title: Reasons for high drop-out rate with self-injection therapy for impotence.
abstract: One hundred and eighty patients, average age of 58 years (range 24-75) were evaluated for impotence and were advised to undergo pharmacologic self-injection therapy with either papaverine/Regitine (90%) or prostaglandin E1 (10%). Follow-up was available from 2 months to 3 years (average 11 months). The cause of impotence was determined by hormonal testing, Rigiscan and psychological testing. The etiology of impotence was organic (70%), psychogenic (20%), and mixed (10%). After the initial test injection 22% of patients did not enroll in the self-injection program or were lost to follow-up. The group with psychogenic impotence had the highest satisfaction/usage rate at 42%. Overall only 20% of patients were satisfied long-term and were actively using self-injection therapy. Of the 140 patients available for follow-up, 112 patients (80%) discontinued self-injection therapy. The reasons for discontinued usage were alternate treatment (prosthesis or vacuum device) 15%, return or improvement of erections 8%, partner dissatisfaction or loss of partner 10%, or complications of injection therapy 10%. Cost was not a factor for discontinued use. Loss of interest caused 57% of patients to stop using self-injection therapy. Although pharmacologic self-injection therapy is initially promising there is a high drop-out rate at long-term follow-up.
authors.affiliation: Long Island Jewish Medical Center, Department of Urology, New Hyde Park, New York 10040, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Weiss
authors.forename: G H
authors.initials: GH
authors.lastname: Badlani
authors.forename: R
authors.initials: R
authors.lastname: Ravalli
authors.forename: N
authors.initials: N
authors.lastname: Brettschneider
mesh_terms: D000328:Adult; D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000008:administration & dosage* / Q000009:adverse effects; D010352:Patient Dropouts / Q000523:psychology*; D010410:Penile Erection / Q000187:drug effects / Q000523:psychology; D011458:Prostaglandins E / Q000008:administration & dosage* / Q000009:adverse effects; D012646:Self Administration / Q000523:psychology
chemical_list: D011458:Prostaglandins E; D010208:Papaverine