Wespes E, Delcour C, Rondeux C, Struyven J, Schulman C C
Department of Urology, University Clinic of Brussels, Erasme Hospital, Belgium.
J Urol. 1987 Nov;138(5):1171-3. doi: 10.1016/s0022-5347(17)43539-7.
Intracavernous papaverine injection may be the first diagnostic step in the assessment of the impotent patient. However, the appreciation of its effect must rely on the evaluation of penile rigidity. Since measurement of rigidity requires a sophisticated procedure that may not be available to the majority of practitioners, we attempted to find a simple and objective method to evaluate the results of this common test. We tested 50 patients complaining of impotence with intracavernous injection of 60 mg. papaverine. The length and circumference of the penis were measured before and after papaverine injection. The rigidity was determined by measuring the angle between the penis and the legs with the patient in the standing position. Afterwards, each patient underwent vascular (Doppler ultrasound and cavernometry) and neurological examinations. A total of 27 patients with no vascular abnormalities had an erectile angle of 96 degrees (range 90 to 130 degrees), while 23 patients had some vascular disorders (9 arterial lesions, 8 venous leakage and 6 combined lesions) and an erectile angle of 36 degrees (range 0 to 60 degrees). There was no significant difference between the groups in the increase of length and circumference of the penis after intracavernous injection of papaverine. The papaverine test can distinguish between patients with vascular and psychogenic problems. A negative papaverine test associated with a normal Doppler examination is characteristic of venous leakage. Measurement of the erectile angle after intracavernous injection of papaverine with the patient in the standing position is a simple, objective and reliable method to evaluate patients with vascular impotence.
海绵体内注射罂粟碱可能是评估阳痿患者的首要诊断步骤。然而，对其效果的评估必须依赖于对阴茎硬度的判断。由于测量硬度需要复杂的程序，大多数从业者可能无法采用，因此我们试图找到一种简单且客观的方法来评估这项常见检查的结果。我们对50名主诉阳痿的患者进行了海绵体内注射60毫克罂粟碱的测试。在注射罂粟碱前后测量阴茎的长度和周长。通过让患者站立位测量阴茎与腿部之间的角度来确定硬度。之后，每位患者都接受了血管（多普勒超声和海绵体测压）及神经学检查。共有27名无血管异常的患者勃起角度为96度（范围为90至130度），而23名患者存在一些血管疾病（9例动脉病变、8例静脉漏和6例混合病变），勃起角度为36度（范围为0至60度）。两组在海绵体内注射罂粟碱后阴茎长度和周长的增加方面无显著差异。罂粟碱试验可区分血管性和心因性问题患者。罂粟碱试验阴性且多普勒检查正常是静脉漏的特征。让患者站立位进行海绵体内注射罂粟碱后的勃起角度测量是评估血管性阳痿患者的一种简单、客观且可靠的方法。
