A Comparison of the Psychosocial Impact of Penile Prosthesis and Intracavernosal Injection Therapy for Erectile Dysfunction Using the Self-Esteem and Relationship (SEAR) Questionnaire

Abstract

ABSTRACT Introduction The few studies that do compare penile prostheses (PP) and intracavernosal injections (ICI) focus predominantly on sexual function leaving self-esteem and relationships understudied. The Self-Esteem and Relationship (SEAR) questionnaire was developed to provide a reliable tool to assess psychosocial variables of ED treatments. We hypothesized that patients with PP would have higher SEAR scores compared to patients treated with ICI. Objective To compare psychosocial variables of PP and ICI treatments using the SEAR questionnaire. Methods IRB-approval was obtained to interview patients by phone who underwent ED treatment by a single surgeon. SEAR questionnaire results were calculated according to the previously described formula and individual questions and domains were compared using T-test statistics. Results Fifty patients (25 PP, 25 ICI) agreed to be interviewed for this study. Prostate cancer (n=21, 45%) and vascular disease (n=7, 14%) were the leading cause of ED in our cohort. PI patients on average suffered from ED for a longer period than patients on ICI (5.6 vs 2.7 years, p=0.005). There were no differences in age or marital status. PP patients reported numerically higher total SEAR scores than PP patients (63 vs 53, p=0.12). PI patients reported higher sexual relationships domain scores than ICI patients (64 vs 46, p=0.04), especially in “I felt confident that during sex my erection would last long enough” (p=0.004), “I was satisfied with my sexual performance” (p=0.05), and “I felt confident about performing sexually” (p=0.02). There were no statistical differences in the confidence domain (p=0.89) or self-esteem (p=0.68) and overall relationship (p=0.80) sub-domains. Conclusions PP patients reported higher sexual relationship domain scores than ICI patients, while confidence, self-esteem, and overall relationships were similar. Regular use of the SEAR questionnaire may help to identify areas of post-treatment psychosocial needs in ED patients that may benefit from support groups or discussion with a counselor. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific