Vacuum devices for ED

Penis pumps are a type of vacuum constriction device which is used by men to achieve and maintain a satisfactory erection (erectile dysfunction).

A vacuum erection device (Pic. 1) helps draw blood into the penis by applying negative pressure. This type of device is sometimes referred to as penis pump and may be used just prior to sexual intercourse. Several types of approved vacuum therapy devices are available with a doctor's prescription. When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. These pumps should be distinguished from other penis pumps (supplied without compression rings) which, rather than being used for temporary treatment of impotence, are claimed to increase penis length if used frequently, or vibrate as an aid to masturbation. 

A penis pump is a cylinder that is fitted over the penis, with a manual or motorized pump to create a partial vacuum around the penis, engorging it as blood is drawn in. A variety of penis pump designs have been adopted by penis pump manufacturers. As vacuum increases, the pressure within the blood vessels of the penis increases as well; excessive vacuum causes vascular damage. Penis pumps may be used to temporarily overcome symptoms of impotence, but do not cure the condition: a tourniquet-like ring must be applied to keep the blood trapped within the penis, otherwise the erection will immediately subside. Pumps may work even if there is nerve or vascular damage preventing a natural erection, but excessive or prolonged use (hours) will cause permanent harm as over-enthusiastic pumping can burst blood vessels and form blisters. 

This method yields a successful erection for intercourse that can be rated as 90%. The satisfaction rates range between 27-94% but about <30% of the patients discontinue use after 2 years because of the negative side effects that include penile pain, delayed ejaculation and numbness that occur.

Factors that increase effectiveness of vacuum erectile devices:

• keeping normal weight
  
• making exercise a part of daily routine
  
• eating a low carbohydrate diet with plenty of olive oil, fresh vegetables and moderate amounts of fruit
  
• stop smoking
  
• reducing stress
  
• sleeping well
  
• keeping blood pressure under control

Impatiently pumping without reading explanatory material can produce too much suction and cause permanent and irreparable injury. Attempts at using vacuum cleaner units for this purpose have resulted in extremely severe injuries because the suction is far too powerful.

Although vacuum devices are generally safe, bruising can occur and the erect penis may lack some support. Other possible side effects may include pain, lower penile temperature, numbness, no or painful ejaculation, and pulling of scrotal tissue into the cylinder.

Vacuum devices are virtually always effective, as they operate by a simple mechanical process, in cases of erectile dysfunction (ED), even when pharmaceutical methods fail. They may nonetheless be found unsatisfactory due to the inconvenience and similar factors.

Early combination treatment of couples psychotherapy and a physical treatment such as a vacuum erectile device may lead to a greater beneficial response in men with ED than therapy alone. The delay of demonstrating the capacity and potential benefit from a physical intervention may have a marked effect on the initial and ongoing response to sex therapy.

There are also few studies with the use of vacuum erection devices in diabetic patients, however, it has been reported by ED diabetic patients that they significantly improved their sexual intercourse with this device, however, only between 20 to 50% had satisfactory erections.