Vacuum erectile device (VED) is 1 of the main approved therapies for erectile dysfunction (ED). The introduction of phosphodiesterase type 5 inhibitor (PDE5i) for ED significantly changed the roles of VED in contemporary sexual medicine.
To provide updated clinical evidence to inform health care providers on best practices with VED.
A consensus panel was held with leading sexual medicine experts during the 5th International Consultation on Sexual Medicine (ICSM). Relevant peer-reviewed literature was reviewed with focus on research from the last 10 years, but not limited to the last 10 years. The expert panel generated consensus statements based on the quality of evidence and criteria of Grading of Recommendations Assessment, Development and Evaluation.
As a primary or combination therapy for ED, VED has been shown to be successful in all populations studied, including difficult to treat cohorts, such as diabetes mellitus, spinal cord injury, and post-radical prostatectomy (RP), but long-term attrition rates are high. Available evidence has shown that VED can preserve or restore penile size for patients after RP, after incision and grafting surgery for Peyronie's disease, before and after penile prosthesis, and after other post pelvic surgeries. However, it has not demonstrated a more rapid recovery of spontaneous erectile function after RP. VED does not increase penile length for subjective short penis. Studies with female specific VED for female sexual dysfunction are very limited.
Since the prior 4th ICSM, more evidence is available to support the new roles of VED in contemporary sexual medicine. Research into the penile pathophysiologic changes with VED therapy and clinical outcomes for various conditions are ongoing. We encourage sexual medicine clinicians to follow the 5th ICSM recommendations, but providers should also use their own judgement and adopt shared decision making with their patients/partners when considering VED for a specific disorder.
Sexual medicine reviews. 2025 Feb 17 [Epub ahead of print]
Run Wang, Francisco E Martins, David Ralph, Georgios Hatzichristodoulou, Daniar Osmonov, Justin Parker, Sung Hun Sean Park, Ignacio Moncada, Carlo Bettocchi, Ricardo Munarriz, Tobias Köhler
Department of Urology, University of Texas MD Anderson Cancer Center and McGovern Medical School at Houston, Houston, TX 77030, United States., Department of Urology, University of Lisbon, School of Medicine, Santa Maria Hospital, Lisbon 1169-028, Portugal., Department of Urology, University College London Hospitals and St Peter's Andrology, London W1G 6AA, United Kingdom., Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg 90491, Germany., Department Urology, University Medical Center Schleswig Holstein, Campus Lübeck, Lübeck 23562, Germany., Department of Urology, Bay Pines VA Health System and University of South Florida College of Medicine, Tampa, FL 33744, United States., Sewum Prosthetic Urology Center of Excellence for Penile Implants, South Korea and Department of Urology, Ajou Universtiy School of Medicine, Suwon 206 KR, South Korea., Department of Urology, Hospital La Zarzuela, Universidad Francisco de Vitoria, Madrid 28023, Spain., Andrology and Male Genitalia Reconstructive Surgery, Department of Urology, University Hospital Foggia, 71122 Foggia FG, Italy., Department of Urology, Boston University School of Medicine Chobanian and Avedisian School of Medicine, Boston, MA 02118, United States., Department of Urology, Mayo Clinic, Rochester, MN 55905, United States.