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Indications and characteristics of penile traction and vacuum erection devices

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Abstract

A variety of devices are available for the management of patients with erectile dysfunction, Peyronie’s disease, penile dysmorphophobia, for support before and after penile prosthesis insertion, and after radical prostatectomy. Traction devices include, but are not limited to, Penimaster PRO (MSP Concept, Berlin, Germany), Andropenis and Andropeyronie (Andromedical, Madrid, Spain), and the Restorex (PathRight Medical, Plymouth, USA). The other type of devices are vacuum devices such the Osbon ErecAid (Timm Medical, MN, USA). Different devices are optimal for different clinical applications, and robust and contemporary clinical data show a variety of strengths and weaknesses for each device. Research currently favours the use of traction devices for improvement of penile curvature and erectile function in patients with Peyronie’s disease compared with vacuum devices; Penimaster Pro and Restorex have been shown to be associated with the best outcomes in this indication. Vacuum devices are favoured for treatment of erectile dysfunction and penile length loss after radical prostatectomy; the Osbon ErecAid is the most well-studied device for this indication. Research into other uses of vacuum and traction devices, such as for penile dysmorphophobia or before and after penile prosthesis, is very limited. Compliance, cost and availability remain substantial challenges, and further high-quality evidence is required to clarify the role of traction devices in urology and sexual medicine.

Key points

  • Some penile traction therapy (PTT) devices and vacuum erection devices (VEDs) have been found to help to decrease penile curvature and increase stretched penile length in Peyronie’s disease.

  • PTT and VEDs are cost-effective with minimal, well-tolerated adverse effects such as numbness, pain and bruising.

  • PTT and VEDs can be used preoperatively before penile prosthesis insertion to help to increase stretched penile length and ease implant insertion.

  • VEDs can also have a role in penile rehabilitation after robotic prostatectomy as early as 1 month postoperatively, encouraging regular traction of corpora cavernosa and, theoretically, counteracting fibrosis caused by a lack of erections.

  • More research is required directly comparing VEDs and PTT devices in the setting of postprostatectomy penile rehabilitation, Peyronie’s disease and erectile dysfunction.

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Fig. 1: Application of vacuum and traction devices to the penis.
Fig. 2: Pathways leading to cavernosal fibrosis at cellular level.

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Authors and Affiliations

  1. Department of Urology, Russell’s Hall Hospital, DGFT, Dudley, UK

    Abida Sultana

  2. Department of Urology, Nottingham University Hospitals, Nottingham, UK

    Peter Grice

  3. Department of Urology, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA

    Josip Vukina

  4. Department of Urology, Manchester University NHS Trust, Manchester, UK

    Ian Pearce & Vaibhav Modgil

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A.S., P.G., I.P. and V.M. researched data for the article. A.S., J.V., I.P. and V.M. made substantial contributions to discussions of content. A.S., P.G. and V.M. wrote the manuscript. All authors reviewed and edited the manuscript before submission.

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Correspondence to Abida Sultana.

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Nature Reviews Urology thanks P. Bajic, W. Hellstrom and J. Yuan for their contribution to the peer review of this work.

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Andropenis: https://www.andropenis.com/

Restorex: https://www.restorex.com/

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Sultana, A., Grice, P., Vukina, J. et al. Indications and characteristics of penile traction and vacuum erection devices. Nat Rev Urol 19, 84–100 (2022). https://doi.org/10.1038/s41585-021-00532-7

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