INTRACAVERNOUS PROSTAGLANDIN E(1) IN ERECTILE DYSFUNCTION

Prostaglandin E(1) (PGE(1)) is a naturally occurring substance that is present in a variety of mammalian tissues, including the semen of fer tile men. Its use in the diagnosis and treatment of erectile dysfuncti on has been extensively studied. In doses of 10-20 mu g, PGE(1) produc es full erections in 70-80% of patients with erectile dysfunction. In diagnostic use PGE(1) is employed as a simple office test and in conju nction with various hemodynamic tests. Self-injection of PGE(1), eithe r with the patient or his partner administering the injection, is a mi nimally invasive and effective treatment for erectile dysfunction in p atients with organic or psychogenic erectile dysfunction. Its use is c ontraindicated in patients with sickle cell anemia, severe coagulopath y, schizophrenia or severe psychiatric disorder, poor manual dexterity , severe venous incompetence, or severe systemic disease. As calculate d from data in the published literature, the most frequent side effect s are pain at the injection site or during erection (occurring in 16.8 % of patients), hematoma/ecchymosis (1.5% of patients), and prolonged erection/priapism (1.3% of patients). The potential for prolonged erec tion/priapism, the most serious side effect, can be minimized by caref ul titration of the dose and through patient education. Systemic side effects occur rarely during PGE(1) use. During extended use, patients should be monitored for potential long-term side effects, such as fibr osis and angulation.