A double-blind, placebo-controlled evaluation of the erectile response to transurethral alprostadil

Hellstrom, Wayne J.G.; Bennett, Alan H.; Gesundheit, Neil; Kaiser, Fran E.; Lue, Tom F.; Padma‐Nathan, Harin; Peterson, Craig A.; Tam, Peter Y.; Todd, Leslie K.; Varady, John; Place, Virgil A.

doi:10.1016/s0090-4295(96)00428-1

Cited by 72 publications

(30 citation statements)

References 18 publications

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“…PGE 1 (alprostadil) and a PGE 1 /prazosin combination was demonstrated to produce erections in a majority of patients with chronic organic ED (Peterson et al, 1998). In a prospective, multicenter, double-blind, placebo-controlled study on 68 patients with long-standing ED of primarily organic origin (Hellstrom et al, 1996), transurethrally administered alprostadil produced full enlargement of the penis in 75.4%, and 63.6% of the patients reported intercourse. The most common side effect was penile pain, experienced by 9.1 to 18.3% of the patients receiving alprostadil.…”

Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

2011

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Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

2011

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“…3,4 In the diabetic cohort, there was a significant difference in both parameters (tumescence and penetration); however, a large number of patients were not successful in intercourse attempts. 4 Likewise, the initial success of the Medical Urethral System for Erection (MUSE) (intraurethral prostaglandin E 1 [PGE 1 ]) 7,8 has been difficult to duplicate in the office setting. 9 -11 It is also important to note the different mechanisms by which sildenafil and PGE 1 relax the corpus cavernosum trabecular smooth muscle, albeit by different pathways, and hence facilitate erection.…”

Section: Introductionmentioning

confidence: 99%

Rationale for combination therapy of intraurethral prostaglandin E1 and sildenafil in the salvage of erectile dysfunction patients desiring noninvasive therapy

et al. 2002

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Corpus cavernosum smooth muscle relaxation and hence penile erection are regulated in part by increases in smooth muscle synthesis of the second messengers cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). The object of this study was to determine 30-month follow-up results in motivated patients desiring noninvasive medical therapy using sildenafil citrate (Viagra) in combination with intraurethral prostaglandin E 1 (PGE 1 ) (Medicated Urethral System for Erection [MUSE]). Twenty-eight patients (mean AE s.d. age, 59 AE 7.3 y; 17 who had undergone radical prostatectomy and 11 who had a diagnosis of organic erectile dysfunction) were included in this study. Detailed history taking and physical examinations were performed and vascular risk factors noted. In these patients, treatment with either 100 mg of sildenafil citrate and=or 1000 m mg of MUSE had failed. None of these patients desired intracavernosal injection. Duplex Doppler ultrasonography after redosing was carried out on all patients. Dynamic infusion corpus cavernosography=cavernosometry was obtained in 17 of 28 patients, and combination therapy was initiated using 100 mg of sildenafil citrate orally 60 min before intercourse and 500 m mg of MUSE intraurethrally immediately before intercourse. Independently, either 100 mg of sildenafil citrate or 1000 m mg of MUSE was not efficacious in inducing an erection sufficient for vaginal penetration in any of the 28 patients. After initiating a combination therapy, at 30 months, all 28 patients were reporting erections sufficient for vaginal penetration, with 3.6 intercourse episodes per month. None of the patients crossed over to intracavernosal therapy or penile prosthesis. During therapy, eight of 28 patients reduced the dose of sildenafil citrate to 50 mg. Combination therapy with MUSE and sildenafil may be more efficacious in the salvage of patients who desire noninvasive therapy but in whom single-treatment modalities fail. Although both cAMP-and cGMP-mediated vasodilation can lead to penile erection, combining therapies that incorporate both pathways may succeed when single therapies fail.

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“…Alprostadil used in intracavernous injection can be applied transurethrally at a higher dose (250-1000 µg) as a therapy for ED with a success rate of 40-69% [32][33][34][35]. Adverse events associated with transurethral alprostadil include urethral pain and injury, vasovagal reflex, hypotension, and priapism (<0.1%).…”

Section: Transurethral Medicationmentioning

confidence: 99%

Erectile Dysfunction and Its Pharmacology: An Overview

Patnaik

Polimati

Pragada

2017

Asian J Pharm Clin Res

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It has been estimated that currently over 150 million men worldwide suffer from erectile dysfunction (ED) and by 2025, the figure will increase beyond 322 millions. ED is the inability to achieve, and/or maintain penile erection sufficient for satisfactory sexual intercourse, and was previously regarded as the part of aging. It is associated with certain diseases and life style habits with a cause-effect relationship, including diabetes mellitus, hypertension, dyslipidemia, and cigarette smoking. Internationally, most of the men with ED fail to pursue treatment due to the complex nature of sexuality, taboos, cultural restrictions, and acceptance of ED as a normal sequel of aging. In this review, we discussed the physiology, diagnosis, and risk factors associated with ED and current treatment strategies for ED.

show abstract

A double-blind, placebo-controlled evaluation of the erectile response to transurethral alprostadil

Cited by 72 publications

References 18 publications

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

Rationale for combination therapy of intraurethral prostaglandin E1 and sildenafil in the salvage of erectile dysfunction patients desiring noninvasive therapy

Erectile Dysfunction and Its Pharmacology: An Overview

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