Maximisation of the erectile response in the investigation of impotence

The aim of this study was to assess whether redosing with a combination of intracavernosal (IC) vasoactive agents could produce a complete erectile response, thereby providing a reliable and reproducible method of dynamic investigation of erectile dysfunction. Forty-one impotent men were redosed with a combination intracavernosal agents until a constant penile rigidity was achieved. They were then shown audiovisual sexual stimulation (VES) by means of a videotape. The erectile responses were monitored continuously by RigiScan (Dacomed). Results: Despite a constant rigidity with intracavernous injection (ICI), 16 men (39%) still had an improved response with VES that was clinically detectable. Conclusion: Dynamic investigation of erectile dysfunction with a combination and redosing of IC agents may still lead to an incomplete erectile response. This may potentially lead to patients being incorrectly labelled and confirms the limitations of follow-up studies using dynamic tests of erectile function.