Injection of prostaglandin E1 (PGE1, Caverjet) into the corpora cavernosa of a man with erectile dysfunction can result in vascular congestion with sufficient penile tumescence to permit intercourse. Failure to perform this correctly can result in serious complications.
Proper Technique |
Consequence of Failure |
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do not use a needle that has been bent previously for the injection |
a restraightened needle may break off and remain embedded within the corpus cavernosum |
use syringe, needle and medication vial once then discard |
reuse of supplies can result in bacterial infection |
store unreconstituted drug vials within temperature specifications (do not freeze, do not warm above 25°C or 77°F) |
drug inactivation |
use the drug within 24 hours after reconstitution and do not refrigerate, freeze or warm above 25°C |
potential for bacterial contamination |
examine the drug solution for precipitate material or discoloration before use |
cellulitis from bacterial or fungal contaminants |
expel air bubbles after drawing the dose into the syringe |
local irritation and pain |
draw up the specified volume of drug |
too little can result in underdosage; too much can result in overdosage |
identify the corpora cavernosa (spongy tissue running along the side of the penis) |
injection into other tissue may result in failure to achieve an erection or the risk for toxic effect |
select a site for injection (alternate between the left and right corpus cavernosum for the injection; vary the site of injection on each side) |
re-use of the same site can result in injury with scarring |
clean skin surface prior to injection |
cellulitis from skin flora |
avoid injection into the blood vessels on the dorsum of the penis in the midline (upperside when erect) |
systemic symptoms, including hypertensions, headache, dizziness, etc. |
avoid injection into the urethra and corpus spongiosum (underside in midline) |
local trauma and no effect |
enter the penile skin at 90° to the surface |
injecting the drug at an acute angle may miss the corpus with drug going into pericavernosal soft tissue with no effect |
discard needles, syringes and drug once injection complete in a safety container |
accidental injury or disease transmission |
monitor the penis for swelling, discoloration or painful areas |
delayed recognition of injury or infection can result in more severe damage |
Specialty: Pharmacology, clinical
ICD-10: ,