Autonomic Nervous System Overactivity in Men With Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

Abstract

ANS hyperactivity is significantly associated with the most commonly used measures of LUTS, namely AUA symptom score and BPH impact index score. Also, the magnitude of the serum norepinephrine increase after tilt predicts prostate size. These relationships persist after controlling for extrinsic influences on ANS activity. The current findings may have important implications concerning the pathophysiological mechanisms underlying or influencing LUTS as well as its optimal treatment in men with BPH.

Characteristics of Autonomic Nervous System Activity in Men With Lower Urinary Tract Symptoms (LUTS): Analysis of Heart Rate Variability in Men With LUTS

“…Choi et al 9 reported that the values of SDNN, RMSSD, TP, VLF, and HF in female patients with overactive bladder were lower than those in normal, healthy women. Also, McVary et al 25 reported the relationship between ANS activity and LUTS. They assessed ANS activity based on hear rate, blood pressure, the response to circulatory stress via tilt table, and plasma and urinary catecholamine and reported that ANS hyperactivity is significantly associated with American urological Association symptom score and BPH impact score.…”

PDE5 inhibitors for LUTS

“…McVary et al 54 have shown that AH leads to LUTS and subjective voiding complaints. As part of the MTOPs study, the authors examined autonomic nervous system activity in 38 men.…”

A survey of commonalities relevant to function and dysfunction in pelvic and sexual organs

“…Direct evidence of a role of autonomic nervous system overactivity is derived from a recent study that identified that autonomic variables (urinary noradrenaline and adrenaline, plasma noradrenaline and change in plasma noradrenaline after a tilt test) were positively correlated with subjective measures of LUTS and BPH and objective markers, such as prostate volume and Q max . 76 These data, derived from a substudy of the MTOPS trial, raise the intriguing possibility that the known beneficial effect of aadrenergic blockers in men with LUTS may be caused, at least in part, by a central, rather than a peripheral effect; a hypothesis that has not been fully explored.…”

“…76,77 In the explanations that follow here, some of these concepts may be found. However, instead of presuming links between discrete symptom complexes, the general proposal is that commonality is to be expected.…”