Floth A, Schramek P
Department of Urology, Allgemeine Poliklinik der Stadt Wien, Austria.
J Urol. 1991 Jan;145(1):56-9. doi: 10.1016/s0022-5347(17)38246-0.
We compared the erectile response to intracavernous injection of a combination of papaverine and prostaglandin E1 with that of a combination of papaverine and phentolamine (49 patients), and prostaglandin E1 alone (38). The degree of erection achieved was significantly better with papaverine plus prostaglandin E1 than with papaverine plus phentolamine and the duration of erection was less, although the incidence of prolonged erections (greater than 5 hours) was similar with both combinations. Papaverine with prostaglandin E1 likewise resulted in a significantly better degree of erection than prostaglandin E1 alone (prolonged erections occurred only after the drug combination). All erections subsided spontaneously and none required medical intervention throughout the study. Pain was noted only after injection of prostaglandin E1. The incidence was clearly lower (7 of 38 versus 13 of 38) after the injection of only 5 micrograms. prostaglandin E1 in combination with papaverine (although the difference is not statistically significant). Subjectively, the side effects caused by the drug combination were described as much less dramatic by the patients than after prostaglandin E1 alone. The combination of papaverine and prostaglandin E1 shows a clearly synergistic effect and might suitably replace papaverine plus phentolamine or prostaglandin E1 alone in patients who do not respond well or suffer side effects after high single doses.
我们比较了海绵体内注射罂粟碱与前列腺素E1的联合制剂、罂粟碱与酚妥拉明的联合制剂（49例患者）以及单独使用前列腺素E1（38例患者）后的勃起反应。罂粟碱加前列腺素E1所达到的勃起程度明显优于罂粟碱加酚妥拉明，且勃起持续时间较短，尽管两种联合制剂导致阴茎异常勃起（超过5小时）的发生率相似。罂粟碱与前列腺素E1联合使用同样比单独使用前列腺素E1产生的勃起程度明显更好（阴茎异常勃起仅在联合用药后出现）。在整个研究过程中，所有勃起均自然消退，无一例需要药物干预。仅在注射前列腺素E1后出现疼痛。仅注射5微克前列腺素E1与罂粟碱联合使用后疼痛发生率明显较低（38例中有7例，而单独注射前列腺素E1时为38例中有13例）（尽管差异无统计学意义）。从主观感受来看，患者描述联合用药引起的副作用比单独使用前列腺素E1时要轻得多。罂粟碱与前列腺素E1的联合制剂显示出明显的协同作用，对于单剂量较高时反应不佳或出现副作用的患者，可能适合替代罂粟碱加酚妥拉明或单独使用前列腺素E1。
