Investigative Urology

Abstract

Objective: To examine the role of pelvic floor exercises as a way of restoring erectile function in men with erectile dysfunction. Patients and Methods: In all, 55 men aged > 20 years who had experienced erectile dysfunction for ≥ 6 months were recruited for a randomized controlled study with a cross-over arm. The men were treated with either pelvic floor muscle exercises (taught by a physiotherapist) with biofeedback and lifestyle changes (intervention group) or they were advised on lifestyle changes only (control group). Control patients who did not respond after 3 months were treated with the intervention. All men were given home exercises for a further 3 months. Outcomes were measured using the International Index of Erectile Function (IIEF), anal pressure measurements and independent (blinded) assessments. Results: After 3 months, the erectile function of men in the intervention group was significantly better than in the control group (P < 0.001). Control patients who were given the intervention also significantly improved 3 months later (P < 0.001). After 6 months, blind assessment showed that 40% of men had regained normal erectile function, 35.5% improved but 24.5% failed to improve. Conclusion: This study suggests that pelvic floor exercises should be considered as a first-line approach for men seeking long-term resolution of their erectile dysfunction. Editorial Comment The first time that pelvic floor exercise was discussed and documented as a realistic alternative for treatment of erectile dysfunction was in 1993 by Claes & Baert, for patients with mild degrees of venous leakage (1). The authors randomized a group of 150 consecutive male patients with erectile dysfunction and proven venous leakage to surgery of to a program of pelvic floor training. Surgery was not superior to the pelvic floor training program either subjectively or objectively. 42% of patients was satisfied with the program and refused surgery (1). Since then, a couple of works have been done on this subject, with somewhat good results (2,3). Doctor Grace Dorey and co-workers have been extensively working in this field, examining the role of pelvic floor muscle exercises (focusing on the bulbocavernosus and ischiocavernosus muscles) as a key to restoring erectile function. The present work is one more important contribution from this group. The authors concluded that pelvic floor muscle exercises should be considered as a first-line approach for erectile dysfunction. This might be more important in men seeking long-term resolution of erectile dysfunction without acute pharmacological and surgical interventions, which can cause significant side-effects.

Wasp venom peptide, synoeca‐MP, from Synoeca surinama shows antimicrobial activity against human and animal pathogenic microorganisms

“…AMPs are oligopolymers, having up to 100 amino acid residues in their primary structure, are part of the innate defense system of vertebrates and invertebrates, and are produced as the first line of defense against pathogens . According to their physicochemical characteristics, these peptides can be classified as cationic, anionic, hydrophobic, or amphipathic molecules .…”