A study of correlation between premature ejaculation and lower urinary tract symptoms among Filipino males

OBJECTIVE: This study aimed to determine the association between Lower Urinary Tract Symptoms (LUTS) and premature ejaculation and define its prevalence and factors associated among Filipino males during the Annual National Digital Rectal Exam (DRE) day. METHODOLOGY: A descriptive cross sectional study was done in all male participants during the Annual National DRE day conducted at the Institute of Urology, St. Luke's Medical Center-Quezon City. All subjects were assessed by urologists for the presence of LUTS using the International Prostate Symptom Score (IPSS), and the Premature Ejaculation Diagnostic Tool (PEDT). The IPSS was categorized into total score (IPSS sum), storage symptoms (FUN - frequency, urgency, nocturia) and voiding symptoms (WISR - weak stream, intermittency, straining and residual urine). Ultrasound was also performed to obtain prostate size. The relationship between age, demographics, prostate size, IPSS scores, storage symptom score, voiding symptom score, and PEDT scores were analyzed using one way ANOVA. The statistical significance was set at P RESULTS: A total of 101 male participants were included in the study. Participants' age ranged from 36 to 86, with a mean age of 61 ±. The mean IPSS was 5.79 (±6.59 SD). The most common symptom is nocturia with prevalence of 32.7%. The prevalence of PE is 26.7% and 16.8% has probable PE. There are no associations between PE and age, LUTS, storage and voiding symptoms, prostate size and co-morbid illnesses such as hypertension and diabetes showing p values of 0.291, 0.226, 0.600, 0.108, 0.908, 0.954 and 0.833 respectively. However PE was associated with weak stream (P= 0.015) and educational attainment (P=0.008). CONCLUSION: Filipino men are becoming more concern about their health. LUTS are commonly seen in men in increasing age. PE is a very common male sexual dysfunction so there is a need for identification of such patients (17). Although, no correlation has been made between age, LUTS and PE in this study, however in further correlational analysis, educational status seems to have an impact in the self-reporting PE which may be due to higher awareness of participants with higher education. It is recommended that clinicians always utilize the screening questions for PE to give the appropriate treatment, since patients are often unwilling to volunteer their symptoms on PE (4.17). Our study also showed significant correlation with PE and weak stream, without association to prostate size. relating to a possible neurologic physiologic pathway rather than anatomic etiology of PE. Further study is recommended.

Terpene compound drug as medical expulsive therapy for ureterolithiasis: A meta-analysis

OBJECTIVE: To investigate the efficacy of terpene compound drug (pinene, camphene, borneol, anethole, fenchone and cineol in olive oil) in facilitating spontaneous passage of ureteral calculiMETHODS: Systematic literature search of the MEDLINE, EMBASE, OVID, Science Direct, Proquest, Google scholar, Cochrane Library databases and rference lists of related literature was done without language restriction. Trials on ureterolithiasis medical expulsive therapy (MET) that compare terpene compound drug versus placebo/control group or alpha-blockers were identified. Articles retrieved were critically appraised by two independent reviewers according to Cochrane Collaboration recommendations. Data from included studies were extracted for calculation of risk ratio (RR) and 95% confidence interval (CI). Effect estimates were pooled using Mantel-Haenszel method with random effect model. Inter-study heterogeneity and publication bias were assessed. The PRISMA guidelines for meta-analysis reporting were followed.RESULTS: Five trials (total of 344 subjects) of adequate methodological quality were included. Pooled effect estimates from homogenous studies showed that compared to placebo/ control group, patients treated with terpene compound drug had significantly higher ureteral calculi expulsion rate (pooled RR: 1.34; 95% CI 1.12, 1.61). Analysis of studies that compare terpene compound drug with alpha-blockers showed no significant difference (pooled RR: 0.79; 95% CI 0.59, 1.06), although significant inter-study heterogeneity was noted. Only minor gastrointestinal adverse effect was reported on terpene compound drug use.CONCLUSIONS: The results suggest that terpene compound drug as MET is effective in promoting passage of ureterolithiasis. High quality large-scale RCTs comparing alpha-blockers and terpene compound drug are warranted to make a more definitive conclusion.

Relationship of dietary intake of omega-3 and omega-6 fatty acids with risk of prostate cancer development: A meta-analyis of cohort studies

OBJECTIVE: To determine the relationship between dietary omega-3 fatty acid(n-3PUFA) and omega-6 fatty acids (n-6PUFA) with prostate cancer risk from a meta-analysis of prospective cohort studies. DESIGN: Cohort studies that investigated the relationship of dietary omega fatty acids and prostate cancer risk were retrieved from MEDLINE, Unbound MEDLINE, EMBASE, OVID, Cochrane Library and Science direct up to June 2011, and were critically appraised using Newcastle-Ottawa Quality Assessment for cohorts. General variance-based method was used to the pool the effect estimates at 95% confidence interval. Heterogeneity was assessed by chi square and quantified by I2. RESULTS: Eight cohort studies were included for meta-analysis. n-3PUFA, n-6PUFA and their derivatives were not significantly associated with risk of prostate cancer in general. A significant heterogeneity (P=0.023,I2=63%) between studies was noted. After inter-study variability adjustment was done, repeat analysis showed a significant negative association between high dietary intake of alpha-linolenic acid(ALA) and prostate cancer risk (pooled RR:0.915;95% CL:0.849, 0.985;P=0.019) Likewise, a slightly positive association was noted on dietary long chain omega-3 fatty acids (EPA+DHA) and prostate cancer risk (pooled RR: 1.135; 95% CI:1.008, 1.278 P=0.036), however when two other cohort studies with data of EPA and DHA both analyzed separately was included into the pool, the association became not significant (RR=1.034;95%CI:0.973,1.096;P=0.2780). CONCLUSION: The intake of n-3PUFA and n-6PUFA does not significantly affect the risk of prostate cancer. High intake of ALA may reduce risk of prostate cancer, while intake of long-chain omega-3 fatty acids does not have a significant effect.

A prospective six-week randomized controlled trial on the efficacy and safety of sodium bicarbonate, citric acid, sodium citrate, and tartaric acid compound compared to potassium citrate in the dissolution of renal stones

OBJECTIVE: To determine the efficacy and safety of sodium bicarbonate, citric acid, sodium citrate, and tartaric acid (compound drug) in comparison to potassium citrate in the treatment of kidney stones. METHODS: Prospective randomized controlled trial of patients with kidney stones recruited from February to October 2011 at Out-patient Department was conducted. Ninety subjects, consented and eligible, were enrolled in this study. Random allocation of subjects into two groups was done using computer generated randomization. Subjects assigned to group I were treated with the compound drug(12 grams/day); while group II subjects were given potassium citrate(60mEq/day) for 6 weeks. Urinary pH levels were examined weekly and the effect of medical treatment on stone size changes was evaluated by ultrasonography every two weeks in the six-week treatment period. Intention to treat analysis was done with 95% confidence level(CI). Statistical analysis of results was determined using analysis of variance (ANOVA) with multiple repeated measures for between group urinary pH changes and chi square for between groups difference in stone size changes. RESULTS: A total of 74 subjects completed the study with a dropout rate of 18%, which was mainly due to geographic and financial reasons. Demographic and baseline stone characteristics of both groups were not significantly different. Treatment outcome between the two groups based on stone size changes (in general and both radiolucent and radioopaque stones subgroups) did not show any significant statistic difference. The pH level changes over six-week treatment period between the two groups showed a total mean pH difference of 0.445, (95% CI: 0.213, 0.677), which was statistically significant (P CONCLUSION:  Urinary alkalinization with sodium bicarbonate, citric acid, sodium citrate, and tartaric acid is a well-tolerated and highly effective treatment resulting in dissolution of non-obstructing kidney stones and is comparable to the gold standard potassium citrate.