0.25 contact hour(s).
Oct 29, 2019
Oct 29, 2020
Estimated time for completion 15.00 minutes
There is no fee for this activity.
To Receive Credit
- Read the article carefully.
- Complete/submit the posttest and evaluation.
- BreakingMED™, a service of @Point of Care, LLC will record your participation for each article in your CME/CE Tracker.
Among the many issues clinicians face today, staying current with advances in medicine is becoming a major challenge. MEDBrief® articles will allow clinicians to stay up-to-date and assimilate new information into their daily practice. The content of these MEDBrief® articles has been validated through an independent expert peer review process.
The Disclosure Policy of Projects In Knowledge® requires that all those who have control of the content of CE activities comply with the ACCME’s Standards for Commercial Support regarding disclosure of relevant financial relationships. Faculty, planners, editorial scientific team, reviewers, and medical writers are required to disclose any financial relationship they or their spouse/partner have with any ACCME-defined commercial interest* relevant to the content of this activity. Any discussions of unlabeled/unapproved uses of drugs or devices will also be disclosed during the presentations.
Kevin Rodowicz, DO, Assistant Professor, St. Luke’s University/Temple University has no relevant financial relationships to disclose.
Salynn Boyles, Contributing Writer, BreakingMED™ has no relevant financial relationships to disclose.
Bernadette Marie Makar, MSN, NP-C, APRN-C (nurse planner) has no relevant financial relationships to disclose.
Projects In Knowledge®, @Point of Care™, and BreakingMED™ staff members have no relevant financial relationships to disclose.
Conflicts of interest are thoroughly vetted by the Executive Committee of Projects In Knowledge®. All conflicts are resolved prior to the beginning of the activity by the Trust In Knowledge peer review process.
The opinions expressed in this activity are those of the faculty and do not necessarily reflect those of Projects In Knowledge®.
*Commercial Interest is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients.
CE Accreditation Statement
Projects In Knowledge®(PIK)is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Upon completion of this course, participants will be awarded 0.25 nursing contact hour(s).
DISCLAIMER: Accreditation refers to educational content only and does not imply ANCC, or PIK endorsement of any commercial product or service.
Men with Peyronie’s disease who used a novel penile traction system developed at the Mayo Clinic, Rochester, showed clinically meaningful improvements in penis curvature and length after 3 months.
Be aware that combining the new generation traction system with collagenase clostridium histolyticum (CCH, Xiaflex) injections may prove to be more effective than using either therapy alone.
NASHVILLE — Men with Peyronie’s disease who used a novel penile traction system developed at the Mayo Clinic, Rochester, showed clinically meaningful improvements in penis curvature and length after 3 months in a recently published randomized trial.
Compared to men with Peyronie’s who received no treatment, those who used the device for 30 to 90 minutes a day also showed significant improvements in erectile function.
Now, new data from the open label, cross-over phase of the study showed continued improvement in penis length, but not curvature, among men who extended their use of the device to 6 months.
Mayo Clinic urologist and study researcher Matthew Ziegelmann, MD, presented the extended trial data Oct. 26 at the 20th Annual Fall Scientific Meeting of the Sexual Medicine Society of North America (SMSNA).
"We did see ongoing length improvements with 3 additional months of traction, although it does appear that the greatest improvements in length occur early on," Ziegelmann said. "But we did not see any additional improvements in curvature with 3 more months of traction."
The RestoreX traction system (PathRight Medical) was developed by Ziegelmann’s Mayo Clinic colleague Landon Trost, MD, as an alternative to earlier-generation penal traction therapies.
Ziegelmann explained that, until recently, no randomized trials of penile traction in men with Peyronie’s disease had been performed.
"The available studies suggested that these devices needed to be worn for up to 6 hours a day to achieve relatively modest benefits," he said.
In an interview with BreakingMED, Trost said combining the new generation traction system with collagenase clostridium histolyticum (CCH, Xiaflex) injections may prove to be more effective than using either therapy alone.
In the original trial, which included 110 men randomized 3:1 to use the traction device or have no treatment, mean baseline disease characteristics included a penile length of 11.5 cm (corona), primary curvature of 46.1 degrees, and composite curvature of 59.9 degrees.
The men in the traction group used the device for 30 minutes a session, 1 to 3 times a day.
All the men in the original trial entered the open label phase for an additional 3 months, and assessments were obtained at baseline, 3 months, and 6 months.
Data were available on 64 men for the extended analysis. Their mean age was 58.4 years and the mean duration of Peyronie’s disease was 58.4 years. One-third of the men (33%) had previously been treated with CCH injections.
Between treatment month 3 and 6, men in the traction arm of the trial experienced a mean 5% additional change in penis length, while the cross-over group saw a 11.1% change. Men in the traction group saw an additional mean −1.7 mean composite change in penis curvature between months 3 and 6 of treatment, while previously untreated men experienced a composite mean −12.5-degree change after 3 months of the therapy.
In all, 77% of men in the penile traction group experienced improved curvature (mean, −17.2 degrees in 28.2% of responders) while 94% experienced increased length (1.6 cm in 10.9%).
Roughly two-thirds of the men in the traction group experienced clinically meaningful improvement in erectile function, determined by responses to the International Index of Erectile Function (IIEF) questionnaire.
Trost said this outcome was unexpected and might result from stretching of the cavernous tissue that becomes engorged with blood during an erection.
He added that his research team is planning a randomized trial with erectile function as a primary endpoint.
"There may be something here, but we can’t really say yet," he said.
He said traction therapy may also prove to be a useful treatment for urethral stricture disease, citing the experience of a single study subject.
"This was a guy who had been catheter dependent for urethral stricture disease for more than 20 years," he said, adding that after the treatment he no longer needed the catheter.
"It was just one patient, so who knows," he said. "But it was an interesting finding."
No conflicts of interest were disclosed.