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Egyptian researchers are exploring the possibility of using Botox injections to treat erectile dysfunction patients who fail to respond fully to oral ED drugs such as Viagra.
Botox injections are perhaps best known for their ability to plump up lips and smooth out frown lines and crow’s feet. Someday in the not too distant future, these injections may also be used to treat erectile dysfunction, particularly in men who are unresponsive to Viagra and other ED drugs alone.
At least that’s the vision being pursued by Cairo University’s Hussein Ghanem, the leader of a research team that has conducted and is continuing preliminary research into this form of treatment.
Botox, scientifically known as onabotulinumtoxinA, is a neurotoxic protein that is known to temporarily relax the clenching of muscles that produce some of the facial imperfections cited above.
How Botox Would Work
The working theory behind its use as a treatment for ED is that injections of Botox into the base of the penis could sufficiently relax smooth muscles within the penis and thus optimize blood flow into the organ. And without robust blood flow, it can be difficult or even impossible to get and keep an erection suitable for intercourse.
After early tests on animals to test this theory produced positive results, Ghanem and his colleagues set up a relatively small-scale clinical trial to see if those same results could be replicated in human subjects.
Researchers in 2015 recruited a cohort of 24 men with severe ED caused by insufficient blood flow to the penis, the most common cause of male impotence. Study participants were divided into two groups.
The first group of 12 men received injections of the botulinum toxin into the base of their penises, while the second group received injections of a saline solution identical in appearance to the botulinum toxin. Subsequent testing showed that men who received the Botox injections had blood flow to their penises improved by 50 percent over those who got the placebo.
Second Round of Clinical Trials
Encouraged by those results, which were published in the January 2018 issue of Sexual Medicine Reviews, the same researchers launched a second clinical trial in late 2017 with a cohort of 160 study participants who were also randomized into equal-size groups, one to get injections of the botulinum toxin and the other to receive placebo injections. Final results from the later study are not yet available.
For men who already get satisfactory results from Viagra or other oral ED medications, this form of therapy isn’t really that meaningful. However, Botox injections could help men who don’t get relief from Viagra alone to benefit from it and other PDE5 inhibitors. Inhibitors increase blood flow to the penis, but if the smooth muscles within the vasculature of the penis aren’t relaxed enough to receive this surge of blood, the drugs’ desired results simply won’t be achieved.
As with almost any form of medical treatment, there are some risks. Interviewed by South Africa-based Independent Online, urologist Raj Persad noted that “overuse could lead to permanent dilation of blood vessels and a permanent erection.”
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