sodium-ethylxanthate and Urination-Disorders

Benign prostatic hyperplasia (BPH) is a common histologic condition among older men, which conveys its morbidity through lower urinary tract symptoms and complications, such as acute urinary retention, obstructive uropathy, and urinary tract infections. The mechanisms linking the histologic process and lower urinary tract symptoms remain uncertain; prostatic enlargement and bladder outlet obstruction are involved. However, measurements of prostate size and the severity of bladder outlet obstruction correlate poorly with the severity of lower urinary tract symptoms. The severity of lower urinary tract symptoms associated with BPH can be measured reliably, from the patient's perspective, with a number of validated questionnaires, including the International Prostate Symptom Score, the Danish Prostate Symptom Score, and the International Continence Society (ICS)male questionnaire. In the clinical setting, these questionnaires can be used (1) to assess the severity of symptoms in men with lower urinary tract symptoms that may be attributable to BPH, based on their age and clinical characteristics; and (2) to follow changes in symptoms over time and with treatment. None of these questionnaires can accurately determine whether a symptomatic patient has underlying bladder outlet obstruction. Additional questionnaires are available to measure the impact of lower urinary tract symptoms on men's lives, as well as associated phenomena, such as continence and sexual function, which may be affected by BPH and its treatments. Men with a severe burden of lower urinary tract symptoms often have measurable decrements in overall health-related quality of life, which can be ameliorated by treatment.

Topics: Aged; Health Status Indicators; Humans; Male; Prostatic Hyperplasia; Quality of Life; Reproducibility of Results; Severity of Illness Index; Sex; Sex Factors; Surveys and Questionnaires; Urethral Obstruction; Urination Disorders

Lower urinary tract symptoms (LUTS), benign prostatic obstruction (BPO), and the overactive bladder have increasing prevalence with age in both men and women (with the obvious exception). The question is, are they interrelated or independently related to age? The specific issue is whether BPO causes the overactive bladder. There are two pieces of evidence that might appear to suggest such a cause and effect. First, the overactive bladder is more common in men than in women of the same age, although physiologically, men are 5-10 years older at the same biological age. Second, the overactive bladder resolves in two-thirds of individuals after surgical interventions such as transurethral prostatectomy. The symptoms suggestive of an overactive bladder are the most troublesome, even though they may not be the most prevalent. Long-term follow-up studies with repeated urodynamic investigations have shown that the incidence of the overactive bladder and its attendant symptoms increases despite there being no deterioration in outlet obstruction over follow-up periods of 10 and 20 years. These data, and others, indicate that the situation is not as straightforward as some believe. The statement that 'the overactive bladder is secondary to BPO' cannot be made, as there are too many unanswered questions and pieces of the puzzle that do not fit. The overactive bladder is undoubtedly associated with BPO, and it leads to the most troublesome LUTS in older men. Epidemiological research, coupled with urodynamic evaluation, may provide further evidence. We also need better and more relevant models (e.g. ageing animals), together with further histological and other biological data before the waters become crystal clear.

Topics: Aging; Health Status; Humans; Male; Medical Records; Prostatic Hyperplasia; Quality of Life; Severity of Illness Index; Sex; Surveys and Questionnaires; Urination Disorders; Urodynamics

Topics: Female; Gender Identity; Humans; Lymphedema; Postoperative Complications; Self Concept; Sex; Social Adjustment; Urination Disorders; Vulvar Neoplasms

Topics: Coitus; Female; Genitalia, Male; Humans; Male; Sex; Spinal Cord Injuries; Urinary Bladder; Urinary Bladder, Neurogenic; Urinary Catheterization; Urinary Diversion; Urinary Tract Infections; Urination; Urination Disorders; Vesico-Ureteral Reflux

Topics: Aging; Australia; Calcinosis; Diet; Emigration and Immigration; Endoscopy; Humans; Incidence; Metabolic Diseases; Occupations; Sex; Soil; Statistics as Topic; Surgical Procedures, Operative; Transients and Migrants; Urinary Calculi; Urinary Tract Infections; Urination Disorders; Water

Topics: Aged; Female; Geriatrics; Humans; Male; Mental Disorders; Middle Aged; Mortality; Psychological Tests; Sex; Urination Disorders