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Vacuum erection devices, also called vacuum constriction devices, can generally be used by all men with erectile dysfunction. Patients must receive thorough instructions in the proper use of such devices. They typically work as follows:
Lack of spontaneity is this method's major drawback.
Penile implants are an option for men who cannot take medication or for who less invasive treatments do not work. In general, they work well in restoring sexual function, and men are usually satisfied with the results.
Two types of surgical implants are used for the treatment of erectile dysfunction:
Erectile tissue is permanently damaged when these devices are implanted, and these procedures are irreversible. Although uncommon, mechanical breakdown can occur, or the device can slip or bulge. In addition, a less than optimal quality of erection may result. Infection is a rare, but serious, complication.
In rare cases, penile vascular surgery may be considered as treatment for erectile dysfunction. Two types of operations are available: revascularization (bypass) surgery, and venous ligation. Some insurance carriers consider these procedures experimental and will not pay for them.
According to the American Urologic Association, men who smoke or who have the following conditions are not candidates for penile vascular surgeries:
Revascularization. The revascularization procedure usually involves taking an artery from a leg and then surgically connecting it to the arteries at the back of the penis, bypassing the blockages and restoring blood flow. Penile arterial revascularization is appropriate only for young men (under age 45) who have blood vessel injury at the base of the pain that was caused by events such as blunt trauma or pelvic fracture.
Venous Ligation. Venous ligation is performed when the penis is unable to store a sufficient amount of blood to maintain an erection. This operation ties off or removes veins that are causing an excessive amount of blood to drain from the erection chambers. Long-term success rates for this procedure are less than 50 percent.
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