The role of intracavernous injection of vasoactive medications for the restoration of erection in spinal cord injured males: a three year follow up.

Fifty-eight spinal cord injured men entered our self injection program for restoration of erections since the program began in September 1985. Early complications included sustained erection (greater than 8 hours) in 4 patients on 6 occasions requiring aspiration of the corpora cavernosa and injection of a dilute epinephrine solution (1/100,000). Bruising at the site of injection was reported at least once by 10 patients. Blood draining from the urethra was noted in 3 patients when the urethra was inadvertently injected. Rigid erections were obtained in all but 5 patients that injected (90%). Late complications included penile plaque in 3 patients (15%). There were no abnormal liver function tests. Average time on the injection program was 2 years (range of 0.5 to 4.5 years). Thirty-one (53%) of the patients have dropped out of the program, most doing so prior to the first injection or during the titration period. The average frequency of injection was twice a month. Injection therapy remains an effective and relatively safe alternative for selective patients with spinal cord injury.