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Intracavernous Injections What are they?

Intracavernous injections or so-called intracavernous pharmacotherapy (ICF) is a way to treat erectile dysfunction by using vasoactive drugs that are administered directly into the penis (intracavernosal). This therapy offers immediate results with an excellent rate of effectiveness.

The mechanism of action of these drugs is vascular, vasodilator. The penis, in order to achieve a firm erection, needs an important inflow of blood, with good pressure and velocity. The drugs used in intracavernosal therapy are vasodilators, which act in local mode, producing relaxation of the cavernous smooth muscle and/or arterial vessels, allowing massive blood inflow and causing erection.

Generally, intracavernous injection is indicated in patients where the oral route is ineffective or contraindicated (first therapeutic step). It is also contraindicated in patients with severe coagulation disorders, hypersensitivity to the components of the injection, severe psychiatric diseases, severe penile fibrosis, or cardiovascular disease that contraindicates the effort of sexual intercourse.

How is the treatment carried out?

The injection itself is composed of a combination of drugs that work together to relax the smooth muscle and open the blood vessels of the penis. There are different protocols for the use of these drugs, but it is generally performed in a personalized manner, tailored to the pathology and need of each patient.

The procedure consists of an injection into the corpora cavernosa by means of an auto-injector with a very fine needle (insulin type). Normally, once the treatment has been decided with the patient, a learning period called dosage is carried out to reach the minimum effective dose that generates an erection with the capacity to penetrate. This process is always carried out in the specialist's office.

Within 5 to 20 minutes after the injection for erectile dysfunction, erection will occur and last for about an hour, whether or not there is erotic stimulation. While many men do not like the idea of injections directly into the penis, the effective results outweigh the momentary discomfort of the injection.

What are the side effects?

Intracevernous pharmacotherapy (ICF) should be administered in strict accordance with the instructions of a specialist physician, both in relation to the mode of administration and in terms of doses appropriate for each patient. However, there are a number of side effects to be taken into account. The most frequent side effect is erectile pain. It occurs in 1 out of 10 injections and resolves when the erection subsides.

Priapism is the most important, although rare, adverse reaction. If the erection is maintained for more than four hours, apart from being accompanied by pain, it can damage the smooth muscle cells of the penile vessels and worsen erectile dysfunction.

Repeated punctures to the penis could lead in the medium to long term to micro-injuries to the tissues that often result in plaques of fibrosis (hardened tissue) in the corpora cavernosa. This, in turn, can lead to the development of acquired penile curvature or Peyronie's disease.

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