Follow up outcome of intracavernous papaverine.

One of the more significant recent therapeutic developments in the treatment of male impotence has been intracavernous pharmacotherapy using penis self-injection technique. The intracavernous pharmacotherapy of impotence results in a relatively normal erection in most cases with minimal alteration of the anatomy, physiology, and psychosocial factor of impotence. However, early treatment success of the patient does not assure long-term success. The objective of this study was to determine the long-term utilization outcome of intracavernous pharmacotherapy in the management of impotence. Of 103 enrolled in the study, 50 patients (49%) were actively using the injection treatment method after 18 months. There were no significant difference in mean age of those patients who discontinued from those who continued to use intracavernous therapy. Of the 53 patients (51%) who discontinued intracavernous therapy, 33 patients (62%) were unsatisfied with the results, nine patients (17%) were unsatisfied with the methodology, eight patients (15%) developed penile complications, and three patients (6%) had improvement of sexual function. Thirty-four (69%) of those who discontinued therapy elected an alternative form of therapy and 16 patients (30%) were not interested in any further treatment. While it is difficult to assess the many factors involved in the outcome of therapy for impotence, the assessment of long-term intracavernous therapy utilization provides a relatively low risk means for clinical evaluation of the therapeutic value of pharmacotherapy for the individual as well as a clinical indication of the sexual function needs of the patient.