Comparison of a mixture of papaverine, phentolamine and prostaglandin E1 with other intracavernous injections.

Objective: evaluation of a self-injection program with a mixture of papaverine, phentolamine and prostaglandin E1 (PGE1).

Methods: a self-injection program for erectile dysfunction was started by 48 patients, using a 1-ml mixture of 4.5 mg papaverine, 0.2 mg phentolamine and 1.5 micrograms PGE1. Patients completed a questionnaire at 6 weeks and at 3 months and were followed at the Outpatients Department for an average of 1 year.

Results: of these patients 25 had previous experience with 20 micrograms PGE1 for intracavernous use and 22 patients had previously used 30 mg papaverine with 1 mg phentolamine. None of these 3 self-injection drugs is obviously superior in its ability to induce erections. Priapism occurred twice on a total of 1,290 injections. After 1-year follow-up, 4 patients had developed problems with fibrosis of the corpora, 2 of whom had encountered this problem also in a previous self-injection program.

Conclusions: this triple mixture has the disadvantage of causing fibrosis and priapism in susceptible patients.