I'm just looking for a little advice regarding vacuum pumps. Prices range from 20 quid to a couple of hundred. So are the cheap ones any good? Should I spend 150 quid or so ? Do they really work ?
Hi Matt, ask through your oncologist or urologist to be referred to the local ED specialist nurse. They will be able to supply good quality equipment via the NHS. Vacuum Pumps do help in the early stages following surgery.
It's a bit of a postcode lottery if you can get it on the NHS or not, but ask anyway.
If you do end up buying your own, ask for it zero VAT rated as you are buying the pump as a medical appliance (zero VAT), and not a sex toy (20% VAT). It's likely only the medical grade suppliers will have the process in place for this, but worth asking anyway.
If you are a Cancer patient, I believe that you automatically qualify for a vacuum pump on the NHS - your GP should be able to refer you to an ED specialist at your local Urology Dept. Hospital for their help.
It's not automatic - it will be based on clinical need. Anyone whose treatment results in temporary or permanent loss of erections is likely to be judged to have a clinical need.
Not having erections for a long period of time damages the corpus cavernosum - the erectile part of the penis. It will start to form fibrous tissue which will reduce its ability to expand in the future (hence reduce length and girth of erections) and can also cause Peyronie's Disease (curvature). Even if you don't knowingly have erections, a healthy man will have 4 or 5 erections during REM sleep each night to maintain penile health, but that stops too if you can't get natural erections. Many men will notice loss of "morning wood" during treatment.
If your erections are temporarily disabled for many months by hormone therapy or during recovery from prostatectomy, you should be doing penile rehab/physio, and one way is using the pump regularly to maintain the health of the penile tissues, so that when you recover, erections are likely to still work. Furthermore, both prostatectomy and hormone therapy result in shrinking of the penis, and the pump can help counteract that.
Even if you are on permanent hormone therapy or had non-nerve-sparing surgery and never want to have sex again, penile health is still important. Many men permanently incapable of having erections eventually suffer from "buried penis" where the penis shrinks sufficiently that there's nothing left sticking out and you can no longer stand to pee, and you can't keep the penis clean which can lead on to a number of other problems.
About 20% of men on hormone therapy can still get erections, and this percentage does increase a bit with the use of PDE5 inhibitors (Viagra/Sildenafil, Cialis/Tadalafil), as well as the quality of the erections. If you are able to get good firm erections at least every couple of days either naturally or with PDE5 inhibitors (and you are prescribed enough to be able to do this every couple of days), then you may not need a pump. Natural erections (with PDE5 inhibitors if necessary) are preferable as they expand the whole penis, whereas the pump only expands the external half of the penis. Cialis/Tadalafil is the preferred PDE5 inhibitor if it works for you because this also improves blood supply in the penis even when you don't have erections, and this may be protective of the tissues too. (Viagra/Sildenafil doesn't last for long enough for that benefit.) But if you're not managing good firm erections every 2 days, then you should ask for a pump, and use that every 1-2 days for penile rehab.
As mentioned, getting a pump (or even enough PDE5 inhibitors - once a week isn't enough) is a postcode lottery. Although NICE says these should be made available to prostate cancer patients, some health areas simply ban prescribing them. It can also be difficult to get a clinician who understands the need even if they are available in your area - many GP's have no expertise in this area, and even some urologists don't. If you're under oncology, they don't even think it's their job to cover your sexual health.
I spoke with my specialist ED nurse yesterday. Hospital is in Kent but I live in East Sussex, which is where my GP is. She said NHS would provide if GP is in Kent but not if in East Sussex. She said she would get their specialist supplier to contact me and send me information, which will be useful. She also said that injections will be provided on the NHS but am a bit of a cowardy custard as far as needles are concerned, so not certain whether I can really go down that route. The pumps look as though they are vastly over priced on the internet. Think I need to get one though. Will probably speak to GP to see if anything can be done on the NHS and if not buy one.
Hi Matt - an update on me. Although the ED nurse told me I couldn't get a pump on the NHS, I wrote to my doctor and low and behold got one. The whole kit would have been just under £200. What I can say is that it is really working for me. Early days and I'm still thinking that time will tell as to how successful it will be in all respects. Certainly provides me with an erection which I have not achieved for a few years as I have T2 diabetes. I did look at the very cheap options and they seemed to operate on water. The one I have works on creating a vacuum by a small manually operated air vacuum pump. Takes me around 30 seconds to get an erection even when I am not aroused. I have no knowledge of the cheaper options but I think they are probably just inconvenient toys. I would have been quite happy spending the £200 with what I know now.
I'm fortunate to have just been prescribed an NHS v pump, and attended a clinic yesterday with a practical test/demo of one on myself (with the clinician assisting). Seems pretty straightforward and I can see that it is likely to help. Hopefully I can pick up my kit this coming week, and start my daily exercises to help ensure best opportunity to recover/improve and see if it can help with the penetrative side of sex. Up to 24 months to achieve best outcome seems like a long time as someone with a high libido! I need to be patient.
Just an update from me after having the pump for two weeks for anyone interested. Really do not wish to offend anyone but I do think that this matter is very important for anyone suffering from ED. Finding it amazing really. I suppose the prime reason for me having the pump is to excercise the little man. I have been using it as instructed 10 minutes per day. Got to do this for 4 to 6 weeks as initial excercise before trying to use it for the other purpose. In that 10 minutes I achieve 20 odd erections, which is what the instructions say should happen. Little man did get sore initially but that has passed. I am really pleased with results and feel very privaliged to have obtained the pump on the NHS. I was feeling quite depressed with the reduction in size and ED but now I feel quite happy about those. Still feel depressed about incontenence but that is slowly improving.
