[Oral-appliance combined with tadalafil for erectile dysfunction induced by severe obstructive sleep apneahypopnea syndrome].

OBJECTIVE: To evaluate the effect of the oral-appliance combined with tadalafil in the treatment of erectile dysfunction (ED) induced by severe obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: We equally randomized 90 patients with severe OSAHS-induced ED to groups A, B, and C to be treated with the oral-appliance, tadalafil (10 mg daily qd), and oral-appliance plus tadalafil, respectively, all for 3 months. Then we compared the therapeutic effects among the three groups of patients using the IIEF-5 questionnaire, Sexual Encounter Profile (SEP) diaries, and the intercourse satisfaction rate of the patients' partners. RESULTS: Totally 87 of the patients accomplished the treatment, 29 in group A, 30 in B, and 28 in C. After treatment, group C, as compared with A and B, showed significant increases in the IIEF-5 score (4.18+/-1.19 vs 2.66+/-1.63 and 2.77+/-1.74, P=0.009 and P=0.026), the success rate of penile intromission (SEP2) (85.7% vs 58.6% and 53.3%, P=0.023 and P=0.008), and the success rate of intercourse (SEP3) (64.3%% vs 37.9% and 33.3%, P=0.047 and P=0.018). The overall satisfaction of the female partners was remarkably higher in groups A and C than in B (P=0.027 and P=0.007). CONCLUSIONS: Oral-appliance combined with tadalafil can improve erectile function in patients with severe OSAHS-induced ED, with a better efficacy than either of them used alone.