USE OF PROSTAGLANDIN-E1 IN THE TREATMENT OF SEXUAL IMPOTENCE AFTER HEART-TRANSPLANTATION - INITIAL CLINICAL-EXPERIENCE

Many patients report problems of impotence after heart transplantation , which definitely impairs their quality of life. Ten men, with a mean age of 41 years, were evaluated for persistent erection problems afte r heart transplantation by measurement of nocturnal penile tumescence using a Rigiscan. Three men had a positive response, and their disturb ances were therefore considered to have a psychological basis; seven m en had a negative or only weakly positive response, and their impotenc e was attributed to organic causes. To all patients, intracavernous in jections of an initial dose of 10 to 20 mug of prostaglandin E1 were a dministered as first-choice treatment. Nine patients obtained a firm, lasting erection 2 to 5 minutes after injection, with no relevant side effects. The patients were then instructed to self-administer the dru g before intercourse, and some were able to return to spontaneous sexu al activity at various intervals. Intracavernous injection of prostagl andin E1 seems to be an effective treatment of erectile impotence in h eart transplant recipients; it is well tolerated with no side effects and considerably improves the patient's quality of life.