Connect with a U.S. licensed healthcare provider about ED, hair loss, skincare, and more. Start now.

Feb 12, 2021
6 min read

Different types of penis pumps for erectile dysfunction

For many men who can’t take PDE5 inhibitors, the next step may be to use what’s commonly known as a penis pump. Two different devices have this nickname. The first is what’s known as a vacuum constriction device (VCD). The second, which is much less common, is a penile implant.

steve silvestro

Reviewed by Steve Silvestro, MD

Written by Seth Gordon

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

What is erectile dysfunction?

In a broad sense, erectile dysfunction (ED) is when a man cannot achieve or maintain an erection hard enough for sexual intercourse (Sooriyamoorthy, 2020). In some cases, it is a symptom of another medical condition or the side effect of a medication. In other cases, it simply happens on its own.

ADVERTISEMENT

Start your free visit for ED treatment

A real, U.S.-licensed healthcare professional will review your information and get back to you within 24 hours.

Learn more

Whichever way it happens, whether the cause is known or unknown, ED can be a heavy burden to carry for a sexually active man. Studies have suggested men with ED are almost three times more likely to have depression, and those with depression are 39% more likely to develop ED than those without (Liu, 2018). This can create a terrible feedback loop for some sufferers.

But know if it happens to you, you’re not alone: data suggests that over half of men between the ages of 40 and 70 have experienced ED (Feldman, 1994). And luckily, it’s highly treatable. Because ED can be caused by an underlying medical condition or side effect of a drug, the first step for many men is to work with their healthcare provider to identify and address the trigger.

In some cases, a little extra help is necessary. One’s ED could be the side effect of medication that simply can’t be substituted. It may be the result of prostatectomy or other prostate surgery, after which it can take some time for normal erectile function to return. 

In these cases, if a man is healthy enough for sexual activity, the next step is often medication. The typical ones prescribed are called phosphodiesterase type 5 (PDE5) inhibitors (Rew, 2016). These include sildenafil (brand name Viagra; see Important Safety Information), tadalafil (brand name Cialis; see Important Safety Information), vardenafil (brand name Levitra), and avanafil (brand name Stendra). In many cases, one of these will relieve the ED.

Some men, though, can’t take PDE5 inhibitors. There are several reasons for this. For some, there could be an adverse interaction with another drug they’re taking, such as nitrates. They may have a health condition that makes their use dangerous or an allergy to one of its ingredients. For others, ED medications simply don’t work well enough.

In many cases, for these men, the next step is what’s commonly known as a penis pump. Now, two different devices have this nickname. The first is what’s known as a vacuum constriction device (VCD). The second, which is much less common, is a penile implant. We’ll talk about each in turn.

Vacuum therapy

Erections are complicated. Many parts of your body, including your brain, blood vessels, and nerves, are involved in making this one thing happen. In the simplest terms, erections come about in two different ways. You can develop an erection in response to something you see, hear, or smell, or you can develop one in response to physical stimulation of the penis or other parts of the body (Miller, 2000).

Whatever may trigger it, once set in motion, a series of events occur that cause increased blood flow into the penis and less blood to flow out of it, resulting in an erection. If you’re suffering from ED, something is getting in the way of that process. An ED vacuum pump works by essentially bypassing the first parts of this process.

Vacuum constriction devices (VCDs), also called vacuum erection devices (VED), work by “forcing” an erection. The patient places a plastic tube over the penis and uses a vacuum pump to pull blood into it. Once the penis is erect, a constriction ring is slid off the end of the tube and placed around the base of the penis. This keeps the blood in the penis and maintains the erection until the ring is removed (Rew, 2016).

The concept of using suction to create an erection isn’t new. It’s one of the oldest treatments for ED we have. It was first conceived by Dr. John King in 1874, though it wasn’t until 1917 when another doctor, Otto Lederer, thought of adding a constriction ring (Hoyland, 2013).

But it was a man named Geddings Osbon, a tire manufacturer whose education ended after grade school, who truly brought modern ED pumps to the world. After being told by his doctor there was nothing he could do to regain intimacy with his wife, he spent 14 years applying his mechanical knowledge to creating a device for himself.

In 1974, Osbon’s “Youth Equivalent Device” hit the market, and despite initially being seen as only a marital aid, was approved by the FDA in 1982. By the early 1990s, it was the most commonly prescribed treatment for erectile dysfunction (Hoyland, 2013).

A VCD can be awkward and take some acclimation. You might need to shave some pubic hair in order to get a proper seal around the base of your penis. It can sometimes take a few minutes to develop an erection, which some men find breaks the mood. And there’s no secret or subtle way to use one. Many men may be sensitive about using one in front of their sexual partner.

However, there is growing evidence that VCDs may be effective at penile rehabilitation for men with certain conditions. Some men who experienced erection problems after prostate surgery and then used a VCD daily were eventually able to achieve natural erectile function, with erections hard enough for intercourse again (Qian, 2016).

Side effects of vacuum constriction devices

There can be potential side effects and complications when using VCDs. One should not wear the constriction ring for more than 30 minutes or injury can occur. If too tight, the constriction ring can close off the urethra and block ejaculation. Because the tissue directly behind the ring does not get hard, for some men, this creates a “hinged” penis that, while erect, doesn’t stick out from the body at the typical angle. It can require some manual manipulation when starting intercourse (Lehrfeld, 2009). 

You should not use a vacuum constriction device if:

  • You have sickle cell anemia
  • You have a history of prolonged, painful erections, also known as priapism
  • You are taking large quantities of aspirin
  • You are taking anticoagulants (blood thinners) such as warfarin (brand name Coumadin)

The above increase the risk of bleeding issues when using a vacuum pump (FDA, 2018).

Do not use a VCD under the influence of alcohol or drugs, as they can impair judgment and dull pain, risking penile injury. If one passes out or falls asleep while wearing the constriction ring, it could cause permanent damage to the penis. And while it should go without saying, never use an electric pump near water due to risk of electrocution. That’s not the kind of charge you’re looking for. 

One should not use a VCD that is not approved by the FDA. There are guidelines manufacturers must meet for FDA approval, including vacuum limiters and manual safety releases on the tube and constriction ring (FDA, 2018). There are numerous unapproved penis pumps out there, often marketed with untrue snake-oil claims of penile enlargement. Using one without safety features is taking one’s penile health into their own hands. Don’t be fooled by words like “medical” or “clinical” on packaging, they don’t mean the device has FDA approval.

Talk to your healthcare provider or urologist before purchasing one and follow their medical advice, as they’ll know the legitimate brands and suggest some options for you. Approved brands include Osbon, Encore Deluxe, Pos-T-Vac, and a number of others. In some cases, with a prescription, your insurance might even cover the cost.

Penile implant pumps

The other type of penile pump device, the inflatable penile prosthesis (IPP), is less complicated because they’re relatively simple to use once in place. You can’t simply go out and buy one off the shelf, though. Typically they’re made from two or three surgically implanted silicone balloons placed in the shaft of the penis. When inflated, they simulate an erection. Prostheses such as these are the final steps when non-surgical methods have failed.

Inflatable penile implants aren’t filled with air from outside but are closed systems. The implants fill with a sterile saline solution that is stored in a reservoir. A user pumps the liquid from this reservoir to the main chambers and presses a hidden release valve to return it. Early versions in the 1970s malfunctioned often. But silicone technology has come a long way since then, modern versions have a high success rate, and leakage is rare (Chung, 2017).

If you suffer from ED and haven’t responded to the usual first-line therapies, don’t fret. There are many other options to explore with your healthcare provider, and pumps (both kinds) have shown great effectiveness for many men in the same situation.

References

  1. Chung, E. (2017). Penile prosthesis implant: Scientific advances and technological innovations over the last four decades. Translational Andrology and Urology, 6(1), 37–45. doi: 10.21037/tau.2016.12.06. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28217449/ 
  2. Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & Mckinlay, J. B. (1994). Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54-61. doi:10.1016/s0022-5347(17)34871-1. Retrieved from https://pubmed.ncbi.nlm.nih.gov/8254833/
  3. Hoyland, K., Vasdev, N., & Adshead, J. (2013). The use of vacuum erection devices in erectile dysfunction after radical prostatectomy. Reviews in Urology, 15(2), 67–71. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24082845/ 
  4. Lehrfeld, T., & Lee, D. I. (2009). The role of vacuum erection devices in penile rehabilitation after radical prostatectomy. International Journal of Impotence Research, 21(3), 158–164. doi: 10.1038/ijir.2009.3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19225465/ 
  5. Liu, Q., Zhang, Y., Wang, J., Li, S., Cheng, Y., Guo, J., Tang, Y., Zeng, H., & Zhu, Z. (2018). Erectile dysfunction and depression: A systematic review and meta-analysis. The Journal of Sexual Medicine, 15(8), 1073–1082. doi: 10.1016/j.jsxm.2018.05.016. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29960891/ 
  6. Miller, T. A. (2000). Diagnostic evaluation of erectile dysfunction. American Family Physician, 61(1), 95–104, 109–110. Retrieved from https://pubmed.ncbi.nlm.nih.gov/10643952/
  7. Qian, S.-Q., Gao, L., Wei, Q., & Yuan, J. (2016). Vacuum therapy in penile rehabilitation after radical prostatectomy: Review of hemodynamic and antihypoxic evidence. Asian Journal of Andrology, 18(3), 446–451. doi: 10.4103/1008-682X.159716. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26289397/ 
  8. Rew, K. T., & Heidelbaugh, J. J. (2016). Erectile dysfunction. American Family Physician, 94(10), 820–827. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27929275/ 
  9. Sooriyamoorthy, T., & Leslie, S. W. (2020). Erectile dysfunction. In: StatPearls [Internet]. Retrieved on Feb. 12, 2021 from https://pubmed.ncbi.nlm.nih.gov/32965924/ 
  10. U.S. Food and Drug Administration (FDA) (2018), External Penile Rigidity Devices – Class II Special Controls Guidance Document for Industry and FDA Staff (OMB 0910-0485) Washington, DC. Retrieved from https://www.fda.gov/medical-devices/external-penile-rigidity-devices-class-ii-special-controls-guidance-document-industry-and-fda-staff