Urethral pellets

For erection problems

Urethral pellets are another option to help with erection problems that can result after treatment for prostate cancer.

They are sometimes referred to as intraurethral suppositories or medicated urethral system for erections (MUSE).

They are made with basically the same medicine (alprostadil) that is used in self-injection drugs (penile injections).

The medicine is inserted into the tip of the penis through the same opening that a man urinates through (called the urethra).

How they are used

The application procedure involves several steps.  If the doctor does not offer to show you how to use a urethral pellet, you may want to ask for a demonstration. 

  1. First, a man urinates (the moistness aids in application and helps dissolve the pellet).
  2. Then he stretches his penis to full length and gently squeezes the tip, which straightens and opens the urethra.
  3. The small pellet is inserted using a disposable applicator that has a very thin tube. The man can do this while sitting or standing.
  4. There is a button on the applicator that releases the pellet. The applicator is held in place for 5 seconds.  A man gently rocks the applicator from side to side to separate the pellet from the applicator.
  5. After the applicator is removed, a man (or his partner) rolls the penis in an upright position and fully stretched between the hands for at least 10 seconds. This helps the medicine dissolve into the walls of the urethra.

How long to work?

It generally takes 5 to 10 minutes to achieve an erection, which is expected to last from 30 to 60 minutes.  Results may vary.  There are different dosages and it may take some time to find the right dose. Like self-injected drugs, there are limitations to how often the pellets can be used. The doctor should give you specific instructions.

Urethral pellets for erection problems

Issues with urethral pellets

  • They may not be as effective as penile injections
  • Oral sex should be avoided
  • After intercourse, some women may experience mild vaginal itching or burning
  • Men may experience aching in the genitals, redness of the penis (due to increased blood flow), and warmth or a burning sensation
  • Minor bleeding may occur if the pellet is not inserted correctly (due to scratching the urethra)

Not for every man

Some men cannot use these drugs, including men with:

  • Sickle cell anemia
  • Leukemia
  • Multiple myeloma
  • An abnormally shaped penis

If your loved one has an erection for more than 4 hours with a urethral pellet (called priapism), seek immediate medical attention.

Back to sex after prostate cancer
Erectile dysfunction drugs
Self-injected drugs
Vacuum pump devices
Penile implants

Urethral pellet references:

American Cancer Society. Ways of dealing with sexual problems. http://www.cancer.org. Accessed September 1, 2008.

Cornell University. Drug Treatment of Erectile Dysfunction. http://www.cornellurology.com/sexualmedicine/ed/vacuum.shtml. http://www.cornellurology.com/sexualmedicine/ed/drugs.shtml. Accessed December 4, 2008.

Kaiser Permanente. MUSE for erection problems. http://members.kaiserpermanente.org/kpweb/healthency.do?hwid=aa66949. Accessed December 4, 2008.

MUSE (alprostadil) [Patient Information]. Vivus Inc.; Mountain View, CA: 2003.

Always consult a medical professional.

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