Assessing the use habits and efficacy of intracavernosal alprostadil: is it tolerable and sustainable?

Background: The aim of this study was to evaluate the efficacy of intracavernosal alprostadil treatment for erectile dysfunction and the evaluation of factors such as ease of drug use, duration of use, and difficulties in habituation. Methods: The data of 40 patients who were treated for erectile dysfunction, had inadequate response from first-line treatment modalities, received intracavernosal alprostadil in second-line treatment and continued treatment for more than 12 weeks without interruption were analyzed. Sexual function status was evaluated by 15-question international ındex of erectile function (IIEF-15) form and degree of erection (1-10 points). In addition, duration of use, self-administered dose, reasons for difficulty, and reasons for treatment interruption were investigated. Results: The mean duration of use was 21.38 months. Patients switched to self-administration after an average minimum dose of 2.23 doses. After 12 weeks, 50% of the patients discontinued self-administration, 10% because of difficulty in administration, 55% because of inadequate erection response, 25% because of time, and 10% because of additional health problems. IIEF-15 parameters and the degree of erection were found to improve significantly after administration (p<0.05 for all parameters). Conclusions: Intracavernosal alprostadil provides significant improvement in sexual function, but since it is an invasive application, patients have difficulty in getting used to it, self-administration is started after a minimum of 2 doses, and the reason for discontinuation is mostly due to inadequate erectile response.