In some entertainment shows on TV and in the cinema, vacuum tubes are sometimes introduced as a joke at the expense of one of the men. In one sense, this use of embarrassment is one of the usual examples of humour of the unkind, but we can never deny the recognition factor. Almost every adult in the audience seeing the image would understand the function. These devices have entered the public consciousness.

Their success in part is due to the simple fact that they work without having to rely on penile injections which some men find intimidating, and surgery which can be the most expensive option.

So how and why do they work? Well, we need to go back to the mechanics of an erection. When blood is pumped into the penis and the veins to allow it to flow out are constricted, the heart pumps the penis up in much the same way as air or fluids are used to inflate any closed system. The more blood that enters the system, the harder the erection becomes. The vacuum device works on exactly the same principle except that the erection is created by drawing the blood into the penis rather than by a pumping action.

So now we enter what may at first sight seem a slightly surreal world of technology. You take the hollow tube, usually made out of clear plastic and insert the latex constriction band into the base. Now, place the device over your penis and press it against your body to create a seal. Next, we have to create the vacuum. The actual method depends on the sophistication of the device you have bought. The simple mechanical models have a hand pump or squeeze bulb which slowly extracts the air. Others have a battery-driven pump. As the vacuum develops, the penis physically expands which draws blood into it. It takes about three minutes of exposure to this vacuum to draw enough blood into the penis to create a hard erection. The latex ring is then detached from the base and this constricts your penis to prevent the blood from simply flowing back out into your body. Depending on the model, this can require some degree of physical dexterity. The better devices have a "hands-free" system for releasing the ring.

Once the ring is in place, the air can be allowed back into the device, and the device can be removed. The ring maintains the erection for about twenty minutes. In reality, the erection can be maintained for longer but as time extends, so the risk of damage to the penis increases. Twenty minutes is a safe limit.

So is this a good device for you? Well, the scientists who did all the research (a fascinating area of medical research to pioneer and place on your resume) found that this works best in men who retain some ability to get an erection naturally. In fact, if you get a full erection but it deflates soon afterwards, you can use the latex constriction bands to maintain the hardness. Alternatively, you and your partner should engage in whatever foreplay you find works best to get your maximum natural response. Then use the device. Unlike the use of oral medications like Viagra, Cialis and Levitra, this piece of equipment cannot be concealed. It can only be used when you and your partner are completely comfortable with it. You may need joint counselling so that it can be integrated into a sexual routine for you both to enjoy. As it is, some couples do find it interferes with foreplay as it builds to what should be a natural conclusion.

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