Sexual Health Table 7: Effects Intraurethral Preparations

Author Year; Country


Research Design

Total Sample Size



Strebel et al. 2004;



Level 4


All 22 patients had a chronic SCI lasting a
median (range) of 63 (7–156) months; 11 had an UMN lesion (six complete, five incomplete), eight a LMN (seven complete, one incomplete) and three a mixed lesion.

Eight tablets of apomorphine sublingual (SL) 3 mg, as a primary or secondary treatment for erectile dysfunction (ED)

Outcome Measures:
International Index of Erectile Function questionnaire, patient diaries. A neurophysiological evaluation included somatosensory evoked potentials of the pudendal nerve, palmar and plantar sympathetic skin responses and bulbocavernous reflex recordings.

  1. There were no significant correlations for electrophysiological or urodynamic findings and treatment success.
  2. Seven patients had some response and reported that the drug helped them to obtain an erection, but only two reported erections sufficient for intercourse and would agree to continue apomorphine SL as their standard treatment; all the others reported being disappointed. Nine patients reported side-effects.

Bodner et al. 1999;




Population: 15 men; Age range: 30-70 yrs, Injury level: 7 tetraplegia, 8 paraplegia.

Treatment: Intraurethral alprostadil (125-1000µg); MUSE (medicated transurethral system for delivery of alprostadil to the male urethra).

Outcome Measures:Efficacy of intraurethral prostaglandin E1.

  1. 12 achieved grade 1-3 erections, 3 achieved grade 4 erections.
  2. All could achieve grade 5 erections with intracavernosal injections therapy. The three that achieved grade 4 erections all tried MUSE at home and were dissatisfied.