Urethral pellets for erection problems

Urethral pellets, which are sometimes referred to as intraurethral suppositories, or medicated urethral system for erections (MUSE), are another option to help with erection problems that can result after treatment for prostate cancer.

It’s basically the same medicine (alprostadil) that is used with self-injection (or penile injection). However, the medicine is inserted into the tip of the penis, through the same opening that a man urinates through (called the urethra).

It involves several steps

Because it’s a bit complicated the first time, if your loved one’s doctor does not offer to show you how to use a urethral pellet, you may want to ask.

First, the man urinates, because the moistness aids in application and helps dissolve the pellet. He then stretches his penis to full length and gently squeezes the tip, which straightens and opens the urethra. The small pellet is inserted using a disposable applicator that has a very thin tube. The man can do this while sitting or standing. There is a button on the applicator to release the pellet. The applicator is held in place for 5 seconds, and the man gently rocks the applicator from side to side to separate the pellet from the applicator. After the applicator is removed, the 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.

It generally takes 5 to 10 minutes to achieve an erection, which is expected to last from 30 to 60 minutes. Results may vary from man to man. There are also different dosages, so it may take some time for you and your loved one 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.

Other issues

According to the American Cancer Society, urethral pellets may not be as effective as penile injections. Oral sex should also 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 (due to scratching the urethra) if the pellet is not inserted correctly.

Urethral pellets cannot be used by men who have sickle cell anemia, leukemia, multiple myeloma, or 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.

Updated 10/11

Always discuss everything you read on this web site with a qualified medical professional.

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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.