Claudia N. Benavides, PT, BSc PT, DPT

A vacuum erection device, also known as a penile pump, is a medical device designed to help individuals achieve and maintain an erection. It consists of a cylindrical chamber that is placed over the penis, combined with a manual or mechanical pump to create a vacuum around the area. This negative pressure helps increase blood flow into the penis, and a constriction ring is placed at the base to help retain the blood, resulting in an erection. Vacuum erection devices have become a widely used, non-invasive treatment for erectile dysfunction related to various conditions, including prostate surgery, Peyronie’s disease, and gender-affirming phalloplasty.

Vacuum Erection Devices After Prostate Surgery

Prostate surgery is often necessary for individuals diagnosed with prostate cancer. While the surgery can effectively treat cancer, it is commonly associated with erectile dysfunction. The effects of prostate surgery on sexual health can be significant, with up to 78.8% of individuals experiencing erectile dysfunction two years after the procedure. This number continues to rise over time, with up to 87% of individuals affected within 15 years of the surgery.

Similarly, radiation therapy for prostate cancer can lead to erectile dysfunction in about 60.8% of patients two years after treatment, with this percentage rising to 94% after 15 years. Given the high rates of erectile dysfunction after prostate treatment, it is essential to explore effective options for managing the condition.

A vacuum erection device offers an effective, non-invasive solution for individuals experiencing erectile dysfunction after prostate surgery. These devices are easy to use, have minimal side effects, and can help restore erectile function, which is vital for both emotional well-being and physical intimacy. Using a vacuum erection device can improve blood flow to the penis, helping individuals achieve and maintain an erection for sexual activities. It is also a suitable option for those who cannot tolerate or have contraindications to other treatments, such as medications or injections.

There are no absolute contraindications for using a vacuum erection device after prostate surgery, making it an accessible and versatile treatment option. Importantly, vacuum erection devices not only address the physical aspects of erectile dysfunction but also play a role in improving the individual’s quality of life. Sexual health issues related to prostate surgery often go beyond the physical, affecting emotional health, self-esteem, and relationships. By restoring erectile function, vacuum erection devices can have a positive impact on these areas as well.

Vacuum Erection Devices for Peyronie’s Disease

Peyronie’s disease is a condition that causes the penis to develop fibrous scar tissue, leading to curvature, pain, and erectile dysfunction. It is most common in men over the age of 50, affecting up to 11% of penis owners, with the highest incidence occurring around age 53. The fibrous tissue that forms in Peyronie’s disease results in bending or deformity of the penis, which can make sexual activity difficult or painful.

Traditional treatments for Peyronie’s disease may include surgery, but these carry certain risks, including the potential for penile shortening and dissatisfaction with the results. As a result, many individuals seek alternative, non-invasive treatments, including the use of a vacuum erection device. The goal of using a vacuum erection device in Peyronie’s disease is to reduce the curvature of the penis and help improve erectile function.

Research has shown that vacuum erection device therapy can be an effective option for managing Peyronie’s disease. A 2020 study by MacDonald et al. found that using a vacuum erection device significantly reduced penile curvature in people with Peyronie’s disease. Patients who used the device experienced a more substantial improvement in curvature compared to those who did not use it. In fact, for individuals who did not use any treatment, some even experienced worsening of the curvature.

The study also found that the amount of curvature initially present was linked to the degree of improvement. Penis owners with more severe curvature at the start of the treatment tended to see more noticeable reductions in curvature after using the vacuum erection device. Interestingly, factors such as age, the duration of Peyronie’s disease, and underlying health conditions like diabetes or smoking did not significantly impact the effectiveness of the vacuum erection device.

While the study showed a slight improvement in sexual function for those using the device, this was not statistically significant. However, it is noteworthy that the untreated group experienced a significant decline in sexual function, highlighting the importance of early intervention with a vacuum erection device.

In summary, vacuum erection device therapy offers a promising non-invasive option for managing Peyronie’s disease. It helps improve penile curvature, which can restore confidence and sexual function for many individuals. The therapy is generally well-tolerated and has minimal side effects, making it a valuable treatment for those looking to avoid surgery or more invasive procedures.

Vacuum Erection Devices for Gender-Affirming Phalloplasty

Phalloplasty is a gender-affirming surgical procedure that constructs a penis for transgender men and non-binary individuals. One of the challenges after undergoing phalloplasty is erectile dysfunction, especially if non-erogenous tissue is used to create the penis. In such cases, achieving a natural erection can be difficult due to reduced sensitivity or insufficient erectile tissue. This is where a vacuum erection device can be a helpful tool.

A vacuum erection device can promote blood flow to the newly constructed tissue, assisting individuals in achieving an erection. This is important not only for sexual function but also for the overall health of the new penile tissue. While the effectiveness of a vacuum erection device after phalloplasty varies depending on factors like the surgical technique and the amount of erectile tissue available, many individuals report improvements in erectile function.

However, it is essential to use a vacuum erection device carefully and under the supervision of a healthcare provider, such as a pelvic health physiotherapist or surgeon. Incorrect use or overuse of the device can cause injury or complications to the newly constructed tissue. By working closely with a healthcare provider, individuals can ensure they are using the device safely and effectively.

Starting Vacuum Erection Device Therapy Early

For the best results, it is crucial to start using a vacuum erection device as soon as possible after surgery or diagnosis. In the case of prostate surgery, Peyronie’s disease, or gender-affirming surgery, starting early can help maintain or restore erectile function and support the health of the penile tissue. Studies suggest that the earlier treatment begins, the better the outcomes are likely to be.

For prostate surgery, in particular, penile tissue can begin to change within the first two months, making it important to start rehabilitation early. Discussing penile rehabilitation with a pelvic health physiotherapist before undergoing surgery can help individuals develop a personalized treatment plan that begins right after surgery.

Working with a pelvic health physiotherapist is an important step when using a vacuum erection device. A physiotherapist can guide individuals on how to use the device correctly, helping them avoid potential complications and maximize its benefits. Whether recovering from prostate surgery, managing Peyronie’s disease, or seeking support after phalloplasty, a pelvic health physiotherapist can help optimize sexual health and overall well-being. Early consultation with a pelvic health physiotherapist can help develop an effective treatment plan tailored to the individual’s specific needs.

Resources: 

1. Domes T, Najafabadi BT, Roberts M, Campbell J, Flannigan R, Bach P, Patel P, Langille G, Krakowsky Y, Violette PD. Canadian Urological Association guideline: Erectile dysfunction. Can Urol Assoc J. 2021 Oct;15(10):310-322. doi: 10.5489/cuaj.7572.

2. Resnick MJ, Koyama T, Fan KH, et al. Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med. 2013;368:436–45. doi: 10.1056/NEJMoa1209978.

3. MacDonald LP, Armstrong ML, Lehmann KJ, Acker MR, Langille GM. Outcome analysis of patients with Peyronie's disease who elect for vacuum erection device therapy. Can Urol Assoc J. 2020 Sep;14(9):E428-E431. doi: 10.5489/cuaj.6205.