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Rezali MS, Mohamad Anuar MF, Abd Razak MA, Chong ZL, Shaharudin AB, Kassim MSA, Mohamed Daud MA, Ismail SB, Said ZM. Prevalence and associated factors of moderate to severe erectile dysfunction among adult men in Malaysia. Sci Rep 2023; 13:21483. [PMID: 38057375 PMCID: PMC10700487 DOI: 10.1038/s41598-023-48778-y] [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: 08/11/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023] Open
Abstract
Erectile dysfunction (ED) is a pervasive problem among men, often shrouded in silence and stigma. This manuscript analysed the National Health and Morbidity Survey 2019 data to identify the prevalence of moderate to severe ED among men aged 18 and above in Malaysia and describe its associated factors. Self-administered questionnaire on ED utilised a locally validated International Index of Erectile Function. Variables on sociodemographics, risky lifestyles and comorbidities were obtained via an interviewer-administered questionnaire. The prevalence was determined using complex sampling analysis, and logistic regression was used to determine the associated factors of ED. A sample of 2403 men aged ≥ 18 participated, with a moderate to severe ED prevalence was 31.6% (95% CI 28.8, 34.6). The mean (± SD) of the total score of IIEF-5 for overall respondents was 18.16 (± 4.13). Multiple logistic regression analysis revealed a significant association between moderate to severe ED among men aged 60 years and above, single or divorcee, men without formal, primary, and secondary education, non-government employees, unemployed, and retiree, as well as physically inactive men. Focused public health interventions are necessary to improve education in sexual health, increase health promotion programs, and promote healthy ageing across the population.
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Affiliation(s)
- Muhammad Solihin Rezali
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Mohamad Fuad Mohamad Anuar
- Biostatistic and Repository Data, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohamad Aznuddin Abd Razak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Zhuo Lin Chong
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Azli Baharudin Shaharudin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Mohd Shaiful Azlan Kassim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | | | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Gelugor, Malaysia
| | - Zakiah Mohd Said
- Adult Health Sector, Family Health Development Division, Ministry of Health Malaysia, Shah Alam, Malaysia
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Babalola OO, Iwaloye O, Ottu PO, Aturamu PO, Olawale F. Biological activities of African medicinal plants in the treatment of erectile dysfunction: a mechanistic perspective. Horm Mol Biol Clin Investig 2023; 44:357-370. [PMID: 38221710 DOI: 10.1515/hmbci-2022-0090] [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: 09/26/2022] [Accepted: 09/24/2023] [Indexed: 01/16/2024]
Abstract
The global incidence of erectile dysfunction is increasingly becoming a significant health concern, as its frequency demonstrates a consistent upward trajectory each year. In recent years, FDA-approved drugs like sildenafil among others has been approved to treat this disorder however the drug is not without its own side effects. In a bid to develop alternative therapeutic option, scientists have now turned to traditional medicine in search of a treatment regimen. Africa is blessed with numerous medicinal plants used in the treatment and management of several diseases including erectile dysfunction. Due to limited access to modern medicine and high-quality medical facilities, a significant number of individuals in Africa continue to depend on traditional medicine as a means of addressing critical health issues. Perhaps one of the grossly explored medicinal properties of plants in Africa is for erectile function. Through years of extensive research in medicinal plants, several plants indigenous to Africa have been identified to show profound ability to mitigate erectile dysfunction. While previous reports have indeed corroborated the ability of this plant to abate erectile dysfunction, there is still a dearth of information regarding the mechanistic aspect of these plants. Hence, the current review aims to provide a comprehensive mechanistic perspective to the major African medicinal plant which have been reported to be effective in the treatment of erectile dysfunction.
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Affiliation(s)
- Olorunfemi Oyewole Babalola
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Opeyemi Iwaloye
- Department of Biochemistry, Federal University of Technology Akure, Akure, Nigeria
| | - Paul Olamide Ottu
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Precious Olayinka Aturamu
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Femi Olawale
- Nanogene and Drug Delivery Group, University of KwaZulu-Natal, Durban, South Africa
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Xu Z, Elrashidy RA, Li B, Liu G. Oxidative Stress: A Putative Link Between Lower Urinary Tract Symptoms and Aging and Major Chronic Diseases. Front Med (Lausanne) 2022; 9:812967. [PMID: 35360727 PMCID: PMC8960172 DOI: 10.3389/fmed.2022.812967] [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: 11/11/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Aging and major chronic diseases are risk factors for lower urinary tract symptoms (LUTS). On the other hand, oxidative stress (OS) is one of the fundamental mechanisms of aging and the development of chronic diseases. Therefore, OS might be a candidate mechanism linking these two clinical entities. This article aims to summarize the studies on the prevalence of LUTS, the role of OS in aging and chronic diseases, and the potential mechanisms supporting the putative link. A comprehensive literature search was performed to identify recent reports investigating LUTS and OS in major chronic diseases. In addition, studies on the impact of OS on the lower urinary tract, including bladder, urethra, and prostate, were collected and summarized. Many studies showed LUTS are prevalent in aging and major chronic diseases, including obesity, metabolic syndrome, diabetes, cardiovascular disease, hypertension, obstructive sleep apnea, autoimmune diseases, Alzheimer’s disease, and Parkinson’s disease. At the same time, OS is a key component in the pathogenesis of those chronic diseases and conditions. Recent studies also provided evidence that exacerbated OS can cause functional and/or structural changes in the bladder, urethra, and prostate, leading to LUTS. The reviewed data support the concept that OS is involved in multiple risk factors-associated LUTS, although further studies are needed to confirm the causative relationship. The specific ROS/RNS and corresponding reactions/pathways involved in chronic diseases and associated LUTS should be identified in the future and could serve as therapeutic targets.
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Affiliation(s)
- Zhenqun Xu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Rania A. Elrashidy
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Bo Li
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- *Correspondence: Guiming Liu,
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Mohamad Anuar MF, Solihin Rezali M, Mohamed Daud MA, Ismail SB. A community-based study on lower urinary tract symptoms in Malaysian males aged 40 years and above. Sci Rep 2022; 12:2345. [PMID: 35149733 PMCID: PMC8837662 DOI: 10.1038/s41598-022-05890-9] [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: 09/18/2021] [Accepted: 01/12/2022] [Indexed: 11/17/2022] Open
Abstract
Lower urinary tract symptoms (LUTS) commonly affecting ageing men and is thought to be linked with other comorbidities and unhealthy lifestyles. This study was performed to report the prevalence of LUTS and its association with quality of life (QOL) in urination and other related factors. The study was part of the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional community-based survey in Malaysia. Validated self-administered bilingual International Prostate Symptom Score (IPSS) was used to assess the LUTS. Other comorbidities and unhealthy lifestyles were recorded using face-to-face interview and in-situ measurements such as anthropometry assessment and blood measurement. There were a total of 2251 respondents. 16.3% of the respondents had clinically significant LUTS (IPSS ≥ 8). LUTS was found to be significantly associated with QOL, age and inactive physical activities. Nocturia was the most prevalent and bothersome symptom. LUTS is a common condition and adversely affect QOL. Ageing and physically inactive males are associated with the development of LUTS. It is recommended to increase public awareness of the condition and availability of treatment options for LUTS. Any upcoming survey should have a more in-depth investigation such as clinical profiling of subjects.
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Affiliation(s)
- Mohamad Fuad Mohamad Anuar
- Sector for Biostatistic and Repository Data, Office of NIH Manager, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia.
| | - Muhammad Solihin Rezali
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Mohamed Ashraf Mohamed Daud
- Urology Unit, Department of Surgery, Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Azuero J, Santander J, Trujillo CG, Caicedo JI, Zuluaga L, Becerra AM, Daza F, Rondón M, Plata M. Potential associations of adult nocturia. Results from a national prevalence study. Neurourol Urodyn 2021; 40:819-828. [PMID: 33550620 DOI: 10.1002/nau.24624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
AIM To determine the prevalence of nocturia and associated risk factors in the Colombian population aged ≥18 years old. METHODS This is a cross-sectional population-based study conducted in 1060 participants in Colombia. Nocturia was assessed with the Spanish version of the ICIQ-OAB, using the ICS terminology. Descriptive statistics were used to evaluate nocturia prevalence. Logistic regression analysis was carried out to determine the association of nocturia with predefined variables. RESULTS The prevalence of nocturia was 55.9% and it was more common in women than men (53.96% vs. 46.04%; p = .004). At least three episodes of nocturia were observed in 20.37% of the participants who had a severe alteration in their quality of life (p < .01). The bivariate model showed an association between nocturia and obesity (odds ratio [OR], 1.69; 90% confidence interval [CI]: 1.22-2.34), diabetes mellitus (OR, 2.99; 90% CI: 1.86-4.83), high blood pressure (OR, 2.04; 90% CI: 1.52-2.72), cardiovascular disease (OR, 1.75; 90% CI: 1.08 - 2.83), depression (OR, 1.89; 90% CI: 1.23-2.89), obstructive sleep apnea (OR, 1.70; 90% CI: 1.17 - 2.46), and childhood enuresis (OR, 1.45; 90% CI: 1.04-2.02). The multivariate model showed an association with obesity (OR, 2.0; 95% CI: 1.14 - 3.51) in women, as well as age ≥ 65 years (OR, 3.18; 95% CI: 1.26 - 8.02) and erectile dysfunction (OR, 3.44; 95% CI: 1.21 - 9.72) in men. Childhood enuresis was significantly associated with nocturia in both genders (OR, 1.61; 95% CI: 1.09 - 2.40 in women and OR, 1.66; 95% CI: 1.09-2.52 in men). CONCLUSION There is a significant prevalence of nocturia in our population and a clear association with impaired quality of life. We consider important to inquire about history of childhood enuresis to define the risk of presenting nocturia in adulthood. Nocturia was associated with multiple comorbidities. Obesity and erectile dysfunction play an important role as modifiable risk factor.
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Affiliation(s)
- Julian Azuero
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Jessica Santander
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Carlos Gustavo Trujillo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Juan Ignacio Caicedo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Laura Zuluaga
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Ana María Becerra
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Fabián Daza
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Martin Rondón
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mauricio Plata
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad de los Andes School of Medicine, Bogotá, Colombia
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Nutalapati S, Ghagane SC, Nerli RB, Jali MV, Dixit NS. Association of erectile dysfunction and type II diabetes mellitus at a tertiary care centre of south India. Diabetes Metab Syndr 2020; 14:649-653. [PMID: 32438327 DOI: 10.1016/j.dsx.2020.04.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Erectile Dysfunction (ED) is more common in diabetic men and, unfortunately, occurs at an earlier age in diabetic patients when compared with the general population. The study aims to evaluate the independent predictors of ED in adult men with type 2 diabetes mellitus (DM) at a tertiary care center of South India. METHODS A total of 720 men aged 30-70 years who had been diagnosed with type 2 DM were enrolled for the study from January 2017 to January 2020 from the outpatient diabetes clinic of the Hospital. All patients completed the abridged version of the International Index of Erectile Function (IIEF-5) questionnaire. RESULTS The mean age of the patients was (58.4 ± 7.8 years). 68.6% of subjects had varying degrees of erectile dysfunction, of which 54.6% had moderate to severe ED. 55.8% had poor glycemic control (HbA1c ≥ 7%). Subjects with ED had a longer duration of DM than those without ED (mean DM duration was 8.1 ± 4.9 years versus 4.4 ± 3.5 years; p < 0.001). Longer duration of DM, poor glycemic control, hypertension, peripheral arterial disease, testosterone deficiency were all independent predictors ED (p < 0.05). CONCLUSIONS A high incidence of erectile dysfunction was observed in type 2 DM patients attending the diabetic clinic, and over half of the people affected were of moderate-to-severe in intensity. Poor glycemic control, testosterone deficiency, peripheral arterial disease were the modifiable risk factors for ED in diabetic subjects. At the same time, a longer duration of type 2 DM was noticed as a glaring non-modifiable risk factor, according to our study.
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Affiliation(s)
- Sreeharsha Nutalapati
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India
| | - Shridhar C Ghagane
- KLES Diabetes Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India; Urinary Biomarkers Research Centre, Department of Urology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - R B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, Karnataka, 590010, India.
| | - M V Jali
- KLE Academy of Higher Education and Research (Deemed to Be University), Nehru Nagar, Belagavi, 590010, India; KLES Diabetes Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
| | - Neeraj S Dixit
- Urinary Biomarkers Research Centre, Department of Urology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, 590010, India
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Isa NMM, Aziz AFA. Lower Urinary Tract Symptoms: Prevalence and Factors Associated with Help-Seeking in Male Primary Care Attendees. Korean J Fam Med 2020; 41:256-262. [PMID: 32019295 PMCID: PMC7385293 DOI: 10.4082/kjfm.19.0012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 09/05/2019] [Indexed: 11/04/2022] Open
Abstract
Background Lower urinary tract symptoms (LUTS) are common among elderly men. However, seeking help for this problem is mostly delayed until complications arise. Primary care clinics serve as the first point of contact for a person’s health needs throughout their life. This study aimed to determine the prevalence of LUTS among primary care attendees, and the factors that influence seeking medical intervention at primary care clinics. Methods Using a universal sampling technique, 460 male patients aged 60 and above visiting an urban based public primary care clinic were recruited. An interviewer administered the questionnaire which used International Prostate Symptoms Score and International Consultation on Incontinence Modular Questionnaire-Lower Urinary Tract Symptoms-Quality of Life. Results The prevalence of any LUTS and clinically significant LUTS were 89.8% and 20.5%, respectively. Among the 385 participants who completed the study, only 41.8% had consulted a doctor for LUTS. Among those with moderate/severe symptoms only 57.6% had sought medical intervention. Multiple logistic regression analysis showed that the presence of more than two comorbidities (P=0.004; odds ratio [OR], 4.695; 95% confidence interval [CI], 1.632–13.508) and quality of life (P=0.002; OR, 1.271; 95% CI, 1.091–1.481) were independent factors significantly associated with seeking help. Conclusion Prevalence of LUTS among elderly men undergoing primary care is high, but more than half of the patients had not sought medical attention. Increasing comorbidities and impact on quality of life influenced elderly men with LUTS to seek help.
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Affiliation(s)
- Noor Mikraz Mohamad Isa
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU Int 2019; 124:587-599. [PMID: 31267639 DOI: 10.1111/bju.14813] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate the global prevalence of erectile dysfunction (ED); as well as its association with physiological and pathological ageing by examining the relationship between ED and cardiovascular disease (CVD), benign prostatic hyperplasia (BPH), and dementia. We also aimed to characterise discrepancies caused by the use of different ED screening tools. METHODS The Excerpta Medica dataBASE (EMBASE) and Medical Literature Analysis and Retrieval System Online (MEDLINE) were searched to find population-based studies investigating the prevalence of ED and the association between ED and CVD, BPH, and dementia in the general population. RESULTS The global prevalence of ED was 3-76.5%. ED was associated with increasing age. Use of the International Index of Erectile Function (IIEF) and Massachusetts Male Aging Study (MMAS)-derived questionnaire identified a high prevalence of ED in young men. ED was positively associated with CVD. Men with ED have an increased risk of all-cause mortality odds ratio (OR) 1.26 (95% confidence interval [CI] 1.01-1.57), as well as CVD mortality OR 1.43 (95% CI 1.00-2.05). Men with ED are 1.33-6.24-times more likely to have BPH then men without ED, and 1.68-times more likely to develop dementia than men without ED. CONCLUSION ED screening tools in population-based studies are a major source of discrepancy. Non-validated questionnaires may be less sensitive than the IIEF and MMAS-derived questionnaire. ED constitutes a large burden on society given its high prevalence and impact on quality of life, and is also a risk factor for CVD, dementia, and all-cause mortality.
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Affiliation(s)
- Anna Kessler
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Sam Sollie
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Ben Challacombe
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Karen Briggs
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
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Mahishale A, Ambre P, Kantanavar KA. Prevalence of urinary incontinence in males with type 2 diabetes mellitus. Diabetes Metab Syndr 2019; 13:2953-2956. [PMID: 31425962 DOI: 10.1016/j.dsx.2019.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 07/08/2019] [Indexed: 11/18/2022]
Abstract
AIM To find the prevalence of Urinary Incontinence (UI) in males with Type 2 Diabetes Mellitus (T2DM) in Belagavi city and also to understand the severity of UI and the impact of variables like age, duration of diabetes, BMI (Body mass index), waist circumference, glycemic control (fasting blood glucose), and medications on the prevalence of UI in males with T2DM. METHODOLOGY This was a cross-sectional, observational study conducted in a tertiary hospital and medical research centre of Karnataka, India in which males aged 35 years or more and suffering with T2DM for at-least 10years were enrolled. UI was assessed using International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). RESULTS Out of 123 male subjects having T2DM screened for the prevalence of UI, 19 subjects were diagnosed to be having UI as per ICIQ-SF questionnaire, accounting to 15.4% of the total sample. The mean ICIQ score of the 19 subjects having UI was 9.2 ± 1.54 showing that the mean severity of UI was moderate in nature. Study also found that the duration of diabetes was significantly high (mean = 18 ± 4.6 years) and glycemic control was significantly poor (Mean FBS = 210 ± 64.21 mg/dL) in subjects with UI than in subjects without UI. CONCLUSIONS Prevalence of UI among adult patients with T2DM was 15.4% and is of moderate severity, as assessed by ICIQ-SF. Long duration of Diabetes and poor glycemic control could possibly increase the risk of UI among T2DM patients.
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Affiliation(s)
- Arati Mahishale
- Dept of OBG Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India
| | - Pooja Ambre
- Dept of OBG Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India.
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Muhamad S, Sengupta P, Ramli R, Nasir A. Sociodemographic factors associated with semen quality among Malaysian men attending fertility clinic. Andrologia 2019; 51:e13383. [DOI: 10.1111/and.13383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/21/2019] [Accepted: 07/10/2019] [Indexed: 01/25/2023] Open
Affiliation(s)
- Suriyani Muhamad
- School of Social and Economic Development Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Pallav Sengupta
- Faculty of Medicine and Biomedical Sciences MAHSA University Jenjarom Malaysia
| | - Roszaman Ramli
- Kulliyyah of Medicine International Islamic University Malaysia Kuantan Malaysia
| | - Aslina Nasir
- School of Informatics and Applied Mathematics Universiti Malaysia Terengganu Kuala Nerus Malaysia
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Lin WY, Huang KT, Lin CL, Kao CH. The risk of venous thromboembolism in patients with lower urinary tract symptoms. UROLOGICAL SCIENCE 2018. [DOI: 10.4103/uros.uros_33_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Male Sexual Function in New Zealand: A Population-Based Cross-Sectional Survey of the Prevalence of Erectile Dysfunction in Men Aged 40-70 Years. J Sex Med 2017; 14:928-936. [PMID: 28673435 DOI: 10.1016/j.jsxm.2017.05.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/02/2017] [Accepted: 05/19/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND Sexual function declines with age and erectile dysfunction (ED) is a common condition worldwide; however, prevalence rates vary markedly between populations and reliable data specific to New Zealand (NZ) are lacking. AIM To assess the prevalence of ED in NZ men using a population-based cross-sectional survey. METHODS Postal questionnaires were sent, according to a modified Dillman method, to a randomly selected age-stratified population-based sample of 2,000 men 40 to 70 years old obtained from the electoral roll. Self-reported erectile function was assessed using the five-item International Index of Erectile Function (IIEF-5) and the single-question self-assessment tool. OUTCOMES The prevalence of ED is presented as crude, age-adjusted to the distribution of the NZ population, and standardized to the World Health Organization World Standard Population (WSP). Associations between sexual function and age were analyzed using χ2 test. RESULTS The response rate was 30% (599) and 28% (562) were complete for analysis. The crude prevalence of ED was 42% (22% mild, 10% mild to moderate, 6% moderate, and 4% severe), the age-adjusted prevalence was 38%, and the WSP-adjusted prevalence was 37%. Among men reporting ED, 16% were medically diagnosed and 22% were treated. ED affected 24% of men in their 40s, 38% in their 50s, and 60% in their 60s (P < .001). Age was associated with a significant increase in diagnosed ED (P = .001), treated ED (P = .006), dissatisfaction with current sexual function (P < .001), associated anxiety or depression (P = .023), and a decrease in sexual activity (P < .001). CLINICAL TRANSLATION Approximately one in three NZ men 40 to 70 years old might have ED. Although comparable to overseas populations, this prevalence is high. STRENGTHS AND LIMITATIONS This study provides the most reliable, comprehensive, and current information on ED and its risk factors in NZ men. Strengths include the large sample, the use of random selection from a population-based sampling frame, established effective survey methods, and the validated IIEF-5. Limitations include the inability of cross-sectional data to determine causation, non-sampling errors associated with the population-based sampling frame, the low response rate, the inability to assess non-respondents, the possibility of men with ED who were sexually inactive not responding or not completing the IIEF-5, and the inherent inability to rule out recall bias. CONCLUSION ED is a marker of subclinical cardiovascular disease. The high prevalence and low levels of diagnosis and treatment indicate a lost opportunity for timely intervention to delay or prevent the progression toward clinical disease. Quilter M, Hodges L, von Hurst P, et al. Male Sexual Function in New Zealand: A Population-Based Cross-Sectional Survey of the Prevalence of Erectile Dysfunction in Men Aged 40-70 Years. J Sex Med 2017;14:928-936.
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Lin WY, Andersson KE, Lin CL, Kao CH, Wu HC. Association of lower urinary tract syndrome with peripheral arterial occlusive disease. PLoS One 2017; 12:e0170288. [PMID: 28301517 PMCID: PMC5354249 DOI: 10.1371/journal.pone.0170288] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 01/03/2017] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To describe atherosclerosis may lead to chronic bladder ischemia, eventually resulting in lower urinary tract syndrome (LUTS), and peripheral arterial occlusive disease (PAOD). We investigated the association of LUTS with PAOD. METHODS This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Database from 2000 to 2010; follow-up lasted until the end of 2011. We identified patients with newly diagnosed LUTS by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. RESULTS In total, 36,042 and 36,042 patients were enrolled in LUTS and non-LUTS cohorts, respectively. After adjustment for age, sex, and comorbidities, the risk of subsequent PAOD was 1.36-fold higher [95% confidence interval (CI) = 1.26-1.46] in the LUTS cohort than in the non-LUTS cohort. The adjusted risk of PAOD was the highest in patients with LUTS without any comorbidity [adjusted hazard ratio (aHR) = 1.93, 95% CI = 1.54-2.41]. The age-specific relative risk of PAOD was significantly higher in all age groups, particularly in those aged <49 years (aHR = 1.80, 95% CI = 1.39-2.34], in the LUTS cohort than in the non-LUTS cohort. CONCLUSION LUTS is a risk factor for PAOD. Physicians should consider the possibility of underlying PAOD in patients with LUTS aged <49 years and without cardiovascular comorbidities. Additional studies developing strategies for decreasing the risk of PAOD are warranted.
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Affiliation(s)
- Wei-Yu Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan
- Chang Gung University of Science and Technology, Chia-Yi, Taiwan
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan
| | - Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Hsi-Chin Wu
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Urology, China Medical University Beigang Hospital, Taichung, Taiwan
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Wang CJ, Hung CH, Tang TC, Chen LY, Peng LN, Hsiao FY, Chen LK. Urinary Incontinence and Its Association with Frailty Among Men Aged 80 Years or Older in Taiwan: A Cross-Sectional Study. Rejuvenation Res 2016; 20:111-117. [PMID: 27651115 DOI: 10.1089/rej.2016.1855] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AIMS To evaluate the prevalence of urinary incontinence (UI) and its association with frailty among men aged 80 years and older in Taiwan. METHODS Residents living in four veterans retirement communities were invited for study and 440 men aged 80 years and older were enrolled. Comprehensive geriatric assessment was performed for them, which composed of Clinical Frailty Scale, Northern Health and Social Care Trust (HSC)-Continence Assessment Form, Charlson's Comorbidity Index (CCI), Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric Depression Scale-5 (GDS-5), and Mini-Nutritional Assessment-Short Form (MNA-SF). RESULTS In this study, the overall prevalence of UI was 19.1% (mostly urgency incontinence and functional incontinence). Univariate analyses were performed to evaluate the associations between UI and other variables. Frailty was more common among subjects with UI than those without (60.7% vs 32.3%, p < 0.001). Besides, subjects with UI had more comorbidity (CCI: 1.40 ± 1.15 vs 0.89 ± 0.89, p < 0.001), poorer physical function (BI: 65.77 ± 33.39 vs 84.12 ± 24.08, p < 0.001; IADL: 3.46 ± 2.64 vs 4.41 ± 2.25, p = 0.003), more depressive symptoms (GDS-5: 1.83 ± 1.78 vs 1.18 ± 1.36, p = 0.02), poorer cognitive function (MMSE: 16.57 ± 7.65 vs 19.37 ± 6.82, p = 0.001), poorer nutritional status (MNA-SF: 10.0 ± 03.03 vs 11.23 ± 2.24, p = 0.001), more polypharmacy (66.7% vs 45.2%, p < 0.001) and higher chance of stool incontinence (22.6% vs 1.7%, p < 0.001). Multivariate logistic regression showed that UI was independently associated with frailty, (odds ratio [OR] = 2.1; 95% confidence interval [CI]: 1.2-3.6; p = 0.012), stool incontinence (OR = 14.4; 95% CI 5.2-39.7; p < 0.001) and depressive symptoms (OR = 1.30; 95% CI 1.10-1.54; p = 0.002). CONCLUSIONS About one fifth of study subjects had UI (mostly urgency and functional incontinence type), which was significantly associated with frailty, stool incontinence and depressive symptoms. Further study is needed to evaluate the possibilities of reversing these geriatric syndromes by an integrated intervention program.
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Affiliation(s)
- Chih-Jen Wang
- 1 Department of Medicine, Changhua Christian Hospital , Changhua, Taiwan .,2 Aging and Health Research Center, National Yang Ming University , Taipei, Taiwan
| | - Cheng-Hao Hung
- 2 Aging and Health Research Center, National Yang Ming University , Taipei, Taiwan .,3 Center for Geriatrics and Gerontology, Taipei Veterans General Hospital , Taipei, Taiwan
| | - Ting-Ching Tang
- 2 Aging and Health Research Center, National Yang Ming University , Taipei, Taiwan .,3 Center for Geriatrics and Gerontology, Taipei Veterans General Hospital , Taipei, Taiwan
| | - Liang-Yu Chen
- 2 Aging and Health Research Center, National Yang Ming University , Taipei, Taiwan .,3 Center for Geriatrics and Gerontology, Taipei Veterans General Hospital , Taipei, Taiwan
| | - Li-Ning Peng
- 2 Aging and Health Research Center, National Yang Ming University , Taipei, Taiwan .,3 Center for Geriatrics and Gerontology, Taipei Veterans General Hospital , Taipei, Taiwan
| | - Fei-Yuan Hsiao
- 4 Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Liang-Kung Chen
- 2 Aging and Health Research Center, National Yang Ming University , Taipei, Taiwan .,3 Center for Geriatrics and Gerontology, Taipei Veterans General Hospital , Taipei, Taiwan
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Andersson KE, Boedtkjer DB, Forman A. The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction. Ther Adv Urol 2016; 9:11-27. [PMID: 28042309 DOI: 10.1177/1756287216675778] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The vascular supply to the human bladder is derived mainly from the superior and inferior vesical arteries, the latter being directly connected to the internal iliac artery. Aging is associated with an impairment of blood vessel function and changes may occur in the vasculature at the molecular, cellular and functional level. Pelvic arterial insufficiency may play an important role in the development of bladder dysfunctions such as detrusor overactivity (DO) and the overactive bladder syndrome. Chronic ischemia-related bladder dysfunction may progress to bladder underactivity and it would be desirable to treat not only lower urinary tract symptoms (LUTS) induced by chronic ischemia, but also the progression of the morphological bladder changes. Studies in experimental models in rabbits and rats have shown that pelvic arterial insufficiency may result in significant bladder ischemia with reduced bladder wall oxygen tension. In turn, this will lead to oxidative stress associated with upregulation of oxidative stress-sensitive genes, increased muscarinic receptor activity, ultrastructural damage, and neurodegeneration. The phosphodiesterase type 5 (PDE5) inhibitor tadalafil, the α1-adrenoceptor (AR) blocker silodosin, the β3-AR agonist mirabegron, and the free radical scavenger melatonin, exerted a protecting effect on urodynamic parameters, and on functional and morphological changes of the bladder demonstrable in vitro. Since the agents tested are used clinically for relieving LUTS, the results from the animal models seem to have translational value, and may be of relevance for designing clinical studies to demonstrate if the drugs may prevent progression of ischemia-related functional and morphological bladder changes.
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Affiliation(s)
- Karl-Erik Andersson
- Institute of Clinical Medicine, Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK 8200 Aarhus N, Denmark
| | | | - Axel Forman
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Denmark
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Chung CM, Lu MZH, Wong CYT, Goh SGK, Azhar MIM, Lim YM, Rusli BN, Khalid BAK. The SAD-MEN questionnaire: a new and reliable questionnaire for assessing sexual dysfunction in Asians with diabetes. Diabet Med 2016; 33. [PMID: 26202696 PMCID: PMC5057321 DOI: 10.1111/dme.12864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AIM The aim of this study is to construct a new tool for the assessment of sexual dysfunction among men with diabetes that is valid and reliable across different ethnicities, languages and socio-economic backgrounds in South East Asia. METHODS Focus group interviews were conducted to determine the construct of the questionnaire. Content and face validity were assessed by a panel of experts. A pilot study was conducted to validate the Sexual Dysfunction in Asian Men with Diabetes (SAD-MEN) questionnaire in English and Malay. The International Index of Erectile Function-5 (IIEF-5) was used for comparison. Construct validity was assessed using exploratory factor analysis, reliability was determined using Cronbach's α (> 0.700), and test-retest reliability using Spearman's rank correlation coefficient. RESULTS The SAD-MEN questionnaire yielded moderate face and content validity, with high reliability as shown by Cronbach's α values of 0.949 for sexual performance and 0.775 for sexual desire for the English version. The Malay language questionnaire had a Cronbach's α value of 0.945 for sexual performance and 0.750 for sexual desire. Test-retest reliability using Spearman's test gave correlation coefficients of r = 0.853, P = 0.000 for the English language questionnaire and r = 0.908, P = 0.000 for the Malay language questionnaire. CONCLUSION The SAD-MEN questionnaire is a valid and reliable tool by which to assess sexual dysfunction in English- and Malay-speaking Malaysian and South East Asian men with diabetes.
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MESH Headings
- Adult
- Aged
- China/ethnology
- Cohort Studies
- Culturally Competent Care
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/psychology
- Focus Groups
- Humans
- India/ethnology
- Malaysia
- Male
- Middle Aged
- Pilot Projects
- Psychiatric Status Rating Scales
- Reproducibility of Results
- Self Report
- Severity of Illness Index
- Sexual Dysfunction, Physiological/complications
- Sexual Dysfunction, Physiological/diagnosis
- Sexual Dysfunction, Physiological/ethnology
- Sexual Dysfunction, Physiological/physiopathology
- Sexual Dysfunctions, Psychological/complications
- Sexual Dysfunctions, Psychological/diagnosis
- Sexual Dysfunctions, Psychological/ethnology
- Sexual Dysfunctions, Psychological/physiopathology
- Socioeconomic Factors
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Affiliation(s)
- C. M. Chung
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - M. Z. H. Lu
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - C. Y. T. Wong
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - S. G. K. Goh
- Jeffrey Cheah School of Medicine and Health SciencesMonash UniversityBandar SunwayMalaysia
| | - M. I. M. Azhar
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - Y. M. Lim
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - B. N. Rusli
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - B. A. K. Khalid
- Jeffrey Cheah School of Medicine and Health SciencesMonash UniversityBandar SunwayMalaysia
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Furukawa S, Sakai T, Niiya T, Miyaoka H, Miyake T, Yamamoto S, Maruyama K, Tanaka K, Ueda T, Senba H, Torisu M, Minami H, Onji M, Tanigawa T, Matsuura B, Hiasa Y, Miyake Y. Nocturia and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study. J Diabetes Investig 2016; 7:786-90. [PMID: 27180646 PMCID: PMC5009143 DOI: 10.1111/jdi.12503] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/26/2016] [Accepted: 02/15/2016] [Indexed: 12/02/2022] Open
Abstract
Aims/Introduction Several epidemiological studies have reported a positive association between nocturia and erectile dysfunction (ED). Yet only limited evidence exists regarding the association between nocturia and ED among patients with type 2 diabetes mellitus, although nocturia and ED are common among type 2 diabetes mellitus patients. Material and Methods Study participants were 332 male Japanese patients with type 2 diabetes mellitus, aged 19–70 years, who had undergone blood tests at our institutions. A self‐administered questionnaire was used to collect information on the variables under study. Adjustment was made for age, body mass index, hypertension, stroke, ischemic heart disease, glycated hemoglobin and diabetic neuropathy. ED, moderate to severe ED and severe ED were defined as present when a participant had a Sexual Health Inventory for Men score <22, <12 and <8, respectively. Study participants were considered to have nocturia if they answered ‘once or more’ to the question: ‘Within 1 week, how many times do you typically wake up to urinate from sleeping at night until waking in the morning?’ Results The prevalence of nocturia was 79.8%. Nocturia was independently positively associated with ED and moderate to severe ED: the adjusted odds ratios were 7.86 (95% confidence interval 2.11–33.56) and 2.17 (95% confidence interval 1.16–4.12), respectively. The positive association between nocturia and severe ED fell just short of significance. Conclusions In Japanese men with type 2 diabetes mellitus, nocturia might be associated with ED and moderate to severe ED. Several epidemiological studies have reported a positive association between nocturia and erectile dysfunction (ED). Yet only limited evidence exists regarding the association between nocturia and ED among patients with type 2 diabetes mellitus, although nocturia and ED are common among type 2 diabetes mellitus patients.
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Affiliation(s)
- Shinya Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Japan
| | - Takenori Sakai
- Department of Internal Medicine, Yawatahama General City Hospital, Yawatahama, Japan
| | - Tetsuji Niiya
- Department of Internal Medicine, Matsuyama Shimin Hospital, Matsuyama, Japan
| | - Hiroaki Miyaoka
- Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama, Japan
| | - Teruki Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shin Yamamoto
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Koutatsu Maruyama
- Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Japan
| | - Teruhisa Ueda
- Department of Internal Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Hidenori Senba
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Masamoto Torisu
- Department of Internal Medicine, Saiseikai Saijo Hospital, Saijo, Japan
| | - Hisaka Minami
- Department of Internal Medicine, Ehime Niihama Hospital, Niihama, Japan
| | - Morikazu Onji
- Department of Internal Medicine, Saiseikai Imabari Hospital, Imabari, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan
| | - Bunzo Matsuura
- Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Japan
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Tong SF, Low WY, Ismail SB, Trevena L, Wilcock S. Determinants of doctors' decisions to inquire about sexual dysfunction in Malaysian primary care settings. Transl Androl Urol 2016; 2:281-90. [PMID: 26816741 PMCID: PMC4708114 DOI: 10.3978/j.issn.2223-4683.2013.09.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors’ decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors’ perceptions of men’s receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men. Methods This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors’ intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors’ attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors’ intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated. Results 198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men’s receptivity to sexual health inquiry significantly predicted the doctors’ intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (P<0.0001) and health checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (P<0.001). Lower cost to health checks only predicted their intention in the follow-up visits (P=0.010). Conclusions Whilst sexual health inquiry should be initiated in an appropriate context, ‘perceived receptivity’ to sexual health inquiry significantly affected doctors’ intention in initiating sexual health inquiry to their male patients. Malaysian men’s health may be substantially improved by strategies that assist doctors to identify patient ‘receptivity’.
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Affiliation(s)
- Seng Fah Tong
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Wah Yun Low
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Shaiful Bahari Ismail
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Lyndal Trevena
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Simon Wilcock
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
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Abstract
The pathophysiology of OAB is complex, multifactorial and still largely unknown. Several pathophysiological mechanisms have been highlighted that may play a different role in different patient groups. There are now experimental evidences that support both the myogenic and neurogenic hypothesis, but in recent years the "integrative" hypothesis has been gaining more and more acceptance, where a disruption in the multiple interactions between different cell types (neurons, urothelium, interstitial cells, myocytes) and network functions represent a central element of lower urinary tract dysfunctions. Of utmost importance, a disorder in the urothelial sensory function and in the urothelial/suburothelial non-neural cholinergic system, favored by age and comorbidities, appears to be crucial for the development of the OAB. Neuroplastic and detrusor changes in OAB are broadly similar to those observed in bladders exposed to outlet obstruction, neuropathies, inflammation or aging, and may be driven by a common urothelial dysfunction. Several signaling substances and their receptors were found to be involved in central pathways of bidirectional communication between the different cell types in the bladder, and were shown to be modified in several animal models of OAB as well as in human models, indicating new potential therapeutic targets.
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Lim J, Bhoo-Pathy N, Sothilingam S, Malek R, Sundram M, Tan GH, Bahadzor B, Ong TA, Ng KL, Abdul Razack AH. Cardiovascular Risk Factors and Ethnicity Are Independent Factors Associated with Lower Urinary Tract Symptoms. PLoS One 2015; 10:e0130820. [PMID: 26098884 PMCID: PMC4476577 DOI: 10.1371/journal.pone.0130820] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 05/26/2015] [Indexed: 11/22/2022] Open
Abstract
Objectives To determine the lower urinary tract symptoms (LUTS) profile and factors affecting its degree of severity including cardiovascular risk profile, age, ethnicity, education level and prostate volume in a multiethnic Asian setting. Materials and Methods We conducted a cross-sectional study of 1021 men aged 40–79 years with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS). Potential factors associated with LUTS including age, ethnicity, education, history of hypertension, diabetes and hypercholesterolemia, height, weight, and prostate volume were evaluated using univariable and multivariable analyses. Results There were 506 (50%) men found to have moderate-to-severe LUTS attaining an IPSS above 7. Overall, nocturia (45.5%) was the most frequently reported symptom. Multivariable analysis showed that age, ethnicity, prostate volume and history of hypertension and hypercholesterolemia were independent factors associated with severity of LUTS (p < 0.05). Considering individual lower urinary tract symptoms, we found a strong association of storage symptom with history of hypertension and hypercholesterolemia. Malay men were significantly bothered by post micturition symptom compared to their Chinese and Indian counterparts. Stratified analyses of LUTS demonstrated a mutually exclusive cardiovascular risk factors profile defined by ethnicity. Conclusion Severity of LUTS varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity and cardiovascular risk factors including hypertension and hypercholesterolemia may also need to be taken into account in managing men with LUTS.
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Affiliation(s)
- Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nirmala Bhoo-Pathy
- Julius Center University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Primary Care, University Medical Center Utrecht, 3508GA, Utrecht, Netherlands
| | | | - Rohan Malek
- Department of Urology, Selayang Hospital, Selangor, Malaysia
| | - Murali Sundram
- Department of Urology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Guan Hee Tan
- Department of Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Badrulhisham Bahadzor
- Department of Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Keng Lim Ng
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Azad Hassan Abdul Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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Kogan MI, Zachoval R, Ozyurt C, Schäfer T, Christensen N. Epidemiology and impact of urinary incontinence, overactive bladder, and other lower urinary tract symptoms: results of the EPIC survey in Russia, Czech Republic, and Turkey. Curr Med Res Opin 2014; 30:2119-30. [PMID: 24932562 DOI: 10.1185/03007995.2014.934794] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) in the Czech Republic, Russia, and Turkey. METHODS Stage one of this population-based survey consisted of computer-assisted telephone interviews to obtain prevalence estimates of storage, voiding, and post-micturition LUTS. Stage two face-to-face interviews evaluated subjects with mixed urinary incontinence (MUI), stress urinary incontinence (SUI) or OAB (case group) and a control group (subjects with other incontinence or LUTS complaints, or no symptoms). OUTCOME MEASURE Prevalence of LUTS categories were determined for each country based on International Continence Society (ICS) criteria. RESULTS AND LIMITATIONS A total of 3130 individuals agreed to participate in the survey, which found high rates of LUTS (men 80%; women 84%) and OAB (men 18%; women 28%). Duration of urinary symptoms was relatively brief (approximately 60% ≤ 3 years) and was associated with relatively modest effects on quality of life and work performance in the majority of individuals. Forty percent had consulted with a healthcare provider about their urinary symptoms, of whom 37% had consulted with a physician and 34% with an urologist, and 12% had been treated with a prescription medication. Drug therapy, while uncommon, was associated with a high degree of self-reported improvement (96%). Because of between-country population differences, aggregate results may not always be representative of results for each of the three countries individually. Study limitations include reliance on patient self-report, and potential bias introduced by patients who declined to participate in the survey. CONCLUSIONS The results of this epidemiologic survey found high rates of LUTS and OAB, but low levels of medical consultation and very low use of medication treatment, despite high levels of improvement when medications were used.
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Yoshida M, Yamaguchi O. Detrusor Underactivity: The Current Concept of the Pathophysiology. Low Urin Tract Symptoms 2014; 6:131-7. [PMID: 26663593 DOI: 10.1111/luts.12070] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 06/27/2014] [Indexed: 12/16/2022]
Abstract
Based on evidence from available literature, we review the pathophysiology of detrusor underactivity (DU). DU is likely to be multifactorial. Aging reduces detrusor activity, but other concomitant causes may aggravate this condition, resulting in decrease of detrusor contractility. Impaired detrusor contractility has been regarded as a major etiologic factor of DU. However, a more complex pathology has been proposed. As contributing factors to DU, we discuss disturbances of the sensory afferent side of the micturition reflex, the central nervous system (CNS) and the efferent side of the reflex, including nerves and the detrusor muscle. Particularly, dysfunction of afferent nerves in the bladder and urethra may play a crucial role in the pathogenesis of DU. In addition, recent studies suggest that chronic bladder ischemia and resultant oxidative stress cause detrusor overactivity progressing to DU and inability to empty the bladder.
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Affiliation(s)
- Masaki Yoshida
- Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Osamu Yamaguchi
- Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Kohriyama, Japan
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Zaman Huri H, Lian Choo T, Sulaiman CZ, Mark R, Abdul Razack AH. Oral drug treatments in patients with erectile dysfunction and multiple comorbidities: a retrospective observational study. BMJ Open 2014; 4:e005381. [PMID: 25001396 PMCID: PMC4091539 DOI: 10.1136/bmjopen-2014-005381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/27/2014] [Accepted: 06/16/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate factors associated with demographic/clinical characteristics and drug selection in patients with erectile dysfunction (ED). The prevalence of ED is increasing worldwide. Studies have shown that ED is associated with age, lifestyle and comorbidities. However, the factors associated with patient characteristics as well as drug selection are incompletely understood. SETTING A tertiary medical centre in Kuala Lumpur, Malaysia. PARTICIPANTS A total of 219 patients (range 23-80 years) who had received phosphodiesterase type-5 (PDE-5) inhibitors as ED treatment were evaluated. INCLUSION CRITERIA Adult patients aged ≥18 years, diagnosed with ED, and prescribed with sildenafil, tadalafil or vardenafil. EXCLUSION CRITERIA Patients diagnosed with ED but who did not receive any PDE-5 inhibitor, or those with missing data. PRIMARY AND SECONDARY OUTCOME MEASURES Factors associated with demographic and clinical characteristics as well as drug selection were assessed. RESULTS Ischaemic heart disease (p=0.025), benign prostatic hyperplasia (p<0.001), obesity (p=0.005), lower urinary tract symptoms (LUTS) (p=0.006) and α-blockers (p<0.001) were significantly associated with elderly patients with ED. Additionally, LUTS (p=0.038) and α-blockers (p=0.008) were significantly associated with the selection of PDE-5 inhibitor. CONCLUSIONS These data showed that elderly patients with ED were significantly associated with comorbidities and α-blockers, whereas LUTS and α blockers were associated with drug selection.
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Affiliation(s)
- Hasniza Zaman Huri
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Clinical Investigation Centre, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Tee Lian Choo
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Che Zuraini Sulaiman
- Department of Pharmacy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Raymond Mark
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Shimizu S, Tsounapi P, Shimizu T, Honda M, Inoue K, Dimitriadis F, Saito M. Lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction: Are these conditions related to vascular dysfunction? Int J Urol 2014; 21:856-64. [DOI: 10.1111/iju.12501] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Shogo Shimizu
- Department of Pharmacology; Kochi Medical School, Kochi University; Nankoku Japan
| | - Panagiota Tsounapi
- Division of Urology; Tottori University School of Medicine; Yonago Japan
| | - Takahiro Shimizu
- Department of Pharmacology; Kochi Medical School, Kochi University; Nankoku Japan
| | - Masashi Honda
- Division of Urology; Tottori University School of Medicine; Yonago Japan
| | - Keiji Inoue
- Department of Urology; Kochi Medical School; Kochi University; Nankoku Japan
| | - Fotios Dimitriadis
- B' Urologic Department; Papageorgiou General Hospital; School of Medicine; Aristotle University; Thessaloniki Greece
| | - Motoaki Saito
- Department of Pharmacology; Kochi Medical School, Kochi University; Nankoku Japan
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Motoya T, Matsumoto S, Yamaguchi S, Wada N, Numata A, Osanai H, Kakizaki H. The impact of abdominal aortic calcification and visceral fat obesity on lower urinary tract symptoms in patients with benign prostatic hyperplasia. Int Urol Nephrol 2014; 46:1877-81. [PMID: 24908284 DOI: 10.1007/s11255-014-0757-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/27/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To investigate the impact of abdominal aortic calcification and visceral fat area (VFA) on lower urinary tract symptoms (LUTS) and clinical parameters in patients with benign prostatic hyperplasia (BPH). METHODS We retrospectively studied 250 patients with LUTS associated with BPH. Each participant was examined with routine examination including measurement of various data; (1) voided volume (VV), maximum urinary flow rate on free uroflowmetry, (2) postvoid residual urine volume and prostate volume using transabdominal ultrasound, (3) International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS), and (4) aortic calcification index (ACI) and VFA were measured by abdominal CT. RESULTS Mean age of the patients was 72.4 ± 9.6 years. ACI significantly correlated with VV (P = 0.0392) and tended to correlate with maximum urinary flow rate, while ACI did not correlate with subjective symptoms. VFA significantly correlated with nocturia score of IPSS (P = 0.0177) and frequency score of OABSS (P = 0.0166) and tended to correlate with urgency score of IPSS and maximum urinary flow rate. CONCLUSIONS Aortic calcification index (ACI) correlated with only objective parameters, while VFA correlated with only storage symptoms. This study suggested that abdominal aortic calcification and VFA have certain influence on LUTS and clinical parameters in patients with BPH.
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Affiliation(s)
- Tadasu Motoya
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1, Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan
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26
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Lower urinary tract symptoms and erectile dysfunction in men with type 2 diabetes mellitus. Int Neurourol J 2013; 17:180-5. [PMID: 24466465 PMCID: PMC3895510 DOI: 10.5213/inj.2013.17.4.180] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 11/05/2013] [Indexed: 11/08/2022] Open
Abstract
Purpose To assess the prevalence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) and the relationships between LUTS, ED, depression, and other factors in Korean men with type 2 diabetes mellitus (T2DM). Methods This cross-sectional study included 124 male patients with T2DM who attended a university hospital diabetes clinic between October 2010 and April 2012. Data were collected using structured interviews and chart reviews. LUTS were measured using the International Prostate Symptom Score (IPSS), ED using the five-item Korean version of the International Index of Erectile Function (IIEF), depression using the Center for Epidemiologic Studies Depression Scale, and glycosylated hemoglobin level from clinical data. Results The IPSS score was 9.2±6.6. The total IPSS scores indicated that 53.3% of the subjects had either moderate or severe symptoms. The mean IIEF score was 7.3±8.6, indicating the severity of ED to be mild, mild to moderate, moderate, and severe in 10.5%, 9.7%, 1.6%, and 66.9% of the participants, respectively. LUTS showed a significant negative correlation with ED (r=-0.26, P=0.003) and a significant positive correlation with depression (r=0.33, P<0.001). ED was negatively correlated with age (r=-0.44, P<0.001), duration of diabetes (r=-0.26, P=0.004), and depression (r=-0.24, P=0.008). Conclusions LUTS and ED were found to have a high prevalence among Korean men with T2DM. More severe ED was associated with worse LUTS, whereas more severe depressive symptoms were found to be associated with more severe ED and LUTS.
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Teng NIMF, Shahar S, Rajab NF, Manaf ZA, Johari MH, Ngah WZW. Improvement of metabolic parameters in healthy older adult men following a fasting calorie restriction intervention. Aging Male 2013; 16:177-83. [PMID: 24044618 DOI: 10.3109/13685538.2013.832191] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Calorie restriction and intermittent fasting are two dietary interventions that can improve aging. Religious fasting also suggested having similar benefit; however, such studies are still scarce. Thus, this study aimed to determine the effect of fasting calorie restriction (FCR) on metabolic parameters and DNA damage among healthy older adult men. METHODS A randomized controlled study was done on men, aged 50-70 years in Klang Valley, Malaysia. Subjects were divided into two groups; FCR (reduction of 300-500 kcal/d combined with 2 days/week of Muslim Sunnah Fasting) and control. Assessment was ascertained at three time point; baseline, weeks 6 and 12. Blood samples were analyzed for lipid profile, DNA damage and malondialdehyde (MDA). RESULTS The FCR group reduced their energy intake for approximately 18% upon completion of the study. A significant interaction effect was found in body weight, body mass index, fat percentage, fat mass, blood pressure, total cholesterol, low-density lipoprotein cholesterol and the ratio of total cholesterol/high-density lipoprotein cholesterol (p < 0.05). A significant improvement (p < 0.001) in total DNA rejoining cells and MDA (p < 0.05) was also observed in the FCR group. CONCLUSION FCR improved metabolic parameters and DNA damage in healthy older adult men. Therefore, there is a need to further examine the mechanism of FCR.
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28
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Yamaguchi O, Nomiya M, Andersson KE. Functional consequences of chronic bladder ischemia. Neurourol Urodyn 2013; 33:54-8. [PMID: 24292974 DOI: 10.1002/nau.22517] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 09/30/2013] [Indexed: 01/22/2023]
Abstract
The pathophysiology of lower urinary tract symptoms (LUTS), particularly in the elderly, seems to be multifactorial. One of the factors involved may be chronic ischemia of the bladder caused by bladder outflow obstruction (male) or atherosclerosis (male/female). The mechanisms by which chronic ischemia initiates and causes LUTS and progressive bladder dysfunction, and the time course of the effects, are incompletely known. Bladder ischemia and repeated ischemia/reperfusion during a micturition cycle may produce oxidative stress, leading to denervation of the bladder and the expression of tissue damaging molecules in the bladder wall. This may be responsible for the development of detrusor overactivity progressing to detrusor underactivity and inability to empty the bladder. The extent of bladder dysfunction in chronic bladder ischemia may depend on the degree and duration of ischemia. To prevent chronic bladder ischemia caused by atherosclerosis and to treat its consequences, more pathophysiological knowledge is needed. Several animal models of atherosclerosis-induced chronic bladder ischemia are available and should be useful tools for further research.
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Affiliation(s)
- Osamu Yamaguchi
- Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan
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29
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Yee CH, Li JKM, Lam HC, Chan ESY, Hou SSM, Ng CF. The prevalence of lower urinary tract symptoms in a Chinese population, and the correlation with uroflowmetry and disease perception. Int Urol Nephrol 2013; 46:703-10. [PMID: 24136186 DOI: 10.1007/s11255-013-0586-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/05/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the prevalence of lower urinary tract symptoms (LUTS) in a population of Chinese men, and its correlation with uroflowmetry and disease perception. MATERIALS AND METHODS Male volunteers above 40-year old were recruited in the community. Assessment with International Prostatic Symptom Score (IPSS), uroflowmetry, and a quiz on prostatic disease knowledge with 12 true-false-type questions were performed. Correlation of IPSS with uroflowmetry results and prostatic disease knowledge was analyzed. RESULTS A total of 319 men were recruited for the study, with a mean age of 62 ± 8 years. About 69.3 % of them had moderate-to-severe symptoms on IPSS. A statistically significant correlation was found between IPSS and Q max (r = -0.260, p < 0.001), IPSS and quality of life (r = -0.172, p = 0.002), and IPSS and post-void residuals (r = 0.223, p < 0.001). About 53.0 % of subjects had less than 4 correct answers for the 12 true-false questions. Negative correlation was noted between the number of correct answers and IPSS (r = -0.185, p = 0001). In other words, for the better knowledge on prostatic diseases, the lower IPSS was found. CONCLUSIONS In a cohort of community-dwelling Chinese men, a significant portion of the population had moderate-to-severe LUTS. While uroflowmetry parameters were found to correlate with IPSS, the degree of knowledge on prostatic diseases also shared a statistically significant correlation with IPSS. This has an implication on the role of urological health education in the future.
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Affiliation(s)
- Chi-Hang Yee
- Division of Urology, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong,
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30
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Ishizuka O, Matsuyama H, Sakai H, Matsubara A, Nagaoka A, Takahashi S, Takeda M, Ozono S, Shiroki R, Shuin T, Hara I, Kakizaki H, Tsukamoto T, Yamanishi T, Yokoyama O, Kakehi Y, Nishizawa O. Nocturia Potentially Influences Maintenance of Sexual Function in Elderly Men with Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 2013; 5:75-81. [PMID: 26663374 DOI: 10.1111/j.1757-5672.2012.00173.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study examined the relationship between bothersome symptoms of nocturia and erectile function. METHODS Subjects comprised patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Patients were prospectively followed on treatment with the alpha-1 blocker naftopidil for 8 weeks. Patient backgrounds and efficacy of naftopidil associated with LUTS and sexual activity were evaluated. RESULTS The percentage of patients who identified nocturia as the most bothersome symptom was 30.2% (n = 135), representing the highest percentage among International Prostate Symptom Score (IPSS) items. The number of patients with nocturia as the most bothersome symptom plateaued at an IPSS for nocturia of two or three points. In contrast, the number of patients with slow stream as the most bothersome symptom increased with symptom severity according to IPSS for slow stream. Logistic regression analysis on association between nocturia and erectile function confirmed that the odds ratio was 1.41 (P < 0.05). Naftopidil showed excellent efficacy related to male LUTS, but International Index of Erectile Function 5 (IIEF5) total score was almost unchanged. Among patients with nocturia improved by naftopidil, IIEF5 total score was significantly changed in the group with IPSS nocturia score ≤1 as compared to the group with IPSS nocturia score ≥2 per night (P = 0.038). CONCLUSION Nocturia the most bothersome symptom correlated with aging. Nocturia could associate erectile dysfunction, and keeping the frequency of nocturia at ≤1 episode might be meaningful for maintaining quality of life in elderly men.
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Affiliation(s)
- Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Hideyasu Matsuyama
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Hideki Sakai
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Akio Matsubara
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Akira Nagaoka
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Satoru Takahashi
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Masayuki Takeda
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Seiichiro Ozono
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Ryoichi Shiroki
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Taro Shuin
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Isao Hara
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Hidehiro Kakizaki
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Taiji Tsukamoto
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Tomonori Yamanishi
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Osamu Yokoyama
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
| | - Osamu Nishizawa
- Department of Urology, Shinshu University School of Medicine, MatsumotoDepartment of Urology, Graduate School of Medicine, Yamaguchi University, UbeDepartment of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, NagasakiDepartment of Urology, Hiroshima University Graduate School of Biomedical Sciences, HiroshimaDepartment of Urology, Faculty of Medicine, Yamagata University, YamagataDepartment of Urology, Nihon University School of Medicine, TokyoDepartment of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, YamanashiDepartment of Urology, Hamamatsu University School of Medicine, HamamatsuDepartment of Urology, Fujita Health University School of Medicine, ToyoakeDepartment of Urology, Kochi Medical School, KochiDepartment of Urology, Wakayama Medical University, WakayamaDepartment of Renal and Urologic Surgery, Asahikawa Medical University, AsahikawaDepartment of Urology, Sapporo Medical University School of Medicine, SapporoDepartment of Urology, Dokkyo Medical University, Tochigi, JapanDepartment of Urology, Faculty of Medical Science, University of Fukui, EiheijiDepartment of Urology, Kagawa University Faculty of Medicine, Kita-gun, Japan
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Abstract
PURPOSE Nocturia is a troubling condition with implications for daytime functioning. However, it often goes unreported. Many prevalence studies exist but differences in populations and definitions of nocturia render assimilation of the data difficult. This review provides an overview of the nocturia prevalence literature. MATERIALS AND METHODS A PubMed® search was performed to identify articles published in English from 1990 to February 2009 reporting nocturia prevalence in community based populations. Rates reported as overall data, and by age and by gender, were plotted for comparison. RESULTS A total of 43 relevant articles were identified. Prevalence rates in younger men (20 to 40 years) were 1 or more voids in 11% to 35.2% and 2 or more voids in 2% to 16.6%. Prevalence rates in younger women were 1 or more voids in 20.4% to 43.9% and 2 or more voids in 4.4% to 18%. In older men (older than 70 years) rates were 1 or more void in 68.9% to 93% and 2 or more voids in 29% to 59.3%. In older women rates were 1 or more void in 74.1% to 77.1% and 2 or more voids in 28.3% to 61.5%. Therefore, in practice up to 1 in 5 or 6 younger people consistently wake to void at least twice each night. In some studies younger women appeared more likely to be affected than men. Up to 60% of older people void 2 or more times nightly. CONCLUSIONS Nocturia is common across populations. It is most prevalent in older people but it also affects a significant proportion of younger individuals. Clinicians should be alert to the possibility that nocturia may impact the sleep, quality of life and overall health of their patients. Since the condition is highly multifactorial, frequency-volume charts are invaluable tools for the diagnosis of underlying factors and for treatment selection.
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Kim JW, Jang HA, Bae JH, Lee JG. Effects of coenzyme Q10 on bladder dysfunction induced by chronic bladder ischemia in a rat model. J Urol 2013; 189:2371-6. [PMID: 23306086 DOI: 10.1016/j.juro.2012.12.101] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 12/28/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE We investigated the protective effects of coenzyme Q10 on bladder dysfunction in a rat model of atherosclerosis induced chronic bladder ischemia. MATERIALS AND METHODS A total of 24 male Sprague-Dawley® rats at age 16 weeks were divided into 4 groups of 6 each, including group 1--untreated, sham operated rats, group 2--coenzyme Q10 treated, sham operated rats, group 3--untreated rats with chronic bladder ischemia and group 4--coenzyme Q10 treated rats with chronic bladder ischemia. Groups 3 and 4 received an endothelial injury to the iliac arteries and were fed a 2% cholesterol diet for 8 weeks. Groups 2 and 4 were treated with coenzyme Q10 and the others were treated with vehicle for 4 weeks. Eight weeks postoperatively we performed continuous in vivo cystometry, an in vitro detrusor muscle strip study and a malondialdehyde assay. Histological examination of the bladder walls and iliac arteries was also done. RESULTS In vivo cystometry revealed that coenzyme Q10 administration after the induction of chronic bladder ischemia prolonged micturition frequency and the intercontraction interval, and increased bladder capacity compared to those in untreated rats with chronic bladder ischemia. In the detrusor muscle strip study coenzyme Q10 administration after the induction of chronic bladder ischemia increased contractile responses compared to those in untreated rats with chronic bladder ischemia. Rats with chronic bladder ischemia also showed higher malondialdehyde in bladder tissue and serum than the other groups. Chronic bladder ischemia induced submucosal fibrosis of the bladder walls and a degenerative change in the blood vessel tunical media, as shown on histological examination. CONCLUSIONS Our study suggests that coenzyme Q10 acts as an antioxidant to protect bladder function in this chronic bladder ischemia model.
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Affiliation(s)
- Jong Wook Kim
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
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Yamaguchi O. Latest treatment for lower urinary tract dysfunction: therapeutic agents and mechanism of action. Int J Urol 2012. [PMID: 23190275 DOI: 10.1111/iju.12008] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Recent studies suggest that antimuscarinics might suppress bladder afferent activity by blocking muscarinic receptors in the urothelium, myofibroblasts and detrusor, thereby improving overactive bladder symptoms. β(3)-Adrenoceptors are predominantly expressed in the human bladder and mediate relaxation of detrusor muscle. β(3)-Adrenoceptor agonists increase bladder capacity and prolong micturition interval. It is assumed that β(3)-adrenoceptor agonists could exert an inhibitory effect on bladder afferent through β(3)-adrenoceptors in the urothelium and detrusor, which eventually improve the symptom of urgency. Mirabegron is a potent and selective β(3)-adrenoceptor agonist. A Japanese phase 3 study showed that mirabegron has excellent efficacy and safety for treating overactive bladder. α(1)-Adrenoceptor antagonists (α(1)-blockers) have become a mainstay of male lower urinary tract symptoms treatment. The α(1)(A) subtype is known to mediate functional obstruction as a result of benign prostatic enlargement. Recent studies have suggested that α(1)(A)-adrenoceptors are additionally involved in the generation of storage symptoms. The α(1)(D) subtype is thought to play a role in the facilitation of voiding reflex; that is; storage symptoms. α(1)-Blockers often fail to alleviate overactive bladder symptoms. In this context, combination therapy with α(1)-blockers and antimuscarinics has been recommended. Treatment with 5α-reductase inhibitor for 1 year improves urinary symptoms and flow rate by reducing prostatic volume in men with benign prostatic enlargement. A pooled analysis showed that the long-term (2 or 4 years) treatment with 5α-reductase inhibitor reduced the rate of progression to acute urinary retention and surgery. Combination therapy with 5α-reductase inhibitor and α(1)-blocker was shown to provide a rapid improvement in lower urinary tract symptoms, and reduce the relative risk of acute urinary retention and benign prostatic hyperplasia-related surgery. Phosphodiesterase inhibitors might target a nitric oxide-cyclic guanosine monophosphate pathway in the prostate, urethra and bladder. Phosphodiesterase-5 inhibitors (sildenafil or tadalafil) were shown to provide clinically relevant improvements in both male lower urinary tract symptoms and erectile dysfunction.
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Affiliation(s)
- Osamu Yamaguchi
- Division of Bioengineering and LUTD Research, Nihon University School of Engineering, Koriyama, Japan.
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Matsui T, Oka M, Fukui T, Tanaka M, Oyama T, Sagawa K, Nomiya M, Yamaguchi O. Suppression of bladder overactivity and oxidative stress by the phytotherapeutic agent, Eviprostat, in a rat model of atherosclerosis-induced chronic bladder ischemia. Int J Urol 2012; 19:669-75. [PMID: 22458726 DOI: 10.1111/j.1442-2042.2012.03000.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To clarify the mechanism by which chronic bladder ischemia causes bladder functional changes, and to investigate the involvement of oxidative stress and pro-inflammatory cytokines, and the effects of the phytotherapeutic drug, Eviprostat, on these biochemical marker levels and bladder function. METHODS Male Sprague-Dawley rats aged 15 weeks were divided into three groups. Arterial injury was experimentally induced by balloon endothelial injury of the iliac arteries, and a 2% cholesterol diet was given for 8 weeks. Rats in the arterial-injury group were given daily oral vehicle or Eviprostat, whereas sham-operated animals on a regular diet (0.09% cholesterol) were given vehicle for the last 2 weeks. Eight weeks after surgery, the levels of bladder pro-inflammatory cytokines, as well as bladder and urinary oxidative-stress markers, were determined. Cystometrograms were carried out without anesthesia or restraint. RESULTS Bladder and urinary oxidative-stress markers, and bladder pro-inflammatory cytokine levels were significantly increased in the arterial-injury group, and Eviprostat markedly suppressed these increase. The cystometrograms showed that arterial injury decreased the intermicturition interval without affecting the micturition pressure. This decrease was reversed by Eviprostat treatment. CONCLUSIONS Oxidative stress and pro-inflammatory cytokines might be involved in the development of overactive bladder by atherosclerosis-induced chronic bladder ischemia. Eviprostat might provide an attractive treatment option for individuals with bladder dysfunction due to chronic bladder ischemia because of its anti-oxidant and anti-inflammatory properties.
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Affiliation(s)
- Takahiro Matsui
- Research Laboratories, Nippon Shinyaku Co., Ltd., Kyoto, Japan.
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35
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Nomiya M, Yamaguchi O, Andersson KE, Sagawa K, Aikawa K, Shishido K, Yanagida T, Kushida N, Yazaki J, Takahashi N. The effect of atherosclerosis-induced chronic bladder ischemia on bladder function in the rat. Neurourol Urodyn 2011; 31:195-200. [DOI: 10.1002/nau.21073] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/21/2011] [Indexed: 11/05/2022]
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TAKAHASHI N, SHISHIDO K, SATO Y, OGAWA S, OGURO T, KATAOKA M, SHIOMI H, UCHIDA H, HAGA N, HOSOI T, NOMIYA M, AIKAWA K, MURAKAMI H, YAMAGUCHI O. The Association between Severity of Atherosclerosis and Lower Urinary Tract Function in Male Patients with Lower Urinary Tract Symptoms. Low Urin Tract Symptoms 2011; 4:9-13. [DOI: 10.1111/j.1757-5672.2011.00098.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Milburn JA, Campbell D, Gunn IG. Lower urinary tract symptoms and sexual dysfunction: an audit of sexual symptoms among patients attending a nurse-led prostate clinic. Scott Med J 2011; 56:12-4. [PMID: 21515525 DOI: 10.1258/smj.2010.010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Significant numbers of men with lower urinary tract symptoms (LUTS) also report symptoms of sexual dysfunction (SD). The prevalence of SD in patients referred to a prostate assessment clinic, was assessed using a confidential questionnaire. Fifty-six percent of patients reported difficulties in maintaining an erection and 48% felt that improving their sexual function would benefit their quality of life. None of the referral letters from primary care mentioned symptoms of SD. Patients with LUTS seen in primary and secondary care should be assessed for SD and offered appropriate advice and management.
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Affiliation(s)
- J A Milburn
- Department of Surgery, Dr Gray's Hospital, Elgin, Grampian, Scotland IV30 1SN, UK
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38
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Abstract
Men's health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men's unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men's health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men's health behaviour must be addressed. A national men's health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges.
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Amano T, Imao T, Takemae K, Iwamoto T, Nakanome M. Testosterone replacement therapy by testosterone ointment relieves lower urinary tract symptoms in late onset hypogonadism patients. Aging Male 2010; 13:242-6. [PMID: 20795793 DOI: 10.3109/13685538.2010.487552] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Patients with late onset hypogonadism (LOH) also suffered from lower urinary tract symptoms (LUTS) and LOH symptoms. The objects of this study are to evaluate the efficacy of testosterone replace therapy (TRT) by testosterone ointment (Glowmin: GL) for LUTS in LOH patients. METHODS The Aging Male Symptom (AMS) scale, Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36), International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) were obtained from patients with LOH. A total of 41 patients with LOH have been treated with TRT using 6 mg/day of GL for 3 months. Serum free testosterone levels (FT) and these four scores were compared before and after TRT. RESULTS Serum FT levels and the scores for the four parameters of AMS, six of eight domains in SF-36, IIEF-5 and total IPSS improved significantly after 3 months TRT. In addition, all IPSS domains also improved significantly, and voiding disturbance seems to have improved more than storage disturbance (P = 0.0280 vs. 0.0483). CONCLUSION TRT by administration of GL is considered to be effective in the improvement of not only ED and LOH symptoms, but also LUTS (especially voiding disturbance) of patients with LOH.
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Affiliation(s)
- Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan.
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40
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Tsai CC, Liu CC, Huang SP, Li WM, Wu WJ, Huang CH, Lee YC, Huang SY, Pan SC. The impact of irritative lower urinary tract symptoms on erectile dysfunction in aging Taiwanese males. Aging Male 2010; 13:179-83. [PMID: 20158390 DOI: 10.3109/13685531003586975] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study assessed the possible associations between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in aging Taiwanese males and investigated the impact of various aspects of LUTS on ED. METHODS A free health screening for aging males (> or =40 years old) was conducted in Kaohsiung Medical University Hospital. All the subjects had completed clinical data and answered questionnaires. ED and LUTS were assessed by validated symptom scales: the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS). RESULTS A total of 339 eligible patients enrolled in this study with a mean age of 60.1 years old. In multiple logistic regression analysis, age and IPSS (p < 0.001 and p = 0.013, respectively) were significantly associated with ED after controlling other comorbidities. In a further age-adjusted multiple regression analysis, our results showed that irritative symptoms (p = 0.042) have a more significant association with ED than the obstructive symptoms (p = 0.101). CONCLUSIONS Our results indicate that age and LUTS are the two most independent risk factors for ED. Aging Taiwanese males with LUTS are at increasing risk for ED, especially for those with significant irritative symptoms.
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Affiliation(s)
- Chia-Chun Tsai
- Department of Urology, Kaohsiung Medical University Hospital, Taiwan
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41
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Abstract
PURPOSE Nocturia is a troubling condition with implications for daytime functioning. However, it often goes unreported. Many prevalence studies exist but differences in populations and definitions of nocturia render assimilation of the data difficult. This review provides an overview of the nocturia prevalence literature. MATERIALS AND METHODS A PubMed search was performed to identify articles published in English from 1990 to February 2009 reporting nocturia prevalence in community based populations. Rates reported as overall data, and by age and by gender, were plotted for comparison. RESULTS A total of 43 relevant articles were identified. Prevalence rates in younger men (20 to 40 years) were 1 or more voids in 11% to 35.2% and 2 or more voids in 2% to 16.6%. Prevalence rates in younger women were 1 or more voids in 20.4% to 43.9% and 2 or more voids in 4.4% to 18%. In older men (older than 70 years) rates were 1 or more void in 68.9% to 93% and 2 or more voids in 29% to 59.3%. In older women rates were 1 or more void in 74.1% to 77.1% and 2 or more voids in 28.3% to 61.5%. Therefore, in practice up to 1 in 5 or 6 younger people consistently wake to void at least twice each night. In some studies younger women appeared more likely to be affected than men. Up to 60% of older people void 2 or more times nightly. CONCLUSIONS Nocturia is common across populations. It is most prevalent in older people but it also affects a significant proportion of younger individuals. Clinicians should be alert to the possibility that nocturia may impact the sleep, quality of life and overall health of their patients. Since the condition is highly multifactorial, frequency-volume charts are invaluable tools for the diagnosis of underlying factors and for treatment selection.
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Affiliation(s)
- J L H Ruud Bosch
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
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42
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Kwong PW, Cumming RG, Chan L, Seibel MJ, Naganathan V, Creasey H, Le Couteur D, Waite LM, Sambrook PN, Handelsman D. Urinary incontinence and quality of life among older community-dwelling Australian men: the CHAMP study. Age Ageing 2010; 39:349-54. [PMID: 20305133 DOI: 10.1093/ageing/afq025] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE to describe the prevalence and impact on quality of life of urinary incontinence in a population-based cohort of older community-dwelling Australian men. SUBJECTS the population comprised 1,705 men aged >or=70 years participating in the Concord Health and Ageing in Men Project, a population-based study of urban older Australian men. METHODS data were collected between January 2005 and June 2007, and the participation rate was 47%. Data on demographics, medical history and from the 12-item Short Form Health Survey (SF-12) and International Consultation on Incontinence Questionnaire were collected. Urinary incontinence was defined as urinary leakage at least two times a week over the past 4 weeks. RESULTS the prevalence of urinary incontinence was 14.8%, increasing from 12.0% for men aged 70-74 years old to 16.3% for those aged >or=90 years, with urgency incontinence being the most frequent type of urinary incontinence. Daily urine leakage was reported by 3% of men. Men with incontinence had lower overall SF-12 scores with greater impact on the physical (PCS) than the mental (MCS) components of that scale. After adjusting for age, number of co-morbidities, enlarged prostate and prostate cancer, men with incontinence had worse PCS (43.6 vs 45.9) and MCS scores (52.2 vs 54.6) compared with continent men. CONCLUSION urinary incontinence is common among older community-dwelling men and is associated with worse quality of life with greater impact on physical than mental factors. As the population ages, urinary incontinence prevalence will increase and increased resources will be needed to address this growing problem.
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Affiliation(s)
- Po Wan Kwong
- The George Institute for International Health, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia
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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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Place of overactive bladder in male lower urinary tract symptoms. World J Urol 2009; 27:723-8. [PMID: 19705127 DOI: 10.1007/s00345-009-0470-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 08/11/2009] [Indexed: 01/29/2023] Open
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Abstract
BACKGROUND Erectile dysfunction (ED) is a common sexual problem in men. Under-reporting of ED is widespread, largely because of the embarrassing nature of the condition. AIM This paper reviews the comorbid conditions that are commonly found in patients with ED patients and discusses the implications. DISCUSSION Erectile dysfunction is often associated with other disorders such as diabetes, cardiovascular disease, hypertension, dyslipidaemia, obesity, depression, chronic obstructive pulmonary disease and lower urinary tract symptoms. Although the aetiology of ED is multifactorial, some of the associated comorbid conditions, including diabetes, cardiovascular disease and hypertension, can be a primary cause of ED. Similarly, ED could be a useful marker for comorbid conditions such as cardiovascular disease and diabetes. Effective treatments for ED are available, including the three phosphodiesterase type 5 inhibitors sildenafil citrate, tadalafil and vardenafil HCl. CONCLUSIONS Thorough medical screening of patients with ED is advisable, as this could lead to earlier diagnosis and treatment of comorbid conditions. Conversely, men with conditions such as cardiovascular disease, diabetes, obesity and depression may have undiagnosed ED and should be questioned appropriately to ascertain any erectile problems and initiate appropriate treatment.
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Affiliation(s)
- G Hackett
- Good Hope Hospital, Rectory Road, Sutton Coldfield, UK.
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Kaplan SA, Roehrborn CG, Chapple CR, Rosen RC, Irwin DE, Kopp Z, Aiyer LP, Mollon P. Implications of recent epidemiology studies for the clinical management of lower urinary tract symptoms. BJU Int 2009; 103 Suppl 3:48-57. [DOI: 10.1111/j.1464-410x.2009.08372.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Lower Urinary Tract Symptoms Revisited: A Broader Clinical Perspective. Eur Urol 2008; 54:563-9. [DOI: 10.1016/j.eururo.2008.03.109] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 03/31/2008] [Indexed: 11/21/2022]
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Sand MS, Fisher W, Rosen R, Heiman J, Eardley I. Erectile Dysfunction and Constructs of Masculinity and Quality of Life in the Multinational Men's Attitudes to Life Events and Sexuality (MALES) Study. J Sex Med 2008; 5:583-94. [DOI: 10.1111/j.1743-6109.2007.00720.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McVary K, Foley KA, Long SR, Sander S, Curtice TG, Shah H. Identifying patients with benign prostatic hyperplasia through a diagnosis of, or treatment for, erectile dysfunction. Curr Med Res Opin 2008; 24:775-84. [PMID: 18237458 DOI: 10.1185/030079908x260916] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH) are highly correlated. This study examined rates of screening, diagnosis, and treatment of BPH/LUTS among men seeking care for ED. RESEARCH DESIGN AND METHODS This was a retrospective US claims data analysis (1999-2004) evaluating men > or = 40 years old with a new diagnosis of or prescription medication for ED. Multivariate analyses were used to examine times to screening, diagnosis, and treatment. RESULTS 81 659 men with ED were identified (mean age 57 years). The baseline prevalence of recorded BPH was 1.5%. During the follow-up period (mean 2.2 years), 7.6% had documented BPH. Time to screening was shorter among patients seeing urologists (121.1 days) compared with those seeing primary-care physicians (282.2 days). Controlling for demographic and clinical characteristics, patients who saw a urologist were more likely to be screened (OR: 2.4, p < 0.0001), diagnosed with BPH (OR: 1.8, p < 0.0001), and treated (OR: 1.3, p < 0.0001), relative to patients seeing other providers. Men aged 75 and over were 43% less likely to be screened (p < 0.0001), but 5.4 times more likely to be diagnosed with BPH (p < 0.0001) and 5.3 times more likely to be treated (p < 0.0001) compared with men aged 40-49. CONCLUSIONS Screening for BPH appears less likely for men with ED who do not see a urologist. When screening does occur, it takes much longer with non-specialty providers. Patient age and provider specialty are key factors associated with screening, diagnosis, and treatment of BPH among men with ED.
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Affiliation(s)
- Kevin McVary
- Department of Urology, Feinberg School of Medicine, Northwestern University School of Medicine, Chicago, IL 60611, USA.
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Choo MS, Ku JH, Park CH, Lee YS, Lee KS, Lee JG, Park WH. Prevalence of nocturia in a Korean population aged 40 to 89 years. Neurourol Urodyn 2008; 27:60-4. [PMID: 17565726 DOI: 10.1002/nau.20458] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIMS The purpose of this study was to evaluate the prevalence of nocturia in Korea, to examine the relationship between nocturia and demographic variables, and to determine the impact of nocturia on daily living. METHODS A national telephone survey using quota sampling methods was conducted in Korea. The clinically validated computer-assisted telephone interview approach was used for the survey. RESULTS Of 2005 subjects (1,005 women and 1,000 men) interviewed, 33.5% reported voiding once per night and 48.2% twice or more per night. Nocturia increased with age among both genders and was more common among young women than young men. In all subjects, multivariate analysis indicated that female gender, older age and an overweight condition were independent risk factors. Body mass index was associated with an increased likelihood of nocturia in male but not in female subjects. In female subjects, the likelihood of at least one night-time void was related to delivery number (odds ratio 1.17, 95% confidence interval 1.04-1.32). An impact of nocturia on daily life was reported by 14.6% of subjects and only 3.8% (4.0% of men and 3.7% of women) sought medical care. Commonly reported reasons for not seeking medical care were the belief that nocturia is a normal consequence of aging or is not a disease (92.8% of subjects reporting an impact of nocturia on daily life). CONCLUSIONS Although nocturia is highly prevalent in the Korean population, it has only a minor impact on daily living, and few individuals seek medical care. Our study provides a valuable insight into the need for tailored nocturia education addressed to the population who view the condition as trivial.
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Affiliation(s)
- Myung-Soo Choo
- Department of Urology, University of Ulsan College of Medicine, Seoul, Korea
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