Audiovisual sexual stimulation by virtual glasses is effective in inducing complete cavernosal smooth muscle relaxation: a pharmacocavernosometric study

Abstract

Audiovisual sexual stimulation (AVSS) is frequently employed to promote cavernosal smooth muscle relaxation (SMR) in hemodynamic diagnostic settings for erectile dysfunction. Our aim has been to adapt conventional AVSS to the particular test conditions of pharmacocavernosometry and pharmacocavernosography (DICC), by the use of virtual glasses. Thirty-seven consecutive patients undergoing DICC were randomized in two groups: no-AVSS and AVSS through commercially available virtual glasses (VG-AVSS) with tri-dimensional capabilities and stereophonic headphones. Such device partially excludes the patient from the surrounding environment. In both groups a standard dose of vasoactive agents was intracavernosally administered, and possibly repeated (re-dosing), until complete SMR was obtained (3 dosesapatient maximum). Psychometric tests (State Trait Anxiety Inventory and ad hoc visual analogue scales for embarrassment, stress and pain) were administered before and after DICC. The no-AVSS group consisted of 18 patients, the AVSS group of 19. Number of needed vasoactive agent doses: in the no-AVSS group 6 patients needed 1 dose, 3 patients 2, 9 patients 3 (mean dose number: 2.17); in the AVSS group 15 patients needed 1 dose, 1 patient 2, 3 patients 3 (mean dose number: 1.37). The difference in the number of doses used in the two groups was statistically signi®cant (Student's t-test P 0.007). Complete SMR, regardless of the number of used doses: in the no-AVSS group 9 patients (50%) achieved complete SMR, in the AVSS group 16 patients (84.2%). The difference in the two groups was statistically signi®cant (chi-square P 0.026). From evaluated psychometric measures no statistically signi®cant difference between the two groups was detected. VG-AVSS signi®cantly promotes complete SMR without increasing test related stress or anxiety. Its induced arousal suggests the possibility of performing dynamic evaluations of the erectile function with the oral agent sildena®l in place of intracavernosally administered vasoactive agents. VG-AVSS furthermore constitutes a promising tool for the investigation of normal physiology and pathophysiology of female sexual function.

Feasability of a Novel Audio-Video Sexual Stimulation System: An Adjunct to the Use of Penile Duplex Doppler Ultrasonography for the Investigation of Erectile Dysfunction

“…Three arteriogenic ED patients and four veno‐occlusive ED patients diagnosed by CDUS under ICI alone would be reclassified as non‐vasculogenic ED if the condition was changed to under AVSS plus ICI. Similar findings were reported by Pescatori et al., which demonstrated that 80% of the patients with AVSS vs. 33% of the patients without AVSS achieved complete cavernous smooth muscle relaxation at the first ICI of the vasoactive agent [17]. The same study also suggested that AVSS could reduce the need to re‐dose the vasoactive agent.…”

“…PSV = mean maximal peak systolic velocity; EDV = mean maximal end diastolic velocity; RI = mean maximal resistive index; Rigidity = mean maximal rigidity. vasoactive agent [17]. The same study also suggested that AVSS could reduce the need to re-dose the vasoactive agent.…”

Efficacy of Sildenafil for Japanese Patients With Audio-Visual Sexual Stimulation (Avss) Test by the Rigiscan Plus

“…The RigiScan Plus, a modified model of the RigiScan [1], is enhanced to easily interpret the mean penile rigidity. The AVSS test was conducted to objectively measure the ED [4,7,8]. Measurement of such parameters as the maximum rigidity and penile tumescence using the RigiScan is useful in evaluating ED.…”

Diagnosing Erectile Dysfunction: instruments for the study of smooth muscle relaxation

“…We safely used up to three doses/patient of a 2 mL solution containing 18.1 mg/mL of papaverine and 0.9 mg/mL of phentolamine (Fig. 2) (Pescatori et al 2000).…”

“…We do not feel that the vision of erotic material in a standard television screen at the simultaneous presence of medical personnel can warrant the necessary privacy that a patient would require to translate the erotic message in psychological arousal and erectile events. Accordingly, we recently carried out a study aimed to adapt conventional AVSS to the particular test conditions of DICC, by the use of commercially available virtual glasses (VG-AVSS) with tri-dimensional capabilities and stereophonic headphones (Pescatori et al 2000).…”