Beyond Oral Therapies: A Practical Approach to Overcoming Barriers to Intracavernosal Injection Therapy in Clinical Practice.

Authors

Lucas Vasconcelos Sanvido, Nilson Marquardt, Thiago Afonso Teixeira, Felipe Carneiro, Bruno Chiesa Gouveia Nascimento, Jorge Hallak

Published in

International braz j urol : official journal of the Brazilian Society of Urology. Volume 52. Issue 5.

Abstract

The objective of this manuscript is to present intracavernous therapy to readers, serving as a model and guide for physicians on how to introduce and manage it in their patients. Furthermore, we propose a strategy designed to ensure maximum safety with minor complications and provide an effective implementation of intracavernosal injection (ICI) therapy for the management of erectile dysfunction (ED). While phosphodiesterase type 5 inhibitors (PDE5i) are recognized as first-line therapy, approximately one-third of patients do not achieve satisfactory clinical outcomes, highlighting the importance of ICI as a highly effective second-line option. This comprehensive review details patient selection, drug formulation, structured patient education, stepwise dose titration, management of adverse events, and longitudinal follow-up. This approach is intended to minimize treatment-related complications, enhance patient confidence and adherence, and optimize long-term therapeutic outcomes. By suggesting a standardized clinical application of ICI therapy, this review aims to address key barriers that currently restrict its broader adoption in routine clinical practice.

PMID:
42391488
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.

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