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Title: Erectile dysfunction: a global review of intracavernosal injectables.
Austin Authors: Duncan, Catriona;Omran, Ghadir J;Teh, Jiasian ;Davis, Niall F;Bolton, Damien M ;Lawrentschuk, Nathan
Affiliation: Department of Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
Young Urologists Research Organization (YURO), Melbourne, Australia
North Eastern Urology, Heidelberg, Victoria, Australia
Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: Jun-2019 2019-03-20
Publication information: World Journal of Urology 2019; 37(6): 1007-1014
Abstract: Data assessing the effectiveness of intracavernosal injections (ICIs) for the treatment of erectile dysfunction (ED) are limited. This study evaluates intracavernosal injectable therapies for ED and reviews available guidelines that inform clinical practice. A systematic search using electronic databases (Medline, Pubmed) was performed for studies investigating injectable management strategies for ED published after 1990. Primary outcome measures were to comparatively evaluate clinical efficacy, continuation rates and adverse event profiles of each injectable agent as monotherapy or in combination. The secondary outcome measurement was to discuss available guidelines that inform clinical practice for injectable agents. ICIs demonstrate clinical efficacy in 54-100% of patients, early discontinuation rates of ≤ 38% and adverse events in ≤ 26%. Discontinuation rates are typically greatest within 3-6 months of commencement. Anxiety related to the initial injection occurs in approximately 65% and anxiety levels can remain high for 4 months. Approval of intracavernosal injection agents is mainly limited to alprostadil with the recent addition of aviptadil/phentolamine combination therapy in a select few geographical regions. Although combination therapies are attractive alternative options, their formulations are variable and should be standardised before widespread acceptance is achieved. ICIs are associated with good clinical efficacy rates, high discontinuation rates and a moderate side-effect profile. They represent an important tool in the urological armamentarium for treating ED in patients that cannot tolerate or are refractory to oral therapies.
DOI: 10.1007/s00345-019-02727-5
ORCID: 0000-0001-8553-5618
Journal: World Journal of Urology
PubMed URL: 30895359
Type: Journal Article
Subjects: Erectile dysfunction (ED)
Intracavernosal injections
Treatment of ED
Treatment of erectile dysfunction
Appears in Collections:Journal articles

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