Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction

Calogero, Aldo E.; Burgio, Giovanni; Condorelli, Rosita A.; Cannarella, Rossella; Vignera, Sandro La

doi:10.1080/13685538.2018.1432586

Cited by 12 publications

(11 citation statements)

References 55 publications

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“…ED has been linked to LUTS/BPH as a part of this syndrome. LUTS/BPH and ED share similar pathogenetic mechanisms such as chronic inflammation, vascular dysfunction, and hormonal alterations (Calogero, Burgio, Condorelli, Cannarella, & La Vignera, 2018, 2019). Exacerbations of LUTS are often accompanied by worsening of the IIEF-5 index.…”

Section: Discussionmentioning

confidence: 99%

Radial Extracorporeal Shock Wave Therapy as a Novel Agent for Benign Prostatic Hyperplasia Refractory to Current Medical Therapy

et al. 2019

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This study aimed to assess efficacy and safety data from pilot trials of the radial extracorporeal shock wave therapy (rESWT) to treat benign prostatic hyperplasia (BPH) refractory to current medical therapy. A total of 29 men with lower urinary tract symptoms (LUTS) suggestive of BPH who had responded poorly to medical therapy for at least 6 months and were poor surgical candidates were enrolled. Each participant was treated with rESWT once a week for 8 weeks, each by 2000 impulses at 2.0 bar and 10 hertz of frequency. International Prostate Symptom Score (IPSS), quality of life (QoL), and International Index of Erectile Function-5 (IIEF-5) were evaluated before treatment, after the fourth and eighth rESWT, and 3 months after the end of treatment. Peak urinary flow ( Q max ) and postvoid residual (PVR) were assessed. Safety was also documented. Statistically significant clinical improvements were reported for IPSS, QoL, and IIEF-5 after treatment, and those were sustained until 3 months follow-up. Q max and PVR improved evidently at 8 weeks with a 63% and 70% improvement, respectively. The only adverse event was the occasional perineum pain or discomfort, which usually disappeared within 3 days. The rESWT may be an effective, safe, and noninvasive treatment for symptomatic BPH in selected patients whose medical treatment has faced failure and are poor surgical candidates.

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Section: Discussionmentioning

confidence: 99%

Radial Extracorporeal Shock Wave Therapy as a Novel Agent for Benign Prostatic Hyperplasia Refractory to Current Medical Therapy

et al. 2019

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“…Cavernous muscle cells express α-adrenergic receptors and, once activated by the sympathetic neurotransmitters, they lead to arterial smooth muscle contraction and hinder penile erection. Several lines of evidence support the negative impact of anxiety on sexual performance and erectile function [4][5][6], and this negative influence is widely accepted [3,7].…”

Section: Introductionmentioning

confidence: 96%

Differences in Penile Hemodynamic Profiles in Patients with Erectile Dysfunction and Anxiety

Cannarella

Calogero

Aversa

et al. 2021

JCM

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Background: Penile echo-color Doppler ultrasound (PCDU) is the gold standard for the diagnosis of arterial erectile dysfunction (ED). Its reliability in patients with anxiety was questioned, due to false-positive results. Aim: To assess the penile hemodynamic response to intracavernous injection (ICI) of alprostadil in patients with anxiety-related ED. Methods: Patients with non-organic ED and a 5-item International Index of Erectile Function (IIEF-5) score ranging between 5 and 7 were enrolled. They were asked to compile the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire to assess the degree of anxiety and were divided according to the GAD-7 score in Group 1 with minimal level of anxiety (n = 20), Group 2 with mild anxiety (n = 20), Group 3 with moderate anxiety (n = 20), and Group 4 with severe anxiety (n = 20). Peak systolic velocity (PSV) and the end-diastolic velocity (EDV) were sampled in all patients, through PCDU in the flaccid state, and 5, 10, 15, and 20 min after ICI of alprostadil at the standard dose of 10 μg. Results: In penile flaccidity, the patients showed a mean PSV of 8.0 ± 4.0 cm/s. The degree of anxiety was found to significantly influence both PSV and EDV at all assessed time-points. Particularly, it was negatively associated with the PSV at time 5 (r = −0.9, p < 0.01), 10 (r = −0.9, p < 0.01), 15 (r = −0.9, p < 0.01), and 20 (r = −0.7, p < 0.01) minutes, and positively with the EDV at time 5 (r = 0.7, p < 0.01), 10 (r = 0.6, p < 0.01), 15 (r = 0.5, p < 0.01), and 20 (r = 0.3, p < 0.01) minutes. Although all patients showed a mean dynamic PSV > 25 cm/s (which excluded an arterial ED according to the current guidelines), a peculiar hemodynamic pattern was found in patients with severe anxiety. In these patients, normal PSV values were reached only after 20 min from ICI, suggesting a “late-responder” profile. Conclusion: If further studies confirm the existence of a distinct hemodynamic profile in patients with severe anxiety, sampling the PSV and the EDV values could be proposed, for detecting patients with severe anxiety-related ED. Dynamic PCDU could be considered an accurate diagnostic test in patients with non-organic ED, since zero false-positive results were found in the present study. PSV in the flaccid state is not able to discriminate between arterial- or non-organic ED.

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“…2,3 The combined prevalence of BPH is approximately 26.2% at the world level. 1 This condition triggers pressure on the urethra causing bladder outflow obstruction, and hence a variability of lower urinary tract symptoms (LUTS).…”

Section: Introductionmentioning

confidence: 99%

“…1 This condition triggers pressure on the urethra causing bladder outflow obstruction, and hence a variability of lower urinary tract symptoms (LUTS). 2,3 The combined prevalence of BPH is approximately 26.2% at the world level. 4 It is also reported that BPH increases with age and affect more than 70% of elderly males.…”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

Subrata

2019

Int J of Uro Nursing

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How can the deterioration of the health-related quality of life (HRQoL) in patients undergoing transurethral resection of the prostate (TURP) be prevented by urological nurses? The intention of this study is to examine the relevant literature regarding HRQoL among those undergoing TURP. Transurethral resection of the prostate is fully considered as a historical reference-standard procedure for treating benign prostatic hyperplasia. Even though this method is highly effective and offers significant progress in urinary functioning, it is related to a risk of complications recognized as TURP syndrome which may impact patients' HRQoL. Several studies have discussed the management of TURP syndrome; however, they did not clearly elucidate the comprehensive aspect of HRQoL pertaining to physiological and psychological elements. As a consequence, this clinical condition may cause unpromising outcomes in regard to residual physical and psychological symptoms after TURP. Wilson and Cleary's model of HRQOL was thoughtfully chosen to guide this study. Several themes of the model were discussed as follows: biological and physiological factors, symptoms and general health perceptions, functional status, patient preferences, emotional and psychological factors, and overall quality of life. We generated a model of HRQoL along with nursing care with respect to the patients undergoing TURP.The findings of this study will render a positive contribution to improving TURP outcomes as well as preventing deterioration of patients' HRQoL. K E Y W O R D Sadvanced nursing practice, benign prostate disease, evidence-based practice, models of nursing, quality of life, TUR syndrome

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Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction

Cited by 12 publications

References 55 publications

Radial Extracorporeal Shock Wave Therapy as a Novel Agent for Benign Prostatic Hyperplasia Refractory to Current Medical Therapy

Radial Extracorporeal Shock Wave Therapy as a Novel Agent for Benign Prostatic Hyperplasia Refractory to Current Medical Therapy

Differences in Penile Hemodynamic Profiles in Patients with Erectile Dysfunction and Anxiety

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

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