The vacuum constriction device consists of a plastic cylinder connected directly or by tubing to a vacuum-generating source (manual or battery-operated pump). After the penis is engorged by the negative pressure, a constricting ring is applied to the base to maintain the erection. To avoid injury, the ring should not be left in place for longer than 30 min.

The erection produced by a vacuum device is different from a physiologic erection or one produced by intracavernous injection. The portion of the penis proximal to the ring is not rigid, which may produce a pivoting effect. The penile skin may be cold and dusky, and ejaculation may be trapped by the constricting ring. The ring can be uncomfortable or even painful. However, in many patients the device can produce an erection that is close to normal and with rigidity sufficient for coitus. The device also engorges the glans and is useful for patients with glanular insufficiency. In patients with severe vascular insufficiency, the device may not produce adequate erection. In these cases, combining intracavernous injection with the vacuum constriction device may enhance the erection.

Complications include penile pain and numbness, difficult ejaculation, ecchymosis, and petechiae. Patients taking aspirin or warfarin sodium (Coumadin) should exercise caution when using these devices.

The patient’s satisfaction rate has been reported to range from 68% to 83% (_{Cookson and Nadig, 1993}). The device is more acceptable to older men in a steady relationship than to young single men in search of a partner. It is safe when used properly and is one of the least costly treatment options available.