In addition to pharmacologic treatments, devices are sometimes used, although scientific validation of effectiveness is limited.
Nonsurgical prostheses include splints such as Rejoyn, a soft rubber brace that holds the flaccid penis rigid and is available in drugstores. The brace exposes the tip of the penis to allow for pleasure. Some women find the device uncomfortable during intercourse. These are available without prescription.
Vacuum constriction devices
Vacuum constriction devices draw blood into the penis, causing an erection, and trap the blood there in order to maintain the erection. These devices include a plastic tube that fits over the penis in order to create an airtight cover. A vacuum is created around the penis by motor or manual pumping. When erection occurs, the tube is removed and a fitted rubber band is placed on the penis at the base to retain the erection for approximately 30 minutes. These devices require a prescription. Many men stop using these devices due to lack of comfort on the part of either the man or the woman.
Surgical penile prostheses
Rigid or flexible rods may be surgically implanted into the penis to make it mechanically erect. There are inflatable models that allow for artificial engorging and deflating of the penis by means of a hydraulic system composed of tubes implanted in the penis and a fluid reservoir (bulb) implanted in one of the testicular sacs (the testis is removed). The tubes are then inflated by squeezing the bulb and deflated by a valve in the bulb. These surgeries permit the penis to be reliably inserted into the vagina. Because implants are irreversible, an implant is the last option for treating ED.
Penile vascular surgery
When there is irreversible damage to the penile arteries and veins, penile vascular reconstruction surgery may be attempted. The results of such surgery are usually poor, but its effectiveness may improve with increased medical knowledge and surgical experience.