Clinical course of penile fibrosis in intracavernosal prostaglandin E1 injection therapy: a follow-up of 44 patients

A study was undertaken of 44 patients who had developed fibrotic changes in the penis in the course of intracavernosal prostaglandin E1 (PGE1) injection therapy for erectile dysfunction. Of these patients, 75.0% (n=33) were followed up for more than 24 months, and 59.1% (n=26) for more than 36 months. Of the patients, 52.3% (n=23) had clinical improvement of the fibrotic changes without therapeutic intervention and despite most (91.3%) continuing intracavernosal PGE1 injection therapy. These included 25.0% (n=11) no longer having clinically detectable penile fibrosis (PF). The presence of penile curvature or pain did not significantly influence this outcome. The ages of men who showed improvement and the duration of their injection therapy were similar to those who did not improve. It would be prudent to defer therapeutic intervention for PF in the course of intracavernosal PGE1 injection therapy in anticipation of possible spontaneous improvement.