Intracavernosal aviptadil with phentolamine mesylate should be offered for treatment of refractory erectile dysfunction
BAUS ePoster online library. Holden F. 06/23/21; 319041; p13-3
Disclosure(s): No disclosures
Ms. Fiona Holden
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Abstract
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Introduction
The combination of aviptadil with phentolamine mesylate (Invicorp) was first approved for use in 1998. The advent of oral phosphodiesterase-5 inhibitors and the availability of intracavernosal alprostadil injections (ICAI) compounded by regulatory issues for Invicorp have limited its use and availability. Invicorp causes less pain on injection and may have a role following failure of ICAI.
Methods
Single centre retrospective review of all men trialling Invicorp after failing ICAI due to pain or poor efficacy following titration to 40mcg. The first injection was performed in clinic with either a half (12.5mcg aviptadil/1mg phentolamine) or full (25mcg aviptadil/2mg phentolamine) dose. Efficacy was assessed after 3 months.
Results
167 men with a median age of 60 years (IQR 53-67) were referred after failing median ICAI dose of 20mcg (IQR 10-40). Aetiology of ED was post radical prostatectomy in 49% and diabetes in 31.9%. All men had failed oral phosphodiesterase-5 inhibitors and 75% found vacuum erection devices inadequate. Sixty-one percent found ICAI too painful while the others reported poor erectile response. Almost two-thirds (63.2%) found Invicorp effective and allowed sexual activity to resume. 15% (n=24) stopped Invicorp because they wanted to stop using injectables or experienced improvement in their erectile function. Fifty-three (32.5%) men developed adverse reactions (facial flushing 92%).
Conclusions
In the largest study to date, Invicorp offers an effective and acceptable third line option for men who have failed most non-surgical treatment for ED. Many men (63%) were given an alternative to penile prosthesis insertion by being offered Invicorp.
The combination of aviptadil with phentolamine mesylate (Invicorp) was first approved for use in 1998. The advent of oral phosphodiesterase-5 inhibitors and the availability of intracavernosal alprostadil injections (ICAI) compounded by regulatory issues for Invicorp have limited its use and availability. Invicorp causes less pain on injection and may have a role following failure of ICAI.
Methods
Single centre retrospective review of all men trialling Invicorp after failing ICAI due to pain or poor efficacy following titration to 40mcg. The first injection was performed in clinic with either a half (12.5mcg aviptadil/1mg phentolamine) or full (25mcg aviptadil/2mg phentolamine) dose. Efficacy was assessed after 3 months.
Results
167 men with a median age of 60 years (IQR 53-67) were referred after failing median ICAI dose of 20mcg (IQR 10-40). Aetiology of ED was post radical prostatectomy in 49% and diabetes in 31.9%. All men had failed oral phosphodiesterase-5 inhibitors and 75% found vacuum erection devices inadequate. Sixty-one percent found ICAI too painful while the others reported poor erectile response. Almost two-thirds (63.2%) found Invicorp effective and allowed sexual activity to resume. 15% (n=24) stopped Invicorp because they wanted to stop using injectables or experienced improvement in their erectile function. Fifty-three (32.5%) men developed adverse reactions (facial flushing 92%).
Conclusions
In the largest study to date, Invicorp offers an effective and acceptable third line option for men who have failed most non-surgical treatment for ED. Many men (63%) were given an alternative to penile prosthesis insertion by being offered Invicorp.
Introduction
The combination of aviptadil with phentolamine mesylate (Invicorp) was first approved for use in 1998. The advent of oral phosphodiesterase-5 inhibitors and the availability of intracavernosal alprostadil injections (ICAI) compounded by regulatory issues for Invicorp have limited its use and availability. Invicorp causes less pain on injection and may have a role following failure of ICAI.
Methods
Single centre retrospective review of all men trialling Invicorp after failing ICAI due to pain or poor efficacy following titration to 40mcg. The first injection was performed in clinic with either a half (12.5mcg aviptadil/1mg phentolamine) or full (25mcg aviptadil/2mg phentolamine) dose. Efficacy was assessed after 3 months.
Results
167 men with a median age of 60 years (IQR 53-67) were referred after failing median ICAI dose of 20mcg (IQR 10-40). Aetiology of ED was post radical prostatectomy in 49% and diabetes in 31.9%. All men had failed oral phosphodiesterase-5 inhibitors and 75% found vacuum erection devices inadequate. Sixty-one percent found ICAI too painful while the others reported poor erectile response. Almost two-thirds (63.2%) found Invicorp effective and allowed sexual activity to resume. 15% (n=24) stopped Invicorp because they wanted to stop using injectables or experienced improvement in their erectile function. Fifty-three (32.5%) men developed adverse reactions (facial flushing 92%).
Conclusions
In the largest study to date, Invicorp offers an effective and acceptable third line option for men who have failed most non-surgical treatment for ED. Many men (63%) were given an alternative to penile prosthesis insertion by being offered Invicorp.
The combination of aviptadil with phentolamine mesylate (Invicorp) was first approved for use in 1998. The advent of oral phosphodiesterase-5 inhibitors and the availability of intracavernosal alprostadil injections (ICAI) compounded by regulatory issues for Invicorp have limited its use and availability. Invicorp causes less pain on injection and may have a role following failure of ICAI.
Methods
Single centre retrospective review of all men trialling Invicorp after failing ICAI due to pain or poor efficacy following titration to 40mcg. The first injection was performed in clinic with either a half (12.5mcg aviptadil/1mg phentolamine) or full (25mcg aviptadil/2mg phentolamine) dose. Efficacy was assessed after 3 months.
Results
167 men with a median age of 60 years (IQR 53-67) were referred after failing median ICAI dose of 20mcg (IQR 10-40). Aetiology of ED was post radical prostatectomy in 49% and diabetes in 31.9%. All men had failed oral phosphodiesterase-5 inhibitors and 75% found vacuum erection devices inadequate. Sixty-one percent found ICAI too painful while the others reported poor erectile response. Almost two-thirds (63.2%) found Invicorp effective and allowed sexual activity to resume. 15% (n=24) stopped Invicorp because they wanted to stop using injectables or experienced improvement in their erectile function. Fifty-three (32.5%) men developed adverse reactions (facial flushing 92%).
Conclusions
In the largest study to date, Invicorp offers an effective and acceptable third line option for men who have failed most non-surgical treatment for ED. Many men (63%) were given an alternative to penile prosthesis insertion by being offered Invicorp.
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