Prostaglandin E1 Versus Mixture of Prostaglandin E1, Papaverine and Phentolamine in Nonresponders to High Papaverine Plus Phentolamine Doses

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Abstract
We evaluated the efficacy of 40 microgram/ml. prostaglandin E1 versus a combination of 17.64 mg./ml. papaverine hydrochloride, 0.58 mg./ml. phentolamine mesylate and 5.8 microgram/ml. prostaglandin E1 (3-drug mixture). A total of 32 patients randomly received 1 ml. of either medication by the intracavernous route. All patients had presented with erectile dysfunction longer than 6 months in duration and had failed to respond to high doses of papaverine (60 mg.) plus phentolamine (1 mg.). Of 32 patients 7 (22 percent) responded to prostaglandin E1 and 16 (50 percent) to the 3-drug mixture, achieving erections allowing penetration (grade E4 or E5, p less than 0.05). Pain was reported by 41 percent of the patients receiving prostaglandin E1 and by 12.5 percent administered the 3-drug mixture. The 3-drug mixture may be regarded as more effective than prostaglandin E1 alone in inducing an erectile response with a decreased incidence of pain.