Intracavernous injection of papaverine for erectile failure.

Once an adrenal origin has been excluded the treatments available for PCO are temporary or symptomatic. Clomiphene can only be used short term under well-controlled conditions in women who want to have children. Anti-androgens can suppress hirsutism but their long-term effects are unknown and they do have to be taken continuously. Only wedge excision of both ovaries permits a full resumption of ovarian function (normal ovulatory cycles) which has been found to be temporary by some workers and long-lasting by others. A major disadvantage of bilateral wedge excision is the formation of pelvic adhesions which may be responsible for iatrogenic sterility in 30% of women treated in this way. On the assumption that numbers of androgen-producing cells could also be much reduced by unilateral oophorectomy (a shorter and easier operation than the bilateral wedge procedure), we have removed one ovary in ten patients with PCO. In all ten patients adrenal disease was rulled out and the ovaries