S Fernández-Pello1, R Gil2, S Escaf3, L Rodríguez Villamil2, A Alzueta4, C Rodríguez4, J M Gonzalo-Orden5. 1. Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, España. Electronic address: spello84@hotmail.com. 2. Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, España. 3. Departamento de cirugía y especialidades médico-quirúrgicas, Universidad de Oviedo, Oviedo, España. 4. Servicio de Neumología, Hospital Universitario de Cabueñes, Gijón, España. 5. Departamento de Cirugía, Universidad de León, León, España.
Abstract
OBJECTIVE: To report the clinical evolution and the urodynamic behaviour of several lower tract urinary symptoms in patients with obstructive sleep apnea syndrome before and after the treatment with continuous positive airway pressure (CPAP) devices. METHODS: A prospective study was performed; patients with recent diagnosis of sleep apnea confirmed by nocturnal sleep polygraphy and absence of medical urological past history. In order to discard important lower urinary tract conditions, urological examinations were previously performed. Urinary symptoms were evaluated using the IPSS and OAB-V8 validated questionnaires, three-day Bladder Diary and invasive urodynamic examinations with a gap of one year before and one year after using the CPAP. RESULTS: 84 urodynamic studies were carried out in 43 patients. The IPSS score decreased by 3.58 points. The OAB-V8 score decreased by 2.87 points. Nocturia episodes decreased to one per night. The percentage of patients with nocturnal polyuria went down to 26%. The bladder compliance significantly increased (97.39 vs 200.40ml/cm H2O). The presence of detrusor overactivity decreased from 11 (before CPAP) to 5 patients (after CPAP). CONCLUSION: The proper treatment with CPAP showed a statistical and clinical improvement of several LUTS with limited urodynamic modifications.
OBJECTIVE: To report the clinical evolution and the urodynamic behaviour of several lower tract urinary symptoms in patients with obstructive sleep apnea syndrome before and after the treatment with continuous positive airway pressure (CPAP) devices. METHODS: A prospective study was performed; patients with recent diagnosis of sleep apnea confirmed by nocturnal sleep polygraphy and absence of medical urological past history. In order to discard important lower urinary tract conditions, urological examinations were previously performed. Urinary symptoms were evaluated using the IPSS and OAB-V8 validated questionnaires, three-day Bladder Diary and invasive urodynamic examinations with a gap of one year before and one year after using the CPAP. RESULTS: 84 urodynamic studies were carried out in 43 patients. The IPSS score decreased by 3.58 points. The OAB-V8 score decreased by 2.87 points. Nocturia episodes decreased to one per night. The percentage of patients with nocturnal polyuria went down to 26%. The bladder compliance significantly increased (97.39 vs 200.40ml/cm H2O). The presence of detrusor overactivity decreased from 11 (before CPAP) to 5 patients (after CPAP). CONCLUSION: The proper treatment with CPAP showed a statistical and clinical improvement of several LUTS with limited urodynamic modifications.