The Relationship Between Lower Urinary Tract Symptoms and Osteoarthritis Symptoms Among Vendors in a Conventional Market / 대한배뇨장애요실금학회지

Purpose@#This study aimed to investigate lower urinary tract symptoms (LUTS) and the correlation between LUTS and osteoarthritis (OA) symptoms in the vendors working in a conventional market. @*Methods@#This cross-sectional study was conducted on 153 vendors aged 40 and over from August 10th to September 8th, 2020, in a conventional market. Data were collected via the self-reported questionnaires. We assessed LUTS by International Prostate Symptom Score (IPSS) and OA symptoms by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). @*Results@#The mean age of 153 subjects was 61.31±9.92 years old. The mean score of IPSS and WOMAC was 5.37±5.68 (range, 0–35) and 16.89±19.61 (range, 0–96). Fifty-one percent of subjects had urinary incontinence at least monthly. Twenty-four point two percent of subjects had moderate-to-severe LUTS which were defined as a score of IPSS ≥8. LUTS were positively correlated with OA symptoms (r=0.41, P<0.001). @*Conclusions@#The results showed that LUTS were associated with OA symptoms, and it also emphasized the need for vendors to be provided with a health education program to manage and prevent their LUTS and OA symptoms.

Management of urinary incontinence in geriatric hospitals

Urinary incontinence (UI) is one of the most common urologic conditions that afflict the elderly in a rapidly aging world. The prevalence of UI increases in both sexes as aging progresses. Additionally, the prevalence of UI is higher in patients of nursing facilities, including geriatric hospitals and sanatoriums, than in the general population because most of them have chronic diseases such as dementia and stroke that can cause neurogenic bladder dysfunction. UI in nursing facilities is often overlooked or neglected, as it may be regarded as a natural part of the aging process. However, UI can have significant negative impacts on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. In many cases, treating UI can improve patients' quality of life and reduce the costs associated with UI itself and its complications. For this purpose, the initial assessment of patients entering a nursing home should include an item on UI, and when a patient exhibits UI, it should be treated as an important disease. The purpose of this review is to provide an overview of the causes, classification, evaluation, and management of geriatric UI in nursing facilities.

New horizons in geriatric urology

No abstract available.

A current perspective on geriatric lower urinary tract dysfunction

Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction.

Benign prostate hyperplasia

The rapid aging of the world population is major global demographic trend. The number of people with age-related disease has increased substantially due to increased life expectancy in the general population. Major geriatric urological diseases include urinary incontinence, urological cancer, bladder outlet obstruction disorders such as benign prostatic hyperplasia (BPH), sexual dysfunction, and urinary tract infection. BPH is the most common benign tumor in urology. Testosterone is considered to play a major role in the development of BPH. Lower urinary tract symptoms due to BPH are classified as related to either storage or voiding. Evaluation of symptom scores, digital rectal examination, urine analysis, serum prostate specific antigen measurement, uroflowmetry, and post-void residual urine testing are mandatory. In addition, in order to rule out prostatic cancer, other screening and diagnostic procedures are often required. Depending on the condition of the patients, approaches such as watchful waiting, pharmacotherapy with an alpha blocker or 5-alpha reductase inhibitor, or surgery such as transurethral resection of prostate are appropriate.

Alpha-Blocker Treatment Response in Men With Lower Urinary Tract Symptoms Based on Sympathetic Activity: Prospective, Multicenter, Open-Labeled, Observational Study / 대한배뇨장애요실금학회지

PURPOSE: In this study, we compared the treatment outcomes for an alpha-blocker between 2 groups of men, one with high sympathetic activity (HSA) and another with low sympathetic activity (LSA) or normal sympathetic activity. METHODS: A total of 159 men (> or =50 years of age) with lower urinary tract symptoms resulting from benign prostatic hyperplasia were analyzed. We assigned patients to groups according to their sympathetic activity, which was evaluated by heart ratevariability measurements. HSA was defined as a low frequency/high frequency ratio greater than 1.6. All patients received 10mg of alfuzosin once a day for 12 weeks. The primary end point was a change in the total International Prostate SymptomScore (IPSS) at 12 weeks from baseline. RESULTS: Sixty-seven men were assigned to the HSA group and 92 men were assigned to the LSA group. The baseline characteristics were not significantly different between the 2 groups, and the response to alfuzosin was good in both groups. Themean total IPSS change was not different between the groups. Both groups were not significantly different with respect to the changes in maximal flow rate, IPSS voiding or storage symptom subscores, quality of life, and rates of adverse drug events. TheHSA group showed a similar willingness to continue treatment compared to the LSA group, although their treatment satisfaction rating was lower. CONCLUSIONS: The therapeutic effects of alfuzosin did not differ in regards to the differences in sympathetic activity, but treatment satisfaction ratings were lower in the HSA group.

Two Young Men Who Complained of Voiding Difficulty After Stuffing Odd Materials Into the Urethra to Obtain Sexual Gratification / 대한배뇨장애요실금학회지

The self-insertion of foreign bodies into the urethra to obtain sexual gratification is an uncommon paraphilia and may be complicated by their passage into the urethra and subsequent difficulties in recovering the foreign body. There are two key areas of discussion in relation to this issue: (1) the psychological aspects of the action and (2) the possible treatment options. With careful attention to the patient's history, it is usually possible to identify the foreign body and the time since insertion. In most cases, the individual seeks emergency surgical treatment. Radiological evaluation is necessary to determine the exact size, location, and number of objects. Endoscopic retrieval is usually successful, but open surgical removal is required in some cases. We present two cases of self-insertion of foreign bodies into the urethra.

Impact of Intravesical Protrusion of the Prostate in the Treatment of Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia of Moderate Size by Alpha Receptor Antagonist / 대한배뇨장애요실금학회지

PURPOSE: To evaluate whether intravesical protrusion of the prostate (IPP) is related to the treatment effect of alpha-1 receptor antagonist in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) with a prostate size of less than 40 g. METHODS: A total of 77 BPH patients over 50 years of age treated with alfuzosin (alpha blocker) were enrolled prospectively. The study included only patients with BPH of 40 g or less. The patients were classified into two groups depending on the presence of IPP at baseline: the IPP group (41 patients) and the non-IPP group (36 patients). Prostate volume, prostate-specific antigen (PSA), International Prostate Symptom Score and quality of life (IPSS/QoL), maximum flow rate (Qmax), and postvoid residual (PVR) volume were compared between the groups. The clinical significance of IPP was evaluated after the patients had been taking alfuzosin for 8 weeks. RESULTS: PSA and IPSS (total and voiding subscore) showed significant correlations with IPP (P<0.05). Comparison of parameters before and after 8 weeks showed that alfuzosin improved the total IPSS and all subscores (P<0.001), QoL (P<0.001), Qmax (P<0.001), and PVR (P=0.030) in the non-IPP group. CONCLUSIONS: Alfuzosin may be less effective in improving symptom scores, PVR, and Qmax in the treatment of LUTS/BPH in the presence of IPP.

Efficacy and Safety of Low-Dose Propiverine in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia with Storage Symptoms: A Prospective, Randomized, Single-Blinded and Multicenter Clinical Trial

PURPOSE: The aim of this study was to evaluate whether low-dose anticholinergics combined with an alpha1-receptor antagonist would continue the effect of an alpha-blocker, decrease the side effects of anticholinergics, and improve the symptoms of lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). MATERIALS AND METHODS: Two hundred nine men with LUTS/BPH with storage symptoms (International Prostate Symptom Score [IPSS] > or =12; storage symptoms > or =4) were randomly assigned in a prospective, multicentered, and single-blind fashion to either the control group (alfuzosin 10 mg, once daily) or the combined group (alfuzosin 10 mg, once daily, and propiverine 10 mg, once daily) for 2 months. IPSS, maximal urinary flow rate (Qmax), and postvoid residual volume (PVR) were used to grade symptoms, side effects, and the impact on quality of life (QoL) at the start of the study and after 1 and 2 months. RESULTS: There were no significant differences in patient background, including age, prostate size, Qmax, and PVR, between the control group and the combined group. In the combined group, the IPSS total score and the IPSS storage symptom score were significantly improved compared with the control group. The IPSS voiding symptom score, QoL, Qmax, and PVR did not differ significantly. There were no serious side effects in either group. CONCLUSIONS: Management with an alpha1-receptor antagonist combined with a low-dose anticholinergic improved the total score and storage symptom score of the IPSS compared with alpha1-receptor antagonist only group without causing serious side effects. This initial combination medication can be considered an effective and safe treatment modality for LUTS/BPH patients with storage symptoms.

Efficacy of Anticholinergics for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Young and Middle-Aged Patients: A Single-Blinded, Prospective, Multi-Center Study / 대한배뇨장애요실금학회지

PURPOSE: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) exhibits variable lower urinary tract symptoms (LUTS). The aim of this study was to evaluate the incidence of LUTS and the efficacy of an anticholinergic agent in young and middle-aged CP/CPPS patients. METHODS: Ninety-six men with CP/CPPS were randomly assigned in a single-blind fashion and received either ciprofloxacin (group 1, 49 patients) or ciprofloxacin and solifenacin (5 mg/day; group 2, 47 patients) for 8 weeks. The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), the International Prostate Symptom Score (IPSS), and the International Index of Erectile Function-5 (IIEF-5) were used to grade the patients' symptoms and the quality of life impact at the start of the study, and at 4 and 8 weeks from the initiation of the study. RESULTS: There was no significant difference between groups 1 and 2 with respect to age, duration of disease, or sub-domains of the IPSS, NIH-CPSI, or IIEF-5 at baseline. Of these patients, 67.4% had LUTS. Statistically significant differences were determined via the NIH-CPSI for total score and the pain and urinary domain scores. Statistically significant differences were determined via the IPSS for total score and the storage domain score. The total score of the IIEF-5 increased, but the change was not significant. There was no statistically significant difference in residual urine. CONCLUSIONS: Many CP/CPPS patients had LUTS. Solifenacin in CP/CPPS demonstrated improvements in the NIH-CPSI and the IPSS total score and storage score. Storage factors significantly improved via the NIH-CPSI and IPSS assessments in the solifenacin treatment group.

Experience of Combination Therapy with Alpha Adrenergic Receptor Antagonist and Anticholinergic Agent in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: 12 Month Follow-up / 대한남성과학회지

PURPOSE: Through more than 12 months of follow-up, the efficacy and safety of combination therapy with alpha adrenergic receptor antagonist and anticholinergic agent was investigated retrospectively. MATERIALS AND METHODS: This study retrospectively analyzed the data of 84 patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) who were managed with an alpha adrenergic receptor antagonist and anticholinergic agent for at least 12 months between Jan 2007 and Dec 2010. On patients' first visit to our department, we obtained the patients' demographic data and information about the prostate total volume, serum prostate specific antigen (sPSA), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual (PVR) of each patient. After 12 months, changes in the above factors and the side-effects of anticholinergic agents were investigated. RESULTS: The mean age of the patients was 66.1 years and the total observation period after drug administration was an average 20 months; the total sPSA and prostatic volume of patients was 1.8+/-0.8 ng/dl and 37.3+/-9.5 g, respectively. Qmax in uroflowmetry was improved after 12 months of medication (changed from 9.0+/-3.4 to 13.8+/-4.5 ml/sec; p<0.001). PVR was increased from 35+/-22.2 ml to 49.3+/-37 ml (p<0.001), but the change was not clinically significant, and no acute urinary retention occurred. The total IPSS score decreased from 21.4+/-5.1 to 13.3+/-4.6 (p<0.001), the storage score of IPSS decreased from 9.8+/-2.4 to 5.6+/-2 (p<0.001), and the voiding score was decreased from 11.6+/-3.7 to 7.7+/-3.2 (p<0.001). The QoL with IPSS was improved from 4.2+/-0.8 to 2.8+/-0.7 (p<0.001). During the 12 months there were 34 patients (56 cases) of adverse events. However, no serious adverse events were reported. CONCLUSIONS: Combination therapy with alpha adrenergic receptor antagonist and anticholinergic agent was safe and made an improvement in LUTS in patients with BPH and storage symptoms.

Changes in Awake Cystometry and Expression of Bladder beta-adrenoceptors after Partial Bladder Outlet Obstruction in Male Rats / 대한배뇨장애요실금학회지

PURPOSE: To explore possible changes in awake cystometry and expression of beta-adrenoceptors (ARs) as a cause for bladder dysfunction in a male rat model of partial bladder outlet obstruction (pBOO). MATERIALS AND METHODS: Awake cystometry was performed in rats with pBOO (16) and sham-operated rats (16), 8 weeks after the operation. The expression of mRNA and protein of beta-ARs was assessed by real-time PCR and western blot. RESULTS: The bladders with pBOO (1030mg) were increased compared to those in control rats (230mg). In the cystometric studies, the maximum intravesical pressure significantly increased in the pBOO group compared to control group rats (p=0.001). The time to reach maximal intravesical pressure during micturition in the pBOO group was significantly longer than the sham group (p=0.003). The frequency of non-void contraction in the pBOO group was significantly more than the sham group (p=0.006). The mRNA expressions of beta2- and 3-ARs were increased insignificantly in pBOO group compared to sham group. The data of pBOO group expressed as folds of corresponding expression in sham group were 1.28 and 1.46 respectively in beta2- and 3-ARs. Compared to the sham groups, the density of 60Kda protein band recognized by beta2-AR antibodies and the density of 45Kda protein band recognized by beta3-AR antibodies were higher in the bladder from pBOO group rats. CONCLUSION: PBOO of male rats increase the maximal intravesical pressure and contraction time during micturition and the frequency of non-void contraction as well as weight of bladder. The expression of beta2- and 3-ARs subtypes was increased insignificantly compared to sham operated group. This study demonstrates that the changes of cystometric or non-void contraction parameters in pBOO is one of the pathophysiologic processes potentially associated with the alterations of bladder beta-ARs.

Changes in Serum Prostate-Specific Antigen after Treatment with Antibiotics in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia with Prostatitis / 대한배뇨장애요실금학회지

PURPOSE: Many urologists have performed prostate biopsy in men with a high level of prostate-specific antigen (PSA) alone. However, high levels of PSA may be induced by infection. We studied the effects of antibiotics on serum total PSA and PSA density (PSAD) in men with total PSA between 4 and 10 ng/ml and normal digital rectal examination (DRE) and transrectal sonographic findings. MATERIALS AND METHODS: From January 2005 to October 2009, a total of 107 patients with complaints of lower urinary tract symptoms (LUTS) or benign prostatic hyperplasia (BPH) were evaluated. To be included in this study, patients had to be at least 50 years old, have a palpably normal DRE, have infection in the prostate, have a total serum PSA of 4 to 10 ng/ml, and have transrectal ultrasound findings that did not show a hypoechoic lesion in the prostate. Only patients in whom the PSA level was rechecked after short-term antibiotics administration (8 weeks) were included. Serum PSA and PSAD were measured before transrectal ultrasound or EPS and after 8 weeks of treatment with antibiotics (quinolone). Age, prostate volume, serum PSA, PSAD, and PSA rate of change were compared. RESULTS: The mean age of the patients was 66.3 years. The mean prostate size was 48.8+/-24.9 g. Forty patients had a high level of PSAD. Total PSA and PSAD significantly decreased after treatment (p<0.05). In 45 of the 107 men, total PSA after antibiotics treatment was normalized (less than 4 ng/ml). PSAD after treatment was normalized (less than 0.15 ng/ml/cm3) in 23 of the 40 patients with a high level of PSAD. Conclusion: Antibiotics treatment for at least 8 weeks in BPH patients with an increased PSA level (4-10 ng/ml), infection, and normal DRE and transrectal sonographic findings may decrease serum PSA significantly. However, because the PSA level was not decreased to the normal range (less than 4 ng/ml) in all patients, it seems that antibiotics therapy before prostatic biopsy is not necessary.

Proteomic Changes in the Female Rat Bladder Tissue following Bilateral Oophorectomy

PURPOSE: To explore the effect of bilateral oophorectomy on the several proteins of female rat bladder via a proteomic approach. MATERIALS AND METHODS: A total of 20 female Sprague-Dawley rats were obtained at 8 weeks of age and were divided randomly into 3 groups: a control groups underwent sham operation and bladders were excised 4 weeks and 8 weeks after operation each. Other two groups underwent bilateral oophorectomy and bladders were excised 4 weeks (group 1) and 8 weeks (group 2) after operation each, too. Each group has 5 rats. Conventional proteomics was conducted via high resolution 2-D gel electrophoresis, followed by image analysis and protein identification through mass spectrometry. RESULTS: Bladder weights were reduced significantly in group 2 as compared with the 8-week control group. A comparison of the bladders of the oophorectomy group subjects with those of the control group subjects demonstrated that the expressions of 11 proteins were altered Eukaryotic translation initiation factor 5A (elF-5A), chaperone grp 75 precursor, actin-depolymerizing factor, contrapsin-like inhibitor 1 precursor, guanine deaminase, actin, peroxiredoxin 2, phosphatidylethanolamine, putative protein kinase, Keratin complex 2 and Enol protein. CONCLUSION: The roles of 11 proteins are variable. A part of these proteins have a role of cellular apoptosis, acute inflammation, and muscle contraction. It seems that these changes of proteins have an influence on bladder functions and LUTS.

Proteomic Analysis of the Proteins That were Changed by Bilateral Orchiectomy in the Rabbit Corpus Cavernosum / 대한비뇨기과학회지

PURPOSE: The pathophysiological role of androgen deprivation in male sexual dysfunction remains controversial, and this is especially true at the molecular level. We investigated the effect of androgen deprivation on the changes of proteins in the penile corpus cavernosum of castrated rabbits by the proteomic approach. MATERIALS AND METHODS: New Zealand white male rabbits(2.5-3kg) were divided into 2 groups: the control group with 5 rabbits and the bilateral orchiectomized group. The bilateral orchiectomized group was divided into the post-operative 4 weeks group(group 1), and the 8 weeks group (group 2) with 5 rabbits in groups 1 and 2, respectively. The penile corpus cavernosum was partly excised at 4 or 8 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis; this was followed by computational image analysis and protein identification with using mass spectrometry. RESULTS: A comparison of the corpus cavernosum of the orchiectomized group with the control group showed that nine proteins had a changed expression. Glycerol-3-phosphate dehydrogenase and F-actin binding protein were under-expressed in groups 1 and 2, and myosin regulatory light chain 2, tropomyosin beta chain and tropomyosin 1 were significantly under- expressed in group 1 and they were insignificantly over-expressed in group 2. In addition there were 4 proteins that were insignificantly under- expressed; skeletal muscle myosin heavy chain MyHC-EO/III, a protein that was similar to suppressor of cytokine signaling 6 isoform, myosin light chain 1 and heat shock 27kDa protein 1. CONCLUSIONS: This data suggests that changes of proteins, and especially tropomyosin 1, mean there is processing of the cellular apoptosis pathway in the orchiectomized rabbits' corpus cavernosum. However more information is needed about human corpus cavernosal tissue.

Proteomic Analysis of the Proteins That were Changed by Bilateral Orchiectomy in the Rabbit Corpus Cavernosum / 대한비뇨기과학회지

PURPOSE: The pathophysiological role of androgen deprivation in male sexual dysfunction remains controversial, and this is especially true at the molecular level. We investigated the effect of androgen deprivation on the changes of proteins in the penile corpus cavernosum of castrated rabbits by the proteomic approach. MATERIALS AND METHODS: New Zealand white male rabbits(2.5-3kg) were divided into 2 groups: the control group with 5 rabbits and the bilateral orchiectomized group. The bilateral orchiectomized group was divided into the post-operative 4 weeks group(group 1), and the 8 weeks group (group 2) with 5 rabbits in groups 1 and 2, respectively. The penile corpus cavernosum was partly excised at 4 or 8 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis; this was followed by computational image analysis and protein identification with using mass spectrometry. RESULTS: A comparison of the corpus cavernosum of the orchiectomized group with the control group showed that nine proteins had a changed expression. Glycerol-3-phosphate dehydrogenase and F-actin binding protein were under-expressed in groups 1 and 2, and myosin regulatory light chain 2, tropomyosin beta chain and tropomyosin 1 were significantly under- expressed in group 1 and they were insignificantly over-expressed in group 2. In addition there were 4 proteins that were insignificantly under- expressed; skeletal muscle myosin heavy chain MyHC-EO/III, a protein that was similar to suppressor of cytokine signaling 6 isoform, myosin light chain 1 and heat shock 27kDa protein 1. CONCLUSIONS: This data suggests that changes of proteins, and especially tropomyosin 1, mean there is processing of the cellular apoptosis pathway in the orchiectomized rabbits' corpus cavernosum. However more information is needed about human corpus cavernosal tissue.

Proteomic Analysis of Proteins changed by Bilateral Orchiectomy in the Male Rabbit Bladder

PURPOSE: The aim of this study was to investigate the effects of testosterone deprivation on urinary bladder in male rabbits by proteomic analysis. MATERIALS AND METHODS: New Zealand white male rabbits (2.5-3 kg) were divided into 2 group; control group with 5 rabbits and bilateral orchiectomized group, bilateral orchiectomized group was divided into post-operative 4 weeks group (group 1), and 8 weeks group (group 2) with 5 rabbits respectively. Bladder wall was excised partly at 4 or 8 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis followed by computational image analysis and protein identification using mass spectrometry. We decided to consider 'significant' if protein had 50% decreasing or 200% increasing expression rate. RESULTS: Six proteins were significantly changed in orchiectomy group, compared to control group; serum albumin precursor, GABA transaminase, dimethylarginine dimethylaminohydrolase 2, serum/glucocorticoid regulated kinase and LOC304923 protein were over-expressed in both group 1 and group 2. Annexin A1 was significantly over-expressed in the group 2 only. CONCLUSION: An overexpression of Annexin A1 and GABA transaminase mean a processing of neuronal reactions to injury in orchiectomized rabbit bladder. Also an overexpression of dimethylarginine dimethylaminohydrolase 2 would increase NO synthesis and thereby promote re-endothelialization in the rabbit bladder after orchiectomy. Serum/glucocorticoid regulated kinase would relate to Na+ transport. Albumin precursor and LOC304923 protein are remained to further research. These data suggested that bilateral orchiectomy would make the urinary bladder unstable. However more information is needed in human bladder tissue.

Efficacy of Propiverine for Chronic Prostatitis / Chronic Pelvic Pain Syndrome

PUROPOSE: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder to men and the syndrome is diagnosed only on the basis of symptoms, principally pain or discomfort in the pelvic region. However many patients have a urinary symptoms, especially storage symptoms such as frequency and urgency. The aim of this study was to evaluate the efficacy of anticholinergics in a prospective randomized, single-blind trial to young and middle aged patients to exclude the effect of benign prostatic hyperplasia as possible. MATERIAL AND METHODS: Forty six men with CP/CPPS (age of third to fifth decades) were randomized in a single-blind fashion to receive either group 1; gatifloxacin (200mg, bid) of 15 patients, or group 2; gatifloxacin (200mg, bid) and propiverine (20mg, once daily) of 31 patients for 2 months. The NIH chronic prostatitis symptom index (NIH-CPSI) and International Prostate Symptom Score (IPSS) were used to grade symptoms and the quality of life (QoL) impact at the start, 1 month and 2 months of the study. RESULTS: There was no significant difference between group 1 and group 2 in about age and duration of the disease. In addition, no significant difference was found between group 1 and 2 in the scores of sub-factors of IPSS and NIH-CPSI at the time of baseline. No statistically significant difference in the NIH-CPSI total score and each domain was seen after treatment. Statistically significant difference in the storage symptom of IPSS was seen after treatment. CONCLUSIONS: The efficacy of propiverine (combined to antibiotics) for CP/CPPS were improvements of the storage symptom of IPSS significantly.

The Effect of Dutasteride on Serum Prostate-specific Antigen (PSA) in Patients with Benign Prostate Hypertrophy

PURPOSE: 5alpha reductase, dutasteride, has widely used to treat enlarged prostate (BPH). By suppressing the conversion of testosterone to dihydrotestosterone it decreases serum prostate-specific antigen (PSA) which is very important screening marker for prostate cancer. We evaluate the early serum PSA changes after dutasteride treatment to Korean BPH patients. MATERIALS AND METHODS: A total 159 men with a clinical diagnosis of BPH and no evidence of prostate cancer were enrolled. They were treated with dutasteride 0.5mg daily for 12 months. Serum PSA was evaluated at 2, 6, and 12 months after the medication. RESULT: Dutasteride statistically significantly reduced serum PSA to 0.70+/-0.52, 0.64+/-0.35, and 0.59+/-0.49 from baseline level at 2, 6, and 12 months after the medication, respectively. However, there was no statistical significance among the three groups in serum PSA changes after dutasteride. There were statistically significant correlations between a high pre-treatment serum PSA level and a large reduction of follow-up PSA levels at 2, 6, and 12 months after dutasteride treatment. CONCLUSIONS: The reduction of serum PSA is variable in patients to patients at 2, 6, and 12 months after dutasteride treatment. The patient with high initial serum PSA revealed a large reduction of serum PSA level after treatment. The traditional concept that follow-up serum PSA level should be doubled for prostate cancer screening may overestimate real serum PSA level within 12 months in Korean men receiving 5alpha reductase inhibitors.

The Efficacy of Alfuzosin for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Young and Middle Aged Patients / 대한비뇨기과학회지

PURPOSE: Many studies about efficacy of alpha blocker to Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) have shown variable results. The aim of this study was to confirm the efficacy of alpha blocker in young and middle aged patients with CP/CPPS to exclude the effect of benign prostatic hyperplasia. MATERIALS AND METHODS: Fifty seven men with CP/CPPS were randomized in a single-blind fashion, to receive either; tosufloxacin(450mg/d)(group 1; 15 patients), or; tosufloxacin(450mg/d) and alfuzosin(10mg/d)(group 2; 42 patients) for 2 months. The NIH chronic prostatitis symptom index (NIH-CPSI), International Prostate Symptom Score(IPSS) and International Index of Erectile Function-5(IIEF-5) were used to grade the symptoms and the quality of life(QoL) impact at the start and 1 and 2 months into the study. RESULTS: There was no significant difference between group 1 and group 2 in relation to age, duration and sub-factor scores of IPSS, NIH-CPSI and IIEF-5 at the baseline. No statistically significant difference in the NIH- CPSI total score was seen, but the urinary and QoL factors in group 2 showed greater improvement. A statistically significant difference was seen in the IPSS total score, especially, obstructive factor in group 2 showed greater improvement. The IIEF-5 total score was seen more increase, but it wasn't significant. CONCLUSIONS: The efficacy of alfuzosin demonstrated improvements in the NIH-CPSI(this was not significant.) and IPSS total score. Especially voiding factors were significantly improved in relation to the NIH-CPSI and IPSS scores in the alfuzosin treatment group.