Introduction: Nocturia and disrupted sleep are common motivating complaints for men to seek lower urinary tract symptom (LUTS) treatment. We previously reported a cross-sectional and longitudinal association between the bother and severity of LUTS, and the severity of sleep disturbances. Convective water vapor thermal therapy (CWVTT) is a new minimally invasive surgical therapy (MIST) for LUTS. Currently, there is a lack of data examining the relationship between nocturia and disrupted sleep following MIST for LUTS, including CWVTT. In this study, we aimed to assess nocturia and subjective sleep quality in men prior to and following CWVTT treatment.
Methods: Patients who underwent CWVTT between 2018-2021 were eligible for inclusion in the study. Patient demographics, peri-operative data, and clinical outcomes data were extracted. Exclusion criteria included missing pre or post-operative symptom scores, and starting or stopping obstructive sleep apnea (OSA) treatment during the follow-up period. Nocturia was assessed via International Prostate Symptom Score – Nocturia question (IPPS-N). Sleep quality was assessed via Jenkins Sleep Score (JSS). Pre-operative IPSS-N and JSS were compared to early ( <60 days) and late (>120) post-operative scores using the Student’s t-tests. Further analysis was also conducted with linear regression.
Results: A total of 107 patients qualified for analysis. The median age of patients was 69 years. Approximately 9.3% of the patients had a diagnosis of OSA. In the early postoperative period, there was a significant improvement in IPSS-N (preoperative IPSS-N=3 vs postoperative IPSS-N=2, p = 0.003), and JSS (preoperative JSS=9.5 vs postoperative JSS=8, p=0.030) following CWVTT. These results were sustained in the late postoperative period for both IPSS-N (preoperative IPSS-N=3 vs postoperative IPSS-N= 2, p <0.001) and JSS (preoperative JSS=9 vs postoperative JSS=6, p<0.001). On multivariable logistic regression, higher age was associated with improvement in IPSS-N (OR 1.06 [95% CI 1.0-1.14], p=0.04) and lower prostate volume was associated with improvement in JSS (OR -0.07 [95% CI -0.12-(-0.02)], p=0.009).
Conclusions: There is a clinically significant improvement in nocturia and subjective sleep quality following CWVTT. Physiologic mechanisms responsible for a global improvement in sleep beyond simply reduced nocturia deserve further study.