INGECTION TREATMENTS FOR ED

Why is a priapism dangerous?

Since the arrival of intrapenile injection therapy, 99 per cent of priapisms arise after using this treatment. Let's look at why a priapism occurs. You will remember that in the early stages of an erection, an increase in blood begins to flow into the penis. This builds up the pressure in the shaft and the end result is a strong erection. Outflow of blood is blocked due to obstruction of draining veins so eventually there is no
further inflow. With priapism, the high pressure in the penis is maintained and there is no flow in or out of the penis. The danger is that when there is no circulation of blood in the penis, all the oxygen in the blood remaining in the penis gets used up, and the muscle tissue begins to be starved of oxygen. When this goes on longer than 12 hours, (or sooner) damage in the tissue of the penis will occur.
With a priapism, pain will usually set in after two hours or even sooner. This is a sign of poor oxygen supply to the penile tissue. It becomes difficult to pass urine because of pressure in the urethra. There is absolutely no reason why anyone should want to have an erection past two hours, especially if it is painful. This is why early intervention is the recommended procedure.
How can a priapism be prevented?
The first test dose of injection therapy should be with Prostaglandin Ei alone. The drug that most commonly causes priapism is Papaverine. The combination of Papaverine, Phentolamine and Prostaglandin Ei (with or without atropine), is one of the most successful combination therapies available for the treatment of erectile dysfunction. However, because of the risk of priapism, it is prudent to test a weaker type of medicine first, usually, Prostaglandin Ei as a single agent. Prostaglandin Ei on its own has been shown to have a low incidence of priapism. It does however produce a higher incidence of pain after injection, but overall is the safest first line of injection therapy treatment. Combination injection therapy should be tried only when the patient is unresponsive to Prostaglandin Ei or if this treatment is too painful.
The majority of priapisms occur after this first exposure to injection therapy. The greatest risk of developing a priapism is after the very first injection into the penis at the initial consultation. If the patient doesn't develop a priapism after this exposure to the medication, he is unlikely to be hypersensitive to it and a priapism will probably never occur. This requires that he stay within the recommended dose.
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