Male Erectile Dysfunction When Intracavernous Injection Therapy Has Not Achieved Adequate Erection
For patients with male erectile dysfunction who have undergone intracavernous injection therapy but have not achieved a rigid erectile response sufficient for satisfactory intercourse, a next-line surgical approach becomes the indicated course of action.
Previous Treatment & Failure Condition
Patients in this clinical scenario have previously received intracavernous injection therapy — including alprostadil as monotherapy, Trimix (papaverine combined with phentolamine and alprostadil), or Invicorp (vasoactive intestinal peptide combined with phentolamine mesylate) — and have not reached the required target: achievement of a rigid erectile response sufficient for satisfactory intercourse.
Next-Line Approach (Partial Overview)
The next step involves a surgical procedure in which an implantable device is placed. Two main categories of implant are available. The full selection criteria, surgical considerations, and device details are contained in the complete protocol.
Treatment Goal
Restoration of penile erection sufficient for satisfactory intercourse — specifically, an erection with rigidity adequate for intercourse.
References
- Implant a penile prosthesis if other treatments fail or depending upon patient preference.
- The surgical implantation of a penile prosthesis may be considered in patients who i) are not suitable for different pharmacotherapies or prefer a definitive therapy; and, ii) do not respond to other treatment modalities.
- The two currently available classes of penile implants include inflatable (two- and three-piece) and semi-rigid devices (malleable, mechanical and soft flexible).
- Efficacy is defined as an erection, with rigidity, sufficient for satisfactory intercourse.
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