Pharmacocavernosography in the evaluation of erectile failure

A total of 148 patients with erectile dysfunction underwent evaluation with Doppler sonography, cavernosography and intracavernous injections of papaverine. Arterial insufficiency was found in 63 patients (42.5%). Cavernosography following intracorporeal injection of papaverine revealed abnormal venous drainage from the cavernous bodies in 25 patients (17%) which, in 3 cases, was associated with Peyronie's disease. Results of vascular investigations were compared with the erectile response to the application of papaverine. Vascular insufficiency was observed in 39 of 55 patients (70%) with a poor response to papaverine. No patient with a venous insufficiency showed a good response. Nevertheless a poor response to papaverine did not exclude psychogenic impotence.