In conclusion, non-pharmacological and non-surgical options for sexual recovery are available. Lastly, we suggest that, in the case where ED can be anticipated from a pending medical treatment, such as a prostatectomy, pre-habilitative approaches may potentially improve adherence to sexual aid use in the long-term. Positional adjustment, such as the receptive partner being on top, may help overcome this problem for some couples.
We show how the normal kinematics of the penis during coitus is not strictly linear (i.e., not uniaxial not just in-and-out), and is impeded by hinging. With a hinged erection, the penis points downward rather than upward. We discuss how erections achieved with the vacuum erection device have a “hinge effect”, that is an underappreciated barrier to the effectiveness of the erection. The most commonly promoted non-medical ED aid offered to patients is the vacuum erection device. Clinicians need to be aware of these devices and their positive attributes, so they can objectively counsel and encourage couples to explore their use as an alternative to more invasive treatments. Patients are not always advised within ED clinics about these options nor why and how they can facilitate non-erection dependent sexual recovery. We review how multi-sensory integration can enhance sexual arousal for men who use such devices, allowing them to achieve orgasm despite intractable ED. Penile sleeves can similarly be customized with a lumen that fits best a patient’s penis for optimal tactile stimulation.
External penile prostheses can be personalized so they match in size and shape a man’s normal full erection. These devices can allow men to participate in penetrative sexual intercourse despite moderate to severe ED.
The aids discussed include external penile prostheses, penile sleeves, and penile support devices. Though not ED treatments per se, anecdotal data suggest that these options may be effective for some patients and their partners in regaining a satisfying sex life. The primary focus of this review, though, is non-pharmacological and non-surgical options for maintaining sexual activity for men with ED. We hypothesize that this erotic association should enhance the sexual aid’s effectiveness and might potentially help improve long-term adherence.
We suggest that having partners engaged from the outset may promote an erotic association of the treatment with the partner, i.e., conceptually linking the aid to the sexual pleasure that the partner provides. We review here the implication of having patients’ partners involved in ED treatment, starting with treatment selection. Even when physiologically effective, long-term adherence to ED treatments is poor. Erectile dysfunction (ED), the most commonly reported sexual problem for men, reduces the quality of life for both patients and their partners.