Pharmacotesting with high dose prostaglandin E1 in impotence

The diagnostic value of pharmacotesting in impotence is controversial. The results of high dose prostaglandin pharmacotesting were compared with those of colour duplex Doppler scanning and pharmacocavernometry in 82 impotent patients and 10 control subjects. Based on the results of 10 control subjects, the prostaglandin test was defined as positive if intracavernous pressure 200 minutes after injection of 40 micrograms prostaglandin E1 was > or = 42 mm Hg and negative if intracavernous pressure was < 42 mmHg. The test was repeated in 29 subjects and classified results were consistent in 24 subjects (86%, k = 0.65). The test was negative in 52 out of 56 patients (sensitivity 93%) with vasculogenic impotence (arteriogenic and/or cavernovenous factor involved) and the test was positive in 21 out of 26 patients (specificity 81%) with non-vasculogenic impotence (arteriogenic or cavernovenous factor not involved). The majority, 27 out of 31 patients (87%) with arteriogenic impotence showed simultaneous dysfunction of cavernovenous occlusion mechanism. In conclusion, pharmacotesting with high dose prostaglandin is a useful screening test of vasculogenic impotence.