title: Intracavernous injections: still the gold standard for treatment of erectile dysfunction in elderly men.
abstract: The objective of this work was to determine the effectiveness of intracavernous injections (ICI) of vasoactive drugs in elderly men with erectile dysfunction and to compare the results obtained with the injection of two different drug combinations. It was a case control study. The sample consisted of 300 men, 63-85 y of age (mean 67.1) with erectile dysfunction of organic origin. Among the patients 180 underwent first trial with injection of prostaglandin E1 (PE). Further on these 180 patients and another 120 (in total 300 patients) were treated with a triple combination of papaverine hydrochlorate, phentolamine messylate and prostaglandin E1 (PPR). The number of responders to the injection of either PE alone or the drug combination was recorded. The quality of the erections was evaluated in the outpatient clinic by the medical staff and through patient's report after home trial. The average volume of either PE or PPR necessary to obtain a functional erection was measured. We observed a statistically significant association between the results obtained after the injection of PPR as compared to PE (chi2 with 2 d.f.: 34.666; P= < 0.001). A functional erection was obtained in 224/300 (74.7%) after the injection of PPR as compared to 87/180 men (48.3%) treated with PE. The average volume of PPR necessary to obtain a functional erection was 0.35+/-0.14 ml whereas that of PE was 1.3+/-0.3 ml. intracavernous injection of vasoactive drugs is still one of the most successful therapies for patients suffering from organic impotence. It is less effective in the older age group as compared to younger. However, if this form of therapy is chosen for aged men the triple combination therapy (PPR) yields a higher response rate than that obtained with prostaglandin alone.
authors.affiliation: Department of Urology, Sapir Medical Center, Kfar Sava, Sackler Faculty of Medicine, University of Tel Aviv, Israel. sanri@netvision.net.il
authors.forename: S
authors.initials: S
authors.lastname: Richter
authors.forename: Y
authors.initials: Y
authors.lastname: Vardi
authors.forename: A
authors.initials: A
authors.lastname: Ringel
authors.forename: M
authors.initials: M
authors.lastname: Shalev
authors.forename: I
authors.initials: I
authors.lastname: Nissenkorn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000527:Alprostadil / Q000008:administration & dosage* / Q000627:therapeutic use; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000627:therapeutic use*; D010410:Penile Erection / Q000187:drug effects; D010413:Penis; D010646:Phentolamine / Q000627:therapeutic use; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D004338:Drug Combinations; D014665:Vasodilator Agents; D010208:Papaverine; D000527:Alprostadil; D010646:Phentolamine