Evaluation of I-C papaverine in patients with psychogenic and organic impotence.

Forty men with organic or psychogenic impotence, who were highly motivated for treatment, were offered instruction in the intracavernosal (I-C) self-injection of papaverine and regular ongoing supervision by the investigator. Twenty declined immediately, citing a number of reasons, notably qualms about pain of the injection, side-effects and the unnaturalness of the method. Eleven patients discontinued the drug within 11 months; nine used it for at least one year, and all were continuing with it albeit less frequently at the time of assessment. Those who discontinued treatment differed significantly from those who did not; the latter initially used the drug less frequently (less than once per month), did not have a regular sexual partner or had a poor relationship with their sexual partner, and reported a decline in libido during use of the drug. The findings suggest that I-C papaverine, although effective in treating impotence, is not a panacea, and a large percentage of users (55% in our study) are likely to discontinue the drug within a relatively short period of time.