Ensuring an erection with penile injection is a treatment method that is applied to men with erectile dysfunction and gives good results. This procedure can also be used for diagnostic purposes in patients.
What is the penile injection?
This treatment, which is applied by injecting drugs that expand penile vessels into the penis in order to achieve an erection, is usually the second method used for erectile dysfunction in patients. So much so that patients who do not get the desired result despite using oral erection drugs may be candidates for injection therapy after evaluation by the doctor.
The factors that determine whether the patient is suitable for this treatment are as follows:
- The level of erectile dysfunction in the patient,
- Whether there are additional diseases,
- Medications that the patient uses regularly,
- Patient’s age and dexterity.
How often inject in to the penis?
The application of injections continues at a certain dose and order. In this process, injection should be done 5-10 minutes before sexual intercourse. The dose of the drug is also determined according to the severity of the erection problem in the patient.
Injection drug application in to the penis can be done up to 3 times a week. It is important to apply it to a different part of the penis each time.
In cases where needle treatment is not sufficient, the most effective treatment is penile prosthesis. Needle therapy in erectile dysfunction provides effective local concentrations with small doses as it is applied directly into the penis.
If the patients cannot inject themselves, their partner should do the application. For this reason, it is important to receive training with the partner for penile injection treatment. Needle treatment in erectile dysfunction gives faster and more advantageous results compared to many other methods. This treatment also prolongs the ejaculation time in patients with premature ejaculation.
Pre-application preparation stage
It is very important to disinfect the injection site correctly and adequately before the application. Other than that, no preparation is required. The drug should be drawn into the injector at the dose recommended by the doctor. If a ready-made drug form is used, dose adjustment should be made at the level recommended by the doctor.
How is the usage?
The effect of the drug begins with the injection of the predetermined dose into the penis about 10 minutes before the intercourse. This effect lasts for 1-2 hours on average. Whether the injection should be made from the right or left side of the penis is not a factor that will change the effect.
However, if the injection was made from the right before, it can be done from the left in the next one, and from the right in the next one if it was done from the left. This is recommended for the patient to be more comfortable.
Who is suitable for penile injection therapy?
Needle therapy can be used for every patient with erectile dysfunction. In particular, penile injection is the most appropriate treatment option for patients who cannot use oral erection medication due to heart disease or drug use.
However, in cases where penile prosthesis surgery is the last resort, injection therapy can be recommended as a treatment option for patients who do not want surgical intervention.
Which patients are not recommended for penile injection?
Continuation of this treatment in patients with limited dexterity may cause some problems. In such a case, the partner of the patient can be trained in this regard and administer the injection to the patient.
It is very important to precisely adjust the appropriate dose, especially in patients with erectile dysfunction due to nerve damage. On the other hand, patients who use blood thinners can easily apply needle therapy.
It will be better for these patients to prevent possible bleeding by applying pressure to the area after the injection.
Apart from these, there are also patients for whom needle treatment is definitely not recommended. Accordingly, injection therapy is not suitable for the following people:
- Patients with a tendency to prolonged erections (priapism),
- People with blood diseases such as sickle cell anemia, leukemia,
- People with a known history of allergy to the drugs to be used, and
- Those with advanced circulatory and nervous system disease.
Things to consider after penile injection
It is recommended to press the area for 1 minute after the needle application to avoid any bruising and bleeding. Apart from this, there is nothing for patients to do.
What are the side effects of penile injection therapy?
It is not possible for every patient to have side effects for needle treatment in erectile dysfunction. In general, calcification can be seen in the penis due to the continuous use of the drug.
However, when the drug is applied to the same area continuously, calcification may occur in the wall of the structures called corpus cavernosum, which causes the penis to harden. Another side effect is pain during injection.
Due to the nature of the drug, there may be a burning sensation in the penis during the injection. On the other hand, the most important side effect is the development of prolonged erection (priapism) that develops after injection and exceeds 4 hours.
For this reason, it is recommended that patients consult a doctor if the erection after the injection exceeds this period.
In addition, if sufficient pressure is not applied to the injection site, bleeding and hematoma may occur. In cases where hygiene is not observed, infection may develop. In rare cases, blood pressure drop or needle breakage during injection is observed.
Is it possible to have penile prosthesis surgery instead of penile injection?
There must be a sexual stimulus for an erection to occur in the penis. Thus, blood flow increases in channels called corpus cavernosum in the penis and an erection occurs.
In erectile dysfunction, there is not enough blood flow to the corpus cavernosum channels.
For this reason, with the injection treatment into the penis, the appropriate drug is injected into the channels.
However, this treatment offers a temporary solution to erectile dysfunction. Penile prostheses are recommended for patients who want a more permanent solution and have severe erectile dysfunction.
Intrapenile injetion in erectile dysfunction due to diabetes
Oral erection drugs are generally less successful in erectile dysfunction in diabetics. Sometimes, no results can be obtained with this method. In these patients, penile injection treatments may be appropriate.
Diabetics with erectile dysfunction are among the most ideal groups for injection treatment. After the urologist’s evaluations and the selection of suitable patients for treatment, diabetics may become able to achieve an erection by injection. Especially those who apply insulin for glucose level control will not have difficulty in injection into the penis.
Treatment of erectile dysfunction with penile injection after prostate cancer
Most of the patients who have undergone surgery or radiotherapy for prostate cancer have erectile dysfunction, reduction in penile size and loss of morning erections after these treatments.
If erection loss in the early period cannot be rehabilitated with appropriate methods, erectile dysfunction may not improve over time and may become permanent.
In fact, another important group for which penile injection may be appropriate is these patients who are being treated for prostate cancer.
The goal is both to protect the internal structure of the penis by providing rehabilitation and to provide an adequate erection.
Are injections better than pills for erectile dysfunction?
Penile injection is a long-standing, well-received and reliable treatment option. So much so that some patients do not prefer oral tablets because of some undesirable side effects. These effects are:
- Nasal congestion,
- Headache,
- Stomach upset,
- Back pain and
- Facial redness.
Since some patients do not want to have penile prosthesis surgery, they prefer penile injection therapy instead. In general, the satisfaction rate of patients using injection therapy for a long time is significantly high.
Types of injectable medications
These injections are usually administered as a single drug, but can sometimes be used as a double or triple combination. The common feature of all these drugs is to increase the blood flow to the penis by expanding the vessels coming to the penis. Medications include:
- Papaverine,
- Phentolamine,
- Prostaglandin E1 (PGE1) or
Can I take Viagra with penile injections?
Viagra, Cialis, or any other oral erectile drug should not be used in conjunction with penile injection therapy. Penile injection drugs should be stored in the refrigerator and used within 90 days.
It is recommended that the patient consult a cardiologist before using penile injections to ensure safety, especially if the patient has a pre-existing heart condition.
What happens if erectile dysfunction injections don’t work?
These drugs are effective for most patients. However, it is possible to talk about a group of patients who do not get the desired results from the drugs, even if it is small. At this point, it should be noted that penile injections have a better effect after being used more than once.
If the result is not obtained despite more than one use, the dose can be changed under the control of the doctor. Another reason why drugs do not work may be the presence of another underlying health problem.
In such a case, it is recommended to carry out the necessary examinations again. In cases where results are not obtained despite all these, the patient is directed to different treatment options.