Double-blind, cross-over study comparing prostaglandin E1 and papaverine in patients with vasculogenic impotence

Intracorporeal injection of vasoactive agents is the treatment of choice for many patients with organic impotence. However, some patients with vasculogenic impotence respond poorly to injections of papaverine or papaverine/phentolamine. This study was conducted to determine if patients with vasculogenic impotence who failed to respond to papaverine might respond to prostaglandin E1 and thus be salvaged from possible prosthetic surgery. A total of 54 patients with vasculogenic impotence were administered intracorporeal prostaglandin E1 (20 micrograms) and intracorporeal papaverine (60 mg) randomized in a double-blind fashion and crossed over one week later. Forty-six percent of patients receiving prostaglandin E1 produced a satisfactory erection compared with 14 percent of patients with a similar response to papaverine. The difference between these results was highly significantly by the McNemar test. The number of side effects were similar for both drugs. Prostaglandin E1 might be considered the intracorporeal agent of choice for patients with significant vasculogenic impotence.