Erectile dysfunction (ED) is a common condition, characterized by the consistent inability to achieve or maintain an erection firm enough for satisfactory sexual activity. A variety of treatments are available, ranging from oral medications to vacuum devices and surgical implants. Among these, intraurethral alprostadil represents a medical approach designed to assist in achieving an erection.
What Intraurethral Alprostadil Is
Intraurethral alprostadil is a specific formulation of the medication alprostadil, which is a synthetic version of prostaglandin E1 (PGE1). This treatment is delivered directly into the urethra, the tube that carries urine and semen out of the body. It typically comes as a small pellet or micro-suppository, measuring about 1.4 mm in diameter and 3 mm or 6 mm in length, housed within a translucent hollow applicator. One common trade name for this product is MUSE, an acronym for Medicated Urethral System for Erections.
How Intraurethral Alprostadil Works
Upon administration, intraurethral alprostadil is absorbed through the urethral lining. The residual urine in the urethra helps disperse the medicated pellet, allowing for absorption by the urethral mucosa. This absorption is biphasic, with approximately 80% of the dose absorbed within the first 10 minutes.
Once absorbed, alprostadil acts locally by causing the smooth muscles within the penis to relax. This relaxation leads to vasodilation, which is the widening of blood vessels in the penile tissues. The increased blood flow into the erectile tissues (corpora cavernosa) expands the lacunar spaces within these bodies. This increased blood flow fills the erectile tissues, leading to penile rigidity.
Using Intraurethral Alprostadil Effectively
It is important to urinate before using the medication to ensure the urethra is clear, as urinating afterward could expel the medication. The medication is stored in the refrigerator and comes as a small pellet within a plastic applicator.
To administer, the applicator stem is gently inserted into the tip of the penis, and the pellet is delivered by depressing a button on the applicator. Some individuals may find that applying a small amount of water or a water-based lubricant to the tip of the penis can reduce discomfort during insertion. A slight stinging sensation may be felt initially, but this typically subsides quickly.
After insertion, gently rolling the penis between the fingers can help disperse the medication and aid absorption. Standing or walking around for a few minutes after application can also enhance effectiveness. The onset of effect is generally rapid, typically occurring within 5 to 10 minutes of administration. The duration of the effect usually lasts for about 30 to 60 minutes, though this can vary among individuals. A healthcare provider will provide specific instructions regarding the appropriate dosage and frequency of use, which should not exceed more than two systems per 24-hour period, with each use spaced out by at least 24 hours.
Potential Effects and Considerations
While generally effective for some men, it may only work for a segment of the population, with effectiveness noted in about 20-30% of men.
Individuals may experience some common side effects, including a burning sensation in the penis or urethra, which is usually temporary and resolves within a few hours. Other reported side effects include penile pain, urethral bleeding, and dizziness. Less common but more serious effects can occur, such as priapism, an erection lasting longer than four hours. If an erection persists for more than four hours, immediate medical attention is necessary to prevent potential permanent damage to the penis. Fainting is another rare but possible side effect.
This treatment is typically prescribed after a thorough evaluation by a healthcare provider. It may be considered for individuals for whom oral medications like PDE-5 inhibitors (e.g., sildenafil) are not effective or suitable. However, it is not advisable for individuals at risk for priapism, those with certain blood disorders, or those with anatomical deformities of the penis. Since intraurethral alprostadil requires a prescription, it should only be used under medical supervision, with adherence to the prescribed dosage and instructions to ensure safety and effectiveness.