Transurethral Alprostadil with MUSE™ (medicated urethral system for erection) vs intracavernous Alprostadil -: a comparative study in 103 patients with erectile dysfunction

A comparative study in 103 unselected patients with erectile dysfunction between MUSE(TM) up to 1000 mu g and intracavernous Alprostadil (Prostavasin(TM)) up to 20 mu g provided total response-rates of 43% (MUSE(TM)) vs 70% (Prostavasin(TM)). Complete rigid erections were reached in 10% (MUSE(TM)) vs 48% (Prostavasin(TM)). The average end-diastolic now values in the deep penile arteries ranged between 9.2-9.4 cm/s after MUSE(TM) and 4.5-4.8 cm/s after i.c. Alprostadil confirming the investigator's assessment, that in the vast majority of patients MUSE(TM) were not able to induce a complete cavernous smooth muscle relaxation. In terms of side effects the reported penile pain/burning-rate after MUSE(TM) was 31.4% compared to 10.6% after i.c. Alprostadil. In addition after MUSE(TM) clinically relevant systemic side-effects like dizziness, sweating and hypotension occurred in 5.8% with syncope in 1%. No circulatory side-effects were encountered after i.c. Alprostadil. Urethral bleeding after MUSE(TM)-application was observed in 4.8%. Due to the superior efficacy and lower side-effects self-injection therapy with Alprostadil remains the 'Gold Standard' in the management of male impotence. MUSE(TM) should be reserved for a subset of patients suffering from erectile dysfunction.