Combined intracavernous injection and stimulation test

Combined Intracavernous Injection and Stimulation (CIS) Test is a diagnostic procedure used in the field of urology and sexual medicine to evaluate erectile function in men. This test helps in diagnosing the underlying causes of erectile dysfunction (ED), distinguishing between psychogenic and organic ED. The CIS test involves the intracavernous injection of vasoactive substances followed by visual or manual sexual stimulation.

Procedure

The CIS test begins with the intracavernous injection of a vasoactive agent, such as alprostadil (PGE1), into the penis. This substance helps in relaxing the smooth muscle in the corpora cavernosa, leading to an erection. Following the injection, visual or manual sexual stimulation is provided to enhance the erection. The quality of the erection is then assessed over a period, usually lasting about an hour.

Indications

The CIS test is indicated for men who have a history of erectile dysfunction. It is particularly useful in cases where the distinction between psychogenic and organic causes of ED is unclear. This test can also be used to assess the effectiveness of intracavernous injection therapy as a treatment option for ED.

Contraindications

There are several contraindications to the CIS test, including:

• Patients with a history of priapism
• Patients with severe cardiovascular disease
• Patients with an infection in the genital area
• Patients with a predisposition to developing blood clots

Risks and Complications

While the CIS test is generally safe, there are potential risks and complications, including:

• Pain at the injection site
• Development of priapism, a prolonged erection that can cause permanent damage to the penis if not treated promptly
• Hematoma or bleeding at the injection site
• Infection

Interpretation of Results

The results of the CIS test are interpreted based on the quality of the erection achieved following the injection and stimulation. A positive response, characterized by the achievement of a full erection, suggests that the erectile dysfunction is more likely of a psychogenic nature. Conversely, a poor response may indicate an organic cause of ED, such as vascular insufficiency or nerve damage.

Conclusion

The Combined Intracavernous Injection and Stimulation test is a valuable diagnostic tool in the evaluation of erectile dysfunction. It provides important information that can guide the choice of treatment, distinguishing between psychogenic and organic causes of ED. However, the test must be conducted with caution, considering the potential risks and contraindications.