LUTS: Lower Urinary Tract Symptoms最新文献_第3页

Urotherapy and biofeedback resistant dysfunctional voiding: How to deal with? 泌尿系统治疗和生物反馈治疗可缓解排尿功能障碍：如何处理？

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-06-25 DOI: 10.1111/luts.12528

M. İrfan Dönmez, Ismail Selvi, Tayfun Oktar, Orhan Ziylan

Objectives

To analyze the management strategies in the children who had treatment-resistant dysfunctional voiding (DV).

Methods

Among 75 children with DV who underwent pelvic floor biofeedback therapy (BF) between 2013 and 2020, 16 patients (14 girls, 87.5%) with a mean age of 9.81 ± 2.53 years that showed incomplete clinical response following urotherapy and initial BF sessions were retrospectively reviewed. The demographic and clinical characteristics, DVSS, and uroflowmetry parameters were recorded before and after the initial BF sessions. Subsequent treatments after initial BF and clinical responses of patients were noted.

Results

Clinical success was observed in one patient by addition of an anticholinergic and in three patients with combination of salvage BF sessions and anticholinergics, whom had predominant overactive bladder (OAB) symptoms. The success rate of TENS alone and in combination with other treatment modalities was 88.8% (8/9 patients). In addition, salvage BF sessions (range 2 to 3) enabled clinical success in five (50%) of 10 cases as a combination with anticholinergics or TENS. In case of incomplete emptying without OAB, adequate clinical response to Botulinum-A was observed during an average follow-up of 29 months in two boys who did not respond to alpha-blockers, even though one required repeat injection after 10 months. The total clinical success rate was 87.5% (14/16 patients) after a median follow-up of 24 months. VV-EBC and Qmax increased by a mean of 30.89% and 7.13 mL/min, respectively, whereas DVSS decreased by a mean of 8.88 points and PVR-EBC decreased by a median of 19.04%.

Conclusions

Our findings showed that clinical success in resistant DV was achieved by various combination treatments in the majority of children. However, a small group may still have persistent, bothersome symptoms despite multiple treatment modalities.

目的分析具有治疗耐药性的排尿功能障碍（DV）儿童的治疗策略。方法回顾性分析2013年至2020年间接受盆底生物反馈疗法（BF）治疗的75名排尿功能障碍儿童，其中16名患者（14名女孩，87.5%）在接受尿路治疗和首次BF治疗后出现不完全临床反应，平均年龄为（9.81 ± 2.53）岁。记录了初次 BF 治疗前后的人口统计学和临床特征、DVSS 和尿流测量参数。记录了患者在初次 BF 治疗后的后续治疗情况和临床反应。结果一名患者在使用抗胆碱能药物后取得了临床成功，三名患者在联合使用挽救性膀胱刺激疗法和抗胆碱能药物后取得了临床成功，这些患者均以膀胱过度活动症（OAB）症状为主。单独使用 TENS 或与其他治疗方法联合使用的成功率为 88.8%（8/9 例患者）。此外，在与抗胆碱能药物或 TENS 联合使用的 10 个病例中，有 5 例（50%）患者通过抢救性 BF 治疗（2 至 3 次）取得了临床成功。对于排空不全但无 OAB 的病例，在平均 29 个月的随访期间，观察到两名对阿尔法受体阻滞剂无反应的男孩对 A 型肉毒杆菌产生了充分的临床反应，尽管其中一人在 10 个月后需要再次注射。中位随访 24 个月后，总临床成功率为 87.5%（14/16 名患者）。VV-EBC 和 Qmax 平均分别增加了 30.89% 和 7.13 mL/min，而 DVSS 平均下降了 8.88 点，PVR-EBC 中位下降了 19.04%。结论我们的研究结果表明，通过各种联合治疗，大多数患儿的耐药 DV 临床治疗取得了成功。然而，尽管采用了多种治疗方法，仍有一小部分患儿可能会持续出现令人烦恼的症状。

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引用次数: 0

Stem cell therapy for interstitial cystitis/bladder pain syndrome 干细胞疗法治疗间质性膀胱炎/膀胱疼痛综合征。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-06-12 DOI: 10.1111/luts.12527

Jung Hyun Shin, Ju Hyun Park, Chae-Min Ryu, Dong-Myung Shin, Myung-Soo Choo

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease with limited treatment options. Current multidisciplinary approach targeting bladder inflammation and urothelial dysfunction has limited durable effect that major surgery is ultimately required for both Hunner and non-Hunner type IC. Various investigational attempts are underway to avoid such operations and preserve the urinary bladder. Stem cell therapy is a fascinating option for treating chronic illnesses. Stem cells can self-renew, restore damaged tissue, and have paracrine effects. The therapeutic efficacy and safety of stem cell therapy have been demonstrated in numerous preclinical models, primarily chemically induced cystitis rat models. Only one clinical trial (phase 1 study) has investigated the safety of human embryonic stem cell-derived mesenchymal stem cells in three Hunner-type IC patients. Under general anesthesia, participants underwent cystoscopic submucosal stem cell injection (2.0 × 10⁷ stem cells/5 mL). No safety issues were reported up to 12 months of follow-up and long-term follow-up (up to 3 years). Although there were variations in therapeutic response, all patients reported significant improvement in pain at 1 month postoperatively. One patient underwent fulguration of the Hunner lesion after the trial, but others reported an overall improvement in pain. The analysis on phase 1/2a trial which had several modifications in protocol is currently ongoing. Despite several limitations that need to be overcome, stem cell therapy could be a potential therapeutic option for treating IC/BPS. Clinical outcome on phase 1/2a trial is important and might provide more insight into the clinical application of stem cell therapy for IC/BPS.

间质性膀胱炎/膀胱疼痛综合征（IC/BPS）是一种慢性疾病，治疗方法有限。目前针对膀胱炎症和尿路上皮功能障碍的多学科治疗方法效果有限，无论是亨纳型还是非亨纳型间质性膀胱炎，最终都需要进行大手术。为了避免此类手术并保留膀胱，目前正在进行各种研究尝试。干细胞疗法是治疗慢性疾病的一个令人着迷的选择。干细胞可以自我更新，恢复受损组织，并具有旁分泌效应。干细胞疗法的疗效和安全性已在许多临床前模型中得到证实，主要是化学诱导的膀胱炎大鼠模型。只有一项临床试验（一期研究）在三名Hunner型IC患者中调查了人类胚胎干细胞衍生间充质干细胞的安全性。在全身麻醉的情况下，参与者接受了膀胱镜黏膜下干细胞注射（2.0 × 107 干细胞/5 mL）。在长达12个月的随访和长期随访（长达3年）中，均未发现安全问题。虽然治疗反应存在差异，但所有患者在术后1个月都报告疼痛明显改善。一名患者在试验后接受了亨纳病变的充填术，但其他患者的疼痛总体上有所改善。1/2a期试验的方案曾多次修改，目前正在进行分析。尽管干细胞疗法还存在一些需要克服的局限性，但它可能是治疗IC/BPS的一种潜在疗法。1/2a期试验的临床结果非常重要，可能为干细胞疗法治疗IC/BPS的临床应用提供更多启示。

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引用次数: 0

Adherence to AUA guidelines for the work-up, medical management, surgical evaluation and treatment of BPH: Work from a quality improvement collaborative 遵守美国前列腺增生协会（AUA）关于良性前列腺增生症的检查、药物治疗、手术评估和治疗指南：质量改进合作组织的工作。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-06-10 DOI: 10.1111/luts.12526

Eric Wahlstedt, John Lee Graves, John Wahlstedt, Alison D'Alessandro, Will Cranford, Nicholas A. Freidberg, Amul Bhalodi, John R. Bell, Andrew James, Jason Bylund, Stephen E. Strup, Andrew Harris

Introduction

Previous studies noted varied adherence to clinical practice guidelines (CPGs), but studies are yet to quantify adherence to American Urological Association BPH guidelines. We studied guideline adherence in the context of a new quality improvement collaborative (QIC).

Methods

Data were collected as part of a statewide QIC. Medical records for patients undergoing select CPT codes from January 2020 to May 2022 were retrospectively reviewed for adherence to selected BPH guidelines.

Results

Most men were treated with transurethral resection of the prostate. Notably, 53.3% of men completed an IPSS and 52.3% had a urinalysis. 4.7% were counseled on behavioral modifications, 15.0% on medical therapy, and 100% on procedural options. For management, 79.4% were taking alpha-blockers and 59.8% were taking a 5-ARI. For evaluation, 57% had a PVR, 63.6% had prostate size measurement, 37.4% had uroflowmetry, and 12.3% were counseled about treatment failure. Postoperatively, 51.6% completed an IPSS, 57% had a PVR, 6.50% had uroflowmetry, 50.6% stopped their alpha-blocker, and 75.0% stopped their 5-ARI.

Conclusions

There was adherence to preoperative testing recommendations, but patient counseling was lacking in the initial work-up and preoperative evaluation. We will convey the data to key stakeholders, expand data collection to other institutions, and devise an improvement implementation plan.

导言：以往的研究表明，临床实践指南（CPG）的遵守情况各不相同，但尚未有研究对美国泌尿协会良性前列腺增生指南的遵守情况进行量化。我们在一项新的质量改进合作项目（QIC）中对指南的遵循情况进行了研究：方法：数据收集是全州 QIC 的一部分。我们对 2020 年 1 月至 2022 年 5 月接受特定 CPT 编码治疗的患者的医疗记录进行了回顾性审查，以了解其对特定良性前列腺增生症指南的遵守情况：结果：大多数男性接受了经尿道前列腺切除术。值得注意的是，53.3%的男性完成了IPSS，52.3%的男性进行了尿检。4.7%的男性接受了行为矫正指导，15.0%的男性接受了药物治疗，100%的男性接受了手术治疗。在治疗方面，79.4% 的人服用α-受体阻滞剂，59.8% 的人服用 5-ARI 。在评估方面，57%的患者进行了PVR检查，63.6%的患者进行了前列腺大小测量，37.4%的患者进行了尿流测定，12.3%的患者接受了有关治疗失败的咨询。术后，51.6%的患者完成了IPSS检查，57%的患者进行了PVR检查，6.50%的患者进行了尿流测定，50.6%的患者停用了α-受体阻滞剂，75.0%的患者停用了5-ARI：结论：术前检查建议得到了遵守，但在初步检查和术前评估中缺乏对患者的指导。我们将向主要利益相关者传达这些数据，将数据收集工作扩展到其他机构，并制定改进实施计划。

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引用次数: 0

Protective effect of equol intake on bladder dysfunction in a rat model of bladder outlet obstruction 在膀胱出口梗阻大鼠模型中，摄入马勃醇对膀胱功能障碍有保护作用。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-05-22 DOI: 10.1111/luts.12518

Nozomu Miyazaki, Ryota Katsura, Chiaki Ozaki, Tatsuo Suzutani

Objectives

This study evaluates the impact of equol, a metabolite of soy isoflavone, on bladder dysfunction in rats with bladder outlet obstruction (BOO). In addition, we investigate its potential as a neuroprotective agent for the obstructed bladder and discuss its applicability in managing overactive bladder (OAB).

Methods

Eighteen male Sprague–Dawley rats were divided into three groups (six rats per group) during the rearing period. The Sham and C-BOO groups received an equol-free diet, while the E-BOO group received equol supplementation (0.25 g/kg). At 8 weeks old, rats underwent BOO surgery, followed by continuous cystometry after 4 weeks of rearing. The urinary oxidative stress markers (8-hydroxy-2′-deoxyguanosine and malondialdehyde) were measured, and the bladder histology was analyzed using hematoxylin–eosin, Masson's trichrome, and immunohistochemical staining (neurofilament heavy chain for myelinated nerves, peripherin for unmyelinated nerves, and malondialdehyde).

Results

Equol reduced BOO-induced smooth muscle layer fibrosis, significantly prolonged the micturition interval (C-BOO: 193 s, E-BOO: 438 s) and increased the micturition volume (C-BOO: 0.54 mL, E-BOO: 1.02 mL) compared to the C-BOO group. Equol inhibited the increase in urinary and bladder tissue malondialdehyde levels. While the C-BOO group exhibited reduced peripherin alone positive nerve fibers within the smooth muscle layer, equol effectively attenuated this decline.

Conclusions

Equol reduces lipid peroxidation and smooth muscle layer fibrosis in the bladder and exhibited neuroprotective effects on bladder nerves (peripheral nerves) and prevented the development of bladder dysfunction associated with BOO in rats. Consumption of equol is promising for the prevention of OAB associated with BOO.

研究目的本研究评估了大豆异黄酮的代谢产物马兜铃醇对膀胱出口梗阻（BOO）大鼠膀胱功能障碍的影响。此外，我们还研究了其作为膀胱梗阻神经保护剂的潜力，并讨论了其在控制膀胱过度活动症（OAB）方面的适用性：方法：18 只雄性 Sprague-Dawley 大鼠在饲养期间被分为三组（每组 6 只）。Sham 组和 C-BOO 组接受不含 equol 的饮食，而 E-BOO 组则补充 equol（0.25 克/千克）。8周大时，大鼠接受BOO手术，饲养4周后进行连续膀胱测定。测量尿氧化应激标记物（8-羟基-2'-脱氧鸟苷和丙二醛），并使用苏木精-伊红、马森三色素和免疫组化染色法（髓鞘神经的神经丝蛋白重链、非髓鞘神经的外周蛋白和丙二醛）分析膀胱组织学：与 C-BOO 组相比，Equol 减少了 BOO 诱导的平滑肌层纤维化，显著延长了排尿间隔时间（C-BOO：193 秒，E-BOO：438 秒）并增加了排尿量（C-BOO：0.54 毫升，E-BOO：1.02 毫升）。Equol 可抑制尿液和膀胱组织中丙二醛水平的增加。虽然 C-BOO 组显示平滑肌层内的外周素单独阳性神经纤维减少，但 Equol 有效地减轻了这种减少：结论：Equol 可减少脂质过氧化和膀胱平滑肌层纤维化，对膀胱神经（周围神经）具有神经保护作用，并可防止大鼠出现与 BOO 相关的膀胱功能障碍。食用马勃醇有望预防与BOO相关的OAB。

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引用次数: 0

Factors associated with symptomatic urinary tract infection in persons with spinal cord lesions who perform clean intermittent catheterization with single-use catheters 使用一次性导尿管进行清洁间歇性导尿的脊髓损伤患者出现症状性尿路感染的相关因素

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-05-01 DOI: 10.1111/luts.12515

Noritoshi Sekido, Ryosuke Takahashi, Fujio Matsuyama, Tatsunori Murata, Mihoko Matsuoka, Atsushi Sengoku, Masashi Nomi, Takeya Kitta, Takahiko Mitsui

Objectives

To investigate factors associated with symptomatic urinary tract infection (sUTI) in persons with chronic spinal cord lesion (SCL) who were using single-use catheters for intermittent self-catheterization (ISC).

Methods

Among respondents to an internet survey on the burden of illness on persons with SCL who were considered to be able to perform ISC, 111 persons using single-use catheters were included to examine factors associated with self-reported sUTI by univariate as well as multivariable analysis.

Results

The incidence of sUTI was significantly higher in males than in females (56.9% vs. 31.6%, p = .011), persons with stocks of antibiotics than those without it (82.9% vs. 28.6%, p < .011), and persons with more frequent bleeding during catheterization than those with less frequent bleeding (100% vs. 46.5%, p = .036). The incidence did not significantly differ between respective groups when various variables were evaluated by other characteristics of the participants, adherence to ISC procedures, and complications. On multivariable analysis, male gender and stocks of antibiotics were significant independent factors for sUTI.

Conclusions

Male gender and stocks of antibiotics were associated with sUTI in persons with SCL who were performing ISC with single-use catheters.

目的调查使用一次性导尿管进行间歇性自我导尿（ISC）的慢性脊髓损伤（SCL）患者出现症状性尿路感染（sUTI）的相关因素。方法在一项关于被认为能够进行间歇性自我导尿的 SCL 患者疾病负担的互联网调查的受访者中，纳入了 111 名使用一次性导尿管的患者，通过单变量和多变量分析来研究与自我报告的 sUTI 相关的因素。结果男性的 sUTI 发生率明显高于女性（56.9% 对 31.6%，p = .011），使用过抗生素的人明显高于未使用过抗生素的人（82.9% 对 28.6%，p < .011），导管插入过程中出血次数较多的人明显高于出血次数较少的人（100% 对 46.5%，p = .036）。根据参与者的其他特征、对 ISC 程序的遵守情况以及并发症等各种变量进行评估后，各组之间的发病率没有明显差异。在多变量分析中，男性性别和抗生素库存是导致 sUTI 的重要独立因素。结论在使用一次性导管进行 ISC 的 SCL 患者中，男性性别和抗生素库存与 SUTI 相关。

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引用次数: 0

Factors related to nocturia-specific quality of life in renal transplantation patients 肾移植患者夜尿症生活质量的相关因素

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-05-01 DOI: 10.1111/luts.12517

Nobuyuki Nakamura, Taiki Emoto, Yuichiro Fukuhara, Takeshi Miyazaki, Chikao Aoyagi, Naotaka Gunge, Yu Okabe, Hiroshi Matsuzaki, Aiko Fujikawa, Chizuru Nakagawa, Masahiro Tachibana, Fumihiro Yamasaki, Kosuke Tominaga, Kazuna Tsubouchi, Shintaro Aso, Nobuhiro Haga

Objectives

Patients following renal transplantation (RTX) may experience nocturia exacerbation due to polyuria and reduced bladder capacity, thereby impacting the specific quality of life (QOL) associated with nocturia. The present study aims to investigate factors associated with the deterioration of nocturia-specific QOL in RTX patients.

Methods

The study cohort comprised 59 consecutive patients who had undergone successful RTX. Nocturia-related QOL questionnaires (N-QOL) were employed to evaluate the specific QOL related to nocturia. The Bother/Concern and Sleep/Energy domains of the N-QOL were also assessed. The primary outcome measure was to explore factors related to the aggravation of nocturia-specific QOL in patients post-RTX.

Results

The mean nocturia frequency post-RTX was 1.3 ± 1.0. Univariate and multivariate analyses revealed a significant reduction in the Bother/Concern domain score associated with increased nocturia (p = .042). Aging significantly decreased the total N-QOL score and the Sleep/Energy domain score (p = .001 and .0002, respectively). Prolonged duration after RTX significantly reduced the scores of both the Sleep/Energy domain and the Bother/Concern domain (p = .018 and .037, respectively). However, the duration of dialysis prior to RTX was not significantly associated with the total score or subdomains of N-QOL.

Conclusions

Nocturia-specific QOL affected not only the nocturia itself, but also aging and the prolonged duration after RTX. Thus, comprehensive approaches to the RTX patients were needed to improve the Nocturia-specific QOL in RTX patients.

目的肾移植（RTX）术后患者可能会因为多尿和膀胱容量减少而导致夜尿加重，从而影响与夜尿相关的特定生活质量（QOL）。本研究旨在探讨与 RTX 患者夜尿特异性 QOL 恶化相关的因素。方法研究队列包括 59 名成功接受 RTX 的连续患者。采用夜尿相关 QOL 问卷（N-QOL）评估与夜尿相关的特异性 QOL。此外，还对 N-QOL 的 "烦扰/担忧 "和 "睡眠/能量 "领域进行了评估。主要研究结果是探讨 RTX 术后患者夜尿特异性 QOL 恶化的相关因素。结果 RTX术后的平均夜尿次数为1.3±1.0次。单变量和多变量分析显示，Bother/Concern域得分的显著降低与夜尿次数增加有关（p = .042）。年龄增长会明显降低 N-QOL 总分和睡眠/能量域得分（p = .001 和 .0002）。RTX 后透析时间延长会明显降低睡眠/能量域和烦恼/忧虑域的得分（p = .018 和 .037）。但是，RTX 之前的透析持续时间与 N-QOL 的总分或子域没有明显关系。结论夜尿症特异性 QOL 不仅影响夜尿症本身，还影响年龄增长和 RTX 后的持续时间。因此，需要对 RTX 患者采取综合方法，以改善 RTX 患者夜尿特异性 QOL。

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引用次数: 0

Correction to “Effects of onabotulinum toxin-A injection on sexual function in women with refractory interstitial cystitis/bladder pain syndrome: A prospective study” 对 "注射奥博毒素-A 对难治性间质性膀胱炎/膀胱疼痛综合征妇女性功能的影响 "的更正：一项前瞻性研究"

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-04-28 DOI: 10.1111/luts.12514

Karaburun, MC, Kubilay, E, Öztuna, D, Gökçe, Mİ, Süer, E, Gülpınar, Ö. Effects of onabotulinum toxin-A injection on sexual function in women with refractory interstitial cystitis/bladder pain syndrome: a prospective study. Lower Urinary Tract Symptoms. 2024; 16(2):e12511. doi:10.1111/luts.12511

The revised date should be 29 January 2024 instead of 17 January 2024.

We apologize for this error.

Karaburun, MC, Kubilay, E, Öztuna, D, Gökçe, Mİ, Süer, E, Gülpınar, Ö. 奥博毒素-A注射液对难治性间质性膀胱炎/膀胱疼痛综合征妇女性功能的影响：一项前瞻性研究。下尿路症状》。 2024; 16(2):e12511. doi:10.1111/luts.12511 修订日期应为 2024 年 1 月 29 日，而非 2024 年 1 月 17 日。我们对此错误表示歉意。

引用次数: 0

Correction to “Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy” 对 "盆腔放疗史患者植入人工尿道括约肌后下尿路症状的纵向恶化 "的更正

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-04-28 DOI: 10.1111/luts.12516

Kataoka, M, Yokoyama, M, Waseda, Y, et al. Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy. Lower Urinary Tract Symptoms. 2024; 16(1):e12507. doi:10.1111/luts.12507

In the abstract section, ‘0.43/year, p = .006’ should read as ‘0.42/year, p = .018’ and the citation of ‘Figure 2’ on page 3 should be corrected to ‘Figure 1’.

We apologize for this error.

Kataoka, M, Yokoyama, M, Waseda, Y, et al. 盆腔放射治疗史患者植入人工尿道括约肌后下尿路症状的纵向恶化。下尿路症状》。 2024; 16(1):e12507. doi:10.1111/luts.12507 在摘要部分，"0.43/year, p = .006 "应为 "0.42/year, p = .018"，第3页 "图2 "应更正为 "图1"。

引用次数: 0

Long-term safety of desmopressin orally disintegrating tablets in men with nocturia due to nocturnal polyuria: Interim results of a specified drug use–results survey in Japan 去氨加压素口腔崩解片对夜间多尿症男性患者的长期安全性：日本特定药物使用效果调查的中期结果

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-04-15 DOI: 10.1111/luts.12513

Yoshimasa Ogawa, Shujiro Murata, Kiyotoshi Kuramoto, Atsushi Nakano

Objectives

This interim report presents the 12-week results of a post-marketing surveillance evaluating the safety of desmopressin orally disintegrating tablets 25 and 50 μg in Japanese men with nocturia due to nocturnal polyuria.

Methods

Of the planned study population of 1000 Japanese men receiving desmopressin for the first time for nocturia due to nocturnal polyuria, 971 cases were enrolled. In this interim analysis, 9 cases, including 6 registry violations and 3 cases of unconfirmed desmopressin dosing, were excluded from the 354 case report forms collected and fixed by the end of December 2021, and data up to 12 weeks after administration in 345 cases were defined as the safety analysis set.

Results

The mean age was 74.5 ± 9.9 years and 88.7% of the survey participants were aged ≥65 years. Desmopressin was started at a dose of 25 μg in 153 cases (44.3%). There were 102 adverse drug reactions (ADRs) reported in 71 cases, including 6 serious ADRs in 3 cases (0.9%). The most common ADR was hyponatremia occurring in 29 cases (8.4%). Eight of the hyponatremic cases were asymptomatic. Symptoms were resolved or slightly improved within 4 weeks of onset in 13 of 29 cases of hyponatremia. In addition, hyponatremia occurred in 11 of 217 cases (5.1%), with a serum sodium level before the administration of desmopressin of ≥140 mmol/L, and in 13 of 87 cases (14.9%), with a level of 135–139 mmol/L, and was not measured in 5 hyponatremia cases. Patient characteristics that showed significant differences in the occurrence of hyponatremia included body weight, body mass index, renal function, and pretreatment serum sodium level. Regular monitoring of serum sodium is necessary for early detection of hyponatremia.

Conclusions

Hyponatremia was the most common ADR when desmopressin orally disintegrating tablets were used to treat nocturia due to nocturnal polyuria over a 12-week period.

目的本中期报告介绍了一项上市后监测的 12 周结果，该监测评估了去氨加压素口腔崩解片 25 μg 和 50 μg 在因夜间多尿引起夜尿的日本男性患者中的安全性。方法在计划的 1000 名首次接受去氨加压素治疗夜间多尿引起的夜尿症的日本男性研究人群中，有 971 个病例入选。在本次中期分析中，从收集到的354份病例报告表中剔除了9个病例，其中包括6个违反注册规定的病例和3个未确认去氨加压素剂量的病例，并在2021年12月底之前进行了固定，345个病例用药后12周内的数据被定义为安全性分析集。结果平均年龄为（74.5±9.9）岁，88.7%的调查参与者年龄≥65岁。153例（44.3%）患者的去氨加压素起始剂量为25微克。71例患者中报告了102例药物不良反应（ADR），其中3例（0.9%）发生了6例严重药物不良反应。最常见的药物不良反应是低钠血症，有 29 例（8.4%）。其中 8 例低钠血症患者无症状。29 例低钠血症中有 13 例在发病后 4 周内症状缓解或略有改善。此外，217 例低钠血症病例中有 11 例（5.1%）在使用去氨加压素前血清钠水平≥140 毫摩尔/升，87 例低钠血症病例中有 13 例（14.9%）血清钠水平为 135-139 毫摩尔/升，5 例低钠血症病例未测量血清钠水平。体重、体重指数、肾功能和治疗前血清钠水平等患者特征在低钠血症发生率上存在显著差异。定期监测血清钠对早期发现低钠血症很有必要。结论低钠血症是去氨加压素口腔崩解片在 12 周内用于治疗夜间多尿引起的夜尿症时最常见的不良反应。

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引用次数: 0

Predictors of postoperative storage symptoms in male patients with lower urinary tract symptoms: A retrospective analysis of prostate surgery for benign prostatic enlargement 下尿路症状男性患者术后储尿症状的预测因素：对良性前列腺增生前列腺手术的回顾性分析

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-04-11 DOI: 10.1111/luts.12512

Hiroki Ito, Masato Takanashi, Takeshi Fukazawa, Hiroki Takizawa, Mari Hioki, Risa Shinoki, Takashi Kawahara, Kazuhide Makiyama, Kazuki Kobayashi

Objectives

This study investigated the effects of prostate surgery on storage symptoms in male patients with lower urinary tract symptoms (LUTS) from benign prostatic enlargement (BPE). This study aimed to identify patient characteristics associated with improved, unchanged, and deteriorated post-surgical storage symptoms and to identify the risk factors for non-improvement or deterioration.

Methods

A retrospective analysis of 586 prostate surgeries performed between 2016 and 2022 at Yokosuka Kyosai Hospital was conducted on patients with LUTS and at least one storage symptom preoperatively. Patients with active urinary tract infection, prostate/bladder cancer, urethral strictures, or dementia were excluded. The study enrolled 230 patients and assessed storage symptoms using the International Prostate Symptom Score (IPSS).

Results

Overall, storage symptoms improved, remained unchanged, and deteriorated in 87.0%, 5.7%, and 7.4% of patients, respectively. The patients in the deteriorated group were significantly older, whereas those in the no-change group had smaller prostate volumes. Patient-reported outcome scores (IPSS, IPSS-QoL, and BII) were significantly higher in the improved group. The predictors of non-improvement included low IPSS storage score, cardiovascular disease, and diabetes mellitus. Predictors of deterioration included advanced age and low IPSS storage score.

Conclusions

Patients with severe LUTS showed greater postoperative improvement in storage symptoms. A low IPSS storage score predicted non-improvement and deterioration. Advanced age, low IPSS storage score, and a history of cardiovascular disease and diabetes mellitus were identified as key predictors. Awareness of these factors may guide preoperative counseling and improve decision-making in prostate surgery, ensuring more personalized and effective treatment strategies.

目的本研究调查了前列腺手术对良性前列腺增生（BPE）引起的下尿路症状（LUTS）男性患者储尿症状的影响。本研究旨在确定与手术后储尿症状改善、不变和恶化相关的患者特征，并确定未改善或恶化的风险因素。方法对横须贺共济医院在 2016 年至 2022 年期间进行的 586 例前列腺手术进行回顾性分析，研究对象为术前患有 LUTS 并至少有一种贮尿症状的患者。排除了患有活动性尿路感染、前列腺癌/膀胱癌、尿道狭窄或痴呆症的患者。该研究共招募了 230 名患者，并使用国际前列腺症状评分（IPSS）对储尿症状进行了评估。结果总体而言，分别有 87.0%、5.7% 和 7.4% 的患者贮尿症状有所改善、保持不变或恶化。恶化组患者的年龄明显偏大，而无变化组患者的前列腺体积较小。病情好转组的患者报告结果评分（IPSS、IPSS-QoL 和 BII）明显更高。未改善组的预测因素包括 IPSS 存储得分低、心血管疾病和糖尿病。恶化的预测因素包括高龄和 IPSS 存储评分低。结论 LUTS 严重的患者术后储尿症状改善程度更大。IPSS 存储评分低预示症状无改善和恶化。高龄、IPSS 存储评分低、心血管疾病和糖尿病史被认为是主要的预测因素。对这些因素的认识可指导术前咨询并改善前列腺手术的决策，从而确保采取更加个性化和有效的治疗策略。

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引用次数: 0