Background Erectile dysfunction is a common condition often resistant to single-drug treatments. This study evaluated whether adjunct celecoxib could enhance the effect of tadalafil on erectile function. Methods In this randomized controlled trial, 50 men with moderate-to-severe erectile dysfunction were randomized to tadalafil 5 mg plus celecoxib 200 mg daily (intervention) or tadalafil 5 mg plus placebo (control) for 8 weeks. Erectile function was assessed with the International Index of Erectile Function (IIEF) questionnaire. Results Of 50 randomized, 47 were analyzed (intervention n = 23; control n = 24). Post-treatment total IIEF scores were higher in the intervention group (18.04 ± 5.06) versus control (15.37 ± 3.59; P = 0.042), while the distribution of erectile-dysfunction severity categories did not differ significantly between groups. Conclusions The combination of tadalafil and celecoxib was associated with a statistically significant improvement in IIEF total scores compared with tadalafil alone. However, the distribution of ED-severity categories did not change significantly; the clinical implication of our findings derives from continuous score improvement rather than categorical transition.
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