Restorex clamp mechanism and other traction devices in the acute phase

[madscientist]

Hi all,

I'm new to the forum, and have yet to find the time to post an introduction about my personal journey - what has worked/ not worked with me - I'm still compiling this, I promise I will post soon. I've had peyronies for 4 years now, and have trialled everything from biologics to steroids to the standard supplements stuff, still pre-injections now.

Although there is a lot of evidence highlighting the efficacy of traction out there, injuries caused by these devices are often under-represented as it can be hard to definitely assess whether these are primary in nature (caused by traction, sex or masturbation) or secondary to the disease progression itself.

After spending time on a urology placement abroad, apart from plaques elsewhere, I noticed a few men presenting with plaques under/around the glans AFTER beginning traction, particularly younger men. These are invariably lateralized to the same side of the original lesion. A commonality between these men is that they all had been experiencing active pain when they began, and had been using traction devices.

I have personally used Unbend.me and Restorex, and the latter gave me a really similar lesion. I think the clamp mechanism on these devices grabs the glans proximally enough that the tunica in the distal corpus is squeezed. This I reckon, can be sufficient to cause the emergence of a new plaque.

Whilst I'm aware that some guidelines out there suggest to begin traction early in the course of the disease, I am not really supportive of the use of these traction devices that clamp the glans in the way I described above.

I think manual traction, by grabbing the glans from the absolute tip using your fingers, can avoid putting undue pressure on the distal aspect of the corpus, which is the least wide, and is thus more susceptible to narrowing than the rest of the corpus.

Just food for thought gents.

Blessings
Madsci

[PeyroniKirai]

Great common sense post, madscientist.  It makes perfect sense that clamp devices would be too harsh when what you're pulling on is a collection of tissues and fibers that are all different.  It's totally different from the traction an orthopedic surgeon might apply to a neck, where the equivalent of the clamp goes on the head, and what he's pulling is clearly the neck vertebrae and the discs inbetween.  With a penis, you have skin and spongy tissue, veins, fibrous areas, all have different stretch qualities, and all of them are soft, so if you put a clamp on it, you're gonna be crushing something.  
 I'm sure people who sell the traction devices will disagree, but I personally have been very skeptical about putting a clamp around my member to pull on it.  I would have to say that your method of pulling with the fingers sounds intuitively to be the best way to do traction.
 Interested to hear what others say as I have not actually used these devices.
Cheers,
PK

[projectpd]

That unbend.me looks like a questionable design, if it was used as in the pics. The idea may have been that distributing a force over two nooses rather than one would improve grip and distribute force to reduce the pressure applied by each. but adding a second noose further down doesn't have the coronal ridge to react against, so would  exert only downward pressure over its narrow area. . Even the cheapest similar Chinese extenders come with a much wider strap that distributes force over a larger area. Perhaps a noose-strap combo would also combine the approaches better.

An advantage of manual traction is the grip can be easily and frequently remade, allowing blood to recirculate and relieving pressure in any particular point, which might help
avoid problems. An ideal mechanical clamp would distribute force efficiently and preferably avoid pressure blood vessels and nerves, and ideally if it could be dynamically reconfigured to redistribute force while in place.

I posted the following recently on another forum that has people who know about hanging, but no responses so far.

As we know , extender devices that are intended to use a strap or noose around the top of the penis, focus most of the grip force onto an area where the dorsal veins, arteries and nerves are located. For a noose, the force is focussed not only mainly to the top of the penis, but also over a narrow region longitudinally. This might unnecessarily increase the tendency to cut off the circulation, or even traumatise the nerve fibres. The Restorex device uses a mostly level clamp which also probably applies most pressure on this area, although it also grips the glans. Weight hanging clamps, though, seem to use a different approach, where pressure is applied more to the sides.

Does anyone have any thoughts, experiences, theories on the most favourable grip design, e.g. Perhaps minimising risks related to circulation loss or nerve injury?

Is there a valid reason, anatomically, rather than mechanically, for hanging and extending to use different grips?

Increasing the longitudinal extent of the grip seems an obvious way to reduce pressure, although I guess then less effective for stretching the tissue under the grip itself, but maybe that's not quite as important for me as the area where the Peyronies scar is in the middle of the shaft.

For myself the goal is treating a dorsal curve (Peyronies disease) as well as length gain, so I realize the dorsal side is exactly where tension is required, even though it's where these vulnerable structures also are, so perhaps there is less to be gained by redistributing force away from them.

For discussion purposes, I've drawn a cross section and labelled the possible forces according to the hours on a clock, and a few possible grip cross sections.

[Pfract]

madscientist:

And where do you have the proof to back up your statements? Where was you ''placement''? What kind of work have you done? If you noticed all of this what did the doctors that you worked with had to say?

[madscientist]

Hi Pfract,

I'm not disclosing any of my personal details here nor where I've done my work. I'd imagine you'd be uncomfortable divulging into your personal life over a forum on the internet, too.

My urology placement 24 weeks long, as I mentioned, I saw quite a few peyronies cases, about a couple of dozen or so. Although a small sample size, I noticed that young men in particular,  that began traction earlier in the inflammatory course of disease had recurrent presentations of exacerbations, often localized to the distal regions of the penis.
I don't have "proof". Even if I had to compile and publish data, this wouldn't really "prove anything other than a correlation. It's actually really hard to "prove" anything, in medicine or otherwise.

My senior colleagues noted that this COULD be due to traction/clamping/banding mechanisms, but again, could be attributed to other aspects - such as more agressive disease progression in younger men, may be due to younger men more likely to engage riskier behaviours (both sexual or otherwise), who knows. Like I said, maybe it was coincidence that this subset happened to be those doing traction.

I said I "reckon" that common traction devices used during this phase in this subset may contribute to more damage, both from anecdotal clinical experiences and from having my own dick experience that fate.

Madsci  

[Pfract]

You can talk about where you have worked and with who, without discussing personal information. A big hospital, supposedly has a lot of people.

Surprising that you saw all that but only have anecdotal evidence? I call bull on it. And you say exactly why on your own post. If it is just a correlation then you might as well post on the off-topic section.

Also worth noting that the first thing you do is join the board and proceed straight to Dr Trost's section and cast doubt on somebody who's work ethic, credentials and attitude speak for themselves. This smells like a shady attempt at throwing shade at his name and that will be dealt with accordingly.

[madscientist]

I am NOT disclosing my personal / work life - this can be used to identify me and it doesn't make me feel comfortable doing so.

I'm addressed valid shortfalls in his study designs, both on the MFPC Trost section and on the Traction section: ones that keep getting deleted:
A) Dr. Trost is the inventor of the device and therefore as the sole lead on all Restorex studies, this represents a conflict of interest. Although Mayo Clinic disagrees with this, stating that he had "the opportunity to pick between being an investor in the company and conducting research and he chose the latter. The financial incentives he may/may not get from Restorex sales or the promotion of said device would be great to disclose - to clarify said conflict of interest.
B) The improvements reported in the studies in question circumscribe around preserving penile length and straightness/reducing curvature. Markers of pain - a significant cause of morbidity in peyronies as you all know, were not assessed. The change in girth measurements; were not measured/reported either - this was in spite the fact that the study medically induced erections in the participants. The studies also failed to measure plaque sizes/numbers, as measured by ultrasound.
C) The studies report "no adverse effects", not one, and the commentary trivializes discomfort/soreness (these very well side effects of a treatment).

I think Dr Trost is a great researcher, nothing wrong critiquing the methodology employed in his studies. If anything this may help him improve/change future study designs. Studies cost money, I'm not wealthy or connected enough in the field as him or other senior urologists to conduct these controlled trials, so commenting on weaknesses in the study is all I can do to forward the science. He also happens to have the only FDA approved device for peyronies, I think that's important to note.

I'm not throwing shade at anyone, and am unsure why healthy scientific discourse around research of someone who happens to be contributing to the forum is frowned upon here. Yeah, that was my first post, and his invaluable presence here/joining the forum is made me want to join.

Questioning should be encouraged here, nobody's work or science is biblical and every study on the planet will have shortcomings. This holds particularly true with Peyronies studies.

Don't "bull" me, the unkindness I've already met here hasn't been pleasant. Perhaps use a kinder tone; there's a human across the screen.
You guys - moderators - could use some mental health training. Perhaps should be a requirement.

Madsci

[madscientist]

You can talk about where you have worked and with who, without discussing personal information. A big hospital, supposedly has a lot of people.

Surprising that you saw all that but only have anecdotal evidence? I call bull on it. And you say exactly why on your own post. If it is just a correlation then you might as well post on the off-topic section.

Also worth noting that the first thing you do is join the board and proceed straight to Dr Trost's section and cast doubt on somebody who's work ethic, credentials and attitude speak for themselves. This smells like a shady attempt at throwing shade at his name and that will be dealt with accordingly.

Also, personal experiences is what anecdotal literally means my man....
Peace

[PeyroniKirai]

As a moderator I will contribute my view, which is that madscientist is making reasonable points which are worth addressing.  Fellow moderator Pfract, let's be more objective and take madscientist's posts at face value.  We are all emotionally involved with Peyronie's and this forum, but I sense indignation and anger in your words.  I can understand why madscientist doesn't want to disclose much more detail and he may indeed have legitimate reasons, so let's not hit him with accusations or write him off.

 If what madscientist says about Dr Trost having financial incentives (beyond just being paid as a doctor) to push Restorex, I think it's reasonable that this point also be addressed.  I can understand a doctor really believing in a certain technology so much that he pushes it above all others, and I can also understand him even wanting to invest in it.  But when a doctor invests in a therapy, there is indeed a potential conflict of interest.  I believe that in an open and fair forum, questions can be asked and decent human beings will not take umbrage if asked to explain themselves.