The patient presents with a prolonged penile erection of four hours or less following intracavernosal injection (ICI) pharmacotherapy for erectile dysfunction. Intracavernosal phenylephrine was administered as the recommended first-line intervention — targeting penile detumescence — and that goal has not been reached.
Intracavernosal phenylephrine injection is the appropriate initial step in this setting. When penile detumescence is not achieved following phenylephrine, escalation to a further intervention is indicated.
The approach at this stage involves a corporal-level procedure directed at resolving the persistent erection. Whether and how this intervention is applied depends on specific clinical conditions detailed in the full protocol. The complete stepwise regimen is available via the link below.
DOI: 10.1097/JU.0000000000002236
In patients presenting with a prolonged erection of four hours or less following intracavernosal injection pharmacotherapy for erectile dysfunction, clinicians should administer intracavernosal phenylephrine as the initial treatment option.
Intracavernosal aspiration and irrigation are likely too aggressive for this specific clinical scenario to be used as a first-line therapy.
However, persistent, prolonged erections may be considered for aspiration/irrigation if phenylephrine alone is unsuccessful.
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