Rigid erection can be
induced and maintained for hours by injecting the penis with
medications that act by relaxing
the cavernosal muscles and dilating the arteries, therefore
increasing blood pumping into the penis and thereby inducing
These medications act
directly on the penis without need for sexual stimulation, and have
the virtue of reaching the penis straight forwards without
dilution in the blood.
They are therefore among
the most powerful and effective erection-inducing medications.
Unfortunately, this has the drawback of causing prolonged erection
that may require medical intervention (priapism)
if injected without medical supervision.
The dose and type of
medication can be calibrated to avoid priapism. Another drawback is
that repeated injection may result in
fibrosis of the penis.
The most popular medication
among the injectable drugs is Prostaglandin E1 (PGE1).
The use of these injections
vary from diagnostic to therapeutic applications. One of the first
step to diagnose the cause of impotence
whether organic or psychogenic is
to inject PGE1 into the penis and
measure the response.
Moreover, the patient can
be taught to inject himself at home, and the dose can be determined
by the physician, enabling "Home Therapy". If prolonged home therapy
is intended, followup is necessary by
penile duplex every 4-6 months to stop treatment if
Injection therapy is ideal
in cases of impotence caused by cutting the nerves connected to the
penis, such as in paraplegia. This is because a small dose is
capable of achieving a strong response, and because oral pills need
nerve impulses to activate their action while injections do not.
In very severe cases,
injections alone may not work, viagra and similar drugs alone may
not work, but a combination of both may work. If this is not enough
to correct impotence, then surgery
Medication is injected in
the corpus cavernosum
and not into the urethra, into arteries, veins or under the skin.
The expiry date and storage
condition of the medication is checked. The bottle is wiped with
alcohol. The syringe is prepared. Injection is performed by an
insulin needle. An accurate amount of the medication is aspirated
into the syringe as dictated by the physician. The needle should be
kept from touching anything but the sterile bottle.
The site of injection is
determined: the near third of the penis, towards the base of the
penis, on the right or left side
Injection should NOT be
through the upper surface of the penis, or else the nerves and
vessels that course on the upper surface will be injured.
Injection should NOT be
through the lower surface of the penis, or else the urethra that
courses on the lower surface will be injured.
An anesthetic spray can be
applied prior to injection to avoid pain, though this is usually
The area is sterilized by
an alcohol swab. The penis is stretched outwards and forwards by
holding it from the glans with the left hand (or the right hand in
The needle is inserted at
the point chosen for injection, 1 cm deep. The plunger is pulled. As
the plunger is pulled, blood should not be aspirated into the
syringe. If blood appears in the syringe, this means that the tip of
the needle is in a blood vessel. Injection SHOULD NOT proceed. The
needle is pulled back for a short distance and the process repeated.
If no blood appears, the plunger is pushed all the way to release
the medication into the penis.