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Commentary on: Low frequency neuromuscular electrical stimulation applied to the bulbospongiosus muscle

International Journal of Impotence Research volume 36, pages 291–292 (2024)Cite this article

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Cizmeci et al. should be praised for promoting our understanding of the physiology of ejaculation [1]. They executed an animal study on Wistar albino rats aiming to evaluate the effect of low- and high-frequency electrical stimulation applied to the bulbospongiosus muscle on various aspects of ejaculation. A control group of rats underwent the same procedure without the application of electrical stimulation. In a very meticulously performed surgical model, they were able to assess ejaculation time, the increase in basal seminal vesical pressure, seminal vesical maximum pressure, number and interval time of seminal contractions as well as electromyography activities of the bulbospongiosus muscle. They eloquently demonstrated that the application of low-frequency electrical stimulation (at 2 Hz frequency with 200 µs current time) to the bulbospongiosus muscle prolongs ejaculation time. This work strengthens the physiological scientific basis of the clinical study done by Schechter et al. [2] who demonstrated that neuromuscular electrical stimulation delivered through an external patch on the perineum, prolongs the IELT during intercourse, non-invasively and on demand.

The two additional muscles involved in the ejaculation process are the bulbocavernosus and the pubococcygeus muscles, which are part of the pelvic floor musculature [3]. Electrical stimulation affecting these muscles has been investigated as a potential treatment for premature ejaculation, with some studies suggesting that it may help to delay ejaculation by modulating the contraction activity of the muscles involved in the ejaculatory process [4].

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References

  1. Cizmeci S, Ongun S, Sarac A, Sel E, Tozburun S, Durmus N. Low frequency neuromuscular electrical stimulation applied to the bulbospongiosus muscle prolongs the ejaculation latency in a rat model. Int J Impot Res. 2023. https://doi.org/10.1038/s41443-023-00678-5. Online ahead of print.

  2. Shechter A, Serefoglu EC, Gollan T, Springer S, Meiry G, Appel B, et al. Transcutaneous functional electrical stimulation-a novel therapy for premature ejaculation: results of a proof of concept study. Int J Impot Res. 2020;32:440–5. https://doi.org/10.1038/s41443-019-0207-y.

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  3. Clement P, Giuliano F. Physiology and pharmacology of ejaculation. Basic Clin Pharm Toxicol. 2016;119(Suppl 3):18–25. https://doi.org/10.1111/bcpt.12546.

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  4. Shechter A, Mondaini N, Serefoglu EC, Gollan T, Deutsch F, Appel B, et al. A novel on-demand therapy for lifelong premature ejaculation using a miniature transperineal electrical stimulator-the vPatch: an as-treated analysis. J Sex Med. 2023;20:22–9. https://doi.org/10.1093/jsxmed/qdac012.

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  5. Waldinger MD, Olivier B. Animal models of premature and retarded ejaculation. World J Urol. 2005;23:115–8. https://doi.org/10.1007/s00345-004-0493-x.

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Authors and Affiliations

  1. The Neuro Urology Unit, Rambam Medical Center, Haifa, Israel

    Ilan Gruenwald, Arik Shechter & Alexander Greenstein

  2. The Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel

    Ilan Gruenwald & Arik Shechter

  3. The Sachler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Alexander Greenstein

Authors
  1. Ilan Gruenwald
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  2. Arik Shechter
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  3. Alexander Greenstein
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Contributions

IG: conceptualizing the commentary, coordinating the writing process, literature review, material collection, analysis, and interpretation of the information presented in the commentary, and writing, drafting, and revising the content. AS: providing expertise in this particular subfield, gathering material and literature search, analyzing information, contributing to the writing and editing process, and ensuring the clarity and coherence of the article. AG: conceptualizing the commentary, writing, editing, revising, and ensuring that the final version aligns with the journal’s guideline.

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Correspondence to Ilan Gruenwald.

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Gruenwald, I., Shechter, A. & Greenstein, A. Commentary on: Low frequency neuromuscular electrical stimulation applied to the bulbospongiosus muscle. Int J Impot Res 36, 291–292 (2024). https://doi.org/10.1038/s41443-023-00723-3

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