Intracavernous injection of prostaglandin E1 for the treatment of erectile dysfunction in spinal cord injured patients: experience with 30 patients

ABSTRACT

To evaluate the efficacy of intracavernous injections of alprostadyl [Caverject] in the treatment of erectile dysfunction in patients with spinal cord injury [SCI] and to determine the mean necessary dose to obtain functional erection. Material and Thirty patients aged between 20 to 44 years, duration of lesion from one to 13 years and level of SCI from C5 incomplete to L3 complete, were included in the study. The treatment started with a minimal dose of 1.125 micrograms and the dosage was titrated to achieve rigid erection. Following the establishment of the effective dose, the patients were trained in the technique of self-injection. They returned periodically for follow up. Twenty seven patients achieved functional erection [Schramek grade 4 or 5] with a dose equal or less than 20 micrograms [mcg] of Caverject. The average effective dose was 11.75 +/- 4.6 mcg. Average duration of erection was 48.3 minutes. No side effects from the t reatment were observed except discomfort in two patients and mild penile pain in one patient. 76% of the patients were satisfied and very satisfied with the treatment. Intracavernous injections of Caverject are e ffective and safe therapy for erectile dysfunction provided that individual dose is established by titration, the patients are trained in the technique of self-injection