Transurethral alprostadil

This treatment is effective in providing adequate erections

• patients are told to void to make sure the urethra is moist
• the pellet is inserted into the urethra via a small applicator and the penis massaged
• in clinical practice only the higher dosages of 500 µg and 1000 µg are effective
• erection occurs in under 10 minutes following insertion of transurethral alprostadil and lasts for 20-60 minutes
• the incidence of priapism is lower than with intracavernosal alprostadil (1)
• the long-term side effects and efficacy of transurethral alprostadil are uncertain
• transurethral alprostadil is less invasive and less effective and works more slowly than injection therapy
• side effects include:
  • penile pain (30-40%) and dizziness (2-10%)
  • urethral bleeding and urinary infection may result from faulty technique
  • urethral discomfort in patients with varicose veins
  • urethral and/or vaginal discomfort (1)
• may be initiated by specialist for erectile dysfunction in patients where phosphodiesterase inhibitors are contraindicated

Reference:

• (1) Hackett G et al. British Society for Sexual Medicine guidelines on the management of erectile dysfunction. J Sex Med. 2008;5(8):1841-65.