Erectile dysfunction (ED) is caused by microvascular or macrovascular insufficiency in the majority of patients. Recent studies have shown that hyperbaric oxygen therapy (HBOT) can induce angiogenesis in different body organs.
The normal erection is a complex event resulting from the coordinated function of psychological, neurological, hormonal, and vascular systems. Penile blood flow disruption due to inadequate vascular perfusion is present in at least 60% of the erectile dysfunction (ED) patients. The first-line therapy used for ED relies on the vasodilatation effect of phosphodiesterase-5 inhibitors (PDE5Is). However, since the vasodilatation effect of PDE5Is is transient and dependent on the presence of adequate blood vessels within the corpora cavernosa (CC), there is a need for a treatment modality that intervenes with the baseline pathology and induces generation of new blood vessels (angiogenesis).
Hyperbaric oxygen therapy (HBOT) has been shown to induce angiogenesis in different tissues experiencing compromised blood perfusion such as the brain and non-healing wounds. HBOT incorporates the inhalation of 100% oxygen at pressures exceeding 1 atmosphere absolute (ATA), thus increasing the amount of oxygen dissolved in the body tissues.
One of the most interesting mechanisms induced by HBOT is angiogenesis mediated by release of omnipotent stem cells capable of differentiating into endothelial cells. HBOT also boosts the release of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1alpha (HIF-1alpha), crucial mediators for the angiogenesis process. In addition, the improved oxygenation by HBOT creates the necessary environment needed for stem cells proliferation. Pre-clinical and clinical studies have demonstrated that HBOT can induce angiogenesis even in tissues with low regenerative potential such as the brain.
Two studies, on both humans and animals, suggested a possible therapeutic effect of HBOT on ED related to surgical injuries. In the clinical study, which included a cohort of 12 men suffering from ED after posterior urethral reconstruction surgery, HBOT significantly improved erectile function.
Sources:
US National Library of Medicine
https://www.ncbi.nlm.nih.gov/pubmed/21110096
International Journal of Impotence Research
https://www.nature.com/articles/s41443-018-0023-9
