The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study
Background: We evaluated ultrasonography variables associated with the improvement of nocturia after administration of alpha adrenoceptor antagonist (alpha blocker) monotherapy. Methods: From February to October 2014, 679 men with lower urinary tract symptoms (LUTS) underwent ultrasonography includi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-03-01
|
| Series: | Prostate International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888215301045 |
| _version_ | 1797711781218484224 |
|---|---|
| author | Byung Hoon Kim Ki Ho Kim Young Hwii Ko Phil Hyun Song Tae-Hwan Kim Bum Soo Kim |
| author_facet | Byung Hoon Kim Ki Ho Kim Young Hwii Ko Phil Hyun Song Tae-Hwan Kim Bum Soo Kim |
| author_sort | Byung Hoon Kim |
| collection | DOAJ |
| description | Background: We evaluated ultrasonography variables associated with the improvement of nocturia after administration of alpha adrenoceptor antagonist (alpha blocker) monotherapy.
Methods: From February to October 2014, 679 men with lower urinary tract symptoms (LUTS) underwent ultrasonography including prostate volume, transitional zone volume, prostatic urethral length, the ratio between prostatic urethral length and prostate volume (RPUL), intravesical prostatic protrusion (IPP), and prostatic urethral angle (PUA). Among them, 108 men who had pre-treatment nocturia without nocturnal polyuria (nocturnal polyuria index < 33%) and were treated with alpha blocker monotherapy over 3 months were enrolled. Patients were divided into the improved (< 2 times of nocturia) and non-improved group (more than 2 times) after administration of alpha blockers. Along with ultrasonography, international prostate symptom score (IPSS) and uroflowmetry was assessed.
Results: After alpha blocker treatment, 25.0% of patients (27/108) showed improvement of nocturia. These patients were significantly younger (59.6 vs 68.0 years, P = < 0.001) with lower PUA (31.8 vs. 39.4°, P = 0.009) compared with the non-improved group. In ROC analysis, the area under the curve using the PUA was 0.653 (95% CI = 0.532–0.774, P = 0.018). Using 33.5° as a cut-off level, the sensitivity and specificity for predicting the improvement of nocturia after medication reached 67.9% and 55.6%, respectively. Patients with lower PUA (PUA < 33.5°) had more improvement of nocturia (36.6 vs. 17.9%, P = 0.030), lower IPSS score (14.2 vs. 18.3, P = 0.005), and better quality of life index (3.1 vs 3.8, P = 0.021).
Conclusions: In the patients with lower PUA (particularly lower than 33.5°), nocturia was improved by administration of alpha blocker monotherapy. |
| first_indexed | 2024-03-12T07:12:05Z |
| format | Article |
| id | doaj.art-49da9a71dba64069be045cfa54f80e79 |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T07:12:05Z |
| publishDate | 2016-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-49da9a71dba64069be045cfa54f80e792023-09-02T23:03:55ZengElsevierProstate International2287-88822016-03-0141303510.1016/j.prnil.2015.12.002The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter studyByung Hoon Kim0Ki Ho Kim1Young Hwii Ko2Phil Hyun Song3Tae-Hwan Kim4Bum Soo Kim5Department of Urology, Keimyung University School of Medicine, Daegu, South KoreaDepartment of Urology, Dongguk University College of Medicine, Gyeongju, South KoreaDepartment of Urology, College of Medicine, Yeungnam University, Daegu, South KoreaDepartment of Urology, College of Medicine, Yeungnam University, Daegu, South KoreaDepartment of Urology, School of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Urology, School of Medicine, Kyungpook National University, Daegu, South KoreaBackground: We evaluated ultrasonography variables associated with the improvement of nocturia after administration of alpha adrenoceptor antagonist (alpha blocker) monotherapy. Methods: From February to October 2014, 679 men with lower urinary tract symptoms (LUTS) underwent ultrasonography including prostate volume, transitional zone volume, prostatic urethral length, the ratio between prostatic urethral length and prostate volume (RPUL), intravesical prostatic protrusion (IPP), and prostatic urethral angle (PUA). Among them, 108 men who had pre-treatment nocturia without nocturnal polyuria (nocturnal polyuria index < 33%) and were treated with alpha blocker monotherapy over 3 months were enrolled. Patients were divided into the improved (< 2 times of nocturia) and non-improved group (more than 2 times) after administration of alpha blockers. Along with ultrasonography, international prostate symptom score (IPSS) and uroflowmetry was assessed. Results: After alpha blocker treatment, 25.0% of patients (27/108) showed improvement of nocturia. These patients were significantly younger (59.6 vs 68.0 years, P = < 0.001) with lower PUA (31.8 vs. 39.4°, P = 0.009) compared with the non-improved group. In ROC analysis, the area under the curve using the PUA was 0.653 (95% CI = 0.532–0.774, P = 0.018). Using 33.5° as a cut-off level, the sensitivity and specificity for predicting the improvement of nocturia after medication reached 67.9% and 55.6%, respectively. Patients with lower PUA (PUA < 33.5°) had more improvement of nocturia (36.6 vs. 17.9%, P = 0.030), lower IPSS score (14.2 vs. 18.3, P = 0.005), and better quality of life index (3.1 vs 3.8, P = 0.021). Conclusions: In the patients with lower PUA (particularly lower than 33.5°), nocturia was improved by administration of alpha blocker monotherapy.http://www.sciencedirect.com/science/article/pii/S2287888215301045Adrenergic alpha-antagonistsBenign prostatic hyperplasiaNocturiaProstate |
| spellingShingle | Byung Hoon Kim Ki Ho Kim Young Hwii Ko Phil Hyun Song Tae-Hwan Kim Bum Soo Kim The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study Prostate International Adrenergic alpha-antagonists Benign prostatic hyperplasia Nocturia Prostate |
| title | The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study |
| title_full | The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study |
| title_fullStr | The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study |
| title_full_unstemmed | The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study |
| title_short | The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study |
| title_sort | prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom a multicenter study |
| topic | Adrenergic alpha-antagonists Benign prostatic hyperplasia Nocturia Prostate |
| url | http://www.sciencedirect.com/science/article/pii/S2287888215301045 |
| work_keys_str_mv | AT byunghoonkim theprostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT kihokim theprostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT younghwiiko theprostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT philhyunsong theprostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT taehwankim theprostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT bumsookim theprostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT byunghoonkim prostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT kihokim prostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT younghwiiko prostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT philhyunsong prostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT taehwankim prostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy AT bumsookim prostaticurethralanglecanpredicttheresponsetoalphaadrenoceptorantagonistmonotherapyfortreatingnocturiainmenwithlowerurinarytractsymptomamulticenterstudy |