Yasin CEYLAN, BÜLENT GÜNLÜSOY, Volkan ŞEN, Tansu DEĞİRMENCİ, Ertuğrul ŞEFİK, Serkan YARIMOĞLU, Deniz BOLAT, Zafer KOZACIOĞLU

Depolamaya ait semptom skorunun işemeye ait semptom skoruna oranının, alt üriner sistem semptomları nedeniyle alfa bloker kullanan hastalardaki tedavi sonuçlarına etkisi

Amaç: Bu çalışmada depolamaya ait semptom skorunun IPSS-V işemeye ait semptom skoruna IPSS-S oranının, alt üriner sistem semptomları nedeniyle alfa bloker kullanan hastalardaki tedavi sonuçlarına etkisini saptamayı amaçladık. Gereç ve Yöntemler: Alt üriner sistem şikayetleri olan 356 hasta çalışmaya dahil edildi. Hastaların depolama semptom skorları IPSSV , işeme semptom skorları IPSS-S ve IPSSV/S oranları hesaplandı. IPSS-V/S ORANI >1 olan hastalara alfa bloker tedavi verildi. Tedavi sonrası hastaların 1. ve 3. aylarda toplam IPSS skoru IPSS-T , IPSS-V, IPSS-S ve yaşam kalitesi hesaplandı. Sonuçlar yaşam kalitesi açısından değerlendirildi. Bulgular: IPSS-V ⁄ S > 1 olan hastalarda IPSS-V ⁄ S ≤1 olanlara gore IPSS-T ve IPSS-V değerleri anlamlı olarak yüksekti p 1 olan hastalar IPSS-V ⁄ S ≤1 olan hastalara gore daha yaşlı idi p=0,034 . Üçüncü aydaki kontrollerde hastaların ortalama IPSST p=0,004 ve IPSS-V p=0,001 değerlerinin azaldığı ve yaşam kalitesinin p1 skoru kullanışlı olarak bulunmuştur.

Anahtar Kelimeler:

Alt üriner sistem semptomları, IPSS-V, IPSS-S, Alfa bloker tedavi

Treatment outcomes of α-blocker therapy based on Prostate Symptom Score voiding to storage subscore ratio in men with lower urinary tract symptoms

Aim: We aimed to assess the usability effectiveness of IPSS voiding to storage subscore ratio in men with lower urinary tract symptoms LUTS who were treated with α-blockers. Material and Methods: A total of 356 men with LUTS were included in this study. The voiding symptom score IPSS-V , storage symptom score IPSS-S , and the IPSS-V/S ratio was calculated. Alpha-blocker therapy was given to patients with IPSS-V/S >1. The IPSS-T, IPSS-V, IPSS-S, QoL quality of life were measured at 1 month and 3 months after treatment. Results were assessed by the changes of QoL. Results: IPSS-T and IPSS-V values were significantly higher in patients with IPSS-V ⁄ S > 1 than IPSS-V ⁄ S ≤1 p 1 were older than IPSS-V ⁄ S ≤1 p=0,034 . The mean IPSS-T and IPSS-V decreased and the QoL improved significantly at third month p=0,004, p=0,001, p1 is a useful tool to define bladder outlet-related LUTD and to predict treatment outcomes in patients with lower urinary tract symptoms.

Keywords:

Lower urinary tract symptoms, IPSS-V, IPSS-S, Alpha-blocker therapy,

PDF

___

Jhang JF, Liao CH, Kuo HC. Severity of lower urinary tract symptoms reflects different composition of bladder stor- age dysfunction and bladder outlet obstruction in men with symptomatic benign prostatic hyperplasia. Int J Clin Pract 2014;68:743-748.
Milson I, Abrams P, Cardoza L, Roberts RG, Thüroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population based prevalance study. BJU Int 2001;87:760-6.
Chapple CR, Roehrborn CG. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol 2006;49:651-658.
Madersbacher S, Pycha A, Kingler CH, Shatzl G, Marberger M. The International Prostate Symptom score in both sexes: a urodynamics-based comparison. Neurol Urodyn 1999;18:173-182.
Barry MJ, Fowler FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The symptom index for benign pros- tatic hyperplasia. The Measurement Commitee of American Urologic Association. J Urol 1992;148:1549-1557.
Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU Int 2008;101:17-21.
Steele GS, Sullivan MP, Sleep DJ, Yalla SV. Combination of symptom score, flow rate and prostate volume for pre- dicting bladder outflow obstruction in men with lower urinary tract symptoms. J Urol 2000;164:344-8.
Liao CH, Chung SD, Kuo HC. Diagnostic value of In- ternational Prostate Symptom Score voiding-to-storage subscore ratio in male lower urinary tract symptoms. Int J Clin Pract 2011;65:552-558.
McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruske- witz RC, Donnell RF, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 2011;185:1793-1803.
Lepor H. Phase III multicenter placebo-controlled study of tamsulosin in benign prostatic hyperplasia. Tamsulo- sin Investigator Group. Urology 1998;51:892-900.
Chapple CR, Roehrborn CG, McVary K, Barry MJ, Bruske- witz RC, Donnel RF, et al. Effect of tadalafil on male lower urinary tract symptoms: an integrated analysis of storage and voiding international prostate symptom subscores from four randomised controlled trials. Eur Urol 2015 ;67:114-22.
de la Rosette JJ, Witjes WP, Schäfer W, Abrams P, Dono- van JL, Peters TJ, et al. Relationships between lower urinary tract symptoms and bladder outlet obstruction: results from the ICS-”BPH” study. Neurourol Urodyn 1998;17:99-108.
Oelke M, Bachmann A, Descazeaud A, Emberton M, Gra- vas S, Michel MC, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 2013 ;64:118-40.
Liao CH, Lin VC, Chung SD, Kuo HC. Therapeutic ef- fect of α-blockers and antimuscarinics in male low- er urinary tract symptoms based on the International Prostate Symptom Score subscore ratio. Int J Clin Pract 2012;66:139-145.
Djavan B, Chapple C, Milani S, Marberger M. State of the art on the efficacy and tolerability of alpha1-adrenoceptor antagonists in patients with lower urinary tract symp- toms suggestive of benign prostatic hyperplasia. Urology 2004;64:1081-8.
Michel MC, Mehlburger L, Bressel HU, Goepel M. Com- parison of tamsulosin efficacy in subgroups of patients with lower urinary tract symptoms. Prostate Cancer Prostatic Dis 1998;1:332-335.
Abrams P, Chapple C, Khoury S, Roehrborn C, de la Ro- sette C. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol 2013;189:93-101.
Jiang YH, Lin VCH, Liao CH, Kuo HC. International Pros- tate Symptom Score voiding-to-storage subscore ratio in association with total prostatic volume and maximum flow rate is diagnostic of bladder outlet-related lower urinary tract dysfunction in men with lower urinary tract symptoms. PLOS ONE 2013;8:59176.
Lee JY, Lee SH, Kim SJ, Kim CS, Lee HM, Kim Cl, et al. Change in International Prostate Symptom storage subscore after long-term medical therapy in BPH patients: finasteride and alpha-blocker combination therapy in men with mod- erate-to-severe LUTS/BPH in Korea. Urology 2011;77:171- 6.
Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. N Engl J Med 1995;332:75-9.
Netto NR Jr, de Lima ML, Netto MR, D’Ancona CA. Evalu- ation of patients with bladder outlet obstruction and mild international prostate symptom score followed up by watch- ful waiting. Urology 1999;53:314-316.
Kingery L, Martin ML, Naegeli AN, Khan S, Viktrup L. Content validity of the Benign Prostatic Hyperplasia Impact Index (BII); a measure of how urinary trouble and prob- lems associated with BPH may impact the patient. Int J Clin Pract 2012;66:883-90.
Peters TJ, Donovan JL, Kay HE, Abrams P, de la Rosette JJ, Porru D, et al. The International Continence Society “Be- nign Prostatic Hyperplasia” Study: the bothersomeness of urinary symptoms. J Urol 1997;157:885-9.
Sountoulides P, van Dijk MM, Wijkstra H, de la Rosette JJ, Michel MC. Role of voiding and storage symptoms for the quality of life before and after treatment in men with void- ing dysfunction. World J Urol 2010;28:3-8.