Welliver · The journal of sexual medicine 2014 · prospective before-and-after pilot study · n=20

A pilot study to determine penile oxygen saturation before and after vacuum therapy in patients with erectile dysfunction after radical prostatectomy.

Cited 40 times in the scientific literature.

Level 4 - case-series / case-control

Uncontrolled prospective before-and-after pilot study

PubMed 24506138 · doi:10.1111/jsm.12445 · record verified 2026-08-27

What was done

Twenty men (mean age 58.2 years, mean time post-surgery 12.6 months, mean SHIM score 7) who underwent radical prostatectomy between 2 and 24 months prior were enrolled prospectively. Participants cycled a vacuum erection device (VED) without a constriction ring 10 consecutive times over approximately 2 minutes to achieve full erection. Penile and control tissue oxygenation was measured at baseline, immediately post-intervention, and over 60 minutes using a tissue oximeter at five sites: left and right corpora, glans, and left and right thighs.

What was found

VED use resulted in an immediate 55% increase in corporal oxygenation. Both glanular and corporal tissue oximetry remained significantly elevated relative to baseline values across the entire 60-minute monitoring window. Control thigh measurements were collected, but specific numerical values beyond the 55% corporal increase were not reported in the abstract.

Why it matters

Post-prostatectomy hypoxia is hypothesized to cause cavernosal fibrosis and long-term erectile dysfunction. These findings demonstrate that short, ringless VED sessions can acutely improve cavernosal tissue oxygenation, providing mechanistic support for VED use in penile rehabilitation.

Limits

The study is limited by a small sample size (n = 20), an uncontrolled single-arm design, and lack of blinding. It only evaluated acute oxygenation changes over a single 60-minute window and did not measure long-term erectile function recovery, fibrosis prevention, or clinical outcomes.

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