[Intracavernous self-injection for treatment of erectile dysfunction inpatients with spinal cord injuries]

Twelve patients (aged 18-70 years, average 41 years) with known spinal cord lesions with durations of 1-25 years and with levels of the lesions from C II incomplete to L III complete received intracavernous injection of papaverine with a commencing dose of 15 mg papaverine. Following this, nine patients could obtain usable erection lasting from 30 to 300 minutes with doses from 15-60 mg. In one patient, however, 60 mg papaverine was supplemented by 5 mg phentolamine. The patients were then trained in the technique of self-injection. On contact 1-37 months after the primary instruction, eight patients had performed a total of 40 self injections with the object of coitus, which was successful in all of the cases. Because he had no partner, one patient had no employed self-injection but would like to employ the method if the appropriate situation arose. Two patients did not want to continue self-injection. One of these considered that the method was too complicated to use and the other had had an episode of prolonged erection requiring treatment. No other side effects requiring treatment were observed. The relationship to possible partners and the experience of libido, "orgasm" and feeling of self esteem as compared to previous experiences were registered. Six out of nine patients had experienced improvement in at least one of these fields and none had experienced deterioration. A total of seven patients planned to employ the method in future. The authors conclude that self-injection of papaverine is a promising supplement in the treatment of erective dysfunction in patients with spinal cord lesions.