Effectiveness of NO-cGMP axis for lower urinary tract syndrome

Yukihide Matsui, Yurika Ito, Tomo Shimizu, Yota Nakajima, Toshihiro Shimizu, Mizuki Kasahara, Koji Tamura, Toshihiro Tai, Masato Nagata, Humito Yamabe, Kuri Aoki, Hideyuki Kobayashi (+2 others)
2016 Urological Science  
Purpose: The aim of this study was to compare the clinical outcomes between diabetic patients and non-diabetic patients receiving transurethral resection of prostate (TUR-P). Materials and Methods: This analysis was a retrospective cohort study using 13 years (2000e2012) of claims data from Taiwan's National Health Insurance Research Database (NHIRD). A total of 4887 patients who had persistent lower urinary tract symptoms (LUTS) and underwent TUR-P for benign prostate hyperplasia (BPH) were
more » ... olled and divided into two groups: Diabetes mellitus (DM) group and Non-DM group. The patients' characteristics, post-operative clinical outcomes, and the medication records after TUR-P were compared. Results: There was no difference between the two groups in regards to age, ratio of urinary tract infection (UTI) and urinary retention before surgery. The pre-operative medication statuses were also similar between the two groups. However, DM group patients had a higher prevalence of comorbidities. Post-operatively, the DM group had lower rates of UTI (OR, 0.78; p¼0.009) and higher rates of urinary retention requiring catheterization (OR, 1.35; p¼0.01) within 1 month after TUR-P. Both of the proportions became insignificantly different during the 1 month to 1 year post-operative period. A higher proportion of patients with DM took anti-muscarinics (OR, 1.23; P ¼ 0.032) within the first 3 months and a-blockers (OR, 1.18; P ¼ 0.049) during 3e12 months after receiving TUR-P. Overall, the DM group patients had a worse post-operative medication-free survival compared to that of non-DM group patients (95% CI¼1.14; p¼0.005). Conclusion: Diabetes Mellitus patients require higher rates of continuing medication after TUR-P, especially anti-muscarinics in three months postop and alpha-blocker after three months post-op. Diabetes Mellitus patients also had higher incidence of urine retention after surgery.
doi:10.1016/j.urols.2016.05.030 fatcat:gddy7rjgkbaubij3socslkbu3a