Multicenter study of the treatment of erectile dysfunction with transurethral alprostadil (MUSE) in Korea

A Korean multicenter study was conducted to assess the effectiveness of tra nsurethral alprostadil with MUSE in 334 subjects with chronic erectile dysf unction (ED) who were enrolled in 21 clinical centers. Patients with psycho genic impotence comprised about 30% of subjects. Intraurethral alprostadil was titrated in a stepwise fashion in the clinics from 250 to 500 or 1000 m eg based on erectile response and tolerability. The erectile responses were evaluated using an erection assessment scale (score of 1-5). The dose that produced a maximal penile response of score 5 (full rigid erection) or 4 ( full tumescence, partial rigidity) was selected for home treatment. Patient s who showed partial erection (score of 3) with 1000 meg were also included in the home-treatment group. In-clinic phase: 198 men (59.3%) had maximal penile responses of score 4 or 5. The rate of maximal responses was not related to patient age, etiology or duration of the ED. A total of 228 (68.3%) men progressed to home treatm ent. The overall level of comfort of the transurethral alprostadil was rate d as uncomfortable or very uncomfortable in 12%. Home phase: During the two -month period of home treatment, 178 (78.1%) men had successful sexual inte rcourse at least once, and 78.2% of administrations (1976) resulted in succ essful intercourse. The main causes of drop-out were insufficient erectile response in 27 men (11.8%), adverse reactions (mostly penile or urethral pa in) in 7 (3.1%) or both in 7 (3.1%). In conclusion, transurethral alprostadil could be a suitable treatment opti on for patients with ED regardless of age and etiology of ED. Efficacy in a n Asian population (Korea) is comparable to that reported previously in Cau casians.