Efficacies of papaverine and sildenafil in the treatment of erectile dysfunction in early-stage paraplegic men

Abstract

The aim of the study was to determine which vasoactive agent was more efficacious for erectile dysfunction (ED), intracavernosal papaverine or oral sildenafil, in paraplegic men within the first year after injury by using a penile color Doppler ultrasound as a quantitative imaging method and to determine the association between responses to these two vasoactive agents and factors such as neurological lesion level and lesion severity. A total of 31 male in-patients with spinal cord injury, aged over 18 years, and with neurological lesions below the T6 level within the first year after injury with ED were included. Visual and auditory sexual stimulus (VASS) on day 1 (group 1), VASS with 25 mg intracavernosal papaverine (group 2) and after a wash-out period of papaverine on day 2, and VASS with 50 mg oral sildenafil on day 5 (group 3) were administered to each patient. Measurements of the peak systolic velocity and end diastolic velocity, which were used as vascular parameters during each procedure type, were taken using penile color Doppler ultrasound. Considering the severity of the lesion and the levels of the neurological lesion, there was a statistically significant difference between the PSV values of the group 1 and the other two groups (P<0.05). There was no statistically significant difference between the peak systolic velocity and end diastolic velocity values of groups 2 and 3 (P>0.05) in terms of both the severity and the levels of the lesion. Efficacies of intracavernosal papaverine hydrochloride or oral sildenafil citrate for ED were similar at all neurological lesion levels and lesion severity in paraplegic men within the first year after spinal cord injury.

Papaverine and its derivatives radiosensitize solid tumors by inhibiting mitochondrial metabolism

“…Papaverine is an ergot alkaloid first isolated in 1848 (16) from Papaver somniferum. Papaverine does not have narcotic properties, but was used as a smooth muscle relaxant for the treatment of vasospasm and erectile dysfunction (17,18). Its vascular effects were thought to be due to its activity as a phosphodiesterase 10A inhibitor (19).…”

Anticancer effects of a non-narcotic opium alkaloid medicine, papaverine, in human glioblastoma cells

“…Papaverine, a non-narcotic opium alkaloid, is isolated from Papaver somniferum [8]. Medicinal papaverine is used as a smooth muscle relaxant for the treatment of vasospasm and erectile dysfunction and functions by inhibiting phosphodiesterase 10A [9–11]. In cancer research, papaverine showed selective anticancer effects in several tumor cells, including prostate carcinoma LNCaP [12, 13] and PC-3 [14]; colorectal carcinoma HT29 [15]; breast carcinoma T47D [15], MCF-7, and MDA-MB-231 [16]; fibrosarcoma HT1080 [15]; and hepatocarcinoma HepG2 [17].…”

Treating Erectile Dysfunction and Central Neurological Diseases with Oral Phosphodiesterase Type 5 Inhibitors. Review of the Literature

“…Two clinical studies were excluded because a single dose of sildenafil 50 mg was used once to see the effect on ED, and the other simply to determine the side effects of the drug on SCI patients with ED [21,22]. Regarding the reliability of the studies, one article was excluded because the authors did not report the dosage of sildenafil used for treating individuals with SCI and ED, and there was a possible bias based on the fact that 10 out of the 16 were concomitantly treating their ED with intracavernous alprostadil injection [23].…”