The vacuum pump is a plastic cylinder into which the penis is placed and a seal is created at the base of the penis. At the far end of the cylinder there is a pump which can be manually or battery-operated. By activating the pump, blood is pulled into the penis by a vacuum. As the penis becomes engorged it will stretch the tunica. It is felt that prolonged stretching of the tunica with the vacuum may result in remodeling of the scar tissue within the tunica and thereby result in some straightening. To date there are only anecdotal reports and no formal studies have been done, although there are plans to initiate such a trial. My initial studies using verapamil injections with or without the addition of vacuum therapy used once to twice per day for up to thirty minutes per treatment did not show any substantial benefit in the men who used the vacuum. I do believe that a more formal, multi-center trial will give us further answers as to whether vacuum therapy will benefit the man with Peyronie’s. For those men with Peyronie’s disease who have used the vacuum device as therapy, there have not been reports of substantial benefit, and it appears that the vacuum device will not worsen their Peyronie’s disease. Clearly, this is something that needs to be managed properly to prevent inadvertent injury. Most importantly, the device should not be left on the penis for longer than 30 minutes as this can result in a low blood flow state which could cause injury to the internal tissues. These devices are now available over-the-counter at many pharmacies and typically cost less than $200. A more professional model is available by prescription from physicians around the country. These devices cost up to $400 for the manual device and $550 for the battery operated device. Many insurance companies will cover a use of the prescription type vacuum devices, especially if they are being used for the treatment of erectile dysfunction.