LUTS: Lower Urinary Tract Symptoms最新文献

Retrospective Comparison of Postoperative Outcomes Between Elderly and Non-Elderly Patients With Benign Prostatic Enlargement Using Holmium Laser Enucleation and Transurethral Vaporization of the Prostate at Multiple High-Volume Centers

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-03-04 DOI: 10.1111/luts.70010

Hiroki Ito, Takuma Nirei, Takeshi Fukazawa, Hiroki Takizawa, Mari Hioki, Risa Shinoki, Yutaro Hayashi, Takashi Kawahara, Shuko Yoneyama, Kazuhide Makiyama, Akitoshi Takizawa, Kazuki Kobayashi

Objectives

This retrospective study aimed to compare the surgical outcomes of holmium laser enucleation of the prostate (HoLEP) and transurethral vaporization techniques between the elderly and nonelderly patients with benign prostatic enlargement (BPE).

Methods

We retrospectively analyzed clinical data from two regional centers that used HoLEP and transurethral vaporization techniques for BPE treatment. The study population consisted of male patients with lower urinary tract symptoms, divided into elderly and nonelderly groups.

Results

Total 477 of 872 patients remained in the study, of which 198 were classified as elderly (age ≥ 75 years) and 279 as non-elderly (age < 75 years). The postoperative decrease in IPSS was significantly lower in the elderly group, and advanced age was associated with less IPSS decline only after vaporization (p = 0.003) but not after HoLEP. In both surgeries, the duration of postoperative catheterization was significantly longer in the elderly group than in the non-elderly group, and hemoglobin drop at 1 day postoperatively showed no age-related difference. The most common complication after HoLEP was intermittent incontinence, which was more frequent in the elderly group (15.0%) than in the non-elderly group (6.2%, p = 0.038). Regardless of age, the overall rate of need for medication at 6 months postoperatively was significantly higher after HoLEP (32/190, 16.8%) than after transurethral vaporization (30/287, 10.5%) (p = 0.042). The need for medication was higher in the elderly for both HoLEP and vaporization than in the non-elderly group with a specific cutoff of age.

Conclusions

Elderly patients with BPE had relatively worse surgical outcomes, including a higher need for postoperative medications and prolonged catheterization. HoLEP demonstrated a reduction in IPSS regardless of age, and transurethral vaporization did not, although it was associated with a higher rate of intermittent incontinence.

{"title":"Retrospective Comparison of Postoperative Outcomes Between Elderly and Non-Elderly Patients With Benign Prostatic Enlargement Using Holmium Laser Enucleation and Transurethral Vaporization of the Prostate at Multiple High-Volume Centers","authors":"Hiroki Ito, Takuma Nirei, Takeshi Fukazawa, Hiroki Takizawa, Mari Hioki, Risa Shinoki, Yutaro Hayashi, Takashi Kawahara, Shuko Yoneyama, Kazuhide Makiyama, Akitoshi Takizawa, Kazuki Kobayashi","doi":"10.1111/luts.70010","DOIUrl":"https://doi.org/10.1111/luts.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This retrospective study aimed to compare the surgical outcomes of holmium laser enucleation of the prostate (HoLEP) and transurethral vaporization techniques between the elderly and nonelderly patients with benign prostatic enlargement (BPE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed clinical data from two regional centers that used HoLEP and transurethral vaporization techniques for BPE treatment. The study population consisted of male patients with lower urinary tract symptoms, divided into elderly and nonelderly groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total 477 of 872 patients remained in the study, of which 198 were classified as elderly (age ≥ 75 years) and 279 as non-elderly (age < 75 years). The postoperative decrease in IPSS was significantly lower in the elderly group, and advanced age was associated with less IPSS decline only after vaporization (<i>p</i> = 0.003) but not after HoLEP. In both surgeries, the duration of postoperative catheterization was significantly longer in the elderly group than in the non-elderly group, and hemoglobin drop at 1 day postoperatively showed no age-related difference. The most common complication after HoLEP was intermittent incontinence, which was more frequent in the elderly group (15.0%) than in the non-elderly group (6.2%, <i>p</i> = 0.038). Regardless of age, the overall rate of need for medication at 6 months postoperatively was significantly higher after HoLEP (32/190, 16.8%) than after transurethral vaporization (30/287, 10.5%) (<i>p</i> = 0.042). The need for medication was higher in the elderly for both HoLEP and vaporization than in the non-elderly group with a specific cutoff of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elderly patients with BPE had relatively worse surgical outcomes, including a higher need for postoperative medications and prolonged catheterization. HoLEP demonstrated a reduction in IPSS regardless of age, and transurethral vaporization did not, although it was associated with a higher rate of intermittent incontinence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Digit Length Ratio as an Indicator of Fetal Androgen Levels: Relationship to Prostate Volume-Related Men Lower Urinary Tract Symptoms

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-02-19 DOI: 10.1111/luts.70009

İsmail Emre Ergin, Abuzer Öztürk, Aydemir Asdemir

Objective

This study aimed to investigate the relationship between the 2nd and 4th digit ratios, which are associated with fetal androgen exposure, and prostate volume and testosterone levels, both of which are linked to lower urinary tract symptoms (LUTS).

Methods

Male patients presenting to our urology clinic with increased prostate volume and LUTS were categorized into two groups: those with BPH and those without (non-BPH). For both groups, the right-hand 2D:4D finger ratio, testosterone levels, prostate volume, uroflow parameters, and IPSS scores were recorded.

Results

The 2D:4D ratio, prostate volumes, Qmax, and IPSS scores differed significantly between the BPH and non-BPH groups (p = 0.023, 0.002, 0.000, 0.001). No significant difference was observed in total testosterone levels between the groups (p = 0.381). The 2D:4D ratio was negatively correlated with prostate volume and IPSS (r = −0.389, −0.308) and positively correlated with Qmax (r = 0.301).

Conclusions

Our study demonstrates that the 2D:4D ratio is a straightforward and effective tool for assessing BPH patients, as it correlates with the severity of LUTS symptoms. This non-invasive measure offers potential value in evaluating LUTS, and with age standardization, it could be applied more broadly across age groups. Further large-scale studies are needed to refine its standardization and expand upon current findings.

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引用次数: 0

The Effect of Providing Video-Animated Information to Female Patients With Stress Urinary Incontinence Before the Urodynamic Study on the Patient's Anxiety, Pain, Satisfaction, and Willingness to Repeat the Procedure

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-01-22 DOI: 10.1111/luts.70007

Recep Burak Degirmentepe, Muammer Bozkurt, Eyyup Danis, Deniz Gul, Yasir Muhammed Akca, Haci Ibrahim Cimen, Fikret Halis

Objectives

To investigate the effect of providing video-animated information to female patients with stress urinary incontinence before urodynamics on the patient's anxiety, pain, satisfaction, and willingness to repeat the procedure.

Methods

Before the procedure, patients were divided into two groups with 1:1 randomization. While one group was given written and verbal information, the other group was additionally given animated video information accompanied by a doctor. Pre-procedure anxiety, hemodynamic parameters during the procedure, as well as post-procedure pain, satisfaction and willingness to repeat the procedure were compared between the groups.

Results

STAI-s levels were found to be statistically significantly lower in the group given video animation information before urodynamics (p < 0.01). It was observed that video information had a positive effect on systolic blood pressure, diastolic blood pressure and heart rate, and the values were measured lower compared to the other group (p < 0.01). While there was no statistically significant difference between the two groups in VAS-pain scores (p = 0.82), VAS-satisfaction and VAS-willingness to repeat the procedure scores were found to be statistically significantly different (p < 0.01). It was observed that video-animated information made a positive contribution to satisfaction and willingness to repeat the procedure.

Conclusions

Video-animated information given to female patients before urodynamics has positive effects on the patient's anxiety. It also contributes positively to the patient's satisfaction and their willingness to repeat the procedure. Video-animated information may be used routinely in addition to written and verbal information before urodynamics.

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引用次数: 0

Usefulness of Mesh Reinforcement in Pubic Fixation Urethral Sling Surgery for Urinary Incontinence After Radical Prostatectomy 补片加固在根治性前列腺切除术后尿失禁的耻骨固定尿道吊带手术中的应用。

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-01-21 DOI: 10.1111/luts.70003

Yasutomo Suzuki, Naoto Hodotsuka, Eigo Kuribayashi, Kyota Suzuki, Yuichiro Honda, Shuma Endo, Yukihiro Kondo

Objectives

In our institution, a unique sling technique is performed for urinary incontinence after radical prostatectomy. However, in cases of severe urinary incontinence or in the medium to long term, the therapeutic effect may be insufficient. Therefore, a urethral sling technique that provides stronger compression of the bulbar urethra was developed, and its effectiveness was compared with the conventional technique.

Methods

Seventeen cases of conventional sling surgery and 16 cases of improved sling surgery were included. The number of pads used per day, safety pad rate, and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were evaluated before and after surgery, and a retrospective comparison was made between the two groups. Furthermore, patients were divided into those who used ≤ 4 pads per day before surgery and those who used ≥ 5 pads per day, and the difference between the two groups was examined. We also examined changes over time between groups.

Results

Compared with the conventional group, the improved group showed significant improvement in the number of pads per day, safety pad rate, and ICIQ-SF 18 months after surgery. In the group with ≤ 4 preoperative pads, the improved group showed significant improvement in all safety pad rates except at 1 and 12 months after surgery. There were no significant differences in all items between the two groups when the number of preoperative pads was ≥ 5.

Conclusions

The improved urethral sling technique appeared to contribute to improving moderate urinary incontinence by adding a simple procedure, especially for patients using ≤ 4 pads per day.

目的：在我们的机构，一种独特的吊带技术用于根治性前列腺切除术后尿失禁。然而，在严重尿失禁或中长期的情况下，治疗效果可能不足。因此，我们开发了一种对球尿道有更强压迫的尿道吊带技术，并与常规技术进行了效果比较。方法：选取17例常规吊带手术和16例改良吊带手术。评估两组患者术前、术后每日使用垫数、安全垫率、国际尿失禁咨询问卷简表（ICIQ-SF），并进行回顾性比较。并将患者分为术前每天使用≤4个垫片组和每天使用≥5个垫片组，比较两组患者的差异。我们还研究了各组之间随时间的变化。结果：与常规组比较，改良组术后18个月每日垫片次数、安全垫率、ICIQ-SF均有显著改善。在术前垫≤4块的组中，除术后1个月和12个月外，改良组的所有安全垫率均有显著提高。术前垫片数≥5个时，两组间各项指标均无显著差异。结论：改进后的尿道吊带技术通过增加一个简单的操作有助于改善中度尿失禁，特别是对于每天使用≤4个尿垫的患者。

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引用次数: 0

Predicting Elevated Postvoid Residual Urine Volume Following OnabotulinumtoxinA Treatment for Overactive Bladder: A Pilot Study 一项初步研究：肉毒杆菌毒素治疗过度活跃膀胱后残留尿量的预测。

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-01-12 DOI: 10.1111/luts.70004

Israel Franco, Marc Schwartz, Kevin Cline, David Glazier, Anand Patel

Objectives

To evaluate possible predictors of elevated postvoid residual volume (PVR) following onabotulinumtoxinA administration in patients with idiopathic overactive bladder (OAB), a condition that may include urinary urgency, frequency, and nocturia, without any identifiable cause or underlying neurological or metabolic condition.

Methods

Adults who had been treated with 100–200 U onabotulinumtoxinA for OAB and had previous failure of other OAB treatments were identified by retrospective review of medical chart data from three urology clinics in the United States treating patients with a variety of urological conditions. A total of 211 patients were allocated to cohorts based on posttreatment PVR < 200 mL (n = 173) and ≥ 200 mL (n = 38). Logistic regression analyses were performed to evaluate potential predictors of posttreatment PVR ≥ 200 mL, including pretreatment peak urine flow rate (Qmax), average urine flow rate (Qavg), and Modified Liverpool Qmax and Qavg flow index (FI), and to determine whether patient age and baseline PVR were associated with the likelihood of PVR ≥ 200 mL. Patients were excluded if symptoms of OAB were secondary to a neurological condition, they had a PVR > 200 mL within 2 weeks prior to the index therapy or had been treated with other botulinum toxin formulations for a urinary condition.

Results

In the predictor analyses, neither Qmax nor Qavg alone was a likely predictor. Odds ratios of PVR ≥ 200 mL for Modified Liverpool Qmax FI and Qavg were 0.30 (95% CI: 0.08–0.91; p = 0.0488) and 0.07 (95% CI 0.01–0.40; p = 0.0045), respectively. When patient age and baseline PVR were incorporated into the analyses, results suggested that Qmax, Qavg, Qmax FI, and Qavg FI, as well as increased age and baseline PVR, were likely predictors of elevated posttreatment PVR.

Conclusions

Patients who are older, have high pretreatment PVR values, and have lower pretreatment urine flow indexes and flows may be at increased risk of developing elevated PVR after receiving onabotulinumtoxinA treatment for OAB.

目的：评估对特发性膀胱过动症（OAB）患者服用肉毒杆菌毒素后膀胱后残留体积（PVR）升高的可能预测因素，这种情况可能包括尿急、尿频和夜尿症，没有任何可识别的原因或潜在的神经或代谢问题。方法：通过对美国三家泌尿外科诊所治疗各种泌尿系统疾病患者的病历数据进行回顾性分析，确定了接受过100- 200u肉毒杆菌毒素治疗OAB的成年人，并且之前曾接受过其他OAB治疗失败。共有211名患者在指数治疗前2周内根据治疗后PVR 200 mL或已接受其他肉毒杆菌毒素制剂治疗泌尿系统疾病的患者分配到队列。结果：在预测分析中，单独的Qmax和Qavg都不是一个可能的预测因子。改良利物浦Qmax FI和Qavg的PVR≥200 mL的优势比为0.30 (95% CI: 0.08-0.91；p = 0.0488)和0.07 (95% CI 0.01-0.40；P = 0.0045)。当将患者年龄和基线PVR纳入分析时，结果表明Qmax、Qavg、Qmax FI和Qavg FI以及年龄和基线PVR的增加可能是治疗后PVR升高的预测因素。结论：年龄较大、预处理PVR值较高、预处理尿流指数和尿流量较低的患者在接受肉毒杆菌毒素a治疗OAB后发生PVR升高的风险增加。

{"title":"Predicting Elevated Postvoid Residual Urine Volume Following OnabotulinumtoxinA Treatment for Overactive Bladder: A Pilot Study","authors":"Israel Franco, Marc Schwartz, Kevin Cline, David Glazier, Anand Patel","doi":"10.1111/luts.70004","DOIUrl":"10.1111/luts.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate possible predictors of elevated postvoid residual volume (PVR) following onabotulinumtoxinA administration in patients with idiopathic overactive bladder (OAB), a condition that may include urinary urgency, frequency, and nocturia, without any identifiable cause or underlying neurological or metabolic condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults who had been treated with 100–200 U onabotulinumtoxinA for OAB and had previous failure of other OAB treatments were identified by retrospective review of medical chart data from three urology clinics in the United States treating patients with a variety of urological conditions. A total of 211 patients were allocated to cohorts based on posttreatment PVR < 200 mL (<i>n</i> = 173) and ≥ 200 mL (<i>n</i> = 38). Logistic regression analyses were performed to evaluate potential predictors of posttreatment PVR ≥ 200 mL, including pretreatment peak urine flow rate (Qmax), average urine flow rate (Qavg), and Modified Liverpool Qmax and Qavg flow index (FI), and to determine whether patient age and baseline PVR were associated with the likelihood of PVR ≥ 200 mL. Patients were excluded if symptoms of OAB were secondary to a neurological condition, they had a PVR > 200 mL within 2 weeks prior to the index therapy or had been treated with other botulinum toxin formulations for a urinary condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the predictor analyses, neither Qmax nor Qavg alone was a likely predictor. Odds ratios of PVR ≥ 200 mL for Modified Liverpool Qmax FI and Qavg were 0.30 (95% CI: 0.08–0.91; <i>p</i> = 0.0488) and 0.07 (95% CI 0.01–0.40; <i>p</i> = 0.0045), respectively. When patient age and baseline PVR were incorporated into the analyses, results suggested that Qmax, Qavg, Qmax FI, and Qavg FI, as well as increased age and baseline PVR, were likely predictors of elevated posttreatment PVR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients who are older, have high pretreatment PVR values, and have lower pretreatment urine flow indexes and flows may be at increased risk of developing elevated PVR after receiving onabotulinumtoxinA treatment for OAB.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laser-Driven Dissection Achieves Earlier Continence Recovery Than Blunt Dissection During Holmium Laser Enucleation of the Prostate 钬激光前列腺摘除术中，激光驱动解剖比钝性解剖更早恢复失禁。

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-01-09 DOI: 10.1111/luts.70006

Ahmed M. Harraz, Saad Aldousari, Abdelrahman I. Eltafahny, Ali Almoumen, Awad Thahir, Feras Ajrawi, Abdullah Alarbid, Ahmad Alghurair, Mohammad Alghanem, Faisal Alhajeri

Objectives

During holmium laser enucleation of the prostate (HOLEP), blunt dissection (BD) by pushing the tip of the scope may exert mechanical force on the sphincter that could be avoided by adopting laser dissection (LD). This study evaluates the continence recovery in consecutive patients who underwent BD and LD.

Methods

A prospective cohort of patients who underwent LD was compared with a retrospective control that underwent BD. In both groups, early apical release was performed, and the adenoma was split at 12 O'clock after complete enucleation. In LD, a trans-capsular plane was sharply created by LD and is guided by the circular capsular fibers. A mechanical push with the resectoscope tip was used to create and maintain the ideal surgical plane in the BD group while the laser energy was used to achieve timely hemostasis. The primary outcome was stress urinary incontinence (SUI), defined as the need to use any number of pads, immediately after catheter removal, at 1 week and 1 month postoperatively.

Results

Consecutive 51 (48.6%) and 54 (51.4%) patients underwent BD and LD, respectively. The LD group tends to be older while other demographics were comparable. Both groups were comparable regarding the estimated prostate volume, enucleation time, and postoperative resolution of symptoms. Continence recovery was in favor of the LD group immediately after removing the catheter (77.8% vs. 43.1%; p < 0.001), at 1 week (92.6% vs. 66.7%; p = 0.002), with no significant difference at 1 month (98.1% vs. 88.2%; p = 0.06).

Conclusions

LD tends to have favorable early continence recovery compared with BD mostly because of less mechanical stress. Minimizing the periods of blunt pushes during the enucleation might benefit continence recovery.

目的：钬激光前列腺摘除术（HOLEP）中，推镜尖端钝性剥离术（BD）对括约肌产生机械力，而激光剥离术（LD）可避免这种情况。本研究评估连续BD和LD患者的尿失禁恢复情况。方法：将LD患者的前瞻性队列与BD患者的回顾性对照进行比较。两组患者均进行早期根尖释放，并在完全去核后12点分离腺瘤。在LD中，LD形成了一个由环形囊纤维引导的跨囊平面。BD组采用切除镜尖端的机械推力来创造和维持理想的手术平面，同时利用激光能量实现及时止血。主要结局是压力性尿失禁（SUI），定义为在拔管后立即、术后1周和1个月需要使用任意数量的尿垫。结果：连续51例（48.6%）和54例（51.4%）患者分别接受了BD和LD治疗。LD群体往往年龄较大，而其他人口统计数据也差不多。两组在前列腺体积、摘除时间和术后症状缓解方面具有可比性。LD组在拔除导管后立即恢复尿失禁(77.8% vs 43.1%；结论：LD较BD有较好的早期失禁恢复，主要原因是机械应力较小。在摘除术中尽量减少钝推的时间可能有利于失禁的恢复。

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引用次数: 0

The Autologous Fascial Pubovaginal Sling for Recurrent Stress Incontinence: A Retrospective Study 自体耻骨阴道筋膜吊带治疗复发性应力性尿失禁的回顾性研究。

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-01-09 DOI: 10.1111/luts.70000

Jin-Yang Luo, Si-Hong Shen, Zhen-Yang Ye, Li-Jing Xu, Jia-Wei Chen, Liao Peng, Hong Shen, De-Yi Luo

Aim

This study aimed to analyze the clinical efficacy and safety of autologous fascial pubovaginal sling (AFPVS) surgery in treating recurrent stress urinary incontinence (SUI) following the failure of mid-urethral sling procedures.

Methods

A retrospective analysis was conducted on the clinical data of SUI patients who underwent AFPVS at our hospital between 2008 June and 2024 June following the failure of mid-urethral sling procedures. The analysis included basic information, surgical parameters, and postoperative complications. Additionally, telephone interviews using the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) and the Incontinence Quality of Life Questionnaire (I-QOL) was conducted at 6-month follow-up.

Results

Thirty-four patients with the mean age of 54.8 ± 15.7 years old were reviewed, and the median disease duration was 3 (2–10) years. Of the 34 patients, 20 (58.8%) were cured, 8 (23.5%) showed improvement, resulting in an overall effectiveness rate of 82.3%. Three cases experienced bladder injury, which resolved after 2 weeks of catheterization, but no patients had urethral or vaginal injuries intraoperatively. Postoperative scores on the ICI-Q-SF significantly decreased (p < 0.001), and postoperative I-QOL scores significantly increased (p < 0.001) compared to preoperative scores.

Conclusion

AFPVS is a safe and effective salvage procedure for recurrent SUI following the failure of mid-urethral sling procedures.

目的：本研究旨在分析自体耻骨阴道筋膜悬吊（AFPVS）手术治疗中尿道悬吊失败后复发性应激性尿失禁（SUI）的临床疗效和安全性。方法：回顾性分析2008年6月至2024年6月在我院行尿道中悬吊失败的SUI患者AFPVS的临床资料。分析包括基本信息、手术参数和术后并发症。此外，在随访6个月时，使用国际失禁咨询问卷-短表（ICI-Q-SF）和失禁生活质量问卷（I-QOL）进行电话访谈。结果：纳入34例患者，平均年龄54.8±15.7岁，中位病程3（2-10）年。34例患者中治愈20例（58.8%），好转8例（23.5%），总有效率82.3%。3例患者出现膀胱损伤，术后2周膀胱损伤消退，术中无患者出现尿道或阴道损伤。结论：AFPVS是尿道中悬吊失败后复发性SUI的一种安全有效的抢救手术。

{"title":"The Autologous Fascial Pubovaginal Sling for Recurrent Stress Incontinence: A Retrospective Study","authors":"Jin-Yang Luo, Si-Hong Shen, Zhen-Yang Ye, Li-Jing Xu, Jia-Wei Chen, Liao Peng, Hong Shen, De-Yi Luo","doi":"10.1111/luts.70000","DOIUrl":"10.1111/luts.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to analyze the clinical efficacy and safety of autologous fascial pubovaginal sling (AFPVS) surgery in treating recurrent stress urinary incontinence (SUI) following the failure of mid-urethral sling procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on the clinical data of SUI patients who underwent AFPVS at our hospital between 2008 June and 2024 June following the failure of mid-urethral sling procedures. The analysis included basic information, surgical parameters, and postoperative complications. Additionally, telephone interviews using the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) and the Incontinence Quality of Life Questionnaire (I-QOL) was conducted at 6-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four patients with the mean age of 54.8 ± 15.7 years old were reviewed, and the median disease duration was 3 (2–10) years. Of the 34 patients, 20 (58.8%) were cured, 8 (23.5%) showed improvement, resulting in an overall effectiveness rate of 82.3%. Three cases experienced bladder injury, which resolved after 2 weeks of catheterization, but no patients had urethral or vaginal injuries intraoperatively. Postoperative scores on the ICI-Q-SF significantly decreased (<i>p</i> < 0.001), and postoperative I-QOL scores significantly increased (<i>p</i> < 0.001) compared to preoperative scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AFPVS is a safe and effective salvage procedure for recurrent SUI following the failure of mid-urethral sling procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and Safety of Silodosin for the Treatment of Female LUTS: A 12-Week Prospective, Single-Center Study

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-01-07 DOI: 10.1111/luts.70005

Chung Beum Wee, Tae-Hyoung Kim, Jong Hyun Tae, Se Young Choi

Objectives

This study aimed to evaluate the clinical efficacy and safety of silodosin in female patients with lower urinary tract symptoms (LUTSs), addressing the limited evidence supporting alpha-blocker use in this population.

Methods

A 12-week, single-arm, prospective, open-label study was conducted from May 2021 to January 2023. Female patients aged over 18 with an International Prostate Symptom Score (IPSS) ≥ 8 were enrolled and treated with silodosin (8 mg once daily). Primary endpoints included changes in IPSS from baseline to 12 weeks. Secondary endpoints assessed IPSS quality of life (QOL), Overactive Bladder Symptom Score (OABSS), maximal urinary flow rate (Q max), and residual urine (RU).

Results

Ninety-five patients were enrolled, with 85 included in the analysis. After 12 weeks, the mean total IPSS significantly decreased from 18.65 ± 6.89 at baseline to 12.54 ± 5.28 (p < 0.001). IPSS-QOL improved from 4.14 ± 1.01 to 3.12 ± 0.79 (p < 0.001). OABSS decreased from 6.89 ± 3.41 to 4.28 ± 2.39 (p < 0.001), and RU reduced from 51.39 ± 55.38 to 29.95 ± 29.83 mL (p < 0.001). Q max increased from 13.96 ± 6.74 to 16.48 ± 6.09 mL/s (p < 0.001), while voiding volume increased from 163.02 ± 70.53 to 176.12 ± 47.16 mL (p = 0.026). Silodosin was well tolerated, with no serious adverse events noted.

Conclusions

Silodosin demonstrates efficacy and safety in treating female patients with moderate-to-severe LUTS, suggesting that it can be considered a viable treatment option alongside established therapies. Further studies are warranted to confirm these findings.

{"title":"Efficacy and Safety of Silodosin for the Treatment of Female LUTS: A 12-Week Prospective, Single-Center Study","authors":"Chung Beum Wee, Tae-Hyoung Kim, Jong Hyun Tae, Se Young Choi","doi":"10.1111/luts.70005","DOIUrl":"https://doi.org/10.1111/luts.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the clinical efficacy and safety of silodosin in female patients with lower urinary tract symptoms (LUTSs), addressing the limited evidence supporting alpha-blocker use in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 12-week, single-arm, prospective, open-label study was conducted from May 2021 to January 2023. Female patients aged over 18 with an International Prostate Symptom Score (IPSS) ≥ 8 were enrolled and treated with silodosin (8 mg once daily). Primary endpoints included changes in IPSS from baseline to 12 weeks. Secondary endpoints assessed IPSS quality of life (QOL), Overactive Bladder Symptom Score (OABSS), maximal urinary flow rate (Q max), and residual urine (RU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-five patients were enrolled, with 85 included in the analysis. After 12 weeks, the mean total IPSS significantly decreased from 18.65 ± 6.89 at baseline to 12.54 ± 5.28 (<i>p</i> < 0.001). IPSS-QOL improved from 4.14 ± 1.01 to 3.12 ± 0.79 (<i>p</i> < 0.001). OABSS decreased from 6.89 ± 3.41 to 4.28 ± 2.39 (<i>p</i> < 0.001), and RU reduced from 51.39 ± 55.38 to 29.95 ± 29.83 mL (<i>p</i> < 0.001). Q max increased from 13.96 ± 6.74 to 16.48 ± 6.09 mL/s (<i>p</i> < 0.001), while voiding volume increased from 163.02 ± 70.53 to 176.12 ± 47.16 mL (<i>p</i> = 0.026). Silodosin was well tolerated, with no serious adverse events noted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Silodosin demonstrates efficacy and safety in treating female patients with moderate-to-severe LUTS, suggesting that it can be considered a viable treatment option alongside established therapies. Further studies are warranted to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of the 3-Year Continuation Rate and Discontinuation Factors Between Vibegron and Mirabegron in Patients With Overactive Bladder: A Retrospective Follow-Up Study in a Rehabilitation Hospital in Japan 日本一家康复医院的回顾性随访研究：威比格隆与美拉贝格隆治疗膀胱过动症患者3年延续率及停药因素的比较

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-12-04 DOI: 10.1111/luts.70001

Shigeto Mukai, Masashi Nomi, Akihiro Yanagiuchi, Atsushi Sengoku

Objectives

The objective of this study is to compare the 3-year continuation rate and discontinuation factors between vibegron and mirabegron in patients with overactive bladder in a rehabilitation hospital in Japan.

Methods

The 3-year continuation rate of the target drugs and reasons for discontinuation as well as patients' backgrounds and adverse effects were evaluated retrospectively from the medical records between September 2018 and December 2020. After selecting patients according to our inclusion and exclusion criteria, 136 cases taking mirabegron and 82 taking vibegron were adjusted for intergroup variability by propensity score matching. We performed Cox proportional hazards regression for the 3-year continuation rate and Fine-Gray proportional hazards regression for the 3-year cumulative incidence of discontinuation events. Subgroup analysis was also performed.

Results

Approximately 70% of the patients analyzed had neurogenic overactive bladder. The 3-year continuation rate was 65.2% in vibegron and 30.3% in mirabegron, and the hazard ratio was 0.41 (95% confidence interval: 0.25–0.68, p < 0.001) as for an incidence of discontinuation events of vibegron against mirabegron. The incidence of discontinuation due to inadequate efficacy was 22.7% in vibegron and 47.0% in mirabegron, and similarly the hazard ratio was 0.43 (95% confidence interval: 0.23–0.80, p < 0.01). In the subgroup analysis, vibegron continued significantly more than mirabegron for the 3-year continuation rate in non-neurogenic overactive bladder (p < 0.001), in spontaneous voiding (p < 0.001), in anticholinergic combination (p = 0.0017), in female (p < 0.001), and in 70 years or older (p = 0.0028). Additionally, a significant interaction was observed regarding the methods of emptying urine (p = 0.0066).

Conclusions

Vibegron was superior to mirabegron in the 3-year continuation rate of administration with a fewer discontinuation due to inadequate efficacy in a patient population with relatively high rates of neurogenic overactive bladder.

目的：本研究的目的是比较日本一家康复医院治疗膀胱过动症患者的维比格龙和米拉贝格龙的3年延续率和停药因素。方法：回顾性分析2018年9月至2020年12月的病历资料，评估目标药物的3年延续率、停药原因、患者背景和不良反应。根据我们的纳入和排除标准选择患者后，通过倾向评分匹配调整136例米拉比格龙和82例威比格龙组间变异性。我们对3年持续率进行了Cox比例风险回归，对3年累计停药事件发生率进行了Fine-Gray比例风险回归。并进行亚组分析。结果：约70%的患者为神经源性膀胱过动症。vibegron的3年延续率为65.2%，mirabegron的3年延续率为30.3%，风险比为0.41（95%可信区间：0.25-0.68,p）。结论：在神经源性膀胱过度活跃率相对较高的患者群体中，vibegron的3年延续率优于mirabegron，且较少因疗效不足而停药。

{"title":"Comparison of the 3-Year Continuation Rate and Discontinuation Factors Between Vibegron and Mirabegron in Patients With Overactive Bladder: A Retrospective Follow-Up Study in a Rehabilitation Hospital in Japan","authors":"Shigeto Mukai, Masashi Nomi, Akihiro Yanagiuchi, Atsushi Sengoku","doi":"10.1111/luts.70001","DOIUrl":"10.1111/luts.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to compare the 3-year continuation rate and discontinuation factors between vibegron and mirabegron in patients with overactive bladder in a rehabilitation hospital in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 3-year continuation rate of the target drugs and reasons for discontinuation as well as patients' backgrounds and adverse effects were evaluated retrospectively from the medical records between September 2018 and December 2020. After selecting patients according to our inclusion and exclusion criteria, 136 cases taking mirabegron and 82 taking vibegron were adjusted for intergroup variability by propensity score matching. We performed Cox proportional hazards regression for the 3-year continuation rate and Fine-Gray proportional hazards regression for the 3-year cumulative incidence of discontinuation events. Subgroup analysis was also performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 70% of the patients analyzed had neurogenic overactive bladder. The 3-year continuation rate was 65.2% in vibegron and 30.3% in mirabegron, and the hazard ratio was 0.41 (95% confidence interval: 0.25–0.68, <i>p</i> < 0.001) as for an incidence of discontinuation events of vibegron against mirabegron. The incidence of discontinuation due to inadequate efficacy was 22.7% in vibegron and 47.0% in mirabegron, and similarly the hazard ratio was 0.43 (95% confidence interval: 0.23–0.80, <i>p</i> < 0.01). In the subgroup analysis, vibegron continued significantly more than mirabegron for the 3-year continuation rate in non-neurogenic overactive bladder (<i>p</i> < 0.001), in spontaneous voiding (<i>p</i> < 0.001), in anticholinergic combination (<i>p</i> = 0.0017), in female (<i>p</i> < 0.001), and in 70 years or older (<i>p</i> = 0.0028). Additionally, a significant interaction was observed regarding the methods of emptying urine (<i>p</i> = 0.0066).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vibegron was superior to mirabegron in the 3-year continuation rate of administration with a fewer discontinuation due to inadequate efficacy in a patient population with relatively high rates of neurogenic overactive bladder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initial Experience of Contact Laser Vaporization of the Prostate Using the New Type of Fiber for Benign Prostatic Hyperplasia in a Single Institution 新型纤维接触激光汽化前列腺治疗良性前列腺增生的初步经验。

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-12-04 DOI: 10.1111/luts.70002

Fukashi Yamamichi, Takaaki Inoue, Masaichiro Fujita, Koki Tominaga, Yousuke Yamashita, Masato Fujisawa

Objectives

The objective of this study is to evaluate our initial experience with contact laser vaporization of the prostate (CVP) using the new type of fiber for benign prostatic hyperplasia (BPH).

Methods

We retrospectively evaluated 43 patients in whom CVP was performed using the new type of fiber from October 2020 to December 2021 at our institution. Total International Prostate Symptom Score (IPSS), IPSS voiding, IPSS storage, IPSS postmicturition, quality of life (QOL) index, maximum urinary flow rate (Qmax), and postvoid residual urine (PVR) were evaluated preoperatively and at 1, 3, 6, and 12 months postoperatively. Prostate volume was assessed preoperatively and at 12 months postoperatively. Complications were also evaluated.

Results

Total IPSS, IPSS voiding, IPSS postmicturition, QOL index, and PVR showed significant improvement at 1 month postoperatively. IPSS storage showed significant improvement at 3 months postoperatively (p = 0.001), and Qmax showed significant improvement at 6 months postoperatively (p = 0.021). The preoperative prostate volume was 87.8 (65.0–116.7) ml and significantly decreased to 80.5 (42.6–97.4) ml at 12 months postoperatively (p = 0.002). The complications were acute prostatitis (9.3%) and temporary urinary retention (7.0%).

Conclusion

CVP using the new type of fiber was found to be a minimally invasive surgical procedure. There were no severe complications, and the short-term outcomes were favorable.

目的：本研究的目的是评估我们使用新型纤维治疗良性前列腺增生（BPH）的接触性激光汽化前列腺（CVP）的初步经验。方法：我们回顾性评估了2020年10月至2021年12月在我院使用新型纤维进行CVP的43例患者。术前及术后1、3、6、12个月评估国际前列腺症状总分（IPSS）、IPSS排尿、IPSS储存、IPSS排尿、生活质量（QOL）指数、最大尿流率（Qmax）、空后残留尿（PVR）。术前和术后12个月评估前列腺体积。并发症也进行了评估。结果：术后1个月IPSS总分、IPSS排尿、IPSS排尿、生活质量指数、PVR均有明显改善。IPSS存储在术后3个月有显著改善（p = 0.001）， Qmax在术后6个月有显著改善（p = 0.021）。术前前列腺体积为87.8 (65.0-116.7)ml，术后12个月降至80.5 (42.6-97.4)ml，差异有统计学意义（p = 0.002）。并发症为急性前列腺炎（9.3%）和暂时性尿潴留（7.0%）。结论：新型纤维CVP是一种微创的手术方法。无严重并发症，短期疗效良好。

{"title":"Initial Experience of Contact Laser Vaporization of the Prostate Using the New Type of Fiber for Benign Prostatic Hyperplasia in a Single Institution","authors":"Fukashi Yamamichi, Takaaki Inoue, Masaichiro Fujita, Koki Tominaga, Yousuke Yamashita, Masato Fujisawa","doi":"10.1111/luts.70002","DOIUrl":"10.1111/luts.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to evaluate our initial experience with contact laser vaporization of the prostate (CVP) using the new type of fiber for benign prostatic hyperplasia (BPH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively evaluated 43 patients in whom CVP was performed using the new type of fiber from October 2020 to December 2021 at our institution. Total International Prostate Symptom Score (IPSS), IPSS voiding, IPSS storage, IPSS postmicturition, quality of life (QOL) index, maximum urinary flow rate (Qmax), and postvoid residual urine (PVR) were evaluated preoperatively and at 1, 3, 6, and 12 months postoperatively. Prostate volume was assessed preoperatively and at 12 months postoperatively. Complications were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total IPSS, IPSS voiding, IPSS postmicturition, QOL index, and PVR showed significant improvement at 1 month postoperatively. IPSS storage showed significant improvement at 3 months postoperatively (<i>p</i> = 0.001), and Qmax showed significant improvement at 6 months postoperatively (<i>p</i> = 0.021). The preoperative prostate volume was 87.8 (65.0–116.7) ml and significantly decreased to 80.5 (42.6–97.4) ml at 12 months postoperatively (<i>p</i> = 0.002). The complications were acute prostatitis (9.3%) and temporary urinary retention (7.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CVP using the new type of fiber was found to be a minimally invasive surgical procedure. There were no severe complications, and the short-term outcomes were favorable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0