Investig Clin Urol.  2018 Jan;59(1):49-54. 10.4111/icu.2018.59.1.49.

Changes in autonomic nervous system activity after treatment with alpha-blocker in men with lower urinary tract symptoms

Affiliations
  • 1Department of Urology, Ajou University College of Medicine, Suwon, Korea. urochoi@ajou.ac.kr
  • 2Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Department of Urology, Chonbuk National University School of Medicine, Jeonju, Korea.
  • 5Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
  • 6Department of Urology, Korea University Anam Hospital, Seoul, Korea.
  • 7Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea.
  • 8Department of Urology, Dankook University College of Medicine, Cheonan, Korea.
  • 9Department of Urology, Inha University College of Medicine, Incheon, Korea.
  • 10Department of Urology, Seoul National University Hospital, Seoul, Korea.
  • 11Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To determine changes in autonomic nervous system activity after treatment in men with lower urinary tract symptoms (LUTS), we evaluated changes in patients' symptoms, uroflowmetry, and heart rate variability (HRV) after treatment with alpha-blockers for 12 weeks.
MATERIALS AND METHODS
Ninety-five men who had LUTS (International Prostate Symptom Score [IPSS] ≥8) were included in this study. We divided them into two groups on the basis of a low frequency/high frequency (LF/HF) ratio of 1.6. After treatment with Xatral XL (Handok Inc., Korea) 10 mg for 3 months, we rechecked their IPSS, uroflowmetry, HRV and compared these with the baseline measurements.
RESULTS
Fifty-four men were assigned to the low LF/HF group (group A: LF/HF ≤1.6) and 41 men to the high LF/HF group (group B: LF/HF >1.6). At baseline and 12 weeks, none of the parameters differed significantly between the groups except for HF, which is one of the parameters of HRV. IPSS, the IPSS-voiding subscore, and the IPSS-storage subscore decreased and maximal uroflow increased significantly after 12 weeks of treatment. Whereas the baseline LF/HF ratio increased from 0.89±0.407 to 1.80±1.804 after treatment in group A, it decreased from 3.93±5.471 to 1.79±1.153 in group B.
CONCLUSIONS
The efficacies of Xatral XL were clear in both groups. We found that the LF/HF ratio in the two groups merged to a value of approximately 1.79 after treatment. We suggest that this could be a clue to the importance of balance in autonomic nervous system activity in men with LUTS.

Keyword

Autonomic nervous system; Prostate; Urination

MeSH Terms

Autonomic Nervous System*
Heart Rate
Humans
Lower Urinary Tract Symptoms*
Male
Prostate
Urination

Figure

  • Fig. 1 Patient disposition and enrollment. HRV, heart rate variability; LF, low frequency; HF, high frequency.

  • Fig. 2 Change in low frequency (LF)/high frequency (HF) ratio after treatment with Xatral XL (group A: LF/HF ≤1.6, group B: LF/HF >1.6).


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