The Vitality manual vacuum therapy sytem has been specifically engineered to provide the best vacuum therapy management for Erectile Dysfunction. The Vitality manual therapy system is recommended as the most conservative, first-line treatment for Erectile Dysfunction. The Negative Pressure Cylinder is made of high-grade medical plastic for years of trouble-free use. System Components: Easy To Use Negative Pressure Device, Negative Pressure Cylinder, Two Sizing Adapters, Five Comfortable Tension Systems, Tension System Loading Applicator, SomaTherapy-ED® Lubricant, Discreet Carrying Case, Instructional Video Tape and Patient Instruction Manual.