Screening tool for sarcopenia (SARC-F) predicts unsatisfactory medical treatment of lower urinary tract symptoms in elderly men aged 75 years or older: a preliminary observational study

Int Urol Nephrol. 2024 Oct 17. doi: 10.1007/s11255-024-04233-z. Online ahead of print.

Abstract

We investigated the influence of sarcopenia on treatment outcomes in elderly patients receiving medical therapy for lower urinary tract symptoms (LUTS). We included male patients with LUTS aged ≥ 75 years who had not changed their medication for 1 year. Current conditions were estimated using IPSS, overactive bladder symptoms score (OABSS), and screening tool for sarcopenia (SARC-F). We also evaluated prostatic volume (PV), serum testosterone level, grip strength, and nutrition status. SARC-F score of ≧4 was defined as sarcopenia. We included 59 patients in this study, including 16 patients (27.1%) with sarcopenia. The mean grip strength was significantly lower in the sarcopenia group than the non-sarcopenia group (25.5 vs. 30 kg, p < 0.01). IPSS total score, voiding symptom score of IPSS, and IPSS-QOL were significantly higher in the sarcopenia group than the non-sarcopenia group. The non-sarcopenia group had significantly larger PV (40 vs. 20 ml, p < 0.01) and higher testosterone levels (497.5 vs. 369 ng/ml, p = 0.03) compared with the sarcopenia group, whereas the percentage of patients taking dutasteride tended to be higher in the non-sarcopenia group than the sarcopenia group (58.1% vs. 31.3%, p = 0.07). Moderate and severe LUTS (IPSS total ≥ 8) persisted in 34 patients (57.6%) after medical treatment. Multivariate analysis showed that only SARC-F was a significant factor affecting the IPSS total ≥ 8 despite medical treatment for 1 year (OR 1.67, 95%CI: 1.13-2.46, p = 0.01). Sarcopenia defined by using SARC-F is a significant factor for unsatisfactory medical treatment of LUTS in elderly men aged ≥ 75 years.

Keywords: Elderly; Lower urinary tract symptoms; Male; SARC-F sarcopenia.