Preference for oral sildenafil or intracavernosal injection in patients with erectile dysfunction already using intracavernosal injection for > 1 year

BJU Int. 2003 Aug;92(3):277-80. doi: 10.1046/j.1464-410x.2003.04324.x.


Authors from Seoul describe their experience with patients already on triple therapy by intracavernosal injection who changed to oral sildenafil. Rather surprisingly, they found that patients had had a greater preference than expected for triple therapy, feeling that they had a better quality of erection on intracavernosal injection. The subject of the effect of renal transplantation on sperm quality and sex hormone levels is discussed by authors from Teheran. They found that sperm morphology and density remained unchanged, but there were significant improvements in sperm mobility. There was also an improvement in hormone levels and sexual function.

Objective: To investigate the efficacy and preference for oral sildenafil or intracavernosal injection (ICI) therapy in patients with erectile dysfunction (ED) already using ICI.

Patients and methods: In all, 69 patients with ED (mean age 55.1 years, sd 12.3) on ICI therapy with triple solution (papaverine/phentolamine/prostaglandin-E1) for > 1 year were recruited for the study. Their erection quality, adverse reactions and selection rate of oral sildenafil or ICI as treatment, after using sildenafil for 3 months, and the reasons for their preferences, were compared between the regimens,

Results: Overall, 52 men (75%) responded to sildenafil; of these men, the erection quality with ICI was better than that with sildenafil in 46 (89%) and 16 (31%) preferred ICI as their treatment. Eighteen patients (35%) used each treatment alternately and 18 (35%) used sildenafil exclusively. The main reason given by patients for choosing ICI was a better quality of erection (74%).

Conclusion: More patients with ED and using ICI preferred it as their main treatment than was expected, even though they had a good response to oral sildenafil. A better quality of erection with ICI was the reason why experienced patients chose this method, differing from the choice of patients starting treatment for ED.

MeSH terms

  • Administration, Oral
  • Adrenergic alpha-Antagonists / pharmacology
  • Adult
  • Aged
  • Choice Behavior
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Humans
  • Impotence, Vasculogenic / drug therapy*
  • Impotence, Vasculogenic / psychology
  • Injections
  • Male
  • Middle Aged
  • Papaverine / administration & dosage
  • Patient Satisfaction*
  • Phentolamine / administration & dosage
  • Piperazines / administration & dosage*
  • Piperazines / adverse effects
  • Purines
  • Sildenafil Citrate
  • Sulfones
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage*
  • Vasodilator Agents / adverse effects


  • Adrenergic alpha-Antagonists
  • Piperazines
  • Purines
  • Sulfones
  • Vasodilator Agents
  • Sildenafil Citrate
  • Papaverine
  • Phentolamine