The Effect of Pelvic Floor Rehabilitation on Males with Sexual Dysfunction: A Narrative Review

Introduction: Increasing evidence has suggested that pelvic floor exercises and manual physical therapy may improve premature ejaculation (PE) and erectile dysfunction (ED) in males. Objectives: To examine the effects of pelvic floor physical therapy treatment in men suffering from PE and ED. Methods: We searched Google Scholar, PubMed, Medline, PEDro databases from inception till January 2020 applying the following keywords: pelvic floor, erectile dysfunction, impotence, physiotherapy, exercises, rehabili-tation, and pelvic floor muscle exercises. Results: The review included 37 papers reporting on PE and ED, of which 5 were randomized controlled trials, 2 meta-analyses, and 4 observational studies. Pelvic floor physical therapy treatment included education and reha-bilitation. The rehabilitation part encompassed manual therapy techniques that contribute to the normalization of muscle tone and improvement of muscle relaxation. Moreover, exercises, according to the patients' clinical assessment were presented. Most of the studies reported that by strengthening the pelvic floor muscles (PFMs), ED and PE can be improved if manual physical therapy treatments are combined with PFM training. Conclusions: A multifaceted approach should be chosen by physical therapists when evaluating and treating ED and PE and contending with both musculoskeletal dysfunction and behavioral contributions. It is recommended that exercises be monitored and situations involving, that is, hyperactivity/increased tone of the PFMs should be avoided. PFM training is simple, safe, and noninvasive; therefore, it should be a preferred approach in the management of ED and PE. This paper presents narrative reviews with a potential bias that systematic reviews or meta-analyses do not have, however, we strove to be all-encompassing and unbiased. There is a demand for high-quality scientific reviews examining the effectiveness of PFM training, manual therapy, and the rationale of pelvic floor physical therapy, in general, in treating individuals with PE and ED. Copyright (C) 2021, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Automated summary

Pelvic floor physical therapy treatment is found to have a positive impact on male premature ejaculation and erectile dysfunction. By providing education, rehabilitation, and manual therapy techniques, the pelvic floor muscles can be strengthened, leading to improvements in ED and PE. Most studies suggest that a multifaceted approach, combining manual physical therapy treatments with pelvic floor muscle training, is effective in managing ED and PE.