Ardicoglu A et al. (2005) Effectiveness of vardenafil versus papaverine in penile Doppler ultrasonography. Urol Int 75: 75–79
Penile color Doppler ultrasound is currently considered the 'gold standard' for the evaluation of erectile dysfunction; however, the technique requires intracavernous injection of vasoactive drugs, such as papaverine, which are associated with adverse effects including prolonged erection and priapism. Anxiety and pain associated with the injection can also interfere with the sensitivity and specificity of the test. This study aimed to determine whether the oral phosphodiesterase type 5 inhibitor vardenafil, which has few adverse effects, could be used instead of papaverine.
This study enrolled 24 men with erectile dysfunction aged between 28 and 62 years. Penile color Doppler ultrasound evaluation of cavernous arterial flow parameters was performed before and after administration of either papaverine or vardenafil, with genital and audiovisual sexual stimulation, at two separate sessions at least 5 days apart. Peak flow velocity had increased significantly by 30 min after oral vardenafil had been taken, reaching a maximum value by 60 min. There was no significant difference in mean peak flow velocity between papaverine injection after 1, 5, 10 and 20 min, compared with oral vardenafil after 30, 45, 60, 75 and 90 min. Whereas 12.5% of patients who received papaverine suffered from prolonged erection requiring pharmacologic intervention, no such effects were seen with vardenafil. Around 83% of patients reported injection-related pain, and around 21% reported this to be severe. The most common side effect reported for vardenafil was headache (12.5%).
The authors conclude that penile color Doppler ultrasound with oral vardenafil has promise as a potential noninvasive technique for evaluating erectile dysfunction.
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Lovegrove, C. Vardenafil compared with papaverine in penile Doppler ultrasonography. Nat Rev Urol 2, 523 (2005). https://doi.org/10.1038/ncpuro0315