The role of intracavernosal vasoactive agents to overcome impotence due to spinal cord injury

Abstract

Twenty-two spinal cord injured men (mean age 35.2 years) referred because of impotence were treated with intracavernosal vasoactive agents. Papaverine 2-20 mg, papaverine 40 mg plus phentolamine 0.5 mg or prostaglandin E1 (1-20 ug) were used. Nineteen responded and were taught to self administer the medication with varying degrees of assistance from their partners. Fourteen men participated in a postal survey; 12 (86%) continued to use the drugs every 1 to 4 weeks and reported satisfaction with the method. Partner responses were positive in half of the group and when not so it influenced the patients to abandon or reduce the frequency of treatment. Counselling was essential to allay anxiety. Clinical management was not compromised and side effects were minimal. Overall we found this treatment effective, safe and worthwhile.

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

“…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).…”

“…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). It should be taken into consideration that the denervated tissues are very sensitive to the drugs used for intracavernosal injection (Beretta et al, 1986;Sidi et al, 1986Sidi et al, , 1987Bodner et al, 1987;Earle et al, 1992;Kapoor et al, 1993). Main complications with injection therapy in SCI men include the risk of prolonged erection (priapism) and fibrosis in the corporal tissue (Juenemann & Alken, 1989).…”

Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application

“…48,49 Spasticity commonly results in typical postures, such as thigh adduction, hip and thigh flexion that can negatively impact positioning conducive to intimacy and sexual functioning. If an individual has significant thigh adduction, determination must be made as to whether the adduction deformity is fixed or not.…”

Sexual function in spinal cord lesioned men

“…To avoid sustained erection (priapism), the SCL men should begin with low doses (papaverine 2 ± 5 mg or prostaglandine E 1 1 ± 2 mg 70,82 ) and gradually increase the dose if necessary. The SCL men must be instructed to seek medical advice if erection lasts for more than 4 ± 6 h, to have the erection reversed.…”