Abstract
The objective of this study is to evaluate the side effects of intracavernous vasoactive agents on clinical and sonographic basis. Two groups of patients were included, group I included 168 ED patients trained on self-injection therapy using one of the three protocols. Protocol A: papaverine; protocol B: PGE1; and protocol C: trimix (papaverine, phentolamine and PGE1). Patients were followed up clinically, sonographically and by laboratory investigations for 6 months to evaluate the occurrence of side effects. Group II included 21 patients presenting to our department for the first time with a complication of intracavernous injection pharmacotherapy (ICI) initiated elsewhere. In all, 168 patients of group I completed the study. Patients on papaverine had the highest incidence of complications concerning prolonged erection, subcutaneous hematoma and penile fibrosis. Postinjection penile pain was observed more with groups B and C than group A. No systemic side effects were reported. Duplex ultrasound was beneficial in detecting mild clinically impalpable fibrosis. In total, 10 patients of group II presented with prolonged erection, seven with penile fibrosis, three with cavernositis and one with intracavernous needle breakage. We conclude that although ICI therapy is an effective second-line treatment option, patients on a self-injection program should be followed up both clinically and sonographically both at the initiation phase and on regular follow-up visits.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Virag R . Intracavernous injection of papaverine for erectile failure. Lancet 1982; ii: 938.
Ishii N et al. Intracavernous injection of prostaglandin E1 for the treatment of erectile impotence. J Urol 1989; 141: 323–325.
Porst H . Ten years of experience with various vasoactive drugs. Int J Impot Res 1994; 6(Suppl 1): D149.
Chen R, Lakin M, Montague DK, Ausmundson S . Penile scarring with intracavernosal injection therapy using prostaglandinE1: a risk factor analysis. J Urol 1996; 155(1): 138–140.
Montorsi F et al. Current status of local penile therapy. Int J Impot Res 2002; 14(Supp 1): S70–S81.
Porst H . Current perspectives on intracavernosal pharmacotherapy for erectile dysfunction. Int J Impot Res 2000; 12(Suppl 4): S91–S100.
Lomas GM, Jarow JP . Risk factors for papaverine-induced prolonged erection. J Urol 1992; 147: 1280–1281.
Serels S, Melman A . Prolonged erection. In: Carson C, Kirby RS and Goldstein I (eds) Textbook of Erectile Dysfunction. Isis Medica: NY, 1999, pp 529–539.
Moreland RB . Is there a role of hypoxemia in penile fibrosis: a viewpoint presented to the society for the study of impotence? Int J Impot Res 1998; 10: 113–120.
Bazzocchi M, Doratiotto S, Marzio A, De Candia A . Ultrasonography study of Peyronie's disease. Arch Ital Urol Androl 2000; 72: 376–383.
Brown SL et al. Hepatotoxicity related to intracavernous pharmacotherapy with papaverine. Urology 1998; 52: 844–847.
Pautler SE, Brock GB . Priapism. Urol Clin N Am 2001; 28: 391–403.
Ralph DJ . What's new in Peyronie's disease? Curr Opin Urol 1999; 9: 569–571.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Moemen, M., Hamed, H., Kamel, I. et al. Clinical and sonographic assessment of the side effects of intracavernous injection of vasoactive substances. Int J Impot Res 16, 143–145 (2004). https://doi.org/10.1038/sj.ijir.3901194
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijir.3901194
Keywords
This article is cited by
-
Low-intensity shock wave therapy ameliorates erectile dysfunction in men with pelvic fractures associated with urethral injury
International Journal of Impotence Research (2019)
-
Erectile dysfunction and coronary slow flow: distinct presentations of endothelial disease
International Journal of Impotence Research (2007)
-
Imaging of penile traumas—therapeutic implications
European Radiology (2005)