Using a vacuum erection device (VED) can improve oxygen saturation in the penis, making VEDs a viable part of penile rehabilitation after radical prostatectomy (RP), according to a pilot study.
VEDs are medical devices designed to create an erection. They include a clear plastic cylinder that is placed over the penis, a hand- or battery-operated vacuum pump that triggers the erection, and a constriction ring that maintains the erection by keeping blood inside the penis.
It is thought that hypoxia – an inadequate supply of oxygen – is one factor that contributes to poor erectile function after radical prostatectomy. Typically, spontaneous erections keep healthy levels of oxygen in the penis. Many men lose these erections after RP, leading to hypoxia, which increases the risk of fibrosis and long-term erectile problems.
In this prospective study, American researchers wanted to determine what changes in penile tissue oxygenation would occur with a VED.
Twenty men who had undergone RP participated in the study. Their mean age was 58 years and the time between RP and study commencement ranged from 2 to 24 months (mean 12.6 months).
All of the men had normal erectile function before surgery, as assessed by the Sexual Health Inventory for Men (SHIM). The men completed the SHIM before RP and at the start of the study.
With the guidance of a study nurse, each man cycled a VED 10 times without using the constriction ring. Combined, these cycles lasted approximately two minutes.
The researchers used an oximeter to measure tissue oxygen saturation before and after VED use. Five sites were tested: the right thigh, the right corpora, the glans penis, the left corpora, and the left thigh. Thigh measurements were used as controls. At least five measurements were taken at each site. After VED use, assessments were made at 5, 15, 30, and 60 minute time points. Overall, 4,223 measurements were taken.
Oxygen saturation for the glans and the corpora significantly increased from baseline measurements for all time points. The oxygenation increase in the corpora was 55%.
The researchers acknowledged that the study lacked a sham group. However, they noted that their study provided a “proof of concept” that using a VED can improve corporal oxygenation.
“This pilot study provides a physiologic rationale for VED use in penile rehabilitation after RP,” the authors wrote, pointing out VEDs are less invasive and less expensive than other penile rehabilitation methods.
The Journal of Sexual Medicine
Welliver, R. Charles, Jr., MD, et al.
“A Pilot Study to Determine Penile Oxygen Saturation Before and After Vacuum Therapy in Patients with Erectile Dysfunction After Radical Prostatectomy”
(Full text. First published online: February 10, 2014)