Since 1997, a product called MUSE (Medicated Urethral System for Erection) has been available as a treatment for erectile dysfunction. MUSE is a suppository that contains a form of prostaglandin E1 called alprostadil. An alprostadil suppository is about the size of a grain of rice, and it is inserted by the patient about one inch into the urethra using a special device. The drug is absorbed by the erectile tissue in the penis, and blood flow is thus increased. Side effects may include pain, minor bleeding in the urethra, dizziness, and the development of fibrous tissue.
Although a suppository may not suit every man who has erectile dysfunction, it can prove helpful for those who do not respond well to pills and who do not want to take penile injections. The response rate is 30 to 50 percent of men who try it, and for men whose erectile dysfunction has psychological causes, the response is reported to be greater than 75 percent.
To treat erectile dysfunction with a suppository, you should urinate before inserting the medication. Once the suppository has been inserted, stand and massage your penis, or have your partner do it for you, until an erection develops. It may take up to 20 minutes to achieve an erection. Use of a suppository provides a normal-appearing erection with a minimum of side effects, which can include dizziness in about 2 percent of men who take a high dose (1,000 micrograms), and bleeding from the urethra, which is mostly due to poor technique and can be corrected with some education by a healthcare professional.
Disadvantages of a suppository include the fact that about 50 percent of men do not respond, and a lack of consistency, because about half the time the drug does not result in a good erection. Inserting the suppository can be painful in men who have erection nerve injury related to diabetes, prostatectomy, or radiation therapy for prostate cancer. The suppository is also costly, and if not covered by a man’s insurance, can set him back about $25 per dose.
CAUTION:
The advertisements on TV for the major ED drugs always advise you to “seek medical attention if you have an erection lasting longer then 4-hours”. One side effect from drugs to treat ED can be a prolonged erection (known as priapism; an erection lasting longer than four hours). A prolonged erection may also be caused by other treatments such as injections and MUSE suppositories.
Priapism is a serious medical condition, because the penis is deprived of oxygen, which damages and destroys erectile tissue. These warnings should be taken seriously and medical attention sought immediately. Often times, your doctor may give you an information card similar to the Sloan-Kettering Wallet Card for patients using penile injections. This card details the serious nature of priapism and advises the attending medical professional of treatment options and other information.
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