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Intraurethral alprostadil for treatment of erectile dysfunction in patients with spinal cord injury
Abstract
Objectives To assess the efficacy of intraurethral prostaglandin E1 (alprostadil, MUSE) in treating erectile dysfunction in patients with spinal cord injury (SCI). Methods Intraurethral alprostadil was tested in 15 patients with SCI to evaluate its effectiveness in treating SCI-associated erectile dysfunction. All patients were at least 1 year after injury, and all had previously used intracavernosal injections successfully (Schramek's grade 5 erection). The intraurethral drug was administered in the office, in the presence of a physician, with monitoring of blood pressure. If effective, the patient was then able to use MUSE at home. The first 3 patients underwent gradual dose escalation starting with 125 microg, without the use of a constriction ring. Because of hypotension, the remaining 12 patients all used a penile constriction ring prior to intraurethral drug administration using 1000 microg. The quality of the erection was compared with that achieved with intracavernosal injections using Schramek's grading. Results The dose escalation (titration) in the first 3 patients demonstrated that the 1000-microg dose was the most effective in creating an erectile response. Transient hypotension was noted in these first 3 patients in whom the constricting band was not used. The highest dose of MUSE (1000 microg) was, therefore, used in the remaining 12 patients, with the constriction band. The quality of the erection varied and appeared to be less rigid in all patients (12 patien…
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“Adverse events associated with transurethral alprostadil include urethral pain and injury, vasovagal reflex, hypotension, and priapism (<0.1%).”
From Erectile dysfunction and its pharmacology: An overview (2017) · cites this paper as [35]
In the citing paper
“Alprostadil used in intracavernous injection can be applied transurethrally at a higher dose (250-1000 µg) as a therapy for ED with a success rate of 40-69% [32-35].”
From Erectile dysfunction and its pharmacology: An overview (2017) · cites this paper as [35]
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Metadata
- Authors
- Bodner, D. R., Haas, C. A., Krueger, B., & Seftel, A. D.
- Affiliations
- Case Western Reserve University (US)
- Corresponding author
- Bodner, Donald R
- Venue
- Urology
- Publisher
- Elsevier BV
- Published
- 1999-01
- Volume
- 53
- Issue
- 1
- Pages
- 199-202
- ISSN
- 0090-4295 (ISSN-L)
- OpenAlex
- W2118874651
- Cited by
- 78
- References
- 15
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 5 · 2015: 6 · 2014: 4 · 2013: 1 · 2012: 3
- FWCI
- 3.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Urology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- Muses, erectile dysfunction, spinal cord injury, prostaglandin E1, intracavernous injection, hypotension, dose titration, patient satisfaction
- MeSH terms
- Adult, Aged, Alprostadil, Humans, Erectile Dysfunction, Middle Aged, Spinal Cord Injuries, Urethra, Vasodilator Agents
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