Sexual rehabilitation for cardiac patients with erectile dysfunction: a randomised clinical trial.

Sexual dysfunction is common in patients with either ischaemic heart disease (IHD) or implantable cardioverter defibrillator (ICD) and has a negative impact on quality of life. Non-pharmacological treatment options are lacking. The purpose of this trial was to assess the effect of sexual rehabilitation versus usual care for males with erectile dysfunction and either IHD and/or ICD.

Participants with erectile dysfunction and IHD and/or ICD were randomised to 12 weeks of sexual rehabilitation consisting of physical exercise training, pelvic floor exercise and psychoeducation, or usual care.

sexual function by the International Index of Erectile Function (IIEF). Secondary outcome: sexual function by the Psychosocial Adjustment to Illness Scale. Exploratory outcomes: exercise capacity, pelvic floor strength/endurance, self-reported health and mental health.

154 participants were included, mean age 61.6 years (SD 6.1). Sexual rehabilitation compared with usual care improved sexual function with a mean difference IIEF score of 6.7 (95% CI 3.1 to 10.4, p<0.0003) at 4 months between groups (unadjusted IIEF mean scores 36.4 vs 31.3) and a mean difference of 6.7, 95% CI 3.2 to 10.1 (p<0.0002) at 6 months between groups (unadjusted mean scores IIEF 37.1 vs 32.2). No effects were seen on the secondary outcome. Sexual rehabilitation improved exercise capacity on cycle ergometer measured by Watt max with a mean difference of 10.3, 95% CI 3.6 to 16.9 (p<0.003) and pelvic floor strength (p<0.01). No differences were seen on self-reported health and mental health.

Sexual rehabilitation compared with usual care improves sexual function and exercise capacity.

NCT01796353; Results.

Heart (British Cardiac Society). 2018 Oct 31 [Epub ahead of print]

Pernille Palm, Ann-Dorthe Olsen Zwisler, Jesper Hastrup Svendsen, Lau Casper Thygesen, Annamaria Giraldi, Karina Gregersen Jensen, Jane Lindschou, Per Winkel, Christian Gluud, Elaine Steinke, Selina Kikkenborg Berg

Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark., The National Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark., National Institute of Public Health, University of Southern Denmark, Ă˜ster Farimagsgade, Denmark., Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., School of Nursing, Wichita State University, Wichita, Kansas, USA.