Purvis K, Brekke I, Christiansen E
Andrology Center, Skøyen Atrium, Oslo, Norway.
Int J Impot Res. 1996 Mar;8(1):9-16.
The study examines the erectile response of intracavernosal injection with increasing doses of prostaglandin E1 (PGE) and papaverine/phentolamine (PP) in 516 men with erectile failure. The response was correlated to age, the duration of erectile failure, the quality of spontaneous erections, tobacco consumption and medicine use. In addition, the erectile response was related to penile brachial index (PBI) the free testosterone index and various hormonal parameters. Over 60% of the subjects obtained satisfactory rigidity of at least 30 min duration with 7-15 micrograms PGE. A further 15% (PGE non-responders at the doses tested) obtained rigidity with PP. The average dose necessary to achieve rigidity was 8.8 micrograms for PGE and 0.94 ml (papaverine: 15 mg/ml; phentolamine 0.5 mg/ml) for PP. The average duration of rigidity was 2.2 h and 2.3 h for PGE and PP, respectively. Tobacco consumption, the duration of erectile failure and the age of the subject did not influence the response to intracavernosal injection. Moreover the PBI, the free testosterone index or libido of the subject, did not appear to be generally important for obtaining satisfactory rigidity. In contrast, chronic medication, especially antihypertensive drugs, was associated with significantly higher numbers of poor responders, a shorter duration of erection in the responders and higher doses of PGE necessary to achieve a satisfactory response. The combination of increasing age and antihypertensive medication was predictive for a poor intracavernosal response. In general, a reduced incidence of morning erections was predictive of a weaker response to PGE. The proportion of men with a PBI lower than 0.75 increased with age. These subjects more often took chronic medication, had a lower frequency of morning erections and exhibited a significantly weaker reaction to PGE than subjects with higher PBI. In summary, a large number of men with erectile failure can obtain satisfactory rigidity with intracavernosal injection. In men taking antihypertensive medication, especially in higher age groups, the dose of the intracavernosal medication had to be increased. A reduced sensitivity to intracavernosal medication could be predicted from a lower PBI and a reduced frequency of spontaneous erections.
该研究检测了516例勃起功能障碍男性患者在阴茎海绵体内注射递增剂量前列腺素E1（PGE）和罂粟碱/酚妥拉明（PP）后的勃起反应。该反应与年龄、勃起功能障碍持续时间、自然勃起质量、吸烟量及用药情况相关。此外，勃起反应还与阴茎肱动脉指数（PBI）、游离睾酮指数及各种激素参数有关。超过60%的受试者在注射7 - 15微克PGE后获得了至少持续30分钟的满意硬度。另有15%（在所测剂量下对PGE无反应者）在注射PP后获得了硬度。达到硬度所需的平均剂量，PGE为8.8微克，PP为0.94毫升（罂粟碱：15毫克/毫升；酚妥拉明0.5毫克/毫升）。PGE和PP产生硬度的平均持续时间分别为2.2小时和2.3小时。吸烟量、勃起功能障碍持续时间及受试者年龄不影响阴茎海绵体内注射的反应。此外，受试者的PBI、游离睾酮指数或性欲，对于获得满意硬度似乎通常并不重要。相比之下，长期用药，尤其是抗高血压药物，与明显更多的反应不佳者相关，反应者的勃起持续时间较短，且达到满意反应所需的PGE剂量更高。年龄增长与抗高血压药物联合使用可预测阴茎海绵体内反应不佳。一般来说，晨勃发生率降低可预测对PGE的反应较弱。PBI低于0.75的男性比例随年龄增加。与PBI较高的受试者相比，这些受试者更常服用长期药物，晨勃频率较低，对PGE的反应明显较弱。总之，大量勃起功能障碍男性患者可通过阴茎海绵体内注射获得满意硬度。在服用抗高血压药物的男性中，尤其是在年龄较大的人群中，必须增加阴茎海绵体内药物的剂量。PBI较低和自然勃起频率降低可预测对阴茎海绵体内药物的敏感性降低。
