Electrical stimulation for erectile dysfunction: a systematic review and meta-analysis of RCTs

Area of Science:

• Urology
• Neuromodulation
• Clinical Trials

Background:

• Erectile dysfunction (ED) is a common condition affecting many men.
• Peripheral electrical stimulation (pES) is an emerging non-invasive therapy for ED.
• Current evidence on pES efficacy for ED requires systematic evaluation.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of pES in treating ED.
• To assess the impact of pES on erectile function outcomes, primarily IIEF-5 scores.
• To identify potential benefits and limitations of pES as an ED treatment.

Main Methods:

• Systematic search of PubMed, Scopus, ScienceDirect, and Web of Science for RCTs (2015-2025).
• Inclusion of studies comparing pES to sham, standard therapy, or no treatment.
• Meta-analysis using a random-effects model to pool IIEF-5 score differences.

Main Results:

• Three RCTs (n=82) met inclusion criteria.
• pES significantly increased IIEF-5 scores by a pooled mean difference of 5.04 points (95% CI, 4.04-6.04).
• High heterogeneity (I²=86%) and variations in pES protocols were observed; no adverse effects reported.

Conclusions:

• pES demonstrates potential as a novel, non-invasive treatment for ED.
• The treatment appears to target multiple physiological pathways involved in erectile function.
• Low evidence certainty, limited RCTs, and heterogeneity necessitate further rigorous research.