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Hadisuyatmana S. et al., 2023: Non-medical and non-invasive interventions for erectile dysfunction in men with type 2 diabetes mellitus: A scoping review.

School of Psychology & Public Health, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
Faculty of Nursing, Universitas Airlangga Indonesia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia.
School of Psychology and Public Health, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
Honorary Fellow at La Trobe University of Australia, Kampus C Jln Mulyorejo, 60115, Surabaya, East Java, Indonesia.
School of Nursing & Midwifery, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
School of Engineering, La Trobe University of Australia, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
Bairnsdale Regional Health Service, Victoria, Australia, 122 Day St, Bairnsdale, VIC, 3875, Australia.

Abstract

Background: Erectile dysfunction (ED) often affects men with type 2 diabetes mellitus (T2DM) due to microvascular damage. However, medical interventions are not always appropriate.

Aim: This scoping review aimed to answer the following question: What evidence is available about the effects of non-medical and non-invasive healthcare interventions to improve ED in men with T2DM?

Method: Potential studies were collected from the Cumulative Index to Nursing and Allied Health Literature via EBSCO, Embase via Ovid, MEDLINE via Ovid, Web of Science, PubMed, ProQuest, and PsycINFO via Ovid.

Findings: From 2,611 identified titles, 17 studies, including 11 interventional and 6 observational studies, were included. Four main alternatives to medical interventions were identified from the included studies. Amongst these, four studies recommended patient education on lifestyle modification, twelve studies encouraged dietary changes and physical activities, two studies emphasized the use of vacuum erectile device, and three studies suggested the application of low-intensity extracorporeal shockwave therapy by healthcare professionals.

Discussion: Dietary modification and physical activities were promoted as effective interventions to help maintaining the erectile function in men with T2DM. Several methods of patient education were identified as the approach to facilitate lifestyle modification in men with T2DM-associated ED. The positive outcomes of this review support early ED screening to help preventing T2DM complications such as ED in men. Further, T2DM management is a shared responsibility between the men and healthcare professionals. Despite the success of Vacuum Erectile Device and Low-intensity Extracorporeal Shockwave Therapy in regaining erectile function, further research is needed in this area based on the recommendations of the American Urological Association. Moreover, the health and quality of life of men with T2DM must be improved.

Heliyon. 2023 Apr 28;9(5):e15778. doi: 10.1016/j.heliyon.2023.e15778. eCollection 2023 May.PMID: 37187905 Review
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Comments 1

Jens Rassweiler on Wednesday, 15 November 2023 08:45

Type 2 Diabetes mellitus (T2DM) patients are at higher risk of developing ED due to factors like hyperglycemia and medication side effects. The review's goal is to identify non-medical and non-invasive options for maintaining erectile function in T2DM patients with ED.

The review followed five stages, from identifying the research question to summarizing results (i):Key terms were developed for consistent research; (ii) databases were searched in February 2022, including Cumulative Index to Nursing and Allied Health Literature, Embase, MEDLINE; (iii) eligible studies were peer-reviewed, written in English, and published between January 2002 and February 2022; (iv) selection occurred through title, abstract, and full-text review stages; data from included studies were extracted and analyzed, and findings were summarized thematically. It is important to note, that there was no urologist involved in this review study.

From 2,611 identified titles, 17 studies, including 11 interventional and 6 observational studies, were included. Four main alternatives to medical interventions were identified from the included studies. Amongst these, four studies recommended patient education on lifestyle modification, twelve studies encouraged dietary changes and physical activities, two studies emphasized the use of vacuum erectile device, and three studies suggested the application of low-intensity extracorporeal shockwave therapy by healthcare professionals.

Studies originated from middle- and high-income countries, such as Italy, the USA, Turkey, China, Egypt, and Australia, showed the magnitude of the issue and the growing awareness of T2DMED in those countries. However, a gap was identified from the absence of such studies in developing countries and the small number of included studies in the present review. Hence, more studies are rec- ommended in future.

Based on their review, the authors discuss the importance of patient education for adopting healthier lifestyles, such as lifestyle modification's effectiveness in preserving/regaining erectile function; need for early diagnosis, lifestyle change initiation, and healthcare professional collaboration; use of assistive devices like Vacuum Erectile Device (VED) and low-intensity extracorporeal shockwave therapy (Li-ESWT).

In summary, the positive outcomes of this review support the initiation of ED screening and discussion to lower the risks of future complications of T2DM in men. The application of multidisciplinary approaches in educating patients about managing T2DM requires a collective and shared responsibility among HCPs. In addition, the use of VED and Li-ESWT is offered as an additional alternative to allow satisfactory erection, despite recommendation for further investigation of these treatments. Thus, the findings of this review should be used in future studies that aim to improve the health and quality of life of men with T2DM.

Type 2 Diabetes mellitus (T2DM) patients are at higher risk of developing ED due to factors like hyperglycemia and medication side effects. The review's goal is to identify non-medical and non-invasive options for maintaining erectile function in T2DM patients with ED. The review followed five stages, from identifying the research question to summarizing results (i):Key terms were developed for consistent research; (ii) databases were searched in February 2022, including Cumulative Index to Nursing and Allied Health Literature, Embase, MEDLINE; (iii) eligible studies were peer-reviewed, written in English, and published between January 2002 and February 2022; (iv) selection occurred through title, abstract, and full-text review stages; data from included studies were extracted and analyzed, and findings were summarized thematically. It is important to note, that there was no urologist involved in this review study. From 2,611 identified titles, 17 studies, including 11 interventional and 6 observational studies, were included. Four main alternatives to medical interventions were identified from the included studies. Amongst these, four studies recommended patient education on lifestyle modification, twelve studies encouraged dietary changes and physical activities, two studies emphasized the use of vacuum erectile device, and three studies suggested the application of low-intensity extracorporeal shockwave therapy by healthcare professionals. Studies originated from middle- and high-income countries, such as Italy, the USA, Turkey, China, Egypt, and Australia, showed the magnitude of the issue and the growing awareness of T2DMED in those countries. However, a gap was identified from the absence of such studies in developing countries and the small number of included studies in the present review. Hence, more studies are rec- ommended in future. Based on their review, the authors discuss the importance of patient education for adopting healthier lifestyles, such as lifestyle modification's effectiveness in preserving/regaining erectile function; need for early diagnosis, lifestyle change initiation, and healthcare professional collaboration; use of assistive devices like Vacuum Erectile Device (VED) and low-intensity extracorporeal shockwave therapy (Li-ESWT). In summary, the positive outcomes of this review support the initiation of ED screening and discussion to lower the risks of future complications of T2DM in men. The application of multidisciplinary approaches in educating patients about managing T2DM requires a collective and shared responsibility among HCPs. In addition, the use of VED and Li-ESWT is offered as an additional alternative to allow satisfactory erection, despite recommendation for further investigation of these treatments. Thus, the findings of this review should be used in future studies that aim to improve the health and quality of life of men with T2DM.
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