Vacuum Erection Devices

Abstract

Vacuum erection devices (VEDs) are safe, effective treatments for erectile dysfunction with few side effects. Vacuum negative pressure more than 100 mmHg causes a combination of arterial and venous blood to fill the corpora cavernosum. The use of an elastic band to trap the blood within the penis allows sufficient rigidity for penetration. Devices approved by the Food and Drug Administration have a vacuum pressure regulator to prevent injury resulting from excessive negative pressure. Nearly all patients with erectile dysfunction can obtain an erection, and even men with hematological defects can safely use a device. Since the advent of oral pharmacotherapy for erectile dysfunction, dropout rates for VED users have increased substantially. However, VED remains an effective and well-accepted treatment in certain populations. Adjunctive uses of the device to enhance erectile responses in men with intracavernosal injection, penile prosthesis, and after explantation of penile implant all have been proposed. The off-label use of the device to rehabilitate erectile function after radical prostatectomy or other causes of erectile dysfunction has not yet been proven effective. Overall, vacuum erection devices remain a cost-effective treatment for erectile dysfunction and an acceptable second-line therapy.