A four-drug vasoactive mixture (papaverine hydrochloride, prostaglandi
n E1, phentolamine mesylate, atropine sulfate) was used for intracaver
nous injection therapy in 94 patients with vasculogenic impotence as d
iagnosed by color Doppler sonography and dynamic infusion cavernosomet
ry-cavernosography. At a mean follow-up of twenty months, 66 patients
(70%) are using the injections with the initial dose and are satisfied
; 14 patients (15%) are using the injections with a smaller dose than
initially given; and 14 patients (15%) dropped intracavernous treatmen
t. Only 4 patients (4%) were unable to achieve a sustained rigid erect
ion during the mixture titration phase. Selected cases of vasculogenic
impotence can be safely and effectively treated by the association of
drugs which rely on different mechanisms of action, producing a pharm
acologic synergism which enhances the overall therapeutic effect.