Reasons of dropout from short- and long-term self-injection therapy for impotence

Objective: To define the satisfaction rate and the dropout causes of intrac avernous self-injection therapy in impotent patients. Methods: A total of 2 50 impotent patients treated with intracavernous injection of drugs from 19 91 to 1997 were mailed a questionnaire about their experience with this met hod. If the patient discontinued therapy, eight possible explanations for d iscontinuation were tested to identify reasons for terminating therapy (mul tiple choices were allowed). The causes of impotence were correlated with t he rates of patients continuing or discontinuing therapy. Results: 144 of 2 50 patients (57.6%) returned the questionnaire. Of the 106 nonresponding pa tients, 50% could not be reached due to relocation. The patients were divid ed into three groups according to the duration of injection use. In group I , 35 of 144 patients (24%) did not continue therapy at home because either they felt it was unnatural (20%), they were dissatisfied (20%), or they exp erienced improvement of spontaneous erections (15%). In group II, 57 of 144 patients (40%) continued therapy at home and dropped out after a mean dura tion of 6.9 (range 0.5-48) months due to dissatisfaction (22%), cost reason s (20%), or insufficient erection for penetration (19.4%). In group Iii, 52 of 144 patients (36%) were continuing therapy with a mean follow-up period of 19.8 (range 2-72) months. The mean ages were not statistically differen t in the three groups. Also the aetiologies of impotence were similar: 35% psychogenic, 25% organic, and 40% mixed psychogenic! organic. Patients with psychogenic aetiology seem to continue therapy more frequently than others . Conclusions: The long-term follow-up revealed a high attrition rate of in tracavernous self-injection therapy. Patient dissatisfaction, cost, and ins ufficient erection for penetration were the major causes of dropout.