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Visscher J, Hiwase M, Bonevski B, O'Callaghan M. The association of smoking with urinary and sexual function recovery following radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2024; 27:222-229. [PMID: 37500786 DOI: 10.1038/s41391-023-00701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Urinary and sexual dysfunction after radical prostatectomy remains a major cause of morbidity, despite widespread availability of pharmacological and rehabilitative treatments. Smoking is a modifiable risk factor known to correlate with erectile and urinary dysfunction and we hypothesise that smoking cessation may improve post-prostatectomy urinary and sexual function recovery. Our objective is to systematically evaluate literature describing the association of smoking status with urinary and sexual function in men following radical prostatectomy. METHODS In total, 310 unique records were identified through a systematic search of the MEDLINE, EMBASE, Scopus, Web of Science, CINAHL and CENTRAL databases up to February 2023. Nine studies reported smoking status and post radical prostatectomy urinary and sexual function outcomes in men with localized prostate cancer. Risk of bias was assessed and meta-analysis included six studies. RESULTS Smokers had inferior erectile function after prostatectomy compared to non-smokers (OR 0.73, [95% CI 0.56-0.95]) during follow-up, while urinary incontinence was not statistically different between groups (OR 1.20, [95% CI 0.75-1.91]). Smoking cessation improved the EPIC-26 sexual domain score with 6.6 points on average [p = 0.03] to a clinically significant maximum of 12.5 points at 18-24 months. CONCLUSIONS Smoking is associated with impaired sexual function recovery after radical prostatectomy and quitting may improve sexual function >18 months. Current evidence shows no such association for urinary outcomes. Further studies are needed to corroborate findings.
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Affiliation(s)
- Jordi Visscher
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Mrunal Hiwase
- Department of Surgery, Central Adelaide Health Network, Adelaide, SA, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Michael O'Callaghan
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Flinders Medical Centre, Urology Unit, Adelaide, SA, Australia
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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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Agostini LCM, Brum CS, Lopes HE, Netto JMB, Figueiredo AA. Evaluation of pedometer use in men with lower urinary tract symptoms: a randomized clinical trial. Int Urol Nephrol 2021; 53:2231-2236. [PMID: 34390436 DOI: 10.1007/s11255-021-02970-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the effect of a pedometer use in men aged between 50 and 59 years presenting lower urinary tract symptoms (LUTS). METHODS A single-center, not blind clinical trial with two parallel groups and equal randomization was performed with 38 men aged 50-59 years with LUTS. All patients received guidance and encouragement to physical activity practice. Only the intervention group received a Pedometer with a goal of 10,000 steps/day. After a period of 12 weeks, the groups were compared through the following variables: number of steps/day, IPSS score, flexibility, anthropometric values and Maximum Oxygen Consumption (VO2max). RESULTS The number of steps per day in the intervention group was 9753 ± 1549 compared to 6212 ± 1152 in the control group (p = 0.004). Pedometer use efficacy was a 50% risk reduction of not achieve the goal of 10,000 steps per day. Regarding IPSS score, the intervention group achieved lower scores (6.95 ± 2.85 vs. 10.16 ± 3.23, p = 0.007). Pedometer use efficacy was a 94% risk reduction of not achieve more than 30% reduction in IPSS score. In VO2max, the intervention group performed better than the control group (34.84 ± 3.25 vs. 32.58 ± 6.89; p = 0.011). There was no difference in flexibility and anthropometric values between the groups. CONCLUSIONS The use of pedometer in LUTS patients provided an increase in the number of steps/day, a decrease in LUTS score and an improvement in VO2max measure. CLINICAL TRIAL REGISTRATION Trial url: www.ensaiosclinicos.gov.br/rg/RBR-4vynk5/ . Register Number: RBR-4vynk5 .
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Affiliation(s)
- Lucas Cortes Machado Agostini
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
| | - Christiano Silva Brum
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
| | - Humberto Elias Lopes
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
- Department of Surgery, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - José Murillo Bastos Netto
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
- Department of Surgery, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - André Avarese Figueiredo
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil.
- Department of Surgery, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.
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Noegroho B, Siregar S, Simangunsong AI. Correlation of Visceral Obesity and Interleukin-6 Level on LUTS Due to Benign Prostatic Enlargement. Res Rep Urol 2021; 13:369-373. [PMID: 34169043 PMCID: PMC8216739 DOI: 10.2147/rru.s310269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Benign prostatic enlargement (BPE) is a common condition in older men causing lower urinary tract symptoms (LUTS). Numerous studies have shown correlations of obesity and age as risk factors of LUTS due to BPE. However, there are only a few studies showing the increase of interleukin-6 (IL-6) as a risk factor in LUTS. IL-6 expression is regulated in the prostate. IL-6 was found to be increased in several conditions, such as infection, inflammation, and obesity. The aim of this study is to correlate visceral obesity and IL-6 expression in the prostate with BPE and LUTS. Methods We analyzed the correlation of the Visceral Adiposity Index (VAI) and IL-6 of 52 patients with LUTS due to BPE. Statistical analysis was tested using an independent t-test. Data were analyzed with SPSS ver 20.1. Results Of 52 BPE subjects, who had not received any therapy, 16 patients presented with severe LUTS (30.77%), while the remaining 69.23% had mild–moderate LUTS complaints. IL-6 examination showed that obese patients and severe LUTS had higher IL-6, with p=0.032 and 0.01, respectively. Correlation analysis showed a weak correlation between IL-6 and obesity (r=0.179, p=0.02). Based on regression study, it was found that the risk for a patient with visceral obesity to develop severe LUTS is 5-times higher than normal (p=0.017). Conclusion This study found a correlation between the degree of visceral obesity assessed by VAI and IL-6 levels in BPE patients. In addition, there is also a correlation between the degree of visceral obesity and IL-6 levels on LUTS severity in people with BPE.
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Affiliation(s)
- Bambang Noegroho
- Department of Urology, Faculty of Medicine Universitas Padjadjaran/Hasan Sadikin Hospital, Bandung, Indonesia
| | - Safendra Siregar
- Department of Urology, Faculty of Medicine Universitas Padjadjaran/Hasan Sadikin Hospital, Bandung, Indonesia
| | - Albert Ivan Simangunsong
- Department of Urology, Faculty of Medicine Universitas Padjadjaran/Hasan Sadikin Hospital, Bandung, Indonesia
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Declemy A, Haddad R, Chesnel C, Charlanes A, Le Breton F, Sheikh Ismael S, Amarenco G. Prevalence of comorbidities in multiple sclerosis patients with neurogenic bladder. Prog Urol 2021; 31:732-738. [PMID: 33941463 DOI: 10.1016/j.purol.2020.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/11/2020] [Accepted: 10/30/2020] [Indexed: 01/22/2023]
Abstract
AIMS The aim of this study was to define the prevalence of comorbidities among multiple sclerosis patients with lower urinary tract symptoms. METHODS A retrospective study of data collected prospectively from January 2000 to March 2016 was carried out using a database. Comorbidities were divided into several classes according to the International Classification of Diseases (ICD-10). RESULTS One hundred and fifty-five patients were included. All had a neurogenic bladder with 150 (96%) overactive bladder. EDSS score was≥6 in 44 patients (28%). Comorbidities were present in 79 (50,9%) and the most frequent ones were cardiovascular (14,2%), endocrinological (10,3%), urological (8,4%), abdominal (7,7%). Overweight (BMI≥25) was observed in 63 (40%). A strict relationship was found for BMI and stress urinary incontinence (P<0.001) as well as voiding dysfunction (P=0.003) without significant association for BMI and overactive bladder. CONCLUSION Prevalence of comorbidities is important in MS (more than 50%). A significant association is found between overweight, stress urinary incontinence and voiding dysfunction. Knowledge of these comorbidities in MS is important since the presence of these urinary symptoms not related to neurogenic bladder must lead to a specific treatment. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- A Declemy
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France.
| | - R Haddad
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - C Chesnel
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - A Charlanes
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - F Le Breton
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - S Sheikh Ismael
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - G Amarenco
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
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Yue L, Ge Y, Wang T, Ge M, Zhang C, Zhang W. The correlation between body mass index and prostatic-related parameters in men 40 years or older in Zhengzhou. Aging Male 2020; 23:483-488. [PMID: 30451056 DOI: 10.1080/13685538.2018.1530754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To understand the relationship between body mass index (BMI), age, prostate volume (PV), prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS) and quality of life (QoL) in Zhengzhou. MATERIALS AND METHODS In the cross-sectional study, men living in Zhengzhou were invited to participate in this study. Men who were 40 years or older were subjected to the IPSS and related examination. A total of 1360 participants were included. Body mass index < 18.5 kg/m2 was determined as underweight, 18.5-24.99 kg/m2 normal, 25-29.99 kg/m2 overweight, and ≥30 kg/m2 obese. RESULTS The mean BMI was 24.92 ± 3.37 kg/m2. The mean PSA was 1.06 ± 0.85 ng/mL. The mean PV was 20.10 ± 9.96 mL. The mean age was 62.72 ± 11.03 years. The mean IPSS was 5.87 ± 3.48 scores. The mean QoL was 2.33 ± 1.28 scores. PSA showed a significant tendency to decrease with increasing BMI (r = -0.061, p = 0.018, ptrend = 0.037). The same with age (r = -0.109, p < .001; ptrend = .045). But the result suggested that both IPSS and QoL were positively correlated with BMI (r = 0.120, p < .001, ptrend < .001; r = 0.083, p = .001, ptrend = .021, respectively). PV increased with increasing BMI (r = 0.110, p < .001, ptrend = 0.045 ). CONCLUSIONS Age, PSA decreased with increasing BMI. But larger PV, IPSS, and QoL were associated with higher BMI.
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Affiliation(s)
- Limin Yue
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yongchao Ge
- Department of Urology, Zhengzhou Third People's Hospital, Zhengzhou, Henan, China
| | - Tao Wang
- Department of General Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengying Ge
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Chengda Zhang
- Department of International Medicine, Beaumont Health System, Royal Oak, MI, USA
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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[Surgical treatment of benign prostatic obstruction (BPO) in patients under anticoagulation: a review of the bleeding risks of established techniques]. Urologe A 2020; 59:1187-1194. [PMID: 32930822 PMCID: PMC7546975 DOI: 10.1007/s00120-020-01319-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND In an aging society an increase of benign prostatic obstruction (BPO) requiring treatment is to be expected and the proportion of patients with cardiovascular comorbidities under anticoagulation is also increasing. As the operative treatment of BPO can be problematic, the hemostatic effect of the techniques is of particular importance. OBJECTIVE This review article discusses the data situation on the bleeding risk of established surgical techniques and the statement of the European Association of Urology (EAU) guidelines "EAU guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO)" on this topic. MATERIAL AND METHODS Data analysis from PubMed. RESULTS The EAU guidelines favor transurethral laser vaporization of the prostate using "greenlight", thulium or diode laser and laser enucleation using a holmium or thulium laser in this patient collective. The bipolar is superior to monopolar transurethral resection (TUR-P) in hemostasis. In the future bipolar enucleation of the prostate (BipoLEP) can be an alternative under good hemostasis. Bleeding is a rare complication after recently established minimally invasive techniques, such as Urolift®, I‑TIND© and Rezum™, the same applies to prostate artery embolization. Aqua-ablation/AquaBeam® seems to be unsuitable due to frequent hematuria. Surgical adenomectomy can be associated with a high risk of bleeding. CONCLUSION According to current data, transurethral laser vaporization and enucleation of the prostate are the treatment of choice for patients under anticoagulation; however, other transurethral techniques, such as BipoLEP have an acceptable risk of bleeding and can be an alternative depending on local resources. Newer minimally invasive approaches could become more important in the future.
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Lu Z, Wu C, Zhang J, Ye Y, Zhang Z, Liao M, Huang L, Tian J, Tan A, Mo Z. Drinking Frequency but not Years may be Associated with Lower Urinary Tract Symptoms: Result from a Large Cross-Sectional Survey in Chinese Men. Risk Manag Healthc Policy 2020; 13:633-642. [PMID: 32607031 PMCID: PMC7320899 DOI: 10.2147/rmhp.s238012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 05/19/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the effect of the drinking frequency and years on lower urinary tract symptoms (LUTS) in a large Chinese male population. Methods The current data were obtained from a consecutive series of 3,229 men aged 18–79 who participated in a routine physical examination in Fangchenggang First People’s Hospital, Guangxi, China. During a face-to-face interview, the detailed demographic variables about alcohol consumption, potential confounding factors were collected. LUTS were assessed by International Prostate Symptom Score (IPSS) and defined as total LUTS, irritative (IRR) and obstructive (OBS) symptoms, respectively. Multivariate logistic regression analysis was used to evaluate the risk of total LUTS, IRR and OBS symptoms affected by alcohol consumption. Results The prevalence of moderate to severe LUTS was 8.3% and apparently increased with age (P<0.001). A significant distribution presented in age, alcohol consumption, BMI, cigarette smoking, education attainment and hypertension among different strata of LUTS severity (P<0.05). Men who drank 1–2 times per week were less likely to have OBS symptoms (OR=0.45, 95%CI=0.29–0.70) regardless of age (OR=0.52, 95%CI=0.33–0.82) or multivariate adjusted (OR=0.52, 95%CI=0.33–0.83). Nevertheless, we did not observe a significant negative or positive association presented between drinking years and the risk of total LUTS, OBS and IRR symptoms. Conclusion The current results imply that moderate drinking frequency may be protective against LUTS, and drinking years did not relate to worsening or improving LUTS.
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Affiliation(s)
- Zheng Lu
- Department of Urology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Chunlei Wu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.,Urology Department, First Affiliated Hospital of Xinxiang Medical University, Weihui City, Henan Province, People's Republic of China
| | - Jiange Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.,Department of Urology, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Yu Ye
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.,Emergency Department, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Zhifu Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.,Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Ming Liao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Lin Huang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Jiarong Tian
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Aihua Tan
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Zengnan Mo
- Department of Urology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.,Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
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Matti B, Zargar-Shoshtari K. Opportunistic prostate cancer screening: A population-based analysis. Urol Oncol 2020; 38:393-400. [DOI: 10.1016/j.urolonc.2019.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/12/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
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10
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Do Lifestyle Factors Affect Lower Urinary Tract Symptoms? Results from the Korean Community Health Survey. Int Neurourol J 2019; 23:125-135. [PMID: 31260612 PMCID: PMC6606931 DOI: 10.5213/inj.1938010.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/12/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the relationships between lower urinary tract symptoms (LUTS) and lifestyle factors (physical activity, smoking, alcohol consumption, body mass index, and stress) in Korean men. METHODS We analyzed the survey results of South Korean men (n=64,439) who were 40 years of age or older among whom interviews were conducted using questionnaires. Trained interviewers performed face-to-face surveys using computer-assisted personal interviewing, the International Prostate Symptom Score (IPSS), and standard questions. We assessed the relationships of lifestyle factors (physical activity, cigarette smoking, alcohol intake, height, weight, and stress) with LUTS. RESULTS We observed higher IPSS scores in participants who engaged in no exercise (n=46,008 [71.7%], IPSS=3.19±5.36) than in those who engaged in vigorous physical activity (n=10,657 [17.6%], IPSS=2.28±4.15). Former smokers showed higher total, storage, and voiding symptom IPSS scores than current smokers and nonsmokers. Nondrinkers had higher IPSS scores than current alcohol drinkers. In multivariable logistic regression analysis, we detected no relationship between LUTS and current alcohol drinking in the moderate and severe LUTS groups, using the mild LUTS group as a reference (moderate: 0.91; 95% confidence interval [CI], 0.91-0.91; P<0.001, severe: 0.78; 95% CI, 0.78-0.78; P<0.001). Participants with moderate to severe stress showed higher total IPSS scores than those with no or mild stress (3.38±5.77 vs. 2.88±4.90), with significant relationships between stress and LUTS found in the moderate and severe LUTS groups. In logistic regression analysis, stronger relationships were found for storage and voiding symptoms in the moderate and severe stress groups compared to the mild stress group. CONCLUSION A history of smoking, low levels of physical activity, low body mass index, and moderate to severe stress were associated with a greater severity of LUTS. Moderate to severe stress was also related to voiding symptoms. However, there was no association between alcohol intake and LUTS severity.
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Chung JH, Kim JB, Kim JH. Lower urinary tract symptoms in male patients with stroke: A nationwide population-based study. Arch Gerontol Geriatr 2019; 83:309-314. [PMID: 31126672 DOI: 10.1016/j.archger.2019.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 04/27/2019] [Accepted: 05/15/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND OBJECTIVES There is a scarcity of large population-based studies investigating lower urinary tract symptoms (LUTS) using the International Prostate Symptom Score (IPSS) in stroke survivors. We investigated the prevalence and severity of LUTS in male stroke survivors and determined the independent effect of stroke on LUTS using data from a nationwide population-based survey. METHODS Cross-sectional data obtained from the 2011 Korean Community Health Survey were analyzed. The prevalence and severity of LUTS were compared between 1936 male stroke patients and 90,506 male non-stroke participants. Multivariable logistic regression was used to identify the independent effect of stroke on LUTS. RESULTS Male stroke patients more frequently reported both storage symptoms (frequency, urgency, and nocturia) and voiding symptoms (straining, weak stream, intermittency, and incomplete emptying) compared to male non-stroke population. The storage and voiding subscores of IPSS and quality of life score were higher in male stroke patients than in male non-stroke population. Multivariable logistic regression adjusted for age, socioeconomic factors, physical and mental health measures, and comorbidities, found stroke to be an independent risk factor for all 7 symptoms of LUTS. CONCLUSION The present study confirmed a high prevalence of LUTS in male stroke survivors that cannot be attributed only to potential confounders, implying that stroke may independently contribute to the development of LUTS. Our findings warrant the need for timely detection by physicians and proper management of LUTS to promote functional outcomes and quality of life in stroke population.
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Affiliation(s)
- Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Jung Bin Kim
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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Kim SY, Song CM, Lim H, Lim MS, Bang W, Choi HG. Bidirectional association between gallstones and renal stones: Two longitudinal follow-up studies using a national sample cohort. Sci Rep 2019; 9:2620. [PMID: 30796254 PMCID: PMC6385337 DOI: 10.1038/s41598-019-38964-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 01/07/2019] [Indexed: 12/29/2022] Open
Abstract
The present study evaluated the associations between gallstones and renal stones using a national sample cohort of the Korean population. The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. We designed two different longitudinal follow-up studies. In study I, we extracted gallstone patients (n = 20,711) and 1:4-matched control I subjects (n = 82,844) and analyzed the occurrence of renal stones. In study II, we extracted renal stone patients (n = 23,615) and 1:4-matched control II subjects (n = 94,460) and analyzed the occurrence of gallstones. Matching was performed for age, sex, income, region of residence, and history of hypertension, diabetes mellitus, and dyslipidemia. Crude and adjusted hazard ratios (HRs) were calculated using a Cox proportional hazards model, and the 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to age and sex. The adjusted HR of renal stones was 1.93 (95% CI = 1.75–2.14) in the gallstone group (P < 0.001). The adjusted HR of gallstones was 1.97 (95% CI = 1.81–2.15) in the renal stone group (P < 0.001). The results were consistent in all subgroup analyses. Gallstones increased the risk of renal stones, and renal stones increased the risk of gallstones.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang Myeon Song
- Department of Otorhinolaryngology-Head & Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Lim
- Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Man Sup Lim
- Department of General Surgery, Hallym University College of Medicine, Chuncheon, Korea
| | - Woojin Bang
- Department of Urology, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.
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Physical Activity as a Protective Factor for Lower Urinary Tract Symptoms in Male Patients: A Prospective Cohort Analysis. Urology 2019; 125:163-168. [PMID: 30634026 DOI: 10.1016/j.urology.2018.12.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/25/2018] [Accepted: 12/31/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess the association between physical activity, evaluated by the Physical Activity Scale for Elderly (PASE) questionnaire and lower urinary tract symptoms (LUTS) in male patients. METHODS From 2009 onward, a consecutive series of patients with LUTS-benign prostatic enlargement were enrolled. Symptoms were evaluated using the International Prostate Symptom Score (IPSS) with its subscores and prostate volume using transrectal ultrasound. Physical activity was evaluated with the PASE questionnaire, consisting of 12 questions regarding frequency and duration of leisure activity and recently used to evaluate physical activity in patients with prostatic disorders. The risk of detecting LUTS (IPSS ≥8), voiding LUTS (vIPSS≥5), and storage LUTS (sLUTS) (sIPSS ≥4) was evaluated using binary logistic regression analysis. RESULTS Six hundred and seventeen patients were enrolled in 2 centers (Rome, Vasto, Italy). Median PASE score was 118 (IQR 73/169), and median IPSS was 9 (IQR 5/15). Overall 189 of 617 (30%) patients presented moderate/severe LUTS. These patients presented a lower PASE score (111 IQR 69/160 vs 125 IQR 83/180; P = .016) when compared to patients with total IPSS ≤7. On multivariate analysis, PASE score (OR = 0.997 per unit, 95%CI: 0.994-1.000; P = .023), and prostate volume (OR = 1.008 per mL, 1.000-1.016; P = .045) were independent predictors of LUTS severity. As well PASE score was an independent predictor of moderate/severe sLUTS (OR = 0.996, 95%CI:0.993-0.999; P = .015). CONCLUSION In our study a reduced physical activity, assessed using the PASE questionnaire, is associated with an increased risk of moderate severe LUTS, more specifically of moderate/severe sLUTS.
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Han CH, Kim SJ, Chung JH. The Association between Male Asthma and Lower Urinary Tract Symptoms Evaluated by the International Prostate Symptom Score: A Population-Based Study. Int Arch Allergy Immunol 2018; 177:334-341. [PMID: 30130757 DOI: 10.1159/000491794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES We explored the association between asthma severity and lower urinary tract symptoms (LUTS) using the International Prostate Symptom Score in a population-based study of males (aged ≥19 years) and evaluated voiding and urine storage symptoms. METHODS This was a cross-sectional study of 101,848 males, 2,544 of whom had asthma, who participated in the 2011 Korean Community Health Survey. All subjects were assessed in terms of sociodemographic data, pre-existing conditions, and the presence of LUTS. Logistic regression was used to identify risk factors for LUTS in asthmatics. RESULTS Urine storage symptoms (frequency, urgency, and nocturia) and voiding symptoms (straining, a weak stream, intermittency, and incomplete emptying) were significantly higher in the asthma group than in the non-asthma group (all p < 0.001). Moderate and severe LUTS were significantly more common in the asthma group (moderate, 24.3%; severe, 22.5%) than in the nonasthma group (moderate, 9.5%; severe, 2.9%). Compared to the mild LUTS group, the odds ratio (OR) for asthma was 2.21 (95% confidence interval [CI] 1.99-2.46) in the moderate LUTS group, and 3.04 (95% CI 2.64-3.51) in the severe LUTS group. In a model evaluating multiple variables, the OR for asthma in the moderate LUTS group was 1.95 (95% CI 1.74-2.16) and that in the severe LUTS group was 2.17 (95% CI 1.87-2.53). Asthma was associated with both voiding and storage symptoms. CONCLUSIONS Male asthma was associated with moderate-to-severe LUTS. More aggressive urological diagnosis and treatment are needed for patients with asthma.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Seung Jun Kim
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of
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15
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Gyasi-Sarpong CK, Acheampong E, Yeboah FA, Aboah K, Laing EF, Amoah G. Predictors of the international prostate symptoms scores for patients with lower urinary tract symptoms: A descriptive cross-sectional study. Urol Ann 2018; 10:317-323. [PMID: 30089993 PMCID: PMC6060591 DOI: 10.4103/ua.ua_4_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Lower urinary tract symptoms (LUTSs) can significantly reduce men's quality of life and may point to serious pathology of the urogenital tract. This study aimed at finding predictors of symptoms score on the International Prostate Symptom Score (IPSS) for patients with LUTS. Materials and Methods The study was cross-sectional conducted among 225 Ghanaian men visiting the urology clinic at Komfo Anokye Teaching Hospital. Trained interviewers used the IPSS, which adds a quality of life question to the American Urology Association symptom index to determine the extent to which patients are troubled by their symptoms. Five milliliters of blood was collected for total prostate-specific antigen (PSA) measurement. Transrectal ultrasonography was performed to evaluate the prostate volume (PV). Results The mean age of the participants was 67.96 ± 14.57. The average score obtained from the study participants using the IPSS scale was 17.52 ± 7.83. There was a significant association between bother score and IPSS symptoms grade (P < 0.0001). Regression plot of the participants' points for IPSS in relation to the age, PSA, and PV showed statistically significant positive associations (P < 0.05). However, the coefficients of determination (R2) were 0.156, 0.022, and 0.048, respectively. This means that each unit increase of age, PSA, and PV only influences 15.6%, 2.3%, and 4.8% of the change in the symptom score. There was statistically significant association between age and moderate-to-severe LUTS with age range of 75 years above recording the highest odds (adjusted odds ratio (AOR) = 18.72, (1.15-99.78), P < 0.0001). The PSA range 20.1-50 ng/ml was significantly associated with moderate-to-severe LUTS (AOR = 17.37 (2.19-223.45), P = 0.006). Moreover, other factors, which were significantly associated with moderate-to-severe LUTS, were smoking (AOR = 0.32 (0.11-0.94) P = 0.038) and being widowed (AOR = 0.05 (0.002-0.52), P =0.010) respectively. Conclusion The study found a statistically significant correlation between age, PSA, PV, and IPSS scores; however, these influences were mild.
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Affiliation(s)
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Agyemamg Yeboah
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kenneth Aboah
- Department of Surgery, Urology Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Edwin Ferguson Laing
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - George Amoah
- Department of Surgery, Urology Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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16
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Rao M, Shangguan H, Zeng Z, Zheng Y, Zhang H, Li H, Xia W, Zhu C, Xiong C, Guan H. Prevalence and risk factors of lower urinary tract symptoms in Chinese adult men: a multicentre cross-sectional study. Oncotarget 2017; 8:113225-113238. [PMID: 29348901 PMCID: PMC5762586 DOI: 10.18632/oncotarget.22378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/05/2017] [Indexed: 11/25/2022] Open
Abstract
There has been no previous population-based study reporting the prevalence and risk factors of male lower urinary tract symptoms (LUTS) among men in mainland China. This cross-sectional study was conducted from 2013 to 2014 in three representative provinces of China: Guangdong, Hubei and Jiangsu. 3250 individuals participated in the interviews, which involved a questionnaire covering sociodemographic characteristics, lifestyle, dietary patterns and the International Prostate Symptom Score (IPSS). Blood was collected for lipids, glucose, insulin and reproductive hormone tests. The incidences of LUTS and its obstructive and irritative symptoms were calculated. Risk factors for LUTS were identified using multivariable logistic regression analysis. The prevalence of moderate to severe LUTS and its obstructive and irritative symptoms was 14.3%, 13.1% and 16.1%, respectively, and increased with age. The prevalence in Guangdong was much lower than that in Hubei and Jiangsu in different ages. Increased fasting plasma glucose and decreased HDL-C levels were associated with an increased risk of moderate to severe LUTS (OR = 1.30, 95% CI: 1.02–1.65 and OR = 2.06, 95% CI: 1.08–3.94, respectively). Free testosterone < 0.22 ng/ml decreased the risk of moderate to severe LUTS and obstructive and irritative symptoms by about 20–30%. An inadequate daily intake of vegetables, fruit and water significantly increased the risk of LUTS by 1.3–to 2.0 times. In conclusion, the prevalence of LUTS in Chinese men is high and increases with age. Dietary patterns may be critical for the development of LUTS. Thus, dietary modifications could be a useful strategy for preventing the development of LUTS.
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Affiliation(s)
- Meng Rao
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Zhengyan Zeng
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yi Zheng
- Department of Venereology, Wuhan Institute of Dermatology and Venereology, Wuhan, China
| | - Huiping Zhang
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Honggang Li
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Xia
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changhong Zhu
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengliang Xiong
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huangtao Guan
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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17
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Seo DH, Yoon S, Choi JH, Do J, Lee SW, Lee C, Jeh SU, Choi SM, Kam SC, Hwa JS, Chung KH, Kwon SW, Kim SC, Park DS, Song JM, Lee KS, Hyun JS. The Correlation between Body Mass Index and Routine Parameters in Men Over Fifty. World J Mens Health 2017; 35:178-185. [PMID: 28879691 PMCID: PMC5746489 DOI: 10.5534/wjmh.16032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 07/07/2017] [Accepted: 07/09/2017] [Indexed: 11/28/2022] Open
Abstract
Purpose This study aimed to investigate the relationships between body mass index (BMI) and prostate-specific antigen (PSA) levels, international prostate symptom score (IPSS), quality of life (QoL), and prostate volume (PV). Materials and Methods Height, weight, PSA levels, PV, and IPSS were analyzed in 15,435 patients who underwent a prostate examination between 2001 and 2014. Patients aged <50 years or with a PSA level ≥10 ng/mL were excluded. The relationships between BMI and PSA, IPSS, QoL, and PV were analyzed by a scatter plot, one-way analysis of variance, and the Pearson correlation coefficient. Results The mean age was 71.95±7.63 years, the mean BMI was 23.59±3.08 kg/m2, the mean PSA level was 1.45±1.45 ng/mL, the mean IPSS was 15.53±8.31, the mean QoL score was 3.48±1.25, and the mean PV was 29.72±14.02 mL. PSA, IPSS, and QoL showed a tendency to decrease with increasing BMI, and there were statistically significant differences for each parameter (p≤0.001). PV showed a significant tendency to increase with BMI (p<0.001). In the correlation analysis, BMI showed a statistically significant correlation (p<0.001) with PSA, IPSS, and QoL, although the correlations were very weak. In contrast, BMI showed a significant correlation with PV (p<0.001), with a meaningful Pearson correlation coefficient of 0.124. Conclusions Higher BMI was associated with lower PSA levels and higher IPSS and QoL scores. Meanwhile, PV increased with BMI. Although obese individuals had a greater PV, obesity did not aggravate lower urinary tract symptoms.
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Affiliation(s)
- Deok Ha Seo
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Sol Yoon
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Jae Hwi Choi
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Jungmo Do
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Sin Woo Lee
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Chunwoo Lee
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Seong Uk Jeh
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - See Min Choi
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Sung Chul Kam
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jeong Seok Hwa
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ky Hyun Chung
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung Won Kwon
- Department of Urology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Sae Chul Kim
- Department of Urology, Seonam University Myongji Hospital, Goyang, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Dong Soo Park
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Jae Mann Song
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Kyung Seop Lee
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Jae Seog Hyun
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea.
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18
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Prostatic vascular damage induced by cigarette smoking as a risk factor for recovery after holmium laser enucleation of the prostate (HoLEP). Oncotarget 2017; 8:14039-14049. [PMID: 27732940 PMCID: PMC5355160 DOI: 10.18632/oncotarget.12538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/04/2016] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the relationship between prostatic vessel changes induced by cigarette smoking and the perioperative outcome of holmium laser enucleation of the prostate (HoLEP). Materials and Methods A total of 268 postoperative patients with benign prostatic hyperplasia (BPH) were prospectively analysed in our department. They were divided into two groups (smokers and non-smokers) according to smoking history. Transrectal colour Doppler ultrasound was performed to evaluate the prostate vascular changes. Pathologically, HE staining, CD31 and CD34 were analysed in prostatic section chips. Furthermore, postoperative outcomes were determined during a 6-month follow-up period. Results The preoperative prostate volume was significantly decreased in smoking patients (P = 0.04). CPI was significantly lower in smoking BPH patients (P < 0.01), whereas RI was significantly increased in smokers compared with non-smokers (P < 0.01). Histological assays revealed elevated CD34 in the smoking BPH individuals presenting an increased number of microvessels. The HoLEP duration was increased in smokers. Interestingly, we identified significantly increased overactive bladder syndrome score (OABSS) and decreased Qmax in smoking individuals during the 6-month follow-up with no difference being observed preoperatively. However, no significant difference between the groups was observed for the International Prostate Symptom Score (IPSS). Conclusions The significantly lower CPI and higher RI values in smoking BPH patients indicated the presence of considerable vascular damage in these subjects. Moreover, cigarette smoking extended the surgical duration and prolonged the recovery period of overactive bladder (OAB) syndrome. Thus, integrated treatment should be suggested for various BPH individuals.
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19
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Méndez-Rubio S, Salinas-Casado J, Esteban-Fuertes M, Méndez-Cea B, Sanz-de-Burgoa V, Cozar-Olmo JM. Urological disease and tobacco. A review for raising the awareness of urologists. Actas Urol Esp 2016; 40:424-33. [PMID: 26920096 DOI: 10.1016/j.acuro.2016.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/17/2016] [Accepted: 01/18/2016] [Indexed: 11/28/2022]
Abstract
CONTEXT Smoking is the leading cause of preventable death in our community. Its relationship with urological disease is well documented. OBJECTIVE To present an updated review on the relationship between urological disease and tobacco consumption and the importance of involving urologists in smoking prevention. ACQUISITION AND SYNTHESIS OF EVIDENCE We conducted a review of current literature, primarily by searching PubMed and using as the main base the report on the consequences of smoking on health performed by the Surgeon General. CONCLUSION Urologists play an essential role in informing patients of the relationship between smoking and urological disease. It is the duty of every urologist to play a more active role in educating patients and promoting smoking cessation.
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Affiliation(s)
- S Méndez-Rubio
- Servicio de Urología, Hospital Universitario Sanitas La Moraleja, Madrid, España.
| | - J Salinas-Casado
- Servicio de Urología, Hospital Clínico San Carlos, Madrid, España
| | - M Esteban-Fuertes
- Servicio de Urología, Hospital Nacional de Parapléjicos, Toledo, España
| | - B Méndez-Cea
- Facultad de Biología, Universidad Complutense de Madrid, Madrid, España
| | | | - J M Cozar-Olmo
- Servicio de Urología, Hospital Universitario Virgen de las Nieves, Granada, España
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20
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Xu H, Fu S, Chen Y, Chen Q, Gu M, Wang Z. Smoking habits and benign prostatic hyperplasia: A systematic review and meta-analysis of observational studies. Medicine (Baltimore) 2016; 95:e4565. [PMID: 27512883 PMCID: PMC4985338 DOI: 10.1097/md.0000000000004565] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Previous studies have warned against the promoting effects of cigarette smoking on benign prostatic hyperplasia (BPH). In contrast, some have argued that smoking confers a protective effect regarding BPH, while others have observed an aggravated effect. Thus, we performed this meta-analysis to determine whether cigarette use is associated with BPH risk.To identify articles from observational studies of relevance, a search was performed concurrent to March 21, 2016, on PubMed, Web of Science, Cochrane, EBSCO, and EMBASE databases. Random-effect model, according to the heterogeneity, was calculated to reveal the relative risks (RRs) and corresponding 95% confidence intervals (CIs).Eight articles were included in this meta-analysis, representing data for 44,100 subjects, of which 5221 (11.8%) had BPH as defined according to the criteria. Seven reports are concerned with analysis between nonsmokers and ex-smokers, in which no significant difference was observed (RR = 0.99, 95% CI 0.94-1.05). Another meta-analysis of 7 studies indicated an observable trend, but without significant difference between groups of nonsmokers and current smokers (RR = 1.17, 95% CI 0.98-1.41). Between groups of heavy (6 articles; RR = 1.02, 95% CI 0.84-1.24) and light smokers (5 articles; RR = 0.90, 95% CI 0.71-1.15), again no significant difference appears. Finally, we combined individuals as never-smokers and ever-smokers and still found no significant difference between the 2 groups of patients (RR = 1.03, 95% CI 0.92-1.15). Sensitivity analysis was displayed and confirmed the stability of the present results.Combined evidence from observational studies shows no significant association between cigarette smoking and BPH risk, either for ex-smokers or for current smokers. The trend of elevated BPH risk from smoking was observed only in current smokers compared with nonsmokers, while marginal significance was observed in comparing ever-smokers with never-smokers in operative patients with BPH.
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21
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Affiliation(s)
- Hyung-Jee Kim
- Department of Urology, Dankook University College of Medicine, Cheonan, Korea
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22
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Factors associated with continuing medical therapy after transurethral resection of prostate. Urology 2014; 84:675-80. [PMID: 25059592 DOI: 10.1016/j.urology.2014.04.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 04/10/2014] [Accepted: 04/15/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To report the clinical characteristics of patients who have persistent lower urinary tract symptoms (LUTS) after surgery for benign prostatic hyperplasia (BPH) and continue their medical therapy postoperatively. MATERIALS AND METHODS We retrospectively studied 372 patients who underwent transurethral resection of prostate for LUTS/BPH in 8 institutions to determine the differences between patients who continued LUTS/BPH medications for >3 months after surgery and those who did not. Preoperative, intraoperative, and postoperative clinical parameters were assessed. The Student t test and chi square test were used to compare each parameter between patient groups. Multivariate logistic regression analysis was performed to identify risk factors for persistent LUTS and continuing medical therapy after surgery. RESULTS There were 205 patients (55.1%) who continued their LUTS/BPH medications for >3 months postoperatively. They reported poorer International Prostate Symptom Scores and uroflowmetry results after surgery. Multivariate analysis showed that age >70 years (odds ratio [OR], 2.474; P = .001), history of diabetes (OR, 1.949; P = .040), history of cerebrovascular accident (OR, 5.932; P = .001), any previous LUTS/BPH medication use (OR, 5.384; P = <0.001), and previous antimuscarinic drug use (OR, 2.962; P = .016) were significantly associated with symptom persistency and continuing medical therapy. CONCLUSION Many patients have persistent voiding dysfunction after surgical treatment for LUTS/BPH. Older age, history of diabetes, history of cerebrovascular accidents, and preoperative antimuscarinic drug uses are possible risk factors.
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23
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Rosenberg MT, Staskin D, Riley J, Sant G, Miner M. The evaluation and treatment of prostate-related LUTS in the primary care setting: the next STEP. Curr Urol Rep 2014; 14:595-605. [PMID: 24026361 DOI: 10.1007/s11934-013-0371-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The primary care provider is in an optimal position to identify and care for the patient affected by prostate-related lower urinary tract symptoms (BPH-LUTS). This assessment can be readily accomplished with a good history and only a few simple, in-office tests. In some instances, the primary care provider may believe that they do not have the experience, comfort level or time to perform an adequate evaluation of the problem. Therefore, in this article, we describe the function of the lower urinary tract, as well as the rationale behind the medical history, examination and tests needed in order to diagnose and treat, or refer, the patient presenting with BPH-LUTS. We will also update the literature-based STEP (simplified treatment of the enlarged prostate) approach, which was initially published in 2009, to include recently described therapeutic options.
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24
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Skeldon SC, Larry Goldenberg S. Bladder cancer: a portal into men's health. Urol Oncol 2014; 33:40-44. [PMID: 24745663 DOI: 10.1016/j.urolonc.2013.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 12/13/2013] [Accepted: 12/15/2013] [Indexed: 01/08/2023]
Abstract
Bladder cancer is the fourth most common cancer among men in the United States, with a 3-fold higher incidence than women. Globally, tobacco smoking remains significantly more common in men, contributing to half of all cases of bladder cancer. To prevent bladder cancer, urologists should promote smoking cessation to patients presenting at earlier ages with concerns such as sexual dysfunction, infertility, pelvic pain, or vasectomy. Bladder cancer also provides an entry point for men into the healthcare system, at which time, urologists can discuss and coordinate attention to other male health issues such as cardiovascular illness, depression, or addiction. By assuming the role of men's health physicians, urologists can have a significant benefit on men's urologic and overall health by targeting risk factors and behaviors.
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Affiliation(s)
- Sean C Skeldon
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Larry Goldenberg
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
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Ahmed MH, Barakat S, Almobarak AO. The association between renal stone disease and cholesterol gallstones: the easy to believe and not hard to retrieve theory of the metabolic syndrome. Ren Fail 2014; 36:957-62. [DOI: 10.3109/0886022x.2014.900424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms. Curr Opin Urol 2014; 24:10-4. [DOI: 10.1097/mou.0000000000000004] [Citation(s) in RCA: 40] [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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Burgio KL, Newman DK, Rosenberg MT, Sampselle C. Impact of behaviour and lifestyle on bladder health. Int J Clin Pract 2013; 67:495-504. [PMID: 23679903 DOI: 10.1111/ijcp.12143] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 01/18/2013] [Indexed: 01/22/2023] Open
Abstract
Bladder conditions, including UTI, UI, and bladder cancer, are highly prevalent and affect a wide range of populations. There are a variety of modifiable behavioral and lifestyle factors that influence bladder health. Some factors, such as smoking and obesity, increase the risk or severity of bladder conditions, whereas other factors, such as pelvic floor muscle exercise, are protective. Although clinical practice may be assumed to be the most appropriate ground for education on behavioral and lifestyle factors that influence bladder health, it is also crucial to extend these messages into the general population through public health interventions to reach those who have not yet developed bladder conditions and to maximize the prevention impact of these behaviors. Appropriate changes in these factors have the potential for an enormous impact on bladder health if implemented on a population-based level.
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Affiliation(s)
- K L Burgio
- Department of Veterans Affairs Medical Center, Birmingham, AL 35233, USA.
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Parsons JK, Sarma AV, McVary K, Wei JT. Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigms and future directions. J Urol 2013; 189:S102-6. [PMID: 23234610 DOI: 10.1016/j.juro.2012.11.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Benign prostatic hyperplasia is a highly prevalent disease in older men with substantial adverse effects on public health. Classic etiological paradigms for benign prostatic hyperplasia focus on nonmodifiable risk factors. However, obesity also potentially promotes benign prostatic hyperplasia. MATERIALS AND METHODS We performed a structured, comprehensive literature review to identify studies of obesity, benign prostatic hyperplasia, lower urinary tract symptoms and physical activity. RESULTS A preponderance of published evidence suggests strong positive associations of obesity with benign prostatic hyperplasia and lower urinary tract symptoms. This evidence encompasses most established metrics of adiposity, including body mass index, waist circumference and waist-to-hip ratio, and falls under 3 general categories, including prostate volume, clinical benign prostatic hyperplasia and lower urinary tract symptoms. 1) Prior studies consistently showed that increased adiposity is positively associated with radiographically determined prostate volume and enlargement, suggesting that obesity promotes prostate growth. 2) Most studies revealed that obesity increases the risk of clinical benign prostatic hyperplasia by several measures, including the initiation of benign prostatic hyperplasia medical treatment, noncancer prostate surgery, physician diagnosed benign prostatic hyperplasia, histological diagnosis and urinary flow rate. 3) Prior studies demonstrated that obesity increases the risk of lower urinary tract symptoms, as measured by a validated questionnaire. Also, most studies showed that physical activity significantly decreases the risk of benign prostatic hyperplasia. CONCLUSIONS Obesity markedly increases the risk of benign prostatic hyperplasia. Since physical activity decreases the risk of benign prostatic hyperplasia, these observations support the development of novel prevention strategies and treatment targeted toward adiposity, weight loss and lifestyle.
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Affiliation(s)
- J Kellogg Parsons
- Division of Urologic Oncology, Moores Cancer Center, University of California-San Diego and San Diego Veterans Affairs Medical Center, La Jolla, CA 92103, USA.
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Lorenzetti F, Pintarelli VL, Seraphim DCC, Dambros M. Low testosterone levels induce apoptosis via active 3-caspase dependent signaling in the bladder wall of male rats. Aging Male 2012; 15:216-9. [PMID: 22967305 DOI: 10.3109/13685538.2012.716876] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The bladder can be considered a target organ for testosterone action, and low testosterone levels possibly cause damage to bladder cells. We set out to study whether hypoandrogenism influences bladder wall cell damage in castrated and senile male rats. METHODS Thirty male Wistar rats were divided into three groups of 10 animals each: group I (3 months old), sham animals; group II (27 months old), senile animals; group III (3 months old), subjected to bilateral orchiectomy, and sacrificed 8 weeks after the procedure. Bladders were excised, weighed and sent for analysis. Stereological assays on collagen fibers and immunohistochemical analysis with active 3-caspase were performed on bladder cells. RESULTS Bladder weights were greater in the senile group than in the others. Stereological collagen fiber analysis demonstrated higher density in group III than in groups I and II (p < 0.05). The absolute density was 4.15 mm(3) in group I, 22.3 mm(3) in group II and 19.3 mm(3) in group III. Semiquantitative active 3-caspase analysis showed greater percentages in the senile group II than in groups I and III. CONCLUSIONS We can state that low plasma testosterone levels are related to higher collagen fiber density and active 3-caspase percentages in the bladder walls of orchiectomized and senile rats, respectively.
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Affiliation(s)
- Fábio Lorenzetti
- Department of Geriatric Urology, Federal University of São Paulo, São Paulo, SP, Brazil
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Kim JH, Shim SR, Lee WJ, Kim HJ, Kwon SS, Bae JH. Sociodemographic and lifestyle factors affecting the self-perception period of lower urinary tract symptoms of international prostate symptom score items. Int J Clin Pract 2012; 66:1216-23. [PMID: 23163502 DOI: 10.1111/j.1742-1241.2012.02988.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
AIMS This study investigated the influence of sociodemographic and lifestyle factors on the lower urinary tract symptom (LUTS) self-perception period and International Prostate Symptom Score. METHOD This cross-sectional study examined 209 men aged ≥ 40 years with non-treated LUTS who participated in a prostate examination survey. Questions included International Prostate Symptom Score (IPSS) items with self-perception periods for each item. Sociodemographic and lifestyle factors were also assessed. Participants were divided by mild LUTS (IPSS less than 8) and moderate-to-severe LUTS (IPSS 8 or higher). RESULTS Self-perception period of the moderate-to-severe LUTS (n = 110) was affected by BMI; the self-perception period of the mild LUTS (n = 90) was affected by age, income, occupation and concomitant disease. Moderate-to-severe LUTS were affected by self-perception period (p = 0.03). Self-perception period was affected by concern for health (p = 0.005) by multivariate analysis, and self-perception period of mild LUTS was affected by BMI (p = 0.012). Moderate-to-severe LUTS were affected by age, number of family members, concern for health and drinking (p < 0.05, respectively) by multivariate analysis. CONCLUSION Lower urinary tract symptom was affected by self-perception period. In moderate-to-severe LUTS, age, concern for health and drinking were affecting factors of self-perception period.
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Affiliation(s)
- J H Kim
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Impact of lower urinary tract symptoms and depression on health-related quality of life in older adults. Int Neurourol J 2012; 16:132-8. [PMID: 23094219 PMCID: PMC3469832 DOI: 10.5213/inj.2012.16.3.132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 09/16/2012] [Indexed: 12/05/2022] Open
Abstract
Purpose We aimed primarily to investigate the level of health-related quality of life (HRQoL), lower urinary tract symptoms (LUTS), and depression in older adults and secondly to identify the impact of LUTS and depression on HRQoL. Methods A community-based cross-sectional study was conducted from April to November 2010. Participants were recruited from five community senior centers serving community dwelling older adults in Jeju city. Data analysis was based on 171 respondents. A structured questionnaire was used to guide interviews; the data were collected including demographic characteristics, body mass index, adherence to regular exercise, comorbidities (hypertension, diabetes mellitus, and osteoarthritis), depression, urinary incontinence, LUTS (measured via the International Prostate Symptom Score [IPSS]), and HRQoL as assessed by use of the EQ-5D Index. Stepwise multiple regression analysis was used to test predictors of HRQoL. Results Eighteen percent (18.6%) of the respondents reported depressive symptoms. The mean LUTS score was 8.9 (IPSS range, 0 to 35). The severity of LUTS, was reported to be mild (score, 0 to 7) by 53% of the respondents, moderate (score, 8 to 19) by 34.5%, and severe (score, 20 to 35) by 12.5%. HRQoL was significantly predicted by depression (Partial R2=0.193, P<0.01) and LUTS (Partial R2=0.048, P=0.0047), and 24% of the variance in HRQoL was explained. Conclusions LUTS and depression were the principal predictors of HRQoL in older adults.
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Ahmed MH, Ahmed HT, Khalil AA. Renal stone disease and obesity: what is important for urologists and nephrologists? Ren Fail 2012; 34:1348-54. [PMID: 23013150 DOI: 10.3109/0886022x.2012.723777] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Currently, obesity has reached an epidemic stage and represents a challenge for health authorities across the globe. Certainly, with emergence of obesity epidemic, we started to see an increase in the prevalence of chronic kidney disease (CKD) and nephrolithiasis. Interestingly, epidemiologic studies have shown that the incident stone risk increases with body mass index (BMI), and no further increase in risk is noticed when the BMI > 30 kg/m(2). Furthermore, metabolic syndrome and diabetes are also associated with an increase in the incidence of renal stones disease. The shared links between these metabolic disorders are insulin resistance. Furthermore, insulin resistance is thought to alter renal acid-base metabolism, resulting in a lower urine pH and increased risk of uric acid stone disease. Obesity is also associated with excess nutritional intake of lithogenic substances such as refined sugars, low fluid intake, calcium, oxalate, and purine-rich foods. Obesity is also associated with an increase in incidence of urinary tract infection. Recent reports suggested that renal stone disease carries risk of myocardial infarction, progression of CKD, and diabetes. Alarmingly, orlistat (obesity medication) and bariatric surgery are associated with hyperoxaluria and associated stone formation and even oxalate nephropathy. Certainly, the many health risks of obesity, including nephrolithiasis, will add more burden on urologists and nephrologists. Shockwave lithotripsy, percutaneous nephrolithotomy, and ureteroscopy are all safe procedures in obese individuals. Further research is urgently needed to address the pathophysiology and management of obesity-induced renal stones disease.
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Affiliation(s)
- Mohamed H Ahmed
- Department of Medicine, Wexham Park Hospital, Slough, Berkshire, UK.
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Risk Factors for New-onset Overactive Bladder in Older Subjects: Results of the Fujiwara-Kyo Study. Urology 2012; 80:71-6. [DOI: 10.1016/j.urology.2012.04.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 04/09/2012] [Accepted: 04/12/2012] [Indexed: 01/08/2023]
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Chung JH, Yu JH, Sung LH, Noh CH, Chung JY. Effect of prostatitis on lower urinary tract symptoms: retrospective analysis of prostate biopsy tissue. Korean J Urol 2012; 53:109-13. [PMID: 22379590 PMCID: PMC3285705 DOI: 10.4111/kju.2012.53.2.109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 10/13/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose Most patients, even some urologists, assume that prostate volume is the most important prognostic factor for lower urinary tract symptoms (LUTS). In some cases, however, prostatic inflammation is a more important factor in LUTS than is prostate volume. For this reason, comparison of the impact on LUTS of inflammation and prostate volume is an attractive issue. Materials and Methods From January 2000 to May 2009, 1,065 men aged between 47 and 91 years (who underwent transrectal ultrasound-guided prostate needle biopsy and transurethral prostatectomy) were retrospectively investigated. Components such as age, serum prostate-specific antigen (PSA) level, prostate volume, and the presence of prostatitis were investigated through independent-sample t-tests, chi-square tests, and univariate and multivariate analyses. Results Chi-square tests between prostatitis, prostate volume, serum PSA, and severe LUTS showed that prostate volume (R=0.173; p=0.041) and prostatitis (R=0.148; p<0.001) were related to LUTS. In particular, for a prostate volume under 50 ml, prostatitis was a stronger risk factor than was prostate volume. Among the multivariate predictors, prostatitis (odds ratio [OR]: 1.945; p<0.001) and prostate volume (OR, 1.029; p<0.001) were found to be aggravating factors of LUTS. Conclusions For patients with prostate volume less than 50 ml, prostatitis was found to be a more vulnerable factor for LUTS. For those with prostate volume over 50 ml, on the other hand, the volume itself was a more significant risk factor than was prostatitis. In conclusion, the presence of prostatitis is one of the risk factors for LUTS with increased prostate volume.
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Affiliation(s)
- Jai Hyun Chung
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Lu Z, Gao Y, Tan A, Yang X, Zhang H, Mo L, Wu C, Hu Y, Mo Z. Increased high-sensitivity C-reactive protein predicts a high risk of lower urinary tract symptoms in Chinese male: Results from the Fangchenggang Area Male Health and Examination Survey. Prostate 2012; 72:193-200. [PMID: 21594882 DOI: 10.1002/pros.21421] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 04/14/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND Reports have shown that increased serum C-reactive protein (CRP) suggests a risk of lower urinary tract symptoms (LUTS) in the West population. However, few studies have investigated the role of CRP as regards LUTS in a Chinese male population. METHODS Data were collected from 1,452 men who participated in the population-based Fangchenggang Area Male Health and Examination Survey (FAMHES), which was carried out in Guangxi, China, from September 2009 to December 2009. In the current study, serum CRP was measured with a high-sensitivity method (hsCRP) and LUTS was assessed by International Prostate Symptom Score (IPSS). Meanwhile, information about potential confounding variables (smoking, hypertension, diabetes, etc.) were included. RESULTS We observed that statistically significant distinction presented in the distribution of hsCRP levels and age between LUTS group and non-LUTS group (P < 0.001). Comparing with the lowest hsCRP tertile, men with the highest hsCRP tertile were 1.72 times more likely to have overall LUTS and 1.93 times more likely to have irritative symptoms. As for individual symptoms of LUTS, statistically significant correlations were noted between serum hsCRP levels and urgency (OR = 1.74, 95% CI = 1.09-2.78) and nocturia (OR = 1.64, 95% CI = 1.18-2.27), when comparing them from the 1st to 3rd hsCRP tertiles. After multivariate adjusted, the results changed slightly and were still significant. CONCLUSIONS In a Chinese male population, we firstly confirmed a positive correlation of serum hsCRP with LUTS. It can be inferred that inflammation may be involved in the processes of LUTS.
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Affiliation(s)
- Zheng Lu
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
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Penson DF, Munro HM, Signorello LB, Blot WJ, Fowke JH. Obesity, physical activity and lower urinary tract symptoms: results from the Southern Community Cohort Study. J Urol 2011; 186:2316-22. [PMID: 22014824 DOI: 10.1016/j.juro.2011.07.067] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Indexed: 10/16/2022]
Abstract
PURPOSE Obesity and physical activity have been posited as modifiable risk factors to delay lower urinary tract symptom progression. In this study we determined the independent associations of physical activity and obesity with lower urinary tract symptoms at followup among white and African-American men. MATERIALS AND METHODS Male participants 40 to 79 years old were identified from the Southern Community Cohort Study, a prospective cohort based in the southeastern United States. Baseline data collection included a validated physical activity questionnaire, height and weight, health history and other information. We excluded participants with a history of or medication use for benign prostatic hyperplasia or prostate cancer. Participants (7,318, 60% African-American) completed the International Prostate Symptom Score approximately 5 years after baseline. Patients with an International Prostate Symptom Score greater than 8 or 20 were classified as having moderate or severe lower urinary tract symptoms, respectively, at followup. Multivariable logistic regression was used to assess the relationships among obesity, physical activity and lower urinary tract symptoms. RESULTS Moderate to severe lower urinary tract symptom severity at followup was significantly associated with a body mass index of 35 kg/m(2) or more (OR 1.38, 95% CI 1.17-1.63). Similarly the lowest categories of physical activity were associated with the onset of severe lower urinary tract symptoms in men with a normal body mass index (OR 1.38, 95% CI 1.05-1.82). These associations were independent of race. CONCLUSIONS Severe obesity is associated with an increased risk of lower urinary tract symptoms at followup, while physical inactivity may permit progression of lower urinary tract symptoms in normal weight men regardless of race. These variables should be considered in future research into modifiable risk factors for lower urinary tract symptoms.
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Affiliation(s)
- David F Penson
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37203-1738, USA.
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Sundvall PD, Ulleryd P, Gunnarsson RK. Urine culture doubtful in determining etiology of diffuse symptoms among elderly individuals: a cross-sectional study of 32 nursing homes. BMC FAMILY PRACTICE 2011; 12:36. [PMID: 21592413 PMCID: PMC3142216 DOI: 10.1186/1471-2296-12-36] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 05/19/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND The high prevalence of bacteriuria in elderly individuals makes it difficult to know if a new symptom is related to bacteria in the urine. There are different views concerning this relationship and bacteriuria often leads to antibiotic treatments. The aim of this study was to investigate the relationship between bacteria in the urine and new or increased restlessness, fatigue, confusion, aggressiveness, not being herself/himself, dysuria, urgency and fever in individuals at nursing homes for elderly when statistically considering the high prevalence of asymptomatic bacteriuria in this population. METHODS In this cross-sectional study symptoms were registered and voided urine specimens were collected for urinary cultures from 651 elderly individuals. Logistic regressions were performed to evaluate the statistical correlation between bacteriuria and presence of a symptom at group level. To estimate the clinical relevance of statistical correlations at group level positive and negative etiological predictive values (EPV) were calculated. RESULTS Logistic regression indicated some correlations at group level. Aside from Escherichia coli in the urine and not being herself/himself existing at least one month, but less than three months, EPV indicated no clinically useful correlation between any symptoms in this study and findings of bacteriuria. CONCLUSIONS Urinary cultures provide little or no useful information when evaluating diffuse symptoms among elderly residents of nursing homes. Either common urinary tract pathogens are irrelevant, or urine culture is an inappropriate test.
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Affiliation(s)
- Pär-Daniel Sundvall
- Sandared Primary Health Care Centre, Strandvägen 11, 518 32 Sandared, Sweden.
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Abstract
Elderly urologic patients require the same cautions as used in development of treatment programs for them in other disciplines. Because of potential interference with poor renal function or crossover effects with central or peripheral nervous system, however, many urologic drugs must be titrated appropriately. In treating cancer, erectile dysfunction, incontinence or urinary infection, patient quality of life and life span become dominant factors in making therapeutic decisions, by behavioral change, medication, or surgical intervention.
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Affiliation(s)
- Thomas J Guzzo
- Division of Urology, Department of Surgery, The Hospital of the University of Pennsylvania, 3400 Spruce Street, 9 Penn Tower, Philadelphia, PA 19104, USA.
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Holden CA, McLachlan RI, Pitts M, Cumming R, Wittert G, Ehsani JP, de Kretser DM, Handelsman DJ. Determinants of male reproductive health disorders: the Men in Australia Telephone Survey (MATeS). BMC Public Health 2010; 10:96. [PMID: 20181284 PMCID: PMC2839972 DOI: 10.1186/1471-2458-10-96] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 02/24/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear. The aim of this study is to describe lifestyle and biomedical associations as possible causes of erectile dysfunction (ED), prostate disease (PD), lower urinary tract symptoms (LUTS) and perceived symptoms of androgen deficiency (pAD) in a representative population of middle-aged and older men, using the Men in Australia Telephone Survey (MATeS). METHODS A representative sample (n = 5990) of men aged 40+ years, stratified by age and State, was contacted by random selection of households, with an individual response rate of 78%. All men participated in a 20-minute computer-assisted telephone interview exploring general and reproductive health. Associations between male reproductive health disorders and lifestyle and biomedical factors were analysed using multivariate logistic regression (odds ratio [95% confidence interval]). Variables studied included age, body mass index, waist circumference, smoking, alcohol consumption, physical activity, co-morbid disease and medication use for hypertension, high cholesterol and symptoms of depression. RESULTS Controlling for age and a range of lifestyle and co-morbid exposures, sedentary lifestyle and being underweight was associated with an increased likelihood of ED (1.4 [1.1-1.8]; 2.9 [1.5-5.8], respectively) and pAD (1.3 [1.1-1.7]; 2.7 [1.4-5.0], respectively. Diabetes and cardiovascular disease were both associated with ED, with hypertension strongly associated with LUTS and pAD. Current smoking (inverse association) and depressive symptomatology were the only variables independently associated with PD. All reproductive disorders showed consistent associations with depression (measured either by depressive symptomatology or medication use) in both age-adjusted and multivariate analyses. CONCLUSION A range of lifestyle factors, more often associated with chronic disease, were significantly associated with male reproductive health disorders. Education strategies directed to improving general health may also confer benefits to male reproductive health.
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Affiliation(s)
- Carol A Holden
- Andrology Australia, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
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Developing a pelvic floor muscle training regimen for use in a trial intervention. Physiotherapy 2009; 95:199-209. [PMID: 19635340 DOI: 10.1016/j.physio.2009.03.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Accepted: 03/22/2009] [Indexed: 11/22/2022]
Abstract
This paper explains the rationale behind the intervention used for a large multi-centred randomised controlled trial for men following transurethral resection of prostate or radical prostatectomy. It shows the content of the protocol used and explains why this particular protocol of pelvic floor muscle exercises and urge suppression techniques was chosen for men in the intervention group. The trial will evaluate whether this intervention will be effective for men with urinary incontinence and sexual dysfunction after prostate surgery. ISRCTN number: ISRCTN87696430.
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Coyne KS, Kaplan SA, Chapple CR, Sexton CC, Kopp ZS, Bush EN, Aiyer LP. Risk factors and comorbid conditions associated with lower urinary tract symptoms: EpiLUTS. BJU Int 2009; 103 Suppl 3:24-32. [PMID: 19302499 DOI: 10.1111/j.1464-410x.2009.08438.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the risk factors and comorbid conditions associated with subgroups of lower urinary tract symptoms (LUTS) in men and women aged > or =40 years in three countries, using data from the EpiLUTS study, as LUTS are common amongst men and women and increase in prevalence with age. SUBJECTS AND METHODS This cross-sectional, population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants were asked to rate how often they experienced individual LUTS during the past 4 weeks on a 5-point Likert scale. Eight LUTS subgroups were created. Descriptive statistics and logistic regressions within each LUTS subgroup were used to assess the data. RESULTS The survey response rate was 59%. The final sample was 30,000 (men and women). The voiding + storage + postmicturition (VSPM) group reported the highest rates of comorbid conditions for both men and women, and the fewest were reported in the no/minimal LUTS and the postmicturition-only groups. Increasing age was associated with increasing LUTS in men, but not in women. Comorbid conditions significantly associated with the VSPM group were arthritis, asthma, chronic anxiety, depression, diabetes (men only), heart disease, irritable bowel syndrome, neurological conditions, recurrent urinary tract infection, and sleep disorders. Risk factors, such as body mass index, exercise level and smoking, played less of a role, except for childhood nocturnal enuresis, which was significantly associated with most LUTS subgroups. CONCLUSION In this large population study, many comorbid conditions and risk factors were significantly associated with LUTS among both men and women. Further longitudinal investigations of the associations noted here would help physicians to understand the pathophysiology of LUTS and comorbid conditions, and provide clinical guidelines for patient management of comorbid conditions sharing common pathophysiological pathways.
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Affiliation(s)
- Karin S Coyne
- United BioSource Corporation, Bethesda, MD 20814, USA.
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Kuo HC. Prevalence of Lower Urinary Tract Symptoms in Male Aborigines and Non-aborigines in Eastern Taiwan. J Formos Med Assoc 2008; 107:728-35. [DOI: 10.1016/s0929-6646(08)60118-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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McVary KT, Siegel RL, Carlsson M. Sildenafil citrate improves erectile function and lower urinary tract symptoms independent of baseline body mass index or LUTS severity. Urology 2008; 72:575-9. [PMID: 18597830 DOI: 10.1016/j.urology.2008.04.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 04/02/2008] [Accepted: 04/12/2008] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate the body mass index (BMI) and lower urinary tract symptom (LUTS) severity on treatment response to sildenafil in men with erectile dysfunction (ED) and moderate to severe LUTS associated with benign prostatic hyperplasia. METHODS A post hoc analysis of data from a 12-week, double-blind, placebo-controlled study of sildenafil (50 mg once daily titrated to 100 mg once daily) was conducted. The BMI categories were obese (> or = 30 kg/m(2)), overweight (> or = 25 to < 30 kg/m(2)), and normal weight (< 25 kg/m(2)). ED was defined as a score of < or = 25 on the erectile function domain of the International Index of Erectile Function, and LUTS was defined by an International Prostate Symptom Score of > or = 12. The maximal urinary flow rate was determined by uroflowmetry. RESULTS Patients receiving sildenafil (n = 189) had a significant improvement in the erectile function domain scores of the International Index of Erectile Function (P < .0001 vs placebo, n = 180), which did not vary across BMI groups. A greater improvement in LUTS score was observed with sildenafil compared with placebo for men with severe LUTS (-8.6 vs -2.4, P < .0001) than in men with moderate LUTS (-3.6 vs -1.7, P = .06). Also, the improvement in LUTS scores was significant (P < or = .02) for men taking sildenafil independent of BMI (obese, -8.9 vs -5.4; overweight, -7.3 vs -3.2; normal weight, -7.1 vs -0.84). No difference was found among the treatment groups in the change from baseline maximal urinary flow rate across all LUTS and BMI categories (range 4.5 to -4.2 mL/s). CONCLUSIONS The results of our study have shown that daily dosing with sildenafil improved ED and LUTS independent of baseline LUTS severity or BMI.
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Affiliation(s)
- Kevin T McVary
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611-3008, USA.
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Dorey G. A clinical overview of the treatment of post-prostatectomy incontinence. ACTA ACUST UNITED AC 2007; 16:1194-9. [DOI: 10.12968/bjon.2007.16.19.27357] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Grace Dorey
- Somerset Nuffield Hospital, Taunton; and Extended Scope Practitioner Physiotherapist, North Devon District NHS Hospital, Barnstaple
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Rosenberg MT, Staskin DR, Kaplan SA, MacDiarmid SA, Newman DK, Ohl DA. A practical guide to the evaluation and treatment of male lower urinary tract symptoms in the primary care setting. Int J Clin Pract 2007; 61:1535-46. [PMID: 17627768 DOI: 10.1111/j.1742-1241.2007.01491.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
AIMS Lower urinary tract symptoms (LUTS) are common in both men and women, and are among the most prevalent patient complaints heard by primary care physicians (PCPs). This article aims to provide PCPs with a logical algorithm for the assessment and initiation of treatment for LUTS in the male patient. RESULTS Management of LUTS involves a focused history and physical, as well as the assessment of bother. In patients for whom treatment is warranted, a series of decisions regarding therapy should be considered. Male patients commonly suffer from storage and/or voiding symptoms. Treatment of male LUTS is commonly begun with agents that are aimed at remedying the outlet symptoms of benign prostatic hyperplasia (BPH). When this intervention is ineffective or when refractory symptoms persist, consideration should be given to treating the storage symptoms characteristic of overactive bladder (OAB). DISCUSSION This article is intended to provide the PCP with a logical guide to the treatment of male LUTS. Benign prostatic hyperplasia and OAB predominate among the causes of these symptoms, and the PCP should be comfortable treating each. Recent data detailing the safety of the use of these treatments in the male patient are reviewed and incorporated into the algorithm. CONCLUSION Primary care physicians are in a unique position to successfully identify and treat male patients with LUTS. With this paper, they now have a tool to approach treatment logically and practically.
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Affiliation(s)
- M T Rosenberg
- Mid-Michigan Health Centers, Department of Family Medicine, Foote Health System, Jackson, MI, USA.
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Rohrmann S, Fallin MD, Page WF, Reed T, Partin AW, Walsh PC, Platz EA. Concordance rates and modifiable risk factors for lower urinary tract symptoms in twins. Epidemiology 2006; 17:419-27. [PMID: 16699472 DOI: 10.1097/01.ede.0000219723.14476.28] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Lower urinary tract symptoms, which are common in older men, are thought to be determined genetically and by modifiable environmental risk factors. We examined the contribution of these 2 etiologic components in a cohort of U.S. twins. METHODS In 1998, a questionnaire that assessed lower urinary tract symptoms, weight, height, alcohol consumption, cigarette smoking, and physical activity was sent out to members of the National Academy of Science-National Research Council Twins Registry. We analyzed 1,723 complete twin pairs with information on lower urinary tract symptoms and zygosity and who did not have a previous diagnosis of prostate cancer. We calculated concordance rates of categories of the International Prostate Symptom Score in monozygotic (MZ) and dizygotic (DZ) twins. Generalized estimating equations were used to calculate the odds ratio of having high-moderate/severe lower urinary tract symptoms. RESULTS Concordance rates were higher in MZ than in DZ twins with concordance rate ratios of 2.2 and 6.9 depending on the specificity of definition of symptoms. Genetic factors contributed 72% to the risk of high-moderate/severe lower urinary tract symptoms. Taking into account correlated individuals, we observed high odds of lower urinary tract symptoms in obese men compared with lean men (odds ratio = 1.91; 95% confidence interval = 1.16-3.15 comparing first versus fourth quartile). Cigarette smoking was not associated with lower urinary tract symptoms, but alcohol consumption was positively associated. Men who were more physically active tended to have lower odds of lower urinary tract symptoms compared with less active men (0.62; 0.36-1.08). CONCLUSION The findings indicate a strong genetic component of lower urinary tract symptoms, but also support previous studies that modifiable environmental risk factors are associated with this condition.
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Affiliation(s)
- Sabine Rohrmann
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Haren MT, Kim MJ, Tariq SH, Wittert GA, Morley JE. Andropause: a quality-of-life issue in older males. Med Clin North Am 2006; 90:1005-23. [PMID: 16962854 DOI: 10.1016/j.mcna.2006.06.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Testosterone deficiency occurs commonly in men as they grow older. This deficiency often is associated with a decline in sexual activity and a loss of muscle mass. Testosterone replacement can reverse many of these effects. At present, no ideal form of testosterone replacement is available. Like the phosphodiesterase-5 inhibitors, testosterone replacement in older men is a quality of life issue.
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Affiliation(s)
- Matthew T Haren
- Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, MO 63104, USA
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Tikkinen KAO, Auvinen A, Huhtala H, Tammela TLJ. Nocturia and obesity: a population-based study in Finland. Am J Epidemiol 2006; 163:1003-11. [PMID: 16597705 DOI: 10.1093/aje/kwj139] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The authors' aim in this study was to analyze the association of nocturia with overweight and obesity. In 2003-2004, a questionnaire was mailed to 6,000 randomly selected Finns aged 18-79 years who were identified from the Finnish Population Register Centre. Information on nocturia was collected through questionnaires using the Danish Prostatic Symptom Score and the American Urological Association Symptom Index. Self-reported body weight and height were used to calculate body mass index (BMI; weight (kg)/height (m)2). Subjects were classified on the basis of BMI as nonoverweight (BMI<25), overweight (BMI 25-29.9 kgm2), or obese (BMI>or=30). Of the 6,000 subjects, 62.4% participated. Among men, the age-standardized prevalence of nocturia, defined as at least one void per night, was 33.4% (95% confidence interval (CI): 28.5, 38.3) in the nonoverweight, 35.8% (95% CI: 31.4, 40.1) in the overweight, and 48.2% (95% CI: 38.8, 57.6) in the obese. Among women, the corresponding figures were 37.2% (95% CI: 33.0, 41.5) in the nonoverweight, 48.3% (95% CI: 42.5, 54.2) in the overweight, and 53.6% (95% CI: 43.9, 63.2) in the obese. The associations remained similar when nocturia was defined as two or more voids per night. The age-standardized attributable fraction (population) of increased BMI for nocturia was 17.7% for men and 18.5% for women, corresponding to an 8.5% increase in the crude prevalence of nocturia in men and a 13.9% increase in women. The authors conclude that obesity is associated with increased nocturia, more strongly among women than among men.
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Affiliation(s)
- Kari A O Tikkinen
- Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland.
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Seim A, Hoyo C, Ostbye T, Vatten L. The prevalence and correlates of urinary tract symptoms in Norwegian men: the HUNT study. BJU Int 2005; 96:88-92. [PMID: 15963127 DOI: 10.1111/j.1464-410x.2005.05573.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To estimate the prevalence of lower urinary tract symptoms (LUTS) by severity (using the International Prostate Symptom Score, IPSS) in a population-based study of men aged > or = 20 years, and to assess the association between putative risk factors and the presence of moderate to severe LUTS. SUBJECTS AND METHODS Between 1995 and 1997, LUTS data were collected from 21 694 male residents aged > or = 20 years in Nord Trøndelag County in Norway, using the IPSS; from the IPSS (score 0-35) LUTS was defined as a score of > or = 8, indicating moderate to severe symptoms. We estimated the prevalence of LUTS and used logistic regression analysis to study lifestyle and anthropometric factors, and comorbidity related to LUTS. RESULTS The overall prevalence of moderate to severe LUTS was 15.8% (13.2% moderate and 2.6% severe). The prevalence of LUTS increased strongly with age, from approximately 5% among men aged < 40 years to > 30% when aged > or = 70 years. Factors positively associated with an increased risk of moderate and severe LUTS were anthropometric (body mass index and waist hip ratio) and lifestyle factors (alcohol consumption and smoking), as well as comorbid conditions, including diabetes, history of stroke, muscle complaints and osteoarthritis. CONCLUSION The findings from this population-based study suggest that the prevalence of LUTS among men aged > or = 20 years may be lower than previously estimated. Although LUTS may be viewed as an inevitable consequence of ageing, it appears to be exacerbated by lifestyle factors and comorbid conditions.
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Affiliation(s)
- Arnfinn Seim
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
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