For men who experience impotence after prostate cancer treatment, urethral suppositories or tablets have been shown to be successful. No needles are involved and the process is less invasive than penile injections or implants. However urethral suppositories may not be for everyone. It is important to see a doctor to determine which treatment option will work best.
Under this technique patients insert
prostaglandin E pellets into the urethra through a plastic
tube, commonly known as MUSE or medicated urethral system
for erection. MUSE delivers the drug alprostadil through
the urethra and has been found effective in about 50%
of men. The inserted drug serves to enhance penile blood
supply resulting in an erection.
MUSE consists of a thin, plastic tube with a button at the top. Immediately following urination, patients using this device insert the tube into the urethral opening. To release the pellet, simply press the button. To evenly distribute the drug, men should roll their penis between their hands for 10 to 30 seconds. Discomfort will be avoided when the penis is kept straight during administration. Once administered patients should remain upright, by sitting, standing, or walking for 10 to 30 seconds in order to achieve an erection that lasts between 30 to 60 minutes. It is possible to maintain erection after an orgasm.
Generally a man will get an erection within 10-15 minutes of application. MUSE can be used twice in any 24-hour period, however 2 units should not be used consecutively.
Side effects include burning in the urethra, penile pain, low blood pressure, minor bleeding or spotting, redness in the penis, and aching in the testicles, legs, and area around the anus. Some female partners of men using urethral suppositories have reported vaginal itching or burning.