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Self-Injection, Transurethral, and Topical Therapy in Erectile Dysfunction

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Contemporary Treatment of Erectile Dysfunction

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

Abstract

At this time 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 mid-1990s, but were quickly downgraded 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 and Swann, J Urol 169(3):1040–1042, 2003). It must be noted, however, that the phosphodiesterase-5 inhibitors (PDE5Is) are ineffective in about 22–35 % of men (McMahon et al., J Urol 164(4):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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Acknowledgment

We would like to thank Dr. Herbert J. Wiser for his contribution and participation in the first edition version of this chapter.

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  1. Department of Surgery, Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA

    Cynthia L. Bednarchik MS, APN, FNP-BC, Michael Kottwitz MD & Scott W. Geiger

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Correspondence to Cynthia L. Bednarchik MS, APN, FNP-BC .

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  1. Southern Illinois University School of Medicine, Springfield, Illinois, USA

    Tobias S. Köhler

  2. Division of Urology Department of Surgery, Southern Illinois University School of Medicine Hospital Affiliates, Springfield, Illinois, USA

    Kevin T. McVary

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Bednarchik, C.L., Kottwitz, M., Geiger, S.W. (2016). Self-Injection, Transurethral, and Topical Therapy in Erectile Dysfunction. In: Köhler, T., McVary, K. (eds) Contemporary Treatment of Erectile Dysfunction. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31587-4_14

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  • DOI: https://doi.org/10.1007/978-3-319-31587-4_14

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