手術治療男性睡眠呼吸中止症後勃起功能障礙及下泌尿道症候群的改善情況

彭致凱、陳順郎¹、曹傑漢²

中山醫學大學附設醫院 ¹泌尿科，²耳鼻喉科

Improvement of erectile dysfunction and lower urinary tract symptoms in men with surgical correction of sleep apnea

Chih-kai Peng, Sung-Lang Chen¹, Chien-Han Tsao²

Department of ¹Urology and ²E.N.T, chung shan medical university hospital, Taichung, Taiwan

Purpose:

To evaluate changes in lower urinary tract symptoms and erectile dysfunction after surgical correction of obstructive sleep apnea (OSA).

Materials and Methods:

This was a prospective observational study on consecutive obstructive sleep apnea men undergoing transoral robotic surgery (TORS) for correction of OSA. Preoperative and postoperative lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) were evaluated using the International Prostate Symptom Score (IPSS) and International index of erectile function (IIEF) questionnaires. The improvement of the OSA was also assessed by Polysomnography (PSG) with Apnea Hypopnea Index (AHI) postoperatively. The changes in IPSS, IIEF and the associated factors were analyzed.  

Results:

This study recruited 31 men with OSA (mean age 40.8 ± 7.9 years) undergoing TORS. After surgery, there was significant AHI reduction from 51.0 ± 23.9 preoperatively to 32.2 ± 20.5 at 3-6 month postoperatively (P < 0.001). There was also significant reduction in IPSS total symptom score (5.5 ± 5.8 at baseline to 2.8 ± 2.5 at 3 months postoperatively, p=0.003), storage symptom score, voiding symptom score and nocturia score (P < 0.05). The erectile dysfunction improved significantly in IIEF score (increased 1.6 ± 2.2, P < 0.001). The reduction of AHI was not associated with improvement of IPSS or IIEF(P>0.05). Besides, IPSS improvement was significantly associated with body weight loss(p=0.039) and more obvious alleviation of ED was observed in older man(p=0.036).

Conclusion:

Transoral robotic surgery (TORS) for correction of obstructive sleep apnea (OSA) was an effective intervention for alleviating the severity of LUTS and ED in the period of post operation 3 months.