Portal de Periódicos da CAPES

THE CAUSES OF PATIENT DROPOUT FROM PENILE SELF-INJECTION THERAPY FOR IMPOTENCE

1999; Lippincott Williams & Wilkins; Volume: 162; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(05)68269-9

1527-3792

John P. Mulhall, ANDREW E. JAHODA, MICHAEL CAIRNEY, Bryan H. Goldstein, ROD LEITZES, JORDAN WOODS, Terry Payton, Robert J. Krane, Irwin Goldstein,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyClinical Urology: Original Articles1 Oct 1999THE CAUSES OF PATIENT DROPOUT FROM PENILE SELF-INJECTION THERAPY FOR IMPOTENCE JOHN P. MULHALL, ANDREW E. JAHODA, MICHAEL CAIRNEY, BRYAN GOLDSTEIN, ROD LEITZES, JORDAN WOODS, TERRY PAYTON, ROBERT J. KRANE, and IRWIN GOLDSTEIN JOHN P. MULHALLJOHN P. MULHALL , ANDREW E. JAHODAANDREW E. JAHODA , MICHAEL CAIRNEYMICHAEL CAIRNEY , BRYAN GOLDSTEINBRYAN GOLDSTEIN , ROD LEITZESROD LEITZES , JORDAN WOODSJORDAN WOODS , TERRY PAYTONTERRY PAYTON , ROBERT J. KRANEROBERT J. KRANE , and IRWIN GOLDSTEINIRWIN GOLDSTEIN View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68269-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Penile self-injection therapy, a second line treatment for erectile dysfunction, is the most efficacious means of reestablishing functional erections when first line therapies fail and the patient wants to avoid penile prosthesis implantation. Despite high efficacy rates, injection therapy has high dropout rates. To our knowledge studies to date analyzing patient attrition have reviewed small numbers of patients followed for only short periods. We elucidate the main reasons for patient dropout in a large penile self-injection program with long-term followup. Materials and Methods: A questionnaire was mailed to 1,424 patients who completed the office training and home use phases of a penile self-injection program. Results: The overall attrition rate was 31% of the 720 men who completed the questionnaire, with a mean followup of 38 months. The main reasons for dropout were cost of therapy, patient and partner problems with the concept of penile injection, lack of partner availability and spontaneous improvement in erections. Lack of efficacy of therapy was the primary reason for only 1 of 7 dropouts. Furthermore, adverse effects of penile injections (priapism, penile nodules, pain) appeared to be only minor contributors to dropout. Conclusions: To our knowledge this study is the largest published, single center cohort of patients treated with injection and followed for an analysis of dropout rates. Based on study data a reduction in dropout rates may be achieved by keeping the cost of therapy low, and ensuring patient and partner education as well as continued support throughout treatment. References 1 : Current treatment and future perspectives for erectile dysfunction. Int. J. Impotence Res.1998; 1: S3. Google Scholar 2 : Pharmacologic management of erectile dysfunction. Drugs1995; 50: 465. Google Scholar 3 : Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. New Engl. J. Med.1998; 338: 1397. Crossref, Medline, Google Scholar 4 : Impotence and its medical and psychological correlates: results of Massachusetts male aging study. J. Urol.1994; 151: 54. Abstract, Google Scholar 5 : Intracavernous injection therapy for male erectile dysfunction. Urol. Clin. N. Amer.1995; 22: 833. Crossref, Medline, Google Scholar 6 : Intracavernosal injection therapy: a practical guide. Tech. Urol.1997; 3: 129. Google Scholar 7 : Why do so many people drop out from auto-injection therapy for impotence?. J. Sex Marital Ther.1989; 15: 121. Google Scholar 8 : High attrition rate with intracavernous injection of prostaglandin E1 for impotence. Urology1994; 43: 84. Google Scholar 9 : Reasons for high drop-out rate with self-injection therapy for impotence. Int. J. Impotence Res.1994; 6: 171. Google Scholar 10 : Long-term follow-up of patients receiving injection therapy for erectile dysfunction. Urology1997; 49: 932. Google Scholar 11 : Drop-out reasons and complications in self-injection therapy with a triple vasoactive drug mixture in sexual erectile dysfunction. Int. J. Impotence Res.1998; 10: 5. Google Scholar 12 : Twelve-month comparison of two treatments for erectile dysfunction: self-injection versus external vacuum devices. Urology1992; 39: 139. Google Scholar 13 : Intracavernous self-injection for impotence: a long-term therapeutic option? Experience in 78 patients. J. Urol.1988; 140: 972. Link, Google Scholar 14 : Intracavernous self-injection of vasoactive drugs in the treatment of impotence: 8-year experience with 615 cases. J. Urol.1991; 145: 287. Link, Google Scholar 15 : Alkalization does not alleviate penile pain induced by intracavernous injection of prostaglandin E1. J. Urol.1996; 156: 999. Link, Google Scholar 16 : Slow injection of prostaglandin E1 decreases associated penile pain. Urology1996; 47: 903. Google Scholar 17 : Influence of the method of intracavernous injection on penile rigidity: a possible pharmacokinetic explanation. Urology1997; 49: 248. Google Scholar 18 : Intracavernous self-injection pharmacotherapy program: analysis of results and complications. Int. J. Impotence Res.1994; 6: 81. Google Scholar 19 : Side effects of self-administration of intracavernous papaverine and phentolamine for the treatment of impotence. J. Urol.1989; 141: 54. Link, Google Scholar 20 : Intracavernous pharmacotherapy: psychological, sexological, and medical aspects. Int. J. Impotence Res.1991; 3: 95. Google Scholar 21 : Intracavernosal pharmacotherapy: the pharmacologic erection program. World J. Urol.1987; 5: 160. Google Scholar From the Department of Urology, Boston University Medical Center, Boston, Massachusetts© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byOberlin D, Matulewicz R, Bachrach L, Hofer M, Brannigan R and Flury S (2014) National Practice Patterns of Treatment of Erectile Dysfunction with Penile Prosthesis ImplantationJournal of Urology, VOL. 193, NO. 6, (2040-2044), Online publication date: 1-Jun-2015.Prabhu V, Alukal J, Laze J, Makarov D and Lepor H (2012) Long-Term Satisfaction and Predictors of Use of Intracorporeal Injections for Post-Prostatectomy Erectile DysfunctionJournal of Urology, VOL. 189, NO. 1, (238-242), Online publication date: 1-Jan-2013.MATTHEW A, GOLDMAN A, TRACHTENBERG J, ROBINSON J, HORSBURGH S, CURRIE K and RITVO P (2018) SEXUAL DYSFUNCTION AFTER RADICAL PROSTATECTOMY: PREVALENCE, TREATMENTS, RESTRICTED USE OF TREATMENTS AND DISTRESSJournal of Urology, VOL. 174, NO. 6, (2105-2110), Online publication date: 1-Dec-2005. Volume 162Issue 4October 1999Page: 1291-1294 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.Keywordsinjectionpatient dropoutspenile erectionimpotenceMetricsAuthor Information JOHN P. MULHALL More articles by this author ANDREW E. JAHODA More articles by this author MICHAEL CAIRNEY More articles by this author BRYAN GOLDSTEIN More articles by this author ROD LEITZES More articles by this author JORDAN WOODS More articles by this author TERRY PAYTON More articles by this author ROBERT J. KRANE More articles by this author IRWIN GOLDSTEIN More articles by this author Expand All Advertisement PDF downloadLoading ...