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Vol. 43. Issue 7.
Pages 371-377 (September 2019)
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Vol. 43. Issue 7.
Pages 371-377 (September 2019)
Original article
DOI: 10.1016/j.acuroe.2019.03.009
Lower urinary tract symptoms and obstructive sleep apnea syndrome: Urodynamic evolution before and after one year of treatment with continuous positive airway pressure
Síntomas de tramo urinario inferior y síndrome de apnea obstructiva del sueño: evolución urodinámica antes y después de un año de tratamiento con presión continua positiva de la vía aérea
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S. Fernández-Pelloa,
Corresponding author
spello84@hotmail.com

Corresponding author.
, R. Gila, S. Escafb, L. Rodríguez Villamila, A. Alzuetac, C. Rodríguezc, J.M. Gonzalo-Ordend
a Servicio de Urología, Hospital Universitario de Cabueñes, Gijón, Spain
b Departamento de cirugía y especialidades médico-quirúrgicas, Universidad de Oviedo, Oviedo, Spain
c Servicio de Neumología, Hospital Universitario de Cabueñes, Gijón, Spain
d Departamento de Cirugía, Universidad de León, León, Spain
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Statistics
Tables (5)
Table 1. Descriptive summary of the general variables analyzed.
Table 2. Distribution of patients with OSAS based on AHI.
Table 3. Evolution of the data derived from invasive and non-invasive urodynamic studies.
Table 4. Table showing the mean values of the variables included in the 3DVD, their evolution before/after CPAP treatment and p values when their evolution is compared after one year.
Table 5. Bibliographic review of the works that analyze OSAS (by polygraphy or nocturnal polysomnography) and LUTS with the employed evaluated methods.
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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.

Keywords:
Obstructive sleep apnea syndrome
Lower urinary tract symptoms
Overactive bladder
Continuous positive airway pressure
Urodynamics
Resumen
Objetivo

Demostrar el potencial impacto urodinámico que puede tener el uso adecuado de presión continua positiva de la vía aérea (CPAP) en pacientes con síndrome de apnea-hipopnea obstructiva del sueño y observar si la posible mejoría de los síntomas de tramo urinario inferior es debida a alguna modificación urodinámica.

Métodos

Estudio prospectivo con pacientes recientemente diagnosticados de síndrome de apnea-hipopnea obstructiva del sueño mediante poligrafía del sueño. Se estudian desde el punto de vista urológico para descartar importantes patologías urológicas. Se utilizan cuestionarios validados IPSS y OAB-V8, diarios miccionales de 3 días y estudios urodinámicos invasivos, todos ellos antes de comenzar con CPAP y tras un año de su uso adecuado.

Resultados

Se llevan a cabo 84 estudios urodinámicos en 43 pacientes. La puntuación IPSS disminuye 3,58 puntos. La puntuación OAB-V8 disminuye 2,87 puntos. Los episodios de nicturia disminuyen más de uno por noche. El porcentaje de pacientes con poliuria nocturna disminuye un 26%. La acomodación vesical significativamente aumenta (97,39 vs. 200,40ml/cm H2O). Disminuye la presencia de detrusor hiperactivo en el estudio urodinámico de 11 (antes de CPAP) a 5 pacientes (tras CPAP).

Conclusión

Tras el tratamiento apropiado con CPAP se observa una mejoría estadística y clínica de distintos síntomas de tramo urinario inferior con escasa repercusión urodinámica.

Palabras clave:
Apnea obstructiva del sueño
Síntomas de tramo urinario inferior
Vejiga hiperactiva
Presión Continua Positiva en la vía Aérea
Urodinámica

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