Vacuum Therapy in Erectile Dysfunction—Science and Clinical Evidence

J Yuan; A N Hoang; C A Romero; H Lin; Y Dai; R Wang

Disclosures

Int J Impot Res. 2010;22(4):211–219 

In This Article

Abstract and Introduction

Abstract

Vacuum therapy (VT) utilizes negative pressure to distend the corporal sinusoids and to increase the blood inflow to the penis. Depending on its purpose, VT could be used as vacuum constriction device (VCD), with the aid of an external constricting ring which is placed at the base of penis to prevent blood outflow, maintaining the erection for sexual intercourse. Also, as a vacuum erectile device (VED), without the application of a constriction ring, just increases blood oxygenation to the corpora cavernosa and for other purposes. The emerging of phosphodiesterase 5 inhibitors (PDE5I) for the treatment of erectile dysfunction (ED) eclipsed VCD as therapeutic choice for ED; however, widespread usage of VED as part of penile rehabilitation after radical prostatectomy and other purposes rekindle the interest for VT. The underlying hypothesis is that the artificial induction of erections shortly after surgery facilitates tissue oxygenation, reducing cavernosal fibrosis in the absence of nocturnal erections, and potentially increases the likelihood of preserving erectile function. Due to its ability to draw blood into the penis regardless of nerve disturbance, VED has become the centerpiece of penile rehabilitation protocols. Herein, we reviewed the history, mechanism, application, side effects and future direction of VT in ED.

Introduction

Vacuum therapy (VT) uses negative pressure to distend the corporal sinusoids and to increase blood inflow to the penis. If a constricting ring is used, VT would be categorized as a vacuum constriction device (VCD); in this setting, an external constricting ring is placed at the base of the penis to prevent blood outflow from the corpora cavernosa, and an erection is maintained for sexual intercourse. A vacuum erectile device (VED) is the use of VT without a constrictive ring, with the objective of increasing blood oxygenation in the corpora cavernosa, among other reasons. As a non-invasive, effective, safe, drug-free and cost-effective erectile dysfunction (ED) treatment, VCD was gradually accepted by the urological community and was finally recommended as an alternative for treatment of ED by the American Urological Association in 1996.[1] With the great success of phosphodiesterase-5 inhibitors (PDE5I) for treatment of ED, VCD lost its luster. However, when PDE5I limitations were shown and VED use expanded, interest about VT has been rekindled. This review addresses the applications of VT for ED, penile rehabilitation (PR) and other urological conditions.

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