J Korean Androl Soc.  1997 Jun;15(1):65-69.

Prostaglandin E1 (Alprostadil) Intracavernosal Self-Injection Therapy in Erectile Dysfunction

• Seong BM
• Kim JJ

Abstract

BACKGROUND: Intracavernosal self-injection is widely used as the first line therapy of erectile dysfunction. The principal drugs used are papaverine, phentolamine, and prostaglandin E1 (PGE1): other agents are phenoxybenxamine, thymoxamine, vasoactive intestinal polypeptide (VIP) and cyclic guanosine 3', 5'-monophosphate (cGRP) either as single agents or in combination. The reported low rates of drug-induced priapism and penile fibrosis have made PGE1 a popular choice for self-injection therapy.
METHODS
We reviewed 65 patients with erectile dysfunction treated with PGE1 for more than 1 month between February 1996 and January 1997. The most common etiologies of erectile dysfunction were psychogenic (52 patients; 80%) and neurogenic (6 patients; 90%). The mean follow-up was 4.3 months and the mean dosage of PGE1 was 12.3 micro gram.
RESULTS
At present, 30 patients are left in the self-injection treatment program, so the drop-out rate was 54%. The principal causes of drop-out were spontaneous recovery of erection (42%), dissatisfaction with the method (fear of needle; 23%), cost (15%), feeling that the method was ineffective (12%). The drop-out related to PGE1 complication (pain, priapism)was 8%.
CONCLUSION
Intracavernosal self-injection of PGE1 is a safe and very effective method of treatment for the patients with erectile dysfunction, although many patients drop out despite good clinical results.

MeSH Terms

Alprostadil*
Erectile Dysfunction*
Fibrosis
Follow-Up Studies
Guanosine
Humans
Male
Moxisylyte
Needles
Papaverine
Phentolamine
Priapism
Vasoactive Intestinal Peptide
Alprostadil
Guanosine
Moxisylyte
Papaverine
Phentolamine
Vasoactive Intestinal Peptide