Phases of Normal Erection:
(1) latency
(2) tumescence
(3) erection
(4) rigidity
(5) detumescence
Procedure:
(1) The skin of the penis at the injection site is carefully decontaminated.
(2) A vasoactive substance (papaverine, papaverine + phentolamine, papaverine + PGE1) is injected into the corpora cavernosa into the lateral position of either side using a 27-gauge needle.
(3) The penile response is then observed.
|
Tumescence
|
Rigidity
|
Grade
|
|
none
|
none
|
E0
|
|
slight
|
none
|
E1
|
|
medium
|
none
|
E2
|
|
full
|
none
|
E3
|
|
full
|
medium
|
E4
|
|
full
|
full
|
E5
|
Interpretation:
• Grades E0 to E3: negative test
• Grades E4 and E5: positive test
• Grades E4 and E5 are sufficient for intercourse
• A positive test practically excludes a venous or cavernous insufficiency. Over 90% of negative tests are associated with a venous or cavernous insufficiency.
• If a full erection occurs after a prolonged latency period (15 - 30 minutes), then an arterial reduction in penile perfusion should be looked for by using Doppler ultrasound of the penile vessels.
