Use of a visual analog scale to assess pain of injection with intracavernous injection therapy

J Sex Med. 2005 May;2(3):428-31. doi: 10.1111/j.1743-6109.2005.20361.x.


Aim: Fear of pain with intracavernosal injection (ICI) therapy may discourage its use in patients with erectile dysfunction (ED).

Methods: We prospectively analyzed patient self-report of discomfort with ICI therapy for ED utilizing a visual analog scale from 0 to 10.

Results: Patient self-report using a visual analog scale revealed minimal discomfort, with 59 consecutive patients reporting an average pain score of 1.93 +/- 1.76. There was no statistical difference between self-administered or nurse-administered injections. The volume of the injection also had no statistical effect on pain score, and there was no difference observed between those who received alprostadil alone or combination treatment. Patients with diabetes mellitus did have significantly higher pain scores than other patients (3.31 +/- 2.25 vs. 1.62 +/- 1.39, P = 0.009), even when controlling for other factors.

Conclusion: Clinicians should be aware of the greater potential for discomfort in ED patients with diabetes. In the majority of ED patients, however, discomfort is minimal, and this information should be helpful in alleviating fear of injection in those who may benefit from this therapy.

MeSH terms

  • Adult
  • Aged
  • Alprostadil / administration & dosage
  • Alprostadil / therapeutic use*
  • Diabetes Mellitus / epidemiology
  • Drug Administration Routes
  • Humans
  • Injections / adverse effects
  • Male
  • Middle Aged
  • Pain / diagnosis*
  • Pain / epidemiology
  • Pain / etiology*
  • Pain Measurement*
  • Papaverine / administration & dosage
  • Papaverine / therapeutic use*
  • Patient Satisfaction*
  • Penis / anatomy & histology*
  • Phentolamine / administration & dosage
  • Phentolamine / therapeutic use*
  • Prospective Studies
  • Severity of Illness Index
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / therapeutic use*


  • Vasodilator Agents
  • Papaverine
  • Alprostadil
  • Phentolamine