A Systematic Review on Administration of Botulinum Toxin in the Management of Male Sexual Dysfunctions.

[BACKGROUND] Male sexual dysfunctions (SDs) like erectile dysfunction (ED), premature ejaculation (PE), and Peyronie's disease (PD) are highly prevalent conditions affecting the quality of life of men and their partners. Botulinum toxin (BTX) is emerging as a promising injectable therapy to treat male SDs.

[OBJECTIVE] To systematically review the current evidence on the use of BTX in the treatment of male SDs.

[MATERIALS AND METHODS] PubMed, Cochrane, and EMBASE databases were queried for all published studies indexed up to October 2024 using predefined keywords.

[RESULTS] Of 108 identified articles, 9 (6 on ED, 2 on PE, and only 1 on PD) met our inclusion criteria. In ED, BTX improved International Index of Erectile Function-Erectile Function domain (IIEF-EF) scores in 41%-57.4% of patients, with benefits lasting up to 6 months. In PE, BTX increased ejaculation latency and subjective satisfaction at 1-3 months, but the effects diminished by 6 months. In PD, a single study showed a significant reduction in penile curvature (-7.9°), plaque thickness, and penile pain. Adverse effects were mild and local, reported in less than 10% of cases.

[CONCLUSIONS] BTX injections demonstrate promising improvements in erectile function, ejaculation latency, and penile curvature with a favourable safety profile. However, current evidence is limited by small, heterogeneous studies and the absence of large randomized controlled trials. Further research is needed to establish optimal dosing, timing, and patient selection.