Nocturnal penile tumescence activity unchanged after long-term intracavernous injection therapy

Purpose: Anecdotal evidence suggests that some men have restored erectile f unction after long-term intracavernous injection therapy for erectile dysfu nction. We objectively assessed this phenomenon using nocturnal penile tume scence testing. Materials and Methods: In our retrospective study 19 men with a mean age of 53.5 years who had organic erectile dysfunction underwent nocturnal penile tumescence testing before and after prostaglandin E1 based intracavernous injection at least 6 months in duration. The nocturnal penile tumescence pa rameters measured included the number of erectile episodes, base and tip tu mescence, and percent of time with rigidity greater than 70% at the penile base and tip. A 5-item questionnaire was given to all patients after the in tracavernous injection period to assess subjective changes in erectile qual ity. Results: Mean time on intracavernous injection was 2.42 years and mean inje ction frequency was 3.74 times monthly. Prostaglandin E1 only, and combined prostaglandin E1, phentolamine and papaverine were used in 7 and 9 cases, respectively. Nine patients believed that unaided erection improved after i ntracavernous injection and 6 achieved intercourse without injection who we re unable to do so before injection. No statistically significant changes w ere noted in any of the 5 objectively measured nocturnal penile tumescence parameters. Conclusions: Long-term prostaglandin E1 based intracavernous injection may provide subjective improvement in erectile function in some men. However, a s measured by nocturnal penile tumescence testing, no objective improvement in spontaneous erectile function occurs.