1
|
Sugai K, Sasaki J, Wada Y, Shimizu N, Ishikawa T, Yanagi K, Hashimoto T, Tanaka A, Suwanai H, Suzuki R, Odawara M. Predictive patterns of lower urinary tract symptoms and bacteriuria in adults with type 2 diabetes. Diabetol Int 2024; 15:253-261. [PMID: 38524941 PMCID: PMC10959893 DOI: 10.1007/s13340-023-00687-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/11/2023] [Indexed: 03/26/2024]
Abstract
Background Numerous studies demonstrated the risk factors for urological complications in patients with diabetes before sodium-glucose co-transporter 2 inhibitor (SGLT2i) became commercially available. This study aimed to comprehensively investigate urological characteristics in patients with type 2 diabetes (T2DM) after SGLT2i became commercially available. Methods We examined 63 outpatients with T2DM suspected of bacteriuria based on urinary sediment examinations. Urine cultures were performed, and lower urinary tract symptoms (LUTS) were assessed via questionnaires. Patients with bacteriuria were assessed using ultrasonography to measure post-void residual volume (PVR). Utilizing demographic and laboratory data, a random forest algorithm predicted LUTS, bacteriuria, and symptomatic bacteriuria (SB). Results Thirty-two patients had LUTS and 31 had bacteriuria. High-density lipoprotein cholesterol level was crucial in predicting LUTS, while age was crucial in predicting bacteriuria. In predicting SB among patients with bacteriuria, creatinine level and estimated glomerular filtration rate were crucial. Our models had high predictive accuracy for LUTS (area under the curve [AUC] = 0.846), followed by bacteriuria (AUC = 0.770) and SB (AUC = 0.938) in receiver operating characteristic curve analysis. These predictors were previously reported as risk factors for urological complications. Although SGLT2i use was not an important predictor in our study, all SGLT2i users with bacteriuria had SB and exhibited higher PVR compared to non-SGLT2i users with bacteriuria. Conclusion This study's random forest model highlighted distinct essential predictors for each urological condition. The predictors were consistent before and after SGLT2i became commercially available. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-023-00687-1.
Collapse
Affiliation(s)
- Keiji Sugai
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Junko Sasaki
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Yuki Wada
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Norihiro Shimizu
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Takuya Ishikawa
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Ketchu Yanagi
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Takeshi Hashimoto
- Department of Urology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Akihiko Tanaka
- Department of General Internal Medicine, Toda Chuo General Hospital, 1-19-3 Honcho, Toda, Saitama 335-0023 Japan
| | - Hirotsugu Suwanai
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Ryo Suzuki
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| | - Masato Odawara
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023 Japan
| |
Collapse
|
2
|
Mohammed MEA, Alshahrani S, Zaman G, Alelyani M, Hadadi I, Musa M. Lipid profile, random blood glucose and carotid arteries thickness in human male subjects with different ages and body mass indexes. Aging Male 2020; 23:1409-1415. [PMID: 32508180 DOI: 10.1080/13685538.2020.1773424] [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: 10/24/2022] Open
Abstract
OBJECTIVE This article investigated the effect of age and body mass index of male humans on the carotid arteries intima media thickness (IMT) and the blood concentration of glucose, triglycerides, total cholesterol and HDL cholesterol. METHODS Thirty seven normal male human subjects participated in this study. The participants were classified to three groups depending on their age; 20-29 (11), 30-39 (14) and 40-49 (12). Also, the study subjects were divided to three groups according to their body mass index; normal (13), overweight (13) and obese (11). The Anova test was used for the statistical analysis of the obtained results. RESULTS The body mass index significantly affected the blood glucose concentration while its effect on all the other parameters was insignificant. The age significantly affected all the studied parameters except the blood glucose, triglycerides and HDL cholesterol. The total cholesterol/HDL ratio was significantly affected by the age and insignificantly by the body mass index. CONCLUSIONS The age was more effective on the studied parameters than the body mass index. Worsening of the lipid profile was seen in the overweight participants rather than the obese ones.
Collapse
Affiliation(s)
| | - Safar Alshahrani
- Family & Community Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Gaffar Zaman
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Magbool Alelyani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ibrahim Hadadi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mustafa Musa
- Department of Radiology, College of Applied Medical Sciences, Jeddah University, Jeddah, Saudi Arabia
| |
Collapse
|
3
|
Onmez A, Gokosmanoglu F, Baycelebi G, Arıkan AA. Carotid Doppler ultrasonographic findings of dapagliflozin use in type 2 diabetic patients. Aging Male 2020; 23:1246-1250. [PMID: 32342718 DOI: 10.1080/13685538.2020.1758657] [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: 12/28/2022] Open
Abstract
AIM Sodium-glucose cotransporter 2 inhibitors have been shown to reduce the risk of cardiovascular disease in type 2 diabetes (T2DM) patients. The purpose of this study was to evaluate cardiovascular disease risk indirectly through Doppler ultrasonography (USG) of carotid artery vascular markers in T2DM patients using dapagliflozin. METHODS One hundred forty-five patients presenting to our clinic between March 2016 and June 2018 and diagnosed with T2DM were included in the study. These were divided into two groups - a dapagliflozin group of 85 patients and a 60-member non-dapagliflozin control group. Common carotid artery end-diastolic velocity (EDV), peak systolic velocity (PSV), and resistive index (RI) parameters were evaluated using Doppler USG in both groups. RESULTS The mean duration of follow-up was 2.2 ± 0.4 years. Mean ages were 45 ± 14 years in the dapagliflozin group and 42 ± 15 in the control group. Mean HbA1c was 7.4 ± 1.6 in the dapagliflozin group and 7.3 ± 2.1 in the control group. Common carotid artery, PSV, and EDV parameters were higher (p = .012/p = .036), while RI was lower (p ˂ .001), in the dapagliflozin group than in the control group. CONCLUSION Vascular resistance was lower in the group using dapagliflozin for diabetes management.
Collapse
Affiliation(s)
- Attila Onmez
- Department of Internal Medicine, Medical Faculty, Duzce University, Duzce, Turkey
| | | | - Gulsah Baycelebi
- Department of Internal Medicine, Atasam Hospital, Samsun, Turkey
| | - Ali Ahmet Arıkan
- Department of Cardiovascular Surgery, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| |
Collapse
|
4
|
Schimit GTF, Gregorio EP, Averbeck MA, de Souza MJ, da Silva ACM, Tavares DR, de Almeida SHM. Is There a Link Between Carotid Atherosclerosis and Idiopathic Overactive Bladder Among Women with Metabolic Syndrome? Res Rep Urol 2020; 12:43-48. [PMID: 32110552 PMCID: PMC7036978 DOI: 10.2147/rru.s244758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/11/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the association between increased intima-media thickness (IMT) and atherosclerotic carotid plaque (CP) with idiopathic overactive bladder syndrome (OAB) in women with metabolic syndrome (MetS). Methods This is a cross-sectional study, which included consecutive women aged 40–75 years with MetS, seeking medical assistance at a reference center between April and December 2016. OAB-V8 questionnaire was used to estimate the prevalence of OAB symptoms, which were defined by a score ≥8 points. All patients underwent bilateral carotid artery ultrasound to assess IMT and CP. Atherosclerosis was defined by the identification of CP during ultrasound, which was diagnosed according to the Mannheim carotid intima-media thickness and plaque consensus. Results Forty-five women were prospectively included. Mean age was 60±9.3 years (range 40–75 ys). Eighteen (40%) patients were diagnosed with OAB. IMT in the general population was 0.72 mm (SD = 0.20). Overall prevalence of atherosclerosis, defined by the presence of the carotid artery plaque, was 51%. OAB prevalence among women with atherosclerosis was higher than in those without atherosclerosis (56.52% versus 22.73%), with a prevalence ratio of 2.49 (p=0.04). Additionally, OAB was associated with degree of carotid stenosis (p = 0.029). Conclusion In this cohort of female patients with MetS, there was an association between carotid atherosclerosis and OAB. Identification of carotid ultrasound abnormalities may lead to refined treatment decision-making among OAB patients.
Collapse
|
5
|
Inamura S, Ito H, Shinagawa T, Tsutsumiuchi M, Taga M, Tsuchiyama K, Kobayashi M, Yokoyama O. Serum C‐reactive protein level is not associated with prostatic inflammation but with overactive detrusor in patients with benign prostatic hyperplasia. Neurourol Urodyn 2019; 38:1728-1736. [DOI: 10.1002/nau.24051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/24/2019] [Accepted: 05/14/2019] [Indexed: 11/12/2022]
Affiliation(s)
- So Inamura
- Department of Urology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
- Department of Tumor Pathology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| | - Hideaki Ito
- Department of Urology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| | - Tomochika Shinagawa
- Department of Urology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
- Department of Tumor Pathology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| | - Manami Tsutsumiuchi
- Department of Urology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
- Department of Tumor Pathology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| | - Minekatsu Taga
- Department of Urology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
- Department of Tumor Pathology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| | - Katsuki Tsuchiyama
- Department of Urology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| | - Motohiro Kobayashi
- Department of Tumor Pathology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| | - Osamu Yokoyama
- Department of Urology, Faculty of Medical SciencesUniversity of FukuiEiheiji Japan
| |
Collapse
|
6
|
Koguchi T, Haga N, Matsuoka K, Yabe M, Hoshi S, Ogawa S, Kataoka M, Akaihata H, Sato Y, Hata J, Ishibashi K, Kojima Y. Atherosclerosis as a predictor of transient exacerbation of overactive bladder symptoms after robot-assisted laparoscopic radical prostatectomy. Int J Urol 2018; 26:234-240. [PMID: 30417567 DOI: 10.1111/iju.13848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 10/11/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess whether atherosclerosis is involved in the development of overactive bladder and the function of lower urinary tract after robot-assisted radical prostatectomy. METHODS The present cohort consisted of 80 consecutive participants. The preoperative cardio-ankle vascular index was used to evaluate the presence of atherosclerosis. The present cohort was split into two groups, the atherosclerotic group, whose cardio-ankle vascular index was ≥9.0, and the control group, whose index was <9.0. The overactive bladder symptom score and lower urinary tract function were compared for 12 months after surgery. RESULTS The total score of the questionnaire was significantly higher at 6 and 9 months after surgery in the atherosclerosis group (P = 0.04, P = 0.03, respectively). Both the urgency and urgency incontinence subscores of the questionnaire showed a parallel tendency to that of the total score after surgery. At 3 months after surgery, there was a significant increase in the prevalence of de novo overactive bladder in the atherosclerosis group (P = 0.04). At 9 and 12 months after surgery, there was a significant decrease of voided volume in the atherosclerotic group (P < 0.01, P = 0.04, respectively). CONCLUSIONS Atherosclerosis delays the improvement in both overactive bladder symptoms and storage function postoperatively, and it is involved in the transient increase in the prevalence of de novo overactive bladder. Atherosclerosis might be a predictor of the development of overactive bladder after robot-assisted radical prostatectomy.
Collapse
Affiliation(s)
- Tomoyuki Koguchi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobuhiro Haga
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Matsuoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Michihiro Yabe
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Hoshi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Soichiro Ogawa
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masao Kataoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hidenori Akaihata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuichi Sato
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junya Hata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ishibashi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| |
Collapse
|
7
|
Haga N, Akaihata H, Hata J, Aikawa K, Yanagida T, Matsuoka K, Koguchi T, Hoshi S, Ogawa S, Kataoka M, Sato Y, Ishibashi K, Suzuki O, Hashimoto Y, Kojima Y. The association between local atherosclerosis of the prostatic artery and benign prostatic enlargement in humans: Putative mechanism of chronic ischemia for prostatic enlargement. Prostate 2018; 78:1001-1012. [PMID: 29786870 DOI: 10.1002/pros.23658] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/07/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND To investigate the possible pathogenesis of the benign prostatic enlargement (BPE) induced by local atherosclerosis, the association between local atherosclerosis and prostatic enlargement was investigated, and molecular biological analyses were performed using human prostatectomy specimens. METHODS A total of 69 consecutive patients who underwent robot-assisted radical prostatectomy (RARP) participated in this prospective study. To evaluate actual local atherosclerosis, prostatic arteries were removed during RARP. Microscopic assessment of local atherosclerosis was classified as one of three degrees of narrowing (minimal, moderate, and severe) according to the degree of obstruction of the inner cavity of the prostatic artery. The expressions of several mediators related to chronic ischemia and cell proliferation of the prostate were investigated by immunohistochemistry. RESULTS The median age of the present cohort was 68 (range: 55-75) years. Although there was no relationship between local atherosclerosis and lower urinary symptoms evaluated by questionnaires, local atherosclerosis was significantly more severe in patients who had a history of treatment for benign prostatic hyperplasia (P = 0.02). Prostate size was significantly larger in the severe local atherosclerosis group than in the minimal and moderate local atherosclerosis groups (P < 0.001 and P = 0.03, respectively). Thepositive expression rates of hypoxia-inducible factor (HIF)-1α, malondialdehyde (MDA), transforming growth factor (TGF)-β1 , and basic fibroblast growth factor (bFGF) in the prostate were significantly higher in patients with local atherosclerosis than in patients without local atherosclerosis (all P < 0.01, respectively). CONCLUSIONS In human surgical specimens, there is evidence that local atherosclerosis of the prostatic artery is significantly associated with prostate size. Given the molecular evidence provided in this study, the putative mechanism for this relationship is that chronic ischemia induced upregulation of oxidative stress pathways, leading to BPE.
Collapse
Affiliation(s)
- Nobuhiro Haga
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hidenori Akaihata
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junya Hata
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ken Aikawa
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomohiko Yanagida
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Matsuoka
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyuki Koguchi
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Hoshi
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Soichiro Ogawa
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masao Kataoka
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuichi Sato
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ishibashi
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Osamu Suzuki
- Departments of Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuko Hashimoto
- Departments of Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiyuki Kojima
- Departments of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| |
Collapse
|
8
|
Haga N, Takinami R, Tanji R, Onagi A, Matsuoka K, Koguchi T, Akaihata H, Hata J, Ogawa S, Kataoka M, Sato Y, Ishibashi K, Aikawa K, Kojima Y. Comprehensive approach for post-prostatectomy incontinence in the era of robot-assisted radical prostatectomy. Fukushima J Med Sci 2017; 63:46-56. [PMID: 28747618 DOI: 10.5387/fms.2017-15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Robot-assisted radical prostatectomy (RARP) has enabled steady and stable surgical procedures due to both meticulous maneuvers and magnified, clear, 3-dimensional vision. Therefore, better surgical outcomes have been expected with RARP than with other surgical modalities. However, even in the RARP era, post-prostatectomy incontinence has a relatively high incidence as a bothersome complication. To overcome post-prostatectomy incontinence, it goes without saying that meticulous surgical procedures and creative surgical procedures, i.e., "Preservation", "Reconstruction", and "Reinforcement" of the anatomical structures of the pelvis, are most important. In addition, medication and appropriate pad usage might sometimes be helpful for patients with post-prostatectomy incontinence. However, patients who have 1) BMI > 26 kg/m2, 2) prostate volume > 70 mL, 3) eGFR < 60 mL/min, or a 4) Charlson comorbidity index > 2 have a tendency to develop post-prostatectomy incontinence despite undergoing the same surgical procedures. It is important for patients who have a high risk for post-prostatectomy incontinence to be given information about delayed recovery of post-prostatectomy incontinence. Thus, not only the surgical procedures, but also a comprehensive approach, as mentioned above, are important for post-prostatectomy incontinence.
Collapse
Affiliation(s)
- Nobuhiro Haga
- Department of Urology, Fukushima Medical University School of Medicine
| | - Ruriko Takinami
- Department of Urology, Fukushima Medical University School of Medicine
| | - Ryo Tanji
- Department of Urology, Fukushima Medical University School of Medicine
| | - Akifumi Onagi
- Department of Urology, Fukushima Medical University School of Medicine
| | - Kanako Matsuoka
- Department of Urology, Fukushima Medical University School of Medicine
| | - Tomoyuki Koguchi
- Department of Urology, Fukushima Medical University School of Medicine
| | - Hidenori Akaihata
- Department of Urology, Fukushima Medical University School of Medicine
| | - Junya Hata
- Department of Urology, Fukushima Medical University School of Medicine
| | - Soichiro Ogawa
- Department of Urology, Fukushima Medical University School of Medicine
| | - Masao Kataoka
- Department of Urology, Fukushima Medical University School of Medicine
| | - Yuichi Sato
- Department of Urology, Fukushima Medical University School of Medicine
| | - Kei Ishibashi
- Department of Urology, Fukushima Medical University School of Medicine
| | - Ken Aikawa
- Department of Urology, Fukushima Medical University School of Medicine
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine
| |
Collapse
|
9
|
Tsujimura A, Hiramatsu I, Aoki Y, Shimoyama H, Mizuno T, Nozaki T, Shirai M, Kobayashi K, Kumamoto Y, Horie S. Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men. Prostate Int 2017; 5:65-69. [PMID: 28593169 PMCID: PMC5448724 DOI: 10.1016/j.prnil.2017.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/06/2017] [Accepted: 01/09/2017] [Indexed: 01/09/2023] Open
Abstract
Background Atherosclerosis is a systematic disease in which plaque builds up inside the arteries that can lead to serious problems related to quality of life (QOL). Lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and late-onset hypogonadism (LOH) are highly prevalent in aging men and are significantly associated with a reduced QOL. However, few questionnaire-based studies have fully examined the relation between atherosclerosis and several urological symptoms. Materials and methods The study comprised 303 outpatients who visited our clinic with symptoms of LOH. Several factors influencing atherosclerosis, including serum concentrations of triglyceride, fasting blood sugar, and total testosterone measured by radioimmunoassay, were investigated. We also measured brachial-ankle pulse wave velocity (baPWV) and assessed symptoms by specific questionnaires, including the Sexual Health Inventory for Men (SHIM), Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), QOL index, and Aging Male Symptoms rating scale (AMS). Stepwise associations between the ratio of measured/age standard baPWV and clinical factors including laboratory data and the scores of the questionnaires were compared using the Jonckheere–Terpstra test for trend. The associations between the ratio of measured/age standard baPWV and each IPSS score were assessed in a multivariate linear regression model after adjustment for serum triglyceride, fasting blood sugar, and total testosterone. Results Regarding ED, a higher level of the ratio of measured/age standard baPWV was associated with a lower EHS, whereas no association was found with SHIM. Regarding LUTS, a higher ratio of measured/age standard baPWV was associated with a higher IPSS and QOL index. However, there was no statistically significant difference between the ratio of measured/age standard baPWV and AMS. A multivariate linear regression model showed only nocturia to be associated with the ratio of measured/age standard baPWV for each IPSS score. Conclusion Atherosclerosis is associated with erectile function and LUTS, especially nocturia.
Collapse
Affiliation(s)
- Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.,Men's Health Clinic Tokyo, Marunouchi Chiyoda-ku, Tokyo, Japan
| | - Ippei Hiramatsu
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.,Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Aoki
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.,Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Shimoyama
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.,Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taiki Mizuno
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Taiji Nozaki
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Masato Shirai
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | | | | | - Shigeo Horie
- Men's Health Clinic Tokyo, Marunouchi Chiyoda-ku, Tokyo, Japan.,Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
10
|
Yabe M, Haga N, Ogawa S, Kataoka M, Akaihata H, Sato Y, Hata J, Ishibashi K, Kojima Y. Atherosclerosis as a predictor of delayed recovery from lower urinary tract dysfunction after robot-assisted laparoscopic radical prostatectomy. Neurourol Urodyn 2015; 35:920-925. [PMID: 26297155 DOI: 10.1002/nau.22824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/16/2015] [Indexed: 11/10/2022]
Abstract
AIMS The aim of the present study was to investigate whether atherosclerosis could be associated with lower urinary tract dysfunction in the early postoperative period after robot-assisted laparoscopic radical prostatectomy (RARP). METHODS Eighty consecutive patients undergoing RARP were investigated. The severity of atherosclerosis was evaluated by the cardio-ankle vascular index (CAVI) before RARP. Patients were divided into two groups, the atherosclerotic group (CAVI ≥9.0) and the control group (CAVI <9.0). International Prostate Symptom Score (IPSS), quality of life (QOL) index, uroflowmetry, post-void residual urine volume (PVR), frequency-volume charts, and the 1-hr pad test were compared between the two groups. Assessments were performed before RARP, and then at 1, 3, and 6 months after RARP. RESULTS Preoperative subjective and objective parameters were not significantly different between the two groups. The voiding symptom score of the IPSS and the QOL index was significantly higher in the atherosclerotic group at 3 months after RARP (P = 0.035, P = 0.001, respectively). The maximum flow rate was consistently lower in the atherosclerotic group, reaching a significant difference at 6 months after RARP (P = 0.027). IPSS total and storage symptom scores, PVR, frequency, and urine loss were not significantly different between the groups after RARP. CONCLUSIONS Atherosclerosis delayed the improvement of both voiding symptoms and voiding function after RARP, leading to aggravation of QOL in the early postoperative period. Atherosclerosis may be a predictor of slower recovery from transient lower urinary tract dysfunction immediately after RARP. Neurourol. Urodynam. 35:920-925, 2016. © 2015 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Michihiro Yabe
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobuhiro Haga
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Soichiro Ogawa
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masao Kataoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hidenori Akaihata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuichi Sato
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junya Hata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ishibashi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| |
Collapse
|
11
|
Associations of carotid artery plaque with lower urinary tract symptoms and erectile dysfunction. Int Urol Nephrol 2014; 46:2263-70. [DOI: 10.1007/s11255-014-0830-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
|