Other Treatments
Vacuum devices, or external management systems, are effective, safe, and simple to use for all forms of impotence except when severe scarring has occurred from Peyronie's disease.
Using the Device. Patients must receive thorough instructions in the proper use of such devices. They typically work as follows:
- The man places the penis inside a plastic cylinder.
- A vacuum is created, which causes blood to flow into the penis, thereby creating an erection.
- A band is tightly secured around the base of the penis, which retains the erection, and the cylinder is removed.
- It takes about 3 to 5 minutes to produce an erection.
Lack of spontaneity is this method's only major drawback. The erection involves only part of the penis shaft, and the process will certainly seem peculiar in the beginning. When these psychological obstacles are overcome, many couples find the result highly satisfactory.
Success Rates. Studies have found that success with the vacuum device is equal to other methods. Between 56 - 67% of men using it reported the device to be effective. In one study of men who had used the vacuum device for many years, almost 79% reported improvement in their relationships with their sexual partners, and 83.5% said they had intercourse whenever they chose. Nevertheless, dropout rates are high. In one 1999 study, for example, the overall drop out rate was 65%. Even in a high-success group, over half stopped using it.
Side Effects. Side effects include blocked ejaculation and some discomfort during pumping and from use of the band. Minor bruising may occur, although infrequently. It is very important to use a medically approved pump. There have been reports of injury from vacuum devices bought through catalogues that do not have a pressure-release valve or other safety elements.
Venous Flow Controllers
Vacuum-less devices that trap blood within the penis are also available. They are called venous flow controllers or simple constricting devices. These devices are typically rubber or silicone rings or tubes that are placed at the base of the erect penis to trap the erection. They can be used by men who can achieve erections but lose them easily. These devices should not be used for longer than 30 minutes or lack of oxygen can damage the penis, and they should not be used by patients who have bleeding problems or are taking anticoagulants ("blood thinners").
Penile Implants
Penile implants are available for men who cannot take medication or who fail less invasive treatments. A 2006 study reported that penile implants helped restore sexual function to 89% of men who had the procedure, and 81% of men were satisfied with the results.
Three types of surgical implants are used for the treatment of erectile dysfunction:
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