Topical Gel Seen as Effective New Treatment for Impotence

Nov. 2, 1999 (New York) -- A gel applied to the penis may be able to help some impotent men achieve an erection, according to a study in a recent issue of the Journal of Urology. However, many users experienced an uncomfortable sensation and the potential effects of the gel on female partners is unknown.

The gel contains a hormonelike substance called alprostadil and an agent known as SEPA that helps deliver the alprostadil through the skin of the penis. Alprostadil has previously been shown to enhance erections but could only be administered with an injection. The topical treatment may be another option for impotence, or erectile dysfunction, a common, treatable condition that affects as many as 20 million American men. Current treatments for impotence include oral medications such as Viagra (sildenafil), injectable drugs, and penile implants.

In the new study, a gel containing either alprostadil or a placebo was applied to the penis in 48 impotent men. Overall, 67-75% achieved an erection after using the alprostadil gel compared with 17% applying the placebo gel, report Kevin T. McVary, MD, and colleagues. McVary is an associate professor of urology at Northwestern University Medical School in Chicago.

No serious side effects were seen, but nearly all patients experienced a warm sensation that went away within 5-20 minutes of application of either gel. Approximately 20% of the men that received the alprostadil gel described discomfort along the penis. The authors say it appears that the alprostadil is responsible for the discomfort. No evidence of serious skin reactions was seen.

In an editorial comment accompanying the study, Geoffrey N. Sklar, MD, points out that while using a gel medication for achieving erections is an attractive possibility, past experience has shown them to be largely ineffective and have many side effects.

"A central issue surrounding this route of administration is whether patients will accept discomfort when using an [erection-inducing] agent," writes Sklar, who is from the division of urology at the University of Maryland School of Medicine in Baltimore. He also suggests that gathering more information about how patients use the gel at home is important. Sklar says that gel medications may be a useful alternative when oral medications fail.

McVary says that with regard to effects the gel might have on female partners, a South American researcher found only one incidence of minor vaginal bleeding in studies of 18 women whose partners used a similar gel. "It's a different drug, but the same concept," he says.

McVary adds that the topical alprostadil gel is potentially useful for virtually all types of impotence since the study included a broad distribution of patients with different causes for their impotence.