VED: New Knowledge
A VED uses negative pressure to distend the corporal sinusoids and to increase blood inflow to the penis. It was first approved by the FDA in 1982 [Lewis and Witherington, 1997]. and recommended as one of the alternatives for organic ED by the AUA in 1996 [Montague et al. 1996]. However, it was not a very popular treatment for ED until the concept of penile rehabilitation was introduced into the urology practice. Recent study showed that it has been the second most commonly used method for penile rehabilitation after radical prostatectomy according to the 2011 AUA survey [Tal et al. 2011]. However, the mechanism of VED therapy for ED after radical prostatectomy was not clear. Recent studies with the use of a unique animal model and a newly designed VED for rats clarified the mechanism of vacuum therapy for penile rehabilitation after radical prostatectomy. By mimicking the clinical use of VED, scientists designed a rat-specific VED based on rat anatomy and the principle of the human VED. The studies demonstrated that VED therapy preserves erectile function through antihypoxic, antiapoptotic and antifibrotic mechanisms by improving the arterial blood flow into the penis [Lin et al. 2013; Yuan et al. 2009, 2010a, 2010b]. This scientific evidence indeed motivated physicians' recommendation and improved patients' compliance with the use of VED therapy after prostate cancer treatment.