Development of a penile rigidity indicator and new concepts in the quantification of rigidity

Pharmacocavernometry: a modified papaverine test

The papaverine test has become established in the investigation of impotence. Although a full response to papaverine excludes a significant vascular lesion, failure to respond may be due to either arterial deficiency or venous leakage. Pharmacocavernometry, which combines the papaverine test and an artificial erection test, was performed in 126 patients. Intracorporeal pressure was monitored following the intracorporeal injection of 80 mg papaverine; 10 min later, saline was infused to determine the presence of a venous leak. Five different responses were observed. Patients with a Type 1 or 2 response were psychogenic or neurogenic. Patients with a Type 3 response were arteriogenic and patients with a Type 4 or 5 response had significant venous leakage. The modified papaverine test permits more information to be gained concerning the aetiology of the impotence.

Saline-induced artificial erection without papaverine: a potential source of error in diagnosing cavernosal venous leakage

The diagnosis of venous leakage as a cause of impotence, based on failure to induce an artificial erection by means of rapid saline infusion alone, may be invalid. Our recent experience with 2 men whose impotence was subsequently found to be psychogenic in nature suggests that saline erection cavernosometry should routinely incorporate the intracavernosal administration of papaverine, in order to avoid a falsely positive diagnosis of venous leakage.