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首页> 外文期刊>The journal of sexual medicine >Effects of surgical vs. nonsurgical therapy on erectile dysfunction and quality of life in obstructive sleep apnea syndrome: A pilot study
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Effects of surgical vs. nonsurgical therapy on erectile dysfunction and quality of life in obstructive sleep apnea syndrome: A pilot study

机译：外科与非外科治疗对阻塞性睡眠呼吸暂停综合征勃起功能障碍和生活质量的影响：一项初步研究

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Introduction: Obstructive sleep apnea syndrome (OSAS) is associated with erectile dysfunction (ED). The improvement of ED after medical therapy including continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs) is still controversial. Furthermore, the efficacy of surgical treatment has been little investigated. Aim: The aim of this nonrandomized prospective study was to evaluate the effects of surgical (uvulopalatopharyngoplasty [UPPP]) and nonsurgical approaches (CPAP and MAD) on ED and quality of life (QOL) in OSAS. Methods: OSAS patients underwent UPPP (N=30), CPAP (N=16), or MAD (N=10) and completed the Korean versions of the International Index of Erectile Function questionnaire (KIIEF-5) and the Calgary Sleep Apnea Quality of Life Index (SAQLI) before and after a median of 7 months of treatment (interquartile range, 4-15 months). All patients underwent a full-night in-laboratory polysomnography at baseline and follow-up. Main Outcome Measure: The main outcome measures are the KIIEF-5 and SAQLI scores. Results: CPAP group showed older age, higher body mass index, and more severe OSAS than other groups. Apnea-hypopnea index and lowest oxygen saturation level improved significantly in all groups, but Epworth Sleepiness Scale score decreased significantly in UPPP and MAD groups. Significant increase of KIIEF-5 was observed in patients who underwent UPPP (P=0.039, paired t-test), but not in nonsurgical treatment group. All groups had the tendency of better QOL after treatment, but statistical significance was found only in MAD group. Neck circumference (r=0.360, P=0.006) and KIIEF-5 score (r=-0.484, P<0.001) at baseline were significantly related to the improvement of KIIEF-5. Conclusions: This study demonstrated that ED in OSAS may improve following UPPP. Better disease-specific QOL was observed after both surgical and nonsurgical therapies in OSAS. These findings suggest that interventions for OSAS can provide the alleviation of ED and increase QOL in OSAS patients with ED, especially if they had pronounced complaints of ED and wide neck circumferences.
机译：简介：阻塞性睡眠呼吸暂停综合症（OSAS）与勃起功能障碍（ED）相关。包括持续气道正压通气（CPAP）或下颌前移装置（MAD）在内的药物治疗后ED的改善仍存在争议。此外，很少研究手术治疗的功效。目的：这项非随机前瞻性研究的目的是评估外科手术（UPLP）和非手术方法（CPAP和MAD）对OSAS中ED和生活质量（QOL）的影响。方法：OSAS患者接受UPPP（N = 30），CPAP（N = 16）或MAD（N = 10）并完成韩文版国际勃起功能指数问卷（KIIEF-5）和卡尔加里睡眠呼吸暂停质量检查治疗前后中位数7个月（四分位间距为4-15个月）前后的生命指数（SAQLI）。所有患者在基线和随访期间均进行了整夜的实验室多导睡眠监测。主要指标：主要指标是KIIEF-5和SAQLI分数。结果：CPAP组比其他组年龄更大，体重指数更高，OSAS更为严重。在所有组中，呼吸暂停低通气指数和最低氧饱和度水平均得到显着改善，但在UPPP和MAD组中，Epworth嗜睡量表得分显着下降。在接受UPPP的患者中观察到KIEIF-5显着增加（P = 0.039，配对t检验），但在非手术治疗组中则没有。所有组治疗后的生活质量都有改善的趋势，但仅MAD组有统计学意义。基线时的颈围（r = 0.360，P = 0.006）和KIIEF-5评分（r = -0.484，P <0.001）与KIIEF-5的改善显着相关。结论：这项研究表明，在OSAS中进行ED可能会改善UPPP。在OSAS中，手术和非手术治疗后均观察到更好的疾病特异性QOL。这些发现表明，OSAS干预可以减轻患有ED的OSAS患者的ED并增加其QOL，特别是如果他们已明确抱怨ED和宽颈围。

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