(323) Injection Pain in Men Using Intracavernosal Injection During Penile Doppler Ultrasound

Abstract

Abstract Introduction Penile Doppler ultrasound (PDUS) is important in assessing erectile dysfunction. Intracavernosal injection (ICI) is utilized to achieve erections during the procedure Objective This study aims to examine the needle injection pain and predictors of severe pain in patients using ICI during PDUS. Methods The patient population included (i) men with poor response to erectogenic agents or (ii) who need curvature assessment due to Peyronie’s disease (PD), (iii) who underwent PDUS, (iv) using ICI vasoactive agent redosing schedule. We performed a descriptive assessment of demographics and comorbidities. All patients graded anxiety before the PDUS procedure and pain after the first ICI. A visual analog scale (VAS) evaluated the anxiety related to the procedure using a single question: “How anxious are you about your PDUS procedure?” This was measured on a 0 (not at all anxious) to 10 (extremely anxious) Likert scale. 7 or higher was defined as high anxiety, 4 to 6 as moderate anxiety, 1 to 3 as mild anxiety, 0 was no anxiety. A VAS assessed the ICI pain by asking, “How painful was your penile injection?”. This was measured on a 0 (not at all painful) to 10 (extremely painful) Likert scale. 6 or higher was defined as severe pain, 4 and 5 as moderate pain, 1 to 3 as mild pain, and 0 was no pain. Predictors of severe pain were analyzed using a Logistic regression model. Factors entered into the model included: patient age, number of comorbidities, and high anxiety. A p-value ≤0.05 was considered statistically significant. Results 162 individuals were included. The median age of 65 (59,72) years. 19% had diabetes, 19% reported ≥ 3 comorbidities, 10% had a history of depression, and 11% had a history of anxiety. 72% had prostate cancer, 6%had bladder cancer, 3% had other cancer, and 19% had no cancer history. 35% described PD. The VAS procedure anxiety median was 3 (1, 5), on which 22% reported no anxiety, 35% mild, 25% moderate, and 18% high anxiety. The VAS median pain with the first ICI was 2 (1, 4), on which 9% reported no pain, 61% mild pain, 19% moderate pain, and 11% severe pain. In the MVA, no predictors of severe pain with ICI during PDUS were identified (Table 1). Conclusions Pain experienced with ICI during PDUS is low, with most patients reporting no or only mild pain. Only 1/3 of the patients Almost half of the patients reported moderate to high anxiety associated with this procedure; however, high procedure anxiety did not predict severe pain with ICI during PDUS Disclosure No.