INTRAURETHRAL PROSTAGLANDIN E-2 CREAM - A POSSIBLE ALTERNATIVE TREATMENT FOR ERECTILE DYSFUNCTION

Prostaglandin E-2 (PGE-2) is an oxytocic agent in suppository form wit h vasodilatory effects similar to prostaglandin E-1 (PGE-1). Because s ome men find intracavernosal injections disagreeable, we investigated whether intraurethral PGE-2 may provide an alternative method for trea ting erectile dysfunction. A PGE-2 cream was made using PGE-2 supposit ories (20 mg or 40 mg), 10 cc of 2% lidocaine (Xylocaine) jelly, and 4 0 cc of surgical lubrication. Two cc of the cream was instilled into t he urethral meatus using a syringe, the cream was massaged down the ur ethra, and the urethra was occluded for five minutes. Treatment respon se was rated as no penile tumescence, partial tumescence, and full tum escence. Overall, 70 percent showed a response and 30 percent had full penile tumescence. Two of 4 men who had no tumescence using PGE-2 had a subsequent full tumescence using intracavernosal PGE-1 (15 mg), whi le 3 of 4 men with a partial tumescence with PGE-2 had a subsequent fu ll tumescence using intracavernosal PGE-1 (15 mg). These data demonstr ate that full penile tumescence may be achieved in impotent men using intraurethral PGE-2 cream. This pilot study supports the necessity for further investigations in a randomized double-blind manner in the use of intraurethral PGE-2 cream as a less invasive treatment alternative for erectile dysfunction.