ED Treatment: Penile Injection Therapy

Hopefully, these tips will do the trick and you won't need to do anything further. How many penile injections can i take each day/week/month? Our general interest e-newsletter keeps you up to date on a wide variety of health topics.

This injection site is often used to administer medications to check for or treat erectile dysfunction in adult men (in e. )‌​ Read this resource carefully before starting injection therapy. A hot shower follows the idea that vasodilation throughout the body will shunt blood away from the penis, but a cold shower follows the idea of vasoconstriction in the penis to make the erection subside. If you’re using the medication for the first time, take the cap off. Also, an erection will not occur. You may be offered alternatives to the drugs you take. 5 mg to 1 mg, well below any toxic levels. If she is, or may be pregnant, you should use a condom.

During this entire build up to taking the injection it’s very important to ensure that the needle remain sterile and the skin where you’re going to inject is also clean otherwise you do run the increased risk of getting an infection.

The implant can be bent downward for peeing or upward for sex. This prevents swelling and bruising. The purpose of this video is to teach you how to use the auto injector for the penile injections. Papaverine and phentolamine also belong to this group of medicines called vasodilators (drugs that relax smooth muscle tissue, causing arteries to open and allowing an influx of blood flow). He started to have high blood-sugar levels. If anything touches the needle, you must throw the entire syringe away in the sharps container and use a new one.

However, if your prescribing Doctor recommends it for you then you should follow their guidelines. The amount of medicine that you take depends on the strength of the medicine. Bleeding problems—These conditions increase the risk of bleeding at the place of injection. Papaverine, Phentolamine, and Prostaglandin E1. We have various levels or doses of medications we can try.

  • What are your top tips for the perfect injection?
  • Helped maintain erections for long periods of treatment erectile time and for a whole host of services to individuals and families affected by eating.
  • It is safe for patients who are taking Aspirin, Persantine and Coumadin.
  • Foreplay often helps, too.
  • This holds the blood in the penis (and keeps it hard) for up to 30 minutes.
  • Rapidly males than females aged 16–44 years from the erectile dysfunction injection medication general population.
  • Some men would like a different treatment for erectile dysfunction.

Alternative Medicine for Erectile Dysfunction

Apply pressure to the injection site for a few minutes. MUSE® comes in a variety of dose strengths. It does not work as a tablet but can also be used as a pellet (MUSE®) or a cream (Vitaros®). Going long periods of time without an erection is unhealthy for erectile tissue and may damage it.

Swab the area you will be injecting (see next step) with an alcohol swab first. Don’t use a twisting or jerking motion, because this may cause bruising. It’s only available by prescription.

  • Hold the syringe like a dart, and then put it straight in.
  • It’s easiest to inject if your penis is pulled straight out in front of you.
  • This is an excellent choice to improve uninterupted intimacy and makes relations more spontaneous.
  • The first injectable drugs commonly used in the UK for erection problems were papaverine and phentolamine, but these were not licensed for ED and have now been replaced by alprostadil.
  • Direct pressure will be applied for 2 minutes.
  • Grasp the head of the penis, not the skin.

Depression & Erectile Dysfunction

The simplest kind of implant is made from two easy-to-bend rods that are most often made of silicone. Papaverine and Phentolamine have been used for the purpose of stimulating an erection since 1983. Erection by the injection method is not treatment.

Slowly push the air bubbles and the extra medication back into the vial.

Attach the plunger to the injection device by turning the blue portion of the plunger clockwise until tight (Figure G). Failure to undo priapism will lead to permanent penile damage and untreatable ED. The alprostadil in Trimix can weaken over time, so Trimix should be stored in the refrigerator and away from light. Your APP will give you more instructions during your call. It also helps spread the medicine. Erections lasting longer than 4 hours can cause permanent damage to your erection tissue. Most men will feel pain and will feel better with a narcotic pain-relief drug for one to two weeks. It's important to hold the vial upright and upside down (when loading your syringe) because otherwise you may end up loading your syringe with air, and then injecting air into the penis.

The emphasis is on temporarily as taking a penile injection will not cure or permanently resolve your symptoms of erectile dysfunction, only mask them for a predefined period of time. This treatment works in up to two-thirds of men and seems particularly suitable for people with diabetes. These videos below, including those from xtube. Do not use the cartridge if it appears damaged or the cake is substantially reduced in size. It's of great value to have the first shot in the doctor's office before doing this on your own. What is the Take Home Message? Other possible side effects include headache, dizziness, and more rarely fainting – usually at the thought of sticking something up one’s urethra!

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These medications are all types of vasodilators and cause tumescence within 10-15 minutes. Your healthcare provider will show you how to do self-injection the first time. But with practice, it will get easier. We use a very small syringe and a small voluminous solution is injected directly into the penis, usually along the side. Their uncircumcised counterparts already have much higher rates of suicidal ideation, suicide attempts, and that sexual orientation is most likely treatment for pearly penile papules as the cause. A convenient carrying case is provided for the reusable edex® (alprostadil for injection) injection device. Do not change your dose without speaking with your APP.

Call your APP and tell them your responses and whether you’re getting the results you want. You put a tiny needle into the side of your penis and inject a medicine. Alprostadil has been used as an injection for the treatment of erection problems in the UK since 1994. The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses). If you have had pelvic surgery for prostate or bladder cancer within the past year, your doctor may have told you to take a low dose of sildenafil (Viagra), vardenafil (Levitra), avanafil (Stendra), or tadalafil (Cialis) every night, except on days or nights you plan to inject.

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Just to again review. Wipe it with an alcohol wipe. However, Prostaglandin E1 has only been used for the past 2-3 years. Place the needle on the site of injection at a 90° angle.

Carefully choose an area of the penis to use as an injection site. Please call your APP when your supplies run low. Generally the most common effect is a bit of pain in the penis. The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically. A recent review of the vitamin D data, however, proposed a much higher recommended intake level of 7,000 IU per day (Nutrients, March 10, 2020). Success rates with self-injection are roughly 85 percent of patients.

The skin will be prepped with alcohol swabs followed by the IC injection of 50 units of BTX-A. As with all prescription medicines, do not allow anyone else to use your medication. If you need to, sit or stand in front of a mirror. With that in mind it’s always best to alternate between the left and right side of the penis when taking the injection. Recent advances in the understanding and management of erectile dysfunction. ED medicines that you take by mouth don't work for everyone. They will go to the top, towards the needle.


In this condition, the erect penis curves, making relations difficult. If you have anxiety about giving the shot, if you have manual dexterity problems, or if you can't see your penis due to your weight, your partner can be taught how to inject the medicine. Check for air bubbles in the syringe. But you’ll have to experiment with temperature here as there are a couple of schools of thought over what is most effective.

Do not allow the needle to touch anything prior to drawing the medication or before injecting the medication. 9 proven metformin uses + side effects, tell raped by family friend were most often diagnosed with migraine. Using papaverine with any of the following medicines is not recommended. Do not inject more than one dose in a day. Ask your pharmacist or APP if you have any questions. Wash your hands thoroughly with soap and water and dry them with a clean towel.

In general, men who suffer from erectile dysfunction and who respond positively to test injections are candidates for this treatment. The medication is given into the spongy tissue of the penis, called the corpora cavernosa. Even less frequently is an increase in the liver enzymes usually associated with the Papaverine injections. You may be nervous about doing self-injection at first.

Using alcohol or tobacco with certain medicines may also cause interactions to occur.

Erectile Dysfunction: Treatment Options Beyond Pills

The injection therapist will tell you the best amount to start with (see contributors below). Impotence definition and meaning, the value of routine endocrinologic testing remains controversial2,15–17 because the incidence of endocrinopathy presenting as erectile dysfunction is low. Patients who are interested should discuss the risks and benefits (informed consent) of each, as well as costs before starting any clinical trials. Holding the vial upright and the syringe downward, insert the needle through the circle in the center of the rubber stopper.

On the other hand, Prostaglandin E1 may result in a transient dull ache at the base of the penis. Proper injection technique and individual dose titration are essential for the safe use of this product. Gently move the injection device in a back and forth motion until the drug has dissolved and the solution is clear. If you’re using Bimix or Papaverine, you don’t need to keep your medication in the refrigerator. Given penile injections are prescribed by a medical professional, always defer to the advice given to you by your consultant as the number of injections and dosage can vary from person to person based on personal health needs. Don’t take any other medication for ED without speaking to your APP.

Interactions With Food/tobacco/alcohol

Two ½ inch, 29 gauge (0. )Common side effects include priapism, bruising, fibrosis, Peyronies, and pain. What types of injections are used to treat ED? This test was described as the “pheochromocytoma test,” and involved the intravenous injection of 5 mg of Phentolamine.

Take the syringe out of its package. Invicorp may work well for men who have found little success with other ED treatments and some may find it less uncomfortable to use than alprostadil injections. Remove the needle cover. Erectile dysfunction is often due to more than one of these causes.

You don’t need to recap it. For the first month, men should limit their physical activity. Grasp the head of your penis, not the skin. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body. Slowly push the plunger back up to your prescribed dose.

Can Vacuum Pump Devices be used with injections?

With proper training, 75 out of 100 men can get a working erection using a vacuum erection device. Where pills are concerned, before they start to effectively work a lot of the nutrients and ingredients tend to dissipate as the drugs get absorbed into your digestive system – given penile injections are injected directly where the results are wanted this means the results are generally a lot quicker and usually a lot more effective. Improper injection and any subsequent scarring can lead to penile curvature and nodules in the penis, so it is important to get proper training before beginning injection therapy. Make sure to insert the needle at a slight angle (either the 10 o’clock or 2 o’clock position, as shown in Figure 3). Your APP will make changes to your penile injection therapy medication dose. Occasionally your partner may have some internal itching or burning. Remove the drawing needle and replace with the 30g injecting needle.

Some patients may not be candidates to undergo injection therapy.

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This may help your erection develop. However, these drugs are effective in only about 60 per cent of men who use them. Once the dosage of medication is established, priapism is rare. PDE5 inhibitors improve on normal erectile responses helping blood flow into the penis. If you feel you’re going to struggle actually preparing the syringe with the correct amount of medication, it is now possible to obtain pre-filled syringes hence reducing the margin of error. Although it is not supposed to be painful, it must be done properly to minimize the risk of Peyronie’s disease as a complication. These products are only available on prescription.

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This will push the medication into the cap and result in the wrong amount when it’s time to inject yourself. Many men may be prescribed medicines that go directly, via injection, into the penis. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office. Do not turn the protective caps counterclockwise as this will loosen the needle. Once the needle is in, push the plunger all the way down, then remove, and put straight in a sharps container. Sit or stand in a comfortable position in a warm, well-lit room. In these cases then, patients are often offered alternative forms of therapy, which may include the use of vacuum device or penile injection therapy.

Other rare side effects include dizziness and headache. They will be ordered from a specialty compounding pharmacy approved by MSK: I have told him repeatedly that he should go off this drug, but two doctors have said there’s no link. Recalled eggs should not be eaten. What is injection treatment? To best avoid breaking the needle, you should pay careful attention to your doctor's instructions and try to handle the injection device properly. So the way to go. Hold the injection device as shown in Figure M.

If the solution does not inject easily, or if you immediately experience a burning pain at the injection site, reposition the needle by advancing it slightly or by partially withdrawing it until the solution can be injected easily and painlessly. You must replace the amount of medication you remove from the vial with air. Insert the needle at a 90° angle (perpendicular) to the shaft. Typically there are no systemic side effects because the drug is just being injected into the spot where we want it to work. The reusable edex® (alprostadil for injection) injection device is for use only with the single-dose, dual-chamber cartridges and needles included in the edex® (alprostadil for injection) Cartridge 2 Pack or 6 Pack. But after testing our blood levels, our doctor put both of us on a 50,000 IU vitamin D pill once a week. You must always wipe the rubber stopper with alcohol before you insert the needle. If you have an erection that lasts 3 hours (you still have an erection 1 hour after taking the pseudoephedrine HCl), call your APP and plan to go to MSK’s Urgent Care Center or your local emergency room.

Urgent Care

Also, since the needle hole is very tiny, very little bruising or bleeding occurs. In general, minor side effects that may occur with penile injection therapy include: You draw air into the syringe (an insulin syringe is most commonly used), down to the amount that you're going to dose with - this isn't going to be a guessing game.