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[Prospective study of the effectiveness and side effects of intracavernous prostaglandin E1 versus papaverine or papaverine phentolamine in the diagnosis and treatment of erection dysfunction. Review of the literature]

Author(s): Chandeck Montesa K, Chen Jimenez J, Tamayo JC, Rodriguez Antolin A, Alvarez Gonzalez E

Affiliation(s): Unidad de Andrologia, Hospital 12 de Octubre, Universidad Complutense, Madrid.

Publication date & source: 1992-03, Actas Urol Esp., 16(3):208-16.

Publication type: Clinical Trial; Randomized Controlled Trial; Review

E1 prostaglandins (E1-PG) by intracavernous injection has been given for diagnostic purposes to 70 randomly selected patients visiting the practice with erectile dysfunction (ED). Sixty-one were suggested to begin a weekly intracavernous self-injection (WICSI) according to the established protocol. Fifty-one patients (83.6%) started the therapy and within an 18-months follow-up interval only 2 (3.27%) preferred to return to papaverine, since 20 patients had previously undergone the papaverine test and 6 were on WICSI with this preparation. Fifty-three patients (75%) achieved complete erection, 8 (11.4%) enough erection to penetrate without manual help, representing a total efficacy of 87%. E1-PG dosage varied from 10 to 40 mcg based on diagnosis, and was readjusted in 6 of the 9 patients which in the initial tests had not obtained sufficient erection, therefore bringing about a final 91.4% erections of sufficient characteristics for intercourse to be considered normal. During the year and a half follow-up a total of 2,880 E1-PG self-injections were injected without during this time cases of priapism, systemic reactions, cavernous bodies infections, arteriovenous fistulae, fibrosis of the cavernous bodies, etc, being observed. Two patients showed prolonged erections of 3-5 hours during the E1-PG tests which remitted spontaneously without sequelae and now continue the WICSI programme after dosage readjustment. In our experience, E1-PG intracavernous injection has proven to be more effective than papaverine in the treatment of erectile dysfunction and therefore, added to its safety and degree of acceptance, we consider it a first choice approach in the diagnosis and treatment of erectile dysfunction in males.

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