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Sasaki K, Suzuki M, Nakamura M, Kume H, Nishino Y, Takahashi S. Trends in drug treatment of benign prostatic hyperplasia in Japan based on the National Database Open Data. Int J Urol 2024. [PMID: 39223065 DOI: 10.1111/iju.15570] [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: 05/28/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE This study examined prescription trends for benign prostatic hyperplasia (BPH) drug therapy in Japan over the past decade, focusing on drugs rated as grade A according to Japanese clinical guidelines. METHODS Using the National Database Open Data, this study analyzed prescription data from the fiscal years of 2014 to 2021, tracking α1-blockers, 5α-reductase inhibitors, and phosphodiesterase type 5 inhibitors. We adjusted for demographics and calculated medication costs to determine prescribing patterns and changes in drug utilization. RESULTS Prescriptions for α1-blockers increased from 9898 per 1000 males in 2014 to 12 613 in 2021. Prescriptions for 5α-reductase inhibitors rose from 1441 per 1000 males in 2014 to 2310 in 2021. Tadalafil prescriptions saw a significant increase, from 900 in 2015 to 2520 in 2021. Despite these increases, the overall market size for BPH drugs decreased from 664 million dollars in 2014 to 279 million dollars in 2021, indicating a shift toward generic medications driven by healthcare policies. CONCLUSIONS Although BPH medication prescriptions are increasing, driven by Japan's aging population and clinical guidelines, market dynamics are shifting owing to generic and government price adjustments. This analysis underscores the changing BPH treatment landscape in Japan, highlighting the importance of continuous evaluation of treatment efficacy and cost-effectiveness in evolving healthcare policies and demographics.
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Affiliation(s)
- Kenichi Sasaki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motofumi Suzuki
- Department of Urology, The Kikkoman General Hospital, Noda City, Chiba, Japan
| | - Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
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Iwai K, Azuma T, Yonenaga T, Sasai Y, Komatsu Y, Tabata K, Nomura T, Sugiura I, Inagawa Y, Matsumoto Y, Nakashima S, Abe Y, Tomofuji T. Predictive Factors Associated with Future Decline in Swallowing Function among Japanese Older People Aged ≥ 75 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:674. [PMID: 38928921 PMCID: PMC11203831 DOI: 10.3390/ijerph21060674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/18/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
Predictive factors associated with a decline in swallowing function after 2 years were examined in 3409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in April 2018 were followed for 2 years. Swallowing function was assessed using a repetitive saliva swallowing test. In our study, 429 participants (13%) who were swallowing less than three times in 30 s based on a repetitive saliva swallowing test after 2 years were diagnosed as those with decline in swallowing function. Multivariate logistic regression analyses showed the decline in swallowing function after 2 years was associated with the male gender (odds ratio [ORs]: 0.772; 95% confidence interval [CIs]: 0.615-0.969), age ≥ 81 years (presence; ORs: 1.523; 95% CIs: 1.224-1.895), support/care-need certification (presence; ORs: 1.815; 95% CIs: 1.361-2.394), periodontal pocket depth (PPD) ≥ 4 mm (presence; ORs: 1.469; 95% CIs: 1.163-1.856), difficulty in biting hard food (yes; ORs: 1.439; 95% CIs: 1.145-1.808), choking on tea and water (yes; ORs: 2.543; 95% CIs: 2.025-3.193), and dry mouth (yes; ORs: 1.316; 95% CIs: 1.052-1.646) at baseline. Therefore, the dental checkup items associated with a decline in swallowing function after 2 years were a PPD ≥ 4 mm, difficulty in biting hard food, choking on tea and water, and dry mouth. PPD status and confirming to the self-administered questionnaire about biting, choking, and dry mouth may be useful in predicting future decline in swallowing function.
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Affiliation(s)
- Komei Iwai
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
| | - Tetsuji Azuma
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
| | - Takatoshi Yonenaga
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
| | - Yasuyuki Sasai
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
| | - Yoshinari Komatsu
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
| | - Koichiro Tabata
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
| | - Taketsugu Nomura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
| | - Iwane Sugiura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
| | - Yujo Inagawa
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
| | - Yusuke Matsumoto
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
| | - Seiji Nakashima
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
| | - Yoshikazu Abe
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
| | - Takaaki Tomofuji
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
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Suto M, Iba A, Sugiyama T, Kodama T, Takegami M, Taguchi R, Niino M, Koizumi R, Kashiwagi K, Imai K, Ihana-Sugiyama N, Ichinose Y, Takehara K, Iso H. Literature Review of Studies Using the National Database of the Health Insurance Claims of Japan (NDB): Limitations and Strategies in Using the NDB for Research. JMA J 2024; 7:10-20. [PMID: 38314426 PMCID: PMC10834238 DOI: 10.31662/jmaj.2023-0078] [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] [Received: 05/18/2023] [Accepted: 10/20/2023] [Indexed: 02/06/2024] Open
Abstract
The use of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) for research has increased over time. Researchers need to understand the characteristics of the data to generate quality-assured evidence from the NDB. In this review, we mapped and characterized the limitations and related strategies using the NDB for research based on the descriptions of published NDB studies. To find studies that used Japanese healthcare claims data, we searched MEDLINE, EMBASE, and Ichushi-Web up to June 2023. Additionally, we hand-searched the NDB data publication list from the Ministry of Health, Labour and Welfare (2017-2023). We abstracted data based on the NDB data type, research themes, age of the study sample or population, targeted disease, and the limitations and strategies in the NDB studies. Ultimately, 267 studies were included. Overall, the most common research theme was describing and estimating the prescriptions and treatment patterns (125 studies, 46.8%). There was a variation in the frequency of themes according to the type of NDB data. We identified the following categories of limitations: (1) lack of information on confounders/covariates, outcomes, and other clinical content, (2) limitations regarding patients not included in the NDB, (3) misclassification of data, (4) lack of unique identifiers and register of beneficiaries, and (5) others. Although the included studies noted several limitations of using the NDB for research, they also provided some strategies to address them. Organizing the limitations of NDB in research and the related strategies across research fields can help support high-quality NDB studies.
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Affiliation(s)
- Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Arisa Iba
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takehiro Sugiyama
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Kodama
- Department of Public Health Policy, National Institute of Public Health, Saitama, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Public Health and Health Policy, School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Reina Taguchi
- Institute for Health Economics and Policy, Tokyo, Japan
| | - Mariko Niino
- Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Ryuji Koizumi
- AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Kenjiro Imai
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Ihana-Sugiyama
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuichi Ichinose
- Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Shin D, Yoon BI, Kim S, Piao J, Jeon KH, Kwon Y, Park SH, Koo YT, Kim JS, Lee DS, Ha US, Kim SW, Jang H, Bae WJ. Cervi Parvum Cornu complex for men with lower urinary tract symptoms: a multicenter, randomized, double-blind, placebo-controlled trial. Prostate Int 2023; 11:222-227. [PMID: 38196553 PMCID: PMC10772165 DOI: 10.1016/j.prnil.2023.09.002] [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: 07/03/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 01/11/2024] Open
Abstract
Background To evaluate the efficacy and safety of Cervi Parvum Cornu, Angelicae Gigantis Radix and Glycyrrhizae Radix complex (CAG) in men with moderate lower urinary tract symptoms (LUTS). Materials and methods From November 2020 to January 2022, participants with International Prostate Symptom Score (IPSS) of 12-19 in two centers were recruited and randomize into three groups: a CAG 500 mg/day group (CAG 500), a CAG 1000 mg/day group (CAG 1000), and a placebo group (PG). They were treated for 12 weeks. The primary endpoint was change of IPSS at the end of study from baseline. Secondary end points included change of prostate specific antigen (PSA), testosterone, dihydrotestosterone (DHT), maximum urinary flow rate (Q max), post-void residual volume (PVR), International Index of Erectile Function (IIEF), and drug safety. Results A total of 103 patients were able to finish the study according to the study protocol. Total IPSS and sub-scores (residual urine sensation, frequency, weak stream, hesistancy, nocturia, and quality of life) in CAG 500 and CAG 1000 were significantly improved at the 12th week compared to those of the PG. Changes of serum PSA, DHT, and testosterone levels at the 12th week from baseline did not show significant differences among the three groups. Q max and PVR changes did not show significant differences among the three groups either. Total IIEF and sub-scores (erectile function, orgasmic function, sexual desire, intercourse satisfaction) in CAG 1000 were significantly improved at 12th week compared to those in PG. No significant adverse events were found. Conclusions CAG is well tolerated in patients with moderate LUTS. Treatment with CAG for 12 weeks has a therapeutic effect on moderate LUTS.
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Affiliation(s)
- Dongho Shin
- Department of Urology, College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Byung Il Yoon
- Department of Urology, College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Soomin Kim
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - JunJie Piao
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Kyung-Hwa Jeon
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Youngjoo Kwon
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Sang-Hyuck Park
- Institute of Cannabis Research, Colorado State University Pueblo, Pueblo, CO, USA
| | | | - Jin-Soo Kim
- Kwang Dong Pharmaceutical Co, Ltd., Seoul, Korea
| | - Dong Sup Lee
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - U-Syn Ha
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sae Woong Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
- Green Medicine Co., Ltd, Pusan, Korea
| | - Hoon Jang
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woong Jin Bae
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Korea
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Nagakura Y, Hayashi M, Kajioka S. Analysis of Japanese nationwide health datasets: association between lifestyle habits and prevalence of neuropathic pain and fibromyalgia with reference to dementia-related diseases and Parkinson's disease. Scand J Pain 2023; 23:662-669. [PMID: 37439280 DOI: 10.1515/sjpain-2023-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES Chronic pain is defined as pain that persists or recurs for more than 3 months. This study focuses on neuropathic pain (NP) and fibromyalgia (FM) which are chronic pain states, and aims to identify lifestyle habits associated with their prevalence. Other neurological disorders are also analyzed as references. METHODS Association between the variable referring to disease prevalence (number of claims for reimbursement of marker drugs) and the variable for lifestyle habits/health examination results (collected from insured individuals aged 40-74 years) was determined by analyzing Japanese nationwide datasets, which were collected in 2018 and aggregated by prefecture. Pregabalin, donepezil, and levodopa were used as marker drugs for the chronic pain states, dementia-related diseases (Alzheimer's disease and Lewy body dementia) and Parkinson's disease (PD), respectively. Pearson's correlation analysis and multiple linear regression analysis were conducted. RESULTS Variables showing correlation coefficient (|r|)>0.5 were put into the multiple linear regression. Exercise habits (ꞵ=-0.3182), smoking habits (0.3218), daily drinking (0.2683), and alanine aminotransferase>51 U/L (0.2309) were finally incorporated in the equation for pregabalin (R 2=0.7268). Walking speed (-0.4543) and daily drinking (0.5077) were incorporated in the equation for donepezil (R 2=0.5718). CONCLUSIONS The prevalence of chronic pain states is associated with lifestyle habits, just like the dementia-related diseases. Exercise in daily life is negatively associated with the prevalence of the chronic pain states, although excessive alcohol drinking, smoking, and high serum ALT are positively associated with it. The prevalence of PD seems less associated with lifestyle habits.
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Affiliation(s)
- Yukinori Nagakura
- School of Pharmacy at Fukuoka, International University of Health and Welfare, Okawa-City, Fukuoka, Japan
| | - Maya Hayashi
- The Ministry of Justice in Japan, Correction Bureau, Tokyo, Japan
| | - Shunichi Kajioka
- School of Pharmacy at Fukuoka, International University of Health and Welfare, Okawa-City, Fukuoka, Japan
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Song Y, Gu Y, Guo H, Yang H, Wang X, Wu H, Wang A, Wang H, Zhang Q, Zhang Q, Liu L, Meng G, Liu B, Niu K. Association Between Neutrophil-to-Lymphocyte Ratio and Benign Prostatic Hyperplasia: Results from the TCLSIH Cohort Study. J Inflamm Res 2023; 16:4857-4866. [PMID: 37904787 PMCID: PMC10613407 DOI: 10.2147/jir.s431049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/18/2023] [Indexed: 11/01/2023] Open
Abstract
Purpose The prevalence of benign prostatic hyperplasia (BPH) in the general Chinese adult male population has risen sharply over the past few decades. Increasing evidence suggests that inflammation plays an important role in the pathogenesis of BPH. To better understand the role of inflammation in the pathogenesis of BPH, we can use the neutrophil-to-lymphocyte ratio (NLR) because it is a simple and effective marker of inflammation and immunity. This study aims to prospectively investigate the association between NLR levels and the prevalence of BPH in a general Chinese adult male population. Patients and Methods This study included a total of 15,783 male participants free from BPH at baseline. NLR was measured according to the complete blood count. BPH was defined as total prostate volume (TPV) ≥30 mL, and TPV was determined by transabdominal ultrasonography. Multivariable Cox proportional hazards models were fitted to calculate hazards ratios (HRs) and corresponding 95% confidence intervals (CIs) for BPH risk with NLR levels. Results During a median follow-up of 2.7 years, 5078 BPH cases were documented. After adjusting for age, body mass index, smoking, alcohol, education, occupation, income, physical activity, total energy intake, personal and family history of disease, and inflammation markers, the multivariable-adjusted HRs of BPH were 1.00 (reference), 1.08 (95% CIs 0.99, 1.17), 1.10 (95% CIs1.02, 1.19), and 1.12 (95% CIs1.03, 1.21), respectively, for participants with NLR in the first, second, third, and fourth quartiles (P for trend <0.01). Conclusion Higher NLR levels were associated with a higher risk of BPH in Chinese adult male population. Our findings support the notion that NLR levels may be an important target for BPH prevention and intervention.
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Affiliation(s)
- Yanqi Song
- Department of Traditional Chinese Medicine, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
| | - Honglei Guo
- School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Honghao Yang
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- Nutritional Epidemiology Institute, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Xuena Wang
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- Nutritional Epidemiology Institute, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Hongmei Wu
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- Nutritional Epidemiology Institute, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Aidi Wang
- Department of Traditional Chinese Medicine, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Haijin Wang
- Department of Traditional Chinese Medicine, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Quan Zhang
- Department of Traditional Chinese Medicine, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Ge Meng
- Nutritional Epidemiology Institute, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Baoshan Liu
- Department of Traditional Chinese Medicine, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Kaijun Niu
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
- Nutritional Epidemiology Institute, Tianjin Medical University, Tianjin, People’s Republic of China
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Park DJ, Kwon SY, Seo YJ, Byun HJ, Lee KS. Changes of resistance indices after medication in benign prostatic hyperplasia: a prospective study. Prostate Int 2023; 11:139-144. [PMID: 37745908 PMCID: PMC10513904 DOI: 10.1016/j.prnil.2023.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 03/03/2023] Open
Abstract
Background This study aimed to determine the relationship between resistive indices (RIs) and changes in prostate size after medical treatment in patients with benign prostatic hyperplasia (BPH). Methods A total of 86 patients with BPH were included in the study, excluding 42 patients with a total prostate volume (TPV) of <30 cc or taking α1-adrenergic blockers and 5α-reductase inhibitors (5ARI) before study participation. Therefore, the data for 44 patients were analyzed. All patients were treated with α1-adrenergic blockers and 5ARIs. The variables examined were prostate-specific antigen, International Prostate Symptom Score, quality of life score, maximal urinary flow rate, residual urine volume, TPV, transition zone volume, and RIs of the urethral artery and left and right capsular arteries. These variables were assessed at baseline and after 3 and 6 months of treatment. Results The mean TPV was 43.5 ± 10.9 and decreased to 35.2 ± 11.5 and 33.9 ± 9.8 after 3 and 6 months of treatment, respectively (p < 0.001). The mean RI of the urethral artery, right capsular artery, and left capsular artery at pretreatment did not decrease significantly. However, comparing the baseline with 3-month data, TPV at 3 months/TPV at baseline was significantly correlated with RI changes in the left capsular artery (r = 758; P < 0.001). Conclusion In patients with BPH, α1-adrenergic blocker and 5ARI medications for 3 and 6 months did not result in a significant reduction in the RI of the urethral artery and both capsular arteries. Larger scale, prospective studies are needed to evaluate the relationship between TPV and RI reductions.
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Affiliation(s)
- Dong Jin Park
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Se Yun Kwon
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Young Jin Seo
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Hye Jin Byun
- Department of Urology, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung Seop Lee
- Department of Urology, Keimyung University School of Medicine, Daegu, Korea
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