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These penile injections like Trimix, alprostadil, papaverine, or phentolamine are often chosen when oral medications fail

As a result of this combinational therapy, the median overall survival time was 14.2 months and the median progression-free survival time was 9.6 months
Oosthuyse B, Moons L, Storkebaum E et al (2001) Deletion of the hypoxia-response element in the vascular endothelial growth factor promoter causes motor neuron degeneration

Bariatric Surgery and Vitamin B Deficiency 4.1