PROSTAGLANDIN AND ALPROSTADIL
The intracavernosal injection therapy is the most effective non-surgical treatment for ED and suggested when oral medications are not effective. The biggest problem of this type of treatment is that it is invasive and has the potential to cause priapism (prolonged erection too). Intravenous injections are given in cases of arteriogenic changes, neurogenic refractory to other treatments psychogenic impotence, impotence arising from some drugs and mixed impotence. There is a contraindication to the use of this type of treatment in cases of clotting problems, severe psychiatric disorders, priapisms repetition and unstable cardiovascular disease. (* 13)
The most used drugs to the intravenous use are prostaglandin, “phentolamine” and “papaverine” used in many formulations and proportions.
The prostaglandin is a substance existent in the human body which is metabolized in the lungs and liver. This substance allows the dilation of the arteries and therefore the filling of the corpora cavernosa, allowing the tumescence of the penis.
A popular treatment technique involves injecting a small amount of medication directly into the erectile tissue of the penis. Erection generally occurs within 10 minutes and lasts 30 to 90 minutes. The use of a separate applicator makes this an easy and painless process.
- Injecting the liquid diluent in glass
- Dilute the powder homogeneously
- Absorb the liquid back into the syringe
Before the application:
- Eliminate the air bubbles: with the needle pointing up, hitting the side to release the bubbles and pressing until squirting a little of the liquid out.
- Clean the injection place with alcohol or soap.
- Insert the needle into the side of the penis and apply the liquid.
The self-administration of medications (always after a medical advice), is already very used in the US and in Brazil. The use of these medications is very frequent in patients with penile prosthesis indication or ischemia of the penis. Through these drugs it is possible to naturally extend an erection until two hours. Normally, prostaglandin derivatives are used, often “alprostadil” in various commercial formulas. There are already in common pharmacies some self-administrated formulations but in specific cases, it becomes necessary to adapt the formulation to the patient requiring the handling of the same in order to get the best result. It is a very effective type of treatment but it always requires guidance and medical care.
The patient in our Institute will always have a medical follow-up, 24 hours a day, with telephone and emergency BIP for the patient to use, if necessary. The dose to be used is set specifically for each patient.