Penile Traction Device Training
Penile traction has been adapted from use in other specialties like orthopedics and plastic surgery as a tool to increase or regain penile length. Small studies on the use of traction in Peyronie’s patients have shown modest improvements in curvature and
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Penile Traction Device Training John P. Mulhall and Lawrence C. Jenkins
Introduction Penile traction has been adapted from use in other specialties like orthopedics and plastic surgery as a tool to increase or regain length. Several studies have looked at the effects of penile traction in patients with Peyronie’s disease and in patients with complaints of a “short penis.” Studies on the use of traction in Peyronie’s patients have shown modest improvements in curvature and stretched flaccid length. However, it appears that the traction must be used for about 3–4 h each day in order to derive a benefit. Changes in stretched flaccid penile length have been reported to range from 0.5 to 2 cm. Penile traction has also been utilized in conjunction with intralesional injections to attempt to obtain the maximal responses using this combination therapy. In patients with body dysmorphophobia, traction has been used to aid in penile lengthening with again modest results. One study showed an average improvement of 1.3 cm in stretched flaccid penile length, no change in penile girth, and modest changes in patient satisfaction.
Indications There have been modest improvements in patients with Peyronie’s disease whether as solo therapy or in combination with intralesional therapies. Traction has also been utilized after plaque incision/excision and grafting surgery to prevent penile length loss. It is also being explored after radical prostatectomy surgery to limit the amount of penile shortening. J.P. Mulhall, MD, MSc, FECSM, FACS (*) • L.C. Jenkins, MD, MBA Department of Surgery, Section of Urology, Memorial Sloan Kettering Cancer Center, 16 East 60th Street, Suite 402, New York, NY 10022, USA e-mail: [email protected]; [email protected] © Springer International Publishing Switzerland 2017 J.P. Mulhall, L.C. Jenkins (eds.), Atlas of Office Based Andrology Procedures, DOI 10.1007/978-3-319-42178-0_15
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J.P. Mulhall and L.C. Jenkins
Pre-procedural Considerations There are several devices on the market, the most commonly used being the USPhysioMed (http://www.usphysiomed.com/home.html), the AndroPenis® devices (https://www.andromedical.com/), and the PeniMaster®/Pro (http://www.penimaster. com). There is typically a minimum erect length to be able to use the device; AndroPenis reports their minimum length as 3.2 in. (8 cm); however, they carry a second device for shorter penises. It is recommended that the patient use the device at least 2 h daily, but longer times might produce greater effects. They should however take breaks after 2 h to reduce any risk for prolonged compression on the tip of the penis (glans ischemia) or prolonged nerve distraction. The device consists of a ring base that goes against the skin; there are two spring-loaded struts with adjustable lengths, which connect to a tension band at the tip of the penis. The struts allow adjustments for varying size penises and to increase the amount of traction over time.
Description of Procedure The traction device is spring loaded and once assembled should be
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