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.