Traction (RestoreX) Clinical Evidence
HCPC: PH80026 | ISSM: M.37761
Written by: Joshua Hearne-Wilkins, Urology Specialist & Independent Nurse Prescriber (NMC: 11l00400e)
Last clinically reviewed:
Published:
Next review due:
Clinical governance statement
All treatments undertaken by MansMatters (Shockwave Clinics Ltd) are subject to clinical review before they are introduced into practice and at regular intervals thereafter. This review considers the safety profile of each intervention, including contraindications and adverse effects as specified in the manufacturer’s instructions for use or the Summary of Product Characteristics; the regulatory status of each medical device and medicinal product; the position of current UK and European clinical guidance, including the European Association of Urology (EAU), the National Institute for Health and Care Excellence (NICE) and the British Association of Urological Surgeons (BAUS); the qualifications and scope of practice of the treating clinicians; the stage and severity of the condition being treated; and the requirements for informed consent. Each patient is assessed individually, and treatment is offered only where it is clinically appropriate.
The basis of clinical evidence
Clinical evidence is derived from several sources, which carry different weight. Systematic reviews and meta-analyses pool the results of multiple studies and provide the highest level of evidence. Randomised controlled trials, including sham-controlled trials, compare a treatment against a control group under defined conditions. Prospective and retrospective cohort studies, published in peer-reviewed journals, describe outcomes in defined groups of patients over time, and the replication of results by independent research groups in different countries strengthens confidence in a finding. Laboratory and mechanistic studies explain how a treatment is thought to act. In-clinic observational studies and structured outcome audits record the results achieved in routine practice and contribute to the developing evidence base, particularly for newer and combined treatments. Long-term follow-up establishes the durability of results and the safety of a treatment over time.
The evidence relevant to this treatment is summarised below. All citations are hyperlinked to the original source.
Is it safe?
RestoreX is manufactured by PathRight Medical (Utah, USA) and is registered with the US FDA as a Class I device. Its listed uses include restoring length lost to disease or surgery and limiting the loss of erectile function after prostate surgery; use for erectile dysfunction from other causes is explained in our consent process. In the clinical trials, side effects were mild and short-lived: redness of the glans, mild discomfort and temporary altered sensation, all falling with continued use, with no moderate or serious adverse events (Joseph et al., J Sex Med 2020). It isn’t suitable if you have a penile implant, severe diabetic complications, impaired penile sensation or skin disease of the glans.
What the evidence shows
In a randomised trial of 82 men after prostate surgery, men using RestoreX for five months gained 1.6 cm in length against 0.3 cm in controls, their erectile function scores held steady while untreated men’s fell by about 6.5 points, and fewer needed injection therapy (19% vs 50%); 87% said they would use it again (Toussi et al., J Urol 2021). At nine months, men treated throughout had a 100% rate of successful intercourse attempts against 33% in untreated men (Zganjar et al., BJU Int 2023). In a randomised trial in Peyronie’s disease, men who also had erectile dysfunction improved their erectile function scores by 4.3 points more than controls (Ziegelmann et al., J Urol 2019).
Guidelines and regulation
The European Association of Urology recommends traction devices to reduce deformity in Peyronie’s disease (EAU Guidelines 2026), and the International Consultation on Sexual Medicine describes traction as a viable option for length gain (Trost et al., J Sex Med 2016). For rehabilitation after prostate surgery, research is continuing. RestoreX is supplied with in-clinic fitting and training by registered clinicians in a clinic registered with the Care Quality Commission.
Independent research
The clinical trials of RestoreX to date come from the US centre where the device was developed, and a 250-man multicentre randomised trial including a UK site is under way (NCT05244486). A 2026 review of traction after pelvic surgery found adherence high and side effects mild (Albayrak and Usta, UroPrecision 2026).
How RestoreX compares
Older traction devices required four to nine hours of daily wear; RestoreX achieves comparable or better length outcomes in 30 to 90 minutes a day. Compared with a vacuum device, traction has better evidence for restoring length, and the two are complementary (Sultana et al., Nat Rev Urol 2022).
How RestoreX is thought to work
Sustained, measured stretching converts mechanical strain into cellular signals that promote collagen remodelling and tissue elongation. In an animal model of nerve injury, daily traction preserved penile length and increased the enzyme that produces nitric oxide in erectile tissue (Dick et al., Transl Androl Urol 2023).
Long-term results and our experience
In the Peyronie’s trial, improvements were maintained at nine months and 84% of men were still using the device (Joseph et al. 2020). After prostate surgery, men who stopped at five months kept their length gain and stable erectile scores at nine months, which shows that early use matters (Zganjar et al. 2023). We already use RestoreX for Peyronie’s disease and record outcomes for every patient.
Who is most likely to benefit
Men recovering from prostate surgery, particularly in the first year; men with erectile dysfunction who have also noticed a loss of length; men with Peyronie’s disease and erectile dysfunction together; and men able to commit to 30 to 60 minutes of daily use for several months. It is not suitable for men with the conditions listed under "Is it safe?".
Before your treatment
Your clinician will assess your medical and surgical history, erectile function and stretched penile length, fit the device in clinic, demonstrate the force indicator and agree a daily programme, reviewed at three and six months. You will be asked to give your consent before treatment begins, and you will receive written instructions and a direct contact for questions.
Further clinical trials and reviews
The following peer-reviewed trials and reviews are also relevant. Each is linked to the original source.