Treatment Of Erectile Impotence Research Articles

Experience with the vacuum‐enhanced tumescence ErecAid system in the treatment of erectile impotence among diabetic patients in Saudi Arabia

AbstractTwenty diabetic patients (16 NIDDM, 4 IDDM) were managed for erectile impotence using a non‐surgical device‐the vacuum erection device (VED). Their ages ranged from 27 to 71 years with a mean of 50.4 and diabetes duration ranged from 6 to 21 years with a mean of 11.5 years. Duration of impotence ranged from one to 10 years with a mean of 3.3 years and the aetiology was neurogenic and/or psychogenic. One to 14 months after prescribing the device, (mean 3.7 months), four patients rated the system poorly while 16 expressed satisfaction with it. Faulty technique in use of the device was successfully corrected in two of the four and, overall, 18 patients (90%) expressed satisfaction with the VED, scoring it an average 7.7 out of 10 in its ability to correct impotence. Four spouses (20%) had sexual dissatisfaction, six patients (30%) had transient penile discomfort and there was impaired ejaculation in four patients (20%). The VED was effective and safe in managing erectile impotence of neurogenic or psychogenic orgin in Saudi diabetic patients. It was relatively easy to use and culturally acceptable. It could be particularly useful for treating erectile failure among diabetic patients in developing countries.

Treatment of Priapism by Injection of Adrenaline Into the Corpora Cavernosa Penis

Intracavernous papaverine injection has gained widespread acceptance in the treatment of erectile impotence. The opposite problem--priapism--can be treated with the same technique using a vasoconstrictive drug such as adrenaline. We report on eight patients successfully treated for priapism by intracavernous injection of adrenaline.

Safety of Intracavernous Injections using an Alpha-Blocking Agent

We tested the possibility of using intracavernous injections of the α-blocking agent moxisylyte (6-acetoxy-thymoxy-ethyl-dimethylamine) as treatment of erectile impotence. Laboratory studies proved moxisylyte to be more active than saline (double-blind with crossover) but less active than papaverine (crossover), since it induced prolonged erection in most patients but rigid erection in only a few. However, penile vibration proved to enhance the moxisylyte effects, the combination resulting in rigid erection in 5 of 8 patients tested. Repeated office injections of moxisylyte in 70 patients resulted in clear improvement of impotence during the subsequent weeks in 50 per cent of the psychogenic, and 18 per cent of the organic and mixed impotent patients. Of 91 impotent patients 42 achieved satisfactory intercourse within 2 hours after an office injection, although previously the same dose induced a rigid erection in the office in only 24. Of 37 patients instructed in moxisylyte self-injections 92 per cent achieved successful results without any significant side effect.The main advantage of moxisylyte proved to be its safety, allowing for less compelling precautions than with papaverine: only 2 of the 170 patients injected with moxisylyte at our clinic had prolonged erections, that is 1.1 per cent compared to 14 per cent in a personal series who received papaverine. In regard to the therapeutic applications of intracavernous injection facilitating drugs, such as moxisylyte, should be tried first, with use of the more potent but also more dangerous drugs, such as papaverine, only when impotence fails to improve.

Experience of intracavernous silicone prosthesis implantation for erectile impotence

At present time surgical treatment of erectile impotence is gaining more and more supporters.
 40 surgical aids for persistent erectile dysfunction were performed at the urological department of the Republican Clinical Hospital of the TASSR Ministry of Health Care in 1985-1987. Prostheses were implanted in both cavernous bodies in 30 patients and in one body in 10 patients. The indications for surgical treatment were complete absence of adequate and spontaneous erections during three years of unsuccessful treatment by a sexopathologist, absence of auditory and visual stimulation, partial regression of libido.

Erectile impotence and its management

AbstractThe use of pharmacologically‐induced penile erections is a most promising mode of diagnosis and treatment of erectile impotence. A combination of papaverine and phentolamine is injected into the corpora cavernosa and the resultant erection usually lasts 2‐4 hours. Insertion of penile prosthesis is expensive with a significant number of complications; whilst penile arterial revascularisation needs to be used very selectively for even moderately successful results to be achieved. Self‐injection of the drugs can be taught and this technique appears to be an extremely safe and useful form of treatment for the majority of men with erectile impotence.

Preliminary Report of a New Concept in the Pharmacological Treatment of Erectile Impotence Using an Implantable Drug Delivery System

Summary— A new approach in the treatment of erectile impotence by means of pharmacologically induced erections using a totally implantable drug delivery system is described. This method allows administration of the appropriate drug at a site remote from the penis, thereby overcoming the pain and discomfort associated with direct intrapenile injection.

827 - Effectiveness of Yohimbine in the Treatment of Erectile Impotence - Retrospective Analysis

827 - Effectiveness of Yohimbine in the Treatment of Erectile Impotence - Retrospective Analysis

Intracavernous self-injection of papaverine in the treatment of erectile impotence after major pelvic surgery.

Intracavernous self-injection of papaverine in the treatment of erectile impotence after major pelvic surgery.

Preliminary results of the treatment of erectile impotence by intracavernous self administration of vasoactive substances

From a group of 120 patients with erectile deficiency, 43 cases with arterial disorders with or without associated nervous, psychologic or venous causes were selected for treatment. Mean age of group was 44.5 years. A preliminary series of test was performed during hospital stay, consisting of injection of phentolamine and papaverine into corpus cavernosum. This allowed determination of the minimal effective dose for maintaining erection, and 41 patients accepted to continue treatment at home by auto-injection of products. Regular review showed that all had erections, considered to be complete in 95%. The initially determined dose was usually reduced, probably due to sexual stimulation. The erections appeared earlier (8 min) and lasted longer (140 min), ejaculation provoking only minimal detumescence. Patients responding poorly had venous losses. During initial tests, 2 patients had abnormally prolonged erections requiring puncture of corpus cavernosum. Incidents or habit-forming did not develop and patients and partners did not present psychological problems.

Implantation of Small-Carrion prosthesis in the treatment of erectile impotence after priapism: difficulties and effects.

The implantation of the Small-Carrion prosthesis through an infrapubic incision enables the patients with postpriapic impotence to full sexual activities. The fibrosis of the corpus cavernosum penis makes the implantation very difficult.

Single Implants in the Treatment of Erectile Impotence

A total of 12 patients with erectile impotence underwent implantation of a Finney flexirod penile prosthesis in 1 corpus cavernosum only. This procedure has a special advantage in developing countries since the cost of the operation is reduced by approximately 50 per cent. The penis is less rigid and longer, and in case of failure the other corpus cavernosum is readily available. This procedure is the method of choice in cases of psychogenic impotence since there is a considerable amount of super erection present in all of the cases.

Diagnosis and Treatment of Erectile Impotence

Solid scientific information on the psychophysiological mechanisms of human erection and impotence is meager, so the clinician has little but clinical experience and largely anecdotal literature to guide his diagnostic investigations and treatment decision. Several recent advances have eliminated some of the problems associated with diagnosis and treatment. Laboratory monitoring of nocturnal penile tumescence adds objectivity to the diagnostic process, and surgical implantation of an inflatable penile prosthesis is appropriate for certain carefully selected patients.

Treatment of erectile impotence using a nocturnal penile tumescence conditioning procedure

Nocturnal penile episodes typically occur every 90–100 minutes during sleep in healthy male adults and last an average of 20–40 minutes. The treatment of a case of male erectile impotence using a conditioning procedure based on these nocturnal penile episodes is described. It is suggested that this procedure be used in those cases of erectile failure where the standard treatment components fail to generate an erectile response.

Surgical treatment of erectile impotence using the inflatable penile prosthesis

The inflatable penile prosthesis provides a safe and effective means of surgically correcting male erectile impotence. This totally implanted, hydraulically operated device provides a means whereby a nearly normal penile erection can be attained when desired, with a flaccid penis at all other times. At the Mayo Clinic, the device has been implanted in 240 male patients who had erectile impotence. Patient selection depends on findings on a complete history, physical examination, routine laboratory studies, psychologic testing employing MMPI, and psychologic evaluation and consultation. Patient with either organic or psychogenic impotence are suitable candidates for penile implantation, the selection being based on specific criteria. The overall success rate with this prosthetic device has been 95%. Infection is the major pathologic complication, occurring in 3.7% and requiring removal of the device. Mechanical complications occur in approximately 5.5% of patients. All mechanical complications are correctable, but they usually require secondary surgical procedures. This experience indicates that the inflatable penile prosthesis is an excellent means of correcting male erectile impotence and reliably achieves the patient's preoperative expectations.

Editorial: Treatment of erectile impotence.

Editorial: Treatment of erectile impotence.