The difference of lower urinary tract symptoms between sympathetic hyperactive and hypoactive men

Area of Science:

• Urology
• Autonomic Nervous System Research
• Cardiology

Background:

• Heart rate variability (HRV) assesses autonomic nervous function.
• Its role in defining sympathetic hyperactivity in men with lower urinary tract symptoms (LUTS) is not established.
• Autonomic nervous system imbalances may contribute to LUTS.

Purpose of the Study:

• To investigate the relationship between HRV and LUTS.
• To determine if LUTS patients can be categorized into sympathetic hyperactive and hypoactive groups based on HRV.
• To compare clinical characteristics between these LUTS groups.

Main Methods:

• 43 men with symptomatic LUTS (International Prostate Symptom Score [IPSS] > 8) and 49 controls were studied.
• Electrocardiographic signals were recorded, and HRV indexes were calculated using spectral analysis.
• LUTS patients were divided into sympathetic hyperactive/hypoactive groups using the low frequency/high frequency (LF/HF) ratio (median value of 1.9 from controls).

Main Results:

• No significant differences in age, prostate-specific antigen (PSA), or prostate volume were found between LUTS groups.
• Significant differences were observed in the International Prostate Symptom Score (IPSS) questionnaires.
• Specifically, LUTS patients with sympathetic hypoactivity reported higher scores for urinary frequency (Q2) and storage symptoms ([Q2+Q4+Q7]/3).

Conclusions:

• Autonomic nervous system imbalance, indicated by HRV, may contribute to varied LUTS.
• Men with LUTS and sympathetic hypoactivity appear more prone to urinary frequency and storage symptoms.
• HRV analysis could offer insights into the pathophysiology of LUTS.