A vacuum is a device which is the least invasive and least expensive treatment for ED. Vacuum constrictive devices are approved by the FDA for over-the-counter distribution. It is a good choice for men who do not want to or cannot take medications due to comorbid conditions such as heart failure or diabetes (96-98). Vacuum therapy devices are available without a prescription.
This therapy works by applying negative pressure to the penis. The vacuum produces an erection that can last for up to 30 minutes and is between 70% and 94% effective. The majority of the devices have 3 components – a vacuum chamber, a pump to create the pressure within the pump, and a tension band which is applied at the base of the penis after the erection is achieved.
Complications from these devices have been minor and self-limited (96-98, 100). Common side effects are numbness, pain, and trapped ejaculation. Patient acceptance and satisfaction with vacuum devices in all types of impotence range from 68% to 83%. Reported reasons for discontinuation include premature loss of penile rigidity, penile pain, pain during ejaculation, and inconvenience of usage (101).