[Pharmacocavernosometry and pharmacocavernosography in erectile dysfunction].

In about 30% of patients with erectile dysfunction (ED), insufficiency of the corpus cavernosum, or a so-called venous outflow disturbance, pharmacocavernosometry (PCM) and pharmacocavernosography (PCG) are at present the most physiological modes of investigation for the use of vasoactive substances. The investigation technique is described and the results of 364 studies are reported. Using PCM, it is possible to quantify venous outflow disturbances and PCG permits them to be localized. In 111 patients, both PCM and PCG were performed, using a new cavernosography pump (AP300, Fresenius). Much lower flow values were found for maintenance flow than had previously been assumed (normal value: less than 15 ml; suspect: 15-30 ml; pathological: greater than 30 ml/min). Pressure drop time was the new measurement used, i.e., the time required for an intracorporal pressure drop from 150 to 50 mmHg. A value of greater than 1 min was established to be the normal value. In cases of pronounced insufficiency of the corpus cavernosum, the pressure drop time amounts to only a few seconds. Evaluation of 200 PCGs showed that an isolated pathological outflow via the deep dorsal vein of the penis could be demonstrated in only 10%, whereas in 72% the deep veins of the penis were involved. These results show that the operative indications for so-called venous outflow disturbances are considerably restricted.