|
1
|
De Win G, Peters M, Pauwels J, Morales EVB, Vereeck S, Vermandel A, Van Dongen S, De Wachter S. The added value of home-uroflowmetry; Analysing an individuals' VV-Qmax curve and inflection point. Urology 2025:S0090-4295(25)00211-0. [PMID: 40074155 DOI: 10.1016/j.urology.2025.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 02/16/2025] [Accepted: 02/24/2025] [Indexed: 03/14/2025]
Abstract
OBJECTIVES To analyse individual VV-Qmax plots based on multiple home uroflowmetries and compare these with cross-sectional nomograms. METHODS Healthy volunteers (16-69 years) without LUTS were asked to take a Minze HomeflowTM device home to register 25 uroflows. Participants reporting urinary tract disorders, malignancy or medication affecting bladder function were excluded. Dysfunctional voiding curves or participants with less than 15 acceptable flows were also excluded. For each individual, a VV-Qmax scatterplot was visually evaluated and a segmented regression was performed to determine the volume at which inflection occurred. RESULTS 145 participants were enrolled. 38 were excluded based on medical history or LUTS, another 3 because the minimum amount of acceptable flows was not reached. This resulted in 104 participants (40M/64F) and 2498 acceptable uroflows with intra-individual differences based on voided volume, urge and time of the day. Individual VV-Qmax plots derived from multiple measurements do not align with the published nomograms based on cross-sectional data. The VV-Qmax curve for an individual demonstrates that Qmax increases with rising voided volumes up to a specific transitional voided volume (VVtrans) of 253ml (in men) and 214ml (in women), after which Qmax remains stable despite further increases in voided volumes. CONCLUSION A single uroflowmetry is insufficient to represents an individuals' voiding pattern. An individuals' VV- Qmax curve may give a better picture and can identify a new parameter, VVtrans, which might be a reflection of a patient's bladder function and urethra patency. Further evaluation and application in clinical LUTS scenarios are needed.
Collapse
Affiliation(s)
- Gunter De Win
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Urology, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium; Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Matthew Peters
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Jasper Pauwels
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Eduard Van Beeck Morales
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Sascha Vereeck
- Department of Gynaecology, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Alexandra Vermandel
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Urology, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium.
| | - Stefan Van Dongen
- Faculty of Sciences, Department of Biology, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Stefan De Wachter
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Urology, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium; Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| |
Collapse
|
|
2
|
Creta M, Baboudjian M, Sakalis V, Bhatt N, Nunzio CD, Gacci M, Herrmann TRW, Karavitakis M, Malde S, Moris L, Netsch C, Rieken M, Schouten N, Tutolo M, Yuan Y, Hashim H, Cornu JN. Management of Primary Bladder Neck Obstruction and Dysfunctional Voiding in Young Men: A Systematic Review and Meta-analysis. Eur Urol Focus 2025:S2405-4569(25)00012-4. [PMID: 39965997 DOI: 10.1016/j.euf.2025.01.011] [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: 11/20/2024] [Revised: 01/02/2025] [Accepted: 01/22/2025] [Indexed: 02/20/2025]
Abstract
BACKGROUND AND OBJECTIVE Management of young men with primary bladder neck obstruction (PBNO) and dysfunctional voiding (DV) is challenging. We systematically reviewed evidence on diagnostic strategies and treatment outcomes in men aged 18-50 yr with PBNO or DV. METHODS We conducted a comprehensive bibliographic search on the Embase, Medline, and Cochrane Library databases in July 2024. KEY FINDINGS AND LIMITATIONS Twenty-five publications were identified. Videourodynamics represents the standard diagnostic approach. Standard therapies for PBNO include alpha-blockers (ABs) as the first-line approach and bladder neck incision (BNI) in patients failing medical therapy. Pooled estimates of total International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax) improvements at 3 mo in patients receiving ABs are 7.0 points and 4.0 ml/s, respectively. The incidence of ejaculatory dysfunction (EjD) and failure rates range from 47% to 50% and from 23% to 52%, respectively. Corresponding figures in patients undergoing surgery are 11.2 points, 6.9 ml/s, 0-88.8%, and 11.1-13.3%, respectively. OnabotulinumtoxinA, as experimental second-line therapy in PBNO, provides 2-mo mean total IPSS and mean Qmax improvements of 14.1 points and 9.1 ml/s, respectively, with a 0% EjD rate. However, improvements deteriorate over time. Behavioral modifications plus biofeedback represent the only approach in patients with DV, providing symptom improvement of at least 50% in 83% of patients at 3 mo. Limits of evidence include few studies, mainly retrospective design, heterogeneous populations, small sample sizes, lack of direct comparisons, and short follow-up. CONCLUSIONS AND CLINICAL IMPLICATIONS Diagnosis of PBNO/DV in young men requires the integration of anatomical and functional data. ABs represent the first-line approach for PBNO followed by BNI in cases of failure. Behavioral modification plus biofeedback represents the only strategy tested for DV. Given the low quality of evidence, a shared decision-making approach for diagnosis and treatment is required.
Collapse
Affiliation(s)
- Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy.
| | | | - Vasileios Sakalis
- Department of Urology, Hippokrateion General Hospital, Thessaloniki, Greece
| | - Nikita Bhatt
- Department of Urology, East of England Deanery, Urology, Cambridge, UK
| | - Cosimo De Nunzio
- Department of Urology, Sapienza University, Ospedale Sant'Andrea, Rome, Italy
| | - Mauro Gacci
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Thomas R W Herrmann
- Department of Urology, Spital Thurgau AG, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
| | - Markos Karavitakis
- Department of Urology, "CENTRAL UROLOGY", Lefkos Stavros the Athens Clinic, Athens, Greece
| | - Sachin Malde
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Lisa Moris
- Department of Urology, University Hospitals Leuven, Leuven, Belgium; Laboratory of Molecular Endocrinology, KU Leuven, Leuven, Belgium
| | | | | | - Natasha Schouten
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Manuela Tutolo
- Department of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Yuhong Yuan
- Department of Medicine, London Health Science Center, Western University, London, ON, Canada
| | | | - Jean-Nicolas Cornu
- Department of Urology, CHU Hôpitaux de Rouen - Hôpital Charles Nicolle, Rouen, France
| |
Collapse
|
|
3
|
Buckley VA, Rosamilia A, Lee JK. Can Female Voiding Dysfunction Be Predicted Using a Questionnaire? Urology 2025; 196:124-129. [PMID: 39557364 DOI: 10.1016/j.urology.2024.11.020] [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: 09/05/2024] [Revised: 11/06/2024] [Accepted: 11/08/2024] [Indexed: 11/20/2024]
Abstract
OBJECTIVE To evaluate symptoms using the modified International Prostate Symptoms Score (wIPSS) questionnaire and clinical factors that could indicate objective voiding dysfunction (VD) in women. METHODS One thousand eighty-three women who underwent urodynamic assessment were retrospectively analyzed. The primary outcome was objective VD. Two definitions were utilized; VD1 defined VD as maximum flow rate <10th centile on the Liverpool nomogram, while VD2 defined VD as Qmax ≤15 mL/s and PVR ≥100 mL. Associations of potential explanatory variables with VD were assessed by standard bivariate testing. Classification and Regression Tree analyses were conducted to assess the discriminatory power of explanatory variables for VD. RESULTS The prevalence of objective VD depended on the definition used (VD1-30.9% vs VD2-5.8%), as did the median wIPSS score (VD1-15, interquartile range (IQR) 10-20 vs VD2-12.5, IQR 10.3-22.8). Age, menopausal status, previous pelvic floor surgery, current degree of anterior/apical prolapse, a medical history of diabetes or neurological disease, the wIPSS score, as well as the wIPSS with additional items were associated with VD. CART analysis revealed the questions regarding force of stream (FOS) and hesitancy were the strongest predictors for VD. CONCLUSION Rates of objective VD depend on the definition used. VD was associated with the overall wIPSS score, and the additional questions of hesitancy and FOS, which proved to be the most powerful predictors. This modified wIPSS may be a useful tool in screening for the absence of objective VD. BRIEF SUMMARY Can we use a non-invasive screening tool to evaluate for female VD?
Collapse
Affiliation(s)
- Victoria A Buckley
- Department of Obstetrics and Gynaecology, Monash Health, Melbourne, Victoria, Australia.
| | - Anna Rosamilia
- Department of Obstetrics and Gynaecology, Monash Health, Melbourne, Victoria, Australia; Cabrini Hospital, Monash University, Melbourne, Victoria, Australia
| | - Joseph K Lee
- St. Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
| |
Collapse
|
|
4
|
Villiger AS, Hoehn D, Ruggeri G, Vaineau C, Nirgianakis K, Imboden S, Kuhn A, Mueller MD. Lower Urinary Tract Dysfunction Among Patients Undergoing Surgery for Deep Infiltrating Endometriosis: A Prospective Cohort Study. J Clin Med 2024; 13:7367. [PMID: 39685825 DOI: 10.3390/jcm13237367] [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: 11/06/2024] [Revised: 11/28/2024] [Accepted: 11/29/2024] [Indexed: 12/18/2024] Open
Abstract
Background/Objectives: Postsurgical lower urinary tract dysfunction (LUTD) is a common problem following deep infiltrating endometriosis (DIE) resection. The condition may be caused either by surgically induced damage to the bladder innervation or by pre-existing endometriosis-associated nerve damage. The aim of this study is to evaluate the efficacy of preoperative and postoperative multichannel urodynamic testing (UD) in identifying pre-existing or surgically induced LUTD among patients with DIE. Methods: Women with suspected DIE and planned surgical resection of DIE at the Department of Obstetrics and Gynecology at the University Hospital of Bern from September 2015 to October 2022 were invited to participate in this prospective cohort study. UD was performed before and 6 weeks after surgery. The primary outcome was the maximum flow rate (uroflow), an indicator of LUTD. Secondary outcomes were further urodynamic observations of cystometry and pressure flow studies, lower urinary tract symptoms (LUTS) as assessed by the International Prostate Symptom Score (IPSS), and pain as assessed by the visual analog scale (VAS). Results: A total of 51 patients requiring surgery for DIE were enrolled in this study. All patients underwent surgical excision of the DIE. The cohort demonstrated a uroflow of 22.1 mL/s prior to surgery, which decreased postoperatively to 21.5 mL/s (p = 0.56, 95%CI -1.5-2.71). The mean bladder contractility index (BCI) exhibited a notable decline from 130.4 preoperatively to 116.6 postoperatively (p = 0.046, 95%CI 0.23-27.27). Significant improvements were observed in the prevalence of dysmenorrhea, abdominal pain, dyspareunia, and dyschezia following surgical intervention (p = <0.001). The IPSS score was within the lower moderate range both pre- and postoperatively (mean 8.37 vs. 8.51, p = 0.893, 95%CI -2.35-2.05). Subgroup analysis identified previous endometriosis surgery as a significant preoperative risk factor for elevated post-void residual (43.6 mL, p = 0.026, 95%CI 13.89-73.37). The postoperative post-void residual increased among participants with DIE on the rectum to 54.39 mL (p = 0.078, 95%CI 24.06-84.71). Participants who underwent hysterectomy exhibited a significantly decreased uroflow (16.4 mL/s, p = 0.014, 95%CI 12-20) and BCI (75.1, p = 0.036, 95%CI 34.9-115.38). Conclusions: Nerve-respecting laparoscopy for DIE may alter bladder function. UD is not advisable before surgery, but the measurement may detect patients with LUTD.
Collapse
Affiliation(s)
- Anna-Sophie Villiger
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Diana Hoehn
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Giovanni Ruggeri
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Cloé Vaineau
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Konstantinos Nirgianakis
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Sara Imboden
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Annette Kuhn
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Michael David Mueller
- Department of Obstetrics and Gynecology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| |
Collapse
|
|
5
|
Shin YS, Soni KK, Lee DY, Kam SC. The relationship between depression, anxiety and lower urinary tract symptoms in men. Prostate Int 2024; 12:86-89. [PMID: 39036760 PMCID: PMC11255884 DOI: 10.1016/j.prnil.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 07/23/2024] Open
Abstract
Purpose Patients with lower urinary tract symptoms (LUTS) often experience comorbid depression and anxiety, yet the mechanisms underlying this association remain incompletely understood. This prospective study aimed to investigate the relationship between depression, anxiety, and LUTS in men. Materials and methods A prospective study was conducted with 350 male patients who underwent urologic examinations at our institution from January 2021 to December 2021. Of these, 131 patients meeting the inclusion criteria were included. Various questionnaires, including the International Prostate Symptom Score (IPSS) and the Hospital Anxiety and Depression Scale (HADS), as well as LUTS examinations (prostate-specific antigen test, transrectal ultrasonography, and urine flowmetry), were administered. Results Among the 350 patients, 131 were included in the analysis, with an average age of 58.0 ± 13.69 years. The total IPSS was 18.0 ± 8.69, with the average voiding symptom score at 8.7 ± 5.19 and the average storage symptom score at 6.0 ± 3.27. Both anxiety and depression were found to be correlated with LUTS (P < 0.05). After adjusting for age, hypertension, and diabetes, anxiety (but not depression) was significantly associated with LUTS based on regression analysis. Conclusion Men with LUTS are more likely to experience anxiety. Therefore, it is essential to assess and address anxiety when managing men with LUTS.
Collapse
Affiliation(s)
- Yu Seob Shin
- Department of Urology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Kiran Kumar Soni
- Department of Physiology, Lord Buddha Koshi Medical College and Hospital, Saharsa, Bihar, India
| | - Dong Yun Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung Chul Kam
- Department of Urology, Gyeongsang National University Changwon Hospital, Institute of Health Sciences of Gyeongsang National University, Gyeongsang National University School of Medicine, Jinju, Korea
| |
Collapse
|
|
6
|
Teunissen TAM, Lagro-Janssen ALM, Akkermans RP, Blanker MH, Knol-de Vries GE. Sex differences in the association between (sexual) abuse and lower urinary tract symptoms. Neurourol Urodyn 2024; 43:1199-1206. [PMID: 38530000 DOI: 10.1002/nau.25456] [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: 11/22/2023] [Revised: 02/10/2024] [Accepted: 03/16/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVES To study the possible association between (sexual) abuse and lower urinary tract symptoms (LUTS) in men and women. To study the differences in this association between men and women, and between the timing of the abuse. SUBJECTS AND METHODS A Dutch observational population-based cross-sectional study was used, based on self-administered questionnaires. Respondents were included if they had answered all questions about abuse and LUTS. Logistic regression was used to analyse the data. RESULTS Included were 558 men and 790 women, of whom 29% and 37%, respectively, reported a history of one of more types of abuse. Abuse was significantly associated with LUTS in both men (odds ratio [OR] 1.7; 1.2-2.5) and women (OR 1.4; 1.1-2.1). This association, testing by two-way interaction, was significantly stronger in men. No association was found between childhood abuse or adulthood abuse and LUTS, in men or women. The association of sexual abuse with LUTS was significant in both men (2.7; 1.4-5.2) and in women (1.5; 1.1-2.2), and this association (testing by two-way interaction) was significantly much stronger in men. CONCLUSION In men more than in women, a history of any type of abuse is associated with LUTS, regardless of whether the abuse occurred during childhood or adulthood. In both sexes, a history of sexual abuse is also associated with experiencing LUTS, with a much stronger association in men than in women. Patients, in particular male patients, presenting with LUTS should therefore be asked about sexual abuse in the past.
Collapse
Affiliation(s)
- Theodora A M Teunissen
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Antoinette L M Lagro-Janssen
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Reinier P Akkermans
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Marco H Blanker
- Primary and Long-term Care, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Grietje E Knol-de Vries
- Primary and Long-term Care, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
|
7
|
Almas F, Dasdelen MF, Seyhan Z, Sargolzaeimoghaddam M, Sarg A, Unlu O, Dasdelen ZB, Horuz R, Albayrak S, Kocak M, Laguna P, de la Rosette J. Reassessing Normal Voiding Standards: A Cross-Sectional Study Based on Medical Professionals' Evaluations with Portable Uroflowmetry and IPSS. J Clin Med 2024; 13:2857. [PMID: 38792399 PMCID: PMC11122113 DOI: 10.3390/jcm13102857] [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: 04/02/2024] [Revised: 04/24/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: LUTS and voiding dysfunctions are prevalent in urology clinics, with uroflowmetry and IPSS as the prevailing diagnostic methods. Nevertheless, objective assessment can be constrained by age, gender, and variability in the test conditions. Portable (home) uroflowmetry addresses these limitations, allowing for more natural urinary flow recordings beyond clinic confines. This study aims to characterize spontaneous voiding patterns in healthcare professionals, exploring gender differences, variability in repeated measurements, and correlations among voiding parameters, IPSS, age, and BMI. Methods: This cross-sectional study was conducted during the SIU 43rd Congress in Istanbul using smart uroflow devices such as the Oruba Oruflow Uroflow Recorder, which were installed in public toilets. A total of 431 healthcare professionals participated by providing demographic information and completing the IPSS questionnaire. The data analysis included uroflowmetric parameters such as maximum flow rate (Qmax), average flow rate (Qave), and voided volume (VV), in addition to IPSS and demographic data to assess the possible associations with IPSS, age, BMI, and gender differences. Results: Of the participants, 76% were male and 24% female, with a higher prevalence of LUTS in women. Despite no significant gender difference in voided volume, men with lower volumes demonstrated more severe LUTS. Notably, women exhibited higher Qmax and Qave rates irrespective of their IPSS scores, contrasting with men whose flow rates declined with age and LUTS severity. In men, the total IPSS score was inversely associated with uroflowmetric performance, particularly impacting voiding symptoms over storage symptoms. Repeated measurements revealed noteworthy variability in Qmax and VV, without any influence from gender, BMI, age, or symptom severity. Conclusions: Our findings highlight the importance of gender-specific considerations in evaluating voiding complaints through uroflowmetry and IPSS. The significant variability observed in repeated uroflowmetry studies underlines the need for multiple measurements. Overall, this research emphasizes the significance of portable (home) uroflowmetry and calls for a reassessment of normal voiding standards in (non) clinical settings.
Collapse
Affiliation(s)
- Furkan Almas
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Muhammed Furkan Dasdelen
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Biostatistics and Medical Informatics, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Zuleyha Seyhan
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | | | - Arya Sarg
- School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.S.); (A.S.); (S.A.)
| | - Omer Unlu
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Zehra Betul Dasdelen
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Rahim Horuz
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Selami Albayrak
- School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.S.); (A.S.); (S.A.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Mehmet Kocak
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Biostatistics and Medical Informatics, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Pilar Laguna
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Jean de la Rosette
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| |
Collapse
|
|
8
|
Sawaqed F, Kharboush I, Suoub M, Albadawi I, Alhawatmeh M, Murad A. A national survey of lower urinary tract symptoms in Jordan. Asian J Urol 2023; 10:518-525. [PMID: 38024424 PMCID: PMC10659976 DOI: 10.1016/j.ajur.2021.12.010] [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: 03/26/2021] [Revised: 08/21/2021] [Accepted: 12/28/2021] [Indexed: 11/07/2022] Open
Abstract
Objective To determine the prevalence of lower urinary tract symptoms (LUTS) and their severity population in Jordan. Methods This cross-sectional survey was conducted using a paper-based survey between August and September in 2019. The study was carried out in the health care centers or hospitals in three different regions of Jordan: North (Irbid and Jarash), Middle (Amman, Madaba, Salt, and Zarqa), and South (Karak and Aqaba). Results To estimate the prevalence of LUTS, two definitions were used, including the first definition (presence of any LUTS regardless of the degree of severity) and the second definition (presence of any LUTS that occurs half the time or more). According to the first definition, 1038 (89.9%) reported LUTS (male: 47.3%, female: 52.7%), while 763 (66.1%) reported LUTS according to the second definition (male: 45.6%, female: 54.4%). According to the International Prostate Symptom Score characterization, 73.9% had nocturia and 62.9% reported daytime increased frequency. Conclusion LUTS are highly prevalent among the Jordanian population, and more than half of them have nocturia or daytime increased frequency as most frequently reported symptoms.
Collapse
Affiliation(s)
- Fadi Sawaqed
- Section of Urology, Department of Special Surgery, Faculty of Medicine, Mu'tah University, Karak, Jordan
| | - Ibrahim Kharboush
- Department of Public Health, Faculty of Medicine Mu'tah University, Karak, Jordan
- High Institute of Public Health, Alexandria University, Egypt
| | - Mohammed Suoub
- Section of Urology, Department of Special Surgery, Faculty of Medicine, Mu'tah University, Karak, Jordan
| | | | | | | |
Collapse
|
|
9
|
Behr A, Salleron J, Mazeaud C, Larose C, Dagry A, Balkau B, Hubert J, Eschwège P. Comparison of surgical procedures for benign prostatic hyperplasia of medium-volume prostates: evaluation of the causes of rehospitalization from the French National Hospital Database (PMSI-MCO). World J Urol 2023; 41:2481-2488. [PMID: 37550549 DOI: 10.1007/s00345-023-04509-6] [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: 02/11/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023] Open
Abstract
PURPOSE In France, transurethral resection of the prostate (TURP) is still the most commonly used surgical treatment for medium sized benign prostatic hyperplasia (BPH), but the Holmium Laser Enucleation of the Prostate (HoLEP) and laser vaporization procedures are becoming more common. For these three surgical procedures, we evaluate the initial complications, the short term (3 months) and the 4-12-month postoperative complications necessitating re-hospitalization. METHODS From the French national hospital data base (PMSI-MCO), all hospitalizations for BPH treatment in 2018 were extracted. We document the complications during the initial hospitalization and any subsequent rehospitalizations during the one-year postoperative period. RESULTS In 2018, 67,220 patients were treated for BPH: 46,242 TURP, 13,509 HoLEP and 7469 laser vaporization. Age and anticoagulation medications were similar for men treated by the three procedures, but TURP patients were more often hypertensive. Infections and hemorrhagic complications were the most common complications at the initial hospitalization: 17%, 10%, 13% for infections and 15%, 8.1%, 11% for hemorrhagic complications respectively, and TURP performed worse than the other two procedures at the initial hospitalization. During the first three months and then the subsequent nine months, there were fewer complications than initially, with little difference between the three procedures, all differences being less than 1%. CONCLUSION Laser vaporization techniques led to fewer complications. However, the PMSI-MCO only registers complications during hospitalizations. This study should be extended to non-hospitalized, more minor complications.
Collapse
Affiliation(s)
- Antoine Behr
- Service d'Urologie CHRU Nancy, Site Brabois, 54000, Nancy, France.
| | - Julia Salleron
- Département de Biostatistiques, Institut de Cancérologie de Lorraine, 54519, Vandoeuvre-les-Nancy Cedex, France
| | - Charles Mazeaud
- Service d'Urologie CHRU Nancy, Site Brabois, 54000, Nancy, France
| | - Clément Larose
- Service d'Urologie CHRU Nancy, Site Brabois, 54000, Nancy, France
| | | | - Beverley Balkau
- INSERM U1018, Epidémiologie Clinique, CESP, 94807, Villejuif, France
| | - Jacques Hubert
- Service d'Urologie CHRU Nancy, Site Brabois, 54000, Nancy, France
| | - Pascal Eschwège
- Service d'Urologie CHRU Nancy, Site Brabois, 54000, Nancy, France
- CNRS UMR 7039, Unité de Biologie des Tumeurs, CRAN, 54511, Vandoeuvre-les-Nancy, France
| |
Collapse
|
|
10
|
Yumusakhuylu Y, Caglar Yagci H, Bayindir SN. Lower Urinary Tract Symptoms in Patients With Chronic Low Back Pain: A Cross-Sectional Study. Cureus 2023; 15:e45939. [PMID: 37885563 PMCID: PMC10599597 DOI: 10.7759/cureus.45939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION This study aimed to determine the extent of lower urinary tract symptoms (LUTS) in patients with chronic low back pain (CLBP) and the relationship between LUTS and patients' clinical and functional factors. METHODS Patients aged 40 to 80 who were admitted with CLBP were included. Demographic data and the duration of CLBP and LUTS were noted. Anteroposterior and lateral lumbar radiographs and lumbar MRI findings were recorded. Short Form 36 (SF-36) and the Oswestry Disability Index (ODI) were used for functional status assessment. For the LUTS evaluation, patients were asked to tick the symptoms from the list of LUTS prepared. RESULTS We included 90 patients with CLBP. The frequency of urinary incontinence was 81.1%. The mean number of LUTS was 2.81±3.22. The LUTS rates were higher in patients with vertebral height loss (p = 0.03), with central (p = 0.02) and lateral spinal narrow canals (p = 0.03), and with facet hypertrophy (p = 0.04). The rates of LUTS were lower in patients with decreased lumbar lordosis (p = 0.02). The ODI and LUTS were found to be related (p = 0.01). The role limitations due to physical problems of the SF-36 subgroups and LUTS were significantly correlated (p = 0.01). CONCLUSION The incidence of the coexistence of CLBP and LUTS is high. Patients cannot match and report LUTS among their complaints, so physicians should inquire about LUTS in patients with CLBP and carry out the appropriate diagnosis and treatment.
Collapse
Affiliation(s)
- Yasemin Yumusakhuylu
- Physical Medicine and Rehabilitation, Istanbul Medeniyet University, Istanbul, TUR
| | - Hanife Caglar Yagci
- Physical Medicine and Rehabilitation, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
| | - Seyma N Bayindir
- Physical Medicine and Rehabilitation, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR
| |
Collapse
|
|
11
|
Filomena GB, Gentile BC, Albanesi L, Bellavia F, D'Ascenzo R, Vermiglio M, Ghahhari J, Riolo S, Lombardo R, Giulianelli R. Long-Term Outcomes Following Bipolar Transurethral Plasma Enucleation of the Prostate: 10-Year Follow-Up. J Endourol 2023; 37:811-816. [PMID: 37218445 DOI: 10.1089/end.2022.0685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Background and Purpose: The aim of our study is to assess the long-term outcomes and safety of bipolar transurethral plasma enucleation of the prostate (B-TUEP) in patients with lower urinary tract symptoms (LUTS) in a single-center cohort study. Our focus is to evaluate the impact on outcomes after 10 years of follow-up (FUP) in terms of recurrence, LUTS, and patients' quality of life after B-TUEP in prostates between 30 and 80 cc. Materials and Methods: Between May 2010 and December 2011, all consecutive patients with benign prostatic hyperplasia undergoing B-TUEP were prospectively enrolled in our study. Data on patients' history, physical examination, prostate volumes, erectile function, prostate-specific antigen levels, International Prostate Symptoms Score (IPSS), and uroflowmetry were collected at 0, 1, 3, 6, 12, 24, 36, 60, and 120 months. Early and long-term complications were recorded. Results: A total of 50 consecutive patients underwent B-TUEP in our facility, all performed by a single surgeon (R.G.). Twelve patients were excluded during the 10 years. No patients had persistent bladder outlet obstruction (BOO) requiring reoperation. In terms of results, the improvement in IPSS was sustained throughout 5 years, and the mean difference from baseline at 5 years was 17 points, with similar results at 10 years. Erectile function was also slightly improved after surgery and maintained for the next 5 years, with a slight age-related decrease at 10 years. Furthermore, the improvements in maximum urine flow rate (Qmax) were maintained at 5 years, with a mean improvement of 16 mL/s, while at 10 years, it settled on a mean improvement from baseline of 12 mL/s. Conclusions: In our 10 years' experience, B-TUEP is a safe and highly effective technique for relieving BOO, with excellent outcomes and no recurrence at 10 years of FUP. Further multicenter studies should confirm our results.
Collapse
Affiliation(s)
- Giovanni Battista Filomena
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, "Università Cattolica del Sacro Cuore," Rome, Italy
| | | | | | - Fabrizio Bellavia
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, "Università Cattolica del Sacro Cuore," Rome, Italy
| | | | | | | | - Sara Riolo
- Department of Urology, Sant'Andrea Hospital, "La Sapienza" University, Roma, Italy
| | - Riccardo Lombardo
- Department of Urology, Sant'Andrea Hospital, "La Sapienza" University, Roma, Italy
| | | |
Collapse
|
|
12
|
Sharifiaghdas F, Narouie B, Taheri M, Jalali S, Shalbafan B, Azadvari M, Dadpour M, Rouientan H, Ahmadzade M, Hanafi Bojd H. Multiple sclerosis and lower urinary tract symptoms: A survey of prevalence, characteristic and urological evaluations. SAGE Open Med 2023; 11:20503121231178047. [PMID: 37384196 PMCID: PMC10293526 DOI: 10.1177/20503121231178047] [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: 02/16/2023] [Accepted: 05/09/2023] [Indexed: 06/30/2023] Open
Abstract
Objective Most multiple sclerosis patients have urological complications such as lower urinary tract symptoms. This study was conducted to evaluate the prevalence of these symptoms and whether they result in a urological evaluation. Methods A cross-sectional study of 517 multiple sclerosis patients at Tehran's referral multiple sclerosis center and neurology clinics between 2018 and 2022 was performed. Data were collected through interviews after patients completed informed consent forms. Urological examinations, including urine analysis and ultrasonography, were evaluated as final assessments. The data were analyzed using descriptive and inferential statistical tests in Statistical Package for Social Science. Results Among all participants, the prevalence of lower urinary tract symptoms was 73% (n = 384), with urgency (44.8% n = 232) being the most common symptom. The prevalence of intermittency was significantly higher among women (p = 0.004). There was no gender-significant difference in terms of the prevalence of other symptoms (p > 0.050). Lower urinary tract symptoms were significantly correlated with age, clinical course, disease duration, and disability (p < 0.001). Additionally, 37.3% and 18.7% of patients with lower urinary tract symptoms, as well as 17.9% and 37.5% of patients with multiple sclerosis attacks, respectively, had undergone urine analysis and ultrasonography. Conclusion Multiple sclerosis patients rarely undergo urological evaluations during the course of their disease. Proper assessment is essential as these symptoms are among the most detrimental manifestations of this disease.
Collapse
Affiliation(s)
- Farzaneh Sharifiaghdas
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Narouie
- Department of Urology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maryam Taheri
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Jalali
- Faculty of land and food systems, University of British Colombia Vancouver, Vancouver, Canada
| | - Bita Shalbafan
- Clinical Research Development Unit of Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohaddeseh Azadvari
- Department of Physical Medicine and Rehabilitation, Urology Research Center, Sina & Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Dadpour
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Rouientan
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadese Ahmadzade
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Hanafi Bojd
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
13
|
Haddad R, Panicker JN, Verbakel I, Dhondt K, Ghijselings L, Hervé F, Petrovic M, Whishaw M, Bliwise DL, Everaert K. The low dopamine hypothesis: A plausible mechanism underpinning residual urine, overactive bladder and nocturia (RON) syndrome in older patients. Prog Urol 2023; 33:155-171. [PMID: 36710124 DOI: 10.1016/j.purol.2023.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Aging is associated with a combination of several lower urinary tract (LUT) signs and symptoms, including residual urine, overactive bladder and nocturia. One of the mechanisms of this LUT dysfunction that has not been discussed in dept so far is the role of dopamine (DA). METHODS In this narrative review, we explore the dopaminergic hypothesis in the development of this combination of LUT signs and symptoms in older adults. RESULTS DA is one of the neurotransmitters whose regulation and production is disrupted in aging. In synucleinopathies, altered DAergic activity is associated with the occurrence of LUTS and sleep disorders. Projections of DAergic neurons are involved in the regulation of sleep, diuresis, and bladder activity. The low dopamine hypothesis could explain the genesis of a set of LUT signs and symptoms commonly seen in this population, including elevated residual urine, Overactive bladder syndrome and Nocturia (discussed as the RON syndrome). This presentation is however also common in older patients without synucleinopathies or neurological disorders and therefore we hypothesise that altered DAergic activity because of pathological aging, and selective destruction of DAergic neurons, could underpin the presentation of this triad of LUT dysfunction in the older population. CONCLUSION The concept of RON syndrome helps to better understand this common phenotypic presentation in clinical practice, and therefore serves as a useful platform to diagnose and treat LUTS in older adults. Besides recognizing the synucleinopathy "red flag" symptoms, this set of multi-causal LUT signs and symptoms highlights the inevitable need for combination therapy, a challenge in older people with their comorbidities and concomitant medications.
Collapse
Affiliation(s)
- R Haddad
- Department of Urology, NOPIA Research Group, Ghent University Hospital, Ghent, Belgium; GRC 001 GREEN Neuro-Urology Research Group, Sorbonne Université, Rothschild Academic Hospital, AP-HP, 75012 Paris, France.
| | - J N Panicker
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - I Verbakel
- Department of Urology, NOPIA Research Group, Ghent University Hospital, Ghent, Belgium
| | - K Dhondt
- Department of Psychiatry, Pediatric sleep center, Ghent University Hospital, Ghent, Belgium
| | - L Ghijselings
- Department of Urology, NOPIA Research Group, Ghent University Hospital, Ghent, Belgium
| | - F Hervé
- Department of Urology, NOPIA Research Group, Ghent University Hospital, Ghent, Belgium; Department of Urology, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - M Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | - M Whishaw
- Department of Aged Care, Royal Melbourne Hospital, Melbourne, Australia
| | - D L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - K Everaert
- Department of Urology, NOPIA Research Group, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
|
14
|
Ortner G, Pang KH, Yuan Y, Herrmann TRW, Biyani CS, Tokas T. Peri- and post-operative outcomes, complications, and functional results amongst different modifications of endoscopic enucleation of the prostate (EEP): a systematic review and meta-analysis. World J Urol 2023; 41:969-980. [PMID: 36752853 DOI: 10.1007/s00345-023-04308-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE To investigate and assess outcomes, complications, and functional results amongst different modifications of endoscopic enucleation of the prostate (EEP). METHODS We conducted a systematic review and meta-analysis according to the PRISMA checklist. We searched the Medline, Cochrane, and Embase databases. We included only randomised-controlled trials (RCT) comparing modifications of EEPs and assessed the risk of bias (RoB). RESULTS Seven RCTs were included in the study. Overall, 1266 patients were treated with Holmium laser enucleation of the prostate (HoLEP) and 80 patients with thulium laser vapo-enucleation of the prostate (ThuVEP). The operative time during pulse shape-modified HoLEP was shorter when compared to standard pulse HoLEP (MD 18.08 min, 95% CI 8.11-28.05 min, p = 0.0004). The decrease in haemoglobin was significantly lower for two-lobe HoLEP when compared to three-lobe HoLEP (MD 0.16 g/dl, 95% CI 0.22-0.1 g/dl, p < 0.00001). Virtual Basket (VB) HoLEP showed a smaller haemoglobin decrease when compared to standard pulse HoLEP (1.12 ± 1.78 vs. 2.54 ± 1.23 g/dl, p = 0.03). When directly comparing one- vs. two- vs. three-lobe HoLEP, surgical time (p < 0.001) and enucleation efficiency (p = 0.006) were significantly different and favouring one- and two-lobe HoLEP in the study with the largest patient population included. No significant differences for complications were observed; however, Clavien-Dindo IVa events were reported for two patients. CONCLUSION All variations of EEP improve symptoms and functional parameters with a low incidence of high-grade complications. One- and two-lobe approaches and pulse shape-modified HoLEP seem to be beneficial in terms of operative time and blood loss.
Collapse
Affiliation(s)
- Gernot Ortner
- Department of Urology and Andrology, General Hospital Hall I.T., Milser Straße 10, 6060, Hall in Tirol, Austria. .,Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
| | - Karl H Pang
- Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Yuhong Yuan
- Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Thomas R W Herrmann
- Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.,Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland
| | | | - Theodoros Tokas
- Department of Urology and Andrology, General Hospital Hall I.T., Milser Straße 10, 6060, Hall in Tirol, Austria.,Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria
| |
Collapse
|
|
15
|
Campbell JG, Hayden JP, Vanni AJ. Biomarkers in Urethral Stricture Disease and Benign Lower Urinary Tract Disease. Urol Clin North Am 2023; 50:31-38. [DOI: 10.1016/j.ucl.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
|
16
|
Huang J, Chan CK, Yee S, Deng Y, Bai Y, Chan SC, Tin MS, Liu X, Lok V, Zhang L, Xu W, Zheng ZJ, Teoh JYC, Ng CF, Wong MCS. Global burden and temporal trends of lower urinary tract symptoms: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2022:10.1038/s41391-022-00610-w. [DOI: 10.1038/s41391-022-00610-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022]
|
|
17
|
Tentor F, Grønholt Schrøder B, Nielsen S, Schertiger L, Stærk K, Emil Andersen T, Bagi P, Feldskov Nielsen L. Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters. Sci Rep 2022; 12:17818. [PMID: 36280778 PMCID: PMC9592621 DOI: 10.1038/s41598-022-21122-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/22/2022] [Indexed: 01/19/2023] Open
Abstract
Intermittent catheterization is the gold standard method for bladder management in individuals with urinary retention and/or incontinence. It is therefore important to understand the performance of urinary catheters, especially on parameters associated to risks of developing urinary tract infections, and that may impact the quality of life for urinary catheter users. Examples of such parameters include, urine flowrate, occurrence of flow-stops, and residual urine left in the bladder after flow-stop. Reliable in-vitro and/or ex-vivo laboratory models represent a strong asset to assess the performance of urinary catheters, preceding and guiding in-vivo animal studies and/or human clinical studies. Existing laboratory models are generally simplified, covering only portions of the catheterization process, or poorly reflect clinical procedures. In this work, we developed an ex-vivo porcine lower urinary tract model that better reflects the catheterization procedure in humans and allows to investigate the performance of standard of care catheters. The performance of three standard of care catheters was investigated in the developed model showing significant differences in terms of flowrate. No differences were detected in terms of residual volume in the bladder at first flow-stop also when tuning the abdominal pressure to mimic a sitting down and standing up position. A newly discovered phenomenon named hammering was detected and measured. Lastly, mucosal suction was observed and measured in all standard of care catheters, raising the concern for microtrauma during catheterization and a need for new and improved urinary catheter designs. Results obtained with the ex-vivo model were compared to in-vivo studies, highlighting similar concerns.
Collapse
Affiliation(s)
- Fabio Tentor
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | | | - Simon Nielsen
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | - Lars Schertiger
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | - Kristian Stærk
- grid.10825.3e0000 0001 0728 0170Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000 Odense, Denmark
| | - Thomas Emil Andersen
- grid.10825.3e0000 0001 0728 0170Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000 Odense, Denmark
| | - Per Bagi
- grid.475435.4Department of Urology, Centre for Cancer and Organ Diseases, Rigshospitalet, Blegdamsvej 9, 2100 København, Denmark
| | | |
Collapse
|
|
18
|
Brant JE, Smith S, Radoslovich SS, Wyland A, Walker JR, Lieberman EG, Yoo JU. Effects of delayed postoperative void and preoperative urologic symptoms on delay in time of discharge for elective lumbar decompression surgery. Spine J 2022; 22:810-818. [PMID: 34963631 DOI: 10.1016/j.spinee.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/19/2021] [Accepted: 12/20/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Almost half of all patients undergoing lumbar spine surgery have preoperative lower urinary tract symptoms (LUTS). These symptoms could affect postoperative voiding and subsequently length of stay. PURPOSE To investigate the association between preoperative LUTS and time to first void and between time to first void and time to discharge among patients undergoing elective lumbar decompression surgery. STUDY DESIGN/SETTING Retrospective analysis of prospectively collected data among patients at a single academic medical center. PATIENT SAMPLE All patients ≥18 years of age undergoing elective lumbar decompression surgery between July 2017 and March 2020. OUTCOME MEASURES The physiologic measure of a delayed time to first void was defined as an initial postoperative void of > 4 hours after anesthesia stop time. The outcome of prolonged time to discharge was defined as a stay of >24 hours after anesthesia stop time. METHODS At their preoperative visit, patients completed the validated International Prostate Symptom Score (IPSS) (range, 0-35 points), which is applicable for LUTS assessment in both sexes. Clinically relevant LUTS are defined as an IPSS score of ≥8. Patients were followed from their preoperative visit to surgery admission discharge. Association of LUTS with time to first void and time to first void with admission discharge were estimated using risk ratios (RR) and 95% confidence intervals (CI) from a multivariable Poisson regression with a robust variance estimate adjusted for potential confounding variables including age, sex, IPSS, and intraoperative Foley catheter use. RESULTS The analytic cohort included 170 patients with an average age of 57 years and 103 (61%) were men. Preoperative LUTS prevalence was 45%, and 111 (65%) of patients voided within 4 hours after surgery. For patients with preoperative LUTS, the unadjusted RR for a first void of >4 hours was 1.04 (95% CI: 0.82-1.32) (p=.77). Adjustment for age, sex, intraoperative Foley catheter use, revision surgery, previous spine surgery, single versus multiple levels, and lumbar location did not materially alter the risk: the multivariable RR was 1.04 (95% CI: 0.82-1.31) (p=.74). The unadjusted RR for a discharge of > 24 hours for patients with a time to first void of > 4 hours was 2.17 (95% CI: 1.51-3.10) (p<.001). After adjusting for age, sex, intraoperative Foley catheter use, IPSS, revision surgery, previous spine surgery, single versus multiple levels, and lumbar location, the multivariable RR was 1.72 (95% CI: 1.22-2.41) (p=.002). CONCLUSIONS Regardless of preoperative LUTS status, an initial first void of >4 hours after surgery is associated with a longer time to discharge among patients undergoing elective lumbar decompression surgery. Future studies are needed to determine if encouraging early postoperative voiding results in timely discharge and shorter length of stay.
Collapse
Affiliation(s)
- Jason E Brant
- Department of Orthopaedics & Rehabilitation, Oregon Health & Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Spencer Smith
- Department of Orthopaedics & Rehabilitation, Oregon Health & Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Stephanie S Radoslovich
- Department of Orthopaedics & Rehabilitation, Oregon Health & Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Alden Wyland
- Department of Orthopaedics & Rehabilitation, Oregon Health & Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Jorge R Walker
- Department of Orthopaedics & Rehabilitation, Oregon Health & Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Elizabeth G Lieberman
- Department of Orthopaedics & Rehabilitation, Oregon Health & Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Jung U Yoo
- Department of Orthopaedics & Rehabilitation, Oregon Health & Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Rd, Portland, OR 97239, USA.
| |
Collapse
|
|
19
|
Dun RL, Mao JM, Yu C, Zhang Q, Hu XH, Zhu WJ, Qi GC, Peng Y. Simplified Chinese version of the international prostate symptom score and the benign prostatic hyperplasia impact index: Cross-cultural adaptation, reliability, and validity for patients with benign prostatic hyperplasia. Prostate Int 2022; 10:162-168. [PMID: 36225281 PMCID: PMC9520413 DOI: 10.1016/j.prnil.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Methods Results Conclusions
Collapse
Affiliation(s)
- Rong-Liang Dun
- Urology Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian-Min Mao
- Andrology, Shanghai Seventh People's Hospital, Shanghai, China
| | - Chao Yu
- Urology Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qiang Zhang
- Urology Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-Hua Hu
- Urology Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen-Jing Zhu
- Urology Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guang-Chong Qi
- Urology Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yu Peng
- Urology Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
|
20
|
Alamdari H, Hajebrahimi S, Abolhasanpour N, Salehi‐Pourmehr H, Alamdari G, Jahantabi E. Prevalence of lower urinary tract symptoms and association with shift working in hospital staff. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Homeira Alamdari
- Urology Department Tabriz University of Medical Sciences Tabriz Iran
| | - Sakineh Hajebrahimi
- Research Center for Evidence‐based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence Tabriz University of Medical Sciences Tabriz Iran
| | - Nasrin Abolhasanpour
- Research Center for Evidence‐based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence Tabriz University of Medical Sciences Tabriz Iran
| | - Hanieh Salehi‐Pourmehr
- Research Center for Evidence‐based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence Tabriz University of Medical Sciences Tabriz Iran
| | - Golsa Alamdari
- Student Research Center Tabriz University of Medical Sciences Tabriz Iran
| | - Elham Jahantabi
- Urology Department Tabriz University of Medical Sciences Tabriz Iran
| |
Collapse
|
|
21
|
Winkler D, Grohmann R, Friedrich ME, Toto S, Bleich S, Seifert J, Konstantinidis A, Shariat SF, Kasper S, Pjrek E. Urological adverse drug reactions of psychotropic medication in psychiatric inpatients - A drug surveillance report from German-speaking countries. J Psychiatr Res 2021; 144:412-420. [PMID: 34741839 DOI: 10.1016/j.jpsychires.2021.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/01/2021] [Accepted: 10/19/2021] [Indexed: 01/21/2023]
Abstract
Urological adverse drug reactions (UADR) are common during treatment with psychotropic medication. The aim of this study was to provide a systematic description of the differential profile of UADR of psychotropic drugs in a large naturalistic population. Data stems from psychiatric hospitals collected by AMSP (Arzneimittelsicherheit in der Psychiatrie), a continuous multi-center pharmacovigilance program in Austria, Germany, and Switzerland. 171 cases of severe UADR (0.037%) among a total population of 462 661 inpatients treated with psychotropic drugs in 99 psychiatric hospitals between 1993 and 2016 were examined. Urinary retention (129 cases, 0.028%) was the most common UADR followed by incontinence (23 cases, 0.005%) and nocturnal enuresis (16 cases, 0.003%). Risk of UADR was higher in patients with mania than in other diagnostic groups. Promethazine and haloperidol were the antipsychotics with the highest rate of UADR. Tricyclic antidepressants had a higher and selective serotonin reuptake inhibitors a lower risk for UADR than the respective other antidepressants. Amitriptyline and clomipramine were the most common causes of urinary retention and clozapine of urinary incontinence. This research improves our knowledge of the urological risk profiles of psychotropic drugs in inpatients and highlights compounds associated with higher or lower risk.
Collapse
Affiliation(s)
- Dietmar Winkler
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
| | - Renate Grohmann
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | | | - Sermin Toto
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Johanna Seifert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | | | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, USA; Institute for Urology and Reproductive Health, I. M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, University of Texas Southwestern, Dallas, TX, USA
| | - Siegfried Kasper
- Center for Brain Research, Medical University of Vienna, Austria
| | - Edda Pjrek
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| |
Collapse
|
|
22
|
Renno-Busch S, Hildesheim H, van Uem JMT, Sünkel U, Röben B, Brockmann K, Mychajliw C, Eschweiler GW, Berg D, Maetzler W. Autonomic Symptoms in Older Adults Are Common and Associated With Health-Related Quality of Life. Front Neurol 2021; 12:757748. [PMID: 34887829 PMCID: PMC8649956 DOI: 10.3389/fneur.2021.757748] [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: 08/12/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Autonomic symptoms are common in older adults, and a large body of literature focusing on age-related diseases shows that autonomic symptoms in these diseases constrain Health-Related Quality of Life (HRQoL). To our best knowledge, the association between autonomic symptoms in older adults, independent of specific diseases, and HRQoL has not yet been assessed. Aim: To assess the frequency and the effect of autonomic symptoms in general, as well as orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor symptoms, on HRQoL in older adults. Methods: Cross-sectional data of the fourth visit of the Tübinger evaluation of Risk factors for Early detection of Neurodegeneration (TREND) study were included. Autonomic symptoms, as assessed with the Composite Autonomic Symptom Score 31 (COMPASS 31), were quantified and compared with HRQoL, as assessed with the EuroQol five-level version (EQ-5D-5L). Statistical analyses included Spearman's rank correlation and multiple linear regression analysis. Results: The analysis included 928 participants with a median of 68 years; 47% were women. Of those, 85% reported at least one autonomic symptom. Gastrointestinal and secretomotor symptoms were most common. The COMPASS 31 total score and all subdomains were significantly associated with reduced HRQoL. Among the subdomains, the strongest correlations with HRQoL were found for gastrointestinal and bladder symptoms. Overall, autonomic symptoms alone explained 20% of the variance of HRQoL; when depressive mood was added, the model explained 32%. Conclusion: Autonomic symptoms are associated with HRQoL and depressive symptoms in older adults.
Collapse
Affiliation(s)
- Sarah Renno-Busch
- Center for Neurology, Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Hanna Hildesheim
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | | | - Ulrike Sünkel
- Center for Neurology, Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Benjamin Röben
- Center for Neurology, Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Kathrin Brockmann
- Center for Neurology, Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Christian Mychajliw
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Gerhard W. Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Daniela Berg
- Center for Neurology, Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | - Walter Maetzler
- Center for Neurology, Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| |
Collapse
|
|
23
|
Senders A, Bauer SR, Chen Y, Oken B, Fink HA, Lane NE, Sajadi KP, Marshall LM. Lower urinary tract symptoms are associated with musculoskeletal pain among older men: Preliminary evidence for central sensitization as a mechanism? Neurourol Urodyn 2021; 40:1929-1938. [PMID: 34396562 PMCID: PMC8556292 DOI: 10.1002/nau.24767] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/17/2021] [Accepted: 07/29/2021] [Indexed: 11/06/2022]
Abstract
AIMS Features of central sensitization (CS) are present in almost all chronic pain conditions, including painful urinary conditions and back pain. Recently CS was proposed as a mechanism of nonpainful lower urinary tract symptoms (LUTS). Using musculoskeletal pain as an indicator of CS, we investigated whether the prevalence of musculoskeletal pain is greater among community-dwelling men with moderate or severe LUTS compared to those with mild LUTS. METHODS We conducted a cross-sectional study of 5966 men ≥65 years who attended the Osteoporotic Fractures in Men Study baseline visit. LUTS were assessed with the American Urological Association Symptom Index (AUA-SI) and categorized as none/mild (0-7), moderate (8-19), or severe (≥20). Self-reported back, neck, hip, or knee pain within the 12 months before baseline was categorized as any pain and multilocation pain. We tested our hypothesis using odds ratios (OR) and 95% confidence intervals (CI) estimated from multivariable logistic regression models. RESULTS The adjusted odds of any pain were higher among men with moderate (OR 1.49, 95% CI: 1.29-1.72) and severe LUTS (OR 1.76, 95% CI: 1.28-2.40) compared to those with no/mild LUTS. The adjusted odds of pain at ≥ 2 locations were 69% higher among men with moderate (OR 1.69, 95% CI: 1.45-196) and more than double among men with severe LUTS (OR 2.24, 95% CI: 1.62-3.10) compared to men with no/mild LUTS. CONCLUSIONS Musculoskeletal pain, especially at multiple locations, is associated with greater LUTS severity among older men. CS may represent a novel shared mechanism of pain and LUTS.
Collapse
Affiliation(s)
- Angela Senders
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Scott R Bauer
- Departments of Medicine and Urology, University of California San Francisco, San Francisco, CA, USA
- Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Yiyi Chen
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Barry Oken
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Howard A Fink
- Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Nancy E Lane
- Department of Medicine, University of California, Davis, CA, USA
| | - Kamran P Sajadi
- Department of Urology, Oregon Health & Science University, Portland, OR, USA
| | - Lynn M Marshall
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | | |
Collapse
|
|
24
|
Mahjani B, Koskela LR, Batuure A, Gustavsson Mahjani C, Janecka M, Hultman CM, Reichenberg A, Buxbaum JD, Akre O, Grice DE. Systematic review and meta-analysis identify significant relationships between clinical anxiety and lower urinary tract symptoms. Brain Behav 2021; 11:e2268. [PMID: 34402598 PMCID: PMC8442597 DOI: 10.1002/brb3.2268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 06/10/2021] [Accepted: 06/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS), such as voiding symptoms, overactive bladder, and interstitial cystitis, and anxiety disorders are often comorbid conditions in patients. However, the existing evidence regarding the rates and nature of the co-occurrence of these conditions has not been systematically evaluated. The aim of this study was to examine these relationships. METHODS We conducted a systematic review and meta-analysis to examine the relationship between LUTS and anxiety. We searched for articles published from January 1990 to July 2019 in PubMed, CENTRAL, PsycINFO, and Google Scholar. Outcomes were anxiety-related disorders and symptoms (clinically significant anxiety) and LUTS. We performed random-effects meta-analyses, inspected funnel plots, and applied the Egger's test to evaluate publication bias. We followed PRISMA guidelines and recorded our protocol on PROSPERO (ID = CRD42019118607). RESULTS We identified 814 articles, of which 94 fulfilled inclusion criteria, and 23 had sufficient data for meta-analysis. The odds ratio (OR) for clinically significant anxiety among individuals with LUTS was 2.87 (95% CI: 2.38,3.46, p < .001). The OR for LUTS among individuals with clinically significant anxiety was 2.87 (95% CI: 1.07,7.74, p < .001), although very few studies examined this relationship. A large value of I2 index suggests high heterogeneity between studies. CONCLUSION The results demonstrate a significant association between clinically significant anxiety and LUTS in both females and males. There were limited studies on younger individuals and on individuals ascertained for clinically significant anxiety, which should motivate further study in these areas. Understanding the co-occurrence of these conditions will lead to better prevention and interventions to ameliorate the progression of the symptoms and improve the quality of life. A thorough assessment of anxiety may provide more optimal care for LUTS patients.
Collapse
Affiliation(s)
- Behrang Mahjani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Division of Tics, OCD, and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Lotta Renström Koskela
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Anita Batuure
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.,Division of Tics, OCD, and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Christina Gustavsson Mahjani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena Janecka
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA.,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, USA.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Olof Akre
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Dorothy E Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, USA.,Division of Tics, OCD, and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, USA.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|
|
25
|
Yow HY, Tiong JJL, Mai CW, van der Werf E, Zainuddin ZM, Toh CC, Ngoo KS, Goh EH, Fadzli AN, Lok SH, Ong TA. Prevalence of nocturia among community-dwelling adults: a population-based study in Malaysia. BMC Urol 2021; 21:95. [PMID: 34187440 PMCID: PMC8243763 DOI: 10.1186/s12894-021-00860-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 06/14/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Nocturia is widely prevalent condition with detrimental effects on quality of life and general health. In Malaysia, there is a lack of up-to-date prevalence study on nocturia. This study aimed to investigate the prevalence of nocturia and awareness pertaining to nocturia among Malaysian adults. METHODS A cross-sectional population-based study was conducted among Malaysian adults aged ≥ 18 years old. The data was collected by mixed mode self-administered questionnaire from May 2019 to September 2019. Nocturia was defined as one or more voids at night. RESULTS There were a total of 4616 respondents with 74.5% of response rate. The overall prevalence of nocturia among Malaysian adults was found to be 57.3%. In multivariate analysis, respondents aged 31-40 (1.91 [1.52-2.40]) or > 60 years old (2.03 [1.48-2.71]), and those who presented with hypertension (2.84 [2.28-3.53]), diabetes mellitus (1.78 [1.42-2.25]), renal disease (3.58 [1.93-6.63]) or overactive bladder (1.61 [1.10-2.35]) were associated with higher prevalence of nocturia. A significantly lower disease prevalence (p < 0.05) was noted among those aged 41-50 (0.73 [0.59-0.91]), male (0.78 [0.69-0.88]) and Chinese (0.47 [0.30-0.74]) or Indian (0.34 [0.21-0.54]) ethnicities. A total of 37.3% of respondents with nocturia reported that they faced sleeping difficulty about half the time or more after waking up in the middle of night. Those who had ≥ 2 voids per night experienced significantly higher mean bother score than those who had 1 void per night (p < 0.001). Approximately half (56.7%) of all respondents were not aware that night time urination is a medical condition. Only 25.2% of respondents with nocturia had sought medical attention for their nocturia. CONCLUSIONS The prevalence of nocturia among Malaysian adults is high and strongly influenced by age, sex, race and comorbidities. However, the general awareness pertaining to nocturia being a health issue remains low among Malaysians. The findings also highlighted the impact of nocturia on sleep and the need for nocturia education to better address this disease.
Collapse
Affiliation(s)
- Hui-Yin Yow
- grid.452879.50000 0004 0647 0003School of Pharmacy, Faculty of Health and Medical Sciences, Taylor’s University (Lakeside Campus), Subang Jaya, Malaysia
| | | | - Chun-Wai Mai
- grid.411729.80000 0000 8946 5787School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Esther van der Werf
- grid.425326.40000 0004 0397 0010Louis Bolk Institute, Bunnik, The Netherlands
| | - Zulkifli Md Zainuddin
- grid.412113.40000 0004 1937 1557Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Charng-Chee Toh
- grid.413442.40000 0004 1802 4561Department of Urology, Hospital Selayang, Selangor, Malaysia
| | - Kay-Seong Ngoo
- Department of Surgery, Hospital Angkatan Tentera Tuanku Mizan, Kuala Lumpur, Malaysia
| | - Eng-Hong Goh
- Urology, Nephrology & Men’s Health Clinic, Prince Court Medical Centre, Kuala Lumpur, Malaysia
| | - Ahmad Nazran Fadzli
- grid.10347.310000 0001 2308 5949Department of Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Sze-Han Lok
- grid.452879.50000 0004 0647 0003School of Pharmacy, Faculty of Health and Medical Sciences, Taylor’s University (Lakeside Campus), Subang Jaya, Malaysia
| | - Teng-Aik Ong
- grid.10347.310000 0001 2308 5949Department of Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| |
Collapse
|
|
26
|
Majima T, Oota Y, Matsukawa Y, Funahashi Y, Kato M, Mimata H, Gotoh M. Feasibility of the Lilium α-200 portable ultrasound bladder scanner for accurate bladder volume measurement. Investig Clin Urol 2021; 61:613-618. [PMID: 33135404 PMCID: PMC7606125 DOI: 10.4111/icu.20200012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/11/2020] [Accepted: 04/03/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The aim of this study was to investigate whether data obtained from the Lilium α-200 (Lilium Otsuka Co., Ltd., Japan) correlated with conventional frequency-volume chart (FVC) and post-void residual urine volume (PVR) obtained by urethral catheterization. MATERIALS AND METHODS This was a prospective multicentre study. Patients hospitalized for the treatment of lower urinary tract symptoms were included. Patients were evaluated with conventional FVC and Lilium α-200 for 2 days. PVR was measured by urethral catherization after urination at the end of the 2 day evaluation period. RESULTS A total of 42 patients were enrolled in this study. Voided volume and PVR measured by Lilium α-200 were significantly correlated with voided volume obtained from conventional FVC and PVR measured by urethral catheterization, respectively. There was considerable measurement error in voided volume measured by Lilium α-200 (-21.0±102.0 mL). In contrast, the error between PVR measured by the Lilium α-200 and PVR obtained by urethral catheterization was 2.4±52.0 mL. Additionally, high body mass index, but not sex, benign prostate hyperplasia, time zone of measurement (daytime vs. nighttime), and examiners (a urologist versus other healthcare providers) were significantly associated with inaccurate results in voided volume. CONCLUSIONS Voided volume and PVR measured by the Lilium α-200 were correlated with voided volume obtained from conventional FVC and PVR measured by urethral catheterization, although accuracy of the measurements was not high. The Lilium α-200 is a useful device to easily measure approximate bladder volume.
Collapse
Affiliation(s)
- Tsuyoshi Majima
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Yumi Oota
- Department of Urology, Oita Oka Hospital, Keiwakai, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiromitsu Mimata
- Department of Urology, Oita University Faculty of Medicine, Oita, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
|
27
|
Sanford TH, Harmon SA, Kesani D, Gurram S, Gupta N, Mehralivand S, Sackett J, Wiener S, Wood BJ, Xu S, Pinto PA, Choyke PL, Turkbey B. Quantitative Characterization of the Prostatic Urethra Using MRI: Implications for Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia. Acad Radiol 2021; 28:664-670. [PMID: 32307270 PMCID: PMC8456710 DOI: 10.1016/j.acra.2020.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/11/2020] [Accepted: 03/14/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The aim of this study was to perform a quantitative assessment of the prostate anatomy with a focus on the relation of prostatic urethral anatomic variation to urinary symptoms. METHODS This retrospective study involved patients undergoing magnetic resonance imaging for prostate cancer who were also assessed for lower urinary tract symptoms. Volumetric segmentations were utilized to derive the in vivo prostatic urethral length and urethral trajectory in coronal and sagittal planes using a piece-wise cubic spline function to derive the angle of the urethra within the prostate. Association of anatomical factors with urinary symptoms was evaluated using ordinal univariable and multivariable logistic regression with IPSS score cutoffs of ≤7, 8-19, and >20 to define mild, moderate, and severe symptoms, respectively. RESULTS A total of 423 patients were included. On univariable analysis, whole prostate volume, transition zone volume, prostatic urethral length, urethral angle, and retrourethral volume were all significantly associated with worse urinary symptoms. On multivariable analysis prostatic urethral length was associated with urinary symptoms with a normalized odds ratio of 1.5 (95% confidence interval 1.0-2.2, p = 0.04). In a subset analysis of patients on alpha blockers, maximal urethral angle, transition zone volume as well as urethral length were all associated with worse urinary symptoms. CONCLUSION Multiple parameters were associated with worse urinary symptoms on univariable analysis, but only prostatic urethral length was associated with worse urinary symptoms on multivariable analysis. This study demonstrates the ability of quantitative assessment of prostatic urethral anatomy to predict lower urinary tract symptoms.
Collapse
Affiliation(s)
- Thomas H Sanford
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, Room B3B85, Bethesda 20892, MD
| | - Stephanie A Harmon
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, Room B3B85, Bethesda 20892, MD; Clinical Research Directorate, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, MD
| | - Deepak Kesani
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, Room B3B85, Bethesda 20892, MD
| | - Sandeep Gurram
- Urologic Oncology Branch, National Cancer Institute, Bethesda MD
| | - Nikhil Gupta
- Urologic Oncology Branch, National Cancer Institute, Bethesda MD
| | - Sherif Mehralivand
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, Room B3B85, Bethesda 20892, MD
| | - Jonathan Sackett
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, Room B3B85, Bethesda 20892, MD
| | | | - Bradford J Wood
- Center for Interventional Oncology, National Cancer Institute, Bethesda, MD
| | - Sheng Xu
- Center for Interventional Oncology, National Cancer Institute, Bethesda, MD
| | - Peter A Pinto
- Urologic Oncology Branch, National Cancer Institute, Bethesda MD
| | - Peter L Choyke
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, Room B3B85, Bethesda 20892, MD
| | - Baris Turkbey
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, Room B3B85, Bethesda 20892, MD.
| |
Collapse
|
|
28
|
Whiting D, Penev B, Ijaaz A, Guest K, Cynk M. En bloc enucleation technique during holmium laser enucleation of the prostate: An analysis of its efficiency. Low Urin Tract Symptoms 2021; 13:372-376. [PMID: 33821575 DOI: 10.1111/luts.12379] [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: 01/27/2021] [Revised: 03/06/2021] [Accepted: 03/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Despite the acknowledgment that holmium laser enucleation of the prostate (HoLEP) is a safe, efficacious procedure with benefits over traditional treatments, it is not widely adopted. Its steep learning curve is considered responsible, and the new en bloc technique (EBT) aims to improve this. METHODS A retrospective analysis of 268 consecutive patients (215 lobe technique [LT] and 53 EBT) who underwent HoLEP between May 2016 and April 2020 was performed. Data were collected on patient demographics, prostate volume, enucleation time, prostatic weight, and length of stay. RESULTS There was no difference in mean prostate volume and enucleated prostatic weight between the LT and EBT (99.2 mL vs 98.5 mL, P = .95216, and 71.7 g vs 69.3 g, P = .92034, respectively). There was a reduction in mean enucleation time with the EBT to 37.7 minutes compared with 53.3 minutes (LT) (P < .00001). This translated to an improved operative efficiency of 1.84 g/min (EBT) compared to 1.33 g/min (LT) (P < .00001). The EBT demonstrated a continuous improvement in operative efficiency with increasing prostate size unlike the LT where efficiency plateaus. CONCLUSIONS The EBT for HoLEP demonstrates a significant improvement in operative efficiency which has the potential to reduce the surgeons' learning curve and lead to more widespread adoption.
Collapse
Affiliation(s)
| | | | - Anam Ijaaz
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | | | - Mark Cynk
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| |
Collapse
|
|
29
|
Whiting D, Ng KL, Barber N. Initial single centre experience of Aquablation of the prostate using the AquaBeam system with athermal haemostasis for the treatment of benign prostatic hyperplasia: 1-year outcomes. World J Urol 2021; 39:3019-3024. [PMID: 33392647 DOI: 10.1007/s00345-020-03534-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Aquablation using the AquaBeam system combines real-time image guidance and robotics to enable precise and heat-free removal of prostatic tissue with a high velocity water jet. The aim of this study is to report the outcomes of Aquablation up to 1 year in a single centre within the UK employing an athermal approach to haemostasis. METHODS Fifty-five consecutive men underwent Aquablation between September 2017 and December 2018 (as part of OPEN WATER trial). Standard Aquablation was performed with the AquaBeam system (PROCEPT® BioRobotics) with 2 passes of Aquablation followed by bladder washout with application of continuous bladder irrigation via a catheter on a continuous traction device. Patients were followed up at 3 and 12 months. The data were prospectively collected on patient demographics, uroflowmetry, prostate volume, International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) and International Index of Erectile Function (IIEF-15). RESULTS The mean age was 64.1 ± 7.9 years. Operating time was 26.9 ± 9.2 min. Mean prostate volume decreased from 58.2 ± 23.9 cc to 33.2 ± 12.9 cc (p < 0.0001). There were significant improvements at the 12 month follow-up in maximum urinary flow rate (9.9 ± 5.1 ml/s vs. 23.9 ± 11.6 ml/s), IPSS (21.7 ± 7.4 vs. 6.1 ± 4.2) and quality of life score (4.8 ± 1.1 vs. 1.4 ± 1.4) (p < 0.0001). There was no significant change in IIEF-15 and MSHQ-EjD scores. There were 8 (14.5%) Clavien grade 2 or higher complications. CONCLUSION Our single centre experience suggests Aquablation using an entirely athermal approach is a safe cavitating procedure resulting in significant LUTS improvement comparable to standard cavitating procedures with greater preservation of sexual function.
Collapse
Affiliation(s)
- Danielle Whiting
- Department of Urology, Frimley Park Hospital, Portsmouth Road, Frimley, Camberley, GU167UJ, UK
| | - Keng Lim Ng
- Department of Urology, Frimley Park Hospital, Portsmouth Road, Frimley, Camberley, GU167UJ, UK
| | - Neil Barber
- Department of Urology, Frimley Park Hospital, Portsmouth Road, Frimley, Camberley, GU167UJ, UK.
| |
Collapse
|
|
30
|
Chou EL. “True gold fears no fire” – High-quality videourodynamic studies make possible precision diagnosis of lower urinary tract symptoms in women. UROLOGICAL SCIENCE 2021. [DOI: 10.4103/uros.uros_126_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
|
31
|
Meta-Analysis of the Efficacy and Safety of Imidafenacin for Overactive Bladder Induced by Benign Prostatic Hyperplasia in Men Receiving Alpha-Blocker Therapy. Int Neurourol J 2020; 24:365-374. [PMID: 33401358 PMCID: PMC7788324 DOI: 10.5213/inj.2040146.073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/16/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose The aim of this meta-analysis was to evaluate the efficacy and safety of imidafenacin for overactive bladder (OAB) induced by benign prostatic hyperplasia (BPH) in men receiving alpha-blocker monotherapy. Methods We performed a systematic research of the PubMed, Embase, and Cochrane Library databases, and searched for studies about alpha-blocker with or without imidafenacin treatment for OAB in patients with BPH. We also investigated the original references of the included texts. Results Four randomized controlled trials including 779 participants with BPH (389 in the alpha-blocker+imidafenacin group and 390 in the alpha-blocker only group) were studied. The main efficacy endpoint was the Overactive Bladder Symptom Score, which showed a mean difference of -1.88 (95% confidence interval, -2.32 to -1.44; P<0.00001), suggesting that alpha-blocker and imidafenacin treatment was effective in treating men with OAB. As other primary efficacy end points, the International Prostate Symptom Score (IPSS) total score (P=0.47), the IPSS storage symptom score (P=0.07), the IPSS voiding symptom score (P=0.60), and the IPSS quality of life score (P=0.18) indicated that 2 methods had no significant differences in treating men with OAB. In terms of safety, which was assessed using postvoid residual volume (P=0.05) and maximum flow rate (P=0.53), the analysis suggested that combination treatment was very well tolerated. Conclusions This study suggested that imidafenacin plus alpha-blocker was an efficacious and safe treatment for OAB symptoms in BPH patients.
Collapse
|
|
32
|
Espósito RC, Medeiros PJ, Dantas Júnior JH, Oliveira AG, Moreira SA, Sales VSDF. Blue November Campaign as an annual male self-care strategy for healthy aging. Aging Male 2020; 23:865-872. [PMID: 31251097 DOI: 10.1080/13685538.2019.1610731] [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: 10/26/2022] Open
Abstract
Men ignore self-care, displaying low frequency in health services. Aging increases the prevalence of LUTS and BPE, impacting the quality of life. The objective is to understand how the advancement of age can be determinant for men's health in Natal, Brazil. Then, 503 men aged between 43 and 83 attended the Blue November Campaign of 2015. All subjects were submitted to anamnesis, clinical and laboratorial evaluation including measuring their blood pressure, waist circumference, glucose, total cholesterol, HDL-C, LDL-C, triglycerides and BMI was calculated. In addition, IPSS, PSA, IIEF-5 and DRE data were collected. The mean IPSS presented an increase with age, 43-59 years (6.28 ± 6.02) and 70-80 years or more (8.65 ± 5.80). PSA dosages increase with aging (adult group 1.63 ± 2.70), being more accentuated in the older group (4.66 ± 5.70), while the mean IIFE-5 showed a decrease with aging in 43-59 years (21.79 ± 4.67) and an important decrease at 70-80 years or more (16.24 ± 6.71). The number of DRE > 30 g showed significant growth in the older group. All presented statistical significance (p < .05) and were associated with aging. The Blue November Campaign creates an annual self-care opportunity for aging men as their health is gradually affected.
Collapse
Affiliation(s)
- Regina Carmen Espósito
- Department of Clinical and Toxicology Analysis, Clinical Immunology Laboratory, Postgraduate Program in Development in Innovation Technogical, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Paulo José Medeiros
- Division of Urology, Department of Integrated Medicine, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - José Hipólito Dantas Júnior
- Division of Urology, Department of Integrated Medicine, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Sueli Aparecida Moreira
- Postgraduate Program in Urban and Regional Studies, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Valéria Soraya de Farias Sales
- Department of Clinical and Toxicology Analysis, Clinical Immunology Laboratory, Postgraduate Program in Development in Innovation Technogical, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| |
Collapse
|
|
33
|
Watanabe M, Yamaguchi S, Kakizaki H, Hirabayashi N, Ishida H. Evaluation of Alpha 1 Adrenoceptor Antagonist Dose Increase Therapy: An Essential Strategy for Patients with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia. Curr Urol 2020; 14:113-121. [PMID: 33224003 DOI: 10.1159/000499250] [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: 05/16/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction There have been a number of reports on dose increase therapy (DI-T) with the alpha 1 adrenoceptor antagonists (α1-blockers) naftopidil and tamsulosin for lower urinary tract symptoms associated with benign prostatic hyperplasia. Methods and Results The reports on DI-T (naftopidil 75 mg/d, tamsulosin 0.4 mg/d) in non-responders to low-dose initial therapy (LI-T, naftopidil 50 mg/d, tamsulosin 0.2 mg/d) were summarized. In each study, a non-responder was defined as a patient without sufficient improvements on the International Prostate Symptom Score (IPSS), IPSS Quality of Life, maximum flow rate of urine, or treatment satisfaction. These reports showed that 22.4-76.1% of patients were non-responders to LI-T, indicating that a novel treatment strategy for such patients is important. Moreover, 22.5-90.0% of non-responders to LI-T showed a response to DI-T, which achieved the same level of efficacy as low-dose maintenance therapy. Specifically, the improvements of the IPSS voiding symptom sub-score and maximum flow rate of urine were superior. The predictive factors for non-response to α1-blockers LI-T were insufficient improvement of subjective symptoms and objective findings during LI-T. These patients require high-dose initial therapy or DI-T at an early stage, since adverse events associated with naftopidil and tamsulosin do not show a dose-response relationship. Conclusions DI-T with α1-blockers has high potential as an essential treatment strategy for lower urinary tract symptoms associated with benign prostatic hyperplasia.
Collapse
Affiliation(s)
- Masaki Watanabe
- Department of Urology, Hokkaido Social Welfare Association Furano Hospital, Furano
| | | | - Hidehiro Kakizaki
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa
| | - Naoki Hirabayashi
- Medical Affairs Department, Asahi Kasei Pharma Corporation, Tokyo, Japan
| | | |
Collapse
|
|
34
|
Przydacz M, Golabek T, Dudek P, Lipinski M, Chlosta P. Prevalence and bother of lower urinary tract symptoms and overactive bladder in Poland, an Eastern European Study. Sci Rep 2020; 10:19819. [PMID: 33188254 PMCID: PMC7666180 DOI: 10.1038/s41598-020-76846-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
The prevalence of lower urinary tract symptoms (LUTS) and overactive bladder (OAB) has been measured by population-based investigations in many parts of the world. However, data are lacking for Eastern Europe, and there has not been any large population-representative study in any country of this region. Therefore, the aim of this study was to evaluate the prevalence and associated bother of LUTS and OAB in a population-representative sample of persons aged ≥ 40 years in Poland. This investigation was conducted as a computer-assisted telephone interview. The survey sample was stratified by age, sex, and place of residence to reflect the entire Polish population. LUTS and OAB were assessed by a standardized protocol based on the International Continence Society definitions and validated questionnaires. Of 6005 participants, 57% were women, and the mean age (range) was 60.7 (40-93) years. The prevalence of LUTS was 69.8% (men 66.2%; women 72.6%). There was no difference in prevalence between urban and rural areas. LUTS were often bothersome among men and women, but women were more likely to be bothered compared with men. There were also statistically significant correlations between the frequency and the bother intensity of each of the LUTS. The prevalence of OAB was higher in women (39.5%) than in men (26.8%), and OAB increased with age. Lastly, LUTS had detrimental effects on the quality of life because one third of the participants had concerns about their urinary-specific quality of life. This investigation was the first nationwide, population-representative epidemiological study of LUTS and OAB in an Eastern-European country. LUTS were highly prevalent, often bothersome, and had negative effects on the quality of life of men and women aged ≥ 40 years. Our findings are comparable with other epidemiologic studies of LUTS and OAB conducted in different regions of the world.Trial registration: NCT04121936.
Collapse
Affiliation(s)
- Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland.
| | - Tomasz Golabek
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Przemyslaw Dudek
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Marek Lipinski
- Department of Urology, Medical University of Lodz, Lodz, Poland
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| |
Collapse
|
|
35
|
Nazari F, Shaygannejad V, Mohammadi Sichani M, Mansourian M, Hajhashemi V. Quality of life among patients with multiple sclerosis and voiding dysfunction: a cross-sectional study. BMC Urol 2020; 20:62. [PMID: 32493262 PMCID: PMC7268392 DOI: 10.1186/s12894-020-00590-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evaluating the usefulness of treatment requires a direct measurement of the health-related quality of life (QOL). Therefore, this study was carried out aiming to determine the QOL of patients with MS and voiding dysfunction. METHODS This cross-sectional study was carried out using multi-stage random cluster sampling method on 602 patients with MS in Isfahan, Iran. All data were collected through interviews using standard questionnaires including International Prostate Symptom Score (IPSS), and the Multiple Sclerosis Quality of Life-54 (MSQOL-54). Data were analyzed using descriptive and inferential statistical tests. RESULTS The prevalence rate of mixed, irritative, and obstructive urinary symptoms was 52.2, 25.5, and 6.5%, respectively. The mixed symptom had the highest prevalence among men and women with rates of 56.5 and 51.1%, respectively. The prevalence of irritative and obstructive symptoms was, respectively, higher and statistically significant among women alone and men alone (P < 0.05). The prevalence of irritative symptoms was higher among patients with MS, EDSS score ≤ 3, disease duration of less than 5 years, and with clinically isolated syndrome. In addition, the prevalence of mixed symptoms was higher among patients with MS of over 30 years of age with a Pre-high school degree, severe disability, disease duration of over 10 years, and progressive MS; the difference was statistically significant (P < 0.05). There was a difference in the combined dimensions of physical and mental health of QOL between the two groups with and without urinary symptoms (P < 0.05). Logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and high age [3.273 (1.083-9.860); P = 0.035]. CONCLUSIONS Mixed urinary symptoms are highly prevalent among MS patients and affect QOL dimensions. In order to improve QOL, more attention and focus should be paid to urinary problems in MS patients.
Collapse
Affiliation(s)
- Fatemeh Nazari
- Isfahan neurosciences Research center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Adult Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Isfahan neurosciences Research center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Mohammadi Sichani
- Isfahan Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology & Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Valiollah Hajhashemi
- Isfahan Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
|
36
|
Moussa M, Papatsoris A, Chakra MA, Fares Y, Dellis A. Lower urinary tract dysfunction in common neurological diseases. Turk J Urol 2020; 46:S70-S78. [PMID: 32384046 DOI: 10.5152/tud.2020.20092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
The lower urinary tract has the main function of urine storage and voiding. The integrity of the lower urinary tract nerve supply is necessary for its proper function. Neurological disorders can lead to lower urinary tract dysfunction (LUTD) and cause lower urinary tract symptoms (LUTS). Common causes of neurogenic LUTS or LUTD include spinal cord injury, multiple sclerosis, Parkinson's disease, cerebrovascular accidents, cauda equina syndrome, diabetes mellitus, and multiple system atrophy. The pathophysiology is categorized according to the nature of the onset of neurological disease. Assessment requires clinical evaluation, laboratory tests, imaging, and urodynamic studies. Impaired voiding is most often managed by clean intermittent self-catheterization if the postvoid residual urine exceeds 100 ml, whereas storage symptoms are most often managed by antimuscarinic medications. Intradetrusor injection of botulinum toxin type A is emerging as an effective treatment for managing refractory neurogenic detrusor overactivity. This review provides an overview of the clinical characteristics, diagnosis, and management of LUTD in patients with central and peripheral common neurological diseases.
Collapse
Affiliation(s)
- Mohamad Moussa
- Department of Urology, Al Zahraa University Medical Center, Beirut, Lebanon
| | | | | | - Yousef Fares
- Department of Neurosurgery, Al Zahraa University Medical Center, Beirut, Lebanon
| | - Athanasios Dellis
- Department of Urology/General Surgery, Areteion Hospital, Athens, Greece
| |
Collapse
|
|
37
|
Guo B, Chen X, Wang M, Hou H, Zhang Z, Liu M. Comparative Effectiveness of Tadalafil versus Tamsulosin in Treating Lower Urinary Tract Symptoms Suggestive of Benign Prostate Hyperplasia: A Meta-Analysis of Randomized Controlled Trials. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020; 26:e923179. [PMID: 32327621 PMCID: PMC7195607 DOI: 10.12659/msm.923179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Evidence directly evaluating the efficacy of tadalafil vs. tamsulosin for lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) is limited. We performed a meta-analysis of published studies to assess the comparative effectiveness of tadalafil vs. tamsulosin in treating LUTS suggestive of BPH. Material/Methods After performing a comprehensive publication search with PubMed, EMBASE, and Cochrane Controlled Trials Register using the search terms “tadalafil”, “tamsulosin”, “lower urinary tract symptoms”, and “controlled”, 335 articles were screened, out of which 7 randomized controlled trials published up to July 2019 were identified and included in this meta-analysis review. Results From 335 screened articles, 7 studies (totalling 1601 patients) were finally included in our analysis. There was no statistically significant difference between tadalafil and tamsulosin in improving the clinical outcomes of total International Prostate Symptom Score (IPSS), voiding subscores, storage subscores, quality of life (QoL) scores, maximum flow rate (Qmax), and postvoid residual urine (PVR), but a statistically significant difference was observed in the International Index of Erectile Function scores (IIEF scores). Conclusions Tadalafil and tamsulosin have similar effects in managing LUTS secondary to BPH. Tadalafil is superior to tamsulosin in treating LUTS suggestive of BPH when associated with erectile dysfunction (ED).
Collapse
Affiliation(s)
- Boda Guo
- Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences/Graduate School of Peking Union Medical College, Beijing, China (mainland)
| | - Xin Chen
- Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
| | - Miao Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
| | - Huimin Hou
- Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
| | - Zhipeng Zhang
- Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
| | - Ming Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences/Graduate School of Peking Union Medical College, Beijing, China (mainland)
| |
Collapse
|
|
38
|
Maiti K, Jaiswal A, Pal DK. A comparative study of alpha-1a blockers (tamsulosin) versus estrogens in the treatment of lower urinary tract symptoms in perimenopausal females. Indian J Pharmacol 2020; 52:6-9. [PMID: 32201440 PMCID: PMC7074429 DOI: 10.4103/ijp.ijp_545_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 05/02/2019] [Accepted: 02/03/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Lower urinary tract symptoms (LUTS) in perimenopausal females are very common. It can be treated with alpha-blockers or application of topical oestrogen. The purpose of this study is to compare the efficacy of alpha-blockers versus topical estrogen in the treatment of LUTS in perimenopausal females. MATERIALS AND METHODS All perimenopausal females between the age group of 45 and 60 years who present with the symptom of voiding LUTS were divided into two groups. Acute urinary retention patients were excluded from the study. The first group was given alpha-blocker (tamsulosin) and other group was given topical estrogen application (0.5%-1%) in the periurethral region. Patients were followed up clinically by voiding components of the International Prostate Symptom Score and objectively by uroflowmetry and postvoid residual (PVR) urine estimation (ultrasonography). RESULTS Alpha-blocker group had 40 females and topical estrogen group had 40 females. During the 6-week period, 8 patients of the first group and 6 patients of the estrogen group discontinued the treatment. In the first group, pretreatment mean Qmax (maximum flow rate) of patients was 7.2 ml/s and posttreatment Qmax was 18.4. In the second group, the values were 7.4 ml/s and 10.2, respectively. This difference was statistically significant (P < 0.0001). In the first group, pretreatment PVR urine was significant, which became insignificant after the treatment, whereas in the second group, PVR was significant posttreatment also. CONCLUSION Alpha-1a blockers should be used as the first-line medical management in perimenopausal females with symptoms of LUTS, as they have a clear advantage over topical estrogens.
Collapse
Affiliation(s)
- Krishnendu Maiti
- Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Alankar Jaiswal
- Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Dilip Kumar Pal
- Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| |
Collapse
|
|
39
|
Al Dandan HB, Coote S, McClurg D. Prevalence of Lower Urinary Tract Symptoms in People with Multiple Sclerosis: A Systematic Review and Meta-analysis. Int J MS Care 2020; 22:91-99. [PMID: 32410904 PMCID: PMC7204365 DOI: 10.7224/1537-2073.2019-030] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND No published study, to our knowledge, has systematically reviewed the prevalence estimates of lower urinary tract symptoms (LUTSs) and LUTS types in the general multiple sclerosis (MS) population. Therefore, a systematic review and a meta-analysis were conducted to determine the totality of literature investigating the prevalence of LUTSs and LUTS types in the general MS population according to International Continence Society definitions. METHODS Various electronic databases were searched between January 4, 2018, and February 12, 2018. This review included observational studies involving adults (18 years or older) with a confirmed diagnosis of MS recruited from the general MS population using self-report and/or objective outcome measures for LUTSs. RESULTS Twelve studies were included in the meta-analysis. The results showed that LUTSs were prevalent in people with MS, with a pooled prevalence of 68.41% using self-report and 63.95% using the objective measure of urodynamics. When considering LUTS types, urinary frequency was the predominant symptom, with a pooled prevalence estimate of 73.45%, followed by urgency assessed using self-report measures at 63.87%. Detrusor overactivity was found to be the most prevalent urodynamic symptom, with a pooled prevalence estimate of 42.9%, followed by detrusor sphincter dyssynergia at 35.44%. CONCLUSIONS This systematic review revealed that LUTSs are highly prevalent in MS. There is a need for improvement in the conduct and reporting of prevalence studies of LUTSs in MS and for the use of validated self-report outcome measures to enable pooling of data in the future.
Collapse
|
|
40
|
Isa NMM, Aziz AFA. Lower Urinary Tract Symptoms: Prevalence and Factors Associated with Help-Seeking in Male Primary Care Attendees. Korean J Fam Med 2020; 41:256-262. [PMID: 32019295 PMCID: PMC7385293 DOI: 10.4082/kjfm.19.0012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 09/05/2019] [Indexed: 11/04/2022] Open
Abstract
Background Lower urinary tract symptoms (LUTS) are common among elderly men. However, seeking help for this problem is mostly delayed until complications arise. Primary care clinics serve as the first point of contact for a person’s health needs throughout their life. This study aimed to determine the prevalence of LUTS among primary care attendees, and the factors that influence seeking medical intervention at primary care clinics. Methods Using a universal sampling technique, 460 male patients aged 60 and above visiting an urban based public primary care clinic were recruited. An interviewer administered the questionnaire which used International Prostate Symptoms Score and International Consultation on Incontinence Modular Questionnaire-Lower Urinary Tract Symptoms-Quality of Life. Results The prevalence of any LUTS and clinically significant LUTS were 89.8% and 20.5%, respectively. Among the 385 participants who completed the study, only 41.8% had consulted a doctor for LUTS. Among those with moderate/severe symptoms only 57.6% had sought medical intervention. Multiple logistic regression analysis showed that the presence of more than two comorbidities (P=0.004; odds ratio [OR], 4.695; 95% confidence interval [CI], 1.632–13.508) and quality of life (P=0.002; OR, 1.271; 95% CI, 1.091–1.481) were independent factors significantly associated with seeking help. Conclusion Prevalence of LUTS among elderly men undergoing primary care is high, but more than half of the patients had not sought medical attention. Increasing comorbidities and impact on quality of life influenced elderly men with LUTS to seek help.
Collapse
Affiliation(s)
- Noor Mikraz Mohamad Isa
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| |
Collapse
|
|
41
|
The resonance® metallic ureteral stent in the treatment of malignant ureteral obstruction: a prospective observational study. BMC Urol 2019; 19:137. [PMID: 31881875 PMCID: PMC6935232 DOI: 10.1186/s12894-019-0569-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/13/2019] [Indexed: 11/25/2022] Open
Abstract
Background To study the outcomes and experiences of using metallic stents in treating patients with malignant ureteral obstruction (MUO), we examined the effects of metallic ureteral stenting using the Cook Resonance® stent in the treatment of MUO. Methods All patients who had a Resonance metallic stent inserted between April 2015 and March 2018 at one of multiple facilities were prospectively observed with a 1-year follow-up. The primary outcome was the patency rate of the metallic ureteral stent. The secondary outcomes included the complications (e.g., infection and fever). Results Although stent insertion was attempted in 50 patients, the stent could not be inserted as a ureteral stent in three patients due to severe ureteral stricture, and one ureteral cancer patient was excluded from the analysis. The remaining 46 patients’ median age was 67 years (range 28–85 years) (16 males, 30 females). Twenty-four patients died during the study; their median survival time was 226 days. The median follow-up period for the censored patients was 355 days (range 16–372 days), and just seven patients were still alive without Resonance failure > 1 year later. The women’s IPSS scores tended to be lower than those of the men. Regarding the OABSS score, although the women’s total score tended to be low, the difference between the men’s and women’s scores was nonsignificant. The bacteria detected from urine culture after stent insertion were more gram-positive than gram-negative. Conclusion Metallic ureteric stenting using the Resonance stent is safe and effective for treating MUO. Subjective symptoms were relatively less in the female patients.
Collapse
|
|
42
|
Bilgic D, Gokyıldız Surucu S, Kizilkaya Beji N, Yalcin O. Sexual function and urinary incontinence complaints and other urinary tract symptoms of perimenopausal Turkish women. PSYCHOL HEALTH MED 2019; 24:1111-1122. [DOI: 10.1080/13548506.2019.1595679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dilek Bilgic
- Gyneocologic and Obstetric Nursing Department, Dokuz Eylul University Faculty of Nursing, İzmir, Turkey
| | | | | | - Onay Yalcin
- Department of Obstetrics and Gynecology, Division of Urogynecology, Istanbul University Istanbul School of Medicine, Istanbul, Turkey
| |
Collapse
|
|
43
|
Lin YH, Huang WY, Chang CC, Chen YF, Wu LY, Chang HC, Huang KH. Trends in the use of antimuscarinics and alpha-adrenergic blockers in women with lower urinary tract symptoms in Taiwan: A nationwide, population-based study, 2007-2012. PLoS One 2019; 14:e0220615. [PMID: 31589615 PMCID: PMC6779229 DOI: 10.1371/journal.pone.0220615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 07/20/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND We aim to examine the trend in the use of antimuscarinics and off-label alpha-adrenergic blockers for treatment of lower urinary tract symptoms (LUTS) in a Taiwanese Women Cohort between 2007 and 2012. METHODS This population-based National Health Insurance Research Database (NHIRD) was used to examine the trends in the use of antimuscarinics or off-label alpha-adrenergic blockers in Taiwan. A sample of 1,000,000 individuals randomly drawn from the whole population of 23 million individuals who were registered in the NHI in 2005. From 2007 through 2012, women aged over 18 years whose claim record contained prescriptions of either of the two drugs for treatment of any of the LUTS-related diagnoses were identified and analyzed. The annual usage of the two drug classes were calculated by defined daily dose (DDD). RESULTS From 2007-2012, there was a 0.80 fold (69676.8 to 125104.3) increase in DDD of antimuscarinics in our cohort. The overall healthcare seeking prevalence of LUTS was 7.33% in 2007 and 12.38% in 2012, in a rising trend. The prevalence of antimuscarinics-treated LUTS in our cohort increased from 2.53 in 2007 to 3.41 per 1000 women in 2012. The prevalence of LUTS treated by antimuscarinics increased especially for those older than 60 years during the study period. CONCLUSIONS This 6-year observational study provided the epidemiologic information of clinically significant LUTS of Asian female population. Moreover, there was a rising trend in the use of antimuscarinics and off-label alpha-adrenergic blockers in the population-based cohort.
Collapse
Affiliation(s)
- Yu-Hua Lin
- Divisions of Urology, Department of Surgery, Cardinal Tien Hospital, Taipei, Taiwan
- Department of Chemistry, Fu Jen Catholic University, New Taipei City, Taiwan
- Graduate Institute of Biochemical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Wei-Yi Huang
- Department of Healthcare and Medical Care, Veterans Affairs Council, Taipei, Taiwan
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Chi-Chih Chang
- The Interdisciplinary Nanoscience Centre, Aarhus University, Aarhus, Denmark
| | - Yu-Fen Chen
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
- Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan
| | - Ling-Ying Wu
- Graduate Institute of European Studies, Tamkang University, Taipei, Taiwan
| | - Hong-Chiang Chang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-How Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
|
44
|
Hwang TY, Kim SK, Kim KH, Kim JY. Association Between Lower Urinary Tract Symptoms and Falls in Adults Males: Based on the Korean Community Health Survey. Asia Pac J Public Health 2019; 31:643-651. [PMID: 31561710 DOI: 10.1177/1010539519878361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to investigate the correlation between lower urinary tract symptoms (LUTSs) and falls considering places where falls can occur in adult males. We analyzed 101 862 males in the 2011 Korean Community Health Survey. LUTSs were assessed using the International Prostate Symptom Score system. The rate of total and indoor falls significantly increased with the LUTS severity, respectively. After adjusting for age and other confounding variables, the odds ratios (ORs) for total falls were significantly high for the mild (OR = 1.63, 95% confidence interval [CI] = 1.54-1.71), moderate (OR = 2.35, 95% CI = 2.16-2.56), and severe groups (OR = 2.83, 95% CI = 2.49-3.22), relative to the normal group. Indoor fall experience was the same for the mild (OR = 1.56, 95% CI = 1.36-1.79), moderate (OR = 2.37, 95% CI = 1.97-2.85), and severe groups (OR = 3.77, 95% CI = 3.00-4.72). Nocturia, hesitancy, and urgency were significantly associated with indoor falls. The association between falls and the degree of LUTS was observed in both the young and the elderly. Therefore, further studies are needed to determine the effects of treatment of LUTS on the risk of falls and the effectiveness of the fall prevention program.
Collapse
Affiliation(s)
| | - Sang-Kyu Kim
- Dongguk University, Gyeongsangbuk-do, Republic of Korea
| | - Ki Ho Kim
- Dongguk University, Gyeongsangbuk-do, Republic of Korea
| | - Jong-Yeon Kim
- Catholic University of Daegu, Daegu, Republic of Korea
| |
Collapse
|
|
45
|
Yunanto A, Rahardjo HE. Urodynamic profile in the Department of Urology, Cipto Mangunkusumo Hospital Between 2010 and 2015. MEDICAL JOURNAL OF INDONESIA 2019. [DOI: 10.13181/mji.v28i2.1666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND This study was aimed to describe urodynamic profiles, the role and advantages of urodynamics for urinary problems detection, and to analyze whether urodynamic examination has been ordered based on accurate indications following guidelines in the Department of Urology Cipto Mangunkusumo Hospital between 2010 and 2015. METHODS Data was retrieved from the patient’s medical records who underwent urodynamic examinations in the Department of Urology Cipto Mangunkusumo Hospital between July 2010 to August 2015. RESULTS 1,091 patients undergone urodynamic procedures in the Department of Urology Cipto Mangunkusumo Hospital. In 553 lower urinary tract symptoms (LUTS) patients, there were 186 (34%) small bladder capacity, 84 (15%) detrusor overactivity (DO), 180 (33%) bladder outlet obstruction (BOO), and 198 (36%) bladder atony patients. In the 317 urinary retention patients, there were 121 (38%) patients with BOO and 2 (1%) patients with a normal voiding phase. In 80 overactive bladder patients, there were 51 (64%) with DO, 17 (21%) with DO incontinence, and 22 (28%) with urodynamic stress incontinence (SI). Among 81 patients with SI problems, there were 63 (78%) urodynamic SI, 9 (11%) DO, and 9 (11%) DO incontinence patients. In 60 (6%) pediatric patients, most LUTS and urinary retention patients were caused by impaired bladder contraction. CONCLUSIONS This study shows the role and superiority of urodynamics in diagnosing patients with voiding disorders, especially if with mixed components in it. Urodynamics played essential roles in detecting urinary problems at Cipto Mangunkusumo Hospital.
Collapse
|
|
46
|
Salman M, Khan JH, Khan AH, Sulaiman SAS, Aslam Z, Asif N, Mustafa ZU, Hassan M, Saleem Z, Iqbal M. Prevalence and predictors of lower urinary tract symptoms in Pakistani men: A cross-sectional study. JOURNAL OF CLINICAL UROLOGY 2019. [DOI: 10.1177/2051415818815371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The purpose of this study was to investigate the prevalence and severity of the condition of lower urinary tract symptoms in Pakistani men, determine its predictors and assess its impact on the quality of life. Methods: A cross-sectional, population-based study was conducted among men aged 30 years and over in three districts of Punjab province, Pakistan. The modified Urdu version of the International Prostate Symptom Score was used to assess the prevalence and severity of lower urinary tract symptoms. Individuals with total symptom score ⩾8 were considered as having lower urinary tract symptoms. The data were analysed using SPSS version 22. The chi-square test and Mann-Whitney U test were used to assess the difference among categorical and continuous variables, respectively. Moreover, binary logistic regressions were performed to determine the predictors of lower urinary tract symptoms. Results: The overall prevalence of lower urinary tract symptoms in our sample was 33.7%. The frequency of individuals having mild, moderate and severe lower urinary tract symptoms was 66.3, 30.3 and 3.4%, respectively. Storage symptoms were more common than voiding symptoms (35.6% vs 28.2%, respectively). Increasing age (one-decade interval age stratum), higher education levels, working status (currently not working), smoking, hypertension, diabetes and renal impairment were positive predictors of lower urinary tract symptoms. Moreover, the condition of lower urinary tract symptoms was associated with a significant reduction in an individual’s quality of life. Conclusion: Around one-third of adult Pakistani men suffer from clinically relevant urinary symptoms, with lower urinary tract symptoms sufferers having poor quality of life as compared to non-sufferers. We recommend that the aging population should be made aware of conventional measures to mitigate mild urinary symptoms affecting their routine activities. Level of evidence: 2c
Collapse
Affiliation(s)
- M Salman
- Punjab University College of Pharmacy, University of the Punjab, Pakistan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Malaysia
| | - JH Khan
- National Hospital and Medical Center, Pakistan
| | - AH Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Malaysia
| | - SAS Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Malaysia
| | - Z Aslam
- Punjab University College of Pharmacy, University of the Punjab, Pakistan
| | - N Asif
- Punjab University College of Pharmacy, University of the Punjab, Pakistan
| | - ZU Mustafa
- Punjab University College of Pharmacy, University of the Punjab, Pakistan
| | - M Hassan
- Punjab University College of Pharmacy, University of the Punjab, Pakistan
| | - Z Saleem
- Punjab University College of Pharmacy, University of the Punjab, Pakistan
| | - M Iqbal
- Punjab University College of Pharmacy, University of the Punjab, Pakistan
| |
Collapse
|
|
47
|
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: 1.0] [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.
Collapse
|
|
48
|
Lademann M, Lademann M, Boeck Jensen A, Brunak S. Incorporating symptom data in longitudinal disease trajectories for more detailed patient stratification. Int J Med Inform 2019; 129:107-113. [PMID: 31445244 DOI: 10.1016/j.ijmedinf.2019.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/13/2019] [Accepted: 06/04/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Use symptoms to stratify temporal disease trajectories. MATERIALS AND METHODS We use data from the Danish National Patient Registry to stratify temporal disease pairs by the symptom distributions they associate to. The underlying data comprise of 6.6 million patients collectively assigned with 7.5 million symptoms from chapter XVIII in the WHO International Classification of Disease version 10 terminology. RESULTS We stratify 33 disease pairs into 67 temporal disease-symptom-disease trajectories from three main diagnoses (two diabetes subtypes and COPD), where the symptom significantly changes the risk of developing the subsequent diseases. We combine these trajectories into three temporal disease networks, one for each main diagnosis. We confirm apparent relations between diseases and symptoms and discovered that multiple symptoms decrease the risk for diabetes progression. CONCLUSION Symptoms can be used to stratify disease trajectories, and we suggest that this approach can be applied to temporal disease trajectories systematically using structured claims data. The method can be extended to also use text-mined symptoms from unstructured data in health records.
Collapse
Affiliation(s)
- Martin Lademann
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, DK-2200, Copenhagen, Denmark; Department of Pulmonary and Infection Medicine, Nordsjællands Hospital, DK-3400, Hillerød, Denmark
| | - Mette Lademann
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, DK-2200, Copenhagen, Denmark
| | - Anders Boeck Jensen
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, DK-2200, Copenhagen, Denmark; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029-5674, USA
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, DK-2200, Copenhagen, Denmark.
| |
Collapse
|
|
49
|
Verze P, Califano G, Sokolakis I, Russo GI, Hatzichristodoulou G, Musi G, Creta M. The impact of surgery for lower urinary tract symptoms/benign prostatic enlargement on both erectile and ejaculatory function: a systematic review. Int J Impot Res 2019; 31:319-327. [DOI: 10.1038/s41443-019-0140-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/09/2019] [Accepted: 03/21/2019] [Indexed: 11/09/2022]
|
|
50
|
Lower Urinary Tract Symptoms and Urinary Bother Are Common in Patients Undergoing Elective Cervical Spine Surgery. Clin Orthop Relat Res 2019; 477:872-878. [PMID: 30844824 PMCID: PMC6437367 DOI: 10.1097/corr.0000000000000666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) and urinary bother have been reported in adults undergoing surgery and have been associated with urinary tract infections, longer hospital stays, increased surgical costs, and decreased patient satisfaction. Previous reports indicate that up to one in two patients with lumbar spine pathology have moderate-to-severe LUTS, but little is known about LUTS in patients with cervical spine conditions. QUESTIONS/PURPOSES (1) What is the prevalence of moderate-to-severe LUTS and clinically relevant urinary bother among patients undergoing elective cervical spine surgery? (2) Does the presence of myelopathy affect frequency of moderate-to-severe LUTS or clinically relevant urinary bother among patients undergoing elective cervical spine surgery? (3) Do MRI findings of spinal cord injury or compression correlate with presence and severity of LUTS? METHODS We performed a cross-sectional study using clinical data collected from adult patients undergoing elective cervical spine surgery. Over an approximately 30-month period, we approached all patients who were evaluated in the preoperative clinic before undergoing elective cervical spine surgery. Of the 257 approached, 242 participated (94%). Study participants ranged in age from 34 to 83 years with a mean age of 58 years (SD 12). There were 108 males (45%) and 134 females (55%). A validated questionnaire, the International Prostate Symptom Score (IPSS), was used to identify LUTS. The IPSS score ranges from 0 to 35 points with LUTS presence defined as a score of ≥ 8 and LUTS severity categorized as mild (IPSS 0-7), moderate (IPSS 8-19), or severe (IPSS 20-35). Quality of life resulting from urinary bother is scored 0 to 6 with scores ≥ 4 considered clinically relevant urinary bother. Patients were grouped into a myelopathy group and a nonmyelopathy group based on diagnosis as assigned by the operating surgeon. MRIs were analyzed by one spine surgeon to identify the presence of cord signal, number of levels with cord compression (mm), and a calculated compression ratio score with cord compression and with compression ratio among patients with myelopathy. RESULTS The prevalence of moderate LUTS in our patient sample was 40% (97 of 242; 95% confidence interval [CI], 34%-47%). The prevalence of severe LUTS in our patient sample was 8% (19 of 242; 95% CI, 5%-12%). Clinically relevant urinary bother was reported in 18% of patients (41 of 228; 95% CI, 13%-24%). After adjustment for age and sex, the odds of moderate-to-severe LUTS among patients with myelopathy was greater than that observed in patients without myelopathy (adjusted odds ratio, 2.0; p = 0.015). The prevalence of clinically relevant urinary bother was higher in patients with myelopathy (30% [26 of 88]) compared with those with no myelopathy (11% [15 of 140]; p < 0.001). With the numbers available, among patients with myelopathy, there was no difference in distribution of LUTS symptom severity or IPSS score according to cord signal presence (50% [23 of 46]) and absence (65% [31 of 48]; p = 0.153), number of levels with compression (70% [seven of 10 with four levels]; 59% [13 of 22 with three levels]; 51% [19 of 37] with two levels; and 60% [15 of 25] with one level; p = 0.730), millimeters of cord compression (r = 0.02; p = 0.854), or compression ratio (r = 0.09; p = 0.413). CONCLUSIONS Nearly half of all patients undergoing elective cervical spine surgery had moderate-to-severe LUTS. This is more than double the prevalence that has been reported in a community-dwelling adult population. These symptoms can impair quality of life, lead to surgical complications (urinary retention or incontinence), and may be mistaken for cauda equina, prompting potentially unnecessary imaging and studies. Given that urinary bother is reported less frequently than LUTS, patients may be less likely to seek care for urinary symptoms before undergoing surgery. Therefore, it is important to increase provider awareness of the high prevalence of LUTS. LEVEL OF EVIDENCE Level III, prognostic study.
Collapse
|