{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:42:30Z","timestamp":1782391350173,"version":"3.54.5"},"reference-count":31,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T00:00:00Z","timestamp":1767484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Erectile dysfunction (ED) is a frequent and significant complication of radical prostatectomy that impacts patients\u2019 quality of life. Intracavernous injection treatment has become an important approach to post-prostatectomy ED, providing an immediate and proven means of regaining erectile function in men who are unresponsive to oral phosphodiesterase type 5 inhibitors. The scope of this article is to discuss the mechanisms, efficacy, and safety of ICI treatments using vasoactive compounds as a second-line treatment for ED after radical prostatectomy. We consider clinical results, satisfaction, and compliance, as well as predictors of success, like nerve-sparing procedures. Through our interpretation of evidence and clinical experience, ICI therapy is a cornerstone of penile rehabilitation and ED management following radical prostatectomy. Also, the prospects for further treatment optimization and patient outcomes are discussed.<\/jats:p>","DOI":"10.3390\/medicina62010111","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T08:40:53Z","timestamp":1767602453000},"page":"111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intracavernous Injection Therapy as Second-Line Treatment for ED After Radical Prostatectomy: A Literature Review"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3461-9170","authenticated-orcid":false,"given":"Adrian George","family":"Vlaicu","sequence":"first","affiliation":[{"name":"Department of Urology, \u201cC.F.2\u201d Hospital, 011464 Bucharest, Romania"},{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7278-5551","authenticated-orcid":false,"given":"Cristian","family":"Mirvald","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Center for Uro-Nephrology and Renal Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salam","family":"Najjar","sequence":"additional","affiliation":[{"name":"Nord Hospital, 010948 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3473-4446","authenticated-orcid":false,"given":"Radion","family":"Garaz","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5107-3523","authenticated-orcid":false,"given":"Igor","family":"Tsaur","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanel","family":"Sinescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Center for Uro-Nephrology and Renal Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Surcel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Center for Uro-Nephrology and Renal Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1056\/NEJMoa1209978","article-title":"Long-Term Functional Outcomes after Treatment for Localized Prostate Cancer","volume":"368","author":"Resnick","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/SPC.0000000000000195","article-title":"Erectile dysfunction after radical prostatectomy: Prevalence, medical treatments, and psychosocial interventions","volume":"10","author":"Emanu","year":"2016","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1080\/14681990701705559","article-title":"Erectile dysfunction and relationships: Views of men with erectile dysfunction and their partners","volume":"23","author":"McCabe","year":"2008","journal-title":"Sex. Relatsh. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3816\/CGC.2004.n.017","article-title":"Current Concepts in the Management of Erectile Dysfunction in Men with Prostate Cancer","volume":"3","author":"Kendirci","year":"2004","journal-title":"Clin. Prostate Cancer"},{"key":"ref_5","unstructured":"Klein, E.A. (2023). Current Clinical Urology, Springer. Available online: www.springer.com\/series\/7635."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.5534\/wjmh.2013.31.1.31","article-title":"Treatment Strategy for Non-Responders to PDE5 Inhibitors","volume":"31","author":"Park","year":"2013","journal-title":"World J. Men\u2019s Health"},{"key":"ref_7","unstructured":"Salonia, A., Bettocchi, C., Capogrosso, P., Carvalho, J., Corona, G., Dinkelman-Smith, M., Hatzichristodoulou, G., Jones, T., Kadioglu, A., and Martinez-Salamanca, J.I. (2024). Sexual and Reproductive Health EAU Guidelines, EAU."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1111\/j.1743-6109.2006.00260.x","article-title":"Intracavernous Injections of Prostaglandin E1 for Erectile Dysfunction: Patient Satisfaction and Quality of Sex Life on Long-Term Treatment","volume":"4","author":"Alexandre","year":"2007","journal-title":"J. Sex. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1124\/pr.111.004515","article-title":"Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction","volume":"63","author":"Andersson","year":"2011","journal-title":"Pharmacol. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1517\/14656566.2014.873789","article-title":"Alprostadil for the treatment of impotence","volume":"15","author":"Hanchanale","year":"2013","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.1038\/sj.ijir.3900504","article-title":"Alpha-adrenergic receptor blockade by phentolamine increases the efficacy of vasodilators in penile corpus cavernosum","volume":"12","author":"Kim","year":"2000","journal-title":"Int. J. Impot. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1038\/aja.2011.2","article-title":"Combination therapy for erectile dysfunction: An update review","volume":"13","author":"Dhir","year":"2011","journal-title":"Asian J. Androl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.5489\/cuaj.1016","article-title":"Optimizing sexual function outcomes after radical prostatectomy","volume":"3","author":"Bella","year":"2009","journal-title":"Can. Urol. Assoc. J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Whalen, M. (2019). Preventing Erectile Dysfunction after Radical Prostatectomy: Nerve-Sparing Techniques, Penile Rehabilitation, and Novel Regenerative Therapies. Prostatectomy, IntechOpen.","DOI":"10.5772\/intechopen.79398"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1111\/bju.12228","article-title":"Penile rehabilitation after radical prostatectomy: What the evidence really says","volume":"112","author":"Fode","year":"2013","journal-title":"BJU Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S403","DOI":"10.1016\/j.jsxm.2018.04.618","article-title":"709 Intracavernosal Injection (ICI) Therapy\u2014Efficacy, Side Effects and Dropouts: Experience of a Single Institution","volume":"15","author":"Alves","year":"2018","journal-title":"J. Sex. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/0090-4295(92)90270-7","article-title":"Twelve-month comparison of two treatments for erectile dysfunction: Self-injection versus external vacuum devices","volume":"39","author":"Turner","year":"1992","journal-title":"Urology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1111\/andr.12237","article-title":"Erectile dysfunction patients are more satisfied with penile prosthesis implantation compared with tadalafil and intracavernosal injection treatments","volume":"4","author":"Kucuk","year":"2016","journal-title":"Andrology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S81","DOI":"10.1038\/sj.ijir.3900503","article-title":"Comparison of oral and intracavernosal vasoactive agents in penile erection","volume":"12","author":"Lue","year":"2000","journal-title":"Int. J. Impot. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.urology.2011.09.009","article-title":"Clinical Outcomes of Intracavernosal Injection in Postprostatectomy Patients: A Single-center Experience","volume":"79","author":"Domes","year":"2012","journal-title":"Urology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1002\/smrj.35","article-title":"Intracavernosal Injection for the Diagnosis, Evaluation, and Treatment of Erectile Dysfunction: A Review","volume":"3","author":"Belew","year":"2015","journal-title":"Sex. Med. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1038\/s41443-024-00861-2","article-title":"Evaluating the management trends for priapism and assessing the risk of priapism after in-office intracavernosal injections: A cross-sectional analysis","volume":"37","author":"Leong","year":"2024","journal-title":"Int. J. Impot. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/00926238908403816","article-title":"Why do so many people drop out from auto-injection therapy for impotence?","volume":"15","author":"Althof","year":"1989","journal-title":"J. Sex Marital. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Gunasekaran, K., and Khan, S.D. (2019). Principles and Practice Sexual Medicine, Springer.","DOI":"10.1007\/978-981-13-1226-7"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"34","DOI":"10.33590\/emj\/10312334","article-title":"Patient Insight and Treatment Expectations in Erectile Dysfunction","volume":"1","author":"Porst","year":"2016","journal-title":"EMJ"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Porst, H., and Buvat, J. (2006). The Standards Committee of the International Society for Sexual Medicine. Standard Practice in Sexual Medicine, Wiley-Blackwell.","DOI":"10.1002\/9780470755235"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S81","DOI":"10.3233\/BME-171627","article-title":"Stem-cell therapy for erectile dysfunction","volume":"28","author":"Yiou","year":"2017","journal-title":"Bio-Med. Mater. Eng."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Poulios, E., Mykoniatis, I., Pyrgidis, N., Kalyvianakis, D., and Hatzichristou, D. (2023). Platelet-Rich Plasma for the Treatment of Erectile Dysfunction: A Systematic Review of Preclinical and Clinical Studies, Oxford University Press.","DOI":"10.1093\/sxmrev\/qead027"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"123","DOI":"10.3109\/21681805.2015.1100675","article-title":"Low-intensity extracorporeal shockwave therapy in the treatment of postprostatectomy erectile dysfunction: A pilot study","volume":"50","author":"Frey","year":"2016","journal-title":"Scand. J. Urol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/MOU.0b013e3283383b02","article-title":"Current state of penile rehabilitation after radical prostatectomy","volume":"20","author":"Garcia","year":"2010","journal-title":"Curr. Opin. Urol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"680","DOI":"10.4103\/aja202525","article-title":"Sexual function recovery following open and robotic radical prostatectomy: Results of an academic penile rehabilitation program","volume":"27","author":"Falagario","year":"2025","journal-title":"Asian J. Androl."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/111\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T09:09:51Z","timestamp":1767604191000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,4]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["medicina62010111"],"URL":"https:\/\/doi.org\/10.3390\/medicina62010111","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,4]]}}}