Vacuum Erection Devices (VED): Basic Principles
VEDs are a useful noninvasive treatment for ED. They involve a cylindrical device that is placed over the penis. Many types of VEDs are now available, and it is recommended that only those available by prescription should be used.¹ ² A VED, which mechanically creates penile blood engorgement, consists of a vacuum chamber or cylinder, a pump to produce negative pressure, and constriction rings.³
VEDs can be used to treat organic or psychogenic ED. Current reviews report successful results in men with a variety of organic etiologies, including spinal cord injuries, postprostatectomy, diabetes, and arterial insufficiency.³
After the penis and constriction rings are coated with water-soluble lubricant and the rings are loaded onto the cylinder base, the cylinder is placed over the penis with the base held firmly against the pubis to maintain a seal. The pump is then activated to slowly create negative pressure, or a vacuum, inside the cylinder, which draws blood into the corpora cavernosa, producing an erection.¹ ³
Once the penis is engorged, the constriction band is pulled from the cylinder onto the base of the penis. The negative pressure is released through a valve, and the cylinder is removed. It takes an average of 2 to 2½ minutes to create an erection through this procedure, according to recent reviews.³
The erectile state produced by VEDs differs from a normal erection: penile skin temperature is lower, the veins of the penis appear distended, and penile circumference is increased. In addition, the penis may pivot at the base, requiring the patient to stabilize the penis during intercourse.¹
How it Works
This mechanical device consisting of a plastic cylinder is placed externally over the penis. Activation of an attached pump creates a vacuum that encourages blood to flow in to the penis. A rubber ring is then snapped over the base of the penis, keeping the blood in the penis and maintaining the erection.
Long-term follow-up of men who chose the vacuum constriction devices as primary treatment for their erectile dysfunction reveals that this treatment option is inappropriate for men with mild Erectile Dysfunction and ineffective for men with severe Erectile Dysfunction. It seems that men with moderate Erectile Dysfunction are the best candidates for this treatment option. Our study, which was recently published in Urology (May 1999), showed that even when properly trained, 65% of patients who purchased the device stopped using it. Of the patients who discontinued, most stopped treatment early (1-4 months).
In addition, now that effective oral medication is available for men with moderate Erectile Dysfunction, the use of vacuum constriction devices in this patient population will most likely also decrease.
Advantages & Limitations
External Vacuum Pump: Advantages
- Least invasive method of all
- Requires no medication or surgery
- Insurance will cover expense
External Vacuum Pump: Limitations
- High rate of discontinued use (65%)
- Painful erection
1. Montague DK, et al, for the AUA Guidelines Panel on Erectile Dysfunction. J Urol. 1996;156:2007-2011.
2. Donatucci CF. In: Mulcahy JJ, ed. Male Sexual Function. Totowa, NJ: Humana Press Inc; 2001:253-261.
3. Levine LA, Dimitriou RJ. Urol Clin North Am. 2001;28:335-341.