{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T08:53:09Z","timestamp":1766739189527,"version":"3.48.0"},"reference-count":27,"publisher":"PAGEPress Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Introduction: VED is a handheld pump that creates negative pressure around the penis to draw blood into the corpora cavernosa. Although included in guidelines as a noninvasive option, its uptake is limited by fragmented evidence. Current Grade C recommendations are largely based on post-prostatectomy studies, and no systematic review\/meta-analysis has evaluated VED across other ED etiologies (diabetic, cardiovascular, idiopathic) or compared it head-to-head with pharmacotherapy using the IIEF. Methods: We searched PubMed, ScienceDirect, and Cochrane Library using relevant keywords to identify studies assessing VED\u2019s effects on erectile dysfunction patients. The primary outcome we assessed in this systematic review was erectile function based on the International Index of Erectile Function (IIEF). Study quality was assessed using the Revised Cochrane Risk of Bias tool (RoB2) for Randomized Controlled Trial (RCT) studies and using ROBINS-I for non-RCT studies. Meta-analyses were conducted using Review Manager 5.4. Results: The meta-analysis results of this study showed that when VED was used as a single therapeutic modality compared with Phosphodiesterase-5 (PDE5) inhibitors (PDE5Is), there was no significant difference (p=0.77). However, when compared with the placebo group (no intervention), VED provided significantly better outcomes [MD: 4.44 (95% CI: 3.04-5.84) p&lt;0.001). Similarly, when VED was combined with PDE5i, its effectiveness was significantly better than PDE5i therapy alone [MD: 4.19 (95% CI: 0.81-7.57; p&lt;0.001)]. In terms of safety, VED is also relatively safe and has mild and reversible side effects. Conclusions: VED is effective as a therapy either alone or as an adjunct to PDE5i therapy in patients with erectile dysfunction.<\/jats:p>","DOI":"10.4081\/aiua.2025.14328","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T13:25:56Z","timestamp":1761571556000},"source":"Crossref","is-referenced-by-count":0,"title":["Is the vacuum erectile device suitable for treating erectile dysfunction? A systematic review and meta-analysis exploring the evidence gap"],"prefix":"10.4081","volume":"97","author":[{"given":"Alymin","family":"Rustandy Theodorus","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3480-7692","authenticated-orcid":false,"given":"Ahmad Taufik Fadillah","family":"Zainal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1179-5366","authenticated-orcid":false,"given":"Moh Anfasa Giffari","family":"Makkaraka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akhmad Zani","family":"Tasir M","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Revina Raissa","family":"Gunawan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7191-2576","authenticated-orcid":false,"given":"Muhammad","family":"Fakhri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"200279","unstructured":"1. 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Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? a randomized controlled trial. Andrology 2017; 5:103-6.","DOI":"10.1111\/andr.12258"},{"key":"200294","doi-asserted-by":"crossref","unstructured":"16. Watanabe T, Chancellor MB, Rivas DA, et al. Epidemiology of current treatment for sexual dysfunction in spinal cord injured men in the USA model spinal cord injury centers. J Spinal Cord Med. 1996; 19:186-9.","DOI":"10.1080\/10790268.1996.11719430"},{"key":"200295","doi-asserted-by":"crossref","unstructured":"17. Turner LA, Althof SE, Levine SB, et al. Twelve-month comparison of two treatments for erectile dysfunction: Self-injection versus external vacuum devices. Urology 1992; 39:139-44.","DOI":"10.1016\/0090-4295(92)90270-7"},{"key":"200296","unstructured":"18. Shen YJ, Li J, Ye DW. Penile rehabilitation after radical prostatectomy: patients\u2019 attitude and feasibility in China. 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Chen J, Mabjeesh NJ, Greenstein A. Sildenafil versus the vacuum erection device: patient preference. J Urol 2001; 166:1779-81.","DOI":"10.1016\/S0022-5347(05)65674-1"},{"key":"200301","doi-asserted-by":"crossref","unstructured":"23. Basal S, Wambi C, Acikel C, et al. Optimal strategy for penile rehabilitation after robot-assisted radical prostatectomy based on preoperative erectile function. BJU Int 2013; 111:658-65.","DOI":"10.1111\/j.1464-410X.2012.11487.x"},{"key":"200302","doi-asserted-by":"crossref","unstructured":"24. Zhang DL, Chen Z, Wang FX, et al. Adding a vacuum erection device to regular use of Tadalafil improves penile rehabilitation after posterior urethroplasty. Asian J Androl 2019; 21:582.","DOI":"10.4103\/aja.aja_50_19;"},{"key":"200303","doi-asserted-by":"crossref","unstructured":"25. Ma M, Qin F, Wu C, et al. Optimal vacuum erectile device therapy regimen for penile rehabilitation in a bilateral cavernous nerve crush rat model. Andrology 2021; 9:894-905.","DOI":"10.1111\/andr.12968"},{"key":"200304","doi-asserted-by":"crossref","unstructured":"26. Wang CM, Wu BR, Xiang P, et al. Management of male erectile dysfunction: From the past to the future. Front Endocrinol 2023;14:1148834.","DOI":"10.3389\/fendo.2023.1148834"},{"key":"200305","doi-asserted-by":"crossref","unstructured":"27. Pajovic B, Dimitrovski A, Fatic N, et al. Vacuum erection device in treatment of organic erectile dysfunction and penile vascular differences between patients with DM type I and DM type II. Aging Male 2017; 20:49-53.","DOI":"10.1080\/13685538.2016.1230601"}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/14328\/13505","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/14328\/13504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T08:47:51Z","timestamp":1766738871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/14328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12,24]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2025.14328","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"type":"electronic","value":"2282-4197"},{"type":"print","value":"1124-3562"}],"subject":[],"published":{"date-parts":[[2025,10,27]]}}}