Mutraghata: An Ayurvedic Review w.s.r to BPH

Lower urinary tract symptoms (LUTS) are quite common in aging males and these affect the quality of life of an individual. Among various etiologies of LUTS, benign hyperplasia (BPH) has a high prevalence. The term Mutraghata stands for low urine output due to obstruction in the passage of urine. Mutraghata, a disease of Mutravaha Srotas (urinary system) described in Ayurveda, closely resembles with benign prostatic hyperplasia (BPH) of the modern medicine. It affects men above the age of 40 years. Histo-pathologically the prevalence of BPH is age dependent, initiate usually after 40 years of age. More than 50% of men in their 60s and upto 90% of men in their 70s and 80s have some symptoms of BPH. In contemporary science conservative and surgical treatment are given to the patients suffering with BPH.

Effect of rape flower on benign prostatic hyperplasia in rats

We were carried out to investigate the efficacy of Rape (Rapeseed, Brassica napus L.) flower on BPH (benign prostatic hyperplasia) in rats. We found that the extract from Rape flower prevented hyperplasia in testosterone-induced BPH model, the relevant animal model of human BPH. Extract reduced the weight of prostate and induced significantly cell apoptosis in prostate in BPH model. In addition, the extract controlled expression of TGF-ß1 in prostate gland and promoted urinary output in dose-dependence in BPH model. Our data provide that Rape flower may be useful for treatment of BPH

Primary development of visual uroflow scale / 北京大学学报(医学版)

OBJECTIVE@#To develop the visual uroflow scale (VUS), analyze the relationship of VUS score and index of free uroflowmetry, assess urination function preliminarily and improve the work efficiency in the clinic.@*METHODS@#Male lower urinary tract symptoms (LUTS) patients, who attended the Department of Urology in Peking University People's Hospital from March 2016 to March 2017, were assessed for their urination function according to the Visual Uroflow Scale without help from clinicians before undertaking a free uroflowmetry test. And afterwards, a free uroflowmetry was undertaken, and variables including maximal flow rate (Qmax), the average flow rate (Qave) and voiding volume (VV) was obtained. During the study, 124 cases were collected and 53 cases met the inclusion and exclusion criteria and were included in the study cohort. The Spearman correlation analysis was used for analyzing the correlation of VUS scores with free uroflowmetry variables and age. The validity of VUS was evaluated.@*RESULTS@#Most of the patients could choose the very figure matched with self-condition by first instinct without any help from the clinician. The data were analyzed by Spearman correlation analysis. In the present study, voiding time was positively correlated with the VUS score (correlation coefficient, 0.62, P < 0.05). In the present cohort, the patients chose the third and fourth figures to take longer time to urinate, implying worse LUTS situation. Flow time and VUS scores were positively correlated (correlation coefficient, 0.61, P < 0.05). The patients with higher VUS scores would spend more time on urinate, no matter how long urinary hesitation was. Both Qmax and Qave were negatively correlated with the VUS score (correlation coefficient －0.54, －0.62, P < 0.05). The study illustrated that the VUS score suggested that the Qmax basically and further reflected the urination function. And its relationship to age revealed the decreased urination function of aging male, which had reached a consensus.@*CONCLUSION@#Development of VUS has helped the clinician assess the urination function preliminarily at the first time. Patients are assessed for a VUS score before getting surgery or receiving the drug for treatment, and can be re-assessed after. The VUS score can provide an objective quantitative basis to evaluate the treatment efficacy. In addition, considering that it is convenient, timesaving and easy to understand, the VUS is available for follow-up.

Comparative Evaluation of Relationship between Prostate Volume and Lower Urinary Tract Symptoms

Lower Urinary tract symptom (LUTS) is a common presentation among elderly male patients in urology clinical practice. International Prostate Symptom Score (IPSS) have contributed much to the objective and quantitative evaluations of LUTS in terms of the elucidation of its pathogenesis and changes accompanied with treatments. Aim: The objective of this study was to evaluate the relationship between IPSS and prostate volume in patients with LUTS. Methods: This prospective study included 58 male patients with lower urinary tract symptoms (LUTS). The IPSS was evaluated using questionnaire and the prostate volume of each patient was then estimated by transabdominal ultrasound. Results: There is a significant relationship between IPSS and prostate volume measured through trans-abdominal ultrasonography. The Total IPSS increases with the prostate volume, as a significant positive relationship between IPSS total score and prostate volume was recorded. Conclusion: There is a significant positive relationship between IPSS total score and prostate volume

Comparison of Low Urinary Tract Symptoms during Pregnancy between Primiparous and Multiparous Women

Low urinary tract symptoms (LUTS) are a common problem during pregnancy. This study aimed to compare changes in the prevalence of LUTS during pregnancy between primiparous and multiparous women. A chart review of consecutive pregnant women who attended our antenatal clinic from August 2015 to December 2016 was performed. All of the women were asked to respond to a LUTS questionnaire in either of the three trimesters. Of the 270 women included, 164 were nullipara and 106 were multipara. The most common LUTS during pregnancy were frequency (77%), followed by nocturia (75.6%), stress urinary incontinence (SUI) (51.1%), incomplete emptying (43.7%), dysuria (17.8%), and urgency incontinence (10.4%). There was a significantly higher prevalence of SUI (P < 0.001) and urgency incontinence (P= 0.005) in the multiparous compared to the nulliparous women. Increasing prevalence rates of frequency, nocturia, SUI, and incomplete emptying were reported with gestational age in both the nulliparous and multiparous women. Frequency and nocturia were the two most common LUTS during pregnancy. The prevalence rates of all LUTS increased with increasing gestational age except for frequency in the nulliparous women during the second trimester. In addition, multipara was a predictor of SUI during Pregnancy.

Relationship Between Grades Of Prostatomegaly On Dre And Prostate Volume On Sonography With Lower Urinary Tract Symptoms: To Believe Your Finger Or The Ultrasound Probe!!!

Elderly men presenting with Lower Urinary Tract Symptoms (LUTS) constitutes around a third of urological practice with prevalence as high as 10-41 % in men older than 40 years. Its adverse impact on the Quality of Life (QoL) makes it imperative for the clinician to guide therapy based on sound diagnostic principles. Clinical evaluation of LUTS secondary to BPH involves International Prostate Symptom Score (IPSS) assessment, digital rectal examination (DRE), urodynamics and sonological evaluation of prostate. Our study aims to correlate the grades of prostatomegaly on DRE and prostate volume on sonography with LUTS assessed by IPSS in elderly males.

Patient-reported ejaculatory function and satisfaction in men with lower urinary tract symptoms/benign prostatic hyperplasia / 亚洲男科学杂志(英文版)

This study aimed to investigate perceived ejaculatory function/satisfaction before treatment for lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and to identify associations between specific categories of ejaculatory dysfunctions (EjDs) and LUTS. A total of 1574 treatment-naïve men with LUTS/BPH were included in this study. All patients underwent routine evaluation for LUTS/BPH including the International Index of Erectile Function and a 5-item questionnaire developed to assess ejaculatory volume/force/pain/satisfaction/latency time. Patients who had sexual intercourse over the past 4 weeks were classified as sexually active group. A total of 783 patients were categorized as sexually active group. Decreased ejaculatory volume and force were reported by 53.4% and 55.7% of 783 sexually active men, respectively. There was a strong correlation between ejaculatory volume and force. Ejaculatory pain/discomfort, premature ejaculation (PE), and delayed ejaculation (DE) were reported in 41.0%, 16.3%, and 41.4% of the patients, respectively. Over 40.0% of men without decreased ejaculation volume/force were satisfied with ejaculatory function, whereas approximately 6.0% of men with decreased volume/force were satisfied with ejaculatory function. About 30.0% of men with decreased volume/force had orgasmic dysfunction, while approximately 10.0% of men without decreased volume/force did. Decreased ejaculatory volume or force was associated with LUTS severity after adjusting for other influential factors including testosterone level, erectile function, and prostate size on ultrasonography, but PE or DE or ejaculatory pain/discomfort was not. In conclusion, a considerable portion of men with LUTS/BPH appear to have a variety of EjDs. Ejaculatory volume/force and satisfaction/orgasm do not always appear to be concordant. Ejaculatory volume or force is independently associated with LUTS severity, whereas PE or DE or ejaculatory pain/discomfort is not.

Clinical Observations on Acupuncture plus Pelvic Floor Biofeedback Treatment for Neurogenic Bladder Following Spinal Cord Injury / 上海针灸杂志

Objective To investigate the clinical efficacy of acupuncture plus pelvic floor biofeedback treatment for the neurogenic bladder following spinal cord injury.Method Ninety patients with neurogenic bladder following spinal cord injury were randomly allocated to acupuncture, biofeedback and combination groups, 30 cases each. Every group of patients received acupuncture, pelvic floor biofeedback treatment or a combination of two treatments in addition to conventional bladder rehabilitation training. The LUTS score and the quality of life score were recorded and the bladder diary was kept before and after treatment. A statistical analysis was carried out.Result The LUTS score, the quality of life score, the residual urine volume and the mean voiding frequency decreased significantly in the three groups of patients after four weeks of treatment compared with before treatment (P<0.05) and decreased more significantly in the combination group than in the acupuncture and biofeedback groups (P<0.05). Maximum voided volume increased significantly in the three groups of patients after treatment compared with before (P<0.05) and increased more significantly in the combination group than in the other two groups (P<0.05).Conclusion Acupuncture plus pelvic floor biofeedback can significantly improve bladder function and the quality of life in patients with neurogenic bladder following spinal cord injury. Its clinical therapeutic effect is superior to that of acupuncture or biofeedback.

Alpha antiadrenergic effect of Achyrocline bogotensis extract ("Vira Vira") in isolated rat aortic ring / Efecto antiadrenérgico alfa del extracto de Achyrocline bogotensis ("Vira Vira") en anillos aislados de aorta de rata

The treatment of symptoms of prostatic hyperplasia is among the traditional uses of Achyrocline bogotensis (Kunth) [N.V. "Vira Vira", Compositae] in Colombia. Pharmacological therapy for this disorder depends mainly on alpha-1 antiadrenergic agents, and the mechanism has not been studied previously using A. bogotensis. Objectives: To assess the alpha-1 antiadrenergic effect of the extract obtained from the aerial parts of A. bogotensis in isolated aortic rings from Wistar rats. Methods: The study compared the effects of the ethanol extract of A. bogotensis, prazosin (reference) and DMSO (control) in rings stimulated with phenylephrine (PE) or KCl. The capacity to reduce the PE pressor effect by the ethanol extract (pD2' value) was determined. To quantify the A. bogotensis relaxant potency, increasing concentrations of the ethanol extract (0.1 µg/mL-0.1 mg/mL), were added cumulatively to isolated aortic rings pre-contracted with PE (0.1 µM) or KCl (80 mM). To explore the possible participation of nitric oxide (NO), L-NAME (100 µM) was administered to aortic rings exposed to cumulatively increasing concentrations of PE in isolated aortic rings in the presence of the extract (10 µg/mL). Aqueous, butanol and dichloromethane fractions (10 µg/mL) obtained from the ethanol extract were assayed. Phytochemical screening was also performed. Results: Prazosin and A. bogotensis extract notably reduced the contraction induced by PE whereas their inhibitory effect in rings contracted with KCl were lower. A. bogotensis ethanol extract showed a high capacity for reducing the PE pressor response (pD´2: 5.51) as well as total efficacy for relaxing rings previously precontracted with PE. The relaxant efficacy and potency of A. bogotensis extract against rings previously contracted with KCl were notably lower. L-NAME partly reverted the inhibitory effect of A. bogotensis. Aqueous, butanol and dichloromethane fractions gave inhibitory responses lower than that obtained with the ethanol extract. Phytochemical screening of A. bogotensis extract revealed the significant presence of flavonoid and triterpene metabolites. Conclusions: These results suggest that A. bogotensis elicits a smooth muscle relaxant effect related to the alpha-1 antiadrenergic mechanism. This response is partially NO dependent and seems to be due to interactions among active metabolites likely to be of flavonoid and/or terpenoid nature.

Antecedentes: Uno de los usos tradicionales de la especie Achyrocline bogotensis (Kunth) [N.V. "Vira Vira", Compositae] en Colombia es el tratamiento de los síntomas de la hiperplasia prostática benigna. La terapia farmacológica de este trastorno se basa principalmente en el uso de agentes que ejercen efecto anti-adrenérgico alfa-1, mecanismo no estudiado previamente en esta especie. Objetivos: Evaluar el efecto anti-adrenérgico alfa-1 del extracto de la especie Achyrocline bogotensis (Kunth) en anillos aislados de aorta de ratas Wistar. Métodos: Se comparó el efecto del extracto etanólico de A. bogotensis, prazosin (patrón) y DMSO (control) en anillos aislados de aorta de ratas Wistar estimulados con fenilefrina (PE) o KCl. Se determinó la capacidad del extracto etanólico de A. bogotensis para reducir el efecto contráctil inducido por PE (pD'2 ). Se cuantificó la potencia relajante del extracto etanólico de A. bogotensis (0.1 µg/ mL - 0.1 mg/mL) en anillos de aorta previamente contraídos con PE (0.1 µM) o KCl (80 mM). Se exploró la posible participación del óxido nítrico (NO), administrando L-NAME (100 µM) en anillos de aorta expuestos a concentraciones acumulativas de PE en presencia del extracto etanólico (10 µg/mL). También se comparó el efecto de las fracciones acuosa, butanólica y diclometanólica (10 µg/mL), obtenidas del extracto etanólico, en anillos estimulados con PE. Además, se efectuó un tamizado fitoquímico del extracto. Resultados: Prazosin y el extracto de A. bogotensis redujeron notablemente el efecto de PE mientras su efecto inhibitorio sobre la contracción inducida por KCl fue menor. El extracto etanólico mostró una ostensible capacidad para reducir el efecto contráctil inducido por PE (pD2 ´: 5.51) así como una eficacia total para relajar anillos previamente contraídos con PE. La potencia y eficacia de relajación del extracto de A. bogotensis frente a anillos previamente contraídos con KCl fue notablemente menor. L-NAME revirtió parcialmente el efecto inhibitorio del extracto de A. bogotensis. Las fracciones acuosa, butanólica y diclorometanólica arrojaron respuestas inhibitorias menores que las inducidas por el extracto etanólico. El tamizado fitoquímico del extracto de A. bogotensis mostró la presencia de metabolitos de naturaleza flavonoide y terponoide. Conclusiones: Estos resultados muestran que la especie A. bogotensis ejerce efectos relajantes sobre el músculo liso vinculados con mecanismos de tipo antiadrenérgico alfa-1. Esta respuesta depende en parte de la presencia de NO y parece deberse a la interacción de metabolitos de naturaleza flavonoide y/o terpenoide.

<b>Effect of Hachimijiogan for Male Lower Urinary Tract Symptoms</b> / 日本東洋医学雑誌

We evaluated the effect of hachimijiogan in 30 cases of anticholinergic agent and α-blocker resistant LUTS. International Prostate Symptom Scores (IPSS), QOL scores, Benign Prostatic Hyperplasia Impact Index (BII) scores and urinary 8-OHdG of the patients were statistically much improved. This study demonstrated improvement in urinary symptoms, urinary QOL and oxidative stress, in LUTS resistant to anticholinergic agents and α-blockers. Further long-term studies will be needed not only in urinary symptoms, but also in effect as an anti-aging medicine.

Is Increased Prostatic Urethral Angle Related to Lower Urinary Tract Symptoms in Males with Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms?

PURPOSE: The prostatic urethra is a bent tube, and the clinical significance of the prostatic urethral angle (PUA) was recently reported. We investigated the statistical significance of an increased PUA on the International Prostate Symptom Score (IPSS) in men with benign prostatic hyperplasia (BPH)/lower urinary tract symptom (LUTS). MATERIALS AND METHODS: A retrospective analysis was done of 270 men with BPH/LUTS from July 2009 to June 2011. Prostate volume, PUA, and intravesical prostatic protrusion (IPP) were measured by transrectal ultrasonography (TRUS). The IPSS was analyzed separately as storage and voiding symptom score. In order to minimize the effect of prostate size on voiding, patients with prostate size over 40 ml were excluded. RESULTS: The mean age was 62.0+/-9.3 years. The mean prostate volume was 29.0+/-5.5 ml (range, 20 to 40 ml), and median PUA and IPP were 34degrees (range, 12 to 52degrees) and 1.7 mm (range, 0 to 5.3 mm), respectively. The mean IPSS, mean IPSS-ss, and mean IPSS-vs were 19.0+/-8.2, 7.3+/-4.0, and 11.6+/-5.5, respectively. The prostate volume had no statistically significant correlation with IPSS, IPSS-ss, or IPSS-vs. IPP had a statistically significant correlation with IPSS (p or =34degrees) with a lower PUA (<34degrees), patients with a higher PUA had a higher IPSS (p=0.001) and a higher IPSS-vs (p=0.001). There was no significant difference in IPSS-ss, prostate volume, or PSA between the two groups. CONCLUSIONS: IPP showed significantly correlated with the IPSS and voiding symptom score was affected by the PUA but not by the prostate volume. As the PUA increased, the patients' voiding symptoms worsened. Further study may be needed.

Urodynamics in women from menopause to oldest age: what motive? what diagnosis?

PURPOSE: To analyze age-associated changes as a motive for urodynamics and urodynamic diagnosis in community-dwelling menopausal women and to discuss the role of menopause and ageing. MATERIALS AND METHODS: Four hundred and forty nine consecutive menopausal women referred for urodynamic evaluation of lower urinary tract (LUT) symptoms, met the inclusion criteria and were stratified into 3 age groups: 55-64 years (A), 65-74 years (B), and 75-93 years (C). Comprehensive assessment included previous medical history and clinical examination. Studied items were motive for urodynamics, results of uroflows (free flow and intubated flow) and cystometry, urethral pressure profilometry, and final urodynamic diagnosis. RESULTS: The main motive was incontinence (66.3 percent) with significant increase of mixed incontinence in group C (p = 0.028). Detrusor function significantly deteriorated in the oldest group, mainly in absence of neurological disease (overactivity p = 0.019; impaired contractility p = 0.028). In the entire population, underactivity predominated in group C (p = 0.0024). A progressive decrease of maximum urethral closure pressure occurred with ageing. In subjects with no detrusor overactivity there was a decrease with age of detrusor pressure at opening and at maximum flow, and of maximum flow while post void residual increased only in the C group. CONCLUSION: In our population of community-dwelling menopausal women, incontinence was the main motive for urodynamics increasing with ageing. A brisk change in LUT function of women older than 75 years underlined deterioration in bladder function with a high incidence of detrusor hyperactivity with or without impaired contractility while change in urethral function was progressive. Effect of ageing appears to be predominant compared to menopause.

Role of Phosphodiesterase Type 5 Inhibitor on Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms / 대한남성과학회지

There is strong evidence from multiple epidemiological studies that benign prostate hyperplasia (BPH) induced lower urinary tract symptoms (LUTS) are correlated with erectile dysfunction (ED). Although a direct causal relationship is not established yet, four pathophysiological mechanisms can explain the relationship. These include alteration in activity of nitric oxide (NO)-cyclic GMP signal pathway, autonomic hyperactivity, increased Rho kinase/Rho A pathway and pelvic atherosclerosis. Androgens have been suggested to have an important role in the maintenance of the functional and structural integrity of the urinary tract. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. Sildenafil is a pioneer of this clinical trial and appears to improve both erectile function and LUTS in subjects with ED. Basically PDE5 I with long half life is an appropriate candidate, therefore tadalafil and undenafil had been used to evaluate both diseases. Placebo-controlled trials of tadalafil showed improvement of LUTS secondary to BPH, but none of the studies showed a significant effect on urodynamic measures. PDE5 Is, such as sildenafil and tadalafil, increase the concentration of cGMP in plasma and smooth muscle, facilitating erection of the penis, relaxation of the bladder neck and prostate and subsequent bladder emptying. And theses PDE5 Is increase cAMP and cGMP levels and are more highly distributed in the prostate than plasma. These findings may help in the assessment of the feasibility of using PDE5 Is to concurrently treat both LUTS and ED.

Efficacy and safety of long-term administration of tamsulosin hydrochloride in patients with LUTS suggestive of BPH / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of long-term administration of tamsulosin hydrochloride 0.2 mg once daily in patients with LUTS of BPH. Methods Patients with LUTS of BPH enrolled in a 4-week placebo run-in period, then 60-week open-label study. Tamsulosin hydrochloride 0.2 mg was administered before breakfast every day during the period of the study. The efficacy and safety parameters were evaluated at the end of treatment period Ⅰ (0-12 weeks). If IPSS was improved by 25% or more, the administration of tamsulosin hydrochloride was continued during treatment period Ⅱ (13-60 weeks). If the improvement rate less than 25%, the patients received concomitant medication of finasteride 5 mg once daily during treatment period Ⅱ. The primary parameters assessed to determine efficacy were the International Prostate Symptom Score(IPSS) and maximum urinary flow rate(Qmax). Results A total of 113 patients were recruited in the study, and 111 patients completed treatment period Ⅰ , and 95 patients completed treatment period Ⅱ. After treatment period Ⅰ , average IPSS was decreased by 4.1 and average Qmax was increased by 1.7 ml/s(P＜0.05). Tamsulosin hydrochloride produced a great improvement in average Qmax (3.0 ml/s, 27.7%)and a significant decrease in average IPSS (6.4,30.3%) after 60-week treatment. Significant improvements were also produced in average urinary flow rate and average residual urine volume. There was no significant difference in changes in IIEF-5 score and the prostate volume after treatment with tamsulosin hydrochloride. During the study period, 13 patients experienced 24 adverse events, and the incidence of adverse event was 11.5%. No serious adverse event and significant changes of the data of laboratory examination were recorded during the study. Conclusions Long-term tamsulosin hydrochloride therapy is a safe, effective and well-tolerated method in improving symptoms and quality of life in patients with LUTS of BPH. Tamsulosin hydrochloride can be used as the conventional drug in the patients with LUTS suggestive of BPH.

Construction and validation of a Malay version of the overactive bladder screener for assessing urinary tract symptoms in Malaysian population

The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (OAB V8) to the Malay language. It was to assess the reliability of the screener in the context of a Malaysian population. The original screener consists of eight symptoms indicative of OAB that has been proven to be highly sensitive and reliable. Translation was done with a modification of the Brislin Method using back translation and a panel of experts as a final review panel. The pilot study had two groups; a symptomatic (n=19 patients) and an asymptomatic group (n=18 patients). All patients performed the test twice at two week intervals once at the clinic and subsequently at home. Test-retest method was used for reliability and Cronbach’s alpha for internal consistency. The translated questionnaire demonstrated good internal consistency in both groups of patients for all eight items individually and for the total score. Cronbach’s alphas ranged from 0.972 to 0.981 for the symptomatic group and from 0.750 to 0.976 for the asymptomatic group. Testretest correlation for all items was highly significant. Intraclass correlation (ICC) was high for both the asymptomatic (ICC ranging from 0.600 to 0.953) and the symptomatic group (ranging from 0.944 to 0.989).The Malay OAB V8 showed itself to be suitable for use, reliable in distinguishing symptomatic and asymptomatic patients and a valid instrument.

Ventricular dyssynchrony is common among heart failure patients with narrow QRS complex

Current selection guideline for CRT uses broad QRS duration (>120 ms) as a marker for ventricular dyssynchrony. However, more recent data supports mechanical marker specifically measured by Tissue Doppler Imaging (TDI) as a better criterion to predict response to CRT. Sixty seven patients with significant left ventricular dysfunction (EF less than 40%) and narrow QRS complex were prospectively enrolled. They underwent Tissue Doppler Imaging (TDI) study to evaluate intraventricular mechanical dyssynchrony. Dyssynchrony index which is defined as standard deviation of time to peak systolic velocity in twelve ventricular segments was measured. A value greater than 32.6 is taken to reflect significant ventricular dyssynchrony. Overall 38 patients (56.7%) demonstrated significant dyssynchrony. There was no significant correlation between QRS duration and the Ts-SD-12 (r = 0.14, p = 0.11). Ventricular mechanical dyssynchrony is common in patients with normal QRS duration. Therefore, QRS duration alone will miss a substantial proportion of suitable patients for CRT and therefore deny them this adjunct therapy. We propose echocardiographic parameters, specifically TDI, to be included in patient selection criteria for CRT.

The Effects of Lower Urinary Tract Symptoms on Depression and Quality of Life among Women in Urban Areas

PURPOSE: This study was performed to investigate the effects of lower urinary tract symptoms on depression and quality of life among women in urban areas. METHODS: The participants in this study were 306 women in P city. Data were collected using a questionnaire from May 1 to June 6, 2008. Lower urinary tract symptoms (LUTS) were measured with BFLUTS-SF and categorized into voiding, filling and incontinence. The data were analyzed through t-test, one-way ANOVA, Fisher exact test, and multiple regression. RESULTS: Age, filling and incontinence, and all of the subcategories of LUTS explained 16% of variance in depression. Older women, LUTS with incontinence, filling and incontinence, and all the problems including filling, voiding and incontinence lowered the quality of life. CONCLUSION: In order to develop nursing interventions for women with urinary tract symptoms, comprehensive understanding of LUTS is needed.

Association between Lower Urinary Tract Symptoms and Erectile Dysfunction / 대한비뇨기과학회지

PURPOSE: The aim of this study was to assess whether there was an association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in men. MATERIALS AND METHODS: 79 patients who had LUTS, between January 2002 and July 2004, were randomly retrospectively analyzed. LUTS and ED were assessed by validated symptom scales, including the International Prostate Symptom Score (IPSS), the Danish Prostate Symptom Score1 (DAN-PSS1) and the International Index of Erectile Function (IIEF). The patients were divided into three group according to age; younger than 60 (group I), 60 to 69 (group II), and 70 years or older (group III). RESULTS: The mean age was 62.6+/-9.19 years. Prevalence rate of mild, moderate and severe LUTS were 12.9, 67.7 and 19.4% in group I, 8.3, 58.3 and 33.4% in group II, and 16.6, 54.2 and 29.2% in group III, respectively. The mean IIEF scores by IPSS according to the severity were 39.8, 38.4 and 28.7 in group I and 54.5, 39.8, and 24.3 in group II and 29.5, 16.5 and 15.6 in group III, retrospectively. In each group, the IIEF score decreased with increasing IPSS, LUTS was also shown to be statistically significantly correlated with the presence of ED (p=0.028). No statistical significance was found between the IPSS and DAN-PSS1 (p=0.740). CONCLUSIONS: These results suggested that ED was highly prevalent among patients with LUTS, and erectile function should be evaluated in the patients with LUTS for the management of ED and to improve the quality of life of these patients.

One Year Long-term Evaluation of Tamsulosin HCl(0.2 mg) in Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction: Analysis of a Korean, Multicenter, Single-Blind Study

PURPOSE: To evaluate the long-term efficacy and safety of tamsulosin 0.2 mg once daily in Korean patients with lower urinary tract symptoms(LUTS) suggestive of benign prostatic obstruction(BPO) treated for up to 1 year. MATERIALS AND METHODS: Two hundred eleven patients were enrolled from 6 centers and 146 patients were included in the analysis. The primary efficacy parameters were improvements in the total, obstructive and irritative International Prostate Symptom Score(IPSS) and maximal urinary flow rate(Qmax). The secondary efficacy parameters were a decrease of >or=30% in IPSS and an increase of >or=30% in Qmax from baseline. Changes in parameters between baseline and 52 weeks were assessed using Student's paired t-test. RESULTS: Statistically significant, gradual improvements in all efficacy parameters were observed over the 1-year period. Tamsulosin 0.2 mg/day produced progressive improvements in total IPSS(41.1%) and Qmax(39.6%, 4.56 ml/sec)(p<0.001). Tamsulosin was well tolerated. The incidence of adverse events was only 6.2%. And There were no withdrawals as a result of adverse events. There were no significant changes in blood pressure or pulse rate during the study. CONCLUSION: Long-term 1-year treatment with tamsulosin 0.2 mg once daily in Korean BPO patients is safe, well tolerated and effective in improving LUTS and urinary flow. The effect on symptoms was apparent after 12 weeks of treatment, and symptom improvement was achieved for up to 1 year at every follow-up period respectively.

Effect of Uroselective alpha-adrenoceptor Antagonist on Irritative Voiding Symptom in Patients with Lower Urinary Tract Symptom

PURPOSE: We evaluated the efficacy of the selective alpha1a and alpha1d antagonist (tamsulosin 0.2 mg) once daily in the treatment of patient with lower urinary tract symptom(LUTS), especially irritative symptom. MATERIALS AND METHODS: A total of 170 men with LUTS were treated for 12 weeks with tamsulosin 0.2 mg/day. The primary efficacy parameters are improvements in total, irritative and obstructive International Prostate Symptom Scores(IPSS), quality of life index(QOL index) and peak urinary flow rate(Qmax). Secondary efficacy parameters include percentage of patients with improvement in total, irritative and obstructive IPSS of at least 25%, Qmax of at least 30% and 3 ml/s increase in Qmax. RESULTS: Statistically significant improvements in all efficacy parameters were observed. Tamsulosin produced improvements in Qmax(21.7%), decrease in total, irritative, obstructive symptom score(25%, 19.1%, 29.2%) and QOL index(0.7 points). Seventy two patients(42.4%) had a > or =25% decrease in total symptom score, 71 patients (41.8%) in irritative and 90 patients(52.9%) in obstructive symptom score after 12 weeks(P or =30% increase and 67 patients(39.4%) had > or =3 ml/s increase in Qmax. CONCLUSIONS: This study showed beneficial short term results for the efficacy of selective alpha(1a) and alpha(1d) blocker (tamsulosin) in treating patients with LUTS, especially irritative symptom.