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Bang WJ, Choi HG, Kang HS, Kwon MJ, Kim JH, Kim JH, Kim SY. Increased Risk of Benign Prostate Hyperplasia (BPH) in Patients with Gout: A Longitudinal Follow-Up Study Using a National Health Screening Cohort. Diagnostics (Basel) 2023; 14:55. [PMID: 38201364 PMCID: PMC10871099 DOI: 10.3390/diagnostics14010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
A previous study reported a high risk of benign prostatic hyperplasia (BPH) in patients with gout. This study intended to evaluate the risk of BPH in gout patients. A total of 514,866 Korean National Health Insurance Service-Health Screening Cohorts were retrieved from 2002 to 2019. Among these individuals, 14,961 gout patients and 58,764 control participants were matched based on demographic factors. The incidence of BPH during the follow-up periods was collected for both the gout and control groups. The risk of BPH was analyzed using stratified Cox proportional hazard models, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Secondary analyses were conducted based on demographic factors and comorbidities. The incidence of BPH was 23.40% in gout patients and 20.70% in control participants. In the adjusted model, the HR of BPH was 1.13-fold higher in gout patients than in the control group (95% CI = 1.09-1.18). Compared with the ≥60-year-old group, the <60-year-old group demonstrated a higher HR for BPH in gout patients (1.19 [1.13-1.24] vs. 1.07 [1.01-1.13]). The risk of BPH in gout patients was consistent according to various comorbidities. Patients with gout demonstrated a greater risk of BPH than participants without gout. The young adult population had a higher risk of BPH related to gout.
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Affiliation(s)
- Woo Jin Bang
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Hyo Geun Choi
- Suseoseoulent Clinic, Seoul 06349, Republic of Korea;
| | - Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea;
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Joo-Hee Kim
- Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13488, Republic of Korea
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Jo JK, Kim H, Bang WJ, Oh CY, Cho JS, Shim M. Effect of Diabetes Mellitus on Symptomatic Improvement After Surgery for Benign Prostatic Hyperplasia in Patients With Lower Urinary Tract Symptom and its Relations With Prostatic Urethral Angulation. Int Neurourol J 2023; 27:116-123. [PMID: 37401022 DOI: 10.5213/inj.2346008.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/08/2023] [Indexed: 07/05/2023] Open
Abstract
PURPOSE To compare improvement of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia in diabetic versus nondiabetic patients after transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HoLEP). METHODS The medical records of 437 patients who underwent TURP or HoLEP at a tertiary referral center from January 2006 to January 2022 were retrospectively analyzed. Among them, 71 patients had type 2 diabetes. Patients in the diabetic mellitus (DM) and non-DM groups were matched 1:1 according to age, baseline International Prostate Symptom Score (IPSS), and ultrasound measured prostate volume. Changes in LUTS were assessed at 3 months after surgery using IPSS and evaluated by categorizing patients according to prostatic urethral angulation (PUA; <50° vs. ≥50°). Medication-free survival after surgery was also investigated. RESULTS No significant differences were noted between the DM and non-DM groups in baseline characteristics except for comorbidities (i.e., hypertension, cerebrovascular disease, and ischemic heart disease, P=0.021, P=0.002, and P=0.017, respectively) and postvoid residual urine volume (115±98 mL vs. 76±105 mL, P=0.028). Non-DM patients showed significant symptomatic improvement regardless of PUA, while DM patients demonstrated improvement in obstructive symptoms only in those with large PUA (≥51°). Among patients with small PUA, DM patients had worse medication-free survival after surgery compared to controls (P=0.044) and DM was an independent predictor of medication reuse (hazard ratio, 1.422; 95% confidence interval, 1.285-2.373; P=0.038). CONCLUSION DM patients experienced symptomatic improvement after surgery only in those with large PUA. Among patients with small PUA, DM patients were more likely to reuse medication after surgery.
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Affiliation(s)
- Jung Ki Jo
- Department of Urology, College of Medicine, Hanyang University, Seoul, Korea
| | - Hwanik Kim
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Woo Jin Bang
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Cheol Young Oh
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jin Seon Cho
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Myungsun Shim
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Liu J, Zhang K, Wu X, Cui B, Liang Z. Radiation dose of prostatic artery embolization for benign prostatic hyperplasia: A protocol for systematic review. Medicine (Baltimore) 2022; 101:e31595. [PMID: 36401467 PMCID: PMC9678554 DOI: 10.1097/md.0000000000031595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Increasing evidence supports the efficacy and safety of prostatic artery embolization (PAE) in the treatment of benign prostatic hyperplasia. However, PAE relies on ionizing radiation, which has not been studied systematically so far. Therefore, the potential associated risks remain largely unknown and are subject to intense debate. We performed a protocol for systematic review and meta-analysis to evaluate the clinical benefits of different radiation doses in patients with benign prostatic hyperplasia undergoing PAE. METHODS A comprehensive search of several databases from 1966 to October 2022 was conducted. The databases include Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and PubMed. Risk of bias of the included studies was assessed by the "Risk of Bias Assessment Tool" of the Cochrane Handbook for randomized controlled trials. All data were analyzed using the Comprehensive Meta-Analysis software package (Biostat, Engelwood, NJ). RESULTS The results will be submitted to a peer-reviewed journal once completed. CONCLUSION This review will provide reliable evidence for extensive application of PAE for benign prostatic hyperplasia and determine the most rational radiation dose for these patients.
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Affiliation(s)
- Jinglei Liu
- Department of Interventional Treatment, 980 Hospital of PLA Joint Logistics Support Forces (Bethune International Peace), Shijiazhuang, China
| | - Kai Zhang
- Department of Oncology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Xiaolong Wu
- Department of Radiotherapy, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Bao Cui
- Department of Interventional Treatment, 980 Hospital of PLA Joint Logistics Support Forces (Bethune International Peace), Shijiazhuang, China
| | - Zhihui Liang
- Department of Interventional Treatment, 980 Hospital of PLA Joint Logistics Support Forces (Bethune International Peace), Shijiazhuang, China
- * Correspondence: Zhihui Liang Department of Interventional Treatment, 980 Hospital of PLA Joint Logistics Support Forces (Bethune International Peace), Shijiazhuang 050082, China (e-mail: )
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Robotic-assisted simple prostatectomy versus holmium laser enucleation of the prostate for large benign prostatic hyperplasia: a single-center preliminary study in Korea. Prostate Int 2022; 10:123-128. [PMID: 36225286 PMCID: PMC9520426 DOI: 10.1016/j.prnil.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/01/2022] [Accepted: 05/24/2022] [Indexed: 12/30/2022] Open
Abstract
Background Holmium laser enucleation of the prostate (HoLEP) and robotic-assisted simple prostatectomy (RASP) are the two most important therapeutic modalities for large benign prostatic hyperplasia. However, there are currently no studies comparing these two treatments in a Korean setting. In this study, the authors seek to compare the safety and efficacy associated with these procedures. Methods The authors retrospectively analyzed 59 male patients who underwent HoLEP (n = 26) or RASP (n = 33) at single center. The following preoperative data were compared: age, the International Prostatic Symptom Score (IPSS), transrectal ultrasonography, uroflowmetry, and hemoglobin. Intraoperative data included operation time and specimen weight. Postoperative data included change in IPSS, uroflowmetry, and hemoglobin. Length of stay, catheterization time, and complications were also reviewed. Results No significant differences between the two groups were found in terms of age, total prostate, and transitional volume. Postoperatively, both groups showed similar improvement in the maximum flow rate, post-void residual urine, IPSS, and quality of life. Intraoperatively, there were no differences regarding operation time and resected prostate volume. Catheter removal time and length of stay were significantly shorter in the HoLEP group than the RASP group. In addition, postoperative hemoglobin changes were significantly lower in the HoLEP group. However, incontinence rates at 1 month and 2 months postoperative in the RASP group were lower than the HoLEP group. Conclusions Both HoLEP and RASP can produce excellent postoperative outcomes. However, catheter removal time, length of stay, and hemoglobin changes were more favorable in the HoLEP group. On the other hand, postoperative incontinence was more favorable in the RASP group. These factors must be heavily considered when deciding surgical the method for large benign prostatic hyperplasia.
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Lee JW, Kim JH. Drug Prescription Patterns During Initial Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Study Based on Health Insurance Review and Assessment Database. J Korean Med Sci 2022; 37:e95. [PMID: 35347903 PMCID: PMC8960941 DOI: 10.3346/jkms.2022.37.e95] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/02/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To evaluate the drug prescription patterns for men diagnosed with benign prostatic hyperplasia (BPH) in Korea. METHODS We extracted the data of 3% of the national patient samples including men aged ≥ 40 years between 2012 and 2017 from the Health Insurance Review and Assessment database and investigated the drugs prescribed for men with the BPH code N40. Men with a diagnosis of BPH but not receiving treatment were excluded. The primary outcome was the drugs prescribed and the changes in drug prescription pattern over 6 years for men first diagnosed with BPH. RESULTS Alpha blockers were the most commonly prescribed drugs in men with BPH, and tamsulosin was the most common. The proportion of prescriptions increased steadily. The number of prescriptions for anticholinergics (ACH) increased, but decreased with the start of mirabegron prescriptions in 2015. Prescriptions of mirabegron are increasing rapidly and replacing ACH. Based on the prescription pattern by drug category, alpha blocker monotherapy decreased, whereas combination therapies such as alpha blocker + 5-alpha-reductase inhibitors (5ARI), and alpha blocker + 5ARI + ACH increased steadily. As for the number of prescriptions by drug ingredient, tamsulosin monotherapy was the most common, and the combination therapy of tamsulosin and mirabegron increased. CONCLUSION Alpha blockers were the most commonly prescribed drug for men first diagnosed with BPH in Korea from 2012 to 2017, and tamsulosin was the most common alpha blocker. Prescriptions of combination therapy and mirabegron are gradually increasing.
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Affiliation(s)
- Jeong Woo Lee
- Department of Urology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
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Commentary on "Changes in Prevalence and Treatment Pattern of Benign Prostatic Hyperplasia in Korea". Int Neurourol J 2022; 25:364. [PMID: 34991306 PMCID: PMC8748305 DOI: 10.5213/inj.2142036.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/22/2021] [Indexed: 11/08/2022] Open
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Reply to Commentary on "Changes in Prevalence and Treatment Pattern of Benign Prostatic Hyperplasia in Korea". Int Neurourol J 2022; 25:365-366. [PMID: 34991307 PMCID: PMC8748306 DOI: 10.5213/inj.2142062.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/07/2021] [Indexed: 11/08/2022] Open
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Lulic Z, Son H, Yoo SB, Cunnington M, Kapse P, Miller D, Cortes V, Park S, Bhak RH, Duh MS. Free combination of dutasteride plus tamsulosin for the treatment of benign prostatic hyperplasia in South Korea: analysis of drug utilization and adverse events using the National Health Insurance Review and Assessment Service database. BMC Urol 2021; 21:178. [PMID: 34933674 PMCID: PMC8691067 DOI: 10.1186/s12894-021-00941-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022] Open
Abstract
Objective To assess the use and safety of free combination therapy (dutasteride and tamsulosin), dutasteride monotherapy, or tamsulosin monotherapy in patients with benign prostatic hyperplasia (BPH). Methods This non-interventional retrospective cohort study used claims data from the Korea Health Insurance Review and Assessment-National Patient Sample database. Patients with BPH ≥ 40 years of age receiving combination therapy (dutasteride 0.5 mg and tamsulosin 0.4 mg daily) or dutasteride 0.5 mg, or tamsulosin 0.4 mg daily dose between 2012 and 2017 were included. The frequency, duration of treatment and risk of any adverse event (AE) or serious AE (SAE) was compared for combination therapy versus each monotherapy using non-inferiority testing. Results Of 14,755 eligible patients, 1529 (10.4%) received combination therapy, 6660 (45.1%) dutasteride monotherapy, and 6566 (44.5%) tamsulosin monotherapy. The proportion of patients treated with combination therapy exceeded the pre-specified 3% threshold for ‘frequent’ use. Safety results indicated a similar risk of any AE and SAE irrespective of treatment group. The adjusted relative risk for any AE over the treatment observation period comparing combination therapy with dutasteride monotherapy was 1.07 (95% confidence interval [CI] 1.03, 1.12), and with tamsulosin monotherapy was 0.98 (95% CI 0.95, 1.02) demonstrating non-inferiority. The adjusted relative risk for any SAE was 1.07 (95% CI 0.66, 1.74) and 0.90 (95% CI 0.56, 1.45), compared with dutasteride and tamsulosin monotherapy, respectively. Although the SAE results did not statistically demonstrate non-inferiority of combination therapy based on pre-specified margins, the 95% CI for the risk ratio estimates included the null with a lower limit below the non-inferiority margins, indicating no meaningful differences in SAE risk between groups. Absolute SAE risks were low. Conclusion Combination therapy with dutasteride and tamsulosin is frequently used in real-world practice in South Korea for treatment of BPH and demonstrates a safety profile similar to either monotherapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12894-021-00941-1.
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Affiliation(s)
| | - Hwancheol Son
- Department of Urology, Seoul National University College of Medicine, Boramae Hospital, Seoul, Korea
| | | | | | | | | | | | - Suna Park
- Analysis Group, Inc., Boston, MA, USA
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Kim SJ. Research Goes on During Coronavirus Disease 2019 Pandemic. Int Neurourol J 2021; 25:271-272. [PMID: 34991303 PMCID: PMC8748301 DOI: 10.5213/inj.2121edi.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Su Jin Kim
- Department of Urology, College of Medicine, Hallym Unversity, Kangdong Sacred Heart Hospital, Seoul, Korea
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