PROBLEMS WITH INJECTION TREATMENTS

Knowledge of the side effects of erectile dysfunction treatment is important before you embark on any program. It's better to know about all the potential complications before you commit yourself to any particular treatment and perhaps end up with some irreversible problem. The possible complications are listed and discussed below, along with some personal experiences.

Priapism
The following story illustrates the problem of priapism:
Grant 35 years old, tradesman
It's 1 a.m. I'm fast asleep. In my dream i can hear the familiar sound of the ringing of my mobile phone. After three rings, I realise that this is not a dream and I need to answer it before the call is diverted to my voice mail. I reach for the phone, tipping the books on my bedside table onto the floor. My wife grumbles something incomprehensible. I hurry out of the room and since I've spent many years as a doctor on call, I have developed a technique of sounding awake even when I'm not.
'Hello,' I say in a voice that belies my level of grogginess.
'Hi doc, it's Grant I saw you in the clinic yesterday afternoon. Doc, I've still got an erection and it's feeling quite uncomfortable.'
'What time did you receive the injection. Grant?'
'Around seven o'clock last night It's been up for six hours now/
'Grant, have you been following the instructions on the priapism sheet that I gave you yesterday?'
'Kind of. I didn't have any Sudafed in the house so I packed some frozen peas around my penis. I kept it there on and off for about an hour. I also took a shower and did some running on the spot And it's still as hard as it was/
'OK, I want you to try one more approach for the next 10 minutes and I will call you back. Lie down on your back and squeeze the penis very tightly. Don't pump it, just give it a consistent squeeze. This forces the blood out of the penis and often helps to bring it down. I will call you back in 10 minutes. Please give me your number/
'OK' I hear from the other end.
I set my alarm for 10 minutes from now, just in case I fall back
to sleep. Ten minutes later, the alarm wakes me up. I call Grant back.
'Grant Is it any better?' 'No, I'm afraid not/
OK, Grant, I need to give you an antidote to bring it down. Please meet me outside the clinic as soon as possible/

Twenty minutes later I am consulting with Grant at the clinic. I ask him to lie down on the bed and pull his pants down to his knees. The erection is strong and throbbing slightly. The antidote of choice is adrenaline, diluted to one tenth of its strength and injected directly into the shaft of the penis. Adrenaline is a vasoconstrictor which constricts the blood vessels (helps make blood vessels smaller). It is similar to the hormone that is released naturally into your body in response to anxiety or stress. It reduces the diameter of the feeding arteries, thereby preventing the rapid inflow of blood into the penis. It often works very quickly to offset the vasodilatory effects of intrapenile injected medication.

Side effects of adrenaline
One side effect is an increase in blood pressure, although only for a short period of time. This could prove dangerous if you suffer from high blood pressure and it is poorly controlled. In this case, it shouldn't be used. To prevent this complication, the patient's blood pressure is monitored, Adrenaline may also cause the heart to start beating quickly, and it will feel as if you're having palpitations. This is also a very temporary side effect. In general, adrenaline is a short acting drug so these side effects will be quite brief. However,
 
the patient should still be monitored. Contraindications to the use of adrenaline or any other antidote for priapism include: those patients with uncontrolled hypertension, and those patients with arrhythmia (a condition with an irregular heart beat).
After Grant's injection of adrenaline, I asked him to squeeze his penis again to help push the blood out— back into the body. But to no avail. The next step in the treatment of the priapism is drainage of the blood. This is not as horrific as it sounds and can be achieved with minimal discomfort. There are very few known complications with this procedure, the most common of which is bruising.
Here is a description of what happens: I anaesthetise the area first, which is the only uncomfortable part of the procedure. Once the local anaesthetic is working, I insert a needle into this area and draw 20 millilitres of blood from the shaft of the penis. In the majority of cases, this is all that is required. The penis comes down and the patient feels instant relief. If it doesn't stay down, which is rare, the procedure is repeated.
Unfortunately, there are two fairly consistent after effects of treating a priapism with this drainage procedure. Firstly, a small bruise usually forms (or a very large one, depending on the skill of the practitioner). This bruise will disappear completely in 5 to 10 days. Secondly, because of the discomfort from a prolonged erection, the patient may feel a temporary aversion to having sex. This usually lasts about a week and will be shorter if the doctor is reassuring and prepares the patient adequately in advance with all the necessary information before the procedure.
Once Grant is dressed the look of anguish on his face has now been replaced by a look of relief. I inform him that although his erection has been up for six hours, it is very unlikely that there has been any damage. However, he will feel somewhat put off having sex for awhile. If he is made aware of this possibility, it's unlikely it will bother him. In fact, I tell him it's probably worth abstaining from sex for at least the next week. For treatment, I will review his problem to make sure it doesn't happen again and ask him to see me in a week.
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