Injection therapy for erectile dysfunction
It is important to discuss with your doctor or specialist which treatment is right for you. Bear in mind that you and your partner will want a treatment that is acceptable to both of you and perhaps more importantly gives you the confidence in the results it will provide.
Injection treatments for Erectile Dysfunction (impotence) have been used for many years to successfully help men achieve an erection suitable for intercourse. This fact sheet provides basic information on injection therapies, for more detailed information you should consult your doctor.
How does it work?
Why an injection?
What medication is used in injection therapy?
How soon after using an injection will an erection occur?
How long will the erection last?
Getting the dose right
What side effects might be associated with injection therapy?
Are there any side-effects on the partner?
What conditions prevent a man using injection therapy?
How can I get injection therapy?
What is Injection Therapy?
Intracavernosal injection treatments were first discovered in the 1980s when it was found that certain drugs could be injected into the penis to stimulate an erection. This discovery not only led to a greater understanding of how an erection happens but also offered an effective treatment for men with ED.
Various different injection systems are available to help you to prepare and inject your treatment. Injection therapy is usually dispensed as a dry sterile powder and dilutent, which need to be mixed before use. It is important that you take time to learn how to administer your injection. Your doctor, nurse or specialist can help you with this. Most patients find that doing the injection is fairly easy and not painful.
How does it work?
Injection therapy normally uses drugs that will relax the blood vessels feeding blood into the penis allowing the blood flow to increase. At the same time a relaxation of the muscle layers surrounding the erectile bodies allows them to expand preventing the flow of blood out of the penis, helping to maintain an erection.
Why an injection?
To have this effect in a very controlled way the drug should be delivered directly into the erectile body. The most effective way of doing this is by injection.
What medication is used in injection therapy?
The first drugs commonly used in the UK - papaverine and phentolamine were unlicensed for this form of treatment and have been superseded by licensed drugs that are designed to be more predictable and easier to use.
The most commonly used drug is alprostadil. This is identical to a substance called prostaglandin-E 1 that occurs naturally in the penis and is involved in the natural erection process. AIprostadil relaxes the blood vessels and muscles in the erectile tissue of the penis allowing increased blood flow, the basis of a normal erection.
How soon after using an injection will an erection occur?
An erection will normally develop in 10 to 15 minutes and should be hard enough for you and your partner to enjoy normal sexual activity again.
How long will the erection last?
An erection that lasts for approximately 60 minutes will normally occur if this form of treatment is effective.
Getting the dose right
The initial dose is selected by your doctor. It is important to use the correct dose and this should only be adjusted on agreement with your doctor or specialist. An overdose might lead to a prolonged erection. A prolonged erection or priapism (a painful erection lasting for over 4 hours) may occur in a small percentage of treated men. This condition may be treated in the first instance by exercise - running up and down stairs or using a bicycle. Should an erection last more than four hours you should seek medical advice without delay. Failure to seek medical advice may lead to permanent impotence.
What side effects might be associated with injection therapy?
Some men experience penile pain after injecting. In rare cases a prolonged erection might occur. Some men develop a nodule in the penis, however this may disappear with a short break from injections. Permanent nodules may occur in a small percentage of men with long term usage. This can sometimes be avoided by alternating the injection site.
Are there any side-effects on the partner?
No side effects have been reported in the partner. (AIprostadil is normally broken down quickly in the penis).
What conditions prevent a man using injection therapy?
Injection therapy should not be used in the following conditions: known hypersensitivity (allergy) to alprostadil; an abnormally formed penis; Peyronie's Disease; angulation; cavernosal fibrosis; patients with a penile implant; in diseases that might result in a prolonged erection (sickle cell anaemia or trait, leukaemia, multiple myeloma); patients in whom sexual activity is inadvisable.
How can I get injection therapy?
These drugs are available only on prescription from your doctor. Injectable alprostadil is available in the UK as Caverject® or Viridal Duo® / Viridal®. You should discuss this form of treatment with your doctor who may prescribe it or refer you to a specialist clinic.
Injectable treatment is a widely used and effective means of treating erectile dysfunction in many men. Your doctor will discuss the range of treatments available and decide with you, which is most suitable for you to resume your normal sexual activity. Injection therapy is one of the range of treatments that may be offered to you. You should always discuss with your doctor, which is most appropriate for you.
