Vacuum appliances have been reported to have some potential benefit in men who have established Peyronie’s disease. All of these studies are anecdotal reports on a limited number of patients, with no objective measures of improvement and no placebo control. It is my opinion that a vacuum device used properly may be able to apply mechanical forces to the penis to stretch the scar and possibly result in some straightening. I have been using vacuum therapy in concert with intralesional injection of verapamil over the last year. My current protocol is to use the vacuum starting at 5 minutes and building up to 30 minutes, once to twice per day. On the day of and the day after an intralesional injection, no vacuum is used so as to reduce the likelihood of bruising. The principle of vacuum therapy is to apply mechanical forces to the scar tissue on a prolonged basis much like applying braces to teeth which results in gradual straightening of the teeth due to remodeling of the bone around the teeth. It is possible that using other types of stretching tools such as the Fast Size or Andropenis device may provide the same type of mechanical stretching forces. To my knowledge, there is no study, which has looked at vacuum or stretching devices as a treatment for Peyronie’s disease.
I am aware of two protocols in development looking at vacuum therapy and the external stretching device used with or without intralesional verapamil injections to study the benefits of one treatment alone versus the two combined. It is my opinion that the combination of mechanical forces will enhance the potential beneficial chemical effects of the injected medication. This is only theoretical and I will make further recommendations based upon the results of these trials, which hopefully will begin sometime in 2006.
It is important for people who are interested in using vacuum devices before these studies are done, that they use the devices carefully with gradual increase in pressure and gradual increase in duration of the vacuum forces. These forces should be applied in a continuous, not in an “up and down” approach as has been suggested by one of the firms making the vacuum device. Therefore, as the individual becomes more comfortable with the vacuum application, they can maintain the vacuum device on the penis, without the constriction band, for as long as but not more than 30 minutes. Exceeding this time period may create vascular injury to the erectile tissue. The goal is also to not only have the vacuum stretch the tissue, but the resulting curvature of the penis will press up against the interior wall of the vacuum tube which may also place mechanical forces to stretch and hopefully straighten the scar tissue.