Article

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 may be
treated by rehabilitation interventions. The purpose of this study was
to determine whether pelvic-floor muscle strengthening interventions could be
associated with increases in intracavernous pressure that would increase penile
rigidity. DESIGN: An observational study was conducted. METHODS: One hundred
twenty-two 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-effects model per group analyzed separately, then jointly, the maximum
change in pressure (DeltaP) and the maximum baseline (ie, 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 2 minutes of each session). RESULTS: Over 20
sessions, the maximum DeltaP increased in erectile dysfunction as well as in
premature ejaculation (87% and 88%, respectively, in men with positive trends).
The maximum baseline also increased (99% and 72%, respectively, in men with
positive trends). The joint modeling indicated that the mean expected
progressions of the intracavernous pressure after 5 sessions in erectile
dysfunction and premature ejaculation were 62.85 and 64.15 cm H2O, respectively.
LIMITATIONS: Indirect measurements were obtained of intracavernous pressure and
ischiocavernosus muscle force. CONCLUSIONS: Pelvic-floor muscle rehabilitation
was found to be beneficial in erectile dysfunction. However, its effects on
symptoms of premature ejaculation, despite intracavernous pressure gains, were
much more difficult to assess. The definitive proof of its benefits requires
rather difficult-to-design clinical trials.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS