[Value of prostaglandin El in the diagnosis of erectile dysfunction in comparison with papaverine and papaverine/phentolamine in 61 patients with erectile dysfunction].
H. Porst
Abstract
H. Porst
Abstract
In 61 patients with erectile dysfunction a comparative study with intracavernous injection of prostaglandin E1 (PGE1), papaverine and a mixture of papaverine and phentolamine was performed. All patients underwent comprehensive multidisciplinary examinations, including bulbocavernosus reflex (BCR) latencies and somatosensory evoked potentials, penile Doppler sonography, dynamic or pharmaco-cavernosonography, and for 11 patients nocturnal penile tumescence (NPT) was also recorded with the Rigiscan. This diagnostic approach suggested that in 24 (39.3%) of the 61 pts the etiology was psychogenic and in the remaining 37 (60.7%) it was organogenic. PGE1 had a much higher erectile potency than papaverine and a somewhat higher potency than the mixture of papaverine and phentolamine. Complete erection was achieved in 41 of the 61 patients (67.2%) with PGE1, as against 20 of the 61 patients (32.8%) with papaverine alone and 20 of the 61 (32.8%) with papaverine/phentolamine. Whereas 7 of 61 patients (11.5%) had priapism of more than 6 h duration and requiring therapy after injection of papaverine or papaverine/phentolamine, no priapism occurred after PGE1. Thus, compared with papaverine and phentolamine, PGE1 offers important advantages in the diagnosis and perhaps also in the therapy of erectile dysfunction.
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In 61 patients with erectile dysfunction a comparative study with intracavernous injection of prostaglandin E1 (PGE1), papaverine and a mixture of papaverine and phentolamine was performed. All patients underwent comprehensive multidisciplinary examinations, including bulbocavernosus reflex (BCR) latencies and somatosensory evoked potentials, penile Doppler sonography, dynamic or pharmaco-cavernosonography, and for 11 patients nocturnal penile tumescence (NPT) was also recorded with the Rigiscan. This diagnostic approach suggested that in 24 (39.3%) of the 61 pts the etiology was psychogenic and in the remaining 37 (60.7%) it was organogenic. PGE1 had a much higher erectile potency than papaverine and a somewhat higher potency than the mixture of papaverine and phentolamine. Complete erection was achieved in 41 of the 61 patients (67.2%) with PGE1, as against 20 of the 61 patients (32.8%) with papaverine alone and 20 of the 61 (32.8%) with papaverine/phentolamine. Whereas 7 of 61 patients (11.5%) had priapism of more than 6 h duration and requiring therapy after injection of papaverine or papaverine/phentolamine, no priapism occurred after PGE1. Thus, compared with papaverine and phentolamine, PGE1 offers important advantages in the diagnosis and perhaps also in the therapy of erectile dysfunction.
Key concepts: Papaverine, Phentolamine, Erectile dysfunction, Medicine, Bulbocavernosus reflex, Priapism, Prostaglandin E1, Urology