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Ly OD, Monaghan TF, Chartier-Kastler E, Petrovic M, Goessaert AS, Everaert K, Robain G, Haddad R. Association between frailty and detrusor overactivity with detrusor underactivity in older women. Neurourol Urodyn 2024; 43:1075-1082. [PMID: 38289326 DOI: 10.1002/nau.25381] [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: 10/02/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 02/01/2024]
Abstract
PURPOSE While detrusor overactivity (DO) with detrusor underactivity (DU) (DO-DU) has been described as typical of aging, the pathogenesis of DO-DU is highly multifactorial, and often thought to involve medical conditions beyond the urinary tract. We aimed to explore potential associations between idiopathic DO-DU and frailty in older women after accounting for age. METHODS The design of the study is a cross-sectional single-center study, in an outpatient urodynamic unit specializing in geriatrics. Participants are consecutive female patients aged ≥65 years without contributory neurological conditions or bladder outlet obstruction who completed a comprehensive geriatric assessment followed by urodynamic evaluation from 2015 to 2019. Participants were categorized as having DO, DU, combined DO-DU, or a negative study. Multinomial logistic regression analysis was used to assess the relationship between urodynamic outcomes and frailty, as quantified using the Frailty index (FI). RESULTS Ninety-five patients were included (median age 78 [interquartile range: 70-83] years), among whom 29% had combined DO-DU. The median FI score was 0.27 (0.2-0.32) (5-12). A higher FI was associated with significantly greater age-adjusted odds of DO-DU when either DU or subjects with a negative urodynamic assessment were used as the reference group. Age was not significantly associated with DO-DU across all multivariable analyses. CONCLUSION A higher FI was associated with an increased likelihood of DO-DU, which could not be attributed to the effect of age alone. The pathogenesis of DO-DU is likely more complex than chronological aging in and of itself and merits further study.
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Affiliation(s)
- Ong Damien Ly
- GRC 001 GREEN Neuro-Urology Research Group, Sorbonne Université, Rothschild Academic Hospital, AP-HP, Paris, France
| | - Thomas F Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - An-Sofie Goessaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Gilberte Robain
- GRC 001 GREEN Neuro-Urology Research Group, Sorbonne Université, Rothschild Academic Hospital, AP-HP, Paris, France
| | - Rebecca Haddad
- GRC 001 GREEN Neuro-Urology Research Group, Sorbonne Université, Rothschild Academic Hospital, AP-HP, Paris, France
- Department of Urology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Alcaraz A, Gacci M, Ficarra V, Medina-Polo J, Salonia A, Fernández-Gómez JM, Ciudin A, Castro-Díaz D, Rodríguez-Antolín A, Carballido-Rodríguez J, Cózar-Olmo JM, Búcar-Terrades S, Pérez-León N, Brenes-Bermúdez FJ, Molero-García JM, Ledesma AFP, Herdman M, Manasanch J, Angulo JC, Group OBOTQUALIPROSTS. Efficacy and Safety of the Hexanic Extract of Serenoa repens vs. Watchful Waiting in Men with Moderate to Severe LUTS-BPH: Results of a Paired Matched Clinical Study. J Clin Med 2022; 11:jcm11040967. [PMID: 35207238 PMCID: PMC8878824 DOI: 10.3390/jcm11040967] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/24/2022] [Accepted: 02/09/2022] [Indexed: 02/01/2023] Open
Abstract
We investigated changes in symptoms and quality of life (QoL) in men with moderate-to-severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) receiving the hexanic extract of Serenoa repens (HESr) and compared results with a matched group on watchful waiting (WW). Data was from a real-world, open-label, prospective, multicenter study. This sub-group analysis included patients with moderate-to-severe symptoms receiving either the HESr 320 mg/daily for six months (HESr) or who remained untreated for LUTS/BPH (WW). Changes in urinary symptoms and QoL were measured by IPSS and BII questionnaires. Two statistical approaches (iterative matching and propensity score pairing) were used to maximize between-group comparability at baseline. Tolerability was assessed in the HESr group. After iterative matching, data for analysis was available for 783 patients (102 WW, 681 HESr). IPSS scores improved by a mean (SD) of 3.8 (4.4) points in the HESr group and by 2.2 (4.5) points in the WW group (p = 0.002). Changes in BII score were 1.8 (2.4) points and 1.0 (2.2) points, respectively (p < 0.001). Three patients (0.9%) treated with the HESr reported mild adverse effects. Moderate-severe LUTS/BPH patients treated for six months with the HESr showed greater improvements in symptoms and QoL than matched patients on WW, with a very low rate of adverse effects.
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Affiliation(s)
- Antonio Alcaraz
- Urology Department, Hospital Clínic, Universitat de Barcelona, IDIBAPS, 08036 Barcelona, Spain;
| | - Mauro Gacci
- Unit of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy;
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Vincenzo Ficarra
- Department of Human and Pediatric Pathology “Gaetano Barresi”, Urology Section, University of Messina, 98125 Messina, Italy;
| | - José Medina-Polo
- Urology Department, Research Institute Hospital 12 de Octubre (i+12), 28041 Madrid, Spain; (J.M.-P.); (A.R.-A.)
- Urology Unit, HM Hospital, 28050 Madrid, Spain
- ROC Clinic, 28010 Madrid, Spain
| | - Andrea Salonia
- Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, 20132 Milan, Italy;
- Unit of Urology, URI, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | | | | | - David Castro-Díaz
- Urology Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain;
| | - Alfredo Rodríguez-Antolín
- Urology Department, Research Institute Hospital 12 de Octubre (i+12), 28041 Madrid, Spain; (J.M.-P.); (A.R.-A.)
| | | | - José M. Cózar-Olmo
- Urology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | | | | | | | | | | | - Michael Herdman
- Insight Consulting and Research, 08301 Mataró, Spain;
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | | | - Javier C. Angulo
- Clinical Department, Universidad Europea de Madrid, 28905 Getafe, Spain
- Urology Department, Hospital Universitario de Getafe, 28905 Getafe, Spain
- Correspondence: ; Tel.: +34-699-497-569
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Bensley JG, Dhillon HM, Evans SM, Evans M, Bolton D, Davis ID, Dodds L, Frydenberg M, Kearns P, Lawrentschuk N, Murphy DG, Millar JL, Papa N. Self-reported lack of energy or feeling depressed 12 months after treatment in men diagnosed with prostate cancer within a population-based registry. Psychooncology 2021; 31:496-503. [PMID: 34623735 DOI: 10.1002/pon.5833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Feeling depressed and lethargic are common side effects of prostate cancer (PCa) and its treatments. We examined the incidence and severity of feeling depressed and lack of energy in patients in a population based PCa registry. METHODS We included men diagnosed with PCa between 2015 and 2019 in Victoria, Australia, and enrolled in the Prostate Cancer Outcomes Registry. The primary outcome measures were responses to two questions on the Expanded Prostate Cancer Index Composite (EPIC-26) patient reported instrument: problems with feeling depressed and problems with lack of energy 12 months following treatment. We evaluated associations between these and age, cancer risk category, treatment type, and urinary, bowel, and sexual function. RESULTS Both outcome questions were answered by 9712 out of 12,628 (77%) men. 981 patients (10%) reported at least moderate problems with feeling depressed; 1563 (16%) had at least moderate problems with lack of energy and 586 (6.0%) with both. Younger men reported feeling depressed more frequently than older men. Lack of energy was more common for treatments that included androgen deprivation therapy than not (moderate/big problems: 31% vs. 13%), irrespective of disease risk category. Both outcomes were associated with poorer urinary, bowel, and sexual functional domain scores. CONCLUSIONS Self-reported depressive feelings and lack of energy were frequent in this population-based registry. Problems with feeling depressed were more common in younger men and lack of energy more common in men having hormonal treatment. Clinicians should be aware of the incidence of these symptoms in these at-risk groups and be able to screen for them.
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Affiliation(s)
- Jonathan G Bensley
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Sue M Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.,Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, Victoria, Australia
| | - Ian D Davis
- Medical Oncology Unit, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lachlan Dodds
- Ballarat Health Services, Ballarat, Victoria, Australia
| | - Mark Frydenberg
- Department of Surgery, Cabrini Institute, Cabrini Health, Monash University, Melbourne, Victoria, Australia
| | | | - Nathan Lawrentschuk
- Department of Surgery and Department of Urology, University of Melbourne at Royal Melbourne Hospital, Melbourne, Victoria, Australia.,EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeremy L Millar
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Nathan Papa
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Alcaraz A, Rodríguez-Antolín A, Carballido-Rodríguez J, Castro-Díaz D, Medina-Polo J, Fernández-Gómez JM, Ficarra V, Palou J, Ponce de León Roca J, Angulo JC, Esteban-Fuertes M, Cózar-Olmo JM, Pérez-León N, Molero-García JM, Fernández-Pro Ledesma A, Brenes-Bermúdez FJ, Manasanch J. Efficacy and tolerability of the hexanic extract of Serenoa repens compared to tamsulosin in moderate-severe LUTS-BPH patients. Sci Rep 2021; 11:19401. [PMID: 34588509 PMCID: PMC8481292 DOI: 10.1038/s41598-021-98586-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/23/2021] [Indexed: 12/28/2022] Open
Abstract
In a subset analysis of data from a 6-month, multicenter, non-interventional study, we compared change in symptoms and quality of life (QoL), and treatment tolerability, in men with moderate to severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) receiving tamsulosin (TAM, 0.4 mg/day) or the hexanic extract of Serenoa repens (HESr, 320 mg/day) as monotherapy. Symptoms and QoL were assessed using the IPSS and BII questionnaires, respectively. Patients in the treatment groups were matched using two statistical approaches (iterative and propensity score matching). Within the iterative matching approach, data was available from a total of 737 patients (353 TAM, 384 HESr). After 6 months, IPSS scores improved by a mean (SD) of 5.0 (4.3) points in the TAM group and 4.5 (4.7) points in the HESr group (p = 0.117, not significant). Improvements in QoL were equivalent in the two groups. TAM patients reported significantly more adverse effects than HESr patients (14.7% vs 2.1%; p < 0.001), particularly ejaculation dysfunction and orthostatic hypotension. These results show that HESr is a valid treatment option for men with moderate/severe LUTS/BPH; improvements in urinary symptoms and QoL were similar to those observed for tamsulosin, but with considerably fewer adverse effects.
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Affiliation(s)
- Antonio Alcaraz
- Urology Department, Hospital Clínic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Alfredo Rodríguez-Antolín
- Urology Department, Research Group in Men's Integral Health, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - José Medina-Polo
- Urology Department, Research Group in Men's Integral Health, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Joan Palou
- Urology Department, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | | | - Javier C Angulo
- Urology Department, Hosp. Univ. de Getafe. Getafe, Madrid, Spain
| | | | - José M Cózar-Olmo
- Urology Department, Hosp. Univ. Virgen de Las Nieves, Granada, Spain
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Urinary Incontinence in Climacteric Women With or Without Depressive Symptoms: A Cross-Sectional Study. Female Pelvic Med Reconstr Surg 2021; 27:e442-e447. [PMID: 32947552 DOI: 10.1097/spv.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate whether the occurrence of urinary incontinence (UI) is associated with increased odds of depression in perimenopausal and postmenopausal women. METHODS This cross-sectional study included 208 women with depressive symptoms, confirmed by the Beck Depression Inventory, and 247 patients without depression. All participants were perimenopausal or postmenopausal women aged 35 to 65 years who attended an outpatient clinic from a tertiary-academic hospital in Northeastern Brazil. Urinary incontinence symptoms were assessed using patient's self-report and the validated versions of the International Consultation on Incontinence Questionnaire-Short Form and the Questionnaire for Urinary Incontinence Diagnosis. To investigate the severity of climacteric symptoms, the Blatt-Kupperman Index was used, and menopause-related quality of life was analyzed using the Utian Quality of Life Questionnaire. RESULTS In univariate analysis, the Beck Depression Inventory-II mean scores for UI and non-UI women were, respectively, 15.5 (95% confidence interval, 14.28-16.72) and 11.83 (10.52-13.13; P < 0.05). Patients with moderate and severe scores of depression reported higher International Consultation on Incontinence Questionnaire-Short Form and Questionnaire for Urinary Incontinence Diagnosis scores when compared with women with mild depression scores and women without depression (P < 0.001). Conversely, in multivariate analysis, having UI was not associated with having depression (odds ratio [OR], 0.85; 0.52-1.37; P = 0.50), after adjusting for confounders. Older age (>55 years) was associated with decreased odds of depression (OR, 0.43; 0.21-0.88; P = 0.02), whereas moderate (OR, 2.28; 1.40-3.71; P = 0.001) and severe (OR, 7.70; 2.79-21.23) intensities of menopause symptoms were associated with increased odds of depression. CONCLUSION Urinary incontinence was not associated with depression within climacteric women after multivariate analysis.
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Konki SK, Khambampati AK, Sharma SK, Kim KY. A deep neural network for estimating the bladder boundary using electrical impedance tomography. Physiol Meas 2020; 41:115003. [PMID: 32726770 DOI: 10.1088/1361-6579/abaa56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Accurate bladder size estimation is an important clinical parameter that assists physicians, enabling them to provide better treatment for patients who are suffering from urinary incontinence. Electrical impedance tomography (EIT) is a non-invasive medical imaging method that estimates organ boundaries assuming that the electrical conductivity values of the background, bladder, and adjacent tissues inside the pelvic domain are known a priori. However, the performance of a traditional EIT inverse algorithm such as the modified Newton-Raphson (mNR) for shape estimation exhibits severe convergence problems as it heavily depends on the initial guess and often fails to estimate complex boundaries that require greater numbers of Fourier coefficients to approximate the boundary shape. Therefore, in this study a deep neural network (DNN) is introduced to estimate the urinary bladder boundary inside the pelvic domain. APPROACH We designed a five-layer DNN which was trained with a dataset of 15 subjects that had different pelvic boundaries, bladder shapes, and conductivity. The boundary voltage measurements of the pelvic domain are defined as input and the corresponding Fourier coefficients that describe the bladder boundary as output data. To evaluate the DNN, we tested with three different sizes of urinary bladder. MAIN RESULTS Numerical simulations and phantom experiments were performed to validate the performance of the proposed DNN model. The proposed DNN algorithm is compared with the radial basis function (RBF) and mNR method for bladder shape estimation. The results show that the DNN has a low root mean square error for estimated boundary coefficients and better estimation of bladder size when compared to the mNR and RBF. SIGNIFICANCE We apply the first DNN algorithm to estimate the complex boundaries such as the urinary bladder using EIT. Our work provides a novel efficient EIT inverse solver to estimate the bladder boundary and size accurately. The proposed DNN algorithm has advantages in that it is simple to implement, and has better accuracy and fast estimation.
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Affiliation(s)
- S K Konki
- Center for Artificial Intelligence, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
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Kitta T, Hattori T, Chiba H, Higuchi M, Kanno-Kakibuchi Y, Ouchi M, Togo M, Abe-Takahashi Y, Michishita M, Kitano T, Kusakabe N, Shinohara N. Are sham-operated mice a valid comparator in studies using a bladder outlet obstruction model? A pitfall reveals a meaningful insight. Int J Urol 2020; 28:346-352. [PMID: 33314337 DOI: 10.1111/iju.14460] [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: 09/20/2020] [Accepted: 11/10/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate voiding behavior characteristics in intact and sham mice, and to examine whether intact mice show changes in "normal" micturition with aging. METHODS A total of 72 8-week-old mice were divided into two groups - intact and sham - and the latter group was subjected to a sham of partial bladder outlet obstruction surgery. Urination frequency was evaluated (through metabolic cages) at 1, 2, 3, 6 and 12 months after the surgery (or at the equivalent time points for the intact mice). To address possible mechanisms for aging and surgical effects on urinary behavior, quantitative real-time polymerase chain reaction assays were carried out. Primary data were evaluated using scatter plots and descriptive statistics. RESULTS In sham mice, urination frequency showed strong variation at the earlier post-surgical time points (especially at 1 month), with variation decreasing with time. Quantitative real-time polymerase chain reaction showed that the serotonin 2C receptor-encoding mRNA accumulated to >28-fold higher levels at 24 months compared with 3 months in intact mice. A major limitation of the quantitative real-time polymerase chain reaction experiments was that we did not separate whole bladder into muscle and mucosa. CONCLUSIONS Although a sham operation is typically used in partial bladder outlet obstruction experiments to provide control animals, the sham group might itself show increased variation in micturition frequency at early times after surgery, compared with intact animals.
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Affiliation(s)
- Takeya Kitta
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Tsuyoshi Hattori
- Department of Medical Affairs, Asahi Kasei Pharma Corporation, Tokyo, Japan
| | - Hiroki Chiba
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Madoka Higuchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yukiko Kanno-Kakibuchi
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Kofu, Yamanashi, Japan
| | - Mifuka Ouchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mio Togo
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yui Abe-Takahashi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mai Michishita
- Laboratory for Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation, Tokyo, Japan
| | - Tatsuya Kitano
- Laboratory for Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation, Tokyo, Japan
| | - Naohisa Kusakabe
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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Subrata SA. Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2020. [DOI: 10.1111/ijun.12216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sumarno A. Subrata
- Doctoral Candidate in Doctor of Philosophy Program in NursingInternational and Collaborative Program with Foreign University Program, Mahidol University Nakhon Pathom Thailand
- Department of Nursing and Wound Research Center, Faculty of Health SciencesUniversitas Muhammadiyah Magelang Magelang Indonesia
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Li Y, Peng Y, Yang X, Lu S, Gao J, Lin C, Li R. Analysis of measurement electrode location in bladder urine monitoring using electrical impedance. Biomed Eng Online 2019; 18:34. [PMID: 30902056 PMCID: PMC6431015 DOI: 10.1186/s12938-019-0651-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/13/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study was to document more appropriate electrode location of a four-electrode-based electrical impedance technology in the monitoring of bladder filling, and to characterize the relationship between bladder filling duration and the measured electrical impedances. Methods A simulation study, based on a 2-dimension computational model, was conducted to determine the preferable locations of excitation and measurement electrodes in a conventional four-electrode setup. A human observation study was subsequently performed on eight healthy volunteers during natural bladder urine accumulation to validate the result of the simulation study. The correlation between the bladder filling time and the measured electrical impedance values was evaluated. Results The preferable location of measurement electrodes was successively validated by the model simulation study and human observation study. Result obtained via the selected electrodes location revealed a significant negative correlation (R = 0.916 ± 0.059, P < 0.001) between the measured electrical impedance and the urine accumulation time, which was consistent with the result of simulation study. Conclusions The findings in this study not only documented the desirable electrodes location to monitor the process of bladder urine accumulation using four-electrode measurement, but also validated the feasibility of utilizing electrical impedance technique to monitor and estimate the bladder urine volume for those with urological disorders.
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Affiliation(s)
- Yaning Li
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Yinglin Peng
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Xin Yang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Shipei Lu
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Jinwu Gao
- School of Engineering, Sun Yat-Sen University, Guangzhou, China
| | - Chengguang Lin
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China.
| | - Rihui Li
- Department of Biomedical Engineering, University of Houston, 4849 Calhoun Road, Houston, TX, 77004, USA.
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Factors that influence lower urinary tract symptom (LUTS)-related quality of life (QoL) in a healthy population. World J Urol 2017; 35:1783-1789. [DOI: 10.1007/s00345-017-2052-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/25/2017] [Indexed: 01/16/2023] Open
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Kim A, Lee KS, Kim TB, Kim HJ, Yoo ES, Yun JH, Kim DY, Jung SG, Lee JT, Kim JM, Oh CK, Shin JH, Jeon SH, Lee SH, Han CH, Lee DH, Cho HJ, Choo MS. Incidence and risk factors of recurrence of overactive bladder symptoms after discontinuation of successful medical treatment. Investig Clin Urol 2017; 58:42-47. [PMID: 28097267 PMCID: PMC5240281 DOI: 10.4111/icu.2017.58.1.42] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 10/29/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose To identify incidence and risk factors of recurrence after discontinuation of successful antimuscarinic therapy in patients with overactive bladder (OAB). Materials and Methods This was a prospective, multicenter trial. Patients who had antimuscarinic agents for more than 12 weeks and showed successful response were enrolled. Successful response was defined as answering 'benefit' for patient perception of treatment benefit and answer lesser than 3 points in patient's perception of bladder condition (PPBC). The enrolled patients discontinued the antimuscarinics, and we evaluated their recurrence with PPBC and OAB symptom score (OABSS) at 1, 3, 6, and 12 months. Primary purpose was to identify the recurrence rate and secondary purpose was to reveal risk factors. Results Four hundred forty-one patients enrolled and 371 patients completed 6-month follow-up. The enrolled patients showed 1.6 points in PPBC, 2.9 points in OABSS and 1.4 points in IPSS (quality of life) which represented successful response after using antimuscarinics. The cumulative rates of recurrence were 25.6%, 42.3%, and 52.2% at 1, 3, 6 months, respectively. Among 177 patients who did not show recurrence at 6 months, 41 patients were followed up and 4 patients of the 41 patients (9.7%) showed recurrence at 12 months. On univariate and multivariate analyses of recurrence, OAB wet was the risk factor for recurrence after 6 months of discontinuation. Conclusions Discontinuation of antimuscarinic therapy after successful treatment resulted in high recurrence rate with time and OAB wet was the independent risk factor for recurrence.
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Affiliation(s)
- Aram Kim
- Department of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Kyu-Sung Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Beom Kim
- Department of Urology, Gil Medicine Center, Gachon University of Medicine and Science, Incheon, Korea
| | - Hyung Joon Kim
- Department of Urology, Konyang University College of Medicine, Daejeon, Korea
| | - Eun Sang Yoo
- Department of Urology, Kyungpook National University, Daegu, Korea
| | - Jong-Hyun Yun
- Department of Urology, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi, Korea
| | - Duk Yoon Kim
- Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Suk Gun Jung
- Department of Urology, Daedong Hospital, Busan, Korea
| | - Jun Taik Lee
- Department of Urology, Busan Saint Mary's Medical Center, Busan, Korea
| | - Jung Man Kim
- Department of Urology, Busan Saint Mary's Medical Center, Busan, Korea
| | - Cheol Kyu Oh
- Department of Urology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ju Hyun Shin
- Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Seung Hyun Jeon
- Department of Urology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seong Ho Lee
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Hwaseong, Korea
| | - Chang Hee Han
- Department of Urology, The Catholic University College of Medicine, Seoul, Korea
| | - Dong Hwan Lee
- Department of Urology, Incheon St. Mary's Hospital, The Catholic University College of Medicine, Incheon, Korea
| | - Hyuk Jin Cho
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Myung-Soo Choo
- Department of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
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Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression. Int Neurourol J 2015; 19:286-92. [PMID: 26739184 PMCID: PMC4703937 DOI: 10.5213/inj.2015.19.4.286] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/07/2015] [Indexed: 12/28/2022] Open
Abstract
Purpose: Lower urinary tract symptoms (LUTS) comprise a set of common, bothersome symptoms in middle-aged and elderly men. Recent research suggests that depressive symptoms may influence the symptoms of benign prostatic hyperplasia (BPH). We performed a community-based cross-sectional study to evaluate the correlation between LUTS and depression. Methods: The survey was conducted in a rural community during four periods in August 2009, 2010, 2011, and 2012. Two validated questionnaires were used to examine LUTS and depressive symptoms. These included the International Prostate Symptom Score/quality of life (IPSS/QoL) and the Korean version of the Center for Epidemiological Studies-Depression scale (CES-D-K). Patients were categorized in the depressive symptom group if their CES-D-K score was >16 points. Results: A total of 711 men were included in this study. Thirty-five participants (4.92%) were found to have depressive symptoms. There was a positive correlation between depressive symptoms and LUTS severity (P<0.001). As compared to the mild LUTS group, the odds ratio (OR) of depression was 2.868 (95% confidence interval [CI], 1.293–6.362; P for trend<0.001) in the moderate LUTS group, and 4.133 (95% CI, 1.510–11.313; P for trend<0.001) in the severe LUTS group. In a model considering multiple variables such as age, education level, smoking, and exercise, the OR in the moderate LUTS group was 2.534 (1.125–5.708, 95% CI, P for trend=0.005), while that in the severe LUTS group was 3.910 (95% CI, 5.708–11.154; P for trend=0.005). In addition, depression was related to voiding symptoms. Conclusions: Men with severe LUTS are at higher risk of depression than those with less severe urinary symptoms. The severity of voiding symptoms worsens depression. More aggressive urological diagnosis and treatment is needed in patients with severe LUTS, due to the impact on depressive symptoms and QoL.
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Cost of illness of medically treated benign prostatic hyperplasia in Hungary. Int Urol Nephrol 2015; 47:1241-9. [PMID: 26093585 DOI: 10.1007/s11255-015-1028-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To perform a cost of illness study in lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH) in Hungary. METHODS A multicentre, cross-sectional survey was carried out in 2014. BPH patients who had never undergone prostate surgery were recruited to the study. EQ-5D and the International Prostate Symptom Score (IPSS) were used to evaluate health status and disease severity. All resource utilisations related to BPH in the past 12 months were recorded. Cost analysis was performed from societal perspective. RESULTS Overall, 246 patients were included with mean age of 70.6 (SD 8.1) years. Mean EQ-5D and IPSS were 0.85 (SD 0.19) and 12.8 (SD 6.3). Total annual per patient cost of BPH amounted to <euro>876 (SD <euro>1829). Distribution of the costs between direct medical, direct non-medical and indirect cost was 46, 31 and 23 %. High costs were related to informal care (<euro>243), medications (<euro>178) and private physician visits (<euro>132). Patients missed from work on average 14 h/year and 20 h/year due to absenteeism and presenteeism. Clinical severity expressed in IPSS score was found the strongest predictor of higher total costs (r = 0.429, p < 0.001). Mean costs of mild, moderate and severe patients were <euro>203, <euro>754 and <euro>2168, respectively. CONCLUSIONS To our knowledge, this is the first study in the literature that assessed indirect costs related to presenteeism in BPH. We found that costs of reduced productivity while working exceed costs of absence from work. As the retirement age is gradually increasing, the importance of presenteeism is getting more significant, especially in pursuit of sustainable employment.
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Drake MJ, Sokol R, Coyne K, Hakimi Z, Nazir J, Dorey J, Klaver M, Traudtner K, Odeyemi IA, Oelke M, van Kerrebroeck P. Responder and health-related quality of life analyses in men with lower urinary tract symptoms treated with a fixed-dose combination of solifenacin and tamsulosin oral-controlled absorption system: results from the NEPTUNE study. BJU Int 2015; 117:165-72. [PMID: 25907003 DOI: 10.1111/bju.13162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effect of a fixed-dose combination (FDC) of solifenacin and an oral-controlled absorption system (OCAS™) formulation of tamsulosin (TOCAS) on health-related quality of life (HRQoL) in men with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). PATIENTS AND METHODS Men with moderate-to-severe storage symptoms and voiding symptoms were treated for 12 weeks with a FDC of solifenacin 6 or 9 mg plus TOCAS (0.4 mg), TOCAS monotherapy (0.4 mg) or placebo in a randomised, double-blind study (NEPTUNE). The co-primary endpoints were Total Urgency Frequency Score (TUFS) and total International Prostate Symptom Score (IPSS). HRQoL was assessed by several secondary endpoints: IPSS QoL index, overactive bladder questionnaire (OAB-q), and Patient Global Impression (PGI) scale. The correlation between symptom improvement (TUFS) and HRQoL was assessed by Spearman rank correlation coefficients. Single and double responder analyses, using subjective and objective measures, were also performed. RESULTS In the responder analyses, men treated with a FDC of solifenacin 6 mg plus TOCAS consistently had significantly improved outcomes compared with placebo (8/8 responder analyses performed) and TOCAS (6/8 responder analyses performed). There was a significant correlation (P < 0.001) between the reduction in TUFS and the improvement in HRQoL defined by IPSS QoL score, OAB-q symptom bother score, PGI overall bladder symptoms and PGI general health. CONCLUSIONS In men with LUTS/BPH who have moderate-to-severe storage symptoms and voiding symptoms, the reduction in symptoms with a once-daily FDC of solifenacin and TOCAS was associated with consistent patient-relevant improvements in HRQoL compared with placebo and TOCAS monotherapy.
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Affiliation(s)
- Marcus J Drake
- University of Bristol and Bristol Urological Institute, Bristol, UK
| | - Roman Sokol
- Private Urological Care Centre, Piaristicka, Trencin, Slovakia
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15
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Choi EPH, Lam CLK, Chin WY. Mental Health Mediating the Relationship Between Symptom Severity and Health-Related Quality of Life in Patients with Lower Urinary Tract Symptoms. Low Urin Tract Symptoms 2015; 8:141-9. [PMID: 27619778 DOI: 10.1111/luts.12086] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/24/2014] [Accepted: 11/04/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Lower urinary tract symptoms (LUTS) can impact both mental health and health-related quality of life (HRQOL). To date, however, their associations with outcomes have only been examined in isolation and the interactive relationship between LUTS, mental health and HRQOL remains poorly understood. The aim of this study was to determine whether mental health mediates the relationship between LUTS severity and HRQOL. METHODS Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire including the International Prostate Symptom Score (IPSS), the adapted Incontinence Impact Questionnaire-7 (IIQ-7), the Chinese (HK) SF-12 Health Survey Version 2 (SF-12 v2) and the Depression, Anxiety and Stress Scale-21 (DASS-21). Mediation modeling was tested using Baron and Kenney's multistage regression approach and bootstrapping method. RESULTS Overall, mental health partially mediated the association between LUTS severity and HRQOL as measured by the SF-12 v2 physical component summary (PCS) and the IIQ-7. The depression, anxiety and stress scores all have similar mediation effects in the relationship between LUTS severity and HRQOL. Subgroup analysis by gender showed that anxiety fully mediated the relationship between LUTS severity and HRQOL as measured by the SF-12 v2 PCS in males whilst the mediation effects of mental health in the relationship between LUTS severity and HRQOL as measured by the SF-12 v2 PCS could not be found in females. CONCLUSIONS In order to enhance HRQOL, LUTS interventions should address the mental health of patients in addition to providing physical relief of symptoms.
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Affiliation(s)
- Edmond P H Choi
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong.
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
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16
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Choi EPH, Lam CLK, Chin WY. The health-related quality of life of Chinese patients with lower urinary tract symptoms in primary care. Qual Life Res 2014; 23:2723-33. [PMID: 24920054 DOI: 10.1007/s11136-014-0725-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the health-related quality of life (HRQOL) of Chinese primary care patients with lower urinary tract symptoms (LUTS). METHODS Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire containing the International Prostate Symptom Score, the adapted Incontinence Impact Questionnaire-7, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Chinese (HK) SF-12 Health Survey Version 2 (SF-12 v2) and the Depression, Anxiety and Stress Scale-21. RESULTS LUTS patients had poorer HRQOL for the General Health and the Vitality domains and lower Physical Component Summary scores, but better HRQOL for the Role Emotion domain than the adjusted Hong Kong population norms. Clinical factors associated with poorer HRQOL measured by the SF-12 v2 included having more severe LUTS and having more severe depressive, anxiety and stress symptoms. Socio-demographic factors associated with poorer SF-12 v2 were consistent with those found in the general populations. Clinical and socio-demographic factors associated with poorer HRQOL assessed by condition-specific measures included having more severe LUTS (excluding intermittency and straining), the presence of mixed urinary incontinence, having more severe anxiety and stress symptoms, younger age, being not married, being in employment and having a lower household income. CONCLUSIONS LUTS had substantial negative impact on patients' overall health perception and global well-being in Chinese population. A decline in HRQOL might be a key determinant for Chinese patients with LUTS to seek treatment. Patients with nocturia, frequency, urgency or mixed urinary incontinence and younger patients deserve more treatment attention because they appear to have poorer HRQOL.
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Affiliation(s)
- Edmond P H Choi
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong,
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