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| |  DG DISPATCH - BAUS: MUSE Effective And Cost-Effective Option For Erectile Dysfunction By David Jack Special to DG News GLASGOW, SCOTLAND -- June 25, 1999 -- The option of giving alprostadil via the urethra (MUSE) has been available in many countries since the start of 1998. In a new study, Dr. L. J. Ashford and colleagues at St. Peter’s Middlesex Hospital, Institute of Urology and Nephrology, London, England, found encouraging results on the use of MUSE as a cost-effective at-home treatment for erectile dysfunction. Dr. Ashford presented these findings at the British Association of Urological Surgeons in Glasgow, Scotland. Their study involved 95 patients with erectile dysfunction (ED) with a variety of aetiologies. Self-administration of MUSE was taught in the clinic and involved 250-500 mcg administered intraurethrally with the dose being titrated up to 1 mg depending on the response achieved at home. Patients were then reviewed during a three-month follow-up period. A total of 55 (58 percent) patients achieved erections that allowed sexual intercourse. Of the 40 (42 percent) who were dissatisfied with their response, 19 achieved minimal or no tumescence while 21 achieved tumescence that was of insufficient rigidity for intercourse. The incidence of side-effects or complaints were as follows: penile pain (n=9), testicular pain (n=1), administration too “clinical” (n=1), unreliable response (n=1), preferred injection therapy (n=2), partner unhappy (n=1) and trying to father a child (n=1). The authors concluded that MUSE is an effective and acceptable option in a significant number of patients. In another study presented at the BAUS meeting, a group led by Dr. A. K. Vohra at the North Middelsex Hospital London found encouraging evidence of MUSE’s cost-effectiveness and efficacy. Dr. Vohra described his group’s experience with 149 patients attending the ED clinic who opted for MUSE rather than intracavaernosal injections or vacuum devices. Patients in the study were titrated up to the optimal dose and then allowed to use MUSE unsupervised. At three- and six-month follow-up, they were asked to complete a questionnaire. A total of 86 (58 percent) were satisfied with MUSE and 57.7 percent of patients achieved Grade 3-4 erections and with successful intercourse. A total of 42 percent failed to pursue therapy after the initial trial; the reasons they gave were relationship problems, disliked therapy and switched to Viagra. Nine to 10 percent of patients reported urethral discomfort and 1 percent reported painful erections. The researchers say their results are encouraging and feel that MUSE respresents a cost-effective option for erectile dysfunction. They also advocate using the services of a Specialist Nurse to help motivate patients. Related Link: MUSE
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