The Effect of Intraurethral Instillation of PGE1 Solution in Patients with Erectile Dysfunction / 대한비뇨기과학회지

PURPOSE: Intracavernosal self injection therapy is now being widely used to treat patients with erectile dysfunction. However, there is a large number of patients who give up the self injection program due to the fear of injection. Therefore, less invasive route of drug administration is highly recommended. We investigated the efficacy of intraurethral instillation of Prostaglandin El (PGE1 ) solution in the patients who showed full erection with intracavernosal injection of PGE1. MATERIALS AND METHODS: Twenty-nine impotent patients who showed full erection with intracavernosal injection of PGE1 were included in this study. We estimated the grades and durations of the penile erection after intraurethral instillation of PGE1 RESULTS: Sixteen out of 29 patients(55.2%) showed full erection with intraurethral instillation. Two patients(6.9%) showed urethral pain which disappeared within 24 hours. But there was no systemic side effect CONCLUSIONS: Intraurethral instillation of PGE1 appears to be safe, well tolerated, and less invasive treatment modality Thus it can be selected as an alternative treatment of impotence in selected cases.

Efficacy of Intraurethral Instillation of Lyposomal Prostaglandin E1 on Induction of Penile Erection / 대한비뇨기과학회지

Intracavernous (IC) injection therapy of vasoactive agents is now being widely choser as the first armamentarium for the treatment of male erectile dysfunction, nevertheless, has a troublesome problems due to the drug delivery vehicle with needle. Therefore, the less invasive route of drug administration has been needed. We investigated the efficacy and safety of intraurethral (IU) instillation of lyposomal prostaglandin E1 on the induction of penile erection. Thirty patients with male erectile dysfunction were enrolled in a prospective study. Overall, 73.3% of cases were responded with 33.3% of full erection and 40% of partial erection after IU instillation. IU self-instillation at home was more effective than at clinic on the induction of penile erection. It is somewhat effective in cases of diabetogenic, psychogenic, neurogenic and mild vasculogenic erectile dysfunction but much less effective in severe vasculogenic and cavernosal disease. Interval of onset and duration of erection were delayed and shortened in IU instillation rather than IC injection. Side effect were mild and transient urethral pain with the most frequent incidence and followed by transient hypotension in less. In conclusion, intraurethral instillation of lyposomal prostaglandin E1 can be selected as one of therapeutic modality to restore the penile erection for some limited patients with erectile dysfunction to want to select a less invasive treatment lternative.

The Effect of Intraurethral instillation of PGE1 Solution in the Patients with Erectile Dysfunction / 대한비뇨기과학회지

Intracavernosal self injection therapy is now being widely used to treat patients with erectile dysfunction. However, there is a large number of patients who gives up the self injection program due to the fear of needle or injection. Therefore, the less invasive route of drug administration is highly recommended. We investigated the efficacy of intraurethral instillation of PGE1 solution in comparison with the trimix intracavernosal injection. A total of 24 patients have been observed with either injection of trimix (11 patients), or intraurethral instillation of PGE1 (13 patients). All patients were evaluated with the penile doppler ultrasonography before 5,15,30 and 45 minutes after the drug administration. Penile length and circumference were measured before and after intraurethral administration of PGE1. Ten out of 11 patients (91%) showed positive response in trimix group and nine of 13 patients (69.2%) in PGE1 group. Mean length and circumference of penile shaft before and after the pharmacologic erection test showed significant difference in PGE1 group. The mean peak systolic velocity at 30 minutes was 28.5% 10.53 cm/sec in Trimix group and 28.2 t8.47 cm/sec in PGE, group (p=0.4773). The mean end diastolic velocity at 30 minutes was 8.4 5.23 cm/sec in Trimix group and 8.2=4.21 cm/sec in PGE1 group (p=0.4689). With the intraurethral administration of PGE1, urethral pain and irritation were the noticeable complications but systemic side effect was not noticed In conclusion, PGE1 intraurethral instillation can be satisfactorily used for the patients with erectile dysfunction of psychogenic, less prominent organic and neurogenic origin, although the effect of intraurethral instillation of PGE1 is obviously less than that of Trimix intracavernosal injection.