A man in his early sixties has already done the hard part. Pills stopped working after his prostate surgery, so his urologist taught him to use alprostadil injections. They work, but they ache badly enough that he dreads them. Late one night he finds a research-catalog listing for “VIP” and a forum reply claiming that “British clinics use VIP shots that do not hurt.” He wonders whether the vial is the same thing.
The forum is pointing at something real: a prescription combination of vasoactive intestinal peptide with a second drug, phentolamine, used by urology teams. That is not a single-peptide catalog vial, and the evidence comes from supervised clinic care.
What the London clinic study found
In 2025, urologists at University College London Hospital published a retrospective review in the Journal of Sexual Medicine of 308 men referred for the aviptadil-phentolamine combination. Aviptadil is the drug name for VIP. Every man had already tried alprostadil injections, and almost all had failed erection pills. Men were taught self-injection in a nurse-led clinic and had a telephone follow-up at six weeks.
Overall, 59 percent found the combination effective at three months, defined as being able to resume penetrative sex. The result split sharply by reason for referral: about 76 percent of men who had stopped alprostadil because of pain did well, compared with about 36 percent of men whose alprostadil had simply failed. Facial flushing was the most common side effect, in about 22 percent of men. One man had ischemic priapism, a prolonged erection that needs urgent care.
The authors listed the limits plainly: one center, looking back at records, without validated questionnaires. An earlier 2008 review in BJU International described the combination’s rationale, noting that VIP and phentolamine act on different parts of the erection process, and summarized earlier clinical studies that reported high response rates with little penile pain. It was a product review, not a new trial.
Why the catalog vial is a different question
The clinic product pairs VIP with phentolamine, is a manufactured prescription medicine (sold in the UK as Invicorp), and is prescribed after a urology assessment, with nurse-led teaching and a plan for what to do if an erection lasts too long. It is not an FDA-approved medicine in the United States, where alprostadil is the approved injection option. A research listing of VIP alone has none of that structure, and no study here tested it.
Everyday Brief has also covered VIP in hospital lung trials and PT-141 studies in men with erectile dysfunction. Erection care with VIP is a separate, urology-only file.
What to ask the urologist
If alprostadil injections hurt, say so. Pain is a recognized reason to change course, and options can include adjusting technique, other injection mixtures, devices, or implant surgery. Ask whether a VIP-phentolamine combination is available where you live, how the supervised teaching works, and what the priapism plan is. Bring the forum claim to the visit rather than to a shopping cart.
Pain from a treatment that works is a solvable problem. The solution in this study was a prescribed combination and a nurse-led clinic, not a vial with a similar name.
Not medical advice.
Sources
- Al-Mitwalli A et al. Intracavernosal injection of aviptadil and phentolamine for refractory erectile dysfunction. J Sex Med, 2025 (PubMed)
- Dinsmore WW, Wyllie MG. Vasoactive intestinal polypeptide/phentolamine for intracavernosal injection in erectile dysfunction. BJU Int, 2008 (PubMed)
- NIDDK: Treatment for erectile dysfunction
- MedlinePlus: Erectile dysfunction
Related reading
- VIP research listings vs hospital aviptadil trial results
- What PT-141 studies in men with ED actually found
- Inhaled VIP for lung pressure: a 20-person cath-lab study
By The Everyday Brief. AI-assisted drafting with human editorial review. Sources fetched 2026-10-14 PT. Not medical advice.