March 1997, Volume 9, Issue 1, Pages 39 – 42

Experience with intracavernous PGE-1 in the treatment of erectile dysfunction: dose considerations and efficacy M Ismail, L Abbott & IH Hirsch Department of Urology, Jefferson Medical College, Philadelphia, PA 19107, USA     Correspondence: Dr I Hirsch, Associate Professor or Urology, Jefferson Medical College, 1025 Walnut St. (Rm. 1103), Philadelphia, PA 19107 USA.

Keywords

prostaglandin E1;   erectile dysfunction;   intracavernous injection;   dose considerations;   efficacy;   side effects

Abstract

The recommended dose of PGE-1 as treatment for erectile dysfunction has ranged from 10-60 mcg in various studies. We conducted the present study to identify factors that influence dose tritration and maintenance. From 96 patients who presented to our institution with erectile impotence, 40 elected self injection with PGE-1. Erectile response to intracavernous injection was assessed in the course of office-based dose titration. Patients were stratified into different groups based on age and etiology of erectile dysfunction. The mean maintenance dose was calculated in each group. Patients were evaluated quarterly by physical palpation of the penis, complete blood count, serum electrolytes, and liver function tests in order to assess safety of therapy. The average maintenance dose varied with the etiology of erectile dysfunction and age of the patient. The central neurogenic group was the most responsive to PGE-1 therapy, requiring an average maintenace dosage of 5 mcg. Men with vascular etiologies required the largest maintenance dosage of 20 mcg. Furthermore, dosage requirement increased linearly with age. We conclude that dosing considerations vary widely in a clinical setting and their determination is greatly facilitated if primary and associated causes of erectile dysfunction and the age of the patient are considered.

Received 15 July 1996; Accepted 27 November 1996

^© Macmillan Publishers Ltd 1997