Experience with intracavernosal tri-mixture for the management of neurogenic erectile dysfunction

Chao, Roberto; Clowers, Diane

doi:10.1016/0003-9993(94)90028-0

Cited by 25 publications

(14 citation statements)

References 23 publications

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“…Another therapeutic method to produce erection in SCI men is the intracavernosal injection of vasoactive drugs (Virag, 1982;Beretta et al, 1986;Sidi et al, 1986Sidi et al, , 1987Bodner et al, 1987;Sonksen et al, 1990;Earle et al, 1992;Kapoor et al, 1993;Chao & Clowers, 1994;Hirsch et al, 1994;Zaslau et al, 1999). A success rate up to 95% is not uncommon in SCI men when success is defined as the achievement of erection adequate for penetration (Bodner et al, 1987;Kapoor et al, 1993).…”

Section: Sexual Functionmentioning

confidence: 97%

Erectile function and male reproduction in men with spinal cord injury: a review

et al. 2010

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Spinal cord injury (SCI) in men results in defects in erectile function, ejaculatory process and male reproductive potential. There are alterations in the capacity of men with SCI to achieve reflexogenic, psychogenic and nocturnal erections. The sexual function in different stages after SCI and the types of erections depend mainly on the completeness of the injury and the level of neurological damage. Furthermore, most of the SCI men demonstrate defects concerning the entrance of semen into the posterior urethra and the expulsion of the semen through the penile urethra and the urethral orifice. In addition, SCI men develop defects in the secretory function of the Leydig cells, Sertoli cells and the male accessory genital glands. The overall result is a decreased quality of the semen is recovered either with penile vibratory stimulation (PVS) or with electroejaculation. Nowadays the therapeutic andrological approach of SCI men focuses on achievement of erectile function, recovery of spermatozoa and assisted reproductive technology. The first line of therapy recommended for infertility in SCI men is collection of semen via PVS with concomitant evaluation of total motile sperm yields for assisted conception which may include intravaginal insemination, intrauterine insemination, or in vitro fertilisation/intracytoplasmic sperm injection. Patients failing PVS may be referred for electroejaculation or surgical sperm retrieval.

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Section: Sexual Functionmentioning

confidence: 97%

Erectile function and male reproduction in men with spinal cord injury: a review

et al. 2010

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“…Further a tri-mixture combination of all three substances may be used. 81 In SCL men it is the general experience that the denervated tissues are supersensitive to the drugs used for intracavernous injection.…”

Section: Pharmacological Managementmentioning

confidence: 99%

Sexual function in spinal cord lesioned men

2001

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Study design: Review of literature. Objective: To review the physical aspects related to penile erection, ejaculatory dysfunction, semen characteristics, and techniques for enhancement of fertility in spinal cord lesioned (SCL) men. Setting: Worldwide: individuals with traumatic as well as non-traumatic SCL. Results: Recommendations for management of erectile dysfunction in SCL men: If it is possible to obtain a satisfactory erection but of insucient duration, then try to use a venous constrictor band to ®nd out if this is sucient to maintain the erection. Otherwise we recommend Sildena®l. If Sildena®l is not satisfactory then use intracavernous injection with prostaglandin E 1 (some SCL men may prefer cutaneous or intraurethral application). We discourage the implantation of penile prosthesis for the sole purpose of erection. Recommendations for management of ejaculatory dysfunction in SCL men: Penile vibratory stimulation (PVS) to induce ejaculation is recommended as ®rst treatment choice. If PVS fails, SCL men should be referred for electroejaculation (EEJ). Semen characteristics: Impaired semen pro®les with low motility rates are seen in the majority of SCL men. Recently reported data gives evidence of a decline in spermatogenesis and motility of ejaculated spermatozoa shortly after (few weeks) an acute SCL. It is suggested that some factors in the seminal plasma and/or disordered storage of spermatozoa in the seminal vesicles are mainly responsible for the impaired semen pro®les in men with chronic SCL. Fertility: Home insemination with semen obtained by PVS and introduced intravaginally in order to achieve successful pregnancies may be an option for some SCL men and their partners. The majority of SCL men will further enhance their fertility potential when using either PVS or EEJ combined with assisted reproduction techniques such as intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. Spinal Cord (2001) 39, 455 ± 470

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“…Therefore, lower doses of prostaglandin E 1 have been combined with lower doses of phentolamine/papaverine to make treatment more cost effective. In a study of 35 men with SCI, all achieved functional erections [47]. At 13.8 months follow-up, two men reported prolonged erections for 6 hours, and a third patient had an erection for more than 6 hours, but had doubled his dose.…”

Section: Intracavernous Injectionsmentioning

confidence: 97%

Treatment of erectile dysfunction following spinal cord injury

Linsenmeyer

2009

Curr Urol Rep

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Spinal cord injury (SCI) has a significant impact on erectile dysfunction. Treatment modalities for individuals with SCI are similar to treatments for those without SCI. Some of the most common methods of management include penile implants, oral phosphodiesterase (PDE) inhibitors, vacuum devices, intraurethral prostaglandins, and intracavernous injections. In addition to the advantages and disadvantages of these various modalities for able-bodied men, there are special considerations for men with SCI. Penile implants may help to keep an external condom catheter in place and provide more penile stability for intermittent catheterization. However, they have an increased risk of infection. Semirigid rods have an increased risk of erosion. Although convenient to use, PDE inhibitors are usually not effective in lower motor injuries. The hypotensive effects of intraurethral prostaglandins and PDE inhibitors need to be considered in SCI men with injuries at or above T6. Intracavernous injections are very effective; however, men with SCI require much lower doses than able-bodied men.

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Experience with intracavernosal tri-mixture for the management of neurogenic erectile dysfunction

Cited by 25 publications

References 23 publications

Erectile function and male reproduction in men with spinal cord injury: a review

Erectile function and male reproduction in men with spinal cord injury: a review

Sexual function in spinal cord lesioned men

Treatment of erectile dysfunction following spinal cord injury

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