Login to Access Video or Poster Abstract: MP84-17
Sources of Funding: none

Introduction

Literature supports a bi-directional relationship between obstructive sleep apnea (OSA) and erection dysfunction (ED). The Eppworth Sleepiness Scale (ESS) is used to make a clinical diagnosis of OSA. The fragmentation of sleep and loss of REM sleep in OSA has been purported to lead to venous leak. No study has to date addressed the link between OSA and the presence of venous leak (VL).

Methods

Patients who had ED, completed the international index of erectile function (IIEF) and underwent a penile duplex Doppler ultrasound constituted the study group. All completed the ESS. A score of >10 was used to define OSA and >16 severe OSA. All PDDU studies were done using a redosing injection agent schedule. Peak systolic velocity (PSV) >30cm/s and end diastolic velocity (EDV) <5cm/s were considered normal. Comorbidity and erectile hemodynamics data were recorded. Data were compared between those with and without OSA. Pearson correlation coefficient was generated for he association between IIEF and ESS scores. Multivariable analysis was performed to define predictors of VL in the study cohort. Potential predictors included: patient age, diabetes, number of vascular comorbidities, history of radical prostatectomy (RP) and ESS.

Results

758 patients were included in the study. 91 (12%) men has an ESS>10 indicating OSA. Mean age: OSA 62±13 vs non-OSA 64±19 years (p=0.03). Vascular comorbidity profile between the 2 groups was similar except for: coronary artery disease 17% vs 11% (p=0.03); BMI 29±6 vs 22±1 (p=0.015); RP history 16% vs 23% (0.02). The percentage of men with abnormal PSV: 26% vs 17% (p<0.01); abnormal EDV 17% vs 4% (p<0.01). There was a good correlation between IIEF erectile function domain score and ESS (r=0.72). Predictors of the presence of VL are shown in the table.

Conclusions

There is a clear association between OSA and ED with greater degrees of OSA translating into poorer erectile function. OSA is a predictor of the presence of VL.

Funding

none