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Shogenji M, Yoshida M, Kitagawa Y. Epidemiological survey of post-void residual urine volume in older adult patients in an acute-care hospital: A cross-sectional observational study. Jpn J Nurs Sci 2024; 21:e12557. [PMID: 37550864 DOI: 10.1111/jjns.12557] [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: 02/10/2023] [Revised: 07/15/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023]
Abstract
AIM To epidemiologically determine post-void residual urine volume (PVR) and identify the characteristics of "potential" older adult patients with voiding dysfunction in an acute-care hospital. METHODS A cross-sectional study was conducted on 614 older adult patients in an acute-care hospital between November 2018 and May 2019. Using portable ultrasound devices, nurses measured the patients' PVR three times after admission. Lower urinary tract symptoms were evaluated using the Core Lower Urinary Tract Symptom Score prior to admission. RESULTS A total of 107 older adult patients (17.4%) had episodes of abnormal PVR ≥100 mL. An age of over 75 years (adjusted odds ratio [aOR]: 1.899) and feeling of incomplete emptying (aOR: 4.337) were associated with having at least one episode of abnormal PVR, whereas neurological or circulatory diseases (aOR: 3.699) were associated with having two or three episodes. CONCLUSIONS The results showed a high prevalence of abnormal PVR in older adult patients. Screening for PVR in older adult patients aged over 75 years who experience incomplete emptying or neurological or circulatory diseases may help identify those at risk for voiding dysfunction.
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Affiliation(s)
- Miho Shogenji
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Japan
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Bladt L, Kashtiara A, Platteau W, De Wachter S, De Win G. First-Year Experience of Managing Urology Patients With Home Uroflowmetry: Descriptive Retrospective Analysis. JMIR Form Res 2023; 7:e51019. [PMID: 37847531 PMCID: PMC10618888 DOI: 10.2196/51019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Lower urinary tract symptoms affect a large number of people of all ages and sexes. The clinical assessment typically involves a bladder diary and uroflowmetry test. Conventional paper-based diaries are affected by low patient compliance, whereas in-clinic uroflowmetry measurement face challenges such as patient stress and inconvenience factors. Home uroflowmetry and automated bladder diaries are believed to overcome these limitations. OBJECTIVE In this study, we present our first-year experience of managing urological patients using Minze homeflow, which combines home uroflowmetry and automated bladder diaries. Our objective was 2-fold: first, to provide a description of the reasons for using homeflow and second, to compare the data obtained from homeflow with the data obtained from in-clinic uroflowmetry (hospiflow). METHODS A descriptive retrospective analysis was conducted using Minze homeflow between July 2019 and July 2020 at a tertiary university hospital. The device comprises a Bluetooth-connected gravimetric uroflowmeter, a patient smartphone app, and a cloud-based clinician portal. Descriptive statistics, Bland-Altman plots, the McNemar test, and the Wilcoxon signed rank test were used for data analysis. RESULTS The device was offered to 166 patients, including 91 pediatric and 75 adult patients. In total, 3214 homeflows and 129 hospiflows were recorded. Homeflow proved valuable for diagnosis, particularly in cases where hospiflow was unreliable or unsuccessful, especially in young children. It confirmed or excluded abnormal hospiflow results and provided comprehensive data with multiple measurements taken at various bladder volumes, urge levels, and times of the day. As a result, we found that approximately one-fourth of the patients with abnormal flow curves in the clinic had normal bell-shaped flow curves at home. Furthermore, homeflow offers the advantage of providing an individual's plot of maximum flow rate (Q-max) versus voided volume as well as an average or median result. Our findings revealed that a considerable percentage of patients (22/76, 29% for pediatric patients and 24/50, 48% for adult patients) had a Q-max measurement from hospiflow falling outside the range of homeflow measurements. This discrepancy may be attributed to the unnatural nature of the hospiflow test, resulting in nonrepresentative uroflow curves and an underestimation of Q-max, as confirmed by the Bland-Altman plot analysis. The mean difference for Q-max was -3.1 mL/s (with an upper limit of agreement of 13 mL/s and a lower limit of agreement of -19.2 mL/s), which was statistically significant (Wilcoxon signed rank test: V=2019.5; P<.001). Given its enhanced reliability, homeflow serves as a valuable tool not only for diagnosis but also for follow-up, allowing for the evaluation of treatment effectiveness and home monitoring of postoperative and recurrent interventions. CONCLUSIONS Our first-year experience with Minze homeflow demonstrated its feasibility and usefulness in the diagnosis and follow-up of various patient categories. Homeflow provided more reliable and comprehensive voiding data compared with hospiflow.
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Affiliation(s)
- Lola Bladt
- Product Development, Faculty of Design Sciences, University of Antwerp, Antwerp, Belgium
| | - Ardavan Kashtiara
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Wouter Platteau
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Stefan De Wachter
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Urology, University Hospital Antwerp, Antwerp, Belgium
| | - Gunter De Win
- Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Urology, University Hospital Antwerp, Antwerp, Belgium
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Seasonal Variation of Drug Prescription Rate for Overactive Bladder in Men Based on National Health Insurance Claims Data, 2012-2016. Int Neurourol J 2020; 24:278-285. [PMID: 33017898 PMCID: PMC7538287 DOI: 10.5213/inj.2040030.015] [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: 05/12/2020] [Accepted: 07/18/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose Overactive bladder (OAB) symptoms might be affected by weather, but only a few clinical studies have investigated this issue. We investigated seasonal variations in OAB-drug prescription rate (DPR) in men using nationwide claims data in Korea. Methods A total of 2,824,140 men aged over 18 years were included from the Health Insurance Review and Assessment service – National Patient Sample data between 2012 and 2016. Depending on the monthly average temperature, the seasons were divided into 3 groups, namely, hot (June, July, August, and September), intermediate (April, May, October, and November), and cold (January, February, March, and December) seasons. OAB-DPR was estimated using the claims data, and differences in its rate were examined among the 3 seasonal groups. Results The overall OAB-DPR was 1.97% (55,574 of 2,824,140). The OAB-DPR were 0.38%, 0.63%, 0.92%, 1.74%, 4.18%, 7.55%, and 9.69% in the age groups of under 30, 30s, 40s, 50s, 60s, 70s, and over 80 years, respectively; thus, the prescription rate increased with age (P<0.001), with a steeper increase after 60 years of age. OAB-DPR was 1.02% in the hot season, 1.19% in the intermediate season, and 1.27% in the cold season, with significant differences among the 3 seasonal groups (P<0.001). These seasonal variations persisted in the subgroup analysis in each age decade (P<0.001). Conclusions OAB-DPR varied with seasons and was significantly higher in the cold season than in the hot season, suggesting that cold weather may affect development and aggravation of OAB symptoms in men.
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Matsumoto M, Tsutaoka T, Yabunaka K, Handa M, Yoshida M, Nakagami G, Sanada H. Development and evaluation of automated ultrasonographic detection of bladder diameter for estimation of bladder urine volume. PLoS One 2019; 14:e0219916. [PMID: 31487299 PMCID: PMC6728037 DOI: 10.1371/journal.pone.0219916] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/03/2019] [Indexed: 12/01/2022] Open
Abstract
Bladder urine volume has been estimated using an ellipsoid method based on triaxial measurements of the bladder extrapolated from two-dimensional ultrasound images. This study aimed to automate this process and to determine the accuracy of the automated estimation method for normal and small amounts of urine. A training set of 81 pairs of transverse and longitudinal ultrasound images were collected from healthy volunteers on a tablet-type ultrasound device, and an automatic detection tool was developed using them. The tool was evaluated using paired transverse/longitudinal ultrasound images from 27 other healthy volunteers. After imaging, the participants voided and their urine volume was measured. For determining accuracy, regression coefficients were calculated between estimated bladder volume and urine volume. Further, sensitivity and specificity for 50 and 100 ml bladder volume thresholds were evaluated. Data from 50 procedures were included. The regression coefficient was very similar between the automatic estimation (β = 0.99, R2 = 0.96) and manual estimation (β = 1.05, R2 = 0.97) methods. The sensitivity and specificity of the automatic estimation method were 88.5% and 100.0%, respectively, for 100 ml and were 94.1% and 100.0%, respectively, for 50 ml. The newly-developed automated tool accurately and reliably estimated bladder volume at two different volume thresholds of approximately 50 ml and 100 ml.
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Affiliation(s)
- Masaru Matsumoto
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takuya Tsutaoka
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Imaging Technology Center, Research & Development Management Headquarters, FUJIFILM Corporation, Minato-ku, Tokyo, Japan
| | - Koichi Yabunaka
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mayumi Handa
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Marketing Planning Group, Ultrasound Promotion Department, FUJIFILM Medical Corporation, Minato-ku, Tokyo, Japan
| | - Mikako Yoshida
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Gojiro Nakagami
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Homma Y, Gotoh M, Kawauchi A, Kojima Y, Masumori N, Nagai A, Saitoh T, Sakai H, Takahashi S, Ukimura O, Yamanishi T, Yokoyama O, Yoshida M, Maeda K. Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia. Int J Urol 2017; 24:716-729. [DOI: 10.1111/iju.13401] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/23/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Yukio Homma
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Momokazu Gotoh
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | | | - Yoshiyuki Kojima
- Department of Urology; Fukushima Prefectural University of Medicine; Fukushima Japan
| | - Naoya Masumori
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Atsushi Nagai
- Department of Urology; Kawasaki Medical School; Kurashiki Japan
| | | | - Hideki Sakai
- Department of Urology; Nagasaki University; Nagasaki Japan
| | | | - Osamu Ukimura
- Department of Urology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | | | | | - Masaki Yoshida
- Department of Urology; National Center of Geriatrics and Gerontology; Obu Japan
| | - Kenji Maeda
- Department of Urology; Maeda Clinic of Internal Medicine; Ageo Japan
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Shim SR, Kim JH, Won JH, Song ES, Song YS. Association between ambient temperature and lower urinary tract symptoms: a community-based survey. Int Braz J Urol 2017; 42:521-30. [PMID: 27286116 PMCID: PMC4920570 DOI: 10.1590/s1677-5538.ibju.2015.0159] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 08/10/2015] [Indexed: 12/11/2022] Open
Abstract
Purpose The aim of this study was to evaluate the individual change of International prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) in each patient by temperature conditions. Materials and Methods The severity of lower urinary tract symptoms (LUTS) was explored using the IPSS and OABSS questionnaires that were completed by 2.486 subjects (923 males and 1.563 females) aged 60 years and older. Korea Meteorological Administration data was used to determine daily average temperature and daily temperature difference on the interview dates at each site. Results The mean IPSS and mean age for males was 13.45±8.24 and 75.03±6.20 years, respectively. The mean OABSS and mean age for females was 4.41±3.10 and 73.74±6.03years, respectively. Daily average temperature and daily temperature difference ranged from-3.4-28.3oC and 2.2-16.9oC, respectively. Age was a significantly risk factor for IPSS, OABSS, and QoL (P<0.001, <0.001, and 0.005, respectively). After multiple regression analysis, daily average temperatures did not show a statistically significant change in IPSS and OABSS. Only daily temperature differences were associated with male LUTS. Conclusions While LUTS could be worsened in low temperatures generally, IPSS and OABSS were not affected by daily average temperature conditions. Daily temperature differences may be more influential than daily average temperatures.
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Affiliation(s)
- Sung Ryul Shim
- Department of Urology, Okmeydani Teaching and Research Hospital, Istanbul, Turkey
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine, Seoul. Korea
| | - Jong Ho Won
- Department of Internal Medicine, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Eun Seop Song
- Department of Obstetrics and Gynecology, Inha University School of Medicine, Incheon, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine, Seoul. Korea
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Taoka R, Kakehi Y. The influence of asymptomatic inflammatory prostatitis on the onset and progression of lower urinary tract symptoms in men with histologic benign prostatic hyperplasia. Asian J Urol 2017; 4:158-163. [PMID: 29264225 PMCID: PMC5717984 DOI: 10.1016/j.ajur.2017.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/09/2017] [Accepted: 02/07/2017] [Indexed: 01/24/2023] Open
Abstract
Benign prostatic hyperplasia (BPH) is a condition that greatly affects the quality of life of middle-aged and elderly men. Histopathologically, hyperplastic changes frequently occur in the prostate tissue of elderly men, the incidence of which has been reported to reach approximately 80% in men in their 70s. In clinical practice, approximately 25% of men with histologic BPH are assumed to experience lower urinary tract symptoms (LUTS) and receive some kind of treatment. In other words, there are some men with histologic BPH who do not exhibit LUTS. For that reason, many factors, such as the change in hormonal environment, the immune or autoimmune response, the alteration of gene expression, and so on, are thought to affect the onset and progression of LUTS in men with histologic BPH. One such factor that has long drawn attention is the presence of asymptomatic histological inflammation, which very often accompanies symptomatic BPH. Recent studies have suggested that asymptomatic histological inflammation causes repeated destruction, healing, and regeneration of the prostate tissue, leading to the enlargement of prostatic nodules, while at the same time causing stromal tissue-predominant remodeling of the prostate tissue, which can increase urination resistance and result in the condition changing from asymptomatic BPH to symptomatic BPH. In future, the biomolecular clarification of the significance of asymptomatic histological inflammation in the prostate tissue could help develop new treatment strategies for BPH accompanied by LUTS.
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Affiliation(s)
- Rikiya Taoka
- Department of Urology, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa, Japan
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Matsuo T, Miyata Y, Kakoki K, Yuzuriha M, Asai A, Ohba K, Sakai H. The efficacy of mirabegron additional therapy for lower urinary tract symptoms after treatment with α1-adrenergic receptor blocker monotherapy: prospective analysis of elderly men. BMC Urol 2016; 16:45. [PMID: 27473059 PMCID: PMC4966767 DOI: 10.1186/s12894-016-0165-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 07/22/2016] [Indexed: 01/18/2023] Open
Abstract
Background Mirabegron is a β3-adrenoreceptor agonist developed for treatment of overactive bladder (OAB). α1-Adrenergic receptor blockers are effective for lower urinary tract symptoms (LUTS) in male patients. However, the efficacy of mirabegron additional treatment in elderly male patients with persistent male LUTS, especially in OAB after monotherapy with α1-adrenergic blockers, is not fully understood. Methods This study was conducted in male LUTS patients who were ≥ 65 years of age and had persistent OAB symptoms, regardless of whether they took an α1-adrenergic receptor blocker orally. Before and 12 weeks after mirabegron additional therapy (50 mg once daily), we evaluated the efficacy of this treatment using the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS), and changes in the maximum flow rate (Qmax) and post-void residual urine volume (PVR). We evaluated patients overall and divided into two groups by age: young-old (from 65 to 74 years old) and old-old (from 75 to 84 years old). Results Fifty men were enrolled in this study. Mirabegron additional therapy improved the total OABSS, total IPSS, and IPSS-quality of life (QOL) score. The voided volume (VV) and Qmax improved after treatment in patients overall. However, there was no significant change in PVR. The total OABSS, total IPSS, and IPSS-QOL score significantly improved in both of the young-old and old-old groups. However, a significant increasing of VV was detected in the young-old group. There were no significant differences in the Qmax or PVR in either group. Conclusions Mirabegron additional therapy was effective for male patients whose persistent LUTS and particularly OAB was not controlled with α1-adrenergic receptor blocker monotherapy, and mirabegron did not have negative effects on voiding function. Additionally, mirabegron additional therapy was considered effective regardless of patient age. Trial registration Trial registration number (TRN) trial registration number (TRN) and date of registration: ISRCTN16759097 in July 8, 2016.
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Affiliation(s)
- Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yasuyoshi Miyata
- Department of Urology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Katsura Kakoki
- Department of Urology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Miki Yuzuriha
- Department of Urology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Akihiro Asai
- Department of Urology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kojiro Ohba
- Department of Urology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hideki Sakai
- Department of Urology, Nagasaki University Graduate School of Biochemical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Shim SR, Kim JH, Doo SW, Yang WJ, Song ES, Song YS. Association Between Ambient Temperature and Lower Urinary Tract Symptoms: A Hospital-Based Cross-Sectional Analysis. Low Urin Tract Symptoms 2016; 10:38-44. [PMID: 27438480 DOI: 10.1111/luts.12138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/03/2016] [Accepted: 04/10/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To date, there is no overall agreement as to risk of ambient temperature for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Thus, we focused on ambient temperature as an environmental factor affecting LUTS and attempted to explain the temperature differences in LUTS severity in cases in real clinical practice. METHODS This was a multicenter, cross-sectional survey. The study involved 1612 men aged 40 years and older who visited 23 university hospitals in 10 major areas in South Korea between September 2010 and December 2011. The participants who had good overall mental and physical health, and complaint of LUTS were included. Korea Meteorological Administration data were used to determine daily average temperatures and daily temperatures on the interview dates at each site. RESULTS The average age of the 1612 men was 66.57 ± 10.03 years. The mean International Prostate Symptom Score (IPSS) and symptom duration were 18.51 ± 6.77 and 3.79 ± 3.89 years, respectively. Daily average temperature and temperature difference ranged from -13.1 to 28.5 °C and 0 to 20.6 °C, respectively. Age was a significant risk factor for IPSS, symptom duration, prostate volume (PV), maximal urinary flow rate (Qmax), average urinary flow rate (Qave) and total voiding volume (P < 0.001) but not QOL. Logistic regression analysis after adjustment for age and PV revealed that Qave and total voiding volume were increased as the temperature declined. However, IPSS and Qmax did not show a statistically significant difference as the temperature declined. CONCLUSION Our findings did not demonstrate an increased clinically significant risk of LUTS severity in connection with ambient temperature in clinical practice.
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Affiliation(s)
- Sung Ryul Shim
- Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Eun Seop Song
- Department of Obstetrics and Gynecology, Inha University School of Medicine, Incheon, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Wang J, Zhai Y, Wu J, Zhao S, Zhou J, Liu Z. Acupuncture for Chronic Urinary Retention due to Spinal Cord Injury: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:9245186. [PMID: 27190542 PMCID: PMC4846757 DOI: 10.1155/2016/9245186] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/20/2016] [Accepted: 03/22/2016] [Indexed: 11/17/2022]
Abstract
No systematic review has been published on the use of acupuncture for the treatment of chronic urinary retention (CUR) due to spinal cord injury (SCI). The aim of this review was to assess the effectiveness and safety of acupuncture for CUR due to SCI. Three randomized controlled trials (RCTs) including 334 patients with CUR due to SCI were included. Meta-analysis showed that acupuncture plus rehabilitation training was much better than rehabilitation training alone in decreasing postvoid residual (PVR) urine volume (MD -109.44, 95% CI -156.53 to -62.35). Likewise, a combination of acupuncture and aseptic intermittent catheterization was better than aseptic intermittent catheterization alone in improving response rates (RR 1.23, 95% CI 1.10 to 1.38). No severe adverse events were reported. In conclusion, acupuncture as a complementary therapy may have a potential effect in CUR due to SCI in decreasing PVR and improving bladder voiding. Additionally, acupuncture may be safe in treating CUR caused by SCI. However, due to the lack of high quality RCTs, we could not draw any definitive conclusions. More well-designed RCTs are needed to provide strong evidence.
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Affiliation(s)
- Jia Wang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing 100053, China
| | - Yanbing Zhai
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing 100053, China
- Beijing University of Chinese Medicine, No. 11 North Third Ring Road, Chaoyang District, Beijing 100029, China
| | - Jiani Wu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing 100053, China
| | - Shitong Zhao
- Beijing University of Chinese Medicine, No. 11 North Third Ring Road, Chaoyang District, Beijing 100029, China
| | - Jing Zhou
- Beijing University of Chinese Medicine, No. 11 North Third Ring Road, Chaoyang District, Beijing 100029, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing 100053, China
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Yeo JK, Choi H, Bae JH, Kim JH, Yang SO, Oh CY, Cho YS, Kim KW, Kim HJ. Korean clinical practice guideline for benign prostatic hyperplasia. Investig Clin Urol 2016; 57:30-44. [PMID: 26966724 PMCID: PMC4778754 DOI: 10.4111/icu.2016.57.1.30] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/24/2015] [Indexed: 11/18/2022] Open
Abstract
In 2014, the Korean Urological Association organized the Benign Prostatic Hyperplasia Guideline Developing Committee composed of experts in the field of benign prostatic hyperplasia (BPH) with the participation of the Korean Academy of Family Medicine and the Korean Continence Society to develop a Korean clinical practice guideline for BPH. The purpose of this clinical practice guideline is to provide current and comprehensive recommendations for the evaluation and treatment of BPH. The committee developed the guideline mainly by adapting existing guidelines and partially by using the de novo method. A comprehensive literature review was carried out primarily from 2009 to 2013 by using medical search engines including data from Korea. Based on the published evidence, recommendations were synthesized, and the level of evidence of the recommendations was determined by using methods adapted from the 2011 Oxford Centre for Evidence-Based Medicine. Meta-analysis was done for one key question and four recommendations. A draft guideline was reviewed by expert peer reviewers and discussed at an expert consensus meeting until final agreement was achieved. This evidence-based guideline for BPH provides recommendations to primary practitioners and urologists for the diagnosis and treatment of BPH in men older than 40 years.
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Affiliation(s)
- Jeong Kyun Yeo
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | - Hun Choi
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Seong Ok Yang
- Department of Urology, VHS Medical Center, Seoul, Korea
| | - Chul Young Oh
- Department of Urology, Hallym University College of Medicine, Chuncheon, Korea
| | - Young Sam Cho
- Department of Urology, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Kyoung Woo Kim
- Department of Family Medicine, Inje University College of Medicine, Busan, Korea
| | - Hyung Ji Kim
- Department of Urology, Dankook University College of Medicine, Cheonan, Korea
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Chua ME, Mendoza J, See M, Esmena E, Aguila D, Silangcruz JM, Reyes BJ, Luna S, Morales M. A critical review of recent clinical practice guidelines on the diagnosis and treatment of non-neurogenic male lower urinary tract symptoms. Can Urol Assoc J 2015; 9:E463-70. [PMID: 26279717 DOI: 10.5489/cuaj.2424] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We provide an overview of the quality of recent clinical clinical practice guidelines (CPGs) for non-neurogenic male lower urinary tract symptoms (LUTS) and summarize the recommendations for their diagnosis, assessment, and treatment. METHODS We systematically searched recent (2008-2013) CPGs for non-neurogenic male LUTS. Eligible CPGs were assessed and appraised using Appraisal of Guidelines, Research and Evaluation II (AGREE II) tool by a CPG-appraisal group. The appraisal scores for each guideline were summarized according to each domain and in total. A recommendation summary was made across the guidelines for diagnostics, conservative management, medical, minimally invasive therapy, and surgical management. RESULTS A total of 8 guidelines were considered. According to AGREE II appraisal of guidelines, the National Institute for Health and Clinical Excellence (NICE), American Urological Association (AUA) and European Association of Urology (EAU) consistently scored high on the guideline domains assessed. Recommendations on diagnostics, conservative management, medical, and surgical management were consistent among the top 3 guidelines. However, we noted a discrepancy in recommending minimally invasive therapy as an alternative management of moderate to severe or bothersome non-neurogenic male LUTS secondary to benign prostatic enlargement (BPE); the NICE guideline, in particular, does not recommend using minimally invasive therapy. CONCLUSION The quality of recent CPGs on non-neurogenic male LUTS was appraised and summarized. The guidelines from NICE, AUA and EAU were considered highly compliant to the AGREE II proposition for guideline formation and development.
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Affiliation(s)
| | - Jonathan Mendoza
- Department of Preventive and Community Medicine, St. Luke's College of Medicine, Manila, Philippines
| | - Manuel See
- Institute of Urology, St. Luke's Medical Center, Manila, Philippines
| | - Ednalyn Esmena
- Comprehensive Pelvic Floor Center, St. Luke's Medical Center, Manila, Philippines
| | - Dean Aguila
- Clinical Information Management Service, St. Luke's Medical Center, Manila, Philippines
| | | | | | - Saturnino Luna
- Institute of Urology, St. Luke's Medical Center, Manila, Philippines
| | - Marcelino Morales
- Department of Urology, National Kidney and Transplant Institute, Manila, Philippines
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Fukuta F, Masumori N. A Review of Naftopidil for Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia. CURRENT BLADDER DYSFUNCTION REPORTS 2015. [DOI: 10.1007/s11884-015-0293-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tanaka T, Kuratsukuri K, Yoshimura R, Adachi T, Yamaguchi T, Ohmachi T, Yamamoto S, Nakamura T, Tamada S, Nakatani T. Efficacy of naftopidil for nocturia in male patients with lower urinary tract symptoms: Comparison of morning and evening dosing. Int J Urol 2014; 22:317-21. [DOI: 10.1111/iju.12669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/25/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Tomoaki Tanaka
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
| | - Katsuyuki Kuratsukuri
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
| | - Rikio Yoshimura
- Department of Urology; Osaka Railway Hospital; Osaka Osaka Japan
| | - Takahisa Adachi
- Department of Urology; Juso Municipal Hospital; Osaka Osaka Japan
| | | | - Tetsuji Ohmachi
- Department of Urology; Bell land General Hospital; Sakai Osaka Japan
| | - Shinji Yamamoto
- Department of Urology; Ikuwakai Memorial Hospital; Osaka Osaka Japan
| | - Takahiro Nakamura
- Department of Urology; Perfect Liberty Hospital; Tondabayashi Osaka Japan
| | - Satoshi Tamada
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
| | - Tatsuya Nakatani
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
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Bock-Omma AA, Dienye PO, Oghu IS. Prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care, Port Harcourt, Nigeria. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2013.10874397] [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
Affiliation(s)
- AA Bock-Omma
- Department of Family Medicine and General Practice, Shawsand Medical Centre, Port Harcourt, Nigeria
| | - PO Dienye
- Department of Family Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - IS Oghu
- Department of Family Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
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Okamura K, Kimura K, Mizuno H, Okamoto N, Aota Y. Core lower urinary tract symptom score questionnaire: A psychometric analysis. Int J Urol 2014; 21:1151-4. [DOI: 10.1111/iju.12522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 05/06/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Kikuo Okamura
- Department of Urology; National Hospital Organization Higashi Nagoya Hospital; Nagoya Japan
| | - Kyosuke Kimura
- Department of Urology; National Hospital Organization Nagoya Medical Center; Nagoya Japan
| | - Hideki Mizuno
- Department of Urology; National Hospital Organization Nagoya Medical Center; Nagoya Japan
| | - Noriko Okamoto
- Department of Urology; National Hospital Organization Nagoya Medical Center; Nagoya Japan
| | - Yasuhiro Aota
- Department of Urology; National Hospital Organization Nagoya Medical Center; Nagoya Japan
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Lee SW, Paick JS, Park HJ, Won JE, Morisaki Y, Sorsaburu S, Viktrup L. The Efficacy and Safety of Tadalafil 5 mg Once Daily in Korean Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: An Integrated Analysis. World J Mens Health 2014; 32:28-35. [PMID: 24872949 PMCID: PMC4026231 DOI: 10.5534/wjmh.2014.32.1.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 03/17/2014] [Accepted: 03/24/2014] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This post hoc integrated analysis assessed the efficacy and safety of tadalafil 5 mg once daily in a large Korean population with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH-LUTS). MATERIALS AND METHODS Individual Korean participant data were integrated from three 12-week, randomized, double-blind, placebo-controlled studies in Asian men with BPH-LUTS, wherein 177 Korean men received placebo and 177 received tadalafil 5 mg once daily. The primary objective was to compare the change from baseline to week 12 in total International Prostate Symptom Score (IPSS) after treatment with tadalafil versus placebo. RESULTS A significantly greater improvement (p<0.001) in total IPSS from baseline to week 12 was observed for tadalafil compared to placebo (least squares mean: tadalafil=-5.97; placebo=-3.94 ). Total IPSS at weeks 4 and 12, IPSS voiding and storage subscores at weeks 4, 8, and 12, and IPSS quality of life index at weeks 8 and 12 were also significantly improved (p<0.05) for tadalafil compared to placebo. There was significant improvement (p<0.001) in the patient global Impression of improvement responses and numerical improvement in the clinician global impression of improvement responses with tadalafil compared to placebo. There were no significant treatment differences for peak urine flow rate or postvoid residual volume. Few participants had treatment-emergent adverse events and there were no unexpected safety findings. CONCLUSIONS This integrated analysis of three randomized, placebo-controlled Asian studies confirmed tadalafil 5 mg once daily as an efficacious and well-tolerated treatment for Korean men with BPH-LUTS.
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Affiliation(s)
- Sung Won Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Seung Paick
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Hyun Jun Park
- Department of Urology, Pusan National University Hospital, Medical Research Institute, Pusan National University School of Medicine, Busan, Korea
| | | | | | | | - Lars Viktrup
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
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Karaman Mİ, Sertkaya Z, Koca O, Akyüz M, Güneş M, Öztürk Mİ. The use of primary and secondary doxazosin XL (8 mg) in the treatment of benign prostate hyperplasia: Is there a new approach in the event of alpha-blocker failure? Turk J Urol 2014; 40:35-9. [PMID: 26328143 DOI: 10.5152/tud.2014.31384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 11/04/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Lower urinary tract symptoms (LUTS), which are related to benign prostate hyperplasia (BPH), are the most commonly encountered diseases in urological practice. In our study, we compared responses to (doxazosin mesylate extended release tablets) treatment. MATERIAL AND METHODS In our study, we included one hundred patients with LUTS who did not receive any medical treatment, and one hundred patients with LUTS who did not respond to alpha-blocker drugs other than doxazosin XL (8 mg). The inclusion criteria for the study were as follows: international prostate symptom score (IPSS)>7, prostate volume >20 cc, Q-max <15 mL/sn, lack of any previous pelvic or prostatic surgery, and /or urethral catheterization. RESULTS The mean age of the patients was 62.2±7.9 years. No statistically significant differences were detected between the groups with respect to age, prostate volume, and total prostate-specific antigen (PSA) levels. The duration of the follow-up period was calculated as 3-26 (mean 11) months. Significant differences were detected in post-voiding residual urine, IPSS, quality of life and Qmax between pre- and post-treatment values. Similar decreases in the IPSS scores, and increases in Qmax values were detected in both groups. CONCLUSION Doxazosin XL (8 mg) treatment was found to be efficient and reliable in primary patients and in patients with severe LUTS who did not respond to medical treatment. Trial of doxazosin XL (8 mg) therapy, before surgery in patients who respond inadequately to other alpha-blocker drugs is a rational approach.
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Affiliation(s)
- Muhammet İhsan Karaman
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Zülfü Sertkaya
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Orhan Koca
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Akyüz
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Mustafa Güneş
- Department of Urology, Faculty of Medicine, Süleyman Demirel University, Turkey
| | - Metin İshak Öztürk
- Department of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
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Morita T, Kubo KKT, Fujisaki A, Natsui S, Nukui A, Kobayashi M, Kurokawa S. Involvement of magnitude of ambient temperature change in nonspecific effect in perceived placebo effect on lower urinary tract symptoms: study on switching of naftopidil in patients with benign prostatic hyperplasia. Res Rep Urol 2014; 5:83-90. [PMID: 24400239 PMCID: PMC3826939 DOI: 10.2147/rru.s42583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine if switching from one brand of the α1-adrenoceptor antagonist naftopidil (Avishot™) to another brand (Flivas™) under the same conditions causes the same changes in lower urinary tract symptoms (LUTS) and quality of life (QOL) as the perceived placebo effect, and if ambient temperature as a nonspecific factor is related to those changes in benign prostatic hyperplasia (BPH) patients. PATIENTS AND METHODS A retrospective study was carried out on 217 BPH patients who had received Avishot™ for more than 6 months and then were switched to Flivas™ at the same dose and timing. The two drugs contain the same principal ingredient and display the same pharmacokinetic properties. The International Prostate Symptom Score (IPSS), QOL score, and average monthly ambient temperature at the patients' residence area from the Automated Meteorological Data Acquisition System in Japan were used for the evaluation. RESULTS A significant change in urinary storage symptoms (P = 0.006), and especially in nighttime frequency (P< 0.001), was observed by switching drugs, suggesting the perceived placebo effect. There was significant improvement of daytime frequency (P< 0.05), nighttime frequency (P< 0.001), storage symptoms (P< 0.001), and total IPSS (P< 0.05) when the magnitude of ambient temperature change from before and 3 months after switching drugs was higher than 10°C, while no significant improvement was noted in any of the parameters examined when the same was lower than 10°C. CONCLUSION The present study showed the nonspecific effect of magnitude of ambient temperature change was involved in the perceived placebo effect on LUTS, especially on storage symptoms, by switching drugs. The nonspecific effect on LUTS with BPH needs to be considered when evaluating subjective treatment efficacy of drugs for LUTS with BPH in routine clinical practice. The present study supports the lifestyle advice "avoid exposing the lower body to cold temperature" or "keep warm when it is cold" for LUTS with BPH.
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Affiliation(s)
- Tatsuo Morita
- Department of Urology, Jichi Medical University, Tochigi, Japan
| | | | - Akira Fujisaki
- Department of Urology, Jichi Medical University, Tochigi, Japan
| | - Shinsuke Natsui
- Department of Urology, Jichi Medical University, Tochigi, Japan
| | - Akinori Nukui
- Department of Urology, Jichi Medical University, Tochigi, Japan
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Komiya A, Kino M, Kato T, Suzuki H, Ichikawa T, Fuse H. Correlations Among Urinary, Sexual, and Testicular Functions and Health-Related Quality of Life. JOURNAL OF MEN'S HEALTH 2013. [DOI: 10.1089/jomh.2012.00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kawahara T, Morita S, Ito H, Terao H, Sakata R, Ishiguro H, Tanaka K, Miyamoto H, Matsuzaki J, Kubota Y, Uemura H. Ramelteon combined with an α1-blocker decreases nocturia in men with benign prostatic hyperplasia. BMC Urol 2013; 13:30. [PMID: 23758651 PMCID: PMC3687682 DOI: 10.1186/1471-2490-13-30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 06/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to α1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study. METHODS Subjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received α1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the α1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon. RESULTS The mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P = 0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P = 0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P = 0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events. CONCLUSIONS Ramelteon in combination with an α1-blocker could be a treatment option for reducing nocturia in men with BPH.
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Ito M, Masuda H, Kawakami S, Fujii Y, Koga F, Saito K, Yamamoto S, Yonese J, Fukui I, Kihara K. Impact of lower urinary tract symptoms on prostate cancer risk among Japanese men with prostate-specific antigen <10 ng/mL and non-suspicious digital rectal examination. Int J Urol 2013; 20:1163-8. [PMID: 23521022 DOI: 10.1111/iju.12141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 02/17/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the association between lower urinary tract symptoms status and prostate cancer risk at initial extended biopsy. METHODS Between 2005 and 2011, the International Prostate Symptom Score was completed on 1467 consecutive men with prostate-specific antigen <10 ng/mL and non-suspicious digital rectal examination. After excluding 308 men treated with alpha-blockers, the remaining 1159 men were enrolled in the present study. Lower urinary tract symptoms status was divided into absent or mild (International Prostate Symptom Score scores of 0-7) and moderate or severe lower urinary tract symptoms (International Prostate Symptom Score scores of 8-35). The risks of prostate cancer diagnosis and high-grade (Gleason score ≥4 + 3) prostate cancer diagnosis in relation to lower urinary tract symptoms status was evaluated using logistic regression. A stratified analysis based on prostate volume (<30 cc, 30-50 cc and >50 cc) was also carried out. RESULTS Of 1159 patients, 421 (36.3%) had a positive biopsy and 590 (51.0%) had moderate or severe lower urinary tract symptoms. On multivariate analysis, absent or mild lower urinary tract symptoms had a significant and positive impact on the risk of prostate cancer and high-grade disease (odds ratio 1.64 and 1.70, P = 0.0007 and 0.0121, respectively). Furthermore, the aforementioned findings for prostate cancer detection did not change throughout every prostate volume subgroup. In contrast, in men with prostate volume ≤50 cc, but not in those with prostate volume >50 cc, prostate-specific antigen or %free prostate-specific antigen remained as a significant predictor of prostate cancer. CONCLUSION In men with elevated prostate-specific antigen, absent or mild lower urinary tract symptoms are positively associated with prostate cancer and high-grade disease regardless of the prostate volume. This finding is especially useful in men with enlarged prostates.
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Affiliation(s)
- Masaya Ito
- Department of Urology, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
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25
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Development of a quality of life scale specific for patients with benign prostatic hyperplasia. Int Urol Nephrol 2013; 45:339-46. [DOI: 10.1007/s11255-013-0384-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 01/12/2013] [Indexed: 11/26/2022]
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Yokoyama O, Yoshida M, Kim SC, Wang CJ, Imaoka T, Morisaki Y, Viktrup L. Tadalafil once daily for lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a randomized placebo- and tamsulosin-controlled 12-week study in Asian men. Int J Urol 2012; 20:193-201. [PMID: 22958078 DOI: 10.1111/j.1442-2042.2012.03130.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 07/26/2012] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To examine the efficacy and safety of tadalafil in Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. METHODS Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia were randomized to once-daily placebo (n=154), tadalafil 2.5 mg (n=151), tadalafil 5.0 mg (n=155) or tamsulosin 0.2 mg (active control, n=152) for 12 weeks. RESULTS Total International Prostate Symptom Score least-squares mean changes from baseline to end-point significantly improved with tadalafil 2.5 mg (-4.8, P=0.003) and 5 mg (-4.7, P=0.004) versus placebo (-3.0). Significant improvement in the International Prostate Symptom Score versus placebo was observed earlier (week 2) for tadalafil 5.0 mg than for tadalafil 2.5 mg (week 8). Significant improvements (P<0.05) in both tadalafil groups versus placebo were observed for the International Prostate Symptom Score voiding subscore, International Prostate Symptom Score Quality of Life, and for Patient and Clinician Global Impressions of Improvement. Significant improvements versus placebo were observed in the International Prostate Symptom Score storage subscore for tadalafil 5.0 mg (-1.7, P=0.021), but not tadalafil 2.5 mg (-1.5, P=0.072). No significant improvements in benign prostatic hyperplasia Impact Index or improvements in peak urinary flow rates were observed with tadalafil 2.5 mg or 5.0 mg versus placebo. Tamsulosin treatment resulted in significant improvements versus placebo across all efficacy parameters, except for peak urinary flow rates. Safety results were consistent with the known tadalafil and tamsulosin safety profiles. CONCLUSIONS Tadalafil once daily represents an effective and well tolerated medical treatment for Asian men presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
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Affiliation(s)
- Osamu Yokoyama
- Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan
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Inoue H, Ishizuka O, Imamura T, Yamagishi T, Noguchi W, Yokoyama H, Kurizaki Y, Nishizawa O. Relationship between Toe Temperature and Lower Urinary Tract Symptoms. Low Urin Tract Symptoms 2012; 4:144-9. [PMID: 26676622 DOI: 10.1111/j.1757-5672.2012.00151.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cold stress can elicit increases in urinary urgency and frequency. We determined if there was a relationship between finger and toe temperatures and lower urinary tract symptoms (LUTS). METHODS We studied 50 people who visited a public health management seminar. The participants were divided into two groups according to self-described sensitivity to cold stress. The cold non-sensitive (CNS) group consisted of 3 males and 20 females (66.9 ± 10.8 years old), and the cold sensitive (CS) group consisted of 4 males and 23 females (65.8 ± 8.01 years old). Each participant was assessed to determine international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), and quality of life (QOL) score. They were then instructed on lifestyle changes and exercises that could improve peripheral blood flow and provide relief for their LUTS. Next, the temperatures of their middle fingers and toes were measured before and after 5-10 min of the exercises. Two weeks later, the IPSS, OABSS, and QOL scores were reassessed. RESULTS Before exercise, the middle fingers were significantly warmer than the middle toes. Exercise had no significant effect on the middle finger temperature of either group; however, it did increase the middle toe temperature for both groups. The increase was greatest for the CS group. The CS group had higher LUTS storage symptoms than the CNS group, and these improved after 2 weeks of lifestyle changes and exercise. CONCLUSION Improvements in lifestyle and daily exercise may be effective for LUTS in CS people.
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Affiliation(s)
- Hiroo Inoue
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuya Imamura
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takahiro Yamagishi
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Wataru Noguchi
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hitoshi Yokoyama
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshiki Kurizaki
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Osamu Nishizawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
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Takeda M, Nishizawa O, Imaoka T, Morisaki Y, Viktrup L. Tadalafil for the Treatment of Lower Urinary Tract Symptoms in Japanese Men with Benign Prostatic Hyperplasia: Results from a 12-week Placebo-controlled Dose-finding Study with a 42-week Open-label Extension. Low Urin Tract Symptoms 2012; 4:110-9. [PMID: 26676616 DOI: 10.1111/j.1757-5672.2012.00144.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the efficacy, safety, and dose response of tadalafil once daily in Japanese men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH-LUTS). METHODS Men ≥45 years with moderate-to-severe BPH-LUTS were randomized to once-daily placebo (N = 140), tadalafil 2.5 mg (N = 142), or tadalafil 5.0 mg (N = 140), in a 12-week double-blind phase, followed by a 42-week, tadalafil 5.0 mg open-label extension (OLE) phase (N = 394). The primary outcome was total International Prostate Symptom Score (IPSS) change from baseline to last available observation in the double-blind phase. RESULTS The least squares (LS) mean difference between placebo and tadalafil in total IPSS change from baseline was -0.7 (P = 0.201) and -1.1 (P = 0.062) for tadalafil 2.5 and 5 mg, respectively (ANCOVA; a dose-dependent improvement in placebo-adjusted total IPSS for tadalafil 5 mg versus 2.5 mg of 57%). Repeated-measures analyses identified a significant total IPSS change for tadalafil 5 mg (LS mean difference between placebo and tadalafil 5 mg: -1.2; P = 0.035), but not tadalafil 2.5 mg, at week 12. Significant improvements for tadalafil 5 mg were demonstrated (ANCOVA) for IPSS obstructive subscore (P = 0.033) and IPSS quality of life index (P = 0.022). Numerical improvements in IPSS scores were maintained over the OLE phase. Tadalafil was well tolerated with no unexpected adverse events. CONCLUSION Tadalafil (5.0 mg) had a favorable benefit-to-risk profile, supporting further investigation of tadalafil (5.0 mg) in Japanese men with BPH-LUTS.
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Affiliation(s)
- Masayuki Takeda
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Osamu Nishizawa
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Takeshi Imaoka
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Yoji Morisaki
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Lars Viktrup
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
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Homma Y, Gotoh M, Yokoyama O, Masumori N, Kawauchi A, Yamanishi T, Ishizuka O, Seki N, Kamoto T, Nagai A, Ozono S. JUA clinical guidelines for benign prostatic hyperplasia. Int J Urol 2011. [DOI: 10.1111/j.1442-2042.2011.02861.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Homma Y, Gotoh M, Yokoyama O, Masumori N, Kawauchi A, Yamanishi T, Ishizuka O, Seki N, Kamoto T, Nagai A, Ozono S. Outline of JUA clinical guidelines for benign prostatic hyperplasia. Int J Urol 2011; 18:741-56. [DOI: 10.1111/j.1442-2042.2011.02860.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Masumori N. Naftopidil for the treatment of urinary symptoms in patients with benign prostatic hyperplasia. Ther Clin Risk Manag 2011; 7:227-38. [PMID: 21753885 PMCID: PMC3132093 DOI: 10.2147/tcrm.s13883] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Indexed: 12/05/2022] Open
Abstract
Naftopidil, approved only in Japan, is an α1-adrenergic receptor antagonist (α1-blocker) used to treat lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Different from tamsulosin hydrochloride and silodosin, in that it has higher and extremely higher affinity respectively, for the α1A-adrenergic receptor subtype than for the α1D type, naftopidil has distinct characteristics because it has a three times greater affinity for the α1D-adrenergic receptor subtype than for the α1A subtype. Although well-designed large-scale randomized controlled studies are lacking and the optimal dosage of naftopidil is not always completely determined, previous reports from Japan have shown that naftopidil has superior efficacy to a placebo and comparable efficacy to other α1-blockers such as tamsulosin. On the other hand, the incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may be lower than for tamsulosin and silodosin having high affinity for the α1A-adrenergic receptor subtype. However, it remains unknown if the efficacy and safety of naftopidil in Japanese is applicable to white, black and Hispanic men having LUTS/BPH in western countries.
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Affiliation(s)
- Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Yokoyama O, Miwa Y, Oyama N, Aoki Y, Ito H, Tanase K, Ishida H, Matsuta Y, Kusukawa N, Yamauchi H, Takahara N, Watanabe N, Tsuchiyama K, Yokoi S, Akino H. Urethral Sensations are Related to the Development of Detrusor Overactivity. Low Urin Tract Symptoms 2011; 3:59-63. [PMID: 26676387 DOI: 10.1111/j.1757-5672.2011.00096.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Urgency is the core symptom of the overactive bladder symptom complex, but the underlying mechanisms are not fully understood. Clinical findings have led to the assumption that bladder outlet obstruction (BOO) caused by benign prostatic enlargement (BPE) induces storage symptoms and detrusor overactivity. Presumably, BOO by BPE accounts for urgency; however, urgency is not always caused by BOO. Sensory nerves in the wall of the urethra fire in response to urethral fluid flow, and this activity initiates bladder contractions in the quiescent bladder and augments ongoing contractions in the active bladder. In humans, prostatic urethral anesthesia results in significant increases in bladder capacity among BPH patients without neurological diseases, therefore sensory stimuli from an anatomically altered prostatic urethra has the possibility to induce urgency and detrusor overactivity. Studies in animals demonstrate the basis for an excitatory urethra to bladder reflex. Urethral stimulation by prostaglandin E2 induces an excitatory effect on micturition reflex by activation of C-fiber afferent nerves. α1A -adrenoceptor blocker has an inhibitory effect on the micturition reflex, suggesting excitatory urethra to bladder reflex is mediated by α1A -adrenoceptor. Even if there is no obstruction, increase in urethral sensory due to BPE may induce the development of the detrusor overactivity.
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Affiliation(s)
- Osamu Yokoyama
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Yoshiji Miwa
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Nobuyuki Oyama
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Yoshitaka Aoki
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Hideaki Ito
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Kazuya Tanase
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Hirokazu Ishida
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Yosuke Matsuta
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Naoya Kusukawa
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Hiroki Yamauchi
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Noriko Takahara
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Nozomu Watanabe
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Katsuki Tsuchiyama
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Satoshi Yokoi
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
| | - Hironobu Akino
- Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan
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Watanabe T, Ozono S, Kageyama S. A Randomized Crossover Study Comparing Patient Preference for Tamsulosin and Silodosin in Patients with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia. J Int Med Res 2011. [DOI: 10.1177/147323001103900105] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Patient preference for benign prostatic hyperplasia (BPH) treatment with the α1-blockers, tamsulosin or silodosin, was compared using patient-reported outcomes. Japanese patients with lower urinary tract symptoms associated with BPH were randomly allocated to either the T–S group (tamsulosin 0.2 mg orally once daily for 4 weeks then silodosin 4 mg orally twice daily for 4 weeks) or the S–T group (silodosin 4 mg orally twice daily for 4 weeks then tamsulosin 0.2 mg orally once daily for 4 weeks). The primary endpoint was the preferred drug for treatment continuation at 8 weeks, determined by a patient-reported questionnaire. In total, 102 patients (mean age 70.3 years) were enrolled and 84 ( n = 42 per group) completed the study. A significant difference was observed between the proportion of patients who preferred tamsulosin (59/84 patients; 70.2%) and those who preferred silodosin (18/84 patients; 21.4%). A major reason for preference of either drug was ‘good efficacy’. Incidence of adverse effects was significantly lower with tamsulosin (3/91 patients; 3.3%) than with silodosin (25/88 patients; 28.4%). These findings indicate that tamsulosin is very effective for BPH, has few adverse effects and that patients want to continue to use it.
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Affiliation(s)
- T Watanabe
- Department of Urology, Maruyama Hospital, Hamamatsu, Japan
| | - S Ozono
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Clinical Guideline for the Diagnosis and Treatment of Urinary Tract Infections: Asymptomatic Bacteriuria, Uncomplicated & Complicated Urinary Tract Infections, Bacterial Prostatitis. Infect Chemother 2011. [DOI: 10.3947/ic.2011.43.1.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Current world literature. Curr Opin Urol 2010; 21:84-91. [PMID: 21127406 DOI: 10.1097/mou.0b013e328341a1a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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The add-on effect of solifenacin for patients with remaining overactive bladder after treatment with tamsulosin for lower urinary tract symptoms suggestive of benign prostatic obstruction. Adv Urol 2010:205251. [PMID: 20981257 PMCID: PMC2964005 DOI: 10.1155/2010/205251] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 10/11/2010] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate the add-on effect of solifenacin for Japanese men with remaining overactive bladder (OAB) symptoms after tamsulosin monotherapy for lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) in real-life clinical practice. METHODS Patients aged ≥ 50 having remaining OAB symptoms (≥ 3 of OAB symptom score (OABSS) with ≥2 of urgency score) after at least 4 weeks treatment by 0.2 mg of tamsulosin for BPO/LUTS received 2.5 or 5.0 mg of solifenacin for 12 weeks. The International Prostate Symptom Score (IPSS), QOL index and OABSS, maximum flow rate (Qmax) and postvoid residual urine volume (PVR) were determined. RESULTS A total of 48 patients (mean age 72.5 years) completed the study. There were significant improvement in IPSS (15.1 to 11.2) and QOL index (4.2 to 3.0) by add-on of solifenacin. Although the IPSS storage symptom score was significantly improved, there were no changes observed in the IPSS voiding symptom score. The OABSS showed significant improvement (8.0 to 4.8). No changes were observed in Qmax and PVR. CONCLUSIONS Under the supervision of an experienced urologist, the additional administration of solifenacin to patients with BPO/LUTS treated with tamsulosin, is effective in controlling remaining OAB symptoms.
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Boscolo-Berto R. Legal claims and bias in creating clinical practice guidelines: Which step in which direction? Int J Urol 2010; 17:498. [DOI: 10.1111/j.1442-2042.2010.02501.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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