Pharmacologically induced penile erections in the assessment and treatment of erectile impotence: a preliminary study of 100 patients
Goonawardena, S.A.; de Silva, W.A.; Ketheeswaran, T.
Ceylon Medical Journal 42(2): 72-74
1997
ISSN/ISBN: 0009-0875 PMID: 9257465 Document Number: 472984
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 20mg 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.