Intracavernous injection of papaverine for erectile failure.
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Biomedical subjects
Publications and source records attributed to R Virag.
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Ten cases of unstable erection by venous insufficiency are reported. Clinical and diagnostic features are emphasized with presentation of cavernosography with passive erection studies and classification of venous incompetence. Surgical correction by the new original technique of arterialization of deep dorsal vein of penis was convenient in 8 up on 10 cases with one year mean follow up. The new concept of unstable erection by venous incompetence is discussed.
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Vasculogenic impotency does exist. Series of 45 operated cases with at least 6 month follow up give the main points of diagnosis and surgical new methods. Organic impotency is assessed by permanent leakage of morning erection, and monitoring of nocturnal penile tumescence (P.E.N.). Arterial insufficiency is present when penile pressure index (I.P.P.) is below 0,95 and Doppler penile notation up to 5 (N.D.P.). Selective hypogastric arteriography shows the site and importance of lesions. Venous incompetence is explored by cavernosography and passive erection output studies. 45 patients experienced 54 vascular procedures with 60% good results at 6 months.
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The aim of our research is to investigate the success of the vasoactive intracavernous therapy in subjects suffering impotence only on a neurological basis. We have submitted 50 subjects to a multisciplinary study including P.B.P.I., intracavernous minitest plus V.S.S., M.M.P.I., B.C.R. latency, duration, aspect and an hormonal screening (SH, LH, PRL, F. TEST, 17 BE2). The patients, or their partners, were instructed in the technique of self intracavernous injection (S.I.C.I.) of vasoactive drugs. Papaverine alone was given to 37 patients in a mean dose of 20.8 +/- 11.7 mg. Other 13 patients were treated with papaverine plus phentolamine in order to obtain a full erection. Comprehensive results of the treatment were judged at 80% effective: only 10 patients discontinued self injection treatment, unable to perform this technique properly.