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Transurethral alprostadil with MUSE (medicated urethral system for erection) vs intracavernous alprostadil--a comparative study in 103 patients with erectile dysfunction.

Abstract
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.
AuthorsH Porst
JournalInternational journal of impotence research (Int J Impot Res) Vol. 9 Issue 4 Pg. 187-92 (Dec 1997) ISSN: 0955-9930 [Print] England
PMID9442415 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)
Chemical References
  • Vasodilator Agents
  • Alprostadil
Topics
  • Alprostadil (administration & dosage, adverse effects, therapeutic use)
  • Arteries
  • Blood Flow Velocity
  • Erectile Dysfunction (drug therapy)
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Penile Erection
  • Penis (blood supply)
  • Self Administration
  • Urethra
  • Vasodilator Agents (administration & dosage)

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