Abstract
Sexual dysfunction due to inadequate or poorly sustained erections is a common problem among patients with spinal cord injury (SCI). While penile prostheses have provided adequate treatment for many patients, the complication rate in spinal cord injured patients remains high and they have not received widespread acceptance among SCI patients or the physicians treating them. Recently, intracavernous injections of vasoactive medications have proved beneficial for treating patients with erectile dysfunction. In the current study, we evaluated 40 SCI patients and 116 patients with vascular based impotence who had been followed for a minimum of 1 month while utilising intracavernous injections of phentolamine and papaverine. SCI patients with neurogenic based erectile dysfunction are significantly different from vascular impaired patients. SCI patients are younger and have been impotent for a longer period of time when treatment is sought. Furthermore, the dose of medication required is significantly less for SCI patients. The time of erection is longer and the quality of erection is better in neurogenic based impotence. Results with this treatment in SCI appear to be quite good with short term followup and long term evaluation of this methodology in SCI appears warranted.
References
Abozeid M, Juenemann K P, Luo J et al 1987 Chronic papaverine treatment: the effect of repeated injections on the simian erectile response and penile tissue. Journal of Urology 138: 1263–1266.
Althof S E, Turner L A, Levine S B et al 1987 Intracavernosal injection in the treatment of impotence; a prospective study of sexual, psychological, and marital functioning. Journal of Sex and Marital Therapy 13: 155–167.
Beretta G, Zanollo A, Fanciullacci F, et al 1986 Intracavernous injection of papaverine in paraplegic males. Acta Europaea Fertilitatis 17: 283–284.
Bodner D R, Lindan R, Leffler E et al 1987 The application of intracavernous injection of vasoactive medications for erection in men with spinal cord injury. Journal of Urology 138: 310–311.
Brindley G S 1983 Cavernosal alpha-blockade: a new technique for investigating and treating erectile impotence. British Journal of Psychiatry 143: 332–337.
Brindley G S 1986 Maintenance treatment of erectile impotence by cavernosal unstriated muscle relaxant injection. British Journal of Psychiatry 149: 210–215.
Comarr A E 1985 Sexuality and fertility among spinal cord and/or cauda equina injuries. Journal of the American Paraplegia Society 8: 67–75.
Golji H 1979 Experience with penile prosthesis in spinal cord injury patients. Journal of Urology 121: 288–289.
Green B G, Sloan S L 1986 Penile prostheses in spinal cord injured patients: combined psychosexual counseling and surgical regimen. Paraplegia 24: 167–172.
Hu K N, Burks C, Christy W C 1987 Fibrosis of tunica albuginea: complication of long-term intracavernous pharmacological self-injection. Journal of Urology 138: 404–405.
Larsen E H, Gasser T C, Bruskewitz R C 1987 Fibrosis of corpus cavernosum after intracavernous injection of phentolamine/papaverine. Journal of Urology 137: 292–293.
Lue T F, Tanagho E A 1987 Physiology of erection and pharmacological management of impotence. Journal of Urology 137: 829–836.
Montgomerie J Z, Morrow J W 1978 Pseudomonas colonization in patients with SCI. Journal of Epidemiology 108: 328–336.
Rossier A B, Fam B A 1984 Indications and results of semi-rigid penile prostheses in spinal cord injury patients: longterm followup. Journal of Urology 131: 59–61.
Scott F B, Bradley W E, Tim G W 1973 Management of erectile impotence. Use of implantable, inflatable prostheses. Urology 2: 80–82.
Sidi A A, Cameron J S, Duffy L M et al 1986 Intracavernous drug induced erections in the management of male erectile dysfunction: experience with 100 patients. Journal of Urology 135: 704–706.
Sidi A A, Cameron J S, Dykstra D et al 1987 Vasoactive intracavernous pharmacotherapy for the treatment of erectile impotence in men with spinal cord injury. Journal of Urology 138: 539–542.
Small M P, Carrion H M, Gordon J A 1975 Small-Carrion penile prosthesis. Urology 5: 479–486.
Virag R 1982 Intracavernous injection of papaverine for erectile failure. The Lancet 2: 938.
Virag R, Frydman D, Legman M et al 1984 Intracavernous injection of papaverine as a diagnostic and therapeutic method in erectile failure. Angiology 35: 79–82.
Wyndaele J J, De Meyer JM, De Sy W A et al 1986 Intracavernous injection of vasoactive drugs, an alternative for treating impotence in spinal cord injury patients. Paraplegia 24: 271–275.
Zorgniotti A W, Lefleur R S 1985. Auto injection of the corpus cavernosum with a vasoactive drug combination for vasculogenic impotence. Journal of Urology 133: 39–41.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lloyd, L., Richards, J. Intracavernous pharmacotherapy for management of erectile dysfunction in spinal cord injury. Spinal Cord 27, 457–464 (1989). https://doi.org/10.1038/sc.1989.72
Issue Date:
DOI: https://doi.org/10.1038/sc.1989.72
Keywords
- Spinal cord injury
- Sexual dysfunction
- Papaverine
- Intracavernous injection
This article is cited by
-
Medical treatment of neurogenic impotence
Sexuality and Disability (1994)
-
Sexuality in neurologic disability: An overview
Sexuality and Disability (1991)
