Characteristics of autonomic nervous system activity in men with lower urinary tract symptoms (LUTS): analysis of heart rate variability in men with LUTS.

Abstract

OBJECTIVES: To identify the difference in autonomic nervous dysfunction activity in men between voiding symptom-predominant lower urinary tract symptoms (LUTS) and storage symptom-predominant LUTS. METHODS: A total of 39 men with LUTS (mean age 56.9 +/- 8.96 years) and 23 healthy men (mean age 57.0 +/- 1.76 years) were included in the present study. Seven questions numbered Q1 to Q7 in the order of appearance in International Prostate Symptom Score were divided into 2 clusters: one with Q1, Q3, Q5, and Q6 and the other with Q2, Q4, and Q7, representing voiding and storage symptoms, respectively. Patients were divided into either voiding symptom-predominant group, if mean voiding symptom score, defined as (Q1 + Q3 + Q5 + Q6)/4, is bigger than mean storage symptom score, defined as (Q2 +Q4 + Q7)/3, or storage symptom-predominant group otherwise. We measured and compared parameters of heart rate variability between men with LUTS and healthy normal subjects. We also compared heart rate variability of men between storage symptom-predominant LUTS and voiding symptom-predominant LUTS. RESULTS: On frequency domain analysis, there was evidence of decreased high frequency (HF) in patients with LUTS (P <.05). In comparison of autonomic nervous dysfunction activity in LUTS patients, men with voiding symptom-predominant LUTS had relatively increased ratio of low frequency and HF than what was observed in men with storage symptom-predominant LUTS. CONCLUSIONS: Patients with LUTS exhibited decreased HF indicated that they may have had some disease or imbalance in the autonomic nervous system, which may distinguish LUTS patients from healthy men. Also, patients with voiding symptom-predominant LUTS had relatively increased sympathetic activity than storage symptom-predominant LUTS patients.