[Intracavernous pharmacotherapy for treatment and evaluation of impotence]

Impotence affects about 10% of all men. During the past decade it has been treated with self-injection of vasoactive drugs into the erectile tissue. In 1982 Virag reported experience with intracavernous injection of papaverine. Since then other vasoactive drugs, such as prostaglandin E1 (PGE1), have been used successfully, and self-injection has been advised. Between 1987-1989 we evaluated 550 patients with erectile dysfunction and 95 aged 21-79, mean 53.7, were found suitable for this treatment, of whom 80 were entered into an autoinjection protocol, of 74 were treated with a mixture of papaverine and regitine and 6 with PGE1. The volume of the injections ranged from 0.1 to 1.0 ml, and erections lasted from 15 minutes to 8 hours. 72% of the patients continued autoinjection during a mean follow-up of 9.9 months and were satisfied with the results. There were 5 cases of corporal fibrosis, and 3 cases had prolonged erections, usually after the papaverine test. The method is simple and inexpensive, and allows many impotent men to resume sexual life. It is a good alternative to the insertion of a penile prosthesis.