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LUTS: Lower Urinary Tract Symptoms最新文献

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How international is the International Prostate Symptom Score? A literature review of validated translations of the IPSS, the most widely used self-administered patient questionnaire for male lower urinary tract symptoms. 国际前列腺症状评分有多国际化?IPSS是最广泛使用的男性下尿路症状自我管理的患者问卷。
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-03-01 Epub Date: 2021-11-03 DOI: 10.1111/luts.12415
Mark W Yao, James S A Green

Objectives: The International Prostate Symptom Score (IPSS) approaches its 30th anniversary. This ubiquitous clinical assessment tool is a standard in the assessment and research of lower urinary tract symptoms in men. The authors explore its history, development, and subsequent dissemination through validated translations across the world. An estimated global coverage is calculated and mapped according to language population.

Methods: Embase and Medline literature searches were performed, with further hand searches of grey literature and online resources. Twenty-two abstracts and journal articles validating language translations of the IPSS were reviewed in full and tabulated. Language population data were gathered from an official database and mapped.

Results: The IPSS is available in 53 languages. Twenty-seven languages have statistically or clinically validated translations for use in male patients. This corresponds to a conservative estimate of global population coverage of approximately 2.3 billion men, or 60% of the worldwide male population. Translation methodology involves forward and back translation. Statistical validation is performed with control patients. Cronbach's alpha is used for internal consistency, and Spearman's coefficient (p) or Pearson's coefficient (r) for test-retest reliability. Issues such as the emergence of altered versions deviating from original validated translations and translation difficulties due to cultural differences are observed. Further translational work is needed to validate versions of the IPSS in languages of the developing world.

Conclusions: The IPSS is the most prevalent patient-administered questionnaire used in urology across the world. There is no other clinical tool seen to have similar coverage. This paper aims to provide a roadmap for future clinical tools to acquire a similar level of translation and dissemination.

目的:国际前列腺症状评分(IPSS)即将迎来30周年。这种无处不在的临床评估工具是评估和研究男性下尿路症状的标准。作者探讨了它的历史,发展和随后的传播通过验证翻译在世界各地。根据语言人口计算和绘制估计的全球覆盖范围。方法:采用Embase和Medline文献检索,并进一步手工检索灰色文献和网络资源。对22篇验证IPSS语言翻译的摘要和期刊文章进行了完整的审查和制表。语言人口数据是从官方数据库收集并绘制的。结果:IPSS有53种语言版本。27种语言有统计或临床验证的翻译,用于男性患者。这相当于对全球人口覆盖率的保守估计,约为23亿男性,或全球男性人口的60%。翻译方法论包括正向翻译和反向翻译。对对照患者进行统计验证。内部一致性采用Cronbach’s alpha,重测信度采用Spearman’s系数(p)或Pearson’s系数(r)。我们观察到一些问题,如出现偏离原始译文的修改版本,以及由于文化差异造成的翻译困难。需要进一步的翻译工作来验证发展中国家语言的IPSS版本。结论:IPSS是全世界泌尿外科最普遍的患者管理问卷。目前还没有其他临床工具具有类似的覆盖范围。本文旨在为未来的临床工具提供一个路线图,以获得类似水平的翻译和传播。
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引用次数: 8
Does urinary urgency drive urinary frequency in overactive bladder? 膀胱过动症患者尿急导致尿频吗?
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-02-28 DOI: 10.1111/luts.12427
E. Versi, E. Rovner, R. Dmochowski, L. Tu, S. de Wachter
To determine if reduction in urgency in patients with refractory overactive bladder syndrome (rOAB) is correlated with a reduction in voiding frequency and symptom bother.
确定难治性膀胱过度活动综合征(rOAB)患者急症的减轻是否与排尿频率和症状困扰的减少相关。
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引用次数: 1
Hypothyroidism is prevalent among adult women with chronic lower urinary tract symptoms 甲状腺功能减退症常见于慢性下尿路症状的成年女性
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-02-27 DOI: 10.1111/luts.12428
M. Zargham, Mohammad-Reza Hajian, F. Alizadeh, Mohammad-Javad Eslami, Noushin Khalili Boroujeni, Farshad Gholipour
To define the prevalence of hypothyroidism in women with chronic lower urinary tract symptoms (LUTS) and to compare the severity of each symptom between patients with hypothyroidism and controls.
定义慢性下尿路症状(LUTS)女性甲状腺功能减退的患病率,并比较甲状腺功能减退患者和对照组之间每种症状的严重程度。
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引用次数: 2
Influence of background characteristics in responders of regenerative therapy by periurethral injection of adipose‐derived regenerative cells for male stress urinary incontinence 尿道周围注射脂肪源性再生细胞治疗男性压力性尿失禁应答者背景特征的影响
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-02-25 DOI: 10.1111/luts.12433
T. Yamanishi, O. Ishizuka, S. Shimizu, Yumiko Kobayashi, F. Kinoshita, Tokunori Yamamoto, A. Mizokami, K. Narimoto, K. Toriyama, Y. Kamei, Y. Kuwatsuka, M. Mizuno, M. Gotoh
To determine if the male responders with post‐prostatectomy incontinence in the ADRESU study, which is a clinical trial of regenerative therapy by periurethral injection of adipose‐derived regenerative cells, are influenced by any background characteristics.
为了确定ADRESU研究中前列腺切除术后尿失禁的男性应答者是否受到任何背景特征的影响。ADRESU研究是一项通过尿道周围注射脂肪来源的再生细胞进行再生治疗的临床试验。
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引用次数: 0
Clinical features of detrusor underactivity in elderly men without neurological disorders 无神经系统疾病老年男性逼尿肌活动不足的临床特征
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-01-29 DOI: 10.1111/luts.12424
Keisuke Kiba, Yasunori Akashi, Yutaka Yamamoto, Akihide Hirayama, Kiyohide Fujimoto, Hirotsugu Uemura

Objectives

To investigate the clinical features of detrusor underactivity (DU) in elderly men without neurological disorders.

Methods

A total of 336 men aged ≥50 years without neurogenic disorders who underwent pressure flow studies and who had DU or bladder outlet obstruction (BOO) were reviewed retrospectively. According to the bladder contractility index (BCI) and the BOO index (BOOI), the subjects were classified into the following three groups: (a) pure DU group, BCI < 100 and BOOI < 40; (b) DU + BOO group, BCI < 100 and BOOI ≥ 40; and (c) pure BOO group, BCI ≥ 100 and BOOI ≥ 40. Subjective and objective parameters were compared among the three groups, and the predictors for pure DU were evaluated by multivariate analysis.

Results

Of the 336 patients, 205 who met the study criteria were included in the analysis: 63 (30.7%) with pure DU, 48 (23.4%) with DU + BOO, and 94 (45.9%) with pure BOO. The proportion of the pure DU group increased with increasing age. Prostate volume was the lowest in the pure DU group. Frequency, urgency on the International Prostate Symptom Score (IPSS), and the IPSS storage subscore were the lowest in the pure DU group. Multivariate analysis showed that age (odds ratio [OR] 1.114 [95% CI, 1.032-1.203], P = .005), prostate volume (OR 0.968 [95% CI, 0.949-0.987], P = .001), and urgency (OR 0.623 [95% CI, 0.431-0.900], P = .012) were predictors of pure DU.

Conclusion

Older age, smaller prostate volume, and less urgency may be clinical features of pure DU.

目的探讨无神经系统疾病的老年男性逼尿肌活动不足的临床特点。方法回顾性分析336例年龄≥50岁、无神经源性疾病、行压力血流检查且患有DU或膀胱出口梗阻(BOO)的男性患者。根据膀胱收缩指数(BCI)和BOO指数(BOOI)将受试者分为3组:(a)纯DU组,BCI < 100, BOOI < 40;(b) DU + BOO组,BCI < 100, BOOI≥40;(c)纯BOO组,BCI≥100,BOOI≥40。比较三组患者的主客观指标,并通过多因素分析评价纯DU的预测因素。结果在336例患者中,205例符合研究标准的患者纳入分析:63例(30.7%)为纯DU, 48例(23.4%)为DU + BOO, 94例(45.9%)为纯BOO。纯DU组的比例随着年龄的增长而增加。纯DU组前列腺体积最小。国际前列腺症状评分(IPSS)的频率、紧迫性和IPSS储存亚评分在纯DU组中最低。多因素分析显示,年龄(比值比[OR] 1.114 [95% CI, 1.032-1.203], P = 0.005)、前列腺体积(比值比[OR] 0.968 [95% CI, 0.949-0.987], P = 0.001)和急症(比值比[OR] 0.623 [95% CI, 0.431-0.900], P = 0.012)是单纯DU的预测因素。结论年龄较大、前列腺体积较小、急迫性较差可能是单纯DU的临床特征。
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引用次数: 3
Freeflow: The novel portable uroflowmeter can help to realize practical urinary conditions at home 自由流:新型便携式尿流仪可以帮助实现实际的泌尿状况在家里
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-01-25 DOI: 10.1111/luts.12426
Shinobu Kato, Hajime Watanabe, Kotaro Yamasue

Objectives

To evaluate the effectiveness of a novel portable urine flowmeter, Freeflow, for examining the actual state of urination at home.

Methods

Forty-three patients with benign prostatic hyperplasia used the Freeflow uroflowmeter in the hospital and at home without accumulating urine. We created a nomogram for each patient's urine volume and maximal urinary flow rate (Qmax). Furthermore, we investigated the actual state of each patient's urination. We also investigated the differences in the micturition status between daytime and nighttime.

Results

Of the 43 patients, 40 were able to provide the necessary data in the hospital, and all patients provided data measured at home. The trial period of the home assessment was 2-7 days. Regarding the average urine volume, no significant difference was observed between in-hospital and at-home patients; however, Qmax and mean flow rate (Qave) were significantly higher at home. The average coefficient of variation was very large. The relationship between daytime and nighttime was observed in 30 patients; urine volume increased significantly at nighttime; however, no significant difference was observed in Qmax and Qave. The nomogram for several days and a completed urinary diary helped to display daytime and nighttime urination characteristics.

Conclusions

Freeflow, the newly developed uroflowmeter, enabled us to determine the fluctuations in the measurements recorded at home and the differences between daytime and nighttime. Thus, creating a nomogram for objectively examining nighttime urination status and utilizing a urination diary was found to be effective for providing correct diagnosis and treatment of lower urinary tract symptoms.

目的评价一种新型便携式尿流量仪Freeflow在检测家庭实际排尿状况中的有效性。方法43例良性前列腺增生患者在医院和家中使用无积尿的Freeflow尿流量仪。我们制作了每位患者的尿量和最大尿流率(Qmax)的nomogram。此外,我们还调查了每位患者的实际排尿状况。我们还调查了白天和夜间排尿状况的差异。结果43例患者中,40例能够在医院提供必要的数据,所有患者都提供了在家测量的数据。居家评估的试用期为2-7天。在平均尿量方面,住院患者与在家患者无显著差异;然而,Qmax和平均流量(Qave)在家里明显更高。平均变异系数非常大。观察30例患者白天和夜间的关系;夜间尿量明显增加;Qmax和Qave无显著性差异。几天的图和完整的尿日记有助于显示白天和夜间的排尿特征。结论Freeflow,新开发的尿液流量计,使我们能够确定在家里记录的测量波动和白天和夜间的差异。因此,创建一个客观检查夜间排尿状态的图,并利用排尿日记,可以有效地提供正确的诊断和治疗下尿路症状。
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引用次数: 2
Men suffering from category III chronic prostatitis may benefit from N-acetylcysteine as an adjunct to alpha-blockers 患有III类慢性前列腺炎的男性可能受益于n -乙酰半胱氨酸作为α受体阻滞剂的辅助药物
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-01-23 DOI: 10.1111/luts.12425
Amir-mohammad Yaryari, Seyed Habibollah Mousavibahar, Shahriar Amirhassani, Maryam Bagheri, Younes Mohammadi, Maryam Mehrpooya

Objective

We designed this study to investigate the potential use of N-acetylcysteine (NAC) as an adjunct to alpha-blockers in the treatment of category III chronic prostatitis (CP).

Methods

Sixty-three men with category III CP with a National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score of 15 or more were randomized to either the NAC treatment group or the placebo treatment group. Besides tamsulosin at a dose of 0.4 mg once daily, participants based on their allocation group received NAC or placebo at a dose of 600 mg twice daily for 12 weeks. The efficacy of the medications was assessed by measuring changes in the NIH-CPSI total score and its subscales, including pain, urinary symptoms, and quality of life.

Results

Based on the general linear model analysis of the data, over the 12-week treatment, NAC+tamsulosin was statistically superior to placebo+tamsulosin in reducing the total NIH-CPSI score, pain subscore, and quality-of-life subscore (P value <.001). Further, after 12 weeks, more patients in the NAC+tamsulosin group than in the placebo+tamsulosin group met the responder criterion, defined as a decrease of at least 6 points in the NIH-CPSI total score (65.6% vs 29.0%). A more favorable outcome was also noted in the NAC+tamsulosin group regarding the number of patients reporting moderate or marked improvement in symptoms (62.5% vs 25.80%). No significant difference was seen between the groups concerning changes in urinary symptoms.

Conclusions

Our study provided clinical evidence that men with category III CP might benefit from NAC treatment. Further studies are needed for the validation of these findings.

目的:研究n -乙酰半胱氨酸(NAC)作为α受体阻滞剂辅助治疗III类慢性前列腺炎(CP)的潜在应用价值。方法将63例美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)总分在15分及以上的III型CP患者随机分为NAC治疗组和安慰剂治疗组。除了每天一次0.4毫克的坦索罗辛外,根据他们的分配组,参与者接受了每天两次600毫克剂量的NAC或安慰剂,持续12周。通过测量NIH-CPSI总分及其亚量表(包括疼痛、泌尿系统症状和生活质量)的变化来评估药物的疗效。结果根据数据的一般线性模型分析,在12周的治疗期间,NAC+坦索罗辛在降低NIH-CPSI总评分、疼痛评分和生活质量评分方面具有统计学上的优势(P值< 0.001)。此外,12周后,NAC+坦索罗辛组比安慰剂+坦索罗辛组有更多的患者符合应答标准,定义为NIH-CPSI总分下降至少6分(65.6% vs 29.0%)。在NAC+坦索罗辛组中,报告症状中度或显著改善的患者人数(62.5% vs 25.80%)也出现了更有利的结果。在泌尿系统症状的改变方面,两组之间没有明显差异。结论我们的研究提供了临床证据,表明III型CP患者可能从NAC治疗中获益。需要进一步的研究来验证这些发现。
{"title":"Men suffering from category III chronic prostatitis may benefit from N-acetylcysteine as an adjunct to alpha-blockers","authors":"Amir-mohammad Yaryari,&nbsp;Seyed Habibollah Mousavibahar,&nbsp;Shahriar Amirhassani,&nbsp;Maryam Bagheri,&nbsp;Younes Mohammadi,&nbsp;Maryam Mehrpooya","doi":"10.1111/luts.12425","DOIUrl":"10.1111/luts.12425","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We designed this study to investigate the potential use of N-acetylcysteine (NAC) as an adjunct to alpha-blockers in the treatment of category III chronic prostatitis (CP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-three men with category III CP with a National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score of 15 or more were randomized to either the NAC treatment group or the placebo treatment group. Besides tamsulosin at a dose of 0.4 mg once daily, participants based on their allocation group received NAC or placebo at a dose of 600 mg twice daily for 12 weeks. The efficacy of the medications was assessed by measuring changes in the NIH-CPSI total score and its subscales, including pain, urinary symptoms, and quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on the general linear model analysis of the data, over the 12-week treatment, NAC+tamsulosin was statistically superior to placebo+tamsulosin in reducing the total NIH-CPSI score, pain subscore, and quality-of-life subscore (<i>P</i> value &lt;.001). Further, after 12 weeks, more patients in the NAC+tamsulosin group than in the placebo+tamsulosin group met the responder criterion, defined as a decrease of at least 6 points in the NIH-CPSI total score (65.6% vs 29.0%). A more favorable outcome was also noted in the NAC+tamsulosin group regarding the number of patients reporting moderate or marked improvement in symptoms (62.5% vs 25.80%). No significant difference was seen between the groups concerning changes in urinary symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study provided clinical evidence that men with category III CP might benefit from NAC treatment. Further studies are needed for the validation of these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39851326","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: 2
The efficacy and safety of desmopressin acetate applied for nocturia in benign prostatic hyperplasia patients: A systematic review and meta-analysis 醋酸去氨加压素治疗良性前列腺增生患者夜尿的疗效和安全性:一项系统综述和荟萃分析
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2022-01-16 DOI: 10.1111/luts.12423
Qihua Wang, Rami Alshayyah, Bo Yang

Background

Desmopressin acetate was recommended for nocturia in benign prostatic hyperplasia (BPH) patients recently, but its effect and safety is still controversial. We aimed to establish a systematic review and meta-analysis to confirm its effect on symptom relief and adverse effects.

Methods

A systematic search was performed in PubMed, Cochrane Library, EMBASE, Medline, Web of Science and Science Direct databases from January 2000 to October 2021 for controlled trials of BPH patients comparing oral desmopressin with control groups. The mean difference (MD) and odds ratio (OR) were meta-analyzed.

Results

Four articles with 500 patients were included. Significantly greater benefit was detected for the desmopressin group in the improvement of nocturia (P = .004), international prostate symptom score – storage (IPSS-S) (P = .03), and quality of life (QoL) (P = .04) scores. Patients treated with desmopressin were at higher risk than the control group for short-term adverse events (P < .001), including nausea (4.71%, P = .04), headache (20%, P < .00001), dizziness (5.88%, P = .02) and hyponatremia (4.71%, P = .04), but the long-term incidence might decrease.

Conclusion

Desmopressin acetate can reduce nocturia frequency and improve the IPSS-S and QoL score in BPH patients. Some adverse reactions of desmopressin, such as hyponatremia, headache, dizziness and nausea, may be mild and short-term. No significant difference of desmopressin was found in improving the overall IPSS score and maximum urine flow.

背景醋酸去氨加压素最近被推荐用于治疗良性前列腺增生(BPH)患者夜尿症,但其疗效和安全性仍存在争议。我们的目的是建立一个系统的回顾和荟萃分析,以确认其对症状缓解和不良反应的影响。方法系统检索2000年1月至2021年10月PubMed、Cochrane Library、EMBASE、Medline、Web of Science和Science Direct数据库,比较口服去氨加压素与对照组的BPH患者对照试验。对平均差异(MD)和优势比(OR)进行meta分析。结果纳入文献4篇,500例患者。去氨加压素组在夜尿症(P = 0.004)、国际前列腺症状评分-存储(IPSS-S) (P = 0.03)和生活质量(QoL)评分(P = 0.04)改善方面获益显著。去氨加压素治疗组近期不良事件发生率高于对照组(P < 0.001),包括恶心(4.71%,P = 0.04)、头痛(20%,P < 0.001)、头晕(5.88%,P = 0.02)、低钠血症(4.71%,P = 0.04),但远期发生率可能降低。结论醋酸去氨加压素可减少前列腺增生症患者夜尿次数,改善患者IPSS-S和生活质量评分。去氨加压素的一些不良反应,如低钠血症、头痛、头晕和恶心,可能是轻微和短期的。去氨加压素在改善总IPSS评分和最大尿流量方面无显著差异。
{"title":"The efficacy and safety of desmopressin acetate applied for nocturia in benign prostatic hyperplasia patients: A systematic review and meta-analysis","authors":"Qihua Wang,&nbsp;Rami Alshayyah,&nbsp;Bo Yang","doi":"10.1111/luts.12423","DOIUrl":"10.1111/luts.12423","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Desmopressin acetate was recommended for nocturia in benign prostatic hyperplasia (BPH) patients recently, but its effect and safety is still controversial. We aimed to establish a systematic review and meta-analysis to confirm its effect on symptom relief and adverse effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was performed in PubMed, Cochrane Library, EMBASE, Medline, Web of Science and Science Direct databases from January 2000 to October 2021 for controlled trials of BPH patients comparing oral desmopressin with control groups. The mean difference (MD) and odds ratio (OR) were meta-analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four articles with 500 patients were included. Significantly greater benefit was detected for the desmopressin group in the improvement of nocturia (<i>P</i> = .004), international prostate symptom score – storage (IPSS-S) (<i>P</i> = .03), and quality of life (QoL) (<i>P</i> = .04) scores. Patients treated with desmopressin were at higher risk than the control group for short-term adverse events (<i>P</i> &lt; .001), including nausea (4.71%, <i>P</i> = .04), headache (20%, <i>P</i> &lt; .00001), dizziness (5.88%, <i>P</i> = .02) and hyponatremia (4.71%, <i>P</i> = .04), but the long-term incidence might decrease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Desmopressin acetate can reduce nocturia frequency and improve the IPSS-S and QoL score in BPH patients. Some adverse reactions of desmopressin, such as hyponatremia, headache, dizziness and nausea, may be mild and short-term. No significant difference of desmopressin was found in improving the overall IPSS score and maximum urine flow.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39824199","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: 3
The new therapeutic option for female stress and stress-predominant mixed urinary incontinence: Periurethral hypertonic saline (10%) injection 女性压力和压力主导混合性尿失禁的新治疗选择:尿道周围高渗生理盐水(10%)注射
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2021-12-12 DOI: 10.1111/luts.12422
Ibrahim Nuvit Tahtali, Turan Yildiz, Muhammed Murat Dincer

Objectives

We aimed to evaluate the safety and efficacy of periurethral hypertonic saline (10% NaCl) injection in the treatment of stress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (S-MUI) in women.

Methods

This was a prospective study conducted between January 2014 and April 2018 with 64 women (44 SUI and 21 S-MUI). Patients with SUI and S-MUI were evaluated using the Urinary Distress Inventory 6. Quality of life was evaluated with the Incontinence Quality of Life Scale and lower urinary tract symptoms of the women were evaluated with the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules. Incontinence status and treatment success were assessed via the Stamey incontinence grade and pad test.

Results

The subjective success rate was 58.5%, and the objective success rate was 81.5%. The rate of reinjection was 21.5%, and the mean duration of reinjection was 8.92 months (3-19 months). Minor adverse effects were observed in 30.4% of the 79 injections. International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules and Incontinence Quality of Life Scale scores improved remarkably starting from the first month. Urinary Distress Inventory 6 scores in the S-MUI group also improved.

Conclusions

The results indicate that hypertonic saline injection is an effective and safe method in the treatment of SUI and S-MUI. Since hypertonic saline is a much cheaper and more accessible substance compared to bulking agents, it seems to be a viable alternative for urinary incontinence treatment in women.

目的评价尿道周围注射高渗盐水(10% NaCl)治疗女性应激性尿失禁(SUI)和应激型混合性尿失禁(S-MUI)的安全性和有效性。方法这是一项2014年1月至2018年4月期间对64名女性(44名SUI和21名S-MUI)进行的前瞻性研究。使用尿窘迫量表对SUI和S-MUI患者进行评估。采用失禁生活质量量表评估患者的生活质量,采用国际失禁调查问卷女性下尿路症状模块评估患者的下尿路症状。通过Stamey尿失禁等级和尿垫试验评估尿失禁状态和治疗成功。结果主观成功率为58.5%,客观成功率为81.5%。再注射率为21.5%,平均再注射时间为8.92个月(3 ~ 19个月)。79次注射中有30.4%出现轻微不良反应。国际咨询失禁问卷女性下尿路症状模块和失禁生活质量量表评分从第一个月开始显著改善。S-MUI组尿窘迫量表6评分也有所改善。结论高渗盐水注射治疗SUI和S-MUI是一种安全有效的方法。与填充剂相比,高渗盐水是一种更便宜、更容易获得的物质,因此它似乎是治疗女性尿失禁的可行选择。
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引用次数: 1
Metabolically healthy obesity is associated with increased risk of lower urinary tract symptoms secondary to benign prostatic hyperplasia: A cohort study of Chinese elderly males 代谢健康的肥胖与继发于良性前列腺增生的下尿路症状的风险增加相关:一项针对中国老年男性的队列研究
IF 1.3 4区 医学 Q2 Medicine Pub Date : 2021-12-09 DOI: 10.1111/luts.12420
Weinan Chen, Sailimai Man, Bo Wang, Gaohaer Kadeerhan, Xiaobo Huang

Objectives

Obesity and metabolic status are both modifiable risk factors of lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). However, the association between metabolically healthy obesity (MHO) and LUTS/BPH is largely unexplored. This study aimed to investigate the risk of LUTS/BPH among different metabolic syndrome-body mass index (MetS-BMI) phenotypes in a cohort of Chinese males.

Methods

A total of 3321 males from the China Health and Retirement Longitudinal Study (CHARLS) without history of LUTS/BPH at baseline were included into the analyses. Participants were categorized into six mutually exclusive groups according to presence or absence of MetS combined with BMI status: metabolically healthy normal weight/overweight/obesity (MHN/MHOW/MHO) and metabolically unhealthy normal weight/overweight/obesity (MUN/MUOW/MUO). Adjusted odds ratios (OR) and 95% CI of LUTS/BPH across MetS-BMI categories were estimated with multivariable logistic regression models.

Results

A total of 394 (11.86%) participants developed LUTS/BPH during the follow-up. After adjusting for age, educational level, smoking status, drinking status, and BMI change, the multivariable-adjusted OR (95% CI) for incident LUTS/BPH comparing MUO, MHO, MUOW, MHOW, and MUN with MHN were 1.99 (1.23-3.22), 2.04 (1.14-3.66), 1.61 (1.11-2.34), 1.45 (1.02-2.05), and 0.91 (0.54-1.56), respectively.

Conclusions

MHO and MHOW were risk populations of LUTS/BPH, suggesting that overweight and obesity can independently contribute to LUTS/BPH, even among metabolically healthy individuals. These findings emphasize metabolically healthy individuals may still benefit from maintaining normal body weight to prevent LUTS/BPH. Our findings also support that those recommendations for LUTS/BPH should highlight the importance of maintaining metabolic health across all BMI groups among Chinese males.

肥胖和代谢状态都是良性前列腺增生(LUTS/BPH)继发下尿路症状的可改变危险因素。然而,代谢健康型肥胖(MHO)与LUTS/BPH之间的关系在很大程度上尚未被探索。本研究旨在探讨中国男性不同代谢综合征-体重指数(MetS-BMI)表型之间LUTS/BPH的风险。方法将中国健康与退休纵向研究(CHARLS)中无LUTS/BPH基线病史的3321名男性纳入分析。参与者根据是否存在MetS和BMI状态被分为六个相互排斥的组:代谢健康的正常体重/超重/肥胖(MHN/MHOW/MHO)和代谢不健康的正常体重/超重/肥胖(MUN/MUOW/MUO)。采用多变量logistic回归模型估计met - bmi类别中LUTS/BPH的校正优势比(OR)和95% CI。结果随访期间共394例(11.86%)发生LUTS/BPH。在调整了年龄、受教育程度、吸烟状况、饮酒状况和BMI变化后,MUO、MHO、MUOW、MHOW和MUN与MHN的LUTS/BPH事件的多变量调整OR (95% CI)分别为1.99(1.23-3.22)、2.04(1.14-3.66)、1.61(1.11-2.34)、1.45(1.02-2.05)和0.91(0.54-1.56)。结论MHO和MHOW是LUTS/BPH的危险人群,提示超重和肥胖可以独立促成LUTS/BPH,即使在代谢健康的个体中也是如此。这些发现强调,代谢健康的个体可能仍然受益于保持正常体重,以预防LUTS/BPH。我们的研究结果也支持这些关于LUTS/BPH的建议应该强调在所有BMI组中维持中国男性代谢健康的重要性。
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引用次数: 1
期刊
LUTS: Lower Urinary Tract Symptoms
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