Management Of Impotence Research Articles

Penile Function Following Intracavernosal Injection of Vasoactive Agents or Saline

Few studies on the pharmacological assessment or treatment of impotence have included controls. In a double-blind crossover study, 18 impotent men received either a 2 ml injection of a solution containing 30 mg papaverine and 1 mg phentolamine or a similar volume of normal saline into the corpus cavernosum. The immediate and delayed effects (4 weeks later) were assessed independently and the alternative injection then given. All injections with papaverine and phentolamine were followed by an immediate increase in penile length and rigidity, and 70% of these patients were able to have sexual intercourse for periods of 1 to 4 weeks. No change in penile length or rigidity occurred following the saline injection and only one patient showed some improvement in erection over the next 4 weeks. In the crossover study, no patient developed any increase in length or rigidity of the penis following injection of saline, and improvement in spontaneous erection occurred in only two cases. In contrast, all patients who received papaverine and phentolamine had an increase in penile length and rigidity, and 50% were able to have normal sexual intercourse over the next 4 weeks. This study confirms the value of a combination of vasoactive agents in the management of impotence, irrespective of its aetiology, and suggests that any placebo effect is minimal in this group of patients with considerable psychological overlay.

Clinical experience with vasoactive intracavernous pharmacotherapy for treatment of impotence

A total of 336 patients with organic impotence completed a testing protocol of penile vasoactive intracavernous pharmacotherapy (VIP) using papaverine hydrochloride (30 mg/ml) or a combination of papaverine (25 mg/ml) and phentolamine mesylate (0.83 mg/ml). Transient functional erections were achieved in 97.2% of patients with neurogenic impotence, 81.6% of those with vascular impotence, 90.7% of those with undetermined organic impotence, and 100% of patients with psychogenic and hormonal impotence. Of the responders, 273 elected to practice VIP as a method to restore erectile function and completed a training session on self- or partner-assisted injection. After an average follow-up of 9.2±6.7 months, 170 patients were still administering self-injections at home, 16 were lost to follow-up, and 87 discontinued the protocol. The average follow-up of patients actively practicing VIP was 11.6±6.5 months. Significant complications were few and included dizziness, sustained erections, and intracorporal hardening and fibrosis. Vasoactive intracavernous pharmacotherapy is a powerful tool in the management of impotence. Careful analysis of the risks and benefits and accurate definition of the long-term complications and their incidence are necessary to establish the role of VIP among other treatment options for impotence.

326 - Comparative Study Between Oral and Intrapenile Vasoactive Drugs in the Management of Impotence in Neurogically Impaired Patients

326 - Comparative Study Between Oral and Intrapenile Vasoactive Drugs in the Management of Impotence in Neurogically Impaired Patients

Recent Advances in the Diagnosis and Management of Impotence

No AccessJournal of Urology1 Apr 1987Recent Advances in the Diagnosis and Management of Impotence A.A. Sidi and P.H. Lange A.A. SidiA.A. Sidi More articles by this author and P.H. LangeP.H. Lange More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)44236-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Recent Advances in the Diagnosis and Management of Impotence." The Journal of Urology, 137(4), p. 812 © 1987 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 137Issue 4April 1987Page: 812 Advertisement Copyright & Permissions© 1987 by The American Urological Association Education and Research, Inc.MetricsAuthor Information A.A. Sidi More articles by this author P.H. Lange More articles by this author Expand All Advertisement PDF downloadLoading ...

Pharmacologic Erection Program for the Treatment of Male Impotence

Recent advances in the understanding of the physiology of the erection process have led to exciting new diagnostic and therapeutic techniques in the management of impotence. Intracavernous injection of pharmacologic agents can be used to both diagnose and treat certain types of impotence. At the Nashville Impotence Center we use intracavernous injections of papaverine-phentolamine to diagnose vascular impotence and to treat certain patients with organic impotence as well as some patients with psychologic impotence. One hundred thirty-six patients are currently enrolled in our self-injection treatment program. Complications and side effects have been rare.

Intracorporal injection of papaverine and phentolamine in the management of impotence.

Intracorporal injection of 0.5 ml papaverine (30 mg/ml) and phentolamine (2.5 mg/ml) was given to 144 patients presenting with various types of impotence. The high response rate (97%) precluded the use of this test to differentiate between types of impotence but provided patients with the choice of embarking on a self-injection programme. Of the 101 patients entering the programme 78 are continuing self-injection therapy with a mean follow-up of 6.5 months. The incidence of complications is low and patients are generally very satisfied with the treatment.

151 The Role of Intracavernosal Injection of Pharmaco-Active Substances in the Diagnosis and Management of Impotence

151 The Role of Intracavernosal Injection of Pharmaco-Active Substances in the Diagnosis and Management of Impotence

Diagnosis and Treatment of Erectile Disturbances: A Guide for Clinicians

ABSTRACT In the past decade, impotence has been recognized as a sequela of a multitude of disease processes. I edited a monograph entitled The Management of Male Impotence in 1982, which emphasized the newer theories of erectile dysfunction, the newer diagnostic methods, and the surgical management of impotent men.Segraves and Schoenberg, a psychiatrist and a urologist, respectively, have organized a text, Diagnosis and Treatment of Erectile Disturbances, which emphasizes in great detail the medical and psychologic aspects of erectile impotence. The internist and family practitioner will find this book useful as a tool to sort out organic from psychogenic causes of impotence.The chapter on pharmacologic agents has a thorough bibliography and ably updates information in previously published material. The endocrine section is extensive and research oriented but unfortunately includes tables and graphs that are difficult to read because of their size and complexity.In the past five years, the

Recent Advances in the Diagnosis and Management of Impotence

Recent experience with the implantation of the OmniPhase, FlexiFlate, and Hydroflex penile prostheses at our institution has shown all three to provide good axial rigidity and relatively good concealment, although the phallus tends to be much more expanded than normal with all three devices when they are in the nonfunctional position. Urologists who are familiar with penile implantation surgery will encounter no technical difficulties with the implantation of these new devices. Rather, long-term mechanical reliability will be the crucial factor that will cause implanting surgeons and their patients to shift from one prosthesis to another.

The Management of Impotence

SummaryThe term impotence is unhelpful. It has perjorative overtones and carries with it an implication of impotence or inadequacy in a broader sense. It is also an imprecise term, being used by some authors to describe ejaculatory difficulties as well as difficulties with erection. This paper concentrates on erectile dysfunction and its management

The Current Status of the Inflatable Penile Prosthesis in the Management of Impotence: Mayo Clinic Experience Updated

During the last 2 years the inflatable penile prosthesis has been implanted at the Mayo Clinic in 63 organically impotent male subjects. Over-all functional success is between 90 and 95 per cent. Experience indicates that 25 per cent of the patients require a second surgical procedure to correct a mechanical problem. Further experience with the technique and improvement in the product design have significantly decreased the number of mechanical problems encountered. Patient partner acceptance of this device continues to be excellent.

Nocturnal penile tumescence (NPT): The phenomenon and its role in the diagnosis of impotence

The diagnosis and management of impotence has been fraught with speculation, confusion of terminology, incomplete evaluations, and a lack of objective methods for assessment. Nocturnal penile tumescence (NPT), the regular occurrence of penile erections during sleep, represents a unique opportunity to study penile rigidity under objective conditions. Some normative data derived from 13 years of study of this phenomenon are presented along with a thorough description of the technique of NPT monitoring and resulting tracing. Further refinements of assessment techniques used in our lab are briefly described. The wide availabity of a new portable device, the NPT Monitor, makes the assessment of NPT the essential minimum in all cases of impotence. Procedures and pitfalls in the use of this instrument are delineated.

The causes and management of impotence

The causes and management of impotence