Vacuum devices have a long history. Following the first scientific report of their effectiveness in 1985, it has been said that they are the most widely used and successful treatment of erectile dysfunction.
They were endorsed by the National Institutes of Health in the United States at the Consensus Conference in the management of erectile dysfunction.
Vacuum constriction devices consist of a clear plastic cylinder and a pump which may be hand or battery operated. The flaccid penis is placed in the cylinder and an air-tight seal is obtained with a lubricating gel. The plastic cylinder is pressed firmly against the body and a partial vacuum created by evacuating the air from within the cylinder.
The penis becomes engorged with blood and, when firm enough for intercourse, a plastic constricting ring is slipped from the end of the cylinder around the base of the penis. This traps blood in the penis and the erection may be safely maintained for up to 30 minutes. Some people prefer to use two constriction rings to obtain a stronger and better maintained erection.
The device is effective for more than 90% of men although it may take up to two weeks for a man to master its use. Once this has been achieved, it usually takes two to three minutes for him to produce a usable erection.
The advantages of a vacuum constriction device are its relative cheapness - it pays to buy a reliable one - and its freedom from side effects. Some bruising is not uncommon but no serious complications have been reported. Discomfort may be associated with prolonged use for more than 30 minutes.
Vacuum devices are particularly useful for those men in a stable relationship who are unable to obtain an erection for physical reasons and for whom the only alternative would be the implantation of a penile prosthesis. It is less attractive to single men and for those with psychological erectile dysfunction.
In one questionnaire study it was reported that there was long term satisfaction in 82% of 115 men after nine months and in 89% of their partners. One third of the partners noted that the penis felt colder than normal when a vacuum constriction device was used. On average the couples had intercourse four times per month.
In brief, vacuum devices were considered to be a gimmick when first introduced but are now being used by increasing numbers of men because they are relatively cheap, non invasive, efficient, and allow many couples to have satisfactory intercourse.
