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Babalola OO, Iwaloye O, Ottu PO, Aturamu PO, Olawale F. Biological activities of African medicinal plants in the treatment of erectile dysfunction: a mechanistic perspective. Horm Mol Biol Clin Investig 2023; 44:357-370. [PMID: 38221710 DOI: 10.1515/hmbci-2022-0090] [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: 09/26/2022] [Accepted: 09/24/2023] [Indexed: 01/16/2024]
Abstract
The global incidence of erectile dysfunction is increasingly becoming a significant health concern, as its frequency demonstrates a consistent upward trajectory each year. In recent years, FDA-approved drugs like sildenafil among others has been approved to treat this disorder however the drug is not without its own side effects. In a bid to develop alternative therapeutic option, scientists have now turned to traditional medicine in search of a treatment regimen. Africa is blessed with numerous medicinal plants used in the treatment and management of several diseases including erectile dysfunction. Due to limited access to modern medicine and high-quality medical facilities, a significant number of individuals in Africa continue to depend on traditional medicine as a means of addressing critical health issues. Perhaps one of the grossly explored medicinal properties of plants in Africa is for erectile function. Through years of extensive research in medicinal plants, several plants indigenous to Africa have been identified to show profound ability to mitigate erectile dysfunction. While previous reports have indeed corroborated the ability of this plant to abate erectile dysfunction, there is still a dearth of information regarding the mechanistic aspect of these plants. Hence, the current review aims to provide a comprehensive mechanistic perspective to the major African medicinal plant which have been reported to be effective in the treatment of erectile dysfunction.
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Affiliation(s)
- Olorunfemi Oyewole Babalola
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Opeyemi Iwaloye
- Department of Biochemistry, Federal University of Technology Akure, Akure, Nigeria
| | - Paul Olamide Ottu
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Precious Olayinka Aturamu
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Femi Olawale
- Nanogene and Drug Delivery Group, University of KwaZulu-Natal, Durban, South Africa
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Nguyen Hoai B, Hoang L, Nguyen Cao T, Pham Minh Q, A Jannini E. Testosterone and aging male, a perspective from a developing country. Aging Male 2023; 26:2223712. [PMID: 37335039 DOI: 10.1080/13685538.2023.2223712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE Hypogonadism is associated with a wide range of physical and psychological symptoms that can affect the overall health of men. However, in a developing country, there are several imposing challenges in the diagnosis and treatment of hypogonadism, including a lack of awareness and understanding of the condition among healthcare providers and patients, limited resources and the high cost of treatment. This review aimed to examine the potential benefits and risks of testosterone replacement therapy (TRT) and provides a perspective of a developing country on the topic. MATERIALS AND METHODS A comprehensive literature review was conducted to gather relevant information on the impact of testosterone deficiency on ageing males and the effectiveness of TRT for treating hypogonadism. Published peer-reviewed articles were analyzed to evaluate the benefits and risks of TRT. Additionally, the unique challenges faced in the diagnosis and treatment of hypogonadism in a developing country were considered. RESULTS Testosterone replacement therapy has been shown to be an effective treatment for hypogonadism, particularly in symptomatic men with low testosterone levels. It offers potential benefits such as improvements in symptoms and overall quality of life. However, there are associated risks and side effects that need to be considered. In a developing country, challenges such as limited awareness and understanding of hypogonadism, resource constraints, and high treatment costs pose additional barriers to accessing TRT and comprehensive care. CONCLUSION In conclusion, TRT holds promise as a treatment for hypogonadism, but its implementation and accessibility face significant challenges in a developing country. Addressing these challenges, including raising awareness, allocating resources, and finding cost-effective solutions, is crucial for ensuring that men with hypogonadism in such settings receive appropriate diagnosis and treatment. Further research and efforts are needed to improve the management of hypogonadism in developing countries and optimize the potential benefits of TRT for affected individuals.
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Affiliation(s)
- Bac Nguyen Hoai
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Thang Nguyen Cao
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Quan Pham Minh
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Emmanuele A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
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Nygård LH, Talala K, Taari K, Tammela TLJ, Auvinen A, Murtola TJ. Antidiabetic drugs, glycemic control and risk of benign prostatic hyperplasia. Prostate 2023; 83:246-258. [PMID: 36325820 DOI: 10.1002/pros.24456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/03/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Diabetes has been associated with an increased risk of benign prostatic hyperplasia (BPH). However, the role of antidiabetic drugs as a BPH risk factor is unclear. The objective of our study was to examine the risk of BPH by antidiabetic drug use and glycemic control in a large population-based cohort of Finnish men. METHODS A total of 74,754 men in the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC) free of BPH at baseline in 1996-1999 were linked to the national medication reimbursement database for information on physician-prescribed antidiabetic drug purchases. Information on recorded BPH procedures and diagnoses was obtained from the National Care Register for Health Care, and for a subgroup of 17,739 men, information on blood glucose levels (BGLs) from the Fimlab Laboratories database. Cox regression with antidiabetic drug use and BGL as time-dependent variables was used to analyze the risks for starting BPH medication, recorded BPH diagnosis, and undergoing BPH surgery. The analysis was adjusted for age, use of statins, antihypertensive medication, and nonsteroidal anti-inflammatory drugs. RESULTS Of the subjects, 14,012 men (18.7%) used antidiabetic medication. Of the subgroup with fasting blood glucose data available, 7487 (42.2%) had diabetic level. The risks for BPH diagnosis (HR: 1.08, 95% CI: 1.03-1.13) and surgery (HR: 1.16, 95% CI: 1.09-1.24) were slightly elevated among antidiabetic drug users compared to nonusers. The association was strongest for insulin use. Similarly, risk of BPH surgery was increased in men with diabetic blood glucose compared to normoglycemic men. The risk association was attenuated by use of antidiabetic drugs. CONCLUSIONS Diabetic BGL and antidiabetic medication use, especially insulin, are associated with an elevated risk of BPH surgery compared to nondiabetic men. These findings support the roles of insulin use and untreated hyperglycemia as possible BPH risk factors.
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Affiliation(s)
- Lotta H Nygård
- Unit of Medicine, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Kirsi Talala
- Mass Screening Registry, Cancer Society of Finland, Finnish Cancer Registry, Helsinki, Finland
| | - Kimmo Taari
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teuvo L J Tammela
- Unit of Medicine, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - Anssi Auvinen
- Unit of Health Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Teemu J Murtola
- Unit of Medicine, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Department of Urology, Tampere University Hospital, Tampere, Finland
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Liu Y, Hu X, Xiong M, Li J, Jiang X, Wan Y, Bai S, Zhang X. Association of BMI with erectile dysfunction: A cross-sectional study of men from an andrology clinic. Front Endocrinol (Lausanne) 2023; 14:1135024. [PMID: 37065736 PMCID: PMC10101565 DOI: 10.3389/fendo.2023.1135024] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/13/2023] [Indexed: 04/18/2023] Open
Abstract
Abnormal body mass index (BMI) is associated with an increased risk of erectile dysfunction (ED). However, the relationship between different BMI categories and the levels of ED severity remains unclear. In the current study, 878 men from the andrology clinic in Central China were recruited. Erectile function was assessed by the International Index of Erectile Function (IIEF) scores. Questionnaires included questions about demographic characteristics (age, height, weight, educational status), lifestyle habits (drinking, smoking, sleep time), and medical history. Logistic regression was used to examine the association between ED risk and BMI. The incidence of ED was 53.1%. BMI was significantly higher in men from the ED group than in those from the non-ED group (P = 0.01). Compared with the normal weight group, obese men had a higher risk of ED (OR = 1.97, 95% CI = 1.25-3.14, P = 0.004), even after adjustment for potential confounders (OR = 1.78, 95% CI = 1.10-2.90, P = 0.02). Moreover, the positive correlation between obesity and moderate/severe ED severity was confirmed by logistic regression analysis (moderate/severe ED, OR = 2.71, 95% CI = 1.44-5.04, P = 0.002), even after adjusting for potential confounders (OR = 2.51 95% CI = 1.24-5.09, P = 0.01). Collectively, our findings indicate a positive correlation between obesity and the risk of moderate/severe ED. Clinicians could pay more attention to moderate/severe ED patients to maintain a healthy body weight to improve erectile function.
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Affiliation(s)
- Yixun Liu
- Department of Urology, Anhui Province Key Laboratory of Genitourinary Diseases, The Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- Department of Urology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xuechun Hu
- Department of Urology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Mengneng Xiong
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jiyan Li
- Assisted Reproduction Laboratory, Jingdezhen Maternal and Child Health Hospital, Jingdezhen, Jiangxi, China
| | - Xiaohua Jiang
- Reproductive and Genetic Hospital, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yangyang Wan
- Reproductive and Genetic Hospital, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Shun Bai
- Reproductive and Genetic Hospital, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiansheng Zhang
- Department of Urology, Anhui Province Key Laboratory of Genitourinary Diseases, The Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
- *Correspondence: Xiansheng Zhang,
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Chaudhuri GR, Das A, Kesh SB, Bhattacharya K, Dutta S, Sengupta P, Syamal AK. Obesity and male infertility: multifaceted reproductive disruption. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2022. [DOI: 10.1186/s43043-022-00099-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
The global prevalence of obesity has soared to a concerning height in the past few decades. Interestingly, the global decline in semen quality is a parallel occurrence that urges researchers to evaluate if obesity is among the most essential causatives of male infertility or subfertility.
Main body
Obesity may alter the synchronized working of the reproductive-endocrine milieu, mainly the hypothalamic-pituitary-gonadal (HPG) axis along with its crosstalks with other reproductive hormones. Obesity-mediated impairment in semen parameters may include several intermediate factors, which include physical factors, essentially increased scrotal temperature due to heavy adipose tissue deposits, and systemic inflammation and oxidative stress (OS) initiated by various adipose tissue-derived pro-inflammatory mediators. Obesity, via its multifaceted mechanisms, may modulate sperm genetic and epigenetic conformation, which severely disrupt sperm functions. Paternal obesity reportedly has significant adverse effects upon the outcome of assisted reproductive techniques (ARTs) and the overall health of offspring. Given the complexity of the underlying mechanisms and rapid emergence of new evidence-based hypotheses, the concept of obesity-mediated male infertility needs timely updates and pristine understanding.
Conclusions
The present review comprehensively explains the possible obesity-mediated mechanisms, especially via physical factors, OS induction, endocrine modulation, immune alterations, and genetic and epigenetic changes, which may culminate in perturbed spermatogenesis, disrupted sperm DNA integrity, compromised sperm functions, and diminished semen quality, leading to impaired male reproductive functions.
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Song G, Wang M, Chen B, Long G, Li H, Li R, Liu Z, Wei C, Wang T, Wang S, Liu J, Zhang Y, Liu X. Lower Urinary Tract Symptoms and Sexual Dysfunction in Male: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:653510. [PMID: 34124091 PMCID: PMC8193225 DOI: 10.3389/fmed.2021.653510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/10/2021] [Indexed: 01/10/2023] Open
Abstract
Background: An association between lower urinary tract symptoms (LUTS) and risk of sexual dysfunction in male remains controversial in recent decades. Materials and Methods: PubMed and Web of Science were searched up to October 28, 2020, for articles reporting the prevalence of sexual dysfunction in men with LUTS. The main outcomes were results from sexual dysfunction assessments. Pooled odds ratio (OR) and weighted mean difference (WMD) with 95% confidence interval (CI) were calculated. The quality assessment of the included studies was performed by using The Newcastle-Ottawa Scale (NOS) or JBI Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Results: A total of 24 full-manuscript papers met the inclusion criteria. The pooled OR for 21 studies suggested that patients with severer LUTS had a higher risk of sexual dysfunction (OR = 3.31, 95% CI: 2.43 to 4.49, p < 0.001, I 2 = 90%). A significant decrease in scores of assessment tools for sexual dysfunction was observed in the patients with higher severity of LUTS compared with those patients with lower severity (WMD = -5.49, 95%CI: -7.25 to -3.27, P < 0.001, I 2 = 96%). Similar outcomes were also found in subgroup analyses. In a detailed analysis of specific sexual function domains, the severity of LUTS was associated with erectile dysfunction, intercourse satisfaction, and overall satisfaction, except for sexual desire. Conclusion: The study demonstrates an association between exposure of lower urinary tract symptoms and risk of sexual dysfunction in male. Assessment of sexual function is necessary for patients with lower urinary tract symptoms. Systematic Review Registration: http://www.crd.york.ac.uk/prospero, identifier: CRD42020208747.
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Affiliation(s)
- Guoda Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Wang
- Department of Emergency and Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bingliang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gongwei Long
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Wei
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yucong Zhang
- Department of Geriatric, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Omran A, Leca BM, Oštarijaš E, Graham N, Da Silva AS, Zaïr ZM, Miras AD, le Roux CW, Vincent RP, Cardozo L, Dimitriadis GK. Metabolic syndrome is associated with prostate enlargement: a systematic review, meta-analysis, and meta-regression on patients with lower urinary tract symptom factors. Ther Adv Endocrinol Metab 2021; 12:20420188211066210. [PMID: 34900218 PMCID: PMC8664322 DOI: 10.1177/20420188211066210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is defined by at least three of the following five criteria: blood pressure ⩾130/85 mmHg, fasting blood glucose ⩾5.6 mmol/l, triglycerides concentration ⩾1.7 mmol/l, waist circumference ⩾102 cm (for men), and high-density lipoprotein cholesterol concentration <1.03 mmol/l (for men). MetS has been associated with worse lower urinary tract symptoms (LUTS) and higher International Prostate Symptom questionnaire scores. MATERIALS AND METHODS MEDLINE, Cochrane, ClinicalTrials.gov, and SCOPUS were critically appraised for all peer-reviewed manuscripts that suitably fulfilled our protocol's inclusion criteria established a priori. Meta-analytical and meta-regression calculations were performed in R using the Sidik-Jonkman and Hartung-Knapp random effects model and predefined covariates. RESULTS A total of 70 studies (n = 90,206) were included in qualitative synthesis. From these, 60 studies focused on MetS and LUTS: 44 reported positive correlations, 5 reported negative correlations, 11 reported no association, and 10 studies focused on MetS and total prostate volume (TPV). MetS positively correlated with moderate LUTS [odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.35-1.80], severe LUTS (OR = 2.35, 95% CI = 1.82-3.03), overactive bladder (OAB; OR = 3.2, 95% CI = 1.6-5.8), and nocturia severity (OR = 2.509, 95% CI = 1.571-4.007) at multivariate analysis. A total of 30 studies (n = 22,206) were included in meta-analysis; MetS was significantly associated with higher TPV (mean differences = 4.4450 ml, 95% CI = 2.0177-6.8723), but no significant predictive factors for effect sizes were discovered. CONCLUSION Our meta-analysis demonstrates a significant association between the aggravating effects of MetS, which commonly coexists with obesity and benign prostate enlargement.
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Affiliation(s)
| | | | - Eduard Oštarijaš
- Institute for Translational Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Natasha Graham
- Department of Obstetrics & Gynaecology, Queen Elizabeth Hospital, London, UK
| | - Ana Sofia Da Silva
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
| | | | - Alexander D. Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Carel W. le Roux
- Diabetes Complication Research Centre, School of Medicine and Medical Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Royce P. Vincent
- Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UKDepartment of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, London, UK
| | - Linda Cardozo
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
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Abstract
Objectives: Determination of the potential effect of metabolic syndrome (MetS) on erectile function in Egyptian men and description of the sociodemographic characteristics of these men.Materials and methods: A cohort of 615 patients presenting to urology department aged between 30 and 75 years were prospectively assessed and divided into two groups. Group I (n = 325) diagnosed with MetS and mean age of 56.07 ± 8.51 years. Group II (n = 290) subjects with no MetS and mean age 54.97 ± 8.14 years. Patients filled the IIEF questionnaire, medical, personal history, and BMI data were tabulated. Metabolic syndrome was determined when three or more of the five risk factors were present according to the NCEP.Results: In Group I (79.4%) of the patients had erectile dysfunction (ED). Of these, 20.3% had mild, 22.5% had moderate, and 36.6% had severe ED and 30% of patients without MetS had ED. Of these, 17.2% had mild, 5.9% had moderate, and 6.9% had severe ED (p < .001; odds ratio 5.549; 95% CI 3.101-9.928). Patients with metabolic syndrome had lower IIEF-EF domain scores. Logistic regression analysis revealed that DM, dyslipidemia, age, and HTN were the most important criteria for ED in the MetS group (p < .01). While in the group without MetS, DM, HTN, HDL, and age were the most important risk factors (p < .01), and TG and BMI were less important.Conclusions: MetS is a potential risk factor for ED in Egyptian men. Patients with MetS should be questioned about ED. The diabetic patients are most risky for ED.
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Affiliation(s)
- Mohammed Nader Salama
- Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Ahmed Abulfotooh Eid
- Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Alaa Hatem
- Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Ahmed Kamal Swidan
- Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
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Cannarella R, Burgio G, Vicari ES, La Vignera S, Condorelli RA, Calogero AE. Urogenital dysfunction in male patients with Charcot-Marie-Tooth: a systematic review. Aging Male 2020; 23:377-381. [PMID: 30064288 DOI: 10.1080/13685538.2018.1491543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Charcot-Marie-Tooth (CMT) is the most common inherited polyneuropathy. Polyneuropathies are likely to affect the urogenital system. Urogenital dysfunction is rarely investigated and may be underestimated in CMT patients. AIM The aim of the present study was to perform a systematic review of the literature to collect all the available evidence on the presence of urogenital dysfunction and in patients with CMT. METHODS Data sources were MEDLINE, Pubmed, Scopus, and Google Scholar. All types of studies describing the presence of lower urinary tract dysfunction, erectile dysfunction (ED), anejaculation, and other sexual disorders in male patients with CMT were included. RESULTS Among 131 records identified, five articles were included in the qualitative synthesis. Lower urinary tract dysfunction, neurogenic bladder, ED, and other sexual dysfunctions have been reported in patients with CMT. One case of anejaculation has been described. CONCLUSION Urogenital dysfunction occurs in patients with CMT. Therefore, uro-andrologic counseling should be performed in the aging male with CMT. This might positively impact on his quality of life.
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Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanni Burgio
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Enzo S Vicari
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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10
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Wong A, Mahmalji W. The role of Rezūm ™ team ablation of the prostate in the treatment of patients with acute urinary retention secondary to benign prostatic hyperplasia. A single center, single surgeon case series and literature review. Aging Male 2020; 23:1620-1626. [PMID: 33818292 DOI: 10.1080/13685538.2021.1901273] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Acute urinary retention (AUR) is one of the most significant complication of benign prostatic hyperplasia (BPH). The gold standard surgical treatment for BPH, transurethral resection of the prostate (TURP), is not without significant side effects and a prolonged hospital stay. The aim of this study is to evaluate the role of Rezūm ™ steam ablation in the treatment of patients with AUR secondary to BPH. METHODS Patients who developed AUR and failed their trial without a catheter (TWOC) were recruited. They were counselled about the procedure and offered the treatment. Pre-operative, intraoperative and post operate data were collected. RESULTS All patients were followed up for a mean period of 7.2 months. 100% of patients passed their TWOC and stopped taking any BPH medications after. There was an average of 43.8% decrease in TRUS volume and a fall of 52.5% in PSA value after intervention. The mean operation time was 8.8 min and mean duration in hospital was 5.8 h. No deterioration in sexual function was reported. CONCLUSIONS Rezūm ™ steam ablation of the prostate is safe, fast and effective day case procedure in treating patients with AUR secondary to BPH. All patients were satisfied with the functional outcomes.
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Affiliation(s)
- Anton Wong
- Hereford County Hospital, Wye Valley NHS Trust, Hereford, UK
| | - Wasim Mahmalji
- Hereford County Hospital, Wye Valley NHS Trust, Hereford, UK
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Taylor WSJ, Cobley J, Mahmalji W. Is aspiration and sclerotherapy treatment for hydroceles in the aging male an evidence-based treatment? Aging Male 2019; 22:163-168. [PMID: 29336195 DOI: 10.1080/13685538.2018.1425987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Symptomatic hydroceles are commonly treated with surgical repair. They are associated with sexual dysfunction in the aging male. Patients who are not fit for surgery often undergo aspiration and sclerotherapy of the hydrocele. There is a range of sclerosing agents used in the literature. I performed a literature search to assess whether one sclerosant was better than the others. STDS is the sclerosing agent with the best cure rate after a single injection and low side effect rates. The cure rates of sodium tetradecyl sulphate (STDS) after a single aspiration and injection were 76%. After multiple treatments 94% achieved a cure. Patient satisfaction rates at mean 40 months were 95%. Complication rates were generally low and much lower than surgical repair. Aspiration and sclerotherapy have a role in treating symptomatic hydroceles. This literature review shows that this is over and above its current use in the UK, where it is used for patients unfit for general anaesthetic. If the patients are carefully selected for this procedure, they can have a good outcome and avoid the higher complication rate and longer recovery rates of surgical repair. Patients should be counselled about aspiration and sclerotherapy as part of the informed consent process.
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Affiliation(s)
- W St J Taylor
- a Urology Department , Hereford County Hospital , Hereford , UK
| | - J Cobley
- a Urology Department , Hereford County Hospital , Hereford , UK
| | - W Mahmalji
- a Urology Department , Hereford County Hospital , Hereford , UK
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Kim A, Park YJ, Heo KO, Choi WS, Park HK, Paick SH, Choo MS, Kim HG. Novel symptom questionnaire for the differential diagnosis of detrusor underactivity and bladder outlet obstruction in men. Aging Male 2019; 22:150-155. [PMID: 29985721 DOI: 10.1080/13685538.2018.1481941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To develop a questionnaire for the differential diagnosis of detrusor underactivity (DUA) and bladder outlet obstruction (BOO) without performing invasive pressure flow studies. STUDY DESIGN AND METHODS Symptoms of men with DUA were analyzed and compared with those of men with BOO using eight questions from the developing questionnaire. Patients with DUA have a bladder contractility index (PdetQmax+5xQmax) less than 100, whereas those with BOO have a BOO index (PdetQmax-2xQmax) greater than 40 in urodynamic studies (UDS). Men with detrusor overactivity in UDS and neurogenic issues were excluded from the analysis. One urologist reviewed patients' medical records, and responded to eight questions without using information from UDS. Scores in the developing questionnaire were then compared to make a differential diagnosis between DUA and BOO. RESULTS Overall, 318 men who underwent UDS were included. Symptoms were compared in patients diagnosed with DUA without BOO (n = 165) and BOO without DUA (n = 153). Questions 1, 2, 4, 5, 6, and 7 were significantly different between groups. The sensitivity and specificity of the questionnaire were 95.8% and 95.4%, respectively, for predicting DUA in patients with scores greater than 45 points (cutoff value). CONCLUSIONS Men with DUA and BOO may be distinguished using a developing questionnaire without invasive evaluation. Men with scores greater than 45 points would be expected to have DUA but not BOO.
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Affiliation(s)
- Aram Kim
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Young-Jin Park
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Kyung Ok Heo
- b Department of Urology , Asan Medical Center, Ulsan University College of Medicine , Seoul , Korea
| | - Woo Suk Choi
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Hyoung Keun Park
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Sung Hyun Paick
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Myung-Soo Choo
- b Department of Urology , Asan Medical Center, Ulsan University College of Medicine , Seoul , Korea
| | - Hyeong Gon Kim
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
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Di Vincenzo A, Busetto L, Vettor R, Rossato M. Obesity, Male Reproductive Function and Bariatric Surgery. Front Endocrinol (Lausanne) 2018; 9:769. [PMID: 30619096 PMCID: PMC6305362 DOI: 10.3389/fendo.2018.00769] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 12/06/2018] [Indexed: 12/21/2022] Open
Abstract
Overweight and obesity are associated with several chronic complications, such as type 2 diabetes, arterial hypertension and atherosclerotic cardiovascular diseases, with relevant consequences for patients and public health systems. Reproductive function abnormalities, such as obesity-related secondary hypogonadism, erectile dysfunction and infertility, represent other abnormalities negatively affecting the quality of life of men suffering from obesity but, despite their high prevalence, these are often understated because of a general lack of awareness in clinical practice. Obesity and gonadal function are closely related, with obesity being associated with hypogonadism that is reversed by body weight reduction thus ameliorating reproductive and sexual health. Clinical studies specifically evaluating the impact of non-surgical weight loss on testosterone levels sometimes showed conflicting results, whereas extensive literature has demonstrated that weight loss after bariatric surgery is correlated with an increase in testosterone levels greater than that obtained with only lifestyle interventions, suggesting the role of surgery also for the treatment of hypogonadism in obese male. However, studies concerning the consequences of bariatric surgery on overall reproductive function in the male, including also sexual activity and fertility, are limited and data regarding long-term effects are lacking. Here we present a brief review summarizing the evidence regarding the interplay between obesity and reproductive abnormalities in the obese male, together with the role of bariatric surgery for the treatment of these complications, describing both the positive effects and the limitations of this procedure.
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Affiliation(s)
- Angelo Di Vincenzo
- Department of Medicine—DIMED, Center for the Study and Integrated Management of Obesity, Clinica Medica 3, University-Hospital of Padova, Padova, Italy
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Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction: from physiology to clinical aspects. Aging Male 2018; 21:261-271. [PMID: 29374992 DOI: 10.1080/13685538.2018.1430758] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Erectile dysfunction, prostatic hyperplasia and lower urinary tract symptoms hare important pathogenetic links. Endothelial dysfunction and hormonal alterations represent the main aspects. The present article examines the anatomical, physiological, and pathophysiological characteristics of this association, finalizing the text to an interpretation of the clinical management of these patients based on these functional considerations.
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Affiliation(s)
- Aldo E Calogero
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Giovanni Burgio
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Rosita A Condorelli
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Rossella Cannarella
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Sandro La Vignera
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
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15
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Kosilov K, Kuzina I, Kuznetsov V, Gainullina Y, Kosilova L, Karashchuk E, Prokofyeva A, Loparev S. The Risk of Sexual Dysfunction and Effectiveness of Treatment of Benign Prostatic Hyperplasia With Severe Lower Urinary Tract Dysfunction With Combination of Dutasteride and Solifenacin. J Sex Med 2018; 15:1579-1590. [DOI: 10.1016/j.jsxm.2018.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 11/16/2022]
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16
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Dursun M, Besiroglu H, Cakir SS, Otunctemur A, Ozbek E. Increased visceral adiposity index associated with sexual dysfunction in men. Aging Male 2018; 21:187-192. [PMID: 29166824 DOI: 10.1080/13685538.2017.1406468] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Visceral adipose index (VAI) is a novel parameter for the evaluation of visceral obesity. As we know that obesity is a risk factor for erectile dysfunction (ED). So, in this study, we compared the VAI levels between the men with ED and without ED. MATERIALS AND METHOD A total of 177 men were included in the study. Ninety-five men with ED and 82 men without ED (control). All men were evaluated for ED by Index of Erectile Function-5 items (IIEF-5). VAI levels were calculated using body mass index, high density lipoprotein and tryglyceride levels. RESULTS Mean age was 53.5 (38-69) in men who have ED and 53.1 (34-69) in control. The men with ED had higher body mass index (BMI), triglyceride (TG) levels, higher waist circumference (WC) and lower high-density lipoprotein-cholesterol (HDL-C) levels. Mean VAI level was 5.18 ± 2.50 in study group and 3.47 ± 1.76 in control goup, respectively. VAI levels were statistically higher in men with ED (p < .001). DISCUSSION The simplicity of WC and BMI measurement and TG and HDL assessment, make VAI an easily applicable index for the evaluation of visceral fat dysfunction. VAI can be useful index for the evaluation and calculation of erectile dysfunction risk.
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Affiliation(s)
- Murat Dursun
- a Department of Urology , Bahcelievler State Hospital , Istanbul , Turkey
| | - Huseyin Besiroglu
- b Department of Urology , Catalca Ilyas Cokay State Hospital , Istanbul , Turkey
| | - Suleyman Sami Cakir
- c Department of Urology , Okmeydani Training and Research Hospital , Istanbul , Turkey
| | - Alper Otunctemur
- c Department of Urology , Okmeydani Training and Research Hospital , Istanbul , Turkey
| | - Emin Ozbek
- d Department of Urology , Istanbul Training and Research Hospital , Istanbul , Turkey
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Moon KH, Park SY, Kim YW. Obesity and Erectile Dysfunction: From Bench to Clinical Implication. World J Mens Health 2018; 37:138-147. [PMID: 30079640 PMCID: PMC6479091 DOI: 10.5534/wjmh.180026] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/17/2018] [Accepted: 05/23/2018] [Indexed: 12/25/2022] Open
Abstract
Obesity is a major public health issue worldwide and is frequently associated with erectile dysfunction (ED). Both conditions may share an internal pathologic environment, also known as common soil. Their main pathophysiologic processes are oxidative stress, inflammation, and resultant insulin and leptin resistance. Moreover, the severity of ED is correlated with comorbid medical conditions, including obesity. Therefore, amelioration of these comorbidities may increase the efficacy of ED treatment with phosphodiesterase 5 inhibitors, the first-line medication for patients with ED. Although metformin was originally developed as an insulin sensitizer six decades ago, it has also been shown to improve leptin resistance. In addition, metformin has been reported to reduce oxidative stress, inflammatory response, and body weight, as well as improve ED, in animal and human studies. Moreover, administration of a combination of metformin and phosphodiesterase 5 inhibitors improves erectile function in patients with ED who have a poor response to sildenafil and are insulin resistant. Thus, concomitant treatment of metabolic derangements associated with obesity in patients with ED who are obese would improve the efficacy and reduce the refractory response to penile vasodilators. In this review, we discuss the connecting factors between obesity and ED and the possible combined treatment modalities.
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Affiliation(s)
- Ki Hak Moon
- Department of Urology, Yeungnam University College of Medicine, Daegu, Korea
| | - So Young Park
- Department of Physiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Yong Woon Kim
- Department of Physiology, Yeungnam University College of Medicine, Daegu, Korea.
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Traish AM, Johansen V. Impact of Testosterone Deficiency and Testosterone Therapy on Lower Urinary Tract Symptoms in Men with Metabolic Syndrome. World J Mens Health 2018; 36:199-222. [PMID: 30079638 PMCID: PMC6119850 DOI: 10.5534/wjmh.180032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/10/2018] [Indexed: 12/11/2022] Open
Abstract
Lower urinary tract function is modulated by neural, vascular and urethral and bladder structural elements. The pathophysiological mechanisms of lower urinary tract symptoms (LUTS) encompass prostate enlargement, alterations in urethra histological structure bladder fibrosis and alterations in pelvic neuronal and vascular networks, The complex pathophysiological relationship between testosterone (T) deficiency (TD) and the constellations LUTS, and metabolic dysfunction manifested in the metabolic syndrome (Met S) remains poorly understood. TD has emerged as one the potential targets by which Met S may contribute to the onset and development as well as worsening of LUTS. Because it has been recognized that treatment of men with Met S with T therapy ameliorates Met S components, it is postulated that T therapy may represent a therapeutic target in improving LUTS. Furthermore, the effect of TD on the prostate remains unclear, and often debatable. It is believed that T exclusively promotes prostate growth, however recent evidence has strongly contradicted this belief. The true relationship between benign prostatic hyperplasia, TD, and LUTS remains elusive and further research will be required to clarify the role of T in both benign prostatic hypertrophy (BPH) and LUTS as a whole. Although there is conflicting evidence about the benefits of T therapy in men with BPH and LUTS, the current body of literature supports the safety of using this therapy in men with enlarged prostate. As the population afflicted with obesity epidemic continues to age, the number of men suffering from Met S and LUTS together is expected to increase.
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Affiliation(s)
- Abdulmaged M Traish
- Department of Urology, Boston University School of Medicine, Boston, MA, USA.
| | - Vanessa Johansen
- Department of Urology, Boston University School of Medicine, Boston, MA, USA
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Angelova P, Kamenov Z, Tsakova A, El-Darawish Y, Okamura H. Interleukin-18 and testosterone levels in men with metabolic syndrome. Aging Male 2018; 21:130-137. [PMID: 29168426 DOI: 10.1080/13685538.2017.1401993] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Interleukin 18 (IL-18) is an adipokine associated with obesity. Data about the relationship of IL-18 to the metabolic syndrome (MS) are still scarce. Low testosterone (T) levels are common in men with MS, but we did not find data about the levels of IL-18 in men with low T. The aim of this study was to determine the levels of IL-18 in men with MS with or without low T. PATIENTS AND METHODS A total of 251 men were included in the study. Of them 218 had MS (IDF 2005) and they were divided according to their morning total testosterone (TT) level (cutoff 10.4 nmol/l) into two groups: MS-low T (N = 84) and MS-normal T (N = 134). The control group consisted of 33 men without MS and low T. IL-18 was determined in serum using enzyme-linked immunosorbent assay. A small group of eight men with MS and low T levels received testosterone therapy for three months and physical and laboratory parameters were monitored at the end of that period. RESULTS MS men were at mean age (±SD) = 53.77 ± 9.59 years; body mass index (BMI) = 34.0 ± 6.3 kg/m2; and TT = 12.59 ± 5.66 nmol/l. The control group was at age = 52.12 ± 5.2 years (NS); BMI = 25.6 ± 2.4 kg/m2 (p < .001); and TT = 17.8 ± 5.68 nmol/l (p < .001), respectively. The levels of IL-18 were higher in the MS group - 345 pg/ml compared to the control one - 264 pg/ml (p < .01). There was no significant difference between MS-low T (330.6 pg/ml) and MS-normal T (350.2 pg/ml) subgroups. The MS-normal T differed more significantly from the control group (p < .001). Significant correlation of testosterone with IL-18 levels was not found. IL-18 correlated with parameters of obesity, lipids, fasting blood sugar (p < .05) and the number of criteria for MS (p < .001). Three months on T treatment showed improvement in obesity parameters and only in one patient IL-18 had clear reduction while the rest showed no change. CONCLUSIONS In this study, higher IL-18 levels were found in the presence of MS compared to healthy men, but they did not differ between men having MS with or without LOH.
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Affiliation(s)
- Petya Angelova
- a Clinic of Endocrinology , Alexandrovska University Hospital, Medical University-Sofia , Sofia , Bulgaria
| | - Zdravko Kamenov
- a Clinic of Endocrinology , Alexandrovska University Hospital, Medical University-Sofia , Sofia , Bulgaria
| | - Adelina Tsakova
- b Central Clinical Laboratory , Alexandrovska University Hospital, Medical University-Sofia , Sofia , Bulgaria
| | - Yosif El-Darawish
- c Laboratory of Tumor Immunology and Immunotherapy , Hyogo College of Medicine , Hyogo , Japan
| | - Haruki Okamura
- d Laboratory of Host Defense , Hyogo College of Medicine , Hyogo , Japan
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20
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Park SG, Yeo JK, Cho DY, Park MG. Impact of metabolic status on the association of serum vitamin D with hypogonadism and lower urinary tract symptoms/benign prostatic hyperplasia. Aging Male 2018; 21:55-59. [PMID: 28414251 DOI: 10.1080/13685538.2017.1311857] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The objective of this study is to investigate the impact of metabolic status on associations of serum vitamin D with hypogonadism and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). PATIENTS AND METHODS A total of 612 men underwent physical examination, biochemical/hormonal blood testing, and transrectal prostate ultrasound. Moreover, the subjects filled out standard questionnaires for identification and grading of LUTS and hypogonadism symptoms. Parameters were statistically compared with independent t-tests and correlation analyses. RESULTS Vitamin D levels positively correlated with total testosterone (TT) but not with prostate volume or International Prostate Symptom Score (IPSS). Patients with metabolic syndrome had significantly lower vitamin D levels, which were not correlated with TT, prostate volume, or IPSS. However, vitamin D was positively correlated with TT, and negatively correlated with prostate volume and quality-of-life IPSS in subjects without metabolic syndrome. CONCLUSION The clinical usefulness of vitamin D for treatment of hypogonadism or LUTS/BPH varies according to metabolic status.
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Affiliation(s)
- Sun Gu Park
- a Department of Preventive Medicine , Gachon University College of Medicine , Incheon , Korea
| | - Jeong Kyun Yeo
- b Department of Urology , Inje University Seoul Paik Hospital , Seoul , Korea
| | - Dae Yeon Cho
- c Department of Urology , Inje University, Sanggye Paik Hospital , Seoul , Korea
| | - Min Gu Park
- b Department of Urology , Inje University Seoul Paik Hospital , Seoul , Korea
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De Nunzio C, Roehrborn CG, Andersson KE, McVary KT. Erectile Dysfunction and Lower Urinary Tract Symptoms. Eur Urol Focus 2017; 3:352-363. [PMID: 29191671 DOI: 10.1016/j.euf.2017.11.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/12/2017] [Accepted: 11/13/2017] [Indexed: 01/10/2023]
Abstract
CONTEXT Lower urinary tract symptoms (LUTSs) and erectile dysfunction (ED) are substantial health concerns with a significant impact on the overall male quality of life. OBJECTIVE To evaluate the available evidence of the association between LUTSs and ED in patients with benign prostatic hyperplasia (BPH), and discuss possible clinical implications for the management of LUTS/BPH. EVIDENCE ACQUISITION A systematic review of the existing literature published between 1997 and June 2017 and available in the Medline, Scopus, and Web of Science databases was conducted using both the Medical Subject Heading (MeSH) and free-text protocols. The MeSH search was conducted by combining the following terms: "lower urinary tract symptoms," "LUTS," "benign prostatic hyperplasia," "BPH," "erectile dysfunction," "sexual dysfunction," "BPE," and "benign prostatic enlargement." The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. EVIDENCE SYNTHESIS Several community-based studies in different geographical areas have provided strong evidence of an age-independent association between LUTSs and ED. Several biological mechanisms have been proposed to explain this association, but further research is required to better understand the molecular pathways involved. It is necessary to evaluate the possible impact of the metabolic syndrome treatment on LUTS/ED management. Considering the possible relationship between LUTSs and ED, their impact on the quality of life, and the possible adverse effects associated with LUTS medical treatment, clinicians should always evaluate ED in patients with LUTSs and take the opportunity to evaluate patients reporting ED for LUTSs. CONCLUSIONS Data from the peer-reviewed literature suggest the existence of an association between LUTS/BPH and ED, although their casual relationship has not been established yet. Emerging data also suggest that pathophysiological mechanisms involved in the metabolic syndrome are key factors in both disorders. Considering the association, it is also recommended that men presenting with LUTSs or ED should be evaluated for both disorders. A better understanding of the molecular pathways behind this association may also help identify new possible targets and develop novel therapeutic approaches to manage LUTSs and ED. PATIENT SUMMARY In this manuscript, we report on all the available evidence linking erectile dysfunction and lower urinary tract symptoms. Our findings suggest the existence of a strong relationship between these two conditions. On the basis of these findings, we recommend that clinicians always explore both conditions in male patients presenting with either of symptoms.
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Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, "La Sapienza" University, Roma, Italy.
| | - Claus G Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Kevin T McVary
- Southern Illinois University School of Medicine, Springfield, IL, USA
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Besiroglu H, Dursun M, Otunctemur A, Ozbek E. The association between triglyceride high density lipoprotein cholesterol ratio and benign prostate hyperplasia in non-diabetic patients:a cross-sectional study. Aging Male 2017; 20:198-204. [PMID: 28332908 DOI: 10.1080/13685538.2017.1303828] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To assess the association between triglyceride (TG)/high density lipoprotein (HDL) ratio and benign prostate hyperplasia/lower urinary tract symptoms (BPH/LUTS). METHODS Four hundred patients who were admitted to the Urology Clinic between January and December 2014 with complaints of BPH/LUTS were enrolled in this cross-sectional study. Patients were divided into two groups according to their International Prostate Symptom Score and prostate volume (PV). They were compared in terms of age, body mass index (BMI), PV, PSA, post micturional residual volume, uroflowmetry Q max value, fasting blood sugar, TG and high density lipoprotein-cholesterol (HDL-C) level and TG/HDL ratio. RESULTS Although univariate analyses reveal that age, BMI, waist circumference (WC), FBS, TG, HDL-C level, and TG/HDL ratio were correlated with PV, only age [1.125 OR (1.088-1.164), p = .00001], BMI [1.119 OR (1.040-1.204), p = .003], TG [(1.043 OR (1.016-1.071), p = .002], HDL-C [(0.923 OR (0.860-0.990), p = .025], and TG/HDL ratio [(1.224 OR (1.130-1.315), p = .014] were statistically significant in multivariate analysis. The calculated area under the curve (AUC) for PV of 30 ml, 40 ml, and 50 ml was 0.668 (0.608-0.727), 0.617 (0.561-0.673), and 0.592 (0.530-0.654), respectively. CONCLUSIONS Our results indicate that the TG/HDL ratio correlates with enhancement in PV. Further studies are warranted to better evaluate this relationship.
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Affiliation(s)
- Huseyin Besiroglu
- a Department of Urology , Catalca Ilyas Cokay State Hospital , Istanbul , Turkey
| | - Murat Dursun
- b Department of Urology , Bahcelievler State Hospital , Istanbul , Turkey
| | - Alper Otunctemur
- c Department of Urology , Okmeydani Training and Research Hospital , Istanbul , Turkey
| | - Emin Ozbek
- d Department of Urology , Istanbul Training and Research Hospital , Istanbul, Turkey
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Bardoli AD, Taylor WSJ, Mahmalji W. Can the UroLift prostatic implant device treat the symptoms of benign prostatic hypertrophy, avoid sexual dysfunction and reduce hospital TURP waiting times? A single centre, single surgeon experience and review of the literature. Aging Male 2017; 20:192-197. [PMID: 28609136 DOI: 10.1080/13685538.2017.1336531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BPH associated with LUTS and sexual dysfunction is common. We performed UroLift on 11 patients, average age 71 years (range 56-90). IPSS improved by an average of 9 points post-procedure. Pre-operatively their post-void residuals were 306.3 ml (range 120-499 ml SD [120.6]) and their QMAX was 7 ml/s (range 4-14 SD [2.8] ml/s). Post-procedure the post-void residual decreased by 35.4% at 4 months (mean difference - 106.3 ml). QMAX improved by an average of 1.7 ml/s, which was not statistically significant. No patients suffered any sexual dysfunction side effects and all patients were satisfied with their result. Hospital stay and theatre time were significantly reduced. Average length of stay was just 10.6 (6-18) hours and average theatre time just 18.7 (12-30) min. This is significantly faster than other surgery for LUTS. We therefore feel that there are significant benefits for both the patients, who are able to go home much faster, and also the hospital, who are able to perform far more surgeries for their patients. Patients also do not require an inpatient bed so patients should not be cancelled on the day of theatre.
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Affiliation(s)
- Antonio D Bardoli
- a College of Medical & Dental Sciences , University of Birmingham Medical School , Birmingham , UK
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Patel JP, Lee EH, Mena-Hurtado CI, Walker CN. Evaluation and Management of Erectile Dysfunction in the Hypertensive Patient. Curr Cardiol Rep 2017; 19:89. [DOI: 10.1007/s11886-017-0889-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Allen S, Aghajanyan I. Use of thermobalancing therapy in ageing male with benign prostatic hyperplasia with a focus on etiology and pathophysiology. Aging Male 2017; 20:28-32. [PMID: 27960590 DOI: 10.1080/13685538.2016.1247151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION We investigated if "thermobalancing" therapy (TT), using Dr Allen's therapeutic device (DATD) in men with benign prostatic hyperplasia (BPH), can aid in understanding the etiology and pathophysiology of BPH. METHODS We compared urinary and other parameters of BPH patients who received TT over 6 months (treatment group) with those of healthy volunteers who had not received the treatment (control group). Dynamics of symptoms and indicators in each group were evaluated in comparison with their data at the beginning and end of the study. Parameters were the International Prostate Symptom Score (IPSS) for urinary symptoms and quality of life (QoL), ultrasound measurement of prostate volume (PV) and uroflowmetry (maximum flow rate, Qmax). TT effectiveness was examined in 124 men with BPH and PV <60 mL. We also investigated the data of five patients with BPH and PV >60 mL. RESULTS TT decreased urinary symptoms and PV, increased Qmax and improved QoL in men with BPH, PV <60 mL, and in men with BPH, PV >60 mL. CONCLUSIONS The present study demonstrated that TT is effective for BPH, suggesting that blood circulation plays a crucial role in its cause. The continuous heat exposure that does not exceed the normal body temperature terminates the trigger of BPH development, "micro-focus" of hypothermia, and the following spontaneous expansion of capillaries. TT could be considered to be a useful tool in BPH treatment.
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Affiliation(s)
- Simon Allen
- a Fine Treatment , Oxford , United Kingdom of Great Britain and Northern Ireland and
| | - Ivan Aghajanyan
- b Urology, Yerevan State Medical University Named after Mkhitar Heratsi , Yerevan , Armenia
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Kosilov K, Loparev S, Kuzina I, Shakirova O, Zhuravskaya N, Lobodenko A. The effective tool for self-assessment of adherence to treatment in patients with benign prostatic obstruction and overactive bladder symptoms. Aging Male 2017; 20:39-44. [PMID: 28074677 DOI: 10.1080/13685538.2016.1247435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Study of validity of the Medication Adherence Self-Report Inventory (MASRI) for use in clinical practice to treat patients with benign prostatic obstruction (BPO) accompanied with overactive bladder (OAB) symptoms. METHODS During 12 weeks of the randomized study, 452 patients with BPO and OAB symptoms (mean age of 61.3 (12.7)) were studied for adherence to the treatment with Tamsulosin, Solifenacin and Trospium using the MASRI. External monitoring instruments included the Brief Medication Questionnaire (BMQ) and the visual remaining pill count. The state of the prostate gland and the lower urinary tract was monitored using questionnaires I-PSS, OAB Awareness Tool, uroflowmetry and voiding diaries. RESULT Correlation between the percentage of men non-adherent to treatment (MASRI) and the percentage of patients having a belief barrier on the screen of the BMQ was r = 0.89, p ≤0.05, r = 0.92, p ≤0.01, r = 0.85, p ≤0.05, a number of missed doses on the Regimen Screen of the BMQ was r = 0.79; p ≤0.05; r = 0.81; p ≤0.05; r = 0.75, p ≤0.05, a number of non-adherent patients according to the BMQ was r = 0.83 (p ≤0.05), r = 0.88 (p ≤0.05), r = 0.79, p ≤0.05, the results of the pill count were r = 0.65-0.76; p ≤0.05-0.01. These data confirm high validity of the MASRI. CONCLUSION The MASRI is a valid tool for rapid assessment of adherence to treatment of patients with BPO and OAB receiving Tamsulosin and antimuscarinic drugs and may be recommended for use in clinical practice.
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Affiliation(s)
- Kirill Kosilov
- a Department of Social Sciences , Far Eastern Federal University , Vladivostok , Russia
| | - Sergey Loparev
- b Department of Urology , Sity Policlinic 3 , Vladivostok , Russia , and
| | - Irina Kuzina
- a Department of Social Sciences , Far Eastern Federal University , Vladivostok , Russia
| | - Olga Shakirova
- c Department of theory and methodology of adaptive physical training , Far Eastern Federal University , Vladivostok , Russia
| | - Natalya Zhuravskaya
- c Department of theory and methodology of adaptive physical training , Far Eastern Federal University , Vladivostok , Russia
| | - Alexandra Lobodenko
- a Department of Social Sciences , Far Eastern Federal University , Vladivostok , Russia
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Alcántara Montero A, Brenes Bermúdez F. Relación entre el síndrome metabólico y los síntomas del tracto urinario inferior en el varón. Semergen 2016; 42:e171-e173. [DOI: 10.1016/j.semerg.2015.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 11/08/2015] [Indexed: 10/22/2022]
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Mollace V, Malara N, Gratteri S, Palma E, Zappia L, Costa N, Rosano G, Paone S. Bergamot polyphenolic fraction counteracts erectile dysfunction occurring in patients suffering from type 2 diabetes. PHARMANUTRITION 2016. [DOI: 10.1016/j.phanu.2015.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Zhao SC, Xia M, Tang JC, Yan Y. Associations between metabolic syndrome and clinical benign prostatic hyperplasia in a northern urban Han Chinese population: A prospective cohort study. Sci Rep 2016; 6:33933. [PMID: 27653367 PMCID: PMC5032014 DOI: 10.1038/srep33933] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/05/2016] [Indexed: 12/30/2022] Open
Abstract
Biologic rationales exist for the associations between metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH). However, epidemiologic studies have yield inconsistent results. The aim of the present study was to prospectively evaluate the associations of MetS with the risk of BPH. The presence of MetS, the number of MetS components, and the individual MetS components were evaluated. After adjusting for potential confounders, MetS was associated with increased risk of BPH (HR: 1.29; 95% CI, 1.08-1.50; p < 0.001). Compared with subjects without any MetS components, the HRs were 0.88 (95% CI, 0.67-1.09; p = 0.86), 1.18 (95% CI, 0.89-1.47; p = 0.29) and 1.37 (95% CI, 1.08-1.66; p = 0.014) for subjects with 1, 2, or ≥3 MetS components, and there was a biologic gradient between the number of MetS components and the risk of BPH (p-trend < 0.001). Central obesity and low high-density lipoprotein cholesterol were the two main divers of the associations between these two conditions, with HRs of 1.93 (95% CI, 1.14-2.72; p = 0.001) for central obesity, and 1.56 (95% CI, 1.08-2.04; p = 0.012) for low HDL-C. Our findings support the notion that MetS may be an important target for BPH prevention and intervention.
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Affiliation(s)
- Si-Cong Zhao
- Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Ming Xia
- Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jian-Chun Tang
- Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yong Yan
- Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Maeda T, Kikuchi E, Hasegawa M, Ando T, Matsushima M, Yuge K, Ito Y, Miyajima A, Oya M. A prospective longitudinal survey of erectile function status in symptomatic benign prostatic hyperplasia patients treated with dutasteride. Aging Male 2016; 19:111-6. [PMID: 26964647 DOI: 10.3109/13685538.2016.1156082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We prospectively evaluated erectile function (EF) using the Sexual Health Inventory for Men (SHIM) and the erectile hardness score (EHS) as well as urinary statuses using the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) before and 3, 6, and 12 months after a daily treatment with 0.5 mg dutasteride (DUT). Significant improvements were observed in IPSS and OABSS in 98 patients with the DUT treatment, and the effects were similar between 28 patients with potency with baseline SHIM of 8 or greater and 70 severe erectile dysfunction (ED) patients at baseline. In the 28 patients with potency, significant decreases were observed in SHIM and EHS after 3, 6, and 12 months of the DUT treatment, with the severity of ED according to SHIM deteriorating in half of these patients after 12 months of the DUT treatment. Eighteen out of 28 patients (64.3%) with potency at baseline had awareness of the occurrence of ED before the DUT treatment, were younger, and had higher SHIM and EHS just before the DUT treatment than their counterparts. Regular assessments of EF may be needed, especially in younger patients and those with higher levels of EF before the administration of DUT.
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Affiliation(s)
- Takahiro Maeda
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Eiji Kikuchi
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Masanori Hasegawa
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Toshiyuki Ando
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Masashi Matsushima
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Kazuyuki Yuge
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Yujiro Ito
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Akira Miyajima
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
| | - Mototsugu Oya
- a Department of Urology , Keio University School of Medicine , Tokyo , Japan
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Lee YC, Juan YS, Liu CC, Bao BY, Wang CJ, Wu WJ, Huang CN, Huang SP. The association of endothelial nitric oxide synthase (eNOS) G894T gene polymorphism with responsiveness to a selective α1-blocker in men with benign prostatic hyperplasia related lower urinary tract symptoms. BJU Int 2016; 118:313-9. [DOI: 10.1111/bju.13468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Yung-Chin Lee
- Department of Urology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Urology; Faculty of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Yung-Shun Juan
- Department of Urology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Urology; Faculty of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Urology; Kaohsiung Municipal Hsiao-Kang Hospital; Kaohsiung Taiwan
| | - Chia-Chu Liu
- Department of Urology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Urology; Faculty of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Health; Executive Yuan; Pingtung Hospital; Pingtung Taiwan
| | - Bo-Ying Bao
- Department of Pharmacy; China Medical University; Taichung Taiwan
- Sex Hormone Research Center; China Medical University Hospital; Taichung Taiwan
- Department of Nursing; Asia University; Taichung Taiwan
| | - Chii-Jye Wang
- Department of Urology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Urology; Faculty of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Wen-Jeng Wu
- Department of Urology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Urology; Faculty of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Chun-Nung Huang
- Department of Urology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Urology; Faculty of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Shu-Pin Huang
- Department of Urology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- Department of Urology; Faculty of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
- Graduate Institute of Medicine; College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
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Videourodynamic analysis in men with lower urinary tract symptoms: Correlation between age and prostate size with lower urinary tract dysfunction. UROLOGICAL SCIENCE 2016. [DOI: 10.1016/j.urols.2015.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Prevalence and risk factors for erectile dysfunction and lower urinary tract symptoms in Russian Federation men: analysis from a national population-based multicenter study. Int J Impot Res 2016; 28:74-9. [DOI: 10.1038/ijir.2016.8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 10/04/2015] [Accepted: 11/23/2015] [Indexed: 11/09/2022]
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Yoon H, Yoon HS, Lee YS, Cho ST, Han DH. Effect of Tamsulosin in Lower Urinary Tract Symptom Patients With Metabolic Syndrome. Urology 2015; 88:135-42. [PMID: 26546811 DOI: 10.1016/j.urology.2015.07.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/25/2015] [Accepted: 07/09/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the efficacy of tamsulosin, a selective alpha-1 blocker, in lower urinary tract symptoms (LUTS) patients with metabolic syndrome (MS). PATIENTS AND METHODS This prospective, multicenter clinical trial included men and women (20-75 years old) with LUTS, with or without MS. Patients were categorized as MS+ or MS-, respectively, and all of them were administered tamsulosin 0.2 mg per oral once daily for 24 weeks. Patients were assessed based on the International Prostate Symptom Score, King's Health Questionnaire (KHQ), Overactive Bladder Questionnaire, uroflowmetry with postvoid residuals, and MS factors (blood pressure, waist-to-hip ratio, and serum levels of fasting blood glucose, triglyceride, and high-density lipoprotein cholesterol) at baseline and at 4, 12, and 24 weeks of treatment. RESULTS Ninety-two patients were enrolled in this study (53/92 were MS- [57.6%]; 39/92 were MS+ [42.4%]). After 24 weeks of tamsulosin treatment, fasting blood glucose (P = .02) and triglyceride (P < .001) levels of changes were significantly greater in the MS+ group than in the MS- group. Total International Prostate Symptom Score, total Overactive Bladder Questionnaire score, and the scores of each question on the KHQ showed significant improvement after treatment without intergroup differences. In KHQ, although improvements in emotional status, sleep quality, fatigue, and personal distress were greater in the MS+ group (P = .05), the difference between the groups did not reach statistical significance. CONCLUSION Tamsulosin was effective in both LUTS patients with and without MS. Furthermore, tamsulosin had beneficial effects on some of the factors associated with MS.
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Affiliation(s)
- Hana Yoon
- Department of Urology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
| | - Hyun Suk Yoon
- Department of Urology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Yong Seong Lee
- Department of Urology, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Sung Tae Cho
- Department of Urology, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Deok Hyun Han
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Doğan Y, Uruç F, Aras B, Şahin A, Kıvrak M, Ürkmez A, Güner ND, Aydın S. The relationships between metabolic syndrome, erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia. Turk J Urol 2015; 41:7-12. [PMID: 26328190 DOI: 10.5152/tud.2015.99997] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/22/2014] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To determine the relationship between erectile dysfunction and metabolic syndrome (MetS) in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). MATERIAL AND METHODS Seventy-eight patients who were admitted to our outpatient clinic because of BPH-related LUTS over 40 years of age were included in the study. Patients with LUTS and erectile dysfunction (ED) were evaluated by International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) forms. The National Cholesterol Education Program Adult Treatment Panel III criteria was used for the diagnosis of MetS. LUTS were classified as mild, moderate, and severe according to IPSS and ED was classified as mild- moderate, moderate, and severe according to the IIEF-5. For the evaluation of data, descriptive statistical methods (mean, standard deviation, median, frequency, ratio, minimum, and maximum) and also for the comparison of the variables with non-normal distribution in 3 or more than 3 groups Student's t test, Mann-Whitney U, ANOVA, chi-square, Fisher Exact tests, and Pearson correlation analysis were used. P<0.05 was accepted as the level of statistical significance. RESULTS Mean age of the patients included in the study was 61.83±9.15. In 34.6% of the patients with MetS, 70.5% of the patients with ED and 37.2% of the patients with severe LUTS were determined. There were no significant differences between the mean age of patients with and without metabolic syndrome (p>0.05). There was a positive correlation with age and severity of LUTS but this relationship was not found to be statistically significant (p>0.05). Mean age of the patients with ED was significantly higher than those without (p<0.001). A statistically significant relationship was not observed between the mean IPSS scores and the severity of LUTS with Mets. However, we observed a weakly positive correlation between triglyceride levels and IPSS. Mean IIEF-5 scores of the patients with MetS were significantly lower than those of the patients without MetS. Severity of ED in the patients with MetS was significantly higher than patients without MetS. The percentage of ED in patients with severe LUTS was found to be statistically higher than other patients with mild, and moderate LUTS. In addition, we found a low degree of negative correlation between IPSS and IIEF-5 scores. CONCLUSION In patients with LUTS as a consequence of BPH, when severity of symptoms increases, frequency of MetS increases proportionally and severe ED is observed much more frequently.
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Affiliation(s)
- Yunus Doğan
- Department of Urology, Tunceli State Hospital, Tunceli, Turkey
| | - Fatih Uruç
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Bekir Aras
- Department of Urology, Dumlupınar University Faculty of Medicine, Kütahya, Turkey
| | - Aytaç Şahin
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Mithat Kıvrak
- Department of Urology, Muş State Hospital, Muş, Turkey
| | - Ahmet Ürkmez
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Numan Doğu Güner
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Sabahattin Aydın
- Department of Urology, İstanbul Medipol University, Istanbul, Turkey
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Maharajh S, Abdel Goad EH, Ramklass SS, Conradie MC. Lower urinary tract symptoms (LUTS) in males: a review of pathophysiology. S Afr Fam Pract (2004) 2015. [DOI: 10.1080/20786190.2014.983307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Russo GI, Castelli T, Urzì D, Privitera S, Fragalà E, La Vignera S, Condorelli RA, Calogero AE, Favilla V, Cimino S, Morgia G. Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis. Aging Male 2015; 18:207-16. [PMID: 26171768 DOI: 10.3109/13685538.2015.1062980] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A significant amount of epidemiological evidences have underlined an emerging link between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement a (BPE). We aimed to assess the connections between LUTS and MetS with its components. Meta-analysis were conducted to determine the mean differences (MD) and confidence intervals of IPSS total score, IPSS-voiding, IPSS-storage and prostate volume (PV) in patients with or without MetS. Ln(odds-ratio) were calculated to estimate the risk of having moderate-to-severe LUTS (IPSS ≥ 8). Nineteen studies were identified as eligible for this systematic review, with a total of 18,476 participants, including 5554 (30.06%) with and 12,922 (69.94%) without MetS. Pooled analysis did not demonstrate significant MD of IPSS, IPSS-voiding and IPSS-storage in men with or without MetS but PV was significantly different (MD = 2.18; p = 0.03). Presence of MetS was not significantly associated with moderate-to-severe LUTS (odds ratio = 1.13; p = 0.53) and only altered serum triglycerides and diabetes were associated with this risk. The association between MetS and LUTS/BPE remain unclear and further observational studies in a population with metabolic disorders should be conducted in order to address it's potential role in determining LUTS/BPE.
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Affiliation(s)
| | | | | | | | | | - Sandro La Vignera
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
| | - Rosita A Condorelli
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
| | - Aldo E Calogero
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
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Russo GI, Cimino S, Morgia G. Benign prostatic hyperplasia and metabolic syndrome: the expanding evidences of a new disease of aging male. Aging Male 2015; 18:133-4. [PMID: 26030349 DOI: 10.3109/13685538.2015.1028353] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Haghsheno MA, Mellström D, Peeker R, Hammarsten J, Lorentzon M, Sundh V, Karlsson M, Ohlsson C, Damber JE. Lower urinary tract symptoms are associated with low levels of serum serotonin, high levels of adiponectin and fasting glucose, and benign prostatic enlargement. Scand J Urol 2014; 49:155-61. [PMID: 25253423 DOI: 10.3109/21681805.2014.936495] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to test whether lower urinary tract symptoms (LUTS) and urinary incontinence are associated with the metabolic syndrome (MetS). The association between LUTS and benign prostatic enlargement (BPE) was also investigated. MATERIAL AND METHODS A cross-sectional, representative risk factor analysis of LUTS, as measured by the International Prostate Symptom Score (IPSS), and urinary incontinence was conducted. Among 950 representative individuals, aged 69-81 years, the association between clinical, anthropometric, endocrine, metabolic and inflammatory factors on the one hand, as both major and minor aspects of MetS, and LUTS and urinary incontinence, on the other hand, was analysed. The prostate gland volume was measured in a subgroup of 155 randomly selected individuals and the association between LUTS and BPE was estimated. RESULTS No significant association was found between LUTS or urinary incontinence and the major aspects of the MetS. However, in a multivariate analysis, serum serotonin showed an independent negative correlation with LUTS and with urinary incontinence while fasting serum glucose and serum adiponectin showed a positive correlation with LUTS. Furthermore, in a subgroup of 155 individuals, the prostate gland volume correlated positively with LUTS. CONCLUSIONS The study did not show an association between LUTS or urinary incontinence and the major components of the MetS. However, serum serotonin showed an independent negative correlation with LUTS and with urinary incontinence while fasting serum glucose and serum adiponectin showed a positive correlation with LUTS. The data confirm the general knowledge that BPE may be one of the causative factors of LUTS.
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Affiliation(s)
- Mohammad-Ali Haghsheno
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska University Hospital , Gothenburg , Sweden
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Is metabolic syndrome truly a risk factor for male lower urinary tract symptoms or just an epiphenomenon? Adv Urol 2014; 2014:203854. [PMID: 24587797 PMCID: PMC3920975 DOI: 10.1155/2014/203854] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 12/06/2013] [Accepted: 12/07/2013] [Indexed: 11/18/2022] Open
Abstract
To define whether the association of male lower urinary tract symptoms (LUTS) and metabolic syndrome (MS) is real or simply an epiphenomenon, 490 male adults (mean age 58 ± 9 years) underwent International Prostate Symptom Score (IPSS), physical and prostate digital examinations, blood analysis, and urinary tract transabdominal ultrasound with prostate volume measurement. Mild, moderate, and severe LUTS were found in 350 (71.4%), 116 (23.7%), and 24 (4.9%) patients, respectively. MS was present in 198 (40.4%) patients, representing 37.4% (131 of 350) of those with mild LUTS, 46.5% (54 of 116) of those with moderate, and 54.1% (13 of 24) of those with severe. The odds ratio of MS having moderate or severe LUTS was 2.1. MS was more common in older age, higher body mass index, and larger prostate size. Moderate and severe LUTS were more frequent in older age, lower levels of high density cholesterol, and higher blood pressure. Older age and body mass index had significant relative risk for lower urinary tract symptoms and only age remained independent factor for LUTS on multivariate analysis. Our results suggest that the association of male LUTS, prostate volume, and MS might be coincidental and related to older age.
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Abstract
Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress - all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes.
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Affiliation(s)
- Maria Ida Maiorino
- Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy
| | - Giuseppe Bellastella
- Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy
| | - Katherine Esposito
- Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
- Correspondence: Katherine Esposito, Endocrinology and Metabolic Diseases Unit, University Hospital at Second University of Naples, Piazza L Miraglia no 2, 80138 Napoli, Italy, Tel +39 081 566 5031, Fax +39 081 566 5054, Email
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Association of Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia Measures With International Index of Erectile Function 5 in Middle-aged Policemen of Korea and the Role of Metabolic Syndrome and Testosterone in Their Relationship. Urology 2013; 82:1008-12. [DOI: 10.1016/j.urology.2013.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 06/28/2013] [Accepted: 07/01/2013] [Indexed: 11/20/2022]
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Fusco F, D'Anzeo G, Sessa A, Pace G, Rossi A, Capece M, d'Emmanuele di Villa Bianca R. BPH/LUTS and ED: Common Pharmacological Pathways for a Common Treatment. J Sex Med 2013; 10:2382-93. [DOI: 10.1111/jsm.12261] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Matsumoto S, Matsuda M, Takekawa M, Okada M, Hashizume K, Wada N, Hori J, Tamaki G, Kita M, Iwata T, Kakizaki H. Association of ED with chronic periodontal disease. Int J Impot Res 2013; 26:13-5. [DOI: 10.1038/ijir.2013.30] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 04/10/2013] [Accepted: 06/04/2013] [Indexed: 11/09/2022]
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Kirby M, Chapple C, Jackson G, Eardley I, Edwards D, Hackett G, Ralph D, Rees J, Speakman M, Spinks J, Wylie K. Erectile dysfunction and lower urinary tract symptoms: a consensus on the importance of co-diagnosis. Int J Clin Pract 2013; 67:606-18. [PMID: 23617950 PMCID: PMC3748789 DOI: 10.1111/ijcp.12176] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 03/22/2013] [Indexed: 12/17/2022] Open
Abstract
Despite differences in design, many large epidemiological studies using well-powered multivariate analyses consistently provide overwhelming evidence of a link between erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). Preclinical evidence suggests that several common pathophysiological mechanisms are involved in the development of both ED and LUTS. We recommend that patients seeking consultation for one condition should always be screened for the other condition. We propose that co-diagnosis would ensure that patient management accounts for all possible co-morbid and associated conditions. Medical, socio-demographic and lifestyle risk factors can help to inform diagnoses and should be taken into consideration during the initial consultation. Awareness of risk factors may alert physicians to patients at risk of ED or LUTS and so allow them to manage patients accordingly; early diagnosis of ED in patients with LUTS, for example, could help reduce the risk of subsequent cardiovascular disease. Prescribing physicians should be aware of the sexual adverse effects of many treatments currently recommended for LUTS; sexual function should be evaluated prior to commencement of treatment, and monitored throughout treatment to ensure that the choice of drug is appropriate.
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Affiliation(s)
- M Kirby
- Faculty of Health and Human Sciences, University of Hertfordshire, Hatfield, UK.
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Lee YC, Liu CC, Juan YS, Wu WJ, Li WM, Yeh HC, Wang CJ, Huang CN, Huang CH, Huang SP. The impact of metabolic syndrome on the responsiveness to α1-blocker in men with BPH/LUTS. Int J Clin Pract 2013; 67:356-62. [PMID: 23409734 DOI: 10.1111/ijcp.12086] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIMS Increasing evidence has proposed the components of metabolic syndrome (MtS) as risk factors for the development of benign prostate hyperplasia (BPH); therefore, it is thought that MtS may play a role in lower urinary tract symptoms related to BPH (BPH/LUTS) aetiology. Considering the closed relationships between MtS and BPH/LUTS, it is possible that patients with MtS might have different drug responsiveness in men with BPH/LUTS. We prospectively investigated the impact of MtS on responsiveness to α1-blocker in men with BPH/LUTS. METHODS We enrolled a total of 109 patients with a mean (SD) age of 59.8 (9.0) years, having a prostate volume of 20 cm(3) or greater with moderate to severe LUTS. All patients received doxazosin GITS (gastrointestinal therapeutic system) 4 mg once daily for a 12-week period of treatment. The efficacy measurement was assessed by the changes from baseline in the total IPSS, maximum urinary flow rate and postvoid residual urine volume. The drug responders were defined as those who had a total IPSS decrease of more than 4 points from baseline after 12 weeks of treatment. RESULTS Using multiple logistic regression analysis, our results showed that MtS was an independent factor for drug non-responder (OR = 4.26, p = 0.002). The rate of drug responder and total IPSS improvements in patients with MtS significantly decreased as the number of MtS components increased (p = 0.012 and p = 0.026). Among the MtS components, abnormal fasting blood glucose (FBG) was the most significantly independent factor for drug non-responder (OR = 3.17, p = 0.020). CONCLUSION This study suggested that the presence of MtS had a significantly negative impact on the responsiveness to α1-blocker in men with BPH/LUTS. Our results are important for BPH/LUTS patients who did not initially respond to α1-blocker or who strive to reduce these metabolic risk factors.
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Affiliation(s)
- Y-C Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Abstract
Erectile dysfunction is a common clinical entity that affects mainly men older than 40 years. In addition to the classical causes of erectile dysfunction, such as diabetes mellitus and hypertension, several common lifestyle factors, such as obesity, limited or an absence of physical exercise, and lower urinary tract symptoms, have been linked to the development of erectile dysfunction. Substantial steps have been taken in the study of the association between erectile dysfunction and cardiovascular disease. Erectile dysfunction is a strong predictor for coronary artery disease, and cardiovascular assessment of a non-cardiac patient presenting with erectile dysfunction is now recommended. Substantial advances have occurred in the understanding of the pathophysiology of erectile dysfunction that ultimately led to the development of successful oral therapies, namely the phosphodiesterase type 5 inhibitors. However, oral phosphodiesterase type 5 inhibitors have limitations, and present research is thus investigating cutting-edge therapeutic strategies including gene and cell-based technologies with the aim of discovering a cure for erectile dysfunction.
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Affiliation(s)
- Rany Shamloul
- Department of Urology, University of Ottawa, Ottawa, ON, Canada.
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Seftel AD, de la Rosette J, Birt J, Porter V, Zarotsky V, Viktrup L. Coexisting lower urinary tract symptoms and erectile dysfunction: a systematic review of epidemiological data. Int J Clin Pract 2013; 67:32-45. [PMID: 23082930 DOI: 10.1111/ijcp.12044] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Assess and categorise the available prevalence data on coexistent LUTS and ED in the general population and among individuals consulting a healthcare provider for any reason or when seeking treatment for LUTS and/or ED. METHODS Literature search of English-language articles published during the last 15 years. RESULTS Of 23 relevant studies identified, 12 used both the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) as assessment tools and 11 used alternative approaches. In studies using both IPSS and IIEF, overall prevalence of coexistent LUTS/ED of any severity was not assessable for men in the general population, but rates ranged from 14-37% based on alternative assessments. In the general male population, 13-29% had moderate to severe LUTS and 8-35% had moderate to severe ED. In studies using both IPSS and IIEF, overall prevalence of coexistent LUTS and ED of any severity was 71-80% among men seeking treatment for LUTS, and 74% based on alternative assessments. Among men who sought treatment for either condition, 67-100% had moderate to severe LUTS and 43-59% had moderate to severe ED. Coexistence of LUTS and ED increased with age, ranging from 59-86% among men aged 40s to 60s in primary care to 79-100% in treatment-seeking men with LUTS aged 50s to 70s. Impact on QoL varied, but health-related QoL was generally worse in treatment-seeking men compared with men in the general population. CONCLUSIONS Although less than one-third of middle-aged and older men in the general population have coexisting LUTS and ED, most men seeking treatment for either LUTS or ED have both conditions. Symptom severity and impact on QoL in each condition increase when LUTS and ED coexist.
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Affiliation(s)
- A D Seftel
- Department of Urology, Cooper University Hospitals, Camden, NJ 081003, USA.
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Yeh HC, Liu CC, Lee YC, Wu WJ, Li WM, Li CC, Hour TC, Huang CN, Chang CF, Huang SP. Associations of the lower urinary tract symptoms with the lifestyle, prostate volume, and metabolic syndrome in the elderly males. Aging Male 2012; 15:166-72. [PMID: 22452270 DOI: 10.3109/13685538.2012.669437] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aimed to evaluate the influence of the lifestyle, prostate volume (PV), and metabolic syndrome (MS) on lower urinary tract symptoms (LUTS) in the elderly males. A total of 764 men aged greater than 40 years were enrolled. Their severities of LUTS were assessed by the International Prostate Symptom Score questionnaire, while their MS was diagnosed according to the criteria developed by the National Cholesterol Education Program Adult Treatment Panel III. Lifestyle factors, PV, and components of MS were compared between no/mild and moderate/severe LUTS groups. In univariate analysis, age, cigarette smoking, alcohol consumption, physical activity, and PV significantly correlated with the severity of LUTS, but the presence or any components of MS did not. Results of multivariate analysis showed that aging, cigarette smoking, lack of regular exercise, and larger PV were independent predictors for moderate/severe LUTS. Notably, the risk factors for LUTS was influenced by the presence of MS. PV may play a role in determining the severity of LUTS for men without MS, while physical activity was the critical factor for men with MS. It was suggested that healthy lifestyle would be beneficial to lessen the severity of LUTS in the elderly males.
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Affiliation(s)
- Hsin-Chih Yeh
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
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SON H, CHOI WS, PAICK JS, PARK WH. Detrusor Overactivity in Hyperchoelsterolemia Rats. Low Urin Tract Symptoms 2012; 4 Suppl 1:16-20. [DOI: 10.1111/j.1757-5672.2011.00124.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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