Erectile dysfunction: intracavernous treatment.

The intracavernous use of papaverine, phentolamine and prostaglandin E1 (PGE1) is reviewed. The value of treatment combinations is also considered. In particular, the beneficial and harmful effects of long-term intracavernous treatment are considered. For example, the use of PGE1 may be associated with a long-term improvement of the penile microcirculation. In order to maximise the benefit from intracavernous therapy there is a need for specialised evaluations, a stepwise management approach and the consideration of patient preference.