A Comparative Pilot Study on The Effect of Intracavernosal Injection Of (Papaverine/Verapamil) And (Papaverine/Phentolamine) In Erectile Dysfunction Patients
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 4074-4081
Abstract
Background: Intracavernosal injection (ICI) as a locally acting therapeutic modality has been tried since early 70s for the treatment of ED. Several vasoactive substances have been tried either a mono-therapy or in combination (i.e. Bimix or Trimix); whereas most of those mixtures were Papaverine based. Verapamil as a calcium channel blocker possess a vasodilator effect, thus it has been tried in very few trials as ICI either alone or in combination with Papaverine. In another perspective, verapamil was found to have anti-fibrotic properties; therefore it could have a dual benefit besides being a vasodilator.Methods: Hereby, our study was conducted trying to assess the effect of ICI of Papaverine/Verapamil mixture on penile erection as well as penile hemodynamics, compared to the traditional Bimix (i.e. Papaverine/Phentolamine) among a subgroup of PDE5I nonresponders (n=50).
Results: Our results showed that there was statistically significant difference while comparing both mixtures (Papaverine/Phentolamine) vs (Papaverine/Verapamil) concerning IIEF-5, cavernosal artery dilatation, PSV and RI with P-values (0.001, 0.003, 0.006 and 0.003) respectively.
Conclusion: Therefore, a bi-mixture of (Papaverine/Verapamil) could be a promising combination for treatment of ED via ICI with its dual-effects as cavernosal smooth muscle relaxant causing erection as well as anti-fibrotic properties.
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