Objective

To review the efficacy of intracavernous injections (ICI) in spinal cord injured (SCI) men and to identify prognostic factors affecting the efficacy of ICI in this population.

Material/patients and methods

Systematic review of the literature using 5 databases. Articles published up to november 2014 using the keywords: alprostadil; papaverine; moxisylyte; alpha-blocking agent; phentolamine; intracavernous injection; spinal cord injuries; paraplegia; quadriplegia; erectile dysfunction; were included.

Results

Twenty-three studies were included (713 SCI patients). ICIs resulted in successful erections in 88% of patients. Erections were obtained respectively in 93% of patients with the combination of papaverine and phentolamine, in 91% with papaverine alone and in 80% with prostaglandin E1. The statistical analysis could not identify specific factors predictive of response to ICI.

Discussion–conclusion

ICIs are an effective treatment of erectile dysfunction in SCI men. No predictive factor for efficacy could be identified. Studies comparing the response to ICI in upper and lower motor neuron lesions could improve our understanding of ICI failure. CIs are an effective treatment of erectile dysfunction in SCI men. No predictive factor for efficacy could be identified. Studies comparing the response to ICI in upper and lower motor neuron lesions could improve our understanding of ICI failure.