Erectile dysfunction is a common disorder affecting the quality of life of many men around the world. Among the various therapeutic solutions on offer, Vitaros, a topical prostaglandin gel, stands out as an alternative option to classic oral treatments such as Viagra or Cialis. But is this treatment really effective? This is the question I’m going to answer in detail in this article, based on my clinical experience and the physiological mechanisms involved in the action of Vitaros.
Introduction to Vitaros treatment
Vitaros is a drug indicated for the treatment of erectile dysfunction. It is a gel containing prostaglandin E1, a molecule that promotes vasodilation, applied directly inside the urethral canal. This local administration aims to stimulate erection by bypassing conventional oral routes, which can be particularly useful in patients who do not respond to phosphodiesterase type 5 (PDE5) inhibitors or have contraindications to their use.
The principle is simple: a drop of gel is deposited in the urethra, where prostaglandin must pass through the tissues to reach the cavernous bodies of the penis, where the vasodilatation required for erection occurs. However, despite this promising mechanism, Vitaros does not always deliver the expected results. In fact, its efficacy is variable, and it’s important to understand why this is the case, to better guide patients towards appropriate treatments.
How does Vitaros work?
To understand the reasons for Vitaros’ fluctuating efficacy, it’s essential to understand its physiological mode of action. When the gel is applied to the urethral canal, prostaglandin E1 must leave this canal to reach the cavernous tissues around it. These tissues are enveloped by a membrane called the albuginea, which plays a key role in the rigidity and erectile function of the penis.
Prostaglandin acts by stimulating local vasodilatation, i.e. opening up the cavernous arteries, enabling better blood circulation and thus an erection. This step is crucial: without good circulation and sufficient dilation of the vessels, an erection cannot take place.
For prostaglandin to work, it has to cross the urethral wall and albuginea to reach the corpora cavernosa. This is one of the main limitations of Vitaros treatment.
Physiological limits of Vitaros treatment
Studies have shown that urethral permeability varies considerably from man to man. Around 50-70% of patients have insufficient permeability, which prevents prostaglandin from efficiently passing through the urethral canal and reaching the corpora cavernosa. This largely explains why many men do not experience a noticeable improvement in erectile function after using Vitaros.
This problem of permeability is a key factor in the success or failure of treatment. Indeed, if the active molecule cannot reach its target, it will not be able to induce the necessary vasodilatation. This physiological barrier is therefore a major obstacle to the efficacy of Vitaros.
For whom is Vitaros effective?
Despite these limitations, Vitaros remains an attractive option for some patients. It is estimated that around 25-30% of treated men achieve a satisfactory result, i.e. an erection sufficient for a satisfying sexual relationship. These patients generally have better urethral permeability, enabling the prostaglandin to act effectively.
This treatment is particularly suitable for
- In patients who cannot use conventional oral treatments (such as Viagra, Cialis or Levitra) due to medical contraindications, e.g. heart disease or drug interactions.
- In those who do not respond to PDE5 inhibitors, either because these drugs are ineffective or because of undesirable side effects.
- As an alternative to intracavernous injections, which can be perceived as invasive or unpleasant.
- For patients wishing to avoid surgery, particularly penile implants.
Vitaros may therefore represent an interesting intermediate solution, offering a compromise between efficacy, ease of use and invasiveness.
Improving the efficacy of Vitaros: practical advice
It’s important to emphasize that the effectiveness of Vitaros can be optimized by proper use and a few practical recommendations. Although I’ll be detailing these tips in a forthcoming publication, here are a few pointers already:
- Scrupulously respect the dosage and application instructions: the gel must be correctly deposited in the urethra, which may require training and medical assistance.
- Take timing into account: the gel must be applied some time before intercourse to allow the prostaglandin to take effect.
- Avoid factors that reduce urethral permeability: certain inflammatory conditions or infections can reduce the effectiveness of treatment.
- Accompany treatment with advice on lifestyle: stop smoking, reduce alcohol consumption, manage stress and take regular exercise, all of which can improve overall erectile function.
These recommendations can significantly improve the chances of Vitaros success and maximize the benefits for the patient.
Comparison with other erectile dysfunction treatments
The treatment of erectile dysfunction is based on several approaches, each with its advantages and disadvantages. Vitaros is a local alternative to oral treatments and intracavernosal injections.
PDE5 inhibitors (Viagra, Cialis, Levitra)
These oral medications are often the first line of treatment, thanks to their ease of use and proven efficacy. However, they are not suitable for all patients, particularly those with cardiovascular disease, those taking nitrates, or those with undesirable side effects.
Intracavernosal injections
These injections deliver the drug directly into the corpus cavernosum, guaranteeing high efficacy. Nevertheless, they are invasive, can be painful, and are often poorly accepted due to fear of needles.
Penile implants
Penile implant surgery is reserved for severe cases or when other treatments have failed. It offers a definitive solution, but carries risks and requires surgery.
Vitaros
Vitaros offers a compromise between these different options. Its local administration avoids the systemic effects of oral treatments, and it is less invasive than injections or surgery. However, its efficacy is highly dependent on urethral permeability, which limits its use to certain patients.
Conclusion: Vitaros, a treatment to be considered with discernment
In summary, treatment with Vitaros is an interesting therapeutic option in the management of erectile dysfunction, particularly for patients who are unable or unwilling to use conventional oral treatments or intracavernosal injections. Its efficacy is based on a complex local mechanism that depends on the ability of prostaglandin to cross the urethra and reach the corpora cavernosa.
Unfortunately, this permeability is insufficient in more than half of patients, which explains why Vitaros doesn’t always work. Nevertheless, around a third of men can achieve a significant improvement in erectile function with this treatment.
It is therefore essential to select patients carefully, to support their use with appropriate practical advice, and to integrate Vitaros into an overall personalized therapeutic strategy. In the meantime, I invite you to keep an eye on my forthcoming publications, where I’ll be detailing precisely how to optimize the efficacy of Vitaros for those who wish to try this solution.
If you have any questions or would like a personalized consultation, don’t hesitate to consult a specialist in urology and andrology. Appropriate treatment is the key to success in the treatment of erectile dysfunction.
Resources and contact
For a more in-depth look at erectile dysfunction and other male sexual disorders, I invite you to visit the playlists on my YouTube channel, where you’ll find videos devoted to male sexual health, diseases such as Lapeyronie’s disease, and other medical and surgical treatments.
- Penis problems, erectile dysfunction, premature ejaculation and more
- Lapeyronie’s disease
- Desire and erection
- Male infertility and contraception
You can also follow me on social networks to keep up to date with the latest news in urology and andrology:
- Instagram : @dr.sebastienbeley
- Facebook : @dr.sebastien.beley
- LinkedIn : Sébastien Beley
- Twitter : @beley_urology
To make an appointment, you can contact me by email at accueil@urologieparisopera.fr or via the Doctolib and Bealy platforms for a video consultation:
Erectile dysfunction is a delicate subject, but there are solutions to suit every situation. Don’t hesitate to seek advice and consult a specialist for personalized support.
