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Biomedical subjects

W Scherb

Publications and source records attributed to W Scherb.

31 records · Page 2Linked to original sources
PubMed1988

Mid-term results of autoinjection therapy for erectile dysfunction.

Of over 300 patients with erectile dysfunction, 186 were selected for intracavernosal autoinjection therapy with a standardized papaverine-phentolamine mixture. A total of 156 patients performed 4,813 protocol autoinjections with a minimum of 10 and a maximum of 230 per patient. The dose that induced a full erection at the hospital could be reduced under home conditions by a mean of 35 per cent. Systemic side effects were not observed. The most inconvenient local side effects were prolonged erections in 24 patients in diagnostic use and in 3 patients in therapeutic use. There were treated easily without further consequences.

Dose-Response Relationship, Drug↗
PubMed1988

Functional evaluation of penile hemodynamics.

A multidisciplinary study was performed on 200 consecutive patients with erectile dysfunction more than 1 year in duration, which included a standardized intracavernous injection of a vasoactive substance mixture (15 mg. per ml. papaverine plus 0.5 mg. per ml. phentolamine). The multidisciplinary findings correlated well with the intracavernous dose needed for full erection. The group without pathological hemodynamic findings (36 patients) needed an average of 0.67 ml. and the group with pathological inflow (107) needed an average of 1.07 ml. In the venous insufficiency group (57 patients) only 18 achieved full erections with an average of 2.1 ml. (39 achieved tumescence only to 3 ml.). The results show that standardized intracavernous injection of a vasoactive substance mixture is a useful method to evaluate penile hemodynamics. This pharmacological test appears to be effective in the differential diagnosis of nonvascular and vascular erectile dysfunction.

Adult↗
PubMed1987

[2 years' experiences with cavernosal autoinjection therapy].

Between February 1985 and January 1987, 186 patients with erectile dysfunction were selected for cavernosal autoinjection therapy (CAT). After more than 4800 protocolled autoinjections and 10-230 CAT/pt., no cavernous fibrosis, penile deviation or cavernitis occurred. The only serious side effects were prolonged erections in about 10% during diagnostic and less than 1% during therapeutic use. These prolonged erections could be easily treated by puncture and aspiration of corpora cavernosa or intracavernosal injection of Metaraminol.

Drug Therapy, Combination↗
PubMed1987

[Venous insufficiency of the corpora cavernosa as (additional) cause of erectile dysfunction].

In 25-30% of the patients with erectile dysfunction, venous insufficiency is the (additional) reason for the erectile failure. Surgical procedures and prognosis depend largely on the precise localisation of the pathological drainage. The venous leakage is proven and exactly localized by a multiprojectional cavernosography, measurement of the maintainance flow and intracavernous pressure monitoring. The most reliable screening test for venous erectile dysfunction is the intracavernous application of a standardised vasoactive drug combination.

Erectile Dysfunction↗
PubMed1987

[Diagnosis of vascular impotence: comparison of Doppler sonography and arteriography].

The use of Doppler ultrasonography to examine penile arteries represents an important step in the multidisciplinary evaluation of erectile dysfunction. This noninvasive method for demonstrating the presence of arterial lesions was found to have a sensitivity of 92.6% and an accuracy of 90% when compared with selective arteriography. The necessity of performing selective arteriography can be markedly reduced in cases of erectile dysfunction by investigations using Doppler ultrasonography.

Adult↗
PubMed1986

[Corpus cavernosum autoinjection therapy: initial experiences in erectile dysfunction].

The cause of erectile dysfunction was evaluated by a multidisciplinary approach in 120 impotent patients. Out of these, the CCAT was proposed to 20 patients with vasculogenic erectile dysfunction, 19 of them accepted this therapy. The dosage of phentolamine mesylate-papaverin hydrochloride injection required was determined in each patient individually. Usually we injected initially 1 cc in one corpus cavernosum. Eighteen patients followed the regimen successfully at home. In 2 patients prolonged erections were observed, which were successfully relieved by simple corpus puncture, however, discontinuation of therapy was not necessary. CCAT failed in 1/19 patients with a severe venous leak. Follow up was carried out weekly.

Drug Therapy, Combination↗
PubMed1985

[Selective arteriography of the internal pudendal artery in posttraumatic erectile dysfunction].

102 patients with erectile dysfunction were evaluated by a multidisciplinary approach including measurement of the bulbocavernous reflex (BCR)-latency, cystometry, dynamic cavernosography and bilateral selective arteriography of the pudendal arteries. Seven patients had a posttraumatic source of their erectile failure. Three patients showed a mixed neurogenic-arteriogenic aetiology of erectile dysfunction, two patients had evidence of isolated arterial damage, one patient had a venous and one an isolated neurogenic cause of erectile dysfunction. The passage of pudendal-penile vessels and nerves through the urogenital diaphragm is the most vulnerable portion of its way through the pelvis. Ruptures of the prostatomembranous urethra are frequently accompanied by injury to the pudendal-penile vessels and nerves, thus causing erectile dysfunction.

Accidents, Traffic↗
PubMedDate not supplied

Long-term results of corpus cavernosum autoinjection therapy for chronic erectile dysfunction.

Between May 1985 and March 1992, 172 patients suffering from chronic erectile dysfunction (21-70 years old) underwent constant corpus cavernosum autoinjection therapy (CAT) with a standardized papaverine phentolamine mixture (16385 injections). Thereafter 41 patients continued CAT with the single agent papaverine (1257 injections). On the basis of both these 17642 protocol auto-injections, and over 6 years of experience with intracavernosal autoinjection therapy we conclude that, especially with the papaverine-phentolamine mixture, CAT constitutes an effective therapy (full rigidity in 95.8%) with tolerable side-effects for chronic erectile dysfunction when preceded by careful patient selection and thorough multi-disciplinary evaluation. This is especially so in the case of arterial and/or neurogenic aetiology of the erectile dysfunction. In addition, the contraindications must be strictly observed, the treatment and technique fully explained, and a regular follow-up instituted. CAT is generally well accepted by the patients and their partners (98.8%/97.6%) and has distinct positive effects on self-esteem (77.8%), performance anxiety (84.4%), and partnership (79.5%). The most serious side-effect was prolonged erection (25 out of 17642 injections). In 6 patients reversible fibrotic changes near the tunica albuginea were observed.

Adult↗