Dr. Anıl Eker and colleagues at the Izmir Bozyaka Education and Training Hospital in Turkey just published a prospective study on the use of Hyperbaric Oxygen Therapy (HBOT) for erectile dysfunction (ED). If you have been around HBOT for a few years, you have heard male patients quietly mention this advantageous side effect of treatment. In fact, many years ago, a colleague of mine arranged a local newscast interview for one of his patients with a diabetic foot ulcer (DFU) in hopes of raising awareness of the use of HBOT for DFUs. To my colleague’s chagrin, the patient wanted to tell the reporter about his improved sexual function rather than his improved foot ulcer. He was not imagining this improvement.

You can read the details of the study for yourself but patients who presented to the hyperbaric unit for non-urological indications and had ED –based on the International Erectile Function Index (IIEF-5) –were randomized to Hyperbaric Oxygen (HBO) treatment (Group 1), no treatment (Group 2), or daily oral tadalafil 5 mg treatment (Group 3) for one month, after which they were assessed again with the IIEF-5. Of the 102 male patients included, 40 received HBO treatment (Group 1), 30 were assigned to the control group (Group 2), and 31 received daily oral 5 mg tadalafil treatment (Group 3). There were significant increases in the mean IIEF-5 scores of the patients in the HBO treated (Group 1) and the group treated with medication (Group 3) (p<0.001, p<0.001). However, there was no significant improvement in the controls (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). However, patients with peripheral vascular disease did not improve with HBO treatment (p=0.285). The HBO treatment effect subsided in 90% of the patients six months after completion of treatment. They concluded that HBO can improve erectile function (similar to treatment with tadalafil) and might be a reasonable alternative for patients who cannot use ED medications (although the effect is not long lasting and would thus require periodic treatments).

I should hasten to add that insurance will not cover the use of HBOT for ED, but it is not unethical to use HBOT “off-label” on a case by case basis.