Most failures are due to improper use. However, the device will not work for a small percentage of men who may be sensitive to the vacuum pressure or who may be anatomically restricted. Common mistakes include; not using the proper lubricant or amount of lubricant, allowing enough time for penile engorgement, or using the wrong tension band. Using the right lubricant is a critical part of the process. Use a generous amount of water based lubricant on the pubic hair and on the penile shaft. The lubricant aids in maintaining the vacuum seal through hair and skin which is necessary for engorgement and allows the penis expansion in the cylinder. Do not use a petroleum-based product for the vacuum process and try to keep as much lubricant as possible off the testicles.

Maintaining vacuum level is another common mistake. The maximum vacuum one should use is the amount tolerable without experiencing pain or discomfort. The erection does not always engorge at the same time vacuum is increased. The maximum tolerable vacuum should be maintained until the penis becomes fully engorged. This process may take a few minutes. Transfer the band to the base of the penis while the vacuum is still applied. Losing vacuum before the band is transferred can cause a loss of engorgement. The tension ring should be tight enough to hold the erection during intercourse, but should not be worn over 30 minutes. You may have to experiment with different size bands to find the proper tension required for your success. Some men experience excessive venous and require a special high-tension ring.