RESUMO
Background: In China, physicians aged 30-45 years who work in tertiary hospitals perform most of the clinical duties, especially outpatient services, and the high-intensity, high-pressure workplace may through long-term sedentary affect their health, particularly urinary health. Methods: The study, conducted from October 2020 to October 2021, included male physicians in Xiangya Hospital, the Second Xiangya Hospital, and the Third Xiangya Hospital of Central South University (Hunan, China). They were divided into surgeon and non-surgeon groups. We collect the data on age, body mass index (BMI), duration of outpatient duties and the International Prostate Symptom Score-voiding (IPSS-V) and IPSS-storage (IPSS-S), and the IPSS-Total, and the IPSS-Quality of Life Index (IPSS-QOL), and the Athens insomnia scale (AIS), and the International Prostate Symptom Score (IIEF-5). Results: The duration of outpatient duties positively correlated with IPSS-Total (P<0.001), IPSS-S (P<0.001), and IPSS-QOL (P<0.001) and negatively correlated with IIEF-5 (p=0.032). Compared to non-surgeons, surgeons performed fewer outpatient duties. The IPSS-Total (P=0.016), IPSS-Storage (P=0.005), and QOL scores (P=0.046) of the non-surgeon group were higher and the IIEF-5 scores were lower (P=0.039). There were no significant differences between the groups regarding age, body mass index, IPSS-Voiding, and Athens insomnia scale scores. A positive correlation between outpatient visit duration and lower urinary tract symptoms (LUTS) in the IPSS-Storage subscale was observed and there was a weak negative correlation between duration of outpatient duties and the IIEF-5 score. Conclusions: Compared to surgeons, non-surgeons had more outpatient duties, and they experienced more severe LUTS and sexual dysfunction, which suggests that outpatient duties maybe should not be more than 4 days/week in Chinese tertiary medical centers.
RESUMO
BACKGROUND: Benign prostatic hyperplasia (BPH) is a common micturition disorder in middle-aged and elderly males, and it is one of the most common urology-related diseases worldwide. However, standard therapeutic drugs (α1-receptor blockers + 5α reductase inhibitors) do not provide anti-inflammatory or anti-infective effects. The Phellodendron Bawei tablet is a proprietary Chinese medicine with anti-inflammatory and anti-infective effects. Here, we analyzed whether the combination of standard therapeutic drugs and Phellodendron Bawei tablets has more advantages than placebo with standard management in improving the lower urinary tract symptoms (LUTs), sleep quality, sexual function, and medication compliance in patients with BPH. METHODS: This study was a prospective, double-blind, single-center, 6-month clinical trial in patients with BPH. Male patients, 45-75 years old, a history of moderate-to-severe BPH/LUTs for more than 6 months, moderate-to-severe LUTs [International Prostate Symptom Score (IPSS) ≥8], maximum urine flow rate (Qmax) of <15 mL/s, and prostate volume (PV) of >30 mL. All patients were randomly divided into two cohorts at baseline. The standard management (SM) group was treated with tamsulosin + finasteride + placebo, while the experimental group was treated with tamsulosin + finasteride + Phellodendron Bawei tablets. The clinical indicators were as follows: Age, body mass index (BMI), blood prostate-specific antigen (PSA), PV, Qmax, IPSS; IPSS voiding subscore (IPSS-V), IPSS storage subscore (IPSS-S), and IPSS quality of life (IPSS-QOL)], five-item version of the International Index of Erectile Function (IEFF-5) score, Athens Insomnia Scale (AIS) score, and the Medication Adherence Questionnaire (MAQ). And adverse drug reactions were observed. Student's t-test was used to analyze results. RESULTS: We randomly divided 120 patients into two groups, with 60 patients in each group, and a total of 105 patients completed the study. IPSS-S (P=0.027) and AIS scores (P<0.001) improved more significantly in the Phellodendron Bawei tablets + SM group, and the MAQ score in this group was lower (P=0.003). CONCLUSIONS: Phellodendron Bawei tablets combined with α1-receptor blockers and 5α-reductase inhibitors can improve lower urinary tract symptoms associated with urine storage, sleep quality, and medication compliance in patients with benign prostatic hyperplasia compared to placebo with standard management. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100046463.
