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Pharmacologically induced penile erections in the assessment and treatment of erectile impotence: a preliminary study
S A Goonawardena1, W A de Silva, T Ketheeswaran
1Genito-urinary Surgical Unit, National Hospital of Sri Lanka, Colombo.
Objective:
To assess and compare the immediate and subsequent response to pharmacologically induced penile erections, using intracavernosal injections of papaverine.
Design:
Preliminary, prospective study.
Setting:
Male sexual dysfunction clinic at the National Hospital of Sri Lanka.
Patients:
100 consecutive patients receiving 20 mg papaverine hydrochloride intracavernosally as the first dose.
Main Outcome Measures:
Assessment of the quality of the erection following the initial injection and determination of the optimum dose to achieve a normal erection; number who elected self-injection at home.
Results:
Mean age of the 100 impotent men was 36.6 years and the mean duration of erectile dysfunction 43.9 months. Of men in the third decade 87.5% had a normal erection but only one-third of patients over 50 years showed a normal response. 16 patients had a reasonably well established organic problem. 42% of patients had normal nocturnal or early morning erections. The drop-out rate after the initial injection was 17%, 19% of men had a normal erection with 20 mg papaverine and 67% had a normal response to 20 to 80 mg papaverine. Seven patients continued on the self-injection program. Prolonged erections were experienced by 6% of men (1.9% of injections).
Conclusions:
Intracavernosal injection of papaverine hydrochloride is effective in a dose of 20 to 80 mg.