Significance of the intracavernosal pharmacological injection test, pharmacocavernosography, artificial erection and cavernosometry in the diagnosis of venous leakage.

149 men suffering from erectile failure underwent a standardized combined procedure including intracavernosal pharmacological injection test (P test) artificial erection, pharmacocavernosography and cavernosometry with analysis of intracavernosal erection pressure and pressure drop. Patients with negative P test were considered to be suffering from 'venous leakage'; data of cavernosography and cavernosometry were analyzed in relation to the results of the P test. 99 men (66.4%) were P-test-negative. 98 of these patients (99%) had pathological cavernous drainage of the plexus santorinii during cavernosography. Flow rates for induction and maintenance of erection of the P-test-negative men were increased and intracavernosal erection pressure decreased significantly compared to the P-test-positive patients. The very diversified range of values made any individual statement impossible. In contrast to these findings, duration of pressure drop was significantly shorter among men with suspicion of venous leakage and without any overlapping compared to P-test-positive men. The findings provide evidence for the necessity, besides pharmacocavernosography, to include an estimation of intracavernosal pressure drop time in the diagnostic procedure of venous leakage in all men with confirmed negative P test.