Metabolic syndrome and smoking are associated with persistence of nocturia after transurethral resection of the prostate

Abstract

Aims The aim of our study was to evaluate the relationship between smoking, metabolic syndrome (MetS) and persistence of nocturia in patients with moderate/severe nocturia (nocturia episodes ≥2), lower urinary tract symptoms (LUTSs), and benign prostatic enlargement (BPE) undergoing transurethral resection of the prostate (TURP). Methods From 2015 onward, a consecutive series of patients with moderate/severe nocturia (nocturia episodes ≥2), LUTS, and BPE undergoing TURP were prospectively enrolled. Medical history, physical examination, and smoking status were recorded. MetS was defined according to Adult Treatment Panel III. Moderate/severe persistent nocturia after TURP was defined as nocturia episodes ≥2. Binary logistic regression analysis was used to evaluate the risk of persisting nocturia. Results One hundred two patients were enrolled with a median age of 70 years (interquartile range: 65/73). After TURP, moderate/severe nocturia was reported in 43 of 102 (42%) of the patients. Overall 40 of 102 (39%) patients presented a MetS, and out of them, 23 of 40 (58%) presented a moderate/severe persistent nocturia after TURP ( P = .001). Overall 62 of 102 (61%) patients were smokers, and out of them, 32 of 62 (52%) presented moderate/severe persistent nocturia after TURP ( P = .034). On multivariate analysis, prostate volume, MetS, and smoking were independent risk factors for moderate/severe persistent nocturia after TURP. Conclusion In our single‐center study, MetS and smoking increased the risk of moderate/severe persistent nocturia after TURP in patients with LUTS‐BPE. Although these results should be confirmed, and the pathophysiology is yet to be completely understood, counseling smokers and MetS patients about the risk of postoperative persistent nocturia is warranted.

Efficacy of Qurmin on Post-Operative Lower Urinary Tract Symptoms After Photoselective Vaporization of the Prostate: A Multicentre Case-Control Study

“…In urology, very few studies have evaluated the role of curcuma to reduce inflammation with conflicting results and however none of the studies have evaluated the role of the highly bioavailable curcuma to improve symptoms after TURP [19,20]. In our study we confirm the role of Qurminin improving IPSS in a different population.…”

The Investigative Role of Statins in Ameliorating Lower Urinary Tract Symptoms (LUTS): A Systematic Review

“…Russo et al [10] showed that the presence of MetS worsened the symptoms of BPH, including PV. Additionally, De Nunzio et al [11] and Sebastianelli et al [33] underlined how MetS, with systemic inflammation, influence the response to the medical treatment of BPE.…”

“…Interestingly, previous data have shown that patients with MetS could be refractory to medical treatments and may exhibit symptoms persistence after surgery [10,11]. In fact, MetS is associated with an increase in intravesical prostatic protrusion (IPP), together with an increase in prostate volume (PV), explaining the lack of satisfaction with medical therapy in those patients with metabolic alterations [10].…”

“…In fact, MetS is associated with an increase in intravesical prostatic protrusion (IPP), together with an increase in prostate volume (PV), explaining the lack of satisfaction with medical therapy in those patients with metabolic alterations [10]. Moreover, De Nunzio et al have shown that MetS and smoking increased the risk of moderate/severe persistent nocturia after the transurethral resection of the prostate (TURP) [11].…”

Metabolic syndrome is associated with prostate enlargement: a systematic review, meta-analysis, and meta-regression on patients with lower urinary tract symptom factors

“…98 Studies did not always collect data on comorbidities such as cardiovascular disease or T2D. 35 Patients with diabetes have been shown to have higher incidences of DO and patients also tend to be older, which is another factor that increases the likelihood of developing LUTS. 99,100 In addition, the following confounding factors could also lead to a variation in results.…”