Details on erectile dysfunction treatments
03/15/99
Gannett News Service
FINAL
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Various erectile dysfunction treatments
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Viagra
Cost: $9 to $10 per pill (not all insurance plans cover it)
Prescription: One 50 mg pill, taken about an hour before intercourse; no more than one a day
How it works: Prevents an enzyme that hinders erection from doing its job. Does not affect libido.
Side effects: Headache, flushed face, heartburn, stuffy nose, blue haze over vision, lowered blood pressure.
Who can't use it: Men with heart disease, who have recently had a heart attack or stroke, who take nitrites, who have abnormally-formed penises, or who are prone to priapism (prolonged erection) -- that includes men with sickle cell anemia, leukemia or bone marrow tumors.
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MUSE
Cost: $12 to $18 per dose (often covered by insurance)
Prescription: One pellet of alprostadil, a naturally occurring substance, dose calibrated to meet your needs. A man can dose himself with MUSE twice a day. Drug keeps longer when refrigerated.
How it works: Medicated pellet inserted into the urethra before sex helps increase blood flow to the penis and triggers erection.
Side effects: Aching groin, burning in the urethra, minor urethral bleeding due to improper insertion of the medication. Less commonly: Swelling of leg veins, dizziness, fainting, rapid pulse, prolonged erection.
Who can't use it: Men who have been told not to have sex, who are sensitive to the medication, with abnormally formed penises, or who are prone to priapism (prolonged erection) -- that includes men with sickle cell anemia, leukemia or bone marrow tumors.
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Caverject
Cost: $5 to $15 per dose (sometimes covered by insurance)
Prescription: One injection of alprostadil, a naturally occurring substance, dose calibrated to meet your needs, right before intercourse. Maximum dosage is three times a week, with 24 hours between each dose.
How it works: Medication injected with a tiny, fin-gauge needle into the side of the penis before intercourse opens blood vessels and triggers erection.
Side effects: Mild to moderate pain after injection, a small amount of blood at injection site. Less commonly: prolonged erection, possible scarring of the penis.
Who can't use it: Men who have been told not to have sex, who have penile implants, who have abnormally formed penises, or who are prone to priapism (prolonged erection) -- that includes men with sickle cell anemia, leukemia or bone marrow tumors.
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Penile implants
Cost: Medicare pays about $1,000 for procedure
Prescription: Surgery.
How it works: Semi-rigid or inflatable cylinders implanted into the penis, attached to a pump in the scrotum with a reservoir in the scrotum or abdomen. Patient pumps up implant before intercourse to create erection.
Side effects: Permanent, last-ditch method of treatment. May destroy any remaining natural ability to have erection. Semi-rigid rods may be hard to hide; poorly-sized rods may protrude through the tip of the penis. Mechanical failure or infection possible; surgical repair may be needed.
Who can't use it: Men with abnormally formed penises or those with severe medical problems.
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Vacuum therapy
Cost: $400 to $500 (cheapest therapy)
Prescription: External mechanical device used to pump up penis. Erection can be maintained safely for 30 minutes.
How it works: Penis placed into a cylindrical vacuum-like device; negative air pressure pulls blood into the penis and creates erection. A tension ring is placed on the end of the penis to keep the blood in; erection subsides after ring is removed.
Side effects: Penis could be damaged if tension ring left in place too long; ejaculation could be hampered; sometimes uncomfortable to use.
Who can't use it: Patients who lack manual dexterity, men who take blood thinners
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