[3 years' experience with intracavernous auto-injection therapy].

Area of Science:

• Urology
• Andrology
• Pharmacology

Context:

• Self-injection of vasoactive drugs for erectile dysfunction (ED) has increased in the past 5 years.
• Evaluation of commonly used vasoactive substances: papaverine, papaverine/phentolamine combinations, and prostaglandin E1.
• Focus on side-effects, particularly persistent erection and penile fibrotic changes.

Purpose:

• Critically evaluate the effects and side-effects of key vasoactive drugs used in ED self-injection therapy.
• Assess the safety and efficacy of different agents, especially prostaglandin E1.
• Determine the optimal vasoactive substance for ED treatment with minimal risk.

Summary:

• Over 500 outpatients with ED were studied; over 90 self-injected for an average of 17.6 months.
• Prostaglandin E1 was used initially in 200 patients and throughout treatment in 45 cases.
• Only one patient reported persistent erection; prostaglandin E1 demonstrated the lowest risk profile.

Impact:

• Prostaglandin E1 is identified as the current vasoactive substance with the least risk for ED diagnosis and treatment.
• Findings guide clinical practice towards safer and more effective ED self-injection therapies.
• Highlights the importance of careful drug selection to minimize adverse events like penile fibrosis.