Perimenis Petros, Karkoulias Kyriakos, Konstantinopoulos Angelis, Perimeni Paraskevi P, Katsenis George, Athanasopoulos Anastasios, Spyropoulos Konstantinos
Department of Urology, University Hospital of Patras, 26500 Rio, Patras, Greece.
Asian J Androl. 2007 Mar;9(2):259-64. doi: 10.1111/j.1745-7262.2007.00085.x.
To assess the efficacy of sildenafil and continuous positive airway pressure (CPAP) in the treatment of concurrent erectile dysfunction (ED) with obstructive sleep apnea (OSA), and to gauge the level of treatment satisfaction in patients and their partners.
Forty men were treated for 12 weeks with sildenafil 100 mg (20 men) or CPAP during nighttime sleep (20 men). Treatment efficacy was assessed by the rate of successful intercourse attempts, and satisfaction with treatment was assessed by patients' and partners' answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction.
Under sildenafil, 128 of 249 (51.4%) intercourse attempts were successful; under CPAP, 51 of 193 (26.9%) attempts were successful ((c)P < 0.001). Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively ((b)P = 0.025), compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP ((c)P < 0.002).
Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.
评估西地那非和持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停（OSA）并发勃起功能障碍（ED）的疗效，并衡量患者及其伴侣的治疗满意度。
40名男性患者，其中20名服用100毫克西地那非治疗12周，另外20名在夜间睡眠时使用CPAP治疗12周。通过成功性交尝试率评估治疗效果，通过患者及其伴侣对治疗满意度勃起功能障碍问卷中问题1的回答评估治疗满意度。
服用西地那非时，249次性交尝试中有128次（51.4%）成功；使用CPAP时，193次尝试中有51次（26.9%）成功（P<0.001）。两组勃起功能均有改善。西地那非和CPAP治疗后，国际勃起功能指数平均领域得分分别为14.3和10.8（P = 0.025），而基线时分别为7.8和7。CPAP和西地那非耐受性良好。CPAP治疗下偶尔出现的鼻干以及西地那非治疗下短暂的头痛和面部潮红均不明显。服用西地那非的患者中有50%对治疗满意，使用CPAP的患者中有25%对治疗满意，他们的伴侣也同样满意。服用西地那非的患者及其伴侣的满意度得分均高于使用CPAP的患者（P<0.002）。
单独使用100毫克西地那非和CPAP均有积极的治疗效果，但西地那非更优。患者及其伴侣对西地那非治疗ED更满意。然而，由于不满意的男性患者及其伴侣比例较高，必须进一步研究新的治疗药物或两种方法的联合应用。
