Sildenafil versus the vacuum erection device: Patient preference

Purpose: We evaluated the preference of patients with erectile dysfunction who had been effectively treated with a vacuum erection device and then swi tched to sildenafil. Materials and Methods: A total of 52 patients with erectile dysfunction who achieved satisfactory erectile function according to the International Ind ex of Erectile Function (IIEF) while using a vacuum erection device were sw itched to an increasing dose of sildenafil (range 25 to 100 mg.) until sati sfactory erection was maintained at least twice a week for at least 1 month . The 2 treatment methods were not used concomitantly. A total of 36 patien ts with a mean age of 59 years (range 35 to 77) who claimed to have achieve d satisfactory erections with a vacuum erection device and sildenafil repor ted their preference to continue sildenafil or resume the use of a vacuum e rection device, reasons for the choice and any adverse side effects. Results: Of the 36 participants in whom the efficacy of sildenafil was simi lar to that of a vacuum erection device according to the IIEF scores (mean plus or minus standard deviation 61.6 +/- 10.4 and 62.5 +/- 6, respectively ), 12 (33.3%) decided to resume use of a vacuum erection device (group 1) w hile 24 (66.6%) preferred to continue sildenafil (group 2). There were no s tatistically significant differences between the groups regarding patient a ge or the etiology and duration of erectile dysfunction. The increase in th e IIEF score while using a vacuum erection device was higher in group 1 tha n 2, with a mean of 66.75 versus 60.4, respectively (p = 0.002). The advers e side effects of sildenafil were the main reasons for preferring a vacuum erection device. Fewer ejaculatory difficulties, efficacy, comfort and ease of use were the main reasons for choosing sildenafil. Conclusions: Even in an era of effective oral medication, the vacuum erecti on device remains a preferred treatment option for a substantial number of patients with erectile dysfunction.