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Trends in Age-Specific Prevalence of Lower Urinary Tract Dysfunction: A Nationwide Population-Based Cohort Study
Young Hwan Kim, Se Hwa Hong, Tae Wook Kang, Hyun Chul Chung, Tae Hyoung Kim, Sae Chul Kim, Sang Baek Koh, Jae Hung Jung
Urogenit Tract Infect 2023;18(3):101-106.   Published online December 31, 2023
DOI: https://doi.org/10.14777/uti.2023.18.3.101
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose: To elucidate the longitudinal changes in the prevalence of lower urinary tract dysfunction (LUTD) according to age over the past 10 years.
Materials and Methods: The changes in the proportion of prevalence for LUTD, including benign prostatic hyperplasia (BPH) and urinary incontinence (UI) among South Koreans from 2009 to 2018, were analyzed using the National Health Information Database established by the Korean National Health Insurance Service. All conditions were defined according to the corresponding Korean Standard Classification of Diseases-8 for diagnosis and surgical procedures and Health Insurance Review & Assessment Service codes for drugs.
Results: The 60-69, 70-79, and over 80 age groups accounted for more than 60% of the LUTD cases from 2009 to 2018, while significant increases in the crude prevalence of LUTD were observed over a 10-year period in all age groups (p for trend <0.05). In age groups over 60 years, LUTD was more prevalent in men than women, but there was no statistically significant difference in proportion (p>0.05). The changes in the prevalence and prevalence proportion exhibited similar trends in BPH, UI, and LUTD.
Conclusions: LUTD was more prevalent in the elderly aged over 60 years old than in younger adults. Therefore, this study suggests the development of nationwide healthcare policies to manage LUTD in the elderly population of South Korea, which is expected to become the world’s most aged population.
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The Feasibility of Radical Prostatectomy for Medication Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Seung Chan Jeong
Urogenit Tract Infect 2022;17(3):76-80.   Published online December 31, 2022
DOI: https://doi.org/10.14777/uti.2022.17.3.76
AbstractAbstract PDFPubReaderePub
Purpose: The purpose of this study was to compare the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) given pharmacological treatment with those who additionally had prostate cancer and underwent surgical treatment.
Materials and Methods: From January 2000 to March 2021, a total of 7,650 patients were diagnosed with chronic prostatitis (N41.1) at our hospital, of which 234 patients were additionally diagnosed with prostate cancer. After excluding patients with severe benign prostatic hyperplasia (>100 g)-related lower urinary tract symptoms or neurological and psychiatric abnormalities, or advanced prostate cancer, 52 patients undergoing pharmacological treatment with a combination of drugs and 20 patients who underwent radical prostatectomy due to additional prostate cancer were included in the analysis. The NIH-CPSI scores of the two groups were compared at the first outpatient visit, 3 months, and 6 months after the first visit. The p-values were calculated using the Mann-Whitney U test, and the Wilcoxon signed rank test.
Results: Patients who underwent radical prostatectomy for prostate cancer showed significant reductions in the voiding and quality of life scores in the NIH-CPSI, but not the pain score at 3 months. After 6 months, there was a significant decrease in the overall NIH-CPSI. On the other hand, in the group on pharmacological therapy, the decrease was statistically significant only in the voiding score at 6 months. However, in the surgery group, 3 patients were found to be suffering from urinary incontinence, and 7 patients from erectile dysfunction.
Conclusions: Radical prostatectomy, therefore, appears to be a promising treatment that can be carefully considered for patients with refractory CP/CPPS who do not receive adequate treatment and thus have a poor quality of life.
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Review
Comprehensive Review of COVID-19 on Benign Prostate Hyperplasia Patient Symptoms
Joongwon Choi, Hong Jin Suh, Dong Hwan Lee, Tae-Kon Hwang, Jung Jun Kim
Urogenit Tract Infect 2022;17(2):31-35.   Published online August 31, 2022
DOI: https://doi.org/10.14777/uti.2022.17.2.31
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Since the outbreak of the global Coronavirus disease (COVID-19) pandemic in 2019, the number of confirmed cases has increased steadily worldwide. The most common symptom of COVID-19 (SARS-CoV-2) is respiratory symptoms. On the other hand, increased voiding frequency and lower urinary tract symptoms (LUTS) have also been reported. Regarding the relationship between LUTS and COVID-19, only small size (n<100) retrospective studies have been reported, but the post-International Prostate Symptom Score (IPSS) increases compared to pre-IPSS after a COVID-19 infection in those older than 50 years. α-blockers and phosphodiesterase-5 inhibitors are relatively safe, but there are conflicting reports on 5α-reductase inhibitors; hence, further research is needed. Four major theories have been argued regarding the relationship between LUTS and COVID-19: renin-angiotensin system-related, androgen-related, inflammation-related, and metabolic derangement-related. In conclusion, elderly male patients often have benign prostate hyperplasia as a co-morbidity, and the severity of COVID-19 is high in this group. Therefore, voiding symptoms in these patient groups is of particular concern.
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