Bunya Kawamoto

Impact of postoperative phosphodiesterase type 5 inhibitor treatment on lower urinary tract symptoms after robot-assisted radical prostatectomy: a longitudinal study

Abstract Objective: This study aimed to assess the role of tadalafil, a phosphodiesterase type 5 inhibitor (PDE5-I), in recovery of lower urinary tract symptoms (LUTS) after robot-assisted radical prostatectomy (RARP). Materials and methods: All patients treated with RARP between October 2010 and August 2013 were enrolled in this retrospective study on prospectively collected data. Patients were retrospectively divided into groups according to postoperative treatment: patients taking tadalafil twice weekly from 1 month to 6 months after RARP, and patients not taking tadalafil. The International Prostate Symptom Score (IPSS), the Overactive Bladder Symptom Score (OABSS) and urinary continence (UC) were assessed preoperatively (2 days before RARP) and at 1, 3, 6, 9 and 12 months after RARP. Results: There was no difference in the overall IPSS score between the groups. At 6 and 9 months, the IPSS storage symptom scores were significantly lower in patients taking tadalafil than in patients not taking tadalafil. In patients with overactive bladder (OAB) before RARP (n = 22), no differences in the total scores of OABSS were seen between patients taking tadalafil and patients not taking tadalafil. On the other hand, in non-OAB patients before RARP (n = 68), at 3, 6 and 9 months, the total scores of OABSS were significantly lower in patients taking tadalafil than in patients not taking tadalafil. No differences in UC rates after surgery were seen between the groups. Conclusion: Postoperative tadalafil treatment may be temporarily effective for the recovery of the IPSS storage symptom scores and OABSS.

Impact of antioxidants on seminal vesicles function and fertilizing potential in diabetic rats.

Diabetes mellitus significantly affects the male reproduction and sexual function. In the present study, we investigated the diabetes-induced dysfunction of seminal vesicles (SVs) in the diabetes-rat model and the role of antioxidants. Streptozotocin-induced diabetes after 4 weeks caused smaller size of the organs, hypercontractility, histological abnormalities, increased concentrations of malondialdehyde in the serum and tissue, overexpression of oxidative stress markers, and cleaved caspase-3 as identified by immunohistochemistry in the SVs. In addition, diabetes resulted in deceased levels of serum testosterone and no newborns after the mating studies. Antioxidants significantly normalized all the above parameters, except for the severely decreased serum testosterone levels and the negative outcome of the mating studies. The present study gives evidence for the important role of diabetes-induced oxidative stress in the function and structure of these androgen-dependent organs. Antioxidants may be a promising supplementary therapy for diabetic male patients to alleviate ejaculatory disorders but alone is not efficient treatment for the mitigation of infertility.

Comparison of the overactive bladder symptom score and the overactive bladder symptom score derived from the bladder diaries

The overactive bladder symptom score (OABSS) is a useful tool for assessing the four key symptoms of overactive bladder (OAB), but it sometimes misrepresents a patients actual voiding status. To examine whether the patient‐determined OABSS underestimates or overestimates the true status, its results were compared to those of the OABSS derived from a 7‐day bladder diary (OABSS‐BD).

Angiotensin II centrally induces frequent detrusor contractility of the bladder by acting on brain angiotensin II type 1 receptors in rats

Angiotensin (Ang) II plays an important role in the brain as a neurotransmitter and is involved in psychological stress reactions, for example through activation of the sympatho-adrenomedullary system. We investigated the effects of centrally administered Ang II on the micturition reflex, which is potentially affected by the sympatho-adrenomedullary system, and brain Ang II receptors in urethane-anesthetized (1.0 g/kg, intraperitoneally) male rats. Central administration of Ang II (0.01, 0.02, and 0.07 nmol per rat, intracerebroventricularly, icv) but not vehicle rapidly and dose-dependently decreased the urinary bladder intercontraction interval, without altering the bladder detrusor pressure. Central administration of antagonists of Ang II type 1 but not type 2 receptors inhibited the Ang II-induced shortening of intercontraction intervals. Administration of the highest dose of Ang II (0.07 nmol per rat, icv) but not lower doses (0.01 and 0.02 nmol per rat, icv) elevated the plasma concentration of adrenaline. Bilateral adrenalectomy reduced Ang II-induced elevation in adrenaline, but had no effect on the Ang II-induced shortening of the intercontraction interval. These data suggest that central administration of Ang II increases urinary frequency by acting on brain Ang II type 1 receptors, independent of activation of the sympatho-adrenomedullary system.

Botulinum toxin type A injection for neurogenic detrusor overactivity: clinical outcome in Japanese patients.

To report our experience with intravesical injection of botulinum toxin type A into the detrusor muscle of patients with neurogenic detrusor overactivity secondary to suprasacral spinal cord lesions or multiple sclerosis.

MP94-08 GROUP III METABOTROPIC GLUTAMATE RECEPTOR-MEDIATED REGULATION OF MICTURITION REFLEX IN URETHANE-ANESTHETIZED RATS

analysis BMI (OR: 1.28 per unit, 95%CI: 1.04-1.58; p 1⁄4 0.019) and severe nocturia (6.26, 95%CI: 1.71-22.92, p 1⁄4 0.006) were independent predictive factors for NP, while only severe nocturia (3.77, 95%CI: 1.2011.83, p 1⁄4 0.023) was an independent predictive factor for a reduced BC. CONCLUSIONS: Patients with NP presented a different BC between day-time and night-time. Severe nocturia ( 3 episodes per night) predicts the presence of NP and a reduced BC. Our data suggest that in patients with severe nocturia both conditions should be considered and managed.

MP97-18 LONGITUDINAL HEALTH-RELATED QUALITY OF LIFE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

The IH recurrence rate was lower in the IPOM group by a clinically relevant but not statistically significant difference (4% vs. 9%; p1⁄40.58) CONCLUSIONS: In patients undergoing RALP and IH repair, IPOM repair is feasible, and may be associated with better perioperative outcomes and safety profile than suture repair. The effectiveness of IPOM repair was superior but not significantly. A prospective comparison against the gold-standard technique is warranted.

MP07-15 ALTERATIONS IN OXIDATIVE STRESS PARAMETERS IN THE TESTIS AND EPIDIDYMIS IN A NICOTINE-EXPOSED RAT MODEL. CAN NICOTINE-ABSTINENCE OVERCOME THE OXIDATIVE DAMAGE?

INTRODUCTION AND OBJECTIVES: Voltage-dependent anion channel (VDAC), a channel protein, exists in the outer mitochondrial membrane of somatic cells and is involved in multiple physiological and pathophysiological processes. Up until now, little has been known about VDAC in male germ cells. In the present study, the relationship between VDAC and human sperm motility was explored. METHODS: Highly motile human spermatozoa were incubated in vitro with anti-VDAC antibody. Total sperm motility, straight line velocity (VSL), curvilinear velocity (VCL), and average path velocity (VAP) were recorded. Intracellular free calcium concentration ([Ca2þ]i), pH value (pHi), and ATP content were determined. RESULTS: Co-incubation with anti-VDAC antibody reduced VSL, VCL, and VAP of spermatozoa. Co-incubation further reduced [Ca2þ]i. Anti-VDAC antibody did not significantly alter total sperm motility, pHi and intracellular ATP content. CONCLUSIONS: The data suggest that co-incubation with antiVDAC antibody reduces sperm motility through inhibition of Ca2þ transmembrane flow. In this way, VDAC participates in the modulation of human sperm motility through mediating Ca2þ transmembrane transport and exchange.

MP94-16 OXIDATIVE STRESS-RELATED ALTERATIONS IN THE BLADDER OF A SHORT-PERIOD DIABETES TYPE-2 RAT MODEL

INTRODUCTION AND OBJECTIVES: Bladder smooth muscle (BSM) caveolae are cholesterol-enriched membrane microdomains that augment or attenuate detrusor functional responses by differentially regulating specific receptor-activated signaling pathways. However, BSM contractions induced by cholinergic activation in the rat are not altered by depletion of caveolae, unlike other smooth muscle systems in which muscarinic receptor signaling is evidently mediated by caveolae. Although this discrepancy may reflect the highly specific regulation imparted by caveolae among different tissues and species, a differential regulation of muscarinic M3 and M2 receptor subtypes in the bladder cannot be excluded. This study examined the functional and molecular relationship between caveolae and muscarinic acetylcholine receptor (mAChR) subtypes M3 and M2. METHODS: BSM tissue strips were prepared from Sprague Dawley rat bladders after removing the mucosa. Tissue was suspended in organ baths for isometric tension studies. Dose response curves to carbachol (CCh, 1nM-10mM) were generated at baseline, as well as in the presence of 4-DAMP (10nM) or AFDX (0.1mM) to inactive M3 or M2 receptors respectively. Responses to CCh were repeated after incubation with methyl-b-cyclodextrin (mbCD, 15mM), an agent that disrupts caveolae by depleting membrane cholesterol. Interaction between caveolin-1 (Cav-1, a protein required for caveolae biogenesis) and M3 or M2 mAChR subtype were investigated by co-immunoprecipitation. RESULTS: Compared to baseline responses, 4-DAMP decreased CCh-induced contractions at each dose. After mbCD treatment and in the presence of 4-DAMP, contractile responses to CCh were significantly enhanced. AFDX had little effect on CCh doseresponse curves. However, the subsequent disruption of caveolae in the presence of AFDX attenuated significantly contractions induced by CCh. Immunoreactive bands corresponding to M3 and M2 mAChR subtypes were detected in Cav-1 immunoprecipitates. CONCLUSIONS: The opposite effect of mbCD on CCh responses in the presence of M2 or M3 antagonists suggests that caveolae negatively regulate M2and positively regulate M3-mediated signaling respectively, but this interaction is masked when only the aggregate effect of CCh is examined. Molecular interaction of Cav-1 and mAChRs is consistent with their localization within caveolae. Changes in the balance among caveolin-mAChR interactions, due to loss of caveolae or changes in mAChR subtype expression, may alter responses to cholinergic activation or the efficacy of anti-muscarinic agents in the bladder.

A prognostic model for predicting urinary incontinence after robot‐assisted radical prostatectomy

The aim of this study is to develop a novel prognostic model for estimating the risk of postoperative urinary incontinence (UI) after robot‐assisted radical prostatectomy (RARP).