Erectile Response of Penis to Intracavernous Injection of Prostaglandin E1 Associated with Audio-Visual Sexual Stimulation (AVSS) and Dynamic Infusion Cavernosometry (DIC)

Abstract

Penile erection is a neuromuscular evetn involiving relaxation of cavernous smooth muscle, arterial dilatation, restriction of venous autflow and is undoubtedly under enural control. Impotence is estimated to affect 10% of male population. The majority of erectile dysfunction have organic origin. Several diagnostic modalities have been used to eval uate impotence, however, none of the methods is wholly satisfactory. In this prospective study of 18 impotent patients, we evaluated their erectile dysfunction by audio-visual sexual stimulation (AVSS) and dynamic infusion cavernosometry (DIC) associated with intracavernous prostaglandin E1 (PEG1) test. Penile erection was induced by intracavernous injection of PEG1 20 ug. Ten minuts later, AVSS was accomplished by watching an erotic videotape for 30 minutes. Erectile response was simultaneously indicated by intracavernous pressure (ICP) monitoring and penile circumference measurement. DIC was expressed by an initiated flow rate (IFR) and a maintanence flow rate (MFR) to full erection (ICP ≧ 150 mmHg). There were 9 patients whose ICP-difference (△P) between ICP at 10 minutes after PEG1 injection and the resting ICP greater than 30mmHg, 6 patients (66.7%) were disclosed arteriogenic impotence. All of the patients responded to AVSS their biothesiometry were also normal. Besides, there were 6 patients their DIC showed IFR more than 150 ml/min and/or MFR more than 50 ml/min whose cavernosograms showed vernous leakage. From our preliminary data, we concluded that it might be a feasibly simple and reliable method to differentiate diagnosis of organic impotence. However, the long-term efficacy must be determined.