Reasons and Predictive Factors for Discontinuation of PDE-5 Inhibitors Despite Successful Intercourse in Erectile Dysfunction Patients Open

S-C Kim; Y-S Lee; K-K Seo; G-W Jung; T-H Kim


Int J Impot Res. 2014;26(3):87-93. 

In This Article

Abstract and Introduction


This study was aimed to identify characteristics of ED patients who discontinued PDE5i despite successful intercourse. Data were collected using a questionnaire from 34 urologic clinics regardless of the effect (success or failure) of PDE5i treatment by visiting the clinics (717), e-mail (64) or post (101) for 882 ED patients who had previously taken any kind of PDE5i on demand four or more times. Discontinuation of PDE5i was defined if the patient had never taken PDE5i for the previous 1 year despite successful intercourse. Of the 882 patients, 485 were included in the final analysis. Difference in the socio-demographic, ED- and partner-related data between the continuation and discontinuation group and factors influencing discontinuation of the PDE5i were analyzed. Among 485 respondents (mean age, 53.6), 116 (23.9%) had discontinued PDE5i use despite successful intercourse. Most common reasons for the discontinuation were 'reluctant medication-dependent intercourse' (31.0%), 'spontaneous recovery of erectile function without further treatment' (30.2%), and 'high cost' (26.7%). In multiple logistic regression analysis, independent factors influencing discontinuation of the drug were cause of ED (psychogenic), short duration of ED, low education (≤ middle school), and religion (Catholic). In partner-related compliance, only partner's religion (Catholic) was a significant factor.


Medication adherence is defined as the extent to which a person's medication-taking behavior coincides with medical advice.[1] To be effective, disease-management interventions must take factors affecting medication adherence into account, including known factors that may influence and predict medication-taking behavior. This understanding could then become the cornerstone of an effective patient education program. Various demographic, medical, behavioral, economic, social and medication- or medical practice-related variables may affect the medication adherence.[1]

Oral PDE5i are a more convenient and noninvasive therapy for ED. PDE5i therapy has become the treatment of choice for men with ED and has proven to be efficacious in approximately 60–80% of unselected patients with ED.[2,3] Yet, ~31–57% of these men abandon treatment despite successful intercourse because of the treatment.[4–6]

Various reasons for their drop-out despite successful intercourse using PDE5i have been reported but their demographic characteristics are unclear. Such knowledge would be valuable in prediction of those at increased risk of discontinuation, and would help in education programs that selectively target these men prior to the treatment to increase compliance with PDE5i use, thereby improving not only their quality of life[7] but also that of their partners[8–10] as possible.

The purpose of this study was to identify socio-demographic, ED- and partner-related characteristics of ED patients who discontinued PDE5i despite successful intercourse because of the treatment.