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Nakamura N, Emoto T, Fukuhara Y, Miyazaki T, Aoyagi C, Gunge N, Okabe Y, Matsuzaki H, Fujikawa A, Nakagawa C, Tachibana M, Yamasaki F, Tominaga K, Tsubouchi K, Aso S, Haga N. Factors related to nocturia-specific quality of life in renal transplantation patients. Low Urin Tract Symptoms 2024; 16:e12517. [PMID: 38693053 DOI: 10.1111/luts.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/30/2024] [Accepted: 04/13/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Patients following renal transplantation (RTX) may experience nocturia exacerbation due to polyuria and reduced bladder capacity, thereby impacting the specific quality of life (QOL) associated with nocturia. The present study aims to investigate factors associated with the deterioration of nocturia-specific QOL in RTX patients. METHODS The study cohort comprised 59 consecutive patients who had undergone successful RTX. Nocturia-related QOL questionnaires (N-QOL) were employed to evaluate the specific QOL related to nocturia. The Bother/Concern and Sleep/Energy domains of the N-QOL were also assessed. The primary outcome measure was to explore factors related to the aggravation of nocturia-specific QOL in patients post-RTX. RESULTS The mean nocturia frequency post-RTX was 1.3 ± 1.0. Univariate and multivariate analyses revealed a significant reduction in the Bother/Concern domain score associated with increased nocturia (p = .042). Aging significantly decreased the total N-QOL score and the Sleep/Energy domain score (p = .001 and .0002, respectively). Prolonged duration after RTX significantly reduced the scores of both the Sleep/Energy domain and the Bother/Concern domain (p = .018 and .037, respectively). However, the duration of dialysis prior to RTX was not significantly associated with the total score or subdomains of N-QOL. CONCLUSIONS Nocturia-specific QOL affected not only the nocturia itself, but also aging and the prolonged duration after RTX. Thus, comprehensive approaches to the RTX patients were needed to improve the Nocturia-specific QOL in RTX patients.
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Affiliation(s)
- Nobuyuki Nakamura
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Taiki Emoto
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yuichiro Fukuhara
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Takeshi Miyazaki
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Chikao Aoyagi
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Naotaka Gunge
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yu Okabe
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Hiroshi Matsuzaki
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Aiko Fujikawa
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Chizuru Nakagawa
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Masahiro Tachibana
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Fumihiro Yamasaki
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Kosuke Tominaga
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Kazuna Tsubouchi
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Shintaro Aso
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Nobuhiro Haga
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
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Warli SM, Ikram MF, Sarumpaet RG, Tala ZZ, Putrantyo II. The efficacy and safety of prostatic urethral lift as a minimally invasive therapeutic modality to treat lower urinary tract symptoms while maintaining sexual function in patients with benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. Arch Ital Urol Androl 2024; 96:12066. [PMID: 38451253 DOI: 10.4081/aiua.2024.12066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/05/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is prevalent among elderly men, necessitating focused attention. The Prostatic Urethral Lift (PUL) procedure, a minimally invasive intervention, has emerged as a promising option for BPH management. It has shown remarkable results in ameliorating lower urinary tract symptoms (LUTS), enhancing quality of life, and preserving sexual function. This study aims to evaluate the effectiveness and safety of PUL in BPH patients. METHODS Key databases (MEDLINE, Cochrane CENTRAL, ScienceDirect, EBSCO, Google Scholar) were systematically searched using pertinent terms related to PUL and BPH. Following the PRISMA checklist, we considered only randomized controlled trials (RCTs) from 2013 to 2023. The assessment focused on LUTS, quality of life, sexual function, and adverse events within three months. Follow-up post-treatment mean values compared with controls (Sham) and the improvement from baseline to post-treatment follow-up duration were considered. Statistical analysis and risk of bias evaluation were conducted using Review Manager 5.4.1, presenting results as difference of mean values (MD) and risk ratios (RR). RESULTS A meta-analysis with a Random Effects Model of 7 RCTs involving 378 confirmed BPH patients demonstrated significant improvements in the PUL arm including International Prostate Symptom Score (IPSS) (MD 5.51, p<0.0001), maximum urinary flow rate (Qmax) (MD 2.13, p=0.0001), BPH Impact Index (BPHII) (MD 2.14, p=0.0001), and IPSS-QoL (MD 1.50, p<0.0001), without significant increase of adverse events (RR 1.51; p=0.50). Positive outcomes were observed in sexual function variables and post-void residual measurements when post-treatment values were compared to baseline. CONCLUSIONS PUL holds advantages over control interventions, providing encouraging prospects for BPH management. This study underscores the need for further exploration of PUL's efficacy and safety in BPH patients.
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Affiliation(s)
- Syah Mirsya Warli
- Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan; Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara-Haji Adam Malik General Hospital, Medan.
| | | | | | | | - Ignatius Ivan Putrantyo
- Department of Urology, Faculty of Medicine, Universitas Indonesia - Haji Adam Malik General Hospital, Medan.
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Seo A, Chang AY. A systematic review of the social impact of diseases in Nordic countries. Scand J Public Health 2024:14034948231217365. [PMID: 38166481 DOI: 10.1177/14034948231217365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
BACKGROUND We review the literature on the social impacts of diseases, defined as the social consequences of having a disease on the people around the patient, such as spouses, caregivers and offspring. The two objectives of this study are to summarise the social outcomes commonly associated with diseases and to compare the social impact across a range of diseases. METHODS A systematic review of the social impact of disease in Nordic countries was conducted using PubMed, PsycINFO and Google Scholar (PROSPERO registration number CRD42022291796). All articles that met the inclusion criteria were reviewed. We tabulated all outcomes and diseases studied, and synthesised the evidence based on the perspectives of patients, spouse/caregiver and offspring. RESULTS A total of 135 studies met the eligibility criteria, covering 76 diseases and 39 outcomes. From the patient's perspective, diseases impact divorce and marriage rates, social functioning, likelihood of committing a crime and being a victim of crime. From the caregiver's perspective, diseases affect their health-related quality of life and physical and psychological health. From the offspring's perspective, diseases impact their development, health and social adversities in later life. Diseases generally had negative social impacts, but there were some diseases associated with positive impacts. CONCLUSIONS The review provides a useful summary and gross comparison of the social impact of different diseases. The social impact of diseases can be large and significant. Thus, it should be considered when policymakers are setting priorities across disease areas.
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Affiliation(s)
- Ahreum Seo
- Department of Public Health, University of Southern Denmark, Denmark
| | - Angela Y Chang
- Danish Institute for Advanced Study, University of Southern Denmark, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Denmark
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van Kollenburg R, van Riel L, Bloemen P, de Reijke T, Beerlage H, de Bruin D, Oddens J. Transperineal laser ablation as treatment for benign prostatic obstruction: Safety, feasibility and functional outcomes-A pilot study. BJUI COMPASS 2024; 5:52-59. [PMID: 38179027 PMCID: PMC10764162 DOI: 10.1002/bco2.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 01/06/2024] Open
Abstract
Background Standard surgical treatment for lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO) requires anaesthesia and hospitalization. Transperineal laser ablation (TPLA) is a novel minimally invasive treatment for BPO, which has been performed using local anaesthetics and conscious sedation. Objectives The aim of this study is to assess safety, feasibility and functional outcomes of TPLA for the treatment of LUTS in men fit also for standard surgery. Methods This prospective, multicentre, interventional pilot study included 20 patients. Eligible patients were men ≥40 years of age, with urodynamically proven bladder outlet obstruction, a peak urinary flow of 5-15 mL/s and a prostate volume of 30-120 cc. All subjects underwent Soractelite™ TPLA using the Echolaser® X4 system. Two to four fibres were placed in the prostate, whereafter laser light induced coagulative necrosis. Twelve months of follow-up included uroflowmetry, an ultrasound of the prostate and PROMs (IPSS and IIEF). Results Twenty patients were treated with TPLA using local anaesthetics and optional sedation. Sixteen patients were treated in an outpatient setting, using only local anaesthetics in 12 of them; four were treated in the operating room, whereof two under general anaesthesia. No device related adverse events occurred, nor did any grade ≥3 adverse events during follow-up. Post-TPLA, 10 men continued spontaneous voiding, and 10 men developed a urinary retention treated by a temporary indwelling catheter for 15.2 ± 3.5 days. At 12 months, Qmax improved from 9.7 ± 3.5 to 14.9 ± 6.0 (p = 0.015), IPSS improved from 21.3 ± 5.2 to 10.9 ± 5.5 (p < 0.0001), QoL improved from 4.9 ± 0.9 to 1.9 ± 1.1 (p < 0.0001), IIEF-15 total score remained stable and 11/13 patients (85%) preserved antegrade ejaculation. Conclusions TPLA is a safe and feasible treatment for men with LUTS due to BPO. TPLA can be performed in an outpatient setting under only local anaesthetics. Functional and quality of life outcomes improved significantly at 12 months, and erectile function remained stable.
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Affiliation(s)
- Rob van Kollenburg
- UrologyAmsterdam University Medical CentresAmsterdamThe Netherlands
- Biomedical Engineering and PhysicsAmsterdam University Medical CentresAmsterdamThe Netherlands
| | - Luigi van Riel
- UrologyAmsterdam University Medical CentresAmsterdamThe Netherlands
- Biomedical Engineering and PhysicsAmsterdam University Medical CentresAmsterdamThe Netherlands
| | - Paul Bloemen
- Biomedical Engineering and PhysicsAmsterdam University Medical CentresAmsterdamThe Netherlands
| | - Theo de Reijke
- UrologyAmsterdam University Medical CentresAmsterdamThe Netherlands
| | - Harrie Beerlage
- UrologyAmsterdam University Medical CentresAmsterdamThe Netherlands
| | - Daniel de Bruin
- UrologyAmsterdam University Medical CentresAmsterdamThe Netherlands
- Biomedical Engineering and PhysicsAmsterdam University Medical CentresAmsterdamThe Netherlands
| | - Jorg Oddens
- UrologyAmsterdam University Medical CentresAmsterdamThe Netherlands
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Laganà A, Di Lascio G, Di Blasi A, Licari LC, Tufano A, Flammia RS, De Carolis A. Ultrasound-guided SoracteLite™ transperineal laser ablation (TPLA) of the prostate for the treatment of symptomatic benign prostatic hyperplasia (BPH): a prospective single-center experience. World J Urol 2023; 41:1157-1162. [PMID: 36853444 PMCID: PMC10160153 DOI: 10.1007/s00345-023-04322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/28/2023] [Indexed: 03/01/2023] Open
Abstract
PURPOSE To evaluate the efficacy and safety of ultrasound-guided transperineal laser ablation (TPLA) in patients with symptomatic BPH. MATERIALS AND METHODS From January 2020 to January 2022, 63 prospectively enrolled patients underwent TPLA with a 1064-nm continuous-wave diode laser (EchoLaser, Elesta SpA). Primary endpoints were the change in IPSS, QoL, Qmax, PVR and prostate volume at 3 and 12 months. RESULTS At 3 months, IPSS improved from 20.8 ± 7.4 to 11.0 ± 6.6 (p < 0.001), QoL from 4.7 ± 1.4 to 1.5 ± 1.2 (p < 0.001) and Qmax from 8.6 ± 3.5 mL/s to 13.2 ± 5.7 mL/s (p = 0.083). PVR decreased from 124.8 ± 115.4 mL to 43.6 ± 53.6 mL (p < 0.001), and prostate volume decreased from 63.6 ± 29.7 mL to 45.6 ± 21.8 mL (p = 0.003). At 12 months, IPSS improved from 20.8 ± 7.4 to 8.4 ± 5.9 (p < 0.001), QoL from 4.7 ± 1.4 to 1.2 ± 0.8 (p < 0.001), and Qmax from 8.6 ± 3.5 mL/s to 16.2 ± 4.3 mL/s (p = 0.014). PVR decreased from 124.8 ± 115.4 mL to 40.6 ± 53.6 mL (p = 0.003), and prostate volume decreased from 63.6 ± 29.7 mL to 42.8 ± 14.2 mL (p = 0.071). Transient complications consisted of two patients with prostatic abscess (Clavien-Dindo grade IIIa) and one patient with orchitis (Clavien-Dindo grade II). CONCLUSIONS TPLA for symptomatic BPH provides clinical benefits at 3 and 12 months, and the treatment is well tolerated.
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Affiliation(s)
| | - Giovanni Di Lascio
- Ospedale San Giovanni Evangelista, Tivoli, Rome, Italy. .,Policlinico Umberto I, Rome, Italy.
| | - Aldo Di Blasi
- Ospedale San Giovanni Evangelista, Tivoli, Rome, Italy
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Iheanacho CO, Okwesilieze CN, Eyong AK. Role of calcium channel blockers in lower urinary tract symptoms in benign prostatic hyperplasia: a literature review. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
Background
Benign prostatic hyperplasia (BPH) and the use of CCBs are common in older persons, and are also associated with lower urinary tract symptoms (LUTS). This review summarised and synthesised relevant information and recent advances to improve clinical knowledge on the role of CCBs in LUTS, BPH symptoms and health-related quality of life.
Main body of the abstract
A search of databases of PubMed, Web of science, Hinari, and Google scholar was performed using several keywords. Relevant studies were also extracted from references of identified studies. Selected studies were assessed for content related to CCBs, BPH and LUTS, and the most relevant reports were included. The inhibition of calcium channels by CCBs interferes with influx of extracellular Ca2+ into the detrusor muscle, which interferes with bladder contraction and relaxation. Hence, CCBs are associated with precipitation or aggravation of urinary storage and voiding symptoms, which are also common symptoms of BPH. This suggests a potential aggravation of BPH symptoms with the use of CCBs.
Short conclusion
Persons at high risk of LUTS such as in BPH, may benefit from other classes of antihypertensive drugs. Therefore, it is essential to identify persons with BPH prior to commencement of therapy with CCBs. Patients on CCBs should be routinely reviewed for any potential precipitation or aggravation of LUTS. Patients should also be counselled to notify their healthcare provider of unusual urinary symptoms during CCB use. This will facilitate enhanced quality of life in patients with BPH.
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Effects of Deep Brain Stimulation on Lower Urinary Tract Function in Neurological Patients. Eur Urol Focus 2022; 8:1775-1782. [PMID: 35662503 DOI: 10.1016/j.euf.2022.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/26/2022] [Accepted: 05/19/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Deep brain stimulation (DBS) has clear beneficial effects on motor signs in movement disorders, but much less is known about its impact on lower urinary tract (LUT) function. OBJECTIVE To evaluate the effects of DBS on LUT function in patients affected by movement disorders. DESIGN, SETTING, AND PARTICIPANTS We prospectively enrolled 58 neurological patients affected by movement disorders, who were planned to receive DBS. INTERVENTION DBS in the globus pallidus internus, ventral intermediate nucleus of the thalamus, or subthalamic nucleus. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Subjective symptom questionnaires (International Prostate Symptom Score) and objective urodynamic studies were carried out before implantation of the DBS leads and several months after surgery. After DBS surgery, urodynamic investigations were performed with DBS ON as well as DBS OFF. RESULTS AND LIMITATIONS We enrolled patients suffering from Parkinson's disease (n = 39), dystonia (n = 11), essential tremor (n = 5), Holmes tremor (n = 2), and multiple sclerosis with tremor (n = 1). DBS of the globus pallidus internus resulted in worsening of LUT symptoms in 25% (four of 16) of the cases. DBS of the subthalamic nucleus in patients with Parkinson's disease led to normalization of LUT function in almost 20% (six of 31 patients), while a deterioration was seen in only one (3%) patient. DBS of the ventral intermediate nucleus of the thalamus improved LUT function in two (18%) and deteriorated it in one (9%) patient with tremor. CONCLUSIONS DBS effects on LUT varied with stimulation location, highly warranting patient counseling prior to DBS surgery. However, more well-designed, large-volume studies are needed to confirm our findings. PATIENT SUMMARY In this report, we looked at outcomes of deep brain stimulation on lower urinary tract function. We found that outcomes varied with stimulation location, concluding that counseling of patients about the effects on lower urinary tract function is highly recommended prior to surgery.
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Bauer SR, Cawthon PM, Ensrud KE, Suskind AM, Newman JC, Fink HA, Lu K, Scherzer R, Hoffman AR, Covinsky K, Marshall LM. Lower urinary tract symptoms and incident functional limitations among older community-dwelling men. J Am Geriatr Soc 2022; 70:1082-1094. [PMID: 34951697 PMCID: PMC8986604 DOI: 10.1111/jgs.17633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) are associated with frailty phenotype, a risk factor for functional decline. Our objective was to determine the association between baseline LUTS and 2-year risk of new functional limitation among older men. METHODS We analyzed data from the Osteoporotic Fractures in Men (MrOS) study with baseline at Year 7 and follow-up through Year 9. Participants included 2716 community-dwelling men age ≥ 71 years without any baseline self-reported functional limitation. LUTS severity (American Urologic Association Symptom Index) was classified as none/mild (score 0-7), moderate (8-19), and severe (20-35). At baseline and follow-up, men reported their ability to complete several mobility, activities of daily living (ADLs), and cognition-dependent tasks. Risk was estimated for 3 incident functional limitation outcomes: (1) mobility (any difficulty walking 2-3 blocks or climbing 10 steps), (2) ADL (any difficulty bathing, showering, or transferring), and (3) cognition-dependent (any difficulty managing money or medications). We used Poisson regression with a robust variance estimator to model adjusted risk ratios (ARR) and 95% CIs controlling for age, site, and comorbidities; other demographic/lifestyle factors did not meet criteria for inclusion. RESULTS Overall, the 2-year risk was 15% for mobility, 10% for ADLs, and 4% for cognition-dependent task limitations. Compared to none/mild LUTS, risk of incident mobility limitations was increased for moderate (ARR = 1.35, 95% CI: 1.12, 1.63) and severe LUTS (ARR = 1.98, 95% CI: 1.48, 2.64). Men were also at higher risk for incident ADL limitations if they reported moderate (ARR = 1.32, 95% CI: 1.05, 1.67) and severe LUTS (ARR = 1.62, 95% CI: 1.07,2.43). Results were somewhat attenuated after adjusting for the frailty phenotype but remained statistically significant. LUTS were not associated with incident cognition-dependent task limitations. CONCLUSIONS LUTS severity is associated with incident mobility and ADL limitations among older men. Increased clinical attention to risk of functional limitations among older men with LUTS is likely warranted.
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Affiliation(s)
- Scott R. Bauer
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA
- Department of Urology, University of California, San Francisco, CA
- San Francisco VA Healthcare System, San Francisco, CA
| | - Peggy M. Cawthon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
- Research Institute, California Pacific Medical Center, San Francisco, CA
| | - Kristine E. Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN
| | - Anne M. Suskind
- Department of Urology, University of California, San Francisco, CA
| | - John C. Newman
- Buck Institute for Research on Aging, Novato, CA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA
| | - Howard A. Fink
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN
- Geriatric Research Education and Clinical Center, Veterans Affairs Health Care System, Minneapolis, MN
| | - Kaiwei Lu
- San Francisco VA Healthcare System, San Francisco, CA
| | - Rebecca Scherzer
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA
- San Francisco VA Healthcare System, San Francisco, CA
| | | | - Kenneth Covinsky
- San Francisco VA Healthcare System, San Francisco, CA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA
| | - Lynn M. Marshall
- Oregon Health and Science University-Portland State University School of Public Health, Portland, OR
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Lyauk YK, Lund TM, Hooker AC, Karlsson MO, Jonker DM. Integrated Item Response Theory Modeling of Multiple Patient-Reported Outcomes Assessing Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia. AAPS JOURNAL 2020; 22:98. [PMID: 32728925 PMCID: PMC7391402 DOI: 10.1208/s12248-020-00484-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/11/2020] [Indexed: 11/30/2022]
Abstract
In clinical trials within lower urinary tract symptoms due to benign prostatic hyperplasia (BPH-LUTS), the International Prostate Symptom Score (IPSS) is commonly the primary efficacy outcome while the Quality of Life (QoL) score and the BPH Impact Index (BII) are common secondary efficacy markers. The current study aimed to characterize BPH-LUTS progression using responses to the IPSS, the QoL, and the BII in an integrated item response theory (IRT) framework and assess the Fisher information of each scale. The power of this approach to detect a drug effect was compared with an IRT approach considering only IPSS responses. A unidimensional and a bidimensional pharmacometric IRT model, based on item-level IPSS responses in a clinical trial with 403 patients, were extended by incorporating patients’ QoL and summary BII scores over the 6-month trial period. In the developed unidimensional integrated model, the QoL score was found to be the most informative, representing 17% of the total Fisher information, while the combined information content of the seven IPSS items represented 70.6%. In the bidimensional model, “storage” and both storage and “voiding” disability drove QoL and summary BII responses, respectively. Sample size reduction of 16% to detect a drug effect at 80% power was obtained with the unidimensional integrated IRT model compared with its counterpart IPSS IRT model. This study shows that utilizing the information content across the IPSS, QoL, and BII scales in an integrated IRT framework results in a modest but meaningful increase in power to detect a drug effect.
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Affiliation(s)
- Yassine Kamal Lyauk
- Translational Medicine, Ferring Pharmaceuticals A/S, Copenhagen, Denmark. .,Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark. .,Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
| | - Trine Meldgaard Lund
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Andrew C Hooker
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Mats O Karlsson
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Daniël M Jonker
- Translational Medicine, Ferring Pharmaceuticals A/S, Copenhagen, Denmark
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Matsukawa Y, Majima T, Ishida S, Funahashi Y, Kato M, Gotoh M. Useful parameters to predict the presence of detrusor overactivity in male patients with lower urinary tract symptoms. Neurourol Urodyn 2020; 39:1394-1400. [DOI: 10.1002/nau.24352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/26/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Yoshihisa Matsukawa
- Department of UrologyNagoya University Graduate School of Medicine Nagoya Japan
| | - Tsuyoshi Majima
- Department of UrologyNagoya University Graduate School of Medicine Nagoya Japan
| | - Shohei Ishida
- Department of UrologyNagoya University Graduate School of Medicine Nagoya Japan
| | - Yasuhito Funahashi
- Department of UrologyNagoya University Graduate School of Medicine Nagoya Japan
| | - Masashi Kato
- Department of UrologyNagoya University Graduate School of Medicine Nagoya Japan
| | - Momokazu Gotoh
- Department of UrologyNagoya University Graduate School of Medicine Nagoya Japan
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11
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van Kollenburg RAA, van Riel LAMJG, Bloemen PR, Oddens JR, de Reijke TM, Beerlage HP, de Bruin DM. Transperineal Laser Ablation Treatment for Lower Urinary Tract Symptoms Due to Benign Prostatic Obstruction: Protocol for a Prospective In Vivo Pilot Study. JMIR Res Protoc 2020; 9:e15687. [PMID: 31961326 PMCID: PMC7001043 DOI: 10.2196/15687] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/11/2019] [Accepted: 09/17/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Standard surgical treatments for lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO) use a transurethral approach. Drawbacks are the need for general or spinal anesthesia and complications such as hematuria, strictures, and cloth retention. Therefore, a minimal invasive technique under local anesthesia is desired to improve patient safety. Recently, SoracteLite transperineal laser ablation (TPLA) has been introduced as a novel minimal invasive treatment for BPO. The system used is unique because 4 laser sources are independently available. This 1064-nm diode laser induces coagulative necrosis. Moreover, TPLA is unique because it has a transperineal approach and can be performed under local anesthesia in an outpatient setting. OBJECTIVE The primary objective of this study is to determine the safety and feasibility of TPLA treatment for men, who are fit for standard surgery, with LUTS due to BPO. The secondary objectives are to determine functional outcomes by flowmetry and patient-reported outcome measures (PROMs), side effects, and tissue changes observed on imaging. METHODS This study is a prospective, single center, interventional pilot study IDEAL framework stage 2a and will include 20 patients. Eligible patients are men ≥40 years of age, with a prostate volume of 30 to 120 cc, have urodynamically proven bladder outlet obstruction, and have a peak urinary flow of 5 to 15 mL per second. All patients will undergo TPLA of their prostate under local anesthesia by using the EchoLaser system. Depending on the prostate volume, 2 to 4 laser fibers will be placed bilaterally into the prostate. Patient follow-up consists of uroflowmetry, PROMs, and imaging by using contrast-enhanced ultrasound. Total follow-up is 12 months following treatment. RESULTS Presently, recruitment of patients is ongoing. Publication of first results is expected by early 2020. CONCLUSIONS TPLA offers the potential to be a novel minimal invasive technique for treatment of LUTS due to BPO in men fit for standard desobstruction. This study will evaluate the safety and feasibility of TPLA and report on functional outcomes and tissue changes observed on imaging following TPLA treatment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15687.
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Affiliation(s)
- Rob A A van Kollenburg
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Luigi A M J G van Riel
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul R Bloemen
- Department of Biomedical Engineering & Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Jorg R Oddens
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Theo M de Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Harrie P Beerlage
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Daniel Martijn de Bruin
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
- Department of Biomedical Engineering & Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
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Matsukawa Y, Takai S, Majima T, Funahashi Y, Sassa N, Kato M, Yamamoto T, Gotoh M. Comparison in the efficacy of fesoterodine or mirabegron add‐on therapy to silodosin for patients with benign prostatic hyperplasia complicated by overactive bladder: A randomized, prospective trial using urodynamic studies. Neurourol Urodyn 2019; 38:941-949. [DOI: 10.1002/nau.23935] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 01/13/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Yoshihisa Matsukawa
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Shun Takai
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Tsuyoshi Majima
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Yasuhito Funahashi
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Naoto Sassa
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Masashi Kato
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Tokunori Yamamoto
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Momokazu Gotoh
- Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
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Pöyhönen A, Åkerla J, Häkkinen JT, Koskimäki J, Tammela TLJ, Auvinen A. Severity and bother of lower urinary tract symptoms among men aged 30-80 years: Tampere Ageing Male Urological Study (TAMUS). Scand J Urol 2018; 52:296-301. [PMID: 30382800 DOI: 10.1080/21681805.2018.1505944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The aim of this study was to determine the severity and bother of lower urinary tract symptoms (LUTS) and evaluate the burden of each symptom in a male population. MATERIALS AND METHODS Postal questionnaires were sent to 7470 men aged 30-80 years. The Danish Prostatic Symptom Score (DAN-PSS-1) was used to determine the severity, bother and total symptom score for each symptom. To assess the total burden of each symptom at the population level, the total symptom scores were weighted by the prevalence they represented. RESULTS The overall response rate was 58.7% (4384/7470 men). Urgency caused the greatest burden to men aged 30-80, with a prevalence-weighted symptom score of 0.712. Urgency affected 66.2% of men and 5.1% experienced moderate symptoms with moderate bother. Post-micturition dribble caused the second greatest burden, with a prevalence-weighted score of 0.704, affecting 58.7% of men and with 31.1% reporting mild bother from it. Nocturia and feeling of incomplete emptying caused the third and fourth greatest burdens, respectively. In young men (aged 30 and 40 years), post-micturition dribble caused the greatest burden, as moderate symptoms were common and caused mild bother to 11.4%. Among retired (70 and 80 years) and middle-aged (50 and 60 years) men, urgency was the most burdensome symptom. CONCLUSIONS The most burdensome LUTS in men aged 30-80 years was urgency, followed by post-micturition dribble, nocturia and feeling of incomplete emptying. Urgency and nocturia were prominent in old men and post-micturition dribble was noted in young men.
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Affiliation(s)
- Antti Pöyhönen
- a Department of Surgery , Central Finland Central Hospital , Jyväskylä , Finland
| | - Jonne Åkerla
- a Department of Surgery , Central Finland Central Hospital , Jyväskylä , Finland
| | - Jukka T Häkkinen
- b Department of Urology , Turku University Hospital , Turku , Finland
| | - Juha Koskimäki
- c Department of Urology , Tampere University Hospital and University of Tampere , Tampere , Finland
| | - Teuvo L J Tammela
- c Department of Urology , Tampere University Hospital and University of Tampere , Tampere , Finland
| | - Anssi Auvinen
- d School of Health Sciences , University of Tampere , Tampere , Finland
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Long-Term Outcomes of Laser Prostatectomy for Storage Symptoms: Comparison of Serial 5-Year Followup Data between High Performance System Photoselective Vaporization and Holmium Laser Enucleation of the Prostate. J Urol 2018; 199:1591-1599. [DOI: 10.1016/j.juro.2018.01.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 11/23/2022]
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Yokoyama O, Ozeki A, Suzuki N, Murakami M. Early improvement of storage or voiding symptoms by tadalafil predicts treatment outcomes in patients with lower urinary tract symptoms from benign prostatic hyperplasia. Int J Urol 2017; 25:240-245. [DOI: 10.1111/iju.13487] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 10/01/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Osamu Yokoyama
- Department of Urology; Faculty of Medical Science; University of Fukui; Fukui Japan
| | - Akichika Ozeki
- Medicines Development Unit Japan; Biometics; Asia Pacific Statistical Science-Japan; Eli Lilly Japan K.K.; Kobe Japan
| | - Nahoko Suzuki
- Medicines Development Unit Japan; Biometics; Japan Scientific Communications Biomedicines; Eli Lilly Japan K.K.; Tokyo Japan
| | - Masahiro Murakami
- Medicines Development Unit; Eli Lilly and Company; Indianapolis Indiana USA
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Rajih E, Tholomier C, Hueber PA, Alenizi AM, Valdivieso R, Azizi M, Gonzalez RR, Eure G, Kriteman L, Hai M, Zorn KC. Evaluation of Surgical Outcomes with Photoselective GreenLight XPS Laser Vaporization of the Prostate in High Medical Risk Men with Benign Prostatic Enlargement: A Multicenter Study. J Endourol 2017; 31:686-693. [DOI: 10.1089/end.2016.0782] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Emad Rajih
- Section of Urology, Department of Surgery, University of Montreal Hospital Center—HSL Site, Montreal, Canada
- Department of Urology, Taibah University, Madinah, Saudi Arabia
| | - Come Tholomier
- Section of Urology, Department of Surgery, University of Montreal Hospital Center—HSL Site, Montreal, Canada
| | - Pierre-Alain Hueber
- Section of Urology, Department of Surgery, University of Montreal Hospital Center—HSL Site, Montreal, Canada
| | - Abdullah M. Alenizi
- Section of Urology, Department of Surgery, University of Montreal Hospital Center—HSL Site, Montreal, Canada
| | - Roger Valdivieso
- Section of Urology, Department of Surgery, University of Montreal Hospital Center—HSL Site, Montreal, Canada
| | - Mounsif Azizi
- Section of Urology, Department of Surgery, University of Montreal Hospital Center—HSL Site, Montreal, Canada
| | | | - Gregg Eure
- Department of Urology, Urology of Virginia, PLLC, Virginia Beach, Virginia
| | - Lewis Kriteman
- North Fulton Urology PC, Georgia Urology, Roswell, Georgia
| | - Mahmood Hai
- Comprehensive Urology, The Surgical Institute of Michigan, Westland, Michigan
| | - Kevin C. Zorn
- Section of Urology, Department of Surgery, University of Montreal Hospital Center—HSL Site, Montreal, Canada
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Kim HJ, Sun HY, Choi H, Park JY, Bae JH, Doo SW, Yang WJ, Song YS, Ko YM, Kim JH. Efficacy and Safety of Initial Combination Treatment of an Alpha Blocker with an Anticholinergic Medication in Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms: Updated Meta-Analysis. PLoS One 2017; 12:e0169248. [PMID: 28072862 PMCID: PMC5224810 DOI: 10.1371/journal.pone.0169248] [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: 11/15/2016] [Accepted: 12/14/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND There is still controversy as to whether initial combination treatment is superior to serial addition of anticholinergics after maintenance or induction of alpha blockers in benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS). OBJECTIVE The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic review and meta-analysis. METHODS We conducted a meta-analysis of improvement in LUTS using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). RESULTS In total, 16 studies were included in our analysis, with a total sample size of 3,548 subjects (2,195 experimental subjects and 1,353 controls). The mean change in total IPSS improvement from baseline in the combination group versus the alpha blocker monotherapy group was -0.03 (95% CI: -0.14-0.08). The pooled overall SMD change of storage IPSS improvement from baseline was -0.28 (95% CI: -0.40 - -0.17). The pooled overall SMD changes of QoL, Qmax, and PVR were -0.29 (95% CI: -0.50 - -0.07), 0.00 (95% CI: -0.08-0.08), and 0.56 (95% CI: 0.23-0.89), respectively. There was no significant difference in the number of acute urinary retention (AUR) events or PVR. CONCLUSIONS Initial combination treatment of an alpha blocker with anticholinergic medication is efficacious for in BPH/ LUTS with improved measures such as storage symptoms and QoL without causing significant deterioration of voiding function.
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Affiliation(s)
- Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Hwa Yeon Sun
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Hoon Choi
- Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Young Park
- Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Young Myoung Ko
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
- * E-mail:
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18
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Chae J, Kim Y. Factors Influencing the Quality of Life of Prostate Cancer Patients. ASIAN ONCOLOGY NURSING 2017. [DOI: 10.5388/aon.2017.17.4.237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jeonghye Chae
- Department of Nursing, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | - Youngsuk Kim
- College of Nursing, Kosin University, Busan, Korea
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Population-level and Individual-level Bother of Lower Urinary Tract Symptoms Among 30- to 80-year-old Men. Urology 2016; 95:164-70. [PMID: 27349526 DOI: 10.1016/j.urology.2016.06.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/06/2016] [Accepted: 06/14/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To estimate the bother using both population- and individual-level bother of lower urinary tract symptoms (LUTS) across a wide age range among men. MATERIALS AND METHODS A total of 7470 men aged 30-80 years were approached using a postal questionnaire in 2004. The overall response was 58.7% (4384 respondents). The Danish Prostatic Symptom Score was used to evaluate bother of 12 LUTS. In the population-level analysis, prevalence of bother was calculated by relating the number of men with bother to the population size (instead of only affected men). To evaluate the bother at individual level, its prevalence among the men experiencing the symptom was assessed. RESULTS In the population-level analysis, postmicturition dribble was the most common cause of bother among 30- and 40-year-old men, as 25% of the men experienced small bother and 4.5% had moderate to major bother. Men aged 70-80 years experienced the most bother from urgency followed closely by nocturia, with about 40% reporting small bother and roughly 20% moderate or major bother. When only symptomatic men were evaluated, incontinence symptoms, especially urge incontinence, were the most bothersome as more than 80% of the men with incontinence reported bother. CONCLUSION At population level, the most bothersome symptom varied by age. Men aged 30-40 years experienced bother most commonly from postmicturition dribble. With increasing age, urgency and nocturia became the most bothersome symptoms by age 70-80 years. At individual level, incontinence symptoms were the most bothersome LUTS, with less influence by age.
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20
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Matsukawa Y, Takai S, Funahashi Y, Kato M, Yamamoto T, Gotoh M. Long-term efficacy of a combination therapy with an anticholinergic agent and an α1-blocker for patients with benign prostatic enlargement complaining both voiding and overactive bladder symptoms: A randomized, prospective, comparative trial using a urody. Neurourol Urodyn 2016; 36:748-754. [DOI: 10.1002/nau.23013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/14/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Yoshihisa Matsukawa
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Shun Takai
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Yasuhito Funahashi
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Masashi Kato
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Tokunori Yamamoto
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Momokazu Gotoh
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
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21
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Mankowski C, Ikenwilo D, Heidenreich S, Ryan M, Nazir J, Newman C, Watson V. Men's preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment. Patient Prefer Adherence 2016; 10:2407-2417. [PMID: 27920507 PMCID: PMC5125770 DOI: 10.2147/ppa.s112161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To explore and quantify men's preferences and willingness to pay (WTP) for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment. SUBJECTS AND METHODS Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8) were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia) urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes. RESULTS In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level), but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency), and £6.65/month and £1.39/month for each unit reduction in night- and daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild urgency and no fluid during ejaculation (dry orgasm). CONCLUSION To compensate for side effects, a medicine for lower urinary tract symptoms/benign prostatic hyperplasia must provide a combination of benefits, such as reduced urgency of urination plus reduced nighttime and/or reduced daytime urination.
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Affiliation(s)
- Colette Mankowski
- Health Economics and Outcomes Research, Astellas Pharma Europe Ltd., Chertsey
- Correspondence: Colette Mankowski, Astellas Pharma Europe Ltd., Astellas Medical Affairs, EMEA, HEOR, 2000 Hillswood Drive, Chertsey, Surrey KT16 0PS, UK, Tel +44 78 8194 0638, Email
| | - Divine Ikenwilo
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Mandy Ryan
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jameel Nazir
- Health Economics and Outcomes Research, Astellas Pharma Europe Ltd., Chertsey
| | - Cathy Newman
- Health Economics and Outcomes Research, Astellas Pharma Europe Ltd., Chertsey
| | - Verity Watson
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
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Huang W, Zong H, Zhou X, Wang T, Zhang Y. Efficacy and Safety of Propiverine Hydrochloride for Overactive Bladder in Adult: a Systematic Review and Meta-analysis. Indian J Surg 2015; 77:1369-77. [DOI: 10.1007/s12262-015-1264-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 03/16/2015] [Indexed: 11/29/2022] Open
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Kullmann FA, Birder LA, Andersson KE. Translational Research and Functional Changes in Voiding Function in Older Adults. Clin Geriatr Med 2015; 31:535-48. [PMID: 26476114 PMCID: PMC4865381 DOI: 10.1016/j.cger.2015.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Age-related LUT dysfunctions result from complex processes controlled by multiple genetic, epigenetic, and environmental factors and account for high costs of health care. This article discusses risk factors that may play a role in age-related LUT dysfunction and presents available data comparing structural and functional changes that occur with aging in the bladder of humans and animal models. A better understanding of factors and mechanisms underlying LUT symptoms in the older population may lead to therapeutic interventions to reduce these dysfunctions.
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Affiliation(s)
- Florenta Aura Kullmann
- Renal-Electrolyte Division, Medicine Department, University of Pittsburgh School of Medicine, 3500 Terrace Street, A1220 Scaife Hall, Pittsburgh, PA 15261, USA
| | - Lori Ann Birder
- Renal-Electrolyte Division, Medicine Department, University of Pittsburgh School of Medicine, 3500 Terrace Street, A1207 Scaife Hall, Pittsburgh, PA 15261, USA; Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Karl-Erik Andersson
- Department of Urology, Institute for Regenerative Medicine, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, USA; AIAS, Aarhus Institute of Advanced Studies, Aarhus University, Høegh-Guldbergs Gade 6B, Building 1632, Aarhus C 8000, Denmark.
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[THE IMPACT OF LOWER URINARY TRACT SYMPTOMS ON GENERIC HEALTH-RELATED QUALITY OF LIFE IN MALE PATIENTS WITHOUT CO-MORBIDITY]. Nihon Hinyokika Gakkai Zasshi 2015; 106:172-7. [PMID: 26419074 DOI: 10.5980/jpnjurol.106.172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE We investigated the impact of lower urinary tract symptoms (LUTS) on generic health-related quality of life (HRQOL) in male patients without co-morbidity. PATIENTS AND METHOD From 2003 to 2011, a total 567 men who presented out urological department completed the questionnaires including International Prostate Symptom Score (IPSS), incontinence-frequency score (IFS) from the UCLA prostate cancer index, MOS 36-Item Short-Form Health Survey (SF-36). Among 230 patients with no coexisting morbidity, the relations between each LUTS score of IPSS indices and IFS and 8 domain scores of SF-36 were analyzed by Pearson's product-moment correlation and stepwise multiple regression analysis. RESULT Univariate analysis showed that the IFS had a significant correlation with all of 8 domain scores of SF-36, and also the IPSS item scores of urgency, nocturia and straining correlated significantly with multiple domain scores of SF-36. In multiple regression analysis, the proportionate contributions of LUTS to each SF-36 domain scores were low (R2 was 10% or less). Incontinence was considered as the most influential factor that had a negative impact on HRQOL in 7 SF-36 domains of physical functioning, role-physical, bodily pain, general health perception, vitality, social functioning and mental health. Additionally, nocturia, straining and urgency were significantly associated with deficit of HRQOL in 4 SF-36 domains (role-physical, general health perception, role-emotional, mental health), 2 domains (bodily pain, social functioning) and 1 domain (role-emotional) of SF-36, respectively. CONCLUSION; Among LUTS, incontinence, nocturia and straining were the most important symptoms in association with the negative impact on generic HRQOL measured by SF-36.
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Matsukawa Y, Takai S, Asai K, Kasugai S, Narita H, Komatsu T, Kashiwagi Y, Kato M, Yamamoto T, Gotoh M. A Slow Stream Is Pathophysiologically Related to a Poor Response to α1-Adrenoceptor Therapy in the Treatment of Storage Symptoms Associated With Benign Prostatic Hyperplasia. Urology 2015; 86:558-64. [DOI: 10.1016/j.urology.2015.03.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 03/26/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
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26
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Choi EPH, Lam CLK, Chin WY. Mental Health Mediating the Relationship Between Symptom Severity and Health-Related Quality of Life in Patients with Lower Urinary Tract Symptoms. Low Urin Tract Symptoms 2015; 8:141-9. [PMID: 27619778 DOI: 10.1111/luts.12086] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/24/2014] [Accepted: 11/04/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Lower urinary tract symptoms (LUTS) can impact both mental health and health-related quality of life (HRQOL). To date, however, their associations with outcomes have only been examined in isolation and the interactive relationship between LUTS, mental health and HRQOL remains poorly understood. The aim of this study was to determine whether mental health mediates the relationship between LUTS severity and HRQOL. METHODS Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire including the International Prostate Symptom Score (IPSS), the adapted Incontinence Impact Questionnaire-7 (IIQ-7), the Chinese (HK) SF-12 Health Survey Version 2 (SF-12 v2) and the Depression, Anxiety and Stress Scale-21 (DASS-21). Mediation modeling was tested using Baron and Kenney's multistage regression approach and bootstrapping method. RESULTS Overall, mental health partially mediated the association between LUTS severity and HRQOL as measured by the SF-12 v2 physical component summary (PCS) and the IIQ-7. The depression, anxiety and stress scores all have similar mediation effects in the relationship between LUTS severity and HRQOL. Subgroup analysis by gender showed that anxiety fully mediated the relationship between LUTS severity and HRQOL as measured by the SF-12 v2 PCS in males whilst the mediation effects of mental health in the relationship between LUTS severity and HRQOL as measured by the SF-12 v2 PCS could not be found in females. CONCLUSIONS In order to enhance HRQOL, LUTS interventions should address the mental health of patients in addition to providing physical relief of symptoms.
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Affiliation(s)
- Edmond P H Choi
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong.
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
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Majumdar R, Mirheydar HS, Palazzi KL, Lakin CM, Albo ME, Parsons JK. Prostate laser vaporization is safe and effective in elderly men. Urol Ann 2015; 7:36-40. [PMID: 25657541 PMCID: PMC4310114 DOI: 10.4103/0974-7796.148595] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/23/2014] [Indexed: 11/22/2022] Open
Abstract
Introduction: There are few data on the safety and efficacy of laser photoselective vaporization (LVP) in elderly men. We compared the safety and efficacy of LVP for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men ≥75 years, who we defined as elderly, to those <75 years. Materials and Methods: Safety and efficacy outcomes in elderly men undergoing LVP for lower urinary tract symptoms secondary to BPH from 2005 to 2012 were compared with men <75 years. Differences between-groups in demographics, perioperative outcomes, complications, and postoperative changes in International Prostate Symptom Score (I-PSS) were calculated. Results: Of 202 patients, 49 (24%) were elderly (range: 75-95 years) and 153 (76%) were <75 years. Preoperatively, elderly men were more likely to have heart disease (35% vs. 20%, P = 0.03), gross hematuria (6.1% vs. 0.7%, P = 0.05), urinary retention (57% vs. 41%, P = 0.07), and take anti-coagulants (61% vs. 35%, P = 0.002). Elderly men had a longer median length of stay (1 day vs. 0 day, P = 0.001). There were no significant between-group differences in transfusion frequency (4.4% vs. 0.7%, P = 0.14) or Clavien III complications (2% vs. 2.6%, P = 1.0). One month postsurgery, elderly patients reported smaller median decreases in I-PSS (5.5 vs. 9, P = 0.02) and urinary bother (1 point vs. 2, P = 0.03) compared with preoperative values. At till 9 months follow-up, there were no significant between-group differences in median I-PSS or urinary bother scores. Conclusions: Despite a higher prevalence of preoperative comorbidity and urinary retention, elderly LVP patients experienced perioperative safety and shorter term efficacy outcomes comparable to younger men.
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Affiliation(s)
- Rohit Majumdar
- University of California, San Diego School of Medicine, La Jolla, USA
| | - Hossein S Mirheydar
- University of California, San Diego School of Medicine, La Jolla, USA ; Department of Urology, UC San Diego Health System, San Diego, USA
| | - Kerrin L Palazzi
- Urologic Cancer, UC San Diego Moores Cancer Center, La Jolla, USA
| | - Charles M Lakin
- University of California, San Diego School of Medicine, La Jolla, USA ; Department of Urology, UC San Diego Health System, San Diego, USA
| | - Michael E Albo
- University of California, San Diego School of Medicine, La Jolla, USA ; Department of Urology, UC San Diego Health System, San Diego, USA
| | - J Kellogg Parsons
- University of California, San Diego School of Medicine, La Jolla, USA ; Department of Urology, UC San Diego Health System, San Diego, USA ; Urologic Cancer, UC San Diego Moores Cancer Center, La Jolla, USA ; Section of Urology, VA San Diego Healthcare System, San Diego, CA, USA
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Goh HJ, Kim SA, Nam JW, Choi BY, Moon HS. Community-based research on the benign prostatic hyperplasia prevalence rate in Korean rural area. Korean J Urol 2015; 56:68-75. [PMID: 25598939 PMCID: PMC4294858 DOI: 10.4111/kju.2015.56.1.68] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/21/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose We investigated the prevalence rate of benign prostatic hyperplasia (BPH) among Korean males in a rural area through a cross-sectional, community-based epidemiologic survey and analyzed the correlation with epidemiologic factors. Materials and Methods A total of 779 males who lived in Yangpyeong County participated in a prostate examination campaign. Targeting these men, we collected the International Prostate Symptom Score (IPSS), medical history, demographic information, serum prostate-specific antigen, and prostate volume as measured by transrectal ultrasonography. The data for 599 participants were analyzed, excluding 180 men who had a possibility of prostate cancer. BPH was defined as an IPSS of 8 points or higher and a prostate volume of 25 mL or more. Results The prevalence rate of BPH was 20.0%. The prevalence rate increased with age. There were 2 subjects (4.4%) in the age group of 40-49 years, 18 subjects (10.9%) in the age group of 50-59 years, 44 subjects (22%) in the age group of 60-69 years, and 56 subjects (26.6%) in the age group of over 70 years; this increase with age was statistically significant (p<0.001). In the BPH group, the average IPSS was 14.67±5.95, the average prostate volume was 37.04±11.71 g, and the average prostate-specific antigen value was 1.56±0.88 ng/mL. In the analysis of correlations between the epidemiologic factors and the risk of BPH, smoking was the only statistically significant factor. Conclusions The total prevalence rate of BPH in this study was 20.0%, which was a little lower than the rate reported in other cities or rural areas.
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Affiliation(s)
- Hyeok Jun Goh
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Shin Ah Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ji Won Nam
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hong Sang Moon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
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Mathias SD, Crosby RD, Nazir J, Klaver M, Drogendijk T, Hakimi Z, Odeyemi IA. Validation of the Patient Perception of Intensity of Urgency Scale in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:823-829. [PMID: 25498777 DOI: 10.1016/j.jval.2014.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/23/2014] [Accepted: 09/13/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To assess the reliability and validity of scores derived from the Patient Perception of Intensity of Urgency Scale (PPIUS) in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). METHODS A post hoc analysis of the phase II Solifenacin and Tamsulosin in Males with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia trial (NCT00510406), a 12-week clinical trial in men with LUTS associated with BPH, assessed the measurement properties of six PPIUS-derived scores: mean score; maximum urgency score; total urgency and frequency score (TUFS; average sum of urgency scores over 3 days); and numbers of urgency episodes, urgency episodes of grade 3 or 4, and urgency incontinence episodes. Test-retest reliability, presence of floor/ceiling effects, responsiveness to change, known-group validity, and concurrent validity were assessed for each score. RESULTS A total of 901 patients had at least one valid PPIUS assessment after baseline. TUFS demonstrated good test-retest reliability (intraclass correlation coefficient >0.8), discriminated between groups defined based on International Prostate Symptom Score storage score severity (known-groups validity), had high concurrent validity, and had high responsiveness to change (Guyatt's responsiveness statistic 0.88), with an absence of floor or ceiling effects. The psychometric properties of other PPIUS-derived scores were not as consistently robust and showed either low-to-moderate responsiveness, presence of a floor or ceiling effect, or low-to-moderate test-retest reliability. CONCLUSIONS This study shows that the PPIUS is reliable and valid in patients with LUTS associated with BPH. TUFS provided the best combination of psychometric properties of the six scores derived from the PPIUS and appeared to be an appropriate measure of urgency and frequency.
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Affiliation(s)
| | - Ross D Crosby
- Health Outcomes Solutions, Winter Park, FL, USA; Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | | | - Monique Klaver
- Astellas Pharma Global Development, Leiden, The Netherlands
| | - Ted Drogendijk
- Astellas Pharma Global Development, Leiden, The Netherlands
| | - Zalmai Hakimi
- Astellas Pharma Global Development, Leiden, The Netherlands
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Choi EPH, Lam CLK, Chin WY. The health-related quality of life of Chinese patients with lower urinary tract symptoms in primary care. Qual Life Res 2014; 23:2723-33. [PMID: 24920054 DOI: 10.1007/s11136-014-0725-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the health-related quality of life (HRQOL) of Chinese primary care patients with lower urinary tract symptoms (LUTS). METHODS Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire containing the International Prostate Symptom Score, the adapted Incontinence Impact Questionnaire-7, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Chinese (HK) SF-12 Health Survey Version 2 (SF-12 v2) and the Depression, Anxiety and Stress Scale-21. RESULTS LUTS patients had poorer HRQOL for the General Health and the Vitality domains and lower Physical Component Summary scores, but better HRQOL for the Role Emotion domain than the adjusted Hong Kong population norms. Clinical factors associated with poorer HRQOL measured by the SF-12 v2 included having more severe LUTS and having more severe depressive, anxiety and stress symptoms. Socio-demographic factors associated with poorer SF-12 v2 were consistent with those found in the general populations. Clinical and socio-demographic factors associated with poorer HRQOL assessed by condition-specific measures included having more severe LUTS (excluding intermittency and straining), the presence of mixed urinary incontinence, having more severe anxiety and stress symptoms, younger age, being not married, being in employment and having a lower household income. CONCLUSIONS LUTS had substantial negative impact on patients' overall health perception and global well-being in Chinese population. A decline in HRQOL might be a key determinant for Chinese patients with LUTS to seek treatment. Patients with nocturia, frequency, urgency or mixed urinary incontinence and younger patients deserve more treatment attention because they appear to have poorer HRQOL.
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Affiliation(s)
- Edmond P H Choi
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong,
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Lee DS, Choe HS, Kim SW, Jung KU, Lee SJ. Impact of the Change in Urinary and Sexual Function on Health-Related Quality of Life after Once Daily Low-Dose Mirodenafil Treatment in Patients with Organic Erectile Dysfunction. Urol Int 2014; 93:84-91. [DOI: 10.1159/000355360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 08/29/2013] [Indexed: 11/19/2022]
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Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms. Curr Opin Urol 2014; 24:10-4. [DOI: 10.1097/mou.0000000000000004] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Coyne KS, Wein A, Nicholson S, Kvasz M, Chen CI, Milsom I. Comorbidities and personal burden of urgency urinary incontinence: a systematic review. Int J Clin Pract 2013; 67:1015-33. [PMID: 24073974 DOI: 10.1111/ijcp.12164] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 02/21/2013] [Indexed: 11/30/2022] Open
Abstract
AIMS Studies on the burden and comorbidities associated with urgency urinary incontinence (UUI) are difficult to compare, partly because of the evolution of definitions for lower urinary tract symptoms and the various instruments used to assess health-related quality of life (HRQL). This article summarises published evidence on comorbidities and the personal burden associated specifically with UUI to provide clinicians with a clear perspective on the impact of UUI on patients. METHODS A PubMed search was conducted using the terms: (urgency urinary incontinence OR urge incontinence OR mixed incontinence OR overactive bladder) AND (burden OR quality of life OR well-being OR depression OR mental health OR sexual health OR comorbid), with limits for English-language articles published between 1991 and 2011. RESULTS Of 1364 identified articles, data from 70 retained articles indicate that UUI is a bothersome condition that has a marked negative impact on HRQL, with the severity of UUI a predictor of HRQL. UUI is significantly associated with falls in elderly individuals, depression, urinary tract infections, increased body mass index, diabetes and deaths. The burden of UUI appears to be greater than that of stress urinary incontinence or overactive bladder symptoms without UUI. UUI adversely impacts physical and mental health, sexual function and work productivity. CONCLUSIONS UUI is associated with numerous comorbid conditions and inflicts a substantial personal burden on many aspects of patients' lives. Healthcare providers should discuss UUI with patients and be aware of the impact of UUI and its associated comorbidities on patients' lives.
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Affiliation(s)
- K S Coyne
- Center for Health Outcomes Research, United BioSource Corporation, Bethesda, MD, USA
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Parsons JK, Sarma AV, McVary K, Wei JT. Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigms and future directions. J Urol 2013; 189:S102-6. [PMID: 23234610 DOI: 10.1016/j.juro.2012.11.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Benign prostatic hyperplasia is a highly prevalent disease in older men with substantial adverse effects on public health. Classic etiological paradigms for benign prostatic hyperplasia focus on nonmodifiable risk factors. However, obesity also potentially promotes benign prostatic hyperplasia. MATERIALS AND METHODS We performed a structured, comprehensive literature review to identify studies of obesity, benign prostatic hyperplasia, lower urinary tract symptoms and physical activity. RESULTS A preponderance of published evidence suggests strong positive associations of obesity with benign prostatic hyperplasia and lower urinary tract symptoms. This evidence encompasses most established metrics of adiposity, including body mass index, waist circumference and waist-to-hip ratio, and falls under 3 general categories, including prostate volume, clinical benign prostatic hyperplasia and lower urinary tract symptoms. 1) Prior studies consistently showed that increased adiposity is positively associated with radiographically determined prostate volume and enlargement, suggesting that obesity promotes prostate growth. 2) Most studies revealed that obesity increases the risk of clinical benign prostatic hyperplasia by several measures, including the initiation of benign prostatic hyperplasia medical treatment, noncancer prostate surgery, physician diagnosed benign prostatic hyperplasia, histological diagnosis and urinary flow rate. 3) Prior studies demonstrated that obesity increases the risk of lower urinary tract symptoms, as measured by a validated questionnaire. Also, most studies showed that physical activity significantly decreases the risk of benign prostatic hyperplasia. CONCLUSIONS Obesity markedly increases the risk of benign prostatic hyperplasia. Since physical activity decreases the risk of benign prostatic hyperplasia, these observations support the development of novel prevention strategies and treatment targeted toward adiposity, weight loss and lifestyle.
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Affiliation(s)
- J Kellogg Parsons
- Division of Urologic Oncology, Moores Cancer Center, University of California-San Diego and San Diego Veterans Affairs Medical Center, La Jolla, CA 92103, USA.
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Long-term effects of doxazosin, finasteride and combination therapy on quality of life in men with benign prostatic hyperplasia. J Urol 2013; 190:187-93. [PMID: 23357210 DOI: 10.1016/j.juro.2013.01.061] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 01/19/2023]
Abstract
PURPOSE We examined the effects of doxazosin, finasteride and combination therapy among men with benign prostatic hyperplasia on quality of life assessed with MOS-SF-36 (Medical Outcomes Study Short-Form 36) and 2 disease specific instruments (BII, benign prostatic hyperplasia Impact Index and I-PSS-QoL, International Prostate Symptom Score-QoL) during 4 years. MATERIALS AND METHODS The MTOPS (Medical Therapy of Prostatic Symptoms) study was a multicenter, randomized, double-blind, placebo controlled clinical trial with a primary outcome of time to benign prostatic hyperplasia progression. Change in quality of life was a secondary outcome. A total of 2,872 men enrolled in the MTOPS study who had 3 baseline quality of life measures and at least 1 followup measure by any of the quality of life instruments were analyzed. RESULTS Compared with men assigned to placebo, men assigned to doxazosin and combination experienced a statistically significant improvement in the BII at year 4. Men assigned to each of the drug groups also experienced a significant improvement in the I-PSS-QoL compared with those assigned to placebo. Considering longitudinal changes during 4 years, a significant improvement in BII and I-PSS-QoL scores was observed in men assigned to the drug groups compared with those assigned to placebo. However, there were no significant differences for the MOS-SF-36 subscales and summary scores when drug groups were compared with the placebo group. CONCLUSIONS The quality of life of men treated with doxazosin, finasteride, and the drugs combined generally improved when assessed with the BII and the I-PSS-QoL compared with those treated with placebo. Quality of life did not show improvement when measured by the MOS-SF-36.
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Moinpour CM, Darke AK, Donaldson GW, Cespedes D, Johnson CR, Ganz PA, Patrick DL, Ware JE, Shumaker SA, Meyskens FL, Thompson IM. Health-related quality-of-life findings for the prostate cancer prevention trial. J Natl Cancer Inst 2012; 104:1373-85. [PMID: 22972968 DOI: 10.1093/jnci/djs359] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Prostate Cancer Prevention Trial (PCPT)-a randomized placebo-controlled study of the efficacy of finasteride in preventing prostate cancer-offered the opportunity to prospectively study effects of finasteride and other covariates on the health-related quality of life of participants in a multiyear trial. METHODS We assessed three health-related quality-of-life domains (measured with the Health Survey Short Form-36: Physical Functioning, Mental Health, and Vitality scales) via questionnaires completed by PCPT participants at enrollment (3 months before randomization), at 6 months after randomization, and annually for 7 years. Covariate data obtained at enrollment from patient-completed questionnaires were included in our model. Mixed-effects model analyses and a cross-sectional presentation at three time points began at 6 months after randomization. All statistical tests were two-sided. RESULTS For the physical function outcome (n = 16 077), neither the finasteride main effect nor the finasteride interaction with time were statistically significant. The effects of finasteride on physical function were minor and accounted for less than a 1-point difference over time in Physical Functioning scores (mixed-effect estimate = 0.07, 95% confidence interval [CI] = -0.28 to 0.42, P = .71). Comorbidities such as congestive heart failure (estimate = -5.64, 95% CI = -7.96 to -3.32, P < .001), leg pain (estimate = -2.57, 95% CI = -3.04 to -2.10, P < .001), and diabetes (estimate = -1.31, 95% CI = -2.04 to -0.57, P < .001) had statistically significant negative effects on physical function, as did current smoking (estimate = -2.34, 95% CI = -2.97 to -1.71, P < .001) and time on study (estimate = -1.20, 95% CI = -1.36 to -1.03, P < .001). Finasteride did not have a statistically significant effect on the other two dependent variables, mental health and vitality, either in the mixed-effects analyses or in the cross-sectional analysis at any of the three time points. CONCLUSION Finasteride did not negatively affect SF-36 Physical Functioning, Mental Health, or Vitality scores.
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Affiliation(s)
- Carol M Moinpour
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, M3-C102 1100 Fairview Ave North, PO Box 19024 Seattle, WA 98109-1024, USA.
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Hrisanfow E, Hägglund D. Impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease. J Clin Nurs 2012; 22:97-105. [PMID: 22805299 DOI: 10.1111/j.1365-2702.2012.04143.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to investigate the impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease in primary health care. BACKGROUND Existing information on the impact of cough and urinary incontinence on quality of life in patients with chronic obstructive pulmonary disease is scant. DESIGN A questionnaire survey. METHOD The study included 391 women and 337 men, aged 50-75 years, with chronic obstructive pulmonary disease. A self-administered questionnaire consisted of CCQ and SF-12 questionnaires. A response rate of 66% was obtained. Most patients had been diagnosed with moderate (Stage II) chronic obstructive pulmonary disease. RESULTS Women and men with urinary incontinence showed a significantly higher presence of symptomatic cough and phlegm production than did women and men without incontinence. Women with incontinence had a significantly higher burden of CCQ symptoms, functional and mental state than did women without incontinence. Concerning quality-of-life scores, women with incontinence had lower physical state scores (37·6 ± 10·4 vs. 41·4 ± 9·9; p < 0·001) and mental state scores (44·3 ± 10·2 vs. 47·1 ± 10·5; p < 0·007) than did women without incontinence. Men with incontinence had a significantly higher burden of CCQ symptoms and mental state than did men without incontinence. When examining the quality-of-life scores, men with incontinence had lower mental state scores than did men without incontinence (46·0 ± 9·7 vs. 49·8 ± 9·7; p < 0·001). CONCLUSION The present results indicate that cough and urinary incontinence lead to poor quality of life in women and men with chronic obstructive pulmonary disease. RELEVANCE TO CLINICAL PRACTICE In the context of primary health care, appropriate questions concerning urinary incontinence and quality of life should be included in care plans for women and men living with chronic obstructive pulmonary disease.
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Affiliation(s)
- Elisabet Hrisanfow
- Clinical Nurse, Family Medicine Research Centre, Örebro University, Örebro, Sweden
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Cohen SA, Parsons JK. Combination Pharmacological Therapies for the Management of Benign Prostatic Hyperplasia. Drugs Aging 2012; 29:275-84. [DOI: 10.2165/11598600-000000000-00000] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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PARK WH, GON KIM H. Low-Dose Anticholinergic Combination Therapy in Male Benign Prostatic Hyperplasia Patients with Overactive Bladder Symptoms. Low Urin Tract Symptoms 2012; 4 Suppl 1:102-9. [DOI: 10.1111/j.1757-5672.2011.00135.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fourcade RO, Lacoin F, Rouprêt M, Slama A, Le Fur C, Michel E, Sitbon A, Cotté FE. Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia. World J Urol 2011; 30:419-26. [PMID: 21892656 PMCID: PMC3360843 DOI: 10.1007/s00345-011-0756-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 08/16/2011] [Indexed: 11/27/2022] Open
Abstract
Objective This study’s aim was to describe and evaluate outcomes of medical strategies used for lower urinary tract symptoms (LUTS) treatment in general practice and to assess impact of LUTS on patients’ general health-related quality of life (HRQoL). Methods This cross-sectional observational study was conducted by French general practitioners. Eligible patients were males aged ≥50 years, diagnosed for at least one year and currently treated for LUTS due to benign prostatic hyperplasia (BPH). Several validated questionnaires were documented by patients to assess severity of LUTS (IPSS), specific quality of life (IPSS-Q8), impact of LUTS (BII), LUTS evolution (VNS) and general HRQoL (EQ-5D). Results Among 1,098 patients included, 82.7% were treated with monotherapies and 17.3% with combinations. Mean treatment duration was 5.2 ± 3.2 years, and 47.2% of patients had at least one treatment modification since initiation. Patients reported diminished quality of life (IPSS-Q8 ≥3) (42.3%), persisting symptoms (IPSS-score ≥12) (35.5%), symptoms worsening (VNS-score ≤−1) (18.8%) and high bother (BII-score ≥9) (2.6%). Globally, 52.8% had at least one of these unsatisfactory outcomes. Regarding general HRQoL, mean EQ-5D utility significantly decreased with LUTS severity (mild: 0.90 ± 0.12; moderate: 0.81 ± 0.21; and severe symptoms: 0.73 ± 0.25; P < 0.001). As well, all five-dimensions of EQ-5D were significantly altered in patients with moderate-to-severe LUTS (<0.001), especially ‘Pain/Discomfort’ and ‘Anxiety/Depression’. In multivariate analyses including age and comorbidities, EQ-5D utility index remained negatively associated with each additional unit in the IPSS-score. Conclusions This study shows that around half of BPH patients medically treated report unsatisfactory outcomes, suggesting consequential unmet medical needs in general practice. Also, moderate-to-severe LUTS significantly impact on general HRQoL.
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Affiliation(s)
| | | | - Morgan Rouprêt
- Department of Urology, Hôpital La Pitié Salpêtrière, Université Pierre et Marie Curie, Paris, France
| | - Alain Slama
- Health Outcomes Studies, Laboratoire GlaxoSmithKline, Marly le Roi, France
| | - Camille Le Fur
- Health Outcomes Studies, Laboratoire GlaxoSmithKline, Marly le Roi, France
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Pöyhönen A, Häkkinen JT, Koskimäki J, Hakama M, Tammela TL, Auvinen A. Prevalence of hesitancy in 30-80-year-old Finnish men: Tampere Ageing Male Urological Study (TAMUS). BJU Int 2011; 109:1360-4. [DOI: 10.1111/j.1464-410x.2011.10443.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Obesity increases and physical activity decreases lower urinary tract symptom risk in older men: the Osteoporotic Fractures in Men study. Eur Urol 2011; 60:1173-80. [PMID: 21802828 DOI: 10.1016/j.eururo.2011.07.040] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 07/12/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND Two potential targets for preventing chronic lower urinary tract symptoms (LUTS) in older men are obesity and physical activity. OBJECTIVE To examine associations of adiposity and physical activity with incident LUTS in community-dwelling older men. DESIGN, SETTING, AND PARTICIPANTS The Osteoporotic Fractures in Men Study (MrOS) is a prospective cohort of men ≥65 yr of age. MrOS participants without LUTS and a history of LUTS treatment at baseline were included in this analysis. MEASUREMENTS Adiposity was measured with body mass index (BMI), physical activity with the Physical Activity Scale for the Elderly (PASE) and self-report of daily walking, and LUTS with the American Urological Association Symptom Index. RESULTS AND LIMITATIONS The mean age (standard deviation [SD]) of the 1695 participants was 72 (5) yr at baseline. At a mean (SD) follow-up of 4.6 (0.5) yr, 524 (31%) of men reported incident LUTS. In multivariate analyses, compared with men of normal weight at baseline (BMI <25 kg/m²), overweight (BMI: 25.0-29.9 kg/m²) and obese (≥30 kg/m²) men were 29% (adjusted odds ratio [OR(adj)]: 1.29; 95% confidence interval [CI], 1.00-1.68) and 41% (OR(adj): 1.41; 95% CI, 1.03-1.93) more likely to develop LUTS, respectively. Men in the highest quartile of physical activity were 29% (OR(adj): 0.71; 95% CI, 0.53-0.97) and those who walked daily 20% (OR(adj): 0.80; 95% CI, 0.65-0.98) less likely than their sedentary peers to develop LUTS, adjusting for BMI. The homogeneous composition of MrOS potentially diminishes the external validity of these results. CONCLUSIONS In older men, obesity and higher physical activity are associated with increased and decreased risks of incident LUTS, respectively. Prevention of chronic urinary symptoms represents another potential health benefit of exercise in elderly men.
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Bae JH, Kim SO, Yoo ES, Moon KH, Kyung YS, Kim HJ. Efficacy and safety of low-dose propiverine in patients with lower urinary tract symptoms/benign prostatic hyperplasia with storage symptoms: a prospective, randomized, single-blinded and multicenter clinical trial. Korean J Urol 2011; 52:274-8. [PMID: 21556215 PMCID: PMC3085621 DOI: 10.4111/kju.2011.52.4.274] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 03/31/2011] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to evaluate whether low-dose anticholinergics combined with an α1-receptor antagonist would continue the effect of an alpha-blocker, decrease the side effects of anticholinergics, and improve the symptoms of lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). Materials and Methods Two hundred nine men with LUTS/BPH with storage symptoms (International Prostate Symptom Score [IPSS] ≥12; storage symptoms ≥4) were randomly assigned in a prospective, multicentered, and single-blind fashion to either the control group (alfuzosin 10 mg, once daily) or the combined group (alfuzosin 10 mg, once daily, and propiverine 10 mg, once daily) for 2 months. IPSS, maximal urinary flow rate (Qmax), and postvoid residual volume (PVR) were used to grade symptoms, side effects, and the impact on quality of life (QoL) at the start of the study and after 1 and 2 months. Results There were no significant differences in patient background, including age, prostate size, Qmax, and PVR, between the control group and the combined group. In the combined group, the IPSS total score and the IPSS storage symptom score were significantly improved compared with the control group. The IPSS voiding symptom score, QoL, Qmax, and PVR did not differ significantly. There were no serious side effects in either group. Conclusions Management with an α1-receptor antagonist combined with a low-dose anticholinergic improved the total score and storage symptom score of the IPSS compared with α1-receptor antagonist only group without causing serious side effects. This initial combination medication can be considered an effective and safe treatment modality for LUTS/BPH patients with storage symptoms.
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Affiliation(s)
- Jae Hyun Bae
- Department of Urology, Korea University Medical Center and Korea University Institute of Regenerative Medicine, Seoul, Korea
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Parsons JK. Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors. CURRENT BLADDER DYSFUNCTION REPORTS 2010; 5:212-218. [PMID: 21475707 PMCID: PMC3061630 DOI: 10.1007/s11884-010-0067-2] [Citation(s) in RCA: 185] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The epidemiology of benign prostatic hyperplasia (BPH) and male lower urinary tract symptoms (LUTS) has evolved considerably during the past several years. The term LUTS describes a distinct phenotype and allows for a broad epidemiologic description of urinary symptoms at a population level. Although it is becoming the preferred term for studying urinary symptoms in populations, LUTS remains interconnected with BPH in the literature. The incidence and prevalence of BPH and LUTS are increasing rapidly as the US population ages. BPH and LUTS are associated with serious medical morbidities, an increased risk of falls, depression, diminished health-related quality of life, and billions of dollars in annual health care costs. Although age and genetics play important roles in the etiology of BPH and LUTS, recent insights at the population level have revealed that modifiable risk factors are likely key components as well. Serum dihydrotestosterone, obesity, elevated fasting glucose, diabetes, fat and red meat intake, and inflammation increase the risk; vegetables, regular alcohol consumption, exercise, and NSAIDs decrease the risk.
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Affiliation(s)
- J. Kellogg Parsons
- In care of Leslie Parker, Division of Urology, University of California, San Diego, 200 West Arbor Drive #8897, San Diego, CA 92103-8897 USA
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Changes in Awake Cystometry and Expression of Bladder β-adrenoceptors after Partial Bladder Outlet Obstruction in Male Rats. Int Neurourol J 2010; 14:157-63. [PMID: 21179333 DOI: 10.5213/inj.2010.14.3.157] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 10/26/2010] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To explore possible changes in awake cystometry and expression of beta-adrenoceptors (ARs) as a cause for bladder dysfunction in a male rat model of partial bladder outlet obstruction (pBOO). MATERIALS AND METHODS Awake cystometry was performed in rats with pBOO (16) and sham-operated rats (16), 8 weeks after the operation. The expression of mRNA and protein of β-ARs was assessed by real-time PCR and western blot. RESULTS The bladders with pBOO (1030mg) were increased compared to those in control rats (230mg). In the cystometric studies, the maximum intravesical pressure significantly increased in the pBOO group compared to control group rats (p=0.001). The time to reach maximal intravesical pressure during micturition in the pBOO group was significantly longer than the sham group (p=0.003). The frequency of non-void contraction in the pBOO group was significantly more than the sham group (p=0.006). The mRNA expressions of β2- and 3-ARs were increased insignificantly in pBOO group compared to sham group. The data of pBOO group expressed as folds of corresponding expression in sham group were 1.28 and 1.46 respectively in β2- and 3-ARs. Compared to the sham groups, the density of 60Kda protein band recognized by β2-AR antibodies and the density of 45Kda protein band recognized by β3-AR antibodies were higher in the bladder from pBOO group rats. CONCLUSION PBOO of male rats increase the maximal intravesical pressure and contraction time during micturition and the frequency of non-void contraction as well as weight of bladder. The expression of β2- and 3-ARs subtypes was increased insignificantly compared to sham operated group. This study demonstrates that the changes of cystometric or non-void contraction parameters in pBOO is one of the pathophysiologic processes potentially associated with the alterations of bladder β-ARs.
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Chartier-Kastler E, Ballanger P, Petit J, Fourmarier M, Bart S, Ragni-Ghazarossian E, Ruffion A, Le Normand L, Costa P. Randomized, crossover study evaluating patient preference and the impact on quality of life of urisheaths vs absorbent products in incontinent men. BJU Int 2010; 108:241-7. [DOI: 10.1111/j.1464-410x.2010.09736.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tsai CC, Liu CC, Huang SP, Li WM, Wu WJ, Huang CH, Lee YC, Huang SY, Pan SC. The impact of irritative lower urinary tract symptoms on erectile dysfunction in aging Taiwanese males. Aging Male 2010; 13:179-83. [PMID: 20158390 DOI: 10.3109/13685531003586975] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study assessed the possible associations between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in aging Taiwanese males and investigated the impact of various aspects of LUTS on ED. METHODS A free health screening for aging males (> or =40 years old) was conducted in Kaohsiung Medical University Hospital. All the subjects had completed clinical data and answered questionnaires. ED and LUTS were assessed by validated symptom scales: the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS). RESULTS A total of 339 eligible patients enrolled in this study with a mean age of 60.1 years old. In multiple logistic regression analysis, age and IPSS (p < 0.001 and p = 0.013, respectively) were significantly associated with ED after controlling other comorbidities. In a further age-adjusted multiple regression analysis, our results showed that irritative symptoms (p = 0.042) have a more significant association with ED than the obstructive symptoms (p = 0.101). CONCLUSIONS Our results indicate that age and LUTS are the two most independent risk factors for ED. Aging Taiwanese males with LUTS are at increasing risk for ED, especially for those with significant irritative symptoms.
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Affiliation(s)
- Chia-Chun Tsai
- Department of Urology, Kaohsiung Medical University Hospital, Taiwan
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Parsons JK, Palazzi-Churas K, Bergstrom J, Barrett-Connor E. Prospective Study of Serum Dihydrotestosterone and Subsequent Risk of Benign Prostatic Hyperplasia in Community Dwelling Men: The Rancho Bernardo Study. J Urol 2010; 184:1040-4. [DOI: 10.1016/j.juro.2010.05.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Indexed: 10/19/2022]
Affiliation(s)
- J. Kellogg Parsons
- Division of Urologic Oncology, Moores University of California-San Diego Cancer Center, La Jolla, California
- Section of Surgery, San Diego Veterans Affairs Medical Center, La Jolla, California
| | - Kerrin Palazzi-Churas
- Division of Urologic Oncology, Moores University of California-San Diego Cancer Center, La Jolla, California
| | - Jaclyn Bergstrom
- Department of Family and Preventive Medicine, University of California-San Diego School of Medicine, La Jolla, California
| | - Elizabeth Barrett-Connor
- Department of Family and Preventive Medicine, University of California-San Diego School of Medicine, La Jolla, California
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Marklund H, Spångberg A, Edéll-Gustafsson U. Sleep and health-related quality of life in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction compared to the general population and patients with inguinal hernia. ACTA ACUST UNITED AC 2010; 44:304-14. [DOI: 10.3109/00365599.2010.488246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Helén Marklund
- Department of Clinical and Experimental Medicine, University Hospital, Linköping, Sweden
- Department of Medicine and Health, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Anders Spångberg
- Department of Clinical and Experimental Medicine, University Hospital, Linköping, Sweden
| | - Ulla Edéll-Gustafsson
- Department of Medicine and Health, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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Kwong PW, Cumming RG, Chan L, Seibel MJ, Naganathan V, Creasey H, Le Couteur D, Waite LM, Sambrook PN, Handelsman D. Urinary incontinence and quality of life among older community-dwelling Australian men: the CHAMP study. Age Ageing 2010; 39:349-54. [PMID: 20305133 DOI: 10.1093/ageing/afq025] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE to describe the prevalence and impact on quality of life of urinary incontinence in a population-based cohort of older community-dwelling Australian men. SUBJECTS the population comprised 1,705 men aged >or=70 years participating in the Concord Health and Ageing in Men Project, a population-based study of urban older Australian men. METHODS data were collected between January 2005 and June 2007, and the participation rate was 47%. Data on demographics, medical history and from the 12-item Short Form Health Survey (SF-12) and International Consultation on Incontinence Questionnaire were collected. Urinary incontinence was defined as urinary leakage at least two times a week over the past 4 weeks. RESULTS the prevalence of urinary incontinence was 14.8%, increasing from 12.0% for men aged 70-74 years old to 16.3% for those aged >or=90 years, with urgency incontinence being the most frequent type of urinary incontinence. Daily urine leakage was reported by 3% of men. Men with incontinence had lower overall SF-12 scores with greater impact on the physical (PCS) than the mental (MCS) components of that scale. After adjusting for age, number of co-morbidities, enlarged prostate and prostate cancer, men with incontinence had worse PCS (43.6 vs 45.9) and MCS scores (52.2 vs 54.6) compared with continent men. CONCLUSION urinary incontinence is common among older community-dwelling men and is associated with worse quality of life with greater impact on physical than mental factors. As the population ages, urinary incontinence prevalence will increase and increased resources will be needed to address this growing problem.
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Affiliation(s)
- Po Wan Kwong
- The George Institute for International Health, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia
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