To evaluate the clinical outcomes and patient satisfaction rate between men aged under and over 70 years who underwent artificial urinary sphincter (AUS) surgery.
Methods
A prospective review of all men who received AUS between January 2008 and January 2018 was undertaken with a minimum 24-month review. All patient demographics and surgical outcomes including data on the Incontinence Impact Questionnaire, Patient Global Impression of Improvement (PGI-I) and National Surgical Quality Improvement Program Frailty Index (NSQIP-FI) scores, as well as patient satisfaction rates, were recorded.
Results
Of the 245 AUS implanted, 60 patients were aged ≥70 years with 45 virgin cases and 15 revision AUS. Reduction in mean pad use and weight over 24 hours were significant at 0.21 (0–1) pads and 8 (0–30) g in both groups with no significant difference (P = 0.76). Kaplan–Meier estimates of AUS survival showed no significant difference between men aged ≥ and <70 years at 1 year (98% versus 96%; P = 0.44). The multivariate logistic regression model showed that radiation (adjusted odds ratio [OR] 3.8, 95% CI 1.4–6.8; P < 0.01) was a significant predictor of AUS revision, while age ≥ 70 years (adjusted OR 1.0, 95% CI 0.8–8.8; P = 0.14) and frailty (NSQIP-FI ≥ 0.27 adjusted OR 0.9, 95% CI 0.2–7.6; P = 0.82) were not. There were no significant differences in PGI-I scores (P = 0.43) and overall satisfaction rate (83% versus 84%; P = 0.44) between the two groups.
Conclusions
Men aged ≥70 years reported similar clinical efficacy as men aged <70 years in terms of device survival and satisfaction rates following AUS surgery.
目的评价70岁以下和70岁以上男性行人工尿括约肌(AUS)手术的临床疗效和患者满意度。方法对2008年1月至2018年1月期间接受AUS治疗的所有男性进行前瞻性评估，至少进行24个月的评估。记录所有患者人口统计数据和手术结果，包括失禁影响问卷、患者总体改善印象(PGI-I)和国家手术质量改进计划脆弱指数(NSQIP-FI)评分以及患者满意度。结果245例植入AUS, 60例年龄≥70岁，其中45例为首次植入，15例为翻修AUS。在24小时内，两组患者在0.21(0-1)个垫子和8 (0-30)g时，平均垫子使用量和体重均显著减少，差异无统计学意义(P = 0.76)。Kaplan-Meier估计，≥70岁和≥70岁男性的1年生存率无显著差异(98% vs 96%;p = 0.44)。多因素logistic回归模型显示辐射(校正优势比[OR] 3.8, 95% CI 1.4-6.8;P < 0.01)是AUS修订的重要预测因子，而年龄≥70岁(调整OR 1.0, 95% CI 0.8-8.8;P = 0.14)和虚弱(NSQIP-FI≥0.27调整OR 0.9, 95% CI 0.2-7.6;P = 0.82)。PGI-I评分(P = 0.43)和总体满意度(83%对84%;P = 0.44)。结论≥70岁男性与≥70岁男性在AUS手术后的器械存活率和满意率方面的临床疗效相似。
{"title":"Is artificial urinary sphincter surgery safe and effective in elderly males aged 70 years and above?","authors":"Eric Chung, Juan Wang, Ross Cartmill","doi":"10.1111/luts.12460","DOIUrl":"10.1111/luts.12460","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the clinical outcomes and patient satisfaction rate between men aged under and over 70 years who underwent artificial urinary sphincter (AUS) surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective review of all men who received AUS between January 2008 and January 2018 was undertaken with a minimum 24-month review. All patient demographics and surgical outcomes including data on the Incontinence Impact Questionnaire, Patient Global Impression of Improvement (PGI-I) and National Surgical Quality Improvement Program Frailty Index (NSQIP-FI) scores, as well as patient satisfaction rates, were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 245 AUS implanted, 60 patients were aged ≥70 years with 45 virgin cases and 15 revision AUS. Reduction in mean pad use and weight over 24 hours were significant at 0.21 (0–1) pads and 8 (0–30) g in both groups with no significant difference (<i>P</i> = 0.76). Kaplan–Meier estimates of AUS survival showed no significant difference between men aged ≥ and <70 years at 1 year (98% versus 96%; <i>P</i> = 0.44). The multivariate logistic regression model showed that radiation (adjusted odds ratio [OR] 3.8, 95% CI 1.4–6.8; <i>P</i> < 0.01) was a significant predictor of AUS revision, while age ≥ 70 years (adjusted OR 1.0, 95% CI 0.8–8.8; <i>P</i> = 0.14) and frailty (NSQIP-FI ≥ 0.27 adjusted OR 0.9, 95% CI 0.2–7.6; <i>P</i> = 0.82) were not. There were no significant differences in PGI-I scores (<i>P</i> = 0.43) and overall satisfaction rate (83% versus 84%; <i>P</i> = 0.44) between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Men aged ≥70 years reported similar clinical efficacy as men aged <70 years in terms of device survival and satisfaction rates following AUS surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/ff/LUTS-14-416.PMC9804846.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10492587","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}
The purpose of this study was to develop the Turkish version of the Core Lower Urinary Tract Symptom Score (CLSS) and determine its psychometric properties in Turkish subjects.
Methods
A total of 428 subjects, 259 with lower urinary tract symptoms (LUTS) and 169 without any complaints, were included in the study. In addition, 40 subjects were included in the study for test-retest analysis. After the Turkish version of the CLSS was created, all patients underwent medical history, physical examination, complete urinalysis, urinary ultrasonography, and filled out a CLSS. In addition, men were asked to fill in International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire-Male LUTS and National Institutes of Health Chronic Prostatitis Symptom Index. Women completed the Bristol Female LUTS-Short Form and IPSS. The patients from the test-retest group were asked to fill out the CLSS two times at 2-week intervals.
Results
CLSS showed high internal consistency (Cronbach's α for men and women was 0.909 and 0.767, respectively). The test-retest reliability of CLSS was high for subdomains (intraclass correlation coefficient was 0.739-0.962). Scores of CLSS were significantly higher in the study group than the control group (P < 0.001). In men and women, it showed very strong convergent validity (P < 0.0001) with subdomain related to other questionnaires. In our confirmatory factor analysis, the original model of CLSS was found to be compatible.
Conclusions
The Turkish version of CLSS is a valid and reliable questionnaire to evaluate the symptoms and disorders of patients with LUTS.
{"title":"Reliability and validity of the Turkish language version of the Core Lower Urinary Tract Symptom Score","authors":"Mehmet E. Erbay, Sena T. Tarhan","doi":"10.1111/luts.12461","DOIUrl":"10.1111/luts.12461","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The purpose of this study was to develop the Turkish version of the Core Lower Urinary Tract Symptom Score (CLSS) and determine its psychometric properties in Turkish subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 428 subjects, 259 with lower urinary tract symptoms (LUTS) and 169 without any complaints, were included in the study. In addition, 40 subjects were included in the study for test-retest analysis. After the Turkish version of the CLSS was created, all patients underwent medical history, physical examination, complete urinalysis, urinary ultrasonography, and filled out a CLSS. In addition, men were asked to fill in International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire-Male LUTS and National Institutes of Health Chronic Prostatitis Symptom Index. Women completed the Bristol Female LUTS-Short Form and IPSS. The patients from the test-retest group were asked to fill out the CLSS two times at 2-week intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CLSS showed high internal consistency (Cronbach's α for men and women was 0.909 and 0.767, respectively). The test-retest reliability of CLSS was high for subdomains (intraclass correlation coefficient was 0.739-0.962). Scores of CLSS were significantly higher in the study group than the control group (<i>P</i> < 0.001). In men and women, it showed very strong convergent validity (<i>P</i> < 0.0001) with subdomain related to other questionnaires. In our confirmatory factor analysis, the original model of CLSS was found to be compatible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Turkish version of CLSS is a valid and reliable questionnaire to evaluate the symptoms and disorders of patients with LUTS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40447787","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}
To clarify Japanese real-world clinical data on the use of desmopressin 25 and 50 μg orally disintegrating tablets (ODT) for male patients with nocturia and evaluate the predictive factors to improve nighttime frequency.
Methods
We retrospectively accumulated real-world clinical data from 27 institutions in Japan. Male patients with two or more episodes of nocturia who received desmopressin ODT for nocturnal polyuria (NP) from 2019 through 2021 were included. The primary endpoint was the change of nighttime frequency until 3 months after desmopressin administration. The secondary endpoints were to clarify the persistence rate, adverse events, and predictive factors of decreasing nighttime frequency.
Results
A total of 118 patients were eligible to participate in this study. The persistence rate of desmopressin on the Kaplan-Meier curve at week 12 was 51.3. The reason for discontinuation was mainly the occurrence of adverse events in 67 patients (56.8%), particularly hyponatremia in 7 patients (5.9%). Nighttime frequencies at baseline, - 1 month and 1 - 3 months after desmopressin administration were 4.1 ± 1.3, 2.9 ± 1.4 (P < .01), and 2.6 ± 1.3 (P < .01), respectively. The mean nighttime urine volume voided at baseline was significantly larger in patients whose nighttime frequency decreased by two or more times than in those with a decrease of less than two times.
Conclusions
Desmopressin 25 and 50 μg ODT treatments are feasible for male patients with NP in Japanese real-world clinical practice. Patients with higher voided volumes, particularly in the nighttime, may have great benefit from desmopressin.
{"title":"Efficacy and safety of desmopressin orally disintegrating tablets 25 and 50 μg in male patients with nocturia: A Japanese real-world multicenter clinical study","authors":"Yuki Kyoda, Makoto Kimura, Takashi Shimizu, Noriomi Miyao, Takuto Ogasawara, Toshiaki Shimizu, Akihiko Iwasawa, Wakako Yorozuya, Jiro Hashimoto, Koji Ichihara, Fumiyasu Takei, Kosuke Uchida, Nodoka Kouzen, Noriyoshi Suzuki, Kimihito Tachikawa, Akihiko Shibuya, Ippei Muranaka, Manabu Okada, Manabu Igarashi, Kosuke Shibamori, Seisuke Nofuji, Keiko Fujino, Tomohiro Toyota, Yu Ito, Nobuo Shinkai, Kohei Hashimoto, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori","doi":"10.1111/luts.12459","DOIUrl":"10.1111/luts.12459","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To clarify Japanese real-world clinical data on the use of desmopressin 25 and 50 μg orally disintegrating tablets (ODT) for male patients with nocturia and evaluate the predictive factors to improve nighttime frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively accumulated real-world clinical data from 27 institutions in Japan. Male patients with two or more episodes of nocturia who received desmopressin ODT for nocturnal polyuria (NP) from 2019 through 2021 were included. The primary endpoint was the change of nighttime frequency until 3 months after desmopressin administration. The secondary endpoints were to clarify the persistence rate, adverse events, and predictive factors of decreasing nighttime frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 118 patients were eligible to participate in this study. The persistence rate of desmopressin on the Kaplan-Meier curve at week 12 was 51.3. The reason for discontinuation was mainly the occurrence of adverse events in 67 patients (56.8%), particularly hyponatremia in 7 patients (5.9%). Nighttime frequencies at baseline, - 1 month and 1 - 3 months after desmopressin administration were 4.1 ± 1.3, 2.9 ± 1.4 (<i>P</i> < .01), and 2.6 ± 1.3 (<i>P</i> < .01), respectively. The mean nighttime urine volume voided at baseline was significantly larger in patients whose nighttime frequency decreased by two or more times than in those with a decrease of less than two times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Desmopressin 25 and 50 μg ODT treatments are feasible for male patients with NP in Japanese real-world clinical practice. Patients with higher voided volumes, particularly in the nighttime, may have great benefit from desmopressin.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40447786","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}
Naoki Hirahara, Shunji Harikai, Atsuko Fujihara, Yasuhiro Yamada, So Ushijima, Osamu Ukimura, KPUM-LUTS Research Group
Introduction
This multicenter and prospective study was performed to evaluate the efficacy of tadalafil on patient-reported bother for each symptom in men with lower urinary tract symptoms (LUTS).
Methods
Men with LUTS received 5 mg of tadalafil daily for 4 weeks. We assessed change in symptom severity using both international prostate symptom score (IPSS), and overactive bladder symptom score (OABSS), as well as patient-reported quality of life (QOL: bother or satisfaction) for each symptoms using IPSS-visual analog scale (IPSS-VAS) and OABSS-VAS.
Results
We found significant improvements in total IPSS (P < 0.001), including voiding symptoms (P < 0.001), storage symptoms (P < 0.001), and QOL (P < 0.001). All VAS measures corresponding to symptoms in IPSS and OABSS also significantly improved (P < 0.001). The most bothersome symptoms for each patient at baseline evaluated by VAS measures significantly improved (P < 0.001). Patients whose most bothersome symptoms at baseline included IPSS-Q7 (nocturia) showed significantly smaller improvement of VAS measure after treatment than those without it (P = 0.024).
Conclusions
Daily tadalafil significantly improved not only symptom severity of LUTS but also patient-reported QOL on each symptom.
{"title":"Efficacy of tadalafil on symptom-specific bother in men with lower urinary tract symptoms","authors":"Naoki Hirahara, Shunji Harikai, Atsuko Fujihara, Yasuhiro Yamada, So Ushijima, Osamu Ukimura, KPUM-LUTS Research Group","doi":"10.1111/luts.12457","DOIUrl":"10.1111/luts.12457","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This multicenter and prospective study was performed to evaluate the efficacy of tadalafil on patient-reported bother for each symptom in men with lower urinary tract symptoms (LUTS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Men with LUTS received 5 mg of tadalafil daily for 4 weeks. We assessed change in symptom severity using both international prostate symptom score (IPSS), and overactive bladder symptom score (OABSS), as well as patient-reported quality of life (QOL: bother or satisfaction) for each symptoms using IPSS-visual analog scale (IPSS-VAS) and OABSS-VAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found significant improvements in total IPSS (<i>P</i> < 0.001), including voiding symptoms (<i>P</i> < 0.001), storage symptoms (<i>P</i> < 0.001), and QOL (<i>P</i> < 0.001). All VAS measures corresponding to symptoms in IPSS and OABSS also significantly improved (<i>P</i> < 0.001). The most bothersome symptoms for each patient at baseline evaluated by VAS measures significantly improved (<i>P</i> < 0.001). Patients whose most bothersome symptoms at baseline included IPSS-Q7 (nocturia) showed significantly smaller improvement of VAS measure after treatment than those without it (<i>P</i> = 0.024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Daily tadalafil significantly improved not only symptom severity of LUTS but also patient-reported QOL on each symptom.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40501863","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}
Biofeedback is an effective treatment in children with standard urotherapy-resistant dysfunctional voiding (DV). However, the duration of the session intervals is not standardized. We aimed to compare the effectiveness of daily and weekly sessions of biofeedback treatments.
Methods
The data of children who received biofeedback due to DV between March 2018 and May 2019 were retrospectively evaluated. The children were divided into two groups, one with daily and the other with weekly sessions. The voiding patterns in uroflowmetry (UF), maximum flow rate (Qmax), electromyography activity, postvoid residual volume (PVR), the ratio of voided volume to expected bladder capacity (EBC) (%), and Dysfunctional Voiding and Incontinence Scoring System (DVISS) were compared between the two groups.
Results
A total of 45 children (39 girls [86.6%] and 6 boys [13.3%]) were included in the study. The daily group consisted of 27 (60%) children and the weekly group of 18 (40%). Qmax, PVR, number of abnormal UF patterns, voiding volume/EBC, and DVISS scores were similar between the two groups before treatment. Voiding parameters improved statistically significantly in both groups following biofeedback, but there was no difference between the two groups. A statistical difference was found between the results of DVISS after treatment (P = .03).
Conclusion
Both types of biofeedback treatment (daily and weekly) are effective methods that improve voiding parameters and DVISS values in children with DV. Therefore, the duration between sessions can be determined according to the suitability of the patient and the biofeedback unit.
{"title":"The effect of duration between sessions on biofeedback treatment in children with dysfunctional voiding","authors":"Raziye Ergun MD, Naime Ipek Ozturk MD, Cagri Akin Sekerci MD","doi":"10.1111/luts.12456","DOIUrl":"10.1111/luts.12456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Biofeedback is an effective treatment in children with standard urotherapy-resistant dysfunctional voiding (DV). However, the duration of the session intervals is not standardized. We aimed to compare the effectiveness of daily and weekly sessions of biofeedback treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of children who received biofeedback due to DV between March 2018 and May 2019 were retrospectively evaluated. The children were divided into two groups, one with daily and the other with weekly sessions. The voiding patterns in uroflowmetry (UF), maximum flow rate (Qmax), electromyography activity, postvoid residual volume (PVR), the ratio of voided volume to expected bladder capacity (EBC) (%), and Dysfunctional Voiding and Incontinence Scoring System (DVISS) were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 45 children (39 girls [86.6%] and 6 boys [13.3%]) were included in the study. The daily group consisted of 27 (60%) children and the weekly group of 18 (40%). Qmax, PVR, number of abnormal UF patterns, voiding volume/EBC, and DVISS scores were similar between the two groups before treatment. Voiding parameters improved statistically significantly in both groups following biofeedback, but there was no difference between the two groups. A statistical difference was found between the results of DVISS after treatment (<i>P</i> = .03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both types of biofeedback treatment (daily and weekly) are effective methods that improve voiding parameters and DVISS values in children with DV. Therefore, the duration between sessions can be determined according to the suitability of the patient and the biofeedback unit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40487407","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}
Pub Date : 2022-07-01Epub Date: 2022-02-15DOI: 10.1111/luts.12429
Zhenglei Fei, Jiazi Yu, Bin Huang, Liangbin Jin
Objectives: This study investigated male voiding dysfunction (VD) or lower urinary tract function in rectal cancer (RC) patients after laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP).
Methods: One hundred and eighty-seven male RC patients admitted between January 2016 and May 2019 were enrolled in this study, 112 of whom underwent laparoscopic total mesorectal excision (LTME) and 75 underwent open total mesorectal excision (OTME). The International Prostatic Symptom Score (IPSS) was compared between the two groups.
Results: The postoperative IPSS in patients with RC was elevated on day 7 and gradually decreased during the first month after surgery. Compared with the OTME group, the IPSS scores decreased less in the LTME group at week 1, and months 1 and 3 postoperatively (6.82 ± 2.13 vs 10.15 ± 3.86, 5.70 ± 2.45 vs 7.21 ± 2.0, and 5.01 ± 2.09 vs 5.75 ± 2.55, respectively; P < 0.05). The VD rate was significantly lower in the LTME group than the OTME group at 1, 2, and 3 weeks postoperatively (21.4% vs 26.8%,13.4% vs 25.3%, and 9.8% vs18.6%, respectively; P < 0.05); however, there was no major difference in the incidence of VD 6 months postoperatively between the two groups (P > 0.05). VD was more frequent in the OTME group than the LTME group 6 months postoperatively, but the difference was not statistically significant (odds ratio = 1.857, 95% CI, 0.964-3.645, P = 0.064).
Conclusions: LTME may be superior to OTME with respect to PANP of lower urinary tract function in males with RC.
目的:本研究探讨直肠癌(RC)患者在腹腔镜或开放式全肠系膜切除术后盆腔自主神经保留(PANP)的男性排尿功能障碍(VD)或下尿路功能。方法:2016年1月至2019年5月期间入院的187例男性RC患者纳入本研究，其中112例接受腹腔镜全肠系膜切除术(LTME)， 75例接受开放式全肠系膜切除术(OTME)。比较两组患者的国际前列腺症状评分(IPSS)。结果:RC患者术后IPSS在术后第7天升高，术后1个月内逐渐降低。与OTME组相比，LTME组在术后第1周、第1个月和第3个月IPSS评分下降幅度较小(分别为6.82±2.13 vs 10.15±3.86、5.70±2.45 vs 7.21±2.0、5.01±2.09 vs 5.75±2.55);P 0.05)。术后6个月，OTME组VD发生率高于LTME组，但差异无统计学意义(优势比= 1.857,95% CI, 0.964-3.645, P = 0.064)。结论:对于RC男性下尿路功能的PANP, LTME可能优于OTME。
{"title":"Comparison of postoperative laparoscopic and open total mesorectal excision on lower urinary tract function in men with rectal cancer.","authors":"Zhenglei Fei, Jiazi Yu, Bin Huang, Liangbin Jin","doi":"10.1111/luts.12429","DOIUrl":"https://doi.org/10.1111/luts.12429","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated male voiding dysfunction (VD) or lower urinary tract function in rectal cancer (RC) patients after laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP).</p><p><strong>Methods: </strong>One hundred and eighty-seven male RC patients admitted between January 2016 and May 2019 were enrolled in this study, 112 of whom underwent laparoscopic total mesorectal excision (LTME) and 75 underwent open total mesorectal excision (OTME). The International Prostatic Symptom Score (IPSS) was compared between the two groups.</p><p><strong>Results: </strong>The postoperative IPSS in patients with RC was elevated on day 7 and gradually decreased during the first month after surgery. Compared with the OTME group, the IPSS scores decreased less in the LTME group at week 1, and months 1 and 3 postoperatively (6.82 ± 2.13 vs 10.15 ± 3.86, 5.70 ± 2.45 vs 7.21 ± 2.0, and 5.01 ± 2.09 vs 5.75 ± 2.55, respectively; P < 0.05). The VD rate was significantly lower in the LTME group than the OTME group at 1, 2, and 3 weeks postoperatively (21.4% vs 26.8%,13.4% vs 25.3%, and 9.8% vs18.6%, respectively; P < 0.05); however, there was no major difference in the incidence of VD 6 months postoperatively between the two groups (P > 0.05). VD was more frequent in the OTME group than the LTME group 6 months postoperatively, but the difference was not statistically significant (odds ratio = 1.857, 95% CI, 0.964-3.645, P = 0.064).</p><p><strong>Conclusions: </strong>LTME may be superior to OTME with respect to PANP of lower urinary tract function in males with RC.</p>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39927909","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}
Objectives: We investigated the efficacy of dutasteride add-on therapy to α-1 adrenoceptor antagonists in patients with benign prostate hyperplasia (BPH) in relation to the transitional zone index (TZI) and evaluated the cutoff value of TZI that predicted improvements of subjective symptoms at 6 months.
Methods: Male BPH patients with prostate volume (PV) ≥ 30 mL receiving dutasteride 0.5 mg/d for 6 months as add-on therapy along with α-1 adrenoceptor antagonists were enrolled. PV, transitional zone volume (TZV), TZI, International Prostate Symptom Score (IPSS), and uroflowmetry parameters before and at 6 months with dutasteride add-on treatment were evaluated.
Results: Eighty-three patients were included. The changes of total IPSS, IPSS voiding subscore, IPSS quality of life score, and voided volume were significantly correlated with TZI. Among baseline parameters, TZV and TZI were significantly associated with the changes of total IPSS in univariate analysis, and only TZI remained as an independent predictive factor for improving total IPSS in multivariate analysis (odds ratio -8.3, P = .048). The cutoff point of TZI for predicting an improvement of the total IPSS by 6 points or more was 0.67 (area under the curve 0.71, sensitivity 0.62, specificity 0.79).
Conclusions: A higher TZI was significantly associated with improvement of subjective symptoms but not uroflowmetric findings for BPH patients with 6 months of dutasteride add-on therapy along with α-1 adrenoceptor antagonists, and the predictive value of TZI for effective dutasteride add-on therapy was higher than 0.67. BPH patients using α-1 adrenoceptor antagonists with a TZI higher than 0.67 can be good candidates for add-on dutasteride therapy.
{"title":"The cutoff value of transitional zone index predicting the efficacy of dutasteride on subjective symptoms in patients with benign prostate hyperplasia.","authors":"Shinsuke Kurokawa, Jun Kamei, Koichi Sakata, Toru Sugihara, Akira Fujisaki, Satoshi Ando, Tatsuya Takayama, Tetsuya Fujimura","doi":"10.1111/luts.12431","DOIUrl":"https://doi.org/10.1111/luts.12431","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the efficacy of dutasteride add-on therapy to α-1 adrenoceptor antagonists in patients with benign prostate hyperplasia (BPH) in relation to the transitional zone index (TZI) and evaluated the cutoff value of TZI that predicted improvements of subjective symptoms at 6 months.</p><p><strong>Methods: </strong>Male BPH patients with prostate volume (PV) ≥ 30 mL receiving dutasteride 0.5 mg/d for 6 months as add-on therapy along with α-1 adrenoceptor antagonists were enrolled. PV, transitional zone volume (TZV), TZI, International Prostate Symptom Score (IPSS), and uroflowmetry parameters before and at 6 months with dutasteride add-on treatment were evaluated.</p><p><strong>Results: </strong>Eighty-three patients were included. The changes of total IPSS, IPSS voiding subscore, IPSS quality of life score, and voided volume were significantly correlated with TZI. Among baseline parameters, TZV and TZI were significantly associated with the changes of total IPSS in univariate analysis, and only TZI remained as an independent predictive factor for improving total IPSS in multivariate analysis (odds ratio -8.3, P = .048). The cutoff point of TZI for predicting an improvement of the total IPSS by 6 points or more was 0.67 (area under the curve 0.71, sensitivity 0.62, specificity 0.79).</p><p><strong>Conclusions: </strong>A higher TZI was significantly associated with improvement of subjective symptoms but not uroflowmetric findings for BPH patients with 6 months of dutasteride add-on therapy along with α-1 adrenoceptor antagonists, and the predictive value of TZI for effective dutasteride add-on therapy was higher than 0.67. BPH patients using α-1 adrenoceptor antagonists with a TZI higher than 0.67 can be good candidates for add-on dutasteride therapy.</p>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39625058","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}
Objectives: Muscarinic M3 (M3 ) receptors mediate cholinergic smooth muscle contraction of the bladder. Current drugs targeting bladder M3 receptors for micturition disorders have a risk of cholinergic side effects due to excessive receptor activation and insufficient selectivity. We investigated the effect of ASP8302, a novel positive allosteric modulator (PAM) of M3 receptors, on bladder function in rats.
Methods: Modulation of carbachol-induced increases in intracellular Ca2+ was assessed in cells expressing rat muscarinic receptors. Potentiation of bladder contractions was evaluated using isolated rat bladder strips and by measuring intravesical pressure in anesthetized rats. Conscious cystometry was performed to investigate the effects on residual urine volume and voiding efficiency in rat voiding dysfunction models induced by the α1 -adrenoceptor agonist midodrine and muscarinic receptor antagonist atropine, and bladder outlet obstruction. To assess potential side effects, the number of stools and tracheal insufflation pressure were measured in conscious and anesthetized rats, respectively.
Results: ASP8302 demonstrated PAM effects on the rat M3 receptor in cell assays, and augmented cholinergic bladder contractions both in vivo and in vitro. ASP8302 improved voiding efficiency and reduced residual urine volume in two voiding dysfunction models as effectively as distigmine bromide, but unlike distigmine bromide did not affect the number of stools or tracheal insufflation pressure.
Conclusions: Our results in rats indicate that ASP8302 improves voiding dysfunction by potentiating bladder contraction with fewer effects on cholinergic responses in other organs, and suggest a potential advantage over current cholinomimetic drugs for treating micturition disorders caused by insufficient bladder contraction.
{"title":"Muscarinic M<sub>3</sub> positive allosteric modulator ASP8302 enhances bladder contraction and improves voiding dysfunction in rats.","authors":"Risa Okimoto, Katsutoshi Ino, Kenichiro Ishizu, Hajime Takamatsu, Kazuyuki Sakamoto, Hironori Yuyama, Katsunori Imazumi, Akiyoshi Ohtake, Noriyuki Masuda, Masahiro Takeda","doi":"10.1111/luts.12430","DOIUrl":"https://doi.org/10.1111/luts.12430","url":null,"abstract":"<p><strong>Objectives: </strong>Muscarinic M<sub>3</sub> (M<sub>3</sub> ) receptors mediate cholinergic smooth muscle contraction of the bladder. Current drugs targeting bladder M<sub>3</sub> receptors for micturition disorders have a risk of cholinergic side effects due to excessive receptor activation and insufficient selectivity. We investigated the effect of ASP8302, a novel positive allosteric modulator (PAM) of M<sub>3</sub> receptors, on bladder function in rats.</p><p><strong>Methods: </strong>Modulation of carbachol-induced increases in intracellular Ca<sup>2+</sup> was assessed in cells expressing rat muscarinic receptors. Potentiation of bladder contractions was evaluated using isolated rat bladder strips and by measuring intravesical pressure in anesthetized rats. Conscious cystometry was performed to investigate the effects on residual urine volume and voiding efficiency in rat voiding dysfunction models induced by the α<sub>1</sub> -adrenoceptor agonist midodrine and muscarinic receptor antagonist atropine, and bladder outlet obstruction. To assess potential side effects, the number of stools and tracheal insufflation pressure were measured in conscious and anesthetized rats, respectively.</p><p><strong>Results: </strong>ASP8302 demonstrated PAM effects on the rat M<sub>3</sub> receptor in cell assays, and augmented cholinergic bladder contractions both in vivo and in vitro. ASP8302 improved voiding efficiency and reduced residual urine volume in two voiding dysfunction models as effectively as distigmine bromide, but unlike distigmine bromide did not affect the number of stools or tracheal insufflation pressure.</p><p><strong>Conclusions: </strong>Our results in rats indicate that ASP8302 improves voiding dysfunction by potentiating bladder contraction with fewer effects on cholinergic responses in other organs, and suggest a potential advantage over current cholinomimetic drugs for treating micturition disorders caused by insufficient bladder contraction.</p>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787865","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}
Pub Date : 2022-07-01Epub Date: 2022-02-17DOI: 10.1111/luts.12432
Muhammad Muneeb Ather, Sadia Aman, Huma Qamar, Rabia Latif, Muhammad Bahadur Baloch, Uruj Zehra
Objectives: The current study is designed to evaluate and compare the histological changes in the surgical samples of prostate taken from patients undergoing transurethral resection of prostate (TURP) for benign prostate hyperplasia (BPH) with different sizes.
Methods: Prostate surgical tissue samples were obtained from BPH patients undergoing TURP after taking informed consent. Ultrasound measure of prostatic weight and prostate-specific antigen (PSA) levels were obtained from the patients along with other clinical and demographic details. Tissue samples were fixed, processed, sectioned and stained with hematoxylin and eosin and Masson's trichrome to look for histological features, specifically smooth muscle proliferation. Immunohistochemical expression of bone morphogenetic protein (BMP)-2 was recorded to assess the calcification potential.
Results: Fifty-nine surgical samples were obtained from the patients of age range 50-90 years and body mass index (BMI) 15.6-33.3 kg/m2 . The range of ultrasound measures of prostate weight was 20-137 g with PSA ranged 1.03-93.3 ng/mL. Patients with small-sized prostate had significant severe smooth muscle proliferation (P < .001). Prostate size/weight had significant positive association with BMI (P < 0.001, r = 0.543) and negative association with BMP-2 (P < 0.001, r = -0.654). Samples with severe smooth muscle proliferation were with increased BMP-2 expression (P < .001) and higher levels of PSA levels (P = 0.004). BMP-2 expression revealed positive significant association with PSA (P < .001, r = 0.432).
Conclusion: From this study we conclude that BPH patients with small-sized glands and high PSA levels have increased smooth muscle proliferation and calcification potential causing the symptoms of lower urinary tract symptoms in these patients.
{"title":"Lower urinary tract symptoms in patients with small prostates: Smooth muscle proliferation and calcification might be causative factors.","authors":"Muhammad Muneeb Ather, Sadia Aman, Huma Qamar, Rabia Latif, Muhammad Bahadur Baloch, Uruj Zehra","doi":"10.1111/luts.12432","DOIUrl":"https://doi.org/10.1111/luts.12432","url":null,"abstract":"<p><strong>Objectives: </strong>The current study is designed to evaluate and compare the histological changes in the surgical samples of prostate taken from patients undergoing transurethral resection of prostate (TURP) for benign prostate hyperplasia (BPH) with different sizes.</p><p><strong>Methods: </strong>Prostate surgical tissue samples were obtained from BPH patients undergoing TURP after taking informed consent. Ultrasound measure of prostatic weight and prostate-specific antigen (PSA) levels were obtained from the patients along with other clinical and demographic details. Tissue samples were fixed, processed, sectioned and stained with hematoxylin and eosin and Masson's trichrome to look for histological features, specifically smooth muscle proliferation. Immunohistochemical expression of bone morphogenetic protein (BMP)-2 was recorded to assess the calcification potential.</p><p><strong>Results: </strong>Fifty-nine surgical samples were obtained from the patients of age range 50-90 years and body mass index (BMI) 15.6-33.3 kg/m<sup>2</sup> . The range of ultrasound measures of prostate weight was 20-137 g with PSA ranged 1.03-93.3 ng/mL. Patients with small-sized prostate had significant severe smooth muscle proliferation (P < .001). Prostate size/weight had significant positive association with BMI (P < 0.001, r = 0.543) and negative association with BMP-2 (P < 0.001, r = -0.654). Samples with severe smooth muscle proliferation were with increased BMP-2 expression (P < .001) and higher levels of PSA levels (P = 0.004). BMP-2 expression revealed positive significant association with PSA (P < .001, r = 0.432).</p><p><strong>Conclusion: </strong>From this study we conclude that BPH patients with small-sized glands and high PSA levels have increased smooth muscle proliferation and calcification potential causing the symptoms of lower urinary tract symptoms in these patients.</p>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39642281","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}
Women working in the medical field may be at risk for pelvic floor dysfunction due to high physical activity levels leading to increased abdominal pressure; however, the actual situation remains unknown. This study aimed to clarify the prevalence of symptoms of pelvic floor dysfunction and its associated factors among Japanese women working in the medical field.
Methods
A cross-sectional study was conducted among female employees at a public hospital in Japan from July to August 2020. Participants answered a web-based questionnaire. Three types of symptoms related to pelvic floor dysfunction were assessed based on one or more subscale scores in the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20).
Results
Out of 466 female employees in the hospital, 294 responded (response rate 63.1%). The mean age was 42.8 ± 10.3 years old and 221 (73.5%) were nurses. The prevalence of at least one type of symptom was 63.9%. The prevalence of recto-anal symptoms (45.9%) was highest, followed by lower urinary tract (37.1%) and pelvic organ prolapse symptoms (22.8%). The total PFDI-20 score was associated with constipation (β = .254), body mass index (β = .136), and part-time work (β = .167) after adjusting for other variables.
Conclusion
This study showed a high prevalence of symptoms related to pelvic floor dysfunction among women working in the medical field. Lifestyle management to prevent constipation and obesity is a promising strategy to improve symptoms of pelvic floor dysfunction.
{"title":"Prevalence of symptoms of pelvic floor dysfunction and related factors among Japanese female healthcare workers","authors":"Moe Sawai, Chikako Yuno, Miho Shogenji, Harumi Nakada, Yoko Takeishi, Maiko Kawajiri, Yasuka Nakamura, Toyoko Yoshizawa, Mikako Yoshida","doi":"10.1111/luts.12455","DOIUrl":"10.1111/luts.12455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Women working in the medical field may be at risk for pelvic floor dysfunction due to high physical activity levels leading to increased abdominal pressure; however, the actual situation remains unknown. This study aimed to clarify the prevalence of symptoms of pelvic floor dysfunction and its associated factors among Japanese women working in the medical field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted among female employees at a public hospital in Japan from July to August 2020. Participants answered a web-based questionnaire. Three types of symptoms related to pelvic floor dysfunction were assessed based on one or more subscale scores in the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 466 female employees in the hospital, 294 responded (response rate 63.1%). The mean age was 42.8 ± 10.3 years old and 221 (73.5%) were nurses. The prevalence of at least one type of symptom was 63.9%. The prevalence of recto-anal symptoms (45.9%) was highest, followed by lower urinary tract (37.1%) and pelvic organ prolapse symptoms (22.8%). The total PFDI-20 score was associated with constipation (β = .254), body mass index (β = .136), and part-time work (β = .167) after adjusting for other variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study showed a high prevalence of symptoms related to pelvic floor dysfunction among women working in the medical field. Lifestyle management to prevent constipation and obesity is a promising strategy to improve symptoms of pelvic floor dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40402786","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}
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