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Question 3#

Regarding alprostadil pharmacotherapy in ED:

a. Prostaglandin E1 cause vasoconstriction of penile veins
b. Intracavernosal alprostadil injection is associated with penile pain in 40% cases
c. When priapism occurs conservative route is feasible for it resolves spontaneously in 50% cases
d. Alprostadil increases introcavernosal nitrous oxide concentration
e. Causes rise in cGMP levels

Correct Answer is B

Comment:

Answer B

Prostaglandin E1 causes direct relaxation of cavernosal smooth muscle and antagonises the action of norepinephrine. These dual effects may explain its efficacy in inducing erections. The Alprostadil Study Group reported a 2% incidence of penile fibrosis. Pain is the major problem associated with alprostadil injection, with an incidence of 16% to 40% and a clear dose dependency. Alprostadil has a higher rate of penile pain compared to papaverine. Prolonged erection occurred in 5% of the men in the Alprostadil Study Group.