Vacuum pump - Dr Walsh disagrees

My sexual health doctor told me that the pump is useful for getting an erection and maintaining length, but not useful for keeping the penis healthy because, as Dr. Walsh says, it fills the penis with unoxygenated blood. So, it is useful to prevent loss of length. I was told the pump is fine for what it is, but that I should get erections without it 3x a week for at least 10 minutes using Viagra or Cialis or, if those don't work (fortunately for me Viagra works), injections.

As I understand it, a VED draws in oxygenated blood to the penis. Once a constriction ring is put in place, that blood is trapped and quickly becomes deoxygenated resulting in the penis turning blue and becoming cold. If you use a VED for rehabilitation without the constriction ring, the penis retains its normal color and temperature. My personal experience backs this up.

I noted one problem after using the pump for about three months. I became allergic to the water-based lubrication and had a huge rash on my penis. Had to stop using the pump.

Hopefully others don’t have this problem.

The ring is painful and I’ve never had any luck with the pump, never got big enough for penetration.

I attended a webinar in September 2023 out of Stanford University titled: “Penile Rehab: Optimizing Recovery of Erectile Function after Prostate Cancer Treatment” —> https://youtu.be/aRp1NXjPGLE?si=VyF2ALSgU1J5r4OI

It’s very informative; the speaker talks about many ED remedies, including the vacuum pump.

I try not to use any one source as gospel - including Walsh, Scholz, Kwon, and others who we’ve all heard about. (I even question my own doctors’ recommendations.) Trust, but verify.

I used a Vacurrect for 6 months as part of my penile rehab program. I had satisfactory return of erectile function at age 74 within 7 month post RP. I used it for 10-15 minutes 5x a week. BUT...I did not leave it pumped up the whole time. Protocol: 30 seconds to build up pressure, enlarging the penis. 2 minutes holding that pressure. Then -- and this I believe is the key -- 30 seconds to release pressure and MASSAGE THE PENIS BACK TOWARDS ITS BASE to help the "old" blood escape and get ready for another infusion of "new" blood.

Scott - how long post radical prostatectomy was it before you were able to get and keep an erection? My urologist supposedly preserved both neuromuscular bundles (how can I prove he lied if he didn't?), but I am 4.5 months post-surgery, and I am a total limp biscuit...wet spaghetti down there. I managed two nearly limp orgasms where I ejaculated urine ("OMG" my doctor didn't mention that would happen), but can't even get an erection now. Cialis does not work...I take it daily.

This is a thoroughly depressing discussion. I am 4.5 months post-RP surgery. My urologist "claims" in his surgical procedure report that he "preserved both neuro-vascular bundles" that are necessary to achieve and maintain an erection. I do not understand how/why some men have written here over the course of several months, that they "had no problem with achieving and maintaining erections immediately after their catheter was removed." "What?" "How?"
I was a very "capable" 69-year man "pre-surgery", but now I have a big wet noodle hanging down there, that seems to show no sign or hope for the future. I take a daily Cialis that my urologist prescribed right after catheter removal, but it doesn't do anything. This is particularly frustrating, because I am newly divorced after 32 years. I was looking forward to having a satisfying sex life when I meet someone new with whom I want to take things to the bedroom. Now, I have put on the brakes to even be seeking to date someone, because I don't want to disappoint them in the bedroom. Granted, not many women over 65-70 years old are interested in sex...at least at the frequency that I would like...but I need to know that I can perform when the moment presents itself. This just kills all hope for the future. I am also pretty good looking and youthful for my age...I am constantly told that I look 10-15 years younger than I am. I attract women that much younger as well, who are obviously more sexually active and desirous. What normal, healthy woman will want a relationship with a divorced 70-year old post-prostatectomy guy who can't perform, and whose cancer is such that there is a 50% probability of it coming back within the first 5 years (I am a pT3b with EPE, surgical margins, cribriform glands, and left seminal vesicle invasion...both seminal vesicles and both vas deferens were removed with the prostate)? A 45-55 year old woman will definitely want to have sex, but it is pointless to even start an honest relationship where I need to tell them that I am "incapable" (thus far). I still have a bit of random urinary incontinence as well...I wear a diaper. How freakin' unsexy is that ?!?!? This is thoroughly depressing.

Scott,
You mentioned that Viagra worked for you. I’m 7 months post-surgery with only one nerve bundle spared and I currently take a 5 mg Cialis tablet daily, but I’m still not able to get an erection on my own. Do you take Viagra daily or just before sex? What dose works for you? I’m wondering if I should try a higher dose before sex.

Am a 70 year old in similar circumstances. It can take up to two years to have your penis functioning. In that time you need to do the rehab given to you by your sexual health Dr. You and my age work against us. For me after nearly 2 years, I have a 75% erection but not enough for penetration. Trimix works well for me. If you want additional information on recovery, I'd suggest connecting with A Touchy Subject -- a blog from the UK around men recovering their sexual function post RP.

Be patient and good luck.