- Best practice in the management of storage symptoms in male lower urinary tract symptoms: a review of the evidence base. [Review]
- TATher Adv Urol 2018; 10(2):79-92
- Storage lower urinary tract symptoms (LUTS) are characterized by an altered bladder sensation, increased daytime frequency, nocturia, urgency and urgency incontinence. Some evidence underlines the ro...
Storage lower urinary tract symptoms (LUTS) are characterized by an altered bladder sensation, increased daytime frequency, nocturia, urgency and urgency incontinence. Some evidence underlines the role of metabolic factors, pelvic ischemia, prostatic chronic inflammation and associated comorbidities in the pathophysiology of storage LUTS. A detailed evaluation of the severity of storage LUTS, and the concomitance of these symptoms with voiding and postmicturition symptoms, is mandatory for improving the diagnosis and personalizing treatment. A detailed medical history with comorbidities and associated risk factors, a physical examination, a comprehensive analysis of all the features of LUTS, including their impact on quality of life, and a frequency-volume chart (FVC) or bladder diary, are recommended for men with storage LUTS. Several drugs are available for the treatment of LUTS secondary to benign prostatic obstruction (BPO). Alpha-blockers (α-blockers), 5-α-reductase inhibitors and phosphodiesterase type 5 inhibitors are commonly used to manage storage LUTS occurring with voiding symptoms associated with BPO. Muscarinic receptor antagonists and Beta 3-agonists (β3-agonists) alone, or in combination with α-blockers, represent the gold standard of treatment in men with predominant storage LUTS. There is no specific recommendation regarding the best treatment options for storage LUTS after prostatic surgery.
- Combination treatment for male lower urinary tract symptoms with anticholinergic and alpha-blockers. [Journal Article]
- COCurr Opin Urol 2018 Feb 09
- CONCLUSIONS: The addition of an anticholinergic to an α-blocker in men with storage and voiding LUTS is an effective practice in reducing both categories of symptoms. The addition of anticholinergic is associated with a low rate of urinary retention and the impact on efficient bladder emptying is minimal. Not unexpectedly, QoL is improved.
- Improvements in Self-reported Lower Urinary Tract Symptoms With Prostate Health Supplement. [Journal Article]
- ATAltern Ther Health Med 2018 Feb 10
- Context • Benign prostatic hyperplasia (BPH) produces lower urinary tract symptoms (LUTS) that diminish quality of life. Conventional treatments are often accompanied by adverse side effects. By cont...
Context • Benign prostatic hyperplasia (BPH) produces lower urinary tract symptoms (LUTS) that diminish quality of life. Conventional treatments are often accompanied by adverse side effects. By contrast, consumers of phytochemicals-based dietary supplements often report a reduction in symptoms without side effects. The field needs studies that quantify the strength and character of perceived benefits. Objectives • The study intended to quantify the character and strength of perceived improvements in LUTS in men, after the consumption of a prostate health supplement. Design • The research team sent questionnaires to 200 potential participants, requesting their self-reported retrospective assessments of their LUTS for the month prior to starting their use of a prostate health supplement, ProstaCaid (ie, at baseline from memory), and their assessments at the time of the study (ie, postintervention) based on their current symptoms. Setting • The study was conducted from consumers of ProstaCaid at their home through a mailed questionnaire from Econugenics (Santa Rosa, CA, USA). Participants • Participants were 65 male patients, ages 56 to 86 y, including those diagnosed with BPH, prostate cancer, or multiple diagnoses, or who had no formal diagnosis. Interventions • Participants had taken at least 2 capsules/d of the supplement for a minimum of 2 mo. Outcome Measures • Participants were asked to recall and rate urinary tract symptoms: (1) incomplete emptying (ie, sensation of not emptying the bladder), (2) urinary frequency, (3) intermittency, (4) urgency, (5) weak stream, (6) straining, and (7) nocturia, (ie, how many times the participant typically gets up at night to urinate). A questionnaire based on the international prostate symptom score questionnaire was used. Logistic regressions, based on the proportional odds ratios of LUTS scores, were used for statistical analysis. Results • The participants reported substantial improvements in a range of individual and composite LUTS scores. In addition, the variability of current scores was substantially reduced compared with recalled, past scores, indicating that the perceived improvements were shared among the respondents. Statistical analysis identified urgency and weak stream as the symptoms showing the greatest reduction in perceived severity, which therefore could be used as the subject of future case-controlled studies. Conclusions • When properly interpreted, retrospective, self-reported data can yield insights into the perceived benefits of supplements and help guide the care of patients who augment traditional treatment with alternative medicines. Reported improvements can also guide the development of testable hypotheses for randomized, case-controlled studies.
- Proteomic analysis of urothelium of rats with detrusor overactivity induced by bladder outlet obstruction. [Journal Article]
- MCMol Cell Proteomics 2018 Feb 01
- Overactive bladder (OAB) syndrome is a condition that has four symptoms: urgency, urinary frequency, nocturia, and urge incontinence and negatively affects a patient's life. Recently, it is considere...
Overactive bladder (OAB) syndrome is a condition that has four symptoms: urgency, urinary frequency, nocturia, and urge incontinence and negatively affects a patient's life. Recently, it is considered that the urinary bladder urothelium is closely linked to pathogenesis of OAB. However, the mechanisms of pathogenesis of OAB at the molecular level remain poorly understood, mainly as a result of lack of modern molecular analysis. The goal of this study is to identify a potential target protein that could act as a predictive factor for effective diagnosis and aid in the development of therapeutic strategies for the treatment of OAB syndrome. We produced OAB in a rat model and performed the first proteomic analysis on the mucosal layer (urothelium) of the bladders of sham control and OAB rats. The resulting data revealed the differential expression of 355 proteins in the bladder urothelium of OAB rats compared to sham subjects. Signaling pathway analysis revealed that the differentially expressed proteins were mainly involved in the inflammatory response and apoptosis. Our findings suggest a new target for accurate diagnosis of OAB that can provide essential information for the development of drug treatment strategies as well as establish criteria for screening patients in the clinical environment.
- A ureteral stent crossing the bladder midline leads to worse urinary symptoms. [Journal Article]
- CECent European J Urol 2017; 70(4):412-417
- CONCLUSIONS: This study shows that a ureteral stent crossing the bladder midline leads to worse urinary symptoms. Choosing the appropriate stent length for each patient is important for improving stent-related symptoms.
- Single-Point Acupuncture for Treatment of Urge Incontinence in Women: A Pilot Nonrandomized Trial. [Journal Article]
- MAMed Acupunct 2018 Feb 01; 30(1):21-24
- CONCLUSIONS: In this pilot trial, single-point acupuncture was associated with significant but short-term improvements in UI symptoms. Future trials should include a control group and an increased sample size for a more-rigorous examination of this potential adjunctive treatment for UI.
- Should the visceral peritoneum be closed over mesh in abdominal sacrocolpopexy? [Journal Article]
- EJEur J Obstet Gynecol Reprod Biol 2018 Jan 30; 222:142-145
- CONCLUSIONS: We noticed that there was no difference between the patients who were peritonized and those who were not in terms of postoperative complications.
- Combined Use of Duloxetine and Olanzapine in the Treatment of Urologic Chronic Pelvic Pain Syndromes Refractory to Conventional Treatment: A Case Report. [Case Reports]
- CPClin Psychopharmacol Neurosci 2018 Feb 28; 16(1):122-125
- Patients with urologic chronic pelvic pain syndromes (UCPPS) report interstitial cystitis/bladder pain syndrome and/or chronic prostatitis/chronic pelvic pain syndrome. The pathogenesis of these synd...
Patients with urologic chronic pelvic pain syndromes (UCPPS) report interstitial cystitis/bladder pain syndrome and/or chronic prostatitis/chronic pelvic pain syndrome. The pathogenesis of these syndromes remains unclear and there is currently no standard treatment. UCPPS is, therefore, often misdiagnosed and its management is complex. The present case report involves a 62-year-old male patient with UCPPS whose main presentation is painful bladder filling and painful urgency refractory to conventional treatment with medication, which was successfully treated with the combined use of duloxetine and olanzapine. The combined use of duloxetine and olanzapine may become a new therapeutic option in the management of UCPPS.
- Fitting NTCP models to bladder doses and acute urinary symptoms during post-prostatectomy radiotherapy. [Journal Article]
- RORadiat Oncol 2018 Feb 02; 13(1):17
- CONCLUSIONS: Different dose metrics were correlated with the symptoms of urgency, incontinence, frequency and nocturia. The symptoms of urinary flow and dysuria were poorly associated with dose. The values of the parameters of three NTCP models were determined for bladder regarding four acute urinary symptoms. All the models could fit the clinical data equally well. The NTCP predictions of urgency showed the best correlation with the patient reported outcomes.
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- Urinary Urgency in Working Women: What Factors Are Associated with Urinary Urgency Progression? [Journal Article]
- JWJ Womens Health (Larchmt) 2018 Feb 02
- CONCLUSIONS: Losing urine with defecation and making the bladder empty faster by pushing down should be explored as intervention targets to prevent women from progressing from Stage 3 to Stage 4.