Vacuum erection device use in elderly men: a possible severe complication.

Erectile dysfunction affects up to 30 million American men and their partners. Between the ages of 40 and 70 years, the probability of complete erectile dysfunction triples from 5.1% to 15%. Erectile dysfunction is defined as the persistent inability to attain or maintain penile erection sufficient for sexual intercourse. In 1992 the National Institutes of Health Consensus Development Conference recommended that the term “erectile dysfunction” replace “impotence” because it more accurately defined the problem with fewer negative implications. Many therapeutic options, with varying degrees of patient satisfaction, are now available for erectile dysfunction. These options include pharmacologic agents such as yohimbine, sildenafil (Viagra), intracavernosal alprostadil (Caverject), and transurethral alprostadil (MUSE). Nonpharmacologic treatment includes vacuum erection devices, penile prostheses, and penile revascularization. Of these choices, vacuum erection devices are most commonly prescribed. In most men, vacuum erection devices induce penile rigidity sufficient for vaginal penetration regardless of the reason for erectile dysfunction. Such devices are considered safe and relatively easy to use. Complications can occur, however. We describe a patient whose case illustrates a potentially dangerous complication of using a vacuum erection device.