Matthew Wosnitzer (Matthew Wosnitzer) is a urology surgeon and physician scientist certified by the committee. He specializes in male infertility.

The penis pump is a mechanical device that can help treat erectile dysfunction (ED). Also known as a vacuum pump or vacuum erection device, its working principle is to create a vacuum and draw blood into the penis to help achieve and maintain the erection required for sex.

Depending on the severity of the condition, the penis pump can be used with or without ED drugs such as Viagra and Cialis. The pump is usually used in conjunction with an erectile dysfunction ring ("penis ring"), and once the erection is complete, it helps to keep blood in the penis.

Although the penis pump cannot cure ED, it can help improve the quality of erections and the sex life of people living with this very common disease.

This article explains the working principle of the penis pump, the expected results, and the risks and limitations of this potentially useful device.

When people hear the term "penis pump", the first thing they think of is penis enlargement. Moreover, although people often buy the device to enlarge their penis, it has more practical uses for ED patients.

For people with ED, the goal is not to enlarge the penis—which the device really cannot do—but to promote erection when there is a problem that prevents blood from flowing into the penis.

Although people often buy novel devices online or in sex shops, there are also medically approved vacuum erection devices (VED) that have built-in protections to prevent penile injuries. Some VEDs work with hand pumps, while others are battery-powered and have digital pressure readings to limit the amount of negative pressure the penis can withstand.

Erection involves a complex interaction of emotions, nerves, hormones, blood vessels and smooth muscles, which work together to congest the penis and prevent blood backflow (venous leakage).

There are two tubular structures in the penis, called the cavernous bodies, which extend along the length of the organ. During sexual arousal, these spongy bodies relax, allowing blood to flood in and flood the tissues.

When the penis swells, it squeezes the fibrous tissue band at the base of the penis, called the albuginea, tightening it and preventing blood from flowing out.

In people with ED, there are many conditions that can interfere with these processes. Many are related to aging-which is why 40% of more than 40% of men and 70% of more than 70% of men have ED-while others do not.

Common causes and risk factors of ED include:

The penis pump is one of several tools your doctor may recommend to help treat ED. It is usually used in combination with ED drugs called phosphodiesterase inhibitors (PDE5 inhibitors).

PDE5 inhibitors are a group of drugs commonly used in the first-line treatment of ED. They work by expanding the cavernous body and making erections through sexual stimulation. There are five PDE5 inhibitors approved for the treatment of ED:

There are also drugs like Caverject (alprostadil) injected into the penis to expand the blood vessels in the cavernous body. There is also a drug called Muse (urogenital alprostadil), which can be inserted into the urethra. If PDE5 inhibitors are ineffective or cannot be used, these can be considered.

Lifestyle changes, such as exercise, weight loss and smoking cessation, can greatly improve the erection of some people, especially young people. In some cases, counseling and testosterone replacement therapy may be recommended.

If the ED is mild, the penis pump may be all you need to achieve an erection. It is usually used with an ED ring ("cock ring"), which is installed at the base of the penis behind the scrotum. This helps support the albuginea by preventing the backflow of blood.

When all conservative treatments fail, surgery can be explored. Options include arterial revascularization to increase blood flow to the penis, venous surgery to help retain blood during erection, and inflatable or solid penile implants that can be inflated or bent as needed.

The penis pump is very effective for many ED patients, but it is not suitable for everyone. As with all medical treatments, there are pros and cons.

The advantages of penis pumps are many, including ease of use and relatively fast erections. Studies have shown that even people with nerve damage after prostatectomy can get an erection through a pump, usually within two to three minutes.

The penis pump is also reusable and cost-effective. They are a good choice for people who cannot use PDE5 inhibitors, such as those with a history of stroke or heart disease, or those who take nitrate or nitroglycerin.

In addition, they can be incorporated into foreplay and are more "on demand" than PDE5 inhibitors. Many people with ED may be able to maintain an erection for 30 minutes or more. Those who are unable to reapply the device to restore erection.

According to a review published in the Journal of Urology in 2018, 6 studies involving ED patients using penile pumps reported satisfaction rates of 80% or higher, while 11 reports reported satisfaction rates of 60% or higher.

Except for bleeding disorders such as hemophilia or coagulation disorders such as sickle cell disease, there are almost no contraindications to the penis pump. Patients with ischemic priapism (recurrent priapism with abnormally prolonged erections) may also be advised to avoid the device.

People taking blood thinners such as warfarin and antiplatelet drugs such as Plavix (clopidogrel) should consult a doctor before using a penis pump, as suction may cause bruising and bleeding.

Even people who do not have these problems may encounter problems. A more common type is petechiae, which is a red skin spot caused by broken capillaries. This is usually due to excessive pumping of the equipment or opening it for too long. Others complain of pain or a cold or blue penis.

Some people, especially the elderly, may find that the penis becomes unstable after aspiration and twists at the root when trying to have sex.

Before using the penis pump, please consult your doctor to make sure that it is the right choice for you and that you are using it correctly.

If you have ED, you can choose to buy a novel penis pump, but it may be safer to use a vacuum erection device (VED) prescribed by a urologist. Some doctors also refer to them as vacuum constriction devices (VCD) or external rigid penile devices (EPRD).

The U.S. Food and Drug Administration classifies VED as a Class II device. Some can be purchased over the counter, while others can only be obtained through professional channels.

The difference between the VED and the new pump is that it must be equipped with a restrictor to limit the vacuum pressure applied to the penis. Devices like this have been approved by the American Urological Association for the treatment of ED.

Another difference of VEDs is that they tend to fit only on the penis instead of the penis and scrotum like some novel devices.

The design of the VED is different, but it consists of a closed transparent plastic cylinder and a vacuum pump, which can be manually or battery powered.

Before pumping, you need to do some preparations. If you plan to use condoms, buy water-based lubricants that will not degrade or damage latex condoms. If you plan to use an ED ring—it almost always improves erection quality—you should also keep it at hand.

To operate a manual or battery-powered VED:

If used properly, a penis pump can increase the hardness and duration of an erection. Having said that, some people have stronger and longer-lasting erections than others. If you start to lose your erection, you can remove the ED ring and start again.

If there is any instability in the penis, you can help stabilize it by fixing it firmly at the base. Lubricate the penis and partner’s vagina or anus. If you still have problems when inserting, switch positions until you find a position that is easier to insert.

Wearing an ED ring should not exceed 30 minutes, because wearing it for a long time can cause nerve damage. If you want your erection to last longer, remove the ring for a few minutes and start again.

Penis pumps are at risk, especially novel pumps. If too much pressure is applied, the pump can cause pain, bruising, urethral bleeding and hematoma (blood pooling due to ruptured blood vessels).

Some people also find it more difficult to ejaculate after using a penis pump because it causes the tissues around the urethra to swell and squeeze the outlet. If ejaculation does occur, it may be painful. The penis itself may also feel numb, and orgasm may be more difficult to achieve.

With long-term overuse of the penis pump, scar tissue will begin to form in the skin and underlying tissues. Although the penis may appear larger due to the accumulation of tissue, it usually feels spongy rather than hard. There may also be permanent numbness.

Excessive use of the ED ring can also cause nerve damage, thereby worsening rather than improving ED. This is why you should never fall asleep wearing an ED ring, especially if you are taking a PDE5 inhibitor like Viagra.

Fast and easy to use

Can be used for foreplay

May be bulky and messy

A penis pump or a vacuum erection device can be used to treat erectile dysfunction. The device is used to draw blood into the penis to help achieve and maintain an erection. Although novel devices are available over the counter, vacuum erection devices prescribed by urologists are safer.

People with coagulopathy or taking anticoagulants should not use vacuum erection devices.

Although erectile dysfunction may seem stressful and embarrassing, it is a common disease and there are several effective treatments. Don't think that your ED cannot be cured just because Viagra or Cialis doesn't work for you. Sometimes, more than one treatment is needed to get your condition back to normal.

A penis pump is such an option. However, instead of just buying one online and checking if it works, talk to your doctor to determine the possible cause of your ED. By doing this, you may find the right combination of treatments that suits you personally.

If a penis pump is recommended, your doctor can point you to the safest option, whether it's over the counter or through professional channels. Some may even be partially covered by your insurance.

Not really. Although people usually buy them under the assumption that they can increase the size of the penis, studies have shown that they have no effect on increasing length, but may nominally increase circumference due to the accumulation of scar tissue.

No, the penis pump just helps you achieve an erection by drawing blood into the penis, which can then be trapped with a constriction ring (aka "penis ring"). Unless the cause is purely psychogenic (psychological), there is no effective treatment for erectile dysfunction.

The constriction ring ("cock ring") is a simple and effective way to improve erection quality. Even so, the wearing time should not exceed 30 minutes, as this can cause nerve damage.

Experts also advise against using solid metal rings, because if they get stuck during erection, they will cut off blood circulation and cause tissue death.

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Yuan J, Hoang A, Romero C, etc. Vacuum treatment of erectile dysfunction-scientific and clinical evidence. International J imports resources. 2010;22:211-219. doi:10.1038/ijir.2010.4

Marra G, Drury A, Tran L, Veale D, Muir GH. A systematic review of surgical and non-surgical interventions for normal men complaining of small penis. Sex Med Rev. 2020; 8(1):158-180. doi:10.1016/j.sxmr.2019.01.004

Hehemann MC, Towe M, Huynh LM, El-Khatib F, Yafi FA. Strategies for penis circumference enlargement: what is the evidence? Sex Med Rev. 2019;7(3):535-547. doi:10.1016/j.sxmr.2018.11.003

Hoyland K, Vasdev N, Adshead J. Application of vacuum erection device in erectile dysfunction after radical prostatectomy. Pastor Urol. 2013;15(2):67–71.

Panchasharam PK, Durland J, Zito PM. Physiology, erection. In: StatPearls StatPearls Publishing; 2021.

Cleveland Clinic Continuing Education Center. Erectile dysfunction.

Sooriyamoorthy T, Leslie SW. Erectile dysfunction. In: StatPearls. StatPearls Publishing; 2021.

Lu KT, Heidelberg JJ. Erectile dysfunction. I am a family doctor. 2016;94(10):820-827.

Krzastek SC, Bopp J, Smith RP, Kovac JR. The latest developments in the understanding and management of erectile dysfunction. F1000Res. 2019; 8:102. doi:10.12688/f1000research.16576.1

Duca Y, Calogero AE, Cannarella R, etc. Erectile dysfunction, physical activity, and physical exercise: clinical practice recommendations. Andrology. 2019;51(5):e13264. doi:10.1111/and.13264

Burnett AL, Nehra A, Breau RH, etc. Erectile dysfunction: AUA guide. J Urol. 2018;200(3):633-641. doi:10.1016/j.juro.2018.05.004

Food and Drug Administration. External Penis Hardness Device-A special type II control guidance document for industry and FDA workers.

Koifman L, Haml D, Silva MI, Pessoa PGA, Ornella AA, Barros R. Treatment options and results of penile constriction devices. Int Braz J Urol. 2019;45(2):384–391. doi:10.1590/S1677-5538.IBJU.2018.0667

Cleveland Clinic. Vacuum shrink device.

Lehrfeld T, Lee D. The role of vacuum erection devices in penile rehabilitation after radical prostatectomy. International J imports resources. 2009;21;158-164. doi:10.1038/ijir.2009.3

International Society of Sexual Medicine. What is a shrink ring? Why use caution?

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