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Intracavernosal Injection of Vasoactive Agents

  • Chapter
Male Sexual Function

Part of the book series: Current Clinical Urology ((CCU))

Abstract

The National Institutes of Health consensus statement on impotence estimates that the number of men with erectile dysfunction in the United States is approx 20 million, presenting with varying degrees of erectile dysfunction. Although significant improvements in the pathophysiology have resulted in newer treatment modalities for the management of erectile dysfunction, intracavernosal vasoactive pharmacotherapy has been successfully utilized as a second-tier modality. These methods, the use of injection pharmacotherapy, account for approx 40% of all treatment options for the management of male sexual dysfunction. Tremendous progress in the use of monotherapy, and subsequent bimix, in conjunction with triple injection therapy, has resulted in improved modalities of treatment satisfaction.

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References

  1. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.

    Google Scholar 

  2. Feldman HA, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    PubMed  CAS  Google Scholar 

  3. Porst H. Current perspectives on intracavernosal pharmacotherapy for erectile dysfunction. Int J Impot Res 2000; 12: S91–S100.

    Article  PubMed  Google Scholar 

  4. Roy JB, et al. A clinical trial of intracavernous vasoactive intestinal peptide to induce penile erection. J Urol 1990; 143: 302–304.

    PubMed  CAS  Google Scholar 

  5. Virag R. Intracavernous injection of papaverine for erectile failure. Lancet 1982; 2: 938.

    Article  PubMed  CAS  Google Scholar 

  6. Brindley GS. Cavernosal alpha-blockade: a new treatment for investigating and treating erectile impotence. Br J Psychiatry 1983; 143: 332–337.

    Article  PubMed  CAS  Google Scholar 

  7. Zorgniotti AW, et al. Auto-injection of the corpus cavernosum with a vasoactive drug combination for vasculogenic impotence. J Urol 1985; 133: 39–41.

    PubMed  CAS  Google Scholar 

  8. Zentgraf M, et al. Diagnosis and therapy of erectile dysfunction using papaverine and phentolamine. Urol Int 1988; 43: 65–75.

    Article  PubMed  CAS  Google Scholar 

  9. Adaikan PG, et al. A possible role for prostaglandin E1 in human penile erection. In: Abstract Book Second World Meeting on Impotence, Prague Abstr 2.6, 1986.

    Google Scholar 

  10. Ishii N, et al. Therapeutic trial with prostaglandin E1 for organic impotence In: Abstract Book Second World Meeting on Impotence, Prague Abstr 11.2, 1986.

    Google Scholar 

  11. Porst H. Comparative usefulness of prostaglandin E1, papaverine and papaverine/phentolamine for the diagnosis of erectile dysfunction in 61 patients. Urology 1988; 27: 22–26.

    CAS  Google Scholar 

  12. Stackl W, et al. Intracavernous injection of prostaglandin E1 in impotent men. J Urol 1988; 140: 66–68.

    PubMed  CAS  Google Scholar 

  13. Hamid S, et al. Combination intracavernous pharmacotherapy in the management of male erectile dysfunction. Int J Impot Res 1992; 4: 109–112.

    Google Scholar 

  14. Buvat J, et al. Safety of intracavernous injections using an alpha-blocking agent. J Urol 1989; 141: 1364–1367.

    PubMed  CAS  Google Scholar 

  15. Earle CM, et al. Prostaglandin E1 therapy for impotence: comparison with papaverine. J Urol 1990; 143: 57–59.

    PubMed  CAS  Google Scholar 

  16. Truss MC, et al. Erfhrungen mit dem stickoxid-donor linsidomine (SIN-1) in diagnostik und therapie der erektilen dysfucntion. Akt Urol 1995; 26: 181–184.

    Google Scholar 

  17. Wegner HE, et al. Effect of nitric oxide-donor linsidomine chlorohydrate in treatment of human erectile dysfunction caused by venous leakage. Urology 1993; 42: 409–411.

    Article  PubMed  CAS  Google Scholar 

  18. Wagner G, et al. Intracavernosal injection of vasoactive intestinal polypeptide (VIP) does not induce erection in man per se. World J Urol 1987; 5: 171–177.

    Article  Google Scholar 

  19. Stief CG, et al. Calcitonin gene related peptide: a possible role in human penile erection and its therapeutic application in impotent patients. J Urol 1991; 146: 1010–1014.

    PubMed  CAS  Google Scholar 

  20. Brock G, et al. Intracavernous sodium nitroprusside: inappropriate impotence treatment. J Urol 1993; 150: 864–867.

    PubMed  CAS  Google Scholar 

  21. Gerstenberg TC, et al. Intracavernous self-injection with vasoactive intestinal polypeptide and phentolamine in the management of erectile failure. J Urol 1992; 147: 1277–1279.

    PubMed  CAS  Google Scholar 

  22. Traish AM, et al. G-protein-coupled receptor agonists augment adenylyl cyclase activity induced by forskolin in human corpus cavernosum smooth muscle cells. Receptors Signal Transduction 1997; 7: 123,124.

    Google Scholar 

  23. Roy AC, et al. Prostaglandin 15-hydroxydehydrognease activity in human penile corpora cavernosa and its significance in prostaglandin mediated penile erection. Br J Urol 1989; 64: 180–182.

    Article  PubMed  CAS  Google Scholar 

  24. Cawello W, et al. Pharmacokinetics of prostaglandin E1 and its main metabolites after intracavernous injection and short-term infusion of prostaglandin E1 inpatients with erectile dysfunction. J Urol 1997; 158: 1403–1407.

    Article  PubMed  CAS  Google Scholar 

  25. Buvat J, et al. Double-blind multicenter study comparing alprostadil alpha-cyclodextrin with moxisylyte chlorohydrate in chronic organic erectile dysfunction. J Urol 1998; 159: 116–119.

    Article  PubMed  CAS  Google Scholar 

  26. Linet OI, et al. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. N Engl J Med 1996; 334: 873–877.

    Article  PubMed  CAS  Google Scholar 

  27. Linet OI, et al. Penile fibrosis during 18 months of intracavernosal therapy with Alprostadil (Caverject™ Upjohn-Pharmacia). Int J Impot Res 1996; 8: D85.

    Google Scholar 

  28. Linet OJ. Long-term safety of Caverject™ (Upjohn-Pharmacia) (Alprostadil S.PO, PGE1) in erectile dysfunction. Int J Impot Res 1998; 10: S37.

    Article  Google Scholar 

  29. Porst H, et al. Intracavernous alprostadil alfadex-an effective and well tolerated treatment for erectile dysfunction. Results of a long-term European study. Int J Impot Res 1998; 10: 225–231.

    Article  PubMed  CAS  Google Scholar 

  30. Sato Y, et al. Effect of neurotropin for penile pain induced by intracavernous injection of prostgladin E1. Int J Impot Res 1996; 8: 139 [abstract D67].

    Google Scholar 

  31. Nehra A. Intracavernosal therapy: when oral agents fail. Curr Urol Reports 2001; 2: 468–472.

    Article  CAS  Google Scholar 

  32. Chew KK, et al. Penile fibrosis in intracavernosal PGE1 therapy for erectile dysfunction. Int J Impot Res 1997; 9: 225–229.

    Article  PubMed  CAS  Google Scholar 

  33. Earle CM, et al. Pain with intracavernosal therapy. Int J Impot Res 1996; 8: 114 [abstract A62].

    Google Scholar 

  34. Montague D, et al. Sexual Function/Infertility, Chapter 1: The Management of Erectile Dysfunction: An AUA Update, J Urol 2005; 74: 230–239.

    Article  Google Scholar 

  35. Porst H. Review article. The rational for prostaglandin E1 in erectile failure a survey of world-wide experience. J Urol 1996; 155: 802–815.

    Article  PubMed  CAS  Google Scholar 

  36. Wijtes WPJ, et al. The efficacy and acceptance of intracavernous auto-injection therapy with the combination of papaverine/phentolamine. A prospective multicenter trial in 60 patients. Int J Impot Res 1992; 4: 65–72.

    Google Scholar 

  37. Girdley FM, et al. Intracavernous self-injection for impotence: a long-term therapeutic option? Experience in 78 patients. J Urol 1988; 140: 972–974.

    PubMed  CAS  Google Scholar 

  38. Lakin MM, et al. Intracavernous injection therapy: analysis of results and complications. J Urol 1990; 143: 1138–1141.

    PubMed  CAS  Google Scholar 

  39. Levine SB, et al. Side effects of self-administration of intracavernous papaverine and phentolamine for the treatment of impotence. J Urol 1989; 141: 54–57.

    PubMed  CAS  Google Scholar 

  40. Juenemann KP, et al. Pharmacotherapy of erectile dysfunction: a review. Int J Impot Res 1989; 1: 71–93.

    Google Scholar 

  41. Bennett AH, et al. An improved vasoactive drug combination for pharmacological erection program. J Urol 1991; 146: 1564,1565.

    PubMed  CAS  Google Scholar 

  42. Goldstein I, et al. Rescuing the failed papaverine/phentolamine erection: a proposed synergistic action of papaverine, phentolamine and prostaglandin E1. J Urol 1990; 143: 304A.

    Google Scholar 

  43. Derouet H, et al. Die Behandlung von SKAT-Non-Responderin mit einme Papverine/ PhentolaminProstaglandin E1-Gemisch. Akt Urol 1996; 27: 271–274.

    Google Scholar 

  44. Soli M, et al. Vasoactive cocktails for erectile dysfunction: chemical stability of PGE1, papaverine and phentolamine. J Urol 1998; 160: 551–555.

    Article  PubMed  CAS  Google Scholar 

  45. Sandhu D, et al. A double blind, placebo-controlled study of intracavernosal vasoactive intestinal polypeptide and phentolamine mesylate in a novel autoinjector for the treatment of non-psychogenic erectile dysfunction. Int J Impot Res 1999; 11: 91–97.

    Article  PubMed  CAS  Google Scholar 

  46. Stief CG, et al. Preliminary report on the effect of nitric oxide donor SIN-1 on human cavernous tissue in vivo. World J Urol 1991; 9: 237–240.

    Article  Google Scholar 

  47. Porst H. Prostaglandin E1 and the nitric oxide donor linsidomine for erectile failure: a diagnostic comparative study of 40 patients. J Urol 1993; 149: 1280–1283.

    PubMed  CAS  Google Scholar 

  48. Martinez-Pineiro L, et al. Preliminary results of a comparative study with intracavernous sodium nitroprusside and prostaglandin E1 in patients with erectile dysfunction. J Urol 1995; 153: 1487–1490.

    Article  PubMed  CAS  Google Scholar 

  49. Mulhall JP, et al. Intracavernosal forskolin: role in management to vasculogenic impotence resistant to standard 3-agent pharmacotherapy. J Urol 1997; 158: 1752–1758.

    Article  PubMed  CAS  Google Scholar 

  50. Buvat J, et al. Reduced rate of fibrotic nodules in the cavernous bodies following auto-intracavernous injection of moxisylyte compared with papaverine. Int J Impot Res 1991; 3: 123–128.

    Google Scholar 

  51. Costa P, et al. Efficiency and side effects of intracavernous injections of moxisylyte in impotent patients: a dose finding study versus placebo. J Urol 1993; 149: 301–305.

    PubMed  CAS  Google Scholar 

  52. Djamilian M, et al. Follow-up results of a combination of calcitonin gene-related peptide and prostaglandin E1 in the treatment of erectile dysfunction. J Urol 1993; 149(Pt 2): 1296–1298.

    PubMed  CAS  Google Scholar 

  53. Schwarzer UJ, et al. Calcitonin-gene-related-peptide for therapy of erectile importance. Int J Impot Res 1992; 4: 219–222.

    Google Scholar 

  54. Limoge JP, et al. Minimally invasive therapies in the treatment of erectile dysfunction in anticoagulated cases: a study of satisfaction and safety. J Urol 1996; 155: 1277–1279.

    Article  Google Scholar 

  55. Mansi MF, et al. Treatment of erectile dysfunction after kidney transplantation with intracavernosal self-injection of prostaglandin E1. J Urol 1998; 159: 1927–1930.

    Article  PubMed  CAS  Google Scholar 

  56. Plekhanov AY, et al. Comparative complication rates after alprostadil intracavernous pharmacotherapy for erectile dysfunction in diabetes mellitus vs non-diabetic patients. Int J Impot Res 1998; 10(Suppl 1): S50.

    Google Scholar 

  57. Padma-Nathan H, et al. Intracavernosal pharmacotherapy: the pharmacologic erection program. World J Urol 1987; 5: 160–165.

    Article  Google Scholar 

  58. Montague D, et al. Clinical Guidelines Panel on Erectile Dysfunction: Summary Report on the Treatment of Organic Erectile Dysfunction. J Urol 1996; 156: 2007–2011.

    Article  PubMed  CAS  Google Scholar 

  59. Lee M, et al. Chart for preparation of dilutions of alpha-adrenergic agonists for intracavernous use in treatment of priapism. J Urol 1995; 153: 1182,1183.

    Article  PubMed  CAS  Google Scholar 

  60. McMahon CG, et al. Treatment of intracorporeal injection non-response with sildenafil alone or in combination with triple agent intracorporeal injection therapy. J Urol 1999; 162: 1992–1997.

    Article  PubMed  CAS  Google Scholar 

  61. Porst H. Editorial comment to McMahon CG, et al. Treatment of intracorporeal injection non-response with sildenafil alone or in combination with triple agent intracorporeal injection therapy. J Urol 1999; 162:1997,1998.

    Google Scholar 

  62. Nehra A, Barrett DM, Moreland RB. Pharmacotherapeutic advances in the treatment of erectile dysfunction. Mayo Clin Proc 1999; 74: 709–721.

    PubMed  CAS  Google Scholar 

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Authors
  1. Alice K. Tsao MD
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  2. Ajay Nehra MD
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© 2006 Humana Press Inc., Totowa, NJ

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Tsao, A.K., Nehra, A. (2006). Intracavernosal Injection of Vasoactive Agents. In: Male Sexual Function. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-59745-155-0_13

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  • DOI: https://doi.org/10.1007/978-1-59745-155-0_13

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-747-1

  • Online ISBN: 978-1-59745-155-0

  • eBook Packages: MedicineMedicine (R0)

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