Sexual rehabilitation for cardiac patients with erectile dysfunction: a randomised clinical trial

Abstract

BackgroundSexual 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.MethodsParticipants 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.Results154 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.ConclusionSexual rehabilitation compared with usual care improves sexual function and exercise capacity.Trial registrationNCT01796353; Results.

A place of understanding: Patients' lived experiences of participating in a sexual rehabilitation programme after heart disease

“…Patients were all participants from a RCT evaluating the effect of a sexual rehabilitation programme consisting of 12‐week physical exercise training including daily pelvic floor exercise and psycho‐educational consultations up to four sessions. A trial protocol and results from the RCT was published .…”

“…Therefore, the CopenHeart SF randomised controlled trial (RCT) was designed with the purpose of testing whether a nonpharmacological sexual rehabilitation intervention consisting of exercise training and psycho‐education would improve male cardiovascular patient's sexual function . The primary outcome was the total sum score on the International Index of Erectile Function (IIEF), and a questionnaire evaluating sexual function and primary results from the RCT showed a statistically significant difference in favour of the sexual rehabilitation group .…”

One Thing at a Time… Timeliness of Rehabilitation for Sexual Problems in Men With Prostate Cancer

“…No matter the best intentions of early intervention for this vulnerable group, we found it impossible to recruit the number of newly diagnosed patients with PC referred to radiotherapy and androgen deprivation therapy as planned. The inclusion rate of 38% was not lower than other randomised trials targeting sexual problems (20,21), but patients available in this single study site were too few according to the time frame and intervention planned. The inclusion period was de ned based on expectations of recruitment of at least four patients every month (Fig.…”

Alternative medicine and herbal remedies in the treatment of erectile dysfunction: A systematic review

“…Furthermore, specific pelvic floor exercises were found to be effective in improving the IIEF compared to lifestyle changes in two studies [ 53 , 54 ]. Pelvic floor exercises combined with physical activity and psychoeducation for sexual rehabilitation also reported an improvement in erectile function in males with ischaemic heart disease or implantable cardioverter defibrillator [ 55 ].…”