PD25-03 COMPARISON OF TREATMENT EFFICACY IN MALE LUTS ACCORDING TO SYMPATHETIC ACTIVITY

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Evaluation & Markers1 Apr 2014PD25-03 COMPARISON OF TREATMENT EFFICACY IN MALE LUTS ACCORDING TO SYMPATHETIC ACTIVITY Jong Bo Choi, Hyun Ik Jang, Jeong Hwan Lee, Hyung Jee Kim, Young Ho Kim, and Dong Hwan Lee Jong Bo ChoiJong Bo Choi More articles by this author , Hyun Ik JangHyun Ik Jang More articles by this author , Jeong Hwan LeeJeong Hwan Lee More articles by this author , Hyung Jee KimHyung Jee Kim More articles by this author , Young Ho KimYoung Ho Kim More articles by this author , and Dong Hwan LeeDong Hwan Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1982AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We suspected that lower urinary tract symptoms (LUTS) would have associated with autonomic nervous system (ANS) and this may be the clue of individual difference of treatment efficacy with alpha blocker in male LUTS. Heart rate variability (HRV) is a tool to measure ANS. We measured their HRV and divided LUTS patients into hyperactive and hypoactive sympathetic group relatively and compared the treatment of efficacy such as changes of IPSS, peak flow rate before and after treatment with alpha blocker. METHODS We selected 39 healthy volunteers who had similar clinical characteristic (age, volume of prostate) with 66 symptomatic LUTS patients who had over 12 total IPSS. No patient had disease which can affect autonomic nervous system, such as diabetes, hypertension and so on. Electrocardiographic signals were obtained from subjects in resting state and calculated their HRV indices with spectral analyses. We divided LUTS patients into two groups by low frequency/high frequency (LF/HF) ratio 1.7 which was median value of healthy volunteer¡¯s LF/HF ratio. Male LUTS patients were treated with alfuzosin 10mg for 1 month and we compare treatment outcomes between two groups such as changes of international prostate symptom score (IPSS), peak urine flow rate were analyzed and compared. RESULTS 38 sympathetic hyperactive men (Group A) and 28 hypoactive men (Group B) were enrolled. There were no statistical differences in age, serum PSA, volume of prostate, maximal urine flow rate between two groups at baseline. After treatment with alfuzosin 10mg for 1 month, sympathetic hyperactive group had better outcome, especially total IPSS and IPSS-voiding subscore (Table 1). CONCLUSIONS Sympathetic activity could be related with the outcome of LUTS treatment. Sympathetic hypeactive male LUTS patients had better outcome in IPSS, especially voiding symptoms after treatment with alfuzosin 10mg. Group A (N=38) Group B (N=28) P-value Age 59.11±9.92 57.89±9.69 0.62 Prostate volume 31.74±10.29 31.17±11.17 0.84 Qmax 11.90±6.84 11.92±7.10 0.99 Total IPSS 21.18±7.81 18.00±7.86 0.10 IPSS-Voiding subscore 12.63±5.28 10.89±5.29 0.19 IPSS-Storage suscore 7.50±4.24 6.54±3.62 0.34 Decrease of total IPSS after treatment 6.00±6.86 -0.11±5.58 0.03 Decrease of IPSS voiding subscore after treatment 6.07±4.98 1.11±3.98 0.02 Decrease of IPSS storage subscore after treatment 0.00±3.96 -1.89±3.76 0.26 Increase of Qmax after treatment 0.40±7.35 2.80±5.70 0.14 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e726-e727 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jong Bo Choi More articles by this author Hyun Ik Jang More articles by this author Jeong Hwan Lee More articles by this author Hyung Jee Kim More articles by this author Young Ho Kim More articles by this author Dong Hwan Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...