Transurethral alprostadil with MUSE (medicated urethral system for erection) vs intracavernous alprostadil--a comparative study in 103 patients with erectile dysfunction.
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.
Porst
H
H
D000527:Alprostadil / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001158:Arteries; D001783:Blood Flow Velocity; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000098:blood supply; D012646:Self Administration; D014521:Urethra; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D000527:Alprostadil