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Lin L, Wang W, Shao Y, Li X, Zhou L. National prevalence and incidence of benign prostatic hyperplasia/lower urinary tract symptoms and validated risk factors pattern. Aging Male 2025; 28:2478875. [PMID: 40084396 DOI: 10.1080/13685538.2025.2478875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Revised: 03/06/2025] [Accepted: 03/07/2025] [Indexed: 03/16/2025] Open
Abstract
BACKGROUND To date, limited research has been conducted within China to elucidate the national prevalence and incidence rates of benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS). Additionally, there is a scarcity of studies that have systematically investigated the reliable risk factor patterns associated with the development of BPH/LUTS among the Chinese population. METHODS The study was in both cross-sectional and prospective cohort study design. The participants were derived from the China Health and Retirement Longitudinal Study (CHARLS). National prevalence and incidence of BPH/LUTS, average onset age of BPH/LUTS, medication rate of BPH/LUTS, and validated risk factors pattern of BPH/LUTS in the Chinese population were investigated. RESULTS The overall prevalence and annual incidence of BPH/LUTS were 11.10% and 2.23%. In China, the male population affected by BPH/LUTS typically presented at an average age of 55-65 years. However, the medication rate was merely more than 30%. After conducting univariate and multivariate logistic regression analysis in both cross-sectional and prospective cohort study designs, we observed that dyslipidemia was the most stable risk factor of BPH/LUTS occurrence in three adjusted models (OR [95% CI]: 2.41 [1.37-4.25]; 2.05 [1.10-3.81] and 2.40 [1.19-4.84], respectively). CONCLUSIONS This is the first study to delineate the prevalence and incidence of BPH/LUTS in Chinese, at the national level. The study reminded us that it was dyslipidemia rather than other chronic diseases or bad habits that posed a detrimental influence on BPH/LUTS occurrence in Chinese. Our data would facilitate the disease's early screening and medical policy formulation.
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Affiliation(s)
- Lede Lin
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Wang
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yanxiang Shao
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Li
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Liang Zhou
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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Jee YM, Hwang SE, Yun JM, Cho SH, Kim ST, Kang YH, Kim HJ, Park JH. Association between air pollution exposure and lower urinary tract symptoms in Korean men. Sci Rep 2025; 15:9253. [PMID: 40102505 PMCID: PMC11920193 DOI: 10.1038/s41598-025-92887-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 03/03/2025] [Indexed: 03/20/2025] Open
Abstract
The purpose of this study was to investigate the association between long-term air pollution exposure and Low Urinary Tract Symptoms (LUTS) in Korean men. This study included 7,979 adult men who underwent health checkups. Each subject's annual average air pollution exposure levels were estimated using the Community Multiscale Air Quality model. LUTS were evaluated using the International Prostate Symptom Score (IPSS) questionnaire, and the IPSS values were analyzed for their association with LUTS severity. The study population had an average age of 56.1 years, with a prevalence of LUTS at 39.8%. None of the air pollutants were significantly associated with overall LUTS prevalence after adjusting for potential confounders. Interestingly, when divided into two symptoms of LUTS, exposures to particulate matter ≤ 2.5 μm in diameter (PM2.5) and particulate matter ≤ 10 μm in diameter (PM10) were significantly associated with an increased prevalence of voiding symptoms, but not with storage symptoms. Regarding the LUTS severity, PM2.5 and sulfur dioxide (SO2) exposures were closely related to an increased severity of overall LUTS. We report for the first time that long-term exposure to ambient air pollution, such as particulate matter, is associated with a higher prevalence and severity of LUTS, particularly voiding symptoms.
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Affiliation(s)
- Young Min Jee
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Seo Eun Hwang
- Department of Family Medicine, Seoul National University Hospital, 103 Daehakro, Yeongun-dong, Jongno-gu, Seoul, 03080, South Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, 103 Daehakro, Yeongun-dong, Jongno-gu, Seoul, 03080, South Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Su Hwan Cho
- Department of Family Medicine, Seoul National University Hospital, 103 Daehakro, Yeongun-dong, Jongno-gu, Seoul, 03080, South Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Soon Tae Kim
- Department of Environmental and Safety Engineering, Ajou University, Suwon-si, Gyeonggi-do, South Korea
| | - Yoon Hee Kang
- Environmental Institute, Ajou University, Suwon-si, Gyeonggi-do, South Korea
| | - Hyun Jin Kim
- Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, South Korea.
| | - Jin Ho Park
- Department of Family Medicine, Seoul National University Hospital, 103 Daehakro, Yeongun-dong, Jongno-gu, Seoul, 03080, South Korea.
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea.
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Iván PM, Alberto BA, Lluís PC, Maurizio D, Jose Luís GB, Francisco Javier VP, Almudena SB, Jaime GH, Esperanza TM, Pablo BA, Gabriela OA, Manuel GB, Miguel Ángel C, Alberto DLCG, Emilio LA. A real-world evidence study of interhospital variability in the surgical treatment of patients with benign prostatic hyperplasia: the REVALURO study. Int Urol Nephrol 2025; 57:775-784. [PMID: 39470938 PMCID: PMC11821794 DOI: 10.1007/s11255-024-04239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Accepted: 10/09/2024] [Indexed: 11/01/2024]
Abstract
PURPOSE Lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) is a growing condition in males associated with a high clinical, economic and humanistic burden. Several surgical techniques are available for the treatment of LUTS/BPH; thus, the aim of this study was to describe and explore the variability in the use of surgical procedures among Spanish hospitals. METHODS The REVALURO was a retrospective, observational study conducted by collecting data from the clinical records of patients with LUTS/BPH aged ≥ 35 years, from 5 national reference hospitals, who were surgically treated between 2018 and 2022. RESULTS Among the 3038 patients who underwent 3084 surgeries, 66% were invasive (2018: 57.5%, 2022: 71.5%), 22% were minimally invasive (MISTs) (2018: 20.7%, 2022: 20.2%) and 12% were highly invasive (2018: 21.8%, 2022: 8.4%). A total of 22.4% of patients' complications, with a maximum incidence of 28.6% (open prostatectomy) and a minimum 0.8% (water vapor thermal therapy (WVTT)] (p < 0.001). The reintervention rate was 1.5% over the study period. The median length of hospital stay after surgery increased from 0 days (interquartile range [IQR]: 0) with WVTT to 5 days (IQR: 4-8) with open prostatectomy (p < 0.001). CONCLUSION Trends in surgical treatment showed that the use of invasive techniques increased, while the use of highly invasive techniques decreased, and the use of MISTs remained constant. However, given the heterogeneity among hospitals, national clinical guidelines and recommendations are needed to guide the decision on which technique should be used and to homogenize the criteria.
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Affiliation(s)
- Povo Martín Iván
- Consorcio Hospital General Universitario, Av. de les Tres Creus, 2, Valencia, Spain
| | - Budía Alba Alberto
- Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, Valencia, Spain
| | - Peri Cusí Lluís
- Hospital Clínic de Barcelona, C. de Villarroel, 170, Barcelona, Spain
| | - D'Anna Maurizio
- Hospital Clínic de Barcelona, C. de Villarroel, 170, Barcelona, Spain
| | | | | | - Sabio Bonilla Almudena
- Hospital Universitario Virgen de las Nieves, Av. De las Fuerzas Armadas, 2, Granada, Spain
| | - García Herrero Jaime
- Hospital Universitario Marqués de Valdecilla, Av. De Valdecilla, Santander, Spain
| | | | | | | | - Gómez-Barrera Manuel
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 - Letter I, Madrid, Spain
| | - Casado Miguel Ángel
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 - Letter I, Madrid, Spain
| | | | - López Alcina Emilio
- Consorcio Hospital General Universitario, Av. de les Tres Creus, 2, Valencia, Spain
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Pitta RM, Kaufmann O, Ritti-Dias RM, Queiroga LDL, Wolosker N. Association between physical activity levels and lower urinary tract symptoms: a cohort study in 20,732 Brazilian men. EINSTEIN-SAO PAULO 2024; 22:eAO1204. [PMID: 39699405 DOI: 10.31744/einstein_journal/2024ao1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/22/2024] [Indexed: 12/20/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the association between physical activity levels and lower urinary tract symptoms in 20,732 Brazilian men. METHODS This cohort study included 20,732 men of ≥40 years of age, who participated in health screening between January 2008 and December 2018. Standardized health data (anthropometric, laboratory, clinical, and lifestyle data) were collected. A logistic regression model was used to examine associations based on the occurrence of lower urinary tract symptoms. RESULTS Depressive symptoms (p<0.001), age (p<0.001), erectile dysfunction (p<0.001), and total prostate-specific antigens (p<0.001) were associated with higher odds of lower urinary tract symptoms in men, after adjusting the other factors. However, physical activity levels were associated with lower odds of developing lower urinary tract symptoms (low active, p<0.001; active, p=0.002; and high active, p=0.005). CONCLUSION All physical activity levels were associated with lower odds of lower urinary tract symptoms in 20,732 Brazilian men.
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Affiliation(s)
- Rafael Mathias Pitta
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade Israelita de Ciências de Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Oskar Kaufmann
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade Israelita de Ciências de Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Raphael Mendes Ritti-Dias
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Nove Julho, São Paulo, SP, Brazil
| | - Luana de Lima Queiroga
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade Israelita de Ciências de Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Nelson Wolosker
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade Israelita de Ciências de Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Przydacz M, Rajwa P, De Cillis S, Guillot-Tantay C, Herve F, Tienza A, Tutolo M, Gokhan Culha M, Geretto P, Raison N, Werneburg GT, Miszczyk M, Gomez Rivas J, Phe V, Chlosta P, Osman N. Association of Aggression with Lower Urinary Tract Symptoms and Overactive Bladder in Men: Observations from a Large Population-representative Study. EUR UROL SUPPL 2024; 68:61-67. [PMID: 39315329 PMCID: PMC11418005 DOI: 10.1016/j.euros.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/25/2024] Open
Abstract
Background and objective Lower urinary tract symptoms (LUTS) and overactive bladder (OAB) intimately affect the psychological wellbeing and mental health of men. However, to date, the association of aggression with LUTS and OAB has not been investigated. To address this knowledge gap, we evaluated the association of aggression with LUTS and OAB in a large representative cohort of men at the population level. Methods We used computer-assisted web interviews that included reliable questionnaires for assessment of LUTS, OAB, and aggression. A population-representative group of men was based on the most recent census. For data analysis, we developed univariate and multivariate regression models. Key findings and limitations We analyzed data for a cohort of 3001 men that was representative for age and place of residence. Aggression was more prevalent among respondents with LUTS and OAB in comparison to men without these conditions (p < 0.001). The scores for aggression were directly proportional to the scores for LUTS and OAB (Spearman's rank correlation coefficients of 0.261 for LUTS and 0.284 for OAB). Univariate linear regression models revealed an association between aggression and LUTS or OAB in all age groups. Finally, multivariable linear regression models confirmed that correlations of aggression with LUTS and OAB were independent of age, sociodemographic parameters, comorbidities, and lifestyle habits (regression coefficients of 0.013 for LUTS and 0.024 for OAB). Conclusions and clinical implications Our study is the first to show that aggression among men is consistently associated with LUTS and OAB. Our results open a new research area on the effect of LUTS and OAB or their causes on psychological wellbeing and mental health, and may even support screening for hostile behavior in the clinical setting for individuals who report LUTS and OAB. Patient summary We performed the first study to investigate whether aggression is linked to lower urinary tract symptoms (LUTS) and overactive bladder (OAB). Results from our survey in a representative group of men in Poland show that aggression is linked to LUTS and OAB. More research is needed to confirm these results.
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Affiliation(s)
- Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Pawel Rajwa
- Department of Urology, Medical University of Silesia, Zabrze, Poland
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Sabrina De Cillis
- Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | | | - Francois Herve
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Antonio Tienza
- Department of Urology, Son Espases University Hospital, Health Research Institute of the Balearic Islands, Palma, Spain
| | - Manuela Tutolo
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Mehmet Gokhan Culha
- Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Paolo Geretto
- Division of Neuro-Urology, Department of Surgical Sciences, CTO Hospital, Citta della Salute e della Scienza, Turin, Italy
| | - Nicholas Raison
- Department of Urology, King’s College Hospital, King’s College, London, UK
| | - Glenn T. Werneburg
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Marcin Miszczyk
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Collegium Medicum Faculty of Medicine, WSB University, Dabrowa Gornicza, Poland
| | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Veronique Phe
- Department of Urology, Sorbonne University, Tenon Academic Hospital, AP-HP, Paris, France
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Nadir Osman
- Department of Urology, Royal Hallamshire Hospital, Sheffield, UK
| | - European Association of Urology Young Academic Urologists Functional Urology Working Group
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
- Department of Urology, Medical University of Silesia, Zabrze, Poland
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
- Service d’Urologie, Hôpital Foch, Suresnes, France
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
- Department of Urology, Son Espases University Hospital, Health Research Institute of the Balearic Islands, Palma, Spain
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
- Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, University of Health Sciences, Istanbul, Turkey
- Division of Neuro-Urology, Department of Surgical Sciences, CTO Hospital, Citta della Salute e della Scienza, Turin, Italy
- Department of Urology, King’s College Hospital, King’s College, London, UK
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
- Collegium Medicum Faculty of Medicine, WSB University, Dabrowa Gornicza, Poland
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
- Department of Urology, Sorbonne University, Tenon Academic Hospital, AP-HP, Paris, France
- Department of Urology, Royal Hallamshire Hospital, Sheffield, UK
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Cusumano LR, Rink JS, Callese T, Maehara CK, Mathevosian S, Quirk M, Plotnik A, McWilliams JP. Cost Comparison of Prostatic Artery Embolization Between In-Hospital and Outpatient-Based Lab Settings. Cureus 2024; 16:e67433. [PMID: 39310461 PMCID: PMC11415309 DOI: 10.7759/cureus.67433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Purpose This study aimed to determine the costs associated with prostatic artery embolization (PAE) performed in hospital and outpatient-based lab (OBL) settings. Methods Procedures were performed in similarly equipped procedure suites located within a tertiary hospital or OBL. Time-driven activity-based costing (TDABC) was utilized to calculate procedural costs incurred by the institution. Process maps were created describing personnel, space, equipment, and materials. The time duration of each procedural step was recorded independently by a nurse caring for the patient at the time of the procedure, and mean values were included in our model. Using institutional and publicly available financial data, costs, and capacity cost rates were determined. Results Thirty-seven PAE procedures met inclusion criteria with a mean patient age of 70.4 (+/- 6.7) years and a mean prostate gland size of 129.7 (+/-56.4) cc. Twenty-six procedures were performed within the hospital setting, and 11 procedures were performed within the OBL. Reduction in International Prostate Symptom Score (IPSS) was not significantly different following hospital and OBL procedures (57.2% vs. 82.4%, P = 0.0796). Mean procedural time was not significantly different between the hospital and OBL settings (136.6 vs. 147.3 minutes, P = 0.1893). However, the duration between admission and discharge was significantly longer for procedures performed in a hospital (468.8 vs. 325.4 minutes, P <0.0001). Total costs for hospital-based procedures were marginally higher ($3,858.28 vs. $3,642.67). Conclusion Total PAE cost was similar between the hospital and OBL settings. However, longer periprocedural times for hospital-based procedures and differences in reimbursement may favor the performance of PAE in an OBL setting.
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Affiliation(s)
- Lucas R Cusumano
- Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Johann S Rink
- Department of Clinical Radiology and Nuclear Medicine, Mannheim University Medical Centre, Mannheim, DEU
| | - Tyler Callese
- Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Cleo K Maehara
- Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, USA
| | - Sipan Mathevosian
- Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Matthew Quirk
- Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Adam Plotnik
- Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Justin P McWilliams
- Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
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Park S, Lee KS, Choi M, Lee M. Factors associated with quality of life in patients with benign prostatic hyperplasia, 2009-2016. Medicine (Baltimore) 2022; 101:e30091. [PMID: 36086750 PMCID: PMC9512327 DOI: 10.1097/md.0000000000030091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
This study analyzed the factors affecting the health-related quality of life of patients with benign prostatic hyperplasia (BPH) according to age. We also aimed to determine appropriate strategies to improve their quality of life. Data from the Korea Health Panel Survey (2009-2016) were used in this study. A total of 3806 patients with BPH were divided into 2 groups: younger adults (aged under 65 years) and older adults (aged over 65 years). In addition, a logistic regression analysis was conducted to identify factors affecting the quality of life of young and older patients with BPH. In younger adult patients with BPH, the higher the level of education, the higher the quality of life by a factor of 1.379, and the more intense the physical activity, the lower the quality of life by a factor of 0.791. Also, the longer the sitting time, the lower the quality of life by a factor of 0.765. In contrast, for older adult patients with BPH, the quality of life improved by factors of 1.601 and 2.921, respectively, for health insurance and higher income level. In addition, it was found that the quality of life decreased by a factor of 0.754 in patients who drink alcohol. In order to improve the quality of life of the middle-aged adult population with BPH, it is necessary to reduce sitting time through constant physical activity. Moreover, the cost of medical care should be reduced and the quality of life increased through reductions in surgical treatment, as the burden of medical expenses will degrade the quality of life for older adults.
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Affiliation(s)
- Sewon Park
- Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - Kyu-Sung Lee
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, South Korea
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mankyu Choi
- Department of Health Policy & Management, College of Health Science, Korea University, Seoul, South Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, South Korea
| | - Munjae Lee
- Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, South Korea
- Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, South Korea
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8
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Tran DNH, Yeh HF, Huang WJ, Wu PW, Liao YJ, Hwang SJ, Kung YY, Yang JL, Wu TP, Hsu CH, Chen FP. Efficacy evaluation of Chinese herbal medicine, VGH-BPH1, for patients with benign prostatic hyperplasia: A randomized, double-blind, placebo-controlled, and crossover study. J Chin Med Assoc 2022; 85:639-646. [PMID: 35385425 DOI: 10.1097/jcma.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) can affect quality of life and cause various complications. Previous studies have suggested that Chinese herbal medicine can alleviate symptoms in patients with BPH. This study aimed to investigate whether the Chinese herbal medicine prescription VGH-BPH1 can alleviate BPH symptoms when used as an add-on treatment. METHODS In this crossover, randomized, double-blind, placebo-controlled trial, patients with BPH were randomly segregated into two groups: group A received VGH-BPH1, and group B received a placebo for 8 weeks. Subsequently, after a 2-week wash-out period, the two groups were switched to the opposite treatment for another 8 weeks. The International Prostate Symptoms Score and Aging Male Symptoms Score were adopted as the primary outcomes to assess improvement in BPH and patient quality of life. The secondary outcomes were the International Index of Erectile Function, Constitution Chinese Medicine Questionnaire, uroflowmetry results, and postvoid residual urine volume. RESULTS VGH-BPH1 treatment significantly decreased the International Prostate Symptoms Score total score (p = 0.027); however, no significant difference was observed between the treatment and placebo groups. The Aging Male Symptoms Score "joint pain and muscular ache" score in the VGH-BPH1 group was significantly lower than that of the placebo group (p = 0.022). The "physical exhaustion" score also exhibited a decreasing trend when both groups were compared (p = 0.057). CONCLUSION Although VGH-BPH1 treatment did not outperform the placebo in terms of improving BPH symptoms, it resulted in improvement in several quality of life indicators when relative to the placebo. Future research using a larger sample size with appropriate amendments to the protocol should be conducted to further investigate the effects of VGH-BPH1.
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Affiliation(s)
- Diem Ngoc Hong Tran
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Hsin-Fu Yeh
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Family Medicine, St. Martin De Porres Hospital, Chiayi, Taiwan, ROC
| | - William J Huang
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Pei-Wen Wu
- Tian-Yun Chinese Medicine Clinic, Taoyuan, Taiwan, ROC
| | - Ying-Ju Liao
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shinn-Jang Hwang
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yen-Ying Kung
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jen-Lin Yang
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ta-Peng Wu
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chung-Hua Hsu
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Chinese Internal Medicine, Linsen Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei, Taiwan, ROC
| | - Fang-Pey Chen
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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9
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Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms: A Markov Model-Based Cost-Effectiveness Analysis. J Am Coll Radiol 2022; 19:733-743. [PMID: 35476943 DOI: 10.1016/j.jacr.2022.02.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/17/2022] [Accepted: 02/26/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study was to investigate whether prostatic artery embolization (PAE) can be considered a long-term cost-effective treatment option in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia in comparison to transurethral resection of the prostate (TURP). METHODS The in-hospital costs of PAE and TURP in the United States were obtained from a recent cost analysis. Clinical outcomes including nature and rate of adverse events for TURP and PAE along with rates of retreatment because of complications or clinical failure were obtained from peer-reviewed literature. A decision tree-based Markov model was created, analyzing long-term cost-effectiveness for TURP and PAE from a US health care sector perspective. Cost-effectiveness over a time frame of 5 years was estimated while assuming a willingness to pay of $50,000 per quality-adjusted life-year (QALY). The primary outcome was incremental cost-effectiveness ratio. RESULTS PAE resulted in overall cost of $6,464.92 and an expected outcome of 4.566 QALYs. In comparison, TURP cost $9,221.09 and resulted in expected outcome of 4.577 QALYs per treatment. The incremental cost-effectiveness ratio for TURP was $247,732.65 per QALY. On the basis of the willingness-to-pay threshold, PAE is cost effective compared with TURP. CONCLUSIONS On the basis of our model, PAE in comparison with TURP can be regarded as a cost-effective treatment option for patients with lower urinary tract symptoms within the US health care system.
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Functional Results after First- and Second-Generation Temporary Implantable Nitinol Device (TIND) for BPH: A Narrative Review of the Literature. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00644-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose of review
In the last decades, new promising technologies for the treatment of BPH-related lower urinary tract symptoms (LUTS) have been widely experienced in clinical practice, with the aim of offering fewer complications but similar functional outcomes compared with the gold standard transurethral resection of the prostate (TURP). Among these so-called minimally invasive approaches, transurethral implantation of first- and second-generation temporary implantable nitinol device (TIND and iTIND, respectively) (Medi-Tate; Medi-Tate Ltd., Or Akiva, Israel) has been included by the European Association of Urology (EAU) Guidelines as one of the available alternative treatments to TURP. In the present paper, we conducted a systematic review of the current literature on TIND and iTIND implantation focusing on functional outcomes. Medline, Embase, and Cochrane databases were queried for relevant Literature in May 2021.
Recent findings
Data regarding the use of temporary implantable nitinol device for BPH are still very limited, with only seven studies currently available in Literature. All the studies report that both TIND and iTIND procedures are safe, effective, and well tolerated. Moreover, such treatments seem to not affect patient’s sexual and ejaculatory functions.
Summary
Current clinical evidence suggests that temporary implantation of first- and second-generation temporary implantable nitinol devices are valid options for the minimally invasive surgical treatment of BPH-related LUTS. Further studies are required in order to confirm the functional results, especially over a long-term follow up.
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Manfredi C, Arcaniolo D, Spatafora P, Crocerossa F, Fusco F, Verze P, Fiori C, Damiano R, Cindolo L, DE Sio M, Otero JR. Emerging minimally invasive transurethral treatments for benign prostatic hyperplasia: a systematic review with meta-analysis of functional outcomes and description of complications. Minerva Urol Nephrol 2021; 74:389-399. [PMID: 34308611 DOI: 10.23736/s2724-6051.21.04530-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Several minimally invasive surgical procedures have been proposed as alternative therapies for benign prostatic hyperplasia (BPH). The present systematic review aimed to describe the functional outcomes and complications of emerging minimally invasive transurethral treatments for BPH. EVIDENCE ACQUISITION A comprehensive bibliographic search on the MEDLINE and Cochrane Library databases was conducted. No chronological restriction was applied. Retrospective and prospective primary studies were included. A meta-analysis of IPSS, IPSS-QoL, Qmax, and PVR was performed. Data on adverse events were presented narratively. EVIDENCE SYNTHESIS A total of 18 studies were included. Thirteen papers were eligible for the meta-analysis. iTIND, Rezūm, and Aquablation were associated with a significant improvement in IPSS (p<0.001), IPSS-QoL (p<0.001), and Qmax (p<0.001) compared to baseline. A significant reduction of PVR from baseline was found with Rezūm (p<0.001) and Aquablation (p<0.001) but not iTIND (p=0.22). A significant difference in IPSS, IPSS-QoL, and Qmax was shown in favor of Aquablation compared to Rezūm and iTIND (p<0.001). Rezūm and iTIND were mainly associated with mild to moderate adverse effects. Hematuria or bleeding was reported in all studies regarding Aquablation (0.8%-26%), the need for transfusion or intervention for bleeding varied between 1.8% and 9%. CONCLUSIONS Aquablation, Rezūm, and iTIND significantly improve urinary functional outcomes compared to baseline; however, Aquablation would seem to lead to better functional results compared to the other procedures. Rezūm and iTIND appear to have an excellent safety profile, while Aquablation would seem to expose patients to a nonnegligible risk of bleeding.
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Affiliation(s)
- Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy -
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pietro Spatafora
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paolo Verze
- Department of Medicine, Surgery, Dentistry Scuola Medica Salernitana, University of, Salerno, Salerno, Italy
| | - Cristian Fiori
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
| | - Marco DE Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Javier R Otero
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Unit of Urology, HM Hospitales, Montepríncipe, Puerta del Sur, Sanchinarro, Madrid, Spain
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12
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Jones P, Siena G, Hameed BMZ, Somani BK. Emerging Data on the Safety and Efficacy of Transurethral Water Vapour Therapy for Benign Prostatic Hyperplasia. Res Rep Urol 2021; 13:273-282. [PMID: 34295845 PMCID: PMC8290348 DOI: 10.2147/rru.s273686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/30/2021] [Indexed: 12/29/2022] Open
Abstract
Benign prostate disease is a disease of prevalence and over 25% of men affected by bothersome lower urinary tract symptoms (LUTS) as a result of it will require surgical intervention during their lifetime. While transurethral resection of the prostate (TURP) has served as the cornerstone treatment for many years, there now exist a multitude of minimally invasive alternatives including the Rezum system. The latter is a novel form of transurethral water vapour therapy, which is attracting increasing attention. It utilizes convective water vapour energy (WAVE) and thereby radiofrequency (RF) in order to generate heat energy. Early studies have demonstrated promising results. To date there have been 12 studies published on Rezum, however only one randomized trial. This review offers an overview and evaluation of this emerging evidence.
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Affiliation(s)
- Patrick Jones
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,EAU Young Academic Urology Urolithiasis and Endourology Working Party, Arnhem, Netherlands
| | - Giampaolo Siena
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - B M Zeeshan Hameed
- EAU Young Academic Urology Urolithiasis and Endourology Working Party, Arnhem, Netherlands.,Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bhaskar K Somani
- EAU Young Academic Urology Urolithiasis and Endourology Working Party, Arnhem, Netherlands.,Department of Urology, University Hospital Southampton, Southampton, UK
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13
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Chughtai B, Rojanasarot S, Neeser K, Gultyaev D, Amorosi SL, Shore ND. Cost-Effectiveness and Budget Impact of Emerging Minimally Invasive Surgical Treatments for Benign Prostatic Hyperplasia. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2021; 8:42-50. [PMID: 33987450 PMCID: PMC8102068 DOI: 10.36469/jheor.2021.22256] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
Background: Benign prostatic hyperplasia (BPH) is one of the most prevalent and costly chronic conditions among middle-aged and elderly men. Prostatic urethral lift (PUL) and convective water vapor thermal therapy (WVTT) are emerging minimally invasive surgical treatments as an alternative to traditional treatment options for men with moderate-to-severe BPH. This study evaluated the cost-effectiveness and budget impact of PUL and WVTT for men with BPH using long-term clinical outcomes. Methods: The cost-effectiveness and budget impact models were developed from a US Medicare perspective over a 4-year time horizon. The models were populated with males with a mean age of 63 and an average International Prostate Symptom Score (IPSS) of 22. Clinical inputs were extracted from the LIFT and Rezum II randomized controlled trials at 4 years. Utility values were assigned using IPSS and BPH severity levels. Procedural, adverse event, retreatment, follow-up, and medication costs were based on 2019 Medicare payment rates and Medicare Part D drug spending. One-way and probabilistic sensitivity analyses (PSAs) were performed. Results: At 4 years, PUL was associated with greater retreatment rates (24.6% vs 10.9%), lower quality-adjusted life-years (QALYs) (3.490 vs 3.548) and higher total costs (US$7393 vs US$2233) compared with WVTT, making WVTT the more effective and less costly treatment strategy. The 70% total cost difference of PUL and WVTT was predominantly driven by higher PUL procedural (US$5617 vs US$1689) and retreatment (US$976 vs US$257) costs. The PSA demonstrated that relative to PUL, WVTT yielded higher QALYs and lower costs 99% and 100% of the time, respectively. Conclusions: Compared to PUL, WVTT was a cost-effective and cost-saving treatment of moderate-to-severe BPH. These findings provide evidence for clinicians, payers, and health policy makers to help further define the role of minimally invasive surgical treatments for BPH.
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Affiliation(s)
| | | | | | | | | | - Neal D Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
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14
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Xiong Y, Zhang Y, Li X, Qin F, Yuan J. The prevalence and associated factors of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in aging males. Aging Male 2020; 23:1432-1439. [PMID: 32583703 DOI: 10.1080/13685538.2020.1781806] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To investigate the prevalence and associated factors of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in Chinese aging males. METHOD Data downloaded from the China Health and Retirement Longitudinal Study (CHARLS) was subjected to descriptive statistics followed by univariate logistic regression and multivariate logistic regression. RESULTS A total of 8563 participants with an overall LUTS/BPH prevalence of 11.97% were enrolled. With aging, the LUTS/BPH prevalence increased (p < 0.001). Men aged over 70 years suffered the highest prevalence of 22.70%. Marital status did nothing to the suffering of LUTS/BPH. Subjects receiving more education or assessed as depression displayed higher incidence of LUTS/BPH (p < 0.001). In rural villages, settlers showed lower prevalence of 10.00% compared to 16.49% for urban residents. Smoking, sleeping time and alcohol consumption seemed to play a protective role in the occurrence of LUTS/BPH. One who slept more than 8 h, was smoking, and drank more than once a month had the lowest prevalence (p ≤ 0.001). CONCLUSIONS For Chinese aging population, LUTS/BPH prevalence increased with aging and was interfered by educational level, depression, sleeping time, geographical region, smoke and alcohol consumption.
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Affiliation(s)
- Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yangchang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiaoyu Li
- Laboratory of Innovation, Basic Medical Experimental Teaching Centre, Chongqing Medical University, Chongqing, China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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15
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Park S, Ryu JM, Lee M. Quality of Life in Older Adults with Benign Prostatic Hyperplasia. Healthcare (Basel) 2020; 8:healthcare8020158. [PMID: 32512888 PMCID: PMC7349344 DOI: 10.3390/healthcare8020158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 12/01/2022] Open
Abstract
The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices.
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Bhatt NR, Davis NF, Witjes WP, Bjartell A, Caris C, Patel A, de la Taille A, Tubaro A. Quality of life with pharmacological treatment in patients with benign prostatic enlargement: results from the Evolution European Prospective Multicenter Multi-National Registry Study. World J Urol 2020; 39:517-526. [PMID: 32367157 DOI: 10.1007/s00345-020-03219-7] [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: 11/01/2019] [Accepted: 04/21/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Lower urinary tract symptoms due to benign prostate enlargement (LUTS/BPE) can lead to significant disturbances to health-related quality of life (HRQoL) and psychological well-being. The aim of this study was to evaluate the effect of pharmacological treatment of LUTS/BPE on disease specific and generic QOL measures. METHODS Evolution was a European prospective, multicenter multi-national, observational registry collecting real-life clinical data over 2 years on the management of LUTS/BPE in primary and secondary care. This study investigated disease-specific QOL using questionnaires such as IPSS Q8, BPH Impact Index (BII) and generic QOL using questionnaires like EuroQOL Five Dimension (EQ5D) which encompassed EQ5D VAS and EQ5D health index. RESULTS The registry enrolled 1838 BPE patients and 1246 patients were evaluable at the end of 24 months. Nearly 70% of patients in the study were previously treated with medical therapy and 17% of these had already discontinued medical treatment previously for various reasons with lack of efficacy being the most common. The mean time since diagnosis of LUTS in the previously treated group was 4.7 years (0-26 years). Medical management produced statistically significant improvement in QOL (disease specific and generic) in previously untreated patients and an insignificant change in generic QOL in previously treated patients. CONCLUSIONS After 5-years from the onset of symptoms, LUTS/BPE patients previously treated with medication had significantly impaired QOL in patients in a manner comparable to other chronic diseases. Earlier intervention with minimally invasive surgical techniques (MIT) should be considered in LUTS/BPE patients that do not show a significant improvement in QOL with medical therapy.
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Affiliation(s)
- Nikita R Bhatt
- Department of Urology, Ipswich Hospital, East Suffolk and North Essex Trust, Ipswich, Suffolk, IP45PD, England, UK.
| | - Niall F Davis
- Department of Urology, Beaumont Hospital and Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - W P Witjes
- EAU Research Foundation, P.O. Box 30016, 6803 AA, Arnhem, The Netherlands
| | - A Bjartell
- EAU Research Foundation, P.O. Box 30016, 6803 AA, Arnhem, The Netherlands.,Department of Urology, Skane Hospital, Lund University, Malmö, Sweden
| | - C Caris
- EAU Research Foundation, P.O. Box 30016, 6803 AA, Arnhem, The Netherlands
| | - A Patel
- Department of Urology, Spire London East Hospital, Roding Lane South, Redbridge, Essex, Ilford, IG4 5PZ, UK
| | - A de la Taille
- Department of Urology, Assistance Publique Des Hopitaux de Paris, 54 Av du Mal de Lattre de Tassigny, 94000, Créteil, France
| | - A Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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17
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Allen S, Aghajanyan I. Use of thermobalancing therapy in ageing male with benign prostatic hyperplasia with a focus on etiology and pathophysiology. Aging Male 2017; 20:28-32. [PMID: 27960590 DOI: 10.1080/13685538.2016.1247151] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION We investigated if "thermobalancing" therapy (TT), using Dr Allen's therapeutic device (DATD) in men with benign prostatic hyperplasia (BPH), can aid in understanding the etiology and pathophysiology of BPH. METHODS We compared urinary and other parameters of BPH patients who received TT over 6 months (treatment group) with those of healthy volunteers who had not received the treatment (control group). Dynamics of symptoms and indicators in each group were evaluated in comparison with their data at the beginning and end of the study. Parameters were the International Prostate Symptom Score (IPSS) for urinary symptoms and quality of life (QoL), ultrasound measurement of prostate volume (PV) and uroflowmetry (maximum flow rate, Qmax). TT effectiveness was examined in 124 men with BPH and PV <60 mL. We also investigated the data of five patients with BPH and PV >60 mL. RESULTS TT decreased urinary symptoms and PV, increased Qmax and improved QoL in men with BPH, PV <60 mL, and in men with BPH, PV >60 mL. CONCLUSIONS The present study demonstrated that TT is effective for BPH, suggesting that blood circulation plays a crucial role in its cause. The continuous heat exposure that does not exceed the normal body temperature terminates the trigger of BPH development, "micro-focus" of hypothermia, and the following spontaneous expansion of capillaries. TT could be considered to be a useful tool in BPH treatment.
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Affiliation(s)
- Simon Allen
- a Fine Treatment , Oxford , United Kingdom of Great Britain and Northern Ireland and
| | - Ivan Aghajanyan
- b Urology, Yerevan State Medical University Named after Mkhitar Heratsi , Yerevan , Armenia
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Allen S, Aghajanyan IG. Thermobalancing conservative treatment for moderate-to-low-degree lower urinary tract symptoms (LUTS) secondary to prostate enlargement. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1195067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Simon Allen
- Department of Health, Fine Treatment, 29 Rewley Road, Oxford OX1 2RA, UK
| | - Ivan Gerasimovich Aghajanyan
- Department of Urology, Yerevan State Medical University, 9 Ezras Hasratyan St, Yerevan 0052, Republic of Armenia
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Positive Response to Thermobalancing Therapy Enabled by Therapeutic Device in Men with Non-Malignant Prostate Diseases: BPH and Chronic Prostatitis. Diseases 2016; 4:diseases4020018. [PMID: 28933398 PMCID: PMC5456275 DOI: 10.3390/diseases4020018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/12/2016] [Accepted: 04/14/2016] [Indexed: 12/18/2022] Open
Abstract
Background: The most common types of non-malignant prostate diseases are benign prostatic hyperplasia (BPH) and chronic prostatitis (CP). The aim of this study was to find out whether thermobalancing therapy with a physiotherapeutic device is effective for BPH and CP. Methods: During a 2.5-year period, 124 men with BPH over the age of 55 were investigated. Clinical parameters were tested twice: via the International Prostate Symptom Score (IPSS) and via ultrasound measurement of prostate volume (PV) and uroflowmetry maximum flow rate (Qmax), before and after six months of therapy. In 45 men with CP under the age of 55, the dynamics of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) were studied. Results: The results of the investigated index tests in men with BPH confirmed a decrease in IPSS (p < 0.001), a reduction in PV (p < 0.001), an increase in Qmax (p < 0.001), and an improvement of quality of life (QoL) (p < 0.001). NIH-CPSI scores in men with CP indicated positive dynamics. Conclusions: The observed positive changes in IPSS, PV, and Qmax in men with BPH and the improvement in NIH-CPSI-QoL in patients with CP after using a physiotherapeutic device for six months as mono-therapy, support the view that thermobalancing therapy with the device can be recommended for these patients. Furthermore, the therapeutic device is free of side effects.
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