December 1997, Volume 9, Issue 4, Pages 187 – 192

Article

Transurethral Alprostadil with MUSETM (medicated urethral system for erection) vs intracavernous Alprostadil–a comparative study in 103 patients with erectile dysfunction H Porst Urological Office, Neuer Jungfernstieg 6a, 20354 Hamburg, Germany

Keywords

erectile dysfunction;   Alprostadil;   Prostaglandin E1;   transurethral therapy;   MUSETM;   self-injection therapy

Abstract

A comparative study in 103 unselected patients with erectile dysfunction between MUSETM up to 1000 µg and intracavernous Alprostadil (ProstavasinTM) up to 20 µg provided total response-rates of 43% (MUSETM) vs 70% (ProstavasinTM). Complete rigid erections were reached in 10% (MUSETM) vs 48% (ProstavasinTM). The average end-diastolic flow values in the deep penile arteries ranged between 9.2-9.4 cm/s after MUSETM and 4.5-4.8 cm/s after i.c. Alprostadil confirming the investigator’s assessment, that in the vast majority of patients MUSETM were not able to induce a complete cavernous smooth muscle relaxation. In terms of side effects the reported penile pain/burning-rate after MUSETM was 31.4% compared to 10.6% after i.c. Alprostadil. In addition after MUSETM clinically relevant systemic side-effects like dizziness, sweating and hypotension occurred in 5.8% with syncope in 1%. No circulatory side-effects were encountered after i.c. Alprostadil. Urethral bleeding after MUSETM-application was observed in 4.8%. Due to the superior efficacy and lower side-effects self-injection therapy with Alprostadil remains the ‘Gold Standard’ in the management of male impotence. MUSETM should be reserved for a subset of patients suffering from erectile dysfunction.

Received 1 August 1997; Accepted 22 September 1997

^© Macmillan Publishers Ltd 1997