title: MUSE: clinical experience.
abstract: BACKGROUND
  In the UK, an estimated 17-19% of men suffer from erectile dysfunction (ED). Until the introduction of sildenafil, the medical treatment of ED mainly depended on intracavernosal injections. The introduction of MUSE has generated interest, since it obviates the use of 'needles'. MUSE is an intra-urethral method of alprostadil (prostaglandin E1 analogue) administration. We investigated the safety and efficacy of MUSE in 100 patients.
  
  
  METHODS
  After confirming the diagnosis of ED, treatment was started with MUSE. Once we were satisfied that the patients could self-administer MUSE, they were discharged from our clinic. They were contacted six months later and asked to complete a questionnaire.
  
  
  RESULTS
  Only 35% of the 100 patients (aged 46-73 years) with ED of mixed aetiology were initially successfully treated with MUSE. All but two of them needed 1,000 microg. After six months, only 43% of these initially successfully treated patients continued to use MUSE; of these, 33% only found it effective on every third occasion, or worse. The remaining 57% of the initially successfully treated patients stopped taking MUSE because it was no longer effective or it caused side-effects (such as urethral bleeding and/or irritation).
  
  
  CONCLUSIONS
  MUSE, in our experience, is moderately effective in treating ED. However, MUSE is an alternative in some patients with ED who do not respond to other treatments or where these options are contraindicated. Owing to the high dropout rate, patients treated with MUSE should be followed-up closely.
authors.affiliation: Department of Urology, Royal Free and University College Medical School (University College London), The Royal Free Hampstead NHS Trust, UK. Ktasmas@aol.com
authors.forename: M A
authors.initials: MA
authors.lastname: Khan
authors.forename: M
authors.initials: M
authors.lastname: Raistrick
authors.forename: D P
authors.initials: DP
authors.lastname: Mikhailidis
authors.forename: R J
authors.initials: RJ
authors.lastname: Morgan
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage* / Q000009:adverse effects; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000527:Alprostadil