SATISFACTION PROFILES AND THEIR DETERMINANTS IN MEN USING INTRACAVERNOSAL INJECTION THERAPY

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Introduction: Intracavernosal injection therapy (ICI) is a well-established treatment strategy for men with erectile dysfunction (ED). Several reports have discussed drop-out rates and the predictors of such attrition. This study was undertaken in men using ICI for at least 6 months to define satisfaction levels and what predicts satisfaction with treatment.
Methods: Men using ICI completed a baseline IIEF and those that had used ICI for greater than 6 months completed a second IIEF questionnaire at least 6 months after starting ICI. At this time they also had erectile rigidity scored using the erection hardness core (EHS). Patient demographic, comorbidity and prior treatment information was compiled. Patients who had had radical pelvic surgery were excluded. Attention was focused on the satisfaction domains of the IIEF, specifically intercourse satisfaction (Q 6-8; max score 25) and overall satisfaction (Q 13-14; max score 10). Multivariable analysis was performed to define predictors of satisfaction. Pearson correlation coefficient was generated for the correlation between EF domain (EFD) score and satisfaction domains.
Results: 122 men were analyzed. Mean age and duration of ED were 68±32 and 3.6±4.2 years. 10% of men had one vascular comorbidity, 42% two, 36% three and 12% ≥4. Baseline IIEF-EF domain score was 13±12 and this rose to 26±2 after 6 months of ICI (p<0.001). 88% of men used trimix, 7% bimix, 2.5% papaverine and 2.5% PGE1 monotherapy. 62% continued to inject at a mean follow-up time-point of 22±7 months. Baseline satisfaction domain scores were: intercourse satisfaction 5±2; overall satisfaction 4±2.5 (Total 9±4.5). These scores rose to 12 (p<0.01) and 7 (p<0.05) respectively (total 19±4) after ICI treatment. Pearson correlation coefficient between EF and total satisfaction scores was 0.66. Predictors of satisfaction included: increased patient age, partner age and greater levels of erectile rigidity (see Table)
Conclusions: One third of men cease injection therapy within 2 years of initiation. The predictors of continued use included older patient age, young partner age, a clinically meaningful increase in IIEF-EF domain score and obtaining a fully rigid erection.

	OR		p Value
Increase of 10 years in patient age	2.1		<0.01
Decrease of 10 years in partner age	2.5		<0.01
Increase of ≥6 points on the EFD score	3.1		<0.01
Obtaining an EHS 4 (fully rigid) erection	6.8		<0.001

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