Advances in Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (15 December 2021) | Viewed by 7536

Special Issue Editors


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Guest Editor
Department of Urology, Jagiellonian University, Krakow, Poland
Interests: prostate cancer; bladder cancer; kidney cancer; urologic surgery; laparoscopy; endourology

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Co-Guest Editor
Medical College, Jagiellonian University, Krakow, Poland
Interests: functional urology; neurourology; overacitive bladder; urinary incontinence

Special Issue Information

Dear Colleagues,

Lower urinary tract symptoms (LUTS) encompass storage (frequency, urgency, nocturia, urinary incontinence), voiding (hesitancy, straining, slow stream, intermittency, terminal dribble), and post-micturition symptoms (sensation of incomplete emptying, post-micturition dribble). LUTS are not disease or condition specific, and despite being commonly related to bladder outlet obstruction, LUTS may be indicative of bladder dysfunction and other structural and/or functional abnormalities of the urinary tract. In addition, they may herald many non-urological conditions. LUTS are particularly prevalent among adult men from the general population. In addition, LUTS significantly affect quality of life.

In light of these data, Medicina is developing a Special Issue on the topic “Advances in Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia.” We are prioritizing high-quality original studies, but also welcome well-designed meta-analyses and well reviews. We look forward to your contribution.

Prof. Dr. Piotr Ludwik Chłosta
Dr. Mikolaj Przydacz
Guest Editors

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Keywords

  • lower urinary tract symptoms
  • overactive bladder
  • benign prostatic hyperplasia
  • urinary incontinence
  • pharmacotherapy
  • population-based studies
  • epidemiology

Published Papers (3 papers)

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Research

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11 pages, 914 KiB  
Article
Association between Lower Urinary Tract Symptoms and Sleep Quality of Patients with Depression
by Mikolaj Przydacz, Michal Skalski, Jerzy Sobanski, Marcin Chlosta, Karol Raczynski, Katarzyna Klasa, Dominika Dudek and Piotr Chlosta
Medicina 2021, 57(4), 394; https://doi.org/10.3390/medicina57040394 - 19 Apr 2021
Cited by 7 | Viewed by 2200
Abstract
Background and Objectives: In the general population, sleep disorders are associated with lower urinary tract symptoms (LUTS) including urinary incontinence (UI). This connection has not been explored fully in specific patient groups. Thus, we investigated the association between sleep quality and LUTS [...] Read more.
Background and Objectives: In the general population, sleep disorders are associated with lower urinary tract symptoms (LUTS) including urinary incontinence (UI). This connection has not been explored fully in specific patient groups. Thus, we investigated the association between sleep quality and LUTS for patients with depression. Materials and Methods: This study was prospective and cross-sectional. We analyzed questionnaire data on depression, sleep quality, LUTS, and UI from depressed patients treated in our department of adult psychiatry. We used the Hamilton Rating Scale for Depression, the Holland Sleep Disorders Questionnaire, the International Prostate Symptom Score, and the International Consultation on Incontinence Questionnaire-Short Form. Results: In total, 102 patients treated for depression were enrolled. We found a statistically significant correlation between depression severity and sleep quality. A significant correlation was also investigated for sleep quality and LUTS severity. The group of depressed patients with moderate or severe LUTS had greater sleep problems compared with patients who had mild urinary tract symptoms or no symptoms. With regression analysis, we further demonstrated that the relationships between LUTS and sleep quality as well as UI and sleep quality in depressed patients are independent from age and sex. Conclusions: In the cohort of patients treated for depression, sleep quality correlated with LUTS including UI. We suggest that the negative effect of LUTS and UI on sleep quality that we observed should lead to the re-evaluation of current recommendations for diagnosis and treatment of sleep problems among patients with depression. Full article
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Review

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11 pages, 327 KiB  
Review
Is Early Surgical Treatment for Benign Prostatic Hyperplasia Preferable to Prolonged Medical Therapy: Pros and Cons
by Cora Fogaing, Ali Alsulihem, Lysanne Campeau and Jacques Corcos
Medicina 2021, 57(4), 368; https://doi.org/10.3390/medicina57040368 - 09 Apr 2021
Cited by 9 | Viewed by 2732
Abstract
Background and objectives: Treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) has shifted over the last decades, with medical therapy becoming the primary treatment modality while surgery is being reserved mostly to patients who are not responding to [...] Read more.
Background and objectives: Treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) has shifted over the last decades, with medical therapy becoming the primary treatment modality while surgery is being reserved mostly to patients who are not responding to medical treatment or presenting with complications from BPH. Here, we aim to explore the evidence supporting or not early surgical treatment of BPH as opposed to prolonged medical therapy course. Materials and Methods: The debate was presented with a “pro and con” structure. The “pro” side supported the early surgical management of BPH. The “con” side successively refuted the “pro” side arguments. Results: The “pro” side highlighted the superior efficacy and cost-effectiveness of surgery over medical treatment for BPH, as well as the possibility of worse postoperative outcomes for delayed surgical treatment. The “con” side considered that medical therapy is efficient in well selected patients and can avoid the serious risks inherent to surgical treatment of BPH including important sexual side effects. Conclusions: Randomized clinical trials comparing the outcomes for prolonged medical therapy versus early surgical treatment could determine which approach is more beneficial in the long-term in context of the aging population. Until then, both approaches have their advantages and patients should be involve in the treatment decision. Full article

Other

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19 pages, 526 KiB  
Systematic Review
De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review
by Maciej Oszczudłowski, Konrad Bilski, Mieszko Kozikowski and Jakub Dobruch
Medicina 2022, 58(3), 381; https://doi.org/10.3390/medicina58030381 - 04 Mar 2022
Cited by 6 | Viewed by 1700
Abstract
Background and objectives: The aim of this systematic review is to evaluate the impact of radical prostatectomy (RP) on bladder function, with special attention towards detrusor underactivity investigated with the means of urodynamic evaluation. Materials and Methods: The review was performed in accordance [...] Read more.
Background and objectives: The aim of this systematic review is to evaluate the impact of radical prostatectomy (RP) on bladder function, with special attention towards detrusor underactivity investigated with the means of urodynamic evaluation. Materials and Methods: The review was performed in accordance with the PRISMA statement and was registered in the PROSPERO (ID#: CRD42020223480). The studied population was limited to men with prostate cancer who underwent urodynamic study prior to and after radical prostatectomy. Eight hundred twenty-seven studies were screened, with twenty-five finally included. A qualitative analysis was performed. Rates of detrusor underactivity (DU) before surgery were reported in eight studies and ranged from 1.6% to 75% (median of 40.8%). DU occurred de novo after RP in 9.1% to 37% of patients (median of 29.1%). On the other hand, preexisting DU resolved in 7% to 35.5% of affected men. Detrusor overactivity (DO) was the most frequently reported outcome, being assessed in 23 studies. The rate of DO preoperatively was from 5% to 76% (median of 25%). De novo was reported in 2.3–54.4% of patients (median of 15%) and resolved after RP in 19.6% to 87.5% (median of 33%) of affected patients. Baseline rates of bladder outlet obstruction (BOO) varied between studies from 19% to 59.3%, with a median of 27.8%. The most pronounced change after surgery was the resolution of BOO in 88% to 93.8% (median of 92%) of affected patients. Results: Rates of de novo impaired bladder compliance (IBC) varied from 3.2% to 41.3% (median of 13.3%), whereas the resolution of IBC was reported with rates ranging from 0% to 47% (median of 4.8%). Conclusions: BOO, DO, and DU are frequently diagnosed in men scheduled for RP. BOO is improved after RP in most patients; however, there is still a substantial rate of patients with de novo DU as well as DO which may impair functional outcomes and quality of life. Full article
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