The role of vacuum erection device and penile traction therapy in the patients after radical prostatectomy: a narrative review.

Abstract

Radical prostatectomy (RP) is a common treatment for localized prostate cancer, which unfortunately often results in sexual dysfunction, including, but not limited to erectile dysfunction (ED), penile atrophy and penile fibrosis. Various therapies have been used to manage these side effects associated with RP, including vacuum erection devices (VEDs) and penile traction therapy (PTT). This review focuses on the mechanisms, efficacy, and clinical applications of VED and PTT in post-RP patients. VED, a well-established, non-invasive modality, enhances penile blood flow, preserves tissue integrity, and facilitates early engagement in sexual activity. Although VED has been shown to help maintain penile length and improve sexual function, its effectiveness in accelerating spontaneous erectile function recovery remains uncertain. PTT, originally developed for Peyronie's disease, has recently been explored for post-RP patients. Preliminary studies suggest its potential in mitigating penile shortening and supporting functional recovery, though long-term efficacy data remain limited. Both therapies face challenges, including lack of standardized protocols, adherence issues, and encouraging, but limited evidence on their combined use with pharmacological interventions. Additionally, factors such as patient education, treatment accessibility, and psychological support play critical roles in therapy adherence and overall success. Further research is needed to optimize treatment protocols, improve patient compliance, and establish the role of VED and PTT in comprehensive post-RP care through large-scale, well-designed clinical trials.