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Nonsurgical Treatment of Erectile Dysfunction

Treatment Options for Erectile Dysfunction

Patient Comments
  • Virtually any man who wishes to have an erection can obtain it, regardless of the underlying cause of his problem.
  • Many reasonable nonsurgical treatment options exist for erectile dysfunction (also called male impotence), including external vacuum devices, medications (oral and topical), hormonal therapy, penile injection therapy, and intraurethral pellet therapy. Sex counseling is another option and is discussed in Living With Erectile Dysfunction.
  • In selected cases and under the supervision of an experienced urologist who treats impotence, therapy combining several of these methods can be used. If none of these therapies is satisfactory, surgical treatment, such as a penile prosthesis, can be considered.
Male reproductive system.

External Vacuum Devices for Erectile Dysfunction

Specially designed vacuum devices to produce erections have been used successfully for many years. Vacuum devices are safe, relatively inexpensive, and reliable. Vacuum devices do not require surgery.

The typical vacuum device consists of a plastic cylinder that is placed over the penis, tension rings of various sizes, and a small hand pump. Air is pumped out, causing a partial vacuum, which draws blood into the penis and creates the erection.

Once an erection is obtained, a tension ring, which acts like a tourniquet to keep the blood in the penis and to maintain an erection, is placed around the base of the penis.

Using the correct size of tension ring is critical in obtaining the best possible result from this type of treatment. If the ring is too tight, it can be uncomfortable. If too large a ring is used, the erection may not last. The tension ring should not be left in place longer than 30 minutes.

Although these devices are generally safe, bruising can occur and the erect penis may lack some support. Other possible side effects include:

  • Pain
  • Lower penile temperature
  • Numbness
  • No or painful ejaculation
  • Pulling of scrotal tissue into the cylinder

Many of these side effects can be helped by proper selection of the tension rings and cylinder size, use of adequate lubrication, adequate practice with the device, and proper technique.

Vacuum pumps are effective in a majority of men. About half of the men who use a penis pump obtain good or excellent erections with them, but only half of these men consistently use the device over long periods of time.

The most common cause of failure is improper use of or unfamiliarity with the device. Other drawbacks to the use of vacuum devices include the need to assemble the equipment and the difficulty in transporting it. Many men also lose interest in the device because of:

  • Necessary preparations (may need to interrupt foreplay)
  • Inability to hide the tension ring
  • Relative lack of spontaneity

Although vacuum devices can be operated and used quickly with experience, they still are perceived by many to be less "romantic" than other nonsurgical treatment options.

An external vacuum device can be used to produce an erection. The typical vacuum device consists of a plastic cylinder, a tension ring, and a small hand pump.

The external vacuum device is shown placed over the penis. Note that, after an erection is obtained, the tension ring is placed at the base of the penis to help maintain the erection.

One of the many types of constricting devices is shown that can be placed at the base of the penis to diminish blood outflow and to improve the quality and duration of an erection. This device can be used in conjunction with medications, injection therapy, or an external vacuum device.

Medically Reviewed by a Doctor on 5/31/2016
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