Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function


To assess the efficacy of vacuum constriction devices (VCD) following radical prostatectomy (RP) and determine whether early use of VCD facilitates early sexual activity and potentially earlier return of erectile function. This prospective study consisted of 109 patients who underwent nerve-sparing (NS) or non-nerve-sparing (NNS) RP between August 1999 and October 2001 and developed erectile dysfunction following surgery. The patients were randomized to VCD use daily for 9 months (Group 1, N=74) or observation without any erectogenic treatment (Group 2, N=35). Treatment efficacy was analyzed by responses to the Sexual Health Inventory of Men (SHIM) (abridged 5-item International Index of Erectile Function (IIEF-5)), which were stratified by the NS status. Patient outcome regarding compliance, change in penile length, return of natural erection, and ability for vaginal intercourse were also assessed. The mean patient age was 58.2 years, and the minimum follow-up was 9 months. Use of VCD began at an average of 3.9 weeks after RP. In Group 1, 80% (60/74) successfully used their VCD with a constriction ring for vaginal intercourse at a frequency of twice/week with an overall spousal satisfaction rate of 55% (33/60). In all, 19 of these 60 patients (32%) reported return of natural erections at 9 months, with 10/60 (17%) having erections sufficient for vaginal intercourse. The abridged IIEF-5 score significantly increased after VCD use in both the NS and NNS groups. After a mean use of 3 months, 14/74 (18%) discontinued treatment. In Group 2, 37% (13/35) of patients regained spontaneous erections at a minimum follow-up of 9 months after surgery. However, only four of these patients (29%) had erections sufficient for successful vaginal intercourse and rest of patients (71%) sought adjuvant treatment. Of the 60 successful users, 14 (23%) reported a decrease in penile length and circumference at 9 months (range, 4–8 months) compared to 12/14 (85%) among the nonresponders. However, in control group 22/35 reported decrease in penile length and circumference. Early use of VCD following RP facilitates early sexual intercourse, early patient/spousal sexual satisfaction, and potentially an earlier return of natural erections sufficient for vaginal penetration.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout


  1. Walsh PC, Marschke P, Ricker D, Burnett AL . Patient – reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000; 55: 58–61.

    Article  CAS  Google Scholar 

  2. McCullough AR . Management of erectile dysfunction following radical prostatectomy. Sexual Dysfunction Med Pfizer 2000; 2(1): 2–8.

    Google Scholar 

  3. Catalona WP, Basler JW . Return of erections and urinary continence following nerve-sparing radical retropubic prostatectomy. J Urol 1993; 150: 905–907.

    Article  CAS  Google Scholar 

  4. Quinlan DM, Epstein JI, Carter BS, Walsh PC . Sexual function following radical prostatectomy: influence of preservation of neurovascular bundles. J Urol 1991; 145: 998–1002.

    Article  CAS  Google Scholar 

  5. Zippe CD, Thukral M, Klein EA, Kedia S, Pasqualotto FF, Kedia A et al. Erectile dysfunction following radical prostatectomy in a pre-operative sexually active population. Poster Presentation at 95th Annual Meeting of AUA, Atlanta, GA, April 29–May 4, 2000.

  6. Fraiman MC, Lepor H, McCullough AR . Changes in penile morphometrics in men with erectile dysfunction after nerve-sparing radical prostatectomy. Mol Urol 1999; 3: 109–115.

    CAS  PubMed  Google Scholar 

  7. Zippe CD, Raina R, Thukral M, Lakin MM, Klein EA, Agarwal A . Management of erectile dysfunction following radical prostatectomy. Cur Urol Rep 2001; 2: 495–503.

    Article  CAS  Google Scholar 

  8. Zippe CD, Jhaveri FM, Klein EA, Kedia S, Pasqualotto FF, Kedia A et al. Role of viagra after radical prostatectomy. Urology 2000; 55: 241–245.

    Article  CAS  Google Scholar 

  9. Padma-Nathan H, McCullough AR, Giuliano F, Bicetre LK, Toler SM, Wohlhuter C et al. Postoperative nightly administration of sildenafil citrate significantly improves the return of normal spontaneous erectile function after bilateral nerve sparing radical prsotatectomy. J Urol 2003; 169: 375 (abstract #1402).

    Article  Google Scholar 

  10. Cookson MS, Nadig PW . Long term results with vacuum constriction device. J Urol 1993; 149: 290–294.

    Article  CAS  Google Scholar 

  11. Dutta TC, Eid JF . Vacuum constriction devices for erectile dysfunction: a long-term, prospective study of patients with mild, moderate, and severe dysfunction. Urology 1999; 54(5): 891–893.

    Article  CAS  Google Scholar 

  12. Colombo F, Cogni M, Deiana G, Mastromarino G, Vecchio D, Patelli E et al. Vacuum therapy. Arch Ital Urol Nephrol Androl 1992; 64: 267–269.

    CAS  Google Scholar 

  13. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J . The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile function. Urology 1997; 49: 822–830.

    Article  CAS  Google Scholar 

  14. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM . Development and evaluation of an Abridged 5-Item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  Google Scholar 

  15. Montorsi F, Guazzoni G, Strambi LF, Da Pozzo LF, Nava L, Barbieri L et al. Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective, randomized trial. J Urol 1997; 158: 1408–1410.

    Article  CAS  Google Scholar 

  16. Derouet H, Caspari D, Rohde V, Rommel G, Ziegler M . Treatment of erectile dysfunction with external vacuum devices. Andrologia 1999; 3: 89–94.

    Google Scholar 

  17. Levine LA, Dimitriou RJ . Vacuum constriction and external erection devices in erectile dysfunction. Urol Clin N Am 2001; 28: 335–341.

    Article  CAS  Google Scholar 

  18. Sidi AA, Becher EF, Zhang G, Lewis JH . Patient acceptance of and satisfaction with an external negative pressure device for impotence. J Urol 1990; 144: 1154–1156.

    Article  CAS  Google Scholar 

  19. Althof SE . When an erection alone is not enough: biopsychosocial obstacles to lovemaking. Int J Impot Res 2002; 14: S99–S104.

    Article  Google Scholar 

  20. Rodriguez VL, Gonzalvo IA, Bono AA, Benejam GJ, Cuesta Presedo JM, Rioja Sanz LA . Erectile dysfunction after radical prostatectomy. etiopathology and treatment. Acta Urol Esp 1997; 21: 909–921.

    Google Scholar 

  21. Chen RN, Lakin MM, Montague DK, Ausmundson S . Prostaglandin E1 injection therapy for post-prostatectomy impotence: an outcome analysis. J Urol 1996; 155: 639.

    Article  Google Scholar 

  22. Evans C . Complications of intracavernosal therapy for impotence. In: Carson C, Kirby R, Goldstein I (eds), Textbook of Erectile Dysfunction. Oxford: Isis Medical Media, 1999, pp. 365–370.

    Google Scholar 

  23. McAuley IW, Kim NN, Min K, Goldstein I, Traish AM . Intracavernosal sildenafil facilitates penile erection independent of the nitric oxide pathway. J Androl 2001; 22: 623–628.

    CAS  Google Scholar 

  24. Medina P, Segarra G, Vila JM, Domenech C, Martinez-Leon JB, Lluch S . Effects of sildenafil on human penile blood vessels. Urology 2000; 56: 539–543.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to R Raina.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Raina, R., Agarwal, A., Ausmundson, S. et al. Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function. Int J Impot Res 18, 77–81 (2006).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


This article is cited by


Quick links