Characteristics of Autonomic Nervous System Activity in Men With Lower Urinary Tract Symptoms (LUTS): Analysis of Heart Rate Variability in Men With LUTS

Choi, Jong Bo; Lee, Jeong Gu; Kim, Young Soo

doi:10.1016/j.urology.2009.08.018

Cited by 17 publications

(28 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Histopathologically, it has been linked to the BPH. However, not all cases of LUTS are prostate related, and there is evidence demonstrating a direct link between the benign prostatic enlargement (BPE), bladder outlet obstruction (BOO) and LUTS [3]. The extended underlying pathophysiology leading to LUTS remains unclear, although it is increasingly recognized that the causes of LUTS extend well beyond BPE and BOO [8].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is widely known that the autonomic nervous system (ANS) is involved in the regulation of the micturition cycle. That is, there are several reports about the correlation between the activity of the ANS and the LUTS [3,4,5,6]. It is presumed that the central sympathetic overactivity might be associated with the LUTS in patients with benign prostatic hyperplasia (BPH); it is associated with metabolic syndrome in men [1,7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Correlation Between the Treatment Efficacy and the Sympathetic Activity in Men With Lower Urinary Tract Symptoms

et al. 2014

Self Cite

View full text Add to dashboard Cite

PurposeIn this study, we examined the difference in the treatment efficacy depending on the sympathetic activity in men with lower urinary tract symptoms (LUTS).MethodsIn the current single-center, retrospective study, we evaluated a total of 66 male patients aged 40-70 years of age, presenting with LUTS, whose International Prostate Symptom Score (IPSS) exceeded 8 points. They had a past 3-month history of taking alfuzosin XL, and their heart rate variability (HRV) was measured before and after the treatment. In addition, we also recruited 39 healthy volunteers who visited a health promotion center for a regular medical check-up. They were aged between 40 and 70 years and had an IPSS of <8 points. We divided the patients with LUTS into two groups: the groups A and B, based on a low frequency/high frequency (LF/HF) ratio of 1.7, which was the mean value of the LF/HF ratio in the healthy volunteers. After a 3-month treatment with alfuzosin XL, we compared treatment outcomes, based on the IPSS and peak urine flow rate, between the two groups.ResultsA 3-month treatment with alfuzosin XL, comprising the measurement of the HRV, was performed for the 23 patients of the group A (23/38) and 17 of the group B (17/28). After a 3-month treatment with alfuzosin XL, total IPSS and IPSS questionnaire 2 and 5 were significantly lower in the group A as compared with the group B. But this was not seen in the group B. Furthermore, there were no significant differences in other parameters, such as maximal flow rate and IPSS storage subscore, between the two groups.ConclusionsOur results indicate that the treatment efficacy was lower in patients with sympathetic hyperactivity as compared with those with sympathetic hypoactivity. Thus, our results will provide a basis for further studies to clarify causes of LUTS in a clinical setting.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Correlation Between the Treatment Efficacy and the Sympathetic Activity in Men With Lower Urinary Tract Symptoms

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

“…Choi et al [17] reported ANS activity in men with voiding symptom-predominant LUTS and storage symptom-predominant LUTS. They showed that patients with LUTS exhibited decreased HF than healthy controls, which indicated that they may had some disease or imbalance in the ANS, that may distinguish LUTS patients from healthy men.…”

Section: Discussionmentioning

confidence: 99%

The Difference of Lower Urinary Tract Symptoms Between Sympathetic Hyperactive and Hypoactive Men

Oh¹,

Cho

Yun

et al. 2013

Int Neurourol J

Self Cite

View full text Add to dashboard Cite

PurposeHeart rate variability (HRV) is a tool used to measure autonomic nervous function; however, there is no evidence that it can be used to define sympathetic hyperactivity in men with lower urinary tract symptoms (LUTS). We suspected that LUTS would differ between sympathetic hyperactive and hypoactive patients. Therefore, we measured HRV and divided the LUTS patients into two groups, a sympathetic hyperactive group and a sympathetic hypoactive group according to the low frequency/high frequency (LF/HF) ratio and made clinical comparisons between the groups.MethodsA total of 43 patients with symptomatic LUTS (International Prostate Symptom Score [IPSS] over 8) and 49 healthy volunteers were enrolled. No subjects had diseases that could affect the autonomic nervous system, such as diabetes or hypertension. Electrocardiographic signals were obtained from subjects in the resting state and HRV indexes were calculated with spectral analyses. We divided the LUTS patients into two groups by an LF/HF ratio of 1.9, which was the median value in the healthy volunteers, and compared the differences in clinical characteristics, IPSS, prostate-specific antigen (PSA), and transrectal ultrasound (TRUS) results. The parameters were compared by independent sample t-test by use of SPSS ver. 19.ResultsThere were no significant differences in age, serum PSA, or volume of the prostate between the 2 LUTS groups. However, analyzing IPSS questionnaires between two groups showed that there were significant differences in mean of Q2 score (frequency) and storage symptom score ([Q2+Q4+Q7]/3) (P<0.05).ConclusionsWe suggest that an imbalance of autonomic nervous system activity may be a factor that evokes varieties of symptoms in men with LUTS. LUTS patients with hypoactive sympathetic tone may suffer from frequency and storage symptoms.

show abstract

“…Ullrich et al [6] also found associations between increases in diastolic blood pressure and cortisol following a laboratory stress test and prostate enlargement and LUTS. More recently, Choi et al [10] found that men with LUTS had lower measures of parasympathetic function compared to unaffected men. However, neither McVary nor Choi adjusted for multiple testing, making it possible that at least some of the observed associations were false-positives.…”

mentioning

confidence: 99%

“…In summary, McVary’s study [5] suggests that ANS overactivity (based on elevated responses to tilt-table testing) was associated with LUTS, while Choi’s study [10] suggests that parasympathetic underactivity (based on lower high frequency heart rate measures) was associated with LUTS. Combined with our negative results, these data suggest that clearly defining the role of the ANS in the development of LUTS requires further study.…”

mentioning

confidence: 99%

Measures of autonomic nervous system activity and lower urinary tract symptoms

et al. 2010

View full text Add to dashboard Cite

Autonomic nervous system (ANS) activity may play an important role in the development of lower urinary tract symptoms (LUTS). Men with severe LUTS and men with mild or no LUTS completed the Valsalva maneuver, quantitative sudomotor axon reflex test, tilt-table, and deep breathing tests. There were no differences between men with severe LUTS compared to men with mild or no LUTS (all P values > 0.05). Systemic ANS tests may not be useful in detecting the underlying physiologic changes that lead to LUTS in aging men.

show abstract

Characteristics of Autonomic Nervous System Activity in Men With Lower Urinary Tract Symptoms (LUTS): Analysis of Heart Rate Variability in Men With LUTS

Cited by 17 publications

References 22 publications

The Correlation Between the Treatment Efficacy and the Sympathetic Activity in Men With Lower Urinary Tract Symptoms

The Correlation Between the Treatment Efficacy and the Sympathetic Activity in Men With Lower Urinary Tract Symptoms

The Difference of Lower Urinary Tract Symptoms Between Sympathetic Hyperactive and Hypoactive Men

Measures of autonomic nervous system activity and lower urinary tract symptoms

Contact Info

Product

Resources

About