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Abdalla HH, Shah J, Nyanja TAN, Shabani JS. Factors associated with depressive symptoms in patients with benign prostatic enlargement. Afr J Prim Health Care Fam Med 2023; 15:e1-e7. [PMID: 37265158 DOI: 10.4102/phcfm.v15i1.3572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Depression is a common condition that may lead to suicide at its worst. It is considered one of the primary causes of morbidity globally. Among the urological causes of depression is benign prostatic enlargement (BPE). AIM To determine the prevalence and factors associated with depressive symptoms among BPE patients. SETTING This study was conducted in the Urology and Family Medicine Clinic at the Aga Khan University Hospital, Nairobi and Urology clinic at the Aga Khan Hospital Mombasa. METHODS The study was a cross-sectional design recruiting 308 males above the age of 40. Patient Health Questionnaire-9 and International Prostate Symptom Score (IPSS) were used to assess depressive symptoms and lower urinary tract symptoms (LUTS), respectively. Association between depressive symptoms and LUTS was determined. Factors associated with depressive symptoms were analysed by logistic regression. RESULTS Prevalence of depressive symptoms among patients with symptomatic benign prostatic enlargement (sBPE) was 42.90%. Factors associated with depressive symptoms included comorbid conditions, medication side effects, reduced libido, alcohol use, disturbed sleep at night and anxiety in regard to the prostate condition. CONCLUSION There is a high prevalence of depressive symptoms among men with BPE. Assessment and early intervention for depressive symptoms among men with BPE should be initiated before clinical depression sets in.Contribution: The study has created a knowledge base on factors associated with depressive symptoms among men with sBPE in the African context.
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Affiliation(s)
- Husni H Abdalla
- Department of Family Medicine, Aga Khan University, Nairobi.
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Lloyd GL, Wiesen B, Atwell M, Malykhina A. Marijuana, Alcohol, and ED: Correlations with LUTS/BPH. Curr Urol Rep 2021; 22:21. [PMID: 33554319 PMCID: PMC8054558 DOI: 10.1007/s11934-020-01031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is a disease complex with enormous societal burden and yet the pathogenesis of LUTS/BPH is poorly understood. We set out to review the literature on the relationship between depression, marijuana usage, and erectile dysfunction (ED) to LUTS/BPH. RECENT FINDINGS LUTS/BPH has independent associations with depression as well as with ED. In each case, the causality and mechanistic relationship is unknown. The impact of marijuana, as it increasingly pervades the general population, on the disease complex of LUTS/BPH is not well studied but recent results support short-term benefit and long-term caution. Depression, a form of central nervous dysfunction, and ED, which is likely mediated via endothelial dysfunction, are independently associated with LUTS/BPH. The presence of cannabinoid receptors in urologic organs, coupled with recent population studies, supports a modulatory effect of marijuana on voiding although an enormous knowledge gap remains.
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Affiliation(s)
- Granville L Lloyd
- Rocky Mountain Regional Veterans Hospital, Aurora, CO, USA.
- Department of Surgery/Urology, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA.
| | - Brett Wiesen
- University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
| | - Mike Atwell
- Division of Urology, Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
| | - Anna Malykhina
- Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
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Kim TH, Lee SE, Lee HE, Lee KS. Safety and efficacy of fesoterodine fumarate in patients with overactive bladder: results of a post-marketing surveillance study in Korea. Curr Med Res Opin 2016; 32:1361-6. [PMID: 27046653 DOI: 10.1080/03007995.2016.1174680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the safety and efficacy of fesoterodine fumarate (fesoterodine; Toviaz ) in Korean patients with overactive bladder (OAB) in routine clinical practice. METHODS This was an open-label, non-interventional, prospective, post-marketing surveillance study submitted to the Korean Ministry of Food and Drug Safety. A total of 3109 patients aged ≥18 years with OAB symptoms were prescribed flexible doses of fesoterodine at the investigator's discretion. Safety was assessed based upon the reporting of adverse events (AEs). Efficacy was evaluated on the basis of patient self-assessment using a bladder diary as well as on the basis of investigator assessment in terms of overall clinical efficacy. RESULTS A final analysis was performed on 3107 (99.9%) and 2978 (95.8%) patients for safety and efficacy analysis, respectively. The mean treatment duration of fesoterodine was 83.2 days. The incidence of AEs was 8.5% (265/3107). Common AEs that accounted for more than 1.0% of the total AE incidence included dry mouth (5.4%, 168/3107), constipation (1.5%, 48/3107) and micturition disorder (1.1%, 35/3107). Mean episodes of urinary frequency, urgency, and urgency urinary incontinence (UUI) per 24 hours decreased by 4.0, 2.4, and 0.8, respectively (all p < 0.001). At the final follow-up visit, the investigators found improvement in clinical efficacy for the majority of patients (90.1%, 2684/2978). Limitations of this study include the observational study design and the relatively short treatment duration. CONCLUSION These results suggest that fesoterodine is a well tolerated and effective treatment for Korean patients with OAB in routine clinical practice.
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Affiliation(s)
- Tae Heon Kim
- a Department of Urology , Samsung Changwon Hospital, Sungkyunkwan University School of Medicine , Changwon , Korea
| | - Sang Eun Lee
- b Department of Urology , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Hahn-Ey Lee
- c Pfizer Pharmaceuticals Korea Ltd. , Seoul , Korea
| | - Kyu-Sung Lee
- b Department of Urology , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
- d Department of Medical Device Management & Research , S.A.I.H.S.T., Sungkyunkwan University , Seoul , Korea
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Dunphy C, Laor L, Te A, Kaplan S, Chughtai B. Relationship Between Depression and Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. Rev Urol 2016; 17:51-7. [PMID: 27222640 DOI: 10.3909/riu0658] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article provides an overview of current data on the relationship between depression and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), with a focus on pathophysiology and patient management implications. Review of the literature indicated a clear relationship between LUTS secondary to BPH and depression. It is unknown whether this relationship is bidirectional or unidirectional. Depression is associated with the impact of LUTS on quality of life in men with BPH. Research suggests that depression alters the experience of LUTS in this population. Medical and surgical treatments for BPH may impact quality of life and, therefore, depression. Results conflict on the exact nature of the relationship examined, and on the extent to which the relationship may be attributed to physiological factors such as inflammation. Practicing clinicians should consider using a brief self-administered scale to assess for depression in patients with BPH. There is a clear need for additional research to decisively determine the nature of the relationship between LUTS secondary to BPH and depression, as well as the extent to which change in either condition may be affected by the other.
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Affiliation(s)
- Claire Dunphy
- Department of Urology, Weill Cornell Medical College, New York, NY
| | - Leanna Laor
- Department of Urology, Weill Cornell Medical College, New York, NY
| | - Alexis Te
- Department of Urology, Weill Cornell Medical College, New York, NY
| | - Steven Kaplan
- Department of Urology, Weill Cornell Medical College, New York, NY
| | - Bilal Chughtai
- Department of Urology, Weill Cornell Medical College, New York, NY
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Kim TH, You HW, Park JH, Lee JG, Choo MS, Park WH, Lee JZ, Park CH, Na YG, Kwon DD, Lee KS. Persistence of solifenacin therapy in patients with overactive bladder in the clinical setting: a prospective, multicenter, observational study. Int J Clin Pract 2016; 70:351-7. [PMID: 27028673 DOI: 10.1111/ijcp.12783] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the persistence with solifenacin therapy over a 12-month period in patients with overactive bladder (OAB). METHODS This is a 52-week long, multicenter, prospective, observational study. The subjects were individuals ≥ 18 years old with OAB symptoms for ≥ 3 months, characterised by a total OAB Symptom Score (OABSS) of ≥ 3 and OABSS urgency item score of ≥ 2. Patients were prescribed 5 mg or 10 mg of solifenacin once daily for OAB symptoms. Drug persistence, reasons for discontinuation and factors related to the persistence were evaluated. RESULTS A total of 1018 patients (329 men, 689 women) with a mean age of 59 years were included. The 52-week drug persistence rate was 22.1%. The drug persistence rates at 12, 24 and 36 weeks were 72.4%, 45.8% and 31.1% respectively. The three most common reasons for discontinuing therapy included symptom improvement in 30.4%, lack of efficacy in 13.4%, and a switch to another antimuscarinic agent in 10.8%. Older patients (odds ratio = 1.02, 95% CI: 1.01-1.04), and female patients (odds ratio = 1.94, 95% CI: 1.37-2.75) were more likely to continue the medication over the 12-month period than were younger, male patients. The number of nocturia episodes was negatively correlated with drug persistence (odds ratio = 0.83, 95% CI: 0.71-0.97). CONCLUSIONS There was low persistence (22%) to solifenacin therapy for OAB symptoms over a 12-month period. Older patients, female patients and those with fewer episodes of nocturia were more persistent to therapy than were others.
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Affiliation(s)
- T H Kim
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H W You
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Park
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J G Lee
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - M-S Choo
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - W H Park
- Department of Urology, Inha University College of Medicine, Incheon, Korea
| | - J Z Lee
- Department of Urology, Pusan National University Hospital, Pusan, Korea
| | - C H Park
- Department of Urology, Keimyung University School of Medicine, Daegu, Korea
| | - Y G Na
- Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea
| | - D D Kwon
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - K-S Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
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Kim TH, Lee KS. Persistence and compliance with medication management in the treatment of overactive bladder. Investig Clin Urol 2016; 57:84-93. [PMID: 26981589 PMCID: PMC4791665 DOI: 10.4111/icu.2016.57.2.84] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 03/04/2016] [Indexed: 01/31/2023] Open
Abstract
Overactive bladder (OAB) is a common and chronic condition that impacts patients' daily activities and quality of life. Pharmaco-therapy for OAB is a mainstay of treatment. Antimuscarinics and β3-adrenoceptor agonists are the two major classes of oral pharmacotherapy and have similar efficacy for treating the symptoms of OAB. Owing to the chronic nature of OAB, long-term use of medication is essential for OAB symptom control and positive health outcomes. However, many patients elect to stop their medications during the treatment period. Unmet expectations of treatment and side effects seem to be the major factors for discontinuing OAB pharmacotherapy. Furthermore, the short- and long-term persistence and compliance with medication management are markedly worse in OAB than in other chronic medical conditions. Improvement in persistence and compliance with OAB pharmacotherapy is a hot topic in OAB treatment and should be an important goal in the treatment of OAB. Effective strategies should be identified to improve persistence and compliance. In this review, we outline what is known about persistence and compliance and the factors affecting persistence with pharmacotherapy in patients with OAB.
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Affiliation(s)
- Tae Heon Kim
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu-Sung Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.; Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
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Kim TH, Choo MS, Kim YJ, Koh H, Lee KS. Drug persistence and compliance affect patient-reported outcomes in overactive bladder syndrome. Qual Life Res 2015; 25:2021-9. [DOI: 10.1007/s11136-015-1216-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 11/30/2022]
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Martin S, Vincent A, Taylor AW, Atlantis E, Jenkins A, Januszewski A, O’Loughlin P, Wittert G. Lower Urinary Tract Symptoms, Depression, Anxiety and Systemic Inflammatory Factors in Men: A Population-Based Cohort Study. PLoS One 2015; 10:e0137903. [PMID: 26445118 PMCID: PMC4622039 DOI: 10.1371/journal.pone.0137903] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 08/22/2015] [Indexed: 11/19/2022] Open
Abstract
Background The relationship between lower urinary tract symptoms (LUTS) and common mental health disorders such as depression and anxiety in men remains unclear. Inflammation has recently been identified as an independent risk factor for LUTS and depression. This study aimed to assess the association between depression, anxiety and LUTS, and the moderating influence of systemic inflammation, in the presence of other biopsychosocial confounders. Methods Participants were randomly-selected from urban, community-dwelling males aged 35–80 years at recruitment (n = 1195; sample response rate:67.8%). Of these, 730 men who attended baseline (2002–5) and follow-up clinic visits (2007–10), with complete outcome measures, and without prostate or bladder cancer and/or surgery, neurodegenerative conditions, or antipsychotic medications use, were selected for the present study. Unadjusted and multi-adjusted regression models of incident storage and voiding LUTS and incident depression and anxiety were combined with serum inflammatory markers (high-sensitive C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-α), interleukin–6 (IL–6), myeloperoxidase (MPO), soluble e-selectin (e-Sel)) and socio-demographic, lifestyle, and health-related factors. Hierarchical multiple regression was used to assessed the moderating effect of inflammatory markers. Results The incidence of storage, voiding LUTS, depression and anxiety was 16.3% (n = 108), 12.1% (n = 88), 14.5% (n = 108), and 12.2% (n = 107). Regression models demonstrated that men with depression and anxiety at baseline were more likely to have incident storage, but not voiding LUTS (OR: 1.26, 99%CI: 1.01–4.02; and OR:1.74; 99%CI:1.05–2.21, respectively). Men with anxiety and storage LUTS at baseline were more likely to have incident depression (OR: 2.77, 99%CI: 1.65–7.89; and OR:1.45; 99%CI:1.05–2.36, respectively), while men with depression and voiding LUTS were more likely to have anxiety at follow-up (OR: 5.06, 99%CI: 2.81–9.11; and OR:2.40; 99%CI:1.16–4.98, respectively). CRP, TNF-α, and e-Sel were found to have significant moderating effects on the development of storage LUTS (1.06, 0.91–1.96, R2 change: 12.7%), depression (1.17, 1.01–1.54, R2 change: 9.8%), and anxiety (1.35, 1.03–1.76, R2 change: 10.6%), respectively. Conclusions There is a bidirectional relationship between storage, but not voiding, LUTS and both depression and anxiety. We observed variable moderation effects for selected inflammatory markers on the development of depression, anxiety and storage LUTS.
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Affiliation(s)
- Sean Martin
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
| | - Andrew Vincent
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, University of Adelaide, Adelaide, South Australia, Australia
| | - Evan Atlantis
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- School of Nursing and Midwifery, University of Western Sydney, Sydney, New South Wales, Australia
| | - Alicia Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Andrzej Januszewski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Peter O’Loughlin
- Chemical Pathology, SA Pathology, Adelaide, South Australia, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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