The Association between Severity of Atherosclerosis and Lower Urinary Tract Function in Male Patients with Lower Urinary Tract Symptoms

Takahashi, Norio; Shishido, Keiichi; Sato, Yuichi; Ogawa, Soichiro; Oguro, Toshiki; Kataoka, Masao; Shiomi, Homare; Uchida, Hisashi; Haga, Nobuhiro; Hosoi, Takayuki; Nomiya, Masanori; Aikawa, Kohsuke; Murakami, Husao; Yamaguchi, Osamu

doi:10.1111/j.1757-5672.2011.00098.x

Cited by 28 publications

(35 citation statements)

References 28 publications

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“…A study with Japanese patients showed similar findings in that the maximum flow rate in men with atherosclerosis assessed by ultrasound examination of the carotid artery was significantly lower than that in the men without it (13.4 ± 5.5 mL/s vs. 16.7 ± 7.7 mL/s). This Japanese study also showed the daytime frequency of urination to be significantly higher in the men with atherosclerosis than in those without it (7.13 ± 3.02 times vs. 8.75 ± 2.50 times), although nocturia was not evaluated 26 . These findings indicate that atherosclerotic disease may play a significant role in the impairments of both voiding and storage function in male patients.…”

Section: Discussionmentioning

confidence: 76%

Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men

Tsujimura

Hiramatsu

Aoki

et al. 2017

Prostate International

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BackgroundAtherosclerosis is a systematic disease in which plaque builds up inside the arteries that can lead to serious problems related to quality of life (QOL). Lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and late-onset hypogonadism (LOH) are highly prevalent in aging men and are significantly associated with a reduced QOL. However, few questionnaire-based studies have fully examined the relation between atherosclerosis and several urological symptoms.Materials and methodsThe study comprised 303 outpatients who visited our clinic with symptoms of LOH. Several factors influencing atherosclerosis, including serum concentrations of triglyceride, fasting blood sugar, and total testosterone measured by radioimmunoassay, were investigated. We also measured brachial-ankle pulse wave velocity (baPWV) and assessed symptoms by specific questionnaires, including the Sexual Health Inventory for Men (SHIM), Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), QOL index, and Aging Male Symptoms rating scale (AMS). Stepwise associations between the ratio of measured/age standard baPWV and clinical factors including laboratory data and the scores of the questionnaires were compared using the Jonckheere–Terpstra test for trend. The associations between the ratio of measured/age standard baPWV and each IPSS score were assessed in a multivariate linear regression model after adjustment for serum triglyceride, fasting blood sugar, and total testosterone.ResultsRegarding ED, a higher level of the ratio of measured/age standard baPWV was associated with a lower EHS, whereas no association was found with SHIM. Regarding LUTS, a higher ratio of measured/age standard baPWV was associated with a higher IPSS and QOL index. However, there was no statistically significant difference between the ratio of measured/age standard baPWV and AMS. A multivariate linear regression model showed only nocturia to be associated with the ratio of measured/age standard baPWV for each IPSS score.ConclusionAtherosclerosis is associated with erectile function and LUTS, especially nocturia.

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Section: Discussionmentioning

confidence: 76%

Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men

Tsujimura

Hiramatsu

Aoki

et al. 2017

Prostate International

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“…Basic research evidence of detrusor overactivity and voiding dysfunction in bladder ischemia has been supported by clinical observations of a close relationship between human lower urinary tract ischemia and LUTS 12–19. In clinical studies, lower urinary tract blood flow has been measured and bladder ischemia documented in elderly patients with LUTS 12–19.…”

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

“…In clinical studies, lower urinary tract blood flow has been measured and bladder ischemia documented in elderly patients with LUTS 12–19. Decreased bladder blood flow significantly correlated with LUTS in both men and women 12–17. The degrees of pelvic atherosclerosis significantly correlated with the severity of LUTS in elderly patients 12,16.…”

Section: Discussionmentioning

confidence: 99%

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Mitochondrial stress and activation of PI3K and Akt survival pathway in bladder ischemia

Yang

Siroky

Yalla

et al. 2017

RRU

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PurposeDetrusor overactivity contributes to bothersome constellation of lower urinary tract symptoms (LUTS) in men and women as they age. However, the underlying mechanisms of non-obstructive detrusor overactivity and LUTS remain largely unknown. Growing evidence suggests that ischemia may be an independent factor in the development of non-obstructive bladder dysfunction. Our goal was to determine the effects of ischemia on detrusor function and voiding behavior and define redox-mediated cellular stress and cell survival signaling in the ischemic bladder.Materials and methodsMale Sprague Dawley rats were randomly divided into treatment (n=8) and control (n=8) groups. In the treatment group, iliac artery atherosclerosis and chronic bladder ischemia were induced. At 8 weeks after bladder ischemia, voiding patterns were examined in metabolic cages, cystometrograms were recorded in conscious animals, and then bladder blood flow was measured under general anesthesia. Bladder tissues were processed for assessment of transcription factors, markers of cellular and mitochondrial stress, mitochondrial respiration, and cell survival signaling pathway.ResultsAtherosclerotic occlusive disease spread from the common iliac arteries to the internal iliac and vesical arteries and produced sustained bladder ischemia. Studies in metabolic cages showed increased micturition frequency and decreased voided volume in bladder ischemia. Conscious cystometrograms produced consistent data showing significant increase in micturition frequency and decreased voided volume and bladder capacity. Voiding behavior and cystometric changes in bladder ischemia were associated with significant decrease in DNA binding activity of Nrf2, significant increase in cellular levels of stress protein Hsp70 and mitochondrial stress protein GRP75, and significant decrease in mitochondrial oxygen consumption and upregulation of PI3K and Akt expression.ConclusionChronic bladder ischemia may be a mediating variable in the development of detrusor overactivity in the non-obstructive bladder. The mechanism may involve ischemia-induced cellular stress, Nrf2 functional deficit, depression of mitochondrial respiration, and upregulation of PI3K/Akt cell survival signaling pathway.

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“…Epidemiological studies have investigated the association between LUTS and vascular risk factors for atherosclerosis such as hypertension, hyperlipidemia, diabetes mellitus and nicotine use 100, 101 , and Ponholzer et al (2006) suggested the potential role of atherosclerosis in the development of LUTS in both sexes 100 . Takahashi et al (2012) also indicated the association between severity of atherosclerosis and male LUTS 102 . Pinggera et al (2006), using transrectal color Doppler ultrasonography, showed that elderly patients with LUTS had a significant decrease in bladder blood flow compared with asymptomatic young individuals 103 .…”

Section: Risk Factorsmentioning

confidence: 98%

Translational Research and Functional Changes in Voiding Function in Older Adults

Kullmann

Birder

Andersson

2015

Clinics in Geriatric Medicine

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Synopsis This article describes a number of changes in lower urinary tract (LUT) function that occurs in the aging population as well as in animal models. Age-related LUT dysfunctions result from complex processes controlled by multiple genetic, epigenetic and environmental factors and accounts for high costs of healthcare. While the underlying factors that contribute to patient symptoms are not known, this article will discuss a number of risk factors that may play a role in age- related LUT dysfunction. In addition, while limited data is available using animal models of aging, there is evidence that many of the structural and functional changes observed in these studies appear to be similar to those observed in humans. A better understanding of factors and mechanisms underlying LUTS in the older population may lead to therapeutic interventions which may be used to reduce these dysfunctions.

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The Association between Severity of Atherosclerosis and Lower Urinary Tract Function in Male Patients with Lower Urinary Tract Symptoms

Abstract: Development of atherosclerosis impairs both voiding and storage function independently of age, suggesting atherosclerosis leads to lower urinary dysfunction.

Cited by 28 publications

References 28 publications

Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men

Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men

Mitochondrial stress and activation of PI3K and Akt survival pathway in bladder ischemia

Translational Research and Functional Changes in Voiding Function in Older Adults

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