Program B — Erectile function and voluntary neurovascular control

Research question

Is combined perineal and respiratory coordination training associated with measurable variation in neurovascular indices in adults without known pathology?

Established knowledge

• Erectile function depends on neurological, vascular, hormonal and psychological interaction.
• Ischiocavernosus and bulbospongiosus muscles contribute to rigidity during erection.
• Autonomic state influences many vascular responses.
• General cardiovascular health is associated with erectile function.

What remains unknown

• Which non-invasive indices are sensitive and reproducible enough?
• How to separate a specific effect from expectation or general physical activity?
• What minimum intervention duration would be relevant?

Proposed proof-of-mechanism study

Candidate objective measures

• Non-invasive peripheral vascular indices.
• Heart-rate variability as an autonomic balance marker.
• Surface perineal EMG: resting tone and release quality.
• Validated questionnaires used only as descriptive covariates.

Comparison with conventional pelvic-floor exercises

• Conventional protocols in this area mostly rely on strengthening.
• The proposed protocol adds respiratory regulation and release, whose specific contribution remains to be evaluated.

Ethics and preregistration

• Prior ethics approval and protocol preregistration.
• No inclusion of participants seeking treatment; referral to healthcare professionals.
• Transparency about the non-therapeutic purpose of the study.
• Full publication of results, including null findings.

Limitations

• Status: proposal. No results available.
• Indices are indirect and sensitive to confounders.
• No clinical conclusion can be drawn from such an exploratory study.