Intraurethral Alprostadil

Aka: Intraurethral Alprostadil, MUSE

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II. Indications

  1. Psychogenic Impotence
  2. Neurogenic Impotence
  3. Vasculogenic Impotence

III. Contraindications

  1. Penile deformity (e.g Peyronie's Disease)
  2. Sexual intercourse with pregnant women
    1. Risk of Preterm Labor
  3. Priapism risk
    1. Sickle Cell Disease or Sickle Cell Trait
    2. Leukemia
    3. Multiple Myeloma
    4. Polycythemia Vera
    5. Thrombocythemia
    6. Anticoagulant use

IV. Preparation

  1. Transurethral preparation
    1. Inserted 3 cm into Urethra with plastic applicator
  2. Semi-solid pellet
    1. Diameter: 1.4 mm
    2. Length: 3-6 mm

V. Efficacy

  1. Successful intercourse in 65% of 1511 tested
  2. Placebo success rate: 19%
  3. Less effective than injectable alprostadil

VI. Adverse effects

  1. Hypotension (3%)
  2. Dizziness (2%)
  3. Mild Erectile discomfort (32%)
  4. Minor Urethral burning or bleeding
  5. Priapism is rare

VII. Dosing

  1. Dose 125-1000 ug ($114-$137 for 6 units)

VIII. Reference

  1. Padma-Nathan (1997) N Engl J Med 336(1):1-7 [PubMed]

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