Injection Anxiety and Pain in Men Using Intracavernosal Injection Therapy after Radical Pelvic Surgery. (30th July 2013)

• Record Type: Journal Article
• Authors: Nelson, Christian J.; Hsiao, Wayland; Balk, Eliana; Narus, Joseph; Tal, Raanan; Bennett, Nelson E.; Mulhall, John P.
• Is Part Of: Journal of sexual medicine. Volume 10:Number 10(2013:Oct.)
• Page Start: 2559
• Page End: 2565
• Publication Date: 2013-07-30
• Subjects: Sexual disorders -- Periodicals; Sex -- Periodicals; Sexual health -- Periodicals; 616.69005
• DOI: 10.1111/jsm.12271
• Languages: English
• ISSNs: 1743-6095

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jsm12271-sec-0001" sec-type="section"> <title>Introduction</title> <p>Intracavernosal injection (ICI) therapy is a well‐recognized treatment strategy with high success rates for men with erectile dysfunction. Despite this, injection anxiety and pain related to injection are significant barriers to its use.</p> </sec> <sec id="jsm12271-sec-0002" sec-type="section"> <title>Aims</title> <p>This study aims to examine injection anxiety and injection pain in patients using ICI.</p> </sec> <sec id="jsm12271-sec-0003" sec-type="section"> <title>Methods</title> <p>Men starting ICI therapy post radical pelvic surgery completed questionnaires at initial visit, at each of the two ICI training sessions and at a 4‐month follow‐up visit.</p> </sec> <sec id="jsm12271-sec-0004" sec-type="section"> <title>Main Outcome Measures</title> <p>Injection Anxiety Scale, Injection Pain Scale, Injection Reaction Inventory, and the Erectile Function Domain of the International Index of Erectile Function.</p> </sec> <sec id="jsm12271-sec-0005" sec-type="section"> <title>Results</title> <p>Average age of the 68 men was 60 ± 8 years. At 4 months, the self‐reported frequency of ICI use was: 29% <1/week, 26% 1/week, 40% 2/week, and 5% 3/week. Mean injection anxiety score at first injection was 5.7 ± 2.8 (range 0–10) and significantly decreased to a 4.1 ± 3 at 4 months (<italic>P</italic> < 0.001). At first injection, 65% reported high injection anxiety (≥5) and this significantly decreased to 42% (<italic>P</italic> = 0.003) at 4 months. Anxiety at first injection was negatively related to ICI frequency at 4 months (<italic>r</italic> = −0.23, <italic>P</italic> = 0.08). Mean injection pain score at first injection was low (2.2 ± 1.8, range 0–10) and 59% rated injection pain ≤2. Injection pain remained consistent across time periods. At first injection, injection anxiety (assessed prior to injection) was related to injection pain (<italic>r</italic> = 0.21, <italic>P</italic> = 0.04) and subjects (n = 21) who reported high injection anxiety (≥5) across time points, reported an increase in injection pain scores from first injection to 4 months (2.7 vs. 3.7, <italic>P</italic> = 0.05).</p> </sec> <sec id="jsm12271-sec-0006" sec-type="section"> <title>Conclusions</title> <p>Although injection anxiety decreased with ICI use, mean injection anxiety remained at a moderate level (4.4) and 42% of men continued to report "high" injection anxiety at 4 months. While injection pain was low, injection anxiety and pain were related. These data suggest the need for a psychological intervention to help lower injection anxiety related to ICI. <bold>Nelson CJ, Hsiao W, Balk E, Narus J, Tal R, Bennett NE, and Mulhall JP. Injection anxiety and pain in men using intracavernosal injection therapy after radical pelvic surgery. J Sex Med 2013;10:2559–2565.</bold></p> </sec> </abstract>