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Prevalence and Management of Lower Urinary Tract Symptoms in Methamphetamine Abusers: An Under-Recognized Clinical Identity

 Kyo Chul Koo  ;  Dong Hoon Lee  ;  Jang Hwan Kim  ;  Koon Ho Rha  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Sang Yol Mah 
 JOURNAL OF UROLOGY, Vol.191(3) : 722-726, 2014 
Journal Title
Issue Date
Adrenergic alpha-Antagonists/therapeutic use* ; Adult ; Case-Control Studies ; Cholinergic Antagonists/therapeutic use* ; Humans ; Lower Urinary Tract Symptoms/chemically induced* ; Lower Urinary Tract Symptoms/drug therapy* ; Lower Urinary Tract Symptoms/epidemiology ; Male ; Methamphetamine/toxicity* ; Middle Aged ; Prevalence ; Quality of Life ; Republic of Korea/epidemiology ; Substance-Related Disorders/complications* ; Treatment Outcome
lower urinary tract symptoms ; methamphetamine ; prevalence ; treatment outcome
PURPOSE: We investigate the prevalence of lower urinary tract symptoms in a cohort of methamphetamine abusers, and assess the therapeutic efficacy of α-blockers and anticholinergics. MATERIALS AND METHODS: From May 2011 to March 2013, 78 male methamphetamine abusers diagnosed with methamphetamine addiction were identified at the National Forensic Hospital, Korea. The I-PSS (International Prostate Symptom Score) with consultation was used to investigate the prevalence of lower urinary tract symptoms, defined as total I-PSS 8 or greater and quality of life index score of 2 or greater. These values for methamphetamine abusers were compared to those of 71 age matched controls. α-Blockers and anticholinergics were administered to methamphetamine abusers with lower urinary tract symptoms according to predominant voiding and storage symptoms based on voiding-to-storage subscore ratios. For methamphetamine abusers with no response, defined as a reduction of 4 or less in total I-PSS, an alternative drug or combination was administered. Efficacy was assessed based on a 4-week interval. RESULTS: The median periods of methamphetamine abuse and abstinence were 18.1 years and 5.7 months, respectively. Methamphetamine abusers showed a higher prevalence of lower urinary tract symptoms compared to controls (77% vs 15%, p <0.001), with higher I-PSS and quality of life index score (13.3 vs 5.6 and 2.9 vs 0.9, respectively; p <0.001). Anticholinergics showed the greatest effect on I-PSS reduction with overall response rates for α-blockers, anticholinergics and combinations of 13%, 61% and 14%, respectively. Seven (12%) methamphetamine abusers did not respond to any therapy. CONCLUSIONS: Lower urinary tract symptoms were highly prevalent among methamphetamine abusers. Our results imply that pathological dopaminergic mechanisms have a role in methamphetamine associated lower urinary tract symptoms. Moreover, first line anticholinergics and prompt combination with α-blockers conferred the most therapeutic benefit to nonresponders.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Kim, Jang Hwan(김장환) ORCID logo https://orcid.org/0000-0002-9056-7072
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Mah, Sang Yol(마상열)
Lee, Dong Hoon(이동훈)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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