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Erectile Dysfunction Treatment

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Vacuum Devices for Erectile Dysfunction

A vacuum device improves firmness by increasing blood flow to the penis. About 80% of men who use the device correctly obtain an erection hard enough for sexual intercourse.

Vacuum erection devices (VED), also called vacuum constriction devices (VCD), are made of three parts:

  1. A clear, plastic tube (cylinder) that slides over the penis.
  2. A manual or battery-operated pump that sucks air out of the cylinder, sending more blood to the penis.
  3. An elastic ring that is placed around the base of the penis after an erection is obtained. The rubber band-like ring helps maintain firmness by preventing blood from leaking out of the penis. The ring comes in different sizes for an individual fit.

A vacuum device can be cumbersome and interfere with a man's ability for sexual spontaneity. The elastic ring may lead to skin irritation, bruising, loss of feeling or sensitivity, or pain.

Vacuum devices are available with or without a prescription. Talk to your doctor before buying or using a vacuum device purchased without a prescription.

Surgery for Erectile Dysfunction

If all other treatments for erectile dysfunction have failed, your doctor may recommend surgery. Surgery is usually only done if you have severe erectile dysfunction and no response from nonsurgical treatments.

Erectile dysfunction surgery falls into two categories:

  • Placement of an implant (prosthesis) in the penis.
  • Vascular reconstruction surgery to improve blood flow to or reduce blood leakage from the penis and surrounding structures.

Implants, or prostheses, help restore firmness for many men with erectile dysfunction. There are two types of implants: malleable and inflatable.

  • Malleable implants are a pair of adjustable rods placed inside the penis. You manually move your penis, and therefore rods, into a position suitable for intercourse. Such implants do not affect penis size.
  • Inflatable implants are a pair of tubes placed in the penis connected to a squeezable pump inside the scrotum. You squeeze the pump to get an erection. Inflatable implants can also help slightly increase length and width.

Once you have a penile implant, you must always use it to get an erection. Implants may cause infection in some men. Men who have a urinary tract infection, skin infection, or systemic (body-wide) infection should not get a penile implant. Other problems with implants may include auto-inflation, mechanical breakdown of the device, and shifting of the pump.

Vascular reconstruction surgery may be done to:

  • Repair blood vessel blockages to improve blood flow to the penis.
  • Block veins to prevent blood from leaking out of the penis and surrounding tissues.

Blood vessel repair is best done in younger men who have a subtle blockage due to an injury. This type of surgery usually is not successful in older men, who tend to have more widespread blood flow blockages.

Vein blockage, called ligation, is the opposite of penile blood vessel repair. A vein is intentionally blocked to reduce blood loss from the penis and surrounding tissues. Blood loss from the penis can lead to a decrease in firmness. This procedure is rarely used, however, because its long-term effectiveness is unclear.

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