COMBINED INTRACAVERNOUS INJECTION OF PAPAVERINE AND STIMULATION (CIS)TEST

The inhibitory effect of the overactivity of the sympathetic nervous s ystem that results from outpatient clinical conditions leads to poor e rectile response to intracavemous injection of papaverine. The effects of self manual genital stimulation for improvement of erectile qualit y in insufficient papaverine response were investigated in 171 impoten t men. Twenty-nine (63.04%) of 46 patients who had a normal vascular s ystem showed partial response to papaverine. Following self manual gen ital stimulation, full erection was achieved in all of them. Better er ections were achieved in 28 of 42 patients with arterial disease. In p atients subclassified as having slight, moderate, and severe arterial disease, improved erections were noted in 100%, 71.42%, and 64.28%, re spectively. In the mixed vascular (arterial + venous) disease group (n = 46), the combined intracavernous injection of papaverine and stimul ation (CIS) test led to a better erection in only 41.30%, whereas in t he pure venogenic group (n = 37), this percentage was 66.66%. The inhi bitory effect of the overactivity of the sympathetic nervous system is significantly reduced by the CIS test.