TCAS 08. Vacuum therapy in ED;Basical and clinical

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 investigation.

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.