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Sayed Ahmed HA, Abdallah EM, Mohamed MAE, Aboelfotoh TM, Nour-Eldein H, Fouad AM. Association between erectile dysfunction and subjective well-being in primary care patients with type 2 diabetes. Diabetol Int 2024; 15:421-432. [PMID: 39101170 PMCID: PMC11291785 DOI: 10.1007/s13340-024-00699-5] [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: 09/20/2023] [Accepted: 01/31/2024] [Indexed: 08/06/2024]
Abstract
Objectives To assess the association between erectile dysfunction and subjective well-being among primary care patients with type 2 diabetes mellitus. Methods This cross-sectional study included 340 men with type 2 diabetes treated in primary health care settings in the Ismailia governorate between April 2021 and April 2022. A multistage random cluster sampling technique was used. Sociodemographic data, disease characteristics, lifestyle, surgical and sexual history, and the Arabic translations of the abridged 5-item version of the International Index of Erectile Function (IIEF-5) Questionnaire, and the 5-item World Health Organization Well-Being Index (WHO-5) were gathered. Results Erectile dysfunction was identified in 72.94% of diabetic patients, with 55% mild or mild-to-moderate (ED I), and 17.9% moderate or severe (ED II). Twenty percent had Poor subjective well-being, with a mean WHO-5 index of 63.4 (± 15.4). Binary logistic regression analysis showed that education, diabetes duration, insufficient income, dyslipidemia, benign prostate hyperplasia, and IIEF-5 score were significantly associated with poor subjective well-being. Increasing IIEF-5 score was significantly associated with a 22% decrease in the odds of poor subjective well-being (OR: 0.78; 95% CI 0.66-0.93). Multinomial regression analysis showed that increasing score of the WHO-5 well-being index was associated with a 11% and 14% reduction in the odds of ED I and II, respectively (OR: 0.89 (95% CI 0.86-0.93), and 0.86 (95% CI 0.81-0.92), respectively). Conclusion Erectile dysfunction and subjective well-being were interrelated. Early detection of erectile dysfunction is essential for improving the positive mental health of men with type 2 diabetes in primary care.
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Affiliation(s)
- Hazem A. Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | | | | | - Hebatallah Nour-Eldein
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed Mahmoud Fouad
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Abdalla HH, Shah J, Nyanja TAN, Shabani JS. Factors associated with depressive symptoms in patients with benign prostatic enlargement. Afr J Prim Health Care Fam Med 2023; 15:e1-e7. [PMID: 37265158 DOI: 10.4102/phcfm.v15i1.3572] [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: 03/28/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Depression is a common condition that may lead to suicide at its worst. It is considered one of the primary causes of morbidity globally. Among the urological causes of depression is benign prostatic enlargement (BPE). AIM To determine the prevalence and factors associated with depressive symptoms among BPE patients. SETTING This study was conducted in the Urology and Family Medicine Clinic at the Aga Khan University Hospital, Nairobi and Urology clinic at the Aga Khan Hospital Mombasa. METHODS The study was a cross-sectional design recruiting 308 males above the age of 40. Patient Health Questionnaire-9 and International Prostate Symptom Score (IPSS) were used to assess depressive symptoms and lower urinary tract symptoms (LUTS), respectively. Association between depressive symptoms and LUTS was determined. Factors associated with depressive symptoms were analysed by logistic regression. RESULTS Prevalence of depressive symptoms among patients with symptomatic benign prostatic enlargement (sBPE) was 42.90%. Factors associated with depressive symptoms included comorbid conditions, medication side effects, reduced libido, alcohol use, disturbed sleep at night and anxiety in regard to the prostate condition. CONCLUSION There is a high prevalence of depressive symptoms among men with BPE. Assessment and early intervention for depressive symptoms among men with BPE should be initiated before clinical depression sets in.Contribution: The study has created a knowledge base on factors associated with depressive symptoms among men with sBPE in the African context.
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Affiliation(s)
- Husni H Abdalla
- Department of Family Medicine, Aga Khan University, Nairobi.
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Sacral Acupuncture for Lower Urinary Tract Symptoms: A Systematic Review of Randomized Controlled Trials. JOURNAL OF ACUPUNCTURE RESEARCH 2022. [DOI: 10.13045/jar.2021.00241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Lower urinary tract symptoms (LUTS) associated with storage, voiding, and post-micturition reduce quality of life and cause mental health problems. In traditional medicine, Baliao points have been empirically used to treat urinary system diseases. In this review, randomized controlled trials (RCTs) using sacral acupuncture on Baliao points with sham treatment, other remedies, or other acupoints were retrieved from 8 electronic databases up to June 2021. Sixteen RCTs met the inclusion criteria. The quality of the included studies was assessed using a risk-of-bias (ROB) tool. Most of the evaluation indicators used in the included RCTs showed that sacral acupuncture had a significant therapeutic effect compared with the sham control intervention groups, and other remedies. However, all studies using acupoints (other than the Baliao points) as a control intervention had a “high” ROB and only reported secondary processed information, making it difficult to evaluate the efficacy of sacral acupuncture treatment for LUTS. No serious adverse effects were reported for sacral acupuncture, and only a low number of minor side effects were observed. These results suggest that sacral acupuncture could be considered as an alternative to existing treatments, with the added benefit of low cost. Large-scale, long-term RCTs are required in the future.
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Martin SA, Tully PJ, Kahokehr AA, Jay A, Wittert GA. The bidirectional association between depression and lower urinary tract symptoms (LUTS) in men: A systematic review and meta-analysis of observational studies. Neurourol Urodyn 2022; 41:552-561. [PMID: 35019156 DOI: 10.1002/nau.24868] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent evidence from observational studies suggests a bidirectional association between lower urinary tract symptoms (LUTS) and depression in men. We sought to systematically quantify the effect of the presence of LUTS on depression symptoms, compared to those without LUTS, in adult males, and vice versa. METHODS Electronic databases (MEDLINE, PsycINFO, SCOPUS, Embase) were examined for articles in English before March 2021. Observational studies of men aged over 18 years; reporting an association between LUTS and depression; including a validated scale for LUTS and depression symptoms were eligible for study inclusion. RESULTS Seventeen studies out of 1787 records identified 163 466 men with reported depression symptoms by LUTS status, while 10 studies reported 72 363 men with LUTS by depression symptoms. Pooled estimates showed a strong effect of LUTS presence on depression risk (OR: 2.89, 95% CI: 2.50-3.33), with a high degree of heterogeneity among the examined studies (I2 = 83%; τ2 = 0,06; p < 0.001). Subgroup analyses demonstrated differences by study region (Q value:13.7, df:4, p = 0.003), setting (7.8(2), p = 0.020), design (7.2(1), p = 0.003), quality (6.2(1), p = 0.013), and LUTS measure (40.9(3), p < 0.001). Pooled estimates also showed a strong effect of depression presence on LUTS risk in men (OR: 3.13, 95% CI: 2.72-3.60), with only moderate heterogeneity between studies (I2 = 58%; τ2 = 0,02; p = 0.001). CONCLUSIONS The strong relationship observed between LUTS and depression implies shared risk factors that cannot be solely attributed to the prostate. This has immediate implications for future studies and the assessment and management of patients with either condition.
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Affiliation(s)
- Sean A Martin
- Freemasons Centre for Male Health & Wellbeing, University of Adelaide, Adelaide, South Australia, Australia
| | - Phillip J Tully
- Freemasons Centre for Male Health & Wellbeing, University of Adelaide, Adelaide, South Australia, Australia.,School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Arman A Kahokehr
- Lyell McEwin Health Service, SA Health, Elizabeth Vale, South Australia, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Department of Urology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Alex Jay
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Gary A Wittert
- Freemasons Centre for Male Health & Wellbeing, University of Adelaide, Adelaide, South Australia, Australia
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Kosilov K, Kuzina I, Kuznetsov V, Barabash O, Fedorishcheva E. Efficacy of a combination of dutasteride, tadalafil, and solifenacin in the treatment of previously unsuccessful patients. Asian J Urol 2022; 9:42-50. [PMID: 35198395 PMCID: PMC8841250 DOI: 10.1016/j.ajur.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/15/2020] [Accepted: 09/09/2020] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of simultaneous administration of dutasteride, tadalafil and solifenacin in the treatment of benign prostatic hyperplasia (BPH) with overactive bladder symptoms and lower urinary tract obstruction in previously unsuccessfully treated men. METHODS Patients in Group A (n=97) received dutasteride 0.5 mg/day, tadalafil 2.5 mg/day, and solifenacin 2.5 mg/day; Group B (n=95) received dutasteride 0.5 mg/day, tadalafil 5 mg/day, and solifenacin 5 mg/day; Group C (n=103) received dutasteride 0.5 mg/day, tadalafil 20 mg/day, and solifenacin 10 mg/day. The functional status of the lower urinary tract was assessed using the International Prostate Symptom Score (I-PSS), Overactive Bladder Questionnaire (OABq), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD) as well as uroflowmetry. RESULTS The total score of the sexual function remained unchanged in Group B of patients 81.3 points vs. 80.2 points (p>0.05) according to MSHQ-EjD, 61.4 points vs. 51.2 points (p>0.05) according to IIEF data. The total assessment of symptoms of hyperactivity significantly decreased in Group C according to OABq data after the 4th week of the study (17.5 points vs. 26.1 points, p<0.05) and remained below the baseline until the end of the study (15.2 points). CONCLUSIONS The simultaneous administration of standard doses of dutasteride, solifenacin, and tadalafil for 3 months is safe, effective, and can be recommended for patients with BPH to reduce symptoms of obstruction and hyperactivity of the bladder and maintain sexual function.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation,Department of Clinical Medicine, School of Medicine, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation,Corresponding author. Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation.
| | - Irina Kuzina
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation
| | - Vladimir Kuznetsov
- Department of Public Health, Pacific State Medical University, Vladivostok, Primorsky region, Russian Federation
| | - Olga Barabash
- Department of Physical Culture and Health and Sports Work, Vladivostok State University of Economics and Service, Vladivostok, Primorsky region, Russian Federation
| | - Ekaterina Fedorishcheva
- Department of Public Health, Pacific State Medical University, Vladivostok, Primorsky region, Russian Federation
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Yang L, Chen X, Liu Z, Sun W, Yu D, Tang H, Zhang Z. The Impact of Illness Perceptions on Depressive Symptoms Among Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptom. Int J Gen Med 2021; 14:9297-9306. [PMID: 34887677 PMCID: PMC8651631 DOI: 10.2147/ijgm.s342512] [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: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed at exploring whether illness perceptions may mediate the relationship between depressive symptoms and lower urinary tract symptoms (LUTS) among benign prostatic hyperplasia (BPH) patients. Methods The Patient Health Questionnaire (PHQ-9) for depression, the International Prostate Symptom Score (IPSS) for the severity of LUTS and the brief Illness Perception Questionnaire (B-IPQ) for illness perceptions (IPs) were used among the 157 BPH patients with LUTS. Pearson’s correlation test and hierarchical regression analyses were used to assess the correlations between LUTS, depressive symptoms and IPs. Results Our study found that the severity of LUTS was associated with depressive symptoms and subscales of illness perception; meanwhile, IPs were associated with the level of education. A positive relationship was found between the scores of PHQ9 and the B-IPQ subscales of illness consequences, identity, timeline, concern and emotion; thus, a negative correlation was found between scores of PHQ9 and the B-IPQ subscales of illness coherence, personal control and treatment control. The hierarchical regression analysis showed IPSS and the B-IPQ subscales of illness consequences, concern and emotion were significantly associated with depression, and explained 85.1% of the variance in depressive symptoms (R2 = 0.851, p < 0.05). Conclusion The relationship between LUTS and depressive symptoms may be mediated by the negative IPs, including consequences, concern and emotions. Clinicians should not only focus on the LUTS but also on the IPs to improve depressive symptoms among BPH patients.
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Affiliation(s)
- Linlin Yang
- Department of Geriatrics Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Xin Chen
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Zhiqi Liu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Wei Sun
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Dexin Yu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Haiqin Tang
- Department of Geriatrics Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.,Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Zhiqiang Zhang
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
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Shim KH, Choo SH, Park SG, Yoo HJ, Choi JB. Survey on disease insight and prevalence of urinary incontinence in women. Investig Clin Urol 2021; 62:577-583. [PMID: 34488252 PMCID: PMC8421990 DOI: 10.4111/icu.20210019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/12/2021] [Accepted: 06/14/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose With a rapidly aging population in Korea, the number of patients with lower urinary tract symptoms is increasing. Therefore, it is important to determine the current extent of incontinence among Korean women to establish future plans. We attempted to create reference materials for organizing public relations and educational activities by investigating the effect of age on incontinence and quality of life in women. Materials and Methods The participants comprised women aged 30 years and older who visited a tertiary center for health screening from September 1 to October 31, 2016. The survey included a questionnaire consisting of 12 questions that took approximately 10 minutes to complete. We analyzed the responses and assessed the prevalence of the disease and its rate of recognition. Results A total of 509 women completed the survey. Irrespective of age, 76.8% of all respondents were aware of urinary incontinence (UI) and 57.4% of the women exhibited lower urinary tract symptoms. The most prevalent symptom was UI (45.8%), and the incidence rates of stress and urge UI were identified as 33.6% and 12.2%, respectively. Only 8.0% of the women had visited a hospital; 38.3% had awaited spontaneous symptom improvement. Many participants (61.2%) answered that a urology clinic is suitable for treating UI, while 58.9% chose a gynecology clinic. Conclusions Our study showed that more than 75% of women are aware of UI, but their perception of the disease mechanism and treatment options was low. We suggest that continuous education and publicity are necessary.
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Affiliation(s)
- Kang Hee Shim
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Seol Ho Choo
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Sung Gon Park
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Hee Jae Yoo
- Department of Urology, Ajou University School of Medicine, Suwon, Korea
| | - Jong Bo Choi
- Department of Urology, Ajou University School of Medicine, Suwon, Korea.
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8
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Lui PSC, Dorji N. Prevalence and predictors of lower urinary tract symptoms in Solomon Islander adult men. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/2051415820945537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Despite growing interest in the prevention of lower urinary tract symptoms (LUTS) globally and in the Asia-Pacific region, population-based evidence is limited in the smaller Pacific Island countries such as in the Solomon Islands. This study aimed to investigate the prevalence and describe the risk factors associated with moderate to severe LUTS among Solomon Islander men. Methods: A cross-sectional survey was conducted among 400 men aged ⩾18 years living in Honiara, Solomon Islands. LUTS were assessed using the International Prostate Symptom Score (IPSS). The association between moderate to severe LUTS and sociodemographic, health conditions and health-related factors were estimated using logistic regression adjusted for age. Results: Overall, 13.8% reported moderate LUTS, and 0.8% reported severe LUTS. Frequent night-time urination was the most commonly reported LUTS. The adjusted odds of moderate to severe LUTS decreased with increasing level of education. The odds increased among men reporting elevated psychological distress, increased stressful events in the past 12 months and depression. Conclusions: About one in six Solomon Islander men experience moderate to severe LUTS, having a negative impact on their mental health and general well-being.
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Affiliation(s)
| | - Nidup Dorji
- Department of Public Health, Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Bhutan
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Changes in Prevalence and Treatment Pattern of Benign Prostatic Hyperplasia in Korea. Int Neurourol J 2021; 25:347-354. [PMID: 33504124 PMCID: PMC8748302 DOI: 10.5213/inj.2040412.206] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/21/2020] [Indexed: 11/08/2022] Open
Abstract
Purpose Benign prostatic hyperplasia (BPH) is associated with lower urinary tract symptoms and negatively affects the quality of life. We aimed to investigate the treatment pattern of BPH in South Korea. Methods Information on treatment modalities and diagnoses of BPH was obtained from the Health Insurance Review and Assessment Service-Aged Patient Sample. Data on BPH patients aged >60 years from 2012 to 2016 were obtained. We surveyed the treatment pattern of BPH, including the types of drugs used and surgeries performed, according to the type of institution. Results In this study, 18,260-24,657 BPH patients treated between 2012 and 2016 were included. The number of patients showed an increasing pattern, and drug therapy was the major treatment method used for BPH (98.77%). Moreover, the pattern of increased pharmacotherapy use for BPH was reinforced by the increasing number of patients. Prescription of α-blockers only was dominant in this cohort (45.7%). Transurethral resection of the prostate (TURP) was the most commonly used surgical treatment for BPH (53.6%), but it showed a decreasing pattern over time. In contrast, holmium laser enucleation of the prostate (HoLEP) showed an increase from 19.4% to 39.7%. Conclusions The most common treatment for BPH was drug therapy, predominantly only α-blocker therapy. The surgical treatment trend has changed from TURP to HoLEP.
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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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Suen LKP, Yeh CH, Yeung SKW, Yeung JWF. Is the combined auriculotherapy approach superior to magneto-auriculotherapy alone in aging males with lower urinary tract symptoms? A randomized controlled trial. Aging Male 2020; 23:544-555. [PMID: 30651007 DOI: 10.1080/13685538.2018.1542673] [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: 12/13/2022] Open
Abstract
The negative impact of lower urinary tract symptoms (LUTS) on affected males is substantial. This study aims to assess whether a combined auriculotherapy (AT) using laser AT (LAT) and magneto-AT (MAT) is more effective than using MAT alone or placebo for managing LUTS of aging males.Methods: A randomized controlled, double-blinded trial was conducted. Sixty-two aging males with moderate or severe LUTS symptoms were randomly allocated into groups: Group 1, placebo LAT plus placebo MAT (n = 20); Group 2, combined AT approach using LAT plus MAT (n = 20); and Group 3, placebo LAT followed by MAT (n = 22). Six ear acupoints assumed to be suitable for alleviating LUTS were used. The total treatment period was 4 weeks, with follow-up visits till 3 months. Generalized estimating equations model was used for the examination of the interactions among the groups over time.Results: A combined AT approach exhibited a stronger treatment effect in relieving voiding problems, improving the peak urinary flow rate, and reducing the post-void residual urine than the placebo group or MAT alone.Conclusions: This study demonstrates that the AT protocol used in this study for aging males with LUTS is feasible and can be adopted in future study of increased scale.
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Affiliation(s)
- Lorna K P Suen
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong
| | - Chao Hsing Yeh
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Simon K W Yeung
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong
| | - Jerry W F Yeung
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong
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Ou MJ, Huang CC, Wang YC, Chen YL, Ho CH, Wu MP, Huang YT, Wu CY, Chen PJ. Depression is a major risk factor for the development of dementia in people with lower urinary tract symptoms: A nationwide population-based study. PLoS One 2019; 14:e0217984. [PMID: 31173611 PMCID: PMC6555508 DOI: 10.1371/journal.pone.0217984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 05/22/2019] [Indexed: 12/17/2022] Open
Abstract
Background/Objectives Studies have shown a strong relationship between depression and dementia. Lower urinary tract symptoms (LUTS) were reported to be independently associated with depression and dementia. However, the relationship between depression and cognitive dysfunction in patients with LUTS is not well characterized. Method We conducted a matched cohort study by using a one-million population-based dataset in Taiwan. A total of 15,944 patients with LUTS aged 50 or older were included from 2001 to 2005 and followed up until their death or the end of 2012. During the follow-up period, 1958 cases developed depression subsequently and were defined as the study group. 7832 patients without depression were then identified as control group, matching by age, gender, insurance premium, status of catastrophic illness certificate, and the index year in a 1:4 ratio. The primary outcome was the onset of dementia. LUTS, depression, dementia, and other comorbidities were defined by the International Classification of Disease, 9th Revision, Clinical Modification coding system. Cox hazards models and Aalen Johansen curves were applied to measure the influence of depression on the risk of dementia in patients with LUTS. Results The crude incidence of depression among people with LUTS was 12.3%. The incidence of dementia in the depression group was significantly higher than that in the control group (12.2% versus 8.9%; P < 0.001). Depression was associated with a significantly greater risk of subsequent dementia after adjusted for socioeconomic status, number of outpatient visits and multiple comorbidities (adjusted hazard ratio: 1.32; 95% confidence interval: 1.13–1.54). Conclusions Depression is a major risk factor for the onset of subsequent dementia in patients with LUTS. Early screening and interventions for depression in patients with LUTS may be important to maintain cognitive function.
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Affiliation(s)
- Ming-Jung Ou
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chun-Che Huang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Yi-Chi Wang
- Department of Family Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yung-Liang Chen
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi-Mei Medical Center, Tainan City, Taiwan
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan
| | - Ming-Ping Wu
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan
- Department of Obstetrics and Gynecology, College of Medicine, Fu-Jan Catholic University, New Taipei City, Taiwan
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statics, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Chien-Yi Wu
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ping-Jen Chen
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, United Kingdom
- Palliative Care Center, Chi-Mei Medical Center, Tainan City, Taiwan
- * E-mail:
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Chung KJ, Shim SR, Brown S, Shim YS, Park IB, Kim KH. Does early depressive mood expire following radical retropubic prostatectomy in patients with localized prostate cancer? J Exerc Rehabil 2019; 15:264-269. [PMID: 31111011 PMCID: PMC6509445 DOI: 10.12965/jer.1938160.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/28/2019] [Indexed: 11/22/2022] Open
Abstract
In this study, the pattern of depressive mood in patients following radical prostatectomy (RP) for localized prostate cancer (PCa) was determined. A total of 30 patients (aged 68.03±6.1 years) who were diagnosed with localized PCa and underwent RP within 1 month entered the study. Evaluations included body mass index, prostate-specific antigen, testosterone, underlying disease, international prostate symptom score and quality of life (QoL), international index of erectile function as well as Beck depression inventory (BDI), both at the initial stage and 3 months later. Basic demographic data, laboratory results, and questionnaires were analyzed statistically. The BDI score significantly decreased 3 months after the surgery. In correlation analysis, BDI was related with the international prostate symptom score but not with the underlying disease, QoL or international index of erectile function. Body mass index was identified as one of the risk factors to decrease the probability of BDI score (≥3) significantly. Underlying disease increased the probability of BDI score. In the assessment of the correlation between BDI and each subscale, sadness, self-dislike, self-criticalness, and worth-lessness showed high correlation. In the early period, depressive mood was improved at the short-term follow-up in localized PCa patients after RP. Voiding symptoms were only related with the depressive mood, but not with other parameters, including sexual function. The depressive mood had no effect on the QoL in the early stage.
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Affiliation(s)
- Kyung Jin Chung
- Department of Urology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Sung-Ryul Shim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Suzana Brown
- Department of Technology and Society, The State University of New York (SUNY) in Korea, Incheon, Korea
| | - Young Sup Shim
- Department of Radiology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Ie Byung Park
- Department of Endocrinology and Metabolism, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Khae-Hawn Kim
- Department of Urology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
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Rhee SJ, Kim EY, Kim SW, Kim SH, Lee HJ, Yoon DH, Ahn YM. Longitudinal study of the relationship between lower urinary tract symptoms and depressive symptoms. J Psychosom Res 2019; 116:100-105. [PMID: 30654985 DOI: 10.1016/j.jpsychores.2018.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/12/2018] [Accepted: 11/20/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To analyze the longitudinal association between lower urinary tract symptoms (LUTS) and the development of incident depressive symptoms in Korean men. METHODS This study initially recruited 16,155 Korean men who underwent routine health examinations between 2005 and 2012, and completed the International Prostate Symptom Score (IPSS) screening tool and Beck Depression Inventory-1 (BDI). The final study population included 9080 men, aged 15-89, who had a baseline BDI score < 10 and follow-up BDI data, with no history of depression, bladder or prostate operations. Cox proportional hazard models were used to assess the relationship between LUTS and the development of incident depressive symptoms. Multiple imputation was used to handle missing values. RESULTS After adjusting for significant covariates, LUTS were associated longitudinally with the development of incident depressive symptoms (hazard ratio [HR] = 1.81 [95% confidence interval [CI] = 1.26-2.61]). An analysis of the specific domains of LUTS revealed that voiding LUTS (HR = 1.58 [95% CI = 1.07-2.33]), but not storage LUTS (HR = 1.43 [95% CI = 0.96-2.13]), were associated longitudinally with depressive symptoms. CONCLUSION LUTS and voiding LUTS, but not storage LUTS, were associated longitudinally with incident depressive symptoms.
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Affiliation(s)
- Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Eun Young Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Mental Health Center, Seoul National University Health Care Center, Seoul, Republic of Korea.
| | - Soo Woong Kim
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Se Hyun Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Hyun Jeong Lee
- Cancer Survivorship Branch, National Cancer Control Institute, Goyang, Republic of Korea..
| | - Dae Hyun Yoon
- Department of Psychiatry, Gangnam Health Promotion Center, Seoul National University Hospital, 737 Yeoksam-Dong, Gangnam-Gu, Seoul 135-984, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
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15
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Klee NS, McCarthy CG, Lewis S, McKenzie JL, Vincent JE, Webb RC. Urothelial Senescence in the Pathophysiology of Diabetic Bladder Dysfunction-A Novel Hypothesis. Front Surg 2018; 5:72. [PMID: 30564582 PMCID: PMC6288180 DOI: 10.3389/fsurg.2018.00072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/12/2018] [Indexed: 12/11/2022] Open
Abstract
Diabetic bladder dysfunction (DBD) is a well-recognized and common symptom affecting up to 50% of all diabetic patients. DBD has a broad range of clinical presentations ranging from overactive to underactive bladder symptoms that develops in middle-aged to elderly patients with long standing and poorly controlled diabetes. Low efficacy of current therapeutics and lifestyle interventions combined with high national healthcare costs highlight the need for more research into bladder dysfunction pathophysiology and novel treatment options. Cellular senescence is an age-related physiologic process in which cells undergo irreversible growth arrest induced by replicative exhaustion and damaging insults. While controlled senescence negatively regulates cell proliferation and promotes tissue regeneration, uncontrolled senescence is known to result in tissue dysfunction through enhanced secretion of inflammatory factors. This review presents previous scientific findings and current hypotheses that characterize diabetic bladder dysfunction. Further, we propose the novel hypothesis that cellular senescence within the urothelial layer of the bladder contributes to the pro-inflammatory/pro-oxidant environment and symptoms of diabetic bladder dysfunction. Our results show increased cellular senescence in the urothelial layer of the bladder; however, whether this phenomenon is the cause or effect of DBD is unknown. The urothelial layer of the bladder is made up of transitional epithelia specialized to contract and expand with demand and plays an active role in transmission by modulating afferent activity. Transition from normal functioning urothelial cells to secretory senescence cells would not only disrupt the barrier function of this layer but may result in altered signaling and sensation of bladder fullness; dysfunction of this layer is known to result in symptoms of frequency and urgency. Future DBD therapeutics may benefit from targeting and preventing early transition of urothelial cells to senescent cells.
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Affiliation(s)
- Nicole S Klee
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Cameron G McCarthy
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Steven Lewis
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Jaine L McKenzie
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Department of Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Julie E Vincent
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - R Clinton Webb
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
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16
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Yoo TK, Lee KS, Sumarsono B, Kim ST, Kim HJ, Lee HC, Kim SH. The prevalence of lower urinary tract symptoms in population aged 40 years or over, in South Korea. Investig Clin Urol 2018; 59:166-176. [PMID: 29744473 PMCID: PMC5934278 DOI: 10.4111/icu.2018.59.3.166] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/19/2018] [Indexed: 01/12/2023] Open
Abstract
Purpose Lower urinary tract symptoms (LUTS) can be distressing and socially isolating, and the economic impact can be substantial. Further data to characterize the epidemiology and effects of LUTS in South Korea would be beneficial. Materials and Methods In an international, internet-based survey, the prevalence and impact of LUTS was evaluated in adults aged ≥40 years. Questions related to International Continence Society (ICS) symptom definitions and the bother associated with each symptom. The international prostate symptom score (IPSS) and the overactive bladder symptom score (OABSS) were assessed. Results Of the 2,080 participants from South Korea, 1,090 (52.4%) were women and 740 (35.6%) were aged ≥60 years. The prevalence of LUTS according to ICS criteria was 68.2% (men, 70.6%; women, 66.0%). LUTS prevalence increased significantly with age (p=0.01 in men and women). Storage symptoms only were reported in 16.2% of men and 30.5% of women, making this the most common ICS symptom group overall. Individual symptoms with the highest prevalence in the overall population were nocturia, frequency, and weak stream (36%, 30%, and 29%, respectively). IPSS results showed that 40.1% of participants had at least moderate symptoms. The prevalence of OABSS-defined overactive bladder was 19.7% (men, 19.5%; women, 19.9%). Fourteen percent of individuals with any LUTS visited healthcare professionals regarding urinary symptoms. Conclusions LUTS affect the majority of adults aged ≥40 years in South Korea. The low percentage of individuals with LUTS consulting healthcare professionals regarding urinary symptoms indicates a need to improve rates of diagnosis and treatment.
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Affiliation(s)
- Tag Keun Yoo
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Kyu-Sung Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee KS, Yoo TK, Liao L, Wang J, Chuang YC, Liu SP, Chu R, Sumarsono B. Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study. BMC Urol 2017; 17:108. [PMID: 29162085 PMCID: PMC5698954 DOI: 10.1186/s12894-017-0294-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022] Open
Abstract
Background Lower urinary tract symptoms (LUTS) and overactive bladder (OAB) symptoms have a substantial effect on quality of life (QoL). We report QoL and mental health results from a LUTS prevalence study in three Asian countries. Methods A cross-sectional, population-representative, internet-based study among individuals aged ≥40 years in China, Taiwan and South Korea. Instruments included: Overactive Bladder Symptom Score (OABSS); International Prostate Symptom Score (IPSS); other International Continence Society (ICS) symptom questions; health-related QoL 12-item short-form (HRQoL-SF12v2); Work Limitations Questionnaire (WLQ); Hospital Anxiety and Depression Scale (HADS). Presence of LUTS was determined according to ICS criteria, with three symptom groups (storage, voiding and post-micturition). Post-stratification weighting matched the age and sex population distribution per country. Initial data analyses were based on descriptive statistics. Significance testing undertaken post hoc included: independent-samples t-test (differences in HRQoL between sexes and between individuals with/without LUTS; relationship between HRQoL score and OABSS; differences in HADS anxiety and depression scores between individuals with/without LUTS; association between HADS anxiety/depression scores and OABSS), chi-square test (association between LUTS prevalence and workplace productivity) and analysis of variance (differences in HRQoL score and in HADS anxiety/depression scores between individuals with different symptom groups, association between HADS anxiety/depression scores and IPSS). Results In total, 8284 participants were included. HRQoL scores were significantly worse (p < 0.001) among individuals with versus without LUTS (ICS criteria): mean physical health domain scores were 61.1 (standard deviation [SD], 20.1) and 76.7 (17.0), respectively; corresponding mental health domain scores were 34.8 (12.7) and 43.7 (10.7). Workplace productivity was best among individuals without LUTS (difficulties reported by 2–3% of individuals), and worst in those with all three ICS symptom groups (difficulties reported by 29–38% of individuals; p = 0.001). Mean HADS scores showed significantly worse (p < 0.001) levels of anxiety and depression among individuals with versus without LUTS: anxiety, 6.5 (SD, 3.7) and 4.0 (3.3); corresponding mean depression scores were 6.8 (4.3) and 4.2 (3.6). Increasing OAB severity was also associated with decreasing HRQoL physical and mental health scores. Conclusion LUTS and increasing OAB severity are both associated with impaired QoL, reduced workplace productivity, and increased tendency towards anxiety and depression. These results highlight the need to ensure that individuals with LUTS receive appropriate, effective treatment. Trial registration ClinicalTrials.gov identifier: NCT02618421, registered 26 November 2015 (retrospectively registered).
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Affiliation(s)
- Kyu-Sung Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tag Keun Yoo
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 68, Hangeulbiseok-ro, Nowon-gu, Seoul, Korea.
| | - Limin Liao
- Department of Urology, China Rehabilitation Research Center, Capital Medical University, Beijing, China
| | - Jianye Wang
- Department of Urology, Beijing Hospital, Beijing, China
| | - Yao-Chi Chuang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Ping Liu
- Department of Urology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Romeo Chu
- Astellas Pharma Singapore Pte. Ltd., Singapore, Singapore.,, Present address: 5 Pemimpin Drive, #19-03 Seasons View, Singapore, Singapore
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Suen LKP, Cheng HL, Yeung SKW, Au-Yeung CH, Lee JCY, Ho KKY, Lau NMY, Ng CKF, Chan IWS. Qualitative insights into the experiences of living with moderate-to-severe lower urinary tract symptoms among community-dwelling ageing males. PLoS One 2017; 12:e0187085. [PMID: 29084282 PMCID: PMC5662182 DOI: 10.1371/journal.pone.0187085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/15/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) comprise a highly prevalent chronic condition among the aging male population. Existing literature on the experiences of men with LUTS is scarce given that only a few studies explored medical care-seeking behaviors and coping strategies. The current understanding of the experiences of elderly males with LUTS is considerably limited. Therefore, the present study aimed to identify the experiences of living with moderate-to-severe LUTS among community-dwelling Chinese ageing males and their coping strategies to facilitate the management of LUTS by healthcare providers. METHODS AND FINDINGS A qualitative exploratory design using thematic analysis was used. Semi-structured interviews with 24 Chinese ageing males with moderate-to-severe LUTS were conducted. According to the participants, LUTS adversely affect the physical aspects of their daily lives. Most of them were unwilling to seek social support and were even embarrassed to share this topic with their peers. A range of psychological responses could be observed from the participants that range from regarding the condition as a natural life course to loss of one's self-esteem. Most of the interviewees lacked knowledge and held misconceptions toward LUTS, which prevented them from pursuing medical advice. Most of the participants also sought alternative treatments and developed self-help methods to cope with their symptoms. CONCLUSION LUTS affects the physical and social aspects of sufferers. The findings of this qualitative study can raise awareness about the life experiences, perceptions, misconceptions, and help-seeking behaviors of Chinese elderly with LUTS. Proper health education and advice can be provided for this population.
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Affiliation(s)
| | - Hui Lin Cheng
- School of Nursing, The Hong Kong Polytechnic Univeristy, HungHom, Hong Kong
| | | | - Cypher Ho Au-Yeung
- School of Nursing, The Hong Kong Polytechnic Univeristy, HungHom, Hong Kong
| | | | | | | | | | - Iris Wai Sze Chan
- Department of Medical & Geriatric, Princess Margaret Hospital, Hong Kong
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Kim KS, Nam JW, Choi BY, Moon HS. The association of lower urinary tract symptoms with incidental falls and fear of falling in later life: The Community Health Survey. Neurourol Urodyn 2017; 37:775-784. [PMID: 28731510 DOI: 10.1002/nau.23345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/29/2017] [Indexed: 01/07/2023]
Abstract
AIM To evaluate the association between lower urinary tract symptoms (LUTS) and incidental falls and fear of falling. METHODS We used data obtained from the 2011 Korean Community Health Survey (KCHS) conducted between August and October 2011 in South Korea. The survey was carried out to estimate patterns of disease prevalence and morbidity in men >40 years old. The trained interviewers performed face-to-face sociodemographic questionnaires using computer-assisted personal interviewing (CAPI) software, the International Prostate Symptom Score (IPSS), the Quality of Life score (EQ-5D), and a questionnaire about past falls and fear of falling. RESULTS Data from 67 457 men were collected and analyzed. The subjects who had previously experienced a fall had slightly higher scores for IPSS, severity of LUTS, voiding LUTS, and storage LUTS than subjects with no prior fall history. A multivariate model of the relationship between falls and LUTS severity indicated that the relationship between the IPSS components and fall history was significant (mild, moderate, severe: OR = 1.00, 2.53, 3.91, respectively, P < 0.0001). A multivariate model of fear of falling and LUTS also showed a significant relationship between severity, voiding, and storage symptoms (severe IPSS: OR = 2.411, 95%CI: 2.2-2.642, P < 0.001; voiding symptoms: OR = 1.766, 95%CI: 1.681-1.856, P < 0.001; storage symptoms: OR = 1.705, 95%CI: 1.625-1.789, P < 0.001). CONCLUSION This study emphasizes the relationship between LUTS and falling. Furthermore, increased LUTS severity led to a higher risk of incidental falls. A high correlation between fear of falling and LUTS was also observed in this study.
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Affiliation(s)
- Kyu Shik Kim
- Department of Urology, Hanyang University College of Medicine, Guri, Korea
| | - Ji Won Nam
- Institute for Health and Society, Hanyang University College of Medicine, Seoul, Korea.,Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Bo Youl Choi
- Institute for Health and Society, Hanyang University College of Medicine, Seoul, Korea.,Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hong Sang Moon
- Department of Urology, Hanyang University College of Medicine, Guri, Korea
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Sociodemographic Factors Related to Lower Urinary Tract Symptoms in Men: A Korean Community Health Survey. Int Neurourol J 2017; 21:143-151. [PMID: 28673065 PMCID: PMC5497199 DOI: 10.5213/inj.1732760.380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/31/2017] [Indexed: 11/08/2022] Open
Abstract
Purpose This study estimated the prevalence of lower urinary tract symptoms (LUTS) in Korean men and the conditions for being diagnosed with or treated for LUTS/benign prostatic hyperplasia (BPH). Methods We analyzed cross-sectional data collected from 69,851 Korean men who were 40 years of age or older and had participated in the Korean Community Health Survey performed in 2011. Interviewers performed face-to-face surveys that included sociodemographic questions, the International Prostate Symptom Score (IPSS), and questions regarding whether the subjects had been diagnosed with or treated for LUTS/BPH. We estimated the prevalence of LUTS and assessed whether the subjects had been diagnosed with or treated for LUTS/BPH. Results Moderate to severe LUTS, storage symptoms, and voiding symptoms increased with age. The IPSS quality of life score was 1.5±0.004 in the mild LUTS group (n=57,701), 3.3±0.01 in the moderate LUTS group (n=9,203), and 4.3±0.02 in the severe LUTS group (n=2,947) (P<0.0001). The prevalence of moderate to severe LUTS in those who had not been diagnosed with LUTS/BPH was 64.5% (7,847 of 12,150), and the prevalence of moderate to severe LUTS in those who had been diagnosed with LUTS/BPH but had not been treated was 23.5% (2,853 of 12,150). Conclusions The severity of LUTS in Korean men increased with age, and the IPSS quality of life score increased with the severity of LUTS. Many Korean men with moderate to severe LUTS had not been diagnosed or treated for LUTS/BPH. Socioeconomic conditions played an important role in health-seeking behavior among patients with LUTS/BPH.
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