Pharmacocavernometry: a modified papaverine test

The papaverine test has become established in the investigation of impotence. Although a full response to papaverine excludes a significant vascular lesion, failure to respond may be due to either arterial deficiency or venous leakage. Pharmacocavernometry, which combines the papaverine test and an artificial erection test, was performed in 126 patients. Intracorporeal pressure was monitored following the intracorporeal injection of 80 mg papaverine; 10 min later, saline was infused to determine the presence of a venous leak. Five different responses were observed. Patients with a Type 1 or 2 response were psychogenic or neurogenic. Patients with a Type 3 response were arteriogenic and patients with a Type 4 or 5 response had significant venous leakage. The modified papaverine test permits more information to be gained concerning the aetiology of the impotence.