Objective penile vascular response to intraurethral prostaglandin E-2 (dinoprostone)

Purpose: Intraurethral prostaglandin E-2 (PGE(2)) administration is a nonin vasive treatment modality for erectile dysfunction. The purpose of this stu dy was to evaluate the objective effects of this agent by measuring peak sy stolic velocities of cavernosal arteries after intraurethral PGE(2) adminis tration and comparing with the results obtained with an intraurethral place bo gel and intracavernous papaverine injection. Materials and Methods: The study group consisted of 22 consecutive impotent volunteers with a mean age of 46 years who had normal penile arterial responses as determined by peni le arterial responses on papaverine-stimulated penile duplex ultrasonograph y. The peak systolic velocity in cavernosal arteries was recorded after int racavernous injection of 60 mg of papaverine. All patients received 1 mg of intraurethral PGE(2) gel and placebo at 15-day intervals. The peak systoli c velocities were recorded after each treatment. Results: Mean peak systoli c velocity achieved by intraurethral administration of PGE(2) gel (25 +/- 8 cm/s) was less than that achieved by intracavernous papaverine (40 +/- 6 c m/s) but higher than that obtained by placebo (15 +/- 4 cm/s). Twelve patie nts had erections, while 9 had partial and 1 had no erection with intrauret hral PGE(2)-Placebo did not cause any erections. No serious side effects we re observed. Conclusion: Intraurethral administration of PGE(2) appears to be an effective and simple method for increasing penile arterial flow and c an be used during penile Doppler ultrasonography to stimulate the penile ar terial system. Copyright (C) 2001 S. Karger AG, Basel.