Using a Vacuum Erection Device for Penile Rehabilitation
Patient information sheet
A vacuum erection device, also called a vacuum pump or penis pump, may be recommended after prostate surgery or another operation or treatment that affects erections.
For rehabilitation, the device is used to gently draw blood into the penis and regularly stretch the erectile tissue.
This may help:
Keep the penile tissue flexible
Reduce loss of penile length
Create erections while the nerves and blood vessels recover
Support sexual activity as part of a broader recovery plan
Vacuum rehabilitation may help preserve penile length and improve erections while the device is being used. However, it has not been clearly shown to make natural, unaided erections recover more quickly after prostate surgery.[1–3]
The most important difference
Rehabilitation is normally performed without a constriction ring
A constriction ring is used to hold an erection for sexual activity.
It is not usually used during penile rehabilitation, because the aim is to repeatedly draw blood into the penis and then allow it to flow out again.[1]
Only use a constriction ring during rehabilitation if your treating clinician has specifically instructed you to do so.
When should I start?
Do not begin using the device until your surgeon or treating clinician has confirmed that it is safe.
The appropriate starting time depends on:
The type of surgery or treatment you had
How well your wounds are healing
Whether you have pain, swelling or infection
Whether you have a catheter or other medical device in place
Do not start simply because another patient began at a particular time. Follow your own clinician’s instructions.
What does the device include?
Most medical-quality vacuum devices contain:
A clear plastic tube that fits over the penis
A hand-operated or battery-powered pump
A button or valve that releases the vacuum
Different-sized inserts or seals
Water-based lubricant
Devices are available with a safety pressure limiter.[1,4]
You do not usually need to place a constriction ring on the device for a rehabilitation session.
A commonly used rehabilitation routine
There is no single routine that has been proven to be best for everyone. A commonly recommended routine is to create a comfortable erection for one to two minutes, release the vacuum for approximately one minute, and repeat this five to eight times over a total of 10–15 minutes.[1]
Follow the routine prescribed by your clinician if it differs from the one below.
Step 1: Prepare the device
Choose a private and relaxed setting.
Make sure the device is clean, correctly assembled and not damaged.
Do not attach or load a constriction ring unless your clinician has told you to use one.
Step 2: Apply lubricant
Apply a small amount of water-based lubricant:
Around the base of the penis
Around the opening of the tube
This helps create an airtight seal and protects the skin.
Step 3: Place the penis inside the tube
Place the penis fully inside the tube.
Press the tube gently but firmly against the body to form a seal.
Keep the testicles and loose scrotal skin outside the tube. If skin or a testicle is pulled inside, release the pressure and reposition the device.
Step 4: Create an erection slowly
Pump slowly using small, gentle movements.
Pause between pumps and allow the penis to gradually become fuller.
The aim is to create a comfortable erection or full stretch, not the strongest erection possible.
You may feel pulling or pressure, but it should not be painful.
Step 5: Hold briefly
Once a comfortable erection has developed, maintain the vacuum for approximately one to two minutes, unless your clinician has recommended a different time.[1]
Do not continue increasing the pressure once a comfortable erection has been achieved.
Step 6: Release the vacuum
Use the release valve to let the pressure out slowly.
Allow the penis to soften and rest for approximately one minute.
Step 7: Repeat the cycle
Repeat the pump, hold and release cycle approximately five to eight times.
A full session commonly takes around 10–15 minutes.[1]
Your clinician may recommend using the device daily or on a different schedule.
What should I expect?
During a rehabilitation session, the penis may:
Become longer and fuller
Feel cooler than a natural erection
Look slightly darker or bluish
Feel mildly stretched
Become soft again after the vacuum is released
These changes should settle after the session.
A rehabilitation session should not cause significant pain.
Possible side effects
Possible temporary side effects include:
Mild discomfort
Small red spots under the skin
Bruising
Temporary swelling
Numbness or reduced feeling
A cool or bluish appearance
Pain or marked bruising may mean that too much pressure was used or the vacuum was increased too quickly.[1,4]
Stop the session if you experience:
Significant pain
Sudden sharp pain
Bleeding
Severe bruising
A blister or skin tear
Marked swelling
A sudden change in penile shape
Skin or a testicle being trapped in the tube
Numbness that continues after releasing the vacuum
Release the vacuum immediately if any of these occur.
When to contact your clinician
Contact your treating clinician if you develop:
Ongoing pain
Increasing swelling
Extensive bruising
Broken skin or a wound
Signs of infection
A new or worsening bend in the penis
Persistent numbness
Difficulty using the device safely
Uncertainty about when or how often to use it
Seek urgent medical attention if the penis remains very painful, swollen or dark after the vacuum has been released.
Common problems
The tube will not form a seal
Apply a little more water-based lubricant.
Press the tube more firmly against the body.
Move pubic hair or loose skin away from the tube opening.
Skin or a testicle is pulled into the tube
Release the vacuum immediately and reposition the device.
An insert that reduces the size of the tube opening may help.
Cannot create a full erection
A completely rigid erection is not always necessary for rehabilitation.
The aim is a comfortable stretch and filling of the penis without pain. Ask your clinician to check your technique if you are unsure.
Develop bruising
Use less pressure and pump more slowly.
Stop until the bruising has settled and contact your clinician if it is severe or keeps happening.
The routine feels uncomfortable or difficult
Do not force the device. Your clinician or specialist nurse may be able to demonstrate the technique and help choose the correct tube insert.
Cleaning the device
After each session:
Take the device apart as instructed.
Clean it according to the manufacturer’s directions.
Allow all parts to dry fully.
Check the tube, seals and tubing for cracks or damage.
Store the device in a clean, dry place.
Do not use boiling water, alcohol or harsh cleaning products unless recommended by the manufacturer.
Do not share the device with another person.
Take home message
Begin only when your surgeon or clinician says it is safe.
Rehabilitation is normally performed without a constriction ring.
Use a medical-quality device with a safety pressure limiter.
Use water-based lubricant.
Pump slowly and stop once a comfortable erection or stretch is reached.
Rehabilitation should not be painful.
Follow the routine prescribed specifically for you.
Regular use may help preserve penile tissue and length, but it does not guarantee recovery of natural erections.
References
Wang R, Martins FE, Ralph D, et al. Vacuum erectile devices for erectile dysfunction: recommendations from the 5th International Consultation on Sexual Medicine. Sex Med Rev. 2025;13(2):172-183.
Qin F, Wang S, Li J, Wu C, Yuan J. The early use of vacuum therapy for penile rehabilitation after radical prostatectomy: systematic review and meta-analysis. Am J Mens Health. 2018;12(6):2136-2143.
Raina R, Agarwal A, Ausmundson S, et al. Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function. Int J Impot Res. 2006;18(1):77-81.
Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-641.