LUTS: Lower Urinary Tract Symptoms最新文献

{"title":"Changes in Bladder Outlet Obstruction After Photoselective Vaporization of the Prostate in Men With and Without Detrusor Underactivity: A Retrospective Propensity Score-Matched Study","authors":"Jurai Shibuya,&nbsp;Yuki Kyoda,&nbsp;Kohei Hashimoto,&nbsp;Ko Kobayashi,&nbsp;Toshiaki Tanaka,&nbsp;Naoya Masumori","doi":"10.1111/luts.70100","DOIUrl":"https://doi.org/10.1111/luts.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare symptomatic improvement after photoselective vaporization of the prostate (PVP) between patients with and without detrusor underactivity (DU), together with objective changes in urodynamic parameters assessed by pressure-flow study (PFS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective study evaluated 136 benign prostatic hyperplasia (BPH) patients treated with a 180 W PVP-XPS system from 2020 through 2025. The patients were divided into DU and non-DU groups based on the bladder contractility index (BCI), with DU defined as BCI &lt; 100. We retrospectively analyzed selected patients with BPH and clinically or urodynamically relevant bladder outlet obstruction (BOO) who underwent PVP and completed PFS before and 6 months after surgery. Propensity score matching (PSM) was applied to adjust for age and the baseline BOO index (BOOI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 105 patients were included in the final analysis and 53 were in the DU group. The DU group had a significantly lower BOOI (48.6 ± 17.5 vs. 71.4 ± 32.3, <i>p</i> &lt; 0.01) than the non-DU group. After PSM, age and baseline BOOI were well balanced, but BCI remained significantly different. No significant differences between the two groups were observed in questionnaire scores or uroflowmetry findings at 6 months after surgery. The BOOI at 6 months after surgery was not significantly different between the DU group (13.4 ± 13.7) and the non-DU group (13.7 ± 19.3) (<i>p</i> = 0.93). BOOI reduction was also not significantly different between the DU group (−37.0 ± 24.1) and the non-DU group (−36.2 ± 24.5) (<i>p</i> = 0.90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In selected patients with clinically or urodynamically relevant BOO, significant improvements in BOOI and LUTS were observed in patients with DU after PVP, with no statistically significant between-group differences detected at 6 months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Prescribing Patterns of Anticholinergics and β3-Adrenoceptor Agonists for Overactive Bladder: A Nationwide Study in Japan, FY2017–FY2024","authors":"Toshikazu Koike,&nbsp;Takashi Kawahara,&nbsp;Akihito Hashizume,&nbsp;Masanobu Yamazaki,&nbsp;Daiji Takamoto,&nbsp;Hiroki Ito,&nbsp;Teppei Takeshima,&nbsp;Hiroji Uemura,&nbsp;Kazuhide Makiyama,&nbsp;Jun-Ichi Teranishi","doi":"10.1111/luts.70099","DOIUrl":"https://doi.org/10.1111/luts.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Drug treatment for overactive bladder (OAB) is changing, with an increasing share of β3-adrenoceptor agonists relative to anticholinergics, but it is not known how far this change has progressed in older people, who are most vulnerable to the risks of anticholinergics. We examined the use of these drugs in Japan by age and sex, and analyzed changes in anticholinergic burden using a large database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed outpatient prescriptions of two β3-adrenoceptor agonists and six anticholinergics from FY2017 to FY2024, using the sex- and age-stratified tables of the NDB Open Data of Japan. Dispensed tablets were converted into patient-days, and the β3-adrenoceptor agonist share was calculated. Anticholinergic burden was measured as ACB-weighted prescription volume (patient-days multiplied by the anticholinergic cognitive burden score). Because FY2021–FY2022 was a period of nationwide generic supply disruption, FY2018 and FY2024 were used as endpoints when estimating change over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The β3-adrenoceptor agonist share rose from 36.2% to 64.9%, but anticholinergic use fell only slightly (3.10 × 10⁸ to 2.94 × 10⁸ tablets; −5.0%). In FY2024, the β3-adrenoceptor agonist share was higher in men than in women in every age group, and the difference widened with age (+1.2 percentage points at 50–54 years and +14.2 at ≥ 90 years). ACB-weighted prescription volume was higher in women than in men, and the female-to-male ratio rose with age (1.1 at 65–74 years, 1.6 at 75–84 years, and 2.8 at ≥ 85 years). Between FY2018 and FY2024, prescription volume fell by about 20% at 65–74 and 75–84 years, but the fall was smallest in women aged ≥ 85 years (−11.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The β3-adrenoceptor agonist share for OAB has continued to increase in Japan, but this change appears slower in older women, in whom anticholinergic exposure remains high.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Photoselective Vaporization of the Prostate on Renal Function: A Pressure Flow Study-Based Analysis","authors":"Kimihito Tachikawa,&nbsp;Yuki Kyoda,&nbsp;Kohei Hashimoto,&nbsp;Ko Kobayashi,&nbsp;Toshiaki Tanaka,&nbsp;Naoya Masumori","doi":"10.1111/luts.70096","DOIUrl":"10.1111/luts.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study assessed changes in renal function from baseline to 6 months after photoselective vaporization of the prostate (PVP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 117 consecutive patients who underwent PVP at our institution between November 2020 and September 2024, 88 patients with complete baseline and 6-month postoperative blood sampling and pressure flow study (PFS) data were included in the analysis. The primary endpoints were the changes in serum creatinine (sCr) and the estimated glomerular filtration rate (eGFR) from baseline to 6 months postoperatively. Secondary endpoints included changes in urodynamic parameters and clinical outcomes from baseline to 6 months postoperatively. An exploratory group comparison was performed between patients with and without an increase in eGFR of ≥ 5 mL/min/1.73 m².</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, median sCr and eGFR showed no significant changes, with sCr remaining at 0.93–0.92 mg/dL and eGFR unchanged at 61.7 mL/min/1.73 m² (<i>p</i> = 0.59 and <i>p</i> = 0.29, respectively). Clinical and urodynamic outcomes improved significantly, including a decrease in median Bladder Outlet Obstruction Index (BOOI) from 54.4 to 13.4 (<i>p</i> &lt; 0.001). Eleven patients (12.5%) met the exploratory eGFR improvement criterion. Compared with the remaining patients, they had a lower baseline eGFR and higher proportions of CKD stage ≥ 3, preoperative catheterization or clean intermittent catheterization, and phasic detrusor overactivity (<i>p</i> = 0.015, <i>p</i> = 0.0027, <i>p</i> = 0.033, and <i>p</i> = 0.0019, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall renal function did not significantly change at 6 months after PVP. The exploratory findings may provide preliminary support for considering PVP in patients with impaired renal function who otherwise meet established indications for surgery; however, they do not establish a renal protective effect and require prospective validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LiESWT on Non-Neurogenic LUTS: An Updated Systematic Review and Meta-Analysis","authors":"Yu-Ting Wang,&nbsp;Su-Wei Hu,&nbsp;Chih-Heng Chen,&nbsp;Chia-Chang Wu,&nbsp;Yuan-Hung Wang","doi":"10.1111/luts.70097","DOIUrl":"https://doi.org/10.1111/luts.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the efficacy of low-intensity extracorporeal shockwave therapy (LiESWT) for non-neurogenic lower urinary tract symptoms (LUTS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis was conducted according to PRISMA guidelines. PubMed, Embase, and the Cochrane Library were searched through February 2026 for studies evaluating LiESWT for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), stress urinary incontinence (SUI), overactive bladder (OAB), and interstitial cystitis/bladder pain syndrome (IC/BPS). Randomized controlled trials (RCTs) and prospective non-randomized studies were included. Random-effects models were used, with treatment-parameter subgroup analyses and RCT-only sensitivity analyses where applicable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two studies involving 1631 patients were included. In CP/CPPS, LiESWT was associated with significant improvements in patient-reported outcomes. RCT-only sensitivity analyses generally supported these findings, although IPSS improvement was not significant at 24 weeks. Symptomatic improvements were also observed in SUI, OAB, and IC/BPS, although estimates were based on few studies and were considered exploratory. Significant patient-reported improvements were observed at follow-up points extending to 48 weeks in CP/CPPS, 4 weeks in SUI, 24 weeks in OAB, and 12 weeks in IC/BPS. Objective outcomes were less consistent and varied across disease entities. In CP/CPPS, treatment-parameter subgroup analyses suggested that cumulative energy delivery may influence treatment response, with no clear incremental benefit at higher cumulative energy levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LiESWT may improve symptoms in patients with non-neurogenic LUTS, with the strongest evidence for CP/CPPS. Evidence for SUI, OAB, and IC/BPS remains limited and exploratory, and long-term efficacy across these conditions remains uncertain. Treatment-parameter findings should be interpreted cautiously given the heterogeneity of treatment protocols and the exploratory nature of the subgroup analyses. Further adequately powered RCTs using standardized treatment protocols and longer follow-up are needed to define optimal treatment parameters and establish the durability of benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149047920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom Bother Is Associated With Medical Care-Seeking for LUTS in Japanese Women: A Survey of 1800 Women","authors":"Tomoki Saito,&nbsp;Takashi Kawahara,&nbsp;Shinnosuke Kuroda,&nbsp;Teppei Takeshima,&nbsp;Yasushi Yumura,&nbsp;Hiroji Uemura,&nbsp;Kazuhide Makiyama,&nbsp;Jun-Ichi Teranishi","doi":"10.1111/luts.70098","DOIUrl":"https://doi.org/10.1111/luts.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Lower urinary tract symptoms (LUTS) are highly prevalent in women, yet care-seeking is very low, and a large treatment gap remains despite the availability of effective treatments. Previous studies, mainly from Western populations, suggest that symptom bother, as well as symptom severity, is associated with medical care-seeking; however, quantitative data in Asian and particularly Japanese women are scarce, the influence of bother on the separate care indicators is unclear, and the willingness to pay (WTP) for treatment has rarely been quantified. We therefore examined the factors associated with medical care-seeking, including symptom bother, and the WTP, in Japanese women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a nationwide web-based survey of 1800 Japanese women aged 40 years or older, covering the OABSS, ICIQ-UI SF, symptom bother (0–10), separate care indicators (consulting, visiting, treatment, and current treatment), reasons for not seeking care, and WTP. Factors associated with visiting a clinic were assessed with multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among symptomatic women, only 12.9% had visited a clinic. Both symptom bother and measured symptom severity were independently associated with visiting (bother ≥ 5, adjusted OR 5.19, 95% CI 3.08–8.76; OABSS ≥ 6, adjusted OR 2.24, 95% CI 1.23–4.07), while age, marital status, children, housing, and income were not significant. The most common reason for not seeking care was “thought it was just aging” (65.1%), and WTP rose with bother.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In Japanese women, symptom bother was independently associated with medical care-seeking (visiting a clinic) for LUTS, as was symptom-score severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Vibegron in Overactive Bladder: A Bayesian Cross-Trial Synthesis of Benefit Probabilities and Decision Thresholds","authors":"Takanobu Yamamoto,&nbsp;Soichiro Yoshida,&nbsp;Shugo Yajima,&nbsp;Hiroshi Fukushima,&nbsp;Yosuke Yasuda,&nbsp;Yuma Waseda,&nbsp;Hiroyuki Sato,&nbsp;Akihiro Hirakawa,&nbsp;Hiroyuki Honda,&nbsp;Yoshinobu Komai,&nbsp;Tomohiro Matsuo,&nbsp;Naoki Wada,&nbsp;Hitoshi Masuda,&nbsp;Yasuhisa Fujii","doi":"10.1111/luts.70095","DOIUrl":"https://doi.org/10.1111/luts.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To synthesize published placebo-controlled trials of vibegron monotherapy for overactive bladder (OAB) and quantify posterior probabilities of benefit and decision-threshold exceedance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We extracted published placebo-adjusted least-squares mean differences at Week 12 from three randomized, double-blind, placebo-controlled Phase III trials evaluating vibegron monotherapy (Japan Phase III trial, Korea bridging study [50 mg], and EMPOWUR trial [75 mg]) for four voiding-diary endpoints: micturitions/day, urgency episodes/day, urgency urinary incontinence (UUI) episodes/day, and voided volume (mL). For each endpoint, a Bayesian normal–normal random-effects model estimated the pooled mean effect and between-trial heterogeneity and calculated posterior probabilities of benefit and of exceeding thresholds predefined in this analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pooled mean effects (95% credible intervals) favored vibegron across all four voiding-diary endpoints: micturitions/day (−0.76, −1.33 to −0.28), urgency episodes/day (−0.69, −1.35 to −0.22), UUI episodes/day (−0.44, −0.93 to −0.03), and voided volume (+24.09 mL, 15.78–32.51). The posterior probabilities of benefit were 99.5%, 99.3%, 98.0%, and &gt; 99.9%, respectively. The probabilities of exceeding thresholds were as follows: for micturitions/day, ≤ −0.5: 90.3% and ≤ −1.0: 14.2%; for urgency episodes/day, ≤ −0.5: 82.8% and ≤ −1.0: 12.7%; for UUI episodes/day, ≤ −0.3: 81.8% and ≤ −0.5: 35.4%; and for voided volume, ≥ +10 mL: 99.5%, ≥ +20 mL: 88.4%, and ≥ +30 mL: 5.8%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bayesian cross-trial synthesis demonstrates a high probability that vibegron improves key OAB voiding-diary outcomes at Week 12. By explicitly quantifying the probability of exceeding clinically interpretable decision thresholds, this approach provides a transparent assessment of both the direction and magnitude of treatment effects, facilitating clinically interpretable decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Rezūm Water Vapor Energy Therapy for Benign Prostatic Hyperplasia With Continued Antithrombotic Therapy: A Comparative Study","authors":"Naoki Fujisawa,&nbsp;Satoshi Washino,&nbsp;Yuka Yasuda,&nbsp;Shigetoshi Maiya,&nbsp;Tetsuo Shinozaki","doi":"10.1111/luts.70094","DOIUrl":"10.1111/luts.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Evidence regarding the safety of water vapor energy (WAVE) therapy in patients continuing antithrombotic (AT) agents remains limited. This study compared the safety and efficacy of WAVE therapy between patients receiving AT therapy and those not receiving such therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective comparative study included 103 consecutive patients who underwent WAVE therapy at a single institution between February 2023 and October 2024. Patients were divided into an AT group (<i>n</i> = 36) and a non-AT group (<i>n</i> = 67). All AT agents continued throughout the perioperative period. Postoperative complications were graded according to the Clavien–Dindo classification. Changes in symptom scores and uroflowmetry parameters were evaluated at baseline and at 3 and 6 months after treatment in patients without a preoperative indwelling catheter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics were generally similar between the two groups, although patients in the AT group were significantly older than those in the non-AT group. Early postoperative bleeding events were comparable (11.1% in the AT group vs. 4.5% in the non-AT group, <i>p</i> = 0.24), and no grade ≥ 3 complications occurred in either group. Late complications occurred only in the non-AT group (6.0%). In the overall cohort, the median IPSS total score decreased from 18.5 (interquartile range: 12.0–25.0) at baseline to 9.0 (3.0–12.8) and 6.0 (3.0–10.8) at 3 and 6 months, respectively. Post-void residual volume decreased from 111 (interquartile range: 52.8–180) mL at baseline to 55.5 (27.3–102) and 50.5 (24.5–92.3) mL. These improvements were comparable between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WAVE therapy appeared feasible in patients who continued AT therapy, with acceptable short-term safety and symptomatic improvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex- and Age-Specific Trends in Prescriptions of Beta-3 Agonists and Anticholinergics in Japan: A Nationwide Prescription Database Study","authors":"Minato Yokoyama,&nbsp;Ayaka Onuki,&nbsp;Kisaki Koshi,&nbsp;Sorami Tsukahara,&nbsp;Haruko Negami,&nbsp;Keiji Shiba,&nbsp;Yuichiro Kato,&nbsp;Akihiro Kojima,&nbsp;Daisuke Kato,&nbsp;Takumasa Amemiya,&nbsp;Tsunehiro Nenohi,&nbsp;Masayasu Urushibara,&nbsp;Motohiro Fujiwara,&nbsp;Touko Asano,&nbsp;Hideto Kano,&nbsp;Kazuhiro Ishizaka","doi":"10.1111/luts.70092","DOIUrl":"https://doi.org/10.1111/luts.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To investigate the nationwide trends in pharmacological treatment for overactive bladder among Japanese adults, specifically focusing on the β3-agonists to anticholinergics prescribed tablet ratio (BAPR) and how this ratio differs by sex and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>National Database Open Data from fiscal year 2015 to 2023 were utilized and the prescription volumes of β3-agonists (mirabegron and vibegron) and anticholinergics (propiverine, solifenacin, imidafenacin, and fesoterodine) were aggregated. The data were categorized by sex and 10-year age groups to analyze prescribed tablet trends per 1000 population for each demographic. We calculated the BAPR by dividing the number of prescribed tablets for β3-agonists by those for anticholinergics and investigated the annual trends for younger and older men and women using an ordinary least squares linear regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, the total number of prescribed tablets for β3-agonists, anticholinergics, and overall total showed changes of +285.3%, −24.7%, and +59.3%, respectively. Total and β3-agonist prescriptions rose annually across all groups, whereas anticholinergic use declined beginning in fiscal year 2018. Additionally, nearly all drugs showed an increase in prescribed tablets per 1000 population as age progressed. Although the BAPR increased significantly in all groups, there were significant differences in the rates of change between groups (<i>p</i> &lt; 0.001), with older men exhibiting the highest rate of increase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A nationwide shift in overactive bladder treatment, where the growth in β3-agonist prescriptions outweighed the decline in anticholinergics, was observed across all demographic groups in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Rates and Predictors of Persistent Lower Urinary Tract Symptom Medication Use After Laser Enucleation of the Prostate”","authors":"Ahmet Murat Bayraktar,&nbsp;Bilgi İşler","doi":"10.1111/luts.70093","DOIUrl":"https://doi.org/10.1111/luts.70093","url":null,"abstract":"","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aquablation/AquaBeam Waterjet Therapy for Benign Prostatic Hyperplasia: Three-Year Functional and Ejaculatory Outcomes in a Multicenter Real-World Italian Cohort","authors":"Angelo Porreca,&nbsp;Daniele D'Agostino,&nbsp;Davide De Marchi,&nbsp;Marco Giampaoli,&nbsp;Filippo Marino,&nbsp;Gian Maria Busetto,&nbsp;Antonio Amodeo,&nbsp;Paolo Corsi,&nbsp;Francesco Claps,&nbsp;Luca Di Gianfrancesco","doi":"10.1111/luts.70088","DOIUrl":"https://doi.org/10.1111/luts.70088","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate the 3-year functional outcomes of Aquablation/AquaBeam waterjet therapy for bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH), with particular attention to urinary symptoms, quality of life, continence, ejaculatory function, and complications.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We performed a retrospective analysis of a prospectively maintained multicenter database including 218 consecutive men who underwent Aquablation/AquaBeam for symptomatic BPH between January 2019 and January 2022 at three referral centers. Functional outcomes assessed preoperatively and during follow-up included International Prostate Symptom Score (IPSS), IPSS quality-of-life item (IPSS-QoL), maximum urinary flow rate (Qmax), post-void residual urine (PVR), continence, and ejaculatory function. Median follow-up was 36 months. Ejaculatory preservation was evaluated only in patients with preserved antegrade ejaculation at baseline.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Median age was 61 years (IQR 57–66), median prostate-specific antigen (PSA) was 2.52 ng/mL (IQR 0.40–21.60), and median prostate volume was 55 mL (IQR 40–73). Median operative time was 56 min, while median catheterization time and length of hospital stay were both 48 h. Functional improvements were evident from the 3-month follow-up and remained stable through 36 months. At 36 months, median IPSS improved to 5 and median Qmax to 18 mL/s. Median PSA changed modestly from 2.52 ng/mL at baseline to 2.75 ng/mL at 36 months. No cases of de novo urinary incontinence were observed throughout follow-up. Among patients with preserved antegrade ejaculation at baseline, 87% maintained antegrade ejaculation at 36 months. Most postoperative complications were minor (Clavien-Dindo grade I-II, 20.2%). One grade III rectal injury occurred (0.5%). Median hemoglobin decreased from 15.2 g/dL preoperatively to 14.0 g/dL before hospital discharge, and two patients required blood transfusion. During the 36-month follow-up, no surgical retreatment was required, whereas 11 patients (5.0%) received temporary medical retreatment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this multicenter real-world cohort, Aquablation/AquaBeam was safe and effective over 3 years, providing durable improvement in lower urinary tract symptoms and quality of life while preserving continence and antegrade ejaculation in most patients. These findings support Aquablation/AquaBeam as a valuable minimally invasive surgical option for selected men with BPH, pa","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}