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Murad L, Bouhadana D, Nguyen DD, Chughtai B, Zorn KC, Bhojani N, Elterman DS. Treating LUTS in Men with Benign Prostatic Obstruction: A Review Article. Drugs Aging 2023; 40:815-836. [PMID: 37556075 DOI: 10.1007/s40266-023-01054-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 08/10/2023]
Abstract
Benign prostatic obstruction (BPO) is a prevalent condition that affects men, primarily toward their old age. The condition is often accompanied by lower urinary tract symptoms (LUTS), which can significantly impair a patient's quality of life and lead to other medical complications. Accurate diagnosis of BPO is essential for effective management of complications secondary to BPO, and treatment plans should be tailored patients, and occasionally according to surgeon experience. As such, this literature review aims to analyze the current available data on male LUTS secondary to BPO by providing a comprehensive overview of relevant studies, as well as the surgical and medical management guidelines from the Canadian Urological Association (CUA), American Urological Association (AUA), and European Association of Urology (EAU). By synthesizing the existing literature, this review purports to summarize the current body of knowledge surrounding BPO and male LUTS, and support healthcare providers in making informed decisions about the management of male LUTS secondary to BPO, ultimately improving patient outcomes and quality of life.
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Affiliation(s)
- Liam Murad
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - David Bouhadana
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - David-Dan Nguyen
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Bilal Chughtai
- Department of Urology, Weill Cornell Medical College-New York Presbyterian, New York, NY, USA
| | - Kevin C Zorn
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Naeem Bhojani
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Dean S Elterman
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
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2
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Silvestri V, Pontecorvi E, Sciuto A, Pacella D, Peltrini R, D'Ambra M, Lionetti R, Filotico M, Lauria F, Sarnelli G, Pirozzi F, Ruotolo F, Bracale U, Corcione F. Preservation of the inferior mesenteric artery VS ligation of the inferior mesenteric artery in left colectomy: evaluation of functional outcomes-a prospective non-randomized controlled trial. Updates Surg 2023; 75:1569-1578. [PMID: 37505437 DOI: 10.1007/s13304-023-01593-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023]
Abstract
Vascular approach during elective laparoscopic left colectomy impacts post-operative outcomes. The aim of our study was to evaluate how different approaches impact positively defecatory, urinary and sexual functions and quality of life during elective laparoscopic left colectomy. A prospective non-randomized controlled trial at two tertiary center was conducted. All patients who underwent elective laparoscopic left colonic resection from January 2019 to July 2022 were analyzed. They were divided into two groups based on Inferior Mesenteric Artery (IMA) preservation with distal ligation of sigmoid branches close to a colonic wall for complicated diverticular disease and IMA high tie ligation for oncological disease. Patients were asked to fulfil standardized, validated questionnaires to evaluate pre and post-operative defecatory, urinary and sexual functions and quality of life. Defecatory disorders were assessed by high-resolution anorectal manometry preoperatively and six months after surgery. A total of 122 patients were included in the study. The 62 patients with IMA preservation showed a lower incidence of defecatory disorders also confirmed by manometer data, minor incontinence and less lifestyle alteration than the 60 patients with IMA high tie ligation. No urinary disorders such as incomplete emptying, frequency, intermittence or urgency were highlighted after surgery in the IMA preservation group. Evidence of any sexual disorders remained controversial. The IMA-preserving vascular approach seems to be an effective strategy to prevent postoperative functional disorders. It is a safe and feasible technique especially for diverticular disease. New prospective randomized and highly probative studies are needed to confirm the effectiveness in specific clinical situations.
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Affiliation(s)
- Vania Silvestri
- Department of General Surgery, SS Annunziata Hospital, 67039, Sulmona, L'Aquila, Italy.
| | - Emanuele Pontecorvi
- Department of General Surgery, SS Annunziata Hospital, 67039, Sulmona, L'Aquila, Italy
| | - Antonio Sciuto
- Department of General Surgery, Santa Maria Delle Grazie Hospital, Pozzuoli, 80078, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Roberto Peltrini
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Michele D'Ambra
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Ruggero Lionetti
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Marcello Filotico
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Federica Lauria
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131, Naples, Italy
| | - Felice Pirozzi
- Department of General Surgery, Santa Maria Delle Grazie Hospital, Pozzuoli, 80078, Naples, Italy
| | | | - Umberto Bracale
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084, Salerno, Italy
| | - Francesco Corcione
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
- Department of General Surgery, Clinica Mediterranea, 80122, Naples, Italy
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3
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Shinohara M, Torimoto K, Matsushita C, Gotoh D, Yoshida H, Saka T, Hirao Y, Hirayama A, Fujimoto K. A new nomogram of urinary flow rate and volume based on multiple measurements per healthy adult Japanese men using a portable uroflowmeter (P-Flowdiary®). BMC Urol 2022; 22:130. [PMID: 36008830 PMCID: PMC9414110 DOI: 10.1186/s12894-022-01086-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To develop a nomogram of urinary volume and flow based on the data of Japanese men without lower urinary tract symptoms and multiple flows per participant whose characteristics were clear. METHODS Overall, 101 Japanese male volunteers without lower urinary tract symptoms aged between 20 and 59 years were enrolled. A portable uroflowmeter (P-Flowdiary®) was used to record urinary information (flow rate and volume) for 2 successive days. The model (quadratic, linear, or logarithmic regression) most fit for the relationship between maximum flow rate and voided volume was determined. The maximum flow rate at > 150 mL was compared among the 20-29-, 30-39-, 40-49-, and 50-59-year age groups. Nomograms appropriate for the age groups were created. RESULTS The mean age, International Prostate Symptom Score, and Overactive Bladder Symptom Score were 38.5 years, 0.42, and 0.24, respectively. The quadratic regression model was the most fit because its mean coefficient determination was 0.93 ± 0.06. The mean maximum flow rate was significantly lower in the 50-59-year age group (21.8 ± 5.05 mL/s, P < 0.01) than in the younger groups (24.14 ± 4.94, 24.05 ± 6.99, and 24.64 ± 5.72 mL/s). The 2 nomograms are Y = 28.99 {1 - exp(- 0.01 × X)} and Y = 25.67 {1 - exp(- 0.01 × X)} for the 20-49- and 50-59-year age groups, respectively. CONCLUSIONS The nomogram can predict maximum flow rate based on voided volume in Japanese men aged 20-59 years without lower urinary tract symptoms.
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Affiliation(s)
- Masatake Shinohara
- Department of Urology, Osaka Gyoumeikan Hospital, Osaka, Japan.,Department of Urology, Nara Medical University, Kashihara, Japan
| | | | - Chie Matsushita
- Department of Urology, Osaka Gyoumeikan Hospital, Osaka, Japan.,Department of Urology, Saiseikai Chuwa Hospital, Sakurai, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara, Japan
| | - Hisashi Yoshida
- Faculty of Biology-Oriented Science and Technology, Kindai University, Kinokawa, Japan
| | - Toshihisa Saka
- Department of Urology, Osaka Gyoumeikan Hospital, Osaka, Japan
| | - Yoshihiko Hirao
- Department of Urology, Osaka Gyoumeikan Hospital, Osaka, Japan
| | - Akihide Hirayama
- Department of Urology, Kindai University Nara Hospital, Ikoma, Japan
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4
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Erbay ME, Tarhan ST. Reliability and validity of the Turkish language version of the Core Lower Urinary Tract Symptom Score. Low Urin Tract Symptoms 2022; 14:421-426. [DOI: 10.1111/luts.12461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | - Sena T. Tarhan
- Department of Internal Medicine Medical School Marmara University, Pendik Training and Research Hospital İstanbul Turkey
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Oyama T, Wada K, Koyama K, Kumagai G, Tanaka S, Asari T, Imai A, Okamoto T, Hatakeyama S, Jung S, Sugimura Y, Ohyama C, Ishibashi Y. Relationship between the cross-sectional area of the lumbar dural sac and lower urinary tract symptoms: A population-based cross-sectional study. PLoS One 2022; 17:e0271479. [PMID: 35951516 PMCID: PMC9371271 DOI: 10.1371/journal.pone.0271479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Abstract
This study aimed to investigate the relationship between the cross-sectional area of the dural sac (DCSA) and lower urinary tract symptoms (LUTS). This study included 270 Japanese participants from a community health check-up in 2016. Overactive bladder (OAB) was diagnosed during the assessment of LUTS. The smallest DCSA of each participant was defined as the minimum DCSA (mDCSA). The cutoff size of the mDCSA in OAB was evaluated using receiver operating characteristic analysis. Multiple logistic regression analyses were performed to identify the independent risk factors for OAB, and a scoring system was developed for estimating these. The prevalence of OAB was 11.1%. Age and low back pain visual analogue scale (LBP VAS) scores were significantly higher, and the mean mDCSA was significantly lower in participants with OAB than in those without. The cutoff size of mDCSA in OAB was 69 mm2. There were significant correlations between OAB and age, LBP VAS score, and mDCSA<70 mm2. Lumbar spinal stenosis (LSS) should be considered a cause of LUTS when mDCSA is <69 mm2. Assessing the mDCSA with age and LBP VAS score was more valuable in detecting LUTS in LSS than the mDCSA alone.
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Affiliation(s)
- Tetsushi Oyama
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
- * E-mail:
| | - Kazushige Koyama
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Gentaro Kumagai
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Sunao Tanaka
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Toru Asari
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Atsushi Imai
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Songee Jung
- Department of Digital Nutrition and Health Sciences, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Yoshikuni Sugimura
- Department of Microbial Flora and Health Science, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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Hwang WY, Kim K, Cho HY, Yang EJ, Suh DH, No JH, Lee JR, Hwang JW, Do SH, Kim YB. The voiding VAS score is a simple and useful method for predicting POUR after laparoscopy for benign gynaecologic diseases: a pilot study. J OBSTET GYNAECOL 2022; 42:2469-2473. [PMID: 35653772 DOI: 10.1080/01443615.2022.2071149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to identify an appropriate scoring system for predicting postoperative urinary retention (POUR) after gynaecological laparoscopic surgery for benign disease. We analysed 99 patients who underwent gynaecological laparoscopic surgery for benign disease. All patients were asked to complete self-administered questionnaires, including the International Prostate Symptom Score (IPSS), voiding visual analogue scale (VAS), and Brief Pain Inventory-Korean version. Of the 99 patients, 27 (27.3%) experienced urinary retention at least once, while 72 (72.7%) did not. The preoperative and postoperative IPSS scores were not associated with the development of POUR. However, the voiding VAS score was significantly lower in patients that developed POUR (p = .014). In conclusion, our results show that the voiding VAS score is a simple and useful method for identifying patients at risk of POUR after gynaecologic laparoscopic surgery for benign disease. IMPACT STATEMENTWhat is already known on this subject? Postoperative urinary retention (POUR) is an often underestimated complication defined as inability to void during the postoperative period despite a full bladder. Undetected POUR may lead to complications such as urinary tract infection, bladder distention, and bladder dysfunction. Routine assessment of POUR by bladder ultrasonography in all surgical patients places a larger workload on the nursing staff.What do the results of this study add? Among the self-scoring assessment tools, the voiding VAS provided the most accurate reflection of POUR in patients undergoing gynaecologic laparoscopic surgery for benign disease.What are the implications of these findings for clinical practice and/or further research? As laparoscopy is the most widely employed surgical procedure in gynaecology, our findings could have significant implications for postoperative care in daily clinical practice.
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Affiliation(s)
- Woo Yeon Hwang
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kidong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hye Yon Cho
- Department of Obstetrics and Gynecology, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Korea
| | - Eun Joo Yang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae Hong No
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jung Won Hwang
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Hwan Do
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yong Beom Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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7
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Beneficial Effects of Saw Palmetto Fruit Extract on Urinary Symptoms in Japanese Female Subjects by a Multicenter, Randomized, Double-Blind, Placebo-Controlled Study. Nutrients 2022; 14:nu14061190. [PMID: 35334848 PMCID: PMC8953103 DOI: 10.3390/nu14061190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 12/04/2022] Open
Abstract
Saw palmetto berry extract (SPE) is the most commonly consumed supplement by men with benign prostatic hyperplasia (BPH). The oral administration of SPE was previously shown to significantly attenuate urodynamic symptoms in the hyperactive bladders of female rats by increasing bladder capacity and prolonging the micturition interval. The amelioration of urodynamic symptoms by SPE may be partly attributed to its binding to muscarinic receptors in the urinary bladder and its inhibition of vanilloid receptors on afferent nerves. Therefore, SPE may be pharmacologically effective at mitigating lower urinary tract symptoms (LUTS) in women. The efficacy and safety of a 12-week treatment with SPE in adult women with urinary symptoms were examined herein. The daytime frequency score in the core lower urinary symptom score (CLSS) questionnaire was significantly lower in women with LUTS treated with SPE for 12 weeks than in the placebo group. A subgroup analysis revealed that SPE alleviated the symptoms of daytime frequency (CLSS Q1) and nocturia (CLSS Q2) in a subset of subjects with a CLSS Q5 score of 1 or higher. The daytime frequency of urination in overactive bladder symptom score (OABSS) Q1 was also significantly improved by the SPE treatment. In conclusion, the present study is the first to demonstrate the potential of SPE to mitigate LUTS in adult women.
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8
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Tachikawa K, Kyoda Y, Fukuta F, Kobayashi K, Masumori N. Efficacy of vibegron in patients with overactive bladder: Multicenter prospective study of real-world clinical practice in Japan, SCCOP study 19-01. Low Urin Tract Symptoms 2021; 14:109-116. [PMID: 34713579 DOI: 10.1111/luts.12417] [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: 06/27/2021] [Revised: 09/09/2021] [Accepted: 10/14/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of vibegron in patients with overactive bladder (OAB) in real-world clinical practice in Japan. METHODS This multicenter, prospective, non-controlled study consecutively enrolled patients with OAB determined by an OAB symptom score (OABSS) of three points or more and a question 3 (urgency) score of two points or more. A total of 212 patients from 43 institutions were recruited from January 2019 through March 2020. Vibegron, 50 mg, was administrated daily for 8 weeks as first-line monotherapy (first-line group, FL), monotherapy switching from antimuscarinics (post-antimuscarinic group, PA) or mirabegron (post-mirabegron group, PM) and combination therapy with antimuscarinics (add-on group). The OABSS was collected at baseline and every 2 weeks. Adverse events were recorded at every visit. RESULTS Of the 212 patients registered, 188 (male 76, female 112) were eligible for analysis (124 in the FL group, 27 in PA, 29 in PM, and eight in the add-on group). The add-on group was excluded from further analysis due to its small number. The OABSS (mean ± SD) showed significant improvement in all groups (FL; 8.8 ± 2.5, 3.8 ± 2.8, PM; 9.4 ± 2.2, 4.5 ± 4.0, PM; 8.9 ± 2.5, 4.7 ± 3.3 at 0 and 8 weeks, respectively). The overall incidence of adverse events was 25%. No grade 3 or higher adverse events were observed. CONCLUSIONS In the real-world clinical setting, vibegron is effective and well-tolerated by OAB patients, including those switching therapy from antimuscarinics and mirabegron.
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Affiliation(s)
- Kimihito Tachikawa
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yuki Kyoda
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.,Department of Urology, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Ko Kobayashi
- 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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9
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Takahashi S, Takei M, Asakura H, Gotoh M, Ishizuka O, Kato K, Koyama M, Takeyama M, Tomoe H, Yamanishi T, Yokoyama O, Yoshida M, Yoshimura Y, Yoshizawa T. Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition). Int J Urol 2021; 28:474-492. [PMID: 33650242 DOI: 10.1111/iju.14492] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/13/2020] [Indexed: 12/13/2022]
Abstract
The present article is an abridged English translation of the Japanese Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition), published in September 2019. These guidelines consist of a total of 212 pages and are unique worldwide in that they cover female lower urinary tract symptoms other than urinary incontinence. They contain two algorithms for "primary treatment" and "specialized treatment," respectively. These guidelines, consisting of six chapters, address a total of 26 clinical questions including: (i) treatment algorithms; (ii) what are female lower urinary tract symptoms?; (iii) epidemiology and quality of life; (iv) pathology and illness; (v) diagnosis; and (vi) treatment. When the patient's symptoms mainly involve voiding and post-micturition symptoms, specialized treatment should be considered. In the event of voiding symptoms concurrent with storage symptoms, residual urine should be measured; if the residual urine volume is <100 mL, then diagnosis and treatment for storage symptoms is prioritized, and if the volume is ≥100 mL, then specialized treatment should be considered. When storage symptoms are the primary condition, then the patient is subject to the primary treatment algorithm. Specialized treatment for refractory overactive bladder includes botulinum toxin injection and sacral nerve stimulation. For stress urinary incontinence, surgical treatment is indicated, such as urethral slings. The two causes of voiding symptoms and post-micturition symptoms are lower urinary tract obstruction and detrusor underactivity (underactive bladder). Mechanical lower urinary tract obstruction, such as pelvic organ prolapse, is expected to improve with surgery.
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Affiliation(s)
- Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Mineo Takei
- Department of Urology, Harasanshin Hospital, Fukuoka, Japan
| | | | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kumiko Kato
- Department of Female Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Masayasu Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masami Takeyama
- Urogynecology Center, First Towakai Hospital, Takatsuki, Japan
| | - Hikaru Tomoe
- Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Tomonori Yamanishi
- Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan
| | - Osamu Yokoyama
- Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Masaki Yoshida
- Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yasukuni Yoshimura
- Female Pelvic Health Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Tsuyoshi Yoshizawa
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
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10
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Impact of early vs. delayed initiation of dutasteride/tamsulosin combination therapy on the risk of acute urinary retention or BPH-related surgery in LUTS/BPH patients with moderate-to-severe symptoms at risk of disease progression. World J Urol 2020; 39:2635-2643. [PMID: 33337513 PMCID: PMC8332595 DOI: 10.1007/s00345-020-03517-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To evaluate the effect of delayed start of combination therapy (CT) with dutasteride 0.5 mg and tamsulosin 0.4 mg on the risk of acute urinary retention or benign prostatic hyperplasia (BPH)-related surgery (AUR/S) in patients with moderate-to-severe lower urinary tract symptoms (LUTS) at risk of disease progression. Methods Using a time-to-event model based on pooled data from 10,238 patients from Phase III/IV dutasteride trials, clinical trial simulations (CTS) were performed to assess the risk of AUR/S up to 48 months in moderate-to-severe LUTS/BPH patients following immediate and delayed start of CT for those not responding to tamsulosin monotherapy. Simulation scenarios (1300 subjects/arm) were investigated, including immediate start (reference) and alternative delayed start (six scenarios 1–24 months). AUR/S incidence was described by Kaplan–Meier survival curves and analysed using log-rank test. The cumulative incidence of events as well as the relative and attributable risks were summarised stratified by treatment. Results Survival curves for patients starting CT at month 1 and 3 did not differ from those who initiated CT immediately. By contrast, significant differences (p < 0.001) were observed when switch to CT occurs ≥ 6 months from the initial treatment. At month 48, AUR/S incidence was 4.6% vs 9.5%, 11.0% and 11.3% in patients receiving immediate CT vs. switchers after 6, 12 and 24 months, respectively. Conclusions Start of CT before month 6 appears to significantly reduce the risk of AUR/S compared with delayed start by ≥ 6 months. This has implications for the treatment algorithm for men with LUTS/BPH at risk of disease progression. Electronic supplementary material The online version of this article (10.1007/s00345-020-03517-0) contains supplementary material, which is available to authorized users.
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11
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Owusu Sekyere E, Hardcastle TC, Sathiram R, Tlou B. Overview of lower urinary tract symptoms post-trauma intensive care unit admission. AFRICAN JOURNAL OF UROLOGY 2020. [DOI: 10.1186/s12301-020-00027-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The study was undertaken to assess the incidence of lower urinary tract symptoms (LUTS) after short-term indwelling urethral catheter (IUC) in polytrauma patients admitted to a level one trauma unit using core lower urinary tract symptom score (CLSS). Data of patients admitted between January 2013 and December 2015 and meeting the study criteria were retrieved from the hospital informatics system. Chart review was done, and patients were subsequently interviewed telephonically.
Results
Ninety-four respondents comprising of 81.9% males and 18.1% females out of the 221 eligible patients were contacted. The most common LUTS reported was urethral pain, and 90% had mild to moderate symptoms. No severe LUTS were identified. There was a positive correlation between the duration of IUC and LUTS, but there was no statistically significant association between age and LUTS in our study population.
Conclusion
Short-term duration of IUC in the trauma ICU patient is associated with predominantly mild irritative LUTS which are mostly self-limiting and may not need further investigations and management. CLSS was found to be a useful screening tool. Further studies are needed to confirm findings in our study.
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12
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Sountoulides P, Mutomba WF. Feeling of incomplete bladder emptying: A definition with clinical implications. Low Urin Tract Symptoms 2019; 11:85. [PMID: 30675770 DOI: 10.1111/luts.12251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/20/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Petros Sountoulides
- 1st Urology Department, Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece
| | - Wilbert F Mutomba
- 1st Urology Department, Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece
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13
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D'Agate S, Wilson T, Adalig B, Manyak M, Palacios-Moreno JM, Chavan C, Oelke M, Roehrborn C, Della Pasqua O. Impact of disease progression on individual IPSS trajectories and consequences of immediate versus delayed start of treatment in patients with moderate or severe LUTS associated with BPH. World J Urol 2019; 38:463-472. [PMID: 31079189 PMCID: PMC6994451 DOI: 10.1007/s00345-019-02783-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/23/2019] [Indexed: 01/07/2023] Open
Abstract
Purpose Despite superiority of tamsulosin–dutasteride combination therapy versus monotherapy for lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH), patients at risk of disease progression are often initiated on α-blockers. This study evaluated the impact of initiating tamsulosin monotherapy prior to switching to tamsulosin–dutasteride combination therapy versus immediate combination therapy using a longitudinal model describing International Prostate Symptom Score (IPSS) trajectories in moderate/severe LUTS/BPH patients at risk of disease progression. Methods Clinical trial simulations (CTS) were performed using data from 10,238 patients from Phase III/IV dutasteride trials. The effect of varying disease progression rates was explored by comparing profiles on- and off-treatment. CTS scenarios were investigated, including a reference (immediate combination therapy) and six alternative virtual treatment arms (delayed combination therapy of 1–24 months). Clinical response (≥ 25% IPSS reduction relative to baseline) was analysed using log-rank test. Differences in IPSS relative to baseline at various on-treatment time points were assessed by t tests. Results Delayed combination therapy initiation led to significant (p < 0.01) decreases in clinical response. At month 48, clinical response rate was 79.7% versus 74.1%, 70.3% and 71.0% and IPSS was 6.3 versus 7.6, 8.1 and 8.0 (switchers from tamsulosin monotherapy after 6, 12 and 24 months, respectively) with immediate combination therapy. More patients transitioned from severe/moderate to mild severity scores by month 48. Conclusions CTS allows systematic evaluation of immediate versus delayed combination therapy. Immediate response to α-blockers is not predictive of long-term symptom improvement. Observed IPSS differences between immediate and delayed combination therapy (6–24 months) are statistically significant. Electronic supplementary material The online version of this article (10.1007/s00345-019-02783-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Salvatore D'Agate
- Clinical Pharmacology and Therapeutics Group, University College London, London, UK
| | | | - Burkay Adalig
- Classic and Established Products, GSK, Istanbul, Turkey
| | - Michael Manyak
- Classic and Established Products, GSK, Washington, DC, USA
| | | | | | - Matthias Oelke
- Department of Urology, St. Antonius Hospital, Gronau, Germany
| | - Claus Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Oscar Della Pasqua
- Clinical Pharmacology and Therapeutics Group, University College London, London, UK.
- Clinical Pharmacology Modelling and Simulation, GSK, Stockley Park, 1-3 Ironbridge Road, Uxbridge, Middlesex, UB11 1BT, UK.
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14
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Fujimura T, Igawa Y, Aizawa N, Niimi A, Yamada Y, Sugihara T, Kamei J, Sato Y, Matsunaga A, Yoshida M, Shinoda Y, Fukuhara H, Nakagawa T, Homma Y, Kume H. Longitudinal change of comprehensive lower urinary tract symptoms and various types of urinary incontinence during robot-assisted radical prostatectomy. Neurourol Urodyn 2019; 38:1067-1075. [PMID: 30995359 DOI: 10.1002/nau.23952] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/17/2018] [Accepted: 01/28/2019] [Indexed: 11/10/2022]
Abstract
AIMS To clarify longitudinal change of lower urinary tract symptoms (LUTS) and various types of urinary incontinence following robot-assisted radical prostatectomy (RARP) using validated questionnaires. MATERIALS AND METHODS The core lower urinary tract symptom score (CLSS) and the International Consultation on Incontinence Questionnaire (ICIQ)-Short Form (SF) questionnaires were administered to 607 consecutive, treatment-naïve men receiving RARP before and after surgery. The time course of comprehensive LUTS and various types of urinary incontinence, including stress-, urgency-, and urinary incontinence with no obvious reason, were evaluated. Continence recovery rates were compared for the different types of incontinence using Cox hazard regression analysis. RESULTS After surgery, stress urinary incontinence (SUI) was reported most frequently (32% of cases) as the chief complaint with the most impact on daily life, as assessed by the CLSS questionnaire, followed by urgency urinary incontinence (UUI; 27% of cases). The rates of continence recovery differed among the different types of urinary incontinence, such as after urinating, when dressed, when asleep, when physically active or exercising, when coughing or sneezing, before reaching the toilet, and for no obvious reason. Incontinence for no obvious reason at 1 month after RARP was a strongest prognostic factor of delayed continence recovery (hazard ratio, 0.61; P < 0.0001), whereas patients reporting SUI and UUI gradually regained continence. CONCLUSIONS Further time course on continent recovery after RARP would be more precisely predictable based on the incontinence status at one month postoperatively. Especially, incontinence with no obvious reason would be a significant factor for delayed recovery.
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Affiliation(s)
- Tetsuya Fujimura
- Department of Urology, Jichi Medical University, Yakushiji, Simotsuke-shi, Tochigi, Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Naoki Aizawa
- Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Aya Niimi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Toru Sugihara
- Department of Urology, Jichi Medical University, Yakushiji, Simotsuke-shi, Tochigi, Japan
| | - Jun Kamei
- Department of Urology, Jichi Medical University, Yakushiji, Simotsuke-shi, Tochigi, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Akiko Matsunaga
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Japan
| | - Mikako Yoshida
- Department of Gerontological Nursing/ Wound Care Management, Graduate School of Medicine, The University of Tokyo, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Japan
| | | | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yukio Homma
- President Japanese Red Cross Medical Center, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Japan
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15
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Zhang AY, Xu X. Prevalence, Burden, and Treatment of Lower Urinary Tract Symptoms in Men Aged 50 and Older: A Systematic Review of the Literature. SAGE Open Nurs 2018; 4:2377960818811773. [PMID: 33415211 PMCID: PMC7774430 DOI: 10.1177/2377960818811773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022] Open
Abstract
We conducted a systematic review of literature from the years 2000 through 2017 on the prevalence and burden of lower urinary tract symptoms (LUTS) in men aged 50 and older, and medical treatments of and alternative nonmedical approaches to LUTS. EBSCOhost (Medline with Full Text) was searched for observational, experimental, and review studies in peer-reviewed journals in the English language. Our review found that LUTS were highly prevalent in the world and estimated to affect 2.3 billion people in 2018, with 44.7% being men. Men with LUTS suffer from not only burdensome symptoms such as nocturia and urgency but also adverse psychological consequences (e.g., anxiety and depression) and financial burden. Current medical treatments are clinically effective, but their efficacy is compromised by side effects and low compliance rates. Alternative nonmedical treatments for LUTS were also sought worldwide. There is evidence that lifestyle modifications such as pelvic muscle exercises and bladder training, physical activity, dietary modification, and nutritional supplements can alleviate LUTS and improve patient quality of life; however, evidence based on rigorous methodology remains minimal and cannot be generalized across populations. Evidence of effectiveness of weight loss programs to reduce LUTS is inconclusive. We conclude that although behavioral treatment is a promising approach to alleviating LUTS, especially when combined with medical treatments, well-designed randomized controlled and longitudinal clinical trials on behavioral treatments of LUTS are still needed. Minimally invasive procedures and neuromodulation therapy also show positive results of alleviating LUTS but require further research as well.
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Affiliation(s)
- Amy Y Zhang
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Xinyi Xu
- University Hospitals Cleveland Medical Center Seidman Cancer Center, Cleveland, OH, USA
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16
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Hayama Y, Doi H, Hasegawa T, Minami Y, Ichimura N, Koike M, Shiomi H, Oh RJ, Oishi F. Lower urinary tract symptoms in patients with prostate cancer under and after intensity-modulated radiation therapy. Low Urin Tract Symptoms 2018; 11:O127-O134. [PMID: 30010254 DOI: 10.1111/luts.12230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/09/2018] [Accepted: 05/24/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the present study was to collect data on the characteristics, degree, and natural course of urinary complications, as well as self-care for such complications, in patients during and after prostate intensity-modulated radiation therapy (IMRT). METHODS Quality of life data were collected retrospectively for all eligible patients who underwent IMRT. In all eligible patients, urinary symptoms were evaluated using questionnaires and face-to-face interview. Participants were asked to respond to a self-administered questionnaire concerning the core lower urinary tract symptom score during the course of IMRT and up to 12 months after the completion of IMRT. RESULTS In all, 29 eligible patients were included in the study. The frequency of urinary symptoms increased over of the course of IMRT, decreased at ≥3 months after completion of IMRT, and disappeared 6 months after IMRT. Responses to the questionnaire revealed a variety of approaches to self-care and adaptations by patients to manage urinary symptoms. CONCLUSIONS During and after IMRT for localized prostate cancer, patients often developed more frequent urination and urgency than at the start of IMRT, and recovered 3-6 months after the completion of IMRT. Based on the present study, clinicians and nurses could help convey this information to patients and thus offer better support.
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Affiliation(s)
- Yuka Hayama
- Department of Nursing, Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyoto, Japan.,Miyakojima IGRT Clinic, Osaka, Japan
| | - Hiroshi Doi
- Miyakojima IGRT Clinic, Osaka, Japan.,Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | | | - Yumi Minami
- Department of Nursing, Faculty of Nursing and Rehabilitation, Mukogawa Women's University, Nishinomiya, Japan
| | | | | | | | | | - Fumiko Oishi
- Department of Nursing, Faculty of Nursing, Seirei Christopher University, Shizuoka, Japan
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17
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Taguchi M, Inoue T, Muguruma K, Murota T, Kinoshita H, Matsuda T. Impact of loop-tail ureteral stents on ureteral stent-related symptoms immediately after ureteroscopic lithotripsy: Comparison with pigtail ureteral stents. Investig Clin Urol 2017; 58:440-446. [PMID: 29124244 PMCID: PMC5671964 DOI: 10.4111/icu.2017.58.6.440] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/27/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate urination-related quality of life (QoL) in patients with an indwelling ureteral stent immediately after ureteroscopic lithotripsy (URSL) for upper urinary calculi. We compared the effects of loop-tail and pigtail ureteral stents on urination-related QoL. Materials and Methods Of 135 patients who underwent URSL between May 2014 and March 2015 at our hospital, we retrospectively analyzed the records of 70 patients (42 men, 28 women; median age, 63 years) in whom the stent tail was positioned inside the bladder without crossing the midline and who completed the core lower urinary tract symptoms score (CLSS) questionnaire pre- and postoperatively. Results There were significant differences in incomplete emptying (p=0.048) and bladder pain (p=0.041) between patients with loop-tail versus pigtail ureteral stents after URSL. In the multivariate analysis, stent type had a stronger association with incomplete emptying (p=0.022) and bladder pain (p=0.018) than age, sex, body mass index, stent side, operation time, diameter of ureteral access sheath, and stent type. Conclusions Patients with loop-tail ureteral stents had better urination-related QoL in the immediate post-URSL stage than patients with pigtail stents.
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Affiliation(s)
- Makoto Taguchi
- Department of Urology and Andrology, Kansai Medical University General Medical Center, Osaka, Japan.,Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | - Takaaki Inoue
- Department of Urology and Andrology, Kansai Medical University General Medical Center, Osaka, Japan
| | - Kouei Muguruma
- Department of Urology and Andrology, Kansai Medical University General Medical Center, Osaka, Japan
| | - Takashi Murota
- Department of Urology and Andrology, Kansai Medical University General Medical Center, Osaka, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | - Tadashi Matsuda
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
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18
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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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19
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Kuang M, Vu A, Athreya S. A Systematic Review of Prostatic Artery Embolization in the Treatment of Symptomatic Benign Prostatic Hyperplasia. Cardiovasc Intervent Radiol 2016; 40:655-663. [PMID: 28032133 DOI: 10.1007/s00270-016-1539-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 12/08/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE To summarize current evidence on outcomes and complications of prostatic artery embolization as a treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. METHODS AND MATERIALS A database search of MEDLINE, Embase, Web of Science, and Cochrane Library was performed for published literature up to August 2015 concerning PAE in the treatment of BPH. Inclusion and exclusion criteria were applied by two independent reviewers, and disagreements were resolved by consensus. Peer-reviewed studies concerning PAE with BPH with a sample size >10 and at least one measured parameter were included. RESULTS The search yielded 193 articles, of which ten studies representing 788 patients, with a mean age of 66.97 years, were included. Patients had LUTS ranging from moderate to severe. At 6 months following procedure, PV, PVR, Qmax, IPSS, and QoL were significantly improved (P < 0.05), while for PSA there was no significant change. At 12 and 24 months, PV, PSA, PVR, Qmax, IPSS, and QoL were significantly improved (P < 0.05). IIEF was unchanged at 6 and 12 months but was significantly reduced at 24 months. CONCLUSION This suggests that PAE is effective in treating LUTS in the short and intermediate term.
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Affiliation(s)
- Michelle Kuang
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Anthony Vu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Sriharsha Athreya
- St. Joseph's Healthcare, Hamilton, ON, Canada. .,McMaster University Faculty of Health Sciences, Centre for Interventional Radiology and Oncology, Josephs Healthcare Hamilton, Rm. T0112, 50 Charlton Ave. E., Hamilton, ON, L8N 4A6, Canada.
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20
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Bozzini G, Provenzano M, Buffi N, Seveso M, Lughezzani G, Guazzoni G, Mandressi A, Taverna G. An observational study of the use of beclomethasone dipropionate suppositories in the treatment of lower urinary tract inflammation in men. BMC Urol 2016; 16:25. [PMID: 27267961 PMCID: PMC4897870 DOI: 10.1186/s12894-016-0144-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 05/31/2016] [Indexed: 12/30/2022] Open
Abstract
Background Nonbacterial prostatitis, together with chronic pelvic pain syndrome, accounts for 90–95 % of prostatitis cases. Anti-inflammatory medications are commonly used to reduce storage/inflammatory symptoms that can deteriorate quality of life. The purpose of this study was to observe the efficacy and safety of beclomethasone dipropionate rectal suppositories (Topster®) in inflammations of the lower urinary tract in men. Methods Patients underwent diagnostic and therapeutic protocols according to current evidence-based practice. Efficacy assessments: voiding parameters, perineal pain, International Prostate Symptom Score (IPSS), digital rectal examination (DRE). Adverse events and patient compliance were recorded throughout the study. Results One hundred eighty patients were enrolled, mean age 52 ± 14.97. Most frequent diagnosis: nonbacterial prostatitis (85 %). All patients completed visits 1 and 2. All patients were treated with beclomethasone dipropionate (BDP) suppositories, 136/180 also with Serenoa repens (SR) extract. Antibiotics were rarely required. 162/180 patients presented clinically significant improvements and terminated treatment. Mean change vs. baseline in voiding frequency: −3.55 ± 2.70 n/day in patients taking only BDP and −3.68 ± 2.81 n/day in those taking both BDP and SR (P<.0001 in both groups). Uroflowmetry improved significantly; change from baseline 3.26 ± 5.35 ml/s in BDP only group and 5.61 ± 7.32 ml/s in BDP + SR group (P = 0.0002 for BDP, P<.0001 for BDP + SR). Urine stream normal in 35 % of patients at visit 1 and 57.22 % of patients at visit 2. Mean change in perineal pain, on 0–10 VAS, −0.66 ± 2.24 for BDP only group (P = 0.0699) and −1.37 ± 2.40 for BDP + SR group (P<.0001). IPSS increased at visit 2. No adverse events were reported. For all parameters, none of the comparisons between groups was found to be statistically significant. Conclusion This study confirmed the drug’s good safety profile. We also observed an improvement in the main storage symptoms and clinical findings associated with lower urinary tract inflammation in patients treated with beclomethasone dipropionate suppositories.
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Affiliation(s)
- Giorgio Bozzini
- Departmentt of Urology, Humanitas Mater Domini, Via Gerenzano 2, I - 21053, Castellanza, Varese, Italy.
| | | | - Nicolò Buffi
- Department of Urology, Humanitas Research Hospital, Milan, Italy
| | - Mauro Seveso
- Departmentt of Urology, Humanitas Mater Domini, Via Gerenzano 2, I - 21053, Castellanza, Varese, Italy
| | | | - Giorgio Guazzoni
- Humanitas University, Milan, Italy.,Department of Urology, Humanitas Research Hospital, Milan, Italy
| | - Alberto Mandressi
- Departmentt of Urology, Humanitas Mater Domini, Via Gerenzano 2, I - 21053, Castellanza, Varese, Italy
| | - Gianluigi Taverna
- Departmentt of Urology, Humanitas Mater Domini, Via Gerenzano 2, I - 21053, Castellanza, Varese, Italy
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21
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Arafa MA, Farhat K, Aqdas S, Al-Atawi M, Rabah DM. Assessment of lower urinary tract symptoms in Saudi men using the International Prostate Symptoms Score. Urol Ann 2015; 7:221-5. [PMID: 25835352 PMCID: PMC4374262 DOI: 10.4103/0974-7796.150492] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/10/2014] [Indexed: 11/04/2022] Open
Abstract
Background: Benign prostatic hyperplasia-related lower urinary tract symptoms (LUTS) are common among older men, the incidence and prevalence are increasing rapidly, and they are associated with diminished health-related quality-of-life (QOL). Objective: The aim was to describe the prevalence of LUTS in Saudi population and its relation to some other parameters. Subjects and Methods: Saudi men over the age of 40 were invited to participate in the study; in Riyadh city from August 2012 through March 2013. All participants were assessed for the serum level of prostate-specific antigen (PSA) and digital rectal examination. Participants were given a linguistically validated Arabic version of the International Prostate Symptom Score (IPSS). Demographic and other medical comorbidities were assessed. Results: Based on the IPSS, a subdivision of men into three symptoms classes has been proposed, resulting in groups with mild (1265, 58.3%), moderate (505, 27.3%), and severe symptoms (81, 4.4%) and the prevalence of moderate to severe was 31.7%. There was a weak, but significant correlation between the total IPSS and age, total prostate volume, and PSA. Severity of symptoms is increasing with increased age. Multiple regression analysis reported that prostate volume and all individual items of IPSS except straining were significant predictors of QOL and patient satisfaction, where frequency and incomplete emptying had the heaviest impact on patient's QOL. Conclusion: LUTS were common among men in Saudi population over 40, the prevalence increases with age and most of them were unpleased because of their urinary symptoms, poor QOL was mainly determined by individual symptoms; mainly frequency and incomplete emptying.
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Affiliation(s)
- Mostafa A Arafa
- Department of Surgery, Division of Urology, Uro-Oncology Research Chair, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Karim Farhat
- Department of Surgery, Division of Urology, Uro-Oncology Research Chair, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Aqdas
- Department of Surgery, Division of Urology, Uro-Oncology Research Chair, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Al-Atawi
- Department of Surgery, Division of Urology, Uro-Oncology Research Chair, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Danny M Rabah
- Department of Surgery, Division of Urology, Uro-Oncology Research Chair, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
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22
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Lu SH, Chen CS. Natural history and epidemiology of benign prostatic hyperplasia. FORMOSAN JOURNAL OF SURGERY 2014. [DOI: 10.1016/j.fjs.2014.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Gokce A, Kumsar S, Halis F. Re: Prevalence and Management of Lower Urinary Tract Symptoms in Methamphetamine Abusers: An Under-Recognized Clinical Identity. J Urol 2014; 192:1298-9. [DOI: 10.1016/j.juro.2014.04.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Ahmet Gokce
- Department of Urology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Sukru Kumsar
- Department of Urology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Fikret Halis
- Department of Urology, Sakarya University School of Medicine, Sakarya, Turkey
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24
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Jiang YH, Liao CH, Kuo HC. How much improvement is needed for a real difference of lower urinary tract symptoms after long-term combination therapy for benign prostatic hyperplasia. Int J Clin Pract 2014; 68:1081-6. [PMID: 24673775 DOI: 10.1111/ijcp.12421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIMS Medical treatment is the first choice in the treatment of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). This retrospective study investigated the changes of measured parameters after 4-year medical therapy based on the reported quality of life index (QoL-I) in the International Prostate Symptom Score (IPSS) questionnaire. MATERIALS AND METHODS Patients with symptomatic BPH received 4-year treatment with doxazosin 4 mg and dutasteride 0.5 mg daily. All patients had a total prostate volume (TPV) of ≥ 30 ml and IPSS ≥ 8 at baseline. The measured parameters included IPSS, maximum flow rate (Qmax), postvoid residual volume (PVR), TPV and prostate specific antigen (PSA). The changes of parameters from baseline to 4th year were compared between patients with different QoL-I. RESULTS Among 243 enrolled patients, 161(66.3%) completed the treatment, 82(33.7%) did not complete the 4-year treatment because of unsatisfactory results (51, 21%) or converted to surgery (31, 12.8%). At the 4th year, 147/161 (91.3%) patients reported a QoL-I of 0-2. All measured parameters show significant improvement. Among the patients with satisfactory QoL (QoL-I 0-2), IPSS ≤ 7 was noted in 113 (76.9%), Qmax ≥ 15 ml/s in 54 (36.79%), PVR < 50 ml in 83 (56.5%), TPV ≤ 39 ml in 63 (42.9%), and PSA ≤ 1.5 ng/ml in 66 (44.9%). Except for the IPSS, a significant change in each parameter from baseline to the 4th year was noted in less than 50% of the patients with satisfactory QoL. CONCLUSION Based on the patients' reported QoL-I, a successful therapeutic result does not need the improvement of all measured parameters.
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Affiliation(s)
- Y-H Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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25
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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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Kim SH, Oh SJ. Nonspecific genitourinary pain improves after prostatectomy using holmium laser enucleation of prostate in patients with benign prostatic hyperplasia: a prospective study. PLoS One 2014; 9:e98979. [PMID: 24901224 PMCID: PMC4047059 DOI: 10.1371/journal.pone.0098979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 04/28/2014] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To investigate changes in nonspecific genitourinary discomfort or pain (GUDP) before and after holmium laser enucleation of prostate (HoLEP). GUDP associated with lower urinary tract symptoms (LUTS) is a common complaint among benign prostatic hyperplasia (BPH) patients, but very little is known about this clinical entity. METHODS From February 2010 to August 2011, 100 HoLEP patients with complete clinical data at a single institution were enrolled in the study to analyze the degree of GUDP with a visual analog scale (VAS) from 0 to 10 points at baseline and at 3 and 6 months postoperatively, and to investigate any relationships between GUDP and urodynamics, uroflowmetry, and scores from the International Prostate Symptom Score (IPSS) questionnaire. RESULTS Fifty-six patients had LUTS only, while the remaining 44 had both LUTS and GUDP. Pain was located in the suprapubic (42.0%), perineal/penile (33.0%), back (17.0%), and perianal (8.0%) regions. During the post-operative period, at six months, the VAS, IPSS, peak flow rate and post-void residual volume had improved significantly in 44 GUDP patients (p<0.010). GUDP had completely resolved in 40 (90.9%) patients and had decreased in four (9.1%) patients, while seven (12.5%) patients developed GUDP with voiding in the urethral and perineal areas by the third month postoperatively. When compared to patients with complete resolution, those with persistent GUDP were found to have a significantly higher preoperative presence of bladder outlet obstruction (BOO) as an independent risk factor (OR 6.173, 95% CI 1.132-1.323). CONCLUSION Both GUDP and LUTS improved significantly after HoLEP. Patients with significant preoperative BOO tended to have persistent GUDP after surgery.
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Affiliation(s)
- Sung Han Kim
- Department of Urology, Prostate Cancer Center, National Cancer Center, Goyang, South Korea
| | - Seung-June Oh
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
- * E-mail:
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Homma Y. Determinants of Nocturia: Pathophysiology and Assessment. J Urol 2014; 191:891-2. [DOI: 10.1016/j.juro.2014.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Yukio Homma
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo, Bunkyoku, Japan
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Fujimura T. Editorial Comment to Evaluation and validation of the Core Lower Urinary Tract Symptom Score as an outcome assessment tool for the treatment of benign prostatic hyperplasia: Effects of the α1-adrenoreceptor antagonist silodosin. Int J Urol 2014; 21:113. [DOI: 10.1111/iju.12180] [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]
Affiliation(s)
- Tetsuya Fujimura
- Department of Urology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
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Overactive Bladder in Elderly Men: Epidemiology, Evaluation, Clinical Effects, and Management. Curr Urol Rep 2013; 14:418-25. [DOI: 10.1007/s11934-013-0367-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Ito H, Sano F, Ogawa T, Yao M. Evaluation and validation of the Core Lower Urinary Tract Symptom Score as an outcome assessment tool for the treatment of benign prostatic hyperplasia: Effects of the α1-adrenoreceptor antagonist silodosin. Int J Urol 2013; 21:108-12. [DOI: 10.1111/iju.12167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 03/12/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Hiroki Ito
- Department of Urology; Yokohama City University Graduate School of Medicine; Yokohama Kanagawa Japan
| | - Futoshi Sano
- Department of Urology; Yokohama City University Graduate School of Medicine; Yokohama Kanagawa Japan
| | - Takehiko Ogawa
- Department of Urology; Yokohama City University Graduate School of Medicine; Yokohama Kanagawa Japan
| | - Masahiro Yao
- Department of Urology; Yokohama City University Graduate School of Medicine; Yokohama Kanagawa Japan
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Ishizuka O, Matsuyama H, Sakai H, Matsubara A, Nagaoka A, Takahashi S, Takeda M, Ozono S, Shiroki R, Shuin T, Hara I, Kakizaki H, Tsukamoto T, Yamanishi T, Yokoyama O, Kakehi Y, Nishizawa O. Nocturia Potentially Influences Maintenance of Sexual Function in Elderly Men with Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 2013; 5:75-81. [PMID: 26663374 DOI: 10.1111/j.1757-5672.2012.00173.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study examined the relationship between bothersome symptoms of nocturia and erectile function. METHODS Subjects comprised patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Patients were prospectively followed on treatment with the alpha-1 blocker naftopidil for 8 weeks. Patient backgrounds and efficacy of naftopidil associated with LUTS and sexual activity were evaluated. RESULTS The percentage of patients who identified nocturia as the most bothersome symptom was 30.2% (n = 135), representing the highest percentage among International Prostate Symptom Score (IPSS) items. The number of patients with nocturia as the most bothersome symptom plateaued at an IPSS for nocturia of two or three points. In contrast, the number of patients with slow stream as the most bothersome symptom increased with symptom severity according to IPSS for slow stream. Logistic regression analysis on association between nocturia and erectile function confirmed that the odds ratio was 1.41 (P < 0.05). Naftopidil showed excellent efficacy related to male LUTS, but International Index of Erectile Function 5 (IIEF5) total score was almost unchanged. Among patients with nocturia improved by naftopidil, IIEF5 total score was significantly changed in the group with IPSS nocturia score ≤1 as compared to the group with IPSS nocturia score ≥2 per night (P = 0.038). CONCLUSION Nocturia the most bothersome symptom correlated with aging. Nocturia could associate erectile dysfunction, and keeping the frequency of nocturia at ≤1 episode might be meaningful for maintaining quality of life in elderly men.
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Affiliation(s)
- Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Hideyasu Matsuyama
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Hideki Sakai
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Akio Matsubara
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Akira Nagaoka
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Satoru Takahashi
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Masayuki Takeda
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Seiichiro Ozono
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Ryoichi Shiroki
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Taro Shuin
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Isao Hara
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Hidehiro Kakizaki
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Taiji Tsukamoto
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Tomonori Yamanishi
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Osamu Yokoyama
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Osamu Nishizawa
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
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Osuga Y, Okamura K, Ando F, Shimokata H. Prevalence of lower urinary tract symptoms in middle-aged and elderly Japanese. Geriatr Gerontol Int 2013; 13:1010-7. [DOI: 10.1111/ggi.12048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Yoko Osuga
- Division of Urology; Department of Surgery and Intensive Care; National Center for Geriatrics and Gerontology; Obu; Japan
| | - Kikuo Okamura
- Division of Urology; Department of Surgery and Intensive Care; National Center for Geriatrics and Gerontology; Obu; Japan
| | | | - Hiroshi Shimokata
- Department for Development of Preventive Medicine; National Center for Geriatrics and Gerontology; Obu; Japan
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Jiang YH, Lin VCH, Liao CH, Kuo HC. International Prostatic Symptom Score-voiding/storage subscore ratio in association with total prostatic volume and maximum flow rate is diagnostic of bladder outlet-related lower urinary tract dysfunction in men with lower urinary tract symptoms. PLoS One 2013; 8:e59176. [PMID: 23527124 PMCID: PMC3601066 DOI: 10.1371/journal.pone.0059176] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 02/12/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the predictive values of the total International Prostate Symptom Score (IPSS-T) and voiding to storage subscore ratio (IPSS-V/S) in association with total prostate volume (TPV) and maximum urinary flow rate (Qmax) in the diagnosis of bladder outlet-related lower urinary tract dysfunction (LUTD) in men with lower urinary tract symptoms (LUTS). METHODS A total of 298 men with LUTS were enrolled. Video-urodynamic studies were used to determine the causes of LUTS. Differences in IPSS-T, IPSS-V/S ratio, TPV and Qmax between patients with bladder outlet-related LUTD and bladder-related LUTD were analyzed. The positive and negative predictive values (PPV and NPV) for bladder outlet-related LUTD were calculated using these parameters. RESULTS Of the 298 men, bladder outlet-related LUTD was diagnosed in 167 (56%). We found that IPSS-V/S ratio was significantly higher among those patients with bladder outlet-related LUTD than patients with bladder-related LUTD (2.28±2.25 vs. 0.90±0.88, p<0.001). TPV was similar between the two groups; however, in contrast to patients with bladder-related LUTD, patients with bladder outlet-related LUTD had higher detrusor voiding pressure, lower Qmax values, and greater postvoid residual volumes. The combination of TPV≥30 ml and Qmax≤10 ml/sec had a PPV of 68.8% and a NPV of 53.5% for bladder outlet-related LUTD. When IPSS-T≥12 or IPSS-T≥15 was considered as an additional criterion, PPV increased to 75.0% and 78.5%, respectively, and the NPV decreased to 50.9% and 50.2%, respectively. When IPSS-V/S>1 or >2 was factored into the equation instead of IPSS-T, PPV were 91.4% and 97.3%, respectively, and NPV were 54.8% and 49.8%, respectively. CONCLUSIONS Combination of IPSS-T with TPV and Qmax increases the PPV of bladder outlet-related LUTD. Furthermore, including IPSS-V/S>1 or >2 into the equation results in a higher PPV than IPSS-T. IPSS-V/S>1 is a stronger predictor of bladder outlet-related LUTD than IPSS-T.
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Affiliation(s)
- Yuan-Hong Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | | | - Chun-Hou Liao
- Department of Urology, Cardinal Tien Hospital and Fu-Jen Catholic University, New Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
- * E-mail:
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Sakai M, Akai T, Takata Y, Shimizu SI, Koyama SI, Iwamoto T. [Screening test for overactive bladder in a newly developed comprehensive geriatric assessment initiative]. Nihon Ronen Igakkai Zasshi 2013; 50:249-257. [PMID: 23979249 DOI: 10.3143/geriatrics.50.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Lower urinary tract symptoms, particularly in overactive bladder (OAB), are frequently observed among elderly patients. The impact of OAB on their quality of life is so strong that the assessment of OAB is necessary in comprehensive geriatric assessment (CGA). As CGA takes time to complete, we established a convenient instrument consisting of 2 questions on OAB and assessed its utility. METHOD We recruited 123 elderly patients with various diseases (mean age: 83.2 years, 63 men), in whom 2 questions on nocturia (Q1) and urinary incontinence at night (Q2) were asked. Thereafter, overactive bladder symptom scores (OABSS) were obtained to diagnose OAB based on the OAB criteria. Statistical analyses for Q1 and Q2 were performed using the OABSS criterion as a gold standard. To elucidate the clinical characteristics of the elderly patients, they were divided into 2 groups on the basis of the presence or absence of nocturia: nocturia (+) and nocturia (-) groups. The nocturia (+) group was subdivided into 2 subgroups: with or without incontinence. RESULTS Nocturia (Q1) was observed in 82 elderly patients and urinary incontinence (Q2) in 23, whereas OAB was diagnosed in 22. The sensitivity, specificity, and positive predictive value (PPV) of Q1 (Q1+Q2) were 100% (68.2%), 40.6% (92.1%), and 26.8% (65.2%), respectively. The nocturia (+) group patients were characterized as predominantly composed of men with cerebrovascular disease, disturbed activities of daily living, interrupted sleep, delayed wake-up time, and treatment with diuretics. Furthermore, Parkinson disease, depressive state, sedentary life style, and treatment without diuretics were frequently observed in patients in the incontinence (+) subgroup. CONCLUSION A low PPV with a high sensitivity of Q1 was improved by using Q1+Q2, where both Q1 and Q2 enable better assessment of OAB resulting in being a useful screening test for OAB.
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Affiliation(s)
- Minoru Sakai
- Department of Geriatric Medicine, Hachioji Medical Center, Tokyo Medical University
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Lee SW, Doo SW, Yang WJ, Song YS. Importance of relieving the most bothersome symptom for improving quality of life in male patients with lower urinary tract symptoms. Urology 2012; 80:684-7. [PMID: 22770617 DOI: 10.1016/j.urology.2012.03.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 03/06/2012] [Accepted: 03/09/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To highlight the importance of relieving the most bothersome symptom for improving quality of life (QoL) in male patients with lower urinary tract symptoms. METHODS From January 2010 to March 2011, 242 men with lower urinary tract symptoms visited our clinic, and 194 finished this study. At first visit, the most bothersome symptom was selected as the "core symptom." The sum of other symptoms except the core symptom was defined as "peripheral symptoms." All patients underwent empirical medical treatment for male lower urinary tract symptoms during an 8- to 12-week period, thereafter, recorded a follow-up International Prostate Symptom Score (I-PSS) questionnaire. We multivariately analyzed the patients' data after medical treatment to assess the influence of relieving their core symptom on the improvement of QoL. RESULTS The patients' mean age was 64.7 years and the mean total I-PSS was 19.7 points. Nocturia was the most common core symptom (29.9%), followed by weak stream (16.5%). Multiple logistic regression revealed that relieving the core symptom (odds ratio [OR] = 39.163, 95% confidence interval [CI] = 13.536-113.309) was significantly associated with QoL improvement. Improvement of peripheral symptoms (OR = 4.849, 95% CI = 1.629-14.433) and the inclusion of the moderate symptom group at first visit (OR = 2.622, 95% CI = 1.009-6.811) were also significant factors in predicting QoL improvement. CONCLUSION In treating benign prostatic hyperplasia or lower urinary tract symptoms, we should focus more on relieving the individual patient's most bothersome symptom to help improve patient QoL.
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Affiliation(s)
- Seung Woo Lee
- Department of Urology, Soonchunhyang University, Seoul Hospital, Seoul, Korea
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