Objective: To define the satisfaction rate and the dropout causes of intracavernous self-injection therapy in impotent patients. Methods: A total of 250 impotent patients treated with intracavernous injection of drugs from 1991 to 1997 were mailed a questionnaire about their experience with this method. If the patient discontinued therapy, eight possible explanations for discontinuation were tested to identify reasons for terminating therapy (multiple choices were allowed). The causes of impotence were correlated with the rates of patients continuing or discontinuing therapy. Results: 144 of 250 patients (57.6%) returned the questionnaire. Of the 106 non-responding patients, 50% could not be reached due to relocation. The patients were divided into three groups according to the duration of injection use. In group I, 35 of 144 patients (24%) did not continue therapy at home because either they felt it was unnatural (20%), they were dissatisfied (20%), or they experienced improvement of spontaneous erections (15%). In group II, 57 of 144 patients (40%) continued therapy at home and dropped out after a mean duration of 6.9 (range 0.5–48) months due to dissatisfaction (22%), cost reasons (20%), or insufficient erection for penetration (19.4%). In group III, 52 of 144 patients (36%) were continuing therapy with a mean follow-up period of 19.8 (range 2–72) months. The mean ages were not statistically different in the three groups. Also the aetiologies of impotence were similar: 35% psychogenic, 25% organic, and 40% mixed psychogenic/organic. Patients with psychogenic aetiology seem to continue therapy more frequently than others. Conclusions: The long-term follow-up revealed a high attrition rate of intracavernous self-injection therapy. Patient dissatisfaction, cost, and insufficient erection for penetration were the major causes of dropout.

Feldman HA, Goldstein I, Hatzichristou DI, Krane RJ, McKinlay JB: Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61.
Sidi AA, Reddy PK, Chen KK: Patient acceptance of and satisfaction with vasoactive intravavernous pharmacotherapy for impotence. J Urol 1988;140:293–294.
Brindly GS: Cavernosal alpha blockade: A new technique for investigating and treating erectile impotence. Br J Psychiatry 1983;143:332–337.
Canale D, Giorgi PM, Lencioni R, Morelli G, Gasperi M, Macchia E. Long-term intracavernous self-injection with prostaglandin E1 for the treatment of erectile dysfunction. Int J Androl 1996;19:28–32.
Virag R: Intra-cavernous injection of papaverine for erectile failure. Lancet 1982;i:938–940.
Schramek P, Dorminger R, Waldhauser M, Konecny P, Porpaczy P: Prostaglandin E1 in erectile dysfunction. Efficacy and incidence of priapism. Br J Urol 1990;65:68–71.
Flynn RJ, Williams G: Long-term follow-up of patients with erectile dysfunction commenced in self-injection with intracavernosal papaverine with or without phentolamine. Br J Urol 1996;78:628–631.
Irwin MB, Kate EJ: High attrition rate with intracavernous injection of prostaglandin E1 for impotence. Urology 1994;43:84–87.
Weiss JN, Badlani GH, Ravalli R, Bresttschneider N: Reasons for high dropout rate with self-injection therapy for impotence. Int J Impot Res 1994;6:171–174.
Abobakr RA, Mulhall J, Golstein B, Leitzes R, Woods J, Payton T, Krane RJ, Goldstein I: The prevalence and causes of patient dropout from long-term self-injection therapy for impotence: Survey result from 708 respondents (abstract). J Urol 1996;155:469A.
Girdley FM, Bruskewitz RC, Feyzi J, Graversen PH, Grasser TC: Intracavernous self-injection for impotence: A long-term therapeutic option? J Urol 1988;140:972–974.
Virag R, Shoukry K, Floresco J, Nollet F, Greco E: Intra-cavernous self-injection of vaso-active drugs in the treatment of impotence: 8 years experience with 615 cases. J Urol 1991;145:287–293.
Lundberg L, Olsson JO, Kihl B: Long-term experience of self-injection therapy with prostaglandin E1 for erectile dysfunction. Scand J Urol Nephrol 1996;30:395–397.
Kim ED, El-Rashidy R, McVary KT: Papaverine topical gel for treatment of erectile dysfunction. J Urol 1995;153:361–365.
Kayigil O, Atahan O, Metin A: Import catheter in erectile dysfunction. J Urol 1997;158:530–532.
Sidi AA, Cameron JS, Duffy LM, Lange PH: Intracavernous drug induced erections in the management of male erectile dysfunction: Experience with 100 patients. J Urol 1986;135:704–706.
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