Intracavernous Pharmacotherapy (ICP) for Erectile Dysfunction

ICP is by far the most effective treatment available. It is safe and suitable for most men with Erectile Dysfunction, regardless of age or medical condition. It's a highly specialized form of ED treatment and yet simple to apply. ICP treatment has been widely used since the mid 80's. Medical professionals who specialize in this form of treatment use various different combinations of medications.

ICP involves painless injection of a small amount of a pre-determined combination of vasodilators into the spongy tissue of the penis, using an auto-applicator. The combination causes dilatation of the penile arteries and penile tissues, resulting in an increase in blood flow to the penis, which is then stored in the erectile chambers. As pressure builds up against an unyielding envelope (called a tunica albugaenia), venous outflow is blocked, an erection develops within a few minutes. This induced erection feels perfectly natural and normal with the exception that it will not go down after ejaculation. The prescribed formula is individually tailored to allow the erection to last approximately 30-60 minutes regardless of the occurrence of ejaculation or the state of mind. Once ICP protocol is established, this treatment works predictably and reliably every time.

The medicine used in ICP is a combination of vasodilators, each of which is FDA-approved, known as papaverine, phentolamine, atropine and prostaglandine E1. Since ICP is a localized form of treatment, the side-effects are minimal and local. Its overwhelming success rate, minimal side-effects and ease of use have made ICP a preferred choice for most patients who have access to this type of treatment. For patients who do not respond to, or suffer from the side-effects of the oral medications, ICP is a welcome relief since it works well in most cases.

The benefits of ICP include:

• Immediate results. It generally works within a few minutes of application, regardless of age or underlying medical conditions. It may take a little longer with severe Erectile Dysfunction.
• ICP has an overwhelming success rat, it works in the majority of patients, even in those who have tried this treatment before elsewhere.
• The medication is applied locally; hence there are no known systemic side-effects.
• ICP can be used without restriction to food, wine or other medications.
• ICP is easy to apply using an Autoject which operates simply with the press of a button.
• ICP is reported to be curative in many patients with Erectile Dysfunction. Results may vary depending on the underlying health problems and the severity of ED.

Even though ICP is effective in most men, it may not be as effective in advanced Erectile Dysfunction when most of the normal elastic tissue has been replaced by fibrosis, a common end-result of delayed treatment. The only remaining solution is the insertion of a penile prosthesis.

Side-effects of ICP:

ICP has a favorable side-effect profile. Given the benefits, the side-effects are minimal. They include:

• Lack of erectile response, caused by incorrect application of ICP or insufficient dose of vasodilators.
• Bruising, caused by accidental piercing of a superficial vein. A bruise is a superficial bleeding. It may last a few days and is harmless.
• Localized pain or tenderness, especially when ED has been a protracted problem. This problem tends to resolve with repeated use when the penile tissue gets used to the sensation of a full erection again.
• A prolonged erection (called a priapism) caused by over-reaction to the combination used. This problem is not common but it can occur on the first exposure to ICP when the sensitivity is yet to be established. A priapism must be reduced and subsequent dose-adjustment is necessary to avoid its recurrence.

How should ICP be used?

You can start and stop ICP any time you wish. ICP enables you to immediately achieve and maintain an erection, the very reason most men seek help at the first place. In that context, ICP can be used on as needed basis. However, long term improvement is unlikely. Such occasional use does not address the issue of poor circulation, poor erectile reflex and the progressive loss of normal healthy tissue and elasticity.

Physicians often recommend ICP as part of a Treatment Program that aims not only to provide a reliable erectile response short- term, but also to improve the long-term prognosis. Each patient is different, hence the treatment program has to be personalized to suit the individual needs and expectations. A course of treatment typically requires 2 to 3 ICP applications a week for a period of twelve (12) months. In more advanced cases, patients may use ICP 3 to 4 times a week. Generally speaking, the more erections you experience, the easier it is for the next one to occur on its own, stronger and more reliable.

You may experience return of natural erections and spontaneous erections during the course of treatment, but it is important to complete the full course of treatment. A follow-up evaluation is necessary.

Additional benefit of ICP in men with Premature Ejaculation (PE)

ICP sustains the erection regardless of the occurrence of ejaculation. With longer-lasting erections and sexual contact, a premature ejaculator becomes less sensitive to sexual stimulation. The assurance that the erection will not go down after ejaculation helps eliminate the performance anxiety, thus reducing the urge to ejaculate. A new habit can be formed and ejaculatory control can improve.

Note: If Premature Ejaculation is of recent onset, it is often a symptom of Erectile Dysfunction. Treating ED will improve the ejaculatory control.

What is the basis for long term improvement with a course of ICP treatment?

As a rule, medical professionals cannot make claims or promise cure but would focus on optimizing the treatment outcome as a balanced decision between benefits and potential side-effects. Such notion is well maintained and respected in order to avoid abuse and false representation.

ICP on its own is not intended to cure Erectile Dysfunction, nor does it promise cure. With proper dosing, it provides a predictable and dependable erectile response. The observation that many ED patients no longer need ICP after a period of time has provoked many debates. Such improvement could be a direct result of a renewed confidence, a psychological gain, or a representation of actual physical improvement, or a combination of both. A few references regarding the claims of "cure" are included at the end of this information package.

Failure to treat Erectile Dysfunction leads to progressive loss of the remaining healthy tissue and eventually irreversible loss of erectile function if the window of opportunity has been passed. So it is important to treat Erectile Dysfunction with urgency, regardless of the final outcome. Long term improvement might be complete or partial; either is worth the effort.

ICP and psychological Erectile Dysfunction

Men with recent-onset psychological Erectile Dysfunction still have a reasonably intact physiological function. Restoring the confidence level with repeatedly successful erections helps resolve the psychological conflicts; the erectile function tends to improve. Untreated, psychological Erectile Dysfunction can deteriorate to physical Erectile Dysfunction, a process called "disuse atrophy", which is then more difficult to reverse.

ICP and physical Erectile Dysfunction

The penile tissue is a vascular organ that requires a healthy supply of oxygenated blood to stay supple and responsive to sexual stimulation. Such provision comes with the occurrence of regular erections, either sexually-induced or physiologically-induced (REM sleep). When the ability to achieve and maintain an erection is compromised for one reason or another, the supply of the much needed oxygenated blood is reduced. The penile tissue starts to atrophy, loses its normal elasticity and responsiveness to sexual stimulation; erectile function worsens. When fibrosis has predominantly replaced the normal healthy penile tissue, the condition becomes unresponsive to medical therapy. A penile prosthesis is then the only solution.

A course of ICP treatment results in regular erections that last 30-60 minutes each time. Each ICP-induced erection helps rebuild the sexual confidence, a psychological benefit, as well as the natural erectile reflex, a physical benefit. Similar to an exercise program intended to rehabilitate a weakened muscle, a course of successive erectile responses can improve the blood flow, the penile elasticity, hence the erectile function. The extent of improvement can vary depending on age, the severity and duration of dysfunction, the presence of concurrent illnesses and other health risk factors. Generally speaking, if a weak dose of ICP, as seen during the diagnostic assessment, results in positive increase in blood flow and an erectile response, full or partial, the condition is said to be reversible and the prognosis is promising.

How do I increase the prospect of long term improvement?

To optimize your chance of long term improvement, complete the full course of treatment as recommended, look after your general health, maintain a healthy diet and an active life-style, reduce stress and control your vascular risk factors, if any.

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