Re-dosing of prostaglandin-E1 versus prostaglandin-E1 plus phentolamine in male erectile dysfunction: a dynamic color power Doppler study
A Aversa1,
V Bonifacio1,
C Moretti2,
G Frajese2 & A Fabbri1
1Cattedra di Andrologia, Dipartimento Fisiopatologia Medica, Università La Sapienza
2Cattedra di Endocrinologia, Dipartimento Medicina Interna, Università Tor Vergata, Rome, Italy
Correspondence to: Dr A Aversa, Cattedra in Andrologia, Dipartimento Fisiopatologia Medica, University of Rome La Sapienza, Viale del Policlinico 00161 Rome, Italy. E-mail: amfaversa@yahoo.com
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During penile pharmacotesting, anxiety may overcome complete smooth muscle relaxation and lead to false positive diagnosis of organic male erectile dysfunction (ED). We tested the efficacy and safety of re-dosing of PGE1 alone versus combination of PGE1 and the 1,2-blocker phentolamine (PHE) to improve an incomplete pharmaco-induced erection during color-power-Doppler (CPD) sonography. 116 consecutive impotent patients were submitted to CPD and injected with 10 µg PGE1 plus audiovisual sexual stimulation. Clinical evaluation of rigidity and CPD parameters were normal in 26 patients while in the remaining they were upgraded in 15% and 35% after re-dosing of 10 µg PGE1 alone and 10 µg PGE1 plus 1 mg PHE, respectively (P<0.05); furthermore, in these latter patients CPD studies showed increased visualisation of distal ramifications of helicine arterioles. The final diagnosis was changed in those patients who responded to re-dosing with no differences in the occurrence of prolonged erections between the two treatments. We conclude that re-dosing of PGE1/PHE mixture is a safe and effective procedure to maximize erectile response during dynamic CPD sonography and has a better diagnostic sensitivity than re-dosing of PGE1 alone. International Journal of Impotence Research (2000) 12, 33-40. |