High classification of chronic heart failure increases risk of overactive bladder syndrome and lower urinary tract symptoms.
ABSTRACT To assess the urologic symptoms among patients with chronic heart failure (CHF) and to explore whether a higher classification of CHF increases the risk associated with overactive bladder syndrome (OAB) and lower urinary tract symptoms.
A total of 214 ambulatory patients with CHF (129 men and 85 women) and 378 age-matched subjects (222 men and 156 women) were enrolled in the present study. The urologic symptoms were evaluated using the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS) from January to June 2010.
Compared with the controls, the patients with CHF had a significantly greater mean OABSS (4.6±3.6 vs 3.4±3.1, P<.001), total IPSS (8.3±6.9 vs 6.9±7.6, P=.021), and storage IPSS (4.8±3.5 vs 3.7±3.3, P<.001). Of the patients with CHF, 34.1% had moderate/severe OAB symptoms (OABSS≥6), and 43.5% had moderate/severe lower urinary tract symptoms (IPSS≥8). Compared with patients who had New York Heart Association (NYHA) class I CHF, the patients with NYHA class III CHF had a significantly greater OABSS and total, storage, and voiding IPSSs. Patients with NYHA class II CHF did not. A greater body mass index and stroke were significantly associated with the OABSS and storage IPSS, and pulmonary disease was significantly associated with the voiding IPSS.
The patients with CHF had more storage urinary symptoms suggestive of OAB than did the age-matched controls. Among the patients with CHF, greater NYHA class heart function was significantly associated with OAB and lower urinary tract symptoms.
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ABSTRACT: Chronic inflammation is considered as one of the contributing mechanisms of lower urinary tract symptoms (LUTS). Serum C-reactive protein (CRP) level is the widely used biomarker of inflammatory status. This study investigated the association between serum CRP level in men with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) before and after medical treatment. A total of 853 men with BPH and LUTS were enrolled. All patients completed the International Prostate Symptoms Score (IPSS) questionnaire and urological examinations. The parameters of uroflowmetry (maximum flow rate, Qmax; voided volume, VV), post-void residual (PVR), total prostate volume (TPV) and transition zone index (TZI), serum prostate specific antigen (PSA), and serum CRP levels were obtained. All patients were treated with alpha-blocker or antimuscarinic agent based on the IPSS voiding to storage subscore ratio (IPSS-V/S). Correlation analyses were performed between serum CRP levels with age, IPSS, TPV, TZI, Qmax, PVR, VV, PSA and between baseline and post treatment. The mean age was 66.9±11.6 years old and the mean serum CRP levels were 0.31±0.43 mg/dL. Univariate analyses revealed serum CRP levels were significantly associated with age (p<0.001), PSA levels (p = 0.005) and VV (p = 0.017), but not significantly associated with TPV (p = 0.854) or PVR (p = 0.068). CRP levels were positively associated with urgency (p<0.001) and nocturia (p<0.001) subscore of IPSS, total IPSS (p = 0.008) and storage IPSS (p<0.001) and negatively associated with IPSS- V/S ratio (p = 0.014). Multivariate analyses revealed that serum CRP levels were significantly associated with age (p = 0.004) and storage IPSS subscore p<0.001). Patients with IPSS-V/S<1 and treated with tolterodine for 3 months had significant decrease of CRP levels after treatment. Serum CRP levels are associated with storage LUTS and sensory bladder disorders, suggesting chronic inflammation might play a role in the patients with storage predominant LUTS.PLoS ONE 01/2014; 9(1):e85588. · 3.53 Impact Factor
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ABSTRACT: Overactive bladder (OAB) is a highly prevalent clinical condition in both men and women, and rates tend to increase with advancing age. A variety of different evaluation methods have been developed to measure both objective and subjective parameters of the condition. OAB has been associated with negative clinical outcomes, particularly in older adults, including depression, social isolation, and impairments of both general and health-related quality of life. Options for treatment include behavioral therapies, medications, and surgical treatments such as chemodenervation. Combined symptoms of OAB and benign prostatic enlargement have recently gained increased research attention. This article reviews recently published literature on epidemiology, evaluation, clinical impacts, and management of OAB, with a focus on elderly men.Current Urology Reports 08/2013;
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ABSTRACT: Nocturia is such a commonplace occurrence in the lives of many older adults that it is frequently overlooked as a potential cause of sleep disturbance. The aim of the present study was to evaluate the prevalence of nocturia among elderly men living in a rural area in Egypt, and its impact on sleep quality and health-related quality of life (HRQoL). This was a cross-sectional study. A total of 1200 elderly men participated in the survey. The Pittsburgh Sleep Quality Index (PSQI) Arabic version and the short form-36 (SF-36) were used in this survey. The prevalence of nocturia in the studied participants (≥1 void/night) was 63.5%. With the criterion (≥2 voids/night) the prevalence was 46.0%. Multivariate logistic regression analysis showed that nocturia is an independent risk factor of poor sleep quality (OR 5.08), and poor sleep is an independent risk factor of the poor physical component of QoL (OR 17.6) and the mental component of QoL (OR 3.2). Nocturia is widely prevalent among elderly men living in a rural area in Egypt. The adverse effect of nocturia on QoL is related to poor sleep. Geriatr Gerontol Int 2013; ●●: ●●-●●.Geriatrics & Gerontology International 09/2013;