[Place of intra-urethral prostaglandin E1 for the treatment of erectile dysfunction]

Transurethral alprostadil (MUSE) is an effective and safe treatment of erectile dysfunction. Never the less, the result after its exit on the US market two years ago were not as good as the investigational studies which claimed around 60% of success rate. In the literature success rate were between 35% and 40% all together. The MUSE had a better acceptance than the intra-cavernous injection despite a lower success rate (40% vs 75%). Since sildenafil came on the market, it seems that the place of MUSE is reduced because comparative studies give better results for sildenafil than MUSE (70% vs 40%) and of course with a better acceptance. Never the less there are absolute and relative counter-indications to the sildenafil which could benefit to the treatment by MUSE. All the comparative studies, IIC, vs MUSE and sildenafil vs MUSE will be studied in this article. In conclusion MUSE should be used as an alternative and should remain an effective tool that must be available to all physicians dealing with erectile dysfunction, perhaps using new formula with a combination of alprostadil with an alpha-blocker.