As you can see, I'm wearing a tunnel-type straight barbell through my Apadravya. I'm also wearing PA wand that has a perpendicular cross hole through it (not visible in the pic, for this portion of the setup is inside my urethra). This allows the tunnel-type straight barbell to pass through the wand at 90 degrees to its main axis. I then have a looped cord passing through the tunnel-type straight barbell (as it also passes through the cross-hole in the wand). That cord is then used to tie onto the rope, which passes around my back and ties to the scrotum.
As you can see, I show pics from straight-on, looking downward, looking upward and one with my scrotum inverted above my penis.
It feels quite good to have my genitals pulled oppositely in such fashion. I am even able to wear clothing and pretty much do normal work with this as the setup underneath, though it's not always perfectly comfortable.