Presentation Authors: Carolyn A. Salter*, Helen Bernie, Denise Asafu-Adjei, Elizabeth Schofield, John P. Mulhall, New York, NY
Introduction: Platelet-rich plasma (PRP) and low-intensity shock wave therapy (LiSWT) are being touted as treatments for erectile dysfunction (ED) without data on long-term safety and efficacy. These treatments are not covered by insurance and are costly. This study attempted to ascertain what information is provided to potential patients.
Methods: 10 clinics providing PRP and 10 providing LiSWT for ED were chosen using website directories. All practices selected had a medical physician. Half of the practices were led by a urologist and half by varied other specialties. We attempted to find similar geographic locations and include a mix of major and minor cities. Three scripts were written for candidate patients: one man who had psychogenic ED, one with severe venogenic ED after triple therapy for prostate cancer, and one with likely arteriogenic ED. The scenarios involved the callers identifying themselves as the partners of potential patients, seeking information on whether the men would be good candidates for treatment prior to presenting for evaluation. A standard data collection form was used and 3 different physicians called all 20 practices, 1 provider for each of the 3 clinical scenarios.
Results: During a pilot trial of phone calls, none of the practices allowed us to utilize the scripts with clinical scenarios and instead urged the caller to book a consultation with the physician. We then adjusted the calls to ask questions only and volunteer specific history only if asked. There were 5 instances for PRP and 6 for LiSWT where we were unable to gather information and these calls were excluded from further analysis. For the PRP practices, the total cost was >$3,000 in 24%. 80% of calls declined to discuss success rates. In terms of side effects, 60% declined to answer, while 32% stated there were no side effects and 8% mentioned only penile pain. When queried how the treatment worked, 48% of calls did not receive an answer whereas 36% received minimal details, 12% sufficient and 4% were comprehensive. Similarly, 75% of LiSWT clinics declined to answer questions on success rates. Total treatment cost was >$3,000 in 58%. Side effects were more varied with 45% of calls not receiving an answer, but 30% reporting no side effects,12% altered penile sensation, 8% pain and 4% bruising. 38% of calls did not answer how treatment worked but 29% provided minimal details, and 33% sufficient details.
Conclusions: Patients attempting to gain information from specific practices regarding PRP and LiSWT for ED are often given limited information on success rates, side effects, and how the treatment works.