Sldenafil Versus Intra-Cavernsoal Injection In Diagnnnosis

The aim of this work is to compare between oral sildenafil and ICI in diagnosis of ED.This work was done on 30 patients complaining of ED recruited from the outpatient clinic of Dermatology and Venereology in Zagazig University Hospitals.These patients were assessed as regards to the following:1- Full history taking.2- Assessment of the severity of ED by using IIEF-5.3- Full clinical examination (general and local).4- Intra-cavernosal injection using increasing doses of papaverine, phentolamine and atropine.5- Sildenafil test (at home) with comparison of its results with the results of ICI.6- Duplex examination to assess the state of the cavernosal arteries with special emphasis on peak systolic, end diastolic velocities and the resistive index for evaluation of the response to both tests used for diagnosis.According to history, examination and duplex results for these patients the frequency distribution of the aetiolgoy was as follows:A- Non vascular ED: was 4 patients.B- Vascular ED: comprised 26 patients distributed as follows:- 15 patients with arteriogenic ED- 8 patients with caverno-venous leakage.- 3 patients with mixed arteriogenic and caverno-venous leakage.This study had shown that the patients who showed failed response to ICI showed also failed response to sildenafil and those patients had vascular ED.The patients who showed positive response to ICI showed also positive response to sildenafil in 77.8% (vascular ED 43% & nonvascular ED 57%) and negative response in 22.2% (vascular ED).The reported side effects of ICI were pain and priapism but, mild and tolerable for sildenafil in the form of headache and flushing.