title: [Intracavernous auto-injection therapy with papaverine phentolamine via an auto-injection pen for patients with an erectile dysfunction: similar results achieved in family practice and urology].
abstract: OBJECTIVE
  To determine the results of an auto-injection therapy with papaverine-phentolamine (using an auto-injection pen) prescribed by a GP or a urologist, in patients with erectile dysfunction.
  
  
  METHODS
  Prospective, comparative, descriptive.
  
  
  METHODS
  A total of 603 men with erectile dysfunction who were prescribed papaverine-phentolamine auto-injection by 59 GPs and 76 urologists participated in the study. The physician completed a questionnaire at the first visit and during the three follow-up visits (the last at 6 months) and the patient kept a diary and gave a satisfaction score on a nine-point scale.
  
  
  RESULTS
  The cause of the erectile dysfunction was most commonly psychogenic/mixed somatic-psychogenic in the GP group and most commonly vascular in the urologist group (p > 0.05). The somatic comorbidity was the same (70%), whereas the prevalence of psychological symptoms differed (GP group: 6%; urologist group: 7%; p < 0.001). Attendance at all of the follow-up examinations was 38% for the GP group and 17% for the urologist group. The mean starting dose in the GP group was 0.49 ml and in the urologist group 0.70 ml (p < 0.001). The mean end dose was the same (about 1 ml). The frequency of adverse reactions was 9%: haematoma (5%), prolonged erection (1.8%). During the course of the investigation, 38% of the patients (31% in the GP group; 40% in the urologist group) discontinued the treatment owing to a limited effect, adverse reactions, difficult administration or problems related to the partner. In both the GP and the urologist group, 72% of the patients and 77% of the partners were satisfied or very satisfied with the auto-injection pen treatment. The patient's mean satisfaction score was 7.2.
  
  
  CONCLUSIONS
  Whether the patient was treated by a GP or a urologist, the auto-injection therapy with papaverine-phentolamine for erectile dysfunction, using an auto-injection pen, was well tolerated and was highly appreciated by both the patients and their partners. Nevertheless one third of the patients discontinued the treatment prior to the end of the study. The mean end dose of the medication was the same in both groups.
authors.affiliation: Universitair Medisch Centrum, Julius Centrum voor Huisartsgeneeskunde en Patiëntgebonden onderzoek, Utrecht. l.j.deboer@med.uu.nl
authors.forename: B J
authors.initials: BJ
authors.lastname: de Boer
authors.forename: A A
authors.initials: AA
authors.lastname: Lycklama a Nijeholt
authors.forename: H A
authors.initials: HA
authors.lastname: Kleinjans
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004338:Drug Combinations; D007172:Erectile Dysfunction / Q000188:drug therapy*; D005194:Family Practice; D005500:Follow-Up Studies; D006801:Humans; D007277:Injections, Jet; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010208:Papaverine / Q000008:administration & dosage*; D017060:Patient Satisfaction; D010646:Phentolamine / Q000008:administration & dosage*; D011446:Prospective Studies; D012646:Self Administration; D016896:Treatment Outcome; D014572:Urology; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D000317:Adrenergic alpha-Antagonists; D004338:Drug Combinations; D014665:Vasodilator Agents; D010208:Papaverine; D010646:Phentolamine