Can Obstructive Sleep Apnea Syndrome be Associated with Urinary Symptoms and Erectile Dysfunction

We planned to investigate the association between Obstructive Sleep Apnea Syndrome (OSAS) and two common urological problems, namely Lower Urinary Tract Symptoms (LUTS) and Erectile Dysfunction (ED). An overnight polysomnograph test was performed for male patients over the age of 50 who presented to Düzce University Medical Faculty, Department of Chest Diseases with symptoms of OSAS. A total of 11 patients with moderate OSAS whose Apnea-Hypopnea index (AHI) was 15-30 and 18 patients with severe OSAS whose AHI was >30 were included in the study as the first group. The 21 OSAS negative patients with AHI <5 constituted the control group. Patients with diseases that could lead to LUTS and ED were excluded from the study for both groups. Urinary symptoms were evaluated with the International Prostate Symptom Score (IPSS), uroflowmetry, prostate volume. Erectile function was assessed according to the International Index of Erectile Function (IIEF). The groups were similar in terms of age, prostate specific antigen (PSA), prostate volume. No statistically significant difference was found between the groups in terms of IPSS values and uroflowmetry parameters (p>0.05). However, there was a statistically significant difference between the groups for nocturia episodes and IIEF scores (p<0.05). OSAS was not found to be an additional risk factor for LUTS other than nocturia. On the other hand, OSAS was related with ED and nocturia. We therefore believe patients with ED and/or nocturia should be evaluated for OSAS. It is also appropriate to investigate OSAS patients in terms of having ED.

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Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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