Effects of TORS-OSA Surgery on Lower Urinary Tract Symptoms, Overactive Bladder Symptoms, and Nocturia in Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome

Yao-Chi Chuang; Pei-Wen Lin; Hsin-Ching Lin; Chun-Tuan Chang; Michael Friedman; Anna M Salapatas; Chih-Yun Lin

doi:10.2147/NSS.S349807

Effects of TORS-OSA Surgery on Lower Urinary Tract Symptoms, Overactive Bladder Symptoms, and Nocturia in Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome

Nat Sci Sleep. 2022 Mar 31:14:547-556. doi: 10.2147/NSS.S349807. eCollection 2022.

Authors

Yao-Chi Chuang^{1

2}, Pei-Wen Lin^{2

3

4}, Hsin-Ching Lin^{2

4

5

6}, Chun-Tuan Chang⁶, Michael Friedman^{7

8}, Anna M Salapatas⁸, Chih-Yun Lin⁹

Affiliations

¹ Division of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
² College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Division of Glaucoma, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁴ Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁵ Department of Otolaryngology, Robotic Surgery Center and Center for Quality Management, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁶ Department of Business Management, Institute of Healthcare Management, National Sun Yat-sen University, Kaohsiung, Taiwan.
⁷ Department of Otolaryngology, Division of Sleep Surgery, Rush University Medical Center, Chicago, IL, USA.
⁸ Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
⁹ Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Abstract

Objective: To determine the presence of lower urinary tract symptoms (LUTS), and overactive bladder (OAB) symptoms in men with obstructive sleep apnea/hypopnea syndrome (OSA) and the effects of transoral robotic surgery (TORS) for the treatment of OSA on these conditions.

Materials and methods: One hundred twenty-three patients with a diagnosis of OSA were prospectively enrolled. The evaluations of LUTS and OAB symptoms were based on self-administered questionnaires containing international prostate symptom score (IPSS) and OAB symptom score (OABSS), respectively. Men with an OABSS urgency score of ≥2 and sum score of ≥3 were considered to have OAB. The therapeutic outcomes were assessed at baseline, and 12 weeks after TORS-OSA Surgery.

Results: There were significant differences in IPSS, and OABSS according to OSA severity. After TORS-OSA surgery, significant improvements on OSA severity, daytime quality of life (QoL) and nighttime sleep quality were observed. TORS-OSA surgery was also associated with a statistically significant improvement of LUTS, LUTS QoL score, and OAB symptoms (IPSS 22.1% decrease; IPSS QoL score 21.1% decrease; OABSS17.4% decrease) at post-operative 3 months' follow-up. The presence of OAB, and severe nocturia was significantly reduced from 22.8% to 11.4% (p=0.001), 5.7% to 0.8% (p=0.031) after TORS-OSA surgery. There were no patients who had acute airway compromise or massive bleeding peri- or post-operatively.

Conclusion: TORS upper airway surgery could improve LUTS and OAB symptoms on male patients with OSA in addition to improvement of major parameters of sleep study and sleep-related QoL.

Keywords: OSA surgery; lower urinary tract symptoms; obstructive sleep apnea; overactive bladder symptoms; snoring; transoral robotic surgery.

Grants and funding

This study was sponsored by the grants from the Chang Gung Memorial Hospital (CMRPG8L1341 and CMRPG8J1541), Kaohsiung, Taiwan. This study was also partially sponsored by Intuitive Surgical Inc., Sunnyvale, CA. However, Intuitive Surgical Inc. had no role in the design or conduct of this study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.