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Contemporary Treatment of Erectile Dysfunction pp 107–125Cite as

Self-Injection, Transurethral and Topical Therapy in Erectile Dysfunction

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Currently there are three main agents for intracavernosal injection (ICI) therapy and one agent for intraurethral therapy approved by the FDA for the treatment of erectile dysfunction (ED). These effective agents were the focus of intense interest in the mid1990s, but were quickly relegated to second line therapy after the appearance of sildenafil. Indeed, while sildenafil prescriptions nearly doubled to 14 million from 1998 to 2001, prescriptions for alprostadil injections dropped by one third to 159,000 and MUSE™ prescriptions fell by two thirds to 132,000 (Wysowski & Swann, Journal of Urology, 169, 1040–1042, 2003). It must be noted, however, that the phosphodiesterase-5 inhibitors (PDE5Is) are ineffective in about 22–35% of men (McMahon, Samali, & Johnson, Journal of Urology, 164, 1192–1196, 2000). Furthermore, of the men treated with oral agents, a significant proportion will ultimately fail (even after PDE5I dose escalation) secondary to progression of their disease. Additionally, there are a significant number of men with contraindications to PDE5Is. The result is a large number of men who are unable to utilize oral treatments for erectile dysfunction. Fortunately, second line therapies in the form of vacuum erection devices (discussed in detail in a separate chapter), ICI and MUSE™ are highly effective treatments that may be used when PDE5Is are contraindicated.

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  1. Division of Urology, Southern Illinois University, 301 N. 8th Street-4B, Springfield, IL, 62794, USA

    Herbert J. Wiser

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  2. Tobias S. Köhler
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Correspondence to Herbert J. Wiser .

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  1. Feinberg School of Medicine, Department of Urology, Northwestern University, East Chicago Avenue 303, Chicago, 60611-3008, Illinois, USA

    Kevin T. McVary

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Wiser, H.J., Köhler, T.S. (2011). Self-Injection, Transurethral and Topical Therapy in Erectile Dysfunction. In: McVary, K. (eds) Contemporary Treatment of Erectile Dysfunction. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-60327-536-1_9

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