title: The science of vacuum erectile device in penile rehabilitation after radical prostatectomy.
abstract: BACKGROUND
  Radical prostatectomy (RP) is a standard surgical treatment for clinically localized prostate cancer. Erectile dysfunction (ED) and penile shrinkage are common complications. Vacuum Erectile Device (VED) therapy uses negative pressure to distend the corporal sinusoids and to increase blood inflow into the penis. It is the second most commonly used method for penile rehabilitation after RP. However, the underlying mechanisms are still unclear. This paper is designed to review the scientific evidences of VED therapy after RP and discuss the possible mechanisms.
  
  
  METHODS
  We reviewed published papers of post-prostatectomy penile rehabilitation using VED. We analyzed the scientific evidences of VED therapy and discussed the possible underlying mechanisms.
  
  
  RESULTS
  There are existing clinical evidences for VED therapy to improve ED and preserve penile size. Emerging basic scientific evidence is available and further study is still needed to understand the mechanisms at the molecular level.
  
  
  CONCLUSIONS
  Current clinical evidences support the safety, tolerability, effectiveness and benefits of early VED therapy after RP. The available basic scientific evidences demonstrate that VED therapy for penile rehabilitation is achieved by increasing arterial inflow, anti-apoptotic, anti-fibrotic and anti-hypoxia mechanisms.
authors.affiliation: 1 Division of Urology, University of Texas Medical School at Houston Texas, USA ; 2 Department of Urology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Haocheng
authors.initials: H
authors.lastname: Lin
authors.affiliation: 1 Division of Urology, University of Texas Medical School at Houston Texas, USA ; 2 Department of Urology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Run
authors.initials: R
authors.lastname: Wang
keywords: Erectile dysfunction; penile rehabilitation; penile shrinkage; radical prostatectomy; vacuum erectile device
references.citation: Int J Impot Res. 2007 Sep-Oct;19(5):501-4
references.pmid: 17657210
references.citation: J Sex Med. 2007 May;4(3):538-43
references.pmid: 17498093
references.citation: Mol Urol. 1999;3(2):109-115
references.pmid: 10851312
references.citation: Mol Hum Reprod. 2002 Dec;8(12 ):1053-64
references.pmid: 12468637
references.citation: Eur J Oncol Nurs. 2010 Apr;14(2):160-5
references.pmid: 19811950
references.citation: Rev Urol. 2005;7 Suppl 2:S26-32
references.pmid: 16985894
references.citation: Urology. 2012 Dec;80(6):1293-6
references.pmid: 23102441
references.citation: J Sex Med. 2009 Jul;6(7):2032-8
references.pmid: 19453918
references.citation: Eur Urol. 2010 Nov;58(5):773-80
references.pmid: 20674151
references.citation: Prostate Cancer Prostatic Dis. 2004;7(3):223-6
references.pmid: 15249931
references.citation: Curr Urol Rep. 2001 Dec;2(6):495-503
references.pmid: 12084237
references.citation: Biol Reprod. 2007 Jan;76(1):19-28
references.pmid: 16988214
references.citation: J Urol. 2003 Apr;169(4):1462-4
references.pmid: 12629384
references.citation: J Urol. 2002 Mar;167(3):1371-5
references.pmid: 11832735
references.citation: Br J Urol. 1995 Jun;75(6):786-91
references.pmid: 7613837
references.citation: Int J Impot Res. 1998 Sep;10(3):159-63
references.pmid: 9788104
references.citation: J Sex Marital Ther. 1991 Summer;17(2):81-93
references.pmid: 1920472
references.citation: BJU Int. 2007 Oct;100(4):858-62
references.pmid: 17822466
references.citation: Int J Impot Res. 2010 Jul-Aug;22(4):211-9
references.pmid: 20410903
references.citation: J Urol. 1995 Mar;153(3 Pt 1):826-34
references.pmid: 7861547
references.citation: Int J Impot Res. 1996 Jun;8(2):91-4
references.pmid: 8858398
references.citation: Urology. 2001 Oct;58(4):567-9
references.pmid: 11597540
references.citation: Adv Urol. 2008;:481218
references.pmid: 18784845
references.citation: CA Cancer J Clin. 2012 Jan-Feb;62(1):10-29
references.pmid: 22237781
references.citation: Curr Urol Rep. 2008 Nov;9(6):506-13
references.pmid: 18947517
references.citation: J Urol. 1993 Feb;149(2):290-4
references.pmid: 8426404
references.citation: J Urol. 2000 Jul;164(1):242
references.pmid: 10896513
references.citation: J Urol. 2007 Aug;178(2):597-601
references.pmid: 17570435
references.citation: BJU Int. 2005 Sep;96(4):472-4
references.pmid: 16104892
references.citation: J Sex Med. 2007 Jul;4(4 Pt 2):1085-97
references.pmid: 17466058
references.citation: Eur Urol. 2012 Sep;62(3):431-52
references.pmid: 22749853
references.citation: Urology. 2003 Mar;61(3):491-7
references.pmid: 12639630
references.citation: J Sex Med. 2011 Aug;8(8):2370-6
references.pmid: 21679306
references.citation: Int J Impot Res. 2006 Jan-Feb;18(1):77-81
references.pmid: 16107868
references.citation: J Urol. 2003 Mar;169(3):1175-9
references.pmid: 12576876
references.citation: J Androl. 2003 Mar-Apr;24(2):239-45
references.pmid: 12634311
references.citation: J Sex Med. 2009 Dec;6(12):3247-53
references.pmid: 19758281