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Intracavernous injections: still the gold standard for treatment of erectile dysfunction in elderly men


The objective of this work was to determine the effectiveness of intracavernous injections (ICI) of vasoactive drugs in elderly men with erectile dysfunction and to compare the results obtained with the injection of two different drug combinations. It was a case control study. The sample consisted of 300 men, 63–85 y of age (mean 67.1) with erectile dysfunction of organic origin. Among the patients 180 underwent first trial with injection of prostaglandin E1 (PE). Further on these 180 patients and another 120 (in total 300 patients) were treated with a triple combination of papaverine hydrochlorate, phentolamine messylate and prostaglandin E1 (PPR). The number of responders to the injection of either PE alone or the drug combination was recorded. The quality of the erections was evaluated in the outpatient clinic by the medical staff and through patient's report after home trial. The average volume of either PE or PPR necessary to obtain a functional erection was measured. We observed a statistically significant association between the results obtained after the injection of PPR as compared to PE (χ2 with 2 d.f.: 34.666; P=<0.001). A functional erection was obtained in 224/300 (74.7%) after the injection of PPR as compared to 87/180 men (48.3%) treated with PE. The average volume of PPR necessary to obtain a functional erection was 0.35±0.14 ml whereas that of PE was 1.3±0.3 ml. intracavernous injection of vasoactive drugs is still one of the most successful therapies for patients suffering from organic impotence. It is less effective in the older age group as compared to younger. However, if this form of therapy is chosen for aged men the triple combination therapy (PPR) yields a higher response rate than that obtained with prostaglandin alone.

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  1. Women's Indicators and Statistics Database, Version 3 CD-Rom. Sales N E95 XVII.6 New York: United Nations 1995.

  2. Kaiser FE et al. Impotence and aging: clinical and hormonal factors. J Am Geriatr Soc 1988 36, 511–519.

    Article  CAS  Google Scholar 

  3. Virag R. . Indications and early results of sildenafil (Viagra) in erectile dysfunction. Urology 1999 54, 1073–1077.

    Article  CAS  Google Scholar 

  4. Edwards AE, Husted JR. . Penile sensitivity, age, and sexual behavior. J Clin Psychol 1976 32, 697–700.

    Article  CAS  Google Scholar 

  5. Feldman HA et al. Impotence and its medical and psychosocial correlates: results of the Massachusets Male Aging Study. J Urol 1994 151, 540–561.

    Article  Google Scholar 

  6. Starr BD, Weiner MB. . The Starr-Weiner Report on Sex and Sexuality in the Mature Years Stein and Day: New York 1981.

  7. Morales A et al. Non-hormonal pharmacological treatment of impotence. J Urol 1982 128, 45–47.

    Article  CAS  Google Scholar 

  8. Morales A et al. The effectiveness of yohimbine in the treatment of impotence: results of a controlled trial. Proceedings of the American Urological Association Meeting 1984 A391, abstract.

  9. Andrade R, Aghajanian GH. . Single cell activity in the noradrenergic A5 region: responses to drugs and peripheral manipulation of blood pressure. Brain Res 1982 242, 125–135.

    Article  CAS  Google Scholar 

  10. Padma-Nathan H, Shabsigh R. . Pharmacotherapy for sexual dysfunction: what does the future hold? Interactive Course 009834 IC Office of Education, American Urological Association Meeting 1998.

    Google Scholar 

  11. Becker AJ et al. Oral phentolamine as treatment for erectile dysfunction. J Urol 1998 159, 1214–1216.

    Article  CAS  Google Scholar 

  12. Peterson CA et al. Erectile response to transurethral alprostadil, prazosin and alprostadil-prazosin combinations. J Urol 1998 159, 1523–1528.

    Article  CAS  Google Scholar 

  13. Ishil N et al. Intracavernous injection of prostaglandin E1 for the treatment of erectile impotence. J Urol 1989 141, 323–325.

    Article  Google Scholar 

  14. Chen J et al. The lowest effective dose of prostaglandin E1 as treatment for erectile dysfunction. J Urol 1995 153, 80–81.

    Article  CAS  Google Scholar 

  15. Shenfeld O et al. Papaverine-phentolamine and prostaglandin E1 versus papaverine-phentolamine alone for intracorporeal injection therapy: a clinical double-blind study. J Urol 1995 154, 1017–1019.

    Article  CAS  Google Scholar 

  16. Govier FE et al. Experience with triple drug therapy in a pharmacological erection program. J Urol 1993 150, 1822–1824.

    Article  CAS  Google Scholar 

  17. Border WA, Ruoslahti E. . Transforming growth factor-beta in disease: the dark side of tissue repair. J Clin Invest 1992 90, 1–7.

    Article  CAS  Google Scholar 

  18. Chung WS, Park YY, Kwon SW. . The impact of aging on penile hemodynamics in normal responders to pharmacological injection: a doppler sonographic study. J Urol 1997 157, 2129–2131.

    Article  CAS  Google Scholar 

  19. Kerfoot WK, Carson CC. . Pharmacologically induced erections among geriatric men. J Urol 1991 146, 1022–1024.

    Article  CAS  Google Scholar 

  20. Richter S, Gross R, Nissenkorn I. . Cavernous injection therapy for the treatment of erectile dysfunction in elderly men. Int J Impot Res 1990 2, 43–47.

    Google Scholar 

  21. McMahon CG, Samali R, Johnson H. . Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction. J Urol 2000 164, 1192–1196.

    Article  CAS  Google Scholar 

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Richter, S., Vardi, Y., Ringel, A. et al. Intracavernous injections: still the gold standard for treatment of erectile dysfunction in elderly men. Int J Impot Res 13, 172–175 (2001).

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