What are the risks and side effects of using penile traction devices long-term?
Executive summary
Long‑term use of penile traction devices (PTDs) is generally reported as potentially beneficial for Peyronie’s disease and penile lengthening but carries documented risks including discomfort, penile paresthesia, rare cases of pubic bone edema from excessive tension, and the potential for device‑related emergencies such as strangulation with rings [1] [2] [3]. The clinical literature stresses small, heterogeneous studies and variable protocols, so the true incidence and spectrum of long‑term adverse effects remain uncertain [4] [5].
1. What the evidence says about benefits — and why that shapes perceived risk
Clinical reviews and trials focus on men with Peyronie’s disease (PD), where PTDs can reduce curvature and increase length; safety endpoints are routinely collected, so reported side effects inform current risk estimates [5] [6]. Randomized and cohort studies fed systematic reviews that generally describe PTDs as “non‑invasive” and “associated with minimal complications,” but these conclusions rest on small samples and different traction regimens, which limit how confidently we can extrapolate safety for prolonged everyday use [5] [4].
2. Common, expected side effects: discomfort, numbness and skin issues
The literature consistently reports patient discomfort and penile paresthesia (numbness or altered sensation) as the main reported adverse effects of traction therapy [2] [1]. Device pressure points, straps and silicone bands can produce local skin irritation; most studies characterize these as manageable if use is modified or paused, though precise rates vary across reports and are not standardized [1] [7].
3. Rare but serious complications documented in case reports
There are documented rare complications tied to excessive tension or improper use: a published case described severe pubic bone edema on MRI after roughly 700 hours of high‑tension use over seven months, attributed to over‑forceful traction [2]. MedicalNewsToday and related reviews also highlight that constrictive rings or components can, in rare situations, cause penile strangulation or scrotal entrapment — recognized medical emergencies [3]. These reports show that overuse and improper fit are central drivers of more severe harm [2] [3].
4. Limitations of the evidence — small studies, mixed protocols, and compliance issues
Multiple reviews and editorial analyses emphasize that most studies are not randomized, have small sample sizes, lack consistent control arms and use widely varying traction protocols (hours per day, tension, device type), making long‑term risk estimates unreliable [4] [6]. Compliance is a major variable: benefits and harms both depend heavily on how long and how forcefully men use devices, but published trials differ in those prescriptions [4] [8].
5. Manufacturer and device variability matters for safety
There are many commercially available extenders and the newer generation devices aim to reduce daily usage time and improve comfort [1] [8]. Adverse events and tolerability depend on design (support ring, straps, dynamic rods) and user instructions; studies that test a specific device do not automatically generalize to all models or to off‑label consumer use [1] [7].
6. Practical risk‑mitigation advice drawn from the literature
Authors advise applying gentle traction, stopping therapy with discomfort, and following prescribed tension/time protocols to reduce complications; case reports specifically recommend counseling patients about avoiding excessive force and recognizing warning signs [2] [1]. Clinical trials monitor adverse events and define stopping criteria — patients using devices outside trial supervision lack this safety net [7] [5].
7. Competing viewpoints and unresolved questions
Some earlier clinical reports and advocates argue PTDs should be first‑line for non‑surgical lengthening and report meaningful gains with acceptable safety [9] [10]. Counterbalancing this, systematic reviewers and editorialists caution that benefits are difficult to quantify and safety data are incomplete because of heterogeneous methods and short follow‑up; thus the balance of long‑term benefit versus harm remains unsettled [4] [5].
8. Bottom line for patients and clinicians
PTDs are associated with mostly mild, manageable side effects (discomfort, numbness, skin irritation) and rare but serious harms when overused or misapplied (pubic bone edema, strangulation risk) — however, available studies are small and heterogeneous, so the full long‑term risk profile is not well defined [2] [4] [3]. Patients should use devices under clinician guidance, adhere to manufacturer/clinical protocols, stop if pain or concerning symptoms occur, and seek medical help for signs of vascular compromise or entrapment [2] [7].
Limitations of this summary: available sources focus on men with Peyronie’s disease and on specific devices and trials; broader consumer use patterns and very long‑term outcomes beyond trial follow‑up are not comprehensively reported in the cited literature [5] [4].