Repeated intracorporeal self-injection: effect on peak systolic velocity and cavernosal artery diameter

Abstract

This work is aimed at evaluating the effect of repeated intracavernosal injection (ICI) self-injection on the peak systolic velocity (PSV) and the diameter of cavernosal arteries. Sixty erectile dysfunction (ED) patients who were positive responders for ICI therapy were studied. Pharmacopenile duplex ultrasonography (PPDU) was carried out before starting ICI and after 10 doses of home therapy in an open-label uncontrolled study. There was significant increase in the cavernosal artery diameter and their PSV before and after injection. Cavernosal arteries diameter before injection in both right and left sides was 0.6470.13 and 0.6370.12 mm at the start and became 0.8170.22 and 0.7970.22 mm respectively at the end with significant differences (Po0.001). Cavernosal arteries diameter after injection in both right and left sides was 1.1070.18 and 1.0970.19 mm at the start and became 1.3470.39 and 1.2770.33 mm respectively at the end with significant differences (Po0.001). PSV at the start was 33.77713.26 and 32.3378.09 cm/s on both right and left sides and became 44.471.19 and 46.175.86 cm/s respectively at the end with significant differences (Po0.001). It is concluded that repeated ICI improves arterial erectile response with associated increase in PSV and cavernosal artery diameters.

Rehabilitation of the cavernous smooth muscle in patients with organic erectile dysfunction

“…(1991) evaluated 466 patients on ICI therapy, reporting that 37% were totally dependent, 49% were partially dependant and 14% were totally independent. Awad et al. (2007) investigated 60 ED cases on ICI, reporting return of spontaneous erection during sexual activity in 10% of cases.…”

“…Different articles explained such improvement by resolved psychogenic issues and/or performance anxiety, improved cavernous blood flow and haemodynamic response, improved cavernous oxygenation decreasing collagen deposition and fibrosis, angiogenesis and neovascularisation of the cavernous tissue, enhanced sleep‐associated erection including tumescence and hypertrophy of cavernous smooth muscle resulting in enhanced efficiency of cavernous physiology (Boolell et al. , 1996 ; Sharlip, 1997; Awad et al. , 2007; Mathers et al.…”

Why a combined intracavernosal injection with trimix and oral sildenafil is reliable therapy in the ultrasonographic evaluation of erectile dysfunction

“…However, the presence of a high state of anxiety can be involved in the failure to reach a complete erectile response during the pharmacological erection test using maximal and supra‐maximal doses of trimix or PGE1. As a rigid, good‐quality erection might not be achieved in all patients during the test, repeated injections, higher doses of the vasoactive medications, and the combination of the ICI with sexual stimulation and oral sildenafil have been used to overcome the problem and improve erectile quality [4,5,12,13].…”