[Evaluation of impotence: intracorporeal injection of papaverine by color duplex sonography].

: From February 1989 to June 1989, 49 patients consulted our OPD for the complaint of impotence. The average age was 46.9 +/- 11.2 y/0. We applied intracorporeal injection of papaverine (60 mg) by color duplex sonography (Acuson 128) for evaluation. The results of the papaverine test were: good response in 6 (12%), imperfect response in 21 (43%) and impaired response in 22 (45%). So the total positive response rate was 55%; and the total negative response rate was 45%; two patients (4%) experienced priapism. Spontaneous detumescence occurred after aspiration of the corpus cavernosum and no complications ensued. We utilized duplex sonography for evaluating penile blood flow before and after papaverine injection. Diameters of the deep artery was: right artery increased from 0.42 +/- 0.13 mm to 0.76 +/- 0.26 mm, while the left artery increased from 0.43 +/- 0.19 mm to 0.64 +/- 0.31 mm. Following injection, the peak velocity and the increased change of peak velocity were higher in patients in the positive response group than in the negative response group. There was no correlation for the percent of increase in diameter of the deep arteries. This technique provides a safe method with few complications for the objective assessment of response to intracorporeal papaverine injection and the anatomic structure of the penis. Use of this technique can also avoid unnecessary examinations and influence the strategy of treatment. After normal values and parameters are established, this method should be a useful diagnostic tool.