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Sheng C, Qiu M, Zhang T, Zhang J, Gao H. Association between the American Heart Association's new "Life Essentials 8" metrics and urgency urinary incontinence and nocturia. Int Urol Nephrol 2024:10.1007/s11255-024-04133-2. [PMID: 38907864 DOI: 10.1007/s11255-024-04133-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Despite its widespread adoption in cardiovascular research, the application of LE8 in other health conditions, particularly urgency urinary incontinence (UUI) and nocturia, has not been thoroughly investigated. Our study used the Life's Essential 8 (LE8) score to evaluate the relationship between cardiovascular health (CVH) and urge urinary incontinence and nocturia in adults. METHODS This analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011-2018. We used the LE8 score as the independent variable, and UUI and nocturia as the dependent variables. Multivariable logistic regression was conducted to explore the association between the LE8 score and the occurrence of UUI and nocturia. RESULTS The study included 12,566 adults aged 20 and older. After adjusting for potential confounders, a higher LE8 score was inversely associated with the risk of UUI (OR = 0.38; 95% CI: 0.27-0.52, p < 0.0001) and nocturia (OR = 0.53; 95% CI: 0.44-0.65, p < 0.0001). CONCLUSION This cross-sectional study revealed an inverse relationship between the LE8 score and the likelihood of both UUI and nocturia.
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Affiliation(s)
- Chen Sheng
- Graduate School, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Minhua Qiu
- Graduate School, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Ting Zhang
- Ruikang Hospital, Guangxi University of Chinese Medicine, No.10 of Huadong Rd., Xingning District, Nanning, 530011, Guangxi, China.
| | - Jianqiang Zhang
- Ruikang Hospital, Guangxi University of Chinese Medicine, No.10 of Huadong Rd., Xingning District, Nanning, 530011, Guangxi, China.
| | - Hongjun Gao
- Ruikang Hospital, Guangxi University of Chinese Medicine, No.10 of Huadong Rd., Xingning District, Nanning, 530011, Guangxi, China.
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2
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Markland AD, Hellemann G, Shan L, Brady SS, Huling JD, Schreiner PJ, Sidney S, Van Den Eeden SK, Lewis CE. Characterizing the spectrum of bladder health and lower urinary tract symptoms among men: Results from the CARDIA study. Neurourol Urodyn 2024; 43:840-848. [PMID: 38407331 PMCID: PMC11031325 DOI: 10.1002/nau.25430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES To operationalize a new definition for bladder health, we examined the distribution and impact of lower urinary tract symptoms (LUTS), along with risk factors, among men in the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS LUTS were defined by American Urologic Association Symptom Index (AUASI) scores and impact on quality of life (QoL). Separate questions assessed urinary incontinence (UI) and postvoid dribbling. We performed cluster analyses using AUASI scores, with and without urine incontinence and postvoid dribbling, and impact collected in 2010-11. We performed analyses to evaluate sociodemographic and cardiovascular risk factors between clusters. RESULTS Among CARDIA men (mean age: 50.0, SD = 3.6; range: 42-56 years) with complete LUTS data (n = 929), we identified and compared four clusters: men who reported no or very mild symptoms and no impact on well-being (bladder health, n = 696, 75%), men with moderate symptoms and moderate impact on well-being (moderate symptoms/impact, n = 84, 9%), men with high symptoms and high impact on well-being (severe symptoms/impact, n = 117, 13%), and a separate group that reported moderate symptoms and UI with a high impact on well-being (UI + moderate symptoms/severe impact, n = 32, 3%). Exploration of the groupings showed a large percentage of postvoid dribbling across groups (overall 69%). Sociodemographic and cardiovascular risk factors were not associated with symptom/impact groups. CONCLUSIONS Bladder health clustered into four categories. A majority of middle-aged men in the community showed no or mild bladder symptoms without impact on QoL. Postvoid dribbling is pervasive but did not cluster with a specific LUTS or impact category.
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Affiliation(s)
- Alayne D Markland
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, Alabama, USA
- Heersink School of Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gerhard Hellemann
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Liang Shan
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sonya S Brady
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jared D Huling
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Pamela J Schreiner
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | | | - Cora E Lewis
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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3
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Suzuki Y, Kaneko H, Okada A, Fujiu K, Jo T, Takeda N, Tanaka A, Node K, Morita H, Yasunaga H, Komuro I. Benign Prostatic Hyperplasia and Incident Cardiovascular Disease. Circ J 2024; 88:408-416. [PMID: 38246651 DOI: 10.1253/circj.cj-23-0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Data regarding the relationship between benign prostatic hyperplasia (BPH) and incident cardiovascular disease (CVD) are scarce. We aimed to clarify the association of BPH with the risk of developing CVD using a nationwide epidemiological database.Methods and Results: This retrospective observational cohort study analyzed data from the JMDC Claims Database between 2005 and 2022, including 2,370,986 men (median age 44 years). The primary endpoints were myocardial infarction (MI), angina pectoris (AP), stroke, heart failure (HF), and atrial fibrillation (AF), which were assessed separately. BPH was observed in 48,651 (2.1%) men. During a mean (±SD) follow-up of 1,359±1,020 days, 7,638 MI, 52,167 AP, 25,355 stroke, 58,183 HF, and 16,693 AF events were detected. Hazard ratios of BPH for MI, AP, stroke, HF, and AF were 1.04 (95% confidence interval [CI] 0.92-1.18), 1.31 (95% CI 1.25-1.37), 1.26 (95% CI 1.18-1.33), 1.21 (95% CI 1.16-1.27), and 1.15 (95% CI 1.07-1.24), respectively. We confirmed the robustness of our primary findings through a multitude of sensitivity analyses. In particular, a history of BPH was associated with a higher risk of developing CVD, even in participants without obesity, hypertension, diabetes, or dyslipidemia. CONCLUSIONS Our analysis of a nationwide epidemiological dataset demonstrated that BPH was associated with a greater risk of developing CVD in middle-aged men.
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Affiliation(s)
- Yuta Suzuki
- Department of Cardiovascular Medicine, The University of Tokyo
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Taisuke Jo
- Department of Health Services Research, The University of Tokyo
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo
- International University of Health and Welfare
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4
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Yin F, He QD, Chen J, Gui TJ, Cai RJ, Wang Y, Xue QX, Li LY, Tian XK, Wang T, Zhe XW. Benign prostatic hyperplasia associated with white matter hyperintensities in men. Clin Neurol Neurosurg 2023; 229:107738. [PMID: 37116223 DOI: 10.1016/j.clineuro.2023.107738] [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: 03/06/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 04/30/2023]
Abstract
PURPOSE Benign prostatic hyperplasia (BPH) describes common noncancerous prostate enlargement. BPH is usually associated with lower urinary tract symptoms and an increased risk of cerebrovascular diseases, such as stroke and its recurrence. White matter hyperintensities (WMHs), markers of cerebral injury, increase the risk of stroke, cognitive impairment, dementia, and death. The relationship between BPH and WMHs remains unclear. This study aimed to determine the association between BPH and WMHs. METHODS A total of 788 male patients from the First Affiliated Hospital of Kunming Medical University from July 2019 to September 2021 were enrolled in this cross-sectional study. BPH was assessed by abdominal ultrasound, and three independent neuroradiologists rated the presence or absence of WMHs. Multiple imputations of chained equations were used to handle missing data. Logistic regression was used to assess the relationship between BPH and WMHs. RESULTS Patients with BPH presented an increased risk of WMHs with a crude odds ratio (OR) of 2.76 (95% CI, 2.02-3.79) and an adjusted OR of 1.75 (95% CI, 1.24-2.48) after controlling for potential confounding factors in the multivariate logistic regression. CONCLUSION We found that BPH was closely associated with WMHs in male Chinese individuals.
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Affiliation(s)
- Fang Yin
- Division of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China
| | - Qi-Da He
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu Province, PR China
| | - Jing Chen
- Department of Pathophysiology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan Province, PR China
| | - Teng-Juan Gui
- Division of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China
| | - Ren-Jiao Cai
- Division of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China
| | - Yue Wang
- Division of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China
| | - Qiu-Xia Xue
- Division of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China
| | - Li-Yun Li
- Information Centre, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China
| | - Xin-Kui Tian
- Division of Nephrology, Peking University Third Hospital, Beijing, PR China
| | - Tao Wang
- Division of Nephrology, Peking University Third Hospital, Beijing, PR China
| | - Xing-Wei Zhe
- Division of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China.
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5
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Xu Z, Elrashidy RA, Li B, Liu G. Oxidative Stress: A Putative Link Between Lower Urinary Tract Symptoms and Aging and Major Chronic Diseases. Front Med (Lausanne) 2022; 9:812967. [PMID: 35360727 PMCID: PMC8960172 DOI: 10.3389/fmed.2022.812967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Aging and major chronic diseases are risk factors for lower urinary tract symptoms (LUTS). On the other hand, oxidative stress (OS) is one of the fundamental mechanisms of aging and the development of chronic diseases. Therefore, OS might be a candidate mechanism linking these two clinical entities. This article aims to summarize the studies on the prevalence of LUTS, the role of OS in aging and chronic diseases, and the potential mechanisms supporting the putative link. A comprehensive literature search was performed to identify recent reports investigating LUTS and OS in major chronic diseases. In addition, studies on the impact of OS on the lower urinary tract, including bladder, urethra, and prostate, were collected and summarized. Many studies showed LUTS are prevalent in aging and major chronic diseases, including obesity, metabolic syndrome, diabetes, cardiovascular disease, hypertension, obstructive sleep apnea, autoimmune diseases, Alzheimer’s disease, and Parkinson’s disease. At the same time, OS is a key component in the pathogenesis of those chronic diseases and conditions. Recent studies also provided evidence that exacerbated OS can cause functional and/or structural changes in the bladder, urethra, and prostate, leading to LUTS. The reviewed data support the concept that OS is involved in multiple risk factors-associated LUTS, although further studies are needed to confirm the causative relationship. The specific ROS/RNS and corresponding reactions/pathways involved in chronic diseases and associated LUTS should be identified in the future and could serve as therapeutic targets.
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Affiliation(s)
- Zhenqun Xu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Rania A. Elrashidy
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Bo Li
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- *Correspondence: Guiming Liu,
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Markland AD, Shan L, Brady SS, Schreiner PJ, Sidney S, Van Den Eeden SK, Lewis CE. Characterizing the Spectrum of Bladder Health and Lower Urinary Tract Symptoms (LUTS) Among Women: Results From the CARDIA Study. Urology 2021; 158:88-94. [PMID: 34087312 PMCID: PMC9060156 DOI: 10.1016/j.urology.2021.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To operationalize a new definition for bladder health, we examined the distribution of lower urinary tract symptoms (LUTS) and impact, along with associated factors, among women in the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS We performed cluster analyses using validated LUTS symptom burden and impact scales collected between 2005-2006 and 2010-2011. We performed multinomial logistic regression analyses to evaluate cardiovascular factors (metabolic syndrome, cardiovascular health behaviors, and inflammation) between clusters after adjusting for covariates (demographic, obstetric/gynecologic, co-morbidities). RESULTS Among CARDIA women (median age 51, range 42-59) with complete LUTS data (n = 1302), we identified and compared 4 cluster groups: women who reported no or very mild symptoms and no impact on well-being (bladder health, 44%, n = 569), versus women with LUTS and negative impact on well-being ranging from mild (31%, n = 407), moderate (20%, n = 259), to severe (5%, n = 67). With each 1-point lower BMI (kg/m2), odds of membership in mild (OR 0.97, CI 0.95-0.99), moderate (OR 0.95, CI 0.93-0.98), and severe (OR 0.90, CI 0.88-0.94) LUTS cluster groups versus the bladder health group were lower. Compared to women with metabolic syndrome, women without metabolic syndrome had lower odds of membership in mild (OR 0.67, CI 0.45-0.99), moderate (OR 0.51, CI 0.33-0.79), and severe (OR 0.48, CI 0.24-0.94) LUTS cluster groups versus the bladder health group. CONCLUSION Two out of 5 midlife women met our definition of bladder health. Bladder health and cardiovascular health among women may share common factors, including lower BMI and the absence of metabolic syndrome.
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Affiliation(s)
- Alayne D Markland
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL; University of Alabama at Birmingham, School of Medicine, Department of Medicine.
| | - Liang Shan
- University of Alabama at Birmingham, School of Medicine, Department of Medicine
| | - Sonya S Brady
- University of Minnesota, School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN
| | - Pamela J Schreiner
- University of Minnesota, School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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7
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Wang X, Su Y, Yang C, Hu Y, Dong JY. Benign prostatic hyperplasia and cardiovascular risk: a prospective study among Chinese men. World J Urol 2021; 40:177-183. [PMID: 34426873 DOI: 10.1007/s00345-021-03817-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/17/2021] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To examine the prospective association of BPH with subsequent risk of CVD, including heart disease and stroke. METHODS We used data from China Health and Retirement Longitudinal Study of 5242 Chinese men aged 45 years or older. During a follow-up of 7 years, we identified 613 cases of non-fatal CVD, including 417 heart diseases and 254 strokes. Cox proportional hazards models yielded hazard ratios (HRs) relating BPH to CVD, heart disease, and stroke incidence. RESULTS Overall, 8.1% of men reported a history of BPH diagnosed by physicians at baseline. As compared with men without a history of BPH, those reporting a history of BPH had an increased risk of developing CVD (multivariable-adjusted HR = 1.43 [1.12, 1.83], heart disease (1.35 [1.00, 1.83]), and stroke (1.50 [1.03, 2.19]). The subgroup analysis by age at baseline (< 60 vs. ≥ 60 years) showed that the associations appeared to be evident among men < 60 years, particularly for CVD (1.82 [1.24, 2.69]) and heart disease (1.72 [1.06, 2.79]). However, interaction tests suggested the associations were not significantly modified by age (P for interaction > 0.10 for all outcomes). CONCLUSION In Chinese men, BPH was associated with higher risks of CVD, heart disease and stroke, particularly among men aged < 60 years.
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Affiliation(s)
- Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan
| | - Yang Su
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450002, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan.
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Tanaka Y, Matsuyama S, Tada H, Hayashi K, Takamura M, Kawashiri MA, Passman R, Greenland P. Association of Lower Urinary Tract Symptoms Based on the International Prostate Symptom Score and Cardiovascular Disease. Circ J 2021; 85:2092-2099. [PMID: 34219077 DOI: 10.1253/circj.cj-21-0278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Because it is unclear whether lower urinary tract symptoms (LUTS) are associated with cardiovascular disease (CVD) in the Japanese population, we explored the association in general Japanese men aged 55-75 years.Methods and Results:The cross-sectional study included male participants who had both national health checkup data and the International Prostate Symptom Score (IPSS) in the same calendar year between 2009 and 2017. LUTS severity was evaluated by IPSS. A robust Poisson regression model was used to assess the association between LUTS severity and the composite CVD outcome [coronary artery disease (CAD), stroke, or atrial fibrillation (AF)] and each component of the composite outcome. Prevalence ratio (PR) was adjusted for conventional cardiovascular risk factors. Of 16,781 male participants (mean age, 67±5 years), mild LUTS were observed in 9,243 (55.1%); moderate, 6,445 (38.4%); and severe, 1,093 (6.5%). Compared with the mild LUTS group, moderate LUTS [PR 1.18, 95% confidence interval (CI) 1.10-1.25, P<0.001] and severe LUTS (PR 1.38, 95% CI 1.24-1.53, P<0.001) were significantly associated with a higher prevalence of CVD. LUTS severity was associated with higher prevalence of CAD and stroke, but not AF. CONCLUSIONS The severity of LUTS was associated with a higher prevalence of CVD, especially CAD and stroke, independent of conventional CVD risk factors.
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Affiliation(s)
- Yoshihiro Tanaka
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine.,Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine.,Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | | | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Rod Passman
- Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine.,Division of Cardiology, Northwestern University Feinberg School of Medicine
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
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Okamoto T, Hatakeyama S, Ando M, Songee J, Imai A, Hamano I, Fujita N, Okamoto A, Yamamoto H, Yoneyama T, Yoneyama T, Hashimoto Y, Ohyama C. The impact of microalbuminuria on overactive bladders: Results from a community-based four-year longitudinal study in Japan. Neurourol Urodyn 2020; 39:1567-1575. [PMID: 32460389 DOI: 10.1002/nau.24405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/14/2020] [Indexed: 11/05/2022]
Abstract
AIMS To investigate the longitudinal association of microalbuminuria with overactive bladder (OAB). METHODS This longitudinal study investigated 561 participants of the Iwaki Health Promotion Project in both 2015 and 2019 in Japan. Microalbuminuria and OAB symptoms were assessed using the urine albuminuria creatinine ratio (ACR) and the overactive bladder symptom score (OABSS), respectively. Urine ACR was defined as high if ≥9.3 mg/gCr. Differences in OABSS between 2015 and 2019 were evaluated as ∆OABSS. Participants were divided into two groups according to ΔOABSS: high (ΔOABSS > 1) and control (≤1). We used baseline data acquired in 2015, such as urine ACR, the Pittsburgh Sleep Quality Index (PSQI), and arterial stiffness expressed by brachial-ankle pulse wave velocity (baPWV). Predictive factors of a ΔOABSS > 1 were assessed by multivariable logistic regression analysis. RESULTS This study included 332 women and 229 men. Of those, 86 (34 males and 52 females) were classified into the ΔOABSS > 1 group. There were significant group differences in age, renal function, and hemoglobin A1c. Participants in the ΔOABSS > 1 had a higher prevalence of PSQI > 5, baPWV ≥ 1400 seconds/cm, and urine ACR ≥ 9.3 mg/gCr (49% vs 20%, P = .001) than those in the control group. Multivariable analysis revealed that PSQI > 5 (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.15-4.60; P = .002) and urine ACR ≥ 9.3 mg/gCr (OR, 1.93; 95% CI, 1.15-3.23; P = .013) were independent risk factors for ΔOABSS > 1. CONCLUSIONS Microalbuminuria may be an independent risk indicator for OAB symptom exacerbation.
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Affiliation(s)
- Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masataka Ando
- Department of Diet and Health Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Jung Songee
- Department of Health and Beauty Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Atsushi Imai
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Akiko Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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10
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Fiev DN, Vinarov AZ, Tsarichenko DG, Kopylov PY, Demidko YL, Syrkin AL, Rapoport LM, Alyaev YG, Glybochko PV. Holter Monitoring (24-Hour ECG) Parameter Dynamics in Patients with Ischemic Heart Disease and Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. Adv Ther 2019; 36:2072-2085. [PMID: 31148056 PMCID: PMC6822867 DOI: 10.1007/s12325-019-00977-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study examined the dynamics of 24-h electrocardiogram (ECG) monitoring parameters (Holter monitoring) in patients with ischemic heart disease (IHD) before and after conservative or surgical treatment of patients with voiding and storage lower urinary tract symptoms (LTS) due to benign prostatic hyperplasia (BPH). METHODS A total of eighty-three 57 to 81-year-old (mean age 70.4 ± 5.75 years) patients with LUTS/BPH and accompanying IHD were examined and treated at the Institute of Urology and Human Reproductive Health and Clinic of Cardiology of Sechenov University. All patients received recommended cardiac therapy at least 6 months before inclusion in the study. RESULTS Our study demonstrated that there is correlation between voiding and storage LUTS/BPH and Holter-detected cardiac impairments in patients with IHD/BPH. These data make it possible to consider LUTS/BPH (voiding and storage) as a factor in the additional functional and psychological load on the activity of patients with ischemic heart disease. Improvement of voiding and storage LUTS due to BPH and objective parameters of urination (Qmax) in patients treated with alpha-1 adrenoceptor blocker tamsulosin correlated with improvement of 24-h ECG monitoring parameters (Holter monitoring) in 72% of patients. Improvement of 24-h ECG monitoring parameters (Holter monitoring) 1 month after transurethral resection of the prostate (TURP) in IHD/BPH patients and indications for surgical treatment was observed in 65.7%. Negative dynamics of the Holter-based ECG was not registered in patients who were operated on. CONCLUSION Holter monitoring helps to identify groups of patients in whom urinary impairments caused by prostatic hyperplasia negatively affect the course of IHD. Restored urination (either conservatively or operatively) in patients with BPH in 72% of cases decreased the number of fits of angina, thus influencing favourably the course of IHD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03856242.
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Affiliation(s)
- Dmitrii N Fiev
- Institute for Urology and Human Reproductive Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrey Z Vinarov
- Institute for Urology and Human Reproductive Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Dmitrii G Tsarichenko
- Institute for Urology and Human Reproductive Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - Yuri L Demidko
- Institute for Urology and Human Reproductive Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Abram L Syrkin
- Department of Preventive and Emergency Cardiology, Sechenov University, Moscow, Russia
| | - Leonid M Rapoport
- Institute for Urology and Human Reproductive Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yuri G Alyaev
- Institute for Urology and Human Reproductive Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Pyotr V Glybochko
- Institute for Urology and Human Reproductive Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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11
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Matsui S, Kajikawa M, Maruhashi T, Iwamoto Y, Oda N, Kishimoto S, Hashimoto H, Hidaka T, Kihara Y, Chayama K, Hida E, Goto C, Aibara Y, Nakashima A, Yusoff FM, Noma K, Kuwahara Y, Matsubara A, Higashi Y. Endothelial dysfunction, abnormal vascular structure and lower urinary tract symptoms in men and women. Int J Cardiol 2018; 261:196-203. [PMID: 29657043 DOI: 10.1016/j.ijcard.2018.02.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/30/2018] [Accepted: 02/09/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) is not only common symptoms in elderly men and women but also risk of future cardiovascular events. The purpose of this study was to evaluate the relationships of vascular function and structure with LUTS in men and women. METHODS We investigated flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) as vascular function, brachial-ankle pulse wave velocity (baPWV) as vascular structure, and LUTS assessed by International Prostate Symptom Score (IPSS) in 287 men and 147 women. RESULTS IPSS was significantly correlated with traditional cardiovascular risk factors, Framingham risk score, FMD, NID and baPWV. Moderate to severe LUTS was associated with the prevalence of coronary heart disease in men but not in women. In men, FMD and NID were significantly lower in the moderate to severe LUTS group than in the none to mild LUTS group (2.1 ± 2.0% vs. 4.0 ± 3.0% and 9.3 ± 6.1% vs. 12.8 ± 6.6%, P < 0.001, respectively). baPWV was significantly higher in the moderate to severe LUTS group than in the none to mild LUTS group (1722 ± 386 cm/s vs. 1509 ± 309 cm/s, P < 0.001). In multivariate analysis, FMD was independently associated with a decrease in the odds ratio of moderate to severe LUTS in men (OR: 0.83, 95% CI, 0.72-0.95; P = 0.008) but not in women. NID and baPWV were not independently associated with moderate to severe LUTS either in men or women. CONCLUSIONS These findings suggest that endothelial dysfunction is associated with LUTS in men. LUTS in men may be useful for a predictor of cardiovascular events. CLINICAL TRIAL REGISTRATION INFORMATION URL for Clinical Trial: http://UMIN; Registration Number for Clinical Trial: UMIN000003409.
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Affiliation(s)
- Shogo Matsui
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yumiko Iwamoto
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nozomu Oda
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruki Hashimoto
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Chikara Goto
- Hiroshima International University, Hiroshima, Japan
| | - Yoshiki Aibara
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ayumu Nakashima
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Farina Mohamad Yusoff
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Kensuke Noma
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan; Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | | | - Akio Matsubara
- Department of Urology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukihito Higashi
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan; Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
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12
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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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13
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Endothelial dysfunction as a common soil of lower urinary tract symptoms and cardiovascular disease. Int J Cardiol 2018; 261:209-210. [PMID: 29657044 DOI: 10.1016/j.ijcard.2018.03.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 11/20/2022]
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14
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Lin WY, Huang KT, Lin CL, Kao CH. The risk of venous thromboembolism in patients with lower urinary tract symptoms. UROLOGICAL SCIENCE 2018. [DOI: 10.4103/uros.uros_33_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Lee B, Lee SW, Kang HR, Kim DI, Sun HY, Kim JH. Relationship between lower urinary tract symptoms and cardiovascular risk scores including Framingham risk score and ACC/AHA risk score. Neurourol Urodyn 2017; 37:426-433. [PMID: 28608963 DOI: 10.1002/nau.23320] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/08/2017] [Indexed: 11/10/2022]
Abstract
AIMS This study attempted to investigate the association between lower urinary tract symptoms (LUTS) and cardiovascular disease (CVD) risk using International Prostate Symptom Score (IPSS) and CVD risk scores and to overcome the limitations of previous relevant studies. METHODS A total of 2994 ostensibly healthy males, who participated in a voluntary health check in a health promotion center from January 2010 to December 2014, were reviewed. CVD risk scores were calculated using Framingham risk score and American College of Cardiology (ACC)/American Heart Association (AHA) score. Correlation and multivariate logistic regression analysis to predict the CVD risk severity were performed. RESULTS Correlation between total IPSS with CVD risk scores demonstrated significant positive associations, which showed higher correlation with ACC/AHA score than the Framingham score (r = 0.18 vs 0.09, respectively). For ACC/AHA score, the partial correlation after adjustment of body mass index (BMI) showed significant positive correlations between all LUTS parameters and PSA. For the Framingham score, all variables, except IPSS Q2 and IPSS Q6, showed significant positive correlations. After adjustment of BMI, prostate volume and PSA, only the severe LUTS group showed significant relationship with intermediate-high CVD risk severity, as compared with normal LUTS group (OR = 2.97, 95%CI (1.35-6.99)). CONCLUSION Using two validated CVD risk calculators, we observed that LUTS is closely associated with future CVD risk. To predict the intermediate-high CVD risk severity, severe LUTS was a sentinel sign, the presence of which warrants the importance of an earlier screening for CVD.
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Affiliation(s)
- Bora Lee
- Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sang Wook Lee
- Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchuhyang University Medical College, Bucheon, Korea
| | - Hye Rim Kang
- Medical biotechnology, Soonchunhyang University, Asan, Korea
| | - Dae In Kim
- Pharmaceutical engineering, Soonchunhyang University, Asan, Korea
| | - Hwa Yeon Sun
- Department of Urology, Soonchunhyang University Hospital, Soonchuhyang University Medical College, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchuhyang University Medical College, Seoul, Korea
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16
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Higashi Y. Lower urinary tract symptoms/benign prostatic hypertrophy and vascular function: Role of the nitric oxide-phosphodiesterase type 5-cyclic guanosine 3',5'-monophosphate pathway. Int J Urol 2017; 24:412-424. [PMID: 28332240 DOI: 10.1111/iju.13336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/19/2017] [Indexed: 11/30/2022]
Abstract
It is well known that there is an association of lower urinary tract symptoms/benign prostatic hypertrophy with cardiovascular disease, suggesting that lower urinary tract symptoms/benign prostatic hypertrophy is a risk factor for cardiovascular events. Vascular function, including endothelial function and vascular smooth muscle function, is involved in the pathogenesis, maintenance and development of atherosclerosis, leading to cardiovascular events. Vascular dysfunction per se should also contribute to lower urinary tract symptoms/benign prostatic hypertrophy. Both lower urinary tract symptoms/benign prostatic hypertrophy and vascular dysfunction have cardiovascular risk factors, such as hypertension, dyslipidemia, diabetes mellitus, aging, obesity and smoking. Inactivation of the phosphodiesterase type 5-cyclic guanosine 3',5'-monophosphate-nitric oxide pathway causes lower urinary tract symptoms/benign prostatic hypertrophy through an enhancement of sympathetic nervous activity, endothelial dysfunction, increase in Rho-associated kinase activity and vasoconstriction, and decrease in blood flow of pelvic viscera. Both endogenous nitric oxide and exogenous nitric oxide act as vasodilators on vascular smooth muscle cells through an increase in the content of cyclic guanosine 3',5'-monophosphate, which is inactivated by phosphodiesterase type 5. In a clinical setting, phosphodiesterase type 5 inhibitors are widely used in patients with lower urinary tract symptoms/benign prostatic hypertrophy. Phosphodiesterase type 5 inhibitors might have beneficial effects on vascular function through not only inhibition of cyclic guanosine 3',5'-monophosphate degradation, but also increases in testosterone levels and nitric oxide bioavailability, increase in the number and improvement of the function of endothelial progenitor cells, and decrease in insulin resistance. In the present review, the relationships between lower urinary tract symptoms/benign prostatic hypertrophy, the phosphodiesterase type 5-nitric oxide-cyclic guanosine 3',5'-monophosphate pathway, vascular function and cardiovascular outcomes are examined.
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Affiliation(s)
- Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University Hospital, Hiroshima, Japan.,Divivsion of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
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17
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Lin WY, Andersson KE, Lin CL, Kao CH, Wu HC. Association of lower urinary tract syndrome with peripheral arterial occlusive disease. PLoS One 2017; 12:e0170288. [PMID: 28301517 PMCID: PMC5354249 DOI: 10.1371/journal.pone.0170288] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 01/03/2017] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To describe atherosclerosis may lead to chronic bladder ischemia, eventually resulting in lower urinary tract syndrome (LUTS), and peripheral arterial occlusive disease (PAOD). We investigated the association of LUTS with PAOD. METHODS This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Database from 2000 to 2010; follow-up lasted until the end of 2011. We identified patients with newly diagnosed LUTS by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. RESULTS In total, 36,042 and 36,042 patients were enrolled in LUTS and non-LUTS cohorts, respectively. After adjustment for age, sex, and comorbidities, the risk of subsequent PAOD was 1.36-fold higher [95% confidence interval (CI) = 1.26-1.46] in the LUTS cohort than in the non-LUTS cohort. The adjusted risk of PAOD was the highest in patients with LUTS without any comorbidity [adjusted hazard ratio (aHR) = 1.93, 95% CI = 1.54-2.41]. The age-specific relative risk of PAOD was significantly higher in all age groups, particularly in those aged <49 years (aHR = 1.80, 95% CI = 1.39-2.34], in the LUTS cohort than in the non-LUTS cohort. CONCLUSION LUTS is a risk factor for PAOD. Physicians should consider the possibility of underlying PAOD in patients with LUTS aged <49 years and without cardiovascular comorbidities. Additional studies developing strategies for decreasing the risk of PAOD are warranted.
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Affiliation(s)
- Wei-Yu Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan
- Chang Gung University of Science and Technology, Chia-Yi, Taiwan
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan
| | - Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Hsi-Chin Wu
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Urology, China Medical University Beigang Hospital, Taichung, Taiwan
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18
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Tibaek S, Gard G, Dehlendorff C, Iversen HK, Biering-Soerensen F, Jensen RH. Lower Urinary Tract Symptoms, Erectile Dysfunction, and Quality of Life in Poststroke Men: A Controlled Cross-Sectional Study. Am J Mens Health 2017; 11:748-756. [PMID: 28193128 PMCID: PMC5675214 DOI: 10.1177/1557988317690283] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of the current study was to compare lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and quality of life (QoL) in poststroke and healthy men. Thirty poststroke men with stroke-related LUTS, and as controls, 96 healthy men participated in this controlled, cross-sectional study. Participants filled in the Danish Prostate Symptom Score (DAN-PSS-1) Questionnaire, the International Index of Erectile Function (IIEF-5), the 36-Item Short Form (SF-36), the Nocturia Quality-of-Life (N-QoL) Questionnaire. In the age group ≤55 years, comparing poststroke men with healthy controls both with LUTS, the results indicated DAN-PSS-1, total score median 13 (4-17) versus 3 (2-6), p = .05; IIEF-5 25 (14-25) versus 24 (23-25), p = .06; SF-12, total score 499 (360-679) versus 695 (644-734), p = .02; and N-QoL 98 (70-100) versus 96 (90-100), p = .65. In the age group >55 years, comparing poststroke men with healthy controls both with LUTS, the results indicated DAN-PSS-1, total score 13 (8-24) versus 5 (2-7), p < .01; IIEF-5 13 (5-20) versus 25 (24-25), p < .01; SF-36, total score 585 (456-718) versus 742 (687-772), p < .01; and N-QoL, total score 81 (66-95) versus 98 (80-100), p < .01. The results demonstrated that in age group above, but not below 55 years, poststroke men with LUTS had significantly higher frequency of severe and bothersome LUTS and ED than the healthy controls with LUTS, while QoL and N-QoL were significantly lower in comparison. It is recommended to identify and assess older poststroke men for LUTS, ED, and QoL.
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Affiliation(s)
- Sigrid Tibaek
- 1 Department of Occupational Therapy and Physiotherapy, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
| | - Gunvor Gard
- 2 Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden
| | | | - Helle K Iversen
- 4 Department of Neurology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
| | - Fin Biering-Soerensen
- 5 Clinic of Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Hornbæk, Denmark
| | - Rigmor H Jensen
- 6 Department of Neurology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
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Gacci M, Corona G, Sebastianelli A, Serni S, De Nunzio C, Maggi M, Vignozzi L, Novara G, McVary KT, Kaplan SA, Gravas S, Chapple C. Male Lower Urinary Tract Symptoms and Cardiovascular Events: A Systematic Review and Meta-analysis. Eur Urol 2016; 70:788-796. [PMID: 27451136 DOI: 10.1016/j.eururo.2016.07.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/04/2016] [Indexed: 11/26/2022]
Abstract
CONTEXT The correlation among metabolic syndrome, lower urinary tract symptoms (LUTS), and cardiovascular disease (CVD) is well established. In particular, CVD has been proposed as a potential risk factor for both LUTS progression and severity. OBJECTIVE To evaluate whether LUTS severity can be considered as a significant risk factor of major adverse cardiac events (MACE) in the male population. EVIDENCE ACQUISITION A systematic literature search was performed using PubMed, Google Scholar, and Scopus. The combination of the following keywords was adopted in a free-text strategy: benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS) and cardiovascular, cardio, major adverse cardiac events, MACE, heart disease, heart, myocardial infarction, myocardial, infarction, stroke, ischemic events, ischemic, cardiac death, coronary syndrome. We included all cross-sectional and longitudinal trials enrolling men and comparing the prevalence or incidence of MACE in men with moderate to severe LUTS compared with those without LUTS or with mild LUTS. The studies in which only nocturia was evaluated were excluded from the analysis. EVIDENCE SYNTHESIS Of 477 retrieved articles, 5 trials longitudinally reported the incidence of MACE in patients with moderate to severe LUTS in comparisons to those with mild or no LUTS and 10 studies reported the prevalence of history of MACE at enrollment. All were included in the present meta-analysis. Among cross-sectional studies, 38 218 patients and 2527 MACE were included in the meta-analysis. The mean age of enrolled patients was 62.2±8.0 yr. Presence of moderate to severe LUTS significantly increased the risk of reported history of MACE (p<0.001). Metaregression analyses showed that the risk of MACE was lower in older patients and higher in those with diabetes. The association between LUTS-related MACE and diabetes was confirmed in a multivariate regression model after adjusting for age (adjusted r=0.498; p<0.0001). Longitudinal trials included 25 494 patients and 2291 MACE. The mean age of enrolled patients was 52.5±5.5 yr, and mean follow-up was 86.8±22.1 mo. Presence of moderate to severe LUTS was associated with an increased incidence of MACE compared with the rest of the sample (odds ratio: 1.68; 95% confidence interval, 1.13-2.50; p=0.01). CONCLUSIONS Men with moderate to severe LUTS seem to have an increased risk of MACE. A holistic approach in considering the morbidities of aging men should be strongly encouraged and represents an important role for the practicing urologist. PATIENT SUMMARY We evaluated whether the severity of lower urinary tract symptoms could be considered as a significant risk factor for major adverse cardiac events (MACE) in the male population. We demonstrated that men with moderate to severe LUTS have an increased risk of MACE.
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Affiliation(s)
- Mauro Gacci
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy.
| | - Giovanni Corona
- Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy
| | | | - Sergio Serni
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy
| | - Mario Maggi
- Andrology Unit, University of Florence, Careggi Hospital, Florence, Italy
| | - Linda Vignozzi
- Andrology Unit, University of Florence, Careggi Hospital, Florence, Italy
| | - Giacomo Novara
- Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy
| | - Kevin T McVary
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Steven A Kaplan
- Department of Urology, Mount Sinai Hospital, New York, NY, USA
| | - Stavros Gravas
- Department of Urology, University Hospital of Larissa, Larissa, Greece
| | - Christopher Chapple
- Department of Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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20
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Statin Medications and Development and Progression of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. CURRENT BLADDER DYSFUNCTION REPORTS 2016. [DOI: 10.1007/s11884-016-0362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Thurmond P, Yang JH, Azadzoi KM. LUTS in pelvic ischemia: a new concept in voiding dysfunction. Am J Physiol Renal Physiol 2016; 310:F738-F743. [DOI: 10.1152/ajprenal.00333.2015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/13/2016] [Indexed: 01/27/2023] Open
Abstract
Lower urinary tract symptoms (LUTS) are a group of voiding symptoms affecting both genders as they age. Traditionally, LUTS in men were commonly attributed to bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE). It was later shown that, in approximately one-third to more than one-half of cases, LUTS in men are not associated with BOO. Urodynamic changes in the male bladder and symptom scores in aging men were found to be identical to their age-matched female counterparts. These observations suggested that LUTS in the elderly do not necessarily relate to BOO and may result from local changes in bladder muscle, nerves, and blood vessels. However, aging factors predisposing to bladder dysfunction and LUTS remain unknown. Growing evidence suggests that aging-associated pelvic ischemia may be a primary factor in the development of nonobstructed nonneurogenic overactive bladder and LUTS. First identified in experimental models and later in clinical studies, pelvic ischemia has been shown to compromise the lower urinary tract structure and lead to dysfunction. Structural and functional consequences of bladder and prostate ischemia have been documented in animal models. Clinical studies have shown that bladder and prostate blood flow decreases with aging. The severity of LUTS in elderly patients correlates with the degrees of bladder ischemia. LUTS improvement with α blockers has been associated with increased bladder blood flow. Pelvic ischemia may be an independent factor in nonobstructed nonneurogenic bladder instability and LUTS. Further research into the pathophysiology of LUTS in pelvic ischemia may lead to better management of this problem in the elderly population.
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Affiliation(s)
- Portia Thurmond
- Department of Urology, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts
| | - Jing-Hua Yang
- Department of Urology, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts; and
| | - Kazem M. Azadzoi
- Department of Urology and Department of Pathology, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts
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Aoun F, Chemaly AK, Albisinni S, Zanaty M, Roumeguere T. In Search for a Common Pathway for Health Issues in Men - the Sign of a Holmesian Deduction. Asian Pac J Cancer Prev 2016; 17:1-13. [DOI: 10.7314/apjcp.2016.17.1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Vlachopoulos C, Oelke M, Maggi M, Mulhall JP, Rosenberg MT, Brock GB, Esler A, Büttner H. Impact of cardiovascular risk factors and related comorbid conditions and medical therapy reported at baseline on the treatment response to tadalafil 5 mg once-daily in men with lower urinary tract symptoms associated with benign prostatic hyperplasia: an integrated analysis of four randomised, double-blind, placebo-controlled, clinical trials. Int J Clin Pract 2015; 69:1496-507. [PMID: 26299520 DOI: 10.1111/ijcp.12722] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The influence of cardiovascular risk factors/comorbidities on response to oral once-daily tadalafil 5 mg was explored in men with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). METHODS This post hoc analysis pooled data from four double-blind studies in which 1498 men with > 6-mo history of LUTS/BPH were randomised and received either once-daily placebo (n = 746) or tadalafil 5 mg (n = 752) for 12 weeks. Descriptive statistics were reported for changes in total International Prostate Symptom Score (IPSS), IPSS voiding and storage subscores, and IPSS quality-of-life (QoL) index. Treatment group differences by baseline clinical and cardiovascular factors and medical therapies were examined using analysis of covariance. RESULTS Tadalafil was effective in men with LUTS/BPH and cardiovascular risk factors/comorbidities except for patients receiving > 1 antihypertensive medication. Placebo-adjusted least squares (LS) mean improvements in total IPSS were -1.2 (95% CI: -2.5 to -0.0) in men taking > 1 antihypertensive medication vs. -3.3 (95% CI: -4.4 to -2.1) in men taking one medication (interaction p = 0.020). In addition, placebo-adjusted LS mean improvements in total IPSS were -0.2 (95% CI, -2.1 to 1.7) in men who reported use of diuretics vs. -2.8 (95% CI, -3.7 to -1.9) in men who reported taking other antihypertensive medications vs. -2.3 (95% CI, -3.2 to -1.5) in men who reported not using any antihypertensive drug (p-value for interaction = 0.053). CONCLUSIONS Once-daily tadalafil 5 mg improved LUTS/BPH, regardless of severity, in men with coexisting cardiovascular risk factors/comorbidities, except for patients with history of > 1 drug for arterial hypertension. Use of diuretics may contribute to patients' perception of a negated efficacy of tadalafil on LUTS/BPH. Comorbidities should be considered when choosing the optimal medicine to treat men with LUTS/BPH.
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Affiliation(s)
- C Vlachopoulos
- 1st Department of Cardiology, Athens Medical School, Athens, Greece
| | - M Oelke
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - M Maggi
- University of Florence, Florence, Italy
| | - J P Mulhall
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - G B Brock
- University of Western Ontario, London, ON, Canada
| | - A Esler
- Inventiv Health Clinical, Indianapolis, IN, USA
| | - H Büttner
- Eli Lilly Biomedicines BU - Men's Health Therapeutic Area Europe, c/o Lilly Deutschland, GmbH, Bad Homburg, Germany
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Wu MP. Lower urinary tract symptoms are beyond lower urinary tract. Gynecol Minim Invasive Ther 2015. [DOI: 10.1016/j.gmit.2015.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bouwman II, Voskamp MJH, Kollen BJ, Nijman RJM, van der Heide WK, Blanker MH. Do lower urinary tract symptoms predict cardiovascular diseases in older men? A systematic review and meta-analysis. World J Urol 2015; 33:1911-20. [PMID: 25971203 PMCID: PMC4655016 DOI: 10.1007/s00345-015-1560-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 04/08/2015] [Indexed: 12/29/2022] Open
Abstract
Purpose To study the incidence of CVD in men at risk, with and without LUTS.
Methods We searched all longitudinal studies describing the association between LUTS and CVD (mortality) in October 2013 and December 2014 using MEDLINE, EMBASE, and the Cochrane Library Central Register. PRISMA criteria were met. Results We included five studies with 6027 men with LUTS and 18,993 men without LUTS in the meta-analyses, with a follow-up period varying from 5 to 17 years. Studies totalled 2780 CVD events. No clear association between CVD and LUTS was demonstrated [pooled effect size: hazard ratio 1.09 (95 % CI 0.90–1.31); p = 0.40]. Two other studies reported the association between nocturia and (CVD) mortality. CVD-specific mortality risk was approximately two times higher for Japanese men with nocturia (357 men aged 70 years and over, 5-year follow-up). A univariable association between nocturia and all-cause mortality was found in Dutch men, but not in age-adjusted analyses (1114 men aged 50–78 years, 13-year follow-up).
Conclusion This meta-analysis conducted on longitudinal studies does not confirm LUTS to be a predictor of CVD in men without a history of CVD, despite the observed association between LUTS and CVD in cross-sectional studies.
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Affiliation(s)
- Iris I Bouwman
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Maarten J H Voskamp
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands.
| | - Boudewijn J Kollen
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Rien J M Nijman
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands.
| | - Wouter K van der Heide
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Marco H Blanker
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
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Russo GI, Castelli T, Privitera S, Fragalà E, Favilla V, Reale G, Urzì D, La Vignera S, Condorelli RA, Calogero AE, Cimino S, Morgia G. Increase of Framingham cardiovascular disease risk score is associated with severity of lower urinary tract symptoms. BJU Int 2015; 116:791-6. [DOI: 10.1111/bju.13053] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Giorgio I. Russo
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Tommaso Castelli
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Salvatore Privitera
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Eugenia Fragalà
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Vincenzo Favilla
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Giulio Reale
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Daniele Urzì
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Sandro La Vignera
- Department of Medical and Paediatric Sciences; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Rosita A. Condorelli
- Department of Medical and Paediatric Sciences; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Aldo E. Calogero
- Department of Medical and Paediatric Sciences; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Sebastiano Cimino
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
| | - Giuseppe Morgia
- Department of Urology; Section of Endocrinology, Andrology and Internal Medicine; University of Catania; Catania Italy
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Thurmond P, Yang JH, Li Y, Lerner LB, Azadzoi KM. Structural modifications of the prostate in hypoxia, oxidative stress, and chronic ischemia. Korean J Urol 2015; 56:187-96. [PMID: 25763122 PMCID: PMC4355429 DOI: 10.4111/kju.2015.56.3.187] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 02/07/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Clinical studies have reported a correlation between pelvic ischemia and voiding dysfunction in elderly men. The aim of this study was to identify and compare prostate structural modifications in cultured cells and in a rabbit model after exposure to hypoxia, oxidative stress, and chronic ischemia. MATERIALS AND METHODS Cultured human prostate smooth muscle cells (SMCs), epithelial cells (ECs), and stromal cells (SCs) were incubated under normoxia, hypoxia, and oxidative stress conditions by use of a computerized oxycycler system. We developed a rabbit model of chronic prostate ischemia by creating aorto-iliac arterial atherosclerosis. Markers of oxidative stress were examined by using fluorometric analysis and enzyme immunoassay. Prostate structure was examined by using Masson's trichrome staining and transmission electron microscopy (TEM). RESULTS Lipid peroxidation was found in SMCs exposed to hypoxia and in all cell types exposed to oxidative stress. We identified protein oxidation in ECs exposed to hypoxia and in all cell types exposed to oxidative stress. Markers indicating oxidative damage were present in chronically ischemic rabbit prostate tissue. These reactions were associated with DNA damage. Prostate ischemia resulted in epithelial atrophy, loss of smooth muscle, and diffuse fibrosis. TEM showed swollen mitochondria with degraded cristae, loss of membrane, loss of Golgi bodies, degenerated nerves, and disrupted cell-to-cell junctions. CONCLUSIONS Human prostate cells exhibited differential reactions to hypoxia and oxidative stress with widespread DNA damage. Structural modifications in ischemic prostate tissue were similar to those in cells exposed to oxidative stress. Structural changes due to ischemia and oxidative stress may contribute to prostatic noncompliance in aging men.
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Affiliation(s)
- Portia Thurmond
- Department of Urology, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
| | - Jing-Hua Yang
- Department of Urology, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
| | - Yedan Li
- Department of Urology, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
| | - Lori B Lerner
- Department of Urology, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
| | - Kazem M Azadzoi
- Department of Urology and Department of Pathology, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
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Kupelian V, Araujo AB, Wittert GA, McKinlay JB. Association of Moderate to Severe Lower Urinary Tract Symptoms with Incident Type 2 Diabetes and Heart Disease. J Urol 2015; 193:581-6. [DOI: 10.1016/j.juro.2014.08.097] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Varant Kupelian
- New England Research Institutes, Inc., Watertown, Massachusetts, and Department of Medicine, University of Adelaide, Royal Adelaide Hospital (GAW), Adelaide, South Australia, Australia
| | - Andre B. Araujo
- New England Research Institutes, Inc., Watertown, Massachusetts, and Department of Medicine, University of Adelaide, Royal Adelaide Hospital (GAW), Adelaide, South Australia, Australia
| | - Gary A. Wittert
- New England Research Institutes, Inc., Watertown, Massachusetts, and Department of Medicine, University of Adelaide, Royal Adelaide Hospital (GAW), Adelaide, South Australia, Australia
| | - John B. McKinlay
- New England Research Institutes, Inc., Watertown, Massachusetts, and Department of Medicine, University of Adelaide, Royal Adelaide Hospital (GAW), Adelaide, South Australia, Australia
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Tan HM, Tan WP, Wong JH, Ho CCK, Teo CH, Ng CJ. Men's Health Index: a pragmatic approach to stratifying and optimizing men's health. Korean J Urol 2014; 55:710-7. [PMID: 25405012 PMCID: PMC4231147 DOI: 10.4111/kju.2014.55.11.710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/15/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose The proposed Men's Health Index (MHI) aims to provide a practical and systematic framework for comprehensively assessing and stratifying older men with the intention of optimising their health and functional status. Materials and Methods A literature search was conducted using PubMed from 1980 to 2012. We specifically looked for instruments which: assess men's health, frailty and fitness; predict life expectancy, mortality and morbidities. The instruments were assessed by the researchers who then agreed on the tools to be included in the MHI. When there was disagreements, the researchers discussed and reached a consensus guided by the principle that the MHI could be used in the primary care setting targetting men aged 55-65 years. Results The instruments chosen include the Charlson's Combined Comorbidity-Age Index; the International Index of Erectile Function-5; the International Prostate Symptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageing and Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the Senior Fitness Test; the Fitness Assessment Score; and the Depression Anxiety Stress Scale-21. A pilot test on eight men was carried out and showed that the men's health index is viable. Conclusions The concept of assessing, stratifying, and optimizing men's health should be incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic position to engage men at the peri-retirement age in a conversation about their life goals based on their current and predicted health status.
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Affiliation(s)
- Hui Meng Tan
- Department of Surgery, Sime Darby Medical Center, Subang Jaya, Malaysia. ; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wei Phin Tan
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jun Hoe Wong
- Department of Surgery, Queens University Belfast, Belfast, United Kingdom
| | | | - Chin Hai Teo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Bouwman II, Blanker MH, Schouten BWV, Bohnen AM, Nijman RJM, van der Heide WK, Bosch JLHR. Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study. World J Urol 2014; 33:669-76. [DOI: 10.1007/s00345-014-1398-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/01/2014] [Indexed: 10/24/2022] Open
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Bouwman II, Kollen BJ, van der Meer K, Nijman RJM, van der Heide WK. Are lower urinary tract symptoms in men associated with cardiovascular diseases in a primary care population: a registry study. BMC FAMILY PRACTICE 2014; 15:9. [PMID: 24422708 PMCID: PMC3898227 DOI: 10.1186/1471-2296-15-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 01/03/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although lower urinary tract symptoms (LUTS) seem to be related to cardiovascular disease (CVD) in men, it is unclear whether this relationship is unbiased. In order to investigate this relationship, we used longitudinal data for establishing the possible predictive value of LUTS for the development of CVD in a primary care population. METHODS We performed a registry study using data from the Registration Network Groningen (RNG). All data from men aged 50 years and older during the study period from 1 January 1998 up to 31 December 2008 were collected. Cox proportional hazard regression analysis was used to determine the association between the proportions of CVD (outcome) and LUTS in our population. RESULTS Data from 6614 men were analysed. The prevalence of LUTS increased from 92/1000 personyears (py) in 1998 up to 183/1000 py in 2008. For cardiovascular diseases the prevalence increased from 176/1000 py in 1998 up to 340/1000 py in 2008. The incidence numbers were resp. 10.2/1000 py (1998) and 5.1/1000 py (2008) for LUTS, and 12.9/1000 py (1998) and 10.4/1000 py (2008) for CVD. Of all men, 23.2% reported CVD (41.1% in men with LUTS vs 19.5% in men without LUTS, p < 0.01). The hazard ratio of LUTS for cardiovascular events, compared to no LUTS, in the adjusted multivariate model, was 0.921(95% CI: 0.824 - 1.030; p = 0.150). CONCLUSION Based on the results, LUTS is not a factor that must be taken into account for the early detection of CVD in primary care.
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Affiliation(s)
- Inge I Bouwman
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
| | - Boudewijn J Kollen
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
| | - Klaas van der Meer
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
| | - Rien JM Nijman
- Department of urology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, GZ 9713, Netherlands
| | - Wouter K van der Heide
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
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Lin HJ, Weng SF, Yang CM, Wu MP. Risk of hospitalization for acute cardiovascular events among subjects with lower urinary tract symptoms: a nationwide population-based study. PLoS One 2013; 8:e66661. [PMID: 23776691 PMCID: PMC3680437 DOI: 10.1371/journal.pone.0066661] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 05/09/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND PURPOSE Lower urinary tract symptoms (LUTS) have been reported to be associated with metabolic syndrome and may predispose subjects to cardiovascular disease. The magnitude of the impact on the medical care remains to be elucidated. Based on a population-based claims dataset in Taiwan, we explored the association between LUTS and the risk of subsequent hospitalization for acute cardiovascular events. MATERIALS AND METHODS Among a representative sample of one million subjects from nationwide health insurance enrollees, subjects with codes of LUTS in service claims and without previous cardiovascular diseases including stroke were compared with age- and sex-matched non-LUTS subjects in subsequent hospitalization for acute coronary syndrome or stroke from the recruited date (between 2001-2004) to 2009. The risk of outcomes was assessed with Kaplan-Meier curves and the impact of LUTS was estimated with Poison regression analysis and Cox proportional hazards models. RESULTS We included 4,553 LUTS subjects and 22,765 matched non-LUTS subjects, with a mean age of 47 years and 43% of men. Hypertension, diabetes, and hyperlipidemia were more prevalent in the LUTS group. The incidence rate of the composite endpoint was significantly higher in the LUTS group than in the non-LUTS group (5.4/1000 vs. 4.0/1000 person-years). The difference mainly derived from stroke rather than acute coronary syndrome. After adjusting for age, sex, diabetes, hypertension, and hyperlipidemia in multivariable analysis, LUTS remained a significant predictor (hazard ratio, 1.29; 95% confidence incidence, 1.06-1.50). CONCLUSION Subjects free of cardiovascular disease and presenting with LUTS are at risk of subsequent hospitalization for acute cardiovascular events, mainly stroke. The information might prompt practitioners encountering such patients to undergo appropriate diagnostic and preventive measures.
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Affiliation(s)
- Huey-Juan Lin
- Department of Neurology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chun-Ming Yang
- Department of Neurology, Chi Mei Medical Center, Tainan, Taiwan
| | - Ming-Ping Wu
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan
- Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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Wu MP, Weng SF, Hsu YW, Wang JJ, Kuo HC. Medical attendance for lower urinary tract symptoms is associated with subsequent increased risk of outpatient visits and hospitalizations based on a nationwide population-based database. PLoS One 2013; 8:e57825. [PMID: 23472108 PMCID: PMC3589460 DOI: 10.1371/journal.pone.0057825] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 01/26/2013] [Indexed: 11/19/2022] Open
Abstract
Introduction Lower urinary tract symptoms (LUTS), which encompass storage, voiding, and postmicturition symptoms, are highly prevalent and recognized globally. Based on a nationwide population-based database, this study tests the hypothesis that medical attendance for LUTS is associated with a subsequent increase in the number of outpatient visits and hospitalizations, with differences among medical specialties and age groups. Methods Participants were selected from a random population sample of approximately one million people as a representative cohort of National Health Insurance (NHI) enrollees in Taiwan. Participants had at least three outpatient service claims with a coding of LUTS during the recruitment period 2001–2004. Both the LUTS group and non-LUTS control group were monitored for subsequent outpatient visits and hospitalizations, excluding LUTS-related healthcare services, for 2 years following the index date. The results were categorized based on medical specialty and age group. Results The outpatient visit rates (no. per person-year) and adjusted incidence rate ratios (IRRs) (95% confidence interval (CI) were significantly higher in urology (4.51, 95%CI 4.15–4.91) and gynecology (1.82, 95%CI 1.76–1.89) for the LUTS group. They were also significantly high in other departments, including internal medicine (1.25), general practice (1.13), Chinese medicine (1.77), family medicine (1.19), surgery (1.38), and psychiatry (1.98). Similarly, the hospitalization rate (no. per 1000 person-year) and adjusted IRRs (95% CI) were significantly higher in urology (5.50, 95% CI = 4.60–6.50) and gynecology (1.60, 95% CI = 1.35–1.90), as well as in internal medicine (1.55) and surgery (1.56), but not in psychiatry (1.12). Furthermore, the IRRs differed among 3 age groups. Conclusions A significantly higher number of outpatient visits and hospitalizations were observed for individuals with LUTS, compared to the control group, and the effects differed with the advancement of age. This study broadens understanding of LUTS by viewing their impact on healthcare services with multiple and overlapping systems, rather than considering them exclusively as symptoms of traditional diseases of the bladder and urethra.
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Affiliation(s)
- Ming-Ping Wu
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan Authority
- Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Authority
| | - Shih-Feng Weng
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Authority
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Authority
| | - Ya-Wen Hsu
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Authority
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Authority
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Authority
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan Authority
- * E-mail:
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Current world literature. Curr Opin Urol 2012. [PMID: 23202289 DOI: 10.1097/mou.0b013e32835bb149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wu MP, Su TH. Do lower urinary tract symptoms (LUTS) predispose the individuals to more admissions in Taiwanese women? - A preliminary report. Taiwan J Obstet Gynecol 2012; 51:402-4. [PMID: 23040925 DOI: 10.1016/j.tjog.2012.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Lower urinary tract symptoms (LUTS) are highly prevalent, and increase significantly as age advances. However, whether LUTS predispose women to more admissions and/or operations has not been well reported. We studied the risks of admissions among women with or without LUTS. MATERIALS AND METHODS Based on a nationwide population-based database, the risks of admissions among women of National Health Insurance enrollees with at least one outpatient service claim, with the coding of LUTS during 2001-2004, were compared with those without LUTS for the following 2 years. RESULTS Total admission rates (per 1000 person-years) were significantly higher in women with LUTS, as compared with the controls; 309.7 versus 173.6, respectively. The adjusted incidence rate ratio (IRR)=1.79 and 95% confidence interval (CI)=1.63-1.95. The adjusted IRRs=1.78 (95% CI=1.56-2.03), 2.02 (95% CI=1.75-2.33), 1.53 (95% CI=1.29-1.81), 2.09 (95% CI=1.13-3.86), 1.40 (95% CI=1.21-1.63), and 4.48 (95% CI=3.37-5.96) in the departments of internal medicine, gynecology, surgery, psychiatry, orthopedics and urology, respectively; all p values < 0.05. Meanwhile, the operation rates were also higher in women with LUTS, as compared with controls, in total and in the departments of gynecology, orthopedics, and surgery; all p values < 0.05. CONCLUSIONS The preliminary data showed a higher risk of admissions and operations among women with LUTS. The possible explanations included: more co-morbidities, a poorer quality of life, a lower threshold of admission, or potential early symptoms of either medical or surgical conditions. This highlights a broad understanding of multiple and overlapping systems in LUTS.
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Affiliation(s)
- Ming-Ping Wu
- Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan
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Editorial Comment. Urology 2011; 78:1067-8. [DOI: 10.1016/j.urology.2011.07.1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 06/28/2011] [Accepted: 07/09/2011] [Indexed: 11/19/2022]
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