Intracavernosal Injection Therapy

What intracavernosal injection therapy is

Intracavernosal injection therapy is a treatment for erectile dysfunction in which a small dose of medication is injected into the side of the penis. The medication relaxes the smooth muscle in the erectile tissue and increases blood flow, producing an erection.

It is commonly used when oral medications have not worked, are not tolerated, or are not suitable, and is a recognised option in international urology guidelines.¹

Who it can suit

Injection therapy can be considered for men with erectile dysfunction of a range of causes, including ED after prostate-cancer treatment, ED related to diabetes, vascular disease, or neurological conditions. Suitability is decided on a case-by-case basis after medical review.

Preparation and training

The first dose is given in the clinic so that response and dose can be assessed safely. Urology NSW's men's health pharmacist then provides one-on-one training in:

• How to draw up the medication from the vial into the syringe.
• How to hold the penis and identify the correct injection site on the side shaft.
• How to perform the injection with minimal discomfort.
• Safe disposal of needles and storage of medication.

Written instructions and diagrams are provided so patients can refer to them at home. Follow-up appointments are used to titrate the dose and troubleshoot any difficulties.

What to expect

The erection usually begins within 5 to 15 minutes of injection and can last from around 30 minutes up to an hour, depending on dose and individual response.¹ The aim during dose titration is to find the lowest dose that reliably produces a suitable erection.

Possible risks and side effects

As with any medical treatment, injection therapy has potential side effects. The main ones to be aware of are:

• Penile pain or aching after the injection, more common with some agents than others.
• Bruising or small bleeding at the injection site.
• Prolonged erection or priapism – an erection that lasts more than four hours. This is uncommon but is a medical emergency. Patients are given clear instructions on what to do if this occurs, including seeking urgent medical attention.^{1, 2}
• Penile fibrosis or scarring with long-term use, which is one reason careful technique and site rotation matter.

Injection therapy is not suitable for everyone. Men with certain blood disorders, penile deformities, or at high risk of priapism may need a different treatment path. These factors are reviewed before the first injection.

Combining with other treatments

Injection therapy can be used as part of a broader plan, including pelvic floor exercises, vacuum pump therapy, or post-prostatectomy rehabilitation.¹ Dr Kooner's clinic coordinates these options as part of an individualised treatment plan.

How to access the service

Injection training is provided through the men's health pharmacist service. To enquire:

• Contact Urology NSW.
• Call the rooms on 02 8382 6980.

Patient information pack

For patients prescribed Caverject Impulse (alprostadil), the manufacturer's information pack is also available on this site. Open the Caverject Impulse Information Pack as a web page · Download the original PDF. Source: Pfizer Caverject Impulse Information Pack (Pfizer Australia). Content reproduced for accessibility.