Effectiveness of Physiotherapy Interventions in the Management of Impotence: A Systematic Review

Background: Impotence, common but less reported disorder with consequential psychological, emotional and physical complications. Efforts are being directed at non-pharmacological approaches in addressing this disorder, but efficacy of approaches are yet to be synchronized for clinical application. This study explored efficacy of physiotherapy for impotence and the determinants of the clinical protocol used.

Materials and nethods: Electronic search of the databases of PubMed, Physiotherapy Evidence Database (PEDro), cochrane central and Google scholar were conducted. Clinical trials were searched from inception till July 2021 with search words including impotence and Physiotherapy further refined to erectile dysfunction, premature ejaculation, exercises, electrical stimulation and biofeedback. Search strategy included expansion via medical subject headings (MeSH) and truncation of key words. Boolean operators 'AND' and 'OR' were utilized.

Results: Thirteen trials were included for review. Pelvic floor muscle exercises with or without other physiotherapeutic modalities are the common approach to the management of impotence. There was statistically significant (0.0001 ≤ p ≤ 0.05) and clinical improvement in erectile dysfunction after the interventions as compared to the controls. The approaches were more effective on erectile dysfunction of vascular origin. There were comparative improvement rates and in overall cures in premature ejaculation. Although treatment protocols varied significantly in time, protocols, contact, frequency and intensity, none of these determined their efficacy.

Conclusion: Physiotherapy is effective in the management of impotence alone or with other treatment. It is effective as first line of treatment for individuals with impotence for non-invasive options of treatment.