MUSE

For men who dislike self injecting, alprostadil is now marketed in a suppository form, which was FDA approved to treat impotence in 1997. MUSE (which stands for "medicated urethral system for erections") is manufactured by Vivus, Inc. and is also known as "transurethral alprostadil." It is administered with a plunger into the urethra, bypassing the need for injecting a needle into the shaft of the penis.

The MUSE system is simple to use, does not cause the same amount of pain or discomfort that some men experience with the injections, and presents less danger of prolonged erections or penile nodules. However, it has been known to cause penile pain, urethral bleeding, dizziness, fainting, and swelling in the veins of the legs.

MUSE utilizes alprostadil in the form of a small pellet held in the plunger. After urination, when the urethra is moist, the plunger is fully inserted into the man's urethra. He then presses a button, releasing the pellet into his penis, where it quickly dissolves. An erection results in about ten minutes and lasts for up to an hour.

In some cases doctors will also prescribe the ACTIS Venous Flow Controller, which can be used in conjunction with the MUSE system. ACTIS is a constriction band that is placed at the base of the penis to hold the ,on. In a recent study, 75 percent of 232 men were able to sustain their erection for approximately 25 minutes and have sexual intercourse using this combination therapy.

When MUSE became available, many men switched from the injections, preferring this less invasive and apparently safer method. An estimated 700 000 prescriptions were written In the first year it was available. What will MUSE users do now that Viagra is upon us? Chances are, most of them will at least give the pill a try to see if it works for them.