Erection Injections Work, But...
NEW YORK (Reuters) -- Men who use injections into the penis to help them achieve and retain an erection say they are happy with the results, yet more than half discontinue the treatment within one year, a new study shows.
The five-year study uncovered several reasons for discontinuance, including desire for a more permanent treatment such as a penile implant, but side effects were not a significant factor.
"It surprised us to find out that despite the high drop-out rate, 82% of all patients said they would recommend the injections to a friend," says senior study author Dr. Jon L. Pryor, associate professor of urologic surgery at the University of Minnesota in Minneapolis.
The study reviewed questionnaire responses and medical records of 100 men with erectile dysfunction, who between 1984 and 1989 used penile injections to allow the organ's tissue to more readily engorge with blood. These "vasoactive" drugs include papaverine, phentolamine, and prostaglandin E1, "and any combination of those," notes Pryor.
Average number of injections per month for the group was four. The highest number was 20.
After one year, only 32% of the patients continued to use the virtually painless self-injections, while 56% had stopped doing so. But the sharp rate of discontinuance appeared to taper off after two years.
"With the injections, erection lasts anywhere from approximately 10 minutes to, on the outside, around two hours," Pryor says. "It's really a very tiny needle and it does not hurt -- I've actually done it myself once for a study."
Pryor says a long-term follow-up study was considered important because "so many people are doing this, and we wanted to know if they drop out, why they drop out, and if there were any complications."
The study found that people who stopped the therapy listed a variety of reasons. Among these: 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%).
Side effects were last on the list, accounting for 4% of the drop-outs.
Pryor and his colleagues found that those who dropped out tended to be significantly older (over 50) and had "a poor initial impression" of the injection treatment.
"But the question is, considering that so many of those who dropped out would still recommend the treatment to a friend, did they find out that erection wasn't so important, that there was something else missing? That's the unknown question," Pryor says.
As to complications, the study found priapism (prolonged, often painful erection) in 13% of patients. Other complications were minor burning and pain, and penile curvature.
Early signs of a more serious complication -- scarring or fibrous thickening of penile tissue (Peyronie's disease) -- were identified only in one case.
"I think this study says it's probably worthwhile to follow these patients, not just to see if they get Peyronie's disease, but if they drop out, to at least let them know there are other therapies if they want them," Pryor says. SOURCE: Urology (1997;49:932-935) |
