Biomedical subjects

C G McMahon

Publications and source records attributed to C G McMahon.

16 recordsLinked to original sources

PubMed2000

Erectile dysfunction.

Erectile dysfunction (ED) is a common condition and can usually be managed pharmacologically, with drugs delivered by intracavernosal injection (ICI), transurethrally or orally. The cardiovascular status of the patient and his overall fitness for renewed sexual activity must be assessed before treatment for ED is initiated. The efficacy of sildenafil is related to the extent and severity of ED, and is significantly reduced in patients with severe vasculogenic ED, ED associated with diabetes and after radical prostatectomy. Alprostadil (prostaglandin E1) is the drug of first choice in patients treated with ICI; it is effective in 72.6% of men with ED and is associated with a low risk of priapism and cavernosal fibrosis. Transurethral alprostadil is significantly less effective than alprostadil ICI, producing improved erections in 30%-40%, but rigid erections in only 10%, of men with ED. There is Level II evidence that: alprostadil ICI is an effective treatment for ED papaverine ICI is associated with a high risk of cavernosal fibrosis and priapism papaverine ICI should be restricted to informed patients refractory to treatment with alprostadil ICI transurethral alprostadil is less effective than alprostadil ICI sildenafil is an effective treatment for ED.

Alprostadil↗

PubMed2000

Sildenafil.

Explore the source record for details and available documents.

3',5'-Cyclic-GMP Phosphodiesterases↗

PubMed2000

Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction.

PURPOSE: We assessed the efficacy and safety of sildenafil citrate as treatment for erectile dysfunction. MATERIALS AND METHODS: A total of 433 completely evaluated men with chronic erectile dysfunction were treated with sildenafil citrate. Response was assessed prospectively by baseline and followup physician interviews, and by a patient self-administered 15-item questionnaire on the domains of patient treatment response and satisfaction, partner treatment satisfaction, comparative previous treatment satisfaction, adverse effects, and patient and partner quality of life. RESULTS: Of the 304 men (70.2%) who completed the questionnaire 278 received sildenafil, including 186 who previously had undergone treatment for erectile dysfunction, principally involving intracavernous injection therapy. A response was elicited by a median dose of 100 mg. in 188 patients (67.6%) who achieved erection suitable for sexual intercourse. Those with psychogenic erectile dysfunction responded significantly better than those with organic dysfunction (p <0.001). Erection suitable for intercourse was attained by 30.8% of patients with erectile dysfunction after radical prostatectomy and 80% with cavernous veno-occlusive dysfunction. Of previous intracavernous injection responders 29.9% were refractory to sildenafil, while 33. 3% of previous intracavernous injection nonresponders responded to sildenafil. The sildenafil response was considered inferior to the intracavernous injection response by 43.6% of the men who previously responded to intracavernous injection, of whom 51.5% continued to receive intracavernous injection as the only treatment (19.5%) or as an alternative to sildenafil (32%). Adverse effects in 53.6% of cases were assessed as mild in 56.4%, moderate in 38.3% and severe in 5.3%. Multiple adverse effects were reported by 62.4% of patients, while 17 (6.1%) discontinued sildenafil as a direct result of intolerable adverse effects. The most common adverse effects were facial flushing in 33.5% of cases, headaches in 23.4%, nasal congestion in 12.6%, dyspepsia in 10.1% and dizziness in 10.8%. Baseline patient and partner quality of life scores significantly improved after sildenafil treatment (p <0.001), while significantly improved quality of life was noticed by 51.5% and 43.1%, respectively. CONCLUSIONS: Sildenafil citrate is effective oral first line treatment for erectile dysfunction. Although more than 50% of men reported adverse effects, most were considered mild and rarely resulted in treatment cessation. There was a trend in those on intracavernous injection who responded to sildenafil to continue intracavernous injection as the only therapy or as an alternative to sildenafil. Also, we noted that some cases refractory to sildenafil responded to intracavernous injection. These findings imply that intracavernous injection remains an effective erectile dysfunction treatment option.

Adult↗

PubMed1999

Treatment of intracorporeal injection nonresponse with sildenafil alone or in combination with triple agent intracorporeal injection therapy.

PURPOSE: We assess the efficacy of sildenafil as salvage therapy for intracorporeal injection therapy nonresponse. MATERIALS AND METHODS: The study group comprised 93 patients with a mean age of 53.6 years (range 24 to 77) with chronic erectile dysfunction. In all cases a home trial of intracavernosal injection of high dose alprostadil and triple agent intracavernosal injection therapy had failed. Patients were treated with sildenafil citrate alone or in combination with intracavernosal injection therapy. RESULTS: The etiology of erectile dysfunction was arteriogenic in 29 cases, cavernosal venous leakage in 36, mixed vasculogenic in 24, psychogenic in 3 and post-priapism intracavernous fibrosis in 1. Of the 32 sildenafil responders (34% of the study group) 30 required 100 and 2 required 50 mg. The 29 sildenafil intracavernosal injection (combined therapy) responders (31% of the study group) required 100 mg. sildenafil. There were 32 nonresponders (34% of the study group). Mean International Index of Erectile Function questions 3 and 4 scores were 1.7 and 1.5 at baseline, 2.3 and 1.9 with intracavernosal injection, 4.6 and 42.2 with sildenafil, and 4.1 and 4.10 with combined therapy, respectively. Of the 93 patients 29 (31%) treated with intracavernosal injection reported adverse effects, including penile pain in 27, dizziness in 5 and headache in 2. Of the patients treated with sildenafil 34 (37%) reported side effects, including headache in 30, facial flushing in 25, dyspepsia in 12, nasal congestion in 9, dizziness in 5 and visual disturbances in 1. Of the 41 patients given combined therapy 20 (49%) reported adverse effects, including penile pain in 15, headache in 15, facial flushing in 12, dyspepsia in 7, nasal congestion in 3, dizziness in 12 and syncope in 1. CONCLUSIONS: Sildenafil alone or sildenafil plus intracavernosal injection is effective salvage therapy for intracavernosal injection nonresponse. Sildenafil in combination with intracavernosal injection is associated with a 33% incidence of adverse effects, including a 20% incidence of dizziness.

Adult↗

PubMed1999

Predictive value of patient history and correlation of nocturnal penile tumescence, colour duplex Doppler ultrasonography and dynamic cavernosometry and cavernosography in the evaluation of erectile dysfunction.

AIMS: The results of history and physical examination, nocturnal penile tumescence testing (NPT), colour flow duplex Doppler ultrasonography and dynamic infusion cavernosometry and cavernosography (DICC) were retrospectively correlated in 207 patients with erectile dysfunction. METHODS AND MATERIALS: The predictive value of the patient's own subjective assessment of early morning and nocturnal erections, history of cigarette smoking, the presence of vascular risk factors was correlated to the outcome of investigations. The result of Rigiscan NPT was correlated to the peak systolic velocity (PSV) and the resistance index (RI) determined at colour flow duplex Doppler ultrasonography, and the maintenance flow rate (Qm) determined at DICC. RESULTS: Eighty-five out of two hundred and seven patients (41%) had normal NPT comprising 48 out of 85 patients (56%) who described rigid early morning and nocturnal erections, 15 out of 85 patients (18%) who smoked cigarettes and 9 out of 85 patients (11%) with other positive vascular risk factors. 72 out of 85 patients (85%) had a normal PSV (>30 cm/s), 80 out of 85 patients (94%) had a normal RI (>0.85) and 82 out of 85 patients (96%) had a normal Qm), (<10 ml/min). Vascular investigations in this group identified 71 out of 85 patients (84%) with no penile vascular disease, 11 out of 85 patients (13%) with arteriogenic impotence, 2 out of 85 patients (2%) with mixed vasculogenic impotence and 1 out of 85 patients (1%) with cavernosal venous leakage (CVL). One hundred and twenty-two out of two hundred and seven patients (59%) had an abnormal NPT comprising 18 out of 122 patients (15%) who continued to experience rigid early morning erections, 65 out of 122 patients (53%) who smoked cigarettes, 59 out of 112 patients (48%) with other positive vascular risk factors, 36 out of 112 patients (29%) had an abnormal PSV (<30 cm/s), 49 out of 122 patients (40%) had an abnormal RI (<0.85) and 55 out of 122 patients (45%) had an abnormal Qm (>10 ml/min). Vascular investigations in this group identified five patients with no penile vascular disease, 51 out of 122 patients (41%) with arteriogenic impotence, 31 out of 122 patients (25%) with cavernosal venous leakage (CVL) and 35 out of 122 patients (29%) with mixed vasculogenic impotence. CONCLUSIONS: (1) a history of cigarette smoking and positive vascular risk factors are good predictors of organic impotence whereas the patient's subjective assessment of his own early morning erections is unreliable; (2) normal NPT correlates well with normal PSV, RI and Qm but does not exclude organic impotence; (3) abnormal NPT correlates well with abnormal PSV, RI and Qm.

Adult↗

PubMed1999

Treatment of premature ejaculation with paroxetine hydrochloride.

AIMS OF THIS STUDY: To evaluate the efficacy of chronic and 'on demand' administration of paroxetine hydrochloride in the drug treatment of premature ejaculation (PE). MATERIALS AND METHODS: Ninety-four normally potent men, aged 18-61 y (mean 39 y) with premature ejaculation were treated between January 1996 and March 1997, with oral paroxetine hydrochloride, a selective serotonin re-uptake inhibitor (SSRI). All men were either married or in a stable relationship. Sixty-four out of ninety-four men (Group A) were initially treated with paroxetine hydrochloride 20 mg administered once daily. Those men who responded with improved ejaculatory control within four weeks, were then treated with 'on-demand' paroxetine hydrochloride (20 mg) administered 3-4 h prior to planned intercourse. The remaining 33 out of 94 men (Group B) were initially treated with 'on-demand' paroxetine hydrochloride 20 mg administered 3-4 h prior to planned intercourse. RESULTS: The mean pre-treatment ejaculatory latency time (ELT) of both group A and B was 0.4 min (range 0-1 min) in 205 intercourses at a frequency of 0.4 intercourses per week. In group A after four weeks of daily administration of paroxetine, the mean ELT was 4.5 min (range 1-anejac.) in 761 intercourses at a frequency of 2.4 intercourses per week. Fifty-three out of sixty-one men in group A regarded their ejaculatory control as improved and were then treated with 'on-demand' paroxetine, achieving an ELT of 3.9 min (range 0-10) in 608 intercourses at a frequency of 2.6 intercourses per week. Thirty-six men in this group of 53 regarded that they had maintained improved ejaculatory control with a mean ELT of 5.5 min (range 2-20 min) after a further four weeks of treatment (P < 0.001). The remaining 17 men reported a recurrence of poor ejaculatory control with a mean ELT of 0.7 min (range 0-2 min). In group B with initial 'on-demand' paroxetine after a mean of 4.5 weeks of treatment, the mean ELT was 1.5 min (range 0-5 min) in 298 intercourses at a frequency of 2.2 intercourses per week. Adverse effects were only recorded in men taking daily paroxetine and included anejaculation in 5 out of 61, inhibited orgasm in 3 out of 61 and reduced libido on 3 out of 61. Erectile dysfunction was not reported and 'on demand' paroxetine was not associated with any adverse effects. CONCLUSIONS: Paroxetine hydrochloride appears to be a useful agent in the pharmacological treatment of premature ejaculation when administered on a chronic, an 'on-demand' basis following chronic treatment or initial 'on demand' basis.

Adolescent↗

PubMed1999

Unexpected contribution of moderate traumatic brain injury to death after major trauma.

BACKGROUND: The cardiovascular reflex responses to injury and simple hemorrhage are coordinated in the central nervous system. Coincidental brain injury, which is present in 64% of trauma patients who die, could impair these homeostatic responses. The occurrence of hemorrhagic shock in the patient with head injury is also known to increase mortality. Therefore, there is a potential bidirectional interaction between traumatic brain injury and peripheral injury, which would result in an increased mortality when these two injuries coexist. Our objective was to test the hypothesis that moderate traumatic brain injury is an independent predictor of outcome in patients with multisystem trauma. METHODS: We carried out an analysis of the UK Trauma Audit and Research Network Database. Moderate traumatic brain injury was defined as an Abbreviated Injury Scale score of 3. The study population included 2,717 patients with multisystem injury: 378 patients had a moderate brain injury with peripheral injury, and 2,339 patients had extracranial injury alone. Mortality rates for both groups were compared at increasing injury severity. RESULTS: Moderate brain injury alone was associated with a mortality rate of 4.2%. However, when combined with extracranial injury, the risk of death was double that attributable to extracranial injury alone (odds ratio, 2.08; 95% confidence interval, 1.57-2.77). CONCLUSION: This study confirms that the coexistence of moderate traumatic brain injury with extracranial injury is associated with a doubling of the predicted mortality rate throughout the injury severity ranges studied.

Adolescent↗

PubMed1999

Pharmacological treatment of premature ejaculation.

Ejaculatory dysfunction is the most common male sexual disorder and premature ejaculation the most common presentation of ejaculatory dysfunction. Convincing data are lacking from controlled clinical studies to support sustainable long term efficacy of psychosexual counselling in the management of premature ejaculation. The pharmacological treatment of premature ejaculation is now receiving increased attention from both physicians with an interest in sexual medicine and from the pharmaceutical industry.

Antidepressive Agents, Tricyclic↗

PubMed1999

Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single-blind placebo controlled crossover studies.

PURPOSE: We evaluate the efficacy of paroxetine hydrochloride as needed for the treatment of premature ejaculation. MATERIALS AND METHOD: Study 1 comprised 26 potent men with a mean age of 39.5 years with premature ejaculation who were randomized to receive 20 mg. oral paroxetine (group A) or placebo (group B) as needed 3 to 4 hours before planned intercourse in a controlled single-blind crossover trial. Study 2 comprised 42 potent men with a mean age of 40.5 years with premature ejaculation who were randomized to receive 10 mg. paroxetine daily for 3 weeks and then 20 mg. paroxetine as needed (group C) for 4 weeks or placebo daily for 3 weeks and then placebo as needed (group D) for 4 weeks. RESULTS: Mean pretreatment ejaculatory latency time was 0.3 minute for study 1. At 4 weeks mean ejaculatory latency time was 3.2 minutes in the paroxetine as needed and 0.45 in the placebo as needed phase for group A (p < 0.001), and 0.6 in the placebo as needed and 3.5 in the paroxetine as needed phase for group B (p < 0.001). There were no adverse effects with paroxetine or placebo in study 1. Mean pretreatment ejaculatory latency time was 0.5 minute for study 2. At 3 weeks mean ejaculatory latency time was 4.3 minutes in the paroxetine daily and 5.8 in the paroxetine as needed phase, and 0.9 in the placebo daily and 0.6 in the placebo as needed phase for group C (p < 0.001). At 3 weeks mean ejaculatory latency time was 0.8 minutes in the placebo daily and 1.1 in the placebo as needed phase, and 3.3 in the paroxetine daily and 6.1 in the paroxetine as needed phase for group D (p < 0.001). Adverse effects in 7 of 42 men (17%) given paroxetine daily included an ejaculation in 3, anorexia in 1, gastrointestinal upset in 3 and reduced libido in 2. Mean ejaculatory latency time was greater in the paroxetine as needed phase of study 2 than that of study 1 (p < 0.05), suggesting that ejaculatory control achieved with paroxetine as needed is significantly better if patients are initially treated with the drug daily. CONCLUSIONS: Paroxetine appears to be superior to placebo in the pharmacological treatment of premature ejaculation when administered on a chronic or as needed basis.

Adult↗

PubMed1999

New treatment options for erectile dysfunction.

BACKGROUND: As increasing insight is gained into the aetiology of erectile dysfunction, many men formerly considered as suffering from psychogenic erectile dysfunction are now recognised as suffering from organic disease. As such, these men are currently identified as candidates for aggressive treatment of the organically caused problem. OBJECTIVE: This article discusses current and recently introduced treatments for erectile dysfunction, highlighting the advantages of each treatment and their position in the therapeutic armamentarium of the general practitioner. DISCUSSION: Investigative and treatment modalities have become more varied, such that to treat sexual dysfunction adequately, physicians must constantly keep abreast of new developments.

Alprostadil↗

PubMed1998

Treatment of premature ejaculation with sertraline hydrochloride: a single-blind placebo controlled crossover study.

PURPOSE: The efficacy of sertraline hydrochloride for the treatment of premature ejaculation is evaluated. MATERIALS AND METHODS: A total of 37 potent men, 19 to 70 years old (mean age 41), with premature ejaculation were treated with 50 mg. oral sertraline and placebo in a controlled randomized single-blind crossover trial. All men were either married or in a stable relationship. None of the patients received any formal psychosexual therapy. Chronic open label treatment with sertraline was continued in 29 patients who had achieved an increase in ejaculatory latency times over pretreatment levels with active drug in the initial crossover study. In an attempt to identify which patients could maintain the improved ejaculatory control after withdrawal of the active drug, serial drug withdrawal was conducted every 4 weeks with drug initiation after a further 2 weeks if improved ejaculatory control was not maintained. RESULTS: The mean pretreatment ejaculatory latency time was 0.3 minute (range 0 to 1). The mean ejaculatory interval after 4 weeks of treatment was 3.2 minutes (range 1 minute to anejaculation) with sertraline and 0.5 minute (range 0 to 1) with placebo (p <0.001). Intravaginal ejaculation was achieved for the first time in 5 patients with primary premature ejaculation and 2 patients experienced anejaculation. One patient described minor drowsiness and anorexia, and 2 patients described mild, transient gastrointestinal upset. Staged drug withdrawal allowed 20 of the 29 patients (67%) on chronic open label treatment with sertraline to discontinue the drug after a mean interval of 7.3 months with a mean ejaculatory latency time of 4.1 minutes (range 1 to 12). CONCLUSIONS: Sertraline appears to be a useful agent in the pharmacological treatment of premature ejaculation.

1-Naphthylamine↗

PubMed1998

Treatment of premature ejaculation with sertraline hydrochloride.

PURPOSE: To evaluate the efficacy of sertraline hydrochloride in the drug treatment of premature ejaculation (P.E.). MATERIALS AND METHOD: Forty-six normally potent men, aged 22 to 63 years (mean 42 years) with premature ejaculation were treated with oral sertraline in a dose ranging study. All men were either married or in a stable relationship. The mean ejaculatory interval was 1 minute (range 0-5 min). All men were started on Sertraline 25 mg daily and were increased to 50 mg after 3 weeks and 100 mg after a further 3 weeks. None of the men received any formal psychosexual therapy. RESULTS: With a dose of 25 mg, the mean ejaculatory interval increased to 7.6 min (range 0-20 min). With a dose of 50 mg, the mean ejaculatory interval increased to 13.1 min (range 7 min-anejaculation) with 4 men experiencing anejaculation. With a dose of 100 mg, the mean ejaculatory interval increased to 16.4 min (range 7 min-anejaculation), 10 men experiencing anejaculation. With a dose of 25 mg, 1 man described transient dizziness. With a dose of 50 mg, 1 man described some drowsiness and anorexia and 1 man experienced minor dyspepsia. With a dose of 100 mg, 2 men described erectile dysfunction and reduced libido, 2 men described transient drowsiness and anorexia, 2 men experienced minor dyspepsia and 2 men described feelings of anxiety. CONCLUSION: Sertraline appears to be a useful agent in the pharmacological treatment of premature ejaculation.

Adult↗

PubMed1998

Correlation of penile duplex ultrasonography, PBI, DICC and angiography in the diagnosis of impotence.

The results of different vascular tests used in the diagnosis of cavernosal arterial insufficiency and cavernosal venous leakage were compared in 168 men, with an average age of 62.9 y to determine which were the most reliable. One hundred and forty-five men had penile arterial insufficiency demonstrated with digital subtraction pharmacoangiography. The penobrachial index correctly identified 87 of the 145 men with penile arterial insufficiency whereas cavernosal artery peak systolic velocity identified 130 men and cavernosal artery occlusion pressures identified 136 men. Ninety-six men had cavernosal venous leakage demonstrated during dynamic infusion cavernosometry and cavernosography. The correlation between maintenance flow rate (Qm) and cavernosal pressure decay rate during pressure loss cavernosometry (dccp) was good (R = 0.95). The Resistance Index (RI) calculated during cavernosal duplex ultrasonography determined 15 min after vasodilator challenge corrected identified 93 out of 96 venous leakers and 68 of the 72 non-venous leakers. However, the Resistance Index (RI) determined 5 min after vasodilator challenge whilst correctly identifying all 96 venous leakers, identified only 5 of the 72 non-venous leakers and incorrectly categorising the remaining 67 non-leakers as having venous leakage. In conclusion, both the peak systolic velocity and cavernosal artery occlusion pressure are accurate predictors of cavernosal artery insufficiency, whereas the penobrachial index is a poor predictor. Cavernosal duplex ultrasonography appears as reliable as angiography, is less invasive and more cost effective. The RI is an accurate predictor of cavernosal venous leakage only if determined once maximal response to vasodilator challenge has occurred.

Angiography↗

PubMed1997

Nonsurgical treatment of cavernosal venous leakage.

OBJECTIVES: To evaluate the results of treating patients with cavernosal venous leakage (CVL) with polyagent self-administered intracavernous pharmacotherapy and vacuum constriction devices (VCDs). METHODS: One hundred eighty-eight chronically impotent patients with a mean age of 58.8 years were studied. This group comprised 103 patients treated with standard-dose and high-dose polyagent self-administered intracavernous pharmacotherapy and 85 patients treated with a VCD. The erectile response was related to the severity of CVL (mild, moderate, and severe). RESULTS: With standard polyagent pharmacotherapy, a response sufficient for satisfactory intercourse was achieved in 18 of 32 patients with mild CVL, 9 of 54 patients with moderate CVL, and in 0 of 17 patients with severe CVL. With high-dose polyagent pharmacotherapy, a response sufficient for satisfactory intercourse was achieved in 22 of 32 patients with mild CVL, 29 of 54 patients with moderate CVL, and in 2 of 17 patients with severe CVL. With a VCD, a response sufficient for satisfactory intercourse was achieved in 23 of 30 patients with mild CVL, 24 of 40 patients with moderate CVL, and in 10 of 15 patients with severe CVL. CONCLUSIONS: CVL of mild to moderate severity can be treated with polyagent pharmacotherapy and VCDs with reasonable expectations of success. Severe CVL responds poorly to polyagent pharmacotherapy but can be treated with VCDs with reasonable results in motivated, adequately instructed patients.

Adult↗

PubMed1996

A pilot study of the role of intracavernous injection of vasoactive intestinal peptide (VIP) and phentolamine mesylate in the treatment of erectile dysfunction.

Twenty men with chronic impotence with a mean age of 46 years (range 26-63 y) were treated with self administration of 0.35 ml of Vasopotin 1 and 2, a combination of 30 mg Vasoactive Intestinal Peptide (VIP) and either 1.0 or 2.0 mg Phentolamine Mesylate. All patient were assessed using a standard protocol which included history and examination, vibratory penile biothesiometry, colour flow duplex Doppler ultrasonography and where indicated, Rigiscan nocturnal penile tumescence testing, dynamic infusion cavernosometry and cavernosography (DICC) and angiography. Impotence was classified as psychogenic in six patients, arteriogenic in nine patients, neurogenic in two patients and cavernosal venous leakage in three patients. A total of 60 injections was given. After sexual stimulation, an erection of sufficient rigidity for intercourse occurred in six patients with psychogenic impotence, seven of the nine patients with arteriogenic impotence, two patients with neurogenic impotence and one of three patients with cavernosal venous leakage. No patients experienced priapism, two patients complained of postinjection penile pain and three patients experienced transient facial flushing. Intracavernous self injection of Vasopotin appears to be a useful treatment for erectile dysfunction.

Adult↗

PubMed1995

An attempt to standardize the pharmacological diagnostic screening of vasculogenic impotence with prostaglandin E1.

The response to the intracavernosal injection of differing doses of prostaglandin E1 (PGE1)(10, 20 and 30 micrograms) was compared in a randomized prospective manner in 283 men with chronic impotence, in an attempt to identify the optimal drug dose for pharmacological diagnosis. The mean age of patients studied was 63.1 years, and comprised 90 men with arteriogenic impotence, 133 men with either pure venogenic impotence or venous leakage associated with arteriogenic impotence, and 60 men with psychogenic impotence. Erectile responses were quantified using real-time RigiScan monitoring and were compared to a diagnosis based on the patient history, examination findings and all subsequent investigations. In patients with arteriogenic impotence, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1, was made in 71, 89 and 90% of patients respectively. In patients with venous leakage, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1 was made in 95, 95 and 93% of patients respectively. In patients with psychogenic impotence, correct pharmacological diagnosis with doses of 10, 20 and 30 micrograms of PGE1 was made in 72, 95 and 98% of patients respectively. This study indicates that pharmacological diagnosis with PGE1, is a useful screening test to differentiate penile vascular disease from psychogenic impotence and arteriogenic impotence from cavernosal venous leakage, achieves optimal sensitivity and specificity with doses of 20 micrograms or greater, but is associated with a high false diagnosis rate of diagnosis of penile vascular disease if doses of less than 20 micrograms are used.

Adult↗