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Acute Phase Peyronie's Disease Management with Traction Device: A Nonrandomized Prospective Controlled Trial with Ultrasound Correlation

Authors

  • Juan I. Martínez-Salamanca MD, PhD,

    Corresponding author
    1. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain
    • Corresponding Author: Juan Ignacio Martinez-Salamanca, MD, PhD, Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, C/ Manuel de Falla 81, Madrid E-28222, Spain. Tel: +34 62 0255030; Fax: +34 91 5348983; E-mail: jims09@me.com

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  • Alejandra Egui MD,

    1. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain
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  • Ignacio Moncada MD,

    1. Department of Urology, Hospital de la Zarzuela, Madrid, Spain
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  • Javier Minaya MD,

    1. Ultrasound Section, Department of Radiology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain
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  • Claudio Martínez Ballesteros MD,

    1. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain
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  • Luis del Portillo MD,

    1. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain
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  • Ignacio Sola MD,

    1. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain
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  • Joaquín Carballido MD, PhD

    1. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Universidad Autónoma de Madrid, Madrid, Spain
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Abstract

Introduction

Outcome data of penile traction therapy (PTT) for the acute phase (AP) of Peyronie's disease (PD) have not been specifically studied.

Aim

The aim of this study was to assess the effectiveness of a penile extender device for the treatment of patients with AP of PD.

Methods

A total of 55 patients underwent PTT for 6 months and were compared with 41 patients with AP of PD who did not receive active treatment (“no intervention group” [NIG]).

Main Outcomes Measures

Pre- and posttreatment variables included degree of curvature, penile length and girth, pain by 0–10 cm visual analog scale (VAS), erectile function (EF) domain of the International Index of Erectile Function questionnaire, Erection Hardness Scale, Sexual Encounter Profile 2 question, and penile sonographic evaluation (only patients in the intervention group).

Results

The mean curvature decreased from 33° at baseline to 15° at 6 months and 13° at 9 months with a mean decrease 20° (P < 0.05) in the PTT group. VAS score for pain decreased from 5.5 to 2.5 after 6 months (P < 0.05). EF and erection hardness also improved significantly. The percentage of patients who were not able to achieve penetration decreased from 62% to 20% (P < 0.03). In the NIG, deformity increased significantly, stretched flaccid penile length decreased, VAS score for pain increased, and EF and erection hardness worsened. PTT was associated with the disappearance of sonographic plaques in 48% of patients. Furthermore, the need for surgery was reduced in 40% of patients who would otherwise have been candidates for surgery and simplified the complexity of the surgical procedure (from grafting to plication) in one out of every three patients.

Conclusions

PTT seems an effective treatment for the AP of PD in terms of pain reduction, penile curvature decrease, and improvement in sexual function. Martínez-Salamanca JI, Egui A, Moncada I, Minaya J, Ballesteros CM, del Portillo L, Sola I, and Carballido J. Acute phase Peyronie's disease management with traction device: A non-randomized prospective controlled trial with ultrasound correlation. J Sex Med 2014;11:506–515.

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