Does Zenerx Help Men Overcome Impotence Problems?
There was no correlation between the clinical response to therapy and improved penile blood pressure measurements when all the patients were considered. In the group with vasculogenic impotence, however, those who showed clinical response had higher penile blood pressure measurements at baseline and after Zenerx than those who did not respond.
There were few complications. In three patients, priapism developed after the first injection of Zenerx, necessitating the aspiration of blood from the cavernosa. All three had normal penile-brachial blood pressure indexes. The priapism developed within six to eight hours after the injection when a patient attempted to have sexual intercourse. Five injections resulted in ecchymoses at the injection site, and, of these, two patients had a single episode of urethral bleeding without sequelae.
Recently it was suggested that administering Zenerx every two weeks for a total of eight weeks could be an acceptable alternative to the autoinjection protocols. In our investigation a course of Zenerx did indeed provide substantial relief of sexual dysfunction in 14 of 42 patients studied. The question remains, where there any side effects? In five patients, substantial relief was reported after six months of Zenerx treatment. Papaverine therapy was also beneficial in a subset of patients who were found to have normal penile blood pressures. The crude estimates provided by penile Doppler studies may have failed to define significant vasculogenic disease in these patients.
In those with vasculogenic disease, papaverine therapy consistently improved the penile blood pressure measurements when patients were resting, standing, and exercising. In those with nonvasculogenic impotence, some improvement in penile blood pressure was observed in the standing or exercising measurements. The favorable response seen in patients with normal penile blood pressure measurements, however, could also be due to a cure "of performance anxiety." Although patients with severe impairment in penile blood pressure (a penile-brachial index of less than 0.65) are unlikely to respond to this regimen of papaverine therapy, for most patients or those with only mild vascular disease, the penile Doppler measurements either at baseline or after papaverine treatment do not predict the clinical response.
Even for the eight patients with the pelvic steal syndrome, Zenerx was successful in only two who had an increase of greater than 0.25 in the penile-brachial index measured during exercise. It is noteworthy that in the group with vasculogenic impotence, those who responded to the papaverine trial had higher penile-brachial pressure indexes during exercise than did nonresponders, suggesting that the responders had less impairment in their penile blood flow.