Obstrüktif Uyku Apne Sendromlu Hastalarda Benign Prostat Hiperplazisi ve Kronik Prostatit Semptomlarının Değerlendirilmesi

Yıl 2025, Cilt: 47 Sayı: 2, 186 - 192, 27.02.2025

Abdullah Gürel , İbrahim Güven Çoşğun

Öz

Obstrüktif uyku apnesi sendromu (OSAS), yaşla birlikte görülme sıklığı artan kronik bir hastalıktır. OSAS sonucu meydana gelen oksidatif stres (OS) ve inflamasyon, birçok hastalığın etyopatogenezinden sorumlu tutulmaktadır. OS ve inflamasyon, benign prostat hiperplazisi (BPH) ve kronik prostatit (CP) etyopatogenezinde yer almaktadır. Çalışmamız OSAS tanılı hastalarda BPH ve CP görülme sıklığının OSAS olmayanlarla karşılaştırılmasını amaçlamaktadır. Çalışmaya 102 OSAS tanılı hasta ve 110 OSAS olmayan gönüllü dahil edildi. Katılımcılara Berlin Anketi, Epworth Uykululuk Anketi, Interantional Prostate Symtom Score (IPSS) ve Chronic Prostatitis Symptom Index (CPSI) anketi uygulandı. OSAS ve OSAS olmayanlar arasında yaş (p=0.267), vücut kitle indeksi(BMI)(p=0.995) açısından farklılık olmadığı görüldü. OSAS grubunda, kontrol grubuna kıyasla Berlin Anketi (p<0.001) ve Epworth Uykululuk Ölçeği (p<0.001) pozitifliğinin daha fazla olduğu görüldü. OSAS grubunda, kontrol grubuna göre IPSS (p<0.001), CPSI ağrı skoru (p<0.001) ve CPSI işeme semptomları (p=0.002) değerlerinin daha yüksek olduğu görüldü. OSAS’lı hastalarda kontrol grubuna göre BPH ve CP semptomlarının daha fazla olduğu gözlendi. OSAS’ın etkin şekilde tedavi edilmesi ilerleyen dönemlerde hastalarda gelişebilecek BPH ve CP gibi yaşam kalitesini olumsuz etkileyen kronik hastalıkların önlenmesi açısından önem arz etmektedir.

Anahtar Kelimeler

Obstrüktif Uyku Apne Sendromu, Kronik Prostatit, Benign Prostat Hiperplazisi

The Evaluation of Benign Prostate Hyperplasia and Chronic Prostatitis Symptoms with Obstructive Sleep Apnea Syndrome Patients

Öz

Obstructive Sleep Apnea Syndrome (OSAS) is a chronic disorder that increases in prevalence with increasing age. Oxidative stress (OS) and inflammation resulting from OSAS are responsible for the etiopathogenesis of many diseases. OS and inflammation have been found to play a role in the etiopathogenesis of benign prostate hyperplasia (BPH) and chronic prostatitis (CP). The present study aims to compare the prevalence of BPH and CP between patients diagnosed with OSAS and non-OSAS volunteers. Included in the study were 102 patients with OSAS and 110 non-OSAS volunteers, all of whom were assessed with the Berlin Questionnaire, the Epworth Sleepiness Scale, the International Prostate Symptom Score (IPSS) and the Chronic Prostatitis Symptom Index (CPSI). No significant difference was found in the age (p=0.267) and body mass index (BMI) (p=0.995) values of the OSAS patients and non-OSAS volunteers. Berlin Questionnaire (p<0.001) and Epworth Sleepiness Scale (p<0.001) positivity was more common among the OSAS patients than in the control group. The IPSS (p<0.001), CPSI pain score (p<0.001) and CPSI urination symptoms (p=0.002) values were higher in the OSAS patients than in the controls. OSAS patients had more BPH and CP symptoms than the controls. The effective treatment of OSAS is important for the prevention of such chronic diseases as BPH and CP that may develop at later stages of life and that can impair the quality of life of the patient.

Anahtar Kelimeler

Obstructive Sleep Apnea Syndrome, Chronic Prostatitis, Benign Prostate Hyperplasia

Kaynakça

• 1. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine : JCSM : official publication of the American Academy of Sleep Medicine. 2017;13(3):479-504.
• 2. Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. The Lancet Respiratory Medicine. 2015;3(4):310-8.
• 3. Lee JJ, Sundar KM. Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome. Lung. 2021;199(2):87-101.
• 4. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology. 2013;177(9):1006-14.
• 5. Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Archives of Internal Medicine. 2002;162(8):893-900.
• 6. Lee JH, Cho J. Sleep and Obesity. Sleep Medicine Clinics. 2022;17(1):111-6.
• 7. Logan AG, Bradley TD. Sleep apnea and cardiovascular disease. Current Hypertension Reports. 2010;12(3):182-8.
• 8. Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Javaheri S, et al. Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. Journal of the American College of Cardiology. 2017;69(7):841-58.
• 9. Chung SD, Hung SH, Lin HC, Tsai MC, Kao LT. Obstructive sleep apnea and urological comorbidities in males: a population-based study. Sleep & Breathing = Schlaf & Atmung. 2016;20(4):1203-8.
• 10. Gu Y, Wu C, Qin F, Yuan J. Erectile Dysfunction and Obstructive Sleep Apnea: A Review. Frontiers in Psychiatry. 2022;13:766639.
• 11. Huang JF, Shen N, Zhao JM, Chen ML, Wang BY, Chen GP. Relationship between severity of obstructive sleep apnea and benign prostatic hyperplasia. Sleep & Breathing = Schlaf & Atmung. 2022.
• 12. Paruthi S, Rosen CL, Wang R, Weng J, Marcus CL, Chervin RD, et al. End-Tidal Carbon Dioxide Measurement during Pediatric Polysomnography: Signal Quality, Association with Apnea Severity, and Prediction of Neurobehavioral Outcomes. Sleep. 2015;38(11):1719-26.
• 13. Prabhakar NR, Kumar GK. Oxidative stress in the systemic and cellular responses to intermittent hypoxia. Biological Chemistry. 2004;385(3-4):217-21.
• 14. Ciftci TU, Kokturk O, Bukan N, Bilgihan A. The relationship between serum cytokine levels with obesity and obstructive sleep apnea syndrome. Cytokine. 2004;28(2):87-91.
• 15. Hu Y, Mai L, Luo J, Shi W, Xiang H, Song S, et al. Peripheral blood oxidative stress markers for obstructive sleep apnea-a meta-analysis. Sleep & Breathing = Schlaf & Atmung. 2022;26(4):2045-57.
• 16. Zong D, Liu X, Shen C, Liu T, Ouyang R. Involvement of Galectin-3 in neurocognitive impairment in obstructive sleep apnea via regulating inflammation and oxidative stress through NLRP3. Sleep Medicine. 2022;101:1-10.
• 17. Du Z, Sun H, Du Y, Li L, Lv Q, Yu H, et al. Comprehensive Metabolomics and Machine Learning Identify Profound Oxidative Stress and Inflammation Signatures in Hypertensive Patients with Obstructive Sleep Apnea. Antioxidants (Basel, Switzerland). 2022;11(10).
• 18. Xu Z, Elrashidy RA, Li B, Liu G. Oxidative Stress: A Putative Link Between Lower Urinary Tract Symptoms and Aging and Major Chronic Diseases. Frontiers in Medicine. 2022;9:812967.
• 19. Minciullo PL, Inferrera A, Navarra M, Calapai G, Magno C, Gangemi S. Oxidative stress in benign prostatic hyperplasia: a systematic review. Urologia Internationalis. 2015;94(3):249-54.
• 20. Fernández-Pello SS, Rodríguez Villamil LL, Gil RR, Escaf SS, Alzueta AA, Gonzalo-Orden J. The role of morphometric and respiratory factors in predicting the severity and evolution of urinary symptoms in patients with obstructive sleep apnea syndrome. Sleep & Breathing = Schlaf & Atmung. 2022;26(2):907-14.
• 21. Chuang YC, Lin PW, Lin HC, Chang CT, Friedman M, Salapatas AM, et al. Effects of TORS-OSA Surgery on Lower Urinary Tract Symptoms, Overactive Bladder Symptoms, and Nocturia in Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome. Nature and Science of Sleep. 2022;14:547-56.
• 22. Hu Y, Niu X, Wang G, Huang J, Liu M, Peng B. Chronic prostatitis/chronic pelvic pain syndrome impairs erectile function through increased endothelial dysfunction, oxidative stress, apoptosis, and corporal fibrosis in a rat model. Andrology. 2016;4(6):1209-16.
• 23. Ihsan AU, Khan FU, Khongorzul P, Ahmad KA, Naveed M, Yasmeen S, et al. Role of oxidative stress in pathology of chronic prostatitis/chronic pelvic pain syndrome and male infertility and antioxidants function in ameliorating oxidative stress. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 2018;106:714-23.
• 24. Abrishami A, Khajehdehi A, Chung F. A systematic review of screening questionnaires for obstructive sleep apnea. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2010;57(5):423-38.
• 25. Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep & Breathing = Schlaf & Atmung. 2008;12(2):161-8.
• 26. Barry MJ, Fowler FJ, Jr., O'Leary M P, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association Symptom Index for Benign Prostatic Hyperplasia. The Journal of urology. 2017;197(2s):S189-s97.
• 27. Coşkun A, Can U, Tarhan F, Kavukoğlu Ö, Narter KF. Reliability and validity of the National Institutes of Health Chronic Prostatitis Symptom Index questionnaire in the Turkish Population. Turkish Journal of Medical Sciences. 2021;51(2):501-7.
• 28. Godoy PH, Nucera A, Colcher AP, de Andrade JE, Alves D. Screening for obstructive sleep apnea in elderly: performance of the Berlin and STOP-Bang questionnaires and the Epworth sleepiness scale using polysomnography as gold standard. Sleep Science (Sao Paulo, Brazil). 2022;15(2):136-42.
• 29. Salman LA, Shulman R, Cohen JB. Obstructive Sleep Apnea, Hypertension, and Cardiovascular Risk: Epidemiology, Pathophysiology, and Management. Current Cardiology Reports. 2020;22(2):6.
• 30. Semelka M, Wilson J, Floyd R. Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. American Family Physician. 2016;94(5):355-60.
• 31. Prabhakar NR, Peng YJ, Nanduri J. Hypoxia-inducible factors and obstructive sleep apnea. The Journal of Clinical Investigation. 2020;130(10):5042-51.
• 32. Dinç ME, Avinçsal M, Balcı MBC, Özdemir C. Effect of Continuous Positive Airway Pressure on Overactive Bladder Symptoms in Patients with Obstructive Sleep Apnea Syndrome. Turkish Archives of Otorhinolaryngology. 2018;56(3):133-8.
• 33. Hwang JH, Ong HL, Chen YC. Surgical treatments for obstructive sleep apnea decrease the risk of erectile dysfunction: A nationwide cohort study. Andrology. 2022;10(3):477-85.
• 34. Madersbacher S, Sampson N, Culig Z. Pathophysiology of Benign Prostatic Hyperplasia and Benign Prostatic Enlargement: A Mini-Review. Gerontology. 2019;65(5):458-64.
• 35. Arslan B, Gezmis CT, Çetin B, Gönültas S, Gökmen E, Gürkan O, et al. Is obstructive sleep apnea syndrome related to nocturia? Lower Urinary Tract Symptoms. 2019;11(3):139-42.
• 36. Chou PS, Chang WC, Chou WP, Liu ME, Lai CL, Liu CK, et al. Increased risk of benign prostate hyperplasia in sleep apnea patients: a nationwide population-based study. PloS one. 2014;9(3):e93081.
• 37. Pena VN, Engel N, Gabrielson AT, Rabinowitz MJ, Herati AS. Diagnostic and Management Strategies for Patients with Chronic Prostatitis and Chronic Pelvic Pain Syndrome. Drugs & Aging. 2021;38(10):845-86.
• 38. Shormanov IS, Mozhaev, II, Sokolova KA, Solovev AS. [The role of stress-induced chronic subclinical inflammation in the pathogenesis of the chronic pelvic pain syndrome IIIB in men]. Urologiia (Moscow, Russia : 1999). 2017(6):131-7.
• 39. Qin Z, Zhang C, Guo J, Kwong JSW, Li X, Pang R, et al. Oral pharmacological treatments for chronic prostatitis/chronic pelvic pain syndrome: A systematic review and network meta-analysis of randomised controlled trials. Eclinical Medicine. 2022;48:101457.
• 40. Yi M, Zhao W, Tan Y, Fei Q, Liu K, Chen Z, et al. The causal relationships between obstructive sleep apnea and elevated CRP and TNF-α protein levels. Annals of Medicine. 2022;54(1):1578-89.