Viagra and the other FDA-approved pills for the treatment of erectile dysfunction truly revolutionized the way we, urologists, treat erectile dysfunction. However, they don’t work for everyone. In fact, at most a probably only handle about 60 to 65 percent of our patients. That leaves a lot of men very frustrated. Fortunately, there is an even more potent, more powerful remedy for erectile dysfunction then these pills and it works in about 80% of patients with very reliable results. What I’m speaking about is an injection therapy.
Penile injection therapy has actually been around longer than Viagra or the other pills, but it has become even more popular now that men have had the courage to come out and speak about their condition. Although the thought of an injection is a somewhat disconcerting or scary thought, in this case, the injection is quite tiny.
It is a tiny caliber needle; it’s the same kind of needle that women will use to inject Botox for wrinkles. It is quite easy to withstand. And the amount of medication is injected tiny. The injection is inserted into the shaft of the penis. The shaft of the penis is kind of like the earlobe or the elbow. It’s an area where there’s not a lot of nerves, so it doesn’t hurt very much unlike the much more sensitive glans of the penis.
The patient learns to inject himself and after a visit or two in our office, he is confident and able to do this easily. It takes just a few moments to give the injection, and it gets to work within about five to fifteen minutes. The expected results are a high reliable erection that lasts anywhere from 40 minutes to an hour.
Penile injection therapy utilizes one of the several different medications. There is an FDA approved medication on the market known as Caverject. This is prostaglandin, and it is typically injected in doses of 5, 10, or 20 micrograms, occasionally 40 micrograms. Prostaglandin as a single ingredient is very effective, but it does have a tendency to cause an increased amount of soreness in the penis while it is active. It is also in rather short supply these days. Most urologists, including myself, use a combination of prostaglandin and other agents. These combinations are known as bimix or trimix. The other ingredients that will add to prostaglandin include phentolamine and papaverine. The combination of the three is synergistic so that less of each of those drugs is required to result in a firmer erection with less soreness.