(153) Hyperbaric Oxygen Therapy as a Treatment for Erectile Dysfunction: A Meta-analysis

Abstract

Abstract Introduction Hyperbaric oxygen therapy (HBOT) is a medical treatment in which the patient is exposed to 100% oxygen at a higher than atmospheric pressure. Over the past few decades, HBOT has been used to treat a variety of medical conditions, including radiation cystitis, decompression sickness and carbon monoxide poisoning. In recent times, there has been a rising curiosity regarding the potential therapeutic benefits of hyperbaric oxygen therapy in the treatment of erectile dysfunction (ED), a prevalent condition that affects a vast number of men globally. Objective The aim of this study was to review and meta-analyze available data regarding the use of HBOT for erectile dysfunction, including its potential mechanisms of action and effectiveness. Methods Two investigators (GS and TN) screened 54 articles and included only those that evaluated the impact of HBOT on ED symptoms using the IIEF score. Prospective non-randomized studies or randomized controlled clinical trials were included, while non-original studies, conference abstracts, and case reports were excluded. Data extraction was performed in duplicate. Data analysis was conducted using Review Manager 5.41, and the presence of heterogeneity between studies was evaluated. The results were presented as the Mean Difference (MD) with 95% confidence intervals (CI). The significance level was set at P = 0.05. Results A total of five studies that reported outcomes using the IIEF scores were included in this analysis, which comprised a total of 175 patients who received HBOT and 178 control patients. The IIEF scores were analyzed by stratifying the studies according to the indication for HBOT or the cause of ED. In patients with post-robotic assisted laparoscopic prostatectomy (RALP)-induced ED, the analysis showed a significant Mean Difference (MD) of -4.13[-6.08, -2.18] p<0.0001 in favor of the control group. Conversely, patients who received HBOT for reasons other than ED exhibited a MD of 4.58[2.63,6.52] p<0.00001. In the group that received HBOT for pure vasculogenic ED, the MD was 10.50[9.92,11.08] in favor of HBOT. Patients with urethral strictures exhibited a MD of 4.25[2.29-6.21] favoring the HBOT intervention. Meta-analysis of these data revealed a nonsignificant difference in erectile function scores, with an MD of 3.86[-2.13, 9.86] p<0.00001. Conclusions The use of HBOT in the treatment of ED appears to be a promising approach. While further research is needed to establish the efficacy and long-term effects of this treatment, preliminary studies have shown encouraging results in terms of improving erectile function in men with vasculogenic ED. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast Investor: Sprout.