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In a tactic called "watchful waiting," the patient does not receive treatment. Instead, regular checkups monitor the progress of the cancer.
Agents that are injected directly into the penis exert their relaxant effect directly on the corpora cavernosal smooth muscle. They can be used as single agents or in combination. The most commonly used agents include PGE1, papaverine, and phentolamine. The dose and most effective combination of these agents must be determined for each patient. These medications can be obtained commercially as Caverject (PGE1) or can be formulated according to the physician's request by compounding pharmacies. Patients can be supplied with vials of a single agent or a combination of agents mixed in a single vial. Patients must be instructed in the proper technique for administration. A single intraurethral agent, PGE1, which has been formulated into a small suppository, is commercially available as MUSE. This agent was available prior to the introduction of sildenafil and is still used by a select group of men.
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