Spinal cord injury erectile dysfunction with

Intracavernosal injection or urethral suppository therapy with alprostadil (PGE1) is useful in the treatment of erectile dysfunction, especially in spinal cord injury. Doses of 2.5-25 ug are used. Penile pain is a frequent side effect that may be related to the algesic effects of PGE derivatives however, only a few patients discontinue the use due to pain. Prolonged erection and priapism are less frequent side effects that occur in fewer than 4% of patients and are minimized by careful titration to the minimal effective dose. When given by injection, alprostadil may be used as monotherapy or in combination with either papaverine or phentolamine. 

Diseases that compromise vascular flow to the corpora caver-nosum (e.g., peripheral vascular disease, arteriosclerosis, and essential hypertension) are associated with an increased incidence of erectile dysfunction. Diseases that impair nerve conduction to the brain (e.g., spinal cord injury or stroke) or conditions that impair peripheral nerve conduction to the penile vasculature (e.g., diabetes mellitus) can result in erectile dysfunction. 

Erectile dysfunction is noted in patients with neurological disorders such as Parkinson s and Alzheimer s diseases, stroke, and cerebral trauma, often secondary to a decrease in libido or inability to initiate the erectile process. Spinal cord injury patients have varying degrees of erectile dysfunction largely dependent on the location and extent of the lesion. Sensory input from the genitalia is essential to achieve and maintain reflexogenic erection, and this input becomes more important as the effect of... 

Some authors have studied the possibility to deliver prostaglandin El using transdermal liposomal formulations through the foreskin in men with erectile dysfunction secondary to spinal cord injury or with mild arterial insufficiency (Foldvari et al. 1998). 

---