The vacuum constriction device (VCD) is an effective nonsurgical treatment for erectile dysfunction, and many types of VCD are used. We tested the VCD on 152 men who presented with impotence to our outpatient clinic between 1993 and 1995. Of
these
men,
48 (32%) achieved an adequate erection with a VCD at first trial, and 82 (54%) achieved an adequate erection after two or more trials. In 24 patients, an adequate erection was not achieved because of scrotal skin aspiration. Nine of these
patients
achieved an adequate erection at the second trial using a constriction disc instead of a constricting ring. Many cases of scrotal skin aspiration and low rates of adequate erection were attributable to an inappropriate diameter of the cylinder.
We therefore compared the erectile response to ErecAid(r)(Osbon Medical Systems, Augusta, GA 30901, U.S.A.) with the response to the smaller VCDSR (Mitsui Health, Tokyo, Japan). In 45 patients, the VCDS and ErecAid produced adequate erections in
22
patients (49%) and 37 (82%) patients, respectively. We could expect higher success rates if a VCD suitable for Korean men was developed. The pharmacologic erection test could not predict the response to VCD. Only 29 of the 82 patients (35%) who
achieved
an adequate erection with the VCD agreed to buy the device. The others did not purchase it because of the bother of the manipulation, high price, distasteful method of achieving erection, insufficient erection, or rejection by the sexual partner.
Only
16 of the 29 patients (55%) who bought a VCD used it regularly. Those who did not use the device cited interruption of erotic mood, frequent aspiration of scrotal skin and pubic hair, and spontaneous improvement of erectile function as reasons.
The mean period of regular VCD use was 9.2 months (406 months). the numbers of patients expressing great satisfaction, satisfaction, and dissatisfaction with the device were 3, 8, and 5, respectively.
In Korea, the low selection rates of VCD therapy are attributable mostly to the bothersome method and the high price. We believe that development of more convenient and less expensive VCDs is necessary to make this method of impotence treatment
more
popular.
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