Levine study: Traction results only with more that 3 hours a day?

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Luciano

I just found this study (article) by levine and others in the journal of sexual medicine volume 9.
Unfortunately its only the abstract, but it has for me 1 important sentence in it.
Here is the Abstract:

Title:   Combination of penile traction, intralesional verapamil, and oral therapies for Peyronie's disease.
Author(s):   Abern MR, Larsen S, Levine LA

Institution:   Department of Urology, Rush University Medical Center, Chicago, IL 60612, USA.
Source:   J Sex Med 2012 Jan; 9(1):288-95.

Abstract:   


Introduction.  There is no current consensus as to the most effective nonsurgical therapy for Peyronie's disease (Peyronies Disease).

Aim.  This study aims to assess the benefit of penile traction therapy (PTT) when added to intralesional verapamil injections (IVIs) combined with oral L-arginine 1 g b.i.d. and pentoxifylline 400 mg t.i.d. in men with Peyronies Disease.

Methods.  Seventy-four men with Peyronies Disease completed 12 IVIs. Patients electing to add PTT were advised to wear the device for 2–8 hours daily and no longer than 2 hours per session. Subjective responses were measured using patient questionnaires. Stretched penile length (SPL) and erect penile curvature (EPC) using penile duplex ultrasound were measured. Response to therapy was defined as at least a 10-degree reduction in EPC.

Main Outcome Measures.  Change in SPL (cm) and change in EPC (degrees).

Results.  Thirty-five patients in group I vs. 39 patients in the PTT group II completed the protocol. Fifty-four percent of men in group II responded to therapy vs. 46% in group I (P = 0.75). Responders in group II had a mean EPC improvement of 26.9 degrees vs. 20.9 degrees in group I (P = 0.22). Mean PTT use was 3.3 hours per day, and men with >3 hours per day use gained 0.6 cm in SPL vs. 0.07 cm using less than or equal to 3 hours per day (P = 0.09), while men in group I lost 0.74 cm of SPL on average. Multivariate analysis revealed that duration of PTT use significantly predicts length gain (0.38 cm gain for every additional hour per day of PTT use, P = 0.007).

Conclusions.  There was a trend toward measured curvature improvement and a significant gain in SPL in men using the combination therapy protocol. Length improvement is related to duration of use of the traction device.


PubMed ID   22024053

----------------------------------


There is nothing really new there IMHO, except:
men with >3 hours per day use gained 0.6 cm in SPL
vs.
0.07 cm using less than or equal to 3 hours per day

So my conclusion is: If you want the traction device to work, then use it more than 3 hours a day.

Luc




BrooksBro

Here is the study on combining verapamil injections and traction.

Luciano

Quote from: BrooksBro on April 06, 2012, 05:58:44 PM
Here is the study on combining verapamil injections and traction.
Thank You!

To bad this study is not also taking different factors into account.
I mean it would have been interesting to have 6 groups instead of two:
Now there is:
traction with VI and MED
VI and MED without traction

I think it would have been interesting to also have:
traction and MED without VI
traction without MED and VI
VI only
Med only

Luc

mike67

I guess I should add my experience with Traction here. As many know , I had graft surgery here in Toronto on Feb. 2,2012. See My History post. After a few short weeks I ended up with a 45 degree "residual" curvature. My surgeon/Urologist recommended starting immediately using Traction and suggested the Fast Size apparatus.
I am now 3 weeks short of completing his recommended 3 month program. This equipment came  from USPhysioMed along with Dr. Levine's helpful book " Understanding Peyronie's Disease".
There have been recent posts suggesting no urologists are recommending traction. Where is that coming from when this thread gives the good doctor's recommended therapy and his book also details same with chances for curvature improvement being good .
I can say that it appears to be working for me as my post operation curvature has gone from 45 degrees to about 20 degrees and I am very pleased.
More than 4 hours per day walking around with that contraption attached to you is a gruesome ordeal. I have managed 3 - 4 hours most days. That's all I can stand.
So I hope this helps some of the sceptics and encourages some to get with the traction as it could do what Dr. Levine has stated if tried according to the prescribed regimen.
Mike
Mikey

newguy

mike67 - Very impressive results. It speaks to the importance of having a knowledgeable surgeon. I tend to believe that the speed in which your curvature has reduced is more than what would be possible for someone with long term plaque. It seems out of the ordinary in terms of such a fast improvement. It may be as has been stated elsewhere, that those in the midst of possible current scar development may benefit more or faster than those with established plaques. Not as though I'm saying that traction is useless for those with long term plaques. Far from it. I've actually started on traction again myself.

Jigsaw

Quote from: Luciano on April 07, 2012, 01:03:51 AM
Quote from: BrooksBro on April 06, 2012, 05:58:44 PM
Here is the study on combining verapamil injections and traction.
Thank You!

To bad this study is not also taking different factors into account.
I mean it would have been interesting to have 6 groups instead of two:
Now there is:
traction with VI and MED
VI and MED without traction

I think it would have been interesting to also have:
traction and MED without VI
traction without MED and VI
VI only
Med only

Luc

The problem is, Luc, that as clinical studies go this one has a fairly small sample. None of the results of the comparisons reached acceptable levels of statistical significance (p<0.05) - the only result that is significant is the slope of the regression for SPL against duration of PTT.

To conduct more comparisons increases the probability of getting a significant difference purely by chance. With 6 comparisons, there is something like a 26% probability that at least one of them will be significant at p<0.05 purely by statistical chance. This makes any results hard to interpret.

Running as many comparisons as you can think of is sometimes called a data dredge, and while lots of epidemiologists might do it, it should set alarm bells ringing if they do!

Trust me, I'm a statistician...

james1947

Everyone can be sceptic regarding a study that as Jigsaw stated is based on few people or not enough groups to check more aspects as Luciano stated but with results as mike67 wrote can't argue.

I would like to see more testimonies from people that are using or used traction devices.
I will quote from a post of Ben
QuoteI never seen anybody with a traction device who had regret it
If one will read the topics on this board will find many positive testimonies.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Jigsaw

While mike67's story will be encouraging to many people here, it is anecdotal evidence - a study based on a sample of 1, which is far less than the Levine study! It has been said numerous times on this site that each individual is different, with their own causes of the disease and their own progression paths. I'm not trying to dampen a great success story, but what works for mike67 may not work for everyone.

As well as more encouraging testimonies, we need more studies - and we could help by running surveys from this site. As I've posted elsewhere, there only seem to have been 3 surveys run on this site: one is closed and I can't find where the results were written up, if ever there were any.
Trust me, I'm a statistician...

james1947

Jigsaw

I agree with you 100% on two issues:
1. In Peyronies what works for one (or even for many) may not work for everyone.
2. We need much more survey regarding the traction device efficiency for Peyronies.

I have done myself such a "research" regarding Pentox on the forum by reading all the posts when the word Pentox was included. It was not an easy job. My conclusion was that it helps in the majority of the cases and I start using it. I have published the "research" on the forum.

To All
If someone have the time and willingness, he may do such "research" regarding traction devices.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

newguy

On penis extension forums there are countless people who have increased their penis size. Hundreds, many with photos. I doubt we'll see any studies in those cases (since strictly speaking I don't suppose they generally have any health issues, mostly ego ones), but I don't for a moment doubt that the penis can be stretched just as many other tissues can.

In the case of those with peyronie's we have to use caution of course as we may be more susceptible to re-injury etc. With a great many peyronie's treatments the notion that they are useful came before studies showed that they are. That's true of pentox, VED etc. I agree that there's no miracle cure out there, but people don't always wait until the full extent of potential improvements are known before embarking on treatments. That can be risky, but to be fair I haven't seen that many totally out there suggestions for treatments on this forum, so by an large I think people strike a sensible balance.  

It's of course encouraging to see large studies and a shame when they don't materialise. I've been waiting for another CoQ10 study for ages for instance, to see if it comes to the same conclusions as the previous on.

Jigsaw

James, I would be grateful if you could link to where you published your findings on this forum - it can be a maze sometimes, especially for newbies like me!  ;)

As for the time and willingness to conduct a survey, I have a number of ideas I'd like to test out after reading the posts here - not just about traction devices. I'm not sure if I have enough time to develop a survey over a short period, but I'm willing to give it a go. The question is, how can I get it endorsed by this site (eg, a link to "please take our survey" on the PDS front page?) And without giving too much detail, I have my own ideas for questions - but what would members here think are worthwhile lines of investigation? And who else would like to help?

Maybe this discussion should be moved to another thread...
Trust me, I'm a statistician...

james1947

As I was asked already a few time where to find it, I have spilt it and set the topic sticky under:
"Oral Treatments for Peyronie's Disease" with the name of "PENTOX effect on Peyronie's - Forum Experience"

You can also give more details regarding of what you would like to do in your topic: Member Polls > Web surveys
or in the "Discussion on our Forum Layout and other News" board

James

Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Mike_O

I have read many anecdotal reports of success with traction (as well as VED) while only finding a few medical studies.

Regarding the time in traction - Levine's study (see post #1 of this thread) is no surprise to me. Many extender users report this simple relationship of the more time in the extender the better the results. Of course this is easier said than done for most men.

3+ hours per day seems to be a minimum with 6+ hours per day a goal. A less-than $100 extender from eBay is adequate (my opinion).

I don't expect many medical studies on extenders. Who will fund such a study?  So, we are left with anecdotal reports of what works.

james1947

Regarding traction, our site is not the only one discussing the subject.
Have other forums regarding penis extenders (traction devices) and many positive post regarding gaining length and girth that many Peyronies sufferers lost both.

I agree is not a research, but more testimonies, I am more convinced it helps.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

newguy

Quote from: james1947 on June 15, 2012, 06:13:11 PM
Regarding traction, our site is not the only one discussing the subject.
Have other forums regarding penis extenders (traction devices) and many positive post regarding gaining length and girth that many Peyronies sufferers lost both.

I agree is not a research, but more testimonies, I am more convinced it helps.

James

Yes, I've read plenty of user reports from men gaining an inch or more. These are men without peyronie's, so it seems that healthy tissue can be stretched (as stands to reason I suppose). I recall Levine and co talking about the scar tissue stretching, but in reality maybe it's all of the tissue. I'm not sure what type of tissue is more likely to adapt first in terms of stretching? One aspect that in theory should be on our side, is that with one side of the penis being shorter than the other (where there is a bend) the longer side isn't being stretched at all, so at least the stretch is applied where it's needed.

A thousand hours is the oft quoted goal that men should aim for with traction. Even with that though on occasion I see posts from men saying they've gained 1 inche or more, but some where people report making no gains at all. It makes me wonder if it's down to how people wear the device. Maybe some men don't increase the tenion correctly? Just a thought. Or it could just be very individual. We're all different of course.






james1947

I agree with you Newguy and your statement is very correct:
Quoteit could just be very individual. We're all different of course.
As all the Peyronies treatments working for some, not working for others.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

stepvan

Hey Hawk I have not been on the site for over three years,finally starting regain my career, everything that happened to me,Divorce,my house,my business, the recession,when all that went down, I got this dreaded disease, I know its related to all that trauma, I moved to a new town and I am getting it together here best move I ever made I know things are going to work out for me I can feel it! Then I am going get back to trying some of therapies from this site. The traction and medication sounds interesting. Thanks talk to you later Steve    PS If anyone will reply get a conversation going that be Great!  

inkhorn

Gentlemen- I use traction as part of my therapy and I'm convinced that it is helping. When I first started using it, I wore it 2 to 3 hours a day. That became too hard for me with my schedule and lifestyle. Now I wear it 1 hour in the am followed by 20 minutes of VED. Even with the 45% dorsal curve (and the 30% twist to the right, that went away), my length and girth remains the same or slightly bigger. Regards Inkhorn

Litani

I wonder if it is the traction or the VED or both. The only thing missing from my therapy is the traction. I started the VED 2 weeks ago.
Care enough to throw everything you got at this disease but do not care enough to ruin your Life!

james1947

Litani

Don't wander too much. Have a few topics regarding "traction vs VED" or "traction and VED".
Some search will help find them.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

restore

With VED, daily pentox and Cialis, my straightness has improved.  However, my reduced length and girth hasn't.  Girth was where I was gifted before Peyronies.

Hawk

I have been erratic with traction.  The first time I used it as recommended by Levine (more or less) and regained 3/8 " in a couple months.  Life issue made me totally leave traction.  Since I do not get natural erections I very slowly lost all gains which I am convinced could have been prevented with a few hours of traction a week (I have no proof of that).

Lately I started to use traction again and have again regained 3/8th of an inch and I think I am still gaining.  I am convinced traction is a very good solution to Peyronies Disease issues but is is an ordeal to say the least.  My measurements are EXACT.  There is nothing approximate about how I measure.

Remember, a gain of just 1/16 of an inch a month is 3/4 of an inch after a year.  At that rate you would only see 1/64th of an inch per week so be patient.

PS: My curve is very minimal at this point.  I use traction to regain size.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Steveo

Sorry to bring up a nearly year-and-a-half old thread, but I'm starting traction too and found this via search.

I suspect that the guys who reported only 2 hours a day weren't actually wearing it that much.  If a study says, "You must wear it at least two hours a day," then participants are going to say they wore it those 2 hours even if they wore it less or not at all.

So my guess would be that gains don't suddenly jump up at 3 hours/day.  I would guess that the guys reporting 2 hours/day were actually using traction less than that, while the guys reporting more hours/day were more accurate in their reporting.

LWillisjr

Is hard to say, but I understand your logic. I do agree that increase don't suddenly increase just by wearing it an additional hour or so each day. Levine simply states that his patients who experienced improvement were the ones who wore it the longest.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

cbg200

I'm a 75 year old guy and wondering if anybody has used the Bath mate?

I am considering a traction device called a Bath Mate. It is like a VED except it is used in the shower bath or hot tub and seems to be much better than a air VED which I never had much success with. Coupled with ED I am hoping to use it about 20 min in the AM and the same at night.
Wife is saying get the implant but not sure I am ready to do that.  

james1947

cbg200

Until you will get some concrete answer, a search for bathmate on the forum main page will give you 67 posts, you may want to read them.
By the way, you have just ED or Peyronies also?
How long you are battling with ED?
We are considering implant (and nay surgeries) as last resort on this forum, but why you are against if wife want it?

James  
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

tomiboy

This is my first post. I have a 45* curve upward. Dr. Levine suggested surgery, but I'm leery since at age 63 I have no ED and everything is working fine, and I am married and the wife isn't concerned. I was told I could just try the Physiomed extender device (his suggestion) and some prescription he gave me. I am having difficulty paying $300 for something I'm not sure I would ever wear 2+ hours a day. I don't know how you guys do it. Plus I don'y see a lot of discussion about this device. I would think if one of the top guys in this field recommends it you all would be using it.

LWillisjr

Dr. Levine is my doctor. His recommendation of Physiomed Extender is fairly new. So will probably take some time before more men use it. He used to recommend devices like Fast Size when I was going for treatment.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

peyroniessufferer

Hi all,
I have been using the UsPhysiomed Extender but have had a lot of difficulties with it and also feel no stretch, pull or fatigue during or after wearing it.
Can anyone please be nice enough to tell me what the next best device is?

Thank you

tomiboy

I got the Phalloson Forte (SP?). It's a b!tch to put on and take off but I do feel the pull. I bought it so I could sleep with it. Problem is I have BHP so I have to get up to pee in the middle of the night and getting this thing off half asleep is tough