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Acupuncture in the treatment of psychogenic erectile dysfunction: first results of a prospective randomized placebo-controlled study

In a prospective study, we investigated the potentially curative effect of acupuncture in patients with psychogenic erectile dysfunction (pED). A total of 22 patients with pED were randomized into two groups. They were either treated with acupunture specific against ED (treatment group) or acupuncture specific against headache (placebo group). Nonresponders of the placebo group were crossed over to the treatment group. Prior to acupuncture, serum sexual hormone levels, IIEF score, nocturnal penile tumescence testing for three nights (Rigiscan) and the erectile response to 50mg sildenafil were evaluated. Out of 21 patients, 20 completed the study, including 10 patients after crossover.

Result:
A satisfactory response was achieved in 68.4% of the treatment group and in 9% of the placebo group (P¼0.0017). Another 21.05% of the pateints had improved errections, that is, sufficient rigidity under simultaneous treatment with 50gm sildenafil. The results of our pilot study indicate that acupuncture can be an effective treatment option in more than two-thirds of patients with psychogenic erectile dysfunction.

Material and methods
In all, 21 consecutive patients with psychogenic erectile dysfunction and without any prior therapy were recruited between January 1999 and December 2001. Informed consent was obtained from all patients, and the study itself was started with the approval of the local ethics commission. The mean age was 38.9y (range 20–61y), and the mean duration of erectile dysfunction was reported to be 23.8 months (range 2–72 months). Evaluation included the medical, sexual and psychologic history, an urological exam and the serum sexual hormone status (total testosterone, free testosterone, sexual hormone binding globulin, follicle-stimulating hormone, luteinizing hormone, oestrogen, prolactin). Exclusion criteria were comorbidities such as hypogonadism, diabetes mellitus, hypertension, cigarette smoking and any type of neurological disorder. During three consecutive nights, nocturnal penile tumescence testing using a Rigiscant was done in every patient, resulting in recurrent erections above the level of 70% in all cases. Patients with normal nocturnal erection during Rigiscant, with normal sexual hormonal levels and no organic comorbidites were defined as psychogenic erectile dysfunction. In addition, every patient reported to obtain a sufficient erection following oral administration of 50mg of sildenafil. Evaluation of the IIEF 15 score was done prior to and after acupuncture therapy.11 According to protocol, patients were randomized into two groups. In group 1 (treatment group), n¼10, acupuncture was done at the standardized spots used in the treatment of erectile dysfunction (N6, N27, KG4, KG6, LG4, MP6, B23).8,9,10,12 In group 2 (placebo group), n¼11, acupuncture was done at points used in the treatment of headache (G39, M41, M25). Acupuncture at these spots has no known effects in the treatment of sexual disorders. Non-responder in group 2 were crossed over to group 1. The duration of each acupuncture was 20min once or twice weekly with disposable hypodermic needles (0.330mm, Seirin Company, Germany). The number of treatments given ranged from 5 to 20 (mean 11) and were exclusively done by two certified coauthors (TZ, LKD). In all, 20 treatment sessions was considerd to be a maximum of treatmentFin case of ineffectiveness or effectiveness of therapy acupuncture was finished earlier. After 5, 10 and 15 sessions, the sexual status was reevaluated. Acupuncture treatment was considered to be effective when erections became sufficient for penetration and sexual intercourse. In case erections became better, but intercourse was only possible in conjunction with an additional therapy, effectiveness of acupuncture was considered as partly effective. Statistical analysis was done using Fisher’s exact test power analysis (Po0.05).

Author: PF Engelhardt 1, LK Daha 2, T Zils 2, R Simak 2, K König 2 and H Pflüger 2

1Department of Urology and Ludwig-Boltzmann-Institute of Andrology and Urology; and 2Ist Department of Internal Medicine, Lainz Hospital, Vienna, Austria

Quelle: International Journal of Impotence Research (2003) 15, 343–346

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