Effect of improvement in lower urinary tract symptoms on sexual function in men: tamsulosin monotherapy vs. combination therapy of tamsulosin and solifenacin.

PURPOSE: To evaluate how much the improvement of lower urinary tract symptoms (LUTS) affects sexual function and which storage symptoms or voiding symptoms have the greatest effect on sexual function. MATERIALS AND METHODS: A total of 187 patients were enrolled in this study. Patients were randomly assigned to receive either tamsulosin 0.2 mg (group A) or tamsulosin 0.2 mg and solifenacin 5 mg (group B). At 4 weeks and 12 weeks, the LUTS and sexual function of the patients were evaluated by use of the International Index of Erectile Function-5 (IIEF5), International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS) questionnaire, uroflowmetry, and bladder scan. RESULTS: Both groups A and B showed statistically significant improvements in IPSS, OABSS, and quality of life (QoL). Group A showed improved maximum flow rate, mean flow rate, and residual urine volume by time. Group B did not show an improvement in flow rate or residual urine volume but total voiding volume increased with time. The IIEF5 score was not improved in either group. In group A, the IIEF5 score dropped from 13.66 ± 4.97 to 11.93 ± 6.14 after 12 weeks (p=0.072). Group B showed a decline in the IIEF5 score from 13.19 ± 5.91 to 12.45 ± 6.38 (p=0.299). Although group B showed a relatively smaller decrease in the IIEF5 score, the difference between the two groups was not significant (p=0.696). CONCLUSIONS: Tamsulosin monotherapy and combination therapy with solifenacin did not improve erectile function despite improvements in voiding symptoms and QoL. The improvement in storage symptoms did not affect erectile function.

Efficacy and safety of low-dose anticholinergics to treat men with lower urinary tract symptoms with overactive bladder: a retrospective study based on real life practice.

PURPOSE: To investigate whether combination treatment using an α-blocker and 2 mg of tolterodine could improve the International Prostate Symptom Score (IPSS) as much as α-blocker and 4 mg of tolterodine without voiding difficulties in real life practice. METHODS: We restrospectively recruited patients who were treated at four urology clinics between January 2006 and May 2008. A total of 1,094 men with lower urinary tract symptoms/overactive bladder (LUTS/OAB) were assigned to one of three groups: an α-blocker only group (group I, n=152), an α-blocker plus tolterodine 2 mg group (group II, n=520), and an α-blocker plus tolterodine 4 mg group (group III, n=574). Eligible patients were 50 years or older men who had a total IPSS of 8 or higher and a IPSS storage subscore of 5 or higher and were followed up for 12 weeks. RESULTS: The total IPSS score and quality of life scores were significantly improved at week 12 in groups II and III. The incidence of acute urinary retention was similar between both combination treatment groups, but the incidence of voiding difficulty was much lower in group II (2.1%) than group III (10.8%) tolterodine. CONCLUSIONS: Our results suggest that treatment of LUTS/OAB patients with an α-blocker plus tolterodine 2 mg is as effective as α-blocker plus tolterodine 4 mg, and the incidence of voiding difficulty was in the low-dose anticholinergic is lower. These results indicate that dose strength should be decided on a case-by-case basis to balance the efficacy and safety.

Translation and linguistic validation of the korean version of the pelvic pain and urgency/frequency patient symptom scale.

PURPOSE: The objective of this study was to achieve a linguistic adaptation of the original version of the Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale into Korean. MATERIALS AND METHODS: Between June 2008 and December 2008, a linguistic adaptation was carried out by 2 native Korean speakers who were also fluent in English. First, the original English version of the PUF was translated into Korean. A panel, which included the 2 translators, reviewed the translations to form a single reconciled forward translation of the Korean version. Then, another bilingual translator, having never seen the original version, back-translated the first draft of the Korean version of the PUF into English, and this back-translation was subsequently assessed for equivalence to the original. The panel discussed all discrepancies and produced a second version. After revising the 2nd version, 10 participants [5 interstitial cystitis (IC) patients and 5 persons from the general population], stratified variously by age, sex, and educational level, answered the PUF and were systematically debriefed afterwards. A summary of the changes from the patient interviews were incorporated into the third version. After the spelling, grammar, layout, and formatting were checked, the third version was verified as the final Korean version of the PUF, without modifications. RESULTS: The multi-step process of forward translation, reconciliation, back-translation, cognitive debriefing, and proofreading of the Korean version of the PUF was completed. CONCLUSIONS: The Korean version of the PUF scale may be helpful for screening IC patients in the Korean population and can now be used in Korea.

A study of lower urinary tract symptoms for the Korean women aged 30 and over.

The purposes of this study were (1) to identify the prevalence of urinary incontinence (UI) and lower urinary tract symptoms (LUTS) for Korean women, (2) to evaluate the LUTS scores of the subjects in relation with each UI patterns and general characteristics, and (3) to identify affecting factors developing LUTS by using self-administered questionnaire. Community-based cross-sectional study was conducted for 3,371 women aged 30 to 89 years old who were allocated at six provinces in South Korea. UI and LUTS were assessed by validated symptom scales including the International Prostate Symptom Score. Of all the respondents, 63.4% had experienced UI more than once a month during the prior 12 months. Among the respondents, 36.6% had no UI, 47.5% had stress UI, 0.4% had urge UI, and 15.5% had mixed UI. The mean LUTS score of the total respondents was 7.8 +/- 4.1. The LUTS was significantly predicted by age (p < .0001) and mixed UI (p < .0001), and 79.4% of variance in LUTS was explained. The highest LUTS scores were shown in the subjects with mixed UI, and we found that LUTS scores increased with age.