Administration of vasoactive drugs intracavernously is a well-known ea
sily used and inexpensive alternative in treatment of a certain group
of patients with erectile dysfunction. There are a few drugs used for
this purpose, but we prefer papaverine as the first choice because it
is easily available and inexpensive in our country. We used alprostadi
l only in nonresponders to papaverine or if there was any complication
with papaverine. We present a series of 69 patients, 24 with psychoge
nic (34.8%), 27 with organic (39.1%), and 18(26.1)with mixed etiology
of erectile dysfunction, treated with intracavernous self-injection th
erapy. Mean follow-up of the patients was 13.6 months (7-30 months). I
n this study, 3,430 papaverine and 780 alprostadil injections were per
formed in 56 and 13 patients, respectively. In 75% of the papaverine i
njections and in 83% of the alprostadil injections, erections were ach
ieved sufficient for sexual intercourse. During the follow-up, there w
ere not any abnormal alterations in liver function tests. The main com
plaint of the patients who used papaverine was a burning sensation (98
%) during administration of the drug, which did not last more than 1 m
inute. Of 13 patients in the alprostadil group, 56.9% of the patients
complained mainly of discomfort during erection. We concluded that int
racavernous therapy is a good and inexpensive option in the management
of erectile dysfunction in carefully selected patients.