Long-Term Results with Vacuum Constriction Device

Cookson, Michael S.; Nadig, Perry W.

doi:10.1016/s0022-5347(17)36059-7

Cited by 136 publications

(75 citation statements)

References 11 publications

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“…The most common side effects include numbness, pain, penile bruising or petechiae. 9,32,37,[44][45][46] Due to the constriction rings, painful ejaculation or sensation of trapped ejaculate has also been commonly reported. 7,9 Other rare complications such as leg spasms, testicular migration, urethral varicosities/bleeding have been reported.…”

Section: Complicationsmentioning

confidence: 99%

Vacuum therapy in erectile dysfunction—science and clinical evidence

et al. 2010

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Vacuum therapy (VT) utilizes negative pressure to distend the corporal sinusoids and to increase the blood inflow to the penis. Depending on its purpose, VT could be used as vacuum constriction device (VCD), with the aid of an external constricting ring which is placed at the base of penis to prevent blood outflow, maintaining the erection for sexual intercourse. Also, as a vacuum erectile device (VED), without the application of a constriction ring, just increases blood oxygenation to the corpora cavernosa and for other purposes. The emerging of phosphodiesterase 5 inhibitors (PDE 5 I) for the treatment of erectile dysfunction (ED) eclipsed VCD as therapeutic choice for ED; however, widespread usage of VED as part of penile rehabilitation after radical prostatectomy and other purposes rekindle the interest for VT. The underlying hypothesis is that the artificial induction of erections shortly after surgery facilitates tissue oxygenation, reducing cavernosal fibrosis in the absence of nocturnal erections, and potentially increases the likelihood of preserving erectile function. Due to its ability to draw blood into the penis regardless of nerve disturbance, VED has become the centerpiece of penile rehabilitation protocols. Herein, we reviewed the history, mechanism, application, side effects and future direction of VT in ED.

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Section: Complicationsmentioning

confidence: 99%

Vacuum therapy in erectile dysfunction—science and clinical evidence

et al. 2010

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“…7,8,10 In our early penile rehabilitation program, the VCD was the preferred erectile aid. The advantage of VCD is that the erections produced are independent of endogenous vasoactive substance such as nitric oxide (NO) production, which is impaired by nerve damage.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] Vacuum constriction devices (VCD) have been successfully used in a variety of patients with organic ED. 10 Its use included those patients treated for prostate carcinoma with either RP or radiation therapy. 7,8,10,11 Colombo et al 12 found that their patients who practiced early application of VCD without the constrictive band to produce 'stretching' for the smooth muscle fibers showed significant improvement of spontaneous erectile ability.…”

Section: Introductionmentioning

confidence: 99%

Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function

et al. 2005

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To assess the efficacy of vacuum constriction devices (VCD) following radical prostatectomy (RP) and determine whether early use of VCD facilitates early sexual activity and potentially earlier return of erectile function. This prospective study consisted of 109 patients who underwent nervesparing (NS) or non-nerve-sparing (NNS) RP between August 1999 and October 2001 and developed erectile dysfunction following surgery. The patients were randomized to VCD use daily for 9 months (Group 1, N ¼ 74) or observation without any erectogenic treatment (Group 2, N ¼ 35). Treatment efficacy was analyzed by responses to the Sexual Health Inventory of Men (SHIM) (abridged 5-item International Index of Erectile Function (IIEF-5)), which were stratified by the NS status. Patient outcome regarding compliance, change in penile length, return of natural erection, and ability for vaginal intercourse were also assessed. The mean patient age was 58.2 years, and the minimum follow-up was 9 months. Use of VCD began at an average of 3.9 weeks after RP. In Group 1, 80% (60/ 74) successfully used their VCD with a constriction ring for vaginal intercourse at a frequency of twice/week with an overall spousal satisfaction rate of 55% (33/60). In all, 19 of these 60 patients (32%) reported return of natural erections at 9 months, with 10/60 (17%) having erections sufficient for vaginal intercourse. The abridged IIEF-5 score significantly increased after VCD use in both the NS and NNS groups. After a mean use of 3 months, 14/74 (18%) discontinued treatment. In Group 2, 37% (13/35) of patients regained spontaneous erections at a minimum follow-up of 9 months after surgery. However, only four of these patients (29%) had erections sufficient for successful vaginal intercourse and rest of patients (71%) sought adjuvant treatment. Of the 60 successful users, 14 (23%) reported a decrease in penile length and circumference at 9 months (range, 4-8 months) compared to 12/14 (85%) among the nonresponders. However, in control group 22/35 reported decrease in penile length and circumference. Early use of VCD following RP facilitates early sexual intercourse, early patient/spousal sexual satisfaction, and potentially an earlier return of natural erections sufficient for vaginal penetration.

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“…As with vacuum devices, they can be used only for a short period not exceeding 30 min, owing to the need for oxygenation of penile smooth muscle. 37 Second-line treatments. When first-line treatments fail or cannot be used, a more aggressive level of therapy is needed.…”

Section: Symptomatic Treatmentsmentioning

confidence: 99%

Core document on erectile dysfunction: key aspects in the care of a patient with erectile dysfunction

Brotons¹,

Campos²,

González-Correales³

et al. 2004

Int J Impot Res

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The aim of this Core Document of the Spanish Consensus on Erectile dysfunction (ED) is to offer guidance to the nonspecialist physician in the management of patients with ED. ED is one of the most frequent chronic health problems in men older than 40 y of age and may also act as a sentinel symptom for other important underlying diseases. Its etiology can be classified into organic, psychogenic, or mixed. In most cases, the underlying cause of ED is usually a chronic health problem (such as diabetes, hypertension, atherosclerosis, and so on) or an adverse drug effect. The initial step in the management is to assess erectile function in patients with risk factors for ED. Once ED has been established, a detailed sexual, medical, and social history, including a review of medications used, is the most important aspect of a patient's assessment. Generally, examination should be limited to the cardiovascular, neurological, and urogenital systems. Fasting glucose and blood lipid profile should be performed in every man with ED, and free testosterone levels in men older than 50 y or if hypogonadism is suspected; other diagnostic tests are optional and should be requested on an individualized basis. In many cases, the most likely cause of ED can be identified based on the above information. Therapeutic intervention should be patient-oriented and based on the expectations and wishes of the patient and his partner, who should be included in discussions whenever possible. Basic interventions common to any type of ED include sexual counseling, lifestyle modifications, treatment of associated medical conditions, and switching to alternative drugs with lower risk of ED. In certain cases, an etiologic treatment may be performed (sex therapy, revascularization surgery, and hormonal therapy). Most patients with ED will benefit from symptomatic treatments; first-line therapy may be prescribed by physicians who are not specialists in ED, and includes oral agents such as inhibitors of phosphodiesterase type 5, currently considered the drugs of choice for initial treatment of ED. Intracavernous drugs are the second-line therapy, and surgical treatments, such as implantation of penile prostheses, are reserved for urologists/ andrologists who specialize in ED. Referral may be appropriate where indicated by age, clinical findings, or the patient's request.

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Long-Term Results with Vacuum Constriction Device

Cited by 136 publications

References 11 publications

Vacuum therapy in erectile dysfunction—science and clinical evidence

Vacuum therapy in erectile dysfunction—science and clinical evidence

Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function

Core document on erectile dysfunction: key aspects in the care of a patient with erectile dysfunction

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