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The concept of vacuum therapy is simple. In order to achieve an erection naturally, blood must flow into the penis. When this does not happen naturally, something must be done to draw the blood in. Vacuum therapy is a drug-free option available to men who do not want to take ED drugs or cannot due to another medical condition they have, for instance, high blood pressure. Vacuum therapy also works on-demand and allows the user full control over their erection.
A vacuum therapy device is a suction pump (which can be battery powered or a manual hand pump) used to apply an external vacuum on the penis, encouraging the blood to flow in as it naturally would. Once an erection is achieved, an anatomically designed ring is applied to the base of the penis in order to sustain it during intercourse.
Once finished, the ring is simply removed and either cleaned for future use or discarded depending on wear.
See this video on how to use Osbon Erecaid, a popular medical vacuum therapy system.