Intracavernous injections for impotence

Article Abstract:

Increased blood flow leading to engorgement of the corpora cavernosa and corpora spongiosa (tissues in the penis) are the mechanisms underlying penile erections. Loss of nerve function following spinal cord injury, bladder or prostate surgery, or castration can cause impotence. Several drugs injected directly into the corpus cavernosum have been effective in inducing erections, although these drugs are not approved for use by the Food and Drug Administration. The drugs generally act by increasing arterial flow by dilating blood vessels, and also block the veins through blood exits from penile tissue. Papaverine, a smooth muscle relaxant, has been used alone or with phentolamine, which blocks certain effects of adrenalin. In a 29-month study of 100 men using these drugs, half discontinued the treatment due to cost, inadequate erections, or spontaneous improvement. Alprostadil, a type of prostaglandin (locally produced and locally acting hormones), is more effective than papaverine alone, and about as effective as papaverine plus phentolamine. However, transient, and sometimes severe, pain before erection is common with alprostadil; pain has rarely been reported with the use of the other two drugs. Other complications include priapism (persistent erection), which is less common with alprostadil; development of nodules containing fibrous tissue, which is also less common with alprostadil; and abnormal liver function tests, which are associated with papaverine. All three drugs sometimes cause low blood pressure and dizziness. The drugs are self-administered by users. Long-term effects are unknown. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Prostaglandins, Phentolamine, Papaverine

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Intracavernous injection of alprostadil for erectile dysfunction

Article Abstract:

Alprostadil (Caverject) injected into the penis may be an effective treatment for erectile dysfunction, or male impotence. While alprostadil can produce an erection, it also causes pain after the injection. Combined with papaverine and with or without phentolamine, alprostadil may be more effective while causing less pain. Alprostadil is a prostaglandin that causes muscle relaxation and expansion. Arteries fill with inflowing blood while venous outflow decreases. Patients with impotence related to nervous system or psychological disorders responded better to low doses of alprostadil than men with blood vessel diseases. Doses range from 2.5 micrograms to a recommended limit of 60 micrograms. Injections should not exceed three times a week, once every 24 hours. The package of Caverject includes a vial of alprostadil powder, sterile water for reconstituting the drug, a syringe, and a 27-gauge needle.

Prostaglandins E, Caverject (Medication)

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Intraurethral alprostadil for impotence

Article Abstract:

A small pellet form of alprostadil has been developed under the trade name MUSE, or Medicated Urethral System for Erection. Alprostadil is used to treat impotence, but it had to be injected into the penis. MUSE is a small pellet in a hollow applicator. The applicator is inserted into the urethra and a button is pushed, which dispenses the pellet into the urethra. In one study of MUSE, 65% of those who used it achieved an erection, compared to 19% who inserted a placebo pellet.

Dosage and administration, Alprostadil, Muse (Medication)

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