Designed and Manufactured by Augusta Medical Systems AND backed up with a ONE YEAR WARRANTY, the Vitality OTC Manual System provides the best Vacuum Therapy Management for Erectile Dysfunction at an affordable price point for customers. The Soma Therapy OTC is made of medical grade plastics and is designed for years of trouble-free use. This product comes complete with an easy to use Manually Operated Negative Pressure Device, a Standard Cylinder, Two Sizing Adapters, Three Comfortable Tension Systems to ensure the return of intimacy without the fear of losing the erection, a tension system loading cone, a tube of SomaTherapy-ED Lubricant, a discreet carrying case and a comprehensive Patient Instruction Manual. Note: This device comes with Standard Cylinder: 2.25in x 8in. We carry 3 different sizes of cylinders, up to 2.5in x 12in sizes. If you need a different cylinder, please call us and we can make the necessary adjustments. This product is an Over the Counter Product (OTC) so that a Prescription is not required and it comes with a 1 Year Warranty! Note: You must register the product within 30 days in order to activate the warranty.