Impotence has plagued mankind for thousands of years. The distress caused by this symptom has provided the stimulus for the development of a series of innovative and ingenious treatments designed to allow men to recapture sexual vigor. Some therapies have evolved as spin-offs of sound scientific research. A few trace their origins to traditional folk remedies; many "guaranteed cures" turn out to be hoaxes. Today, the impotent man is offered an extraordinary range of therapeutic options, quite literally running the gamut from A (aphrodisiacs) to Z (zinc). Bringing up the end of the therapeutic alphabet are vacuum devices, vitamin E, yohimbine, and zinc. This chapter will describe the use of vacuum devices. (For more on vitamin E, yohimbine, and zinc see Chapter 21.)
Any system encouraging blood to flow into and be captured in the penis should produce an erection. This is the principle behind the vacuum constrictor device (VCD) now offered as a noninvasive means of restoring erections for some impotent men.
Devices resembling the VCD have been shuttling in and out of favor for more than seventy years. The original concept has been traced to the inventor Otto Lederer, who in 1917 was granted a patent for a unit that would allow "persons considered completely impotent to perform sexual intercourse in a normal manner." It is not known whether the Lederer device was ever produced. A newer product, undoubtedly a variation on the original theme, was developed by a man to help him deal with his own impotence. It is marketed under the name ErecAid and sells for about $400. The Encore vacuum erection device is about half that cost. All work using the same principle.
There are several components to the ErecAid device. (See Figure 20.1.) A cylinder designed to fit over the limp penis is connected to a hand-operated vacuum pump. Suction from the pump creates a negative pressure within the cylinder, and this encourages an increased flow of arterial blood into