Why is the VED not recognized by most urologists as being a viable treatment for PD?

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Dr. Mulhall answers: Most urologists are driven by results (physicians often use the terms data or outcomes) and safety in deciding what to do for patients. The absence of data demonstrating that VED is of benefit for Peyronie’s disease patients has resulted in much of the disinterest among urologists for using this strategy. Furthermore, it is recognized that the use of the VED (particularly non-FDA approved devices such as can be bought “over-the-counter”) by men without Peyronie’s disease can result in the development of Peyronie’s disease. Therefore at this time VED therapy is not on the list of recognized treatments for Peyronie’s disease.

Of course there are anecdotal reports (word of mouth but not in the medical literature) of men seeing improvement in their curvature using VED. There are 2 potential reasons for this. The first is that the VED minimizes the degree of curvature because of the blood engorgement of the subcutaneous tissues with the use of the vacuum. So when the penis is in the VED chamber and the device is activated a man who really has 45 degrees of curvature may look as if he has only 30 degrees. This is an artificial “improvement” which is not present when he has a natural erection. The other reason why some men “swear” by the VED is that as previously mentioned some men with Peyronie’s disease improve over time without any treatment at all. It is entirely possible that some of the men who “responded” to VED therapy may in fact have been those who would have improved anyway. Until such time as there is a well conducted study assessing the VED in this patient population, it is unlikely to assume a significant role in the treatment of men with Peyronie’s disease.