Analysis of the consistency of intraurethral prostaglandin E-1 (MUSE) during at-home use

Objectives. To determine the consistency of a successful response to intrau rethral prostaglandin El (MUSE), an effective treatment for a proportion of patients with erectile dysfunction, during at-home use in men who had a su ccessful response in the office, to define the factors that correlated with the consistency of the response, and to determine whether patients continu ed long-term use. Methods. The study group consisted of men with documented erectile dysfunct ion who had a successful response (grade 3 or 4 erection) to MUSE during an initial in-office dose. All enrollees completed a home diary assessing the treatment success during at least five medication administrations. Factors such as patient age, vascular risk factor status, and degree of in-office response were prospectively evaluated as correlates of response consistency . Finally, patient follow-up was conducted in an attempt to define how many patients were continuing to use this medication as a long-term treatment m odality. Results. Two hundred twelve patients underwent screening and 72 (34%) patie nts had in-office success. The overall per patient at-home consistency rate was 51%. None of the aforementioned factors correlated with the consistenc y of the response, At a mean of 9 months after beginning treatment, only 31 % of the in-off ice responders were continuing to use MUSE. Conclusions. Although MUSE is an appropriate and safe treatment for many pa tients with erectile dysfunction, the lack of consistency is a significant consideration. Clinicians should pay close attention to patient education i n an effort to promote realistic expectations for MUSE therapy. Furthermore , the lack of consistency may significantly lower the patient's interest in continuing this treatment long term. UROLOGY 58: 262-266, 2001. (C) 2001, Elsevier Science Inc.