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Rédacteurs : Johan Nguyen, Henri Truong

Erectile Dysfunction

Dysfonction érectile : évaluation de l'acupuncture

3. Systematic Reviews and Meta-Analysis

☆☆☆ Evidence for effectiveness and a specific effect of acupuncture
☆☆ Evidence for effectiveness of acupuncture
Limited evidence for effectiveness of acupuncture
Ø No evidence or insufficient evidence

3.1. Jiang 2018

Jiang Rongmin, Qu You, Wang Tao , Wan Yunli, Xu Wenbin. [Meta-analysis of clinical effectiveness of the acupuncture treatment for erectile dysfunction]. The Chinese Journal of Human Sexuality. 2018;2:82-85. [201795].

ObjectivesTo evaluate the clinical effectiveness of the acupuncture treatment for erectile dysfunction (ED).
MethodsAccording to the strict inclusion criteria, randomized controlled trial (RCT) which had been published regarding acupuncture for erectile dysfunction were searched in databases (such as CNKI,WAN FANG DATA,VIP).The software of Cochrane Hand book 5.1.0 were used to evaluate the bias risk. Revman 5.3 was applied for statistical analysis.
Results589 patients in 6 researches were included. The result suggested that both using acupuncture alone and acupuncture combined with traditional Chinese medicine can improve the IIEF-5 score of patients. However, the clinic effective rates could not be combined due to the significant difference among the including groups.
ConclusionAlthough the current evidence can confirm the therapeutic effect of acupuncture for erectile dysfunction, the including articles are short of rigorous design and objective indicators, so the conclusion should be treated with caution.

3.2. Cui 2016

Cui X, Zhou J, Qin Z, Liu Z. Acupuncture for erectile dysfunction: a systematic review. Biomed Res Int. 2016;2016:2171923. [176601].

ObjectiveAcupuncture is increasingly used to treat patients with erectile dysfunction (ED), and our systematic review aimed to evaluate the current evidence for the efficacy and safety of acupuncture in treating ED.
Methods An electronic searchwas conducted in eight databases to identify randomized controlled trials (RCTs) of acupuncture for treating erectile dysfunction that were published in English and Chinese. The Cochrane Risk of Bias tool was used to assess the risk of bias.
ResultsThree RCTs with a total of 183 participants met the inclusion criteria. One trial showed the beneficial effects of acupuncture compared with sham acupuncture while the others did not. One trial suggested that acupuncture combined with psychological therapy was superior to psychological therapy alone. However, the overall methodological and reporting quality of the studies was low. The safety of acupuncture for ED was unclear because there were too few reports on this topic.
Conclusion The available evidence supporting that acupuncture alone improves ED was insufficient and the available studies failed to show the specific therapeutic effect of acupuncture.

3.3. Lee 2009

Lee MS, Shin BC, Ernst E. Acupuncture for treating erectile dysfunction: a systematic review. BJU Int. 2009;104:366-70. 153134

ObjectiveWe evaluated the current evidence for the use of acupuncture to treat erectile dysfunction (ED).
Methods Systematic searches were conducted in 15 electronic databases, with no language restrictions. Hand-searches included conference proceedings and our files. All clinical studies of acupuncture as a treatment for ED were considered for inclusion, and their methodological quality was assessed using the Jadad score.
ResultsOf the four studies included, one randomized controlled trial (RCT) showed beneficial effects of acupuncture compared with sham acupuncture in terms of response rate, while another RCT found no effects of acupuncture. The remaining two studies were uncontrolled clinical trials. Collectively these data showed that RCTs of acupuncture for ED are feasible but scarce. Most investigations had methodological flaws, e.g. inadequate study design, poor reporting of results, small sample size, and publication without appropriate peer review process.
Conclusion The evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED. Further research is required to investigate whether there are specific benefits of acupuncture for men with ED.

4. Overviews of Systematic Reviews

4.1. Ernst 2011

Ernst E, Posadzki P, Lee MS. Complementary and alternative medicine (CAM) for sexual dysfunction and erectile dysfunction in older men and women: an overview of systematic reviews. Maturitas. 2011;70(1):37-41. [169139].

BackgroundOlder patients with sexual dysfunction (SD) and/or erectile dysfunction (ED) often use complementary and alternative medicine (CAM).
AimThe aim of this overview of systematic reviews is to critically evaluate the evidence for or against the effectiveness of CAM.
Methods Six electronic databases were searched to identify all relevant systematic reviews (SRs). Their methodological quality was assessed independently by two reviewers using the Oxman score.
Results- conclusionsFour SRs met our inclusion criteria. They evaluated: acupuncture, ginseng, maca and yohimbine. The methodological quality of all of the SRs was good. However, the primary studies were often associated with considerable risk of bias. Cautiously positive conclusions were drawn for yohimbine and ginseng as treatment options for ED. For acupuncture and maca the evidence was insufficient for ED and SD respectively. It is concluded that there is some encouraging evidence but more and better studies are required to establish the value of CAM for SD and ED.