Alt üriner sistem semptomlu hastalarda cinsel disfonksiyonun araştırılması, testosteron, leptin, kan lipidleri ile ilişkisi: Alfa bloker (Tamsulosin) tedavisi sonrası yeniden değerlendirme
Küçük Resim Yok
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda, alt üriner sistem semptomları (AÜSS) ve erektil disfonksiyon (ED) birlikteliğin olası nedenlerini ve bu nedenler ile bazı değişkenlerin (vücut kitle indeksi (VKİ), serum leptin, serbest testosteron (sT), kan lipidleri) ilişkisini incelemeyi amaçladık. Temmuz 2003-Şubat 2004 arası 46 hasta çalışmaya alındı. Tüm hastalara parmakla rektal muayeneyi içeren fizik muayene, tam idrar analizi, idrar akım hızı ve rezidüel idrar volümü incelemesi yapılmıştır. Ayrıca hastaların serum lipid değerleri, serum serbest testosteron düzeyleri ve serum leptin düzeyleri ölçülmüştür. Hastaların VKİ'leri belirlenmiştir. Hastaların semptom süreleri belirlenerek IPSS, IIEF ve DAN-PSS seks soru formları ile tedavi öncesi ve sonrası AÜSS, erektil fonksiyon ve ejakülatuar durumları incelendi. AÜSS skoru ile ED semptom skoru arasında negatif bir korelasyon tespit edilmiştir (p<0.05). Alfa bloker tedavisi sonrası hafif ED sıklığında azalma saptanırken, orta ve şiddetli ED formlarında artış saptanmıştır. IIEF ile serbest testosteron arasında anlamlı bir korelasyon görülmemiştir. Kan lipidleri ile çalışılan hiçbir parametre arasında bağlantı tespit edilmemiştir. Leptin düzeyi ED olan grupta ED olmayan gruba göre daha düşük saptanmıştır. AÜSS için ilaç kullanımı önerilen hastaların çoğunda AÜSS'de gerileme ancak ED'de ve ejakülatuar sorunlarda artış tespit edilmiştir. AÜSS'nin şiddeti arttıkça ereksiyon kaybı da artmaktadır. AÜSS ile gelen ve medikal tedavi ihtiyacı olan hastaların özellikle ED açısından değerlendirilmesi önemlidir. Gelecekteki çalışmalarda, AÜSS ve ED birlikteliğini öngörmede leptin seviyeleri önem kazanabilir.
Introduction: Lower urinary tract symptoms (LUTS) associated with BPH and erectile dysfunction (ED) are common problems in aging male. In this study, we aimed to determine the causes of the relationship between LUTS and ED, and the possible effects of body mass index (BMI), serum leptin, free testosterone (fT) and lipid levels on LUTS and ED etiology. Materials and Methods: Between June 2003 and February 2004, 46 patients were recruited in this study. All patients underwent physical examination including digital rectal examination, urine analysis, uroflowmetry and residual urine volume assessment. Serum leptin, lipid and free testosterone levels were analyzed. All patients' BMI were determined. Thirty-three patients received alpha blocker treatment and 13 patients were in the watchful waiting group. Erectile capacity and voiding symptoms of the patients were analyzed with International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), respectively before and after alpha blocker treatments. Ejaculatory function was assessed with Danish Prostate Symptom Score sexual-function questionnaire (DAN-PSSsex). Data were analyzed using the Pearson correlation test, Mann-Whitney test and Kruskal-Wallis test. Results: There was a negative correlation between IPSS and IIEF (p<0.05). The incidences of ED in patients with LUTS were 50%, 81.8% and 69.2% in patients with mild, moderate and severe symptom, respectively. The frequency of erectile dysfunction was very high in patients especially with moderate symptoms. After alpha blocker treatment the percentage of patients with mild symptoms decreased, but those with moderate and severe symptoms increased. In our study there was no significant correlation between IIEF and fT levels but the mean level of fT in patients with ED was under 15 ng/ml. There was no correlation between serum lipid levels and the other parameters. Conclusion: There is a strong correlation between LUTS and ED. As the severity of LUTS increases the incidence of ED increases. Alpha blocker treatment seems to slightly increase the incidence of ED and ejaculatory problems. Patients with LUTS and ED have lower levels of fT, but this is not statistically significant. There is no correlation between serum lipids and other parameters. Leptin levels might be important in predicting LUTS and ED relationship for future research.
Introduction: Lower urinary tract symptoms (LUTS) associated with BPH and erectile dysfunction (ED) are common problems in aging male. In this study, we aimed to determine the causes of the relationship between LUTS and ED, and the possible effects of body mass index (BMI), serum leptin, free testosterone (fT) and lipid levels on LUTS and ED etiology. Materials and Methods: Between June 2003 and February 2004, 46 patients were recruited in this study. All patients underwent physical examination including digital rectal examination, urine analysis, uroflowmetry and residual urine volume assessment. Serum leptin, lipid and free testosterone levels were analyzed. All patients' BMI were determined. Thirty-three patients received alpha blocker treatment and 13 patients were in the watchful waiting group. Erectile capacity and voiding symptoms of the patients were analyzed with International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), respectively before and after alpha blocker treatments. Ejaculatory function was assessed with Danish Prostate Symptom Score sexual-function questionnaire (DAN-PSSsex). Data were analyzed using the Pearson correlation test, Mann-Whitney test and Kruskal-Wallis test. Results: There was a negative correlation between IPSS and IIEF (p<0.05). The incidences of ED in patients with LUTS were 50%, 81.8% and 69.2% in patients with mild, moderate and severe symptom, respectively. The frequency of erectile dysfunction was very high in patients especially with moderate symptoms. After alpha blocker treatment the percentage of patients with mild symptoms decreased, but those with moderate and severe symptoms increased. In our study there was no significant correlation between IIEF and fT levels but the mean level of fT in patients with ED was under 15 ng/ml. There was no correlation between serum lipid levels and the other parameters. Conclusion: There is a strong correlation between LUTS and ED. As the severity of LUTS increases the incidence of ED increases. Alpha blocker treatment seems to slightly increase the incidence of ED and ejaculatory problems. Patients with LUTS and ED have lower levels of fT, but this is not statistically significant. There is no correlation between serum lipids and other parameters. Leptin levels might be important in predicting LUTS and ED relationship for future research.
Açıklama
Anahtar Kelimeler
Üroloji ve Nefroloji
Kaynak
Türk Üroloji Dergisi/Turkish Journal of Urology
WoS Q Değeri
Scopus Q Değeri
Cilt
31
Sayı
4
