Is There Still a Role for Vacuum Erection Devices in Contemporary Sexual Medicine?

The vacuum erection device (VED) is the oldest therapy used for male sexual function among all approved modalities. It was introduced for erectile dysfunction (ED) nearly 150 years ago, cleared by U.S. Food and Drug Administration in 1982 and adopted by American Urological Association (AUA) in 1996 as a standard of care. 1 Yuan J Hoang AN Romero CA et al. Vacuum therapy in erectile dysfunction–science and clinical evidence. Int J Impot Res. 2010; 22: 211-219 Crossref PubMed Scopus (54) Google Scholar Significant amount of clinic evidence has proven the effectiveness of VED for ED since the early 1980s. Patients’ satisfaction rates varies from 27% to 92%. 1 Yuan J Hoang AN Romero CA et al. Vacuum therapy in erectile dysfunction–science and clinical evidence. Int J Impot Res. 2010; 22: 211-219 Crossref PubMed Scopus (54) Google Scholar Since introduction of phosphodiesterase type 5 inhibitor (PDE5i) for ED after 1998, the role of VED in sexual medicine has changed significantly. Compared to PDE5i, only 33% of patients prefer VED for ED due to its inconvenience. 2 Chen J Mabjeesh NJ Greenstein A. Sildenafil versus the vacuum erection device: patient preference. J Urol. 2001; 166: 1779-1781 Crossref PubMed Scopus (34) Google Scholar The effect of VED requires a constrictive ring to maintain erection for penetration 1 Yuan J Hoang AN Romero CA et al. Vacuum therapy in erectile dysfunction–science and clinical evidence. Int J Impot Res. 2010; 22: 211-219 Crossref PubMed Scopus (54) Google Scholar ; which can be uncomfortable and possibly painful during ejaculation. Good dexterity is also required to use devices. However, this cumbersome, yet time-tested modality has persevered and has also found new indications in sexual medicine in the PDE5i era. This expert opinion is to summarize current use of VED in sexual medicine. Studies published in English from the Medline PubMed search are included.