Inzidenz und Bedeutung prolongierter Erektionen bei der intrakavernösen Anwendung von Papaverin und Phentolamin in der Praxis

Abstract

ZusammenfassungBei 26 von 270 Patienten traten im Rahmen von Diagnostik und Therapie der erektilen Dysfunktion bei der intrakavernösen Anwendung einer Papaverin-Phentolamin-Kombination 36 prolongierte Erektionen auf. Nur eine prolongierte Erektion wurde während der Therapie, 35 während der Diagnostik und Einstellung beobachtet. Die Behandlung der prolongierten Erektionen erfolgte mittels intrakavernöser Injektion von Metaraminol (2 mg) und ggfs. der Aspiration von Blut. Klinisch relevante Schädigungen des kavernösen Schwellkörpergewebes waren in keinem Fall nachweisbar. Incidence and Meaning of Prolonged Erections Using Intracavernously Applied Papaverine and Phentolamine in Urological PracticeIn 26 of 270 patients we saw 36 prolonged erections after intracavernous application of a combination containing papaverine (15mg/ml) and phentolamine (0,5mg/ml). Only one prolonged erection occurred during pharmacotherapy, whereas 35 prolonged erections have been during diagnosis and dose adjustment. Prolonged erections were treated with intracavernous injection of metaraminol and, if necessary, aspiration of intracavernous blood.

Intrakavernöse Phenylephrininjektion bei pharmakologisch induzierter prolongierter Erektion

“…Es handelt sich dabei ü berwiegend um ein Ereignis der diagnostischen Phase (10 %) und es wird seltener in der Dauerbehandlung (3 %) darü ber berichtet [15].…”

How Safe Is the Treatment of Impotence with Intracavernous Autoinjection?

“…If remedial action is taken within this time span, e.g. injec tion of an a-mimetic drug, this generally suffices to resolve the erection promptly [38]. An alternative mea sure, or one which can be used concomitantly with the a-mimetic, is the puncture and insertion of a butterfly cannula into the corpus cavemosum [17].…”

“…An alternative mea sure, or one which can be used concomitantly with the a-mimetic, is the puncture and insertion of a butterfly cannula into the corpus cavemosum [17]. This remedial action has been successfully tried on over 150 patients [16,22,38], The incident described by Hashmat and Abraham [7], in which the injection of papaverine pro duced life-threatening pulmonary embolism following prolonged erection with infection, clearly indicates that measures must be taken in time to prevent endangering the patient's life. However, we do not recommend inject ing an a-mimetic as an antidote into the semiflaccid penis (after puncture or partial spontaneous detumes cence).…”

“…Tests against placebo revealed the fact that both single agents (papaverine and phentolamine) can cause an increase in tumescence and/or rigidity of the penis when injected intracavemously [3,43], In vitro tests using human cavernous body tissue [6,21,23] and a clinical study [44] demonstrated the additive effect of papaverine and phentolamine. Numerous reports and [39] 270 low dosages. Although no permanent damage was ob served with very prolonged erections [39], erection should cease within 6 h so as to prevent hypoxia in the corpus cavemosum with all the sequelae this entails.…”

“…Numerous reports and [39] 270 low dosages. Although no permanent damage was ob served with very prolonged erections [39], erection should cease within 6 h so as to prevent hypoxia in the corpus cavemosum with all the sequelae this entails. If remedial action is taken within this time span, e.g.…”