The correlation between the treatment efficacy and the sympathetic activity in men with lower urinary tract symptoms

Abstract

PURPOSE: In this study, we examined the difference in the treatment efficacy

depending on the sympathetic activity in men with lower urinary tract symptoms

(LUTS). METHODS: In 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. RESULTS: A 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.

CONCLUSIONS: Our 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.