QUALITY-OF-LIFE EFFECTS OF ALPROSTADIL THERAPY FOR ERECTILE DYSFUNCTION

Purpose: We evaluated the quality of life effects of self-administered intracavernosal injection of alprostadil sterile powder for erectile dysfunction when used by patients for up to 18 months. Materials and M ethods: Clinical and self-reported measurements were used to assess ph ysiological and psychological status at baseline, and at 3, 6, 12 and 18 months for 579 patients who entered the self-injection phase of an open label, flexible dose clinical trial. Quality of life was measured using the Center for Marital and Sexual Health Sexual Functioning Que stionnaire, which focuses on the psychosocial and physical dimensions of erectile dysfunction; the Brief Symptom Inventory, which measures m ental health, and the Duke Health Profile, which measures general qual ity of life. The primary evaluations were quality of life changes from baseline to post-initiation periods and reasons for treatment discont inuation. Results: The Center for Marital and Sexual Health Sexual Fun ctioning Questionnaire displayed improvements at all post-initiation p eriods in 10 questions (p <0.001, Student's paired t tests) grouped in to scales representing frequency of sexual activity, erection, orgasm and satisfaction domains. On the Brief Symptom Inventory interpersonal sensitivity, anxiety and depression as well as global scores improved (p <0.001). Overall mental health as measured by the Duke Health Prof ile also improved (p <0.01) between baseline and 6 months. The reasons most frequently cited for treatment discontinuation were nonfirm erec tions and injection site pain. Conclusions: Clinical improvements in e rectile function due to alprostadil therapy were associated with impro vements in sexual activity, sexual satisfaction and overall mental hea lth.