Penile Injection Therapy has been used for several years to stimulate erections in men with erectile dysfunction. It has also been used by men with poor erections due to diabetes and other medical problems for many years and the technique is simple and has few complications. It will restore the ability to obtain erections to most men following prostate cancer surgery.
Various drugs have been found to be capable of stimulating erections when injected into the erectile tissue of the penis (the corpora). No single agent is guaranteed to be effective in all cases. However, Papaverine is widely used and accepted. Another drug which is becoming more widely used is Prostaglandin E1 (also known as Caverject). We recommend Trimix(which is a triple medication therapy including Papaverine, prostaglandin E1 and phenotolamine).
Both these drugs have their effect by causing dilatation (widening) of the blood vessels to the penis. The erection usually starts between 5 to 10 minutes after the injection and the erection usually lasts between 1 and 2 hours.
Although a wide range of dosages have been tried, the lowest effective dose for any individual is recommended. This dose can only be ascertained on a ‘trial and error’ basis by injecting different doses of the drug until the optimal response is obtained.
Self injection into the penis may be performed a maximum of two to three times per week. Never more than once in any 24 hour period.
All drugs have some side effects and these may vary according to the dosage used and the sensitivity of the individual to the substance. Prolonged Erection (Priapism)
Occasionally after long term use of injection therapy, fibrosis (thickening or hardening) in the erectile tissues of the penis may occur.
This occurs only rarely so the risk is probably very small.
However, be aware of the possibility and if you suspect anything like this may be happening to you report it to your Doctor.
All self administered injections should be performed in the sitting or lying position and in a sterile fashion.
You will be taught the technique. A little apprehension is natural at first but as you become familiar with the technique it will become easier. You will only be supplied with the necessary drugs, syringes and needles for home use when you have demonstrated satisfactorily that you are competent to draw up and inject the correct dose of drug safely. It may take from 2-6 visits before you reach this stage.
You will be required to return for regular follow up visits whilst using this drug.
A new syringe and needle must be used each time. The unused contents of drug ampoules must be discarded immediately by flushing down a sink or toilet. Glass ampoules, needles and syringes must be disposed of in a sensible and responsible manner to avoid injury to others, for example the garbage collector.
All patients are strongly advised to take their sexual partners fully into their confidence when on this program. This is not the time to be secretive about what you are doing. Be honest and open with your partner and gain their support.
If the erection does not subside within half an hour, contact our on call physician and/or go to the nearest Emergency Department.ic cancer in a population of men presenting for erectile dysfunction. Lap Davinci Prostatectomy, Laparoscopic Urologic Surgery, Vasectomy, Laser Prostate Surgery.
Contact Dr. Gholami at 408-358-2030 or via online below:
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