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Biomedical subjects

Grace Dorey

Publications and source records attributed to Grace Dorey.

12 recordsLinked to original sources
PubMed2005

Pelvic floor exercises for erectile dysfunction.

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 > or = 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.

Adult↗
PubMed2005

Male pelvic floor: history and update.

Our understanding of the male pelvic floor has evolved over more than 2,000 years. Gradually medical science has sought to dispel ancient myths and untruths. The male pelvic floor has many diverse functions. Importantly, it helps to support the abdominal contents, maintains urinary and fecal continence, and plays a major role in gaining and maintaining penile erection. Weakness of the male pelvic floor muscles may cause urinary and fecal incontinence and erectile dysfunction. Function may be restored in each of these areas by a comprehensive pelvic floor muscle training program. Spasm of the pelvic floor muscles may produce pain and require relaxation techniques. Additional research is needed to add further evidence to our knowledge base.

Anatomy↗
PubMed2004

Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction.

BACKGROUND: The pelvic floor muscles are active in normal erectile function. Therefore, it was hypothesised that weak pelvic floor muscles could be a cause of erectile dysfunction. AIMS: To compare the efficacy of pelvic floor muscle exercises and manometric biofeedback with lifestyle changes for men with erectile dysfunction. DESIGN OF STUDY: Randomised controlled trial. SETTING: The Somerset Nuffield Hospital, Taunton, United Kingdom. METHOD: Fifty-five men with erectile dysfunction (median age 59.2 years; range 22-78 years) were enrolled from a local urology clinic. Of these, 28 participants were randomised to an intervention group and engaged in pelvic floor exercises, as well as receiving biofeedback and suggestions for lifestyle changes. Twenty-seven controls were solely advised on lifestyle changes. Baseline, 3- and 6-month assessments were: erectile function domain of International Index of Erectile Function (IIEF), Partner's International Index of Erectile Function (PIIEF), Erectile Dysfunction-Effect on Quality of Life (ED-EQoL), anal manometry, digital anal measurements, and clinical assessment by an assessor blind to treatment allocation. After 3 months, the control group were transferred to the active arm. RESULTS: At 3 months, compared with controls, men in the intervention group showed significant mean increases in the erectile function domain of the IIEF (6.74 points, P = 0.004); anal pressure (44.16 cmH(2)O, P <0.001); and digital anal grades (1.5 grades, P <0.001). All showed further improvement in these outcomes at 6 months. Similar benefits were seen in men of the control arm after transfer to active treatment. A total of 22 (40.0%) participants attained normal function, 19 (34.5%) participants had improved erectile function, and 14 (25.5%) participants failed to improve. CONCLUSION: Pelvic floor muscle exercises and biofeedback are an effective treatment for men with erectile dysfunction.

Adult↗
PubMed2004

Pelvic floor exercises for treating post-micturition dribble in men with erectile dysfunction: a randomized controlled trial.

PURPOSE: The purpose of this trial was to compare the efficacy of pelvic floor muscle exercises and manometric biofeedback for post-micturition dribble (PMD) in men with erectile dysfunction. METHODS: Fifty-five men with erectile dysfunction (median age 59.2 years; range 22-78) were enrolled from a local urology clinic. Twenty-eight subjects were randomized to an intervention group and received pelvic floor muscle exercises including a strong post-void "squeeze out" pelvic floor muscle contraction, biofeedback, and suggestions for lifestyle changes. Twenty-seven control subjects were solely advised on lifestyle changes. The PMD status, anal manometry, and digital anal muscle grade were assessed at baseline, 3, and 6 months. After 3 months, the control group received the intervention with pelvic floor muscle exercises and biofeedback. Both groups were followed for an additional 3 months of home exercises. An independent assessor who was blinded to the grouping assessed the PMD status of subjects at 3 and 6 months. RESULTS: Thirty-six (65.5%) of the 55 subjects reported PMD at baseline. At 3 months, there was significant reduction in PMD after intervention (p=0.001) compared to the control subjects (p=0.102). In both groups combined after 3 months of pelvic floor muscle exercises and 3 months of home exercises, 27 (75%) subjects became asymptomatic of PMD, 3 (8.3%) improved, 5 (13.9%) dropped out, and 1 (2.8%) subject still reported PMD. PMD was not correlated to age, erectile function, anal manometric pressure, or digital anal muscle grade. CONCLUSION: Pelvic floor muscle exercises including a post-void "squeeze out" pelvic floor muscle contraction are an effective treatment for post-micturition dribble in men with erectile dysfunction.

Adult↗
PubMed2003

Are erectile and ejaculatory dysfunction associated with postmicturition dribble?

Research findings from two earlier literature reviews were examined to determine if there may be an association between erectile dysfunction and postmicturition dribble. From the review, bulbocavernosus and ischiocavernosus muscle dysfunction may be responsible for both erectile and ejaculatory dysfunction, as well as a cause of postmicturition dribble and loss of the postvoid milking reflex. Pelvic floor muscle exercises may help to improve these conditions. However, research to investigate the conclusions proposed following the literature review is necessary for an association or relationship to be stated conclusively.

Erectile Dysfunction↗
PubMedDate not supplied

Outcome measures for erectile dysfunction. 1: Literature review.

This article describes and evaluates critically the outcome measures available for the assessment of the conservative treatment of erectile dysfunction (ED). The literature review identified 26 outcome measures. Of these, 14 were subjective and 12 were objective. Objective measures can provide more accurate information. However, owing to the sensitive nature of the problem, questionnaires which are reliable and sensitive to change can provide valuable data. Different outcome measures were needed for each of the separate components of ED. These components were found to be rigidity, vascular flow, nerve conductivity, intracavemosal pressure, ischiocavernosus muscle power, partner satisfaction and quality of life. An evaluation of outcome measures for each component of ED is provided in the second part of this article. Quick, simple, inexpensive and efficient outcome measures can be used by nurses to evaluate the impact of conservative treatment for ED.

Erectile Dysfunction↗
PubMedDate not supplied

Outcome measures for erectile dysfunction 2: evaluation.

This article, the second of two parts, discusses and evaluates the range of outcome measures for erectile dysfunction (ED) identified from the literature review in part one (Vol 11(1): 54-64). The literature review identified 14 subjective and 12 objective measures. These outcome measures are needed for the components: rigidity, vascular flow, nerve conductivity, intracavernosus muscle power, partner satisfaction and quality of life. Instruments selected should provide good validity, reliability and responsiveness. Quick, simple, inexpensive and efficient outcome measures can be used by nurses.

Erectile Dysfunction↗
PubMedDate not supplied

Restoring pelvic floor function in men: review of RCTs.

The male pelvic floor muscles support the abdominal contents, are active during breathing, maintain urinary and faecal continence, increase local blood supply and are active during sexual intercourse. It was hypothesized that weak pelvic floor muscles would compromise these functions in men and lead to urinary and faecal incontinence and sexual dysfunction and that pelvic floor muscle strengthening would restore normal function. After a literature search of randomized controlled trials was undertaken, it was found that weak pelvic floor muscles compromised normal pelvic floor function and led to urinary incontinence and erectile dysfunction. Strengthening the pelvic floor muscles was shown to significantly improve post-prostatectomy urinary continence, post-micturition dribble and erectile function. It would be prudent for all men to exercise their pelvic floor muscles to maintain normal pelvic floor function.

Erectile Dysfunction↗
PubMedDate not supplied

Pelvic floor exercises as a treatment for men with erectile dysfunction.

Erectile dysfunction was defined by a National Institutes of Health conference in 1993 as 'the inability to achieve or maintain an erection sufficient for satisfactory sexual performance (for both partners)' (National Institutes of Health, 1993). The degree of erectile dysfunction may be graded according to the number of satisfactory attempts out of 10 (mild 7-8, moderate 4-6, and severe 0-3) (Albaugh and Lewis, 1999).

Clinical Trials as Topic↗