Effect of Intracavernosal Injection of Prostaglandin E1 on Duration and Rigidity of Erection in Patients with Vasculogenic Erectile Dysfunction: Is it Dose Dependent?

OBJECTIVE: To assess if the effect of intracavernosal injection (ICI) of prostaglandin E1 (PGE1) on duration and rigidity of erection is dose dependent in patients with different types of vasculogenic erectile dysfunction (ED)?

METHODS: A hundred patients with ED were assigned into 4 groups (n=25/each); group (A) patients with arteriogenic ED, group (B) patients with veno-occlusive ED, group (C) patients with mixed (arteriogenic and veno-occlusive) ED and group (D) patients who have only psychogenic ED (control). After ICI of PGE1 patients were assessed using penile doppler ultrasonography and erection hardness score together with calculation of erection duration. The starting dose of PGE1 was 5μg which was increased to 10µg and 20µg as a maximal dose when needed.

RESULTS: The mean PSV of patients in groups A, B, C and D were 24.38±3.3, 37.74±8.28, 22.24±3.85 and 47.76±6.27 respectively. In group D, 88% have achieved the best response at dose of 5 µg while 5.3%, 21.7% and 0% have achieved the best response at dose of 5µg in groups A, B and C respectively (p<0.05 for each). The rest of patients have required either 10 or 20µg to achieve the best response. Patients in group C have required the highest dose of PGE1 to achieve the best response (p<0.05).

CONCLUSION: Intracavernosal injection of PGE1 in escalating doses have improved the rigidity and duration of erection in patients with different types of vasculogenic ED. Patients with mixed arteriogenic and veno-occlusive ED have required the highest dose of PGE1 to achieve the best response.