Injection therapy for erectile dysfunction involves administering medication directly into the base or shaft of the penis to help achieve an erection. This method is a common and effective treatment option, particularly when oral medications are not suitable or have proven ineffective.
How It Works
Injection therapy increases blood flow to the penis. The penis contains sponge-like erectile tissue, the corpora cavernosa, which fills with blood to create an erection. The medications used in these injections relax the smooth muscle within these tissues and dilate the arteries that supply blood to the penis. Common medications include alprostadil, which is the only FDA-approved agent for intracavernosal injections. Other medications like papaverine and phentolamine are also used. Often, these drugs are combined into formulations like “bimix” (papaverine and phentolamine) or “trimix” (alprostadil, papaverine, and phentolamine) to enhance their effects, allowing for a synergistic action and leading to a sustained erection.
Administering the Injection
Administering the injection requires preparation and technique, often with initial guidance from a healthcare professional. First, thoroughly wash your hands and gather all necessary supplies: the medication vial, a small insulin syringe with a fine needle (typically 27- or 30-gauge), and alcohol wipes. Clean the medication vial’s rubber stopper with an alcohol wipe and let it dry before drawing the dose into the syringe.
To prepare the penis, gently grasp the head and stretch it straight out or slightly to the side. If uncircumcised, pull the foreskin back to prevent the needle from going between the skin and erectile tissue. The injection site should be in the middle third of the penis, typically at the 10 o’clock or 2 o’clock position on the side, avoiding visible veins, nerves, or the top and bottom surfaces. It is important to alternate injection sides with each use to prevent scar tissue formation.
After cleaning the site with an alcohol wipe and letting it dry, hold the syringe like a pencil or dart at a 90-degree angle to the skin. Quickly and smoothly insert the needle all the way into the shaft of the penis. Once the needle is fully inserted, slowly push down on the plunger to inject the medication. After injecting the full dose, quickly pull the needle straight out without twisting or jerking. Immediately apply gentle pressure to the injection site with an alcohol pad or gauze for 2 to 3 minutes, or up to 5 minutes if taking blood thinners, to minimize bruising or bleeding.
Potential Effects and Considerations
Following the injection, an erection typically develops within 5 to 20 minutes, often with stimulation. The duration of the erection can vary but usually lasts between 30 minutes to 2 hours, and may persist through climax. Firmness and duration depend on the medication and dosage, which a healthcare provider may adjust.
Potential side effects can occur. Common effects include penile pain or ache, a burning sensation (especially with alprostadil), and bruising at the injection site. To alleviate pain, taking acetaminophen about 30 minutes before the injection might be helpful. More serious, though less frequent, side effects include priapism, a prolonged erection lasting more than four hours. Priapism requires immediate medical attention to prevent tissue damage and permanent erectile dysfunction.
Long-term use may also lead to penile fibrosis or scar tissue development at injection sites. Injection therapy is typically recommended as a second-line treatment option, often after oral medications have been ineffective or poorly tolerated. It can be effective for men with nerve damage or other conditions affecting blood flow. However, it may not be suitable for individuals with limited manual dexterity, those on certain blood thinners, or those with significant penile scarring. Consult a healthcare professional to determine if injection therapy is appropriate and for personalized guidance.