Revue rapide: 381 sujets impuissants,explores en 2 ans,dont 207 avec Prostaglandine E1

During the last two years, 381 impotent patients have been tested, 174 with papaverine and 207 with prostaglandin E1 (PGE1: Alprostadil). More positive responses were obtained using PGE1 (76.8%) than papaverine (44.8%), and some patients whose response to an initial PGE1 test was negative demonstrated a positive effect after a second injection. Two non-responders to PGE1 showed a positive response to papaverine+phentolamine. Tolerance of PGE1 was extremely good, provoking fewer prolonged erections than papaverine. Pain following intracavernosal injection of PGE1 was distressing in 10% of cases, all young men with psychogenic impotence. A therapeutic trial of repeated injections, carried out in 49 selected patients with mild organic dysfunction but strong psychogenic inhibition, typically showed a rapid clinical improvement. Moreover, 16 patients with cavernosal sclerosis and vascular impotence who were treated by injections two or three months apart (instead of having a prosthetic implant) showed a recovery of sexual activity. Consequently, during these two years only 35 patients (9.1%) were treated surgically, 21 by the implantation of hydraulic prostheses. The significant benefits of PGE1, especially the ease of self-administration, demonstrate the need for new therapeutic trials.