Penile injection therapy is one of the several approaches that we can use
to help patients who have erectile dysfunction.
There are several treatments available, which include medication,
such as Viagra, Levitra, Cialis, penile injection therapy as well as
vacuum devices and there may be a role for injection therapy.
It can be used in situations where medications may not be effective or where
patients may have significant side effects from some of the medications
that they've tried.
In these cases then, patients are often offered alternative
forms of therapy, which may include the use of vacuum device or penile
injection therapy.
Let's talk about how we do penile injection therapy.
Basically, a formulation of medications, usually a mixture
of several compounds that have properties that create vasodilation,
or dilation of blood vessels in the penis, is formulated and this formulation
is then directly injected into the side of the penis.
We use a very small syringe and a small voluminous solution is injected directly into
the penis, usually along the side.
You never want to inject on top or on the bottom because there are
critical structures in those areas.
But we instruct patients on how to do these injections.
The injection is done to the side of the penis and the medication is
directly delivered into the penile tissues where the medication then has
direct effect on those tissues to stimulate an erection.
The advantage of doing this is that there is much less medication
that then gets absorbed systemically throughout the body.
So we tend not to see certain side effects that you can see with medications,
things such as headaches, dizziness, diarrhea, upset stomach, stuffiness
or flushing.
These are all common systemic side effects that occur with
medications.
However, with injection therapy, we tend not to see these
types of side effects.
There can be other side effects that occur, these
are due to the injection process.
There can be bruising along the side of the penis.
As with medication therapy, with injection therapy, if you have an erection
that lasts longer than four hours, that is a medical emergency and you need
to bring that to the attention of your physicians.
There can be bleeding or something called a hematoma, which is a clot
formation under the skin.
There may be certain warnings.
Some patients may not be candidates to undergo injection therapy.
These include patients who are on blood thinners
for various other medical conditions.
Because those blood thinners can increase the risk of bleeding
from injection therapy.
So, it is an effective treatment for erectile dysfunction when done properly.
A lot of people are concerned about the actual act of doing the injection.
What I tell my patients is that it's similar to a diabetic using insulin.
Those patients inject with insulin syringes everyday.
We have various levels or doses of medications we can try.
And we have multiple formulations or combinations of medications
so that if one is not effective, we may be able to try other formulations
that may work slightly better.
In cases where there has been surgery and there has been damage to the
nerves going to the penis, in those cases, medications are not likely to
have a significant effect.
However, penile injection therapy, because it
does not work through the use of intact nerves, may actually still work
even in the absence of solid intact nerves that go to the penile tissues.
So, it is one approach that can be used for patients who have undergone
prior surgery and have erectile dysfunction as a result of injury to the
nerves.
As I mentioned, it can be used in patients for whom medications are
no longer effective or not working or where patients have significant side
effects from them.