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Urology/penile injection therapy


Hi Dr. I am trying to gain some understanding regarding penile injection therapy as the oral medication in my case is not responding well after about successful 10-15 years taking Viagra and Cielis. To date, i still do not understand what has changed and it remains mystery .
Per our previous communications, you have recommended penile injection therapy as another option. Would greatly appreciated if you can provide more information for my understanding:

1- For how long this technology have been used by patients
2- What % of men with ED have already adopted this methods
3- What are the side effects
4- what % of patients end up in emergency room because of erection that resist to go away
5- is there a chance damaging your penis permanently by using this method

Appreciate your feedback.



1. 20 plus years.
2. I do not have an answer of exact stats but at least 15-20%.
3. Bruising, irritation and redness at injection site and potential prolonged erection, mild burning from PH of medication.
4. Very few if the physician dials in the correct dose and the patient uses pseudoephederine 2 tabs (60mgs) after 1 hour of erection.
5. Not from the injection but a priapism untreated.

I recommend EDEX (alprostadil) be used first (not caverject) same drug but EDEX is PH balanced not to burn when injected.

If EDEX is not potent enough then Bimix (alprostadil- papaverine) or Trimix (alprostadil-papaverine-phentolamine)

If not effective or effect diminishes (Super 8 Trimix) double strength.

Last injectable is quad mix (alprostadil-phentolamine-papaverine-forskelin or atropine) .

When a patient is taught correct technique and has had a penile duplex study to evaluate the root of the ED then the injectable is a very safe and effective option.  


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Thomas A Suppe RDMS CLT


Invervential urologic radiology , urologic laser surgery, cryotherapy of the prostate and kidney, extracorporal shockwave lithotripsy, holmium laser lithotripsy, urodynamics (video-non video),male infertility, erectile dysfunction, Peyronies disease, hypogonadism ,kidney stones, prostate cancer detection, BPH, voiding dysfunction, bladder cancer and continent diversions.


For the past 20 years performing intervential and diagnostic uro-radiology for a multitude of urologic surgeons from New York, New Jersey, Lousianna and Texas. Founder of DMS medical LLC introducing the Texas Medical Center to the first high power Green Light laser for the treatment of BPH just after its release by the FDA from Laserscope and its sucessful trials at the Mayo Clinc.

American Registery of Diagnostic Medical Sonographers (ARDMS), American Urologic Assocoation (AUA), American Medical Systems (AMS) Laserscope,Oncura, Allergan and Auxilliam pharmaceuticals.

Comprehention of Urologic Ultrasonography for the Resident Physician (Journal of Urology 2012), Author of the syllabus for the uro-radiology residency course at The Scott Dept of Urology at Baylor College of Medicine Houston Texas (2010 to present). Past Clinical Studies: Principal radiology investigator Allergan Inc for "The treatment of BPH with intra-prostatic injections of Botox" with Larry I Lipshultz MD 2011-2012, principal radiology investigator for Allergan Inc for "The treatment of Peyronies disease by intra-lesional penile injections of Botox" with Mohit Khera MD MBA MPH (2011-2012). Current studies: Principal investigator of "Blood pressure risk factors of intra cavernosal injections of Trimix and PGE1 during Penile Duplex's.

BS from Ramapo College of NJ, Registered diagnostic medical sonographer with the ARDMS, 2 year fellowship of Uro-Radiology and intervential sonography at Baylor College of Medicine Houston TX, laser safty officer in state of Texas and certified in KTP, Holmium and Lithium Tri-boride laser systems from Laserscope San Jose, California and American Medical Systems Minnatonka Minnasota, trained and certified by Oncura Inc Isreal in ultrasound guided argon cryotherapy of the prostate and kidney.

Awards and Honors
Honorary instructor of GU ultrasound course 2012 international meeting of the American Urologic Association. Author of the the AUA course for "Ultrasonography of the Testes and Scrotum" 2012.

Past/Present Clients
Baylor College of Medicine (BCM) Lousianna State University (LSU), LSU Medical Center Shreeveport LA, The Methodist Hospital Houston Texas, St Lukes Episcopal Hospital Houston Texas, Memorial Herman Health Systems Houston Texas, Palestine RMC Texas, Doctors Regional Hospital Corpus Christi Texas, Valverde Regional Medical Center DelRio Texas, Current instructor/technologist for two internationally recognized urologists : Larry I Lipshultz MD and Mohit Khera MD, MBA, MPH at Baylor College of Medicine. I served as intervential sonography consultant for Oncura Inc cryotherapy systems. Former lead trainer for Urosource mobile medical services , training new surgeons in PVP or photo-selective vaporization of the prostate for BPH, BNCs and urethral stricture vaporization.

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