Transurethral Alprostadil with MUSE^TM (medicated urethral system for erection) vs intracavernous Alprostadil—a comparative study in 103 patients with erectile dysfunction

Abstract

A comparative study in 103 unselected patients with erectile dysfunction between MUSE^TM up to 1000 μg and intracavernous Alprostadil (Prostavasin^TM) up to 20 μg provided total response-rates of 43% (MUSE^TM) vs 70% (Prostavasin^TM). Complete rigid erections were reached in 10% (MUSE^TM) vs 48% (Prostavasin^TM). The average end-diastolic flow values in the deep penile arteries ranged between 9.2–9.4 cm/s after MUSE^TM and 4.5–4.8 cm/s after i.c. Alprostadil confirming the investigator’s assessment, that in the vast majority of patients MUSE^TM were not able to induce a complete cavernous smooth muscle relaxation. In terms of side effects the reported penile pain/burning-rate after MUSE^TM was 31.4% compared to 10.6% after i.c. Alprostadil. In addition after MUSE^TM clinically relevant systemic side-effects like dizziness, sweating and hypotension occurred in 5.8% with syncope in 1%. No circulatory side-effects were encountered after i.c. Alprostadil. Urethral bleeding after MUSE^TM-application was observed in 4.8%.

Due to the superior efficacy and lower side-effects self-injection therapy with Alprostadil remains the ‘Gold Standard’ in the management of male impotence. MUSE^TM should be reserved for a subset of patients suffering from erectile dysfunction.