Alprostadil (al-PROS-tuh-dil) is a synthetic form of the hormone prostaglandin E. This hormone helps relax smooth muscle tissue in the penis, which in turn allows blood to flow into the cylinders of sponge tissue, causing an erection. It can be intected into the penis.
The idea might make you flinch, but it’s not as scary or painful as it might sound. You use a very fine needle, which minimises pain, to inject the drug into the base or side of the penis five to 20 minutes before you want to start sexual activity. Once you’ve had some practice to get the technique and dose right, it’s easy. The erection lasts between 30 and 60 minutes. This medication (sold under the trade name of Caverjet) should not be used more than three times a week.
As with any medication, there is some risk: repeated injections may cause internal scarring that can worsen impotence in about five percent of men. Another possible complication is that of an erection that does not abate for longer than four hours (priapism). Far from turning you into a sexual long-distance athlete, this condition can damage the penis permanently if it does not receive prompt medical attention. Fortunately, only about one percent of men who regularly use injections will experience this problem. Another possible side-effect is minor bleeding from the injection site.
Regular use of Caverjet can be difficult to afford at a cost of about R110 per use.
Reviewed by Dr Werner Botha Specialist Urologist, Cape Town Medi-clinic. May 2005.