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.

Evaluation of the super-selective prostate artery embolization combined with TURP for patients with large volume (＞ 80 ml) benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To explore the saffety and efficacy of super-selective prostate artery embolization (PAE) combined with TURP (transurethral resection of prostate) as an alternative method for patients with severe large BPH (＞ 80 ml).Methods From March 2015 to June 2017,a total of 40 patients with large benign prostatic hyperplasia who failed in medical treatment were selected for PAE combined with TURP (18 cases)and TURP (22 cases).In the PAE combined with TURP group,the mean age was (75.0±8.7) years (ranging60-88 years) and the mean prostatic volume was (111.0 ±23.3) ml,ranged from 83 to 145 ml).The international prostate symptom score (IPSS),quality of life (QOL),maximal t rine flow rate (Qmax) and postvoid residual urine(PVR) were(25.2 ±3.6),(5.1 ± 1.0),(6.4 ± 2.3) ml/s and (107.7 ± 32.6) ml,respectively.In the TURP group,the mean age was (76.0 ± 6.9) years (ranging 62-85 years) and the mean prostatic volume was (107.5 ±27.4) ml,ranged from 80 to 150 ml).The IPSS,QOL,Q andPVRwere(24.3±4.2),(4.9 ±0.9),(6.7±2.2)ml/s and (106.6±32.2)ml,respectively.Clinical data of all of patients were analyzed retrospectively,including operative time,estimate blood loss,weight and efficacy of resected tissue,time of continuous bladder irrigation and catheterization,IPSS,QOL,PVR,Q and postoperative complications.Results There were significant differences in the operative time [(75.8 ± 25.1) min vs.(103.2 ± 27.7) min],estimate blood loss [(122.8 ± 33.9) ml vs.(447.6 ± 36.0) ml],weight of resected tissue [(99.9 ± 24.2) g vs.(82.9 ± 15.5) g],efficacy of resected tissue [(76.9 ± 20.7) g/h vs.(41.7 ± 14.2) g/h],continuous bladder irrigation time [(1.4 ± 0.5) d vs.(2.4 ± 0.8) d] and catheterization time [(2.2 ± 0.4) d vs.(3.4 ± 0.6) d] between PAE combined TURP group and TURP group (P ＜ 0.05).The postoperative complications of PAE combined TURP group and TURP group were included secondary hemorrhage (0 case vs.3 cases),secondary TURP (0 case vs.3 cases),temporary urinary incontinence (2 case vs.4 case),urinary tract infection (1 case vs.2 case).After 1-year follow up,the IPSS,QOL,Qmax and PVR of PAE combined TURP group and TURP group were (6.7 ±1.5)and(6.9± 1.5),(2.3 ±0.5) and(2.3 ±0.6),(15.6 ±2.3) ml/s and(15.0 ±2.1) ml/s,(32.8±6.5) ml and(32.3± 8.4)ml,respectively.Both goups were found to have significantly improved in IPSS,QOL,Q and PVR,as compared with preoperative indexes,respectively (P ＜ 0.05).However,there was no significant difference in those indexes between two groups (P ＞ O.05).Conclusions PAE combined TURP could be used a safe and effective therapy for treating patients with LUTS due to large volume (＞ 80 ml) BPH.It has been a priority in less blood,more efficient of resected tissue and less postoperative complications.

The histologic characteristics of small -size prostatic hyperplasia and the effect on low urinary tract symptoms / 中国基层医药

Objective To investigate the histologic characteristics of small -size prostatic hyperplasia (SBPH)and the effect on low urinary tract symptoms (LUTS).Methods 154 patients with SBPH who received transurethral resection of prostate (TURP) were enrolled,preoperative examinations included the obtainment of International Prostate Symptom Score(IPSS),evaluation of the quality of life(QOL),cases of urinary retention,ultra-sonography,urodynamic examination,and cystoscopy,postoperative pathology specimen analysis was conducted.The histologic characteristics of small -size prostatic hyperplasia(the histology prostatis and the grade of inflammation) and the effect on LUTS were analyzed.Results A total of 141 cases (91.56%)were diagnosed as SBPH with histo-logical prostatitis,13 cases(8.44%)in grade 0,18 cases(11.69%)in grade 1,76 cases(49.35%)in grade 2 and 47 cases(30.52%)in grade 3.There were statistically significant differences among ages,IPSS,QOL,Qmax,cases of urinary retention between the pure SBPH group and SBPH with HP group(t/χ2 =2.610,6.607,4.925,2.673, 4.421,all P 0.05).Conclusion The main pathologic type is stroma hyperplasia(fibrous and smooth muscle)of SBPH,SBPH is mostly complicated with histological prostatitis,which are mostly moderate and severe.The severity of LUTS is positively correlated with the grade of inflammation.

Saw palmetto fruit extract improves LUTS in type ⅢA prostatitis patients / 中华男科学杂志

Objective@#To assess the clinical efficacy of the saw palmetto fruit extract (SPFE) in the treatment of lower urinary tract symptoms (LUTS) in patients with type ⅢA prostatitis.@*METHODS@#This retrospective study included 54 cases of type ⅢA prostatitis treated in the Outpatient Department of our hospital from January to December 2015. The patients were aged 35.06 ± 5.85 years, with a mean disease course of 3.8 ± 2.1 years, and all received oral medication of SPFE Capsules at the dose of 320 mg qd for 12 weeks. We assessed the therapeutic effects by comparing the NIH-chronic prostatitis symptom indexes (NIH-CPSI), voiding diary, International Prostate Symptom Scores (IPSS), and results of urodynamic examination before and after treatment.@*RESULTS@#Compared with the baseline, both NIH-CPSI and IPSS were significantly decreased after medication (27.61 ± 3.76 vs 18.6 ± 5.34, P <0.01; 20.44 ± 4.51 vs 10.96±4.62, P <0.01), and urodynamic examination and voiding diary showed dramatic post-medication improvement in the average urinary flow rate (［8.05±1.42］ vs ［12.05±2.60］ ml/s, P <0.01 ), maximum urinary flow rate (［14.22±1.74］ vs ［21.32±4.51］ ml/s, P <0.01), residual urine volume (［46.15±16.57］ vs ［14.55±10.21］ ml, P <0.01), maximum urethral closure pressure (［76.52±3.53］ vs ［65.32±4.75］ cm H2O, P <0.01), mean urinary volume (［124.63±40.55］ vs ［285.93±58.68］ ml, P <0.01), urination frequency (16.96±4.17 vs 8.96±2.50, P <0.01), and nocturia frequency (8.94±3.23 vs 3.15±1.90, P <0.01). No apparent adverse reactions were observed in any of the patients.@*CONCLUSIONS@#SPFE Capsules can safely and effectively improve LUTS and thus the quality of life of patients with type ⅢA prostatitis.

Effect of self-management on lower urinary tract symptoms and life quality of benign prostatic hyperplasia patients / 中华泌尿外科杂志

ObjectiveTo evaluate the efficacy of self-management to improve the lower urinary tract symptoms (LUTS) and life quality in benign prostatic hyperplasia (BPH) patients.MethodsTwo hundred and twenty-two men were recruited to take αblockers for at least 3 months from March 2008 to September 2009. Participants were randomized to either attend a self-management program in addition to standard care or to standard care alone. Difference of scores of International Prostate Symptom Score (IPSS) and BPH-specific quality of life scale between the two groups was analyzed during enrollment period, the 1st week, the 3rd month and 6th month of therapy.ResultsAll participants were followed up for 6 months.The IPSS scores of the SMI group were 20.5 and 20.5 and the QOL were 50.9 and 50.8 at the 1st week.While the numbers were 19.6 and 19.3 for IPSS and 51.1 and 51.1 for QOL in the control group. There was no statistic difference in the control group.Whereas during the 3rd and 6th month assessment, the scores of IPSS and quality of life of self-management interventional group were statistically significantly lower than those of the control group.ConclusionsSelf-management intervention could reduce the LUTS symptoms and improve quality of life in BPH patients who were taking medicines.

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH), a pathological terminology that means benign proliferation of prostatic tissue, is commonly used as a clinical terminology indicating low urinary tract symptoms (LUTS) resulting from prostate enlargement. It mainly arises from the transition zone of the prostate by stimulation of dihydrotestosterone (DHT), and its incidence is about 21~28% in men with age over fifty. LUTS related to BPH consist of frequency, residual urine sense, nocturia, interruption, urgency, weak stream, and hesitancy. The International Prostate Symptom Score (IPSS) is currently being used for the evaluation of the patient in the clinical setting. The size of the prostate (>30 g), an elevated serum prostate-specific antigen level (PSA: >1.5ng/mL), high IPSS ( 20), and a large amount of post-void residual urine (>100ml) are considered as risk factors of BPH aggravation. Physical examination including digital rectal examination, urinalysis, serum PSA, and uroflowmetry with residual urine measurement are performed as basic test items for BPH. Standard initial treatment of BPH is medical therapy: mainly alpha adrenergic blockers and 5-alpha reductase inhibitors, and optionally anticholinergics, desmopressin, and phytotherapy. The standard surgical treatment of BPH nowadays is transurethral resection of prostate (TURP) but open prostatectomy or minimally invasive treatment such as transurethral incision of prostate (TUI), thermal therapy, and photoselective vaporization of prostate (PVP) can be applied in selected cases.

Survey of lower urinary tract symptoms in 2811 men in Wuhan City / 中华泌尿外科杂志

Objective To assess the prevalence and presentation of low urinary tract symptoms (LUTS) in Chinese men. Methods A random sample was obtained from men dwelling at communities,factories,institutions and colleges in a district in Wuhan City.By completion of the questionnaire and exclusion of individuals with operation and trauma history,2811 men (age range,20～82 years) were assigned into 6 groups according to 10-year age stratum.Frequency of symptoms and severity of discomfort were assessed using the International Prostate Symptom Score (IPSS). Results The 2811 men accounted for 71.7% of the surveyed population. The occurrence of LUTS was as follows.In 20～29 year group,only 5 (0.6%) of 798 men had mild LUTS (IPSS,1～7).In 30～39 year group,55 (12.1%) of 453 men had mild LUTS.In 40～49 year group,143 (26.6%) of 537 men had LUTS;of them 118 were of mild LUTS,20 of moderate (IPSS,8～19),5 of severe (IPSS,20～35).In 50～59 year group,244 (52.5%) of 465 men had LUTS;of them 109 were of mild,117 of moderate,18 of severe.In 60～69 year group,240 (65.6%) of 366 men had LUTS;of them 78 were of mild,138 of moderate,24 of severe.In≥70 year group,162 (84.4%) of 192 men had LUTS;of them 47 were of mild,68 of moderate,47 of severe.Differences between age groups in incidence rates of LUTS were significant (?2=998.385,P