Cardiology patients using nitroglycerin can not use any of the oral agents. The side effects of facial flushing or blue vision may preclude the use of oral drugs for others. The oral agents certainly do not work in all patients. Patients may also lack the manual dexterity to perform self-injection with Caverject.
A viable alternative for patients such as these is the vacuum erection device (VED). VEDs have been in use for many years, and prior to the introduction of the oral pharmacotherapies, were a very popular treatment alternative.
This is a very safe form of treatment and can be used safely in most patients; however patients with sickle cell disease or other maladies that are associated with bleeding disorders should not use VEDs.
These devices consist of a cylinder that is placed on the penis. This is then hooked up to suction which can either be a battery operated source or a manual pump device.
By applying negative suction (vacuum), blood is drawn into the penis, and then a rubber constriction band is placed around the base of the penis to trap the blood. The cylinder is then removed and an erection is maintained.
This treatment is fairly inexpensive, easy to use and fairly reliable. However drawbacks to its usage do exist.
Satisfaction rates of up to 80% have been reported with VEDs, although some patients and their partners complain of a cold glans penis despite the erection being present.
Patient complaints include difficulty with ejaculation (the penile constriction band also compresses the urethra preventing the ejaculation from occurring), penile bruising and pain.
All currently approved non-surgical treatments have been discussed. Next we will begin to discuss surgical alternatives for the treatment of erectile dysfunction.
I would like to wish you all a happy holidays and best wishes for a happy and healthy new year!