Clinical Research Directory

Pilates protocol that will be used in the present study consisted of 11 different Pilates postures: Pilates Breathing, Spine Stretch, Swan, Shoulder Bridge, Hundreds, Double Leg Stretch, Footwork, Roll up, Single Leg Stretch, Leg Pull Back, Kick front and back. It will be performed thrice a week, with each session lasting 60 minutes, for 12 weeks, totaling 36 sessions. The progression of the exercises will be based on increasing the number of repetitions of the exercise, and variations in posture from beginner to intermediate and advanced, for each exercise. The movements will be repeated six to eight times each.

Participants will attend an educational session conducted by a physiotherapist on pelvic floor anatomy, the physiology of erection, and the roles of the ischiocavernosus and bulbocavernosus muscles in erectile function. They will be instructed on proper pelvic floor muscle contraction by simulating the interruption of urine flow and performing maximal voluntary contractions. A home-based PFMT program will be prescribed. Exercises will initially be performed in the supine position with knees flexed and subsequently progressed to sitting or standing positions as tolerated. Participants will be instructed to perform PFMT twice daily (morning and evening), consisting of 15 short contractions (1 second each) and 15 sustained contractions (6-10 seconds each). Adherence will be monitored through a mobile messaging application, where participants will report completion of daily exercises and receive reminders when necessary.

Participants will receive sildenafil citrate 25 mg orally once daily and sildenafil citrate 50 mg orally on demand, taken approximately 1 hour before sexual intercourse, throughout the study period.