VASOACTIVE INTESTINAL POLYPEPTIDE AND PHENTOLAMINE MESYLATE ADMINISTERED BY AUTOINJECTOR IN THE TREATMENT OF PATIENTS WITH ERECTILE DYSFUNCTION RESISTANT TO OTHER INTRACAVERNOSAL AGENTS

Objective To study the effect of vasoactive intestinal polypeptide (VI P) and phentolamine mesylate (PM) on patients in whom previous intraca vernosal therapy had failed. Patients and method The study comprised 7 0 consecutive patients attending a clinic for erectile dysfunction, in whom previous therapy with intracavernosal prostaglandin-E1 (20 mu g and papaverine (30 mg) combined with 1 mg PM had failed. They were giv en intracavernosal injections, initially with 25 mu g VIP/1 mg PM (VIP 1) and if unsuccessful, 25 mu g VIP/2 mg PM (VIP2). Both VIP1 and VIP2 were administered using a pre-filled ready-to-use autoinjector fitted with a 29 G needle. The patients were diagnosed as having spinal cord lesion (eight), diabetes (21), ischaemic heart disease (12), hyperten sion (six), other diagnoses (nine), or idiopathic causes (14). Result Forty-seven (67%) of patients achieved erections sufficient for sexual :intercourse (33 on VIP1 and 14 on VIP2), initially under clinical sup ervision and subsequently during home use. Minor side-effects were tra nsient facial flushing in 37 (53%), truncal flushing in six (9%), brui sing in 14 (20%) and pain from the injection needle in eight (11%). No patients reported priapism or other serious adverse events. Conclusio n The combination of VIP and PM at the dose used was a safe and effect ive treatment in patients in whom other therapies had failed.