Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

An initial study on the effect of functional electrical stimulation in erectile dysfunction: a randomized controlled trial


Erectile dysfunction (ED) affects approximately 150 million men worldwide. Functional electrical stimulation (FES) therapy has shown a high regenerative capacity for smooth muscle cells and, therefore, is being increasingly adopted. FES can be a beneficial treatment option when the cause of ED is related to degeneration of cavernous smooth muscle. To evaluate the impact of FES on erectile function in men with erectile dysfunction. Twenty-two patients with ED participated in this randomized clinical trial. Participants were randomly assigned to two groups: intervention (IG) or control (CG). IG participants underwent FES therapy (50 Hz/500 µs) for a total of 4 weeks, divided into two weekly sessions lasting 15 min each, with intensity lower than the motor threshold. CG participants were treated with placebo FES and followed the same routine as the IG. Erectile function was assessed by the validated International Index of Erectile Function (IIEF-5) and Erection Hardness Score (EHS), applied before and after treatment, and quality of life, by the WHOQOL questionnaire. Statistically significant differences in IIEF-5 and EHS were found between the IG and CG after treatment (p <  0.05), as well as a within-group difference in the IG when comparing the post-treatment periods (p < 0.0001) The WHOQOL revealed a significant difference between CG and IG after treatment (p < 0.05), as well as a within-group difference in the IG after treatment (p < 0.0001), except in the Environment domain, in which there was no difference between the pre- and post-treatment periods (50.9 ± 2.8 pre vs. 52.3 ± 3.1 post). This trial showed that FES therapy may improve erectile function and quality of life in men with ED.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1
Fig. 2


  1. 1.

    NIH Consensus Development Panel on Impotence. Impotence-NIH Consensus Conference. JAMA. 2013;270:83–90.

    Google Scholar 

  2. 2.

    Pournaghash-Tehrani S, Etemadi S. ED and quality of life in CABG patients: an intervention study using PRECEDE-PROCEED educational program. Int J Impot Res. 2014;26:16–9.

    CAS  Article  Google Scholar 

  3. 3.

    McMahon CN, Smith CJ, Shabsigh R. Treating erectile dysfunction when PDE5 inhibitors fail. BMJ. 2006;332:589–92.

    Article  Google Scholar 

  4. 4.

    Hackett G. Patient preferences in treatment of erectile dysfunction: the continuing importance of patient education. Clin Cornerstone. 2005;1:57–65.

    Article  Google Scholar 

  5. 5.

    Al-Shaiji T, Brock G. Phosphodiesterase Type 5 inhibitors for the management of erectile dysfunction: preference and adherence to treatment. Curr Pharm Des. 2009;15:3486–95.

    CAS  Article  Google Scholar 

  6. 6.

    Hwancheol S, Kwanjin P, Soo-Woong K, Jae-Seung P. Reasons for discontinuation of sildenafil citrate after successful restoration of erectile function. Asian J Androl. 2004;6:117–20.

    Google Scholar 

  7. 7.

    Claes H, Van Kampen M, Lysens R, Baert L. Pelvic floor exercise in the treatment of impotence. Eur J Phys Med Rehabil. 1995;5:42–6.

    Google Scholar 

  8. 8.

    Derouet H, Nolden W, Jost W, Osterhage J, Eckert R, Ziegler M. Treatment of erectile dysfunction by an external ischiocavernous muscle stimulator. Eur Urol. 1998;34:355–9.

    CAS  Article  Google Scholar 

  9. 9.

    Andersson K-E Erectile physiological and pathophysiological pathways involved in erectile dysfunction. J Urol. 2003;170(2 Pt 2):S6-13-4.

  10. 10.

    Hurt KJ, Musicki B, Palese Ma, Crone JK, Becker RE, Moriarity JL, et al. Akt-dependent phosphorylation of endothelial nitric-oxide synthase mediates penile erection. Proc Natl Acad Sci USA. 2002;99:4061–6.

    CAS  Article  Google Scholar 

  11. 11.

    Gratzke C, Angulo J, Chitaley K, Dai Y-T, Kim NN, Paick J-S, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med. 2010;7(1 Pt 2):445–75.

    CAS  Article  Google Scholar 

  12. 12.

    Stief CG, Weller E, Noack T, Djamilian M, Meschi M, Truss M, et al. Functional electromyostimulation of the corpus cavernosum penis--preliminary results of a novel therapeutic option for erectile dysfunction. World J Urol. 1995;13:243–7.

    CAS  PubMed  Google Scholar 

  13. 13.

    Dean R, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. 2005;32:379–95.

    Article  Google Scholar 

  14. 14.

    Ignarro LJ, Bush PA, Buga GM, Wood KS, Fukuto JM, Rajfer J. Nitric oxide and cyclic GMP formation upon electrical field stimulation cause relaxation of corpus cavernosum smooth muscle. Biochem Biophys Res Commun. 1990;170:843–50.

    CAS  Article  Google Scholar 

  15. 15.

    Jiang J, He Y, Jiang R. Ultrastructural changes of penile cavernous tissue in multiple sclerotic rats. J Sex Med. 2009;6:2206–14.

    Article  Google Scholar 

  16. 16.

    Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57:804–14.

    Article  Google Scholar 

  17. 17.

    Paick J, Goldsmith P, Barta A, Nunes L, Padula C, Lue T. Relationship between venous incompetence and cavernous nerve injury: Ultrastructural alteration of cavernous smooth muscle in the neurotomized dog. Int J Impot Res. 1991;3:173–84.

    Google Scholar 

  18. 18.

    Myung-Cheol G, Yun-Chul O, Tae-Woo K. The effect of treatment of erectile dysfunction with electrical stimulation. Kor J Androl. 2000;18:149–55.

    Google Scholar 

  19. 19.

    Althof S. Quality of life and erectile dysfunction. Urology. 2002;59:803–10.

    Article  Google Scholar 

  20. 20.

    Araujo A, Durante R, Feldman H, Goldstein I, McKinlay J. The relationship between depressive symptoms and male erectile dysfunction: cross-sectional results from the Massachusetts Male Aging Study. Psychosom Med. 1998;60:458–65.

    CAS  Article  Google Scholar 

  21. 21.

    Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED, et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;7(4 Pt 2):1598–607.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Cristiane Carboni.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Carboni, C., Fornari, A., Bragante, K.C. et al. An initial study on the effect of functional electrical stimulation in erectile dysfunction: a randomized controlled trial. Int J Impot Res 30, 97–101 (2018).

Download citation


Quick links