NON-PHARMALOGICAL TREATMENT Flashcards
WHat is VED stand for?
Vacuum erection device (VED) is a noninvasive medical device with few contraindications to use.
Available over-the-counter.
A patient makes a
onetime purchase, and the device can be used repeatedly.
How to use VED (Vacuum erection device)
A VED has two parts:
1) a pump, which generates a negative vacuum pressure,
2) a cylinder, which is closed at one end
The patient applies
lubricant to and inserts his penis into the open end of the cylinder, which is then pushed up flush against his lower abdomen to create a vacuum
chamber. The lubricant helps maintain a tight seal between the VED and the patient’s abdomen.
Then, the patient activates the pump to produce a
vacuum pressure, which draws arteriolar blood into the corpora cavernosa. To prolong the erection, the patient places constriction bands or tension rings at the base of the erect penis. The bands or rings trap arteriolar blood in the corpora cavernosa and reduce venous outflow from the penis.
With the assistance of loading cones to protect the glans, these bands or rings can be rolled over the glans penis onto the erect penile shaft.
Alternatively, the bands or rings can be first threaded onto the plastic cylinder before the penis is inserted. Once the penis is erect, the band or ring can be rolled off
the cylinder onto the base of the penis. However, some patients prefer to apply the band or ring before the penis is erect
What is VED onset of action?
3-20 mins
A faster onset of 2-3 mins is associated with continued, more experienced use.
What patient group appears to benefit the most from Vacuum Erectile Devices (VEDs)?
VEDs appear to work best in older patients who are married or have stable sexual relationships.
In what circumstances can VEDs be considered first-line therapy for erectile dysfunction?
VEDs can be considered first-line therapy, especially for older patients who are married or in stable relationships, with an overall satisfaction rate ranging from 60% to 80%.
How might VEDs be used as second-line therapy?
VEDs can be used as second-line therapy for patients who do not respond to oral phosphodiesterase type 5 inhibitors. This includes patients post-radical prostatectomy or those unresponsive to injectable drug treatments.
What is the potential benefit of combining VEDs with other treatments like intracavernosal alprostadil or phosphodiesterase type 5 inhibitors?
Combining a VED with intracavernosal or intraurethral alprostadil, or a phosphodiesterase type 5 inhibitor, has a higher efficacy rate compared to using VEDs alone.
In what scenario might combination therapy be attempted before considering penile prosthesis surgery?
Combination therapy might be attempted before penile prosthesis surgery for a patient who fails to respond to VED alone
What is VED side effect?
Penile pain, bruising, cold/numbness from the constricting bands used to sustain an erection. Because these rings trap blood in the corpora and reduce arteriolar flow into the penis, the penile shaft may feel cold and numb. If the constriction bands are applied for longer than 30 minutes, the penile shaft may turn blue and hurt
