{"id":4204,"date":"2018-05-14T01:48:16","date_gmt":"2018-05-14T01:48:16","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/ed\/?page_id=4204"},"modified":"2020-04-04T19:07:00","modified_gmt":"2020-04-04T19:07:00","slug":"penile-injections-do-not-work","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/ed\/ici\/penile-injections-do-not-work\/","title":{"rendered":"Why Penile Injections Do Not Work and Erectile Dysfunction Treatment Options in NYC"},"content":{"rendered":"

What to Do When Erectile Dysfunction Treatment with Penile Injections Does Not Work<\/strong><\/h1>\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n

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If you have any questions, to schedule a consultation<\/a>, please <\/a>contact us<\/a> or call\/text: <\/strong>1-646-663-5211<\/span><\/a>.<\/strong><\/p>\n

We have excellent reviews from patients <\/a><\/strong>and their partners.  Information for out-of-state and international patients<\/a>.  Find out our office hours or directions to our office<\/a>. <\/strong><\/span><\/p>\n

We offer affordable appointment prices<\/a> with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.<\/strong><\/span><\/p>\n

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Reasons Penile Injections Are Not Effective <\/strong><\/h1>\n

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Penile injections with PGE1 (prostaglandin 1)<\/a> or Trimix <\/strong>(papaverine, phentolamine and prostaglandin E1) are among the most effective treatment options for erectile dysfunction<\/strong>. <\/p>\n

Injectable medications in the penis often work when a medication such as Cialis stops working<\/a> and Viagra does not work<\/a><\/strong>.<\/p>\n

Most Common Reasons Why Penile Injections for ED Stop Working:<\/h2>\n

Incorrect administration of medications<\/strong> is the most common cause of why penile injections work in the doctor’s office but do not work at home. Penile injections of PGE1 such as Caverject<\/a> and Trimix for ED<\/a> should be administered deep inside the penis<\/strong> where the blood flow is (intra-cavernosal)<\/a>. <\/p>\n

Often men do not insert the needle deep enough<\/strong> or inject at the wrong angle in the penis; as a result, medication is injected just below the skin and not deep enough to where it needs to be to cause an erection. <\/p>\n

At New York Urology Specialists<\/a> we make an effort to teach our patients proper injection technique<\/strong>, which is always successful for men if the medication is effective. Please schedule an appointment<\/a><\/strong> if you need help.<\/p>\n

Medications used for penis injections for the treatment of erectile dysfunction come in two varieties: medications that require or do not require refrigeration<\/strong>. It is important to store medications properly <\/strong>especially when it comes to medications that require refrigeration.  When medications that require refrigeration are not stored properly, they can lose their potency and may not work well. Prostaglandin is particularly volatile and can lose potency quickly.<\/strong><\/p>\n

An incorrect dose of medications<\/strong> for penile injections is used. Medications such as Bimix, Trimix, and QuadMix<\/a> are custom-prepared medications mixed in compounding pharmacies.  Formula and concentrations of each medication differ<\/strong> among compounding pharmacies. <\/p>\n

As a result, medications are not interchangeable between different pharmacies<\/strong>.  If a new pharmacy is used to order medications, office test injections in the physician office should be performed to make sure that the dose of medications is appropriate.  At New York Urology Specialists, we perform test dosing for all our patients to make sure that the dose is both adequate and not excessive to avoid the risk of a prolonged erection that does not go away<\/a>.<\/p>\n

Common Reasons Why Penile Injections Do Not Work.<\/strong><\/h2>\n

There are 2 primary causes of erectile dysfunction: Erectile dysfunction caused by arterial insufficiency<\/strong> and erectile dysfunction caused by corpora-venous occlusive insufficiency<\/strong><\/a>.<\/p>\n

Penile injections work well for the treatment of erectile dysfunction<\/a> caused by arterial insufficiency.  A small number of men with severe arterial insufficiency may find that penile injections do not work well for them; for these men, a penile implant<\/strong><\/a> is usually the most effective treatment option.<\/p>\n

Penile injections with medications such as Trimix often work for some men with mild corpora-venous occlusive insufficiency<\/a><\/strong>. For many men suffering from moderate to severe corpora-venous occlusive insufficiency, penile injections usually do not work.  This is one of the reasons why penile Doppler ultrasound<\/strong><\/a> is a valuable test in determining the cause of erectile dysfunction and guiding a patient to appropriate treatment.<\/p>\n

Men with Peyronie’s disease<\/strong><\/a>, especially with severe hourglass appearance, may find that penile injection such as Trimix and PGE1 E work well in the part of the penis toward the tip of the penis but do not cause an adequate erection in the part of the penis involved by the plaque that causes hour-glass appearance.<\/p>\n

Men with Low-T (low testosterone)<\/strong><\/a> may find that the benefit of penile injections is reduced.  Addressing low T may lead to an improvement in penile injection effectiveness for ED.<\/p>\n

Options When Penile Injections are Not Effective<\/strong><\/h2>\n

It is important that a patient is taught to inject medication such as prostaglandin E1<\/a> and Trimix correctly.  In-office injection of medications to titrate to appropriate dose is an important component of treatment with penile injections and is recommended by the ED treatment guidelines from the American Urological Association.<\/p>\n

For patients with low testosterone, testosterone replacement therapy<\/strong><\/a> is advisable.  Similarly, patients with other hormonal abnormalities such as low or high thyroid levels or high prolactin levels should have hormonal abnormalities treated.  Weight loss and treatment of high cholesterol and high blood pressure are important components of holistic treatment for erectile dysfunction.<\/p>\n

Shockwave therapy for ED<\/strong> <\/a>is a new treatment option for men with erectile dysfunction.  Shockwave therapy may help some men with vascular erectile dysfunction for whom penile injections do not work well to regain the ability to use penile injections or oral medications for the treatment of ED.<\/p>\n

Penile Implant is an Effective Alternative Treatment to Penile Injections<\/strong><\/h2>\n

Usually, medications such as Viagra, Cialis and Levitra are tried prior to using penile injections.  Most men progress to using penile injections for ED when an oral medication such as sildenafil (Viagra) does not work<\/a><\/strong>.  Vacuum erection devices (VED)<\/a> are an option but most men give up using VED after a short period of time due to inconvenience.  Typically, vacuum erection devices did not work nearly as well as do penile injections or medication such as Viagra or Cialis.<\/p>\n

The most reliable and effective treatment option<\/strong> for men for whom penile injections for the treatment of erectile dysfunction (Bimix, Prostaglandin E1, Trimix, and Quadmix) do not work is a penile implant<\/strong><\/a>.  There are 2 types of penile implants: a malleable penile implant and an inflatable penile implant.  Penile implants such as AMS 700 penile prosthesis<\/a> and Titan Touch Inflatable penis prosthesis<\/a> have high patient satisfaction.  Penile implants work for men regardless of the cause of ED.  Penile implants can help men with diabetes<\/a>, high blood pressure<\/a> and kidney failure among other problems to regain sexual function.<\/strong><\/p>\n

Dr. Alex Shteynshlyuger<\/a> is among a small number of top urologists in the United States who perform penile implant procedures for men with erectile dysfunction, Peyronie\u2019s disease associated with ED, as well as penile fibrosis caused by priapism<\/a>.<\/p>\n

Where to Get Treatment for ED in NYC?<\/h2>\n

At New York Urology Specialists, we offer specialized treatment for ED for men<\/strong>. Same-day appointments are available.<\/p>\n

Call\/text today: 1-646-663-5211<\/span><\/a><\/span> <\/span><\/strong>or <\/span>make an appointment<\/span><\/a> online.  <\/span><\/span><\/strong><\/p>\n

We treat sexual and erection problems<\/a><\/strong> and offer comprehensive STD testing<\/a><\/strong> for infections.  We treat penile problems in men<\/a><\/strong>, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy<\/strong>, vasectomy reversal, cosmetic circumcision<\/strong><\/a>, circumcision revision<\/a><\/strong>, penile frenuloplasty. We offer confidential<\/strong> appointments.<\/p>\n

Our prices are ED treatment prices<\/a> are affordable with or without insurance<\/strong>.  Low-cost<\/strong> Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification<\/strong>.<\/p>\n

Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.<\/h2>\n

We offer ED treatment to patients within driving distance to our offices as well as from other states and countries.  Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.<\/p>\n