1. What is your birth year?
2. How would you describe your gender?
Male
Female
Non-binary
Transgender
Prefer not to say
3. Please describe your position.
Physician (specify type)
APP
Nurse (RN or LPN)
Sex therapist
Trainee (fellow, resident)
Other (specify)
4. Have you completed US-based urology residency?
Yes
No
5. Have you completed a clinical fellowship in sexual medicine, andrology, or reconstructive urology?
Yes
No
6. How many years have you been in practice, excluding training?
7. Are you an SMSNA member?
Yes
No
30-40 years old
41-50 years old
51-60 years old
61 years or older
1. In what zip code is your primary practice located? Note that this will remain confidential.
2. How many urologists (MD, DO) does your practice employ?
3. How many APPs does your practice employ?
4. How would you categorize your practice?
I am employed by an academic medical center (e.g. we have a residency program)
I am in a private practice but treat patients at an academic medical center
I am hospital employed
I am part of a multi-specialty group
I am part of a urology private practice group
I am employed exclusively by the VA or work primarily at an armed services hospital
I have a solo practice
5. Do you interact with and/or train residents?
Yes
No
6. Approximately how many beds does your primary hospital have?
0-100
100-250
250-500
500-1000
Over 1000
7. How many new patients do you see for ED per week?
0-5
5-10
10-20
Over 20
8. Please check all boxes for treatments you personally offer for ED.
1. How familiar are you with wave therapies (focused shockwave, radial wave)?
Never heard of it
Vaguely familiar
I have a working knowledge but have never prescribed it
I have offered it in the past or currently offer it
2. Are you comfortable describing the differences between the types of wave therapy offered or advertised for treatment for ED? radial wave therapy and focused shockwave therapy?
Yes
No
1. Does your group (including you) offer radial wave therapy? Phoenix, Zimmer, Storz Falcon handpiece, Gainswave devices
We do not, and we have no plans to do so
We are planning to offer soon
We do offer this treatment
We offered this treatment but no longer offer it
2. Do you personally offer radial wave therapy?
I do not, and I have no plans to do so
I do not, but I am considering
I am planning to offer soon
I do offer this treatment
I offered this treatment but no longer offer it
3. For what indications do you offer RWT?
Erectile dysfunction
Peyronie's curve
Peyronie's pain
Length Enhancement
Girth Enhancement
4. If you offer RWT for ED, what criteria do you use to select candidates (check all that apply)?
Mild ED only, responsive to PDE5is (SHIM score 17-21)
Mild to Moderate ED (SHIM score 12-16)
Moderate ED (SHIM score 8-11)
Severe ED (SHIM score 1-7)
5. If you offer RWT for ANY indication (ED/PD), do you offer it to patients who have a history of a genitourinary cancer diagnosis?
Yes
No
6. If yes, how many patients do you treat per month with radial wave therapy?
0-2
3-5
6-20
Over 20
7. What do your patients who receive a full course of radial wave therapy through your practice typically pay for this treatment on average?
N/a
On trial
$0-500
$500-1000
$1000 - 2000
$2000 - 5000
Over $5000
8. In your opinion, how strong is the evidence supporting the use of radial wave therapy?
No evidence
Moderate evidence
Strong evidence
Very strong evidence
9. If you offer radial wave therapy are you currently collecting research data on your patient outcomes?
Yes
No
10. What do you counsel patients on for the success rates of this treatment?
1. Does your group (including you) offer focused shockwave therapy? Storz sepia handpiece, urogold
We do not, and we have no plans to do so
We do not, but we are considering
We are planning to offer soon
We do offer this treatment
We offered this treatment but no longer offer it
2. Do you personally offer fSWT?
I do not, and I have no plans to do so
I do not, but I am considering
I am planning to offer soon
I do offer this treatment
I offered this treatment but no longer offer it
3. What indications do you offer fSWT?
Erectile dysfunction
Peyronie's curve
Peyronie's pain
Length Enhancement
Girth Enhancement
4. If you offer fSWT for ED, what criteria do you use to select candidates (check all that apply)?
Mild ED only, responsive to PDE5is (SHIM score 17-21)
Mild to Moderate ED (SHIM score 12-16)
Moderate ED (SHIM score 8-11)
Severe ED (SHIM score 1-7)
5. If you offer fSWT for ANY indication (ED/PD), do you offer it to patients who have a history of a genitourinary cancer diagnosis?
Yes
No
6. If yes, how many patients do you treat per month with fSWT?
0-2
3-5
6-20
Over 20
7. What do patients who receive a full course of fSWT through your practice pay for this treatment on average?
N/a
On trial
$0-500
$500-1000
$1000 - 2000
$2000 - 5000
Over $5000
8. In your opinion, how strong is the evidence supporting the use of fSWT?
No evidence
Low evidence
Moderate evidence
Strong evidence
Very strong evidence
9. If you offer focused shock wave therapy are you currently collecting research data on your patient outcomes?
Yes
No
10. What do you counsel patients on for the success rates of this treatment?
11. Do you have any comments on fSWT you would like to add?
1. How familiar are you with PRP?
Never heard of it
Vaguely familiar
I have a working knowledge but have never prescribed it
I have offered it in the past or currently offer it
2. Do you feel comfortable describing the PRP process?
Yes
No
3. For which indications do you offer PRP? Check all that apply.
Erectile dysfunction
Peyronie's curve
Peyronie's pain
Length Enhancement
Girth Enhancement
4. If you offer PRP for ED, what criteria do you use to select candidates (check all that apply)?
Mild ED only, responsive to PDE5is (SHIM score 17-21)
Mild to Moderate ED (SHIM score 12-16)
Moderate ED (SHIM score 8-11)
Severe ED (SHIM score 1-7)
5. In your opinion, how strong is the evidence supporting the use of PRP?
No evidence
Low evidence
Moderate evidence
Strong evidence
Very strong evidence
6. Does anyone in your group (including you) offer PRP?
We do not, and we have no plans to do so
We do not, but we are considering
We are planning to offer soon
We do offer this treatment
We offered this treatment but no longer offer it
7. Do you personally offer PRP?
I do not, and I have no plans to do so
I do not, but I am considering
I am planning to offer soon
I do offer this treatment
I offered this treatment but no longer offer it
8. If yes, how many patients do you treat with PRP per month?
0-2
3-5
6-20
Over 20
9. What do patients who receive PRP through your practice pay for this treatment on average?
N/a
On trial
$0-500
$500-1000
$1000 - 2000
$2000 - 5000
Over $5000
10. If you offer PRP, are you currently collecting research data on your patient outcomes?
Yes
No
11. What do you counsel patients on for the success rates of this treatment?
1. How familiar are you with SCT?
Never heard of it
Vaguely familiar
I have a working knowledge but have never prescribed it
I have offered it in the past or currently offer it
2. Do you feel comfortable describing the SCT process?
Yes
No
3. For which indications do you offer SCT? Check all that apply.
4. If you offer SCT for ED, what criteria do you use to select candidates (check all that apply)?
5. If you offer SCT for ANY indication (ED/PD), do you offer it to patients who have a history of a genitourinary cancer diagnosis?
Yes
No
6. In your opinion, how strong is the evidence supporting the use of SCT?
No evidence
Low evidence
Moderate evidence
Strong evidence
Very strong evidence
7. Does anyone in your group (including you) offer SCT?
We do not, and we have no plans to do so
We do not, but we are considering
We are planning to offer soon
We do offer this treatment
We offered this treatment but no longer offer it
8. Do you personally offer SCT?
I do not, and I have no plans to do so
I do not, but I am considering
I am planning to offer soon
I do offer this treatment
I offered this treatment but no longer offer it
9. If yes, how many patients do you treat with SCT per month?
0-2
3-5
6-20
Over 20
10. What do patients who receive SCT through your practice pay for this treatment on average?
N/a
On trial
$0-500
$500-1000
$1000 - 2000
$2000 - 5000
Over $5000
11. If you offer SCT, are you currently collecting research data on your patient outcomes?
Yes
No
12. What do you counsel patients on for the success rates of this treatment
1. How familiar are you with penile botox?
Never heard of it
Vaguely familiar
I have a working knowledge but have never prescribed it
I have offered it in the past or currently offer it
2. For which indications do you offer penile botox?
Erectile dysfunction
Peyronie's curve
Peyronie's pain
Length Enhancement
Girth Enhancement
3. If you offer penile botox for ED, what criteria do you use to select candidates (check all that apply)?
Mild ED only, responsive to PDE5is (SHIM score 17-21)
Mild to Moderate ED (SHIM score 12-16)
Moderate ED (SHIM score 8-11)
Severe ED (SHIM score 1-7)
4. In your opinion, how strong is the evidence supporting the use of penile botox?
No evidence
Low evidence
Moderate evidence
Strong evidence
Very strong evidence
5. Does anyone in your group (including you) offer penile botox?
We do not, and we have no plans to do so
We do not, but we are considering
We are planning to offer soon
We do offer this treatment
We offered this treatment but no longer offer it
6. Do you personally offer penile botox?
I do not, and I have no plans to do so
I do not, but I am considering
I am planning to offer soon
I do offer this treatment
I offered this treatment but no longer offer it
7. If yes, how many patients do you treat with penile botox per month?
0-2
3-5
6-20
Over 20
8. What do patients who receive penile botox through your practice pay for this treatment on average?
N/a
On trial
$0-500
$500-1000
$1000 - 2000
$2000 - 5000
Over $5000
9. If you offer penile botox, are you currently collecting research data on your patient outcomes?
Yes
No
10. What do you counsel patients on for the success rates of this treatment
1. How familiar are you with penile girth or length enhancing procedures?
Never heard of it
Vaguely familiar
I have a working knowledge but have never prescribed it
I have offered it in the past or currently offer it
2. Do you feel comfortable describing the penile girth or length enhancing procedures?
Yes
No
3. For which indications do you offer penile girth or length enhancing procedures?
Erectile dysfunction
Penile girth dissatisfaction
Peyronie's curve
Peyronie's pain
Length Enhancement
Girth Enhancement
4. Does anyone in your group (including you) offer girth or length enhancing procedures?
We do not, and we have no plans to do so
We do not, but we are Aconsidering
We are planning to offer soon
We do offer this treatment
We offered this treatment but no longer offer it
5. Do you offer girth-enhancing procedures? Check all that apply
No
Penuma
Hyaluronic acid
Silicone injection
Fat transfer
PMMA
6. Do you offer length-enhancing procedures (not for Peyronie's treatment or as part of routine prosthetic insertion)?
No
Suspensory ligament release
Cosmetic scrotoplasty
Suprapubic lipectomy
Sliding technique
Tunical expansion (multi-slice)
Other (comment)
7. If yes, how many patients do you treat with girth or length enhancing procedures per month?
n/a
under $5000
$5000 to $10000
$10000 to 20000
Over $20000
8. What do you charge for girth-enhancing procedures?
n/a
under $5000
$5000 to $10000
$10000 to 20000
Over $20000
9. What do you charge for length-enhancing procedures?
n/a
under $5000
$5000 to $10000
$10000 to 20000
Over $20000
10. Do you require psychology assessment prior to surgical intervention?
Yes
No
11. If you offer penile girth or length enhancing procedures, are you currently collecting research data on your patient outcomes?
Yes
No
12. What do you counsel patients on for the success rates of this treatment?