Vacuum therapy combined with psychotherapy for management of severe erectile dysfunction.

We used vacuum therapy in combination with psychotherapy in 145 patients with different types of erectile dysfunction (ED). The age range was 24-82 years (average 53.4 +/- 2.7 years). The patients were divided into 3 groups according to the type of ED: 26.2% psychogenic, 36.5% organic, 37.2% mixed. All received the same treatment. Improvement in sexual function parameters, both subjective (adequate erection, spontaneous erection) and objective (penile brachial index, maximal rigidity of penis) were compared among the groups. The best results were noted in the psychogenic and organic ED patients. Of the 38 patients with psychogenic ED, 12 (31.5%) had coitus after treatment without any intervention, 23 (60.5%) had coitus with help of the vacuum constriction device (VCD). Of 53 patients with organic ED, 11 (20.7%) had coitus without any intervention, and 39 (73.5%) had coitus with help of the VCD. Of the total study population (n = 145), 31 (21.3%) had coitus without any intervention, 98 (67.5%) had coitus with help of the VCD. In 16 (11%) cases, there was no improvement in either subjective or objective parameters of sexual function.