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searching for cheap viagra? brand viagra online without prescription As a partner of a man with ED, you are also affected. Here are some tips to help you better deal with the situation. A. To achieve an erection, the user places the clear plastic cylinder over his penis and uses either a manual or special electrical pump to create negative air pressure in the cylinder. Regardless of the source of the erection problem, this vacuum causes the vessels in the penis to fill with blood, just as they would during a normal erection. Once an erection is achieved (it takes about two minutes or so), the user slips off a flexible tension ring from the bottom of the cylinder and places it around the base of his penis to keep the blood from flowing out. This sustains the erection once the cylinder has been removed. The resulting erection can be sustained for at least 30 minutes. One drawback to the use of these external vacuum devices is the need to assemble the equipment and the difficulty in transporting it. Many patients lose interest in using the device because of the preparations that are necessary, the lack of easy transportability, the inability to hide the tension ring, and the relative lack of spontaneity. Approximately half the men who use a vacuum device obtain very good erections, but only half of these men consistently use the device for a prolonged period. Neither age, ethnicity, obesity, nor tobacco use had any significant effect on the likelihood of the link between the two conditions.