• Giovanna Stilo, Claudio Vicini, Isabella Pollicina, Antonino Maniaci, Jérôme René Lechien, Christian Calvo-Henríquez, Miguel Mayo Yáñez, Giannicola Iannella, Annalisa Pace, Giovanni Cammaroto, Giuseppe Meccariello, Angelo Cannavicci, Antonio Moffa, Manuele Casale, and Ignazio La Mantia.
• Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy.
• Medicina (Kaunas). 2023 Jul 17; 59 (7).

AbstractBackground and Objectives: This study aimed to assess the comparative effectiveness of continuous positive airway pressure (CPAP) therapy and sildenafil pharmacological therapy in improving sexual function among patients with obstructive sleep apnea (OSA) and erectile dysfunction (ED). Materials and methods: Population: Patients affected by OSA and ED; Intervention: CPAP therapy vs. Comparison: Sildenafil pharmacological therapy; Outcomes: Improvement in erectile function, as measured by the International Index of Erectile Function 5 (IIEF-5) scoring system; Time: A systematic review of the literature from the past 20 years; Study Design: Observational studies comparing erectile function improvements after OSA treatment. Results: A total of eight papers were included in the qualitative summary, involving four hundred fifty-seven patients with ED and OSA. Erectile function improvements were observed in both treatment groups. After sildenafil and CPAP treatment, the mean IIEF-5 domain scores were 37.7 and 27.3, respectively (p < 0.001). Sildenafil 100 mg demonstrated a higher therapeutic impact compared to CPAP treatment. Conclusions: CPAP therapy significantly improved sexual parameters in most studies for OSA patients with ED. The findings suggest that CPAP therapy effectively alleviates erectile dysfunction symptoms, resulting in improved sexual performance in OSA patients. The comparison of the two treatments indicates that sildenafil has a more substantial therapeutic impact on erectile function than CPAP therapy; however, a combined treatment will provide a cumulative effect.

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