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Rogel R, Lorenzo L, Avargues A, Lujan S, Broseta E, Arlandis S. ANalogical UroFlowmetry (ANUF): Correspondence Between This New Visual Pictogram and Uroflowmetry in Men With Lower Urinary Tract Symptoms: A new approach for the study of male micturition dynamics. Urology 2020; 146:236-241. [PMID: 32866510 DOI: 10.1016/j.urology.2020.08.027] [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: 12/23/2019] [Revised: 07/27/2020] [Accepted: 08/16/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To study the correlation between a new visual tool (ANalogical UroFlowmetry (ANUF)) and uroflowmetry (UF) parameters when performed to assess male lower urinary tract symptoms (MLUTS). METHODS We configured an original pictogram composed of 4 different urine streams. In the setting of a University Hospital based prospective study where 545 men were enrolled between September 2018 and January 2019. Variables collected were age, UF pattern, Qmax, average flow rate (Qave), voided volume, postvoid residual, and selected image. The Spearman's rank test, ANOVA, and Tukey test, as well as the lineal regression model were used. RESULTS A total of 358 patients fulfilled the inclusion criteria. Mean age was 64.6 ± 12 years. Mean value and standard deviationfor the Qmax were 20.4 ± 10.5 mL/s for Image1; 15.5 ± 6.4 mL/s for Image2; 13.5 ± 6.0 mL/s for Image3 and 10.4 ± 5.4 mL/s for Image4. Statistically significant negative correlations were found between ANUF and Qmax (r = -0.317; P<.0001), and ANUF and Qave (r = -0.305; P<.0001). Qmax mean values among images were statistically different when compared in pairs, except Image1 and Image2 (P= .153). The confidence intervals calculated through the lineal regression model for the Qmax and each image were Image1) 17.8, confidence interval [CI] 95%: [14.9-21.5] mL/s; Image2) 14.3, CI 95%: [13.0-15.7] mL/s; Image3) 12.3, CI 95%: [11.5-13.1] mL/s and Image4) 9.1, CI 95%: [8.1-10.3] mL/s. CONCLUSION According to our results, ANUF is a useful and inexpensive tool presenting a correlation with the Qmax as well a correspondence of each image with a range of Qmax and its mean value.
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Affiliation(s)
- Ramon Rogel
- Department of Urology, La Fe University Hospital and Polytechnic, Valencia, Spain.
| | - Laura Lorenzo
- Department of Urology, La Fe University Hospital and Polytechnic, Valencia, Spain
| | - Ana Avargues
- Department of Urology, La Fe University Hospital and Polytechnic, Valencia, Spain
| | - Saturnino Lujan
- Department of Urology, La Fe University Hospital and Polytechnic, Valencia, Spain
| | - Enrique Broseta
- Department of Urology, La Fe University Hospital and Polytechnic, Valencia, Spain
| | - Salvador Arlandis
- Department of Urology, La Fe University Hospital and Polytechnic, Valencia, Spain
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Distress Due to Urinary Problems and Psychosocial Correlates among Retired Men in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072533. [PMID: 32272771 PMCID: PMC7177229 DOI: 10.3390/ijerph17072533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/28/2020] [Accepted: 03/31/2020] [Indexed: 11/17/2022]
Abstract
Urinary problems are common among aging men, but there is a paucity of research efforts to understand the psychosocial aspects of the illness. This study aims to understand how common and distressing urinary problems are for newly retired men in Hong Kong and to test the associations between mental health, self-stigma of seeking help, fatigue, self-efficacy, self-esteem, and distress due to urinary problems. To assess this, 139 out of 200 members of a retired men's social club (mean age 63.5) were successfully interviewed. Two-fifths of the participants felt distressed due to their urinary problems and one-third of the participants had been troubled by urinary incontinence or nocturia in the past six months. Yet the majority of the participants (55%) did not seek help from any medical profession. The group who were distressed by urinary problems showed significantly poorer mental health, reported more fatigue symptoms, were less satisfied with their sexual relationships and overall self-esteem, and were less able to stop unpleasant thoughts or to get social support than the non-distressed group. Cultural perceptions of masculinity and decreased sexual vigor might have affected participants' willingness to seek help at an early stage. Targeted health education, mutual support groups, and sensitively designed services at the community level are suggested to address these physical and mental health issues.
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3
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Lower urinary tract symptoms and health-related quality of life in Hong Kong primary care: a cross-sectional study. Qual Life Res 2020; 29:1311-1321. [PMID: 31900760 DOI: 10.1007/s11136-019-02402-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE To estimate the prevalence of lower urinary tract symptoms (LUTS) in primary care using the International Continence Society symptom definition; to evaluate the association between LUTS and health-related quality of life (HRQOL); and to evaluate the treatment gaps. METHODS Patients aged 40 and above were randomly recruited in a Hong Kong public primary care. Patients were asked (i) how often they experienced 18 individual LUTS during the past 4 weeks and (ii) whether they had sought treatments for their LUTS. The 12-Item Short Form Health Survey version 2 (SF-12 v2) and the modified Incontinence Impact Questionnaire-Short Form (IIQ-7) were used to measure HRQOL. RESULTS 500 patients completed the survey. 75.8% of the patients had at least one LUTS "at least sometimes", with patients with a combination of storage, voiding, and post-micturition symptoms being the most prevalent (22.2%), followed by a combination of voiding and storage symptoms (14%). Only 14% of LUTS patients had sought treatments for their LUTS. LUTS was associated with a negative effect in all domains of the SF-12 v2 and IIQ-7 and patients with a combination of storage, voiding, and post-micturition symptoms had the worst HRQOL. Finally, having a combination of storage, voiding, and post-micturition symptoms and poorer HRQOL were factors associated with having sought treatments for LUTS. CONCLUSION A high prevalence of LUTS but low treatment-seeking rates implied possible unmet needs of LUTS patients in primary care, suggesting the potential for more active interventions to alleviate the negative impact of LUTS on patients' HRQOL.
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Wu DBC, Yee CH, Ng CF, Lee SWH, Chaiyakunapruk N, Chang YS, Lee KKC. Economic Evaluation of Combination Therapy Versus Monotherapy for Treatment of Benign Prostatic Hyperplasia in Hong Kong. Front Pharmacol 2018; 9:1078. [PMID: 30386234 PMCID: PMC6198045 DOI: 10.3389/fphar.2018.01078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) is a common condition affecting men. Studies have shown that the prevalence of LUTS/BPH increases with age, which will cause considerable economic burden to the healthcare system and society. The aim of the present study was to evaluate the long term cost effectiveness of dutasteride and tamsulosin therapy compared to tamsulosin alone in men with BPH in Hong Kong. Methods: A Markov decision model was constructed to estimate the economic impact from a healthcare payers' perspective, which only included direct costs. Analyses were conducted for a 4-year time frame. Results: When compared to tamsulosin alone, combination therapy was more expensive but also more effective in preventing complications and reduced the need for surgery. Over life-time projection suggest that combination therapy will be cost-effective if the willingness-to pay threshold of USD 20,000. Conclusion: Findings of this study found that combination therapy of tamsulosin and dutasteride was more cost-effective compared to tamsulosin alone across a wide range of scenario.
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Affiliation(s)
- David Bin-Chia Wu
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes, Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Chi Hang Yee
- Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Fai Ng
- Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes, Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes, Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Malaysia.,School of Pharmacy, University of Wisconsin, Madison, WI, United States.,Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Center of Pharmaceutical Outcomes Research, Naresuan University, Phitsanulok, Thailand
| | - Yu-Shan Chang
- College of Commerce, Tamkang University, New Taipei City, Taiwan
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5
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Yee CH, Yip JSY, Cheng NMY, Kwan CH, Li KM, Teoh JYC, Chiu PKF, Wong JHM, Chan ESY, Chan CK, Hou SSM, Ng CF. The cardiovascular risk factors in men with lower urinary tract symptoms. World J Urol 2018; 37:727-733. [PMID: 30083830 DOI: 10.1007/s00345-018-2432-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/02/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE It has been hypothesized that endothelial dysfunction and pelvic atherosclerosis may contribute to lower urinary tract symptoms (LUTS). We assessed the relationship between cardiovascular risk factors and LUTS severity in male patients presented to urology clinic. METHODS It is a cross-sectional study on patients who presented between 2013 and 2015 with LUTS. A total of 1176 male patients were encountered, and 966 were included for analysis after excluding patients with urinary tract malignancy, urethral stricture, bladder stone and history of urinary tract surgery. Cardiovascular risk factors including components of Framingham risk score, body mass index, uroflowmetry, International Prostate Symptoms Score, fasting blood glucose and serum prostate-specific antigen (PSA) were assessed. Correlation between Framingham risk score, cardiovascular risk factors and severity of LUTS was investigated. RESULTS Multinomial logistic regression analysis showed that severe LUTS significantly associated with Framingham score (P = 0.008) and its components of total cholesterol (OR = 1.318; P = 0.010) and age (OR = 1.032; P = 0.006) compare with mild symptoms. Framingham risk score was found to correlate with storage symptoms (CC = 0.083; P < 0.0001) but not voiding symptoms (CC = - 0.029; P = 0.185). CONCLUSIONS Severity of LUTS and storage symptom significantly increases Framingham risk score, particularly with the components of total cholesterol level and age.
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Affiliation(s)
- Chi-Hang Yee
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| | - Jenny S Y Yip
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Nicole M Y Cheng
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Cheuk-Hang Kwan
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Kai-Man Li
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Jeremy Y C Teoh
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Peter K F Chiu
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Joseph Hon-Ming Wong
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Eddie S Y Chan
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Chi-Kwok Chan
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Simon S M Hou
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Chi-Fai Ng
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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6
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Wang JY, Liao L, Liu M, Sumarsono B, Cong M. Epidemiology of lower urinary tract symptoms in a cross-sectional, population-based study: The status in China. Medicine (Baltimore) 2018; 97:e11554. [PMID: 30142751 PMCID: PMC6112902 DOI: 10.1097/md.0000000000011554] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lower urinary tract symptoms (LUTS) are reported to affect over half of all adults, and they are associated with significantly impaired quality of life (QOL). We performed a population-based study to evaluate the overall prevalence and impact of LUTS including overactive bladder (OAB) in adults aged ≥40 years in China.Adults aged ≥40 years were eligible to participate in this internet-based survey, provided that they had the ability to access the internet, to use a computer and to read the local language. The survey contained questions relating to International Continence Society (ICS) symptom definitions, the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS). The primary study objective was to determine the prevalence of LUTS using the ICS 2002 symptom definition.Among the 4136 respondents, 2080 (50.3%) were men and 1347 (32.6%) were aged ≥60 years. LUTS prevalence according to ICS criteria was 60.3% in men and 57.7% in women. All 3 ICS symptom groups (voiding, storage, and postmicturition) were present in 22.8% of women and 24.2% of men, making this the most common combination of ICS symptom groups. The most bothersome symptoms were terminal dribble and nocturia. According to IPSS scores, 32.9% of participants had at least moderate symptoms. The prevalence of OAB was 23.9%. The presence of LUTS-particularly all 3 ICS symptom groups-was associated with reduced sexual QOL in women, reduced satisfaction with erectile function in men, higher anxiety and depression scores, and reduced health-related QOL (physical health and mental health domains). The overall percentage of participants with LUTS visiting healthcare professionals for urinary symptoms was 38%.In conclusion, LUTS affect the majority of adults aged ≥40 years in China, and prevalence increases with increasing age. LUTS are associated with impaired QOL and mental health, but fewer than half of individuals in China with LUTS seek healthcare for their symptoms. There is therefore a need to improve awareness and treatment of the condition.ClinicalTrials.gov identifier: NCT02618421.
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Affiliation(s)
| | - Limin Liao
- Department of Urology, China Rehabilitation Research Center, Capital Medical University, Beijing, China
| | - Ming Liu
- Department of Urology, Beijing Hospital
| | | | - Min Cong
- Astellas Pharma China, Inc., Beijing, China
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7
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Rao M, Shangguan H, Zeng Z, Zheng Y, Zhang H, Li H, Xia W, Zhu C, Xiong C, Guan H. Prevalence and risk factors of lower urinary tract symptoms in Chinese adult men: a multicentre cross-sectional study. Oncotarget 2017; 8:113225-113238. [PMID: 29348901 PMCID: PMC5762586 DOI: 10.18632/oncotarget.22378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/05/2017] [Indexed: 11/25/2022] Open
Abstract
There has been no previous population-based study reporting the prevalence and risk factors of male lower urinary tract symptoms (LUTS) among men in mainland China. This cross-sectional study was conducted from 2013 to 2014 in three representative provinces of China: Guangdong, Hubei and Jiangsu. 3250 individuals participated in the interviews, which involved a questionnaire covering sociodemographic characteristics, lifestyle, dietary patterns and the International Prostate Symptom Score (IPSS). Blood was collected for lipids, glucose, insulin and reproductive hormone tests. The incidences of LUTS and its obstructive and irritative symptoms were calculated. Risk factors for LUTS were identified using multivariable logistic regression analysis. The prevalence of moderate to severe LUTS and its obstructive and irritative symptoms was 14.3%, 13.1% and 16.1%, respectively, and increased with age. The prevalence in Guangdong was much lower than that in Hubei and Jiangsu in different ages. Increased fasting plasma glucose and decreased HDL-C levels were associated with an increased risk of moderate to severe LUTS (OR = 1.30, 95% CI: 1.02–1.65 and OR = 2.06, 95% CI: 1.08–3.94, respectively). Free testosterone < 0.22 ng/ml decreased the risk of moderate to severe LUTS and obstructive and irritative symptoms by about 20–30%. An inadequate daily intake of vegetables, fruit and water significantly increased the risk of LUTS by 1.3–to 2.0 times. In conclusion, the prevalence of LUTS in Chinese men is high and increases with age. Dietary patterns may be critical for the development of LUTS. Thus, dietary modifications could be a useful strategy for preventing the development of LUTS.
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Affiliation(s)
- Meng Rao
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Zhengyan Zeng
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yi Zheng
- Department of Venereology, Wuhan Institute of Dermatology and Venereology, Wuhan, China
| | - Huiping Zhang
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Honggang Li
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Xia
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changhong Zhu
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengliang Xiong
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huangtao Guan
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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8
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Jiang YH, Kuo HC. Recent research on the role of urodynamic study in the diagnosis and treatment of male lower urinary tract symptoms and urinary incontinence. CI JI YI XUE ZA ZHI = TZU-CHI MEDICAL JOURNAL 2017; 29:72-78. [PMID: 28757770 PMCID: PMC5509199 DOI: 10.4103/tcmj.tcmj_19_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although evidence shows that urodynamic study may not improve outcomes, it can be used to evaluate men with lower urinary tract symptoms (LUTSs) which have not been adequately delineated and treated. In young men with LUTS not responding to treatment based on clinical examination, or elderly men with LUTS and incontinence, a complete urodynamic evaluation is mandatory to understand the pathophysiology underlying LUTS, such as bladder outlet obstruction (BOO), detrusor overactivity, and detrusor underactivity. Preoperative urodynamic study-proven BOO is a predictor of a successful surgical outcome. An urodynamic study should be performed when patients with LUTS are planning to undergo surgical treatment for benign prostatic obstruction.
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Affiliation(s)
- Yuan-Hong Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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9
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Yee CH, Wong JHM, Chiu PKF, Teoh JYC, Chan CK, Chan ESY, Hou SM, Ng CF. Secondary hemorrhage after bipolar transurethral resection and vaporization of prostate. Urol Ann 2016; 8:458-463. [PMID: 28057992 PMCID: PMC5100153 DOI: 10.4103/0974-7796.192110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: We evaluated the factors associated with secondary hemorrhage after bipolar transurethral resection of prostate (TURP) and vaporization of prostate. Materials and Methods: The perioperative data of patients undergoing endoscopic surgery for benign prostatic hyperplasia (BPH) were prospectively collected. Procedures involved included bipolar TURP, bipolar vaporization of prostate, and hybrid bipolar TURP/vaporization of prostate. Secondary hemorrhage was defined as bleeding between 48 h and 30 days postsurgery requiring hospital attendance with or without admission. Risk factors for secondary hemorrhage were analyzed. Results: From 2010 to 2013, 316 patients underwent bipolar surgery for BPH. Bipolar TURP accounted for 48.1% of the procedures, bipolar vaporization accounted for 20.3% of the procedures, and the rest were hybrid TURP/vaporization of prostate. Among this cohort of patients, fifty patients had secondary hemorrhage with hospital attendance. Consumption of platelet aggregation inhibitors (PAIs) was found to be associated with secondary hemorrhage (P < 0.0005). Age, prostate volume, operation type, the use of 5-alpha reductase inhibitors, and being with a urethral catheter before operation were not found to be statistically significant risk factors for secondary hemorrhage. Conclusions: Secondary hemorrhage after bipolar surgery for BPH is a common event. Consumption of PAI is a risk factor for such complication.
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Affiliation(s)
- Chi-Hang Yee
- SH Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Peter Ka-Fung Chiu
- SH Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jeremy Yuen-Chun Teoh
- SH Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi-Kwok Chan
- SH Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Eddie Shu-Yin Chan
- SH Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - See-Ming Hou
- SH Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi-Fai Ng
- SH Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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10
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Yee CH, Wong JHM, Chiu PKF, Chan CK, Lee WM, Tsu JHL, Teoh JYC, Ng CF. Short-stay transurethral prostate surgery: A randomized controlled trial comparing transurethral resection in saline bipolar transurethral vaporization of the prostate with monopolar transurethral resection. Asian J Endosc Surg 2015; 8:316-22. [PMID: 26042336 DOI: 10.1111/ases.12197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the present study was to establish the safety and efficacy profile of transurethral resection in saline (TURis) bipolar vaporization of the prostate relative to monopolar transurethral resection of prostate (TURP) and to test the hospital stay efficiency after TURis vaporization. MATERIALS AND METHODS in this multicenter, double-blinded, prospective, randomized controlled trial, men aged 50-75 years old were randomized into two arms: TURis bipolar vaporization and monopolar TURP. Intraoperative details, perioperative parameters, and postoperative functional outcomes were assessed after intervention. Follow-up with symptom score assessment, prostate volume measurement, and uroflowmetry were performed at 3 and 6 months. RESULTS Eighty-four patients (mean age, 65.0 ± 5.6 years) were randomized into each study arm. TURis bipolar vaporization had a longer operative time than monopolar TURP (51.6 ± 24.5 vs 38.5 ± 20.3 min, P < 0.001). Postoperatively, the TURis group had a shorter catheter time (33.6 ± 23.7 vs 40.8 ± 29.4 h, P = 0.013) and a shorter length of hospital stay (43.14 ± 18.79 vs 52.33 ± 30.58 h, P = 0.013). The postoperative dysuria score was higher in the TURis vaporization arm. There was no statistically significant difference between the two arms in terms of hemoglobin change and postoperative complication. No significant difference was observed in quality of life score at 3 and 6 months. CONCLUSIONS TURis bipolar vaporization of the prostate is a safe and comparable alternative to monopolar TURP. It leads to a reduction in both catheter time and length of hospital stay.
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Affiliation(s)
- Chi-hang Yee
- Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | | | - Peter Ka-fung Chiu
- Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Chi-kwok Chan
- Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Wai-man Lee
- Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - James Hok-leung Tsu
- Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Jeremy Yuen-chun Teoh
- Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Chi-fai Ng
- Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
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11
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Yee CH, So WY, Yip SKH, Wu E, Yau P, Ng CF. Effect of weight reduction on the severity of lower urinary tract symptoms in obese male patients with benign prostatic hyperplasia: a randomized controlled trial. Korean J Urol 2015; 56:240-6; discussion 246-7. [PMID: 25763129 PMCID: PMC4355436 DOI: 10.4111/kju.2015.56.3.240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 02/04/2015] [Indexed: 11/29/2022] Open
Abstract
Purpose We assessed whether weight reduction is an effective intervention for the management of lower urinary tract symptoms (LUTS) and investigated the relationship between obesity and LUTS. Materials and Methods This was a prospective randomized controlled trial that enrolled obese men older than 50 years with LUTS. The study period was 52 weeks. All patients received standardized alpha-adrenergic blocker therapy for the treatment of benign prostatic hyperplasia (BPH) during the run-in period. Patients were randomized to receive either a standardized prerecorded video program on the general principle of weight reduction or a comprehensive weight reduction program. Patients were assessed at different time points with symptom assessment, uroflowmetry, transrectal ultrasound, and metabolic assessment. Results Sixty-five patients were allocated to each study arm. After the study period, no significant difference in weight reduction was found between the two arms. When the pre- and postintervention parameters were compared, none were statistically different between the 2 arms, namely nocturia, International Prostate Symptom Score, quality of life assessment, and uroflowmetry parameters. When the whole study population was taken as a single cohort, these parameters were also not significantly different between the group with a body mass index of 25 to <30 kg/m2 and the group with a BMI of 30 to 35 kg/m2. Conclusions We found no association between obesity and LUTS. This could have been due to the less marked weight difference in our cohort. Whereas weight reduction may be an effective measure to improve LUTS, the implementation of a successful program remains a challenge.
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Affiliation(s)
- Chi-Hang Yee
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. ; Department of Surgery, Prince of Wales Hospital, Hong Kong, China
| | - Wing-Yee So
- Department of Surgery, Prince of Wales Hospital, Hong Kong, China
| | - Sidney K H Yip
- Department of Surgery, Prince of Wales Hospital, Hong Kong, China
| | - Edwin Wu
- Department of Surgery, Prince of Wales Hospital, Hong Kong, China
| | - Phyllis Yau
- Department of Surgery, Prince of Wales Hospital, Hong Kong, China
| | - Chi-Fai Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
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