Peyronie’s disease (PD)-related penile deformity is managed with multiple treatment modalities including oral medications, intralesional injections, and surgery. Penile traction therapy (PTT) is one such modality with purported benefits, albeit with notable differences in the characteristics of available traction devices and published study protocols. We provide a comprehensive review of the available data supporting PTT for PD treatment. We performed a rigorous database search to identify all studies pertaining to PTT for the treatment of PD through November 2019. Seventeen trials explored use of PTT as monotherapy or in combination with surgical or nonsurgical treatment, using over five different commercially available devices. All devices were well tolerated, although compliance and daily duration of use were highly variable. PTT resulted in variable improvements in stretched penile length and penile curvature, depending on study protocol, patient population, and device. PTT appears to be a safe and well-tolerated treatment for PD as monotherapy or in combination with other nonsurgical and surgical treatments, and for men in both the acute and chronic phases. Further studies are needed to compare available devices, evaluate device characteristics associated with treatment success, differentiate outcomes in acute vs. chronic PD populations, and determine the optimal duration of use.
Subscribe to Journal
Get full journal access for 1 year
only $32.38 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Hellstrom WJ. History, epidemiology, and clinical presentation of Peyronie’s disease. Int J Impot Res. 2003;15:S91–92.
Arafa M, Eid H, El-Badry A, Ezz-Eldine K, Shamloul R. The prevalence of Peyronie’s disease in diabetic patients with erectile dysfunction. Int J Impot Res. 2007;19:213–7.
Dibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X. A population-based study of Peyronie’s disease: prevalence and treatment patterns in the United States. Adv Urol. 2011;2011:282503.
La Pera G, Pescatori ES, Calabrese M, Boffini A, Colombo F, Andriani E, et al. Peyronie’s disease: prevalence and association with cigarette smoking. A multicenter population-based study in men aged 50-69 years. Eur Urol. 2001;40:525–30.
Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A, et al. Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening. J Urol. 2004;171:2350–3.
Chung E, De Young L, Solomon M, Brock GB. Peyronie’s disease and mechanotransduction: an in vitro analysis of the cellular changes to Peyronie’s disease in a cell-culture strain system. J Sex Med. 2013;10:1259–67.
Terrier JE, Nelson CJ. Psychological aspects of Peyronie’s disease. Transl Androl Urol. 2016;5:290–5.
Scroppo FI, Mancini M, Maggi M, Colpi GM. Can an external penis stretcher reduce Peyronie's penile curvature? Int J Impot Res. 2001;13.
Gontero P, Di Marco M, Giubilei G, Bartoletti R, Pappagallo G, Tizzani A, et al. 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. J Sex Med. 2009;6:558–66.
Martinez-Salamanca JI, Egui A, Moncada I, Minaya J, Ballesteros CM, Del Portillo L, et al. Acute phase Peyronie’s disease management with traction device: a nonrandomized prospective controlled trial with ultrasound correlation. J Sex Med. 2014;11:506–15.
Levine LA, Newell M, Taylor FL. Penile traction therapy for treatment of Peyronie’s disease: a single-center pilot study. J Sex Med. 2008;5:1468–73.
Moncada I, Krishnappa P, Romero J, Torremade J, Fraile A, Martinez-Salamanca JI, et al. Penile traction therapy with the new device ‘Penimaster PRO’ is effective and safe in the stable phase of Peyronie’s disease: a controlled multicentre study. BJU Int. 2019;123:694–702.
Hellstrom WJ, Feldman R, Rosen RC, Smith T, Kaufman G, Tursi J. Bother and distress associated with Peyronie’s disease: validation of the Peyronie’s disease questionnaire. J Urol. 2013;190:627–34.
Ziegelmann MJ, Viers BR, Montgomery BD, Avant RA, Savage JB, Trost LW. Clinical experience with penile traction therapy among men undergoing collagenase clostridium histolyticum for Peyronie disease. Urology. 2017;104:102–9.
Stewart CA, Yafi FA, Knoedler M, Mandava SH, McCaslin IR, Sangkum P, et al. Intralesional injection of Interferon-alpha2b improves penile curvature in men with Peyronie’s disease independent of plaque location. J Urol. 2015;194:1704–7.
Ziegelmann M, Savage J, Toussi A, Alom M, Yang D, Kohler T, et al. Outcomes of a novel penile traction device in men with peyronie’s disease: a randomized, single-blind, controlled trial. J Urol. 2019;202:599–610.
Rosen RC, Allen KR, Ni X, Araujo AB. Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol. 2011;60:1010–6.
Ibrahim A, Gazzard L, Alharbi M, Rompre-Brodeur A, Aube M, Carrier S. Evaluation of oral pentoxifylline, colchicine, and penile traction for the management of Peyronie’s disease. Sex Med. 2019;7:459–63.
Abern MR, Larsen S, Levine LA. Combination of penile traction, intralesional verapamil, and oral therapies for Peyronie’s disease. J Sex Med. 2012;9:288–95.
Yafi FA, Pinsky MR, Stewart C, Sangkum P, Ates E, Trost LW, et al. The effect of duration of penile traction therapy in patients undergoing intralesional injection therapy for Peyronie’s disease. J Urol. 2015;194:754–8.
Gallo L, Sarnacchiaro P. Ten-year experience with multimodal treatment for acute phase Peyronie’s disease: a real life clinical report. Actas Urol Esp. 2019;43:182–9.
Gelbard M, Goldstein I, Hellstrom WJ, McMahon CG, Smith T, Tursi J, et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190:199–207.
Levine LA, Cuzin B, Mark S, Gelbard MK, Jones NA, Liu G, et al. Clinical safety and effectiveness of collagenase clostridium histolyticum injection in patients with Peyronie’s disease: a phase 3 open-label study. J Sex Med. 2015;12:248–58.
Gelbard M, Lipshultz LI, Tursi J, Smith T, Kaufman G, Levine LA. Phase 2b study of the clinical efficacy and safety of collagenase Clostridium histolyticum in patients with Peyronie disease. J Urol. 2012;187:2268–74.
Alom M, Sharma KL, Toussi A, Kohler T, Trost L. Efficacy of combined collagenase clostridium histolyticum and restoreX penile traction therapy in men with Peyronie’s disease. J Sex Med. 2019;16:891–900.
Rybak J, Papagiannopoulos D, Levine L. A retrospective comparative study of traction therapy vs. no traction following tunica albuginea plication or partial excision and grafting for Peyronie’s disease: measured lengths and patient perceptions. J Sex Med. 2012;9:2396–403.
Levine LA, Rybak J. Traction therapy for men with shortened penis prior to penile prosthesis implantation: a pilot study. J Sex Med. 2011;8:2112–7.
Wymer K, Kohler T, Trost L. Comparative cost-effectiveness of surgery, collagenase clostridium histolyticum, and penile traction therapy in men with peyronie’s disease in an era of effective clinical treatment. J Sex Med. 2019;16:1421–32.
Chen R, McCraw C, Lewis R. Plication procedures-excisional and incisional corporoplasty and imbrication for Peyronie’s disease. Transl Androl Urol. 2016;5:318–33.
Haney NM, Kohn TP, Nichols PE, Jg Hellstrom W. The effect of adjunct mechanical traction on penile length in men undergoing primary treatment for peyronie’s disease: a systematic review and meta-analysis. Urology. 2018;122:110–5.
Nikoobakht M, Shahnazari A, Rezaeidanesh M, Mehrsai A, Pourmand G. Effect of penile-extender device in increasing penile size in men with shortened penis: preliminary results. J Sex Med. 2011;8:3188–92.
Nowroozi MR, Amini E, Ayati M, Jamshidian H, Radkhah K, Amini S. Applying extender devices in patients with penile dysmorphophobia: assessment of tolerability, efficacy, and impact on erectile function. J Sex Med. 2015;12:1242–7.
Conflict of interest
The authors declare that they have no conflict of interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Bole, R., White, L., Parikh, N. et al. A modern review of penile traction monotherapy and combination therapy for the treatment of peyronie’s disease. Int J Impot Res 33, 251–258 (2021). https://doi.org/10.1038/s41443-020-0247-3
The Journal of Sexual Medicine (2020)
International Journal of Impotence Research (2020)