Pharmacologically induced penile erections in the assessment and treatment of erectile impotence: a preliminary study of 100 patients.

OBJECTIVE

To assess and compare the immediate and subsequent response to pharmacologically induced penile erections, using intracavernosal injections of papaverine.

DESIGN

Preliminary, prospective study.

SETTING

Male sexual dysfunction clinic at the National Hospital of Sri Lanka.

PATIENTS

100 consecutive patients receiving 20 mg papaverine hydrochloride intracavernosally as the first dose.

MAIN OUTCOME MEASURES

Assessment of the quality of the erection following the initial injection and determination of the optimum dose to achieve a normal erection; number who elected self-injection at home.

RESULTS

Mean age of the 100 impotent men was 36.6 years and the mean duration of erectile dysfunction 43.9 months. Of men in the third decade 87.5% had a normal erection but only one-third of patients over 50 years showed a normal response. 16 patients had a reasonably well established organic problem. 42% of patients had normal nocturnal or early morning erections. The drop-out rate after the initial injection was 17%, 19% of men had a normal erection with 20 mg papaverine and 67% had a normal response to 20 to 80 mg papaverine. Seven patients continued on the self-injection program. Prolonged erections were experienced by 6% of men (1.9% of injections).

CONCLUSIONS

Intracavernosal injection of papaverine hydrochloride is effective in a dose of 20 to 80 mg.