تاثير پاپاورين در ناتواني جنسي مبتلايان به ديابت

Erectile Dysfunction in Diabetics and Response to Papaverin

Impotence is an important complication of diabetes that has not been considered much in our society. In this study we have evaluated 250 married male diabetic of 25-60 years old referring to Mashhad University endocrine clinics for evidence of impotence and response to intracavemosal papaverin injection. We used protocol of Sexual Health Inventory for Men (SHIM) to evaluate our patients. There are five basic questions and each has maximum of five marks (total of 25), 21 mark or less is considered impotence. From 250 male diabetics 134 had impotence according to SHIM protocol (less than 21 mark with highest of 25), 12 cases were found to have another reason for impotence and were omitted from the study and 238 patients were followed, 24 patients had type. One (10.08%) and 214 patients had type II diabetes (89.92%). We injected 30-mg papaverin hydrochloride into carpous cavemosus in each patient. Mean age of patients was 45.05 years and mean duration of erectile dysfunction was 3.45 years. Total incidence of impotence was 51.26% (122 patients). Incidence of erectile dysfunction in seven patients with type I diabetes cases was 29.16% and in 115 patients with type II diabetes was 53.74%. Total response rate to papaverin injection was 46.72%. Response rate was 85.71% in type 1, 44.35% in type II diabetes. The most common side effect was periapism, which occurred in one patient and responded to treatment. Erectile dysfunction is an important complication of diabetes and should be evaluated in our patients. Papaverin injection although is not the first choice but can be considered as a rather safe and cheap way to manage the impotency.