title: Long-term satisfaction and predictors of use of intracorporeal injections for post-prostatectomy erectile dysfunction.
abstract: OBJECTIVE
  Intracorporeal injections have low use rates and high discontinuation rates. We examined factors associated with intracorporeal injection use, long-term satisfaction with intracorporeal injection and reasons for discontinuation in men treated with radical prostatectomy.
  
  
  METHODS
  Between October 2000 and September 2003, 731 men who underwent open radical retropubic prostatectomy were enrolled in a prospective outcomes study. The 8-year followup evaluation included the UCLA-PCI, and a survey capturing intracorporeal injection use, satisfaction and reasons for discontinuation. Logistic regression was used to determine associations between intracorporeal injection use and preoperative variables.
  
  
  RESULTS
  The 8-year self-assessment was completed by 368 (50.4%) men. Of these men 140 (38%) indicated prior or current intracorporeal injection use, with only 34 using intracorporeal injection at 8 years. Overall, 44% of the men were satisfied with intracorporeal injections. Reasons for discontinuation included dislike (47%), pain (33%), return of erection (19%), inefficacy (14%) and no partner (6%). Men trying intracorporeal injections had greater preoperative UCLA-PCI sexual function scores (75.2 vs 65.62, p = 0.00005) as well as greater decreases in this score at 3 months (p = 0.0002) and 2 years (p = 0.003). Higher preoperative sexual function scores were independently associated with the use of intracorporeal injections in a model adjusted for age, marital status, nerve sparing status and body mass index (OR 1.021, 95% CI 1.008-1.035).
  
  
  CONCLUSIONS
  Men pursuing intracorporeal injections have better baseline erectile function and experience greater deterioration in erectile function during the early postoperative period. Despite the high efficacy of injections, many men discontinue intracorporeal injections due to dislike or discomfort. Satisfaction rates for intracorporeal injections indicate their long-term role in restoring sexual function in men with post-prostatectomy erectile dysfunction.
authors.affiliation: Department of Urology, New York University School of Medicine, New York, New York 10016, USA.
authors.forename: Vinay
authors.initials: V
authors.lastname: Prabhu
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Alukal
authors.forename: Juliana
authors.initials: J
authors.lastname: Laze
authors.forename: Danil V
authors.initials: DV
authors.lastname: Makarov
authors.forename: Herbert
authors.initials: H
authors.lastname: Lepor
mesh_terms: D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D013997:Time Factors