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

被引:46
作者
Moncada, Ignacio [1 ]
Krishnappa, Pramod [1 ,2 ]
Romero, Javier [3 ]
Torremade, Josep [4 ]
Fraile, Agustin [5 ]
Ignacio Martinez-Salamanca, Juan [6 ]
Porst, Hartmut [7 ]
Levine, Laurence [8 ]
机构
[1] Hosp Univ Sanitas Zarzuela, Madrid, Spain
[2] NU Hosp, Bangalore, Karnataka, India
[3] Hosp Univ 12 Octubre, Madrid, Spain
[4] Hosp Univ Bellvitge, Barcelona, Spain
[5] Hosp Univ Ramon & Cajal, Madrid, Spain
[6] Hosp Univ Puerta Hierro, Madrid, Spain
[7] Private Inst Urol & Sexual Med, Hamburg, Germany
[8] Rush Univ, Med Ctr, Chicago, IL 60612 USA
关键词
#Andrology; #Peyronies; Conservative treatment; Penile Curvature; penile traction therapy; Penimaster PRO; Peyronie's disease; COLLAGENASE CLOSTRIDIUM-HISTOLYTICUM; NATURAL-HISTORY; EXTENDER;
D O I
10.1111/bju.14602
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives To evaluate the efficacy and safety of a new penile traction device (PTD), 'Penimaster PRO', in a group of patients with stable Peyronie's disease (PD) compared with a non-intervention group in a multicentre study. Material and Methods A total of 93 patients with chronic stable PD (without erectile dysfunction, with no significant pain, and with a unidirectional curvature of at least 45 degrees being stable for > 3 months) were recruited and followed for a 12-week period. Of these patients, 47 were randomly assigned to the Penimaster PRO group (PG) and 46 to the non-intervention group (NIG). Patients were asked to apply the PTD 3-8 h a day for 12 consecutive weeks, with specific instructions regarding the progressive increase of traction force applied to the penis over time. The primary outcome of the study was the change in the degree of curvature measured in the fully erect state after intracavernosal injection of alprostadil at baseline, 1, 2 and 3 months. Other variables, such as the type of curvature, stretched penile length (SPL), Peyronie's Disease Questionnaire (PDQ) scores, erectile function domain of the International Index of Erectile function (IIEF-EF) score and adverse events (AEs) were also assessed in each visit. Results Forty-one patients in the PG and 39 in the NIG completed the study. There was an overall reduction in curvature of 31.2 degrees (P < 0.001) at 12 weeks compared to baseline in the PG, representing a 41.1% improvement from baseline, which significantly correlated with the number of daily hours the device was applied in a dose-dependent manner. Those patients using the device < 4 h/day experienced a reduction of 15 degrees-25 degrees (mean 19.7 degrees, 28.8% improvement; P < 0.05), while patients using the device > 6 h/day experienced greater curvature reduction, ranging from 20 degrees to 50 degrees (mean of 38.4 degrees, 51.4% improvement; P < 0.001). In contrast, no significant changes in curvature were observed in the NIG. Furthermore, SPL increased significantly in the PG compared to baseline and compared with the NIG, ranging from 0.5 to 3.0 cm (mean 1.8 cm; P < 0.05). The IIEF-EF score also improved in patients in the PG (by a mean of 5 points). Mild AEs occurred in 43% of patients, such as local discomfort and glans numbness. Conclusion The use of the Penimaster PRO PTD, a non-invasive treatment, should be offered to patients with stable PD for 3 consecutive months before performing any corrective surgery, as this provided a significant reduction in the curvature, an increase in penile length and a significant improvement of the symptoms and bother induced by PD.
引用
收藏
页码:694 / 702
页数:9
相关论文
共 20 条
  • [1] Combination of Penile Traction, Intralesional Verapamil, and Oral Therapies for Peyronie's Disease
    Abern, Michael R.
    Larsen, Stephen
    Levine, Laurence A.
    [J]. JOURNAL OF SEXUAL MEDICINE, 2012, 9 (01) : 288 - 295
  • [2] Implications of tensile loading for the tissue engineering of nerves
    Bueno, Franklin Rivera
    Shah, Sameer B.
    [J]. TISSUE ENGINEERING PART B-REVIEWS, 2008, 14 (03) : 219 - 233
  • [3] THE NATURAL-HISTORY OF PEYRONIES DISEASE
    GELBARD, MK
    DOREY, F
    JAMES, K
    [J]. JOURNAL OF UROLOGY, 1990, 144 (06) : 1376 - 1379
  • [4] 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
    Gontero, Paolo
    Di Marco, Massimiliano
    Giubilei, Gianluca
    Bartoletti, Riccardo
    Pappagallo, Giovanni
    Tizzani, Alessandro
    Mondaini, Nicola
    [J]. JOURNAL OF SEXUAL MEDICINE, 2009, 6 (02) : 558 - 566
  • [5] Hatzimouratidis K, 2017, EAU ANN C LOND 2017
  • [6] External tissue expanders as adjunct therapy in closing difficult wounds
    Laurence, Vincent G.
    Martin, Jenna B.
    Wirth, Garrett A.
    [J]. JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, 2012, 65 (10) : E297 - E299
  • [7] FastSize™ medical extender for the treatment of Peyronie's disease
    Levine, Laurence A.
    Newell, Mark M.
    [J]. EXPERT REVIEW OF MEDICAL DEVICES, 2008, 5 (03) : 305 - 310
  • [8] Penile traction therapy for treatment of Peyronie's disease: A single-center pilot study
    Levine, Laurence A.
    Newell, Mark
    Taylor, Frederick L.
    [J]. JOURNAL OF SEXUAL MEDICINE, 2008, 5 (06) : 1468 - 1473
  • [9] Clinical Safety and Effectiveness of Collagenase Clostridium Histolyticum Injection in Patients with Peyronie's Disease: A Phase 3 Open-Label Study
    Levine, Laurence A.
    Cuzin, Beatrice
    Mark, Stephen
    Gelbard, Martin K.
    Jones, Nigel A.
    Liu, Genzhou
    Kaufman, Gregory J.
    Tursi, James P.
    Ralph, David J.
    [J]. JOURNAL OF SEXUAL MEDICINE, 2015, 12 (01) : 248 - 258
  • [10] Acute Phase Peyronie's Disease Management with Traction Device: A Nonrandomized Prospective Controlled Trial with Ultrasound Correlation
    Martinez-Salamanca, Juan I.
    Egui, Alejandra
    Moncada, Ignacio
    Minaya, Javier
    Martinez Ballesteros, Claudio
    del Portillo, Luis
    Sola, Ignacio
    Carballido, Joaquin
    [J]. JOURNAL OF SEXUAL MEDICINE, 2014, 11 (02) : 506 - 515