Abstract

Objectives: Since 1977 botulinum toxin has been used in an increasing number of therapeutic indications now extending to the field of androsexology. Introduction: For the past decade, a large number of publications based on retrospective or controlled studies have highlighted the interest in using botulinum toxin in intracavernous injections to treat erectile dysfunction. Materials / method: This treatment is used either as monotherapy or in combination with oral treatments already established if they prove insufficient. It is by inhibiting the adrenergic and cholinergic pathways that the toxin promotes erection. Results: The facilitative effect on erection lasts more than 6 months after injection as we have clinically proven successfully, confirming the tests published elsewhere: IIEF, SHIM and EHS. Here we describe the technique of injections. Even if this indication is an off-label use, botulinum toxin, because of its efficacy and its inocuity can be offered to patients resistant to IPDE5, avoiding them to switch to second-line treatments, more restrictive, which are intracavernous injections of prostaglandin E1 to be performed before each sexual intercourse. Conclusion: Further work is however needed to establish more precise protocols, including toxin type, doses and frequency of injections.