Double-blind randomized crossover study comparing intracorporeal prostaglandin e 1 with combination of prostaglandin e 1 and lidocaine in the treatment of organic impotence

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Objectives To study the efficacy of lidocaine 1% in relieving pain associated with intracorporeal prostaglandin E 1 and to assess its effect on the pharmacological erection. Methods Twenty-two patients who had previously experienced pain with intracorporeal prostaglandin E 1 injections were submitted to a double-blind randomized crossover study to evaluate comparatively the effects of intracorporeal prostaglandin E 1 alone and in combination with lidocaine. The signed rank test was used for statistical analysis of the results. Results With prostaglandin E 1 monotherapy (20 μg) 86.3% of patients experienced pain and 27.2% had an adequate erection. With combination therapy (prostaglandin E 1 20 μg plus lidocaine 1% 1 cc) 45.4% of patients experienced pain and 57.8% of patients had improvement of pain compared with prostaglandin E 1 monotherapy. The adequate erectile response rate with combination therapy was 63.6%; in addition, 31.8% of patients noted enhancement in the duration of erection. The signed rank test was significant for the pain response ( P <0.01) and for the degree of erection ( P <0.01). The signed rank test was not, however, significant for the increase in duration of erection after combination therapy. No significant side effects were noted after either injection. Conclusions Lidocaine 1 % can be safely and usefully combined with intracorporeal prostaglandin E 1 in the treatment of erectile dysfunction with alleviation of pain and enhancement of erectile effect.