Introduction Sexual dysfunction is an under-recognized problem in men and women with obstructive sleep apnea (OSA). Epidemiologic findings were inconclusive regarding the risk for sexual dysfunction associated with OSA. Aim The aim of this study was to examine the association between OSA and sexual dysfunction. Methods The PubMed, Cochrane Library, and Embase databases were searched for observational studies on the OSA and the risk of sexual dysfunction. The methodologic quality of the case–control and cohort studies was assessed with Newcastle–Ottawa Scale (NOS). The cross-sectional study quality methodology checklist was used for cross-sectional study. Data were pooled for the random-effects model. Sensitivity analyses were conducted to assess potential bias. Main Outcome Measure The association between OSA and sexual dysfunction was summarized using relative risk (RR) with a 95% confidence interval (CI). Results This meta-analysis included 1,275 participants from nine studies. Five studies reported the incidence of erectile dysfunction (ED); the remaining four studies reported the incidence of female sexual dysfunction (FSD). Pooled results demonstrated that OSA was associated with increased risk of ED (pooled RR = 1.82, 95% CI: 1.12–2.97) as well as FSD (pooled RR = 2.00, 95% CI: 1.29–3.08). Estimates of the total effects were generally consistent in the sensitivity analysis. No evidence of publication bias was observed. Conclusions Evidence from the observational studies suggested that OSA individuals might have an increased incidence of sexual dysfunction despite significant heterogeneity. More researches are warranted to clarify the relationship between OSA and the increased risk of sexual dysfunction.

Recently published studies had shown that there may be a potential link between the Single nucleotide polymorphism (SNP) of Toll‐like receptor‐4 (TLR4), and the risk of urinary tract infection (UTI); however, no consensus was reached. To further understand the relationship between TLR SNPs and urinary tract infections, we searched for related studies published in PubMed, EMBASE, and Web of Science before October 30, 2018, for further systematic review and meta‐analysis. Our study accrued 10 case‐control studies, which included 1476 urinary tract infection patients and 1449 healthy controls in TLR4(rs4986790, rs4986791). R3.4.2 and Stata 15.0 software were used for the analysis. In general, there was no statistically significant association between rs4986790 and urinary tract infection in the four genetic models. However, in the subgroup analysis, the Asian population showed significantly difference in the allelic model (G vs A: OR = 1.88 [95% CI:1.42‐2.49], P = .03). In addition, there were also significant differences in the dominant model (GG + AG vs AA OR = 1.97 [95% CI:1.46‐2.66], P = .01). Due to the small number of available literatures, no meaningful conclusion can be drawn regarding the relationship between TLR4 (rs4986791) and the risk of urinary tract infections in general. Nevertheless, our meta‐analysis shows that in Asian populations, TLR4 (rs4986790) may be associated with risk of urinary tract infection.