Use of Vacuum Erection Devices for Peyronie’s Disease
Peyronie’s disease (PD) is characterized by formation of fibrous plaque involving the tunica albuginea of penis. These plaques are often felt as hard nodules over upper or under surface of penile shaft. These plaques consist of collagen and reduce the elasticity of penis. This produces abnormal curvature of penis and restricts satisfactory sexual intercourse. PD is associated with various penile deformities, including penile shortening, narrowing, pain, erectile dysfunction and sexual dysfunction.
Treatment options for Peyronies disease include observation, conservative therapy and surgery. One of the non-surgical therapies is the use of Vacuum Erection Devices. These devices are available commercially and can be used easily at home.
Vacuum erection devices allow stretching of penile scar which forms as a result of collagen deposition. They should ideally be used under medical supervision till the procedure is completely understood. Thereafter it may be performed at home as per physician instructions.
The device consists of a penile cylinder and a vacuum pump that is battery powered or manual. No tension ring or band is applied. The cylinder is worn over the penis and negative pressure is applied by drawing the air out of cylinder using the pump. The cylinder should be firmly pressed against the body to maintain the negative pressure for 10 to 15 minutes. This promotes an erection by drawing blood into the penis and the cylinder restricts the curvature thereby stretching the penis. Penile engorgement with blood also stretches areas where collagen deposition restricts penile elasticity. This procedure is performed 1 to 2 times daily for 4 to 6 months. It should not cause any pain if used correctly.
It works on the principle that mechanical stress reorients and modulates the fibroblast function. Histological studies have shown that collagen fibres in the penile plaque reorient parallel to the axis of stress. It also reduces extent of fibrosis by upregulation of antifibrotic genes.
Research has shown that this therapy results in significant curvature improvement. The outcome is even better if used along with colchicine therapy that prevents fibrosis. Increase in penile length has also been reported.
Research has also shown that if vacuum erection device is used excessively, it may result in aggravation of fibrosis due to inflammation induced by ischemia and acidosis. Therefore more research is indicated to determine the duration and degree of negative pressure required for optimal results.
Alternative approach is to use a penile stretching device.
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