Vacuum Devices for Erectile Dysfunction

CHAPTER 125 Vacuum Devices for Erectile Dysfunction



John R. Holman


Erectile dysfunction is a common medical problem occurring in nearly 30 million American men. Vacuum devices to promote erection are safe and have overall clinical success rates of approximately 90% but are considered second-line therapy given the efficacy, favorable side effect profile, and ease of use of phosphodiesterase inhibitors. They are useful in nearly all men with erectile dysfunction except those with severe cavernous fibrosis. Therapy depends on the ability to transfer blood into the corpus cavernosa, which is limited if fibrosis is present.


A number of devices are available for use. The majority have three common components: a vacuum chamber or cylinder, a vacuum pump that creates a negative pressure within the chamber, and an elastic constriction band.


The devices create a nonphysiologic erection by trapping blood in both the intracorporeal and extracorporeal compartments of the penile shaft by means of the negative-pressure vacuum. The constrictor band is then placed before the chamber, over the proximal shaft, constricting blood flow into and out of the penis and maintaining an erection for sexual intercourse. Erection is maintained distal to the constricting band. Most manufacturers recommend that the vacuum-induced erection be maintained for less than 30 minutes because penile distention, edema, and cyanosis may ensue with prolonged use. The American Urologic Association, in its erectile dysfunction clinical practice guideline, reviewed and validated in 2009 and based on panel consensus, recommends only vacuum constriction devices containing a vacuum limiter–relief valve should be used, whether purchased over-the-counter or procured with a prescription.



Indications


Erectile dysfunction resulting from


• Vascular disorders

• Neurologic disorders

• Psychogenic disorders

• Hormonal disorders

• Medications, when the medication cannot be altered or terminated


Contraindications



• Blood dyscrasias, coagulation disorders, or anticoagulation drug therapy

• Impaired manual dexterity to operate the device


Equipment



• Vacuum erection device, including chamber, vacuum pump, and constriction bands (Fig. 125-1A). Battery-operated suction devices may be preferable in patients with impaired manual dexterity or after debilitating neurologic events such as stroke or quadriplegia. Constriction bands come in a variety of sizes to fit the penile shaft.

• Lubricant as needed.


image


image

image

Figure 125-1 A, Typical vacuum device for erectile dysfunction. B, Constricting rings on device, cross-sectional view. C, How to activate the pump.


(A, Courtesy of TIMM Medical Technologies, Eden Prairie, Minn. B, Redrawn from TIMM Medical Technologies.)

Related posts:

  1. Electrical Cardioversion
  2. Removal of Perianal Skin Tags (External Hemorrhoidal Skin Tags)
  3. Knee Braces
  4. Compartment Syndrome Evaluation

Stay updated, free articles. Join our Telegram channel
Tags:
May 14, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Vacuum Devices for Erectile Dysfunction

Full access? Get Clinical Tree
Get Clinical Tree app for offline access