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Vartolomei L, Cotruș A, Tătaru SO, Vartolomei MD, Man A, Ferro M, Stanciu C, Sin AI, Shariat SF. Lower urinary tract symptoms are associated with clinically relevant depression, anxiety, and stress symptoms. Aging Male 2022; 25:62-66. [PMID: 35179090 DOI: 10.1080/13685538.2022.2040981] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVES To investigate the correlation between lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and testosterone deficiency (TD) with depressive, stress, and anxiety symptoms. MATERIAL AND METHODS From October 2019 to March 2020, 113 males were included. Inclusion criteria: age 40-75, no clinical suspicion of prostate cancer, no serious cardiovascular comorbidities. All patients completed a set of questionnaires: International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and Depression Anxiety Stress Scales (DASS-21). RESULTS Median age was 62 years (range 40-74), mean IPSS score was 10.94 (SD 7.75), mean IIEF-5 score 13.12 (SD 7.08), and mean DASS-21 score 11.35 (SD 8.24). According to DASS-21 subscales, 28 (24.8%) patients had depressive symptoms, 25 (22.1%) anxiety symptoms, and 25 (22.1%) stress symptoms. Depression was associated with LUTS (14.5 vs. 8 score, p = .002). Similarly, stress symptoms were associated with LUTS (IPSS 15 vs. 7 score, p = .0001) and with ED (IIEF-5 5 vs. 15 score, p = .01). Positive Spearman's rho correlations between LUTS and all three, depression, anxiety, and stress symptoms were found (p values <.001). CONCLUSIONS LUTS is associated with depression, anxiety, and stress symptoms. Screening for these symptoms could help with individual counseling and management.
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Affiliation(s)
- Liliana Vartolomei
- I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Department of Psychology, Dimitrie Cantemir University from Târgu Mureș, Târgu Mureș, Romania
| | - Andrei Cotruș
- Department of Psychology, Dimitrie Cantemir University from Târgu Mureș, Târgu Mureș, Romania
| | - Sabin Octavian Tătaru
- I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
| | - Mihai Dorin Vartolomei
- I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
| | - Adrian Man
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology, Milan, Italy
| | - Camelia Stanciu
- Department of Psychology, Dimitrie Cantemir University from Târgu Mureș, Târgu Mureș, Romania
| | - Anca Ileana Sin
- Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
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Lui PSC, Dorji N. Prevalence and predictors of lower urinary tract symptoms in Solomon Islander adult men. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/2051415820945537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Despite growing interest in the prevention of lower urinary tract symptoms (LUTS) globally and in the Asia-Pacific region, population-based evidence is limited in the smaller Pacific Island countries such as in the Solomon Islands. This study aimed to investigate the prevalence and describe the risk factors associated with moderate to severe LUTS among Solomon Islander men. Methods: A cross-sectional survey was conducted among 400 men aged ⩾18 years living in Honiara, Solomon Islands. LUTS were assessed using the International Prostate Symptom Score (IPSS). The association between moderate to severe LUTS and sociodemographic, health conditions and health-related factors were estimated using logistic regression adjusted for age. Results: Overall, 13.8% reported moderate LUTS, and 0.8% reported severe LUTS. Frequent night-time urination was the most commonly reported LUTS. The adjusted odds of moderate to severe LUTS decreased with increasing level of education. The odds increased among men reporting elevated psychological distress, increased stressful events in the past 12 months and depression. Conclusions: About one in six Solomon Islander men experience moderate to severe LUTS, having a negative impact on their mental health and general well-being.
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Affiliation(s)
| | - Nidup Dorji
- Department of Public Health, Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Bhutan
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Chiu MYL, Wong HT, Yang X. Distress Due to Urinary Problems and Psychosocial Correlates among Retired Men in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2533. [PMID: 32272771 PMCID: PMC7177229 DOI: 10.3390/ijerph17072533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/28/2020] [Accepted: 03/31/2020] [Indexed: 11/17/2022]
Abstract
Urinary problems are common among aging men, but there is a paucity of research efforts to understand the psychosocial aspects of the illness. This study aims to understand how common and distressing urinary problems are for newly retired men in Hong Kong and to test the associations between mental health, self-stigma of seeking help, fatigue, self-efficacy, self-esteem, and distress due to urinary problems. To assess this, 139 out of 200 members of a retired men's social club (mean age 63.5) were successfully interviewed. Two-fifths of the participants felt distressed due to their urinary problems and one-third of the participants had been troubled by urinary incontinence or nocturia in the past six months. Yet the majority of the participants (55%) did not seek help from any medical profession. The group who were distressed by urinary problems showed significantly poorer mental health, reported more fatigue symptoms, were less satisfied with their sexual relationships and overall self-esteem, and were less able to stop unpleasant thoughts or to get social support than the non-distressed group. Cultural perceptions of masculinity and decreased sexual vigor might have affected participants' willingness to seek help at an early stage. Targeted health education, mutual support groups, and sensitively designed services at the community level are suggested to address these physical and mental health issues.
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Affiliation(s)
- Marcus Yu Lung Chiu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Ave, Kowloon Tong, Kowloon, Hong Kong, China
| | - Ho Ting Wong
- Institute of Health Care Management, Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Xue Yang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China;
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen 518172, China
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Rhee SJ, Kim EY, Kim SW, Kim SH, Lee HJ, Yoon DH, Ahn YM. Longitudinal study of the relationship between lower urinary tract symptoms and depressive symptoms. J Psychosom Res 2019; 116:100-105. [PMID: 30654985 DOI: 10.1016/j.jpsychores.2018.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/12/2018] [Accepted: 11/20/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To analyze the longitudinal association between lower urinary tract symptoms (LUTS) and the development of incident depressive symptoms in Korean men. METHODS This study initially recruited 16,155 Korean men who underwent routine health examinations between 2005 and 2012, and completed the International Prostate Symptom Score (IPSS) screening tool and Beck Depression Inventory-1 (BDI). The final study population included 9080 men, aged 15-89, who had a baseline BDI score < 10 and follow-up BDI data, with no history of depression, bladder or prostate operations. Cox proportional hazard models were used to assess the relationship between LUTS and the development of incident depressive symptoms. Multiple imputation was used to handle missing values. RESULTS After adjusting for significant covariates, LUTS were associated longitudinally with the development of incident depressive symptoms (hazard ratio [HR] = 1.81 [95% confidence interval [CI] = 1.26-2.61]). An analysis of the specific domains of LUTS revealed that voiding LUTS (HR = 1.58 [95% CI = 1.07-2.33]), but not storage LUTS (HR = 1.43 [95% CI = 0.96-2.13]), were associated longitudinally with depressive symptoms. CONCLUSION LUTS and voiding LUTS, but not storage LUTS, were associated longitudinally with incident depressive symptoms.
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Affiliation(s)
- Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Eun Young Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Mental Health Center, Seoul National University Health Care Center, Seoul, Republic of Korea.
| | - Soo Woong Kim
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Se Hyun Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Hyun Jeong Lee
- Cancer Survivorship Branch, National Cancer Control Institute, Goyang, Republic of Korea..
| | - Dae Hyun Yoon
- Department of Psychiatry, Gangnam Health Promotion Center, Seoul National University Hospital, 737 Yeoksam-Dong, Gangnam-Gu, Seoul 135-984, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Free testosterone correlated with erectile dysfunction severity among young men with normal total testosterone. Int J Impot Res 2018; 31:132-138. [PMID: 30349000 DOI: 10.1038/s41443-018-0090-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/04/2018] [Accepted: 10/01/2018] [Indexed: 12/28/2022]
Abstract
Erectile dysfunction (ED) due to androgen deficiency is rare in the young population. We retrospectively evaluated in this study men aged 18-40 years presenting with ED from 2015 to 2017. The International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Grade Scores (EHGS) were used to assess erectile function. Total testosterone (TT), sex hormone-binding globulin (SHBG), lipid profile, and glycometabolic indicators were tested in fasting blood sample. TT and SHBG were detected by electrochemiluminescence immunoassay, and free (FT) and bio-available testosterone (BT) were calculated from a validated formula. Linear regression was used to analyze the data. In total, 140 cases (30.56 ± 4.81 years) with a mean TT levels of 6.15 ± 2.17 ng/ml were enrolled. Decreased levels of FT were associated with lower IIEF-5 scores(β = 0.176, P = 0.048) and EHGS (β = 0.198, P = 0.026) after adjustment for age, body mass index (BMI), smoking, comorbidities, high-sensitive C-reactive protein (hsCRP), uric acid, fructosamine, and quantitative insulin sensitivity check index (QUICKI). TT was only associated with EHGS in the crude model (β = 0.177, P = 0.037) and some single factor adjustment models, whereas BT and SHBG were not related with erectile function in any model. Low FT level, even in the presence of normal TT, is associated with ED severity in young men. FT levels should be screened in ED patient even with normal total testosterone.
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Liu Q, Zhang Y, Wang J, Li S, Cheng Y, Guo J, Tang Y, Zeng H, Zhu Z. Erectile Dysfunction and Depression: A Systematic Review and Meta-Analysis. J Sex Med 2018; 15:1073-1082. [PMID: 29960891 DOI: 10.1016/j.jsxm.2018.05.016] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 05/23/2018] [Accepted: 05/28/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Some studies have reported that exposure to depression increases the risk of erectile dysfunction (ED), whereas others have observed no association. Moreover, additional studies have reported that exposure to ED increases the risk of depression. AIM To identify and quantitatively synthesize all studies evaluating the association between ED and depression and to explore factors that may explain differences in the observed association. METHODS We conducted a systematic review and meta-analysis. We searched Medline, Ovid Embase, and the Cochrane Library through October 2017 for studies that had evaluated the association between ED and depression. Studies were included in accordance with Patient Population or Problem, Intervention, Comparison, Outcomes, and Setting (PICOS) inclusion criteria. OUTCOMES The odds ratio (OR) was regarded as the effect size, and the heterogeneity across studies was assessed using the I2 statistic. RESULTS We identified 49 eligible publications. The pooled OR for studies evaluating depression exposure and risk of ED was 1.39 (95% CI: 1.35-1.42; n = 46 publications with 48 studies). Although we observed large heterogeneity (I2 = 93.6%), subgroup analysis indicated that it may have been as a result of variations in study design, comorbidities, ED assessment, depression assessment, the source of the original effect size, etc. No significant publication bias was observed (P = .315), and the overall effect size did not change by excluding any single study. The pooled OR for studies evaluating ED exposure and risk of depression was 2.92 (95% CI: 2.37-3.60; n = 5 publications with 6 studies). No significant heterogeneity (P < .257, I2 = 23.5%) or publication bias (P = .260) was observed. CLINICAL IMPLICATIONS Patients reporting ED should be routinely screened for depression, whereas patients presenting with symptoms of depression should be routinely assessed for ED. STRENGTHS AND LIMITATIONS There are several strengths to this study. First, evaluations of the association between ED and depression are timely and relevant for clinicians, policymakers, and patients. Second, we intentionally conducted 2 meta-analyses on the association, allowing us to include all potentially relevant studies. However, our study also possesses some limitations. First, the OR is a measure of association that only reveals whether an association is present. Thus, this study was unable to determine the direction of causality between ED and depression. Second, the high heterogeneity among studies makes it difficult to generalize the conclusions. CONCLUSION This study demonstrates an association between depression and ED. Policymakers, clinicians and patients should attend to the association between depression and ED. Liu Q, Zhang Y, Wang J, et al. Erectile dysfunction and depression: A systematic review and meta-analysis. J Sex Med 2018;15:1073-1082.
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Affiliation(s)
- Qian Liu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youpeng Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sen Li
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongbiao Cheng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jialun Guo
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Tang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hanqing Zeng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaohui Zhu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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7
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Choi EPH, Lam CLK, Chin WY. Mental Health Mediating the Relationship Between Symptom Severity and Health-Related Quality of Life in Patients with Lower Urinary Tract Symptoms. Low Urin Tract Symptoms 2015; 8:141-9. [PMID: 27619778 DOI: 10.1111/luts.12086] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/24/2014] [Accepted: 11/04/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Lower urinary tract symptoms (LUTS) can impact both mental health and health-related quality of life (HRQOL). To date, however, their associations with outcomes have only been examined in isolation and the interactive relationship between LUTS, mental health and HRQOL remains poorly understood. The aim of this study was to determine whether mental health mediates the relationship between LUTS severity and HRQOL. METHODS Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire including the International Prostate Symptom Score (IPSS), the adapted Incontinence Impact Questionnaire-7 (IIQ-7), the Chinese (HK) SF-12 Health Survey Version 2 (SF-12 v2) and the Depression, Anxiety and Stress Scale-21 (DASS-21). Mediation modeling was tested using Baron and Kenney's multistage regression approach and bootstrapping method. RESULTS Overall, mental health partially mediated the association between LUTS severity and HRQOL as measured by the SF-12 v2 physical component summary (PCS) and the IIQ-7. The depression, anxiety and stress scores all have similar mediation effects in the relationship between LUTS severity and HRQOL. Subgroup analysis by gender showed that anxiety fully mediated the relationship between LUTS severity and HRQOL as measured by the SF-12 v2 PCS in males whilst the mediation effects of mental health in the relationship between LUTS severity and HRQOL as measured by the SF-12 v2 PCS could not be found in females. CONCLUSIONS In order to enhance HRQOL, LUTS interventions should address the mental health of patients in addition to providing physical relief of symptoms.
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Affiliation(s)
- Edmond P H Choi
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong.
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
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Chung RY, Leung JCS, Chan DCC, Woo J, Wong CKM, Wong SYS. Lower urinary tract symptoms (LUTS) as a risk factor for depressive symptoms in elderly men: results from a large prospective study in Southern Chinese men. PLoS One 2013; 8:e76017. [PMID: 24098757 PMCID: PMC3786898 DOI: 10.1371/journal.pone.0076017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 08/16/2013] [Indexed: 11/19/2022] Open
Abstract
A cross-sectional relationship between lower urinary tract symptoms (LUTS) and depressive symptoms was previously reported among Southern Chinese men; however, the temporal relationship was unclear. Our objective is to evaluate the temporal relationship between moderate to severe lower urinary tract symptoms and clinically significant depressive symptoms in elderly Chinese men aged 65 in a prospective manner. In a prospective cohort of 2,000 Chinese men aged 65 to 92 years in Hong Kong, we studied the association of having moderate to severe LUTS at baseline and having clinically relevant depressive symptoms at year 2 follow-up. After excluding men with prostate or bladder cancer or surgery (n = 20) and lost to follow-up (n = 254), data on 1,726 subjects were analyzed. LUTS were measured by the International Prostate Symptom score; and clinically relevant depressive symptoms were measured by the Geriatric Depression Scale. The multiple logistic regressions showed that the presence of moderate-to-severe LUTS at baseline were significantly associated with increased risk for being depressed at two-year follow-up, with adjustments for demographic, lifestyle, medical factors, weight status and stressful life events (OR = 2.97; CI: 1.70-5.20). Association remained significant with additional adjustments for baseline GDS score (OR = 1.88; CI: 1.03-3.41). LUTS are important risk factors in predicting the presence of clinically relevant depressive symptoms. In elderly men, increased awareness and possible screening are needed to detect the increased risk of clinically relevant depressive symptoms.
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Affiliation(s)
- Roger Y. Chung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C. S. Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dicken C. C. Chan
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Carmen K. M. Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Y. S. Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- * E-mail:
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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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Takao T, Tsujimura A, Okuda H, Yamamoto K, Fukuhara S, Matsuoka Y, Miyagawa Y, Nonomura N, Okuyama A. Lower urinary tract symptoms and erectile dysfunction associated with depression among Japanese patients with late-onset hypogonadism symptoms. Aging Male 2011; 14:110-4. [PMID: 20828247 DOI: 10.3109/13685538.2010.512374] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to investigate the relation between lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and depression in Japanese patients with late-onset hypogonadism (LOH) symptoms. The study comprised 87 Japanese patients with LOH symptoms (>27 points on the Aging Males Symptoms Scale). Thirty-four patients were diagnosed as having depression and the remaining 53 patients were diagnosed as not having depression by the Mini International Neuropsychiatric Interview. We compared the International Index of Erectile Function (IIEF) 5, International Prostate Symptom Score (IPSS), IPSS quality-of-life (QOL) index, King's Health Questionnaire (KHQ), endocrinological data, and free uroflow study between depression and non-depression patients and performed multiple logistic regression analysis. IIEF5 scores of depression patients were significantly lower than those of non-depression patients. In KHQ, only the category of general health perceptions was significantly higher in depression patients than non-depression patients. However, IPSS, QOL index, and endocrinological and uroflowmetric data showed no significant difference between the groups. Multiple logistic regression analysis revealed moderate and severe ED to be risk factors for depression. However, LUTS are not related to depression. Moderate and severe ED is correlated with depression, whereas LUTS are not related to depression in Japanese LOH patients.
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Affiliation(s)
- Tetsuya Takao
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
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11
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Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men. Int J Obes (Lond) 2010; 34:1396-403. [PMID: 20404829 DOI: 10.1038/ijo.2010.76] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Abdominal obesity and type 2 diabetes mellitus are associated with erectile and urinary dysfunction in men. The extent to which sexual function and lower urinary tract symptoms (LUTSs) are improved by weight loss remains unclear. SUBJECTS We compared the effects of 8 weeks of a low-calorie diet using meal replacements (Kicstart) on insulin sensitivity, plasma testosterone levels, erectile function (measured by the five-item version of the International Index of Erectile Function, IIEF-5), sexual desire (measured by the Sexual Desire Inventory, SDI) and LUTS (measured by the International Prostate Symptom Score, IPSS), in abdominally obese (body mass index >or=30 kg m(-2), waist circumference (WC) >or=102 cm) men (mean age 49.7 years) with uncomplicated diet or oral hypoglycemic-treated type 2 diabetes mellitus (n = 19) or without type 2 diabetes mellitus (n=25), with a control group of nondiabetic men (n = 26) with similar body mass index and WC. RESULTS Weight loss of ∼ 10% was significantly associated with increased insulin sensitivity, plasma testosterone levels, IIEF-5 and SDI scores, as well as reduced WC and IPSS scores, in diabetic as well as nondiabetic men. The degree of weight loss was significantly associated with improvements in plasma testosterone levels (r = -0.34), erectile function (r = -0.26) and LUTS (r=0.65). Reduction in LUTS was significantly associated with increased plasma testosterone (r = -0.35), erectile function (r = -0.42) and sexual desire (r = -0.40). CONCLUSIONS Diet-induced weight loss significantly and rapidly improves sexual function, and reduces LUTS, in obese middle-aged men with or without diabetes.
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Coyne KS, Wein AJ, Tubaro A, Sexton CC, Thompson CL, Kopp ZS, Aiyer LP. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int 2009; 103 Suppl 3:4-11. [PMID: 19302497 DOI: 10.1111/j.1464-410x.2009.08371.x] [Citation(s) in RCA: 298] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the impact of lower urinary tract symptoms (LUTS) on urinary-specific health-related quality of life (HRQL), generic health indices, depression and anxiety in a population-representative sample of men and women, as research has linked LUTS with reduced HRQL and depression, but little is known about the effects of individual LUTS on HRQL, depression and anxiety. SUBJECTS AND METHODS A cross-sectional population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants rated the frequency and symptom-specific bother of individual LUTS and condition-specific HRQL, generic health status, anxiety and depression. Descriptive statistics were used to evaluate outcome differences by International Continence Society LUTS subgroups; logistic regressions were used to determine associations of LUTS and perception of bladder problems, anxiety and depression. RESULTS The overall survey response rate was 59.2%; 30 000 subjects (14 139 men and 15 861 women) participated. Men and women with LUTS in the all LUTS subgroup (storage, voiding and postmicturition) reported the lowest levels of HRQL and highest levels of anxiety and depression, with 35.9% of men and 53.3% of women meeting self-reported screening criteria for clinical anxiety (Hospital Anxiety and Depression Scale, HADS, Anxiety > or =8), and 29.8% of men and 37.6% of women meeting self-reported criteria for clinical depression (HADS Depression > or =8). In both men and women, storage symptoms were significantly associated with greater perceived bladder impact, whereas voiding symptoms were not. Significant predictors of anxiety included nocturia, urgency, stress urinary incontinence, leaking during sexual activity, weak stream and split stream in women; and nocturia, urgency, incomplete emptying and bladder pain in men. For depression, weak stream, urgency and stress urinary incontinence were significant for women, and perceived frequency and incomplete emptying were significant for men. CONCLUSION The negative effect of LUTS is apparent across several domains of HRQL and on overall perception of bladder problems, general health status and mental health. The high level of psychiatric morbidity in patients with multiple LUTS has important implications for treatment and highlights the need for further research to pinpoint specific mechanisms underlying this association.
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Affiliation(s)
- Karin S Coyne
- United BioSource Corporation, Bethesda, MD 20814, USA.
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Weber BA, Roberts BL, Mills TL, Chumbler NR, Algood CB. Physical and emotional predictors of depression after radical prostatectomy. Am J Mens Health 2008; 2:165-71. [PMID: 19477780 DOI: 10.1177/1557988307312222] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Radical prostatectomy commonly results in urinary, sexual, and bowel dysfunction that bothers men and may lead to depressive symptomatology (hereafter depression) that occurs at a rate 4 times greater for men with prostate cancer than healthy counterparts. The purpose of this study was to assess depressive symptoms in men shortly after radical prostatectomy and to identify associated risk factors. Seventy-two men were interviewed 6 weeks after surgery. Measured were depression (Geriatric Depression Scale), self-efficacy (Stanford Inventory of Cancer Patient Adjustment), social support (Modified Inventory of Socially Supportive Behaviors), physical and emotional factors (UCLA Prostate Cancer Index), and social function (SF-36 subscale). Results indicate that men with high self-efficacy and less sexual bother were 45% and 55% less likely to have depressive symptoms, respectively. Findings from this study add to the limited amount of information on the complex relationship between prostate cancer treatment and depression in men.
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Affiliation(s)
- Bryan A Weber
- Collegeof Nursing, Box 100197, Gainesville, FL 32610-0197, USA.
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Fitzgerald MP, Link CL, Litman HJ, Travison TG, McKinlay JB. Beyond the lower urinary tract: the association of urologic and sexual symptoms with common illnesses. Eur Urol 2007; 52:407-15. [PMID: 17382458 PMCID: PMC2396456 DOI: 10.1016/j.eururo.2007.03.014] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Accepted: 03/06/2007] [Indexed: 01/23/2023]
Abstract
OBJECTIVE In addition to being prevalent and bothersome, urologic and sexual symptoms may be related to chronic medical illnesses. We investigate the relationship between ten urologic and sexual symptoms and four major illnesses (type II diabetes, cardiac disease, hypertension, and depression). METHODS We analyzed data from the Boston Area Community Health (BACH) survey, a community-based epidemiologic study of urologic symptoms and risk factors. BACH used a two-stage stratified cluster sampling design to recruit 5,506 adults aged 30-79 (2301 men, 3205 women; 1770 black, 1877 Hispanic, and 1859 white). RESULTS In bivariate analyses, most urologic and sexual symptoms were associated with type II diabetes, cardiac disease, hypertension, and depression. However, in multivariate models adjusting for all four illnesses, gender, race/ethnicity, age, alcohol intake, smoking, physical activity, and body mass index there were fewer significant associations. We found that all urologic symptoms were significantly related to at least one illness, with depression increasing the odds of all urologic and sexual symptoms studied. CONCLUSIONS Urinary tract specialists should consider factors outside the urinary tract that may be contributing to urologic symptoms. It remains unknown whether treatment of medical and psychological illnesses can result in meaningful improvement in urologic symptoms, or conversely, whether urinary tract symptoms can provide valuable insight into an individual's overall health status.
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Affiliation(s)
| | - Carol L. Link
- New England Research Institutes, Watertown, MA 02472
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