What are common short-term and long-term complications of penile traction therapy?
Executive summary
Penile traction therapy (PTT) is generally reported as a well-tolerated, noninvasive option for men with Peyronie’s disease and post-prostatectomy penile shortening, with most trials documenting only transient, mild adverse events such as discomfort, numbness, minor swelling or skin changes [1] [2] [3] [4]. However, rare but serious complications have been documented — notably a published case of severe pubic bone edema likely linked to excessive, prolonged traction — and the literature contains persistent gaps in standardized dosing (force/duration) and long-term safety data [5] [6] [7].
1. Short-term harms most consistently observed: discomfort, skin changes and nerve symptoms
Across randomized trials and contemporary reviews, the common short-term complaints are predictable mechanical effects: local discomfort or pain while wearing the device, transient penile paresthesia or numbness, minor swelling, and slight skin discoloration; these adverse effects are almost uniformly described as mild and self-limited in randomized and open-label studies [1] [2] [8] [3]. Case-series and patient questionnaires in device trials report that most men tolerate PTT well and that adverse events resolve quickly after stopping therapy, with high proportions willing to repeat treatment [9] [4].
2. Less common but important short-term complications: tissue and urethral stress
Beyond superficial symptoms, mechanical traction transmits force through the penile base and pubic area and can theoretically and occasionally cause deeper tissue reactions; a documented instance of severe pubic bone edema on MRI attributed to months of excessive traction highlights that deep musculoskeletal or soft-tissue injury is possible if force or wear-time is excessive [5]. Patient education gaps and the ready availability of devices online increase the risk of improper use, and some experts warn that traction that pulls the urethra or surrounding tissues could create relative shortening or other unintended effects if misapplied [10] [11].
3. Long-term complications: reassuring trial data but incomplete evidence
Longer-term randomized and cohort data have not shown a signal for major permanent damage from appropriately used devices — studies report maintained or improved penile curvature, length and even erectile function with adverse events described as transient [2] [8] [4]. Systematic reviews and narrative analyses, however, emphasize important limitations: heterogeneity in devices and regimens, no consensus on safe traction force or minimum/maximum daily duration, and limited long-term follow-up across diverse patient groups — all of which leave uncertainty about rare delayed complications or effects appearing years later [12] [6] [7].
4. Psychological and quality-of-life consequences, and the role of misuse
The therapeutic aim of PTT is often restorative — to reduce curvature and preserve or increase length — and many patients report psychosocial benefits, yet prolonged therapy demands and unmet expectations can provoke emotional distress, frustration, or dissatisfaction when results are slow or modest [6] [13]. Importantly, most documented harms arise from overuse, incorrect application, or inadequate medical supervision; published guidance from professional societies frames PTT as safe when used per protocols and with clinician oversight, while warning that unsupervised, aggressive use carries higher risk [3] [10].
5. Bottom line and limits of current reporting
The preponderance of evidence portrays PTT as low-risk when applied per studied protocols, with common short-term complications limited to mild, transient local effects and rare reports of deeper tissue injury from excessive traction [1] [2] [5] [3]. Yet the literature lacks standardized force/duration rules and robust long-term surveillance, so rare or delayed adverse outcomes cannot be fully excluded; available systematic reviews and narrative overviews call for standardized protocols, longer follow-up, and clinician-guided use to minimize harm [12] [6] [7].