Introduction
Vacuum erection devices (VEDs) have been approved in the United States since 1982 and offer a viable alternative to oral phosphodiesterase type 5 inhibitors (PDE5i), injections and transurethral suppositories. Studies have demonstrated efficacy in erectile dysfunction (ED) associated with a variety of conditions. More recently, this modality has been evaluated in initial phosphodiesterase inhibitor nonresponders as well as for post-prostatectomy penile rehabilitation.
Aim
This article provides a detailed overview of the history of VEDs, a review of the literature, and a concise description of their new applications in modern urological practice.
Methods
A retrospective review of publications relevant to the field of VEDs.
Main Outcome Measures
Review of the historical milestones, evolution, and modern utilization of VEDs in modern urological protocols.
Results
Studies have demonstrated efficacy in ED associated with a variety of conditions. Early penile rehabilitation after surgery for prostate cancer with the VED appears to improve erectile function and penile length. Adverse events are transient and not serious.
Conclusions
The VED has continued to show efficacy for treatment of ED due to various etiologies and should be considered an attractive second-line therapy. In select cases such post-prostatectomy penile rehabilitation, as well as in men who cannot use a PDE5i, the vacuum device should be considered first-line treatment.
The Escape basket appears to be safe and effective in preventing stone migration and facilitating ureteroscopic laser lithotripsy and stone extraction.
Introduction
We describe a 51-year-old man with a history of radiation therapy and large bowel diversion for rectal cancer who underwent an uneventful penile implant surgery for erectile dysfunction that was refractory to conservative therapy. The patient presented with acute left lower extremity swelling and pain a few days after surgery. Workup revealed compression of the pelvic veins by the prosthesis reservoir.
Aim
To highlight an avoidable, adverse event related to penile prosthesis reservoirs.
Methods
Retrospective review of a clinical case.
Results
The patient underwent repositioning of the reservoir followed by venous thrombectomy and Greenfield filter placement.
Conclusion
To the best of our knowledge, this is the first report of an early diagnosis and successful thrombectomy of the external iliac and common femoral vein thrombosis secondary to reservoir compression. Awareness of this possible adverse event and the management strategy are helpful to surgeons who perform penile prosthesis surgery.
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