Studies on male sexual impotence. Report 18. Therapeutic trial with prostaglandin E1 for organic impotence

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  • 男性インポテンスに関する研究 : (第18報)器質的インポテンスのブロスタグラソディンE_1による治療の試み

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Abstract

We have been performing the operation of inserting a penile prosthesis as a therapy for organic impotence. Actually, not so many patients in Japan want to be subjected to this procedure, and the development of noninvasive techniques is desirable. Considering this, we examined the possibility of therapeutic application of the intrapenile-cavernous injection of prostaglandin E1 (PGE1), which has a strong dilatating effect on vascular smooth muscles, for organic impotence. The injection of 20 μg of PGE1 dissolved in 2 to 20 ml of saline into the penile cavernous body was performed by employing a small gauge Gordh needle of 22 to 27G; the effect was detected by an Erectiometer and a thermometer measuring the change of the temperature of the penis. The intraarterial infusion of 20μg of PGE1 dissolved in 20 ml of saline was also performed by means of a vascular catheter. As a result, among 71 patients who received the PGE1 injection into the penile cavernous body, perfect erections were observed in 51 (72%), imperfect erections in nine (13%), only enlargement of the penis in six (8%) and no change in five (7%). In the patients exhibiting perfect erections, the penis enlarged in two to three minutes following the PGE1 injection and this condition persisted for two to three hours. Most of the patients exhibiting almost no erection were those suspected of having penile cavernous body atrophy or vascular deficiencies, or were elderly men.

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