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The role of intracavernosal injection therapy and the reasons of withdrawal from therapy in patients with erectile dysfunction in the era of PDE 5 inhibitors
Author(s) -
Sung H. H.,
Ahn J. S.,
Kim J. J.,
Choo S. H.,
Han D. H.,
Lee S. W.
Publication year - 2014
Publication title -
andrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.947
H-Index - 43
eISSN - 2047-2927
pISSN - 2047-2919
DOI - 10.1111/j.2047-2927.2013.00155.x
Subject(s) - discontinuation , erectile dysfunction , medicine , adverse effect , sexual dysfunction
Summary There has been little data regarding the role of intracavernosal injection ( ICI ) treatment, its discontinuation rate and the reasons of withdrawal in patients with erectile dysfunction ( ED ) in the era of phosphodiesterase type 5 ( PDE 5) inhibitors. The aim of this study was to investigate the rate of withdrawal and its associated reasons in patients undergoing ICI therapy. Patients who were prescribed with ICI treatment two times or more were included since the introduction of sildenafil in K orea in 1999. Telephone surveys were performed to evaluate intercourse rates, withdrawal rates and their associated reasons, adverse events and the patients' satisfaction with their sex lives after the ICI treatments. Two hundred and ninety‐four men were contacted by telephone. The mean age was 61.8 ± 7.9 years with a follow‐up duration of 25.6 ± 32.1 months. At the last follow‐up, 79.9% had discontinued the treatment. Most patients had previously failed PDE 5 inhibitor treatment prior to the ICI therapy, and more than half had two or more risk factors of ED . Adequate penile rigidity after ICI therapy was restored in 60.2% of patients. The reasons for discontinuation of ICI were poor response (43.1%), inconvenience of use (18.3%), switch to other treatments (10.7%), loss of libido (6.7%), adverse events (5.5%) and return of spontaneous erection (2.8%). Pain was the most common adverse event in the withdrawal group, whereas prolonged erection was most common in the continuing group. Following ICI treatment, PDE 5 inhibitors were the most common therapeutic option (63.1%). The overall satisfaction rate regarding sex life was significantly high in the treatment‐continuing group. In conclusion, patients on ICI treatment had severe ED and high withdrawal rates in the era of PDE 5 inhibitors. The most common reason for treatment discontinuation was poor response. Before initiating ICI treatments, sufficient counselling is necessary.