Drug Therapy: Self Injection
Self-injection therapy is applied to treat impotence. In this procedure a small amount of drug is injected directly into the side of the penis with a short needle. Erection may be achieved in 5-15 minutes after injection and its duration may vary from 30 to 120 minutes. The procedure is not painful
This treatment does not help in all cases. Yet 70% of men are satisfied with the result of injection. One or two visits of doctor are enough to learn how to do this. The doctor may want to see patients several times at the beginning of treatment to check the effect and determine if the treatment is good for this individual case and set the doses.
Prostaglandin (PGE-1 or Prostin or Alpoprostadil or Caverject), papaverine hydrochloride and phentolamine (Regitine) are usually used for injections.
Of all the above only prostaglandin is officially recognized to be approved drug for treating impotence. Papaverine and phentolamine were used for this earlier, but have not yet get official approval. But the practice of urologists shows that all three substances are safe to apply.
Drugs involved in this treatment are “experimental” and all of them have side effects that include infection, possible bleeding or bruising during injection, dizziness, heart palpitations and/or a flushed feeling when using these medications.
Priapism is considered to be the most common risk of this treatment. It is a phenomenon when duration of erection exceeds 4 hours. The probability of it is not high. But it this occurs man has to visit doctor to relieve the erection by medication. Erection maintained for more than 4 hours is not healthy and needs medical interference.
Injection may also result in scarring within the penis. It usually happens to men who make injections with wrong frequency, more often than once in 4-7 days. The proper frequency depends on the kind of medication and individual factors of patient’s body. Scarring can imply serious erection problems and even prevent a patient from placement of a penile prosthesis.
Advantages and Disadvantages of Self-Injection Therapy
Self-injection does not take much time and efforts. The resulting erection is close to natural and its duration is sufficient. This treatment does not influence orgasm or ejaculation.
This kind of medication requires no surgery and does not bring pain. The cost is $8 - $10 per injection but it is not as costly as surgery.
Injection is not a treatment that is acceptable and effective for anyone. Sometimes erection after injection is insufficient or too long. Injection is made into the penis that may be a problem for patient or his partner. There is a necessity to visit doctor at the beginning. For some people injection is too expensive.
Drug Therapy: Urethral Suppositories (MUSE)
Uretheral Suppositoriers (MUSE) is an alternative to injection. It uses the fact that tissues surrounding urethra can absorb certain substances from it. Prostaglandin E1 (alprostadil) is used as suppository. The same drug may be used as injection.
A period between procedure and erection is 5 to 10 minutes. The duration of erection is approximately 30 to 60 minutes, though, it is individual.
Side effects are aching in the penis, testicles, legs and in the area between the scrotum and the rectum, a warmth or burning sensation in the urethra, redness of the penis, and minor urethral bleeding or spotting that usually occurs in case of improper administration.
Medical Device Therapy (vacuum devices)
Vacuum devices help men to achieve and develop erection mechanically.
Patients that can achieve partial natural erections get the best effect from this. The idea of vacuum devices is to pump more blood into the penis and make it stay there. A man inserts his penis in plastic tube and presses it to his body to avoid access of air inside.
Then he creates a vacuum inside the tube with a small hand pump so that blood runs to the penis and makes it engorge, become bigger and achieve rigidity. 1-3 minutes of vacuum are enough to get good erection. After that a man should place a soft rubber O-ring around the base of the penis so that blood stay inside and sustain the erection. The penis is ready fro use immediately after the procedure. The erection will stay for 25 – 30 minutes, after that the O-ring shall be removed.
Advantages and Disadvantages of Vacuum Devices
This treatment has neither any limitations on frequency, nor side effects. It does not require injections or surgery. It can be applied to solve any erectile problem, and is much cheaper than surgery or long self-injection therapy.
The prices vary from $300 to $500 and the prescription is required. Sometimes the cost of this kind of treatment may be repaid by insurance company. If it is bought from large manufactures and takes no effect the customer may get pay-out from the company that is assured by a special refund policy.
Mechanical process is involved in this treatment; it takes time, so the foreplay shall be interrupted for a while. It can be hard to apply for some men because of peculiarities of body. The O-ring can not be placed on the very base of the penis, so the length between the body and the ring is not erected that may lead to floppiness of the penis. Sometimes the O-ring prevents semen from going out. It is not harmful and the problem will resolve by its own when the ring will be taken off.
Coldness and/or numbness of the penis after the O-ring are possible. The ring shall not be worn more than 25 to 30 minutes, because it prevents blood circulation. Men having blood clotting problems or using blood thinners shall not apply vacuum devices.
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