Vacuum Erection Devices (VEDs) are amongst the most overlooked men’s health devices. They play a pivotal role whether they’re used on their own, in conjunction with other erectaids, or as part of penile rehabilitation.

The insights I’m about to reveal are gleaned from my interactions with patients and discussions with pelvic physical therapists well-versed in the art of VEDs.

In this article, I’ll share some invaluable tips I teach to my patients to simplify the VED process for sexual activity and make it a more comfortable experience.

1. Patient Preparation:

   To ensure a comfortable and snug fit, be sure to tell your patients to trim their pubic hair, and be sure the area is washed and clean before use. This is often overlooked and is one of the first things I instruct my patients to do.

   Also, make sure to advise your patients that when using the device, foreplay is key. While this is a mechanical aid and you technically don’t need foreplay, a little goes a long way.

2. VED Set-up: One of the most common incidents I hear about is the patient having their scrotum or testicle being suctioned into the tube during use. Normally, this happens because of an improper fit or seal. An easy way to avoid this is to direct your patients to use a body shield. This creates a buffer between the body and the device that prevents unwanted anatomy from being suctioned in.
3. Proper VED Pumping:

   Overpumping is another common issue patients have trouble with. I direct my patients to use the following pumping protocol to avoid over-pumping:
    

   1. Start by pumping the device three times or for three seconds if you are using a battery-powered VED.
   2. Pause for 10 seconds to allow for blood to flow into the penis.
   3. Repeat steps 1 and 2 until you achieve a full erection with a gentle stretch.
   4. Once your erection is achieved, secure the erection with a constriction ring (also referred to as tension ring or cock ring)

      1. Tip: Use two different-sized constriction rings to secure the erection if you’re having trouble with one.
   5. I always remind my patients to take it slow and that comfort is key. Avoiding rapid pumping or over-pumping can help eliminate discomfort or bruising. Practice makes perfect—it often takes several attempts for your patients to find their ideal VED routine.
4. Post VED Use:

   When teaching this to patients, I always get asked about what they should do with the body shield after pumping and before sexual activity. The body shield doesn’t hurt or get in the way, so I tell my patients to not worry about removing the body shield. Removing the body shield could loosen the seal of the constriction ring causing them to lose their erection, so it’s safer to leave it on. My final tip for my patients is to apply lubrication to the penile shaft PRIOR to removing constriction rings. This helps reduce any uncomfortable pinching from the ring during removal.

5. Combining VED with Other ED Therapies:

   I believe that VEDs complement various ED treatments really nicely. I will often combine other treatments, like oral phosphodiesterase inhibitors with VED’s for enhanced results. The key to combining therapies is to make sure your patient gives the oral medication sufficient time to take effect. Using a vacuum pump before injections is also beneficial for patients. I advise my patients to use a VED in combination with injection therapy to help prepare their tissue, reduce discomfort, and for some men, doing so may aid in identifying the target injection location.

The Takeaway:

Mastering the use of a VED is all about technique and patience. VEDs are powerful tools that, when used correctly, can make a significant difference in the lives of patients dealing with erectile dysfunction. By following these tips and techniques, you can help your patients make the most of their VEDs, promoting better sexual health and overall well-being.