Intracavernosal self-injection therapy in men with erectile dysfunction: Satisfaction and attrition in 119 patients

This study describes a 12-24 month follow-up on 119 ED patients in an attem pt to understand satisfaction with and dropout from ICI use. Results indica te 40% attrition, attributed primarily to a lack of efficacy of ICI, but al so to spontaneous return of erectile function and to negative reactions sur rounding the injection procedure. Multivariate analyses indicated that ICI dropouts were more likely to have co-existing premature ejaculation, low re sponses during psychophysiological screening, a lack of spontaneous erectio ns prior to ICI, and an etiology that included an organogenic component. Th ese same factors, along with low satisfaction with their sex life, were rel ated to attrition due specifically to a lack of drug efficacy. In contrast, attrition due to recovery of spontaneous erections was associated with hig h sexual satisfaction. Among ongoing users, dissatisfaction was associated with higher age, shorter erections during ICI use, and low satisfaction wit h sex life. These findings identify a number of factors related to attritio n and satisfaction, emphasizing the importance of specifying the cause for ICI attrition and, demonstrating that a substantial portion of patients who dropout do so for positive reasons.