How does one perform penile injection therapy?
Before you start to use intracavernous injection therapy at home, you are test dosed in the office. Of all of the therapies available, intracavernous injection therapy carries the highest risk of priapism, up to 2%. Most cases of priapism occur with first use, during the test dosing, which is important because if you return to your urologist’s office within 3 to 4 hours, the erection can easily be brought back down with just an injection of another chemical. If your urologist is concerned about priapism, he or she may choose to terminate your erection by injecting you with a chemical to stop the erection before you head home. Thus, test dosing minimizes your risk of having a case of priapism at an inopportune time. Secondly, your urologist can use the test dosing as a time for hands-on instruction, and you can be shown how to inject and actually perform your first self-injection with guidance in the office. This is very important because the first time you perform the injection therapy at home, you will be nervous, and remembering that you performed the injection in the office may help you relax.
The needle that you use to inject is quite small and short. It does not need to pierce deeply into the penis, just into the corpora on one side, for it to be effective (Figure 8). The syringe used is small also because the volume that you will be injecting is usually 1 cc or less. After your initial test dose, your urologist will decide on a dose that you will try initially at home. Do not get discouraged if this initial dose is not adequate. Most of us would prefer to prescribe a dose that is too small and then increase it as needed in order to avoid priapism.
However, as we stated: intracavernosal injection therapy is an excellent short term solution paradigm as we ramp up the healing of your underlying problems. There’s essentially three core types of injection mixes: Bi, Tri and Quad. All are uniquely mixed based upon your own circumstances by time-tested formulations.