Tadalafil versus Papaverine in Pharmaco Penile Duplex Ultrasonography-A Comparative Study

Abstract

Introduction: ‘Erectile Dysfunction’ (ED) traditionally defined as inability to achieve and/or maintain an erection for satisfactory sexual intercourse. It can affect men of all age groups, but prevalence increases with age. Aim: The aim of the present study was to assess whether oral Tadalafil is as useful as injectable Papaverine in the evaluation of men with ED. Materials and Methods: Pharmaco penile duplex ultrasonography was done using a linear broadband phased array transducer (7–12 MHz) on an E-Saote MyLab 60 ultrasound-colour Doppler system on 36 patients over a period of two years. Visual grading score for erection, cavernosal artery diameter, Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV), Resistive Index (RI) and Acceleration Time (AT) were obtained in all patients following administration of oral Tadalafil and intracavernosal injection of Papaverine in one week gap. All the data was analysed using SPSS software version 22.0 (SPSS Inc., Armonk, NY, USA). Results: In Tadalafil mode, visual grading for erectile response was E1 in four patients, E2 in eight patients, E3 in seven patients, E4 in two patients and E5 in 15 patients. In Papaverine mode, visual grading for erectile response was E1 in three patients, E2 in seven patients, E3 in five patients, E4 in two patients and E5 in 19 patients. In Tadalafil mode, a total of 17 patients showed evidence of arterial insufficiency and two patients showed evidence of venous insufficiency. In Papaverine mode, a total of 12 patients showed evidence of arterial insufficiency, two patients showed evidence of venous insufficiency and one patient showed indeterminate results. Conclusion: In the present study, oral Tadalafil contributed significantly in the evaluation of ED and showed statistically significant results similar to intracavernosal injection of Papaverine.

Keywords

• erectile dysfunction
• penile doppler
• vascular disease