Improvement in erectile dysfunction in patients undergoing hyperbaric oxygen treatment: A prospective, double-blind, double controlled study

Abstract Background: Erectile dysfunction (ED) is a worldwide health problem. Oral phosphodiesterase type 5 inhibitors (PDE5I) are used in its first-line treatment. This study aimed to compare the effects of hyperbaric oxygen (HBO) treatment with PDE5I treatment and determine the patient-dependent factors affecting the efficacy of the HBO treatment and duration of action of HBO treatment. Methods: Adult male patients who presented to the HBO unit for HBO treatment with non-urological indications and had ED based on the International Erectile Function Index (IIEF-5) constituted the target population of this study. Participants were given HBO treatment (Group 1), no treatment (Group 2), or daily oral tadalafil 5 mg treatment (Group 3). The treatment duration was one month. Patients were assessed by IIEF-5 both initially and after the completion of one month. Results: 102 male patients were included. Among these patients, 40 received HBO treatment, and 31 received daily oral 5 mg tadalafil treatment. Thirty-one patients were assigned to the control group (Group 2). There were significant increases in the mean IIEF-5 scores of the patients in Group 1 and Group 3 (p<0.001, p<0,001). However, there was no significant improvement in Group 2 (p=0,496). Also, the post-treatment IIEF-5 scores of Group 1 and Group 3 were significantly higher than Group 2 (p<0,001). There was no significant difference between the IIEF-5 scores and ∆IIEF-5 values of Group 1 and Group 3 (p=0,166, p=0,093). Evaluation regarding comorbidities revealed that patients with the peripheric vascular disease did not improve with HBO treatment (p=0,285). Analysis concerning the duration of action of HBO treatment revealed that treatment effects subsided in 90% of the patients six months after completion of treatment. Conclusion: HBO can improve erectile functions, and it can be a reasonable alternative for patients who cannot use PDE5Is due to comorbidities or treatment side effects.