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Improved hemodynamic response after long-term intracavernous injection for impotence
G A Marshall1, J Breza, T F Lue
1Department of Urology, University of California School of Medicine, San Francisco.
Urology
|June 1, 1994
Summary
Long-term intracavernous injection therapy, using vasodilating drugs like prostaglandin E1 (PGE1), significantly improved penile blood flow velocity. This enhancement led to spontaneous erections in over a third of patients, suggesting improved erectile function.
Area of Science:
- Urology
- Andrology
- Vascular Biology
Background:
- Intracavernous injection therapy is a common treatment for erectile dysfunction.
- Long-term efficacy and physiological changes associated with this therapy require further investigation.
Purpose of the Study:
- To assess changes in penile hemodynamics in patients undergoing long-term intracavernous injection therapy.
- To investigate the occurrence of spontaneous erections as a result of treatment.
Main Methods:
- Duplex ultrasonography was used to evaluate penile circulation in 35 patients before and after a mean of 31 months of therapy.
- Patients received either prostaglandin E1 (PGE1) alone or a combination of papaverine, phentolamine, and PGE1.
Main Results:
- Penile arterial diameter remained unchanged, but peak flow velocity significantly increased (P < 0.001).
- Mean peak flow velocity rose from 17.9-21.2 cm/s to 24-29 cm/s post-treatment.
- 35% of patients reported achieving functional erections without injections.
Conclusions:
- Long-term intracavernous injections may improve penile arteriolar and sinusoidal smooth muscle function.
- The combination of vasodilators and sexual stimulation appears beneficial for erectile function.