title: The correlation between the treatment efficacy and the sympathetic activity in men with lower urinary tract symptoms.
abstract: OBJECTIVE
  In this study, we examined the difference in the treatment efficacy depending on the sympathetic activity in men with lower urinary tract symptoms (LUTS).
  
  
  METHODS
  In the current single-center, retrospective study, we evaluated a total of 66 male patients aged 40-70 years of age, presenting with LUTS, whose International Prostate Symptom Score (IPSS) exceeded 8 points. They had a past 3-month history of taking alfuzosin XL, and their heart rate variability (HRV) was measured before and after the treatment. In addition, we also recruited 39 healthy volunteers who visited a health promotion center for a regular medical check-up. They were aged between 40 and 70 years and had an IPSS of <8 points. We divided the patients with LUTS into two groups: the groups A and B, based on a low frequency/high frequency (LF/HF) ratio of 1.7, which was the mean value of the LF/HF ratio in the healthy volunteers. After a 3-month treatment with alfuzosin XL, we compared treatment outcomes, based on the IPSS and peak urine flow rate, between the two groups.
  
  
  RESULTS
  A 3-month treatment with alfuzosin XL, comprising the measurement of the HRV, was performed for the 23 patients of the group A (23/38) and 17 of the group B (17/28). After a 3-month treatment with alfuzosin XL, total IPSS and IPSS questionnaire 2 and 5 were significantly lower in the group A as compared with the group B. But this was not seen in the group B. Furthermore, there were no significant differences in other parameters, such as maximal flow rate and IPSS storage subscore, between the two groups.
  
  
  CONCLUSIONS
  Our results indicate that the treatment efficacy was lower in patients with sympathetic hyperactivity as compared with those with sympathetic hypoactivity. Thus, our results will provide a basis for further studies to clarify causes of LUTS in a clinical setting.
authors.affiliation: Department of Urology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Hyun Ik
authors.initials: HI
authors.lastname: Jang
authors.affiliation: Department of Urology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Sung Gon
authors.initials: SG
authors.lastname: Park
authors.affiliation: Department of Urology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kang Hee
authors.initials: KH
authors.lastname: Shim
authors.affiliation: Department of Urology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jong Bo
authors.initials: JB
authors.lastname: Choi
authors.affiliation: Department of Urology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Korea.
authors.forename: Dae Sung
authors.initials: DS
authors.lastname: Cho
keywords: Autonomic nervous system; Heart rate; Lower urinary tract symptoms