Vacuum Erection Devices (VED): Basic Principles

VEDs are a useful noninvasive treatment for ED. They involve a cylindrical device that is placed over the penis. Many types of VEDs are now available, and it is recommended that only those available by prescription should be used.¹ ² A VED, which mechanically creates penile blood engorgement, consists of a vacuum chamber or cylinder, a pump to produce negative pressure, and constriction rings.

VEDs can be used to treat organic or psychogenic ED. Current reviews report successful results in men with a variety of organic etiologies, including spinal cord injuries, postprostatectomy, diabetes, and arterial insufficiency.

After the penis and constriction rings are coated with water-soluble lubricant and the rings are loaded onto the cylinder base, the cylinder is placed over the penis with the base held firmly against the pubis to maintain a seal. The pump is then activated to slowly create negative pressure, or a vacuum, inside the cylinder, which draws blood into the corpora cavernosa, producing an erection.

Once the penis is engorged, the constriction band is pulled from the cylinder onto the base of the penis. The negative pressure is released through a valve, and the cylinder is removed. It takes an average of 2 to 2½ minutes to create an erection through this procedure, according to recent reviews.

The erectile state produced by VEDs differs from a normal erection: penile skin temperature is lower, the veins of the penis appear distended, and penile circumference is increased. In addition, the penis may pivot at the base, requiring the patient to stabilize the penis during intercourse.

How it Works

This mechanical device consisting of a plastic cylinder is placed externally over the penis. Activation of an attached pump creates a vacuum that encourages blood to flow in to the penis. A rubber ring is then snapped over the base of the penis, keeping the blood in the penis and maintaining the erection.

Long-Term Experience

Long-term follow-up of men who chose the vacuum constriction devices as primary treatment for their erectile dysfunction reveals that this treatment option is inappropriate for men with mild Erectile Dysfunction and ineffective for men with severe Erectile Dysfunction. It seems that men with moderate Erectile Dysfunction are the best candidates for this treatment option. Our study, which was recently published in Urology (May 1999), showed that even when properly trained, 65% of patients who purchased the device stopped using it. Of the patients who discontinued, most stopped treatment early (1-4 months).

In addition, now that effective oral medication is available for men with moderate Erectile Dysfunction, the use of vacuum constriction devices in this patient population will most likely also decrease.


Advantages & Limitations

External Vacuum Pump: Advantages

    Least invasive method of all

    Requires no medication or surgery

    Insurance will cover expense

External Vacuum Pump: Limitations

    High rate of discontinued use (65%)

    Cumbersome

    Painful erection

    Ineffective

How To Prevent Erection Failures

If you observe that erection failures occur more frequently, probably, you are waiting too much from yourself or you are trying to make sex in an inappropriate place. Check below ways to reduce to minimum these failures. Most important thing is that these tips would help to avoid anxiety which leads to a serious long-term problems.

 - Make sex only when you are disposed to it.

 - Admit that you are a human and not a machine. Your feelings and sexual performance not necessarily should be equal. Sometimes you are in condition of greater readiness and sometimes you need an additional stimulation. You should say this to your partner.

 - Avoid accidental partners, at least until you acquire self-confidence. You will trouble less and work better if you would create steady relationships with a partner whose reactions you know and whom you may trust.

 - Do not judge your quality observing condition of your penis. Mutual satisfaction may be achieved without sexual intercourse, though during physical contact erection may occur without your conscious participation.

- If you cannot achieve erection or it disappeared before sexual intercourse or during it, you should not get upset. Explain to your partner what has happened. “Probably, I am very tired today. Let us try tomorrow in the morning.” Do not feel yourself guilty and assure your partner that there is no his guilt in that. Most important is not to withdraw physically and mentally from each other only because this time you cannot achieve erection for performing sexual intercourse. Stay close with your partner by any means except sex. If you like to be together, no matter if you have erection or not, you will be less anxious the next time when experiencing erection failure.

Psychogenic Erectile Dysfunction

Erection refers to the most simple physiological male sexual response. This reaction involves only two mechanisms  vascular and neurogenic. Ironically, while the reactions of psychosexual disorders the most common is male erectile dysfunction .
The presence of an erection for men is more important fact than the sexual act itself . That is why any erectile dysfunction is not perceived as a single problem, but as a downfall to the male in principle.
If we turn to the terminology  erectile dysfunction means - impossible to achieve an erection at all, or inability to maintain it throughout the intercourse.
Erectile dysfunction can occur at any age. Most frequently observed inability to enter the penis into the vagina. Somewhat less evident disappearance of erection when attempting copulation, though before it can be quite strong. Also, there are cases when a man can achieve an erection only in certain conditions or any situations.
Research on European and American scientists have revealed the following facts: erectile dysfunction were recorded in more than 80 millions men younger than 40. Number of older men suffering from erectile dysfunction, twice that number.
Do not take as psychogenic erectile dysfunction single erectile dysfunction cases (or lack thereof extinction at the most inopportune moment). Individual episodes still is nothing, it may be caused by a variety of reasons: stress, tension, unsuitable conditions, especially relations with a new partner. If you experience a failure and think about the possibility of its recurrence, it can lead to a true psychogenic erectile dysfunction and a phenomenon known as psychogenic impotence .

Psychological causes of erectile dysfunction
Erectile dysfunction is quite often provoked by psychogenic disorders. The most common form of the syndrome is the expectation of failure. Random sexy failure - the reduction or disappearance of erection - leads to doubt in his masculine power. Fear intensifies in anticipation of sexual intercourse, resulting in a loss of erection. Triggered the principle of auto-suggestion: the more such concerns, the more likely their implementation. Over time, manifested genuine problems with achieving and maintaining an erection begins the so-called psychogenic impotence. Subsequently, this may cause loss of interest in sex as such, the loss of faith in yourself. Numerous attempts to overcome self intercourse converted into a set of  "saving " rituals, partners can not concentrate on anything other than monitoring and evaluation of response to their actions. This suppresses the possibility of even stronger erections and exacerbates psychogenic erectile dysfunction.
As a result, we are seeing a vicious circle:
• weakness of erection ;
• fear of further failures ;
• change his position on the role of the observer ;
• erectile dysfunction ;
• strengthening the fear of failure ;
• psychogenic erectile dysfunction .
If at any time not to break this cycle, erectile dysfunction will constantly get reinforcements.

Treatment of psychogenic erectile dysfunction
Psychogenic erectile dysfunction treatment combines psychotherapy and pharmacotherapy . Therapist can help relieve anxiety and fear of sexual intercourse. Pharmacotherapy initially exhausted by symptomatic agents - tranquilizers, which helped to get rid of anxiety for a short time  Also used homeopathic remedies that are based primarily on the placebo effect.
In the last decade the situation has changed with the advent of PDE5 inhibitors type. They are used in all kinds of erectile dysfunction, regardless of what caused the breach. Especially these drugs are effective in the case of the vascular nature of violations. But psychogenic erectile dysfunction retreats before the action of the inhibitors.
PDE-5 inhibitors may be the type of drug treatment as psychological impotence and as a means of psychological protection: if there is attraction and provide a powerful means of stimulating the vascular effect, minimizing the possibility of failure. Therefore, the appointment of PDE- 5, it is desirable to continue to completion of psychogenic disorders: their effect is both symptomatic and pathogenetic. It is also desirable parallel with the reception held inhibitors in therapy because Fear of failure can reduce the effect of even such an effective means of, and psychological erectile dysfunction again prevail over medicines.
Increasingly inhibitors are used in situations where disorder is not yet evident, but there are prerequisites for sexual failures: increased workload, change of the partner, stress, fatigue. However, inhibitors use should certainly be after consultation with a specialist.

What Controls the Erection?

Indeed, some say that the biggest sexual organ is in our heads. It is the brain "in charge" all forms of human sexual sphere: it creates an emotional mood, the need for sexual intercourse, attraction to the opposite sex and provides a reaction, realizing this attraction. In the language of science attraction to the opposite sex called "libido." Against the background of libido erotic pictures in combination with stimulation of the areas causing sexual arousal center in the brain. As a result, nerve impulses are rushing from the center to the various organs and cause heart "flutter", and breathing - more frequent. Blood pressure rises. Under the "leadership" centers of the spinal cord penis fills with blood, repeatedly (4-10 times) increases and strains. So there is an erection. Emotional arousal and activation of the glans penis lead to a reduction in seminal vesicles and release of sperm - ejaculation and orgasm. Violation of any of the coordinated work of these links may cause sexual disorders, primarily the loss of the capacity for erection. From ancient times was the search for means that would help the man. He drank a love potion, or better yet unobtrusive swallowed a pill - and please, appeared before a woman in full force and readiness. Such tools called "afrodiziakum" on behalf of Aphrodite, the Greek goddess of sensual love. Despite the centuries-old quest, the vast majority of these funds were either tonic like ginseng and vitamins, or exciting, like coffee and chocolate, or just mascots, acting purely psychological. The only effective means was the bark of the African yohimbe tree. Why is it so hard to influence the behavior of the penis? After all, people are usually well managed by his body: even with his eyes closed and in weightlessness his hands and feet in full are subject to the will. But the thing is that we are able to command only those muscles which are attached to bones. But there are other muscles that are not subject to us. They are located in the walls of internal organs and blood vessels. The penis is under the control of these muscles, and therefore almost independent of the will of the owner. Nevertheless, its behavior is determined by nerve impulses. Nervous system of regulation reminds telegraphy. At the command post there is an "order" in the form of electrical signals that run through the wires - the nerves. At the end of the wire sits "telegraph," sending the pulses in the order, which serve the public. These orders and there are those substances that cause the muscle is reduced, then relax.
Inside the penis are two so-called cavernous body. Along the walls of the "caves" are the muscles through which they can change their volume. In the usual, "sluggish" state of the muscles of cavernous bodies and muscles of small arteries of the penis in a state of weak reductions - tone. They constantly circulates a small amount of blood, but to give the elasticity of the penis is not enough. The situation is completely changed when sexual excitement. By genitals received powerful impulses that cause relaxation of muscle fibers in the walls of arteries and corpus cavernosum penis. As a result, the penis and erectile tissues fill with arterial blood, increasing in size - there is an erection. When sexual arousal decreases, the muscles in the cavernous bodies are reduced and squeezed out their blood like water from a sponge - there comes an end to an erection. Substance which gives the order to relax the muscles, called acetylcholine. It is rapidly destroyed special enzyme. When rats were injected substances, suspending the operation of this enzyme, they copulate for hours. However, these substances act indiscriminately. American scientists have proposed another solution to this problem. In 1998 he was awarded the Nobel Prize in Medicine for his discovery of special chemical link between acetylcholine and muscle. This nitric oxide, which ensures the formation of substances that lead to relaxation of the muscles of the corpora cavernosa and the erection. Now, pharmacologists were able to manage this process.
At what age erections appears and disappears when the norm?
The first physiological erection occur in boys as early as 5-6 years and are not affiliated with erotic feelings. Then erection become more frequent, and during puberty, they are already there as a sign of attraction to the opposite sex. Maximum capacity for erection in men about 20 years old, then it gradually decreases, but completely disappears each in its time - someone is saved up to 90 years old, someone lost and after 40 years.
What diseases lead to the loss of capacity for erection?
First alcoholism, because in large doses alcohol acts detrimental to the ability to erect. The same thing - drugs, especially cocaine, ecstasy, fenamin: they are for a short time increase the potency, but just a few tricks "turning off" her. Reduces the potency and prostate, and diabetes, and some hormonal diseases, as well as sclerosis of the vessels, especially vessels of the lower extremities. The same happens if, without the doctor's advice begin taking male sex hormones - their excess acts exactly the opposite way. Bad affects depression, anxiety, waiting for some kind of trouble.
When there is a breakdown of erection?
In young people's erection during first sexual intercourse is often disrupted due to excessive excitation. The more the young person wants to close, the harder erection occurs. And here it is important to conduct discreet women - for some reason in itself, in that it is something not said or done. If something does not work after repeated contacts - can be suspected pathology. In general, individual women is not so much to men in 20 years, but the older he gets, the more important it becomes for her individuality.
How does an erection on the intensity of sexual activity?
Bad affects any deviation from the norm - as the excess and deficiency. It is known that long periods - several months - reduce erections. There is even a concept such as "impotence of seafarers. On the other hand, 7-8 sex acts a week, too, can reduce the potency.
What may be considered normal sexual life?
Everyone, of course, it is ours. But the average family man is 2.3 sexual intercourse per week. Minimum normal frequency - once every two weeks.
Is the ability to conceive with erection?
Not directly. The man making the peak of sex hormones is achieved by 30 years, and the potency of this time is reduced, albeit very slowly. The ability to conceive remains much longer. Although, if infertility due to lack of sex hormones may be impaired and erection.
How does physical activity?
Moderate exercise increases the potency, excessive - decreases. The fault is not only fatigue. Building strong muscles "takes" a lot of sex hormones, resulting in reduced potency. This is to remember those who are keen on bodybuilding.
Does the capacity for erection of nationality?
It is known that Southerners easily and quickly excited, but can not long retain an erection. Northerners - the opposite.