Rival T, Clapeau L
16, rue de la Liberté, 38000 Grenoble, France.
74, avenue de Constantine, 38100 Grenoble, France.
Prog Urol. 2017 Dec;27(17):1069-1075. doi: 10.1016/j.purol.2017.09.004. Epub 2017 Oct 10.
The pelvic floor is now well known and its role in the mechanism of erection is demonstrated. We wanted to know what is the evidence of the effectiveness of perineal rehabilitation in erectile dysfunction.
An English search was performed in Google scholar and databases PubMed, Medline, Pedro with the keywords "pelvic floor, erectile dysfunction, impotence, physiotherapy, exercises, rehabilitation, PFMT". We have selected randomized clinical trials published in indexed journals.
Six randomized trials were selected. Five of them have shown statistically and clinically significant effectiveness in populations of men with erectile dysfunction and various underlying pathologies. In the fifth trial, the difference in effectiveness was not statistically significant. At 3 months, the best-conducted study showed an average improvement of 7 points at IIEF-5 compared to the control group (P-value: 0.004). Rehabilitation has not resulted in any adverse side effects. However, these studies were conducted in heterogeneous populations and the protocols for pelvic floor muscle strengthening rehabilitation differed from one study to another, making it impossible to formulate a specific recommendation for clinical practice.
Based on the results of this literature review, perineal physiotherapy may have a role to play in the management of erectile dysfunction.
盆底现已广为人知，其在勃起机制中的作用也已得到证实。我们想了解会阴康复治疗勃起功能障碍有效性的证据是什么。
在谷歌学术以及PubMed、Medline、Pedro数据库中进行英文检索，关键词为“盆底、勃起功能障碍、阳痿、物理治疗、锻炼、康复、盆底肌训练”。我们选取了发表在索引期刊上的随机临床试验。
选取了六项随机试验。其中五项在患有勃起功能障碍及各种潜在病理状况的男性人群中显示出统计学和临床意义上的显著有效性。在第五项试验中，有效性差异无统计学意义。在3个月时，开展得最好的研究显示，与对照组相比，国际勃起功能指数-5（IIEF-5）平均提高了7分（P值：0.004）。康复治疗未产生任何不良副作用。然而，这些研究是在异质性人群中进行的，而且盆底肌强化康复方案在不同研究中各不相同，因此无法为临床实践制定具体建议。
基于这篇文献综述的结果，会阴物理治疗可能在勃起功能障碍的管理中发挥作用。
