World J Mens Health.  2019 Sep;37(3):322-338. 10.5534/wjmh.180090.

Acupuncture for Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis

• Lai BY
• Cao HJ
• Yang GY
• Jia LY
• Grant S
• Fei YT
• Wong E
• Li XL
• Yang XY
• Liu JP

• KMID: 2455409
• DOI: http://doi.org/10.5534/wjmh.180090

Abstract

PURPOSE
To assess the effectiveness and safety of acupuncture for erectile dysfunction (ED).
MATERIALS AND METHODS
We searched six major English and Chinese databases included randomized controlled trials (RCTs) testing acupuncture alone or in combination for ED. Dichotomous data were presented as risk ratio (RR) and continuous data were presented as mean difference (MD) both with 95% confidence interval (CI). The Revman (v.5.3) was used for data analyses. Quality of evidence across studies was assessed by the online GRADEpro tool.
RESULTS
We identified 22 RCTs, fourteen of them involving psychogenic ED. Most of the included RCTs had high or unclear risk of bias. There was no difference between electro-acupuncture and sham acupuncture with electrical stimulation on the rate of satisfaction and self-assessment (RR, 1.50; 95% CI, 0.71-3.16; 1 trial). Acupuncture combined with tadalafil appeared to have better effect on increasing cure rate (RR, 1.31; 95% CI, 1.00-1.71; 2 trials), and International Index of Erectile Function-5 scores (MD, 5.38; 95% CI, 4.46-6.29; 2 trials). When acupuncture plus herbal medicine compared with herbal medicine alone, the combination therapy showed significant better improvement in erectile function (RR, 1.68; 95% CI, 1.31-2.15; 7 trials). Only two trials reported facial red and dizziness cases, and needle sticking and pruritus cases in acupuncture group.
CONCLUSIONS
Low quality evidence shows beneficial effect of acupuncture as adjunctive treatment for people mainly with psychogenic ED. Safety of acupuncture was insufficiently reported. The findings should be confirmed in large, rigorously designed and well-reported trials.

Keyword

Acupuncture; Erectile dysfunction; Meta-analysis; Randomized controlled trial; Systematic review

MeSH Terms

Acupuncture*
Asian Continental Ancestry Group
Bias (Epidemiology)
Dizziness
Electric Stimulation
Erectile Dysfunction*
Herbal Medicine
Humans
Male
Needles
Odds Ratio
Pruritus
Self-Assessment
Statistics as Topic
Tadalafil
Tadalafil

Figure

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  Fig. 1 Study selection flow diagram. CNKI: China National Knowledge Infrastructure, VIP: Chinese Science Journal Database, RCT: randomized controlled trial.

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  Fig. 2 Risk of bias summary.

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