The Resurgence of the Vacuum Erection Device (VED) for Treatment of Erectile Dysfunction

IntroductionVacuum erection devices (VEDs) have been approved in the United States since 1982 and offer a viable alternative to oral phosphodiesterase type 5 inhibitors (PDE5i), injections and transurethral suppositories. Studies have demonstrated efficacy in erectile dysfunction (ED) associated with a variety of conditions. More recently, this modality has been evaluated in initial phosphodiesterase inhibitor nonresponders as well as for post‐prostatectomy penile rehabilitation.AimThis article provides a detailed overview of the history of VEDs, a review of the literature, and a concise description of their new applications in modern urological practice.MethodsA retrospective review of publications relevant to the field of VEDs.Main Outcome MeasuresReview of the historical milestones, evolution, and modern utilization of VEDs in modern urological protocols.ResultsStudies have demonstrated efficacy in ED associated with a variety of conditions. Early penile rehabilitation after surgery for prostate cancer with the VED appears to improve erectile function and penile length. Adverse events are transient and not serious.ConclusionsThe VED has continued to show efficacy for treatment of ED due to various etiologies and should be considered an attractive second‐line therapy. In select cases such post‐prostatectomy penile rehabilitation, as well as in men who cannot use a PDE5i, the vacuum device should be considered first‐line treatment.