Injection Therapy

Content written by Irwin Goldstein MD

Intracavernosal injection therapy for erectile dysfunction (ED) from arterial insufficiency, bicycle riding, cancer treatment, diabetes, metabolic syndrome, pelvic or perineal trauma, thyroid problems or venous leak has been utilized as a safe and effective therapy since 1983. Self-injection therapy is indicated for men who were not successful with oral medications or for whom oral therapies were not options. Although some men hesitate to think about placing a needle into the base of their stretched penis, and some defer their treatment to “think” about it, most men choosing injection therapy quickly realize that the benefit of the injection far outweighs the slight momentary discomfort. The injection allows most patients to have reliable erections on command, and the needle size has been reduced to an ultra fine diabetes needle.

Indications for injections are moderate to severe erectile dysfunction from venous leakage, usually associated with diabetes, hypertension, cigarette smoking, high cholesterol, obesity, metabolic syndrome, or aging, post-radical prostatectomy and neurologic impotence such as multiple sclerosis or spinal cord injury which fails traditional medical management.

A strict training program is required of all patients to minimize side effects from this therapy that can include penile pain, penile bleeding and bruising. Scar tissue formation as a result of post-injection bleeding can be avoided with proper post-injection compression. Priapism, an unwanted persistent rigid erection lasting for many hours, can be avoided with medically supervised dose-titration office visits. Dose titration is part of the formal training program for intracavernosal injection therapy.