title: Lower urinary tract symptoms in patients with liver cirrhosis.
abstract: OBJECTIVE
  To evaluate the prevalence of lower urinary tract symptoms (LUTS) in men with liver cirrhosis.
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria, markus.margreiter@meduniwien.ac.at.
authors.forename: Markus
authors.initials: M
authors.lastname: Margreiter
authors.forename: Birgit B
authors.initials: BB
authors.lastname: Heinisch
authors.forename: Remy
authors.initials: R
authors.lastname: Schwarzer
authors.forename: Tobias
authors.initials: T
authors.lastname: Klatte
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Arnulf
authors.initials: A
authors.lastname: Ferlitsch
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D008111:Liver Function Tests; D059411:Lower Urinary Tract Symptoms / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D011388:Prolactin