LUTS: Lower Urinary Tract Symptoms最新文献

{"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}

{"title":"Impact of Preoperative Catheter Duration on Perioperative Safety and Functional Outcomes Following Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia: Results From a Single-Center Series","authors":"Carlo Giulioni,&nbsp;Federico Falsetti,&nbsp;Matteo Tallè,&nbsp;Alessio Papaveri,&nbsp;Francesco Mengoni,&nbsp;Roberto Orciani,&nbsp;Valentina Maurizi,&nbsp;Felice Crocetto,&nbsp;Daniele Castellani,&nbsp;Vineet Gauhar,&nbsp;Angelo Cafarelli","doi":"10.1111/luts.70039","DOIUrl":"10.1111/luts.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the perioperative safety and functional outcomes of high-power holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH) and long-term indwelling urinary catheter (IUC) use, with a specific focus on the impact of catheter duration on postoperative outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on 380 patients who underwent HoLEP between 2016 and 2022, stratified into two groups based on catheter duration: long-term (≥ 28 days; Group 1) and short-term catheterization (Group 2). Demographic, intraoperative, and follow-up data were collected. Functional outcomes, including International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and post-void residual (PVR), were assessed preoperatively and during follow-up at 3 and 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both groups demonstrated significant and sustained improvement in voiding function and symptom scores following HoLEP. Although perioperative metrics, such as operative time, hospital stay, and catheter removal time, were comparable, Group 1 had longer enucleation times (<i>p</i> = 0.02). No difference in postoperative complication rate was noted. At 3 months, Group 2 exhibited superior symptom relief (IPSS: 10 vs. 12, <i>p</i> = 0.01), though Qmax and PVR were similar. No patients in either group required re-catheterization postoperatively. By 12 months, functional outcomes converged between groups. Multivariate analysis showed that catheter duration predicted poorer symptomatic recovery one year after surgery (OR 0.786, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HoLEP is effective and safe for patients with BPH and preoperative catheterization. However, prolonged catheterization negatively impacts early symptom recovery. Early surgical intervention should be considered to optimize long-term outcomes and prevent catheter-related complications.</p>\u0000 </section>\u0000 </div>","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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505391","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 Transurethral Resection of the Prostate in Male Patients With Impaired Detrusor Contractile Function and Urinary Retention","authors":"Balázs Kenyeres,&nbsp;Alexandra Helmeczi,&nbsp;Ákos Pytel","doi":"10.1111/luts.70040","DOIUrl":"10.1111/luts.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Detrusor underactivity (DUA) increasingly affects aging male patients with voiding symptoms, while its management remains challenging, with less favorable surgical outcomes compared to bladder outlet obstruction. Our aim was to evaluate the efficacy of TURP in male patients with urinary retention and unfavorable urodynamic findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective, single-center study included 67 male patients undergoing TURP between September 2021 and September 2024 after a failed trial of voiding. Patients were divided into three groups labeled as detrusor acontractility (DA, <i>n</i> = 18, voided without detrusor contraction), DUA (<i>n</i> = 19, voided with BCI &lt; 100 and BOOI &lt; 20), or non-voiders (<i>n</i> = 30, failed to urinate and lacked measurable detrusor contractions on pressure-flow study). Surgical success was defined as successful voiding with post-void residual (PVR) &lt; 150 mL at 3 months. Baseline parameters (PSA, prostate volume, cystoscopy and urodynamic findings), rate of surgical success, Patient Global Impression of Improvement (PGI-I) score and adverse events (subsequent surgeries and urinary tract infection) were registered and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall 37 (55.2%) patients became catheter-free within 3 months. The mean follow-up duration was 25.4 ± 9.6 months. Surgical success was achieved in DA, DUA, and non-voider groups in 6 (33%), 13 (68.4%), and 18 (60%) cases, respectively, and a PGI-I score greater than 4 was reported by 35 (52.2%) patients. Multivariate analysis showed higher prostate volume as an independent predictor for failure (OR: 1.7; 95% CI: 1.010–2.940; <i>p</i> = 0.046). Two patients developed stress urinary incontinence, and three required additional surgical intervention due to urethral stricture. Urinary tract infections occurred more frequently in the treatment failure group: Nine patients (30%) were hospitalized, and 16 (53%) required more than two antibiotic prescriptions within a 6-month period. In contrast, among the success group, only two patients (5.4%) were hospitalized, and none required frequent antibiotic therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TURP offers a reasonable chance for catheter discontinuation in case of unfavorable urodynamic parameters. With careful patient selection in mind, surgery remains a viable option even in this patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495831","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":"Reply to the Letter to the Editor: “Unraveling the Links Between Posture and Urinary Symptoms in Parkinson's Disease: Missing Pieces to Consider”","authors":"Betül Kuz,&nbsp;Mustafa Ertuğrul Yaşa,&nbsp;Rıza Sonkaya,&nbsp;Selman Aktaş","doi":"10.1111/luts.70036","DOIUrl":"10.1111/luts.70036","url":null,"abstract":"","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431848","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":"Associations of Dietary Inflammation Index and Composite Dietary Antioxidant Index With Overactive Bladder in Adults: NHANES 2011–2018","authors":"Xuexue Hao,&nbsp;Zhunan Xu,&nbsp;Song Li,&nbsp;Chengrui Zhang,&nbsp;Xiaoqiang Liu","doi":"10.1111/luts.70038","DOIUrl":"10.1111/luts.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Overactive bladder (OAB) is a common urinary condition, with multiple contributing factors. Dietary factors affecting inflammation and oxidative stress are increasingly recognized as significant triggers. This study investigates the associations between the Dietary Inflammatory Index (DII), the Comprehensive Dietary Antioxidant Index (CDAI), and OAB in adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES) was analyzed. The DII and CDAI were calculated based on nutrient intake, and OAB was assessed using the Overactive Bladder Symptom Score (OABSS). Weighted multivariable logistic regression models were applied to evaluate associations, and subgroup analysis and restricted cubic spline (RCS) analysis were used to explore potential interactions and dose–response relationships. Additional analyses were performed to examine the associations of DII and CDAI with dry and wet OAB subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with OAB exhibited higher DII scores and lower CDAI scores. Increased DII was significantly associated with an elevated risk of OAB, particularly in the highest quartile (OR = 1.55, 95% CI: 1.19–2.02, <i>p</i> = 0.001). In contrast, higher CDAI was associated with a reduced risk of OAB (OR = 0.68, 95% CI: 0.53–0.88, <i>p</i> = 0.004). Subgroup analysis revealed significant interactions with age and alcohol intake. RCS analysis confirmed a positive linear relationship between DII and OAB risk, and a negative linear relationship between CDAI and OAB risk. Further stratified analysis showed that the association between DII and OAB was stronger in wet OAB than in dry OAB, whereas CDAI showed no significant association with either subtype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A diet with low inflammatory potential and rich in antioxidants may reduce the risk of OAB, particularly in younger individuals and heavy drinkers. Dietary modification presents a practical approach for OAB management, warranting further research to establish causality and inform intervention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431898","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":"Unraveling the Links Between Posture and Urinary Symptoms in Parkinson's Disease: Missing Pieces to Consider","authors":"Christian Messina","doi":"10.1111/luts.70034","DOIUrl":"10.1111/luts.70034","url":null,"abstract":"","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431889","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":"Mechanistic Insights From Reduced Bladder Preparations: A Necessary Complement to In Vivo Models","authors":"Bin Feng,&nbsp;George A. Kuchel","doi":"10.1111/luts.70035","DOIUrl":"10.1111/luts.70035","url":null,"abstract":"","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431895","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":"Re: Woon et al. 2025 Pharmacological Targeting of Hyperpolarization-Activated Cyclic Nucleotide-Gated Cation Channels on Bladder Afferent Sensory Transmission","authors":"Pradeep Tyagi","doi":"10.1111/luts.70037","DOIUrl":"10.1111/luts.70037","url":null,"abstract":"","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431822","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":"Barriers to Seeking Medical Consultation for Urinary Incontinence: A Nationwide Population-Based Study in Saudi Arabia","authors":"Ebtesam Almajed,&nbsp;Norah Alqntash,&nbsp;Badriyah AlDejain,&nbsp;Noura AlQurashi,&nbsp;Mohammed Alshehri,&nbsp;Ali AbdelRaheem,&nbsp;Nojoud Alamri","doi":"10.1111/luts.70033","DOIUrl":"https://doi.org/10.1111/luts.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Urinary incontinence (UI) is prevalent and often underreported due to various barriers affecting healthcare-seeking behavior. This study aimed to identify barriers preventing patients from seeking help for UI, assess the influence of sociodemographic and clinical factors on these barriers, and determine the associations between UI types and barriers in Saudi Arabia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationwide, cross-sectional study was conducted from June 2024 to April 2025 among individuals aged ≥ 18 years who experienced UI and had not sought medical consultation. Participants completed a questionnaire that comprised sociodemographic data, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and a modified Barriers to Incontinence Care Seeking Questionnaire (BICS-Q). Data were analyzed using descriptive statistics, independent <i>t</i>-tests, ANOVA, and binary logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 505 eligible participants, 80.6% were female, predominantly aged 31–45 (40.0%), and the most common UI type was mixed UI (37.2%). The most significant barriers were embarrassment (33.3%), logistical inconvenience (appointments scheduled too far in advance, 36.8%), and provider-related issues (lack of available providers, 12.3%). Gender, obesity, residency region, and type of UI significantly influenced barrier perception. Fear-related barriers were notably higher in nocturnal UI, whereas embarrassment and cultural concerns were highest among those with mixed UI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights significant embarrassment, inconvenience, and provider-related barriers deterring healthcare-seeking among UI patients in Saudi Arabia. Findings emphasize the need for culturally tailored interventions, improved healthcare accessibility, and targeted public awareness campaigns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272757","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}