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Preservation of penile length after radical prostatectomy: early intervention with a vacuum erection device


Radical prostatectomy has been shown to have a potential negative impact on penile health. Stretched penile length (SPL), which most closely correlates with erect penile length, was significantly reduced in almost half of men undergoing surgery in several studies. The purpose of this study was to test whether early intervention after surgery with a vacuum erection device could prevent the changes in penile health, as defined by SPL, found in prior studies. Forty-two men with good preoperative sexual function undergoing nerve-sparing radical prostatectomy underwent measurement of SPL preoperative and at 3 months postoperative by a single investigator. Daily use of a vacuum erection device (VED) was begun the day after catheter removal, and continued for 90 days. Men kept a log of their compliance with daily VED use. A decrease in SPL of 1.0 cm was considered significant. Out of 42 men, 39 completed the study. In men who used the VED >50% of possible days, only 1/36 (3%) had a decrease in SPL of 1.0 cm. Of the three men with poor VED compliance, two (67%) had a reduction in SPL of 1.0 cm. When compared to prior studies where 48% of men after surgery had a significant reduction in SPL, early intervention with the daily use of a VED resulted in a significantly lower risk of loss of penile length (P<0.0001). For men wishing to preserve penile health/length after surgery, early intervention with the daily use of a VED should be strongly recommended.

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Correspondence to B L Dalkin.

Appendix 1

Appendix 1

Penile health study: use of the VED

  1. 1

    Assemble the handle to the tube with the writing on the tube facing up, and the lever on the handle facing down.

  2. 2

    Put lubricant in the bottom of the tube where your penis will be, then around the outside edge of the tube where it will contact your skin.

  3. 3

    You may need to trim the pubic hair at the base of the penis to give a better seal for the tube.

  4. 4

    Use the pump either standing up or sitting forward on the edge of a chair to allow the scrotum skin to hang down out of the way.

  5. 5

    Gently but firmly compress the tube against yourself to create a nice seal to then begin pumping.

  6. 6

    Begin pumping by compressing the handle once every several seconds to allow for a slow engorgement of the penis.

  7. 7

    Continue until the penis is fully engorged, usually when it elevates off the floor of the cylinder and is in the middle of the tube.

  8. 8

    Leave the penis fully engorged inside the pump for 5 min. Then let the penis deflate fully for 1–2 min and repeat to full engorgement for another 5 min.

  9. 9

    Perform daily beginning the day after your catheter is removed from your bladder.

  10. 10

    There is a safety regulator in the system that prevents you from creating too much pressure to injure yourself.

Feel free to use the VED for sexual intercourse as well. This involves the use of the constriction bands, which is reviewed in the manual with the VED.

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Dalkin, B., Christopher, B. Preservation of penile length after radical prostatectomy: early intervention with a vacuum erection device. Int J Impot Res 19, 501–504 (2007).

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