Staerman F, Veilhan L A, Guiraud P, Coeurdacier P, Cipolla B, Lobel B
Service d'Urologie, Hôpital Pontchaillou, Rennes, France.
Prog Urol. 1996 Aug-Sep;6(4):564-8.
Dose adaptation in self-administered intracavernous PGE1 injections is poorly defined in learning protocols and its degree of difficulty depends on the aetiology of the erectile dysfunction. The authors tried to standardize this phase by studying the results and complications of a protocol using an identical initial dose of PGE1 regardless of the aetiology of erectile dysfunction.
101 patients consulting for erectile dysfunction participated in a learning protocol of self-administered intracavernous PGE1 injections, consisting of 3 injections systematically starting with 10 micrograms of PGE1, following assessment of the aetiology.
For an efficacy of 58.4%, 79.2% and 88.1% after one, two or three injections, respectively, the prolonged erection rate (> or = 6 hours) was 2.7% after the first injection and 0% after the other injections. However, erection durations of 2 to 6 hours have frequently been reported in neurological patients. Discontinuations during the learning phase were only observed in patients presenting with tumescence without rigidity after one injection (5.4%) or two injections (21%).
In the light of these results and to minimize prolonged erections and discontinuations, while ensuring efficacy, PGE1 dose adaptation can be simply performed by starting with 10 micrograms in all patients except for neurogenic patients (5 micrograms) with an increase to 20 or 30 micrograms in the case of failure.
在自我注射海绵体内前列地尔（PGE1）的学习方案中，剂量调整的定义尚不明确，其难度程度取决于勃起功能障碍的病因。作者试图通过研究一种方案的结果和并发症来规范这一阶段，该方案无论勃起功能障碍的病因如何，均使用相同的初始剂量PGE1。
101例因勃起功能障碍前来咨询的患者参与了自我注射海绵体内PGE1的学习方案，该方案包括3次注射，在评估病因后，均从10微克PGE1开始。
一次、两次或三次注射后的有效率分别为58.4%、79.2%和88.1%，首次注射后阴茎异常勃起率（≥6小时）为2.7%，其他注射后为0%。然而，神经功能障碍患者经常出现阴茎勃起持续2至6小时的情况。在学习阶段，仅在一次注射后出现肿胀但无硬度的患者（5.4%）或两次注射后出现这种情况的患者（21%）中观察到停药现象。
鉴于这些结果，为了在确保疗效的同时尽量减少阴茎异常勃起和停药情况，除神经源性患者（5微克）外，所有患者均可从10微克开始进行PGE1剂量调整，若治疗失败则增加至20或30微克。
