Local application of alprostadil cream helps in reducing erectile dysfunction significantly in a broad range of patients and is generally well tolerated. The most frequently reported side effect of Alprostadil is burning or redness at the site of application. Studies of the cream show that the topical agent produces a small but statistically significant improvement in erectile function in many patients with mild-to-severe dysfunction. Injections of alprostadil directly into the penis have been used to treat erectile dysfunction, but administration can be cumbersome or uncomfortable Researchers from the University of Southern California, Beverly Hills and from Lake Forest, Illinois, USA, conducted a study involving more than 1700 men with erectile dysfunction who were randomised to Alprostadil cream, in dosages ranging from 100 to 300 micrograms, or to placebo cream. Alprostadil topical cream is formulated with enhanced skin-penetrating properties and is applied onto the penis. The study population included men with diabetes, men who had had their prostates removed, and men taking nitrates or alpha-blockers as well as men who had failed with sildenafil (Viagra). Their mean age was 60 years. It was found that erectile function scores rose by a mean of nearly 2 to 3 points over baseline in the Alprostadil groups and fell by 0.7 points in placebo patients. In addition, scores for vaginal penetration and maintenance of erection until ejaculation improved slightly but significantly. Although overall improvements were modest, 52 percent of patients who used the 300 microgram Alprostadil cream reported improved erections versus 20 percent of placebo patients. The findings suggest that topical alprostadil cream is safe and efficient in improving erectile dysfunction in many patients.
Urology,
September 2006