Penile self-injection therapy, also known as intracavernosal injection (ICI), is one of the most effective treatments for erectile dysfunction. This therapy involves injecting medication directly into the penis to produce an erection, and it works for many men who haven't had success with oral medications like Viagra or Cialis.
While the idea of self-injection may seem intimidating at first, most men find the process straightforward and nearly painless once they learn the proper technique. This comprehensive guide will walk you through everything you need to know about penile self-injection therapy.
Penile injection therapy involves injecting medication directly into the corpora cavernosa (the erectile tissue) of the penis. The medication causes the blood vessels to relax and dilate, allowing increased blood flow into the penis, which produces an erection.
This treatment is highly effective because it bypasses many of the common causes of erectile dysfunction, working directly on the penile tissue rather than relying on systemic circulation or nerve pathways.
A combination of three medications: alprostadil (prostaglandin E1), phentolamine, and papaverine. This is the most commonly prescribed formulation due to its effectiveness and customizable dosing.
Contains only two medications: papaverine and phentolamine. Used when patients have sensitivity to alprostadil.
Adds atropine to the Trimix formula for enhanced effectiveness in some patients.
Single-agent therapy that is FDA-approved but may cause more burning sensation than combination medications.
Penile injection therapy may be an excellent option if you:
Haven't had success with Viagra, Cialis, or Levitra
Cannot take oral ED medications due to heart conditions or drug interactions
Recovering from prostate surgery or radiation therapy
Want predictable, consistent erections with high success rates
Have nerve damage from diabetes, spinal cord injury, or other conditions
Want erections that occur within 5-15 minutes
Success rates range from 70-90%, significantly higher than oral medications. Works even when oral medications have failed.
Produces an erection within 5-15 minutes, much faster than oral medications which can take 30-60 minutes.
Erection typically lasts 30-60 minutes, providing adequate time for sexual activity without the extended duration of oral medications.
Works regardless of what you've eaten or had to drink, unlike oral medications which can be affected by food and alcohol.
Medication acts locally on the penis without causing headaches, facial flushing, nasal congestion, or vision changes common with oral ED medications.
Generally more affordable than brand-name oral ED medications, especially when obtained from compounding pharmacies.
Medication strength can be easily adjusted to find the perfect dose for your needs, providing optimal results with minimal side effects.
Follow these detailed instructions carefully. Your healthcare provider will demonstrate the technique during your first visit and may supervise your initial injections.
Gather the following items:
Thoroughly wash your hands with soap and water for at least 20 seconds. This is crucial to prevent infection.
Important: Inject into the side of the penis shaft, NOT the top, bottom, head, or base.
Use an alcohol swab to clean the injection site. Allow it to air dry completely (do not blow on it or wipe it off).
Pro Tip: Most men report the injection feels like a small pinch or mosquito bite. The needle is very small and thin.
Immediately apply firm pressure to the injection site with gauze or tissue for 2-3 minutes. This helps:
Place the used needle and syringe in a sharps container immediately. Never recap needles or throw them in regular trash.
An erection should develop within 5-15 minutes. You can stimulate the penis gently to encourage the erection, but it's not required. The erection will typically last 30-60 minutes.
While penile injection therapy is generally safe and well-tolerated, it's important to be aware of potential side effects and risks:
Small amount of bleeding at injection site is normal
Temporary discomfort during or after injection
Usually temporary and resolve on their own
Mild discomfort during erection (more common with alprostadil)
An erection lasting more than 4 hours is a medical emergency. If left untreated, it can cause permanent damage to the penis and erectile tissue.
If your erection lasts more than 4 hours, go to the emergency room immediately or call 911.
Rare but possible. Watch for redness, warmth, swelling, pus, or fever. Seek medical attention if these symptoms develop.
Long-term use can cause scar tissue buildup, which may lead to penile curvature (Peyronie's disease). This risk is minimized by alternating injection sites and using proper technique.
Rarely, the medication can affect blood pressure or heart rate. Report any dizziness, chest pain, or irregular heartbeat to your doctor.
Your healthcare provider will start you on a low dose and gradually increase it until you find the amount that produces a satisfactory erection lasting 30-60 minutes.
Important: Never adjust your dose without consulting your healthcare provider. Even small increases can significantly affect results.
Open communication with your partner about this treatment can enhance your experience:
Most men report minimal discomfort. The needle is very small and thin (similar to an insulin needle). Many describe it as feeling like a small pinch or mosquito bite. The sensation typically lasts only a second or two. Some men report feeling nothing at all.
Most men develop an erection within 5-15 minutes after injection. This is much faster than oral medications, which typically take 30-60 minutes to work. The erection usually lasts 30-60 minutes, though this can vary based on the dose and individual response.
This should only be done under close medical supervision. Combining treatments increases the risk of priapism (prolonged erection). However, some doctors may prescribe a low-dose combination approach for specific patients. Always consult your healthcare provider before combining ED treatments.
If your erection lasts more than 4 hours, this is a medical emergency called priapism. You should:
Cost varies depending on the medication formulation and pharmacy. Compounded Trimix from specialty pharmacies typically ranges from $50-150 per vial, with each vial containing 5-10 doses. This makes it significantly more cost-effective than brand-name oral ED medications. Some insurance plans may cover the medication, though coverage varies.
No. The erection produced by penile injection looks and feels completely natural. There is no visible injection mark after a few minutes, and the erection is indistinguishable from a spontaneous erection. Your partner will not be able to tell you used medication unless you choose to share that information.
Yes. Penile injection therapy only affects blood flow to produce an erection. It does not change sensation, arousal, or the ability to achieve orgasm and ejaculation. Your sexual experience and pleasure remain the same.
Good candidates typically include men who:
Schedule a consultation with Dr. Wille to determine if penile injection therapy is right for you.
Penile injection therapy is a highly effective, safe, and convenient treatment for erectile dysfunction. While the idea of self-injection may seem daunting at first, most men quickly become comfortable with the process and appreciate the reliability and effectiveness of this treatment option.
With proper instruction, technique, and dosing, penile injections can restore your confidence and sexual function, allowing you to enjoy a fulfilling intimate life. The high success rate and minimal side effects make this an excellent choice for many men, especially those who haven't had success with oral medications.
Highly effective treatment with 70-90% success rate, even when oral medications have failed
Fast-acting and predictable – produces erections within 5-15 minutes lasting 30-60 minutes
Nearly painless when proper technique is used with small, thin needles
Requires proper training from a healthcare provider and careful attention to technique and dosing
Main risk is priapism (erection lasting more than 4 hours) – seek emergency care if this occurs
This article is for educational purposes only and does not replace medical advice from your healthcare provider. Penile injection therapy should only be used under the supervision of a qualified physician.
Seek immediate emergency care if: Your erection lasts more than 4 hours, you experience severe pain, you notice signs of infection (redness, warmth, swelling, pus, fever), or you have chest pain, difficulty breathing, or irregular heartbeat.
Schedule a consultation with Dr. Wille to learn if penile injection therapy is right for you. We'll provide comprehensive training and ongoing support.