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MP86-11 PROSPECTIVE ASSESSMENT OF PSYCHOLOGICAL SYMPTOMS IN MEN WITH LATE-ONSET HYPOGONADISM WHO RECEIVED TESTOSTERONE REPLACEMENT THERAPY
THE JOURNAL OF UROLOGYâ
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validation of FLOW vs AUA-SS, and perform a critical analysis of the AUA-SS via validated literacy and numeracy scales. METHODS: A total of 161 men were recruited from clinics at Nashville General Hospital, a safety net hospital in Nashville, TN. We collected demographic data and assessed literacy/numeracy using validated tools: the revised Rapid Estimate of Adult Literacy in Medicine (REALM-R), the Brief Health Literacy Screen (BHLS), and the Subjective Numeracy Scale (SNS). Patients were administered the FLOW questionnaire and the AUA-SS. We evaluated the completion rates, completion times, and whether or not patients required assistance to complete either questionnaire. RESULTS: Median age was 56 years, 99 men (61.5%) identified as Black/African American, and the median REALM-R score was six. There was a significant correlation between FLOW scores and AUA-SS (r¼0.63, p<0.001). Among men with adequate health literacy (REALM-R 6-8; n ¼87), all were able to complete the FLOW and AUASS; however, among men with low literacy (REALM-R <6; n ¼74) all were able to complete the FLOW but only 81% were able to complete the AUA-SS (p<0.001). For the FLOW, health literacy was unrelated to median completion time (21.5 sec), the median number of prompts needed (0), or median score (2). For the AUA-SS, although the median number of prompts needed to complete the questionnaire (2) and median AUA-SS score (10.5) did not differ as a function of the men’s health literacy, men with low health literacy who completed it had a median completion time of 129.5 seconds compared to 92 seconds for those with adequate health literacy (p<0.001). CONCLUSIONS: The FLOW questionnaire meets criterion validity due to its strong, significant correlation with the AUA-SS for those who were able to complete both measures. However, a critical analysis of the AUA-SS utilizing valid health literacy and numeracy scales reveals the AUA-SS is frequently not completed, required prompting, and/or took longer to complete for men with low health literacy. Further studies of the FLOW questionnaire in a larger cohort in diverse clinical settings are needed. Source of Funding: Vanderbilt CTSA grant UL1 TR000445 from NCATS/NIH
MP86-10 RELATIONSHIP BETWEEN OVERACTIVE BLADDER AND METABOLIC SYNDROME: A CROSS-SECTIONAL STUDY AMONG JAPANESE MEN AND WOMEN. Yoshitaka Aoki*, Chieko Matsumoto, Yosuke Matsuta, Hideaki Ito, Yukinori Kusaka, Osamu Yokoyama, Fukui, Japan INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) has been implicated in the aetiology of lower urinary symptoms and a few previous epidemiological studies have suggested a relationship between MetS and overactive bladder (OAB) in women. We thus aimed to evaluate the relationship between OAB and MetS or components of MetS among Japanese men and women. METHODS: We collected data on 12,478 individuals (5,313 males and 7,165 females) who participated in a multiphasic health screening in 2015, in Fukui, Japan. As part of a multiphasic health screening, waist circumference, blood pressure, fasting blood sugar, triglycerides and HDL-cholesterol were measured. All participants were asked to answer a standardized self-reported questionnaire for OAB screening (SQOAB, Screening Questionnaire for Overactive Bladder) [Int J Urol, 2009].We analyzed the relationships between OAB and other variables including age, gender, waist circumference, high blood pressure, impaired glucose tolerance, and dyslipidemia. The relationships between OAB and MetS were also analyzed. MetS in the Japanese criteria was diagnosed in individuals who had a high waist circumference ( 85 cm in men and 90 cm in women) plus any 2 of the following: (a) high blood pressure (systolic blood pressure 130/85 mmHg and/or current use of antihypertensive medicine); (b) impaired glucose tolerance (fasting glucose concentration 110 mg/dL and/or
Vol. 197, No. 4S, Supplement, Monday, May 15, 2017
current use of antidiabetic medication); and (c) dyslipidemia (triglyceride concentration 150 mg/dL and/or HDL-cholesterol level < 40 mg/dL). The chi-square test and logistic regression modeling were used for statistical analyses. Values of p<0.05 were considered statistically significant. RESULTS: The median age of participants was 69 (18-95) years. The overall prevalence of OAB and MetS were 13.5% (11.2% for men and 15.2% for women) and 15.2% (24.5% for men and 8.2% for women), respectively. The prevalence was higher in older age groups. A significant association was found between OAB and MetS The ageadjusted odds ratio (95% CI) were 1.22 (1.06-1.39) for men and 1.49 (1.21-1.83) for women, respectively. We also analyzed the relationships between OAB and the number of components of MetS. In the multivariate analysis, a significant association was found between OAB and the following: age (odds ratio ¼ 1.05) and high waist circumference (1.24) for men, and, age (1.04) , high waist circumference (1.42) and hyperglycemia (1.17) for women. CONCLUSIONS: Our study confirmed the relationship between OAB and MetS in both men and women. These findings suggest that OAB is a facet of the MetS. Source of Funding: JSPS KAKENHI
MP86-11 PROSPECTIVE ASSESSMENT OF PSYCHOLOGICAL SYMPTOMS IN MEN WITH LATE-ONSET HYPOGONADISM WHO RECEIVED TESTOSTERONE REPLACEMENT THERAPY Kenta Sumii*, Mikito Tanaka, Takaki Ishida, Noritoshi Enatsu, Koji Chiba, Kei Matsushita, Masato Fujisawa, Kobe, Japan INTRODUCTION AND OBJECTIVES: The objective of this study was to characterize the status of psychological symptoms in Japanese men with late-onset hypogonadism (LOH) treated with testosterone replacement therapy (TRT). METHODS: The psychological symptoms in 100 consecutive Japanese men with LOH undergoing TRT for at least 6 months were prospectively evaluated before and 6 months after the initiation of TRT using several written questionnaires, including Mini International Neuropsychiatric Interview (M.I.N.I.), Self-rating Depression Scale (SDS), Aging Male Symptom (AMS) score and the Medical Outcomes Study 8-items Short-Form health survey (SF-8). RESULTS: In these 100 patients, 69 men consulted our outpatient clinic with a chief complaint of psychological symptoms, such as depressed mood, lack of motivation, anxiety and irritation. The other 31 men were with a chief complaint of physiological or sexual symptoms. Before the introduction of TRT, 62 patients were diagnosed as being complicated with depression by M.I.N.I.. Although there were not significant correlations between serum testosterone level and all evaluated psychological questionnaires scores, including SDS, mind domain of AMS and mental component summary of SF-8, before the initiation of TRT, all these scores at 6 months after TRT significantly improved compared with those before TRT in these 100 patients. When divided these 100 men into 2 groups, with and without depression, there was no significant difference in serum testosterone level between these 2 groups before TRT. The psychological symptoms assessed by several questionnaires in this study were significantly severe in men with depression compared with men without depression. However, all evaluated psychological questionnaires scores at 6 months after TRT significantly improved compared with those before TRT even in men with depression. CONCLUSIONS: TRT appeared to significantly improve the status of psychological symptoms in men with LOH, regardless of a complication of depression. Source of Funding: none
e1160
validation of FLOW vs AUA-SS, and perform a critical analysis of the AUA-SS via validated literacy and numeracy scales. METHODS: A total of 161 men were recruited from clinics at Nashville General Hospital, a safety net hospital in Nashville, TN. We collected demographic data and assessed literacy/numeracy using validated tools: the revised Rapid Estimate of Adult Literacy in Medicine (REALM-R), the Brief Health Literacy Screen (BHLS), and the Subjective Numeracy Scale (SNS). Patients were administered the FLOW questionnaire and the AUA-SS. We evaluated the completion rates, completion times, and whether or not patients required assistance to complete either questionnaire. RESULTS: Median age was 56 years, 99 men (61.5%) identified as Black/African American, and the median REALM-R score was six. There was a significant correlation between FLOW scores and AUA-SS (r¼0.63, p<0.001). Among men with adequate health literacy (REALM-R 6-8; n ¼87), all were able to complete the FLOW and AUASS; however, among men with low literacy (REALM-R <6; n ¼74) all were able to complete the FLOW but only 81% were able to complete the AUA-SS (p<0.001). For the FLOW, health literacy was unrelated to median completion time (21.5 sec), the median number of prompts needed (0), or median score (2). For the AUA-SS, although the median number of prompts needed to complete the questionnaire (2) and median AUA-SS score (10.5) did not differ as a function of the men’s health literacy, men with low health literacy who completed it had a median completion time of 129.5 seconds compared to 92 seconds for those with adequate health literacy (p<0.001). CONCLUSIONS: The FLOW questionnaire meets criterion validity due to its strong, significant correlation with the AUA-SS for those who were able to complete both measures. However, a critical analysis of the AUA-SS utilizing valid health literacy and numeracy scales reveals the AUA-SS is frequently not completed, required prompting, and/or took longer to complete for men with low health literacy. Further studies of the FLOW questionnaire in a larger cohort in diverse clinical settings are needed. Source of Funding: Vanderbilt CTSA grant UL1 TR000445 from NCATS/NIH
MP86-10 RELATIONSHIP BETWEEN OVERACTIVE BLADDER AND METABOLIC SYNDROME: A CROSS-SECTIONAL STUDY AMONG JAPANESE MEN AND WOMEN. Yoshitaka Aoki*, Chieko Matsumoto, Yosuke Matsuta, Hideaki Ito, Yukinori Kusaka, Osamu Yokoyama, Fukui, Japan INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) has been implicated in the aetiology of lower urinary symptoms and a few previous epidemiological studies have suggested a relationship between MetS and overactive bladder (OAB) in women. We thus aimed to evaluate the relationship between OAB and MetS or components of MetS among Japanese men and women. METHODS: We collected data on 12,478 individuals (5,313 males and 7,165 females) who participated in a multiphasic health screening in 2015, in Fukui, Japan. As part of a multiphasic health screening, waist circumference, blood pressure, fasting blood sugar, triglycerides and HDL-cholesterol were measured. All participants were asked to answer a standardized self-reported questionnaire for OAB screening (SQOAB, Screening Questionnaire for Overactive Bladder) [Int J Urol, 2009].We analyzed the relationships between OAB and other variables including age, gender, waist circumference, high blood pressure, impaired glucose tolerance, and dyslipidemia. The relationships between OAB and MetS were also analyzed. MetS in the Japanese criteria was diagnosed in individuals who had a high waist circumference ( 85 cm in men and 90 cm in women) plus any 2 of the following: (a) high blood pressure (systolic blood pressure 130/85 mmHg and/or current use of antihypertensive medicine); (b) impaired glucose tolerance (fasting glucose concentration 110 mg/dL and/or
Vol. 197, No. 4S, Supplement, Monday, May 15, 2017
current use of antidiabetic medication); and (c) dyslipidemia (triglyceride concentration 150 mg/dL and/or HDL-cholesterol level < 40 mg/dL). The chi-square test and logistic regression modeling were used for statistical analyses. Values of p<0.05 were considered statistically significant. RESULTS: The median age of participants was 69 (18-95) years. The overall prevalence of OAB and MetS were 13.5% (11.2% for men and 15.2% for women) and 15.2% (24.5% for men and 8.2% for women), respectively. The prevalence was higher in older age groups. A significant association was found between OAB and MetS The ageadjusted odds ratio (95% CI) were 1.22 (1.06-1.39) for men and 1.49 (1.21-1.83) for women, respectively. We also analyzed the relationships between OAB and the number of components of MetS. In the multivariate analysis, a significant association was found between OAB and the following: age (odds ratio ¼ 1.05) and high waist circumference (1.24) for men, and, age (1.04) , high waist circumference (1.42) and hyperglycemia (1.17) for women. CONCLUSIONS: Our study confirmed the relationship between OAB and MetS in both men and women. These findings suggest that OAB is a facet of the MetS. Source of Funding: JSPS KAKENHI
MP86-11 PROSPECTIVE ASSESSMENT OF PSYCHOLOGICAL SYMPTOMS IN MEN WITH LATE-ONSET HYPOGONADISM WHO RECEIVED TESTOSTERONE REPLACEMENT THERAPY Kenta Sumii*, Mikito Tanaka, Takaki Ishida, Noritoshi Enatsu, Koji Chiba, Kei Matsushita, Masato Fujisawa, Kobe, Japan INTRODUCTION AND OBJECTIVES: The objective of this study was to characterize the status of psychological symptoms in Japanese men with late-onset hypogonadism (LOH) treated with testosterone replacement therapy (TRT). METHODS: The psychological symptoms in 100 consecutive Japanese men with LOH undergoing TRT for at least 6 months were prospectively evaluated before and 6 months after the initiation of TRT using several written questionnaires, including Mini International Neuropsychiatric Interview (M.I.N.I.), Self-rating Depression Scale (SDS), Aging Male Symptom (AMS) score and the Medical Outcomes Study 8-items Short-Form health survey (SF-8). RESULTS: In these 100 patients, 69 men consulted our outpatient clinic with a chief complaint of psychological symptoms, such as depressed mood, lack of motivation, anxiety and irritation. The other 31 men were with a chief complaint of physiological or sexual symptoms. Before the introduction of TRT, 62 patients were diagnosed as being complicated with depression by M.I.N.I.. Although there were not significant correlations between serum testosterone level and all evaluated psychological questionnaires scores, including SDS, mind domain of AMS and mental component summary of SF-8, before the initiation of TRT, all these scores at 6 months after TRT significantly improved compared with those before TRT in these 100 patients. When divided these 100 men into 2 groups, with and without depression, there was no significant difference in serum testosterone level between these 2 groups before TRT. The psychological symptoms assessed by several questionnaires in this study were significantly severe in men with depression compared with men without depression. However, all evaluated psychological questionnaires scores at 6 months after TRT significantly improved compared with those before TRT even in men with depression. CONCLUSIONS: TRT appeared to significantly improve the status of psychological symptoms in men with LOH, regardless of a complication of depression. Source of Funding: none