Penile Injection Therapy & Erectile Dysfunction

The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Having injected yourself with the correct dosage of solution, immediately withdraw the needle (do not twist or jerk as this will increase the chances of bruising) and at the earliest opportunity place the used needle in the provided sharps bin. You can use an empty detergent or bleach bottle with a cap, or a metal coffee can with a plastic top. This is generally well-tolerated by the patient and does not interfere with intercourse. Any injection into the penis has the risk of causing a scar (plaque) in the penile tissue.

Papaverine and Phentolamine may produce a painful, prolonged erection known as priapism. Your doctor may point out ‘risk factors' that can be changed or improved. You must always wipe the rubber stopper with alcohol before you insert the needle.

Touch the needle to your skin and quickly slide it into the shaft of your penis. Alprostadil is a vasoactive agent that is a synthetic version of the chemical prostaglandin E. Miraculously supposed to enlarge the to increase penis size and since they are in their late 20s afflicted with this disease. If you see any air bubbles, pull more medication into the syringe. Withdrawing the medication Pull the plunger down past your prescribed dose. However, with injection therapy, we tend not to see these types of side effects.

When you place the cap back on the syringe, make sure you don’t push the plunger by accident. Don’t change the dose without speaking to your APP. If you aren’t circumcised, pull your foreskin back before grasping the head of your penis. Push the air into the bottle. Follow us on Instagram: Go to your local emergency room if you’re more than 30 minutes away from MSK’s Urgent Care Center. To give papaverine injection:

  • Push the medication in slowly - over 8 to 10 seconds.
  • Make sure to have pseudoephedrine HCl with you as long as you’re using the penile injections.
  • I suffer from what seems to be vasovagal syncope.

Gaining An Erection

It is very rare but possible and you need to know what to do if it happens. If you imagine the penis as a clock, you are injecting into either 10 o'clock or 2 o'clock. Very often with injections, a man may develop erections lasting two to three hours. Two alprostadil products are currently available for injection – Caverject® and Viridal®. Check expiration date of medication. Do not inject more than one dose in a day. If you are a current subscriber with Society Membership or an Account Number, claim your access now.

The active ingredient in the ‘medicated urethral system for erection’ (MUSE®) is alprostadil, which has been used as an injection for many years (see the previous section).

Things to Remember

With that in mind it’s always best to alternate between the left and right side of the penis when taking the injection. If you aren’t treated quickly, it’s possible that you will end up with permanent ED. But she says that as long as she washes her hands and her eggs, she doesn’t care about the recall. Don’t take any other medication for ED without speaking to your APP.

It’s important that you follow the treatment plan that your APP gave you. Erection problems (erectile dysfunction), parkinson's disease drugs. The patient (or his partner) is taught by a nurse or doctor how to inject the drug directly into the shaft of the penis when he wants an erection (up to a maximum of 3 times per week and not more than once daily). This is called "priapism" and can cause permanent damage to the erection tissue of the penis.

Priapism is easily reversed when treated early.

Money & Education

Prostaglandin E1, on the other hand, must be kept refrigerated at 5 degrees Centigrade, and it will last for four months. If it’s not used properly, it can permanently damage the penis. It should be used 5 to 30 minutes before intercourse and improvements in erection should last between 1 and 2 hours. This information will help you learn to inject medication into your penis. Please feel free to email us or phone our Helpline (our contact details are at the bottom of this page). Once inserted, carefully push down on the plunger to administer the dosage. You may be nervous about doing self-injection at first.

Penile Injection Instructions.

The alprostadil then passes into the surrounding tissues of the penis, creating an erection. It's important to hold the vial upright and upside down (when loading your syringe) because otherwise you may end up loading your syringe with air, and then injecting air into the penis. With the implant, men can control firmness and, sometimes, the size of the erection. This side effect generally occurs while the doctor is attempting to adjust the dosage of medication. Also, external stimulation to the penis increases blood flow to the penis and allows the medication to take effect faster. Even though the thought of this brings tears to the eyes of some of the strongest men, the procedure is easy to learn and, surprisingly, it is not too uncomfortable. The surgeon or health care expert in the surgeon's office will talk about how to inflate and deflate the implant. There can be other side effects that occur, these are due to the injection process.

Insert the cartridge into the injection device with the tip facing toward the attached needle (Figure F). It should not be painful. You remove this, and then you’re going to compress. For your injection to work, the medication needs to go into the erectile tissue. The process is already used in sport medicine to rejuvenate torn ligaments.

Injecting blood isn’t the only treatment being trialled to improve sexual dysfunction - a study in the Journal Of Urology researching new therapies for erectile dysfunction found that "neovascularisation using vascular growth factors have been demonstrated to be feasible in animal models". Male impotence & erectile dysfunction treatments, how do you rate your confidence that you could get and keep an erection? Papaverine is available only with your doctor's prescription. You put a tiny needle into the side of your penis and inject a medicine.

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As with any drug product, extremes in temperature should be avoided. Yes, it is safe and beneficial to use a Vacuum Pump with Penile Injections. Alprostadil has been used as an injection for the treatment of erection problems in the UK since 1994. Set the injection device down on a clean, level surface and do not allow the needle to touch anything. Insert the same volume of air into vial matching the injection dose (if dose is 10 units inject 10 units of air).

You want to avoid any visible veins or arteries. You may be asked to change certain food habits, stop smoking, increase workouts or stop using drugs or alcohol. They have kept him on all the drugs.

The rational for selecting the minimum 2-weeks waiting period is to give a chance for the BTX-A to reach its maximum effect. It’s a 29 or 30-gauge needle, which means it’s very fine. Other rare side effects include dizziness and headache. Updated visitor restrictions now in effect. Throw the cap away. Apply pressure at the injection site for 2 to 3 minutes with your thumb on the injection site and your index finger on the opposite side of your penis.

Related Resources

Helped maintain erections for long periods of treatment erectile time and for a whole host of services to individuals and families affected by eating. If your dose is different, do not change it unless your doctor tells you to do so. After your second training visit, your medication will be delivered directly to your home from the compounding pharmacy (specialized pharmacy). You draw air into the syringe (an insulin syringe is most commonly used), down to the amount that you're going to dose with - this isn't going to be a guessing game. When you have a full erection, no fresh blood flows into your penis. We spend a lot of time outside and get plenty of sun since we both play golf. Do not keep outdated medicine or medicine no longer needed.

The interactive transcript could not be loaded. The first target is the body of the penis, which will produce an erection. In the first few injections you may find that the dosage needs to be increased as although an erection is attained, the strength of that erection perhaps isn’t quite substantial enough to allow for penetration. Check with your doctor immediately if any of the following side effects occur: Check for air bubbles in the syringe. Following just a single injection, results are seen approximately 5-15 minutes later. The treatments below are available to treat ED directly. Make sure you tell your doctor if you have any other medical problems, especially:

Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Most men with penile implants and their partners say that they're satisfied with the results, and they return to more spontaneous intimacy. If it doesn't stop, check with your doctor. Penile duplex will be performed to assess a vascular etiology before the treatment and 2 weeks later. Follow the directions on your disposal container for proper disposal procedures. If present, the pain usually subsides in 15 minutes. The erection hardness score (EHS) will be assessed during the Doppler exam. The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses).

  • In addition to dilating the arteries in the heart, Papaverine has also been used to treat Alzheimer’s disease and Multiple Sclerosis.
  • You have occasionally gotten questions about Viagra being expensive.
  • If she is, or may be pregnant, you should use a condom.
  • 20 mg of vardenafil (Levitra) taken on an empty stomach.

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This helps the medicine spread to all parts of the penis, so that it will work better. “First the doctor or nurse applies a numbing cream to the Penis and the arm. How long does a penile injection last? This will allow your penis to be more fully stretched. Call your healthcare provider if you have: Attach the needle to the tip of the edex® (alprostadil for injection) injection device by turning clockwise until tight (Figure C).

If no particular cause is identified, most men are treated with medications such as sildenafil (Viagra), which work by improving the blood flow to the penis. Don’t place your index finger or thumb on the plunger. Similar to the effect of Papaverine, Prostaglandin E-1 causes the relaxation of the muscle cells of the arteries in the penis, resulting in an erection.

Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options. As well as insuring that you don’t have too many injections within a specified time frame, it’s also important that you alternate between the left and right side of the penis when injecting. Do not touch the exposed needle (Figure B). Check to see if the seal on the base of the needle is intact. Please read this information carefully before you prepare the edex® (alprostadil for injection) solution. If the erection is lasting two hours, you can start to manually bring the erection down using methods to constrict the blood vessels. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Adults—30 to 60 milligrams (mg) injected very slowly into the area of your penis as directed by your doctor.

Reporting Your Injections

Your dose has been customized for your individual needs. EXTREMELY graphic: A patient will either go home on the same day or spend one night in the hospital. Here are links to Trimix injection videos. Remove the cap covering the needle. Never inject into the top, underside or tip of the penis whilst also ensuring you avoid injecting into any nerves or blood vessels.

Wipe it with an alcohol wipe. Failure to undo priapism will lead to permanent penile damage and untreatable ED. It might even cause a bend in the penis, this is called Peyronie's Disease. Vascular surgeons and radiologists have used Papaverine for procedures involving the arteries. Many men may be prescribed medicines that go directly, via injection, into the penis. ‌​ Read this resource carefully before starting injection therapy.

This will limit delays in delivery.

Topical Drugs & Erectile Dysfunction

To best avoid breaking the needle, you should pay careful attention to your doctor's instructions and try to handle the injection device properly. If a penile prosthesis is removed, other non-surgical treatments may no longer work. First significantly improved mental fatigue and lack of energy and other symptoms produced by an increased blood flow within the sexual health service in the birmingham. To improve comfort and to reduce bruising and swelling, make sure that you alternate the side of the penis you inject in – if your last injection was on the left side of your penis, this time use the right side and vice versa. Within two or three seconds, the fluid will be injected. If there is a post-operative infection, the implant will likely be removed.

This test was described as the “pheochromocytoma test,” and involved the intravenous injection of 5 mg of Phentolamine.

Related to Erectile Dysfunction

Although there is no specific information comparing the use of papaverine for erectile dysfunction in the elderly with use in other age groups, papaverine is not expected to cause different side effects or problems in older people than it does in younger adults. By comparison prescription strength drugs for erectile dysfunction cost roughly between $20 to $40 per dose so it’s easy to see the cost benefit of choosing penile injections over the likes of Viagra another mainstream branded impotence pills. Imagine that your penis is divided in 3 parts. My family doctor is suggesting that I have a tilt table test.

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None of these videos is pornographic and all are purely instructional with some of them featuring members of this forum. This means that when injecting you should only feel a slight scratch as you insert the very thin needle approximately 1cm into the skin. TriMix includes papaverine and phentolamine along with alprostadil.

It usually takes a few injections to find the right dose for an erection firm enough to have sex. However, penile injection therapy, because it does not work through the use of intact nerves, may actually still work even in the absence of solid intact nerves that go to the penile tissues. The erection will last 30 minutes to an hour or up to orgasm. Subscribe to our YouTube channel:

There are two types of penile implants. Side effects include heart beat irregularities, diarrhea, and abdominal discomfort. What is topical treatment? Scientists are rethinking how much vitamin D is necessary on a daily basis. Do this quickly to reduce discomfort.

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The vagus nerve can slow down the heart and dilate blood vessels inappropriately due to neurological signals, causing blood pressure to go down, in response to many conditions, such as emotional stress, pain, fear, prolonged standing and heat exposure. The guidelines for treating a prolonged injection recommend 120 milligrams, so for Sudafed you would take two tablets. How do i know if i’ve used a big enough dose? Like us on Facebook:

Do not click on these links if you are offended by images typically seen on porn sites.

What are the risks of Penile Injection Therapy?

They are available in a variety of dose strengths. The cost of a per dosage penile injection will invariably differ depending on location, the type of injection solution (the compounding pharmacy) used and the amount of solution (defined by your consultant) required to attain the desired results. 24 males with will be included in the study. How should i store Alprostadil or TriMix penile injections? This is an excellent choice to improve uninterupted intimacy and makes relations more spontaneous.

Experts & Community

Wash your hands with an anti-bacterial soap. So, it is one approach that can be used for patients who have undergone prior surgery and have erectile dysfunction as a result of injury to the nerves. Where erectile dysfunction is concerned, an erection hardness score (or EHS) is used to evaluate the strength of a man’s ability or inability to gain and maintain an erection. The simplest kind of implant is made from two easy-to-bend rods that are most often made of silicone. For information about storing and disposing of your home medical sharps, read our resource How to Store and Dispose of Your Home Medical Sharps. It is very unlikely that injection in the wrong place or into the urethra will cause a problem. (If it doesn’t, stop right away.)

Monday through Friday between 9: This helps the blood flow and spread the medication throughout the penis. The needle should be facing the floor.

The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically. Grasp the head of your penis, not the skin. If the pain is more than just a bit, there are methods that you can use to circumvent this. Rarely, scarring or a plaque of the penis can occur. Excess solution will be expelled through the needle. “Then, using a high speed centrifuge, platelet rich plasma is isolated from the red blood cells, and contains valuable growth factors.

You shouldn’t continue to inject with the same dose if you took pseudoephedrine HCl for a prolonged erection.

  • The reusable edex® (alprostadil for injection) injection device is used to prepare and administer the edex® (alprostadil for injection) solution.
  • Although it is not supposed to be painful, it must be done properly to minimize the risk of Peyronie’s disease as a complication.
  • There are several treatments available, which include medication, such as Viagra, Levitra, Cialis, penile injection therapy as well as vacuum devices and there may be a role for injection therapy.

ADVERTISEMENT Thanks for watching! Slowly push the air bubbles and the extra medication back into the vial. If the solution does not inject easily, or if you immediately experience a burning pain at the injection site, reposition the needle by advancing it slightly or by partially withdrawing it until the solution can be injected easily and painlessly.

Please make sure to include the information below in your injection reports. If you notice bleeding at the site when you inject papaverine, put pressure on the spot until the bleeding stops. All patients will sign an informed consent. As I mentioned, it can be used in patients for whom medications are no longer effective or not working or where patients have significant side effects from them. In general, the amount of time that it takes to obtain an erection is a correlate to the extent of arterial blockage.

Erectile Dysfunction

Hold the injection device in an upright position with the needle pointing up. For non-prescription products, read the label or package ingredients carefully. In most cases the ache is very dull and mild to moderate in nature. Please feel free to add to this list of links. Since it is a natural product of the body, the enzymes locally present in the penis can break down Prostaglandin E1.

If you’re taking a blood thinner or aspirin, hold the pressure for 5 minutes. After that, the patient learns to inject under Dr. Cbem llc, you can find out more from an such misotrol or abilitynet, a different delivery that helps certain people to get and use selling place. Don’t use the medication if: Some men would like a different treatment for erectile dysfunction. If they are pregnant, breastfeeding or of childbearing age, it is advised that you use a condom.

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You can also jump in the shower. Wash your hands well with soap and water. If you cannot see or cannot grasp the broken end, you should promptly contact your doctor. The second category of side effects is produced by the medications themselves. My wife and I live in Florida.

If you are interested in donating, please click here or contact us for more information (details at the bottom of this page). My erection was a _________ on a scale of 0 to 10. This can keep the medication good for a few additional months.


Priapism (prolonged erection) emergency room treatment. MUSE® comes in a variety of dose strengths. With an inflatable implant , fluid-filled cylinders are placed lengthwise in the penis. Swab the area you will be injecting (see next step) with an alcohol swab first. The procedure is not for the faint-hearted, as the patient's blood is withdrawn and processed through a centrifuge to create platelet-rich plasma which contains growth factors. This can help prevent pain. You can also visit the NHS Choices website at www. If you want to buy the pseudoephedrine HCl at your local pharmacy, you don’t need a prescription, but the boxes are kept behind the pharmacy counter.


Using a very thin, fine needle (which means discomfort is reduced to the absolute minimum), a specific amount of medication is injected into the corpus cavernosum vein which is located in the penis. Sometimes, penile injections can cause priapism (an erection that lasts too long). Once the needle is in, push the plunger all the way down, then remove, and put straight in a sharps container. We are as surprised as you are that your sun exposure hasn’t boosted your vitamin D levels. The tissue that causes you to get an erection (erectile tissue) is a muscle. I found your website on the Internet and it seems to have a lot of helpful information for guys in my position. In the rare and unlikely event that bleeding persists after 10 minutes of pressure being applied, you should seek medical attention as quickly as possible.

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