Apport de l’injection intracaverneuse de Prostaglandine E1 lors de la premiere consultation de l’impuissant: à propos de 414 cas

Abstract

The authors report their experience of 414 injections of prostaglandin E1 (prostine). The diagnostic orientation between functional or organic impotence was assessed through questionaires and more particularly on the presence or absence of nocturnal or morning erections. The prostine reconditioning and self injection use techniques are precised: 80% of positive responses with better results in the oldest patients, whatever their medical antecedents. No relation between positive response to prostaglandin E1 and normal nocturnal erections could be found. Patients still presenting erections can present good or bad responses. This confirms the results previously given only allow us to put in evidence the good functional and anatomic state of cavernous bodies, without any etiological orientation (not mentioning the cases in which these self-injections reveal the presence of deformation, bend or fibrosis). The acceptance of self injection is low (30%) as well as a regular and prolonged medical observance (only 15%). This work confirms the low rate of local complications after repeated injections and the low rate of prolonged erections or priapism during Test 1. However, these possibilities must incite to prudence as for the generalization of this kind of treatment, out of specialized centers.

Résumé

Les auteurs rapportent 414 cas d’utilisation de la prostaglandine E1 en première intention. La dose utilisée dans la majorité des cas a été de 15 microgrammes, avec des réponses positives dans près de 80% des cas. L’acceptabilité et la régularité dans la pratique des auto-injections est faible (30 et 15%). L’intérêt de la prostaglandine E1 réside dans la rareté des complications, qu’il s’agisse de nodules, de déformations et surtout de priapisme.