BACKGROUND: In men, involuntary or voluntary ischiocavernosus muscle contractions after erection lead to intracavernous blood pressures far higher than the systolic pressure, which builds and maintains penile rigidity.
Thus, erectile dysfunction may be partly due to ischiocavernosus muscle atrophy and treated by rehabilitation interventions.
OBJECTIVE: Determine whether pelvic floor muscle strengthening interventions could be associated with increases in intracavernous pressure that would increase penile rigidity.
DESIGN: Observational study.
METHODS: 122 men with isolated erectile dysfunction and 108 men with isolated premature ejaculation participated (no neuromuscular diseases or previous perineal rehabilitation). Thirty-minute sessions of voluntary contractions coupled with electrical stimulation were designed to increase ischiocavernosus muscle strength (monitored through intracavernous pressure increase). A linear mixed effect model per group analyzed separately then jointly the maximum ΔP and the maximum baseline (i.e., respectively, the average contraction-generated difference in intracavernous pressure and the intracavernous pressure plateau at full erection, both measured during the highest moving average of the best two minutes of each session).
RESULTS: Over 20 sessions, the max ΔP increased in erectile dysfunction as in premature ejaculation (87% and 88% men with positive trends). The max baseline increased too (99% and 72% men with positive trends). The joint modelling indicated that the mean expected progressions of the intracavernous pressure after five sessions in erectile dysfunction and premature ejaculation were 62.85 and 64.15 cm H2O, respectively.
LIMITATIONS: Indirect measurements of intracavernous pressure and ischiocavernosus muscle force.
CONCLUSIONS: Pelvic floor muscle rehabilitation was found beneficial in ED. However, its effects on PE symptoms, despite intracavernous pressure gains, were much more difficult to assess. The definitive proofs of its benefits require rather difficult-to-design clinical trials.
Written by:
Lavoisier P, Roy P, Dantony E, Watrelot A, Ruggeri J, Dumoulin S. Are you the author?
Centre d'Etudes des Dysfonctions Sexuelles (CEDS), 153 Rue Pierre Corneille 69003, Lyon, France; Hospices Civils de Lyon, Service de Biostatistique; Université Lyon 1, F-69100, Villeurbanne, France; and CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Bio Statistique Santé, Pierre-Bénite, F-69310, Lyon, France; Hospices Civils de Lyon, Service de Biostatistique; Université Lyon 1, F-69100, Villeurbanne, France; and CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Bio Statistique Santé, Pierre-Bénite, F-69310, Lyon, France; Centre de Recherche et d'Etudes de la Stérilité (CRES), Hopital Natecia 22 Avenue Rockefeller F-69008, Lyon, France.
Reference: Phys Ther. 2014 Jul 31. Epub ahead of print.
doi: 10.2522/ptj.20130354
PubMed Abstract
PMID: 25082919