How does the morbidity of prostaglandin injections compare with the older, less expensive papaverine or phentolamine?
Although similar in efficacy, prostaglandin E1 is less stable at room temperature and much more expensive than papaverine or phentolamine. Proponents cite a shorter half-life (less chance of priapism) and less injection-site pain and scarring as reasons to use this substance despite its expense. We identified six noncomparative case-series studies51-56 and one RCT57 that reported the numbers of side effects. Although the efficacy of these two treatments is similar, priapism and discomfort are reported more frequently with papaverine.
