LUTS: Lower Urinary Tract Symptoms最新文献

{"title":"Effects of Vibegron, a β3-Adrenoceptor Agonist, on Lower Urinary Tract Dysfunction in Diabetic Rats","authors":"Daisuke Gotoh,&nbsp;Kazumasa Torimoto,&nbsp;Kazuki Ichikawa,&nbsp;Akira Tachibana,&nbsp;Nobutaka Nishimura,&nbsp;Yuki Oda,&nbsp;Mitsuru Tomizawa,&nbsp;Kenta Onishi,&nbsp;Yosuke Morizawa,&nbsp;Shunta Hori,&nbsp;Yasushi Nakai,&nbsp;Makito Miyake,&nbsp;Kiyohide Fujimoto","doi":"10.1111/luts.70051","DOIUrl":"10.1111/luts.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In this study, we aimed to investigate the impact of vibegron, a β₃-adrenergic receptor agonist, on lower urinary tract dysfunction in a diabetic rat model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Female rats were categorized into three groups: non-diabetic controls (N), streptozotocin-induced diabetic rats receiving vehicle (D), and diabetic rats treated with vibegron (DV). In the DV group, vibegron was administered orally at 30 mg/kg/day starting 7–8 weeks after diabetes induction. At 8 weeks post-induction, voiding assays, urinary 8-hydroxydeoxyguanosine (8-OHdG) measurements, cystometry, and analysis of bladder mRNA expression levels of ischemia- and inflammatory-related markers were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 24-h voiding assays showed that Groups D and DV had markedly higher urine volume, average voided volume, voiding frequency, and water intake compared to Group N. Urinary 8-OHdG levels were markedly elevated in Group D than those in Groups N and DV. Group D also exhibited higher opening pressure and non-voiding contractions. Intercontraction intervals, voided volume, post-void residual volume, bladder capacity, and compliance were significantly increased, while voiding efficiency was markedly decreased in Groups D and DV compared to that in Group N. Bladder mRNA expression of hypoxia-inducible factor-1 alpha <i>(Hif1a)</i>, vascular endothelial growth factor A (<i>Vegfa</i>), transforming growth factor-beta 1 (<i>Tgfb1</i>), and tumor necrosis factor alpha (<i>Tnfa</i>) was upregulated in Group D compared with that in Groups N and DV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that vibegron may be a promising therapeutic option for addressing detrusor overactivity, ischemia, and inflammation of the bladder associated with diabetes mellitus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142864","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":"Efficacy of Transobturator Vaginal Tape in the Treatment of Coital Incontinence: A Prospective Study Using a Condition-Specific Questionnaire","authors":"Marilena Gubbiotti,&nbsp;Chiara Gilli,&nbsp;Stefano Rosadi,&nbsp;Emanuele Rubilotta","doi":"10.1111/luts.70049","DOIUrl":"10.1111/luts.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Aim of this study was to evaluate the impact of transobturator vaginal tape (TVT-O) implant on Coital Incontinence (CI), using a specific questionnaire for CI, the “International Female Coital Incontinence- Questionnaire” (IFCI-Q).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>TVT-O was performed on sexually active women diagnosed with urodynamic (UD) stress urinary incontinence (SUI), who also experienced CI with penetration and/or orgasm. At baseline patients underwent to medical history, UD, and VAS scale to assess the impact of CI on quality of life. The success rate for CI was assessed by the IFCI-Q. Follow- up evaluations were performed at 3, 6, and 12- months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty women were enrolled. Mean (±SD) age was 52.8 ± 10.2 years. Patients underwent implantation of TVT-O. At 12-month follow-up, success rate was 91.6%. Comparison of pre- and post-operative IFCI scores revealed a significant improvement of the total IFCI score. At baseline 50/60 (83.3%) women complained of CI at penetration and 10/60 (16.7%) referred both types of CI. According to the IFCI-Q scores, at 3-, 6-, and 12-month follow-up a significant decrease in frequency of CI, an improvement in quality of intercourse, and in the psychological status of patients persisting over time were demonstrated. At 12-month follow-up, five patients complained of persistent mild SUI. VAS score statistically improved at 12 months follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that the TVT-O procedure is an effective and secure treatment not only for SUI but also for CI. This is the first time that CI has been evaluated before and after the surgery using a validated questionnaire specifically designed for CI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113584","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":"Association Between Maternal Bladder Descent Angle and Urinary Incontinence in Late Pregnancy: A Transperineal Ultrasonography Study","authors":"Ryoko Minami,&nbsp;Yumiko Tateoka,&nbsp;Akihiro Kawauchi","doi":"10.1111/luts.70050","DOIUrl":"10.1111/luts.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To quantitatively evaluate bladder morphological changes induced by fetal head descent during late pregnancy using transperineal ultrasonography (US) and to investigate the association with urinary incontinence (UI). This study aimed to introduce a novel, imaging-based approach for assessing pregnancy-related urinary dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, 14 women with singleton pregnancies beyond 36 weeks of gestation were evaluated. During routine antenatal visits, participants completed a validated questionnaire assessing urinary symptoms, and the bladder descent angle (BDA) was measured using transperineal US. The BDA was defined as the angle between the bladder base and the inferior margin of the pubic symphysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UI was reported in 57.1% of participants, with stress urinary incontinence (SUI) being the most common subtype (62.5%). Ultrasonography revealed that BDA increased in late pregnancy. The SUI group exhibited a significantly greater BDA compared with the no-UI group (<i>p</i> = 0.03), whereas the overall UI group showed only a non-significant trend (<i>p</i> = 0.081).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The BDA assessed by transperineal US is considered a practical and simple marker for the evaluation of UI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12866369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113550","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":"A High Anticholinergic Burden Is Independently Associated With Nocturia in Turkish Older Women","authors":"Yılmaz Onal,&nbsp;Suleyman Emre Kocyigit","doi":"10.1111/luts.70048","DOIUrl":"10.1111/luts.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to examine the relationship between nocturia and anticholinergic burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The female participants aged ≥ 65 years who presented to the outpatient geriatric clinic between November 2022 and January 2025 were retrospectively reviewed. Nocturia was defined as waking up from bed at night for urination at least twice per night. All participants underwent a comprehensive geriatric assessment (CGA). Demographic characteristics, comorbidities, geriatric syndromes, laboratory findings, and CGA parameters were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 422 total patients, nocturia was present in 65.9% of them. Patients with nocturia were older (<i>p</i> = 0.021) and had higher rates of coronary artery disease (<i>p</i> = 0.036) heart failure (<i>p</i> = 0.002), and chronic lung disease (<i>p</i> = 0.046). Recurrent falls (<i>p</i> = 0.005), polypharmacy (<i>p</i> &lt; 0.001), depression (<i>p</i> &lt; 0.001), and lower gait-balance (<i>p</i> = 0.033) and activities of daily living scores (<i>p</i> &lt; 0.001) were more frequent in the nocturia group. The proportion of patients with a high anticholinergic burden (Anticholinergic Cognitive Burden [ACB] score ≥ 3) was significantly higher in those with nocturia (<i>p</i> = 0.024). There was a significant association between high ACB scores and nocturia, independent of age (OR = 1.69; 95% CI: 1.05–2.69; <i>p</i> = 0.028), comorbidities (OR = 1.60; 95% CI: 1.01–2.60; <i>p</i> = 0.048), and laboratory parameters (OR = 1.63; 95% CI: 1.01–2.60; <i>p</i> = 0.046).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that a higher anticholinergic burden is independently associated with nocturia in older female adults. Clinicians should be alert to anticholinergic burden as a modifiable factor in the management of nocturia in older female patients and consider deprescribing when appropriate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105895","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":"Genitourinary Toxicity, Function, and Quality of Life in Patients Undergoing Prostate Radiation Therapy—A Scoping Review","authors":"Casper Vrij,&nbsp;John Heesakkers,&nbsp;Evert Jan Van Limbergen,&nbsp;Jan-Erik Palmgren,&nbsp;Mathie Leers,&nbsp;Marc de Jong,&nbsp;Dennis Oerlemans,&nbsp;Harman Maxim Bruins,&nbsp;Tom Marcellissen,&nbsp;Kevin Rademakers,&nbsp;Peter de Vries,&nbsp;Elisabeth J. M. Driessen,&nbsp;Frits van Osch,&nbsp;Franchette van den Berkmortel,&nbsp;Joep van Roermund,&nbsp;Tom Hermans","doi":"10.1111/luts.70046","DOIUrl":"10.1111/luts.70046","url":null,"abstract":"<p>The effects of prostate radiotherapy (external beam radiation therapy (EBRT) and brachytherapy (BRT)) on urinary adverse events (UAEs), lower urinary tract function, and quality of life were examined in this scoping review. PubMed, Cochrane, and Embase (OVID) were used to identify relevant articles. We discuss the results of 23 studies. Included studies showed that UAEs are common after prostate radiation therapy. Across modalities, approximately one third experience acute events (Grade ≥ 2 median 36% for both EBRT and BRT), while one quarter experience late events (Grade ≥ 2 median 20% for EBRT and 26% for BRT). These estimates vary by UAE grading definitions and study designs. In the long term, patients with mild lower urinary tract symptoms (LUTS) report minimal improvement or worsening of urinary function after radiotherapy. Patients with moderate to severe baseline LUTS experience improvement in general but continue to experience bothersome LUTS. The limited urodynamic data show a similar pattern in which peak flow rate declines and post-void residual increases in the short term but return to baseline after long-term follow-up. These findings underscore the need for additional research to improve patient management and selection, and thereby improve genitourinary toxicity, function, and quality of life with contemporary radiotherapy techniques.</p>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966401","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":"Model of Nocturnal Polyuria in Older Japanese Adults Receiving Enteral Nutrition in Medical Long-Term Care Hospitals: An Exploratory Cross-Sectional Study","authors":"Madoka Takimoto,&nbsp;Tamami Taniguchi","doi":"10.1111/luts.70044","DOIUrl":"10.1111/luts.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Nocturnal polyuria (NP) with urinary incontinence increases the risk of sleep disturbance, incontinence-associated dermatitis, and urinary tract infection. Factors associated with NP in older adults receiving enteral nutrition (EN) have not been clearly identified. This study aimed to evaluate the direct and indirect associations between NP and related factors in older adults receiving EN in medical long-term care hospitals (MLTCHs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional observational study enrolled men and women aged 65 years or older, hospitalized at MLTCHs, and receiving EN. Participants underwent 72-h urine monitoring and multiple clinical assessments, including body composition. Structural equation modeling was used to explore associations with nocturnal urinary volume (NUV), with extensive model modifications based on data patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 101 participants (43 men) with a median age of 86 years were included. The NP model showed an excellent fit (CFI = 1.00, RMSEA = 0.00, SRMR = 0.09) and explained 29% of the variance in NUV; however, this was not statistically significant (<i>p</i> = 0.16). Significant direct associations with NUV were observed for fluid and salt intake, sex, serum sodium, fat-free mass, and diuretic use. Estimated glomerular filtration rate, body mass index, age, and the change in extracellular water volume from night to morning also showed non-significant but theoretically relevant direct associations. Indirect associations were observed for nocturnal systolic blood pressure, protein intake, and fasting blood glucose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NUV in older adults receiving EN in an MLTCH was complexly associated with multiple factors. This study suggests future research directions for comprehensive evaluation indices of NP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952570","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":"Combined Effect of Vitamin D Status and Physical Activity on Urinary Flow Rate: A Cross-Sectional Study","authors":"Jie Gao,&nbsp;Yunran Wang,&nbsp;Jieqiong Ren,&nbsp;Kefang Wang","doi":"10.1111/luts.70045","DOIUrl":"https://doi.org/10.1111/luts.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore the independent and combined effects of vitamin D status and physical activity on urinary flow rate (UFR), a key indicator of voiding function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 17 670 participants in the National Health and Nutrition Examination Survey (2009–2016). Physical activity status was assessed via self-reported weekly moderate-to-vigorous recreational activity. Vitamin D status was evaluated by measuring total serum 25-hydroxyvitamin D [25(OH)D] levels. Weighted linear regression models and restricted cubic spline (RCS) regression models were used to examine associations between serum 25(OH)D, physical activity, and UFR. An XGBoost model was applied to assess variable importance. Stratified analyses and interaction tests were performed to assess the combined effects of serum 25(OH)D and physical activity on UFR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher serum 25(OH)D levels were significantly associated with increased UFR. RCS analysis indicated a nonlinear relationship between serum 25(OH)D and UFR (<i>p</i> for nonlinear = 0.0426). Active physical activity was positively associated with UFR (<i>β</i> = 0.085, 95% CI: 0.053–0.116, <i>p</i> &lt; 0.001). XGBoost model confirmed serum 25(OH)D and physical activity as key predictors of UFR. A significant interaction was observed between serum 25(OH)D levels and physical activity status in relation to UFR. Stratified analyses revealed a stronger positive linear association between serum 25(OH)D and UFR in participants with active or vigorous physical activity, while an inverted L-shaped relationship was found in the inactive group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher serum 25(OH)D levels were associated with increased UFR, particularly when combined with active or vigorous physical activity. These findings provide a scientific foundation for developing integrated interventions that combine nutritional supplementation and physical activity to manage lower urinary tract symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145887437","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":"Rezūm Therapy in Very Elderly Men With BPH: Two-Year Outcomes From a Multicenter Cohort","authors":"Mario Henrique Bitar Siqueira,&nbsp;Sagi Shprits,&nbsp;Naeem Bhojani,&nbsp;Bilal Chughtai,&nbsp;Kevin C. Zorn,&nbsp;Luca Cindolo,&nbsp;Giovanni Ferrari,&nbsp;Katherine Lajkosz,&nbsp;Dean Elterman","doi":"10.1111/luts.70043","DOIUrl":"10.1111/luts.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Rezūm water vapor thermal therapy is a minimally invasive surgical option with demonstrated efficacy and safety. However, real-world evidence on 2-year outcomes in the population aged above 80 years remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective registry was created as part of the International Rezūm Registry database at two high-volume centers. Data were reviewed from patients monitored between April 2019 and August 2024. Men aged ≥ 80 years who underwent Rezūm therapy were included. Baseline and follow-up assessments at 3, 6, 12, and 24 months included International Prostate Symptom Score (IPSS), IPSS Quality of Life (QoL) subscore, peak urinary flow rate (Qmax), and post-void residual volume (PVR). Safety outcomes and adverse events were also recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-eight patients (mean age 84.4 ± 4.4 years) were included, with a mean prostate volume of 80.1 ± 42.1 cc. The mean IPSS decreased from 19.8 ± 7.4 at baseline to 12.4 ± 7.9 at 24 months. The IPSS quality of life (QoL) score declined from 4.2 ± 1.8 at baseline to 2.6 ± 1.5 at the corresponding follow-up interval. Qmax improved from 8.5 ± 5.8 mL/s at baseline to 15.0 ± 4.0 mL/s at 24 months, respectively. PVR was reduced from 115.5 ± 93.7 mL at baseline to 42.8 ± 29.2 mL over the same period. However, neither Qmax nor PVR demonstrated a statistically significant change at any time point. Adverse events were infrequent, with urinary tract infections (8.6%), epididymitis (5.2%), and acute urinary retention (3.4%). Only one patient required hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rezūm water vapor thermal therapy is a safe and effective treatment for BPH in patients over 80 years of age. It results in durable improvements in urinary symptoms and function with a low rate of complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"18 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850013","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":"Hidden Bladder Dysfunction in Well-Controlled Diabetes: A Urodynamic Study of Men With Lower Urinary Tract Symptoms","authors":"Yoshihisa Matsukawa,&nbsp;Shun Takai,&nbsp;Tsuyoshi Majima,&nbsp;Yushi Naito,&nbsp;Shohei Ishida,&nbsp;Tomokazu Kimura,&nbsp;Momokazu Gotoh,&nbsp;Shusuke Akamatsu","doi":"10.1111/luts.70042","DOIUrl":"10.1111/luts.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate in detail whether well-controlled diabetes mellitus (DM) without neuropathy, retinopathy, or nephropathy affects lower urinary tract symptoms (LUTS) and function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of treatment-naïve men with LUTS, those with DM but with good glycemic control (hemoglobin A1c [HbA1c] &lt; 7.0%) and no obvious DM-related complications were included in the DM group. The patients matched to the DM group for backgrounds that might affect lower urinary tract function, including age and prostate volume, were set as the non-DM group, and urodynamic parameters were compared between the groups. In addition, clinical factors associated with bladder dysfunction were examined within the DM group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 139 men were included in each group (DM group: mean age 73.3 years, prostate volume 38.8 mL, HbA1c 6.6%, DM duration 122 months). Although bladder outlet obstruction index did not differ significantly between the two groups, bladder voiding efficiency, maximum flow rate, and bladder contractility index were significantly lower in the DM group. Notably, the proportion of patients with detrusor underactivity (DU) was significantly higher in the DM group (41.7% vs. 25.9%, <i>p</i> = 0.005). Furthermore, in the DM group, a longer duration of DM and smaller prostate size were significant factors associated with the development of DU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A significant decrease in detrusor contractility was observed in men with DM even with good glucose control. Among men with LUTS, even with well-controlled DM, those with a longer disease duration and smaller prostate size are at a high risk of LUTS due to bladder dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>UMIN000056036</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604777","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":"Intramural Blood Vessels as a Primary Site of Vascular LUTS","authors":"Hikaru Hashitani,&nbsp;Retsu Mitsui","doi":"10.1111/luts.70041","DOIUrl":"10.1111/luts.70041","url":null,"abstract":"<p>Ischaemia has been considered a primary cause of lower urinary tract symptoms (LUTS). The existing concept is that ischaemic LUTS develops subsequent to structural narrowing of feeder arteries of the LUT due to atherosclerosis. However, the distribution of blood flow within each LUT organ that is regulated by intramural microvasculature should also be considered. Thus, the blood supply of the mucosal and detrusor smooth muscle (DSM) in the bladder and the blood flow of the mucosal, smooth muscle and striated muscle in the urethra need to be adjusted to meet their differing energy consumption. Sympathetic overdrive that is commonly seen in aged populations and patients with metabolic syndrome enhances arteriolar constrictions resulting in a disturbed intramural flow distribution so that cell populations with a higher energy demand are more readily affected. In addition to endothelial nitric oxide (NO) that plays a pivotal role in regulating vasocontractility, NO released from perivascular parasympathetic nerves appears to counteract sympathetic activity (sympatholysis) in the LUT. Thus, any diminished neuronally released NO would cause sympathetic overactivity. Capillary rarefaction, the reduced density/function of capillaries, the site of blood-tissue exchange, would also be critically involved in the pathogenesis of LUTS. In the bladder, capillary pericytes appear to function as pacemaker cells driving arteriolar vasomotion facilitating capillary perfusion and may also play a role in maintaining suburothelial homeostasis. Considering the fundamental roles of the intramural microvasculature in maintaining LUT functions, enhanced NO-mediated sympatholysis and/or capillary revascularization could have therapeutic and preventive potential for the ischaemic LUT.</p>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495823","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}