Vacuum therapy (VT) utilizes negative pressure to distend the
corporal sinusoids and to increase the blood inflow to the penis.
Depending on its purpose, VT could be categorized as vacuum
constriction device (VCD) and vacuum erectile device (VED).
In VCD, an external constricting ring is placed at the base of
the penis to prevent blood outflow, maintaining the erection
for sexual intercourse. In VED, no constriction ring is used; the
object is increasing blood oxygenation to the corpora cavernosa
and for other purposes.
To VCD, more focus is on its usage other than its underlying
mechanism, although there were few researches to explain its
negative pressure range and ischemic condition. To VED, as
one of the three clinical used penile rehabilitation methods,
especially with more and more clinical reports supporting its
efficacy, exploring its underlying mechanisms and optimizing
its regimen are becoming the unavoidable task, although
historically there were a few literatures revealed its beneficial
mechanism. Recently, the rat VED had been created and applied
on the bilateral cavernous nerve crush rat model. The underlying
primitive molecular mechanisms were revealed by our group.
The further mechanism and optimal protocol were under
With the better understanding of VED mechanisms
and optimized regimen, VED, as the centerpiece of penile
rehabilitation protocol for post-prostatectomy/pelvic injuries,
will be accepted more widely in clinic. Along with VCD, VT will
be an indispensable modality in the urological armamentarium
for the management of ED and related conditions.