Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization Surgery
Purpose In this case-control study, we explored the relationships among pelvic ischemia, lower urinary tract symptoms (LUTS), and sexual function in patients with common iliac artery steno-occlusive disease, along with the potential therapeutic role of revascularization. Methods We recruited 33 men...
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| Format: | Article |
| Language: | English |
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Korean Continence Society
2023-06-01
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| Series: | International Neurourology Journal |
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| Online Access: | http://einj.org/upload/pdf/inj-2346028-014.pdf |
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| author | Efstathios Papaefstathiou Sotirios Gatsos Konstantinos Tigkiropoulos Ioannis Apostolidis Periklis Koukourikis Ioannis Lazaridis Apostolos Apostolidis |
| author_facet | Efstathios Papaefstathiou Sotirios Gatsos Konstantinos Tigkiropoulos Ioannis Apostolidis Periklis Koukourikis Ioannis Lazaridis Apostolos Apostolidis |
| author_sort | Efstathios Papaefstathiou |
| collection | DOAJ |
| description | Purpose In this case-control study, we explored the relationships among pelvic ischemia, lower urinary tract symptoms (LUTS), and sexual function in patients with common iliac artery steno-occlusive disease, along with the potential therapeutic role of revascularization. Methods We recruited 33 men diagnosed with radiologically documented common iliac artery stenosis (>80%) who underwent endovascular revascularization, and 33 healthy controls. Five patients had obstruction of the abdominal aorta (Leriche syndrome). The International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire, and International Index of Erectile Function were used to evaluate LUTS and erectile function. Medical history, anthropometrics, urinalysis, and blood tests, including levels of serum prostate-specific antigen, urea, creatinine, triglycerides, cholesterol, low-density lipoprotein, high-density lipoprotein, and hemoglobin A1c, were recorded. Uroflow (maximum flow, average flow, voided volume, and voiding time) and ultrasound parameters (prostate volume and postvoid residual [PVR]) were also measured. Patients with moderate-to-severe LUTS (IPSS>7) underwent complete urodynamic investigation. Patients were examined at baseline and 6 months postoperatively. Results Patients exhibited poorer total IPSS (P<0.001), storage (P=0.001) and voiding symptom (P<0.001) subscores, as well as worse OAB-bother (P=0.015), OAB-sleep (P<0.001), OAB-coping (P<0.001), and OAB-total (P<0.001) scores than control participants. Additionally, erectile function (P=0.002), sexual desire (P<0.001), and satisfaction from intercourse (P=0.016) deteriorated in the patient group. Six months postoperatively, significant improvements were observed in erectile function (P=0.008), orgasm (P=0.021), and desire (P=0.014). Similarly, PVR significantly improved (P=0.012), while fewer patients experienced increased bladder sensation (P=0.035) and detrusor overactivity (P=0.035) upon postoperative urodynamic study. No significant differences were found between patients with bilateral and unilateral obstruction or between either of those groups and Leriche syndrome patients. Conclusions Patients with steno-occlusive disease of the common iliac artery experienced more severe LUTS and sexual dysfunction than healthy controls. Endovascular revascularization alleviated LUTS in patients with moderate-to-severe symptoms and improved bladder and erectile function. |
| first_indexed | 2024-03-13T02:37:15Z |
| format | Article |
| id | doaj.art-52ffa63009bf4dfe90244eb03fde4561 |
| institution | Directory Open Access Journal |
| issn | 2093-4777 2093-6931 |
| language | English |
| last_indexed | 2024-03-13T02:37:15Z |
| publishDate | 2023-06-01 |
| publisher | Korean Continence Society |
| record_format | Article |
| series | International Neurourology Journal |
| spelling | doaj.art-52ffa63009bf4dfe90244eb03fde45612023-06-28T23:48:35ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312023-06-0127212913810.5213/inj.2346028.0141061Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization SurgeryEfstathios Papaefstathiou0Sotirios Gatsos1Konstantinos Tigkiropoulos2Ioannis Apostolidis3Periklis Koukourikis4Ioannis Lazaridis5Apostolos Apostolidis6 2nd Department of Urology, Aristotle University of Thessaloniki, ‘Papageorgiou’ General Hospital, Thessaloniki, Greece 2nd Department of Urology, Aristotle University of Thessaloniki, ‘Papageorgiou’ General Hospital, Thessaloniki, Greece 1st Department of General Surgery, Aristotle University of Thessaloniki, ‘Papageorgiou’ General Hospital, Thessaloniki, Greece 2nd Department of Urology, Aristotle University of Thessaloniki, ‘Papageorgiou’ General Hospital, Thessaloniki, Greece 2nd Department of Urology, Aristotle University of Thessaloniki, ‘Papageorgiou’ General Hospital, Thessaloniki, Greece 1st Department of General Surgery, Aristotle University of Thessaloniki, ‘Papageorgiou’ General Hospital, Thessaloniki, Greece 2nd Department of Urology, Aristotle University of Thessaloniki, ‘Papageorgiou’ General Hospital, Thessaloniki, GreecePurpose In this case-control study, we explored the relationships among pelvic ischemia, lower urinary tract symptoms (LUTS), and sexual function in patients with common iliac artery steno-occlusive disease, along with the potential therapeutic role of revascularization. Methods We recruited 33 men diagnosed with radiologically documented common iliac artery stenosis (>80%) who underwent endovascular revascularization, and 33 healthy controls. Five patients had obstruction of the abdominal aorta (Leriche syndrome). The International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire, and International Index of Erectile Function were used to evaluate LUTS and erectile function. Medical history, anthropometrics, urinalysis, and blood tests, including levels of serum prostate-specific antigen, urea, creatinine, triglycerides, cholesterol, low-density lipoprotein, high-density lipoprotein, and hemoglobin A1c, were recorded. Uroflow (maximum flow, average flow, voided volume, and voiding time) and ultrasound parameters (prostate volume and postvoid residual [PVR]) were also measured. Patients with moderate-to-severe LUTS (IPSS>7) underwent complete urodynamic investigation. Patients were examined at baseline and 6 months postoperatively. Results Patients exhibited poorer total IPSS (P<0.001), storage (P=0.001) and voiding symptom (P<0.001) subscores, as well as worse OAB-bother (P=0.015), OAB-sleep (P<0.001), OAB-coping (P<0.001), and OAB-total (P<0.001) scores than control participants. Additionally, erectile function (P=0.002), sexual desire (P<0.001), and satisfaction from intercourse (P=0.016) deteriorated in the patient group. Six months postoperatively, significant improvements were observed in erectile function (P=0.008), orgasm (P=0.021), and desire (P=0.014). Similarly, PVR significantly improved (P=0.012), while fewer patients experienced increased bladder sensation (P=0.035) and detrusor overactivity (P=0.035) upon postoperative urodynamic study. No significant differences were found between patients with bilateral and unilateral obstruction or between either of those groups and Leriche syndrome patients. Conclusions Patients with steno-occlusive disease of the common iliac artery experienced more severe LUTS and sexual dysfunction than healthy controls. Endovascular revascularization alleviated LUTS in patients with moderate-to-severe symptoms and improved bladder and erectile function.http://einj.org/upload/pdf/inj-2346028-014.pdfpelvic ischemialower urinary tract symptomsinternational index of erectile functioncommon iliac artery steno-occlusive diseaseleriche syndrome |
| spellingShingle | Efstathios Papaefstathiou Sotirios Gatsos Konstantinos Tigkiropoulos Ioannis Apostolidis Periklis Koukourikis Ioannis Lazaridis Apostolos Apostolidis Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization Surgery International Neurourology Journal pelvic ischemia lower urinary tract symptoms international index of erectile function common iliac artery steno-occlusive disease leriche syndrome |
| title | Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization Surgery |
| title_full | Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization Surgery |
| title_fullStr | Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization Surgery |
| title_full_unstemmed | Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization Surgery |
| title_short | Role of Pelvic Ischemia in Human Lower Urinary Tract Symptoms and Sexual Function Among Patients With Common Iliac Artery Obstruction Undergoing Revascularization Surgery |
| title_sort | role of pelvic ischemia in human lower urinary tract symptoms and sexual function among patients with common iliac artery obstruction undergoing revascularization surgery |
| topic | pelvic ischemia lower urinary tract symptoms international index of erectile function common iliac artery steno-occlusive disease leriche syndrome |
| url | http://einj.org/upload/pdf/inj-2346028-014.pdf |
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