Penile Traction Therapy for Peyronie’s Disease
Peyronie’s disease (PD) is a condition where scar tissue forms in the tunica albuginea, which can lead to penile curvature, indentation/hourglass deformity, pain, erectile dysfunction, and loss of length. Management is usually guided by whether PD is in an active phase or stable phase, plus how much the deformity affects sexual function and quality of life.¹,²
One of the most studied conservative options is penile traction therapy (PTT)—the use of a device that applies controlled stretching forces to the penis over time. The goal is to counteract scar-related shortening and encourage tissue remodeling, potentially improving length and reducing curvature in selected men.³
What do guidelines say?
Guidelines are supportive but appropriately cautious, largely because published studies vary in device design, daily wear time, inclusion criteria, and outcome measurement.
PTT is guideline-recognised as a reasonable conservative strategy—especially for men prioritising length preservation and recovery. But outcomes depend heavily on correct use and consistency, and not every deformity type has equal evidence.¹,²
How traction therapy is thought to work
PTT applies a mechanical load along the shaft. In connective tissues, sustained or repeated stretching can influence collagen alignment and remodeling. In PD, this may help reverse some shortening forces created by the plaque, with gradual changes seen over months rather than days.²,³
What does the scientific literature show?
1) Randomized controlled trial evidence
A key advancement in the traction literature is a randomized, controlled trial evaluating a modern traction device used for 30–90 minutes per day. In that trial, traction was reported as safe and associated with clinically meaningful improvements in penile curvature and length, with no significant adverse events reported.⁴
A follow-up paper from the same research program reported outcomes during open-label and follow-up phases, again describing continued improvements in length and curvature and favourable tolerability without significant adverse events.⁵
Historically, older traction approaches often required multiple hours per day, which can be hard to sustain. Shorter daily protocols supported by randomized data may improve adherence for many patients—an important factor because traction outcomes are strongly dose-and-consistency dependent.⁴,⁵
2) Controlled prospective evidence in stable-phase disease
Beyond the RCT above, controlled multicentre data exist for traction therapy in men with stable-phase PD, showing improvements in curvature and patient outcomes with an acceptable safety profile.⁶ Although devices and protocols differ between studies, the overall message is that traction can be effective in carefully selected, motivated patients—particularly when used consistently.³,⁶
3) Systematic reviews and meta-analyses
A 2023 systematic review and meta-analysis evaluating traction devices in PD concluded that available evidence suggests traction can be a safe and effective option to reduce curvature, while highlighting the need for more high-quality RCTs and longer follow-up to define ideal timing, patient subtypes, and protocols.⁷
Earlier reviews similarly emphasised two repeating themes:
traction may improve length and, in some men, deformity; and
outcomes require meaningful patient commitment and compliance.³
Who is most likely to benefit?
Penile traction therapy tends to fit best when:
Length loss is a major concern (traction has one of the more consistent signals for length preservation/gain among conservative options).²,³
You want a non-surgical approach and can commit to a daily routine for several months.³,⁷
Curvature is bothersome but erections are adequate enough for sexual activity.¹,²
You understand that certain deformities may respond less predictably, and the evidence is less robust for these subgroups.²
Realistic expectations
The best-supported message for patients is incremental improvement over months. In the randomized and follow-up studies using shorter daily sessions, many men experienced measurable improvements in both curvature and length.⁴,⁵ However, results vary: baseline curvature severity, deformity complexity, erectile function, and—most importantly—adherence all influence outcomes.²,³,⁷
A realistic framing is:
Weeks 0–4: learning proper technique, building tolerance and routine.
Months 2–3: early objective changes may be measurable in responders.⁴
Months 6–9: additional gains may occur with ongoing consistent use in some men.⁵
Safety and side effects
Across published studies, traction therapy is generally reported as low risk when used as directed. Common issues are typically local and temporary—discomfort, skin irritation/redness, pressure effects, or mild bruising. Serious complications appear uncommon in the key RCT and follow-up publications.⁴,⁵
Practical safety tips:
Increase wear time gradually (consistency matters more than “pushing through” pain).²,³
Ensure correct fitting and take breaks if skin irritation occurs.³,⁷
Seek review if there is significant worsening pain, new hinge instability, or concerns about severe bruising.¹,²
How to use traction therapy well
Published protocols vary, but successful programs share common features:
A defined daily schedule (often 30–90 minutes/day).⁴,⁵
A multi-month commitment (3 months is common in trials).⁴,⁵
Objective tracking (photographs of curvature and measured stretched penile length) to document change.²
If you’re considering traction, it’s worth discussing:
whether your PD appears active vs stable,
whether your deformity pattern is suitable
what outcome you’re prioritising.¹,²
FAQ
Does traction therapy work for Peyronie’s disease?
Evidence from randomized trials, controlled studies, and meta-analyses suggests traction therapy can improve penile length and may reduce curvature in selected men, especially with consistent use over months.²–⁵,⁷
How long does traction therapy take to show results?
Studies often assess outcomes at 3 months, with some reporting additional improvements at 6–9 months in ongoing users.⁴,⁵
Is penile traction therapy safe?
In published studies, side effects are usually mild and local (discomfort, irritation). Serious events are uncommon in major trials when devices are used as directed.⁴,⁵,⁷
References
Nehra A, Alterowitz R, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh JJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745-753. doi:10.1016/j.juro.2015.05.098.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Penile curvature (Peyronie’s disease) chapter. EAU (online edition, accessed 26 Feb 2026).
Chung E, Brock GB. Penile traction therapy and Peyronie’s disease: a state of art review of the current literature. Ther Adv Urol. 2013;5(1):59-65. doi:10.1177/1756287212454932.
Ziegelmann MJ, Viers BR, Montgomery BD, 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. PMID:30916626.
Joseph J, Ziegelmann M, Alom M, et al. Outcomes of penile traction therapy in men with Peyronie’s disease: results from open label and follow-up phases of a randomized trial. J Sex Med. 2020;17(12):2462-2471. doi:10.1016/j.jsxm.2020.10.003.
Moncada I, Krishnappa P, Romero J, et al. Penile traction therapy with a new device is effective and safe in the stable phase of Peyronie’s disease: a controlled multicentre study. BJU Int. 2019;123(4):694-702. doi:10.1111/bju.14602.
Almsaoud NA, Safar O, Alshahrani ST, et al. The effect of penile traction device in men with Peyronie’s disease on penile curvature, penile length, and erectile dysfunction: a systematic review and meta-analysis. Transl Androl Urol. 2023;12(11):1673-1685. doi:10.21037/tau-23-310. PMID:38106680.
