The resurgence of the vacuum erection device (VED) for treatment of erectile dysfunction.

Background: Vacuum 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.

Objective: This 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.

Methods: A retrospective review of publications relevant to the field of VEDs. Methods: Review of the historical milestones, evolution, and modern utilization of VEDs in modern urological protocols.

Results: Studies 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.

Conclusions: The 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.