title: Traction therapy for men with shortened penis prior to penile prosthesis implantation: a pilot study.
abstract: BACKGROUND
  Loss of penile length after penile prosthesis implantation is one of the most common complaints. There is no recognized reliable technique to gain length once the device is placed.
  
  
  OBJECTIVE
  This noncontrolled pilot study was designed to evaluate the efficacy and safety of external penile traction therapy in men with a shortened penis used before inflatable prosthesis implantation.
  
  
  METHODS
  Ten men with drug refractory erectile dysfunction and a complaint of a shorter penis as a result of radical prostatectomy in four, prior prosthesis explantation in four, and Peyronie's disease in two were entered into this trial. External penile traction was applied for 2-4 hours daily for 2-4 months prior to prosthesis surgery.
  
  
  METHODS
  Baseline stretched penile length (SPL) was compared with post-traction SPL and postimplant inflated erect length. A non-validated questionnaire assessed patient satisfaction.
  
  
  RESULTS
  All men completed the protocol. Daily average device use was 2-4 hours and for up to 4 months. No man had measured or perceived length loss after inflatable penile prosthesis placement. Seventy percent had measured erect length gain compared with baseline pre-traction SPL up to 1.5 cm. There were no adverse events.
  
  
  CONCLUSIONS
  External traction therapy appears to result in a preservation of penile length, as no man had measured or perceived length loss following prosthesis placement, but in fact, a small length gain was noted in 70% of the subjects with no adverse events. The protocol is tedious and requires compliance to be effective. External traction therapy prior to inflatable penile prosthesis placement appears to preserve and possibly result in increased post-prosthesis implant erect length.
authors.affiliation: Department of Urology, Rush University Medical Center, Chicago, IL, USA. drlevine@hotmail.com
authors.forename: Laurence A
authors.initials: LA
authors.lastname: Levine
authors.forename: James
authors.initials: J
authors.lastname: Rybak
mesh_terms: D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D007172:Erectile Dysfunction / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010409:Penile Diseases / Q000209:etiology / Q000517:prevention & control*; D019935:Penile Implantation / Q000009:adverse effects*; D010411:Penile Induration / Q000150:complications; D010413:Penis / Q000473:pathology* / Q000601:surgery; D010865:Pilot Projects; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D014143:Traction; D016896:Treatment Outcome