Prostaglandin E1 Monotherapy for Impotence

Chung, Woo Sik; Park, Young Yo; Kwon, Sung Won

Abstract

Intracavernous injection of prostaglandin E1 as a treatment for erectile dysfunction has achieved widespread acceptance due to low rates of drug induced priapism and penile fibrosis. We assessed the efficacy and side effects through our experience in a pharmacologic erection program using prostaglandin E1 only. A total of 79 impotent patients received a prostaglandin E1 monotherapy as a first-line pharmacological erection program for more than 2 months. Suspecting etiologies were non-vasculogenic non-neurogenic in 39, vasculogenic in 38 and neurogenic in 2 patients. The average duration using prostaglandin E1 was 4.6 months with a range of 2 to 14 months and the mean frequency of drug use was 4.9 per week. The average prostaglandin E1 dose used by patients in the program was 7.4Hg(0.37ml). No one had any side effects such as prolonged erection or fibrotic curvature. Dropout rate from prostaglandin E1 monotherapy after using for more than 2 months was 49%(39 patients) and reasons were penile pain in 7, drug expense in 4, inadequate response in 3, recovery of spontaneous erection in 2 and unclear in 23 patients. Among these dropout patients, 14 received Trimix(the mixture of 15mg of papaverine, 1. 25mg of phentolamine and 5ug of prostaglandin E1 per 1ml of solution) injection as a second- line pharmacological erection program with a good erectile response. We conclude that the prostaglandin E1 monotherapy represents a safe and efficacious method for the first-line selfinjection therapy.