Vacuum erection devices in the management erectile dysfunction: A systematic review.

Erectile dysfunction (ED) is a prevalent male sexual disorder associated with aging and comorbidities. Vacuum erection device(s) represent a non-invasive therapeutic option that can be proposed to patients with ED, either as monotherapy or in combination with pharmacological or psychosexual therapies. This systematic review summarizes the current evidence on vacuum erection device(s) in ED management based on a focused literature review which allowed the AFU/SFMS 2024 guidelines elaboration. Evidence shows that vacuum erection device(s) improve penile length in surgical candidates, enhance outcomes in combination with phosphodiesterase type 5 inhibitors, and may support psychosexual interventions. Their safety profile is favorable, although long-term adherence remains variable. Vacuum erection device(s) should be systematically considered as part of a personalized treatment strategy for ED after considering first intention treatment as PDE5 inhibitors or local drug treatment.