Virtual reality in the management of male sexual dysfunction: an updated narrative review of the literature

Introduction: Virtual reality (VR) has emerged as a promising technology in medicine, offering innovative approaches for diagnostics, treatment, and patient education. However, its role in male sexual dysfunction (MSD) management remains underexplored, particularly among urologists. Objectives: To review the current evidence on the use of VR in the diagnosis and treatment of MSDs, assessing its feasibility, efficacy, and potential integration into clinical practice. Methods: A comprehensive bibliographic search for a narrative review was conducted in October 2024 using Google Scholar, PubMed, Scopus, and Web of Science to identify literature on VR applications in MSD management. The PICO framework of article selection was employed to include prospective and retrospective studies evaluating VR-based diagnostic and therapeutic interventions for MSD. Studies involving nonmale participants, nonsexual applications of VR, and technologies not classified as immersive VR (eg, televisions and laptops) were excluded. Results: In erectile dysfunction, VR-based audiovisual sexual stimulation (VR-AVSS) has demonstrated potential for assessing erectile function, providing an objective measure of arousal through RigiScan-based monitoring. Additionally, VR has been studied in psychosexual therapy, showing promise in managing performance anxiety and related psychological factors contributing to MSDs. In premature ejaculation, VR-based interventions may complement existing psychosexual and pharmacological treatments by facilitating behavioral training in immersive environments. While no clinical studies have directly examined VR applications in Peyronie’s disease, theoretical models suggest its utility in patient education and 3-dimensional curvature simulation, aiding treatment planning and adherence. Emerging applications of VR in forensic settings include the assessment of sexual preferences, aversion disorders, and deviant sexual behaviors, utilizing physiological and eye-tracking metrics to enhance diagnostic accuracy. Conclusion: While current research has predominantly focused on psychological interventions, VR’s potential in urological practice remains largely unexplored. Future studies are needed to validate VR’s efficacy, optimize its clinical applications, and establish standardized protocols for its integration into MSD management.