Long-term follow-up of patients receiving injection therapy for erectile dysfunction

Chandru Sundaram, William Thomas, Laurie E. Pryor, A. Ami Sidi, Kevin Billups, Jon L. Pryor

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Objectives. During the last decade, vasoactive intracavernosal pharmacotherapy (VIP) has been used extensively for the treatment of erectile dysfunction. However, there is concern about high discontinuation rates and the possibility of long-term complications. Because of few long-term studies on VIP, we investigated efficacy, side effects, satisfaction index, and drop- out rate for injection therapy in patients who started treatment more than 5 years ago. Methods. Questionnaires were mailed to 108 patients who were started on VIP more than 5 years ago, between November 1984 and July 1989. The hospital records and data from the 100 responders (93%) were reviewed. Results. Only 32% of the patients continue to use VIP. Most (56%) of those who discontinued did so during the first year. The patients cited one or more of the following reasons for discontinuation: desire for a permanent modality of therapy (29%), lack of a suitable partner (26%), fear of needles (23%), poor response (23%), fear of complications (22%), and lack of sexual spontaneity (21%). This study, which has one of the longest follow-up periods in the literature, has significant new findings in three areas: discontinuation rates fall after 2 years, long-term complications are relatively minor, and patients who discontinue therapy are significantly older or have a poor initial impression of VIP. Paradoxically, discontinuing VIP was apparently unrelated to side effects or etiology of erectile dysfunction, and 82% of patients would still recommend VIP to a friend. Conclusions. This study conclusively shows that because of high initial satisfaction and relatively minor side effects, VIP should remain as one of the initial options for long-term treatment of erectile dysfunction. However, despite seemingly doing well, patients often discontinue therapy, and therefore should be followed closely so that alternative therapy can be offered.

Original languageEnglish
Pages (from-to)932-935
Number of pages4
JournalUrology
Volume49
Issue number6
DOIs
StatePublished - Jun 1997
Externally publishedYes

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Erectile Dysfunction
Drug Therapy
Injections
Therapeutics
Fear
Hospital Records
Complementary Therapies
Needles

ASJC Scopus subject areas

  • Urology

Cite this

Long-term follow-up of patients receiving injection therapy for erectile dysfunction. / Sundaram, Chandru; Thomas, William; Pryor, Laurie E.; Ami Sidi, A.; Billups, Kevin; Pryor, Jon L.

In: Urology, Vol. 49, No. 6, 06.1997, p. 932-935.

Research output: Contribution to journalArticle

Sundaram, C, Thomas, W, Pryor, LE, Ami Sidi, A, Billups, K & Pryor, JL 1997, 'Long-term follow-up of patients receiving injection therapy for erectile dysfunction', Urology, vol. 49, no. 6, pp. 932-935. https://doi.org/10.1016/S0090-4295(97)00079-4
Sundaram, Chandru ; Thomas, William ; Pryor, Laurie E. ; Ami Sidi, A. ; Billups, Kevin ; Pryor, Jon L. / Long-term follow-up of patients receiving injection therapy for erectile dysfunction. In: Urology. 1997 ; Vol. 49, No. 6. pp. 932-935.
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abstract = "Objectives. During the last decade, vasoactive intracavernosal pharmacotherapy (VIP) has been used extensively for the treatment of erectile dysfunction. However, there is concern about high discontinuation rates and the possibility of long-term complications. Because of few long-term studies on VIP, we investigated efficacy, side effects, satisfaction index, and drop- out rate for injection therapy in patients who started treatment more than 5 years ago. Methods. Questionnaires were mailed to 108 patients who were started on VIP more than 5 years ago, between November 1984 and July 1989. The hospital records and data from the 100 responders (93{\%}) were reviewed. Results. Only 32{\%} of the patients continue to use VIP. Most (56{\%}) of those who discontinued did so during the first year. The patients cited one or more of the following reasons for discontinuation: desire for a permanent modality of therapy (29{\%}), lack of a suitable partner (26{\%}), fear of needles (23{\%}), poor response (23{\%}), fear of complications (22{\%}), and lack of sexual spontaneity (21{\%}). This study, which has one of the longest follow-up periods in the literature, has significant new findings in three areas: discontinuation rates fall after 2 years, long-term complications are relatively minor, and patients who discontinue therapy are significantly older or have a poor initial impression of VIP. Paradoxically, discontinuing VIP was apparently unrelated to side effects or etiology of erectile dysfunction, and 82{\%} of patients would still recommend VIP to a friend. Conclusions. This study conclusively shows that because of high initial satisfaction and relatively minor side effects, VIP should remain as one of the initial options for long-term treatment of erectile dysfunction. However, despite seemingly doing well, patients often discontinue therapy, and therefore should be followed closely so that alternative therapy can be offered.",
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