Clinical reliability of multi-drug intracavernous vasoactive pharmacotherapy for diabetic impotence.
The aim of this study was to assess the effectiveness and safety of intracavernous injections of a four-drug vasoactive mixture in diabetic patients with organic impotence. A group of 60 diabetic patients with either pure neurogenic, pure vasculogenic or mixed neurovasculogenic impotence were treated with intracavernous injections of a combination of 12.1 mg/ml papaverine hydrochloride, 1.01 mg/ml phentolamine mesylate, 10.1 micrograms/ml prostaglandin E1 and 0.15 mg/ml atropine sulphate ('full-dose' mixture). A mixture of the same drugs but at one-third concentrations ('reduced-dose' mixture) was also used. The mean (+/- SEM) volumes of the full-dose and reduced-dose mixtures used were 0.21 +/- 0.03 ml and 0.31 +/- 0.02 ml, respectively. All the patients were able to sustain a rigid erection at the end of the titration phase of the study. At a mean follow-up of 18 months, 48 patients (80%) were successfully using the mixture, 6 patients (10%) were using the mixture at a dose lower than the initial dose and 6 patients (10%) had dropped out from the injection therapy. No major complications were seen. The association of multiple vasoactive drugs which use different mechanisms of action, thus exerting a pharmacological synergism, is an effective and safe procedure in intracavernous pharmacotherapy for diabetic patients with organic impotence.
Montorsi
F
F
Institute of Human Anatomy, Scientific Institute H. San Raffaele, Milan, Italy.
Guazzoni
G
G
Bergamaschi
F
F
Zucconi
M
M
Rigatti
P
P
Pizzini
G
G
Miani
A
A
Pozza
G
G
D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage / Q000627:therapeutic use*; D001285:Atropine / Q000008:administration & dosage / Q000627:therapeutic use*; D048909:Diabetes Complications; D004338:Drug Combinations; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000008:administration & dosage / Q000627:therapeutic use*; D010410:Penile Erection / Q000187:drug effects*; D010646:Phentolamine / Q000008:administration & dosage / Q000627:therapeutic use*; D012646:Self Administration; D016896:Treatment Outcome
D004338:Drug Combinations; D001285:Atropine; D010208:Papaverine; D000527:Alprostadil; D010646:Phentolamine