Can continuous positive airway pressure improve lower urinary tract symptoms and erectile dysfunction in male patients with severe obstructive sleep apnea syndrome?

Abstract

Purpose We aimed to investigate the effect of continuous positive airway pressure (CPAP) administered for the treatment of obstructive upper airway on lower urinary tract symptoms and erectile dysfunction in male patients. Materials and Methods A total of 626 male with suspected obstructive sleep apnea syndrome (OSAS) were evaluated prospectively. Nocturnal polysomnography tests were administered to the male. After application of the exclusion criteria, 54 patients with severe OSAS (Apnea-Hypopnea Index ≥30) were included in the study. International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-15), and nocturia were assessed in all patients before and after CPAP therapy, and prostate volume, total prostate-specific antigen (tPSA), and uroflowmetric measurements were assessed in patients aged >40 years. Results The mean age of the 54 patients was 47.06±11.15 years. Post-treatment IIEF scores were better than pre-treatment scores (24.27±7.58 vs. 22.68±8.65, p=0.014). IPSS values, nocturia, and uroflowmetric outcomes significantly improved after CPAP therapy (p<0.05). On the other hand, mean values of body mass index, tPSA, prostate volume, and postvoid residual urine volume did not differ significantly after treatment. Conclusions CPAP therapy improves lower urinary tract symptoms, nocturia, and erectile dysfunction in male with severe OSAS.

Is Continuous Positive Airway Pressure a Valid Alternative to Sildenafil in Treating Sexual Dysfunction among OSA Patients? A Systematic Review and Meta-Analysis

“…We have included eight articles [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] in our systematic literature review. Out of a total of 457 OSAS patients with erectile dysfunction, 381 (83.36%) were treated with CPAP [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] and 76 (16.63%) with sildenafil [ 21 , 22 , 25 ] ( Table 1 ).…”

“…Two papers (120 patients) [ 23 , 24 ] analyzed the ESS outcomes after CPAP treatment, demonstrating a significant reduction from 11.88 ± 1.82 to 6.2 ± 1.48 ( p < 0.001).Three papers analyzed the AHI outcomes after CPAP treatment, demonstrating a significant reduction from 32.24 ± 24.96 to 10.67 ± 2.51 ( p < 0.01); LOS were reported in three papers, with a significant score improvement from the value of 78.8 ± 7.9 to 89.4 ± 3.9 ( p < 0.01) [ 23 , 25 , 26 ]. At pooled analysis for EF outcomes, both medical treatments demonstrated a higher EF score, but sildenafil reported greater outcomes than CPAP (mean: CPAP 27.3 vs. sildenafil 37.7; ( p < 0.01) [ 20 , 21 , 24 ].…”

“…Several studies have reported an association between erectile dysfunction (ED) and obstructive sleep apnea (OSA) [ 21 , 26 , 27 , 28 ].…”

Don't let sleeping men lie

“…The severity of LUTS and OSA are directly associated 11 . The effective treatment of OSA results in prompt resolution of nocturia 12 …”

“…Erectile dysfunction occurs almost twice as frequently in men with OSA, and the likelihood of its occurrence and severity increases with increasing AHI 13 . Treatment of OSA with CPAP improves erectile function, 12 and the addition of phosphodiesterase 5 inhibitors provides further benefit if required. Sexual desire and overall function are also broadly impaired in men with OSA.…”