What are Intracavernosal Injections?
Intracavernosal injections are medications which are injected directly into the cavernosal tissue of the penis to cause erections.
Caverject Impulse (Alprostadil) is most commonly used initially and contains a form of Prostaglandin. It works by increasing the blood flow to your penis. The increased blood flowing into the penis is trapped in the spongy erectile tissue of the penis called the Corpora Cavernosa. When these chambers fill with blood they swell and cause an erection. The firmness and duration of the erection is dependent on the dosage given and is different for each patient.
What do I need to do before starting Intracavernosal Injections?
- You need to take your script to your pharmacy at least a week before you wish to use it as your pharmacist may need to order the medication in for you
- If possible, you should watch your instructional USB movie (subject to availability) or read the instructional information sheet a couple of times to familiarise yourself with the injection technique
- You should also read over any information leaflet included in the box with your dispensed medication
What happens on the day of your education session with the nurse?
- We have a test dose injection for your use on the day
- You will need to bring your dispensed script with you on the day
- The urology nurse will go through the injection technique with you and talk to you about the possible side effects of the treatment
- Under the supervision of the urology nurse you will then inject the medication into your penis
- The erection will usually start 5-20 minutes after injecting the medication
- You will then be able to discuss with the nurse the effectiveness of the dose and whether it needs to be adjusted
- If you feel well, you will be able to go home
What happens after this?
- Depending on the results of your test dose, you will now be able to use the injection at home with your partner
- It is very important that you talk to your doctor or nurse if you are experiencing any serious side effects
What are the side effects?
- Painful erection – this may depend on the dose given
- Bruising or bleeding at the injection site - this can be minimised by correct technique, but may be due to other medications you are taking e.g. Warfarin or blood thinners, and you should discuss this with your doctor before commencing treatment
- Fibrosis (scarring) of the penile tissue – rare long term complication (risk reduced by rotating the site of your injections)
- Prolonged erections or “Priapism” (lasting greater than 4 hours) - needs to be treated as a matter of urgency to avoid permanent damage to the penile tissue. If your erection lasts more than 2 hours:
- walk up and down a set of stairs several times
- next try having a cold shower
- If still no result, walk up and down the stairs again
- If your erection continues longer than 4 hours after all these things have been tried, you should go to the nearest Emergency Department.
Is there anything else I need to know?
- With Caverject - the syringe will only inject the dose of medication that you have chosen (or dialled up). You cannot use any leftover medication. This does not apply to re-usable vials that come with some of the other intracavernosal injection preparations.
- Your dosage needs to be specifically selected to produce an erection that is satisfactory for sexual intercourse, not painful and not exceeding one hour in duration.
- Intracavernosal injections should be used only once in a 24-hour period, and a maximum of 3 times per week.