The penis is placed in a vacuum tube and the air is pumped out. This creates negative pressure and allows blood to flow into the penis. Once the penis becomes erect, a rubber ring is placed around the base of the penis to prevent the blood from leaving. The vacuum tube is then removed. This non-invasive mode of therapy is effective in treating erectile problems form most causes although the device can be cumbersome to use.
Surgical therapy is the most invasive form of treatment for erectile dysfuction.
The penile implant is a very good option for those men who have failed medical therapy or have a severe arterial or venous causes of impotence. Penile microsurgical revascularization procedures are reserved for those men who have a discrete identifiable penile arterial blockage. This surgery is technically challenging and must be performed by an experienced microvascular surgeon. The overall results are good in carefully selected patients. Penile vein ligation surgery has met with some controversy over its effectiveness but may yield fair results in patients with a venous leak.