Assessment of Effectiveness of Pelvic Floor Muscle Training With Biofeedback in Male With Hypogonadism and Erectile Dysfunction

July 3, 2026 updated by: Wojciech Pawlowski, Poznan University of Physical Education

Assessment of Effectiveness of Pelvic Floor Muscle Training (PFMT) With Biofeedback in Male With Hypogonadism and Erectile Dysfunction (ED) a Randomised Control Trial.

The goal of this clinical trial is to learn if Pelvic Floor Muscle Training (PFMT) with biofeedback works to treat Erectile Disorders (ED) in males with Functional Hipogonadism. The main hypothesis is:

1. Biofeedback-assisted Pelvic Floor Muscle Training will cause greater improvement in pelvic floor muscle strength and endurance and sexual life than in group without biofeedback and control group in males with Erectile Disorders caused by functional hypogonadism.

The main questions it aims to answer are:

  1. Does biofeedback-assisted pelvic floor muscle training cause greater improvement in pelvic floor muscle strength and endurance and sexual life than in group without biofeedback and control group.
  2. Does using handheld biofeedback trainer device improves technique of Pelvic Floor Muscle Training performance compare to NO biofeedback.
  3. Does 12-week intervention cause greater improvement in analyzed parameters than 6-week intervention.
  4. Does participants using biofeedback will have greater adherence to training protocol than no biofeedback group.

Research will compare biofeedback-assisted Pelvic Floor Muscle Training to non-biofeedback Pelvic Floor Muscle Training and control group to see if Pelvic Floor Muscle Training works to treat Erectile Disorders in males with functional hypogonadism.

Participants will:

  1. Be measured using questionnaires and pelvic floor muscle electromyography
  2. Do Pelvic Floor Muscle Training for 12 weeks
  3. Provide a diary of their training routine
  4. Have repeated measurements in 6 and 12 weeks

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Background and study aims:

The study aims to evaluate whether pelvic floor muscle training (PFMT), supported by biofeedback improves the treatment outcomes in male with erectile dysfunction (ED) and functional hypogonadism, compared to PFMT alone and standard pharmacological therapy. ED is a common condition affecting approximately 30-60% of men, with prevalence increasing with age. The aetiology of ED is multifactorial and includes vascular, hormonal, neurological, and psychological factors. Despite its prevalence only 25% of them seek treatment.

Current ED treatment relies primarily on pharmacotherapy, including testosterone replacement therapy (in confirmed deficiency) and PDE5 inhibitors, which are effective in many patients (60-80%) but less so in specific populations, such as those with diabetes. There is increasing interest in physiotherapy interventions, particularly PFMT, as a supportive treatment for ED. However, evidence regarding its effectiveness in hormonally driven ED remains limited.

The primary hypothesis is that PFMT supported by biofeedback will lead to greater improvements in pelvic floor muscle function, erectile performance, and sexual quality of life compared with PFMT without biofeedback and pharmacological treatment alone. Additional hypotheses suggest that biofeedback enhances exercise technique, increases patient adherence to training, and that longer intervention (12 weeks vs. 6 weeks) leads to superior outcomes.

Study design and material:

This study is designed as a prospective, randomized controlled trial (RCT) with a mixed design (repeated measures over time) and three parallel groups. Approximately 100 men aged 18-60 with diagnosed functional hypogonadism (serum testosterone <12 nmol/L; free testosterone <225 pmol/L) and erectile dysfunction will be recruited. All participants will have been prescribed pharmacological treatment (e.g. testosterone therapy, GLP-1 analogues, or dual GLP-1/GIP receptor agonists) prior to enrolment, according to medical indications.

Participants will be randomised into one of three groups: a control group receiving only pharmacotherapy, a group performing PFM training, and a group performing PFM training with biofeedback. Various measurements will be taken, including physical parameters, sexual function questionnaires, muscle activity (EMG), and psychological assessments.

All participants will continue previously prescribed and stable pharmacological treatment according to medical indications. The study intervention consists of adding PFMT, with or without biofeedback, to standard pharmacological care.

Methods:

Participants will be randomly allocated into three groups:

Control group will receive standard pharmacological treatment only Exercise group will continue pharmacotherapy while performing pelvic floor muscle (PFM) training without biofeedback Exercise + Biofeedback group will combine pharmacotherapy with PFM training supported by portable biofeedback devices.

Baseline and final assessment

All participants will undergo a detailed clinical interview aimed at identifying contraindications and collecting information on comorbidities and current medications. A comprehensive set of baseline measurements will be collected, including:

anthropometric data (height, body mass, waist and hip circumference), physical activity levels assessed by the short version of the International Physical Activity Questionnaire (IPAQ), sexual function evaluated using the standardized International Index of Erectile Function (IIEF), sexual quality of life evaluated using the standardized Sexual Quality of Life - Male (SQOL-M) pelvic floor muscle function will be assessed by palpation based on the PERFECT scheme and the Oxford scale, electromyographic (EMG) evaluation of pelvic floor muscles and synergistic muscle groups using surface electrodes, psychological status, including levels of depression and perceived stress, will be measured using validated tools such as the BDI-II and PSS-10 questionnaires.

Intervention Both intervention groups will follow an PFMT programme based on the 'Graduated Strength Training: Pelvic Floor Muscle Training' protocol. Participants will also receive education on healthy lifestyle practices and pelvic floor health. The biofeedback group will additionally use a handheld biofeedback device connected to a mobile application, providing real-time feedback on muscle activity and training performance. Those in the biofeedback group will receive additional instruction on the proper use of the device.

Duration: 12 weeks. Frequency: ≥5 sessions per week. Session duration: 5-10 minutes Mode: home-based training in a seated position Participants will maintain training diaries to monitor adherence. On-line follow-up consultations will be conducted at weeks 2, 4 and 9 to evaluate progress and adjust training if necessary.

Follow-up and measurements:

baseline (week 0): full assessment (all groups) week 6: repeated assessment (intervention groups only) week 12: final assessment (all groups)

Potential outcomes:

The study is expected to provide evidence on the effectiveness of PFM training-particularly when supported by biofeedback-in improving erectile function and pelvic floor muscle performance in male with functional hypogonadism. The findings may contribute to the development of clinical guidelines, optimization of treatment strategies, and improved patient quality of life and health awareness.

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Poland
    • Wielkopolska
      • Poznan, Wielkopolska, Poland, 61-871
        • Poznan University of Physical Education

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • diagnosed functional hypogonadism
  • diagnosed erectile disorders
  • no diagnosed neurological disorders in pelvic floor area
  • no surgical interventions in pelvic floor area
  • no cancer in its active phase
  • ability to give individual consent
  • consent of participation and following the protocol

Exclusion Criteria:

  • severe cardiovascular diseases
  • cancer treatment in progress
  • scars and surgical interventions in the pelvic floor area
  • neurological disorders affecting to pelvic floor
  • scars that makes measurements impossible
  • other treatment that affects sexual field similar to this protocol
  • participation in other rehabilitation programme less than 6 months before this programme
  • severe neurological disorders that makes cooperation impossible
  • no technical possibilities to do the measures to the patient
  • disagreement to participate in the programme

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Grup 1: Exercise + Biofeedback
Participants in this group will be measured with EMG and questionnaires at the beginning of the intervention, after 6 and 12 weeks. Participants in this group will continue standard pharmacotherapy as before recruitment and will also do standardised PFMT as prescripted with handheld biofeedback trainer device. Participant will also provide a diary of their training.
Device: Training with handheld biofeedback device
Participants will get handheld biofeedback device, and will do PFMT using those device.
Other: Pelvic Floor Muscle Training (PFMT)
Participants will do PFMT as prescripted
Experimental: Intervention grup 2: Exercise + NO biofeedback
Participnats in this grup will be measured with EMG and questionaires at the begining of the intervention, after 6 and 12 weeks. Participants in this grup will continue standard pharmacotherapy as before recrutation and will also do PFMT as prescripted WITHOUT handheld biofeedback trainer. Participant will also provide a diary of their training.
Other: Pelvic Floor Muscle Training (PFMT)
Participants will do PFMT as prescripted
No Intervention: Control grup
Participnats in this grup will be measured with EMG and questionaires at the begining of the intervention, and after 12 weeks. Participants in this grup will continue standard pharmacotherapy as before recrutation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Erectile performance
Time Frame: From enrollment to the end of treatment at 12 weeks
Measured by International Index of Erectile Function (IIEF) questionnaire. Patient can get from 0 to 75 points (15 questions rated from 0 to 5 each). Lower score means more severe problem.
From enrollment to the end of treatment at 12 weeks
Maximal Voluntary Contraction (MVC)
Time Frame: From enrollment to the end of treatment at 12 weeks
Measured by EMG device in micro volts.
From enrollment to the end of treatment at 12 weeks
Fatigue
Time Frame: From enrollment to the end of treatment at 12 weeks
Measured by EMG device as an increase in the amplitude and duration of the muscle action potential
From enrollment to the end of treatment at 12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sexual quality of life
Time Frame: From enrollment to the end of treatment at 12 weeks
Measured by SQOL-M (Sexual Quality of Life Male) questionnaire. Patient can get from 11 to 66 points (11 items rated from 1 to 6 each). The higher score means better quality of life.
From enrollment to the end of treatment at 12 weeks
Adherence to protocol
Time Frame: From enrollment to the end of treatment at 12 weeks
Measured by training diary
From enrollment to the end of treatment at 12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Poznan University of Physical Education

Collaborators

Poznan University of Medical Sciences

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

June 1, 2029

Study Completion (Estimated)

June 1, 2029

Study Registration Dates

First Submitted

June 26, 2026

First Submitted That Met QC Criteria

July 3, 2026

First Posted (Actual)

July 7, 2026

Study Record Updates

Last Update Posted (Actual)

July 7, 2026

Last Update Submitted That Met QC Criteria

July 3, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 340/26

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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