title: High-tone electric muscles stimulation of thigh augments the impaired penile blood flow of diabetic patients without improving symptoms of erectile dysfunction.
abstract: OBJECTIVE
  Erectile dysfunction (ED) is a major complication in diabetes mellitus. A novel method, high-tone external muscle stimulation (HTEMS), has been proven to be useful in the therapy of diabetic and uremic peripheral polyneuropathy. The aim of this study was to test the potential effect of HTEMS on ED in diabetic patients.
  
  
  METHODS
  An open-label, self-controlled interventional prospective study was conducted at the 2nd Department of Internal Medicine and N.C. University of Pécs, Hungary. Six Type 2 diabetic patients (mean age 59 ± 7 years) with severe ED (International Index of Erectile Function (IIEF) score: 7.7 ± 8.5) and impaired renal function (eGFR: 61 ± 16 ml/min) were involved.
  
  
  METHODS
  The thigh muscles of the patients were treated with HTEMS for 1 h 3 times per week for a duration of 4 weeks.
  
  
  METHODS
  Penile peak systolic velocity (PSV) (in the flaccid state and semi-rigid (after 10 mg intracavernous papaverine injection)), IIEF score, quality of life and laboratory parameters. At the beginning also the acute effect of HTEMS on penile PSV was investigated.
  
  
  RESULTS
  Under basal conditions penile PSV was rather low. The first HTEMS session of the thighs induced an insignificant increase of PSV in the flaccid state (4.1 ± 1.2 to 6.3 ± 3.3 cm/s) and a significant rise of PSV in the semi-rigid penis (from 6.5 ± 2.5 to 8.9 ± 2.2 cm/s (p = 0.009)). After 4 weeks of HTEMS treatment, under basal conditions no significant change of penile PSV (flaccid and semirigid) was observed. Similarly, IIEF score did not improve over the time period (7.7 ± 8.1 vs. 6.7 ± 8.5, p > 0.05). Also, metabolic parameters and eGFR were not influenced.
  
  
  CONCLUSIONS
  In a pilot study of diabetic patients with severe ED HTEMS of the thighs induced an acute rise of penile PSV in the semi-rigid state. However, after 4 weeks of HTEMS therapy the basal PSV and symptoms of ED were not improved.
authors.affiliation: Department of Urology, University of Pécs, Pécs, Hungary.
authors.forename: Miklós
authors.initials: M
authors.lastname: Damásdi
authors.forename: Katalin
authors.initials: K
authors.lastname: Vágási
authors.forename: Gergå A
authors.initials: GA
authors.lastname: Molnár
authors.forename: László
authors.initials: L
authors.lastname: Farkas
authors.forename: István
authors.initials: I
authors.lastname: Wittmann
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D003929:Diabetic Neuropathies / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000098:blood supply*; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000628:therapy*; D010865:Pilot Projects; D012039:Regional Blood Flow / Q000502:physiology*; D012720:Severity of Illness Index; D013848:Thigh / Q000098:blood supply; D016896:Treatment Outcome; D014511:Uremia / Q000150:complications*