A Systematic Review of Pelvic Floor Muscle Training for Erectile Dysfunction After Prostatectomy and Recommendations to Guide Further Research. Issue 4 (3rd February 2020)

• Record Type: Journal Article
• Authors: Wong, Calvin; Louie, Dennis R.; Beach, Cheryl
• Is Part Of: Journal of sexual medicine. Volume 17:Issue 4(2020)
• Page Start: 737
• Page End: 748
• Publication Date: 2020-02-03
• Subjects: Prostatectomy -- Pelvic Floor -- Erectile Dysfunction -- Physiotherapy -- Sexual Dysfunction -- Rehabilitation; Sexual disorders -- Periodicals; Sex -- Periodicals; Sexual health -- Periodicals; 616.69005
• DOI: 10.1016/j.jsxm.2020.01.008
• Languages: English
• ISSNs: 1743-6095

Abstract

Abstract: Background: Erectile dysfunction is one potential complication after radical prostatectomy; often pelvic floor muscle training is offered as an intervention to improve quality of life and erectile function post-operatively. Aim: To provide a summary of current evidence regarding the effectiveness of pelvic floor muscle training in the management of erectile dysfunction after radical prostatectomy and provide recommendations for future research. Methods: An electronic search was conducted for relevant research studies using PubMed, EMBASE, CINAHL, Medline, and PEDro. Quality of selected trials was assessed by 2 independent reviewers using the Modified Downs and Black Checklist; disagreements were resolved by consensus. Main Outcome Measure: The main outcome measure is the International Index of Erectile function (IIEF-5). Results: 9 studies of various study design were included in this review. Most studies demonstrated improvements in erectile dysfunction with pelvic floor muscle training; however, lack of methodological rigor for several studies and variability among training protocols limited interpretation of results. Clinical Implications: Further well powered and rigorously designed randomized controlled trials are needed to investigate the effect of pelvic floor muscle training on erectile dysfunction after radical prostatectomy. Strengths & Limitations: This review employed a systematic method of appraising the available evidence for pelvic floor muscle training for erectile dysfunction after radical prostatectomy. Limited high-quality articles were identified and few conclusions could be drawn from the existing evidence. Conclusion: Future high-quality randomized controlled trials should include strategies to improve adherence to exercise, clearly describe exercise protocols, and integrate new evidence for verbal cues and biofeedback for muscles involved in erection.