title: Patient-reported pain with initial intracavernosal injection.
abstract: BACKGROUND
  Despite the efficacy of intracavernosal injections, one of the greatest impediments to injection therapy is the negative reaction of men to the thought of a needle inserted into the penis.
  
  
  OBJECTIVE
  To determine the severity of pain associated with the initial intracavernosal self-injections for erectile dysfunction (both pain associated with the needle insertion and the medications).
  
  
  METHODS
  This is a descriptive study of self-reported pain associated with intracavernosal self-injections in 65 men with erectile dysfunction. Pain was assessed immediately after needle insertion and again approximately 10-20 minutes postinjection, utilizing a verbal 0-10 pain scale.
  
  
  METHODS
  A verbal 0-10 pain rating scale was used to assess pain both for injection pain and medication pain.
  
  
  RESULTS
  For needle insertion, the mean pain rating was 0.80 (standard deviation [SD] = 0.81), with 40% reporting no pain at all. Of the 39 patients who reported pain, the mean pain rating was 1.33 (SD = 0.61). For the medication itself, the mean pain rating was 0.92 (SD = 1.5), with more than half (64.6%) reporting no pain. For those experiencing pain from the medication (N = 23), the mean pain rating was 2.6 (SD = 1.27, range 0.5-5.0). Significantly more patients with radical prostatectomy experienced pain from the medication than other men (51.9% vs. 23.7%, P = 0.02).
  
  
  CONCLUSIONS
  The majority of patients experienced little or no pain from either the needle insertion or the medication. Even for men who experienced pain, the severity was relatively low. This study provides information to help diminish fears about injection pain for patients considering penile injections. In addition, this study suggests that medication pain is more common in men postradical prostatectomy, so that it may be advisable to start with lower dosages of prostaglandin alone or in combination with other vasoactive medications for these patients.
authors.affiliation: Department of Sexual Health Program, Northwestern Memorial Wellness Institute and Jesse Brown VA Medical Center, Chicago, IL 60611, USA. jaalbaug@nmh.org
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Albaugh
authors.forename: Carol Estwing
authors.initials: CE
authors.lastname: Ferrans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004358:Drug Therapy / Q000379:methods*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007267:Injections / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000209:etiology*; D010147:Pain Measurement; D010413:Penis; D011446:Prospective Studies; D011468:Prostatectomy / Q000706:statistics & numerical data; D012646:Self Administration; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires