Effect of Sleep Apnea Treatment on Urine Flow in a Patient with BPH

Benign Prostatic Hyperplasia (BPH) is a chronic condition presenting with lower urinary tract symptoms that affects up to 70% of US men 60and69 years of age and 80% of those 70 years or older (Wei et. al. 2005). Obstructive Sleep Apnea (OSA) is a chronic condition with excessive daytime fatigue and chronically elevated sympathetic nerve activity that affects at least 5-7% of men and 2-5% of women and increases significantly with age (Punjabi 2008). Moreover, both disorders often go undiagnosed. The increased sympathetic activity accompanying OSA likely affects BPH symptoms, however this has not been systematically investigated. Thus, this case study was a preliminary investigation of whether treatment of OSA alters BPH symptoms. A 58 year old adult male with a history of BPH and concurrent OSA with moderate compliance to using BiPAP for OSA treatment recorded urine flow and volume throughout a 4 month period during which the patient either did not use BiPaP at all, or used it throughout the night. Peak urine flow (UFlow meter) and net urine volume were recorded in the morning of each data collection. Results: A Mann-Whitney Rank Sum analysis revealed that peak flow was significantly increased (p< 0.05) and total urine volume was increased (p< 0.01) on nights in which there was complete BiPAP treatment. Conclusion: These results demonstrate that effective OSA treatment has a positive impact on BPH symptoms. This study suggests an interaction between OSA, its treatment, and BPH symptoms and this association warrants further investigation.