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Which Happens Earlier, Lower Urinary Tract Symptoms or Erectile Dysfunction? Sex Med 2021; 9:100275. [PMID: 33540364 PMCID: PMC8072163 DOI: 10.1016/j.esxm.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Although an association between erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) has been suggested, it was not clarified whether LUTS developed before ED or vice versa. Aim To clarify whether LUTS develop before ED or vice versa and which symptoms predicted the onset of the other condition in a longitudinal community-based study. Methods We conducted a longitudinal community-based study on LUTS and ED in aged Japanese men. A follow-up study was conducted to determine their longitudinal changes of LUTS and ED after 15 years. Erectile function was evaluated using a validated questionnaire. LUTS were evaluated based on the International Prostate Symptom Score, quality of life index, and prostate volume. Main outcome measure We evaluated the baseline symptoms among the participants who had LUTS and ED in the follow-up survey and what prior symptoms could predict the onset of the other condition using the data from a long-term longitudinal survey. Results A total of 108 men were enrolled in this study. Of the 47 men having both LUTS and ED in the follow-up study, men having only LUTS (n = 16) were more frequent than those having only ED (n = 6) in the initial study. Likewise, of the 38 men having both nocturia and ED at the time of the follow-up study, those having only nocturia (n = 12) were more frequent than those having only ED (n = 5) in the initial study. In multivariable analysis, age 60 years or older (odds ratio: 7.10, 95% CI: 2.09-24.13) and nocturia (odds ratio: 15.83, 95% CI: 3.05-82.15) were independent predictors for the onset of ED. Conclusion There were more men with prior onset of LUTS, especially nocturia, than men with prior onset of ED among those with both ED and LUTS in this long-term longitudinal study. Nocturia may be a predictor of subsequent ED. Matsuda Y, Kobayashi K, Fukuta F, et al. Which Happens Earlier, Lower Urinary Tract Symptoms or Erectile Dysfunction?. J Sex Med 2021;9:100275.
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Adomi M, Iwagami M, Kawahara T, Hamada S, Iijima K, Yoshie S, Ishizaki T, Tamiya N. Factors associated with long-term urinary catheterisation and its impact on urinary tract infection among older people in the community: a population-based observational study in a city in Japan. BMJ Open 2019; 9:e028371. [PMID: 31221889 PMCID: PMC6589038 DOI: 10.1136/bmjopen-2018-028371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aimed to identify factors associated with long-term urinary catheterisation (LTUC) in community-dwelling older adults and to evaluate the risk of urinary tract infection (UTI) among people with LTUC. DESIGN Population-based observational study. SETTING Medical and long-term care insurance claims data from one municipality in Japan. PARTICIPANTS People aged ≥75 years living at home who used medical services between October 2012 and September 2013 (n=32 617). OUTCOME MEASURES (1) Use of LTUC, defined as urinary catheterisation for at least two consecutive months, to identify factors associated with LTUC and (2) the incidence of UTI, defined as a recorded diagnosis of UTI and prescription of antibiotics, in people with and without LTUC. RESULTS The 1-year prevalence of LTUC was 0.44% (143/32 617). Multivariable logistic regression analysis showed that the male sex, older age, higher comorbidity score, previous history of hospitalisation with in-hospital use of urinary catheters and high long-term care need level were independently associated with LTUC. The incidence rate of UTI was 33.8 and 4.7 per 100 person-years in people with and without LTUC, respectively. According to multivariable Poisson regression analysis, LTUC was independently associated with UTI (adjusted rate ratio 2.58, 95% CI 1.68 to 3.96). Propensity score-matched analysis yielded a similar result (rate ratio 2.41, 95% CI 1.45 to 4.00). CONCLUSIONS We identified several factors associated with LTUC in the community, and LTUC was independently associated with the incidence of UTI.
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Affiliation(s)
- Motohiko Adomi
- School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | | | - Shota Hamada
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, University of Tokyo, Tokyo, Japan
| | - Satoru Yoshie
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan
- Institute of Gerontology, University of Tokyo, Tokyo, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Tatsuro Ishizaki
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
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Roehrborn CG, Lowe FC, Gittelman M, Wruck JM, Verbeek AE. Management of Male Lower Urinary Tract Symptoms in a Simulated, Over-the-Counter Setting: An Exploratory Study of Tamsulosin. Drugs Aging 2019; 36:179-188. [PMID: 30607798 DOI: 10.1007/s40266-018-0621-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH) are common in men, considerably affecting quality of life. AIMS The self-directed use of over-the-counter (OTC) tamsulosin (0.4 mg) and potential safety risks were evaluated in an open-label, uncontrolled, exploratory, 8-week OTC-simulated study. METHODS Men (≥ 18 years) were recruited via mass advertising about bothersome LUTS. In a working retail environment, respondents reviewed the product and decided whether it was appropriate for them to use (self-selection phase). After purchasing the product, participants' ability to use it as directed by the proposed drug facts label (DFL) was assessed (home-use phase). RESULTS Of 1446 eligible men, 679 completed the self-selection phase, and 73.9% (502/679) self-selected to use tamsulosin correctly according to the DFL. Of 369 participants who purchased tamsulosin and entered the home-use phase, 321 took one or more doses of tamsulosin and participated in at least one telephone interview. In total, 85.4% (274/321) of participants adhered to the 'Stop Use' and 'Directions' instructions in the DFL. Overall, 139 (39.6%) participants experienced one or more adverse events (AEs); 65 (18.5%) were deemed drug-related, including dizziness (11 [3.1%]), ejaculation disorder (6 [1.7%]), and semen volume decrease (6 [1.7%]). No unexpected AEs were reported. CONCLUSIONS Of the men interested in self-managing their LUTS, a majority had moderate-to-severe LUTS of long duration. Most men were able to appropriately self-select and use tamsulosin in concordance with DFL instructions and directions. No unexpected AEs were reported during self-directed use. With further label refinement, an over-the-counter tamsulosin option might be feasible. TRIAL REGISTRATION ClinicalTrials.gov NCT01726270.
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Affiliation(s)
| | - Franklin C Lowe
- Weiler Hospital, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marc Gittelman
- South Florida Medical Research, Uromedix/Division of 21st Century Oncology, Aventura, FL, USA
| | - Jan M Wruck
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
| | - Anna E Verbeek
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA.
- Sanofi, 55 Corporate Drive, Bridgewater, NJ, 08807, USA.
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Kobayashi K, Fukuta F, Masumori N. Prevalence of post-micturition dribble in Japanese men and its relationship with benign prostatic hyperplasia/lower urinary tract symptoms. Low Urin Tract Symptoms 2017; 11:O38-O41. [PMID: 29265685 DOI: 10.1111/luts.12210] [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: 07/12/2017] [Revised: 09/20/2017] [Accepted: 10/26/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Post-micturition dribble (PMD) is one of the post-micturition lower urinary tract symptoms (LUTS). Although there have been many studies of LUTS in Japanese men, PMD is not completely understood in the Japanese population. In the present study, we investigated the prevalence and bother of PMD in Japanese men. METHODS From 2007 to 2008, a cross-sectional community-based study on LUTS was conducted in Japanese men aged 40-79 years in Shimamaki-mura, Hokkaido, Japan. The prevalence and bother of PMD were investigated using a validated questionnaire, and prostate volume (PV) and the peak flow rate (Qmax ) were measured. RESULTS The prevalence of PMD in men aged their 40s, 50s, 60s, and 70s was 13.6%, 39.0%, 44.2%, and 41.2%, respectively. PMD was not rare compared with other LUTS. The degree and bother of PMD were statistically correlated (r = 0.558, P < .001), suggesting that the presence of PMD impairs quality of life. There was no significant relationship between the prevalence of PMD and PV or Qmax . CONCLUSIONS PMD is not rare compared with other LUTS. The presence of PMD impairs quality of life.
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Affiliation(s)
- Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Takayanagi A, Kobayashi K, Fukuta F, Matsuki M, Matsuda Y, Mori M, Masumori N. Changes of sexual function and perception in Japanese men: A 15-year cross-sectional community-based study. Int J Urol 2016; 23:941-945. [PMID: 27520708 DOI: 10.1111/iju.13184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 07/13/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the longitudinal changes of sexual function of Japanese men. METHODS From 1992 to 1993, we carried out a cross-sectional community-based study on sexual function in Japanese men aged 40-79 years. After 15 years, a follow-up study was carried out to determine longitudinal changes of their sexual function. Of the 319 participants in the initial study, 135 participated again in the follow-up study. Sexual function was assessed using the same validated questionnaire in the two studies. RESULTS Erectile rigidity declined in men of each age decade at baseline (40s, 50s, 60s and 70s) of the initial study (P < 0.01, <0.01, <0.01 and <0.05). The frequency of sexual drive was significantly decreased in men aged in their 40s, 50s and 60s (P < 0.05, <0.01 and <0.01). Men aged in their 40s were dissatisfied with their decreased sexual function (P < 0.05). In contrast, men aged in their 70s were satisfied with their sexual life (P < 0.01). CONCLUSIONS Over a 15-year period, the sexual function of Japanese men declined in each age decade. However, the perception of this decline differed among different age group. Most elderly Japanese men did not worry about their impaired sexual function.
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Affiliation(s)
- Akio Takayanagi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiro Matsuki
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Yohei Matsuda
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Mitsuru Mori
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Pinkawa M, Klotz J, Djukic V, Petz D, Holy R, Eble MJ. Transurethral resection of the prostate after radiotherapy for prostate cancer: impact on quality of life. Int J Urol 2014; 21:899-903. [PMID: 24724611 DOI: 10.1111/iju.12460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 03/10/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the impact of transurethral resection of the prostate on quality of life after radiotherapy for prostate cancer. METHODS A group of 49 consecutive patients with and 487 without prior transurethral resection of the prostate responded to the Expanded Prostate Cancer Index Composite questionnaire before, on the last day, and a median time of 2 months and 16 months after external beam radiotherapy (70-78 Gy). A matched-pair analysis was used to avoid the influence of treatment-associated confounding factors, including dose, treatment volume and hormonal therapy. RESULTS Significantly smaller acute urinary score changes relative to baseline levels resulted with versus without prior transurethral resection of the prostate (mean function/bother score decrease of 3/6 vs 18/21 points at the end of radiotherapy; P < 0.01), affecting urinary incontinence (pads to control urinary leakage in 4% vs 24%; P = 0.03) and irritative/obstructive symptoms (big/moderate problem with weak urinary stream in 11% vs 37%; P = 0.02). As opposed to acute changes, transurethral resection of the prostate was a significant predisposing factor for a long-term urinary function score decrease >10 points (20% vs 6% of patients with vs without prior resection; P = 0.04). Urinary incontinence risk was higher for patients with a longer time from resection to radiotherapy. CONCLUSIONS Transurethral resection of the prostate significantly affects acute (considerably fewer symptoms) and long-term (relevant toxicity in some cases) urinary quality of life after radiotherapy for prostate cancer.
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Affiliation(s)
- Michael Pinkawa
- Department of Radiation Oncology, RWTH Aachen University, Aachen, Germany
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