INGECTION TREATMENTS FOR ED

WHAT TO WATCH OUT FOR WITH INJECTABLE TREATMENTS

1.         Site of injection: If a needle penetrates the penis regularly in the same site, the tissue will become irritated and inflamed. It will not have time to recover between injections. Scar tissue will form at this site. Therefore, it is important to vary the site of the injection each time so that the previous site can have time to mend.
2.         Frequency of injection: Do not inject more than two to three times a week. This allows for a different site for injection. Using injection therapy any more frequently than this means that you will have to re-inject in the same sites. This puts the tissue at risk.
3.         Volume of the injection: The larger the volume of the medication, the greater the risk of tissue displacement. In the early days of injection therapy when single drugs such as Papaverine were used as opposed to today's combination therapy, volumes of up to 3 millilitres (300 units) and more were used regularly. These large volumes will cause tissue
disruption which may result in inflammation and scar tissue formation. The incidence of scar tissue was very high as a result of this. Now, by using combination therapy, volumes have been reduced to an average of 0.2 millilitres (20 units) and the incidence of scar tissue formation has reduced significantly.
4.         Type of medication: In earlier days when papaverine was the only available drug, there was a high incidence of scar tissue formation in users. At that time, it was surmised that Papaverine was the cause of the scar tissue. This idea has remained within the medical community, but studies have not proved this conclusively. Prostaglandin Ei is thought to have the lowest incidence of scar tissue formation in the injectable drugs currently available.
5.         Bruising: Occurs if either an artery or a vein is punctured during the injection procedure.An artery tends to bruise more severely. Because the injected medication is a combination of blood vessel dilators, it may augment the bleeding. Usually, however, the bleeding stops long before the injected medication can make a contribution. The problem is that the majority of blood vessels cannot be seen as they are not superficial. The bruising that one may get with injection is not dangerous. It may track down to the head of the penis and apper like a collar around the rim of the head. It may involve the whole penis and look horrific. However, it is painless and will last for five to ten days and then disappear completely.
Joan has been working in my clinic as my receptionist in Melbourne for five years now. She is very experienced in dealing with patients seeking treatment for erectile dysfunction. She understands the anxiety and embarrassment that they are experiencing and is sensitive to it. She did not, however, expect what happened to her one spring day.

Andrew, 56 years old, engineer
The door of the clinic opened and a middle-aged man stormed in. Joan immediately recognised him as one of the patients who had visited the clinic the previous day. He looked frustrated and angry. Before Joan could say hello, he blurted out:
1 want to see the doctor right now!'
'Unfortunately, he's with a patient right now/ she said, 'but if you wait in one of the waiting rooms, he will see you after this patient/
'Do you know what he did to me? he exclaimed.
Before Joan could answer, he had undone the front of his trousers and pulled them down together with his underwear. He held his limp penis in his hand and showed Joan a big bruise which had developed at the site of the injection he had received the day before.
Without thinking, Joan leaned over her desk to take a closer look. After a few seconds, she realised what was happening. She pulled back and composed herself. Trying to act as casually and professional as possible, she showed him into one of the waiting rooms.
When Andrew came out of the doctor's office, ready to leave, Joan was still shaking with embarrassment. For some reason she found it very difficult to look him in the eyes.
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