The first treatment option is to irrigate the penis and aspirate the old blood out. Simply removing the blood and oxygenating the tissues with fresh blood is sometimes all that is necessary. If, however, it is a fairly resistant erection and returns, I then use a mixture of phenylephrine. Blood pressure and heart rate must be carefully monitored as cases of cardiac problems have been related to these medications as well. Another worrisome complication is scarring.
All drugs have different cases of scarring.
Prostaglandin tends to have the lowest instance of scarring, and some studies indicate that prostaglandin may actually protect the corporal smooth muscle from the development of scarring related to age. Papaverine has been associated with the most degree of scarring. This was initially thought to be related to the pH of the solution, and the occurrecne is nearly 100 percent in some cases. Rare long-term side effects of scarring include curvature, similar to Peyronie's disease. Severe scarring may require a straightening procedure, much like the treatment for Peyronie's disease.