Enhanced external counterpulsation in rehabilitation of erectile dysfunction: a narrative literature review

Figures & data

Figure 1 Flow diagram of the study selection process.

Table 1 Clinical studies on effects of EECP in patients with ED

Study	Year	N	Treatment duration (hours)	Main findings
Froschermaier et al^Citation29	1998	13	20 hours	• An 87.5% increase in the peak systolic flow (P=0.017) • A 13.5% increase in the penile resistance index (P˂0.008) • A 58.2% increase in the quality of erection (P ˂0.003) assessed by a four-item questionnaire • An 84.6% of patients had improvement in ED with 38.5% showing complete resolution after EECP
Lawson et al^Citation11	2007	120	35 hours	• The post EECP erectile function domain score of the IIEF questionnaire improved from 10.0 to 11.8 (P=0.003). Intercourse satisfaction domain score increased from 4.2 to 5.0 (P=0.009) and overall satisfaction domain score improved from 4.7 to 5.2 (P=0.001) with no significant change in orgasmic function or sexual desire domain scores • The total score of IIEF increased from 28 to 31 (P=0.01) after EECP
EI-Sakka et al^Citation44	2007	44	35 hours	• An overall satisfaction of 79.5% of patients about both anginal and erectile function improvement before and after EECP assessed by two separate questions • A significant difference in the erectile function domain, Q3, and Q4 of IIEF questionnaire (P˂0.05) pre and post EECP • The efficacy and satisfaction rate of EECP were negatively influenced by smoking and the presence of more than two risk factors
EI-Sakka et al^Citation16	2007	44 (The same patients of the previous study)	35 hours A similar course was repeated for patients with no or minimal improvement from class IV to class III angina after the first course	• EF domain, Q3, and Q4 of IIEF questionnaire answers were significantly higher before and after EECP in patients with <5 years duration of IHD than those with ≥5 years of duration • At the end of the first course of treatment, the pre and post EECP results regarding EF domain, Q3, and Q4 of IIEF questionnaire were significantly better in patients who received only one course than those who required a second course of treatment

Abbreviations: ED, erectile dysfunction; EECP, enhanced external counterpulsation; IHD, ischemic heart disease; IIEF, International Index of Erectile Function.

FroschermaierSEWernerDLeikeSEnhanced external counterpulsation as a new treatment modality for patients with erectile dysfunctionUrol Int19986131681719933838

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LawsonWEHuiJCKennardEDIEPR InvestigatorsEffect of enhanced external counterpulsation on medically refractory angina patients with erectile dysfunctionInt J Clin Pract200761575776217493089

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El-SakkaAMorsyAFagihBEnhanced external counterpulsation in patients with coronary artery disease-associated erectile dysfunction. Part I: effects of risk factorsJ Sex Med20074377177917433083

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El-SakkaAIMorsyAMFagihBIEnhanced external counterpulsation in patients with coronary artery disease-associated erectile dysfunction. Part II: impact of disease duration and treatment coursesJ Sex Med2007451448145317634052

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