Papaverine or Prostaglandin Injections

This consists of injecting the substance into the shaft of your penis, the same as in the diagnostic test mentioned a few pages ago. I realize it sounds painful when you read about it, but it usually is not. A very fine needle is used. In some men, however, the medicine itself, not the shot, does cause pain. This method requires a prescription after your urologist determines the correct dose and teaches you how to inject yourself. When you want an erection, you give yourself a shot. Within fifteen to thirty minutes, you’ll have a good erection that will last from thirty minutes to an hour or longer.

ADVANTAGE:

• The ability to have good, long-lasting erections when you want without incurring the cost, pain, and risks of surgery. The erections produced by injections look and feel more “natural” — the size and rigidity are more like what you used to have — than those produced by vacuum devices and implants.

DISADVANTAGES:

• The idea of putting a needle into their penises is not appealing for many men and they won’t even consider this option. Or they consider it briefly but turn to other methods before they give it a chance. Others are willing to inject themselves regularly, but they don’t like it; one reason, of course, is the pain some of them experience, presumably as a side effect of the drug.
• Injecting yourself can interfere with spontaneity, but this is easily remedied by making the shot a part of loveplay.
• These injections have been used only since 1983, and we don’t know a lot about long-term effects. There is some evidence that over time the injections form scar tissue in the penis, making it difficult or even impossible to continue giving them.
• These shots continue to be needed to get erections. It was once thought that many men would regain confidence after a few shots and be able to have erections without them. Unfortunately, this has proven to be true in only a small number of cases.
• Although the risk is small, a few men who inject themselves get priapism, an erection that won’t go down. This necessitates a trip to the doctor’s office or a hospital emergency room for treatment.

Regarding both vacuum devices and injections, it’s well to keep in mind that they can cause some difficulties in the beginning. Most couples, after all, are not accustomed to stopping loveplay in order to do something special to attain erection, and many couples are not accustomed to talking openly about sex. There can be embarrassment, anxiety, and hesitation. One man, for instance, didn’t have sex for weeks after he got his injection materials, because he couldn’t figure out how to tell his partner that he wanted to go to another room to inject himself. This despite the fact that she had been to the urologist with him and knew full well about the shots. Even though they now have a way to get an erection, some men still feel like failures because they can’t get “normal” erections. This feeling makes them hesitant to use their artificial method. Such difficulties can usually be worked out easily if the partners are able to talk openly about their concerns, but in some cases a few sessions with a sex therapist are advisable.

DRUG THERAPY FOR ERECTILE DYSFUNCTION

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