LONG-TERM RESULTS OF THERAPY WITH INTRACAVERNOSAL INJECTIONS AND PENILE VENOUS SURGERY IN CHRONIC ERECTILE DYSFUNCTION

A follow up study of 603 patients with chronic erectile failure was ca rried out concerning the long term effects of intracavernous injection therapy with papaverine/phentolamine (n=172 evaluable) and venous sur gery (n=134 evaluable). Injection therapy was effective in 95.8% of in jections. Side effects included prolonged erections in 0.15% of inject ions and fibrotic palpable indurations in 3.4%. Acceptance of therapy was high among patients and their partners and improvement of self ima ge or partnership was reported in 77.8% and 79.5% respectively. Result s of venous surgery were not satisfactory. Only 19.4% of patients achi eved sufficient spontaneous erections and 35.1% needed adjuvant inject ions. Spongiosolysis yielded better results. Patients with neurologica l impairment, diabetes mellitus, postoperative onset of erectile dysfu nction and age above 40 years showed poorer surgical results. Venous s urgery should only be offered to a highly selected group of patients.