Other Treatment

Other treatments for erection problems (erectile dysfunction) include vacuum devices, external penile splints, and counseling (psychotherapy).

Other Treatment Choices

• Vacuum devices are useful for all types of erection problems—physical, psychological, or both. The device has a tube you place around the penis. You pump the device to create a vacuum that leads to an erection. Then you place a band around the base of the penis to maintain the erection for up to 30 minutes.
• Counseling (psychotherapy) is recommended for men whose erection problems are caused, at least in part, by psychological factors. It may include sex therapy, which focuses on methods to improve attitudes toward sex and specific sexual techniques. Counseling also may be used with medication treatment or vacuum devices for erection problems that have psychological and physical causes.
• External penile splints may be another nonsurgical option. External penile splints are mechanical supports that “hold up” the penis. Although penile splints have been available for years, they have not often been used because they covered much of the penis or resulted in painful intercourse. Their advantages are that they are noninvasive, inexpensive, and often reusable. More recent penile splints do away with many of the old problems. However, they must be sized to each man and are best used by those who are capable of partial erection.

What To Think About

Some men take the amino acid L-arginine as a dietary supplement to try to treat erection problems. The amino acid increases the amount of nitric oxide, which relaxes blood vessels; theoretically, L-arginine could improve erections. However, there is little scientific evidence that it is effective for this purpose. 

No matter what approach you use to treat an erection problem, including your partner in the decision is helpful and may improve results.

A vacuum device, which is sometimes used to treat erection problems (erectile dysfunction), is a tube made of plastic that fits around the penis. You coat the base of the penis with lubricant and insert it into the tube. Air is pumped out of the tube, which creates a vacuum. The vacuum helps blood flow into the penis, producing an erectionlike state in about 5 minutes. A constrictive band is placed around the base of the penis to maintain the erection, and the tube is removed.

See an illustration of a vacuum device below

The constrictive band may be left in place for up to 30 minutes. If you want the erection to last longer, you may remove the band for a few minutes and then repeat the process.

Vacuum devices block ejaculation. You still have an orgasm but do not ejaculate (release semen).

Some men say the erection is “wobbly” or has a “hingelike” feeling, since the tissues beneath the ring on the base of the penis don’t get hard. A small number of men consider this a major problem, and it may make penetration difficult.

A prescription is not needed to buy these devices. They are reusable and should be cleaned after each use.

What To Expect After Treatment

The device usually produces an erection, which goes away when the constrictive band is removed.

Why It Is Done

Most men who have erection problems from physical causes can use vacuum devices. Men who have erection problems because of psychological causes may also use these devices.

These devices can be used by men who take medications to prevent blood clots (anticoagulants, such as warfarin [Coumadin]).

How Well It Works

Studies indicate that more than 90% of men using these devices are able to get an erection that is satisfactory for sexual intercourse. 

Most men and their partners are satisfied with the device and the quality of the erections. Studies have reported satisfaction rates ranging from 70% to 94%. However, some studies report that only 26% to 30% of men are satisfied with the erections they receive from a vacuum device. 

Most men who stop using the vacuum device do so for a variety of reasons, including inconvenience and interruption of foreplay (the man has to take a brief “time-out” to use the device to get an erection). Your satisfaction with the device may be better if you meet with a representative of the manufacturer who can show you how to use the device correctly. Your doctor can arrange a meeting.

Regular use may improve success and satisfaction. Most men who use the device successfully for 3 months continue to use it. With regular use, the time it takes to get an erection decreases.

Men who have erection problems from psychological factors may regain the ability to have unaided erections after using the device for a time.

The cause of the erection problem (blood vessel, nerve, or psychological) does not appear to affect the results. The device also may produce erections in men who have had a failed penile implant.

Risks

The risk of side effects is low and they are usually minor. Possible problems may include:

• Bruising.
• Pain or discomfort.
• Numbness or loss of sensitivity. This occurs occasionally in about half of men but is a major problem for only a few men.
• A sensation that the penis is cold.
• Pinching scrotal tissue in the device.

No significant side effects or complications have been reported.

What To Think About

Be sure to discuss using a vacuum device with your partner. It is important that both of you have realistic expectations of what the device can do. The vacuum device gives you an erection that may be suitable for sexual intercourse but is not the same as a normal erection.

A trial period at home is helpful. The device can be difficult to learn to use, and about four tries are needed to learn to use it successfully.

Some men find the band around the base of the penis distracting or irritating during sex. Also, the band may prevent ejaculation.