[Why are auto-intracavernous injections abandon in the long-term?]

Self-administered intracavernous injections are proposed in the treatment of impotence, but are frequently discontinued in the long-term. The objective of this study was to assess the reasons for discontinuation of treatment.

Between 1991 and 1996, 250 patients consulting for impotence, to whom self-administered injections were proposed, received a questionnaire at home concerning the frequency of use, duration of erections and acceptability of self-administered injections, as well as the reasons for discontinuation of treatment. The sensitivity of the study was increased by contacting the patient by telephone. The results were analysed according to the aetiology of impotence.

144 patients (57.6%) answered the questionnaire. Of the 106 patients who failed to answer the questionnaire, the telephone call revealed that 66 patients had changed address, 36 had not received the questionnaire and 4 did not wish to participate. Of the 144 patients answering the questionnaire, 35 did not continue treatment at home (group I, 24.3%) because they were dissatisfied (22% of answers), encountered technical problems (22%) or had regained spontaneous erections (15%). 57 of the remaining 109 patients (group II, 57/144 (39.5%)) subsequently discontinued treatment after a mean duration of 6.9 months, because of personal dissatisfaction (33%), financial problems (20%), and erections insufficient to allow penetration (19.4%). Fifty two patients continued treatment (group III, 52/144 (36.2%)). The discontinuation rate was equivalent regardless of the drug used. The three groups did not differ in terms of mean age. The distribution of the causes of impotence was essentially similar in the 3 groups with 35% of psychogenic causes, 40% of mixed causes and 25% of organic causes.

Intracavernous injections appear to be a reliable and lasting solution for the treatment of erectile impotence requiring selection of motivated couples, regularly reviewed in the outpatients department and having totally integrated the concept of self-administered intracavernous injection.