Comparison of penile vascular effect induced by intracavernous injection of papaverine and prostaglandin E1.

Abstract

An intracavernous injection with papaverine or prostaglandin E1 (PGE1) combined with duplex ultrasonography is an objective technique to conduct a penile blood flow study (PBFS). Three hundred patients with impotence underwent papaverine (9-60 mg) induced PBFS at the University of California School of Medicine, San Francisco (UCSF), U.S.A. and another 80 patients with impotence received PGE1-induced (20 micrograms) PBFS at Veterans General Hospital-Taichung (VGH-TC), R.O.C. Preliminary evaluation of age, duration of disease and pre-injection diameter of cavernous arteries disclosed no significant difference in these 2 series. It was interesting to find that almost all parameters of vascular response to pavaverine vs PGE1 differed significantly, such as onset of response (6.5 +/- 6.5 vs 11.7 +/- 6.4 min, slower in the PGE1 group, p less than 0.001); post-injection diameter of cavernous arteries (right: 0.73 +/- 0.20 vs 0.79 +/- 0.18 mm, p = 0.03; left: 0.74 +/- 0.20 vs 0.82 +/- 0.21 mm, p = 0.005); diametral increment of cavernous arteries (right: 0.23 +/- 0.17 vs 0.33 +/- 0.17 mm, p less than 0.001; left: 0.24 +/- 0.17 vs 0.36 +/- 0.19 mm, p less than 0.001) and peak velocity (right: 27.5 +/- 16.1 vs 42.0 +/- 20.1 cm/sec, p less than 0.001; left: 28.9 +/- 15.9 vs 39.7 +/- 17.9 cm/sec, p less than 0.001). The side effects, primarily injection pain (23.8%, 19/80) in the PGE1 group and dizziness (3.0%, 9/300) in the papaverine group, were minor in these 2 series. Prolonged erection was not encountered in either series; however, immediate treatment was performed if a papaverine-induced erection lasted over 60 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)