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Almas F, Dasdelen MF, Seyhan Z, Sargolzaeimoghaddam M, Sarg A, Unlu O, Dasdelen ZB, Horuz R, Albayrak S, Kocak M, Laguna P, de la Rosette J. Reassessing Normal Voiding Standards: A Cross-Sectional Study Based on Medical Professionals' Evaluations with Portable Uroflowmetry and IPSS. J Clin Med 2024; 13:2857. [PMID: 38792399 PMCID: PMC11122113 DOI: 10.3390/jcm13102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: LUTS and voiding dysfunctions are prevalent in urology clinics, with uroflowmetry and IPSS as the prevailing diagnostic methods. Nevertheless, objective assessment can be constrained by age, gender, and variability in the test conditions. Portable (home) uroflowmetry addresses these limitations, allowing for more natural urinary flow recordings beyond clinic confines. This study aims to characterize spontaneous voiding patterns in healthcare professionals, exploring gender differences, variability in repeated measurements, and correlations among voiding parameters, IPSS, age, and BMI. Methods: This cross-sectional study was conducted during the SIU 43rd Congress in Istanbul using smart uroflow devices such as the Oruba Oruflow Uroflow Recorder, which were installed in public toilets. A total of 431 healthcare professionals participated by providing demographic information and completing the IPSS questionnaire. The data analysis included uroflowmetric parameters such as maximum flow rate (Qmax), average flow rate (Qave), and voided volume (VV), in addition to IPSS and demographic data to assess the possible associations with IPSS, age, BMI, and gender differences. Results: Of the participants, 76% were male and 24% female, with a higher prevalence of LUTS in women. Despite no significant gender difference in voided volume, men with lower volumes demonstrated more severe LUTS. Notably, women exhibited higher Qmax and Qave rates irrespective of their IPSS scores, contrasting with men whose flow rates declined with age and LUTS severity. In men, the total IPSS score was inversely associated with uroflowmetric performance, particularly impacting voiding symptoms over storage symptoms. Repeated measurements revealed noteworthy variability in Qmax and VV, without any influence from gender, BMI, age, or symptom severity. Conclusions: Our findings highlight the importance of gender-specific considerations in evaluating voiding complaints through uroflowmetry and IPSS. The significant variability observed in repeated uroflowmetry studies underlines the need for multiple measurements. Overall, this research emphasizes the significance of portable (home) uroflowmetry and calls for a reassessment of normal voiding standards in (non) clinical settings.
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Affiliation(s)
- Furkan Almas
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Muhammed Furkan Dasdelen
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Biostatistics and Medical Informatics, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Zuleyha Seyhan
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | | | - Arya Sarg
- School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.S.); (A.S.); (S.A.)
| | - Omer Unlu
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Zehra Betul Dasdelen
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Rahim Horuz
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Selami Albayrak
- School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.S.); (A.S.); (S.A.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Mehmet Kocak
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Biostatistics and Medical Informatics, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Pilar Laguna
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Jean de la Rosette
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
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Zlotta AR, Teillac P, Raynaud JP, Schulman CC. Evaluation of Male Sexual Function in Patients with Lower Urinary Tract Symptoms (LUTS) Associated with Benign Prostatic Hyperplasia (BPH) Treated with a Phytotherapeutic Agent (Permixon®), Tamsulosin or Finasteride. Eur Urol 2005; 48:269-76. [PMID: 15939527 DOI: 10.1016/j.eururo.2005.03.029] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 03/24/2005] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Sexual function is one of the aspects in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) that has gained increasing attention. We compared the influence on men's sexuality of Permixon, a lipido-sterolic extract of Serenoa Repens, with Tamsulosin and Finasteride using a specific validated questionnaire exploring patient's sexual functions. METHODS A database was created comprising patients from 3 main double-blind, randomized studies - Permixon vs. Finasteride, Permixon vs. Tamsulosin and Permixon 160 mg vs. 320 mg including a total of 2511 patients. Three hundred fifty four were on Tamsulosin, 545 on Finasteride and 1612 patients on Permixon. LUTS were assessed using the I-PSS questionnaire. Peak flow rates and prostate volume were recorded. The MSF-4 questionnaire, including 4 items that explore the patient's interest in sex, quality of erection, achievement of orgasm and ejaculation, was used across the studies. This questionnaire was demonstrated as highly reproducible and both psychometrically and clinically valid across different cultures. Correlation coefficients were given to assess the linear relationship between continuous variables. RESULTS At 3 months, there were no statistically significant differences between the three treatment groups in terms of I-PSS or Qmax evolutions (all p values > 0.05). At 6 months, as compared to pretreatment data, there was a slight increase in sexual disorders in Tamsulosin (+0.3) and Finasteride (+0.8) treated patients while it slightly improved with Permixon therapy (-0.2). Ejaculation disorders were the most frequently reported side effects after Tamsulosin or Finasteride (both +0.2 on the specific MSF-4 question 4). There was no correlation between the evolution of the MSF-4 scores and the evolution in I-PSS neither in patients treated with Permixon, Finasteride or Tamsulosin. However, there was a slight correlation between the MSF-4 score at baseline and the I-PSS at baseline (r2 = 0.032). Although there was a correlation between the MSF-4 and age at baseline (r2 = 0.1452), there was no correlation between the evolution in MSF-4 during therapy and the age of the patients. CONCLUSION The present study demonstrates that Permixon therapy has no negative impact on male sexual function. Both Finasteride and Tamsulosin had a slight impact on sexual function, especially on ejaculation, although these effects were rare and in line with previous reports about these two drugs.
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Affiliation(s)
- Alexandre R Zlotta
- Department of Urology, Erasme Hospital, University Clinics of Brussels, 808 route de Lennik, B-1070 Brussels, Belgium.
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