Intracavernosal injection (ICI) therapy - Efficacy, side effects and dropouts: experience of a single institution
Alves, L1; Lopes, S1; Cosme, C1; Gameiro, C1; Graça, B1; Sousa, R1
1: Hospital Beatriz Ângelo, Portugal
Objectives: To evaluate the efficacy, side effects and dropouts of ICI therapy in our institution.
Material and Methods: Retrospective review of the electronic medical records of all pts submitted to ICI in Hospital Beatriz Ângelo, from January 2015 to October 2017.
Results: A total of 28 pts with erectile dysfunction (ED) with a median age of 68 [44;77] were included, 17 pts had a previous history of pelvic surgery. All of them failed the treatment with phosphodiesterase type 5 inhibitors. Thus, those pts were proposed to the ICI therapy with alprostadil. On a first appointment, a nurse ensures both the patient and partner’s education by administering the penile injection, as well as, providing further information about results and possible side effects. Continued support is offered throughout treatment. ICI showed no efficacy in 4 pts. Regarding the remaining pts, 6 are still on therapy. The reasons for dropout were: difficulties or fear performing the injection (8 pts), pain (6 pts), priapism (2 pts) and partner reaction (2 pts).
Conclusions: ICI therapy is a well-established second line treatment for ED with high efficacy. In our population, high rates of withdrawal were described. The most common reasons for discontinuing treatment were difficulties with or fear of performing the penile injection by themselves and pain. Priapism and lack of partner support appeared to me minor contributors to dropout. Although the study includes only a small number of pts, these results are in accordance with the current published data. Counselling and support are the cornerstones in maintaining treatment. Nevertheless, ICI is still a cause of anxiety among man, from whom, new drugs such as intraurethral/topic alprostadil may be a safe alternative.
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