Erectile Dysfunction (ED) can take a significant toll on a man’s confidence and quality of life. While there are many available treatment options, not all of them work for every individual. One treatment that has shown particular promise for men with nerve-related ED is intraurethral alprostadil, commonly known by its brand name, MUSE (Medicated Urethral System for Erection).
As a vascular surgeon specializing in ED, I’ve worked with many patients who suffer from nerve damage due to diabetes, spinal cord injury, or prostate and pelvic surgeries. For these individuals, intraurethral alprostadil can be an effective, non-surgical solution.
What Is Intraurethral Alprostadil (MUSE)?
MUSE is a single-use applicator that delivers a small pellet containing alprostadil, a synthetic version of prostaglandin E1 (PGE1), directly into the urethra. This medication works by dilating the blood vessels in the penis, increasing blood flow to the erectile tissue and leading to an erection.
How Does It Work?
- Application: The applicator is gently inserted into the tip of the urethra.
- Absorption: The alprostadil pellet dissolves and is absorbed into the surrounding erectile tissue.
- Vasodilation: The medication causes the blood vessels to dilate, promoting blood flow to the penis.
- Erection: Within 5 to 10 minutes, an erection typically occurs and may last between 30 to 60 minutes.
Why Is It Effective for Nerve-Damaged ED?
ED caused by nerve damage—whether from prostate surgery, spinal cord injury, diabetes, or other conditions—disrupts the normal communication between the brain and the penile blood vessels. Because MUSE works directly on the blood vessels, it bypasses the need for functional nerve pathways. This makes it a valuable option for men whose ED is due to neurological causes and who may not respond to oral medications.
Clinical Evidence
Numerous studies have demonstrated the effectiveness of intraurethral alprostadil in men with nerve damage. Patients who have undergone radical prostatectomy or have spinal cord injuries have reported improved erectile function and overall satisfaction when using this treatment.
Benefits
- Rapid Onset: Takes effect within minutes.
- Localized Action: Minimizes systemic side effects since it works directly at the site of action.
- Alternative for Non-Responders: Especially useful for men who cannot tolerate or do not respond to PDE5 inhibitors.
Potential Side Effects
Like all medications, MUSE may cause side effects in some men, such as:
- Mild burning or discomfort in the urethra or penis
- Minor bleeding at the application site
- Rare instances of dizziness or a drop in blood pressure
Precautions
- Avoid use if you have urethral strictures, severe penile curvature, or a history of prolonged erections (priapism)
- Always inform your physician of any drug allergies, particularly to prostaglandins
Conclusion
Intraurethral alprostadil (MUSE) can be a highly effective treatment for men with ED caused by nerve damage. Its ability to bypass nerve signaling and act directly on penile blood vessels makes it a strong option when other treatments have failed.
As always, this treatment should be discussed with a healthcare professional who understands the underlying causes of your ED. At the Vascular Institute for Erectile Dysfunction, we’re here to help guide you through your treatment options and find what works best for your individual case.
— Dr. Khalil Masabni
