Sildenafil combined with continuous positive airway pressure for treatment of erectile dysfunction in men with obstructive sleep apnea

Perimenis, Petros; Konstantinopoulos, Angelis; Karkoulias, Kiriakos; Markou, S.; Perimeni, Paraskevi P.; Spyropoulos, Konstantinos

doi:10.1007/s11255-006-9079-4

Cited by 35 publications

(32 citation statements)

References 29 publications

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“…. Perimenis et al 47 investigated the concurrent effects of ED and obstructive sleep apnea. Forty patients with these dual comorbidities were randomized to combination continuous positive airway pressure plus PDE5I versus continuous positive airway pressure alone.…”

Section: Miscellaneous Combinationsmentioning

confidence: 99%

Combination therapy for erectile dysfunction: an update review

Dhir¹,

Lin

Canfield³

et al. 2011

Asian J Androl

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The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy for erectile dysfunction (ED). However, a significant proportion of patients with complex ED will be therapeutic non-responders to PDE5I monotherapy. Combination therapy has recently been adopted for more refractory cases of ED, but a critical evaluation of current combination therapies is lacking. A thorough PubMed and Cochrane Library search was conducted focusing on the effectiveness of combination therapies for ED in therapeutic non-responders to PDE5I therapy. Journal articles spanning the time period between January 1990 and December 2010 were reviewed. Criteria included all pertinent review articles, randomized controlled trials, cohort studies and retrospective analyses. References from retrieved articles were also manually scanned for additional relevant publications. Published combination therapies include PDE5I plus vacuum erectile device (VED), intraurethral medication, intracavernosal injection (ICI), androgen supplement, a-blocker or miscellaneous combinations. Based on this review, some of these combination treatments appeared to be quite effective in preliminary testing. Caution must be advised, however, as the majority of combination therapy articles in the last decade have numerous limitations including study biases and small subject size. Regardless of limitations, present combination therapy research provides a solid foundation for future studies in complex ED management. 1 Current projections indicate an increase in the prevalence of ED due to aging as well as the continued abundance of comorbidities such as coronary artery disease, hypertension and diabetes in industrialized nations. Over 320 million people in Westernized nations will be affected by 2025, more than double the prevalence seen 15 years ago, indicating a growing need to reevaluate ED therapeutic strategies.2 Over the past four decades, the treatment of ED has evolved rapidly and is still changing with new discovery. Before the 1970s, psychotherapy was the primary means of treatment and undoubtedly was limited in its success. During the 1970s, penile prostheses combined with psychotherapy remained popular but relatively inaccessible. The 1980s was dominated by intracavernous injection (ICI) and followed by intraurethral therapy in the mid-1990s. Despite this transition towards non-surgical management, available treatment modalities were not patient-friendly. The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy.

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Section: Miscellaneous Combinationsmentioning

confidence: 99%

Combination therapy for erectile dysfunction: an update review

Dhir¹,

Lin

Canfield³

et al. 2011

Asian J Androl

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“…In a study concerning the results of CPAP treatment performed on ED patients with OSAS, Perimenis et al compared the results of CPAP therapy with combined therapy (CPAP plus sildenafil therapy). They achieved better results with combined therapy 9 . In our country, in 2008, a study was performed by Taskin et al including 17 men with severe OSAS…”

Section: Treatment Of Patients With Osas May Be Classified Under Fivementioning

confidence: 96%

Obstructive sleep apnea syndrome and erectile dysfunction: does long term continuous positive airway pressure therapy improve erections?

Tokgöz¹,

Ersoz²,

Erol³

et al. 2015

Afr H. Sci.

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Objectives: The aim of this age-matched, controlled, prospective clinical study was to investigate frequency and degree of erectile dysfunction (ED) in patients with obstructive sleep apnea syndrome (OSAS) and to evaluate the results of only continuous positive airway pressure (CPAP) therapy on ED in patients with OSAS. Materials and Methods: A total of 90 patients were evaluated for potential OSAS. They were given an International Index of Erectile Function questionnaire (IIEF) and Beck Depression Inventory. Sixty-two patients with the diagnosis of OSAS were regarded as study group. Twenty-eight patients in whom the OSAS was excluded, were regarded as the control group. Biochemical and hormonal laboratory evaluation were performed. Then all patients underwent a full-night in laboratory polysomnography examination. The degree of OSAS were evaluated by an expert from chest diseases department. Results: When compared to the control group, a decrease in IIEF-5 scores was found in patients with OSAS. However, this decrease was not statistically significant. After 3 months of CPAP usage in patients with mild to moderate and severe degree OSAS, improvement in IIEF-5 scores was statistically significant. Mean value of IIEF-5 score was 16.63±5.91 before CPAP and were improved up to 20.92±6.79 (P=0.001). Conclusion: It is not certainly possible to say that OSAS is clearly associated with ED. However, after 3 months of regular CPAP usage, ED complaints in patients with OSAS might improve positively. Trials with larger series may give more conclusive data.

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“…Several treatment modalities for the management of ED have been reported [13][14][15][16][17]. The treatment of choice for ED varies according to the individual patient.…”

Section: To the Editormentioning

confidence: 99%