Piano, I just pump up, hold vacuum for 30 seconds or so, then let down , repeating a couple times, after arranging my alcohol patch, loaded syringe and such at hand. My aim is to infuse tissue with blood and stretch the cavities some. My veinous valve funtion is still non-functioning, so any blood in runs right back out. I do clamp down on the base of the penis with my fingers to hold the drug in while doing the 'slight massaging', that seems to help keep it in place and diffuse it throughout the cavities.
I have used a constricting ring a couple times, it works fine. Just don't choose one so small it cuts off the blood flow as it holds in the drug. You still need blood flow into the penis to fill it as the drug works on the cavities, remember,,,,lol
I had another failure last night, I think I got it into the penile skin, rather than the cavity. Little response, with slightly swollen skin this morning. That seems to be my biggest failure cause. I don't know if I flinch and don't insert deeply enough or pull back after making the stick or what. It always occurs on the left side, which is the more difficult side for my right hand.