Efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in anejaculation: A randomized controlled trial

Author:

Wang Ming1ORCID,Liu Qiushi1ORCID,Gao Hui1,Peng Dangwei1,Wang Weinan1,Ma Juncheng1,Chen Zihang1,Zhang Wangheng1,Jannini Tommaso B.2,Jannini Emmanuele A.3ORCID,Jiang Hui4ORCID,Zhang Xiansheng1ORCID

Affiliation:

1. Department of Urology the First Affiliated Hospital of Anhui Medical University Hefei China

2. Department of Experimental Medicine Tor Vergata University of Rome Rome Italy

3. Chair of Endocrinology and Medical Sexology (ENDOSEX) Department of Systems Medicine University of Rome Tor Vergata Rome Italy

4. Department of Urology Peking University First Hospital Institute of Urology Peking University Andrology Center Beijing China

Abstract

AbstractBackgroundAnejaculation represents significant psychological distress and sexual and reproductive challenges among male individuals and couples. Effective fertility management options are available to address the reproductive challenges associated with anejaculation. However, there is a lack of methods to reverse the condition itself.ObjectivesThis study aims to assess the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in patients suffering from anejaculation.MethodsA total of 94 patients with anejaculation individuals were randomly assigned to receive high‐frequency (HF) stimulation on the left dorsolateral prefrontal cortex (DLPFC), low‐frequency (LF) stimulation on the right DLPFC, and sham stimulation for 4 weeks, with daily sessions of stimulation occurring on five consecutive weekdays each week.ResultsAfter 4 weeks of rTMS treatment, the patients in both the HF and LF groups exhibited a similar reduction in their male sexual health questionnaire for ejaculatory dysfunction bother/satisfaction score, Hamilton Anxiety Scale score, Hamilton Depression Scale score, and Pittsburgh Sleep Quality Inventory score, which were statistically significant compared with sham treatment. Additionally, there were no significant differences observed in erectile function and cognitive function across the three groups. However, there were notable disparities in the cure rates between HF‐ and LF‐group patients (16.1% vs. 54.8%, p = 0.001). Additionally, it is worth noting that only two HF group patients and one LF group patient experienced spontaneously resolving minor adverse effects during the treatment process. At the 8‐week follow‐up, among patients who initially responded to the treatment, only one from the HF group experienced a relapse.Discussion and conclusionThe findings of this study demonstrate that rTMS represents a secure and efficacious remedy for anejaculation patients.

Funder

National Natural Science Foundation of China

Publisher

Wiley

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