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This study aimed to explore whether and how anti-lysyl oxidase (anti-LOX) combined with a vacuum device (VD) could promote penile lengthening and to evaluate the effect on erectile function.This study was performed on four groups of adult rats: control,anti-LOX,VD (negative pressure value of-300 mmHg),and anti-LOX + VD.Penile length was measured by a modified VD method and verified on exposed length data.Intracavernous pressure (ICP) and maximum ICP/mean arterial pressure (MAP) ratio were recorded to assess erectile function.For corpus cavernosum,LOX activity and concentrations of pyridinoline,desmosine,hydroxyproline,and elastin were analyzed;transmission electron microscope and Hart's elastin staining were performed to monitor microstructural changes.Anti-LOX and VD significantly lengthened the penis by 10.8％ (3.75 mm) and 8.2％ (2.48 mm) compared with the control group,respectively,while anti-LOX + VD achieved the longest penile size (40.58 ± 0.40 mm) which was 17.4％ longer than the control group (34.58 ± 0.54 mm).After 1-week washout,no penile retraction was observed.Meanwhile,exposed penile length data confirmed that the penis in the anti-LOX + VD group was also significantly longer.Anti-LOX inhibited LOX activity to reduce pyridinoline level,which led the penile tunica albuginea remodeling.However,it had no effect on hydroxyproline,desmosine,and elastin levels.Moreover,anti-LOX had no impact on erectile function,which was determined by ICP and ICP/MAP ratio.These results suggest that anti-LOX elongates the penis by reducing pyridinoline,which induces tunica albuginea remodeling.This lengthening effect was more obvious when combined with a VD.All procedures had no impact on erectile function.