DOI: 10.1093/jsxmed/qdae001.009 ISSN: 1743-6095

(011) Implementing Virtual Intracavernosal/ Penile Injection Therapy (ICI) Training in a Prostate Cancer (PC) Supportive Care Program

A Alhamam, C Zarowski, M Lui, I Yu, R Ho, D Sare, J Kennedy, A Hwang, M Sundar, C Higano, R Flannigan
  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health



The Sexual Health Clinic (SHC) offered by our prostate cancer (PC) supportive care program delivers sexual health care for PC patients and their partners. Over a two-year period, patients receive seven appointments in which different options for sexual satisfaction are explored, including intracavernosal/penile injection therapy (ICI). Since April 2020, sexual health clinicians have provided virtual and in-person ICI training appointments. Before each appointment, patients are instructed to review educational material, including an educational video, an ICI instruction booklet, and ICI dosing handout.


To evaluate the effectiveness of ICI training presented virtually compared to in-person by comparing clinical and patient-reported outcomes (PROs) in each group.


All patients who received ICI training between January 2019 and April 2023 were included in this retrospective chart review. PROs from the SHC were obtained prospectively during service as part of usual clinical care.


Over 4.3 years, 74 patients received ICI training, 54 virtually and 24 in-person. All patients were in heterosexual relationships and rated their pre-treatment erectile function as a median of 9 on a scale of 0-10, with 10 being the highest level of erectile function. In contrast, the median erectile function for all patients was 0 after PC treatment. At the time of attending the SHC, most patients expressed ‘resume intercourse’ as their goal of treatment. Table 1 shows that the demographics of each group are similar with respect to age, education level, ethnicity, and partner information. The use of erectile aids after PC therapy is shown in Table 2. Most patients had not attempted ICI before enrollment in the SHC and were not satisfied with other options offered by the SHC. Details of ICI treatments and response to therapy are shown in Table 3. Overall outcomes and satisfaction rates were similar between groups.


Overall, clinical outcomes with ICI training in the virtual format do not appear to differ from that done in person. Patient satisfaction with ICI is better than other erectile aid options in each group but is still low. In the future, we will prospectively assess ICI usage and outcomes at 3, 6, and 12 months after ICI training to determine treatment adherence, complications, and long-term patient satisfaction with ICI training across the different delivery methods.



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