MUSE THERAPY - PRELIMINARY CLINICAL OBSERVATIONS

Objectives. Intracavernosal injection of vasodilating agents has been a mainstay in the treatment of erectile dysfunction. Recently, a trans urethral delivery system (MUSE) for alprostadil (prostaglandin E1) was introduced as an alternative form of pharmacotherapy. Methods. One hu ndred consecutive patients with erectile dysfunction were treated with MUSE in doses ranging from 125 to 1000 mu g and their erections were observed in the clinical setting. All patients had previous intracaver nosal injections of combination pharmacotherapy (papavarine, Regitine, and/or prostaglandin E1). Results. Of these 100 patients that used MU SE, only 7% had well-sustained, rigid erections while 30% had full ere ctions but with partial rigidity. The remaining 63% of patients did no t achieve erections that they thought were adequate for penetration. P enile and/or perineal pain occurred in 24% of patients, 3% had a synco pal episode, and 3% experienced urethral bleeding. One patient had pri apism that required drainage. Using intracavernosal injections, 49% ha d sustained rigid erections, 40% had full erections with partial rigid ity, and 11% did not have a response satisfactory for penetration. Con clusions. These data suggest that intracavernosal injections appear to be more effective than MUSE in achieving a rigid erection in men with erectile dysfunction. (C) 1997, Elsevier Science Inc. All rights rese rved.