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penile injections for erectile dysfunction

penile injections for erectile dysfunction

Possible Side Effects and Risks

Before beginning any new medication or treatment program, it’s important to ask your doctor about the possible side effects and risks. Keep in mind that not all men will experience these side effects. Additionally, consider putting a medical card in your wallet that describes your penile injection, just in case of medical emergencies.

Pain: Most men do not experience significant pain from penile injections for erectile dysfunction. However, some men are particularly susceptible to it, and they may experience an aching pain in the penis for about 30 to 60 minutes following each injection. Talk to your doctor if you experience pain. Sometimes, switching to another medication in the injection can help.

Penile Scarring: This risk is uncommon. Only about 5% of men who use penile injections for erectile dysfunction will develop scarring inside the penis. Consult your doctor if you notice bending of the erection.

What Are Penile Injections for ED?

Intracavernosal injections involve using an ultrathin needle to deliver one of several medications to the penis to initiate an erection. If you decide to try this form of treatment, your healthcare provider will show you how to self-inject so you feel only minimal discomfort.

The specific medication you will use can vary. Some of the common medications used when giving injections for erectile dysfunction include papaverine hydrochloride, phentolamine (Regitine), and prostaglandin E-1. Papaverine relaxes the muscles in the arterial wall, which will cause dilation and increased blood flow. Phentolamine works by blocking nerve signals that result in muscle contractions. The end result is also muscle relaxation. Prostaglandin E-1 is a naturally occurring chemical that you already have in your body. It is a vasodilator. Injecting additional prostaglandin E-1 also relaxes the muscles to cause an erection.


Prolonged erections greater than four hours in duration occurred in 4% of all patients treated up to 24 months. The incidence of priapism (erections greater than 6 hours in duration) was < 1% with long-term use for up to 24 months. In the majority of cases, spontaneous detumescence occurred. Pharmacologic intervention and/or aspiration of blood from the corpora was necessary in 1.6% of 311 patients with prolonged erections/priapism. To minimize the chances of prolonged erection or priapism, edex® (alprostadil for injection) should be titrated slowly to the lowest effective dose (see DOSAGE AND ADMINISTRATION). The patient must be instructed to immediately report to his prescribing physician or, if unavailable, to seek immediate medical assistance for any erection that persists longer than six hours. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result.


Intracavernous injections of edex® (alprostadil for injection) can lead to increased peripheral blood levels of PGE1 and its metabolites, especially in those patients with significant corpora cavernosa venous leakage. Increased peripheral blood levels of PGE1 and its metabolites may lead to hypotension and/or dizziness.

Regular follow-up of patients, with careful examination of the penis at the start of therapy and at regular intervals (e.g. 3 months), is strongly recommended to identify any penile changes. The overall incidence of penile fibrosis, including Peyronie's disease, reported in clinical studies up to 24 months with edex® (alprostadil for injection) was 7.8%. Treatment with edex® (alprostadil for injection) should be discontinued in patients who develop penile angulation, cavernosal fibrosis, or Peyronie's disease. Treatment can be resumed if the penile abnormality subsides.

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