To evaluate the clinical outcomes of intracavernosal injection (ICI) use in an undifferentiated group of men with erectile dysfunction at various stages after radical prostatectomy.

Retrospective charts, mailed questionnaires, and a telephone survey of patients after radical prostatectomy prescribed ICI by a single urologist from January 2006 to January 2008. The patient demographics and prostate cancer profiles, current ICI use patterns, adverse outcome, and clinical efficacy were collected.

A total of 117 patients completed the questionnaire. The mean age was 65 ± 6.2 years, and the patients had undergone radical prostatectomy 4.1 ± 2.7 years earlier. Most patients had hypertension (38%) and dyslipidemia (26%); 51% of the patients actively used ICI, with a median of 3 attempts monthly. Sixty-eight percent of all patients were sexually active (98% of ICI users vs 36% of ICI nonusers, P < .001). In the sexually active patients, ICI was associated with significantly greater International Index of Erectile Function scores (20.8 ± 4.1 vs 16.0 ± 6.9, P = .008). ICI was most frequently discontinued because of patient-perceived ineffectiveness (48%), pain (21%), and prolonged erections (11%). Twenty-eight percent of patients had erections lasting longer than they had wished at some point in their treatment, with 10% incidence of priapism.

ICI use among patients after prostatectomy can be highly effective but has a significant attrition rate (49%). The identification of reasons for discontinued use can aid healthcare providers to support patients in the early period after adoption of ICI and to direct their counseling more effectively.