Introduction. Many authors have shown that perineal muscles training improves erectile function. We decided to perform our research of the effectiveness of perineum muscle training in the treatment of erectile dysfunction (ED).
Materials and methods. We assessed 32 men (22-74 years old, 44.8 ± 2.5 years) with a duration of ED of 19 ± 2.6 months, IIEF –16.1 ± 0.6 points. The twenty-four of them had organic and 7 had psychogenic ED. A comprehensive diagnostic was carried out, including consultations of a GP, urologist, evaluation of the cardiovascular system, 25 blood parameters. The strength of the perineum muscles was determined on a Furun medical chair (South Korea), a pharmacological test was conducted with an intracavernous injection of 10 μg alprostadil E1 before and after training. The surface stiffness was measured by the magnetodynamic pressure indicator IGD-03 (JSC «GRPZ», Russia) during the test. The longitudinal stiffness was measured using a Digital Inflection Regidometr device (Uroan 21, Spain). The training course consisted of 21 perineum muscle trainings session on the Furun chair 6 times a week (2 sessions of 30 minutes each). Three hours a week training was conducted to increase general physical endurance, strengthen the muscles of the abdominal press, thighs, buttocks, and perineum.
Results. The twenty-four patients with organic ED increased the strength of the perineal muscles 3.42 times from 3.89 ± 0.35 to 11.9 ± 0.9 Kgs (p <0.001) аfter training. In the pharmacological test, surface hardness increased by 26% from 27 ± 1.8 to 33.3 ± 1.8 relative units (р<0,05). The longi- tudinal stiffness with a basic tone of the perineal muscles increased on 57% from 376.9 ± 27 g to 550.8 ± 38.2 g (p <0.01), with a maximum voluntary muscle tension also by 57% - s 544 ± 40.5 g to 805 ± 48.5 g (p <0.001). In 16 out of 24 patients (66.7%), complete rigidity was achieved, in 4 (16.7%) improvement with insufficient rigidity, in 4 (16.7%) positive dynamics did not occur. In 7 patients with psychogenic ED, the perineal muscle strength increased 3.65 times, from 2.64 ± 0.39 to 10.3 ± 2.18 Kg (p <0.01), an increase in the initial high longitudinal stiffness was also observed ( p> 0.05). The initially high values of the surface stiffness index remained nearly unchanged. Six out of seven patients (85.7%) reported an improvement in erectile function. The effectiveness of this treatment method depended on the age and duration of ED. The less age and the shorter the duration of ED lead to higher likelihood of erectile function recovery. A decrease in body weight and an increase in general physical endurance also had a positive effect. Arterial hypertension, antihypertensive therapy, hormonal status, anatomical dimensions of the organ have no effect. Negative impact was observed for age over 60 years, the duration of ED more than 2 years, diabetes.
Conclusions. Improvement of erectile function after a course of perineal muscle training was observed in 84% of patients. Complete normalization of erectile function was achieved in 67% and partial improvement in 17% patients with organic ED. Improvement was obtained in 86% of patients with psychogenic ED.
Conflict of interest. The authors declare no conflict of interest.