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Eficacia y seguridad comparativas de intervenciones no farmacológicas para la disfunción eréctil: una revisión

Xinlei He¹, Tingxin Li², Wenrui Huang³

¹Urology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan Province, Chengdu 610031, China.

Sexual medicine reviews

|February 6, 2026

Resumen

La estimulación eléctrica (EE) combinada con ejercicio mejora significativamente la disfunción eréctil (DE) más que otras intervenciones no farmacológicas. Si bien la EE sola también muestra beneficios, se necesita más investigación para confirmar la eficacia a largo plazo.

Área de la Ciencia:

Urología
Medicina de Rehabilitación
Ingeniería Biomédica

Sus antecedentes:

Muchos pacientes con disfunción eréctil (DE) no responden bien a los inhibidores de la fosfodiesterasa tipo 5 (PDE5i).
Las intervenciones no farmacológicas (NPI) están surgiendo como tratamientos alternativos o adyuvantes prometedores para la DE.
Evaluar la eficacia comparativa de varias NPI es crucial para la toma de decisiones clínicas.

Objetivo del estudio:

Revisar sistemáticamente y realizar un meta-análisis en red que compare la eficacia y seguridad de diferentes NPI para la DE.
Identificar los NPI más efectivos para mejorar la función eréctil según la evidencia actual.

Principales métodos:

Se realizó una revisión sistemática y un meta-análisis en red (NMA) de acuerdo con las directrices PRISMA.
Se incluyeron ensayos controlados aleatorizados (ECR) que evaluaron la Estimulación Eléctrica (EE), Ejercicio, Terapia de Ondas de Choque Extracorpóreas de Baja Intensidad (Li-ESWT), Terapias Basadas en Acupuntura (ABT) e Hiperbaroterapia (HOT) para la DE.
Los resultados primarios incluyeron el Índice Internacional de Función Eréctil-5 (IIEF-5), la Puntuación de Dureza de la Erección (EHS) y la Velocidad Sanguínea Sistólica Pico (PSV); la seguridad se evaluó mediante Eventos Adversos (EA).
El riesgo de sesgo y la certeza de la evidencia se evaluaron utilizando RoB 2.0 y CINeMA, respectivamente.

Principales resultados:

Se analizaron 31 ECR que involucraron a 1874 participantes.
La Estimulación Eléctrica (EE) más Ejercicio demostró la mejora más significativa en las puntuaciones del IIEF-5 en comparación con el placebo/sham (MD = 6.81), con evidencia de alta certeza.
La EE sola también produjo mejoras significativas (MD = 2.86), mientras que la Li-ESWT mostró beneficios modestos (MD = 0.65).
La EE fue más efectiva para la mejora de la EHS y la Li-ESWT más Ejercicio para el aumento de la PSV, sin reportarse eventos adversos graves.

Conclusiones:

Las NPI, particularmente las terapias basadas en EE, muestran un potencial significativo para mejorar la DE.
La combinación de EE y Ejercicio parece ser la más efectiva y consistente para el tratamiento de la DE.
Se necesitan más ensayos a gran escala y de alta calidad para confirmar la eficacia y seguridad en diversas poblaciones debido a las limitaciones de la evidencia actual.

Palabras clave:

Eficacia Disfunción eréctil Meta-análisis en red Intervenciones no farmacológicas Revisión sistemática

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