Treatment of Erectile Failure with Prostaglandin E1: A Double-Blind, Placebo-Controlled, Dose-Response Study

We report a double-blind, randomized, placebo-controlled, dose-response study of prostaglandin E1 as treatment for erectile failure. A total of 15 men 55.8 +/- 9.2 years old with a mean duration of erectile dysfunction of 7.6 years participated. During phase 1 (double-blind) subjects received injections of prostaglandin E1 twice weekly at doses of 0 micrograms. (placebo), 2.5 micrograms., 5.0 micrograms., 7.5 micrograms. and 10 micrograms. During phase 2 (nonblind) the dose was increased until a full erection or intolerance developed. Response was measured using a RigiScan monitor. During phase 3 the subjects injected prostaglandin E1 at home. Of the subjects 66% achieved an erection adequate for intercourse, with an average rigidity of 59%. The dose-response curve reached a plateau at 5 to 10 micrograms. Among those responding to prostaglandin E1 intercourse was rated satisfactory by 81% of the subjects and by 90% of the partners. There were no prolonged erections requiring reversal and pain was reported with only 10% of the injections. In summary, intracavernous prostaglandin E1 is an efficacious and effective treatment for erectile failure.