Role of the nitric oxide donor linsidomine chlorhydrate (SIN-1) in the diagnosis and treatment of erectile dysfunction.

Abstract

OBJECTIVES:

Recently, nitric oxide was shown to be a mediator of penile erection in men and the nitric oxide donor linsidomine chlorhydrate (SIN-1) was introduced as a novel treatment option in patients with erectile dysfunction. We now present our follow-up results with the intracavernous application of SIN-1.

METHODS:

One hundred thirteen patients with erectile dysfunction of various etiologies and 10 normal control subjects underwent intracavernous pharmacotesting with 1 mg SIN-1. Of the 113 patients, 71 (62.8%) underwent additional pharmacotesting with a mixture of papaverine (15 mg/mL) and phentolamine (0.5 mg/mL) (P/P). Forty-eight responders to SIN-1 were enrolled in an autoinjection program with this substance.

RESULTS:

All normal control subjects had full rigid erections lasting 40 to 70 minutes. Of 113 patients, 78 (69%) had responses sufficient for intercourse with SIN-1, and the other 35 patients (31%) demonstrated inadequate responses. All 44 responders to SIN-1 who also received P/P had erections sufficient for intercourse with P/P in doses of 0.25 to 2 mL (mean, 0.6 +/- 0.3 mL). Six patients (13.6%) had prolonged erections with minimal to moderate doses of P/P. From the total of 27 patients who had erections insufficient for intercourse with SIN-1, 20 (74.1%) had good responses with 0.25 to 2.0 mL P/P (mean, 1.5 +/- 0.5 mL). One patient (4%) had a prolonged erection with 1.0 mL P/P: After 10 to 150 injections/patient (total of 1160 injections; mean, 24.1 injections), no significant side effects were noted with SIN-1.

CONCLUSIONS:

Our data suggest that intracavernous SIN-1 is safe and efficacious in the majority of patients with erectile dysfunction; however, it has a lower smooth muscle relaxing effect than a combination of P/P. The absence of severe side effects, including priapisms, may be explained by the use of a physiologic pathway for induction of the erectile response and the rapid intracavernous decomposition of SIN-1.

• Authors: M C Truss, A J Becker, M H Djamilian, C G Stief, U Jonas
• Journal: Urology (Urology) Vol. 44 Issue 4 Pg. 553-6 (Oct 1994) ISSN: 0090-4295 [Print] United States
• PMID: 7941195 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Vasodilator Agents
• linsidomine
• Molsidomine
• Papaverine
• Phentolamine

Topics

• Adult
• Aged
• Drug Therapy, Combination
• Electromyography
• Erectile Dysfunction (drug therapy, etiology, physiopathology)
• Follow-Up Studies
• Humans
• Injections
• Male
• Middle Aged
• Molsidomine (analogs & derivatives, pharmacology, therapeutic use)
• Papaverine (pharmacology, therapeutic use)
• Penile Erection (drug effects)
• Phentolamine (pharmacology, therapeutic use)
• Self Administration
• Vasodilator Agents (pharmacology, therapeutic use)