Diabetic impotence treated by intracavernosal injections: High treatment compliance and increasing dosage of vaso-active drugs

Aims:To compare patient compliance with treatment and the dosages of vaso-a ctive drugs used, for the management of impotence in diabetic and non-diabe tic patients. Methods: Eighteen diabetic and a control group of 22 non-diabetic men were followed up regularly for 7 years after they had begun self-injections for severe erectile dysfunction. Rigiscan was used for the objective determinat ion of the initial dosage and then doses were regulated in order to introdu ce an erection suitable for penetration and maintenance of erection for 30 min. Results: Sixteen of 18 diabetic men are still using self-injections success fully after 7 years while of the 22 non-diabetic men, only 7 still continue injections. Compliance of diabetic men with treatment is significantly hig her compared to the control group (p = 0.001). Doses of prostaglandin El (P GE,) or mixtures of PGE, and papaverine (PAP) had to be increased over time . Although self-injections were a safe kind of treatment and no major compl ications were observed in both groups, a decrease in the frequency of injec tions was observed, particularly in the diabetic group, but this was not st atistically significant (p = 0.15). Conclusions: Diabetic patients with severe erectile dysfunction have much h igher compliance with self-injections than the non-diabetic patients. They respond initially to reasonable doses of PGE, but over time need increasing doses of PGE, or mixtures of PGE, and PAR Frequent follow-up visits and th e adjustment of dosage to continue the success of therapy may prevent patie nt dissatisfaction and drop-out from treatment. Patients treated with self- injections decrease the frequency of injections over time. They are satisfi ed with less frequent but successful intercourse and have a low risk of sid e-effects. Copyright (C) 2001 S. Karger AG, Basel.