title: Intracavernous injection during diagnostic screening for erectile dysfunction; five-year experience with over 600 patients.
abstract: Psychophysiological diagnostic screening (PDS) was carried out on just over 1000 consecutive patients with erectile dysfunction (ED) during 1995 through 1999. Roughly one-third did not require an intracavernous injection (ICI) because of optimal penile response during visual and tactile penile sexual stimulation. The present article deals with those other patients (n = 609) who required an ICI and completed a 24-hour-postinvestigation questionnaire (PIQ). The two ICI preparations used, prostaglandin and papaverine + fentolamine, were virtually equally effective in the doses applied, with very low and similar percentages of unwanted side effects, for example, prolonged erection. Somatic ED patients displayed the lowest penile responses to ICI, whereas psychogenic ED patients had the highest penile responses. ED patients who also suffered from premature ejaculation (PE) ejaculated significantly more readily during PDS that those without PE. An ICI following an ejaculation/orgasm could lead to an erection presumably sufficient for intromission, which indicates ICI as a therapeutic option for rapid ejaculators. Our elaborate and lengthy PDS procedure, particularly the use of penile vibration as an addition to the visual sexual stimulation, obviates the diagnostic use of the PIQ.
authors.affiliation: Department of Clinical Psychology, University of Utrecht, Utrecht, The Netherlands. slob@endov.fgg.eur.nl
authors.forename: A K
authors.initials: AK
authors.lastname: Slob
authors.forename: A C M
authors.initials: AC
authors.lastname: Verhulst
authors.forename: L
authors.initials: L
authors.lastname: Gijs
authors.forename: P A
authors.initials: PA
authors.lastname: Maksimovic
authors.forename: J J
authors.initials: JJ
authors.lastname: van der Werff ten Bosch
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003687:Dehydroepiandrosterone / Q000008:administration & dosage / Q000627:therapeutic use*; D004333:Drug Administration Routes; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007267:Injections; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D000276:Adjuvants, Immunologic; D003687:Dehydroepiandrosterone