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Vacuum Erection Associated Impotence and Peyronie's Disease

1996; Lippincott Williams & Wilkins; Volume: 155; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(01)66442-5

1527-3792

Lukman Hakim, Ricardo Munarriz, Haluk Kulaksızoğlu, Ajay Nehra, Daniel Udelson, Irwin Goldstein,

Eating Disorders and Behaviors

No AccessJournal of UrologyClinical Urology: Original Article1 Feb 1996Vacuum Erection Associated Impotence and Peyronie's Disease Lawrence S. Hakim, Ricardo M. Munarriz, Haluk Kulaksizoglu, Ajay Nehra, Daniel Udelson, and Irwin Goldstein Lawrence S. HakimLawrence S. Hakim , Ricardo M. MunarrizRicardo M. Munarriz , Haluk KulaksizogluHaluk Kulaksizoglu , Ajay NehraAjay Nehra , Daniel UdelsonDaniel Udelson , and Irwin GoldsteinIrwin Goldstein View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66442-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Use of a nonmedical, catalogue type vacuum erection device resulted in a case of vacuum induced vasculogenic impotence and Peyronie's disease. Materials and Methods: A 66-year-old potent man used a nonmedical vacuum erection device (cylinder plus a hand pump without a pressure-release valve and a doughnut-shaped ring at the base without tension bands) after having achieved a spontaneous rigid erection. The resultant excessive overinflation of the penis was followed by dorsal curvature, diminished rigidity and decreased erectile maintenance. Results: Physical examination revealed a dorsal mid shaft Peyronie's plaque. Nocturnal penile tumescence testing and office injection testing were abnormal and demonstrated partial, shortlived, dorsally curved erections. Dynamic pharmaco-cavernosometry and pharmaco-cavernosography established vasculogenic impotence with site-specific crural (unrelated to the Peyronie's plaque) veno-occlusive dysfunction and dorsal penile curvature. Conclusions: Vacuum erection devices create pulling forces on the penis. We estimate that the pulling forces in this case were prohibitively high (approximately 29 pounds) due to absence of a pressure-release valve and to the preexistent erection at vacuum application. These intense pulling forces are hypothesized to have damaged the tunica in the mid shaft (Peyronie's disease) and the crus (veno-occlusive dysfunction), the latter being the site of attachment of the corpora to the ischiopubic ramus and a most likely location for high magnitude pulling forces to exert an abnormal injury effect. The patient underwent a Nesbit plication procedure and presently performs self-injection for satisfactory sexual activity. References 1 : Treating erectile dysfunction with external vacuum devices: impact upon sexual, psychological and marital functioning. J. Urol.1990; 144: 79. Link, Google Scholar 2 : Skin necrosis caused by use of negative pressure device for erectile impotence. J. Urol.1993; 144: 983. Google Scholar 3 : The effect of subatmospheric pressure on the simian penis. J. Urol.1989; 142: 1087. Link, Google Scholar 4 : Development of Peyronie's disease with the use of a vacuum constriction device. J. Urol.1993; 149: 1314. Abstract, Google Scholar 5 : Plaque-associated corporal veno-occlusive dysfunction in idiopathic Peyronie's disease: a pharmacocavernosometric and pharmacocavernosographic study. World J. Urol.1990; 8: 90. Google Scholar Department of Urology, Boston University School of Medicine and Department of Aerospace and Mechanical Engineering, College of Engineering, Boston University, Boston, Massachusetts.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byJarow J and Lowe F (2018) PENILE TRAUMA: AN ETIOLOGIC FACTOR IN PEYRONIE'S DISEASE AND ERECTILE DYSFUNCTIONJournal of Urology, VOL. 158, NO. 4, (1388-1390), Online publication date: 1-Oct-1997. Volume 155Issue 2February 1996Page: 534-535 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Lawrence S. Hakim More articles by this author Ricardo M. Munarriz More articles by this author Haluk Kulaksizoglu More articles by this author Ajay Nehra More articles by this author Daniel Udelson More articles by this author Irwin Goldstein More articles by this author Expand All Advertisement PDF downloadLoading ...