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Sens-Albert C, Weisenburger S, König BC, Melcher SF, Scheyhing UAM, Rollet K, Lluel P, Koch E, Lehner MD, Michel MC. Effects of a proprietary mixture of extracts from Sabal serrulata fruits and Urtica dioica roots (WS ® 1541) on prostate hyperplasia and inflammation in rats and human cells. Front Pharmacol 2024; 15:1379456. [PMID: 38560358 PMCID: PMC10979176 DOI: 10.3389/fphar.2024.1379456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction: Phytotherapeutics, particularly extracts from Sabal serrulata (saw palmetto) fruit or Urtica dioica (stinging nettle) root, are popular for the treatment of male lower urinary symptoms in many countries, but their mechanism of action is poorly understood. We performed in vivo and in vitro studies to obtain deeper insight into the mechanism of action of WS® 1541, a proprietary combination of a Sabal serrulata fruit and an Urtica dioica root extract (WS® 1473 and WS® 1031, respectively) and its components. Methods: We used the sulpiride model of benign prostatic hyperplasia in rats and tested three doses of WS® 1541 in comparison to finasteride, evaluating weight of prostate and its individual lobes as well as aspects of inflammation, oxidative stress, growth and hyperplasia. In human BPH-1 cells, we studied the effect of WS® 1473, WS® 1031, WS® 1541 and finasteride on apoptosis, cell cycle progression and migrative capacity of the cells. Results: WS® 1541 did not reduce prostate size in sulpiride treated rats but attenuated the sulpiride-induced changes in expression of most analyzed genes and of oxidized proteins and abrogated the epithelial thickening. In vitro, WS® 1473 and WS® 1031 showed distinct profiles of favorable effects in BPH-1 cells including anti-oxidative, anti-proliferative and pro-apoptotic effects, as well as inhibiting epithelial-mesenchymal-transition. Conclusion: This data supports a beneficial effect of the clinically used WS® 1541 for the treatment of lower urinary tract symptoms associated with mild to moderate benign prostate syndrome and provides a scientific rationale for the combination of its components WS® 1473 and WS® 1031.
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Affiliation(s)
- Carla Sens-Albert
- Preclinical R&D, Dr. Willmar Schwabe GmbH and Co., KG, Karlsruhe, Germany
| | | | - Beatrix C. König
- Preclinical R&D, Dr. Willmar Schwabe GmbH and Co., KG, Karlsruhe, Germany
| | - Silas F. Melcher
- Preclinical R&D, Dr. Willmar Schwabe GmbH and Co., KG, Karlsruhe, Germany
| | | | - Karin Rollet
- Urosphere SAS, Parc Technologique Du Canal, Toulouse, France
| | - Philippe Lluel
- Urosphere SAS, Parc Technologique Du Canal, Toulouse, France
| | - Egon Koch
- Preclinical R&D, Dr. Willmar Schwabe GmbH and Co., KG, Karlsruhe, Germany
| | - Martin D. Lehner
- Preclinical R&D, Dr. Willmar Schwabe GmbH and Co., KG, Karlsruhe, Germany
| | - Martin C. Michel
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
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Qasrawi H, Tabouni M, Almansour SW, Ghannam M, Abdalhaq A, Abushamma F, Koni AA, Zyoud SH. An evaluation of lower urinary tract symptoms in diabetic patients: a cross-sectional study. BMC Urol 2022; 22:178. [PMID: 36357918 PMCID: PMC9648430 DOI: 10.1186/s12894-022-01133-1] [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: 06/13/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) are common among diabetic patients and represent hidden and mysterious morbidity. The pathophysiology of LUTS among diabetes mellitus (DM) patients is multifactorial. Importantly, LUTS is known to cause physical and psychological distress. Thus, this study describes LUTS among DM patients, investigates factors that may associate with it, and assesses the possible relationship between LUTS and the quality of life of diabetics. METHODS Over 6 months, data were collected from 378 diabetic patients in primary health care clinics. Demographic and clinical characteristics, Urogenital Distress Inventory-6 (UDI-6), and Incontinence Impact Questionnaire-7 (IIQ-7) were used to collect data. Univariate and multivariate analyses were performed. RESULTS Three hundred seventy-eight participants were included in this study. (29.9%) were (58-67) years old. 49% were female. Half of the cohort was overweight, and a third were obese. 81% were Type 2 DM. Almost all of them are on medical treatment. A median score of 5.50 (2.00-8.00) for the UDI-6 scale and a median score of 5 (0.00-10.00) for the IIQ-7 scale were reported. Multiple linear regression models showed that residency (p = 0.038) and regular exercise (p = 0.001) were significantly and negatively correlated with the UDI-6 score, while female gender (p = 0.042), insulin use (p = 0.009) and the presence of comorbidities (p = 0.007) were positively correlated with this score. Furthermore, age (p = 0.040) and body mass index (BMI) (p < 0.001) were significantly and positively associated with the IIQ-7 score. CONCLUSION LUTS is significant morbidity among DM patients. Factors such as age, BMI, and co-morbidities exacerbate LUTS, which can be modified and controlled. On the other hand, regular exercise and weight loss strategies help diabetic patients to improve LUTS.
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Affiliation(s)
- Hala Qasrawi
- Department of Radiology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Mahmoud Tabouni
- Department of Anaesthesia, An-Najah National University Hospital, Nablus, 44839, Palestine
| | | | | | | | - Faris Abushamma
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Department of Urology, An-Najah National University Hospital, Nablus, 44839, Palestine.
| | - Amer A Koni
- Division of Clinical Pharmacy, Hematology and Oncology Department, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
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Comparison of Tamsulosin and Tadalafil effects in LUTS treatment considering patients' atherosclerosis risk level. Ann Med Surg (Lond) 2022; 80:104137. [PMID: 35846856 PMCID: PMC9283796 DOI: 10.1016/j.amsu.2022.104137] [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: 05/14/2022] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction To date, no study evaluates the effect of atherosclerosis risk level on the efficacy of BPH drug therapies. Therefore, the present study aimed to assess the effect of atherosclerosis risk levels on the effectiveness of Tamsulosin and Tadalafil in LUTS treatment. Methods The present study was a randomized clinical trial that assessed men with LUTS symptoms (at least six months). The inclusion criteria were being older than 50 years, international prostate symptom score (IPSS) ≥ 13, and maximum urinary flow rate (Qmax) between 4 and 15 ml/s. Framingham Risk Score was used to measure atherosclerosis risk. The patients were classified into four groups, including group 1: Patients with low risk and treated with Tamsulosin (0.4 mg/day), group 2: Patients with low risk and treated with Tadalafil (5 mg/day), group 3: Patients with high risk and treated with Tamsulosin (0.4 mg/day), group 4: Patients with high risk and treated with Tadalafil (5 mg/day). Results The study included 44 and 38 patients receiving Tamsulosin and Tadalafil, respectively. The means (SD) of the baseline age for the Tamsulosin and Tadalafil groups were equal to 60.6 (6.8) and 58.8 (6.7), respectively (p-value = 0.213). The models revealed no impact of the atherosclerosis risk level on the drugs' effects (p-values = 0.378, 0.975, 0.743 for IPSS, QMAX, and VOID, respectively). Conclusions The present study's findings could not show the impact of atherosclerosis risk levels on the efficiency of Tamsolusin and Tadalafil in men with LUTS. Assessing the impact of atherosclerosis risk level on the effectiveness of Tamsulosin and Tadalafil in LUTS treatment. The present study's findings could not show the impact of atherosclerosis risk level on the efficiency of Tamsulosin and Tadalafil in men with LUTS.
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4
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Exploring the Role of Testosterone Replacement Therapy in Benign Prostatic Hyperplasia and Prostate Cancer: A Review of Safety. URO 2022. [DOI: 10.3390/uro2010005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Increased risk of prostate diseases triggered by testosterone replacement therapy (TRT) remains a worldwide concern. That said, we reviewed the safety of TRT in the spheres of benign prostatic hyperplasia (BPH) and prostate cancer (PCa), exploring clinical findings in this regard. Compelling evidence based on meta-analyses of randomized and observational studies indicates safety for TRT in patients suffering from prostate disorders such as BPH and PCa, at the same time improving lower tract urinary symptoms. Thus, the harmful relationship geared toward androgens and BPH seems to be overestimated as TRT has sufficient safety and, if properly prescribed, may counteract several metabolic problems. Even after PCa treatment, the benefits of TRT could outweigh the risk of recurrence, but further long-term randomized clinical trials are needed to elucidate unresolved questions.
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Bengtsen MB, Heide-Jørgensen U, Blichert-Refsgaard LS, Hjelholt TJ, Borre M, Nørgaard M. Positive Predictive Value of Benign Prostatic Hyperplasia and Acute Urinary Retention in the Danish National Patient Registry: A Validation Study. Clin Epidemiol 2020; 12:1281-1285. [PMID: 33235508 PMCID: PMC7678697 DOI: 10.2147/clep.s278554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background and Aim Benign prostatic hyperplasia comprises a significant burden to ageing men due to frequently associated lower urinary tract symptoms and the risk of developing serious complications, such as acute urinary retention. Healthcare databases are a valuable source of epidemiological research; however, continuous validation of definitions is imperative. We examined the positive predictive values of International Classification of Diseases, 10th Revision (ICD-10), diagnostic coding for benign prostatic hyperplasia and acute urinary retention in men in the Danish National Patient Registry. Methods We investigated a random sample of 100 men diagnosed with benign prostatic hyperplasia and 100 men diagnosed with acute urinary retention between 2011 and 2017 in the Central Denmark Region. Using medical record review as reference standard, we estimated the positive predictive value with corresponding 95% confidence intervals (CI) overall and stratified by age, type of hospital (university hospital vs regional hospital), type of hospital contact (inpatient, outpatient or emergency room), calendar year group (2011–2013, 2014–2017), and department (department of urology, geriatrics, endocrinology or emergency room). Results Medical records were available for all 200 sampled patients. We found an overall positive predictive value (PPV) of 95% (95% CI: 89–98%) for benign prostatic hyperplasia and 98% (95% CI: 93–99%) for acute urinary retention. The PPVs were consistent across age, type of hospital, type of hospital contact, calendar year group, and department. Conclusion The PPVs of ICD-10 codes for benign prostatic hyperplasia and acute urinary retention recorded in the Danish National Patient Registry are high.
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Affiliation(s)
| | - Uffe Heide-Jørgensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | | | | | - Michael Borre
- Department of Urology, Aarhus University Hospital, Aarhus N, Denmark
| | - Mette Nørgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
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Michel MC, Schumacher H, Mehlburger L, de la Rosette JJMCH. Factors Associated With Nocturia-Related Quality of Life in Men With Lower Urinary Tract Symptoms and Treated With Tamsulosin Oral Controlled Absorption System in a Non-Interventional Study. Front Pharmacol 2020; 11:816. [PMID: 32581791 PMCID: PMC7287125 DOI: 10.3389/fphar.2020.00816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
Nocturia impairs quality of life (QoL). We have performed a non-interventional study in which men with lower urinary tract symptoms (LUTS) were treated for at least 3 months with tamsulosin oral controlled absorption system (0.4 mg q.d.). Other than observing efficacy and tolerability of this drug formulation, the study was designed to explore the relative roles of number of nocturia episodes and of non-urological causes of nocturia on nocturia-related QoL at baseline and treatment-associated changes thereof. The study enrolled 5775 men seeking treatment of their LUTS. Tamsulosin improved LUTS, e.g. International Prostate Symptom Score from 19.5 ± 5.9 to 10.1 ± 4.9 (means ± SD). This was associated by clinically meaningful improvements in the Nocturia QoL score (from 45 ± 19 to 73 ± 17 points) and other QoL scores. Number of nocturnal voids was the key driver of all QoL scores at baseline; change of number of nocturia episodes that of improvement of all QoL scores upon treatment. In contrast, non-urological causes of nocturia such as heart failure, diabetes, sleep apnea, fluid or alcohol intake or use of diuretics or hypnotics had only small if any effects on baseline QoL or treatment-associated improvements thereof. The observed effects of non-urological causes on QoL apparently were largely driven by their effect on number of nocturnal voids. These data further support the idea that improvement of nocturia may be an important treatment goal in male LUTS.
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Affiliation(s)
- Martin C Michel
- Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany
| | | | - Ludwig Mehlburger
- Department of Medical Affairs, Boehringer Ingelheim, Ingelheim, Germany
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Oeyen E, Willems H, 't Kindt R, Sandra K, Boonen K, Hoekx L, De Wachter S, Ameye F, Mertens I. Determination of variability due to biological and technical variation in urinary extracellular vesicles as a crucial step in biomarker discovery studies. J Extracell Vesicles 2019; 8:1676035. [PMID: 31681468 PMCID: PMC6807909 DOI: 10.1080/20013078.2019.1676035] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 09/09/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022] Open
Abstract
Urinary extracellular vesicles (EVs) are an attractive source of biomarkers for urological diseases. A crucial step in biomarker discovery studies is the determination of the variation parameters to perform a sample size calculation. In this way, a biomarker discovery study with sufficient statistical power can be performed to obtain biologically significant biomarkers. Here, a variation study was performed on both the protein and lipid content of urinary EVs of healthy individuals, aged between 52 and 69 years. Ultrafiltration (UF) in combination with size exclusion chromatography (SEC) was used to isolate the EVs from urine. Different experimental variation set-ups were used in this variation study. The calculated standard deviations (SDs) of the 90% least variable peptides and lipids did not exceed 2 and 1.2, respectively. These parameters can be used in a sample size calculation for a well-designed biomarker discovery study at the cargo of EVs.
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Affiliation(s)
- Eline Oeyen
- Health Department, Flemish Institute for Technological Research (VITO), Mol, Belgium.,Centre for Proteomics (CFP), University of Antwerp, Antwerp, Belgium
| | - Hanny Willems
- Health Department, Flemish Institute for Technological Research (VITO), Mol, Belgium.,Centre for Proteomics (CFP), University of Antwerp, Antwerp, Belgium
| | - Ruben 't Kindt
- Research Institute for Chromatography, Kortrijk, Belgium
| | - Koen Sandra
- Research Institute for Chromatography, Kortrijk, Belgium
| | - Kurt Boonen
- Health Department, Flemish Institute for Technological Research (VITO), Mol, Belgium.,Centre for Proteomics (CFP), University of Antwerp, Antwerp, Belgium
| | - Lucien Hoekx
- Urology Department, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Stefan De Wachter
- Urology Department, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Filip Ameye
- Urology Department, AZ Maria Middelares Ghent, Ghent, Belgium
| | - Inge Mertens
- Health Department, Flemish Institute for Technological Research (VITO), Mol, Belgium.,Centre for Proteomics (CFP), University of Antwerp, Antwerp, Belgium
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Ikenwilo D, Heidenreich S, Ryan M, Mankowski C, Nazir J, Watson V. The Best of Both Worlds: An Example Mixed Methods Approach to Understand Men's Preferences for the Treatment of Lower Urinary Tract Symptoms. THE PATIENT 2018; 11:55-67. [PMID: 28660567 DOI: 10.1007/s40271-017-0263-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Discrete choice experiments (DCEs) are widely used to quantify individuals' preferences for healthcare. Guidelines recommend the design of DCEs should be informed by qualitative research. However, only a few studies go beyond guidelines by fully presenting qualitative and quantitative research jointly together in a mixed methods approach (MMA). OBJECTIVES Using an example study about men's preferences for medical treatment of lower urinary tract symptoms (LUTS), we demonstrate how qualitative research can complement DCEs to gain a rich understanding of individuals' preferences. METHODS We were the first to combine online discussion groups (ODGs) with an online DCE. A thematic analysis of the ODGs and a conceptual map provided insights into men's quality of life (QoL) with LUTS and relevant treatment attitudes. This was used to design the DCE. Men's willingness to pay (WTP) for these attributes was estimated. Findings from ODGs and DCE were compared to understand WTP and preference heterogeneity. KEY FINDINGS Men mostly valued medicine that reduced urgency and night-time frequencies of urination but avoided sexual side effects. We find heterogeneity in the effect of sexual side effects on men's preferences. The ODGs suggest this is because several men may be sexually inactive due to their age, being widowed or having comorbidities. The ODGs also raised concern about men's awareness of LUTS. CONCLUSION We argue that the insights gained into men's preferences for treatment and how LUTS affects men's QoL could not have been obtained by either the qualitative research or the DCE alone.
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Affiliation(s)
- Divine Ikenwilo
- Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Sebastian Heidenreich
- Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
| | - Mandy Ryan
- Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Colette Mankowski
- Astellas Pharma EMEA, 2000 Hillswood Drive, Chertsey, Surrey, KT16 0RS, UK
| | - Jameel Nazir
- Astellas Pharma EMEA, 2000 Hillswood Drive, Chertsey, Surrey, KT16 0RS, UK
| | - Verity Watson
- Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
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López-Calderero I, López-Fando L, Ríos-González E, Maisonobe P, Hernández-Yuste E, Sarmiento-Jordán M. Impact of locally advanced or metastatic prostate cancer on the quality of life. Actas Urol Esp 2017; 41:368-375. [PMID: 28256271 DOI: 10.1016/j.acuro.2016.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 12/20/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to assess the health-related quality of life of patients with prostate cancer in advanced phases to obtain additional information on the patients' health. The growing interest in understanding the patient's perspective and the scarcity of prospective studies of this population motivated this research study. MATERIAL AND METHODS We present an observational study performed on 131 urology consultations, with a sample of 601 patients with locally advanced or metastatic prostate cancer, assessed during 2 visits: baseline and at 12 months. We collected demographic, clinical, quality-of-life (PROSQoLI and EuroQoL-5D-5L questionnaires) and anxiety/depression (HADS questionnaire) endpoints. RESULTS The mean age (SD) was 73.8 (8.2) years, and 87.2% of the participants were retired or pensioners. Some 58.7% of the patients presented locally advanced prostate cancer. Urinary symptoms were the most common, decreasing significantly after one year (P<.05). Urinary problems and fatigue were the most affected measures, and pain/discomfort was the dimension present in most patients (65.3%). According to the linear regression model, asthenia and pain were 2 of the factors most closely related to a poorer quality of life. The presence of anxiety/depression was low. Finally, the health condition as assessed by the clinician was more positive than when assessed by the patients. CONCLUSIONS This study broadens the scarce information on the quality of life of the population with advanced prostate cancer, information of use for the clinical management of these patients.
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Suh J, Kim KH, Lee SH, Kim HS, Lee YJ, Lee SR, Jeong CW. Prevalence and management status of urologic disease in geriatric hospitals in South Korea: A population-based analysis. Investig Clin Urol 2017; 58:281-288. [PMID: 28681039 PMCID: PMC5494353 DOI: 10.4111/icu.2017.58.4.281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/15/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose This study aimed to investigate the prevalence and management status of urologic disease in geriatric hospitals in Korea. Materials and Methods We conducted population-based analyzed using cohort established by the National Health Insurance Service of Korea, which contains the medical insurance data of 1 million people from 2002 to 2013. The prevalence, prescription rate, and complication incidence of urologic disease in geriatric hospitals were compared with similar-sized general hospitals. We analyzed the changes that followed the adoption of the fixed sum medical fee per day for geriatric hospitals, which began in January 2008. Subgroup analysis was conducted in an elderly group and a propensity score matching (PSM) group. Results During this time, the number of geriatric hospitals exponentially increased over general hospitals (675.5%/y vs. 30.9%/y). The prevalence, prescription rate, and complication incidence of urologic disease was higher in geriatric hospitals than in general hospitals (2.1, 1.8, and 1.4 times higher). In the elderly group, the prevalence of urologic disorders was higher in geriatric hospitals than in general hospitals, but the prescription rate was lower (26.5% vs. 19.9% and 6.8% vs. 10.0%). This tendency also founded in the PSM analysis. After the medical fee system changed, diagnosis and prescription rates decreased in geriatric hospitals but increased in general hospitals. Conclusions Urologic diseases are more prevalent yet management has some problem in geriatric hospitals. Lack of institutional urologists and changes in the medical payment system should be associated with this problem. Additional study and political support are needed to overcome this issue.
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Affiliation(s)
- Jungyo Suh
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Khae Hawn Kim
- Department of Urology, Gachon University Gil Medical Center, Incheon, Korea
| | - Sang Heon Lee
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung Suk Kim
- Department of Urology, Dongguk University Ilsan Medical Center, Goyang, Korea
| | - Young Ju Lee
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Rim Lee
- Community Nursing Science, Seoul National University College of Nursing, Seoul, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
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11
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MASON M, RICHAUD P, BOSNYAK Z, MALMBERG A, NEIJBER A. Degarelix Versus Goserelin Plus Bicalutamide in the Short-Term Relief of Lower Urinary Tract Symptoms in Prostate Cancer Patients: Results of a Pooled Analysis. Low Urin Tract Symptoms 2015; 9:82-88. [DOI: 10.1111/luts.12114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/15/2015] [Accepted: 07/13/2015] [Indexed: 01/26/2023]
Affiliation(s)
- Malcolm MASON
- School of Medicine; Institute of Cancer and Genetics, Cardiff University; Cardiff UK
| | - Pierre RICHAUD
- School of Medicine; Institute of Cancer and Genetics, Cardiff University; Cardiff UK
| | - Zsolt BOSNYAK
- School of Medicine; Institute of Cancer and Genetics, Cardiff University; Cardiff UK
| | - Anders MALMBERG
- School of Medicine; Institute of Cancer and Genetics, Cardiff University; Cardiff UK
| | - Anders NEIJBER
- School of Medicine; Institute of Cancer and Genetics, Cardiff University; Cardiff UK
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Nocturia is the Lower Urinary Tract Symptom With Greatest Impact on Quality of Life of Men From a Community Setting. Int Neurourol J 2014; 18:86-90. [PMID: 24987561 PMCID: PMC4076485 DOI: 10.5213/inj.2014.18.2.86] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 04/05/2014] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Lower urinary tract symptoms are numerous, but the specific impact of each of these symptoms on the quality of life (QoL) has not been evaluated in community-dwelling men. An assessment of these symptoms and their effects on QoL was the focus of this study. METHODS We performed a cross-sectional study with 373 men aged >50 years from a community setting. Patients completed the International Prostate Symptom Score questionnaire, which includes questions on each of the specific urinary symptoms and a question addressing health-related QoL that are graded from 0 to 5. We used the Pearson correlation test to assess the impact of each symptom on QoL. RESULTS Nocturia (58.9%) was the most prevalent urinary symptom. The mean score was 0.9±1.4 for incomplete emptying, 1.0±1.5 for frequency, 0.9±1.3 for intermittency, 0.8±1.3 for urgency, 1.0±1.5 for weak stream, 0.5±1.0 for straining, and 2.0±1.6 for nocturia. Nocturia and frequency were the only symptoms associated with poorer QoL, with nocturia showing a stronger association. CONCLUSIONS Nocturia affects 50% of community dwelling men aged >50 years, and is the lower urinary tract symptom with the greatest negative impact on QoL.
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Xin Z, Huang Y, Lu J, Zhang Q, Chen C. Addition of Antimuscarinics to Alpha-blockers for Treatment of Lower Urinary Tract Symptoms in Men: A Meta-analysis. Urology 2013; 82:270-7. [DOI: 10.1016/j.urology.2013.04.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 04/23/2013] [Accepted: 04/26/2013] [Indexed: 11/26/2022]
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Affiliation(s)
- Raymond C Rosen
- Chief Scientist, New England Research Institutes, Watertown, MA, USA.
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15
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Huang MH, Chiu AF, Kuo HC. Reliability and Validity of the King's Health Questionnaire for Male Lower Urinary Tract Symptoms in Taiwan. Low Urin Tract Symptoms 2013; 6:11-4. [PMID: 26663494 DOI: 10.1111/luts.12011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the reliability and validity of the King's Health Questionnaire (KHQ), and understand the impacts of lower urinary tract symptom (LUTS) on health-related quality of life (HR-QoL). METHODS A cross-sectional design was used and a convenience of 393 men participated in the study. The reliability was measured by testing the Cronbach's α coefficients. Factor analysis was used to explore the underlying factor structure of the KHQ. The discriminant validity was assessed using the one-way analysis of variance (ANOVA) tests with post hoc analysis (Games-Howell method) by comparing the differences scores in KHQ domains between men with three LUTS severity groups (mild, moderate, and severe). RESULTS Men with severe, moderate, mild LUTS accounted for 7.9, 25.4, and 66.7%, respectively. Internal consistency of KHQ was excellent with Cronbach's α coefficients of 0.750-0.943. Factor analysis showed three underlying components to explain constructive validity. The KHQ subscores in both the severe and moderate LUTS groups were significantly higher than those in mild LUTS group (all P < 0.05), implying that the discriminant validity was adequate. Excepting for two single-item questions, the first three greater disparities in KHQ domains between the severe and mild LUTS groups were "Emotion", "Sleeping/Energy", and "Physical limitation", while the least disparities was found in "Personal relationships" domain. CONCLUSION LUTS could produce a substantial impact on different domains of HR-QoL. The traditional Chinese KHQ has suitable reliability and validity for men with general LUTS, and might be a useful tool for HR-QoL measure in future.
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Affiliation(s)
- Mei-Huang Huang
- Department of Nursing, Meiho University, PingtungDepartment of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Aih-Fung Chiu
- Department of Nursing, Meiho University, PingtungDepartment of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Nursing, Meiho University, PingtungDepartment of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Anderson J, Al-Ali G, Wirth M, Gual JB, Gomez Veiga F, Colli E, van der Meulen E, Persson BE. Degarelix versus goserelin (+ antiandrogen flare protection) in the relief of lower urinary tract symptoms secondary to prostate cancer: results from a phase IIIb study (NCT00831233). Urol Int 2012; 90:321-8. [PMID: 23258223 DOI: 10.1159/000345423] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 10/05/2012] [Indexed: 12/13/2022]
Abstract
INTRODUCTION No studies to date have assessed the efficacy/tolerability of degarelix in the relief of lower urinary tract symptoms (LUTS) secondary to prostate cancer (PrCa). METHODS Patients were randomised to degarelix 240/80 mg or goserelin 3.6 mg + bicalutamide flare protection (G+B); both treatments were administered for 3 months. The primary endpoint was change in International Prostate Symptom Score (IPSS) at week 12 compared with baseline. RESULTS This study was stopped early due to recruitment difficulties. 40 patients received treatment (degarelix n = 27; G+B n = 13); most had locally advanced disease and were highly symptomatic. Degarelix was non-inferior to G+B in reducing IPSS at week 12 in the full analysis set (p = 0.20); the significantly larger IPSS reduction in the per-protocol analysis (p = 0.04) was suggestive of superior reductions with degarelix. Significantly more degarelix patients had improved quality of life (IPSS question) at week 12 (85 vs. 46%; p = 0.01). Mean prostate size reductions at week 12 were 42 versus 25% for patients receiving degarelix versus G+B, respectively (p = 0.04; post hoc analysis). Most adverse events were mild/moderate; more degarelix patients experienced injection site reactions whereas more G+B patients had urinary tract infections/cystitis. CONCLUSION In 40 men with predominantly locally advanced PrCa and highly symptomatic LUTS, degarelix was at least non-inferior to G+B in reducing IPSS at week 12.
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Affiliation(s)
- John Anderson
- Department of Urology, Royal Hallamshire Hospital, Sheffield, UK
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Van Dijk MM, Wijkstra H, Debruyne FM, De La Rosette JJMCH, Michel MC. The role of nocturia in the quality of life of men with lower urinary tract symptoms. BJU Int 2012; 105:1141-6. [PMID: 22299137 DOI: 10.1111/j.1464-410x.2009.08969.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To determine the role of treatment-associated improvement in nocturia in health-related quality of life (HRQL) in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia, and secondarily to confirm the role of nocturia in HRQL at baseline and to compare the effects of watchful waiting, transurethral microwave treatment (TUMT) and transurethral resection of the prostate (TURP) to those of α1-adrenoceptor antagonists (α-blockers) on nocturia. PATIENTS AND METHODS We retrospectively analysed using multiple regression a large single-centre database of patients receiving routine care for treatment-associated alterations of symptoms and HRQL (assessed at baseline, 2611 men) and 6-12 months after initiation of treatment (1258 men). RESULTS Among the symptoms assessed using the International Prostate Symptom Score, nocturia (together with urgency and weak stream) had the strongest correlation with HRQL at baseline and after treatment. Watchful waiting, α-blockers, TUMT and TURP reduced nocturia episodes by a mean (sd) of 7 (53)%, 17 (40)%, 32 (47)% and 75 (23)%, respectively. The treatment-associated improvements in nocturia (together with those of weak stream) had the strongest association with those of HRQL. CONCLUSIONS We conclude that among all LUTS assessed in the IPSS, nocturia has one of the strongest associations with HRQL, and that treatment-associated improvements in nocturia contribute considerably to overall improvements in HRQL.
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Affiliation(s)
- Marleen M Van Dijk
- Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Bouwman II, Van Der Heide WK, Van Der Meer K, Nijman R. Correlations between lower urinary tract symptoms, erectile dysfunction, and cardiovascular diseases: Are there differences between male populations from primary healthcare and urology clinics? A review of the current knowledge. Eur J Gen Pract 2009; 15:128-35. [DOI: 10.3109/13814780903329536] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Esquirol-Caussa J, Herrero-Vila E, Sánchez-Aldeguer J. Sexualidad en la edad geriátrica: disfunción eréctil, sintomatología urinaria del tracto inferior y posibilidades de tratamiento. Rev Int Androl 2009. [DOI: 10.1016/s1698-031x(09)71615-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schneider T, de la Rosette JJMCH, Michel MC. Nocturia: A non-specific but important symptom of urological disease. Int J Urol 2009; 16:249-56. [DOI: 10.1111/j.1442-2042.2008.02246.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Speakman MJ. Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia (LUTS/BPH): More Than Treating Symptoms? ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.eursup.2008.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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