Forty men with organic or psychogenic
impotence, who were highly motivated for treatment, were offered instruction in the intracavernosal (I-C) self-injection of
papaverine and regular ongoing supervision by the investigator. Twenty declined immediately, citing a number of reasons, notably qualms about
pain of the injection, side-effects and the unnaturalness of the method. Eleven patients discontinued the
drug within 11 months; nine used it for at least one year, and all were continuing with it albeit less frequently at the time of assessment. Those who discontinued treatment differed significantly from those who did not; the latter initially used the
drug less frequently (less than once per month), did not have a regular sexual partner or had a poor relationship with their sexual partner, and reported a decline in libido during use of the
drug. The findings suggest that I-C
papaverine, although effective in treating
impotence, is not a panacea, and a large percentage of users (55% in our study) are likely to discontinue the
drug within a relatively short period of time.