Transurethral alprostadil with MUSE (medicated urethral system for erection) vs intracavernous alprostadil--a comparative study in 103 patients with erectile dysfunction

• Published in: International journal of impotence research Vol. 9; no. 4; pp. 187 - 192
• Main Author: Porst, H
• Format: Journal Article
• Language: English
• Published: England 01-12-1997
• Subjects: Alprostadil - administration & dosage; Alprostadil - adverse effects; Alprostadil - therapeutic use; Arteries; Blood Flow Velocity; Erectile Dysfunction - drug therapy; Humans; Injections; Male; Middle Aged; Penile Erection; Penis - blood supply; Self Administration; Urethra; Vasodilator Agents - administration & dosage
• ISSN: 0955-9930
• DOI: 10.1038/sj.ijir.3900318

A comparative study in 103 unselected patients with erectile dysfunction between MUSE up to 1000 micrograms and intracavernous Alprostadil (Prostavasin) up to 20 micrograms provided total response-rates of 43% (MUSE) vs 70% (Prostavasin). Complete rigid erections were reached in 10% (MUSE) vs 48% (Prostavasin). The average end-diastolic flow values in the deep penile arteries ranged between 9.2-9.4 cm/s after MUSE and 4.5-4.8 cm/s after i.c. Alprostadil confirming the investigator's assessment, that in the vast majority of patients MUSE were not able to induce a complete cavernous smooth muscle relaxation. In terms of side effects the reported penile pain/ burning-rate after MUSE was 31.4% compared to 10.6% after i.c. Alprostadil. In addition after MUSE 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 MUSE-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. MUSE should be reserved for a subset of patients suffering from erectile dysfunction.