Intracavernous injection of vasoactive drugs, an alternative for treating impotence in spinal cord injury patients

Abstract

SummaryWe report on our results with the intracavernous injection and self-injection of papaverine-phentolamine in a group of spinal cord injury patients with erectile impotence. This technique offers the possibility of achieving a full erection which continues for a few hours and disappears afterwards. In our limited experience no major complications have occurred. If our findings are confirmed, in future, the self-injection technique may become a valuable alternative to implanting a prosthesis in impotent paraplegics and tetraplegics.

Diagnosis and Therapy of Erectile Dysfunction Using Papaverine and Phentolamine

“…Wyndaele et al [64] obtained similar results over a 6-month monitoring period. During a follow-up of 26 months (on average), 3 of 201 patients monitored by Padma-Nathan et al [78] developed papaverinerelated hepatotoxicity (elevated liver function tests).…”

“…From a therapeutic point of view, intracavemous injection of vasoactive agents offers an important alter native to conventional methods (prosthetic implants, revascularization surgery). Diabetic [6,66] and para plegic patients in particular [7,64], who previously had to rely on penile implants, will benefit most from this new method of treatment.…”

“…[85] 1987 76 USA Padma-Nathan et al [78] 1987 201 USA Robinette and Moffat [44] 1986 144 Canada Schramek [47] 1987 26 Austria Sidi and Chen [79] 1987 336 USA Speranza et al [49] 1986 40 Argentina Steffens et al [38] 1987 120 FRG Stiefel al. [97] 1987 186 FRG Trapp [71] 1987 700 USA Wetterauer et al [76] 1987 110 FRG Williams et al [80] 1987 125 UK Wyndaele et al [64] 1987 12 Belgium Zorgniotti [65] 1987 250 USA…”

Clinical value of combined electrophysiological and urodynamic recordings to assess sexual disorders in spinal cord injured men

“…Basic physiological knowledge of the neurogenic control of human male sexual function is mainly extrapolated from animal studies [De Groat and Booth, 1993] or based on the clinical observation of sexual disorders following a spinal cord lesion [Courtois et al, 1995]. Some of the diagnostic methods that have been suggested to assess sexual dysfunction (nocturnal penile tumescence recordings (NPTR) [Morales et al, 1990], intracavernous injections [Wyndaele et al, 1986], corpus cavernosum EMG [Wagner et al, 1989]) are not well standardised. Moreover, most of these tests examine only one component (vascular, psychogenic or neurogenic) of the complex erection phenomenon, whereas others, especially NPTR, are controversial regarding their diagnostic value [Fowler et al, 1988;Morales et al, 1990].…”

Sexual function in spinal cord lesioned men

“…20,69 ± 73,77, 78 Monga et al 31 write that the neurologic condition may enhance the release of erection-inducing neurotransmitters from the parasympathetic nervous system. Another reason for the good response in SCL men is because it generally is a younger population with a low prevalence of signi®cant vascular disease and other comorbidities.…”