Effects of transanal pelvic plexus stimulation on penile erection: clinical implications

Effectiveness of Physiotherapy Interventions in the Management Male Sexual Dysfunction: A Systematic Review

Background

Male sexual dysfunction is a common disorder with consequential implications. Hitherto, treatment was based on pharmacological approach which has yielded little success in sustainability and produced attendant complications including overweight/obesity, and cardiovascular problems. Hence, the paradigm is toward non-pharmacological approach, but their efficacy is yet to be summarized for clinical practice. This study summarized efficacy of physiotherapy for male sexual dysfunction to inform clinical decision-making and practice.

Methodology

Electronic search of clinical trials on PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Central, Scopus, and Google Scholar was conducted covering from inception till July 2021 using words, such as male sexual dysfunction and physiotherapy and further refined to erectile dysfunction, premature ejaculation, exercises, electrical stimulation, biofeedback. Search strategy included expansion via medical subject headings (MeSH) and truncation of keywords. Boolean operators "AND" and "OR" were utilized.

Results

Out of 239 studies, 13 eligible ones were included in this study. Outcome measures used were full/abridged versions of International Index of Erectile Function (IIEF/IIEF-5), Manometric, or digital anal pressure measurement. Eleven studies were on erectile dysfunction/erectile dysfunction with climacturia and two on premature ejaculation. Physiotherapy was for 6-12 weeks covering 9-20 sessions. Physiotherapy used was standalone/combinations of pelvic floor muscle exercises, electrical stimulation, or biofeedback. PEDro scores of the studies were 4-9/10. Studies involved 912 participants (472/440 intervention/control) between 19 and 83 years with erectile dysfunction lasting 6-360 months. There was significant (0.0001 ≤ p ≤ .05) improvement in sexual function (interventions > controls). Nothing determines the efficacy of physiotherapy or choice of approach.

Conclusion

Physiotherapy is an effective non-pharmacological treatment approach for male sexual dysfunction.

Comparative Effectiveness of Electrical Stimulation and Aerobic Exercise in the Management of Erectile Dysfunction: A Randomized Clinical Trial

BACKGROUND

Electrical stimulation and aerobic exercise have been indicated to be beneficial in the management of erectile dysfunction individually. However, there is a scarcity of evidence comparing the two treatment approaches. This study investigated the effects of Electrical Stimulation (ES) compared with Eerobic Exercise (AE) in the management of individuals with Erectile Dysfunction (ED).

METHODS

This study was a single-blind parallel randomized clinical trial. Thirty (30) patients diagnosed with ED (Mean age of 39.17 ± 6.21 years) were recruited and randomized into two groups, A and B with 15 participants in each group. Group A received ES while Group B received AE. International Index of Erectile Function (IIEF-5) was used to assess the sexual functions of the participants at baseline and after 6 weeks of intervention. Within-group and between-group differences were analyzed using dependent and independent t-tests respectively.

RESULTS

The result indicated a significant difference between groups A and B [20.83 (1.83) Vs 14.33 (2.07), p=0.001] after 6 weeks of intervention. However, the mean effect was significantly higher in the ES group than in the AE group.

CONCLUSION

The finding of this study indicated that ES is more effective than AE in the management of individuals with ED.Trial Registration: Pan African Clinical Trial Registry (PACTR201906776769795).

Sexual dysfunction in male patients with multiple sclerosis: a need for counseling!

Sexuality and sexual health are significant factors in determining the quality of life (QoL). Multiple sclerosis (MS) is one of the most serious causes of neurological disability in young adults, therefore it can considerably reduce sexuality. Physical and cognitive symptoms of MS as well as mental and psycho-social issues can directly affect sexual life and body representation, causing reduced libido and self-esteem. Male patients with MS frequently develop sexual dysfunction (SD) as a result of their neurological impairment: in fact physical, psychological and neuropsychological changes indirectly interfere in the sexual response. Thus, MS physicians' greater concern on SD has led to the enhancement of diagnostic and therapeutic diagnoses on neurogenic SD. Given the increasing number of people coping with MS, a more effective focus on MS-related problems, including SD, is absolutely essential to provide the patients and their partner with the necessary information to achieve a better sexual health and consequently improve their QoL. This review aims to investigate the epidemiology and pathophysiology of SD in male patients, provide an insight into multidisciplinary diagnostic and therapeutic approaches, and focus on the need of proper counseling.