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  • Title: [Significance of the penile pressure index and value of the papaverine mini-test (8 mg)].
    Author: Virag R, Bouilly P, Daniel C.
    Journal: J Mal Vasc; 1987; 12(1):40-5. PubMed ID: 3559410.
    Abstract:
    The main non invasive test to quantify arteriogenic impotence is the penile blood pressure (P.B.P.I.). However, its signification is still in discussion. In this work, after discussion of the previous literature, we have revisited the P.B.P.I. signification by quoting it in comparison to the dynamic tests of erection (artificial erection, papaverine test, nocturnal penile tumescence (N.P.T.) with the findings of arteriography. A series of 51 cases having been studied with the multidisciplinary evaluation that we recommend were analyzed and compared to the location of the arterial lesions (aorto-iliac and/or internal pudendal) and to the response to the 80 mg papaverine test (rigidity and initial intracavernous flow (I.I.F.). A significant difference (p less than 0.05) for P.B.P.I. has been demonstrated between normal arteriograms and bilateral lesions. The P.B.P.I. is significantly lower when the lesions are located to the main arteries and bilateral. I.I.F. helps to differentiate hemodynamically severe arterial lesions where surgery is recommended from mild lesions where intracavernous drugs are first proposed. After discussion of the risks of the 80 mg papaverine test in unspecialized units, the authors propose a standardized method to evaluate the penile arteries, using the Doppler and the 8 mg papaverine mini-test which does not carry the risks of prolonged erection. This approach allows a precise morphologic and hemodynamic evaluation for the arterial impotence.
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