Investigating the Effects of Manual Therapy and Pelvic Floor Training on Erectile Dysfunction: A Case Study

Introduction: Erectile dysfunction (ED) is a common issue in men, often associated with various factors, such as obesity, diabetes, and more. This case study examines the impact of friction massage combined with pelvic floor exercises on ED in three patients, linked to prostatic adenectomy, aging, and diabetes. Case Description: Patients followed a one-month regimen of pelvic floor exercises and techniques. The technique’s progress was monitored via video calls twice a week. Exercises lasted for 10 min daily, along with a 10-min massage. We assessed improvement using the international index of erectile function 15 (IIEF15) questionnaire and erection hardness score (EHS), as well as ultrasound scans. Results: Following treatment, all three patients showed increased EHS and IIEF15 15 scores. Muscular thickness increased in the ischiocavernosus and bulbospongiosus muscles, while the cavernosal artery exhibited higher systolic velocity and lower diastolic velocity, although maximum blood flow velocity in the posterior vein decreased. Treatment had the most significant impact on the adenectomy patient, followed by the elderly patient and then the diabetic patient. Conclusion: Combining friction massage and pelvic floor exercises led to improved erection- related indicators and increased patient satisfaction.