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

Recent studies have explored peripheral electrical stimulation (pES) as a potential treatment for erectile dysfunction (ED). This systematic review and meta-analysis evaluate the efficacy of pES in ED patients. A systematic search was conducted across PubMed, Scopus, ScienceDirect, and Web of Science to identify randomized controlled trials (RCTs) published between 2015 and 2025. Studies comparing pES to sham procedures, standard therapies, or no treatment were included. Eligible studies assessed objective or subjective erectile function outcomes, primarily using the International Index of Erectile Function (IIEF-5). A meta-analysis was performed using a random-effects model. Only three RCTs (n = 82) met inclusion criteria. pES was associated with a significant mean increase in IIEF-5 scores versus controls, with a pooled mean difference of 5.04 points (95% CI, 4.04-6.04). However, heterogeneity was high (I² = 86%, p < 0.001) and a significant difference in terms of pES protocols was noted. No adverse effects were reported. Hypothetical mechanisms of pES in ED have been discussed. pES shows potential as a novel, non-invasive ED treatment targeting multiple physiological pathways. The low certainty of evidence, limited number of RCTs, and study heterogeneity highlight the need for further research.