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Westhofen T, Feyerabend E, Buchner A, Schlenker B, Becker A, Eismann L, Rodler S, Jokisch F, Stief CG, Kretschmer A. Impact of Preoperative LUTS on Health-related Quality of Life Following Radical Prostatectomy: A Propensity Score Matched Longitudinal Study. Urology 2024; 192:52-58. [PMID: 38679296 DOI: 10.1016/j.urology.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To assess the impact of preoperative lower urinary tract symptoms (LUTS) on long-term health-related quality of life (HRQOL) up to 10 years after radical prostatectomy (RP) for prostate cancer (PC). METHODS Within our prospective institutional database of 6487 patients treated with RP for PC (2008-2020), 2727 patients with preoperative LUTS (IPSS score of ≥8) were identified. A 1:1 propensity-score matched analysis of 3056 men (n = 1528 LUTS, n = 1528 no LUTS) was conducted. Primary endpoint was HRQOL (based on EORTC QLQ-C30 and PR25). Linear regression models tested the effect of preoperative LUTS on the net change in general HRQOL (P <.05). RESULTS Median follow-up was 48 months. Preoperative mean global health status (GHS) score (67.4 vs 75.7) was significantly lower in the LUTS cohort (P <.001). Post-RP the difference in general HRQOL between the LUTS cohort and the no-LUTS cohort became smaller (65.7 vs 67.8), however, remaining statistically significant (P = .037). In long-term follow-up, general HRQOL was comparable between both subcohorts (P-range 0.716-0.876). Multivariable linear regression analysis revealed increased preoperative IPSS as an independent predictor for increased perioperative improvement of IPSS (P <.001) CONCLUSION: For patients undergoing RP, preoperative LUTS were associated with a postoperative improvement of HRQOL outcomes. In long-term follow-up, HRQOL was comparable to patients without preoperative LUTS. Hence, RP is an efficient option to treat PC as well as LUTS in those patients.
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Affiliation(s)
- Thilo Westhofen
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany.
| | - Enya Feyerabend
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Alexander Buchner
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Boris Schlenker
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Armin Becker
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lennert Eismann
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Severin Rodler
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Friedrich Jokisch
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christian G Stief
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Alexander Kretschmer
- Department of Urology, University Hospital Großhadern, Ludwig-Maximilians-University Munich, Munich, Germany; Janssen Global Research and Development, Los Angeles, CA
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Haga K, Akagashi K, Tobe M, Uchida K, Honma I, Hirobe E, Ishizaki J, Shimizu T, Nakajima H, Urahama S, Sato Y. One hundred cases of Rezum water vapor thermal therapy for benign prostatic hyperplasia: Real-world data at a single institution in Japan. Int J Urol 2024. [PMID: 39187956 DOI: 10.1111/iju.15558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/30/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVE The objective of our study was to assess the efficacy of Rezum, a minimally invasive surgical treatment, for patients with lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) in real-world clinical practice at a single institution in Japan. MATERIALS AND METHODS We conducted a prospective study involving 100 patients who underwent the Rezum procedure between October 2022 and February 2024. We analyzed patient backgrounds that are compliant with Japanese regulations and assessed descriptive outcomes such as symptom scores, peak flow in uroflowmetry, post-void residual (PVR) volume, and prostate volume (PVol). These data were collected at 1 and/or 3 months postoperatively. RESULTS On average, 4.7 water vapor injections were administered during the Rezum procedures, with a mean operative time of 6.3 min. Patients experienced significant relief in symptoms, with reductions of 55% in International Prostate Symptom Score, 53% in quality of life score, and 30% in Overactive Bladder Symptom Score. There was also a significant decrease in mean PVR volume (50% reduction) and PVol (27% reduction). Among the subgroup of 23 pre-interventional catheter-dependent patients, 91% achieved catheter independence. CONCLUSION Our single-center analysis demonstrates that Rezum is an effective and safe minimally invasive therapeutic option for patients with BPH. This promising novel technique can be particularly beneficial for patients at an augmented risk of bleeding or those considered high risk for anesthesia.
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Affiliation(s)
- Kazunori Haga
- Sanjukai Urological Hospital, Sapporo, Hokkaido, Japan
| | | | - Musashi Tobe
- Sanjukai Urological Hospital, Sapporo, Hokkaido, Japan
| | - Kosuke Uchida
- Sanjukai Urological Hospital, Sapporo, Hokkaido, Japan
| | - Ichiya Honma
- Sanjukai Urological Hospital, Sapporo, Hokkaido, Japan
| | - Emi Hirobe
- Sanjukai Urological Hospital, Sapporo, Hokkaido, Japan
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Romano L, Pellegrino R, Arcaniolo D, Gravina AG, Miranda A, Priadko K, De Gennaro N, Santonastaso A, Palladino G, Crocetto F, Barone B, Cuomo A, Facchiano A, Mucherino C, Spirito L, Sciorio C, de Sio M, Romano M, Napolitano L. Lower urinary tract symptoms in patients with inflammatory bowel diseases: A cross-sectional observational study. Dig Liver Dis 2024; 56:628-634. [PMID: 37880017 DOI: 10.1016/j.dld.2023.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Inflammatory Bowel Diseases (IBD), Crohn's Disease (CD), and Ulcerative Colitis (UC) may have extraintestinal manifestations, including disorders of the urinary tract. The prevalence of lower urinary tract symptoms (LUTS) in IBD patients remains unclear. AIMS Assess the prevalence of LUTS in patients with CD or UC, evaluate the variables implicated in any difference in LUTS prevalence between CD or UC, and assess any relationship between disease activity and LUTS METHODS: LUTS were evaluated in 301 IBD patients through standardised questionnaires: Bristol Female Lower Urinary Tract Symptoms (BFLUTS), NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), and International Prostate Symptom Score (IPSS). IBD activity was determined through the Crohn's Disease Activity Index (CDAI), Partial Mayo Score (PMS), and Total Mayo Score (TMS). RESULTS BFLUTS total score for females was 6 (3-11). Patients with a higher age at diagnosis had worse filling symptoms (p = 0.049) and a worse quality of life (p = 0.005). In males, 67.1% had mild, 28.5% moderate, and 4.4% severe IPSS symptom grades. The overall NIHCPSI prevalence of chronic prostatitis-like symptoms was 26.8%. The questionnaires revealed some significant differences in the subgroups analysed. CONCLUSION LUTS should be evaluated in IBD patients by urologic-validated questionnaires for prompt diagnosis and early treatment.
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Affiliation(s)
- Lorenzo Romano
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy; Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Raffaele Pellegrino
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Davide Arcaniolo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy.
| | - Agnese Miranda
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Kateryna Priadko
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Nicola De Gennaro
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Antonio Santonastaso
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Giovanna Palladino
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Felice Crocetto
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy
| | - Biagio Barone
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy
| | - Antonio Cuomo
- Gastroenterology Unit, "Umberto I" General Hospital, Nocera Inferiore 84014, Italy
| | - Angela Facchiano
- Gastroenterology Unit, "Umberto I" General Hospital, Nocera Inferiore 84014, Italy
| | - Caterina Mucherino
- Gastroenterology Unit, "Sant'Anna and San Sebastiano" General Hospital, Caserta 81100, Italy
| | - Lorenzo Spirito
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Carmine Sciorio
- Urology Unit, "A.Manzoni" General Hospital, Lecco 23900, Italy
| | - Marco de Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Marco Romano
- Department of Precision Medicine and Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples "Federico II", Naples 80131, Italy
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Winkler T, von Klot CAJ, Madersbacher S, Kuczyk MA, Wolters M. Rezum water vapor thermal therapy for treatment of lower urinary tract symptoms: A retrospective single-centre analysis from a German high-volume centre. PLoS One 2023; 18:e0279883. [PMID: 36607843 PMCID: PMC9821484 DOI: 10.1371/journal.pone.0279883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Rezum is a minimal invasive surgical treatment for patients with lower urinary tract symptoms (LUTS) related to benign prostatic enlargement (BPE). The aim of our study was to assess safety and efficacy of the Rezum procedure in a consecutive series of patients. MATERIAL AND METHODS A retrospective study was performed in a single tertiary care hospital in patients undergoing Rezum procedure between 2018 and 2020. All patients that underwent intervention because of drug-refractory moderate to severe LUTS were assessed. Descriptive outcomes such as symptoms scores (IPSS, IPSS-QoL), peak flow in uroflowmetry (Qmax), post-micturition residual urine volume (PVR) and prostate volume (PVol) were analysed. RESULTS In total, 92 Rezum procedures were performed in the observational period. All interventions were competed without device- or procedure relates adverse events. Patients achieved a significant symptom relief as measured in IPSS (50% reduction, p<0.001, n = 35) and IPSS-QoL score (53% reduction, p<0.001, n = 35). Qmax improved by 7.3 ml/s from 10.6 ± 4.2 ml/s to 17.9 ± 9.3 ml/s (p = 0.003, n = 20) were as mean PVR significantly decreased by 136 ml from 175 ± 194.1 to 39 ± 62 ml (p = 0.007, n = 20). PVol significantly decreased by 40.3% from 73.9 ± 41.2 to 44.9 ± 29 ccm (p = 0.024, n = 17). All pre-interventional catheter-depending patients (28.3% of all patient) were catheter independent after six weeks. CONCLUSION Rezum therapy is safe and effective and can be considered a viable treatment option for BPH related LUTS.
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Affiliation(s)
- Thorben Winkler
- Department of Urology and Urologic Oncology, Hannover Medical School (MHH), Hannover, Germany
- * E-mail:
| | | | - Stephan Madersbacher
- Department of Urology, Klinik Favoriten, Vienna, Austria and Department of Urology, Sigmund Freud Private University, Vienna, Austria
| | - Markus A. Kuczyk
- Department of Urology and Urologic Oncology, Hannover Medical School (MHH), Hannover, Germany
| | - Mathias Wolters
- Department of Urology and Urologic Oncology, Hannover Medical School (MHH), Hannover, Germany
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Gottschalk S, König HH, Nejad M, Dams J. Measurement properties of the EQ-5D in populations with a mean age of ≥ 75 years: a systematic review. Qual Life Res 2023; 32:307-329. [PMID: 35915354 PMCID: PMC9911506 DOI: 10.1007/s11136-022-03185-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE Healthcare interventions for middle-old and oldest-old individuals are often (economically) evaluated using the EQ-5D to measure health-related quality of life (HrQoL). This requires sufficient measurement properties of the EQ-5D. Therefore, the current study aimed to systematically review studies assessing the measurement properties of the EQ-5D in this population. METHODS The databases PubMed, Cochrane library, Web of Science, Embase, and EconLit were searched for studies providing empirical evidence of reliability, validity, and/or responsiveness of the EQ-5D-3L and EQ-5D-5L in samples with a mean age ≥ 75 years. Studies were selected by two independent reviewers, and the methodological quality was assessed using the COSMIN Risk of Bias checklist. Results were rated against updated criteria for good measurement properties (sufficient, insufficient, inconsistent, indeterminate). The evidence was summarized, and the quality of evidence was graded using a modified GRADE approach. RESULTS For both EQ-5D versions, high-quality evidence for sufficient convergent validity was found. Known-groups validity was sufficient for the EQ-5D-5L (high-quality evidence), whereas the results were inconsistent for the EQ-5D-3L. Results regarding the reliability were inconsistent (EQ-5D-3L) or entirely lacking (EQ-5D-5L). Responsiveness based on correlations of change scores with instruments measuring related/similar constructs was insufficient for the EQ-5D-3L (high-quality evidence). For the EQ-5D-5L, the available evidence on responsiveness to change in (Hr)QoL instruments was limited. CONCLUSION Since the responsiveness of the EQ-5D in a population of middle-old and oldest-old individuals was questionable, either using additional instruments or considering the use of an alternative, more comprehensive instrument of (Hr)QoL might be advisable, especially for economic evaluations.
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Affiliation(s)
- Sophie Gottschalk
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Hans-Helmut König
- grid.13648.380000 0001 2180 3484Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Mona Nejad
- grid.13648.380000 0001 2180 3484Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Judith Dams
- grid.13648.380000 0001 2180 3484Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
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Kayigil Ö, Altay Y, Okulu E. A new diagnostic definition for patients with lower urinary tract symptoms evaluated by corpus cavernosum electromyography: 'Pelvic autonomic dysfunction'. Andrologia 2022; 54:e14626. [PMID: 36285558 DOI: 10.1111/and.14626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
This study investigates the use of corpus cavernosum electromyography (CC-EMG) recording as a diagnostic tool for identifying the presence of pelvic autonomic dysfunction (PAD) in patients with LUTS and concurrent ED. Fifty patients were included in the study, and the electromyographic and urodynamic findings were compared. The 50% relaxation degree was accepted as a threshold value for PAD. According to relaxation degree in CC-EMG recordings, patients were grouped as; Group 1 (with PAD) = 23 patients with a relaxation degree of less than 50%. Group 2 (without PAD) = 27 patients with a relaxation degree greater than 50%. The mean age of the patients was 58 ± 3.2 (50-71) years. The comparison of the urodynamic parameters and transrectal ultrasound revealed that the postvoiding residual urine volume (PVR) (p = 0.0007), P det Qmax (p = 0.0005), and P det compliance (0.003) values were statistically significantly lower in Group 2. The mean IIEF-5 and IIEF-15 scores of the patients in Group 1 were 2.5 ± 0.7 and 8.1 ± 1.1 respectively. In Group 2, mean IIEF-5 and IIEF-15 scores were 7.2 ± 2.9, and 17.2 ± 3.5 (p: 0.00023 and p: 0.0009). The mean I-PSS score was 22.8 ± 3 in Group 1 and 16 ± 2.3 in Group 2 (p = 0.001). The mean relaxation degree (RD) in Group I was 30.73 ± 6.8%, and in Group 2 was 66.3 ± 5.1%. The mean amplitude values of the patients in Group I were 261.41 ± 112.97 before papaverine injection, and in Group 2 were 246 ± 101.28 respectively. The inter-group difference was statistically significant (p < 0.05). The mean amplitude value of the patients in Group I after papaverine injection was 182.73 ± 60.71, and in Group 2, that value was 83.2 ± 29.19. The inter-group difference was also significant (p < 0.05). Increased electrical bursts and decreased relaxation responses on CC-EMG indirectly indicated an increase in the contractility of the bladder sphincter. Therefore, we concluded that CC-EMG could be a diagnostic tool for PAD and cavernous autonomic dysfunction.
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Affiliation(s)
- Önder Kayigil
- Faculty of Medicine, The Urology Clinics of Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Yucel Altay
- The Urology Clinics of Ergani State Hospital, Diyarbakir, Turkey
| | - Emrah Okulu
- Faculty of Medicine, The Urology Clinics of Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
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Iheanacho CO, Okwesilieze CN, Eyong AK. Role of calcium channel blockers in lower urinary tract symptoms in benign prostatic hyperplasia: a literature review. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
Background
Benign prostatic hyperplasia (BPH) and the use of CCBs are common in older persons, and are also associated with lower urinary tract symptoms (LUTS). This review summarised and synthesised relevant information and recent advances to improve clinical knowledge on the role of CCBs in LUTS, BPH symptoms and health-related quality of life.
Main body of the abstract
A search of databases of PubMed, Web of science, Hinari, and Google scholar was performed using several keywords. Relevant studies were also extracted from references of identified studies. Selected studies were assessed for content related to CCBs, BPH and LUTS, and the most relevant reports were included. The inhibition of calcium channels by CCBs interferes with influx of extracellular Ca2+ into the detrusor muscle, which interferes with bladder contraction and relaxation. Hence, CCBs are associated with precipitation or aggravation of urinary storage and voiding symptoms, which are also common symptoms of BPH. This suggests a potential aggravation of BPH symptoms with the use of CCBs.
Short conclusion
Persons at high risk of LUTS such as in BPH, may benefit from other classes of antihypertensive drugs. Therefore, it is essential to identify persons with BPH prior to commencement of therapy with CCBs. Patients on CCBs should be routinely reviewed for any potential precipitation or aggravation of LUTS. Patients should also be counselled to notify their healthcare provider of unusual urinary symptoms during CCB use. This will facilitate enhanced quality of life in patients with BPH.
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Grüne B, Siegel F, Waldbillig F, Pfalzgraf D, Kamdje Wabo G, Herrmann J, Kriegmair MC, Nuhn P, Michel MS, von Hardenberg J. Long-term Reinterventions after Thulium Laser Enucleation of the Prostate: 12-Year Experience with more than 1000 Patients. Eur Urol Focus 2022; 8:1370-1375. [PMID: 35016861 DOI: 10.1016/j.euf.2021.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/27/2021] [Accepted: 12/15/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Thulium laser enucleation of the prostate (ThuLEP) is an established treatment option for benign prostatic enlargement (BPE), but long-term outcomes have not yet been reported. OBJECTIVE To prove the durability of ThuLEP by investigating its long-term efficacy and morbidity. DESIGN, SETTING, AND PARTICIPANTS All patients who underwent ThuLEP at a German tertiary referral center between 2009 and 2021 were retrospectively followed up for reinterventions for persistence or regrowth of prostate adenoma (ReIP) or long-term complications (ReIC). INTERVENTION ThuLEP. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We calculated the cumulative incidence for ReIP and ReIC at 10 yr. Univariate and multivariate Cox regression models were constructed to identify predictors of ReIP and ReIC. RESULTS AND LIMITATIONS Overall, 1097 patients underwent ThuLEP. The median overall follow-up was 6.0 yr (interquartile range [IQR] 2.4-9.2). For one-third of patients (n = 369), median follow-up of 10 yr (IQR 9.1-11.2) was available. A total of 42 patients (3.8%) underwent ReIP after a median of 2 yr (IQR 0.3-4.9). The rate of long-term ReIC was 2.6% (n = 29) and the median time to ReIC was 0.5 yr (IQR 0.3-1.7). The most frequent ReIC was urethrotomy (n = 16, 1.5%). The cumulative incidence of ReIP and ReIC at 10 yr was estimated at 5.6% and 3.4%, respectively. Enucleation weight ≥60 g was a significant predictor of ReIP (hazard ratio 1.2, p = 0.014). The retrospective study design and the lack of functional outcomes are the main limitations. CONCLUSIONS ThuLEP is a durably effective and safe procedure with low reintervention rates within 12 yr. PATIENT SUMMARY This study investigated long-term outcomes of thulium laser enucleation of the prostate for benign enlargement of the prostate (BPE). Low rates of repeat treatment for BPE recurrence or for other complications were observed. Our results show the safety and efficacy of this treatment over a period of 12 years.
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Affiliation(s)
- Britta Grüne
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Fabian Siegel
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany; Department of Biomedical Informatics at the Center for Preventive Medicine and Digital Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Frank Waldbillig
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel Pfalzgraf
- Department of Urology, Heilig-Geist-Hospital Bensheim, Bensheim, Germany
| | - Gaetan Kamdje Wabo
- Department of Biomedical Informatics at the Center for Preventive Medicine and Digital Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jonas Herrmann
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maximilian C Kriegmair
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Philipp Nuhn
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maurice Stephan Michel
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jost von Hardenberg
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
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Liu Y, Han J, Guo X, Fang L, Liu T. Scanning Imaging Study of Patients with Parkinson's Disease Lower Urinary Tract Dysfunction Based on Linear Equation. SCANNING 2022; 2022:9506328. [PMID: 35686156 PMCID: PMC9166962 DOI: 10.1155/2022/9506328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
A predictive method based on a linear equation was proposed to study the factors influencing lower urinary tract dysfunction in Parkinson's disease. A 10-month follow-up of 200 selected Parkinson's patients from January to December 2020 used a linear regression equation to analyze whether depletion function was associated with a specific nonmotor function loss, and a linear regression equation was used for analysis. A loss of emptiness function was used to determine whether there are complications associated with lower motor function and cognitive function. The experimental results showed that dysuria in Parkinson's disease was related to the following nonmotility disorders: gastrointestinal dysfunction (OR 2.52, 95% CI 1.57-3.92, P < 0.001), cardiovascular dysfunction (OR 2.31, 95% CI 1.23~4.11, P = 0.014), respiratory dysfunction (OR 1.72, 95% CI 1.32~3.24, P = 0.029), cutaneous autonomic dysfunction (OR 1.91, 95% CI 1.15~3.08, P = 0.023), and sleep disorders (OR 2.01, 95% CI 1.32~3.14, P = 0.001). In addition, dysuria was associated with higher UPDRS-III (regression coefficient 1.74, 95% CI 0.56-2.67, P = 0.001). Thus, nonmotor disorders have been shown to be associated with early impairment.
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Affiliation(s)
- Yong Liu
- Neurology Department, The 80th Group Army Hospital of the People's Liberation Army, Weifang, Shandong 261021, China
| | - Jiasheng Han
- Urinary Surgery, The 80th Group Army Hospital of the People's Liberation Army, Weifang, Shandong 261021, China
| | - Xuguang Guo
- Urinary Surgery, The 80th Group Army Hospital of the People's Liberation Army, Weifang, Shandong 261021, China
| | - Lei Fang
- School of Public Health, Weifang Medical College, Weifang, Shandong 261021, China
| | - Ting Liu
- Urinary Surgery, The 80th Group Army Hospital of the People's Liberation Army, Weifang, Shandong 261021, China
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Cheng WM, Liou YJ, Fan YH. Type D Personality Is an Independent Predictor of Lower Urinary Tract Symptoms in Young Men. Front Psychol 2022; 13:822490. [PMID: 35273543 PMCID: PMC8901569 DOI: 10.3389/fpsyg.2022.822490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/18/2022] [Indexed: 12/28/2022] Open
Abstract
This cross-sectional study, which included men aged 20-40 years, aimed to determine the relationships among type D personality, depressive symptoms and lower urinary tract symptoms in young men. An internet-based questionnaire was administered, and General demographics, International Prostate Symptom Scores, Type D Scale-14 scores, and Depression and Somatic Symptom Scale scores were analyzed. A total of 3,127 men were included; of these, 762 (24.4%) reported moderate/severe lower urinary tract symptoms, and 1,565 (50.05%) met the criteria for type D personality. Men with type D personality had significantly higher body mass index and total and sub-scores for the International Prostate Symptom Score and Depression and Somatic Symptom Scale. Furthermore, the type D personality group had a higher prevalence of lower urinary tract symptoms, particularly voiding symptoms. Univariate analysis revealed that all parameters, except for body mass index, were significant predictors of moderate/severe lower urinary tract symptoms. Multivariate analysis showed that age >30 years, type D personality, and depressive and somatic Depression and Somatic Symptom Scale sub-scores were independent predictors of moderate/severe lower urinary tract symptoms. Regarding Type D Scale-14 subscales, social inhibition, rather than negative affectivity, impacted moderate/severe lower urinary tract symptoms. Mediation analysis revealed that depressive symptoms mediated the relationship between type D personality and lower urinary tract symptoms. This study established correlations between type D personality, depressive symptoms, and lower urinary tract symptoms. As previous studies suggested that patients with type D personality are less likely to consult and adhere to treatment, and are at higher risk for depression, urologists should therefore actively recognize patients with TDP.
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Affiliation(s)
- Wei-Ming Cheng
- Program in Molecular Medicine, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Biopharmaceutical Science, School of Life Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan
| | - Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Hua Fan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan.,Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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11
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Song HJ, Bluhm MDL, Lee M, Kim HJ, Moon HS. The Relationship Between Lower Urinary Tract Symptoms and Osteoarthritis Symptoms Among Vendors in a Conventional Market. Int Neurourol J 2022; 26:37-44. [PMID: 34922425 PMCID: PMC8984692 DOI: 10.5213/inj.2142146.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/03/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to investigate lower urinary tract symptoms (LUTS) and the correlation between LUTS and osteoarthritis (OA) symptoms in the vendors working in a conventional market. METHODS This cross-sectional study was conducted on 153 vendors aged 40 and over from August 10th to September 8th, 2020, in a conventional market. Data were collected via the self-reported questionnaires. We assessed LUTS by International Prostate Symptom Score (IPSS) and OA symptoms by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). RESULTS The mean age of 153 subjects was 61.31±9.92 years old. The mean score of IPSS and WOMAC was 5.37±5.68 (range, 0-35) and 16.89±19.61 (range, 0-96). Fifty-one percent of subjects had urinary incontinence at least monthly. Twenty-four point two percent of subjects had moderate-to-severe LUTS which were defined as a score of IPSS ≥8. LUTS were positively correlated with OA symptoms (r=0.41, P<0.001). CONCLUSION The results showed that LUTS were associated with OA symptoms, and it also emphasized the need for vendors to be provided with a health education program to manage and prevent their LUTS and OA symptoms.
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Affiliation(s)
- Hyo Jeong Song
- College of Nursing, Jeju National University, Jeju, Korea
| | - M. Danet Lapiz Bluhm
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Moonju Lee
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hyung Jee Kim
- Department of Urology, Dankook University College of Medicine, Cheonan, Korea
| | - Hong Sang Moon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
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Culpan M, Acar HC, Cella D, Tahra A, Cakici MC, Efiloğlu Ö, Atis G, Yildirim A. Turkish validation and reliability of the symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index-29 (LURN SI-29) questionnaire in patients with lower urinary tract symptoms. Neurourol Urodyn 2021; 40:2034-2040. [PMID: 34499765 DOI: 10.1002/nau.24791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/31/2021] [Indexed: 11/07/2022]
Abstract
AIMS To evaluate the validity and reliability of the Turkish version of the Symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index-29 (LURN SI-29). METHODS Patients with lower urinary tract symptoms (LUTS) were included in a single-center study between January and April 2021. Patients' demographics, such as age, sex, and level of education, were recorded. The Turkish version of the LURN SI-29 and the International Prostate Symptom Score (IPSS) were administered to all patients, and the Urogenital Distress Inventory (UDI-6) was additionally administered to female patients. Construct validity was evaluated by confirmatory factor analysis. Concurrent validity was evaluated with correlations to similar measures. Internal consistency (Cronbach's alpha) and split-half reliability analyses were used to establish the scale's reliability. RESULTS A total of 295 participants, 35.3% females and 64.7% males, were included in the final analysis. The mean age was 56.4 ± 11.7 years. The median total LURN SI-29 scores were 38.0 (26-50) and 26.0 (18-43) for female and male patients, respectively. The LURN SI-29 scale showed a high correlation with IPSS and UDI-6 scales (r = .758, p < .001; r = .774, p < .001, respectively) in concurrent validity analysis. Cronbach's alpha coefficient of the scale and all subscales were greater than 0.70 for both female and male patients. CONCLUSIONS This measurement tool can potentially be used to evaluate LUTS in Turkish women and men. Further studies should be performed to reveal the clinical usefulness of this scale.
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Affiliation(s)
- Meftun Culpan
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hazal C Acar
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ahmet Tahra
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mehmet C Cakici
- Department of Urology, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Özgür Efiloğlu
- Department of Urology, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Gokhan Atis
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
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Landeira M, Mora Blázquez AM, Martins de Almeida R, Covernton PJO, Medina‐Polo J, Montero AA. A retrospective analysis comparing persistence and adherence to treatment with free- vs fixed-dose combination of an alpha blocker and an antimuscarinic agent in men with LUTS in Spain. Int J Clin Pract 2020; 74:e13616. [PMID: 32681522 PMCID: PMC7685104 DOI: 10.1111/ijcp.13616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/08/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Combination therapy with an alpha blocker (AB) plus an antimuscarinic (AM) is recommended for men with moderate-to-severe mixed lower urinary tract symptoms (LUTS) when monotherapy is not effective in relieving storage symptoms. This study compared treatment persistence and adherence with an AB plus AM fixed-dose combination (FDC) vs an AB plus AM free-dose combination in men with LUTS in Spain. METHODS Retrospective study using the Spanish IQVIA Cegedim Electronic Medical Records database. Men prescribed AB plus AM combination therapy were included in an FDC or free-dose combination cohort based on their index treatment. Treatment persistence was the time from index date to first discontinuation of ≥1 of the two index drugs over 12 months. Adherence was measured using the fixed medication possession ratio (MPR). RESULTS Of 3114 patients identified, 999 were included (FDC, n = 790; free-dose combination, n = 209). Median (95% CI) persistence was longer in the FDC (125 [109-151] days) than in the free-dose combination (31 [31-36] days) cohort (hazard ratio [HR], 2.9; 95% CI, 2.4-3.4; P < .0001). The 12-month persistence rates were 31.1% (FDC cohort) and 8.9% (free-dose cohort). The mean (SD) fixed MPR was higher in the FDC cohort (48.8 [37.2]) compared with the free-dose cohort (23.1 [28.4]); more patients in the FDC cohort (34.2%) than in the free-dose cohort (10.0%) were adherent (MPR ≥ 80%). The probability of treatment persistence and adherence increased with age (>80 vs <65 years, persistence HR, 0.7 [95% CI, 0.5-0.9]; MPR difference, 12.5), polypharmacy (persistence HR, 0.7 [95% CI, 0.6-0.9]; MPR difference, 10.7) and previous use of AB (persistence HR, 0.8 [95% CI, 0.7-1.0]; MPR difference, 5.7) or AB/AM combinations (persistence HR, 0.7 [95% CI, 0.5-0.9]; MPR difference, 11.1). CONCLUSIONS Treatment with an AB/AM FDC is associated with better persistence and adherence vs a free-dose combination in men with LUTS in Spain.
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The frequency of impairments in everyday activities due to the overuse of the internet, gaming, or smartphone, and its relationship to health-related quality of life in Korea. BMC Public Health 2020; 20:954. [PMID: 32552690 PMCID: PMC7301989 DOI: 10.1186/s12889-020-08922-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/14/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study aimed to investigate the relationships between the frequency of impairments in daily activities due to the overuse of the Internet, gaming, or smartphones (IGS) and sociodemographic characteristics, social relationships (including family) & activities, psychosocial characteristics, health status, and health-related quality of life (HRQoL) of Korean adults. METHODS Secondary data from the 2017 Community Health Survey, a large-scale sample survey conducted yearly in South Korea, were analyzed for 190,066 adults over 19 years of age. Three categories were created for impairment groups due to IGS overuse: No Impairment, Mild Impairment, and Moderate-to-Severe groups. And between-group differences were examined using a one-way ANOVA for health status measured with the EQ-5D-3 L and chi-square tests for all categorical dependent variables, which included sociodemographic characteristics, social relationships & activities, and psychosocial factors. The association between frequencies of daily activity impairments due to IGS overuse and the dependent variables were examined using a multivariate logistic regression analysis and a linear regression model. RESULTS Approximately 21,345 (11.23%) of the 190,066 participants reported experiencing impairments in daily activities due to IGS overuse at least once in the previous year and the impairments were more severe in males than females. Participants experiencing impairments in daily activities contacted their friends a significantly higher number of times (4 times or more per month) and engaged in leisure activities more frequently (more than once per month) than those without impairments. There was also a significant positive relationship between IGS overuse and stress, depression, suicidal ideation, and suicide attempts. Among participants aged 19-64, impairments in daily activities due to IGS overuse were associated with a lower HRQoL. Conversely, for those aged 65 and over, mild and moderate-to-severe impairments due to IGS overuse were associated with a significantly higher HRQoL. CONCLUSIONS Increased impairments in daily activities due to IGS overuse may negatively affect mental health. However, among older adults, the frequency of such impairments was positively associated with HRQoL. This finding could be considered to apply interventions with Internet usage or ICT devices for older adults to enhance their quality of life.
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