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Sexual rehabilitation for cardiac patients with erectile dysfunction: a randomised clinical trial
Pernille Palm1,2, Ann-Dorthe Olsen Zwisler3, Jesper Hastrup Svendsen1,4
1Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
Insights
Sexual rehabilitation significantly improved sexual function and exercise capacity in men with erectile dysfunction, ischaemic heart disease (IHD), or implantable cardioverter defibrillators (ICD). This non-pharmacological approach offers a new treatment avenue for these common conditions.
Area of Science:
- Cardiology
- Sexual Medicine
- Rehabilitation
Background:
- Sexual dysfunction is prevalent in patients with ischaemic heart disease (IHD) or implantable cardioverter defibrillators (ICD), negatively impacting quality of life.
- Limited non-pharmacological treatment options exist for sexual dysfunction in this patient population.
Purpose of the Study:
- To evaluate the efficacy of a sexual rehabilitation program compared to usual care for males experiencing erectile dysfunction alongside IHD and/or ICD.
Main Methods:
- A randomized trial involving 154 male participants with erectile dysfunction and IHD and/or ICD.
- Intervention group received 12 weeks of sexual rehabilitation (physical exercise, pelvic floor exercises, psychoeducation).
- Control group received usual care.
Main Results:
- Sexual rehabilitation significantly improved sexual function, as measured by the International Index of Erectile Function (IIEF) score (mean difference of 6.7 at 4 and 6 months, p<0.0003).
- Improved exercise capacity (Watt max) and pelvic floor strength were observed in the rehabilitation group.
- No significant effects were noted on psychosocial adjustment, self-reported health, or mental health.
Conclusions:
- Sexual rehabilitation is an effective non-pharmacological intervention for improving sexual function in men with IHD and/or ICD.
- The program also enhances physical capacity, suggesting broader benefits beyond sexual health.
Background:
Sexual dysfunction is common in patients with either ischaemic heart disease (IHD) or implantable cardioverter defibrillator (ICD) and has a negative impact on quality of life. Non-pharmacological treatment options are lacking. The purpose of this trial was to assess the effect of sexual rehabilitation versus usual care for males with erectile dysfunction and either IHD and/or ICD.
Methods:
Participants with erectile dysfunction and IHD and/or ICD were randomised to 12 weeks of sexual rehabilitation consisting of physical exercise training, pelvic floor exercise and psychoeducation, or usual care.
Primary Outcome:
sexual function by the International Index of Erectile Function (IIEF). Secondary outcome: sexual function by the Psychosocial Adjustment to Illness Scale. Exploratory outcomes: exercise capacity, pelvic floor strength/endurance, self-reported health and mental health.
Results:
154 participants were included, mean age 61.6 years (SD 6.1). Sexual rehabilitation compared with usual care improved sexual function with a mean difference IIEF score of 6.7 (95% CI 3.1 to 10.4, p<0.0003) at 4 months between groups (unadjusted IIEF mean scores 36.4 vs 31.3) and a mean difference of 6.7, 95% CI 3.2 to 10.1 (p<0.0002) at 6 months between groups (unadjusted mean scores IIEF 37.1 vs 32.2). No effects were seen on the secondary outcome. Sexual rehabilitation improved exercise capacity on cycle ergometer measured by Watt max with a mean difference of 10.3, 95% CI 3.6 to 16.9 (p<0.003) and pelvic floor strength (p<0.01). No differences were seen on self-reported health and mental health.
Conclusion:
Sexual rehabilitation compared with usual care improves sexual function and exercise capacity.
Trial Registration:
NCT01796353; Results.
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