In the treatment of premature ejaculation, methods that support penile muscle control are frequently used. Penile physiotherapy is a clinical approach that aims to strengthen voluntary contraction–relaxation control during sexual intercourse by developing the bulbocavernosus and ischiocavernosus muscles located at the base of the penis. The goal is to enable the patient to use these penile muscles more effectively when the ejaculation reflex is triggered, thereby delaying ejaculation.
What Is Penile Physiotherapy?
Classic forms of Kegel exercises are primarily used to strengthen pelvic floor muscles in men with urinary or fecal incontinence. Penile physiotherapy, however, specifically targets the muscles at the base of the penis. This selectivity teaches and reinforces control over the target muscles that are activated during premature ejaculation.
How Is Penile Physiotherapy Applied?
- Clinical Assessment and Muscle Awareness: In the first session, muscle tone and coordination are evaluated. The physician or physiotherapist provides tactile feedback at specific points and guides the patient through “contract–relax” commands, teaching correct muscle isolation.
- Manual Therapy and Neuromuscular Training: Short, controlled contractions (e.g., 2–3 seconds) followed by full relaxation phases train neuromuscular control. Duration and repetitions are gradually increased over time.
- Muscle Activation with TENS: Low-dose electrical stimulation (TENS) is selectively applied to the penile base muscles. This enhances excitability, strengthens the muscle–nerve connection, and accelerates exercise learning.
- Home Exercises: Short, regular exercises are assigned between sessions (2–3 sets per day; short contraction–long relaxation; gradually adding “sustained contraction”). The goal is to automate conscious muscle control during sexual activity when the ejaculation reflex is triggered.
Who Is Penile Physiotherapy Suitable For?
It is ideal for men seeking functional support alongside medication or surgical treatments, particularly those with weak muscle coordination at the penile base or difficulty initiating and ending contractions during intercourse, as seen in premature ejaculation.
Benefits of Penile Physiotherapy
Penile physiotherapy adds a functional solution to premature ejaculation management by targeting the penile base muscles with a selective program. The combination of manual training, TENS, and structured home exercises enhances control, coordination, and endurance of these muscles, contributing to prolonged ejaculation time. Optimal results are achieved through proper muscle isolation, consistent session follow-up, and regular home exercises.
