You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II1 Apr 2017PD26-05 THE IMPACT OF ATHEROSCLEROSIS-INDUCED PELVIC ISCHEMIA ON LUTS IN ELDERLY MEN Daniel Costa, Alice Porto, Ana Coelho, João Neves, Luís Vale, Carlos Silva, Tiago Antunes-Lopes, and Francisco Cruz Daniel CostaDaniel Costa More articles by this author , Alice PortoAlice Porto More articles by this author , Ana CoelhoAna Coelho More articles by this author , João NevesJoão Neves More articles by this author , Luís ValeLuís Vale More articles by this author , Carlos SilvaCarlos Silva More articles by this author , Tiago Antunes-LopesTiago Antunes-Lopes More articles by this author , and Francisco CruzFrancisco Cruz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1213AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several studies demonstrated the association between LUTS and atherosclerosis risk factors and metabolic syndrome. However, a direct impact of chronic pelvic ischemia on LUTS in elderly men was never fully determined. The only evidence is coming from animal models of iliac obstruction which show significant bladder dysfunction after ischemia. Herewith, we investigated LUTS and urinary levels of nerve growth factor (NGF) in elderly men with chronic pelvic ischemia caused by documented aorta, unilateral or bilateral common/internal iliac obstruction. METHODS Thirteen men >60y, with aorta, unilateral or bilateral common/internal iliac artery occlusion documented by angio-CT scan or angiography, were enrolled from the vascular surgery department. Twelve men >60y without significant aorto-iliac disease, as confirmed by image studies, were used as controls. Exclusion criteria included neurogenic bladder dysfunction, bladder or prostate cancer, prostate surgery, pelvic radiotherapy or chronic treatment for LUTS. Participants underwent urological examination, including IPSS score to assess LUTS, uroflowmetry, postvoid residual (PVR) and prostate volume determination. Urine samples were collected from all participants and urinary NGF was measured by ELISA to explore the presence of chronic neurogenic inflammation. RESULTS Data are summarized in the table. Both groups were identical for age and prostate volume. BMI was slightly higher in the control group. IPSS score was statistically significant higher in the pelvic ischemia group than in controls. The IPSS difference between the two groups was 3 points. Urinary NGF/creatinine was significantly higher in the ischemic patients. CONCLUSIONS Severe pelvic ischemia in elderly men is associated with a significant increase in LUTS and chronic bladder neurogenic inflammation, as suggested by the increase of NGF release, a neurotrophin that may sensitize bladder primary afferents. These findings confirm the relevance of pelvic ischemia in bladder function and validate animal models of bilateral iliac artery occlusion currently under use to investigate the pathophysiologic mechanisms at stake. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e507-e508 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Daniel Costa More articles by this author Alice Porto More articles by this author Ana Coelho More articles by this author João Neves More articles by this author Luís Vale More articles by this author Carlos Silva More articles by this author Tiago Antunes-Lopes More articles by this author Francisco Cruz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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