Prostaglandin E1 Versus Mixture of Prostaglandin E1, Papaverine and Phentolamine in Nonresponders to High Papaverine Plus Phentolamine Doses

Bechara, Amado; Casabé, A.; Chéliz, G.; Romano, Salomón Víctor; Fredotovich, N.

doi:10.1097/00005392-199603000-00032

Cited by 14 publications

(15 citation statements)

References 8 publications

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“…The latter finding is not consistent with the results of a prospective study performed by Bechara et al, 18 who showed that the three-drug mixture is more effective than high-dose PGE1 alone in achieving erections suitable for penetration. However, our satisfaction and compliance rates are similar to those of Mulhall et al 3 and Purvis et al 6 Using an institutional questionnaire, Mulhall et al found a good response in 75% of their patient group using PGE1, which included patients with ED of all etiologies.…”

Section: Discussioncontrasting

confidence: 79%

Long-term efficacy and compliance of intracorporeal (IC) injection for erectile dysfunction following radical prostatectomy: SHIM (IIEF-5) analysis

et al. 2003

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Baseline and follow-up data from 102 patients using intracorporeal (IC) injection for erectile dysfunction (ED) following RP were retrospectively collected. We compared baseline International Index for Erectile Function (IIEF) questionnaires with the abridged IIEF-5 questionnaires, referred to as the Sexual Health Inventory of Men (SHIM) to determine drug efficacy. The mean presurgery SHIM score was 21.75 7 5.23, which decreased to 4.23 7 3.48 after surgery and increased to 19.46 7 8.78 post-treatment. Overall, 68% (69/102) of patients achieved and maintained erections sufficient for sexual intercourse and 48% (49/102) of patients continued long-term therapy with a mean use of 3.7 7 1.9 y. In all, 52% (53/102) patients discontinued IC therapy. However when excluding patients who switched to oral therapy, had loss of partner or return of normal erections; the compliance to IC injections was 70.6% (71/102). There was no difference in the SHIM analysis between the nerve sparing (NS) and the non-NS or between the types of medications used. IC injections can provide excellent long-term efficacy and compliance in up to 70% of the patients. This study suggests that IC injections are an excellent salvage option in NS patients who fail oral therapy and a first option in patients with non-NS procedures.

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Section: Discussioncontrasting

confidence: 79%

Long-term efficacy and compliance of intracorporeal (IC) injection for erectile dysfunction following radical prostatectomy: SHIM (IIEF-5) analysis

et al. 2003

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“…6 In nonresponders to doses as high as 40 mg PGE 1 , Tx combination produced a response in 31%. 16 The cost of the medication is another important issue where Tx has an advantage ( Table 2). In men on ICI therapy, the total dropout rate was 31% and 28.3% dropped out because the therapy was too expensive.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized study to optimize the dosage of trimix ingredients and compare its efficacy and safety with prostaglandin E1

et al. 2005

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Intracavernous injection of Trimix (Tx) is indicated for patients unsuitable for prostaglandin E 1 (PgE 1 ) injection due to lack of response, pain or cost. We believe that the ideal ratio of ingredient doses in Tx is yet to be found. We postulated that increasing the doses of individual drug components in an orderly manner would convey important data on penile hemodynamic response. Such information is needed to choose an effective and less costly alternative to PgE 1 with least side effects. We set out to evaluate the impact of varying the ingredient dosage on response and shortterm safety of Tx compared with PgE 1 . We prospectively randomized 180 consecutive patients with erectile dysfunction into nine equal groups and each group received a different dose of Tx, namely phentolamine (1 mg) plus one dose of PgE 1 (2.5, 5 or 10 lg) and one dose of papaverine (5, 10 or 20 mg). Each patient was injected with 20 lg PgE 1 and one dose of Tx in two clinic visits 1 week apart. Following injection, duplex ultrasound of cavernous arteries and axial rigidometry were carried out. Patients ranked the quality of erection, estimated overall satisfaction and reported time to detumescence and side effects. Patients' mean age was 50.5711.7 y with underlying organic condition in 91.1%. There were no significant differences between PgE 1 and Tx with regard to peak cavernous artery flow, time to erection, patients' satisfaction, average axial rigidity and pain. PgE 1 produced higher end diastolic velocity, shorter duration of erection and less priapism. Patients did not show a preference for either drug or any particular dosage. We conclude that even at the smallest dose of ingredients of Tx, there are no significant differences in hemodynamic effects, rigidity, pain and self-satisfaction between the two drugs. However, Tx produces a longer duration of erection and more priapism than PgE 1 .

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“…The majority of published reports in this area concern the evaluation of specific diagnostic and therapeutic strategies. [1][2][3][4][5][6] Indeed, the field has advanced significantly in recent years with the advent of intracavernosal injection [7][8][9][10] and intraurethral therapy. 11 As health care increasingly moves to the primary care setting, generalists must be more attuned to the pathophysiology, treatments, and psychosocial impacts of erectile dysfunction in their patients.…”

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confidence: 99%

Health-related quality of life in men with erectile dysfunction

1998

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OBJECTIVE:To assess health-related quality of life (HRQOL) in men with erectile dysfunction. DESIGN:Descriptive survey with general and disease-specific measures. The instrument contained three established, validated HRQOL measures, a validated comorbidity checklist, and sociodemographics. The RAND 36-Item Health Survey 1.0 (SF-36) was used to assess general HRQOL. Sexual function and sexual bother were assessed using the UCLA Prostate Cancer Index. The marital interaction scale from the Cancer Rehabilitation Evaluation System Short Form (CARES-SF) was used to assess each patient's relationship with his sexual partner. SETTING:Urology clinics at a university medical center and the affiliated Veterans Affairs (VA) Medical Center. PARTICIPANTS:Thirty-five (67%) of 54 consecutive university patients presenting for erectile dysfunction and 22 (42%) of 52 VA patients who were awaiting a previously prescribed vacuum erection device participated. MAIN RESULTS:The university respondents scored slightly lower than population normals in social function, role limitations due to emotional problems, and emotional well-being. The VA respondents scored lower than expected in all eight domains. Scores for the VA population were significantly lower than those for the university population in physical function, role limitations due to physical problems, bodily pain, and social function. A significant correlation was seen between marital interaction and sexual function ( r ‫؍‬ ؊ .33, p ‫؍‬ .01) but not between marital interaction and sexual bother ( r ‫؍‬ ؊ .15, p ‫؍‬ .26) in the total sample. Sexual function also correlated significantly with general health perceptions ( r ‫؍‬ .34, p ‫؍‬ .01), role limitations due to physical problems ( r ‫؍‬ .29, p ‫؍‬ .03), and role limitations due to emotional problems ( r ‫؍‬ .30, p ‫؍‬ .03). Sexual bother did not correlate with any of the general HRQOL domains. Affluent men reported better sexual function ( p ‫؍‬ .03). CONCLUSIONS:The emotional domains of the SF-36 are associated with more profound impairment than are the physical domains in men with erectile dysfunction. Erectile dysfunction and the bother it causes are discrete domains of HRQOL and distinct from each other in these patients. With increased attention to patient-centered medical outcomes, greater emphasis has been placed on such variables as HRQOL. This should be particularly true for a patient-driven symptom, such as erectile dysfunction.KEY WORDS: erectile dysfunction; impotence; health-related quality of life; medical outcomes. J GEN INTERN MED 1998;13:159-166.

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Prostaglandin E1 Versus Mixture of Prostaglandin E1, Papaverine and Phentolamine in Nonresponders to High Papaverine Plus Phentolamine Doses

Abstract: The 3-drug mixture may be regarded as more effective than prostaglandin E1 alone in inducing an erectile response with a decreased incidence of pain.

Cited by 14 publications

References 8 publications

Long-term efficacy and compliance of intracorporeal (IC) injection for erectile dysfunction following radical prostatectomy: SHIM (IIEF-5) analysis

Long-term efficacy and compliance of intracorporeal (IC) injection for erectile dysfunction following radical prostatectomy: SHIM (IIEF-5) analysis

A prospective randomized study to optimize the dosage of trimix ingredients and compare its efficacy and safety with prostaglandin E1

Health-related quality of life in men with erectile dysfunction

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