of PD. The role of PTT as a combination therapy during collagenase Clostridium histolyticum injections is unclear. Fewer and lower level-of-evidence studies are available on VEDs and suggest potential roles in curvature correction, before penile prosthesis placement, or after PD surgery. Guideline statements from the American Urological Association and International Consultation on Sexual Medicine also support the potential role of PTT and VED in managing PD. Conclusions PTT and VED represent viable therapeutic options for managing PD, with more data currently available on PTT. Because all PTT studies used a similar style of traction device, it is unclear whether results reflect outcomes of these particular devices or traction more broadly. Further studies are required to better delineate the benefits of PTT and VED, particularly in relation to other established treatments. Avant RA, Ziegelman M, Nehra A, et al. Penile Traction Therapy and Vacuum Erection Devices in Peyronie's Disease. Sex Med Rev 2019;7:338–348.
  • References (54)
  • Citations (4)
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References54
Newest
#1Amr Abdel Raheem (Cairo University)H-Index: 11
#2M. Capece (UCLH: University College Hospital)H-Index: 2
Last. David J. Ralph (UCLH: University College Hospital)H-Index: 46
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Objectives To evaluate the efficacy and safety of collagenase clostridium histolyticum (CCH) (Xiapex®, Xiaflex®) in the treatment of Peyronie's disease (PD) using a new modified treatment protocol which aims at reducing the number of injections needed and reducing patient visits, thus reducing the cost and duration of treatment. Patients and Methods A prospective study of 53 patients with PD who had treatment with CCH at a single center using a new modified protocol. The angle of curvature asses...
29 CitationsSource
#1Haocheng Lin (PKU: Peking University)H-Index: 6
#2Chunhui Liu (SEU: Southeast University)H-Index: 2
Last. Run Wang (University of Texas at Austin)H-Index: 23
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Abstract Background Penile traction therapy with the use of a traction device (TD) or vacuum erectile device (VED) has been studied as local modalities for Peyronie’s disease (PD). Aim To identify changes of penile curvature, erectile function, and possible cellular and molecular mechanisms between the TD and VED in a rat model of PD. Methods Peyronie’s plaque was induced in 30 adult male rats. Then, rats were randomly divided into control (PD without treatment), VED, and TD groups. In the VED g...
7 CitationsSource
#1Yoshifumi Kadono (Kanazawa University)H-Index: 13
#2Kazuaki Machioka (Kanazawa University)H-Index: 5
Last. Atsushi Mizokami (Kanazawa University)H-Index: 37
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Objective To measure changes in penile length (PL) over time before and after radical prostatectomy (RP), and to investigate the underlying mechanisms for these changes. Patients and Methods The stretched PL (SPL) of 102 patients was measured before, 10 days after, and at 1, 3, 6, 9, 12, 18 and 24 months after RP. The perpendicular distance from the distal end of the membranous urethra to the midline of the pelvic outlet was measured on mid-sagittal magnetic resonance imaging (MRI) slice at thre...
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#1Matthew J. Ziegelmann (Mayo Clinic)H-Index: 9
#2Boyd R. Viers (Mayo Clinic)H-Index: 13
Last. Landon Trost (Mayo Clinic)H-Index: 16
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Objective To evaluate the outcomes in men undergoing collagenase Clostridium histolyticum (CCH) with concurrent penile traction therapy (PTT) for the treatment of Peyronie disease (PD). Materials and Methods We identified patients treated with CCH between March 2014 and July 2016. Patients were recommended to perform modeling and PTT between injection series. A final curve assessment was performed after patients completed CCH. A prospective database was maintained, including patient-reported fre...
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#1Faysal A. Yafi (Tulane University)H-Index: 16
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Last. Wayne J.G. Hellstrom (Tulane University)H-Index: 63
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Abstract Introduction Peyronie's disease (PD) is a wound-healing disorder of the tunica albuginea often associated with penile deformity. Less commonly, patients with PD might display atypical presentations such as ventral curvature, hourglass deformity, significantly shortened penis, and/or multiplanar curvature. Aim To review the available literature on the prevalence of and management options for atypical PD. Methods A literature review was performed through PubMed from 1982 through 2016 rega...
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#1Onder Canguven (Hamad Medical Corporation)H-Index: 5
#2Raidh A. Talib (Hamad Medical Corporation)H-Index: 4
Last. Abdulla Al-Ansari (Hamad Medical Corporation)H-Index: 13
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Summary Patient concerns about penile length after penile prosthesis (PP) implantation for erectile dysfunction (ED) have significant impact on patients and their partners. In addition, corporal fibrosis is associated with difficult PP implantation. The preoperative use of vacuum erectile devices (VED) is an uncommon physical treatment for such concerns. Therefore, the current randomized controlled study assessed two outcomes: whether pre-operative VED use for a month before surgery would signif...
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#1Landon Trost (Mayo Clinic)H-Index: 16
#2Ricardo Munarriz (BU: Boston University)H-Index: 29
Last. Laurence A. Levine (Rush University Medical Center)H-Index: 51
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Abstract Introduction The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. Aim To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. Methods A consensus panel was held with leading sexual medicine experts during the 2015 International Consu...
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#1Matthew J. Ziegelmann (Mayo Clinic)H-Index: 9
#2Boyd R. Viers (Mayo Clinic)H-Index: 13
Last. Landon Trost (Mayo Clinic)H-Index: 16
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Purpose: Collagenase clostridium histolyticum is approved for the treatment of Peyronie’s disease. To date, no post-release study to our knowledge has evaluated patient perceived outcomes and satisfaction. Therefore, we evaluated patient perceived experience with collagenase clostridium histolyticum injection for Peyronie’s disease in a clinical practice.Materials and Methods: From March 2014 to July 2015, 69 patients underwent 1 to 4 series of collagenase clostridium histolyticum injections for...
44 CitationsSource
#1Faysal A. Yafi (Tulane University)H-Index: 16
#2Michael R. Pinsky (Tulane University)H-Index: 81
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Purpose: The concomitant use of penile traction therapy with interferon α-2b has been previously described. We present an update on our clinical experience to assess the benefit and duration of daily traction.Materials and Methods: A retrospective review of patients who underwent interferon α-2b therapy between 2001 and 2012 was performed. Charts were reviewed and data collected regarding various patient demographics, vascular parameters, objective length and curvature measurements, and use of p...
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#1Martin K. GelbardH-Index: 16
#2Larisa ChaganH-Index: 1
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While surgery remains the gold standard for the treatment of penile deformity associated with Peyronie’s disease, various non-surgical options including oral and topical agents, penile traction, and intralesional injections are available with varying levels of evidence and treatment efficacy seen in the literature. Herein we review various non-surgical managements for Peyronie’s disease and describe our techniques for intralesional injections with verapamil and Collagenase Clostridium histolytic...
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#1Joshua Halpern (NU: Northwestern University)H-Index: 14
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Humans have been preoccupied with penile augmentation from time immemorial. In modern times, a wide variety of approaches have sought to increase penile length, girth, or, in some cases, both. While there is no consensus regarding appropriate indications, penile augmentation has been used in the setting of microphallus, fibrosis, trauma, and penile dysmorphia. Techniques for girth enhancement include injectable therapies, grafting, and implants. Penile lengthening procedures include traction the...
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#1Karen Randhawa (Western General Hospital)
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Peyronies disease (PD) is estimated to affect approximately 3–9% of men worldwide and maybe associated with pain, erectile dysfunction and penile deformity including shortening. The condition has s...
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Abstract Introduction Peyronie's disease (PD) is the fibrous scar tissue inside the penis that causes curved and painful erections. PD is associated with, diabetes, hypertension, dyslipidemia and low testosterone. PD causes erectile dysfunction (ED). The aim of this study was to evaluate the prevalence of PD in type 2 diabetic (T2DM) patients in Yazd. Methods This cross-sectional study was conducted on 317 patients with T2DM referred to the Diabetes Research Center of Yazd. Inclusion Criteria we...
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