Frailty and benign prostatic hyperplasia: The thrilling underlying impact
https://doi.org/10.4081/aiua.2022.3.345
Accepted: July 22, 2022
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Background: World population is aging. The number of individuals aged over 65 are expected to be 71 million only in the US. 43% of this population will be men. Benign prostatic hyperplasia (BPH), defined as the benign neoplasm of the prostate gland affects 8% of men by their forties, but 90% of men over 90 years old. Lower urinary tract symptoms (LUTS) can be caused by an enlarged prostate, and it seems to be associated more with older and frailer individuals.
Methods: The purpose of this study is to review the potential interplay between frailty syndrome and benign prostatic hyperplasia. A thorough MEDLINE/PubMed non-systematic literature review was conducted from 1990 to March of 2022. The terms used for the search were “frailty and benign prostatic hyperplasia” and “low muscle mass and benign prostatic hyperplasia”.
Results: It seems that, frailty poses a negative impact on the prognosis of patients with BPH, as it is associated with increased incidence of LUTS. In addition, frailty seems to be a strong predictor concerning surgical procedure failure and mortality following invasive procedures for BPH. Prostatic stent placement on the other hand appears to be the ideal solution for frail patients.
Conclusions: BPH has a strong association with frailty and increasing age.
Bauer SR, Walter LC, Ensrud KE, et al. Assessment of frailty and association with progression of benign prostatic hyperplasia symptoms and serious adverse events among men using drug therapy. JAMA Netw Open. 2021; 4:e2134427. DOI: https://doi.org/10.1001/jamanetworkopen.2021.34427
Omwancha J, Brown TR. Selective androgen receptor modulators: in pursuit of tissue-selective androgens. Current opinion in investigational drugs. 2006; 7:873-81.
Welliver C, Feinstein L, Ward JB, et al. Trends in lower urinary tract symptoms associated with benign prostatic hyperplasia, 2004 to 2013: the Urologic Diseases in America Project. J Urol. 2020;203:171-8. DOI: https://doi.org/10.1097/JU.0000000000000499
Suskind AM. Frailty and lower urinary tract symptoms. Curr Urol Rep 2017; 18:67. DOI: https://doi.org/10.1007/s11934-017-0720-9
Platz EA, Smit E, Curhan GC, Nyberg LM, Giovannucci E. Prevalence of and racial/ethnic variation in lower urinary tract symptoms and noncancer prostate surgery in U.S. men. Urology. 2002; 59:877-83. DOI: https://doi.org/10.1016/S0090-4295(01)01673-9
McConnell JD, Roehrborn CG, Bautista OM,, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. New Engl J Med. 2003; 349:2387-98. DOI: https://doi.org/10.1056/NEJMoa030656
Oelke M, Becher K, Castro-Diaz D, et al. Appropriateness of oral drugs for long-term treatment of lower urinary tract symptoms in older persons: results of a systematic literature review and international consensus validation process (LUTS-FORTA 2014). Age Ageing. 2015; 44:745-55. DOI: https://doi.org/10.1093/ageing/afv077
Welk B, McArthur E, Fraser LA, et al. The risk of fall and fracture with the initiation of a prostate-selective alpha antagonist: a population based cohort study. BMJ 2015; 351:h5398. DOI: https://doi.org/10.1136/bmj.h5398
Coupland CAC, Hill T, Dening T, et al. Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study. JAMA Intern Med. 2019; 179:1084-93. DOI: https://doi.org/10.1001/jamainternmed.2019.0677
Sarkar RR, Parsons JK, Bryant AK, et al. Association of treatment with 5alpha-reductase inhibitors with time to diagnosis and mortality in prostate cancer. JAMA Intern Med. 2019; 179:812-9. DOI: https://doi.org/10.1001/jamainternmed.2019.0280
Duan Y, Grady JJ, Albertsen PC, Helen Wu Z. Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia. Pharmacoepidemiol Drug Saf. 2018; 27:340-8. DOI: https://doi.org/10.1002/pds.4361
Abrams P, Chapple C, Khoury S,, et al. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol. 2013; 189(1 Suppl):S93-S101. DOI: https://doi.org/10.1016/j.juro.2012.11.021
Walston J, Bandeen-Roche K, Buta B, et al. Moving frailty toward clinical practice: NIA intramural frailty science symposium summary. J Am Geriatr Soc. 2019; 67:1559-64. DOI: https://doi.org/10.1111/jgs.15928
Platz EA, Joshu CE, Mondul AM, et al. Incidence and progression of lower urinary tract symptoms in a large prospective cohort of United States men. J Urol. 2012; 188:496-501. DOI: https://doi.org/10.1016/j.juro.2012.03.125
Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in america project: benign prostatic hyperplasia. J Urol. 2008; 179(5 Suppl):S75-80. DOI: https://doi.org/10.1016/j.juro.2008.03.141
Bauer SR, Jin C, Kamal P, Suskind AM. Association between lower urinary tract symptoms and frailty in older men presenting for urologic care. Urology. 2021; 148:230-4. DOI: https://doi.org/10.1016/j.urology.2020.09.041
Noguchi N, Chan L, Cumming RG, et al. A systematic review of the association between lower urinary tract symptoms and falls, injuries, and fractures in community-dwelling older men. Aging Male. 2016; 19:168-74. DOI: https://doi.org/10.3109/13685538.2016.1169399
Akerla J, Pesonen JS, Poyhonen A, et al. Impact of lower urinary tract symptoms on mortality: a 21-year follow-up among middleaged and elderly Finnish men. Prostate Cancer Prostatic Dis. 2019; 22:317-23. DOI: https://doi.org/10.1038/s41391-018-0108-z
Lepor H. Pathophysiology of lower urinary tract symptoms in the aging male population. Rev Urol. 2005; 7 Suppl 7:S3-S11.
Bauer SR, Cawthon PM, Ensrud KE, et al. Lower urinary tract symptoms and incident functional limitations among older community-dwelling men. J Am Geriatr Soc. 2022; 70:1082-1094 DOI: https://doi.org/10.1111/jgs.17633
Bauer SR, Scherzer R, Suskind AM, et al. Co-Occurrence of Lower Urinary Tract Symptoms and Frailty among Community-Dwelling Older Men. Journal of the American Geriatrics Society. 2020; 68:2805-13. DOI: https://doi.org/10.1111/jgs.16766
Jang IY, Lee CK, Jung HW, et al. Urologic symptoms and burden of frailty and geriatric conditions in older men: the Aging Study of Pyeong Chang Rural Area. Clin Interv Aging. 2018; 13:297-304. DOI: https://doi.org/10.2147/CIA.S158717
Soma O, Hatakeyama S, Imai A, et al. Relationship between frailty and lower urinary tract symptoms among communitydwelling adults. Low Urin Tract Symptoms 2020; 12:128-36. DOI: https://doi.org/10.1111/luts.12292
Eredics K, Meyer C, Gschliesser T, et al. Can a simple geriatric assessment predict the outcome of TURP? Urol. Int. 2020; 104:367-72. DOI: https://doi.org/10.1159/000506717
Pichon T, Lebdai S, Launay CP,, et al. Geriatric assessment can predict outcomes of endoscopic surgery for benign prostatic hyperplasia in elderly patients. J Endourol. 2017; 31:1195-202. DOI: https://doi.org/10.1089/end.2017.0325
Suskind AM, Walter LC, Zhao S, Finlayson E. Functional outcomes after transurethral resection of the prostate in nursing home residents. J Am Geriatr Soc. 2017; 65:699-703. DOI: https://doi.org/10.1111/jgs.14665
Sethi K, Bozin M, Jabane T, et al. Thermo-expandable prostatic stents for bladder outlet obstruction in the frail and elderly population: An underutilized procedure? Investig Clin Urol. 2017; 58:447-52. DOI: https://doi.org/10.4111/icu.2017.58.6.447
Coyne KS, Wein AJ, Tubaro A, et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU International. 2009; 103 Suppl 3:4-11. DOI: https://doi.org/10.1111/j.1464-410X.2009.08371.x
Suskind AM. The aging overactive bladder: a review of agingrelated changes from the brain to the bladder. Curr Bladder Dysfunct Rep. 2017; 12:42-7. DOI: https://doi.org/10.1007/s11884-017-0406-7
Silva V, Grande AJ, Peccin MS. Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction. Cochrane Database Syst Rev. 2019; 4:CD012044. DOI: https://doi.org/10.1002/14651858.CD012044.pub2
Coyne KS, Sexton CC, Kopp Z, et al. Assessing patients' descriptions of lower urinary tract symptoms (LUTS) and perspectives on treatment outcomes: results of qualitative research. International journal of clinical practice. 2010; 64:1260-78. DOI: https://doi.org/10.1111/j.1742-1241.2010.02450.x
Russo GI, Castelli T, Urzi D, et al. Emerging links between nonneurogenic lower urinary tract symptoms secondary to benign prostatic obstruction, metabolic syndrome and its components: A systematic review. Int J Urol. 2015; 22:982-90. DOI: https://doi.org/10.1111/iju.12877
Siddiqui NY, Helfand BT, Andreev VP, et al. Biomarkers implicated in lower urinary tract symptoms: systematic review and pathway analyses. J Urol. 2019; 202:880-9. DOI: https://doi.org/10.1097/JU.0000000000000257
Hijazi RA, Cunningham GR. Andropause: is androgen replacement therapy indicated for the aging male? Annu Rev Med. 2005;56:117-37. DOI: https://doi.org/10.1146/annurev.med.56.082103.104518
Bhasin S, Buckwalter JG. Testosterone supplementation in older men: a rational idea whose time has not yet come. J Androl. 2001;22:718-31.
Roubenoff R, Hughes VA. Sarcopenia: current concepts. The journals of gerontology Series A, Biological sciences and medical sciences. 2000; 55:M716-24. DOI: https://doi.org/10.1093/gerona/55.12.M716
Dartigues JF, Le Bourdonnec K, Tabue-Teguo M, et al. Co-occurrence of geriatric syndromes and diseases in the general population: assessment of the dimensions of aging. J Nutr Health Aging. 2022;26:37-45. DOI: https://doi.org/10.1007/s12603-021-1722-3
Pyrgioti EE, Karakousis ND. B12 levels and frailty syndrome. J Frailty Sarcopenia Falls. 2022; 7:32-7. DOI: https://doi.org/10.22540/JFSF-07-032
Kostakopoulos NA, Karakousis ND. Frailty assessment and postoperative complications in urologic oncology operations. J Frailty Sarcopenia Falls. 2020; 5:57-61. DOI: https://doi.org/10.22540/JFSF-05-057
Pilotto A, Custodero C, Maggi S, et al. A multidimensional approach to frailty in older people. Ageing Res Rev. 2020; 60:101047. DOI: https://doi.org/10.1016/j.arr.2020.101047
Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. European Journal of Internal Medicine. 2016; 31:3-10. DOI: https://doi.org/10.1016/j.ejim.2016.03.007
Hackett GI. Testosterone replacement therapy and mortality in older men. Drug Saf. 2016; 39:117-30. DOI: https://doi.org/10.1007/s40264-015-0348-y
Tan RS, Salazar JA. Risks of testosterone replacement therapy in ageing men. Expert Opin Drug Saf. 2004;3:599-606. DOI: https://doi.org/10.1517/14740338.3.6.599
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