Vacuum devices or external management systems are effective, safe, and simple to use for all forms of impotence except when severe scarring has occurred from Peyronie's disease.
Mechanical vacuum devices cause erection by creating a partial vacuum around the penis, which draws blood into the penis, engorging it and expanding it. The devices have three components: a plastic cylinder, in which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis, to maintain the erection after the cylinder is removed and during intercourse by preventing blood from flowing back into the body.
The penis is placed inside a plastic cylinder; a vacuum is created, which causes blood to flow into the penis, thereby creating an erection. The cylinder is removed after a band has been tightly secured around the base of the penis. Patients must receive thorough instructions in its proper use.
Air is pumped out of the cylinder with the hand held pump to create a vacuum and cause an erection. The constriction band is then pulled off the cylinder onto the base of the erect penis which retains the erection, and the cylinder is removed.
After putting a liquid or gel around the penis to help create an air-tight seal, the tube is place over the penis.
The pump is now squeezed repeatedly, reducing the air pressure in the tube, allowing the blood to flow into the penis.
When the erection occurs, the tube is removed and a tension ring that was around the end of the tube is slipped off onto the penis. This is to keep the blood in the penis. The erection should last for 30 minutes.
When the tension ring is removed, the blood will leave and the penis will go flaccid
This treatment is reliable and has few adverse effects when used properly It is often accepted by older patients in a longstanding relationship, whereas younger patients may prefer to try other treatments.
Studies have found that success with the vacuum device is equal to other methods, including injection therapy. Between 56% and 67% of men using it reported the device to be effective.
Side effects include blocked ejaculation and some discomfort during pumping and from use of the band. Minor bruising may occur, although infrequently. In general, however, lack of spontaneity is this method's only major drawback; it takes about three to five minutes to produce an erection, the erection involves only part of the penis shaft, and the process will certainly seem peculiar in the beginning. When these psychological obstacles are overcome, however, many couples find the result highly satisfactory.
In one study of men who had used the vacuum device for many years, almost 79% reported improvement in their relationships with their sexual partners, and 83.5% said they had intercourse whenever they chose.
There are many vacuum devices, either manual or battery operated, currently available for treating erectile dysfunction. The penis placed in a plastic tube, and venous blood is drawn into it by suction. Once it is erect, a rubber constriction ring is placed at its base to prevent detumescence. These devices are generally safe, but the erection should not be maintained for more than 30 minutes as the penis may become cold and painful because of the constriction.
Vacuum devices are the preferred option for patients who are afraid of injections or in whom injections have not been successful.