1. Pumps
  2. Vascular reconstructive surgery 
  3. Surgical implants 

Over the past decade impotence treatments like Viagra and Levitra have become more popular and readily available, and have received increased widespread coverage.

However, other methods of boosting erectile firmness, such as vacuum pumps and surgical implants, don’t seem to get as much coverage.

As a result, many people are unaware of their existence as a serious treatment option, and a considerable number of those of who are aware of them will likely not be able to tell you how they work.

People taking other medications or living with certain conditions may not be able to use them safely; meaning that they may need to seek treatment in other forms. ED pills are a popular and effective choice for millions of men around the world. That said, they aren’t suitable for absolutely everyone.

They may also not function sufficiently in 100 per cent of cases, and a different approach may be required.

You might also be interested in: Injectable ED treatments

Here is our guide to three less thought-of, non-medicinal treatment options for erectile dysfunction, and how they work:


Otherwise known as a vacuum constriction device, or VCD, the pump has been available since 1985, is a viable option and can be very effective.

A study quoted by the NHS noted that as many as 90 per cent of men with ED who use the pump are able to have intercourse afterwards.

It has been useful for men with reduced blood flow to the penis stemming from diabetes, those who have had prostate or colon surgery, as well as those with impotence stemming from depression or nervousness.

One study conducted by urologists in London also found that pumps can be an effective treatment option for Peyronie’s disease, helping to slow down or improve curvature of the penis.

The pump is made up of two parts: a cylindrical chamber with a pump on the end; and a flexible rubber ring, called a constriction band. The pump can be either hand-operated or run on batteries. The chamber is placed over the penis, and pumped to generate a vacuum.

Blood then flows into the penis, and once erect, the constriction band is slid over with a lubricant, so that it fits around the base of the penis. After the vacuum has been released, the chamber is removed.

When in place, the band helps to maintain the erection facilitated by the pump and can be left on during intercourse, for up to half an hour. Once its use has been sufficiently mastered, the device will produce a firm erection in around three minutes.

As with other ED treatments, there are numerous issues to consider before purchasing one.

Usually, it will take more than one attempt to become accustomed to using the device. To lower the risk of injury, it is important to follow the instructions carefully, and use a device with a quick-release facility.

Some side effects have been associated with use, including bruising and pain.

Pumps are also not suitable for men who are using anticoagulant medicines, or have a condition which increases their risk of priapism, such as sickle cell anaemia or leukemia.

The Sexual Advice Association advises that, for safety reasons, VCDs should only ever be purchased from a reputable source.

Costs tend to vary between £250 and £400, depending on whether you prefer a hand or battery-operated pump, and they aren’t as discreet as erectile dysfunction pills like Cialis and Spedra.

However, for those men in a long-term relationship who are susceptible to recurring blood flow problems, a one-off purchase of this kind can prove to be a worthwhile investment.

Vascular Reconstructive Surgery

This type of treatment also works by easing the passage of blood to the penis.

It is a highly delicate and somewhat invasive procedure, which involves either: surgically re-routing the arterial pathways leading to the penis, so as to bypass blocked arteries restricting blood flow; or unblocking those vessels which are causing an obstruction. Freer blood flow and better erectile potency is the desired result.

It is generally designated for younger men, under the age of 45, who may have had an injury or experienced trauma which caused damage to one or more blood vessels around the base of the penis.

Because it is such an intricate, invasive and costly procedure, only certain men are eligible. The American Urological Association has said that it does not consider vascular reconstructive surgery to be a ‘justifiable’ option for those men with ED related to atherosclerosis.

Studies have found that vascular surgery for impotence produces mixed results.

While it has shown to be beneficial in the short term in many cases, its effectiveness decreases over time, and complications may arise.

Vascular reconstructive surgery does, however, produce better results in instances where it is used to correct damage caused by pelvic or similar injury.

Surgical Implants (Prostheses)

This option involves the surgical insertion of a prosthesis into the penis, of which there are two types.

A ‘malleable’ prosthesis is the more straightforward of these.

It consists of two rods which are implanted into the penis, and induce a permanent state of part-rigidity. As a result, the penis simply needs to be manipulated into an erect position to be prepared for sex.

While an erection stable enough for intercourse is more or less guaranteed, however, prostheses of this kind may not be as easy to hide at other times.

The more popular prosthetic choice for men is the ‘inflatable’ version.

This is comprised of two cylinder units, which are inserted into the penis, and connected via a tube to a reservoir and a pump, surgically placed in the scrotal sack. When the user wants to get an erection, they simply apply pressure to the pump.

Fluid from the reservoir is then sent to the penile cylinders, which inflate and result in an erection.

To release the fluid from the cylinders and send it back to the reservoir, the user simply presses a small valve on the pump; and the penis then becomes flaccid.

Besides a tiny scar at the position where the penis comes into contact with the scrotal sack, the inflatable implant is not aesthetically detectable and will go unnoticed.

Of those with the inflatable prosthesis, between and eight and nine out of every ten report being satisfied with the treatment, according to WebMD.

One of the drawbacks of this option however, is that after use, a person’s natural erection reflex may become compromised and eventually disappear. This is something to consider if, for instance, the prosthesis becomes infected and has to be removed.

While infection is a possibility, and is thought to affect two or three per cent of users, research has found that these are becoming easier to prevent.

Other possible complications include mechanical failure, the erosion of tissue and bleeding after surgery.


If you are experiencing erectile dysfunction and are considering a permanent, non-medicinal solution, it is always advisable to speak to your doctor or a specialist, and discuss it thoroughly with them and your partner before coming to a decision.

Page last reviewed:  24/08/2018