Atuação do fisioterapeuta na disfunção erétil de causa vasculogênica: revisão sistemática

Abstract

INTRODUCTION: Erectile dysfunction (ED) is defined by the inability to achieve or maintain an erection long enough to engage in satisfactory sexual practices. One of the main causes of ED refers to vascular impairment, which can be associated with age and diseases such as hypertension, diabetes, atherosclerosis and hyperlipidemia, causing vasculogenic ED. Therefore, the objective was to analyze, through a systematic review, what are the physiotherapeutic interventions in vasculogenic erectile dysfunction. METHODOLOGY: This is a systematic review carried out using the flowchart: “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA), which included randomized clinical trials (RCTs) in the Embase, PEDro, PubMed, Science databases Direct and Web of Science. Inclusion criteria were RCTs focusing on physical therapy treatment in vasculogenic ED. To search for articles, the PICOS strategy and RoB 2-0 were used in the risk of bias analysis. RESULTS: Of the 2.277 works analyzed, only 4 were included in the review. The sample of the selected studies was 328 participants and the groups had an average age of 57,18 years. The treatment groups used low-intensity extracorporeal shock wave therapy (TOCE), with intervention duration between 15 and 20 minutes, with the majority using a standard application protocol, followed by 300 shocks with an energy density of 0,09 mJ/mm2 at each treatment point of five distributed in the penile region. Low-intensity shock wave therapy was able to improve IIEF scores in all treatment groups and provide benefits over time, while ESWT developed improvements in the domains of sexual desire and general satisfaction, in penile hemodynamic

parameters. CONCLUSION: From this systematic review, it is concluded that low- intensity shockwave therapy is the most indicated in the treatment of

vasculogenic ED as it provides improvements in the erectile function of these men, with more research needed to determine the most effective physiotherapeutic approach and evaluate its impacts on patients’ quality of life.