We conducted a prospective dose-escalating study of the erectile response to intracavernosal injection of a alprostadil (Caverject(r)) on 50 patients with erectile dysfunction. The response was assessed by penile palpation. A total of 47 patients
24 to
66 years old (mean age 45.3 years) completed the study. All subjects received intracavemous injection of alprostadil at doses of 2.5, 5, 10, 15, 20, 30 or 40㎍ until a positve response (an erection suffcicent for intromission that was maintained
for at
least 30 minutes )was achieved. If a positive response was not achieved with 40㎍, the patients had underlying diseases (one hypertension and three diabetics), of whom three showed a positive response. The etioligy of the impotence in the 43
positive
responders, the mean dosage needed to induce erection and the duration of erection were 17(40%) vasculogenic; 8.7㎍, 45.3 minutes; 11(26%) psychogenic; 6.4%, 54.6 minutes; 2(5%) neurogenic; 8.8㎍, 35 minutes; and 13(30%) undetormined; 14.6㎍,
48.2
inutes. Of the 43 positive responders, 16(37%) achieved the positive response with 2.5㎍, 6(14%) with 5㎍, 7(16%) with 10㎍, with 10㎍, 2(5%) with 20㎍, 1(2%) with 30㎍ and 2(5%) with 40㎍. Half of the patients(51%) achie4ved a positive response
with
5㎍ or less. No patient had a prolonged erection and only 4patients(8.5%) reported severe penile pain(2 with 2.5㎍., 1with 15㎍ and 1 with 20㎍. ). In conclusion, intracavernous injection of Caverject(r) appears to be a safe, effective treatment
for
impotence and 2.5㎍ would be a reasonable starting dose. ㎍
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