Schnyder von Wartensee M, Studer U E
Schweiz Med Wochenschr. 1986 Jul 26;116(30):994-9.
The introduction of intracorporeal papaverin injections has significantly changed the investigation and treatment of erectile dysfunction. Papaverin acts on the smooth (vascular) muscle cell and induces erection. A good response to papaverin injection excludes major vascular disturbances within the penis. The interpretation of a negative result is more difficult. Depending on the Doppler blood-flow measurements, further radiological investigations (dynamic cavernosography or selective angiography of the pudendal arteries) may be needed. Treatment of impotence with papaverin is most successful in patients with psychogenic disturbances, which are often coincident with minor vascular pathology. Autoinjection is easily learned for long-term treatment by patients with moderate vascular disorders or neurogenic dysfunction. Major vascular disturbances, e.g. occlusion of the penile arteries or marked venous shunt, require surgery by a trained urologist. Papaverin may cause side effects, especially priapism, which may lead to definitive impotence. Careful investigation of erectile disturbances and search for the appropriate papaverin dosage are therefore crucial.
体内注射罂粟碱显著改变了勃起功能障碍的检查和治疗方法。罂粟碱作用于平滑肌（血管）细胞并诱导勃起。对罂粟碱注射有良好反应可排除阴茎内的主要血管紊乱。对阴性结果的解读则更为困难。根据多普勒血流测量结果，可能需要进一步的放射学检查（动态海绵体造影或阴部动脉选择性血管造影）。罂粟碱治疗阳痿在伴有精神性障碍的患者中最为成功，这类患者常伴有轻微血管病变。对于中度血管疾病或神经功能障碍患者，自行注射便于长期治疗。严重的血管紊乱，如阴茎动脉闭塞或明显的静脉分流，则需要由训练有素的泌尿科医生进行手术。罂粟碱可能会引起副作用，尤其是阴茎异常勃起，这可能导致永久性阳痿。因此，仔细检查勃起功能障碍并寻找合适的罂粟碱剂量至关重要。
