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Unclear Rosano 200552 1 0 1 1 1 4 Unclear Kirby 200553 1 0 1 1 1 4 Unclear De Rose 200554 1 1 0 0 1 3 Adequate Gontero 200555 1 1 1 1 1 5 Adequate Katz 200556 1 1 1 0 1 4 Unclear Carson 200450 1 -1 1 1 1 4 Unclear Fonseca 200457 1 0 1 0 0 2 Unclear Wheatley 200458 1 1 1 1 0 4 Adequate Abdel-Naser 200459 1 0 0 0 1 2 Unclear Parsons 200460 1 1 1 0 0 3 Inadequate Deveci 200461 1 0 1 0 0 2 Unclear Seftel 200462 1 0 0 0 0 1 Inadequate Eardley 200463 1 0 0 0 0 1 Unclear Gentile 200464 1 -1 1 0 0 2 Unclear Staab 200465 1 -1 1 1 1 3 Adequate Montorsi 200466 1 0 1 1 0 3 Unclear Skoumal 200467 1 1 1 1 1 5 Unclear Rosen 200468 1 -1 1 0 1 2 Unclear Shabsigh 200469 1 0 1 1 0 3 Unclear Seftel 200470 1 1 1 1 1 5 Unclear Nagao 200471 1 -1 1 1 1 3 Adequate Perimenis 200472 1 -1 1 -1 1 1 Unclear Tignol 200473 1 0 0 0 0 1 Unclear Perimenis 200474 1 1 1 1 1 5 Unclear Carson 200475 1 1 0 0 1 3 Unclear Eardley 200476 1 0 1 0 1 3 Unclear Stief 200477 1 1 0 0 0 2 Unclear Hatzichristou 1 0 1 1 1 4 Unclear 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Unclear Thadani 2002104 1 0 1 0 1 3 Unclear Saenz, I 2002105 1 1 1 0 0 3 Inadequate Hellstrom 2002106 1 0 1 0 1 3 Unclear Seibel 2002107 1 0 1 0 1 3 Unclear Bocchi 2002108 1 0 1 0 1 3 Unclear Ugarte 2002109 1 1 1 0 1 4 Adequate Gomez 2002110 1 1 1 1 1 5 Adequate Becher 2002111 1 0 1 0 1 3 Unclear Glina 2002112 1 0 0 0 0 1 Unclear Schanz 2002113 1 0 1 1 1 4 Unclear Padma-Nathan 2002114 1 0 1 0 1 3 Unclear Lebret 2002115 1 0 1 1 0 3 Unclear Lindsey 2002116 0 0 0 0 0 0 Unclear Lim 2002117 0 0 0 0 1 1 Unclear van der Windt 1 1 1 0 0 3 Unclear Author Year 2002118 Jadad Q-1 Jadad Q-2 Jadad Q-3 Jadad Q-4 Jadad Q-5 Total Scores Allocation Concealment Kunelius 2002119 1 1 1 1 1 5 Unclear Lammers 2002120 1 0 1 1 1 4 Unclear De Rose 2002121 1 0 0 0 1 2 Unclear Eardley 2002122 1 1 1 1 1 5 Inadequate Hatzichristou 2001123 1 0 1 0 0 2 Unclear Incrocci 2001124 1 1 0 0 1 3 Adequate Stark 2001125 1 0 1 1 1 4 Unclear Choppin 2001126 0 0 1 1 1 3 Unclear Porst 2001127 1 0 1 0 1 3 Unclear Mann 2001128 1 0 1 0 0 2 Unclear Dula 2001129 1 0 0 0 0 1 Unclear Safarinejad 2001130 1 0 1 1 1 4 Unclear Gomaa 2001131 1 0 1 0 1 3 Unclear Olsson 2001132 1 0 1 0 0 2 Unclear Padma-Nathan 2001133 1 0 1 0 0 2 Unclear Klotz 2001134 1 0 1 1 0 3 Adequate Goldstein 2001135 1 0 1 0 0 2 Unclear Kloner 2001136 1 0 1 0 0 2 Unclear Fu 2000137 1 0 1 0 0 2 Unclear Montorsi 2000138 1 -1 1 1 1 3 Unclear Enzlin 2000139 1 0 1 0 0 2 Unclear Baum 2000140 1 0 0 0 0 1 Unclear Wessells 2000141 1 0 1 1 1 4 Unclear Cappelleri 2000142 1 0 1 0 1 3 Unclear Ekman 2000143 1 0 0 0 0 1 Unclear Dula 2000 144 1 0 1 0 1 3 Unclear Rabkin 2000145 1 0 1 0 0 2 Unclear Shabsigh 2000146 1 0 0 0 0 1 Unclear Anderson 1999147 1 0 1 1 1 4 Unclear Palmer 1999148 1 1 1 1 1 5 Adequate Shokeir 1999149 1 1 0 0 0 2 Unclear Le Roux 1999150 1 0 0 0 1 2 Unclear Sandhu 1999151 1 0 1 1 1 4 Unclear Costabile 1999152 1 0 0 0 1 2 Unclear Dinsmore 1999153 1 0 1 1 1 4 Adequate Chen 1999154 1 0 1 0 0 2 Unclear Montorsi 1999155 1 1 1 0 0 3 Unclear Dinsmore 1 0 1 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Rowland 1997181 1 0 1 0 0 2 Unclear Padma-Nathan 1997182 1 0 1 0 1 3 Unclear Aversa 1996183 1 0 1 0 0 2 Unclear Hellstrom 1996184 0 0 1 1 0 2 Adequate Colli 1996185 1 0 1 0 1 3 Unclear Godschalk 1996186 1 0 0 0 0 1 Unclear Mann 1996187 1 0 1 0 0 2 Unclear Gheorghiu 1996188 1 0 1 0 0 3 Unclear Peskircioglu 1996189 1 1 1 0 1 4 Unclear Gomaa 1996190 1 0 1 0 1 3 Unclear Linet 1996191 1 0 1 0 0 2 Unclear Bechara 1996192 1 0 0 0 0 1 Unclear Author Year Knoll 1996193Jadad Q-1 1 Jadad Q-2 0 Jadad Q-3 1 Jadad Q-4 0 Jadad Q-5 0 Total Scores 2 Allocation Concealment Unclear Wegner 1995194 1 0 1 1 1 4 Unclear van Ahlen 1 0 0 0 0 1 Unclear 1995195 Guay 1995196 1 0 0 0 0 1 Unclear Vanderschueren 1 1 1 1 0 4 Unclear 1995197 Georgitis 1995198 1 0 1 0 1 3 Unclear el-Saleh 1995199 1 1 1 1 0 4 Unclear Ogrinc 1995200 1 0 1 0 0 2 Unclear Kattan 1995201 1 0 1 0 0 2 Unclear Martinez-Pineiro 1 1 0 0 0 2 Unclear 1995202 Cavallini 1994203 1 0 1 0 0 2 Unclear Lazzeri 1994204 1 0 1 1 1 4 Unclear Wegner 1994205 1 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Distinct Clinical SubgroupsEvidence on incremental therapeutic benefits associated with the use of PDE5 inhibitors was consistent across a broad spectrum of patients with ED. Injection therapy involves injecting a substance into the penis to enhance blood flow and cause an erection. The FDA approved a drug called alprostadil (Caverject) for this purpose in 1995. Alprostadil relaxes smooth muscle tissue to enhance blood flow into the penis. It must be injected shortly before intercourse I Have Taken Too Many Forzest. Another, similar drug that is sometimes used is papaverine. Either drug may sometimes cause painful erections or priapism that must be treated with a shot of epinephrine. Alprostadil may also be administered into the urethral opening of the penis. In MUSE (medical urethral system for erection), the man inserts a thin tube the width of a spaghetti noodle into his urethral opening and presses down on a plunger to deliver a tiny pellet containing alprostadil into his penis. The drug takes about 10 minutes to work and the erection lasts about an hour. The main side effect is a sensation of pain and burning in the urethra, which can last about five to 15 minutes. The injection process itself is often painful.