Recent studies have explored peripheral electrical stimulation (pES) as a potential treatment for erectile dysfunction (ED). This systematic review and meta-analysis evaluate the efficacy of pES in ED patients. A systematic search was conducted across PubMed, Scopus, ScienceDirect, and Web of Science to identify randomized controlled trials (RCTs) published between 2015 and 2025. Studies comparing pES to sham procedures, standard therapies, or no treatment were included. Eligible studies assessed objective or subjective erectile function outcomes, primarily using the International Index of Erectile Function (IIEF-5). A meta-analysis was performed using a random-effects model. Only three RCTs (n = 82) met inclusion criteria. pES was associated with a significant mean increase in IIEF-5 scores versus controls, with a pooled mean difference of 5.04 points (95% CI, 4.04-6.04). However, heterogeneity was high (I² = 86%, p < 0.001) and a significant difference in terms of pES protocols was noted. No adverse effects were reported. Hypothetical mechanisms of pES in ED have been discussed. pES shows potential as a novel, non-invasive ED treatment targeting multiple physiological pathways. The low certainty of evidence, limited number of RCTs, and study heterogeneity highlight the need for further research.
International journal of impotence research. 2025 Oct 07 [Epub ahead of print]
Álvaro Navas Mosqueda, Giuseppe Maiolino, Gracia María Gallego Sendarrubias, Víctor Jiménez Díaz-Benito, Eduardo Cimadevilla Fernández-Pola, Cristina Ojedo Martín, Marina Gómez De Quero Córdoba, Eldiberto Manuel Fernández Fernández, Enrique Lledó García, Juan Ignacio Martínez-Salamanca, Esaú Fernández-Pascual
Physiotherapy and Health Research Group (FYSA), Faculty of Health Sciences - HM Hospitals, University Camilo José Cela, Madrid, Spain., Department of Andrology and Sexual Medicine, Lyx Institute of Urology, Universidad Francisco de Vitoria, Universidad Francisco de Vitoria, Madrid, Spain. ., Department of Sport Sciences, Faculty of Physical Activity and Sport Sciences, Universidad Europea de Madrid, Madrid, Spain., Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain., Department of Nursing, Universitat Rovira i Virgili, Tarragona, Spain., Department of Urology, Hospital Viamed Santa Elena, Madrid, Spain., Department of Andrology and Sexual Medicine, Lyx Institute of Urology, Universidad Francisco de Vitoria, Universidad Francisco de Vitoria, Madrid, Spain.