3 years' experience with intracavernous auto-injection therapy

In the last 5 years, self-injection of vasoactive drugs into the spongy body of the penis as a treatment for erectile dysfunction has become considerably more widespread. The effects and side-effects of the most frequently used vasoactive substances (papaverine, combinations of papaverine and phentolamine, and prostaglandin E1) are critically evaluated, with particular reference to persistent erection and fibrotic changes in the spongy body of the penis. Over 500 outpatients with ED were examined according to a standard program. Over 90 patients practiced self-injection for an average of 17.6 months (7320 recorded injections). Prostaglandin E1 was used for the initial injection in 200 patients. Persistent erection requiring treatment was reported by only 1 patient. In 45 cases the patients used prostaglandin E1 throughout the treatment. This is currently the vasoactive substance involving least risk in use for the diagnosis and treatment of erectile dysfunction.