Intraurethral prostaglandin improves quality of vacuum erection therapy

The aim of this study was to investigate whether intraurethral prostaglandin E1 (PGE1) improves vacuum-induced penile rigidity.Nineteen patients with a mean age of 55 years (range 30-66 years) complaining of erectile dysfunction for 24 months (range 3-156 months) were investigated. The penile diameter was measured and a mark was made 50 mm proximal of the coronary sulcus on the flaccid penis. Twenty micrograms of liquid PGE1 (pH 4.5; 308 mosm/l) were instilled intraurethrally; thereafter the meatus was occluded for 10 min. Penile diameter and increase in length of the initially 50-mm line were measured with both pure vacuum-induced erection as well as combined with PGE1.The vacuum erection device alone lengthened the distance by 26 mm (range 18-64 mm) and the diameter by 4 mm (range 2-10 mm). Combined with PGE1, 36 mm (range 27-70 mm; p = 0.016) and 7 mm (range 2-11 mm; p = 0.04) were found, respectively.We conclude that PGE1 significantly increases vacuum-induced tumescence. Optimized pharmacological preparations for intraurethral application are a new way to further improve vacuum-assisted erection.