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Liu YF, Wang HH, Geng YH, Han L, Tu SH, Chen JS, Wen CY. Uncovering the Potential Mechanisms and Effects of Hyperuricemia and its Associated Diseases on Male Reproduction. Reprod Sci 2024; 31:2184-2198. [PMID: 38379071 DOI: 10.1007/s43032-024-01453-7] [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: 09/21/2023] [Accepted: 01/03/2024] [Indexed: 02/22/2024]
Abstract
Male fertility and metabolic disorders, including obesity and diabetes, are closely connected. Since hyperuricemia and metabolic syndrome are strongly related, male fertility and hyperuricemia may, to some degree, be associated. According to recent studies, hyperuricemia imposes various effects on sex hormones, semen quality, and male erectile dysfunction. Some researchers claim that uric acid worsens male semen and raises the risk of erectile dysfunction (ED), while others state that it safeguards both penile erection and male semen. Additionally, it has been shown that gout and metabolic syndrome also raise the risk of ED. To clarify this controversy, the influence and potential mechanisms of hyperuricemia on ED, semen quality, sex hormone levels, and the effects of hyperuricemia-related disorders on ED will be comprehensively summarized.
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Affiliation(s)
- Ya-Fei Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Huan-Huan Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yin-Hong Geng
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liang Han
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng-Hao Tu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-She Chen
- The Reproduction Center, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, China
| | - Cai-Yuzhu Wen
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Corona DG, Vena W, Pizzocaro A, Rastrelli G, Sparano C, Sforza A, Vignozzi L, Maggi M. Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study. J Endocrinol Invest 2023; 46:2195-2211. [PMID: 37515706 DOI: 10.1007/s40618-023-02136-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/09/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS-along with its components-and ED. METHODS All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively. RESULTS Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED-as derived from preclinical and clinical models-although independent, is marginal. CONCLUSIONS The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.
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Affiliation(s)
- D G Corona
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy.
| | - W Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - C Sparano
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - A Sforza
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Omran A, Leca BM, Oštarijaš E, Graham N, Da Silva AS, Zaïr ZM, Miras AD, le Roux CW, Vincent RP, Cardozo L, Dimitriadis GK. Metabolic syndrome is associated with prostate enlargement: a systematic review, meta-analysis, and meta-regression on patients with lower urinary tract symptom factors. Ther Adv Endocrinol Metab 2021; 12:20420188211066210. [PMID: 34900218 PMCID: PMC8664322 DOI: 10.1177/20420188211066210] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is defined by at least three of the following five criteria: blood pressure ⩾130/85 mmHg, fasting blood glucose ⩾5.6 mmol/l, triglycerides concentration ⩾1.7 mmol/l, waist circumference ⩾102 cm (for men), and high-density lipoprotein cholesterol concentration <1.03 mmol/l (for men). MetS has been associated with worse lower urinary tract symptoms (LUTS) and higher International Prostate Symptom questionnaire scores. MATERIALS AND METHODS MEDLINE, Cochrane, ClinicalTrials.gov, and SCOPUS were critically appraised for all peer-reviewed manuscripts that suitably fulfilled our protocol's inclusion criteria established a priori. Meta-analytical and meta-regression calculations were performed in R using the Sidik-Jonkman and Hartung-Knapp random effects model and predefined covariates. RESULTS A total of 70 studies (n = 90,206) were included in qualitative synthesis. From these, 60 studies focused on MetS and LUTS: 44 reported positive correlations, 5 reported negative correlations, 11 reported no association, and 10 studies focused on MetS and total prostate volume (TPV). MetS positively correlated with moderate LUTS [odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.35-1.80], severe LUTS (OR = 2.35, 95% CI = 1.82-3.03), overactive bladder (OAB; OR = 3.2, 95% CI = 1.6-5.8), and nocturia severity (OR = 2.509, 95% CI = 1.571-4.007) at multivariate analysis. A total of 30 studies (n = 22,206) were included in meta-analysis; MetS was significantly associated with higher TPV (mean differences = 4.4450 ml, 95% CI = 2.0177-6.8723), but no significant predictive factors for effect sizes were discovered. CONCLUSION Our meta-analysis demonstrates a significant association between the aggravating effects of MetS, which commonly coexists with obesity and benign prostate enlargement.
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Affiliation(s)
| | | | - Eduard Oštarijaš
- Institute for Translational Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Natasha Graham
- Department of Obstetrics & Gynaecology, Queen Elizabeth Hospital, London, UK
| | - Ana Sofia Da Silva
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
| | | | - Alexander D. Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Carel W. le Roux
- Diabetes Complication Research Centre, School of Medicine and Medical Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Royce P. Vincent
- Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UKDepartment of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, London, UK
| | - Linda Cardozo
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
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Erkoc M, Besiroglu H, Otunctemur A, Polat EC, Bozkurt M. Metabolic syndrome is associated worsened erectile function in patients undergoing TURP due to benign prostatic hyperplasia. Aging Male 2020; 23:533-537. [PMID: 30468407 DOI: 10.1080/13685538.2018.1541133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Transurethral resection of the prostate (TURP) is the gold standard method for surgical treatment of benign prostatic hyperplasia (BPH). So, the complications of TURP is important, in which erectile dysfunction is the most important. The aim of the present study is to evaluate erectile dysfunction in patients undergoing TURP treatment for BPH and investigate the correlation between metabolic syndrome and erectile dysfunction. MATERIALS AND METHODS This study included 120 patients who underwent surgery for BPH at Beylikdüzü State Hospital and Okmeydani Training and Research Hospital. IIEF-5 form was administered to the patients before the surgery and six months after the surgery. The Student's t-test, Wilcoxon, and chi-square test were used in the statistical analysis. RESULTS The patients were investigated by IIEF-5 scoring into three groups (severe, moderate, and non-ED (erectyl disfunction)-mild). The statistical analysis of IIEF-5 form administered to 120 patients who underwent surgery did not show any significant difference before surgery and six months after surgery (p > 0.05). Metabolic syndrome and erectile dysfunction correlation were examined, and a significant correlation was obtained between metabolic syndrome and severe erectile dysfunction (p < 0.05). CONCLUSIONS IIEF-5 results administered before and after surgery showed no significant difference. The study showed that patients with metabolic syndrome have a higher probability of having erectile dysfunction after TURP compared to patients without metabolic syndrome. Moreover, post-surgery, patients with metabolic syndrome seemed to be affected negatively regarding erectile dysfunction compared to patients with no metabolic syndrome.
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Affiliation(s)
| | - Huseyin Besiroglu
- Department of Urology, Catalca Ilyas Cokay State Hospital, Istanbul, Turkey
| | | | - Emre Can Polat
- Turkiye Cumhuriyeti Saglik Bakanligi Okmeydani Egitim ve Arastirma Hastanesi, Istanbul, Turkey
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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: 5.3] [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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Cannarella R, Burgio G, Vicari ES, La Vignera S, Condorelli RA, Calogero AE. Urogenital dysfunction in male patients with Charcot-Marie-Tooth: a systematic review. Aging Male 2020; 23:377-381. [PMID: 30064288 DOI: 10.1080/13685538.2018.1491543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Charcot-Marie-Tooth (CMT) is the most common inherited polyneuropathy. Polyneuropathies are likely to affect the urogenital system. Urogenital dysfunction is rarely investigated and may be underestimated in CMT patients. AIM The aim of the present study was to perform a systematic review of the literature to collect all the available evidence on the presence of urogenital dysfunction and in patients with CMT. METHODS Data sources were MEDLINE, Pubmed, Scopus, and Google Scholar. All types of studies describing the presence of lower urinary tract dysfunction, erectile dysfunction (ED), anejaculation, and other sexual disorders in male patients with CMT were included. RESULTS Among 131 records identified, five articles were included in the qualitative synthesis. Lower urinary tract dysfunction, neurogenic bladder, ED, and other sexual dysfunctions have been reported in patients with CMT. One case of anejaculation has been described. CONCLUSION Urogenital dysfunction occurs in patients with CMT. Therefore, uro-andrologic counseling should be performed in the aging male with CMT. This might positively impact on his quality of life.
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Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanni Burgio
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Enzo S Vicari
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Qian S, Sheng X, Xu D, Shen H, Qi J, Wu Y. Variation of prostatic morphology in Chinese benign prostatic hyperplasia patients of different age decades. Aging Male 2020; 23:457-463. [PMID: 30777473 DOI: 10.1080/13685538.2018.1522626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Our study aimed to investigate the age-related growth in prostatic morphological parameters in Chinese benign prostatic hyperplasia (BPH) patients, and to find out the regularity of how these parameters change with aging. METHODS Medical records of 1038 BPH patients were obtained from a retrospective database of first-visit men with BPH. Change regularity of prostatic anatomical factors with aging was analyzed. RESULTS Patients were classified into four groups according to different age decades. All prostatic anatomical factors assessed in this research increased with age growth (p < .0001). However, these anatomical factors sustained stably when older than 70 years. By analyzing the detailed correlation between age and prostatic morphological parameters, transitional zone index (TZI) (Pearson r = 0.358, r2 = 0.128, p < .0001) and transitional zone width (TZW) (Pearson r = 0.344, r 2= 0.118, p < .0001) showed the best correlation coefficient with age. After adjusted the influence of cardiovascular disease (CVD) and diabetes mellitus (DM), the result remained still similarly. CONCLUSION Prostatic morphological parameters increase progressively with age growth when patients were younger than 70 years, indicating reasonable interventions to be provided to BPH patients before 70 years. In addition, TZI and TZW are two practical, easy-to-measure prostatic parameters that are significantly associated with the growth of age compared to others.
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Affiliation(s)
- Subo Qian
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xujun Sheng
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ding Xu
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Haibo Shen
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Qi
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Wu
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Choi WS, Song WH, Park J, Yoo S, Son H. Relationship between each IPSS item score and erectile dysfunction in the Korean Internet Sexuality Survey (KISS): do men with weak streams have low sexual function? World J Urol 2020; 38:3219-3226. [DOI: 10.1007/s00345-020-03128-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 02/04/2020] [Indexed: 02/01/2023] Open
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Kim A, Park YJ, Heo KO, Choi WS, Park HK, Paick SH, Choo MS, Kim HG. Novel symptom questionnaire for the differential diagnosis of detrusor underactivity and bladder outlet obstruction in men. Aging Male 2019; 22:150-155. [PMID: 29985721 DOI: 10.1080/13685538.2018.1481941] [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] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To develop a questionnaire for the differential diagnosis of detrusor underactivity (DUA) and bladder outlet obstruction (BOO) without performing invasive pressure flow studies. STUDY DESIGN AND METHODS Symptoms of men with DUA were analyzed and compared with those of men with BOO using eight questions from the developing questionnaire. Patients with DUA have a bladder contractility index (PdetQmax+5xQmax) less than 100, whereas those with BOO have a BOO index (PdetQmax-2xQmax) greater than 40 in urodynamic studies (UDS). Men with detrusor overactivity in UDS and neurogenic issues were excluded from the analysis. One urologist reviewed patients' medical records, and responded to eight questions without using information from UDS. Scores in the developing questionnaire were then compared to make a differential diagnosis between DUA and BOO. RESULTS Overall, 318 men who underwent UDS were included. Symptoms were compared in patients diagnosed with DUA without BOO (n = 165) and BOO without DUA (n = 153). Questions 1, 2, 4, 5, 6, and 7 were significantly different between groups. The sensitivity and specificity of the questionnaire were 95.8% and 95.4%, respectively, for predicting DUA in patients with scores greater than 45 points (cutoff value). CONCLUSIONS Men with DUA and BOO may be distinguished using a developing questionnaire without invasive evaluation. Men with scores greater than 45 points would be expected to have DUA but not BOO.
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Affiliation(s)
- Aram Kim
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Young-Jin Park
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Kyung Ok Heo
- b Department of Urology , Asan Medical Center, Ulsan University College of Medicine , Seoul , Korea
| | - Woo Suk Choi
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Hyoung Keun Park
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Sung Hyun Paick
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
| | - Myung-Soo Choo
- b Department of Urology , Asan Medical Center, Ulsan University College of Medicine , Seoul , Korea
| | - Hyeong Gon Kim
- a Department of Urology , Konkuk University Medical Center, Konkuk University School of Medicine , Seoul , Korea
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Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Epidemiology and risk factors of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male 2019; 22:12-19. [PMID: 29392976 DOI: 10.1080/13685538.2018.1434772] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is very common in aging men and causes lower urinary tract symptoms (LUTS), which decrease health-related quality of life. A number of evidence suggests that other than ageing, modifiable factors, such as increasing prostate volume, obesity, diet, dyslipidemia, hormonal imbalance, hypertension, metabolic syndrome, alcohol, and smoking, also contribute to the development of BPH and/or LUTS. More recently, erectile dysfunction (ED) has been linked to LUTS/BPH as a part of this syndrome, suggesting that patients with BPH or LUTS easily develop ED, and that LUTS/BPH symptoms often coexist with ED. This article focuses on the epidemiology and risk factors of the combined phenotype LUTS/BPH - ED.
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Affiliation(s)
- Aldo E Calogero
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Giovanni Burgio
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Rosita A Condorelli
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Rossella Cannarella
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Sandro La Vignera
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
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Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Aging Male 2018; 21:272-280. [PMID: 29378485 DOI: 10.1080/13685538.2018.1432586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This article summarizes years of challenging research on erectile dysfunction (ED), a condition that has an important social and cultural relevance. Preclinical and clinical research progress has led to new therapeutic approaches to ED in patients with different comorbidities and particularly in those with low urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). These goals were possible only by combined work of specialists and researchers of different and intertwined medical disciplines. Currently, tadalafil (5 mg/d) is the best choice; other phosphodiesterase-5 inhibitors (PDE5i) are not included among options, despite the growing evidence of therapeutic effects. Different regimens of tadalafil may be prescribed based on patient needs, severity of LUTS/BPH - ED profile, and clinical experience. An integrated approach is necessary to choose for a combined therapy with PDE5i and α-blockers following urological and cardiac counseling in terms of outcomes and adverse effects.
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Affiliation(s)
- Aldo E Calogero
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Giovanni Burgio
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Rosita A Condorelli
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Rossella Cannarella
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Sandro La Vignera
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
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Calogero AE, Burgio G, Condorelli RA, Cannarella R, La Vignera S. Lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction: from physiology to clinical aspects. Aging Male 2018; 21:261-271. [PMID: 29374992 DOI: 10.1080/13685538.2018.1430758] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Erectile dysfunction, prostatic hyperplasia and lower urinary tract symptoms hare important pathogenetic links. Endothelial dysfunction and hormonal alterations represent the main aspects. The present article examines the anatomical, physiological, and pathophysiological characteristics of this association, finalizing the text to an interpretation of the clinical management of these patients based on these functional considerations.
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Affiliation(s)
- Aldo E Calogero
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Giovanni Burgio
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Rosita A Condorelli
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Rossella Cannarella
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
| | - Sandro La Vignera
- a Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico", University of Catania , Catania , Italy
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Guzelsoy M, Aydos MM, Coban S, Turkoglu AR, Acibucu K, Demirci H. Comparison of the effectiveness of IPSS and VPSS without any help in LUTS patients: a prospective study. Aging Male 2018; 21:193-199. [PMID: 29228847 DOI: 10.1080/13685538.2017.1414178] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AIM To compare the correlation of visual prostate symptom score (VPSS) and international prostate symptom score (IPSS). To investigate the effect of educational level and age in the responses to VPSS and IPSS. METHOD Three hundred and nine patients who gave consent and applied via LUTS to our institution were included in this study. They were requested to fill IPSS and VPSS. The patients were divided into two groups as middle-aged and elderly with a cutoff point of 65 years. They were divided into six groups based on educational level. SPSS was used for the statistical evaluation. RESULTS The mean age of the patients was 61.5 ± 8.9 years. The correlation was found between IPSS and VPSS (p < .05). Education was found not to contribute for answering IPSS and VPSS (p = .332 and .138, respectively). No difference was found between the middle-aged and elderly groups in terms of the rates of inability to answer IPSS and VPSS (p = .177 and .681, respectively). CONCLUSIONS There is a correlation between VPSS and IPSS. VPSS can be used as an auxiliary or alternative tool instead of IPSS in evaluating LUTS; however, has no superiority to IPSS in elderly group. Currently, the best option to exclude bias in illiterate group is VPSS.
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Affiliation(s)
- Muhammet Guzelsoy
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Mustafa Murat Aydos
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Soner Coban
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Ali Riza Turkoglu
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Kadir Acibucu
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Hakan Demirci
- b Department of Family Medicine , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
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Kosilov K, Kuzina I, Kuznetsov V, Gainullina Y, Kosilova L, Prokofyeva A, Loparev S. Cognitive functions and health-related quality of life in men with benign prostatic hyperplasia and symptoms of overactive bladder when treated with a combination of tamsulosin and solifenacin in a higher dosage. Aging Male 2018; 21:121-129. [PMID: 29113548 DOI: 10.1080/13685538.2017.1398723] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AIM To study the cognitive functions and health-related quality of life (HRQoL) in individuals taking a combination of tamsulosin and solifenacin in a higher dosage. METHODS All patients (n = 262) were assigned to group A (N = 93, tamsulosin 0.4 mg + solifenacin 10 mg per day), group B (N = 83, tamsulosin 0.4 mg + solifenacin 20 mg), and control group C (N = 86; tamsulosin 0.4 mg + placebo). The lower urinary tract (LUT) condition was assessed on the scales International Prostate Symptom Score, Over Active Bladder Awareness Tool and uroflowmetry. The state of cognitive status was assessed on the scales Mini-mental State Examination, Controlled Oral Word Association Test, Wechsler Adult Intelligence Scale-Revised, Wechsler III, Color Trails Test, California Verbal Learning Test. RESULTS The values of cognitive function indicators in the individuals from all groups after treatment did not significantly differ from the respective values at the baseline (p > .05). The values of most HRQoL parameters of the functional state of the LUT significantly improved in groups A and B. A significant correlation between the state of cognitive status and HRQoL, as well as LUT was absent (r <0.3). CONCLUSION The combination of solifenacin in a double dosage along with tamsulosin can be recommended for elderly benign prostatic hyperplasia patients with overactive bladder symptoms.
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Affiliation(s)
- Kirill Kosilov
- a Department of Social Sciences, School of Humanities , Far Eastern Federal University , Vladivostok , Russian Federation
- b Department of Public Health , Pacific State Medical University , Vladivostok , Russian Federation
| | - Irina Kuzina
- c Department of Social Science , Far Eastern Federal University , Vladivostok , Russian Federation
| | - Vladimir Kuznetsov
- b Department of Public Health , Pacific State Medical University , Vladivostok , Russian Federation
| | - Yuliya Gainullina
- a Department of Social Sciences, School of Humanities , Far Eastern Federal University , Vladivostok , Russian Federation
| | - Liliya Kosilova
- d Department of Functional Diagnostics , Med. Association № 2 of Vladivostok-city , Vladivostok , Russian Federation
| | - Alexandra Prokofyeva
- c Department of Social Science , Far Eastern Federal University , Vladivostok , Russian Federation
| | - Sergey Loparev
- e Department of Urology , City Polyclinic № 3 , Vladivostok , Russian Federation
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Besiroglu H, Ozbek E, Dursun M, Otunctemur A. Visceral adiposity index is associated with benign prostatic enlargement in non-diabetic patients: a cross-sectional study. Aging Male 2018; 21:40-47. [PMID: 28823197 DOI: 10.1080/13685538.2017.1365833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the association between visceral adiposity index (VAI) - a novel indicator for the assessment of visceral adipose tissue and prostate enlargement in non diabetic patients. MATERIAL AND METHODS Four hundred patients who were admitted to the Urology clinic between January and December 2014 with complaints of BPH(benign prostatic hyperplasia )/LUTS(male lower urinary tract symptoms)were enrolled in this cross-sectional study. Patients were divided into two groups according to their prostate volume and international prostate symptom score (IPSS) value. They were compared in terms of age, body mass index (BMI), VAI, prostate volume, PSA, post micturional residual volume (PMRV), uroflowmetry Q max value, triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and fasting blood sugar (FBS). RESULTS Although univariate analyses reveal that age, BMI, waist circumference (WC), FBS, TG, HDL-C level and TG/HDL ratio were correlated with prostate volume, only age [1.125 OR (1.088-1.164), p = .00001], BMI [1.119 OR (1.040-1.204), p = .003], TG [1.043 OR (1.016-1.071), p = .002], HDL-C [0.923 OR (0.860-0.990), p = .025] and VAI [1.194 OR (1.110-1.305), p = .011] were statistically significant in multivariate analysis. A positive correlation was found between VAI value and prostate volume in the Spearman correlation test (r = 0.29, p = .00001). The calculated area under the curve (AUC) for prostate volumes of 30, 40 and 50 ml were 0.680 (0.621-0.738), 0.625 (0.570-0.681) and 0.590 (0.528-0.652), respectively. CONCLUSION Our study revealed a positive correlation between VAI and prostate volume. Our results are needed to be tested with well-designed randomized prospective cohort studies.
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Affiliation(s)
- Huseyin Besiroglu
- a Department of Urology , Catalca Ilyas Cokay State Hospital , Istanbul , Turkey
| | - Emin Ozbek
- b Department of Urology , Istanbul Training and Research Hospital , Istanbul , Turkey
| | - Murat Dursun
- c Department of Urology , Bahcelievler State Hospital , Istanbul , Turkey
| | - Alper Otunctemur
- d Department of Urology , Okmeydani Training and Research Hospital , Istanbul , Turkey
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16
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Fortney L. Erectile Dysfunction. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00063-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Wong CKH, Choi EPH, Chan SWH, Tsu JHL, Fan CW, Chu PSK, Cheung FK, Ma WK, Mah ISF, Yip SKH, Hou SSM, So HS, Lam CK. Use of the International Prostate Symptom Score (IPSS) in Chinese male patients with benign prostatic hyperplasia. Aging Male 2017; 20:241-249. [PMID: 28787255 DOI: 10.1080/13685538.2017.1362380] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To test the psychometric properties of the International Prostate Symptom Score (Hong Kong Chinese version 2) (IPSS) in Chinese male patients with benign prostatic hyperplasia (BPH) under secondary care. METHODS A prospective longitudinal study was done by interviewing subjects at baseline, at 2 week after baseline for assessing test-retest reliability and at 26 week after baseline for assessing responsiveness. All subjects were interviewed to complete a structured questionnaire including IPSS, Short Form-12 Health Survey version 2 (SF-12v2) and Depression Anxiety Stress Scale (DASS). RESULTS The IPSS HRQOL score had weak correlations with SF-12v2 summary and DASS domain scores. For reliability analysis, Cronbach's alpha coefficient was 0.90 for the seven symptom-related items. The intraclass correlation coefficients of the IPSS total symptom score and HRQOL score were 0.90 and 0.86, respectively. For sensitivity, statistically significant differences were detected between the subjects with BPH and those without for IPSS total symptom score (effect size = 0.68) but not the IPSS HRQOL score. The areas under ROC curves for the IPSS total symptom and HRQOL scores were 0.67 and 0.60, respectively. CONCLUSIONS The IPSS was valid, reliable instrument in Chinese patients with BPH. The IPSS total symptom score, but not the HRQOL score, is sensitive in differentiating subgroups.
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Affiliation(s)
- Carlos King-Ho Wong
- a Department of Family Medicine and Primary Care , The University of Hong Kong , Hong Kong
| | | | | | | | - Chi-Wai Fan
- e Department of Surgery , Pamela Youde Nethersole Eastern Hospital , Hong Kong
| | | | - Fu-Keung Cheung
- g Department of Surgery , Princess Margaret Hospital , Hong Kong
| | - Wai-Kit Ma
- d Department of Surgery , Queen Mary Hospital , Hong Kong
| | | | | | | | - Hing-Shing So
- k Department of Surgery , United Christian Hospital , Hong Kong
| | - CindyLo-Kuen Lam
- a Department of Family Medicine and Primary Care , The University of Hong Kong , Hong Kong
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De Nunzio C, Roehrborn CG, Andersson KE, McVary KT. Erectile Dysfunction and Lower Urinary Tract Symptoms. Eur Urol Focus 2017; 3:352-363. [PMID: 29191671 DOI: 10.1016/j.euf.2017.11.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/12/2017] [Accepted: 11/13/2017] [Indexed: 01/10/2023]
Abstract
CONTEXT Lower urinary tract symptoms (LUTSs) and erectile dysfunction (ED) are substantial health concerns with a significant impact on the overall male quality of life. OBJECTIVE To evaluate the available evidence of the association between LUTSs and ED in patients with benign prostatic hyperplasia (BPH), and discuss possible clinical implications for the management of LUTS/BPH. EVIDENCE ACQUISITION A systematic review of the existing literature published between 1997 and June 2017 and available in the Medline, Scopus, and Web of Science databases was conducted using both the Medical Subject Heading (MeSH) and free-text protocols. The MeSH search was conducted by combining the following terms: "lower urinary tract symptoms," "LUTS," "benign prostatic hyperplasia," "BPH," "erectile dysfunction," "sexual dysfunction," "BPE," and "benign prostatic enlargement." The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. EVIDENCE SYNTHESIS Several community-based studies in different geographical areas have provided strong evidence of an age-independent association between LUTSs and ED. Several biological mechanisms have been proposed to explain this association, but further research is required to better understand the molecular pathways involved. It is necessary to evaluate the possible impact of the metabolic syndrome treatment on LUTS/ED management. Considering the possible relationship between LUTSs and ED, their impact on the quality of life, and the possible adverse effects associated with LUTS medical treatment, clinicians should always evaluate ED in patients with LUTSs and take the opportunity to evaluate patients reporting ED for LUTSs. CONCLUSIONS Data from the peer-reviewed literature suggest the existence of an association between LUTS/BPH and ED, although their casual relationship has not been established yet. Emerging data also suggest that pathophysiological mechanisms involved in the metabolic syndrome are key factors in both disorders. Considering the association, it is also recommended that men presenting with LUTSs or ED should be evaluated for both disorders. A better understanding of the molecular pathways behind this association may also help identify new possible targets and develop novel therapeutic approaches to manage LUTSs and ED. PATIENT SUMMARY In this manuscript, we report on all the available evidence linking erectile dysfunction and lower urinary tract symptoms. Our findings suggest the existence of a strong relationship between these two conditions. On the basis of these findings, we recommend that clinicians always explore both conditions in male patients presenting with either of symptoms.
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Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, "La Sapienza" University, Roma, Italy.
| | - Claus G Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Kevin T McVary
- Southern Illinois University School of Medicine, Springfield, IL, USA
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Qian X, Liu H, Xu D, Xu L, Huang F, He W, Qi J, Zhu Y, Xu D. Functional outcomes and complications following B-TURP versus HoLEP for the treatment of benign prostatic hyperplasia: a review of the literature and Meta-analysis. Aging Male 2017; 20:184-191. [PMID: 28368238 DOI: 10.1080/13685538.2017.1295436] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To conduct a systematic review and Meta-analysis of the literature on the efficacy and safety of B-TURP versus HoLEP for the treatment of benign prostatic hyperplasia (BPH) in terms of demographic and clinical baseline characteristics, peri-operative variables, and postoperative outcomes and complications. METHODS Trials comparing B-TURP and HoLEP were identified systematically using Pubmed, Embase, CNKI, Web of Science and the Cochrane Library. Primary outcomes were the peak urinary flow rate (Qmax), post-void residual volume (PVR) and international prostate symptom score (IPSS). Secondary outcomes were operation time, irrigation duration, catheterization duration, resected tissue and complications. RESULTS Four trials assessing B-TURP and HoLEP were considered eligible for Meta-analysis, including three randomized controlled trials (RCTs) and one retrospective study. There was no statistically significant difference between B-TURP and HoLEP in terms of Qmax, IPSS, PVR at 3-6 months follow-up, operation duration, catheterization duration, resected tissue and complications (p > 0.05). HoLEP was associated with a significantly shorter irrigation time as compared with B-TURP (p < 0.05). CONCLUSION Both B-TURP and HoLEP are safe and minimally invasive techniques that are similar in terms of symptomatic relief, although these findings need further validation in larger RCTs involving larger numbers of patients and over a longer follow-up duration for B-TURP or HoLEP before a new gold standard procedure emerges for surgical treatment of BPH.
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Affiliation(s)
- Xiaoqiang Qian
- a Urology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China and
| | - Hailong Liu
- b Urology Department, Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Ding Xu
- b Urology Department, Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Le Xu
- a Urology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China and
| | - Fang Huang
- a Urology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China and
| | - Wei He
- a Urology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China and
| | - Jun Qi
- b Urology Department, Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Yu Zhu
- a Urology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China and
| | - Danfeng Xu
- a Urology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China and
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Alcántara Montero A, Brenes Bermúdez F. Relación entre el síndrome metabólico y los síntomas del tracto urinario inferior en el varón. Semergen 2016; 42:e171-e173. [DOI: 10.1016/j.semerg.2015.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 11/08/2015] [Indexed: 10/22/2022]
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21
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Wang JY, Fu YY, Kang DY. The Association Between Metabolic Syndrome and Characteristics of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2016; 95:e3243. [PMID: 27175628 PMCID: PMC4902470 DOI: 10.1097/md.0000000000003243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The purpose of this systematic review was to examine the association of metabolic syndrome (MS) with measures of benign prostatic hyperplasia (BPH) including prostate growth rate, prostate volume, International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA) level, and maximal flow rate.Medline, Cochrane CENTRAL, EMBASE, CBM, and Google Scholar databases were searched until March 23, 2015 using combinations of the keywords benign prostate hyperplasia/BPH, metabolic syndrome, total prostate volume, prostate growth rate, prostate specific antigen, International Prostate Symptom Score/IPSS, maximal flow rate. Cohort or case-control studies of patients with BPH and MS that reported quantitative outcomes were included. The pooled mean differences of the outcome measures were compared between patients with and without MS.A total of 158 potentially relevant studies were identified, and 8 were included in the meta-analysis. The 8 studies included in the meta-analysis contained a total of 3093 BPH patients, wherein 1241 had MS and 1852 did not have MS. BPH patients with MS had a significantly higher prostate growth rate (pooled mean difference = 0.67 mL/y, P < 0.001) and larger prostate volume (pooled mean difference = 6.8 mL, P = 0.010) than the BPH patients without MS. There was no significant difference in IPSS score (pooled mean difference = 1.58, P = 0.202) or maximal flow rate (pooled mean difference = -1.41 mL/s, P = .345) between BPH patients with and without MS. A borderline nonsignificant difference in PSA (pooled mean difference = 0.24 ng/mL, P = 0.056) was noted between BPH patients with and without MS.The results of this meta-analysis are consistent with literature indicating that BPH patients with MS have a higher prostate growth rate and larger prostate volume than those without MS; however, further study is necessary to determine the association of BPH and metabolic disorder elements and the potential risk of disease progression in BPH patients with MS.
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Affiliation(s)
- Jian-Ye Wang
- From the Department of Urology, Beijing Hospital, Ministry of Health (J-YW); MSD China, Medical Affairs Department, Beijing Office, Beijing (Y-YF); and Department of Evidence Based Medicine and Clinical Epidemiology (D-YK); West China Hospital, Sichuan University, Chengdu China (D-Y K)
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Maharajh S, Abdel Goad EH, Ramklass SS, Conradie MC. Lower urinary tract symptoms (LUTS) in males: a review of pathophysiology. S Afr Fam Pract (2004) 2015. [DOI: 10.1080/20786190.2014.983307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Russo GI, Cimino S, Morgia G. Benign prostatic hyperplasia and metabolic syndrome: the expanding evidences of a new disease of aging male. Aging Male 2015; 18:133-4. [PMID: 26030349 DOI: 10.3109/13685538.2015.1028353] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Association of Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia Measures With International Index of Erectile Function 5 in Middle-aged Policemen of Korea and the Role of Metabolic Syndrome and Testosterone in Their Relationship. Urology 2013; 82:1008-12. [DOI: 10.1016/j.urology.2013.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 06/28/2013] [Accepted: 07/01/2013] [Indexed: 11/20/2022]
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Matsumoto S, Matsuda M, Takekawa M, Okada M, Hashizume K, Wada N, Hori J, Tamaki G, Kita M, Iwata T, Kakizaki H. Association of ED with chronic periodontal disease. Int J Impot Res 2013; 26:13-5. [DOI: 10.1038/ijir.2013.30] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 04/10/2013] [Accepted: 06/04/2013] [Indexed: 11/09/2022]
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Fortney L. Erectile Dysfunction. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00044-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Current world literature. Curr Opin Urol 2011; 21:535-40. [PMID: 21975510 DOI: 10.1097/mou.0b013e32834c87d0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Martínez-Salamanca JI, Carballido J, Eardley I, Giuliano F, Gratzke C, Rosen R, Salonia A, Stief C. Phosphodiesterase type 5 inhibitors in the management of non-neurogenic male lower urinary tract symptoms: critical analysis of current evidence. Eur Urol 2011; 60:527-35. [PMID: 21684677 DOI: 10.1016/j.eururo.2011.05.054] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 05/30/2011] [Indexed: 11/15/2022]
Abstract
CONTEXT A large body of epidemiologic data suggests a causal relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Recently reported studies on phosphodiesterase type 5 inhibitors (PDE5-Is) and LUTS have further contributed to the understanding of mechanisms involved in this relationship and of potential treatment options. OBJECTIVE A nonsystematic descriptive review was performed to summarize the literature concerning the role of PDE5-Is in men with LUTS, particularly looking at data derived from clinical trials in relation to the different PDE5-Is or their association with α-blockers. EVIDENCE ACQUISITION A comprehensive electronic search was conducted in October 2010 using the Medline database to identify all publications relating to ED and BPH and treatment with sildenafil, vardenafil, tadalafil, udenafil, UK-369003, and combination therapy with alfuzosin and tamsulosin. EVIDENCE SYNTHESIS In studies in which either ED or LUTS was the entry criterion, sildenafil appears to improve both erectile function and LUTS in subjects with ED. Placebo-controlled trials of tadalafil and vardenafil showed improvement of LUTS secondary to benign prostatic hyperplasia (BPH), but none of the studies showed a significant effect on urodynamic measures. Exploratory studies with UK-369003 showed improvements in LUTS and ED. Sildenafil or tadalafil associated with alfuzosin or tamsulosin showed greater benefits for the combination therapy for both LUTS and ED. The coadministration of udenafil and an α-blocker in patients with BPH and ED also appeared to improve both LUTS and ED severity. CONCLUSIONS Consistent evidence of improvements in LUTS has been shown with PDE5-Is, either alone or in combination with α-blockers. However, effects on urodynamics or objective measures of urinary flow are lacking. Further areas of research include investigation of mechanism of PDE5-Is, urodynamic studies, identification of new efficacy end points, head-to-head comparison with standard of care, potential benefit of add-on treatment, and long-term outcomes.
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Affiliation(s)
- Juan I Martínez-Salamanca
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain.
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