FUNCTIONAL ELECTROMYOSTIMULATION OF THE CORPUS CAVERNOSUM PENIS - PRELIMINARY-RESULTS OF A NOVEL THERAPEUTIC OPTION FOR ERECTILE DYSFUNCTION

Transcutaneous application of low-frequency electric current in the tr eatment of partially or temporarily denervated striated muscles is wid ely used to prevent or treat muscular atrophy. Due to the high regener ative capacity of smooth-muscle cells, this approach should be benefic ial in the treatment of diseases with smooth-muscle degeneration due t o partial denervation. Our study was done to evaluate the possible ben eficial effect of transcutaneously applied low-frequency electric curr ent on the corpus cavernosum penis in the treatment of erectile dysfun ction. After a comprehensive workup, 21 patients with chronic erectile dysfunction (20/21 vasoactive nonresponders) received daily (3-5 x 20 min) transcutaneous functional electromyostimulation of the corpus ca vernosum smooth muscles [FEMCC; zero-line symmetric impulses of trapez oid shape, 2-channel device with alternating stimulations; frequency ( f), 10-20 Hz for channel I and 20-35 Hz for channel II; impulse durati on (t(i)), 100-150 mu s; approx. 12 mA; rise time, 0.5 s; stimulation time, 5 s/channel; pause between stimulations, 0.5 s. In all, 4/21 pat ients (19%) regained full spontaneous erections and another 3/21 (14%) responded to vasoactive drugs after FEMCC. Overall, 14/21 were FEMCC failures, including 2 who subjectively ''improved.'' In a similar grou p of patients who were evaluated during the same period but received n o therapy, no spontaneous improvement in erectile function was observe d. Our preliminary findings suggest that FEMCC is feasible and results in an improvement in erectile capacity in a significant number (33%) of patients. Further studies will be carried out to corroborate our re sults, to improve the stimulation parameters, and to evaluate the sele ction criteria for patients suitable for FEMCC.