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

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


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