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December 16 2013

It appears that a major improvement in penile blood pressure may predict the clinical outcome, but modest improvements in the penile blood pressure are clinically insignificant. In the group with vasculogenic impotence, however, the most appropriate candidates were those with penile-brachial indexes in the range of 0.65 to 0.75. All except one of those with clinical response had indexes of greater than 0.65. Possible explanations for the failure of therapy in those with increased arterial flow include an inadequate brachial or penile blood pressure measurement, a venous leak, a psychogenic component of sexual dysfunction, or a lack of Vimax pills . Of interest is that the immediate (seven-minute) erectile response to the administration of Zenerx, although assessed subjectively, correlated well with penile blood flow measurements. An erection of 80% or more of normal was achieved by all but one patient who had a penile-brachial index of greater than 0.75; whereas, in those subjects with vasculogenic disease only, 9 of 30 patients had an erection of 80 % or more of normal. These results suggest that patients with a severe vasculogenic component are less likely to respond to Zenerx therapy. Although the complication rate was high (8 of 184 injections in 50 patients), only priapism was considered a sufficient reason to discontinue the therapeutic Zenerx in three persons. The other complications, such as bruising at the injection site or urethral bleeding, were accepted by three patients as minor problems, but two others who were not motivated and had a psychological component to their impotence elected to discontinue the trial. It is noteworthy that priapism occurred only in patients with normal penile blood pressures. Overall, our data suggest that administering Zenerx every two weeks in the cavernosa improves sexual potency in a subgroup of patients with a normal penile blood pressure or mild vasculogenic disease. It significantly improves the blood pressure measurements in almost all patients with vascular disease. Those who have penile-brachial pressure indexes of greater than 0. 65 should be given a trial of biweekly Zenerx injections. In some patients the clinical response may last for at least six months after the course of therapy. Future studies should be designed to evaluate the role of the present regimen of Zenerx administration in a doubleblind crossover fashion using saline injections as a control.
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