Margreiter Markus, Heinisch Birgit B, Schwarzer Remy, Klatte Tobias, Shariat Shahrokh F, Ferlitsch Arnulf
Department of Urology, General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria,
World J Urol. 2015 Mar;33(3):315-21. doi: 10.1007/s00345-014-1313-6. Epub 2014 May 6.
To evaluate the prevalence of lower urinary tract symptoms (LUTS) in men with liver cirrhosis.
In total, 128 men with known liver cirrhosis were prospectively evaluated using the validated German version of the International Prostate Symptom Score (IPSS) questionnaire. In parallel, all men underwent a detailed examination including medical history; physical examination; Child-Pugh liver function score (CPS) assessment; and measurement of blood levels of prostate-specific antigen (PSA), total and free testosterone, sexual hormone-binding globulin (SHBG), prolactin, luteotropic hormone (LH), and follicle-stimulating hormone (FSH).
Mean patient age and mean IPSS was 56 ± 9 years and 8 ± 6, respectively. Mild (IPSS: 1-7), moderate (IPSS: 8-19), and severe (IPSS: 20-35) LUTS were present in 60.2 % (77/128), 31.3 % (40/128), and 7.0 % (9/128) of the patients, respectively. Storage symptoms increased with the CPS (p = 0.04). Voiding symptoms and overall IPSS did not differ between the CPS groups (p = 0.93 and p = 0.67). No correlation was found between ascites volume and IPSS, storage symptoms, voiding symptoms, or quality of life (QoL) (p = 0.46, p = 0.26, p = 0.81, p = 0.87). From CPS groups A to C, mean PSA levels (p = 0.04), total and free testosterone levels (p < 0.001 and p < 0.001), and SHBG levels decreased (p = 0.03); however, prolactin levels increased (p = 0.03). LH and FSH levels did not differ between the CPS groups (p = 0.15 and p = 0.35).
Men with liver cirrhosis commonly have LUTS, with a predominance of storage symptoms. Liver cirrhosis may also affect PSA-based prostate cancer risk assessment. Accurate diagnosis and therapy strategies are warranted to improve the QoL of these patients.
评估肝硬化男性患者下尿路症状（LUTS）的患病率。
总共对128例已知肝硬化的男性患者使用经过验证的德文版国际前列腺症状评分（IPSS）问卷进行前瞻性评估。同时，所有男性患者均接受了详细检查，包括病史、体格检查、Child-Pugh肝功能评分（CPS）评估，以及前列腺特异性抗原（PSA）、总睾酮和游离睾酮、性激素结合球蛋白（SHBG）、催乳素、促黄体生成素（LH）和促卵泡生成素（FSH）的血液水平测定。
患者的平均年龄和平均IPSS分别为56±9岁和8±6。轻度（IPSS：1 - 7）、中度（IPSS：8 - 19）和重度（IPSS：20 - 35）LUTS分别出现在60.2%（77/128）、31.3%（40/128）和7.0%（9/128）的患者中。储尿期症状随CPS升高而增加（p = 0.04）。排尿期症状和总体IPSS在CPS各亚组间无差异（p = 0.93和p = 0.67）。腹水容量与IPSS、储尿期症状、排尿期症状或生活质量（QoL）之间未发现相关性（p = 0.46、p = 0.26、p = 0.81、p = 0.87）。从CPS A组到C组，平均PSA水平（p = 0.04）、总睾酮和游离睾酮水平（p < 0.001和p < 0.001）以及SHBG水平下降（p = 0.03）；然而，催乳素水平升高（p = 0.03）。LH和FSH水平在CPS各亚组间无差异（p = 0.15和p = 0.35）。
肝硬化男性患者常出现LUTS，以储尿期症状为主。肝硬化还可能影响基于PSA的前列腺癌风险评估。需要准确的诊断和治疗策略以改善这些患者的生活质量。
