Erectile dysfunction: vacuum constriction devices

A vacuum constriction device (VCD) is an external pump with a band on it that a man with erectile dysfunction can use to get and maintain an erection.

The VCD consists of an acrylic cylinder with a pump that may be attached directly to the end of the penis. A constriction ring or band is placed on the cylinder at the other end, which is applied to the body. The cylinder and pump are used to create a vacuum to help the penis become erect; the band or constriction ring is used to help maintain the erection.

The pump helps the penis become erect while the band maintains the erection.

How does it work?

To use the device:

• Place the pump, which can be pumped by hand or run on batteries, over the penis.
• Pump the air out of the cylinder so that a vacuum is created. The vacuum draws blood into the shaft of the penis and causes it to swell and become erect.
• Once the penis is erect, with the help of lubricant, slide the retaining band down onto the lower end of the penis.
• Remove the pump after releasing the vacuum.

Intercourse can be attempted with the constriction band in place to help maintain the erection. The band can be left on safely for up to 30 minutes to allow for successful intercourse.

How well do vacuum constriction devices work?

Studies suggest that about 50%-80% of men are satisfied with the results of VCD. As with any other method of treatment for erectile dysfunction (ED), satisfaction rates may decrease with time.

Who should consider using a vacuum constriction device?

Vacuum constriction devices are safe and can be used by patients with ED caused by many conditions, including:

• Poor blood flow to the penis
• Diabetes
• Surgery for prostate or colon cancer
• Psychological issues such as anxiety or depression.

Vacuum constriction devices should not be used by men who may have a significant congenital bleeding disorder or a disorder that predisposes them to a condition called priapism (a prolonged, sometimes painful erection lasting several hours). Examples include sickle-cell anaemia, some forms of leukaemia, and other blood conditions.

What are the side effects?

An erection obtained with the vacuum constriction device is not the same as an erection achieved naturally. The penis tends to be purplish in colour and can be cold or numb. Other side effects can include:

• A black and blue mark or small area of bruising on the shaft of the penis. This is usually painless and generally will resolve in a few days.
• Decrease in the force of the ejaculation. The constriction band traps the ejaculate or semen at the time of orgasm. This is not dangerous and usually does not cause pain. The semen will usually dribble out once the constriction band is removed. Generally, this does not interfere with the pleasure of a climax or orgasm.

How much does the device cost?

Vacuum constriction devices vary in cost from £200 to £300, depending on the brand and type. The battery-powered versions tend to be more expensive, but also tend to work a little more quickly. Battery-powered devices are especially helpful for men who do not have good hand strength or coordination, or who have arthritis.

There are several devices currently on the market that work effectively. Some of these devices can be obtained without a prescription.