1. Transurethral resection of prostate for acute urinary retention is linked to shorter survival in younger men
Asian Journal of Andrology 2019;21(5):468-472
It is largely unknown whether lower urinary tract symptoms (LUTS) or acute retention of urine (AROU) is linked to shorter life expectancy in men. We conducted a multicenter, retrospective database analysis of patients undergoing transurethral resection of prostate (TURP) to study their relationships. Multivariate Cox regression analysis and Kaplan-Meier analysis with stratification to age and indication of TURP were performed. We further performed an age- and sex-matched survival analysis with the general population using data from the Census and Statistics Department of the Hong Kong Special Administrative Region (Hong Kong, China). From January 2002 to December 2012, 3496 patients undergoing TURP were included in our study, with 1764 patients in the LUTS group and 1732 patients in the AROU group. Old age, ischemic heart disease, cerebrovascular accident, and AROU were risk factors of mortality. Patients aged 70 years (adjusted hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.11-2.09, P = 0.010) and 70-80 years (adjusted HR: 1.39, 95% CI: 1.15-1.70, P = 0.001) in the AROU group had worse survival than those in the LUTS group, but such difference was not demonstrated in patients aged 80 years. Compared to the general population, younger patients in the LUTS group appeared to have better survival (70 years, P = 0.091; 70-80 years, P = 0.011), but younger patients in the AROU group had worse survival (70 years, P = 0.021; 70-80 years, P = 0.003). For patients aged 80 years, survival was similar with the general population in both the LUTS and AROU groups. In conclusion, AROU at young age was associated with mortality, while early detection and management of LUTS may improve survival.
2.The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy.
Chi Hang YEE ; Jeremy Yuen Chun TEOH ; Pui Tak LAI ; Vivian Yee Fong LEUNG ; Winnie Chiu Wing CHU ; Wai man LEE ; Yuk Him TAM ; Chi Fai NG
International Neurourology Journal 2017;21(2):128-132
PURPOSE: The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. METHODS: This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. RESULTS: From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029), serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006). CONCLUSIONS: Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.
Cohort Studies
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Creatinine
;
Cross-Sectional Studies
;
Cystitis
;
Demography
;
Humans
;
Hydronephrosis
;
Ketamine
;
Liver
;
Liver Function Tests
;
Logistic Models
;
Lower Urinary Tract Symptoms
;
Odds Ratio
;
Pelvic Pain
;
Prevalence
;
Prospective Studies
;
Ultrasonography
;
Urinary Bladder
;
Urinary Tract*
;
Urination Disorders
3.Health-Related Quality of Life Assessment in Prostate Cancer Patient Undergoing Androgen Deprivation Therapy: Real-World Experience in the READT Study
Jasmine LIM ; Chi-Fai NG ; Yong WEI ; Teng Aik ONG ; Peggy Sau-Kwan CHU ; Wayne Kwun Wai CHAN ; Chao Yuan HUANG ; Kuo-Kang FENG ; Jeremy Yuen-Chun TEOH ; Ning XU ; Jer Wei LOW ; Wei Sien YEOH ; Peter Ka-Fung CHIU ; Chi-Hang YEE ; Steven Chi Ho LEUNG
The World Journal of Men's Health 2024;42(2):449-459
Purpose:
To investigate the effect of androgen deprivation therapy (ADT) on health-related quality of life (HRQOL) in Asian men with all stages of prostate cancer.
Materials and Methods:
READT (real-life evaluation of the effect of ADT in prostate cancer patients in Asia) was a multi-center, prospective observational study involving six sites across four Asian populations. We enrolled eligible prostate cancer patients, who opted for ADT alone or in combination without prior neoadjuvant or adjuvant ADT within 12 months. The EuroQoL-5 dimensions, 5 level scale (EQ-5D-5L) utility index scores and visual analog scale (VAS) were evaluated at baseline, month 6 and month 12.
Results:
A total of 504 patients were recruited into READT between September 2016 and May 2020 with 52.9% diagnosed with metastatic prostate cancer. The EQ-5D-5L was evaluable in 442/504 (87.7%) of patients. Overall baseline EQ-5D-5L utility index score was 0.924 (interquartile range [IQR] 0.876–1.000). We observed a statistically significant difference in baseline EQ-5D-5L utility index score among different populations with a median EQ-5D-5L utility index score of 1 for Taiwan & Hong Kong, 0.897 for China and 0.838 for Malaysia. Similar trend was observed throughout multiple treatment time-points. Stage IV prostate cancer were significantly associated with a lower baseline EQ-5D-5L utility index score compared to stage I–III prostate cancer, producing a median disutility value of -0.080. Participants had a high median VAS (80, IQR 70–90), indicating good overall health on average during ADT initiation.
Conclusions
The study highlights the differences in health state utility index scores among various Asian prostate cancer patients receiving ADT at real-world setting. Our findings will be informative and useful in cost-effectiveness evaluation and policy decision making.
4.Transurethral resection of prostate for acute urinary retention is linked to shorter survival in younger men.
Jeremy Yuen-Chun TEOH ; Chi-Kwok CHAN ; Maggie Haitian WANG ; Chi-Ho LEUNG ; Eddie Shu-Yin CHAN ; Peter Ka-Fung CHIU ; Chi-Hang YEE ; Hon-Ming WONG ; Simon See-Ming HOU ; Chi-Fai NG
Asian Journal of Andrology 2019;21(5):468-472
It is largely unknown whether lower urinary tract symptoms (LUTS) or acute retention of urine (AROU) is linked to shorter life expectancy in men. We conducted a multicenter, retrospective database analysis of patients undergoing transurethral resection of prostate (TURP) to study their relationships. Multivariate Cox regression analysis and Kaplan-Meier analysis with stratification to age and indication of TURP were performed. We further performed an age- and sex-matched survival analysis with the general population using data from the Census and Statistics Department of the Hong Kong Special Administrative Region (Hong Kong, China). From January 2002 to December 2012, 3496 patients undergoing TURP were included in our study, with 1764 patients in the LUTS group and 1732 patients in the AROU group. Old age, ischemic heart disease, cerebrovascular accident, and AROU were risk factors of mortality. Patients aged <70 years (adjusted hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.11-2.09, P = 0.010) and 70-80 years (adjusted HR: 1.39, 95% CI: 1.15-1.70, P = 0.001) in the AROU group had worse survival than those in the LUTS group, but such difference was not demonstrated in patients aged >80 years. Compared to the general population, younger patients in the LUTS group appeared to have better survival (<70 years, P = 0.091; 70-80 years, P = 0.011), but younger patients in the AROU group had worse survival (<70 years, P = 0.021; 70-80 years, P = 0.003). For patients aged >80 years, survival was similar with the general population in both the LUTS and AROU groups. In conclusion, AROU at young age was associated with mortality, while early detection and management of LUTS may improve survival.
Age Factors
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Aged
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Aged, 80 and over
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Databases, Factual
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Humans
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Kaplan-Meier Estimate
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Lower Urinary Tract Symptoms
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Male
;
Middle Aged
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Prostate/surgery*
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Prostatic Hyperplasia/surgery*
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Retrospective Studies
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Risk Factors
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Survival Analysis
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Transurethral Resection of Prostate/methods*
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Urinary Retention/surgery*