Skip to main content


Place de la prostaglandine E1 intra urétrale dans le traitement de l’impuissance érectile

What is the place left for transurethral alprostadil in the treatment of erectile dysfunction?

  • 209 Accesses


La place de l’asprostadil intra-urétral (Muse) dans le traitement de l’insuffisance érectile reste maintenant à définir depuis l’avènement des thérapeutiques per os et en particulier bien sûr le Sildenafil. L’alprostadil intra-urétral est un traitment local efficace de l’insuffisance érectile dans environ 35 à 40 % des cas. Les études comparatives avec les injections intra-caverneuses et le sildenafil sont en faveur de ces derniers mais le Muse conserve des indications et doit rester une arme dans l’arsenal thérapeutique en particulier dans les contre-indications du sildenafil et les cas de refus des injections intracaverneuses.


Transurethral alprostadil (Muse) is an effective and safe treatment of erectile dysfunction. Nevertheless, the result after its exit on the US market two years ago were not as good as the investigational studies which claimed aroud 60% of sccess rate. In the litterature success rate were between 35% and 40% all together. The Muse had a better acceptance than the intra-cavernous injection despite a lower success rate (40 % v.s 75 %). Since Sildenafil came on the market, it seems that the place of Muse is reduced because comparative studies give better results for Sildenafil than Muse (70 % v.s 40 %) and of course with a better acceptance. Nevertheless there are absolute and relative counter-indications to the Sildenafil which could benefit to the treatment by Muse.

All the comparative studies, IIC, v.s Muse and sildenafil v.s Muse will be studied in this article.

In conclusion Muse should be used as an alternative and should remain an effective tool that must be available to all physicians dealing with erectile dysfunction, perhaps using new formula with a combination of alprostadil with an alpha-blocker.


  1. 1.

    ADAIKAN PG, KOTTEGODA SR, RATNAM SS. A possible role for prostaglandin E, in human penile erection. In: Abstract book Second World Meeting on Impotence, Prague 1986, Abs. 2.6.

  2. 2.

    FLYNN T.N, GUEST J.F. Intra corporeal and transurethral. Application of alprostadil: A review of litterature. Int. J. Impot. Res. 1998, 10, Supplt 3, S 47.

  3. 3.

    FULGHAM P.F, COCHRAN J.S, DENMAN J.L, and al: Disappointing initial results with transurethral alprostadil for erectile dysfunction in an urology practice setting. J. Urol. 1998 160, 6 2041–6.

  4. 4.

    GHAZI S.A, ALMELIGY A. Transurethral alprostadil and the prostaglandin E1 intra-corporal injection in the treatment of erectile dysfunction: A comparative study. Int. J. Impot. Res. 1998, 10 Supplt 3, S 13.

  5. 5.

    GETTMAN M.T, NIENOW D.A, PATTERSON D.E and al: Muse therapy for male sexual dysfunction. In 454 consecutive patients: subjective and objective results at initial evaluation at dose titration. Int J. Impot. Res. 1998, 10 (Supplt3), S 552.

  6. 6.

    HELLSTROM W.J.G, SIKKA S.C, WANG R and al: Does transurethral alprostadil affect the concentration of prostaglandins in the human ejaculate or the viability and motility of human sperm? Int. J Androl. 1997, 20(suppl1): 104.

  7. 7.

    ISHII N, WATANABE H, IRISAWA C, KIKUCHI Y. Therapeutic trial with prostaglandin E1 for organic impotence. In: Abstract Book Second World Meeting on Impotence, Prague 1986, Abs. 11.2

  8. 8.

    LABASKY R.C, SPIVACK A.P and al: transurethral alprostadil for the treatment of erectile dysfunction: Two-year safety update. J. Urol. 1998, 159,5, (supplt) 235

  9. 9.

    LEWIS RW, WELDON K, NEMO K. Combined use of transurethral alprostadil and adjustable penile constriction band in men with erectile dysfunction, results from a multicenter trial. Int. J. Impot. Res. 1998, 10,supplt 3, S 49.

  10. 10.

    PADMA-NATHAN H ET aL. Hemodynamic effects of intraurethral alprostadil: The medicated Urethral System for Erection (MUSE*). J Urol 1994, 151: 345 A: 469.

  11. 11.

    PADMA-NATHAN H., HELLSTROM W.J.G., KAISER F.E. and al: Treatment of men with erectile dysfunction with transurethral alprostadil. New-Engl. J. Med 1997: 336: 1–7.

  12. 12.

    PETERSON C.A, BENNETT A.H, HELLSTROM W.J.G and al: Erectile response to transurethral alprostadil, prazosin and alprostadil-prazosin combinations. J. Urol 1998, 159, 1523–1528.

  13. 13.

    PORST H. Transurethral alprostadil with Muse V.S intra-cavernous alprostadil. A comparative study in 100 patients with erectile dysfunction. Int. J. Impot. Res. 1997, 9, 187–192.

  14. 14.

    STIEF C.G, MESCHI M., SCHULTHEISS D. Efficacy and acceptance of intra-cavernous versus intra-urethral PGE1 versus sildenafil. Int. J. Impot. Res. 1998, 10, Supplt 3, S 46.

  15. 15.

    WERTHMAN P., RAJFER J. Muse therapy: Preliminary clinical observations. Urology 1997, 50 (5): 809–11

  16. 16.

    WILLIAMS G, ABBOU C.C, AMAR E.T and al: Efficacy and safety of transurethral alprostadil therapy in men with erectile dysfunction. Brit J. Urol 1998, 81, 889–894.

  17. 17.

    WILLIAMS G, ABBOU C.C, AMAR E.T and al: The effect of transurethral alprostadil on the quality of life of men with erectile dysfuncction and their partners. Brit. J. Urol 1998, 82, 847–854.

Download references

Author information

Correspondence to E. Amar.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Amar, E. Place de la prostaglandine E1 intra urétrale dans le traitement de l’impuissance érectile. Androl. 9, 60–67 (1999) doi:10.1007/BF03034381

Download citation


  • Insuffisance érectile
  • Alprostadil intraurétral
  • Prostaglandine E1
  • injections intra-caverneuses
  • Sildenafil
  • Etude comparative


  • Erectile dysfunction
  • transurethral alprostadil
  • intra-cavernous injection
  • Sildenafil
  • comparative study
  • Prostaglandine E1