Intracavernous Sodium Nitroprusside (SNP) Versus Papaverine/Phentolamine in Erectile Dysfunction: A Comparative Study of Short‐Term Efficacy and Side‐Effects

Abstract

We read the article by Shamloul et al. with interest [ 1 Shamloul R. Atteya A. Elnashaar A. Gadallah A. Zohdy W. Abdelselam W. Intracavernous sodium nitroprusside (SNP) versus papaverine/phentolamine in erectile dysfunction: A comparative study of short‐term efficacy and side effects. J Sex Med. 2005; 2: 117-120 Crossref PubMed Scopus (13) Google Scholar ]. In this article the authors claimed that sodium nitroprusside (SNP) was potentially an effective and safe intracavernous agent. We previously performed a study in 32 patients with erectile dysfunction in which the effectiveness of SNP (360 µg) and papaverine (60 mg) was evaluated by erectile response and color Doppler ultrasonography. We observed that SNP did not have an erectile response similar to papaverine, and it did have a hypotensive side‐effect [ 2 Tarhan F. Kuyumcuoðlu U. Kolsuz A. Özgül A. Cangüven Ö. Effect of intracavernosal sodium nitroprusside in impotence. Urol Int. 1996; 56: 211-214 Crossref PubMed Scopus (9) Google Scholar ]. In addition, Martinez‐Pinerio et al. found that the higher dose of SNP (600 µg) was less effective than prostaglandin E1 and had a hypotensive effect in 7% of subjects [ 3 Martinez‐Pineiro L. Cortes R. Cuervo E. Lopez‐Tello J. Cisneros J. Martinez‐Pineiro J.A. Prospective comparative study with intracavernous sodium nitroprusside and prostaglandin E1 in patients with erectile dysfunction. Eur Urol. 1998; 34: 350-354 Crossref PubMed Scopus (15) Google Scholar ].