Degree Of Lower Urinary Tract Symptoms Research Articles

Revisiting the Spectrum of Bladder Health: Relationships Between Lower Urinary Tract Symptoms and Multiple Measures of Well-Being.

Background: Little research to date has investigated the spectrum of bladder health in women, including both bladder function and well-being. Therefore, we expanded our previous baseline analysis of bladder health in the Boston Area Community Health (BACH) Survey to incorporate several additional measures of bladder-related well-being collected at the 5-year follow-up interview, including one developed specifically for women. Methods: At follow-up, participants reported their frequency of 15 lower urinary tract symptoms (LUTS), degree of life impact from and thought related to urinary symptoms or pelvic/bladder pain/discomfort, and perception of their bladder condition. Prevalence ratios were calculated by generalized linear models with robust variance estimation, adjusting for LUTS risk factors and individual LUTS. The BACH Survey was approved by the New England Research Institutes Institutional Review Board and all participants provided written informed consent. Results: Generally similar findings were observed in the 5-year cross-sectional analysis as at baseline, irrespective of how we categorized LUTS or measured bladder-related well-being. Approximately one in five women (16.2%-18.0% of 2527 eligible women) reported no LUTS and no diminished bladder-related well-being, the majority (55.8%-65.7%) reported some LUTS and/or diminished well-being, and a further one in five (16.9%-26.6%) reported the maximum frequency, number, or degree of LUTS and/or diminished well-being. Measures of storage function (urinating again after <2 hours, perceived frequency, nocturia, incontinence, and urgency) and pain were independently associated with bladder-related well-being. Conclusions: Our similar distribution of bladder health and consistent associations between LUTS and bladder-related well-being across multiple measures of well-being, including a female-specific measure, lend confidence to the concept of a bladder health spectrum and reinforce the bothersome nature of storage dysfunction and pain.

The prevalence of lower urinary tract symptoms based on individual and clinical parameters in patients with multiple sclerosis

BackgroundMost patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS.MethodsThis cross-sectional study was performed on 602 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Multistage random cluster sampling was performed and the informed consent form was signed by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS) and DASS-21 questionnaire. The data were analyzed using descriptive and inferential statistical tests in SPSS.ResultsThe prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between women and men in terms of the prevalence of other symptoms (P > 0.050). A significant difference was observed in the degree of LUTS with age, marital status, marriage duration, education, illness duration, clinical course, disability, anxiety, depression, and stress (P< 0.05). Moreover, logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and a high EDSS score [0.67 (0.507–0.903), P = 0.008].ConclusionsA high prevalence of LUTS was found among patients with MS. There was a higher probability of a urinary tract problem among patients with MS and a high EDSS score. Therefore, it is recommended that the health system take the necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS.

Association Between Lower Urinary Tract Symptoms and Falls in Adults Males: Based on the Korean Community Health Survey.

This study aimed to investigate the correlation between lower urinary tract symptoms (LUTSs) and falls considering places where falls can occur in adult males. We analyzed 101 862 males in the 2011 Korean Community Health Survey. LUTSs were assessed using the International Prostate Symptom Score system. The rate of total and indoor falls significantly increased with the LUTS severity, respectively. After adjusting for age and other confounding variables, the odds ratios (ORs) for total falls were significantly high for the mild (OR = 1.63, 95% confidence interval [CI] = 1.54-1.71), moderate (OR = 2.35, 95% CI = 2.16-2.56), and severe groups (OR = 2.83, 95% CI = 2.49-3.22), relative to the normal group. Indoor fall experience was the same for the mild (OR = 1.56, 95% CI = 1.36-1.79), moderate (OR = 2.37, 95% CI = 1.97-2.85), and severe groups (OR = 3.77, 95% CI = 3.00-4.72). Nocturia, hesitancy, and urgency were significantly associated with indoor falls. The association between falls and the degree of LUTS was observed in both the young and the elderly. Therefore, further studies are needed to determine the effects of treatment of LUTS on the risk of falls and the effectiveness of the fall prevention program.

Appearance of High Endothelial Venule-Like Vessels in Benign Prostatic Hyperplasia is Associated With Lower Urinary tract Symptoms.

Chronic prostatic inflammation is implicated in the pathogenesis of benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS). Previous studies evaluated the degree of chronic prostatic inflammation based on histological scores, which may contain subjective factors. We previously demonstrated that the number of high endothelial venule (HEV)-like vessels correlates positively with the magnitude of inflammation in chronic inflammatory gastrointestinal diseases. Here, we evaluated the degree of BPH-associated chronic prostate inflammation based on appearance of HEV-like vessels and determined whether the extent of inflammation correlated with LUTS severity, as evaluated by a urodynamic study. Eighty-six BPH tissue specimens derived from patients who had undergone urodynamic analysis were immunostained for CD34 and MECA-79 to determine HEV-like vessel number. Triple immunohistochemistry for either CD3 and CD20 or CD4 and CD8, together with MECA-79, was conducted to identify lymphocyte subsets associated with HEV-like vessels. We also determined whether the magnitude of chronic prostatic inflammation, as assessed by HEV-like vessel number, correlated with the degree of LUTS. HEV-like vessels were induced in lymphoid aggregates seen frequently in BPH. The number of HEV-like vessels positively correlated not only with the magnitude of chronic prostatic inflammation but also with the degree of LUTS, particularly with symptoms associated with voiding function, which was measured objectively in a pressure flow study. Chronic prostate inflammation may promote BPH and resulting voiding dysfunction. Assessment of the number of HEV-like vessels could be a surrogate for identifying the degree of chronic prostatic inflammation. Prostate 77:794-802, 2017. © 2017 Wiley Periodicals, Inc.

Effects of bariatric surgery on male lower urinary tract symptoms and sexual function.

To investigate the effect of bariatric surgery on male lower urinary tract symptoms (LUTS) and sexual function. Fifty-five consecutive obese men who underwent a laparoscopic sleeve gastrectomy were prospectively enrolled. Two validated questionnaires, the International Prostate Symptoms Score (IPSS) and the International Index of Erectile Function (IIEF) were used to assess LUTS and sexual function, before and 3 months after surgery. Fifty-three men (mean age 39 ± 12.5 years) completed all pre and postoperative questionnaires. Mean body mass index (BMI) before and 3 months after surgery was 42.8 ± 5.3 and 31.3 ± 5.4 kg/m2 ; respectively. Preoperatively, 41 (77%) men (mean age 40 ± 12.9, mean BMI 42.2 ± 5 kg/m2 ) had some degree of LUTS and 39 (74%) men (mean age 40.7 ± 12.4, mean BMI 42.8 ± 5.6 kg/m2 ) were sexually active. Postoperatively, the total IPSS score decreased significantly (5.5 ± 4.4 vs. 2.7 ± 2.6; P < 0.001), however this change was due to improvement in storage phase LUTS, measured by questions 2, 4, and 7 of the IPSS questionnaire. No statistically significant changes of voiding phase LUTS, measured by questions 1, 3, 5, 6 of the IPSS, were observed. Of the various aspects of sexual dysfunction, only erectile function, measured by questions 1-5 and 15 of the IIEF questionnaire was significantly improved (22.7 ± 7.2 vs. 26.1 ± 6.5, P = 0.02). Postoperative overall intercourse satisfaction (9.5 ± 4.2 vs. 11.5 ± 3, P = 0.01) and overall satisfaction (7.9 ± 2.5 vs. 8.9 ± 1.3, P = 0.02) were significantly improved as well. Male storage phase LUTS and erectile function were significantly and rapidly improved following bariatric surgery. Larger and long-term studies are required to investigate these apparently beneficial effects. Neurourol. Urodynam. 36:636-639, 2017. © 2016 Wiley Periodicals, Inc.

English

Objective: To investigate the correlation between Intravesical Prostatic Protrusion (IPP) and Prostate Uretral Angle (PUA) in Benign Prostatic Hyperplasia (BPH) patient with Lower Urinary Tract Symptoms (LUTS) on International Prostatic Symptoms Score (IPSS) and uroflowmetry. Methods: A cross sectional study was done to 71 BPH patients with LUTS who attended Urologic Clinic in Dr. Hasan Sadikin General Hospital and matched the inclusion and exclusion criterias. The Intravesical Prostatic Protrusion and PUA were measured using transrectal ultrasound and the degree of LUTS was measured using IPSS and uroflowmetry. Patients were classified based on PUA ( 10mm). Data were analyzed using Spearman correlation test. Results: Prostatic-Urethral Angle has a strong correlation with IPSS total and voiding (0.670 and 0.715) but the correlation was weak with IPPS storage (0.381). Furthermore, PUA has a strong negative correlation with Qmax dan Qave values. The bigger the PUA, the smaller Qmax dan Qave values. IPP has a strong correlation with IPSS total and voiding (0.645 and 0.662), but has moderate correlation with IPSS storage (0.442). Furthermore, IPP has no correlation with the values of Qmax, Qave, Voided volume and PVR. Conclusions: Prostatic-Urethral Angle and Intravesical Prostatic Protrusion have a strong correlation with the occurence of LUTS in BPH patients. Keywords: Benign prostatic hyperplasia, intravesical prostatic protrusion, lower urinary tract symptoms, prostate-urethral angle DOI: 10.15850/ijihs.v3n2.583

Prevalence of Lower Urinary Tract Symptoms Among Individuals Aged 50 Years and Over and Its Effect on the Quality of Life in a Semi-Rural Area of Western Turkey.

The number of individuals with lower urinary tract symptoms (LUTS) is increasing as the average age of the men in the community increases. This study aimed to determine the prevalence of LUTS and to assess the quality of life in men aged 50 years and older in Sivrihisar. This cross-sectional study was conducted in men aged over 50 years and included 450 subjects. The quality of life was evaluated using the SF-36 Health-Related Quality of Life Scale and the International Prostate Symptom Score (IPSS) to assess the presence and severity of LUTS. The statistical analysis was conducted using Mann-Whitney U-tests, χ2 tests and logistic regression analysis. The prevalence of LUTS was 78.7%, and the prevalence of moderate to severe LUTS was 32.4%. Comparative analyses between the individuals who had moderate to severe LUTS and those who did not indicated that individuals aged 60 and over, those with a primary school education or below, those without social insurance, those who were current smokers, those having any chronic disease diagnosed by a physician, those with a history of using diuretics, and those with a family history of prostate or bladder disease were associated with a higher prevalence of LUTS. In our study, the quality of life is adversely affected by an increased severity of LUTS. The prevalence of LUTS was found to be high in the men in this region of Turkey, and the degree of LUTS is inversely correlated with the quality of life.

A prevalence study of lower urinary tract symptoms (LUTS) in males

Background: Lower urinary tract symptoms (LUTS) are storage, voiding and post-micturition symptoms affecting the lower urinary tract. LUTS can significantly reduce men's quality of life and may point to serious pathology of the urogenital tract. LUTS are common and not necessarily a reason for suspecting prostatic hyperplasia (BPH). Aims & Objective: This study is aimed to clarify the relationship between lower urinary tract symptoms (LUTS) and their association with various etiopathologies. Materials and Methods: In this study total 600 men above the age of 40 years attending the surgical outpatient department in LG hospital, Maninagar, Ahmedabad (AMC MET Medical College) were suggested to detail history taking including IPSS questionnaire for evaluating LUTS. Abdominal examination, Rectal examination, Nervous system examination were done and Patient were investigated by Ultrasound scanning (Abdominal & Transrectal), Blood tests and urine tests. In selected cases, Prostate Specific Antigen (PSA), flow rate measurement, uroflowmetry and cystourethroscopy were done. Results: Of the 600 men, 222 had specific diseases (37%) responsible for occurrence of LUTS (BPH 45%, stricture urethra 40%, Neurogenic 7.5%, Miscellaneous 7.5%). About 15% of total subjects (90/600) had BPH. Among 400 men who had some degree of LUTS no specific disease was found responsible for these symptoms. Nocturia remained important symptom of LUTS in Bladder outflow obstruction. Conclusion: The study indicated that LUTS are not only because of BPH, but there are many other urological and non-urological factors in the etiology & pathogenesis of LUTS. Nocturia remains important symptom in IPSS. Patient with LUTS need well planned assessment of disease, clear cut understanding of the relevant pathophysiology and proper approach to diagnosis and treatment.

Impact of erectile function and age in men with lower urinary tract symptoms on ejaculatory dysfunction and premature ejaculation

Lower urinary tract symptoms (LUTSs) and ED are clearly correlated, but to date no correlation with ejaculatory dysfunction (EjD) has been identified. Therefore, this study evaluated the impact of erectile function in men with LUTS on EjD and premature ejaculation (PE). Erectile function, PE and EjD of 239 men (mean age, 53.0 ± 10.65 years), International Prostate Symptom Score (IPSS), International Index of Erection Function (IIEF), intravaginal ejaculatory latency time (IELT) and the seven-item Male Sexual Health questionnaire (MSHQ)-EjD were used to compare with the degree of LUTS. Ages were divided into five groups (<40, 40-49, 50-59, 60-69 and >70 years). The IPSS categorized patients into three symptom groups: mild, 1-7; moderate, 8-19; and severe, >19. ED was classified into five categories based on IIEF-EF scores: severe (0-6), moderate (7-12), mild-to-moderate (13-18), mild (19-24) and normal (25-30). The correlations among age, IIEF-EF, IELT and the MSHQ-EjD domain were studied through regression and cross-tabulation analyses. The results revealed that aging significantly affected each item of the MSHQ-EjD (P<0.05). The IIEF-EF domain was also correlated with each question on the MSHQ-EjD (P<0.05). PE (IELT <1 min) increased in incidence as patients got older but was not linked to IIEF-EF (P>0.05). These results indicate that EjD is closely related to age and erectile function, and that PE is closely related to age, although PE is not related to erectile function.

Prevalence of Lower Urinary Tract Symptoms in Austrian Males: Update 2009

Introduction: The prevalence of lower urinary tract symptoms (LUTS) in a representative sample of Austrian males aged 15–89 years was assessed in 2009. The results were compared with the findings of a similar study conducted in 1995. Materials and Methods: A population-based cross-sectional survey on LUTS was conducted in 2009 in Austria. A quota sample of 1,926 Austrians was selected. The sample comprised 0.03% of the population and was representative in terms of age, sex, occupational status and area of residence. Results: Some degree of LUTS is reported by 64.6% of the male population in Austria aged 15–89 years. IPSS correlates significantly with age. In all age groups storage symptoms are more prevalent than voiding symptoms. The prevalence of voiding symptoms (IPSS >0) among Austrian males is 35.5% and the prevalence of storage symptoms is 61.6%. In both groups the prevalence increases with age. Compared to 1995, the prevalence of dissatisfaction declined significantly. An extrapolated number of more than 35,000 men are ‘terribly’ dissatisfied with their current urinary condition. Conclusions: The prevalence of LUTS in Austria meliorated in Austria significantly between 1995 and 2009. This in part may be attributed to intensified contact of males with urologists in the past.

Prevalence of overactive bladder in a community-based male aging population

To investigate the situation of overactive bladder (OAB) in a community-based male population. Male participants over 50 years old were randomly selected from multiple communities in Beijing. The evaluation of lower urinary tract symptoms (LUTS) including the International Prostate Symptom Score (IPSS), quality of life (QOL) score, prostate volume and post voiding residue (PVR) by abdominal ultrasonography, and maximum flow rate (Qmax). Definition of OAB was determined as the score of item number 4 in IPSS ≥ 2. Of 1656 male participants enrolled, a total of 1639 men met our study criteria. The mean age was (64 ± 10) years. The prevalence of OAB was 26.3% (431/1639), and was significantly related to age, IPSS, QOL score, prostate volume, PVR and Qmax (P < 0.01). The prevalence of OAB was closely associated with aging (P < 0.01) and the degree of LUTS (P < 0.01). The prevalence of OAB increased with aging of the community-based male population. OAB would obviously affect the quality of life of the aging men.

Effects of α1-Blockers for Lower Urinary Tract Symptoms and Sleep Disorders in Patients with Benign Prostatic Hyperplasia.

We evaluated the association of lower urinary tract symptoms (LUTS) and sleep disorders (SD) in patients with benign prostatic hyperplasia (BPH). We also examined improvement of SD following the α1-blocker therapy for LUTS. Sixty-eight male patients were enrolled in the study, consisting of 38 cases with LUTS and BPH (BPH group), and 30 men without significant LUTS or BPH (non-BPH group). The degree of LUTS and SD was evaluated by the International Prostate Symptom Score and the Pittsburg Sleep Quality Index (PSQI), respectively. The patients of BPH group then were treated with α1-blocker for 4 weeks, and were re-examined by all the questionnaires to evaluate the therapeutic efficacies. The correlation analyses showed a significant association of LUTS with SD in BPH group (r = 0.4995, P = 0.0068). Twenty cases (52.6%) in BPH group showed 5.5 or more PSQI scores. Following 4 weeks of α1-blocker administration, the average PSQI decreased significantly from 6.3 to 4.8 points (P < 0.001). Significant improvement was observed in domains of "sleep quality" and "sleep disturbances" among PSQI (P = 0.0215 and 0.0391, respectively). Moreover, significant association between α1-blocker induced improvements of nocturia and SD was identified in patients with 5.5 or more PSQI score at baseline (r = 0.445, P = 0.0334). These results suggested that SD is associated with LUTS among BPH patients and therapeutic effects of α1-blockers on LUTS lead to improvements of SD.

One-third of the Swedish male population over 50 years of age suffers from lower urinary tract symptoms

To investigate the prevalence of and restrictions in various parts of daily life due to lower urinary tract symptoms (LUTS) in an unselected Swedish male population. A random selection of 3345 men throughout Sweden, aged between 41 and 80, was contacted by telephone and evaluated according to International Prostate Symptom Score (IPSS). The responders were then sent two different questionnaires based on degree of LUTS, IPSS <8 or >7. 2106 men (66%) answered the questionnaire. Of these, 33.4% had an IPSS > 7 and the IPSS increased with age. Of the men with IPSS >7 only 41% had consulted health services for their symptoms and 23% had received treatment. Thirty-seven per cent claimed that their problems had a great negative effect on their quality of life and 77% that they had affected their relationship with their spouse negatively to a great extent. Forty per cent did not consult health services despite their symptoms. In men with an IPSS <8 as many as 33% believed that LUTS would limit them in at least some part of their daily life. LUTS is a common condition among Swedish men with a severe impact on quality of life and everyday life. Despite readily available medical assistance, two out of five men with LUTS still do not try to obtain a remedy. The data presented here identify a need for improved education regarding LUTS, to increase awareness of the condition and the treatment options that are available.

The Relationship between Prostate Inflammation and Lower Urinary Tract Symptoms: Examination of Baseline Data from the REDUCE Trial

ObjectiveThe ongoing REDUCE trial is a 4-yr, phase 3, placebo-controlled study to determine if daily dutasteride 0.5mg reduces the risk of biopsy detectable prostate cancer. Prostate biopsies performed in all men prior to entry were centrally reviewed, thus allowing an examination of the relationship between inflammatory changes and lower urinary tract symptoms (LUTS). MethodsEligible men were aged 50–75 yr, with serum prostate-specific antigen ≥2.5ng/ml and ≤10ng/ml (50–60 yr), or ≥3.0ng/ml and ≤10ng/ml (>60 yr) and an International Prostate Symptom Score (IPSS)<25 (or <20 if already on alpha-blocker therapy). Acute prostatitis was an exclusion criterion. For a given individual, inflammation was assessed across all cores and the amount of inflammation scored as none (0), mild (1), moderate (2), or marked (3). LUTS was assessed with the use of the IPSS. The relationship between inflammation scores (averaged over all cores) and total IPSS; grouped IPSS (0–3, 4–7, 8–11, 12–15, 16–19, ≥20); and irritative, obstructive, and nocturia subscores was determined by Spearman rank correlations. The relative contribution of inflammation, age, and body mass index was then examined with the use of linear regression analyses. ResultsData were available for 8224 men. Statistically significant but relatively weak correlations were found between average and maximum chronic inflammation and IPSS variables (correlation coefficients, 0.057 and 0.036, respectively; p < 0.001 for total IPSS). Both age and average chronic inflammation were significant in the linear regression after adjustment for other covariates; for both variables, more severe inflammation was associated with higher IPSS scores. ConclusionsIn the REDUCE population, there is evidence of a relationship between the degree of LUTS and the degree of chronic inflammation. Study entry criteria that selected older men and decreased enrolment of men with a greater degree of inflammation and LUTS may have limited the strength of this relationship. The impact of baseline prostate inflammation on progression of LUTS and/or associated complications will be determined during 4-yr longitudinal follow-up.

Correlation between risk factors for vascular disease and the American Urological Association Symptom Score

To evaluate the correlation between risk factors for vascular disease and the American Urological Association Symptom Score (AUA-SS), by comparing the presence of these risk factors with the degree of lower urinary tract symptoms (LUTS). We retrospectively reviewed the medical history, AUA-SS, and prostate volume of men who had a radical prostatectomy. The degree of LUTS in men with and without risk factors for cardiovascular disease was compared. The mean AUA-SS was 7.2 for the entire cohort, 5.6 in men with no risk factors, and 7.9 in men with at least one risk factor (P < 0.05). In men with one to four risk factors, the mean AUA-SS was 6.9, 7.9, 10.7, and 19.5, respectively. There was no correlation between the AUA-SS and prostate size in the entire cohort or among any groups. Men with risk factors for vascular disease are more likely to have a higher AUA-SS than men without these risk factors. These findings suggest the possibility of an association between vascular disease and the development and severity of LUTS in men.