What does the procedure involve?
Self-injection of alprostadil (Caverject®) into the penis to produce an erection sufficient for intercourse.
What are the alternatives to the procedure?
Tablets, vacuum erection devices, penile implants, MUSE, psychosexual counselling, no treatment.
What should I expect before the procedure?
Penile injections do not require any form of anaesthetic and are usually performed in the andrology clinic (Urology Treatment Suite) under the supervision of a Nurse Specialist. The Nurse Specialist will demonstrate the technique and will make sure you are comfortable with the procedure. The technique of penile injection produces the most natural form of erection for a man with impotence.
What happened during the procedure?
You will insert the needle into the side of the penis with a sharp thrust, pushing it in to its full depth. This may be slightly painful but a firm and rapid thrust improves or minimises the pain of needle insertion. You may experience a slight pricking sensation on injection which is not unusual. If there is severe pain, stop the injection immediately and seek medical advice if the pain does not settle within 30 minutes.
What happens immediately after the procedure?
When the contents of the syringe have been injected, remove the needle and use your finger or thumb to put gentle pressure on the injection site for a few minutes. Gently massaging the penis a few times between thumb and finger will help distribute the drug throughout the penis. A satisfactory erection should be achieved within 10 minutes. The Nurse Specialist will adjust the dose as necessary depending on the response to treatment.
Are there any side effects?
You may experience pain or discomfort at the time of injection, and you can develop bruising at the injection site. Some men (5%) may develop bending of the penis on erection following repeated injections. Some men may not be able to get an erection with injections – the overall success rate is approximately 80%.
What should I expect when I get home?
Your erection may last anything from 5 minutes to 2 hours. If your erection lasts more than 4 hours or becomes very painful, you should attend the Emergency Admission Suite at Freeman Hospital immediately so that you can receive treatment to stop the erection.
What else should I look out for?
You may develop a small bruise under the skin of the penis at the site of injection. This is nothing to worry about and will disappear by itself over the next few days.
Are there any other important points?
You should not use this technique for obtaining erections more than 3 times in any one week and injections should not be used more than once in any one day. More frequent injections risks damage to the erectile tissue of the penis (which can make you impotent again). If the dose of drug produces no erection, you should contact the Nurse Specialist who will arrange for you to be re-assessed in the Andrology Clinic.
Who can I contact for more help or information?
Sister Judith Heckels on (0191) 213 7001.
