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Psychosocial interventions for erectile dysfunction.

T Melnik1, B G O Soares, A G Nasselo

  • 1Universidade de São Paulo, Psychiatry, Rua Prof José de Andrade Figueira 540/ 121 Morumbi, São Paulo, Brazil. tameln@terra.com.br

The Cochrane Database of Systematic Reviews
|July 20, 2007
PubMed
Summary
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Psychotherapy, particularly group and sex-focused therapy, shows promise in improving erectile dysfunction (ED) outcomes. Combining psychotherapy with sildenafil citrate further enhances treatment success and reduces dropout rates compared to medication alone.

Area of Science:

  • Sexual Health
  • Psychiatry
  • Urology

Background:

  • Erectile dysfunction (ED) is a complex condition influenced by psychological, endocrine, vascular, and neurological factors.
  • Psychological factors play a significant role in a substantial number of ED cases, often in conjunction with organic causes.
  • Despite advances in somatic research, findings on the efficacy of psychotherapy for ED remain contradictory.

Purpose of the Study:

  • To systematically evaluate the effectiveness of psychosocial interventions for treating ED.
  • To compare psychosocial interventions against oral drugs, local injections, vacuum devices, and other psychosocial approaches.

Main Methods:

  • A comprehensive search of multiple databases (MEDLINE, EMBASE, psycINFO, LILACS, CENTRAL) was conducted for randomized and quasi-randomized controlled trials.

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  • Eleven trials involving 398 men with ED met the inclusion criteria.
  • Data were extracted, trial quality assessed, and results analyzed using pooled relative risks and mean differences, with statistical heterogeneity addressed.

    • Main Results:

    • Group psychotherapy demonstrated a significant reduction in the persistence of erectile dysfunction compared to control groups (waiting list).
    • Sex-group psychotherapy showed a higher response rate in reducing ED persistence compared to no treatment.
    • Combining group therapy with sildenafil citrate resulted in significant improvements in successful intercourse and lower dropout rates compared to sildenafil alone. Group psychotherapy also showed superiority over sildenafil citrate alone.

    Conclusions:

    • Group psychotherapy is evidenced to potentially improve erectile function in men with ED.
    • Focused sex-group therapy exhibited greater efficacy than no treatment, though treatment response varied among patient subgroups.
    • Psychosocial interventions showed comparable effectiveness to local injections and vacuum devices for ED treatment.