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1

Benign prostate hyperplasia (BPH) - resources  

MedlinePLUS

Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... following organizations provide information on benign prostatic hyperplasia ( prostate enlargement ): National Kidney and Urologic Diseases Information Clearinghouse - ...

2

Prostate: Benign Prostatic Hyperplasia (BPH)  

MedlinePLUS

... prostatic hyperplasia (BPH)? As a man ages, his prostate gland commonly becomes enlarged. This condition is known ... especially at night. This condition develops as the prostate enlarges and presses against the urethra, causing it ...

3

BPH: Minimally Invasive Management (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... sit amet, consectetur adipiscing elit. BPH: Minimally Invasive Management (Benign Prostatic Hyperplasia/Enlarged Prostate) Throughout a man's ... BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate) BPH: Management (Benign Prostatic Hyperplasia/Enlarged Prostate) BPH: Medical Management ( ...

4

BPH: Medical Management (Benign Prostatic Hyperplasia /Enlarged Prostate)  

MedlinePLUS

... dolor sit amet, consectetur adipiscing elit. BPH: Medical Management (Benign Prostatic Hyperplasia /Enlarged Prostate) Throughout a man's ... can I get more information? BPH: Diagnosis BPH: Management BPH: Minimally Invasive Management BPH: Surgical Management Benign ...

5

Prostate Enlargement: Benign Prostatic Hyperplasia (BPH)  

MedlinePLUS

... Topics and Titles : Prostate Enlargement: Benign Prostatic Hyperplasia Prostate Enlargement: Benign Prostatic Hyperplasia On this page: The ... Needed? Hope through Research Additional Reading Glossary The Prostate Gland The prostate is a walnut-sized gland ...

6

Benign Prostatic Hyperplasia (BPH), or Enlarged Prostate: Questions to Discuss with Your Doctor  

MedlinePLUS

... contact us Benign Prostatic Hyperplasia (BPH), or Enlarged Prostate Questions to Discuss With Your Doctor: Over the ... infections? Have you ever had surgery on your prostate, bladder, or kidneys? Do you have gastrointestinal problems ...

7

Role of laser therapy in benign prostate hyperplasia (BPH)  

NASA Astrophysics Data System (ADS)

Benign prostatic hyperplasia (BPH) is a common disease in males older than 50 years of age. 75-80% of this population is considered to have some degree of BPH causing clinical symptoms and requiring urological treatment. Transurethral resection of the prostate (TUR-P) is currently the standard surgical treatment modality for BPH. In an attempt to minimize the need for hospitalization and the associated perioperative and postoperative morbidity, alternatives have been sought. Various types of laser techniques such as interstitial laser coagulation and side-firing technology have been proposed. Numerous studies have shown that laser procedures safely and effectively reduce the volume of the prostate. Intra- and postoperative bleeding are nearly unknown complications for laser procedures, whereas this is the most relevant complication for the TUR-P. Due to significant tissue edema after laser treatment, patients commonly show delayed time to void adequately and, therefore, catheter drainage is often necessary for 3 to 21 days. Retrograde ejaculation is reported to occur less (0- 10%) compared to TUR-P (greater than 60%). Urinary tract infections are very common after interstitial laser coagulation. Although not many long-term clinical data are available, various studies have shown that BPH patients improve in symptom score, flow rate and post-void residual up to 3 years after laser treatment. This paper presents a concise review of efficacy, advantages and disadvantages of the most frequently used laser techniques as well as the long-term clinical data compared to TUR-P.

de Riese, Werner T.; Sharpe, Brent A.; Aronoff, David B.; Mittemeyer, Bernhard T.

2001-05-01

8

BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... common urological condition caused by the non-cancerous enlargement of the prostate gland in aging men. As ... surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate or obstruct ...

9

BPH: Surgical Management (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... that are similar in form and function. transfusion: Transfer of whole blood, blood components or bone marrow ... ablation. Destroys excess prostate tissue with electromagnetically generated heat by using a needle-like device in the ...

10

Targeting Androgen Receptor to Suppress Macrophage-induced EMT and Benign Prostatic Hyperplasia (BPH) Development  

PubMed Central

Early studies suggested macrophages might play roles in inflammation-associated benign prostatic hyperplasia (BPH) development, yet the underlying mechanisms remain unclear. Here we first showed that CD68+ macrophages were identified in both epithelium and the stromal area of human BPH tissues. We then established an in vitro co-culture model with prostate epithelial and macrophage cell lines to study the potential impacts of infiltrating macrophages in the BPH development and found that co-culturing prostate epithelial cells with macrophages promoted migration of macrophages. In a three-dimensional culture system, the sphere diameter of BPH-1 prostate cells was significantly increased during coculture with THP-1 macrophage cells. Mechanism dissection suggested that expression levels of epithelial-mesenchymal transition (EMT) markers, such as N-cadherin, Snail, and TGF-?2, were increased, and administration of anti-TGF-?2 neutralizing antibody during co-culture suppressed the EMT and THP-1-mediated growth of BPH-1 cells, suggesting THP-1 might go through EMT to influence the BPH development and progression. Importantly, we found that modulation of androgen receptor (AR) in BPH-1 and mPrE cells significantly increased THP-1 and RAW264.7 cell migration, respectively, and enhanced expression levels of EMT markers, suggesting that AR in prostate epithelial cells might play a role in promoting macrophage-mediated EMT in prostate epithelial cells. Silencing AR function via an AR degradation enhancer, ASC-J9, decreased the macrophage migration to BPH-1 cells and suppressed EMT marker expression. Together, these results provide the first evidence to demonstrate that prostate epithelial AR function is important for macrophage-mediated EMT and proliferation of prostate epithelial cells, which represents a previously unrecognized role of AR in the cross-talk between macrophages and prostate epithelial cells. These results may provide new insights for a new therapeutic approach to battle BPH via targeting AR and AR-mediated inflammatory signaling pathways.

Lu, Tianjing; Lin, Wen-Jye; Izumi, Kouji; Wang, Xiaohai; Xu, Defeng; Fang, Lei-Ya; Li, Lei; Jiang, Qi

2012-01-01

11

Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).  

PubMed

Sexuality is an essential aspect of a couple's relationship and has a significant impact on life satisfaction. Benign prostatic hyperplasia (BPH) is a condition that commonly affects older men and is often associated with lower urinary tract symptoms (LUTS) and sexual dysfunction. Men with moderate-to-severe LUTS are at increased risk for sexual dysfunction, including moderate-to-severe erectile dysfunction (ED), ejaculatory dysfunction (EjD), and hypoactive desire (HD). The results of several recent large-scale studies have shown a consistent and strong relationship between LUTS and both ED and EjD. It appears that the pathophysiological mechanisms of LUTS and the related prostatic enlargement of BPH as well as certain treatments for this condition may have an impact on both the erection and ejaculation components of the sexual response. Validated questionnaires that assess sexual function provide clinicians with valuable information to help guide treatment selection decisions. Effective medical therapies for LUTS associated with BPH include alpha(1)-adrenergic receptor antagonists (i.e., alfuzosin, doxazosin, tamsulosin, and terazosin) and 5alpha-reductase inhibitors (i.e., finasteride and dutasteride). The side effects of these medications, including sexual dysfunction, are important distinguishing features. The successful management of patients with LUTS associated with BPH should include assessments of sexual function and monitoring of medication-related sexual side effects. For men with LUTS and sexual dysfunction, an appropriate integrated management approach, based on each patient's symptoms and outcome objectives, is warranted. PMID:15925080

Rosen, Raymond C; Giuliano, Francois; Carson, Culley C

2005-06-01

12

Novel drug targets for the pharmacotherapy of benign prostatic hyperplasia (BPH)  

PubMed Central

Benign prostatic hyperplasia (BPH) is the major cause of lower urinary tract symptoms in men aged 50 or older. Symptoms are not normally life threatening, but often drastically affect the quality of life. The number of men seeking treatment for BPH is expected to grow in the next few years as a result of the ageing male population. Estimates of annual pharmaceutical sales of BPH therapies range from $US 3 to 10 billion, yet this market is dominated by two drug classes. Current drugs are only effective in treating mild to moderate symptoms, yet despite this, no emerging contenders appear to be on the horizon. This is remarkable given the increasing number of patients with severe symptoms who are required to undergo invasive and unpleasant surgery. This review provides a brief background on prostate function and the pathophysiology of BPH, followed by a brief description of BPH epidemiology, the burden it places on society, and the current surgical and pharmaceutical therapies. The recent literature on emerging contenders to current therapies and novel drug targets is then reviewed, focusing on drug targets which are able to relax prostatic smooth muscle in a similar way to the ?1-adrenoceptor antagonists, as this appears to be the most effective mechanism of action. Other mechanisms which may be of benefit are also discussed. It is concluded that recent basic research has revealed a number of novel drug targets such as muscarinic receptor or P2X-purinoceptor antagonists, which have the potential to produce more effective and safer drug treatments.

Ventura, S; Oliver, VL; White, CW; Xie, JH; Haynes, JM; Exintaris, B

2011-01-01

13

Urinary Tract Symptoms (LUTS) Secondary to Benign Prostatic Hyperplasia (BPH) and LUTS/BPH with Erectile Dysfunction in Asian Men: A Systematic Review Focusing on Tadalafil  

PubMed Central

This review assesses lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with or without erectile dysfunction (ED) and related therapies focusing on tadalafil. A literature search was obtained and reviewed for the epidemiology, treatment therapies, pathophysiology, and efficacy and safety of phosphodiesterase type 5 inhibitor (PDE5i) tadalafil in patients with LUTS/BPH. Approximately 42% of men aged 51 to 60 years have BPH. Approximately 90% of men aged 45 to 80 years have LUTS. Occurrence of LUTS increases with age for almost all racial/ethnic groups (range, 32% to 56%) with prevalence of LUTS highest among Hispanic men, then Blacks, Caucasians, and Asians. There is an independent relationship with LUTS/BPH and ED, with approximately 70% of men with LUTS/BPH having ED with severity of one disease often correlating with the other. The European Urological Association guidelines include the use of the PDE5i tadalafil. Tadalafil is the only therapy recommended for treatment of co-existing BPH and ED, while other therapies have unwanted ED side effects. The mode of action of tadalafil may involve different areas of the lower urinary tract such as smooth muscle cell relaxation in the bladder neck, prostate, and urethra, but there may also be resulting modulation of the afferent nerve activity. Tadalafil (5 mg) in Asian men with LUTS/BPH, similar to global studies, is efficacious and safe. Tadalafil (5 mg) improves co-existing LUTS/BPH and ED, independently. Men with LUTS/BPH likely also have ED. Asian men with LUTS/BPH have similar incidence rates, co-existing ED, comorbid diseases, and risks as non-Asian men. Tadalafil can improve co-existing LUTS/BPH and ED.

Park, Hyun Jun; Won, Ji Eon Joanne; Sorsaburu, Sebastian; Rivera, Paul David

2013-01-01

14

Prostatic ischemia induces ventral prostatic hyperplasia in the SHR; possible mechanism of development of BPH  

PubMed Central

In the light of increasing evidence that benign prostatic hyperplasia is associated with cardiovascular disease, we have investigated the relationship between prostatic blood flow and prostatic hyperplasia in the spontaneously-hypertensive-rat (SHR). Twelve-week-old male SHRs were treated with nicorandil for six weeks. Wistar-Kyoto rats were used as controls. Six weeks after nicorandil treatment, blood pressure and the prostatic blood flow were estimated, and tissue levels of malondialdehyde, HIF-1?, TGF-?1, bFGF, dihydrotestosterone, and ?-SMA were measured. SHRs showed significant increases in blood pressure, tissue levels of malondialdehyde, HIF-1?, TGF-?1, bFGF, ?-SMA and a significant decrease in the prostatic blood flow. Although treatment with nicorandil failed to alter the blood-pressure and ?-SMA, it significantly ameliorated the increased levels of malondialdehyde, HIF-1?, TGF-?1, and bFGF. There were no significant differences in tissue levels of dihydrotestosterone among any groups. These data indicate that development of prostatic hyperplasia may be associated with prostatic hypoxia, which nicorandil prevents via its effect to increase the blood flow.

Saito, Motoaki; Tsounapi, Panagiota; Oikawa, Ryo; Shimizu, Shogo; Honda, Masashi; Sejima, Takehiro; Kinoshita, Yukako; Tomita, Shuhei

2014-01-01

15

Prostatic ischemia induces ventral prostatic hyperplasia in the SHR; possible mechanism of development of BPH.  

PubMed

In the light of increasing evidence that benign prostatic hyperplasia is associated with cardiovascular disease, we have investigated the relationship between prostatic blood flow and prostatic hyperplasia in the spontaneously-hypertensive-rat (SHR). Twelve-week-old male SHRs were treated with nicorandil for six weeks. Wistar-Kyoto rats were used as controls. Six weeks after nicorandil treatment, blood pressure and the prostatic blood flow were estimated, and tissue levels of malondialdehyde, HIF-1?, TGF-?1, bFGF, dihydrotestosterone, and ?-SMA were measured. SHRs showed significant increases in blood pressure, tissue levels of malondialdehyde, HIF-1?, TGF-?1, bFGF, ?-SMA and a significant decrease in the prostatic blood flow. Although treatment with nicorandil failed to alter the blood-pressure and ?-SMA, it significantly ameliorated the increased levels of malondialdehyde, HIF-1?, TGF-?1, and bFGF. There were no significant differences in tissue levels of dihydrotestosterone among any groups. These data indicate that development of prostatic hyperplasia may be associated with prostatic hypoxia, which nicorandil prevents via its effect to increase the blood flow. PMID:24448152

Saito, Motoaki; Tsounapi, Panagiota; Oikawa, Ryo; Shimizu, Shogo; Honda, Masashi; Sejima, Takehiro; Kinoshita, Yukako; Tomita, Shuhei

2014-01-01

16

Serenoa repens monotherapy for benign prostatic hyperplasia (BPH): an updated Cochrane systematic review  

PubMed Central

Objective To estimate the effectiveness and harms of Serenoa repens monotherapy in the treatment of lower urinary tract symptoms (LUTS) consistent with benign prostatic hyperplasia (BPH). Materials and methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and other sources through to January 2012 to identify randomised trials. Trials were eligible if they randomised men with symptomatic BPH to receive Serenoa repens extract monotherapy for at least 4 weeks in comparison with placebo, and assessed clinical outcomes and urodynamic measurements. Our primary outcome was improvement in LUTS, based on change in urological symptom-scale scores. Results In all, 17 randomised controlled trials (N = 2008) assessing Serenoa repens monotherapy (typically 320 mg/day) vs placebo met inclusion criteria, although only five reported American Urological Association Symptom Index (AUASI) or International Prostate Symptom Scores (IPSS). Trial lengths ranged from 4 to 72 weeks. The mean age of all enrolees was 64.3 years and most participants were of White race. The mean baseline total score was 14 points, indicating moderately severe symptoms. In all, 16 trials were double blinded and adequate treatment allocation concealment was reported in six trials. In a meta-analysis of three high quality long-to-moderate term trials (n = 661), Serenoa repens therapy was no better than placebo in reducing LUTS based on the AUASI/IPSS (weighted mean difference [WMD] ?0.16 points, 95% confidence interval [CI] ?1.45 to 1.14) or maximum urinary flow rate (Qmax; WMD 0.40 mL/s, 95% CI ?0.30 to 1.09). Based on mostly short-term studies, Qmax measured at study endpoint were also not significantly different between treatment groups (WMD 1.15 mL/s, 95% CI ?0.23 to 2.53) with evidence of substantial heterogeneity (I2 58%). One long-term dose escalation trial (72 weeks) found double and triple doses of Serenoa repens extract did not improve AUASI compared with placebo and the proportions of clinical responders (? 3 point decrease in the AUASI) were nearly identical (43% vs 44% for Serenoa repens and placebo, respectively) with a corresponding risk ratio of 0.96 (95% CI 0.76–1.22). Long-term, Serenoa repens therapy was no better than placebo in improving nocturia in one high-quality study (P = 0.19). Pooled analysis of nine short-term Permixon® trials showed a reduction in the frequency of nocturia (WMD ?0.79 times/night, 95% CI?1.28 to ?0.29), although there was evidence of heterogeneity (I2 76%) Adverse events of Serenoa repens extracts were few and mild, and incidences were not statistically significantly different vs placebo. Study withdrawals occurred in ?10% and did not differ between Serenoa repens and placebo. Conclusions Serenoa repens therapy does not improve LUTS or Qmax compared with placebo in men with BPH, even at double and triple the usual dose. Adverse events were generally mild and comparable to placebo.

MacDonald, Roderick; Tacklind, James W.; Rutks, Indulis; Wilt, Timothy J.

2012-01-01

17

Phytopharmaceutical and synthetic agents in the treatment of benign prostatic hyperplasia (BPH).  

PubMed

At present, a number of plant extracts and synthetic agents are available for the drug treatment of symptomatic BPH. In Germany, phytotherapeutic agents represent the therapeutic standard in the early stages of BPH. By now, the clinical efficacy of phytopharmaceuticals has been demonstrated in placebo-controlled studies as well as in prospective long-term studies in an extensive patient population. The synthetic 5?-reductase inhibitor, finasteride, could not achieve a better therapeutic success, it clearly had higher side effect rates. The published study results indicate that the prostate volume is reduced under finasteride treatment; however, a clinically relevant improvement of micturition complaints was only observed in a third of the treated BPH patients and then after six months of treatment, at the earliest. The selective alpha-blockers represent a new, interesting approach to treatment. BPH patients which respond to the treatment with alpha-blockers experience an alleviation of their micturition symptoms in a relatively short time. The problem with this treatment option is the lowering of blood pressure by some preparations and the accompanying side effects induced by alpha-blocker administration. A comparison of the synthetic BPH therapeutic agents with the phytotherapeutic method demonstrates a high benefit-risk ratio for phytotherapy, particularly in the context of the required long-term treatment. PMID:23195186

Bach, D; Schmitt, M; Ebeling, L

1997-02-01

18

Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH)  

Microsoft Academic Search

Because benign prostatic hyperplasia (BPH) is relatively common, it is important to discover safe and effective means to treat this often debilitating perturbation. Accordingly, we examined the effectiveness of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) in treating symptoms of BPH. We undertook a randomized, placebo-controlled, double-blind study. Patients were enrolled from 3 urological practices in

Harry G. Preuss; Charlyn Marcusen; James Regan; Ira W. Klimberg; Timothy A. Welebir; William A. Jones

2001-01-01

19

A practical primary care approach to lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH-LUTS).  

PubMed

In the primary care office the evaluation of prostate related lower urinary tract symptoms (BPH-LUTS) in the male can be confusing. Are the symptoms, in fact, from the prostate or is there another etiology such as the bladder or medical conditions causing or contributing to the problems? If the cause is the prostate, how does the physician choose from the multitude of available treatment options and when is referral appropriate? The prevalence of BPH-LUTS is high and commonly encountered by the primary care physician (PCP). An understanding of the normal prostate is essential to identifying the patient when symptoms do occur. Then the evaluation and treatment of the affected patient can occur effectively and efficiently in the PCP setting. In this article we present the background information needed for the PCP to provide this evaluation of the patient with BPH-LUTS. We explain the various treatment options that are best suited for the individual which are based on symptom severity, sexual dysfunction and risk of progression. We also identify follow up parameters and reasons for referral. PMID:24978629

Rosenberg, Matt T; Witt, Erik S; Miner, Martin; Barkin, Jack

2014-06-01

20

Enlarged Prostate (BPH)  

MedlinePLUS

The prostate is a gland in men. It helps make semen, the fluid that contains sperm. The prostate surrounds the tube that carries urine out of the body. As men age, their prostate grows bigger. If it gets too large, it ...

21

Genetic Markers Associated with Benign Prostatic Hyperplasia.  

National Technical Information Service (NTIS)

The present invention regards expression profiles of one or more nucleic acids indicative of the presence of, susceptibility to, and/or predicting response to therapy of benign prostatic hyperplasia (BPH) in an individual. The present invention identifies...

D. M. Spencer E. Canto J. Levitt K. M. Slawin M. Ittmann

2006-01-01

22

Men's Theories About Benign Prostatic Hyperplasia and Prostate Cancer Following a Benign Prostatic Hyperplasia Decision Aid  

PubMed Central

Objective To use qualitative methods to explore audiotape evidence of unanticipated confusion between benign prostatic hyperplasia (BPH) and prostate cancer in using a videotape BPH treatment decision aid (DA). Design Qualitative analysis of semi-structured interviews and surveys originally collected to study men's interpretation of a DA. Setting and Participants Community sample of college and noncollege educated African American and white men (age?50; n=188). Measures Transcript analysis identified themes in men's comments about BPH and cancer. Surveys measured BPH general and prostate cancer-specific knowledge, literacy (Short Test of Functional Health Literacy in Adults), BPH symptoms, and demographics. Results In transcript analysis, 18/188 men spontaneously talked about BPH and cancer as being related to each other, despite explicit statements to the contrary in the video. Survey data suggest that up to 126/188 men (67%) persisted in misconceptions even after viewing the DA video. Three themes were identified in the transcripts: (1) BPH and cancer are equated, (2) BPH surgery is for the purpose of removing cancer, and (3) BPH leads to cancer. Conclusions Overall knowledge increases with DA use may mask incorrect theories of disease process. Further research should identify decision support designs and clinical counseling strategies to address persistence of beliefs contrary to new information presented in evidence-based DAs.

Holmes-Rovner, Margaret; Price, Chrystal; Rovner, David R; Kelly-Blake, Karen; Lillie, Janet; Wills, Celia; Bonham, Vence L

2006-01-01

23

A Prospective Randomized Study of Transurethral Resection of the Prostate and Transurethral Vaporization of the Prostate as a Therapeutic Alternative in the Management of Men with BPH  

Microsoft Academic Search

Objective: The common goals of new surgical treatment for benign prostatic hyperplasia (BPH) are to improve subjective and objective symptoms, to decrease the risk of postoperative complications and short hospitalization. Transurethral electrovaporization of the prostate (TUVP) is a new, minimally invasive and a promising alternative to standard transurethral resection of the prostate (TURP) in the treatment of BPH. The aim

Sadettin Küpeli; Sümer Baltac?; Tarkan Soygür; Suat Aytaç; Erdal Y?lmaz; Mehmet Budak

1998-01-01

24

Benign Prostatic Hyperplasia: from Bench to Clinic  

PubMed Central

Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options.

Cho, Hee Ju

2012-01-01

25

Prostate Tissue Composition and Response to Finasteride in Men With Symptomatic Benign Prostatic Hyperplasia  

Microsoft Academic Search

PurposeWe sought to quantify prostate tissue changes induced by finasteride and to identify a predictor of finasteride response in men with symptomatic benign prostatic hyperplasia (BPH) via a randomized, placebo controlled, double-blind clinical trial.

Leonard S. Marks; Alan W. Partin; Glenn J. Gormley; Frederick J. Dorey; Erlinda D. Shery; Joel B. Garris; Eric N. P. Subong; Elizabeth Stoner; Jean B. deKernion

1997-01-01

26

Percutaneous Ethanol Injection of the Prostate as Minimally Invasive Treatment for Benign Prostatic Hyperplasia: Preliminary Report  

Microsoft Academic Search

Objective: To evaluate the feasibility, safety and efficacy of a minimally invasive treatment for benign prostatic hyperplasia (BPH) consisting of percutaneous ethanol injection inside the prostate under ultrasound surveillance.Material and Methods: Transperineal ethanol injection into the prostate was performed in 8 patients who were affected by obstructive BPH according to AUA symptom score, impaired urinary flow, and volume of postvoiding

Gianfranco Savoca; Stefano De Stefani; Ignazio Gattuccio; Daniele Paolinelli; Fulvio Stacul; Emanuele Belgrano

2001-01-01

27

A role for epithelial-mesenchymal transition in the etiology of benign prostatic hyperplasia  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) is usually described as a pathological proliferation of prostatic fibroblasts\\/myofibroblasts and epithelial cells. In the present study of BPH samples, we have made a morphological and immunohistochemical study of BPH prostatic sections using markers of proliferation, apoptosis, hormone receptors, and TGF-beta signaling. We found no evidence of proliferation in the stroma but in the epithelium of

Paloma Alonso-Magdalena; Clemens Brössner; Angelika Reiner; Guojun Cheng; Nobuhiro Sugiyama; Margaret Warner; Jan-Åke Gustafsson

2009-01-01

28

Androgen Regulated Genes in Human Prostate Xenografts in Mice: Relation to BPH and Prostate Cancer  

PubMed Central

Benign prostatic hyperplasia (BPH) and prostate carcinoma (CaP) are linked to aging and the presence of androgens, suggesting that androgen regulated genes play a major role in these common diseases. Androgen regulation of prostate growth and development depends on the presence of intact epithelial-stromal interactions. Further, the prostatic stroma is implicated in BPH. This suggests that epithelial cell lines are inadequate to identify androgen regulated genes that could contribute to BPH and CaP and which could serve as potential clinical biomarkers. In this study, we used a human prostate xenograft model to define a profile of genes regulated in vivo by androgens, with an emphasis on identifying candidate biomarkers. Benign transition zone (TZ) human prostate tissue from radical prostatectomies was grafted to the sub-renal capsule site of intact or castrated male immunodeficient mice, followed by the removal or addition of androgens, respectively. Microarray analysis of RNA from these tissues was used to identify genes that were; 1) highly expressed in prostate, 2) had significant expression changes in response to androgens, and, 3) encode extracellular proteins. A total of 95 genes meeting these criteria were selected for analysis and validation of expression in patient prostate tissues using quantitative real-time PCR. Expression levels of these genes were measured in pooled RNAs from human prostate tissues with varying severity of BPH pathologic changes and CaP of varying Gleason score. A number of androgen regulated genes were identified. Additionally, a subset of these genes were over-expressed in RNA from clinical BPH tissues, and the levels of many were found to correlate with disease status. Our results demonstrate the feasibility, and some of the problems, of using a mouse xenograft model to characterize the androgen regulated expression profiles of intact human prostate tissues.

Love, Harold D.; Booton, S. Erin; Boone, Braden E.; Breyer, Joan P.; Koyama, Tatsuki; Revelo, Monica P.; Shappell, Scott B.; Smith, Jeffrey R.; Hayward, Simon W.

2009-01-01

29

Therapeutic options in the treatment of benign prostatic hyperplasia  

PubMed Central

Current theraputic options for the treatment of symptomatic benign prostatic hyperplasia (BPH) are reviewed. Therapeutic options for mild lower urinary tract symptoms (LUTS), as defined by the American Urological Association, are generally treated medically. Moderate to severe LUTS can be treated medically or with surgical therapy. Current medical and surgical treatments for LUTS secondary to BPH are reviewed and evolving treatments are explored.

Sandhu, Jaspreet S

2009-01-01

30

Symptomatic and asymptomatic benign prostatic hyperplasia: Molecular differentiation by using microarrays  

NASA Astrophysics Data System (ADS)

Benign prostatic hyperplasia (BPH) is a disease of unknown etiology that significantly affects the quality of life in aging men. Histologic BPH may present itself either as symptomatic or asymptomatic in nature. To elucidate the molecular differences underlying BPH, gene expression profiles from the prostate transition zone tissue have been analyzed by using microarrays. A set of 511 differentially expressed genes distinguished symptomatic and asymptomatic BPH. This genetic signature separates BPH from normal tissue but does not seem to change with age. These data could provide novel approaches for alleviating symptoms and hyperplasia in BPH.

Prakash, Kulkarni; Pirozzi, Gregorio; Elashoff, Michael; Munger, William; Waga, Iwao; Dhir, Rajiv; Kakehi, Yoshiyuki; Getzenberg, Robert H.

2002-05-01

31

Clinical value of prostate segmentation and volume determination on MRI in benign prostatic hyperplasia.  

PubMed

Benign prostatic hyperplasia (BPH) is a nonmalignant pathological enlargement of the prostate, which occurs primarily in the transitional zone. BPH is highly prevalent and is a major cause of lower urinary tract symptoms in aging males, although there is no direct relationship between prostate volume and symptom severity. The progression of BPH can be quantified by measuring the volumes of the whole prostate and its zones, based on image segmentation on magnetic resonance imaging. Prostate volume determination via segmentation is a useful measure for patients undergoing therapy for BPH. However, prostate segmentation is not widely used due to the excessive time required for even experts to manually map the margins of the prostate. Here, we review and compare new methods of prostate volume segmentation using both manual and automated methods, including the ellipsoid formula, manual planimetry, and semiautomated and fully automated segmentation approaches. We highlight the utility of prostate segmentation in the clinical context of assessing BPH. PMID:24675166

Garvey, Brian; Türkbey, Bar??; Truong, Hong; Bernardo, Marcelino; Periaswamy, Senthil; Choyke, Peter L

2014-01-01

32

Use of PR2000, a Herbal Formulation in the Medical Management of Benign Prostatic Hyperplasia  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) is one of the most common processes affecting elderly men. This study was undertaken to evaluate the efficacy of PR-2000, an herbal preparation in the treatment of patients with benign prostatic hyperplasia. The trial included 68 patients who were diagnosed with BPH and graded accordingly using the American Urological Association (AUA) symptom score, uroflowmetric study and

C. U. Shah; Mahender Nayak; Kala Suhas Kulkarni

33

Optimizing the management of benign prostatic hyperplasia  

PubMed Central

One of the challenges facing primary care physicians and specialists as the population ages is the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While as many as 18% of men in their 40s report bother from an enlarged prostate, that figure rises dramatically, whereby 50% of men in their 50s and 90% of men in their 90s will complain of bothersome symptoms related to an enlarged prostate. Studies have shown that BPH is a progressive disease, which if left untreated can result in worsening of symptoms, acute urinary retention and renal failure. Until about 20 years ago the only management option available to urologists was surgery. In the early 1990s medical therapy emerged as the predominant treatment for BPH. Therapy may be tailored to target symptoms and progression of disease.

Elterman, Dean S.; Kaplan, Steven A.

2012-01-01

34

Human Prostate Cancer and Benign Prostatic Hyperplasia: Molecular Dissection by Gene Expression Profiling1  

Microsoft Academic Search

Critical aspects of the biology and molecular basis for prostate malig- nancy remain poorly understood. To reveal fundamental differences be- tween benign and malignant growth of prostate cells, we performed gene expression profiling of primary human prostate cancer and benign pros- tatic hyperplasia (BPH) using cDNA microarrays consisting of 6500 hu- man genes. Frozen prostate specimens were processed to facilitate

Jun Luo; David J. Duggan; Yidong Chen; Jurga Sauvageot; Charles M. Ewing; Michael L. Bittner; Jeffrey M. Trent; William B. Isaacs

2001-01-01

35

Anthropometric and metabolic factors and risk of benign prostatic hyperplasia: A prospective cohort study of Air Force veterans  

Microsoft Academic Search

ObjectivesThe relationship between anthropometric and metabolic factors and benign prostatic hyperplasia (BPH) is poorly understood. We investigated the associations of BPH with anthropometric and metabolic parameters in this prospective study of Vietnam War veterans.

Amit Gupta; Sachin Gupta; Marian Pavuk; Claus G. Roehrborn

2006-01-01

36

Efficacy and Safety of a Herbal Preparation PR2000 in the Treatment of Symptomatic Benign Prostatic Hyperplasia  

Microsoft Academic Search

As the life expectancy for men increases, more cases of benign prostatic hyperplasia (BPH) will be expected. Symptomatic BPH causes morbidity and can lower the quality of life. We investigated whether short-term administration of a herbal preparation known as PR-2000 could improved BPH symptom in men. Thirty patients with moderate to severe symptomatic BPH were treated with PR-2000, 2 tablets

M. Sahu

37

Inflammation in benign prostatic hyperplasia: a 282 patients' immunohistochemical analysis  

PubMed Central

Introduction and objectives Prostatic inflammation could be a key component in prostate enlargement and benign prostatic hyperplasia (BPH) progression. Our aim was to characterize inflammatory cells infiltrate within BPH tissue and to correlate inflammation and clinical data. Material and methods Inflammation was profiled on three clinical outcome tissue microarrays (TMAs), including 282 patients treated by surgery for a complicated and/or symptomatic BPH. Inflammation score was defined by combining six cytological parameters and 5 markers on immunohistochemistry (IHC). Cytological parameters were lymphocytes, macrophages and polynuclears leukocytes infiltrates, and three glandular aspect modifications: glandular atrophy, glandular destruction and tissue fibrosis. IHC markers were CD3, CD4 and CD8 decorating T-lymphocytes, CD20 decorating B-lymphocytes, and CD163 decorating macrophages. Results The majority of patients had inflammatory cells infiltrating BPH tissues: 81% had T-lymphocytes markers (CD3), 52% had B-lymphocytes markers (CD20) and 82% had macrophages markers (CD163). IPSS score (21 vs 12; p=0,02) and prostate volume (77cc vs 62cc; p=0.002) were significantly higher in patients with high grade prostatic inflammation. Conclusion We characterized inflammatory cells infiltrate in a large cohort of surgically treated BPH specimens. The role of inflammation in BPH development was highlighted by the strong correlation between histological inflammation, IPSS and prostate volume. Prostate enlargement due to chronic inflammatory process may progressively conduce to BPH progression. Therefore, inflammation is a therapeutic target for BPH.

Robert, Gregoire; Descazeaud, Aurelien; Nicolaiew, Nathalie; Terry, Stephane; Sirab, Nanor; Vacherot, Francis; Maille, Pascale; Allory, Yves; De La Taille, Alexandre

2009-01-01

38

Prostatic Artery Embolization as a Primary Treatment for Benign Prostatic Hyperplasia: Preliminary Results in Two Patients  

Microsoft Academic Search

Symptomatic benign prostatic hyperplasia (BPH) typically occurs in the sixth and seventh decades, and the most frequent obstructive urinary symptoms are hesitancy, decreased urinary stream, sensation of incomplete emptying, nocturia, frequency, and urgency. Various medications, specifically 5--reductase inhibitors and selective -blockers, can decrease the severity of the symptoms secondary to BPH, but prostatectomy is still considered to be the traditional

Francisco Cesar Carnevale; Alberto Azoubel Antunes; Joaquim Mauricio da Motta Leal Filho; Luciana Mendes de Oliveira Cerri; Ronaldo Hueb Baroni; Antonio Sergio Zafred Marcelino; Geraldo Campos Freire; Airton Mota Moreira; Miguel Srougi; Giovanni Guido Cerri

2010-01-01

39

Change in urinary symptoms and quality of life in men with benign prostatic hyperplasia after transurethral resection of prostate  

Microsoft Academic Search

The aim of this study was to determine the improvement in symptoms and quality of life in men with Ben ign Prostatic Hyperplasia (BPH) after transurethral res ection of prostate (TURP). Fifty consecutive patien ts fit for undergoing TURP for BPH were included in this study. All patients were assessed prior to definitive su rgical treatment using standardized questionnaires of

PR Chalise

40

Artificial neural network (ANN) velocity better identifies benign prostatic hyperplasia but not prostate cancer compared with PSA velocity  

Microsoft Academic Search

BACKGROUND: To validate an artificial neural network (ANN) based on the combination of PSA velocity (PSAV) with a %free PSA-based ANN to enhance the discrimination between prostate cancer (PCa) and benign prostate hyperplasia (BPH). METHODS: The study comprised 199 patients with PCa (n = 49) or BPH (n = 150) with at least three PSA estimations and a minimum of

Carsten Stephan; Nicola Büker; Henning Cammann; Hellmuth-Alexander Meyer; Michael Lein; Klaus Jung

2008-01-01

41

Giant Prostatic Hyperplasia  

PubMed Central

A giant prostatic hyperplasia (GPH) weighing more than 700 g is a rare entity. It is believed that only eight such cases have been previously reported in the medical literature. This case report concerns a patient with a GPH weighing 740 g which was successfully removed by suprapubic prostatectomy. To our knowledge, this is the fourth largest benign prostatic enlargement ever reported in the literature.

Maliakal, Joseph; Mousa, Emad E.; Menon, Varna

2014-01-01

42

Pharmacological treatment for common prostatic conditions in dogs - benign prostatic hyperplasia and prostatitis: an update.  

PubMed

The two most frequent prostatic diseases in dogs are benign prostatic hyperplasia (BPH) and prostatitis. Prostatitis requires prolonged antibiotic treatment. In acute prostatitis, the blood-prostate barrier is broken, thus facilitating the penetration of antibiotics, whereas in chronic prostatitis, the barrier prevents the penetration of many drugs into the gland. The selection of antibiotic agents is based on the sensitivity test and the drug's ability to penetrate into the gland. Many protocols for the treatment of BPH are available. In non-breeding dogs, surgical and optionally pharmacological castration by means of GnRH agonists may be performed. In breeding dogs, drugs retaining fertility are used. Recently, androgen receptor antagonistic treatment with osaterone acetate has been applied. Other drugs used for BPH treatment include progestagens, oestrogens, antioestrogens and 5?-reductase inhibitors. Some of these compounds may provoke severe side effects. The efficiency of GnRH antagonists used for the treatment of prostatic diseases, such as neoplasia and BPH, in humans has been recently investigated in dogs. This androgen deprivation therapy (ADT) is devoid of an initial exacerbation of androgen-dependent symptoms, which is typical for GnRH agonistic treatment. In many cases, BPH and prostatitis must be treated simultaneously as these conditions may develop in combination. PMID:24947855

Ni?a?ski, W; Levy, X; Ochota, M; Pasikowska, J

2014-06-01

43

The role of combination medical therapy in benign prostatic hyperplasia  

Microsoft Academic Search

To review key trials of monotherapy and combination therapy of ?1-adrenergic receptor antagonists (?1-ARAs), 5?-reductase inhibitors (5?RIs) and anti-muscarinic agents in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). To assess the safety and efficacy of combination therapies for LUTS associated with BPH, a search of the MEDLINE and Cochrane databases (1976–2008) was conducted

K A Greco; K T McVary

2008-01-01

44

Prostate Stem Cells in the Development of Benign Prostate Hyperplasia and Prostate Cancer: Emerging Role and Concepts  

PubMed Central

Benign Prostate hyperplasia (BPH) and prostate cancer (PCa) are the most common prostatic disorders affecting elderly men. Multiple factors including hormonal imbalance, disruption of cell proliferation, apoptosis, chronic inflammation, and aging are thought to be responsible for the pathophysiology of these diseases. Both BPH and PCa are considered to be arisen from aberrant proliferation of prostate stem cells. Recent studies on BPH and PCa have provided significant evidence for the origin of these diseases from stem cells that share characteristics with normal prostate stem cells. Aberrant changes in prostate stem cell regulatory factors may contribute to the development of BPH or PCa. Understanding these regulatory factors may provide insight into the mechanisms that convert quiescent adult prostate cells into proliferating compartments and lead to BPH or carcinoma. Ultimately, the knowledge of the unique prostate stem or stem-like cells in the pathogenesis and development of hyperplasia will facilitate the development of new therapeutic targets for BPH and PCa. In this review, we address recent progress towards understanding the putative role and complexities of stem cells in the development of BPH and PCa.

Prajapati, Akhilesh; Gupta, Sharad; Mistry, Bhavesh; Gupta, Sarita

2013-01-01

45

Microwave Treatment of Prostate Cancer and Hyperplasia  

NASA Technical Reports Server (NTRS)

Microwave ablation in the form of microwave energy applied to a heart muscle by a coaxial catheter inserted in a vein in the groin area can be used to heat and kill diseased heart cells. A microwave catheter has been developed to provide deep myocardial ablation to treat ventricular tachycardia by restoring appropriate electrical activity within the heart and eliminating irregular heartbeats. The resulting microwave catheter design, which is now being developed for commercial use in treating ventricular tachycardia, can be modified to treat prostate cancer and benign prostatic hyperplasia (BPH). Inasmuch as the occurrence of BPH is increasing currently 350,000 operations per year are performed in the United States alone to treat this condition this microwave catheter has significant commercial potential.

Arndt, G. Dickey; Ngo, Phong; Carl, J. R.; Raffoul, George

2005-01-01

46

Overview of interventional treatment options for benign prostatic hyperplasia  

PubMed Central

Transurethral resection of the prostate (TURP) remains the gold standard surgical intervention for men with benign prostatic hyperplasia (BPH). However, there are other, newer technologies that have also demonstrated safety and efficacy at least equivalent to that of TURP (e.g., Holmium laser, photoselective vaporization of the prostate). These minimally invasive techniques may be particularly useful for selected patient populations (e.g., those on anticoagulant therapy).

Elhilali, Mostafa M.

2012-01-01

47

Various treatment options for benign prostatic hyperplasia: A current update  

PubMed Central

In benign prostatic hyperplasia (BPH) there will be a sudden impact on overall quality of life of patient. This disease occurs normally at the age of 40 or above and also is associated with sexual dysfunction. Thus, there is a need of update on current medications of this disease. The presented review provides information on medications available for BPH. Phytotherapies with some improvements in BPH are also included. Relevant articles were identified through a search of the English-language literature indexed on MEDLINE, PUBMED, Sciencedirect and the proceedings of scientific meetings. The search terms were BPH, medications for BPH, drugs for BPH, combination therapies for BPH, Phytotherapies for BPH, Ayurveda and BPH, BPH treatments in Ayurveda. Medications including watchful waitings, Alpha one adrenoreceptor blockers, 5-alpha reductase inhibitors, combination therapies including tamsulosin-dutasteride, doxazosin-finasteride, terazosin-finasteride, tolterodine-tamsulosin and rofecoxib-finasteride were found. Herbal remedies such as Cernilton, Saxifraga stolonifera, Zi-Shen Pill (ZSP), Orbignya speciosa, Phellodendron amurense, Ganoderma lucidum, Serenoa Repens, pumpkin extract and Lepidium meyenii (Red Maca) have some improvements on BPH are included. Other than these discussions on Ayurvedic medications, TURP and minimally invasive therapies (MITs) are also included. Recent advancements in terms of newly synthesized molecules are also discussed. Specific alpha one adrenoreceptor blockers such as tamsulosin and alfuzosin will remain preferred choice of urologists for symptom relief. Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery. Due to lack of proper evidence Phytotherapies are not gaining much advantage. MITs and TURP are expensive and are rarely supported by healthcare systems.

Shrivastava, Alankar; Gupta, Vipin B.

2012-01-01

48

Transurethral Microwave Thermotherapy for Management of Benign Prostatic Hyperplasia: A Single-Institution Experience  

Microsoft Academic Search

Objectives. This is the first and largest single institution retrospective study in the United States to examine the effects of transurethral microwave thermotherapy (TUMT) for the treatment of benign prostatic hyperplasia (BPH).Methods. From September 1996 to June 1997, 78 men with moderate to severe symptomatic BPH were treated with the Prostatron at our institution. Patient age ranged from 52 to

Konstantinos G Stravodimos; Evan R Goldfischer; Wlodek J Klima; Michel E Jabbour; Arthur D Smith

1998-01-01

49

Risk Assessment and Medical Management of Acute Urinary Retention in Patients with Benign Prostatic Hyperplasia  

Microsoft Academic Search

Acute urinary retention (AUR) is a serious complication in patients with benign prostatic hyperplasia (BPH). It is defined as the sudden inability to pass urine which results in painful distension of the bladder and necessitates immediate decompression by catheterization. In the understanding of the natural history of BPH considerable progress has been achieved. In primary prevention of AUR it is

Christian Gratzke; Oliver Reich; Michael Staehler; Michael Seitz; Boris Schlenker; Christian G. Stief

2006-01-01

50

Prostatic Artery Embolization as a Primary Treatment for Benign Prostatic Hyperplasia: Preliminary Results in Two Patients  

Microsoft Academic Search

Symptomatic benign prostatic hyperplasia (BPH) typically occurs in the sixth and seventh decades, and the most frequent obstructive\\u000a urinary symptoms are hesitancy, decreased urinary stream, sensation of incomplete emptying, nocturia, frequency, and urgency.\\u000a Various medications, specifically 5-?-reductase inhibitors and selective ?-blockers, can decrease the severity of the symptoms\\u000a secondary to BPH, but prostatectomy is still considered to be the traditional

Francisco Cesar Carnevale; Alberto Azoubel Antunes; Joaquim Mauricio da Motta Leal Filho; Luciana Mendes de Oliveira Cerri; Ronaldo Hueb Baroni; Antonio Sergio Zafred Marcelino; Geraldo Campos Freire; Airton Mota Moreira; Miguel Srougi; Giovanni Guido Cerri

2010-01-01

51

Pharmacotherapy for benign prostatic hyperplasia.  

PubMed Central

Benign prostatic hyperplasia is a benign neoplasm of the prostate seen in men of advancing age. Microscopic evidence of the disorder is seen in about 70% of men by 70 years of age, whereas symptoms requiring some form of surgical intervention occur in 30% of men during their lifetime. Although the exact cause of benign prostatic hyperplasia is not clear, it is well recognized that high levels of intraprostatic androgens are required for the maintenance of prostatic growth. In recent years, extensive surveys of patients undergoing transurethral resection of the prostate reveal an 18% incidence of morbidity that has essentially not changed in the past 30 years. This procedure is also the second highest reimbursed surgical therapy under Medicare. These findings have resulted in an intensive search for alternative therapies for prostatic hyperplasia. An alternative that has now been well defined is the use of alpha-adrenergic blockers to relax the prostatic urethra. This is based on findings that a major component of benign prostatic hyperplasia symptoms is spasm of the prostatic urethra and bladder neck, which is mediated by the alpha-adrenergic nerves. A second approach is to block androgens involved in maintaining prostate growth. Several such drugs are now available for clinical use, and we discuss their side effects and use. We also include the newer recommendations on evaluating benign prostatic hyperplasia that are cost-effective yet comprehensive. Images

Narayan, P; Indudhara, R

1994-01-01

52

Different perforin expression in peripheral blood and prostate tissue in patients with benign prostatic hyperplasia and prostate cancer.  

PubMed

Perforin (P) is a prototypical cytotoxic molecule involved in cell-mediated immunity against various pathogens, alloantigens and particularly different tumours. The purpose of this study was to determine P expression in different lymphocyte subpopulations isolated from peripheral blood and prostate tissue of patients with benign prostatic hyperplasia (BPH) and prostate cancer (PCa) and compare it with the P expression found in the control group. Twenty subjects were recruited in each of the groups. Prostate mononuclear cells of the BPH and PCa tissues were isolated by enzymatic digestion and gradient density centrifugation, whereas peripheral blood mononuclear cells were isolated by gradient density centrifugation alone. Cells and tissue samples were labelled using monoclonal antibodies against P and different surface antigens (CD3, CD4, CD8 and CD56) and analysed by immunofluorescence and flow cytometry. Total P expression in peripheral blood lymphocytes did not differ significantly between BPH/PCa patients and control group, although the BPH and PCa tissue showed lower P expression level. A negative correlation between prostate-specific antigen levels and the overall percentage of P(+), CD3(+) CD56(-) P(+) , and CD3(-) CD56(+) P(+) cells in the prostate tissue was observed only in patients with PCa. Our findings indicate that the low frequency of P(+) lymphocytes, including T, NKT and NK cells, in the prostate tissue of patients with BPH and, particularly, PCa could be the consequence of local tissue microenvironment and one of the mechanisms involved in the pathogenesis of prostate hyperplasia following malignant alteration. PMID:21535078

Tokmadži?, V S; Tomaš, M I; Sotošek, S; Laškarin, G; Dominovi?, M; Tuli?, V; Dor?evi?, G; Susti?, A; Mrakov?i?-Šuti?, I

2011-10-01

53

Finasteride Reduces the Risk of Incident Clinical Benign Prostatic Hyperplasia  

PubMed Central

Background Despite the high prevalence of clinical benign prostatic hyperplasia (BPH) among older men, there remains a notable absence of studies focused on BPH prevention. Objective To determine if finasteride prevents incident clinical BPH in healthy older men. Design, setting, and participants Data for this study are from the Prostate Cancer Prevention Trial. After excluding those with a history of BPH diagnosis or treatment, or an International Prostate Symptom Score (IPSS) ?8 at study entry, 9253 men were available for analysis. Outcome measurements and statistical analysis The primary outcome was incident clinical BPH, defined as the initiation of medical treatment, surgery, or sustained, clinically significant urinary symptoms (IPSS >14). Finasteride efficacy was estimated using Cox proportional regression models to generate hazards ratios (HRs). Results and limitations Mean length of follow-up was 5.3 yr. The rate of clinical BPH was 19 per 1000 person-years in the placebo arm and 11 per 1000 person-years in the finasteride arm (p < 0.001). In a covariate-adjusted model, finasteride reduced the risk of incident clinical BPH by 40% (HR: 0.60; 95% confidence interval, 0.51–0.69; p < 0.001). The effect of finasteride on incident clinical BPH was attenuated in men with a body mass index ?30 kg/m2 (pinteraction = 0.04) but otherwise did not differ significantly by physical activity, age, race, current diabetes, or current smoking. The post hoc nature of the analysis is a potential study limitation. Conclusions Finasteride substantially reduces the risk of incident clinical BPH in healthy older men. These results should be considered in formulating recommendations for the use of finasteride to prevent prostate diseases in asymptomatic older men.

Parsons, J. Kellogg; Schenk, Jeannette M.; Arnold, Kathryn B.; Messer, Karen; Till, Cathee; Thompson, Ian M.; Kristal, Alan R.

2014-01-01

54

Economic modeling to assess the costs of treatment with finasteride, terazosin, and transurethral resection of the prostate for men with moderate to severe symptoms of benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesWe developed a decision analytic model to compare the costs of treatment for an initial 2-year period with finasteride, terazosin, and transurethral resection of the prostate (TURP) in men with at least moderate symptoms of benign prostatic hyperplasia (BPH). Outcome measures were BPH treatment costs, duration of symptomatic improvement, and lost productivity days (work or other customary activity).

Franklin C. Lowe; Ron L. Mcdaniel; Joseph J. Chmiel; Alan L. Hillman

1995-01-01

55

Benign prostatic hyperplasia: An overview of existing treatment  

PubMed Central

Benign prostatic hyperplasia (BPH) is the most common condition in aging men, associated with lower urinary tract symptoms (LUTS). A better understanding of the prostate physiology, function, and pathogenesis has led to the development of promising agents, useful in the management of LUTS in men. The specific approach used to treat BPH depends upon number of factors like age, prostrate size, weight, prostate-specific antigen level, and severity of the symptoms. 5?-reductase inhibitors decrease the production of dihydrotestosterone within the prostate, which results in decreased prostate volume, increased peak urinary flow rate, improvement of symptoms, decreased risk of acute urinary retention, and need for surgical intervention. ?1-adrenergic receptor (?1-AR) antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Clinical efficacy of either 5?-reductase inhibitor or ?1-AR antagonist has been further improved by using combination therapy; however, long-term outcomes are still awaited. Many more potential new therapies are under development that may improve the treatment of BPH. This article gives a brief account of rationale and efficacy of different treatment options presently available in the management of BPH.

Dhingra, Neelima; Bhagwat, Deepak

2011-01-01

56

Can finasteride reverse the progress of benign prostatic hyperplasia? a two-year placebo-controlled study  

Microsoft Academic Search

ObjectivesTo study if placebo-induced improvement in men with symptomatic benign prostatic hyperplasia (BPH) is maintained over 2 years, and to study the efficacy and safety from intervention with finasteride 5 mg for 24 months.

J. T. Andersen; P. Ekman; H. Wolf; H. O. Beisland; J. E. Johansson; M. Kontturi; T. Lehtonen; K. Tveter

1995-01-01

57

Randomized Trial of the Shared Decision-Making Program for Benign Prostatic Hyperplasia. Abstract, Executive Summary, Final Report and Appendix.  

National Technical Information Service (NTIS)

The authors had previously developed a multimedia educational program for men with benign prostatic hyperplasia (BPH), and in this study evaluated its ability to improve treatment decisions. The authors conducted a prospective randomized trial of a comput...

M. J. Barry

1995-01-01

58

Efficacy of finasteride is maintained in patients with benign prostatic hyperplasia treated for 5 years  

Microsoft Academic Search

Objectives. The purpose of this open-label study extension was to assess the long-term safety and efficacy of finasteride in the treatment of men with benign prostatic hyperplasia (BPH).Methods. A Phase III North American BPH trial originally enrolled 895 men, 297 of whom were randomized to receive finasteride 5 mg. An enlarged prostate gland by digital rectal examination, symptoms of urinary

Perry B. Hudson; Rex Boake; John Trachtenberg; Nicholas A. Romas; Sidney Rosenblatt; Perinchery Narayan; Jack Geller; Michael M. Lieber; Mostafa Elhilali; Richard Norman; Lynn Patterson; Jean-Paul Perreault; Gholam H. Malek; Reginald C. Bruskewitz; Johnny B. Roy; Amy Ko; Carol A. Jacobsen; Elizabeth Stoner

1999-01-01

59

Contemporary surgical management of benign prostatic hyperplasia: What do recent trends imply for urology training?  

Microsoft Academic Search

We are in the midst of a paradigm shift in the surgical management of benign prostatic hyperplasia (BPH). After decades of\\u000a decline, there is a recent surge in the rate of BPH surgeries—largely represented by laser prostatectomy and office-based\\u000a thermotherapies. In the United States, the number of transurethral resections of the prostate (TURP) continues to decline,\\u000a now representing a minority

Sean P. Elliott; Robert M. Sweet

2009-01-01

60

Prostate Changes That Are Not Cancer  

MedlinePLUS

Prostate Changes That Are Not Cancer What is prostatitis and how is it treated? What is enlarged ... even realize they're happening." What is enlarged prostate or BPH? BPH stands for benign prostatic hyperplasia. ...

61

The Functional Role of Reactive Stroma in Benign Prostatic Hyperplasia  

PubMed Central

The human prostate gland is one of the only internal organs that continue to enlarge throughout adulthood. The specific mechanisms that regulate this growth, as well as the pathological changes leading to the phenotype observed in the disease benign prostatic hyperplasia (BPH), are essentially unknown. Recent studies and their associated findings have made clear that many complex alterations occur, involving persistent and chronic inflammation, circulating hormonal level deregulation, and aberrant wound repair processes. BPH has been etiologically characterized as a progressive, albeit discontinuous, hyperplasia of both the glandular epithelial and stromal cell compartments coordinately yielding an expansion of the prostate gland and clinical symptoms. Interestingly, the inflammatory and repair responses observed in BPH are also key components of general wound repair in post-natal tissues. These responses include altered expression of chemokines, cytokines, matrix remodeling factors, chronic inflammatory processes, altered immune surveillance and recognition, as well as the formation of a prototypical ‘reactive’ stroma which is similar to that observed across various fibroplasias and malignancies of a variety of tissue sites. Stromal tissue, both embryonic mesenchyme, and adult reactive stroma myofibroblasts, has been shown to exert potent and functional regulatory control over epithelial proliferation and differentiation as well as immunoresponsive modulation. Thus, the functional biology of a reactive stroma, within the context of an adult disease typified by epithelial and stromal aberrant hyperplasia, is critical to understand within the context of prostate disease and beyond. The mechanisms that regulate reactive stroma biology in BPH represent targets of opportunity for new therapeutic approaches that may extend to other tissue contexts. Accordingly, this review seeks to address the dissection of important factors, signaling pathways, genes, and other regulatory components that mediate the interplay between epithelium and stromal responses in BPH.

Schauer, Isaiah G.; Rowley, David R.

2011-01-01

62

Qianliening capsule inhibits benign prostatic hyperplasia angiogenesis via the HIF-1? signaling pathway  

PubMed Central

Angiogenesis plays an important role in the progression and development of benign prostatic hyperplasia (BPH), and has become a promising target for BPH treatment. The hypoxia-inducible factor-1? (HIF-1?) signaling pathway promotes the process of angiogenesis, contributing to the growth and progression of a number of hyperplasia diseases, including BPH. Qianliening capsule (QC) is a traditional Chinese formula that has been used clinically in China to treat BPH for a number of years. Recently, QC was demonstrated to inhibit prostatic cell growth and induce apoptosis in vivo and in vitro via regulating the epidermal growth factor/signal transducer and activator of transcription 3 signaling pathway and mitochondrion-dependent apoptosis pathway. However, the mechanisms underlying the anti-BPH effect remain largely unknown. To further elucidate the mechanism of QC activity in BPH treatment, a rat BPH model established by injecting testosterone following castration was established and the effect of QC on prostatic tissue angiogenesis was evaluated, as well as the underlying molecular mechanisms. QC was shown to reduce the prostatic index in BPH rats, but without affecting the body weight, demonstrating that QC is effective in the treatment of BPH and without apparent toxicity. In addition, QC treatment significantly reduced the intraprostatic microvessel density, indicating antiangiogenesis activity in vivo. In addition, treatment with QC inhibited the expression of HIF-1? in BPH rats, as well as the expression of vascular endothelial growth factor and basic fibroblast growth factor. Therefore, for the first time, the present study hypothesized that QC inhibits angiogenesis in prostatic tissue of BPH rats via the inhibition of the HIF-1? signaling pathway, which may be one of the mechanisms in which QC treats BPH.

LIN, JIUMAO; ZHOU, JIANHENG; XU, WEI; HONG, ZHENFENG; PENG, JUN

2014-01-01

63

Lower urinary tract symptoms, benign prostatic hyperplasia, and obesity  

Microsoft Academic Search

Obesity has emerged as a global public health challenge. During the past 20 years, there has been a dramatic increase in obesity\\u000a in the United States. In 2007, only one state had a prevalence of obesity less than 20%. In this growing epidemic of national\\u000a concern is an emerging relationship between lower urinary tract symptoms (LUTS), benign prostatic hyperplasia (BPH),

Anne K. Mongiu; Kevin T. McVary

2009-01-01

64

Impact of Benign Prostatic Hyperplasia Pharmacological Treatment on Transrectal Prostate Biopsy Adverse Effects  

PubMed Central

Background. Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Among 242 consecutive unselected patients who underwent prostate biopsy, after excluding those with history of prostate biopsy/surgery or using medications not for BPH, we studied 190 patients. On the 15th day after procedure patients were questioned about symptoms lasting over a week and classified according to pharmacological BPH treatment. Results. Thirty-three patients (17%) were using alpha-blocker exclusively, five (3%) 5-alpha-reductase inhibitor exclusively, twelve (6%) patients used both medications, and 140 (74%) patients used none. There was no difference in regard to age among groups (P = 0.5). Postbiopsy adverse effects occurred as follows: hematuria 96 (50%), hematospermia 53 (28%), hematochezia 22 (12%), urethrorrhagia 19 (10%), fever 5 (3%), and pain 20 (10%). There was a significant negative correlation between postbiopsy hematuria and BPH pharmacological treatment with stronger correlation for combined use of 5-alpha-reductase inhibitor and alpha-blocker over 6 months (P = 0.0027). Conclusion. BPH pharmacological treatment, mainly combined for at least 6 months seems to protect against prostate biopsy adverse effects. Future studies are necessary to confirm our novel results.

Falcone, Ciro Eduardo; Amstalden Neto, Arnaldo; Moretti, Tomas Bernardo Costa; Magna, Luis Alberto; Denardi, Fernandes; Reis, Leonardo Oliveira

2014-01-01

65

Medications and surgical interventions for benign prostatic hyperplasia are potential confounders of prostate-specific antigen.  

PubMed

Prostate-specific antigen (PSA) is the most widely used marker for prostate cancer (CaP) screening and monitoring benign prostatic hyperplasia (BPH) progression. However, lack of an established abnormal threshold and the presence of other benign processes confound the interpretation of PSA levels. Many factors besides inflammation, trauma, and instrumentation can influence PSA levels; specifically, BPH and its associated medical and surgical therapies frequently complicate the interpretation of this serum blood test. For example, the commonly used 5 alpha reductase inhibitor (5ARI) medications directly affect PSA levels by decreasing prostate volume. The amount of time and potentially even the 5ARI formulary a patient is administered has been implicated to directly impact the degree of reduction in PSA (a proxy for prostate volume). In addition, each of the currently available surgical procedures for BPH appears to remove varying amounts of prostatic adenoma. This directly confounds CaP screening because each procedure is associated with a relatively specific postoperative nadir PSA level, and PSA kinetics are not well described in the literature. Taken together, it is important for clinicians to comprehend that BPH and its associated medical and surgical interventions should directly influence their interpretation of PSA and PSA velocity when screening for CaP or following BPH progression. PMID:20467844

Modi, Parth; Helfand, Brian T; McVary, Kevin T

2010-07-01

66

Silodosin in the treatment of benign prostatic hyperplasia  

PubMed Central

Benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS due to BPH. Alpha-adrenergic receptor blockers remain one of the mainstays in the treatment of male LUTS and clinical BPH. They exhibit early onset of efficacy with regard to both symptoms and flow rate improvement, and this is clearly demonstrated in placebo-controlled trials with extensions out to five years. These agents have been shown to prevent symptomatic progression of the disease. The aim of this article is to offer a critical review of the current literature on silodosin, formerly known as KMD-3213, a novel alpha-blocker with unprecedented selectivity for ?1A-adrenergic receptors, as compared with both ?1B- and ?1D -adrenoceptors, exceeding the selectivity of all currently used ?1-blockers, and with clinically promising effects.

Rossi, Maxime; Roumeguere, Thierry

2010-01-01

67

Renal Capsule Xenografting and Subcutaneous Pellet Implantation for the Evaluation of Prostate Carcinogenesis and Benign Prostatic Hyperplasia  

PubMed Central

New therapies for two common prostate diseases, prostate cancer (PrCa) and benign prostatic hyperplasia (BPH), depend critically on experiments evaluating their hormonal regulation. Sex steroid hormones (notably androgens and estrogens) are important in PrCa and BPH; we probe their respective roles in inducing prostate growth and carcinogenesis in mice with experiments using compressed hormone pellets. Hormone and/or drug pellets are easily manufactured with a pellet press, and surgically implanted into the subcutaneous tissue of the male mouse host. We also describe a protocol for the evaluation of hormonal carcinogenesis by combining subcutaneous hormone pellet implantation with xenografting of prostate cell recombinants under the renal capsule of immunocompromised mice. Moreover, subcutaneous hormone pellet implantation, in combination with renal capsule xenografting of BPH tissue, is useful to better understand hormonal regulation of benign prostate growth, and to test new therapies targeting sex steroid hormone pathways.

Nicholson, Tristan M.; Uchtmann, Kristen S.; Valdez, Conrad D.; Theberge, Ashleigh B.; Miralem, Tihomir; Ricke, William A.

2014-01-01

68

Renal capsule xenografting and subcutaneous pellet implantation for the evaluation of prostate carcinogenesis and benign prostatic hyperplasia.  

PubMed

New therapies for two common prostate diseases, prostate cancer (PrCa) and benign prostatic hyperplasia (BPH), depend critically on experiments evaluating their hormonal regulation. Sex steroid hormones (notably androgens and estrogens) are important in PrCa and BPH; we probe their respective roles in inducing prostate growth and carcinogenesis in mice with experiments using compressed hormone pellets. Hormone and/or drug pellets are easily manufactured with a pellet press, and surgically implanted into the subcutaneous tissue of the male mouse host. We also describe a protocol for the evaluation of hormonal carcinogenesis by combining subcutaneous hormone pellet implantation with xenografting of prostate cell recombinants under the renal capsule of immunocompromised mice. Moreover, subcutaneous hormone pellet implantation, in combination with renal capsule xenografting of BPH tissue, is useful to better understand hormonal regulation of benign prostate growth, and to test new therapies targeting sex steroid hormone pathways. PMID:24022657

Nicholson, Tristan M; Uchtmann, Kristen S; Valdez, Conrad D; Theberge, Ashleigh B; Miralem, Tihomir; Ricke, William A

2013-01-01

69

[alpha ]-methylacyl-CoA racemase (P504S) expression in evolving carcinomas within benign prostatic hyperplasia and in cancers of the transition zone  

Microsoft Academic Search

Carcinomas of the transition zone (TZ) constitute approximately 20% of all prostate cancers. The TZ is the site of origin of grade 1 and grade 2 cancers, the most well-differentiated of the Gleason grade tumors, as well as for benign prostatic hyperplasia (BPH). In this regard, grade 1 carcinoma has architectural features that closely mimic gland-rich BPH nodules. Although a

Irwin Leav; John E. McNeal; Shuk-Mei Ho; Zhong Jiang

2003-01-01

70

Comparing the Immunoexpression of FUT3 and FUT6 between Prostatic Adenocarcinoma and Benign Prostatic Hyperplasia.  

PubMed

Prostatic Adenocarcinoma (PA) and Benign Prostatic Hyperplasia (BPH) have their etiology not fully understood mainly in glycidic aspects. Glycan changes are associated with cell alterations where glycosylation is carried out by glycosyltransferases, such as fucosyltransferases (FUTs). These enzymes catalyze the insertion of L-fucose residues in a variety of glycan structures often in the final stage of glycosylation. The present study aimed to investigate the expression of FUT3 and FUT6 in PA and BPH as well as to correlate immunostaining of these transferases with PA clinic-histopathologic data. The FUT3 and FUT6 expressions were evaluated by immunohistochemistry in formalin-fixed, paraffin-embedded biopsies of PA (n=40) and BPH (n=40). FUT3 and FUT6 showed a high expression in both prostatic diseases, especially FUT6. FUT6 was more immunoexpressed in PA cases than the FUT3 (p<0.0001) as well as in BPH cases but in a not significant way (p=0.0661). Besides, FUT3 was more expressed in BHP lesion than in PA cases (p<0.0001). Our study presented a new data about FUT3 and FUT6 expression in PA and BPH, revealing high FUT6 expression in both lesions and FUT3 overexpression in BHP in relation to PA, proposing that this enzyme could be a promising biomarker for benign prostate alterations. PMID:23836950

de Albuquerque Vasconcelos, Juliana Lúcia; de Almeida Ferreira, Steffany; de Lima, Amanda Lucena Rosendo; de Melo Rêgo, Moacyr Jesus Barreto; Bandeira, Ana Rosa Galdino; de Lima Bezerra Cavalcanti, Carmelita; de Melo Lira, Mariana Montenegro; Beltrão, Eduardo Isidoro Carneiro

2013-06-27

71

High-Energy Microwave Thermotherapy in the Treatment of Benign Prostatic Hyperplasia  

Microsoft Academic Search

Introduction: Transurethral microwave thermotherapy is an anesthesia-free, outpatient method of treating lower urinary tract symptoms due to benign prostatic hyperplasia (BPH). Our results with the use of this technique in 25 patients are reported. Materials and Methods: Twenty-five patients with BPH, 8 of whom with complete urinary retention, were treated with high-energy transurethral microwave thermotherapy (HE-TUMT) (Prostatron system). Preoperative investigations

L. Cavarretta; E. Scremin; G. Cucciarrè; M. Todeschini; G. Novella; A. Tasca

2003-01-01

72

Effects of finasteride on hematuria associated with benign prostatic hyperplasia: long-term follow-up  

Microsoft Academic Search

Objectives. To report long-term follow-up in 18 patients with gross hematuria associated with benign prostatic hyperplasia (BPH) who have been treated with finasteride and to report preliminary follow-up in an additional 10 patients.Methods. The charts of the 18 original patients, and 10 additional patients who had been placed on finasteride (5 mg daily) for intermittent gross hematuria associated with BPH,

Mark I. Miller; Peter J. Puchner

1998-01-01

73

Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction  

PubMed Central

Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors – including age, genetics and geography – play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies.

Patel, Nishant D.; Parsons, J. Kellogg

2014-01-01

74

Seoritae Extract Reduces Prostate Weight and Suppresses Prostate Cell Proliferation in a Rat Model of Benign Prostate Hyperplasia  

PubMed Central

Seoritae is a type of black soybean that is known to have health-promoting effects due to its high isoflavone and anthocyanin contents. We evaluated whether Seoritae extract (SE) had beneficial effects on the reduction of prostate weight in a rat model of benign prostatic hyperplasia (BPH). BPH was induced by intramuscular injections of testosterone enanthate once a week for 5 weeks in Sprague-Dawley rats, and rats were treated with or without daily oral doses of SE during BPH induction. After 5 weeks, the oxidative stress (superoxide dismutase and 8-hydroxy-2-deoxyguanosine), apoptosis (caspase-3), and activity of 5-alpha reductase were evaluated in the serum and prostate. The SE treatment group showed a significant decrease in prostate weight, oxidative stress, apoptosis, and 5-alpha reductase activity compared to the nontreated BPH group. These results show that SE is effective in decreasing the weight and proliferation of the prostate, and suggest that SE may be an effective treatment for BPH.

Bae, Woong-Jin; Yuk, Seung-Mo; Han, Dong-Seok; Ha, U-Syn; Hwang, Seong-Yeon; Yoon, Shin-Hee; Kim, Sae-Woong; Han, Chang-Hee

2014-01-01

75

Prostatic artery embolization for enlarged prostates due to benign prostatic hyperplasia. How I do it.  

PubMed

Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results. PMID:23903785

Carnevale, Francisco C; Antunes, Alberto A

2013-12-01

76

Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It  

SciTech Connect

Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results.

Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Antunes, Alberto A., E-mail: antunesuro@uol.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil)

2013-12-15

77

Laser Treatment of Benign Prostatic Hyperplasia: Dosimetric and Thermodynamic Considerations  

NASA Astrophysics Data System (ADS)

Benign prostatic hyperplasia (BPH) is the most commonly occurring neoplastic disease in the aging human male. Currently, surgical treatment of BPH is the primary therapeutic method. However, due to surgical complications, less invasive methods of treatment are desirable. In recent years, thermal coagulation of the hyperplastic prostate by a laser has received a considerable amount of attention. Nevertheless, the optimum laser irradiation parameters that lead to a successful and safe treatment of BPH have not been determined. This dissertation studies the physics of laser coagulation of prostate from both basic science and practical perspectives. Optical properties of prostatic tissue are determined over a spectrum of wavelengths. Knowledge of these properties allows for selection of appropriate laser wavelengths and provides a basis for performing dose equivalency studies among various types of lasers. Furthermore, knowledge of optical properties are needed for development of computer simulation models that predict the extent of thermal injury during laser irradiation of prostate. A computer model of transurethral heating of prostate that can be used to guide the clinical studies in determining an optimum dosimetry is then presented. Studies of the effects of non-laser heating devices, optical properties, blood perfusion, surface irrigation, and beam geometry are performed to examine the extent of heat propagation within the prostate. An in vitro model for transurethral laser irradiation of prostate is also presented to examine the effects of an 810 nm diode laser, thermal boundary conditions, and energy deposition rate during Nd:YAG laser irradiation. Results of these studies suggest that in the presence of laminar irrigation, the convective boundary condition is dominated by thermal diffusion as opposed to the bulk motion of the irrigation fluid. Distinct phases of thermal events are also identified during the laser irradiation. The in vivo studies of transurethral laser irradiation of prostate in canine models are also performed to search for an optimum dosimetry that will result in a maximum zone of coagulation necrosis.

Anvari, Bahman

1993-01-01

78

Potential protective mechanisms of aryl hydrocarbon receptor (AHR) signaling in benign prostatic hyperplasia  

PubMed Central

The aryl hydrocarbon receptor (AHR) is an evolutionarily conserved ligand activated transcription factor best known for its role in mediating toxic responses to dioxin-like environmental contaminants. However, AHR signaling has also emerged as an active participant in processes of normal development and disease progression. Here, we review the role of AHR signaling in prostate development and disease processes, with a particular emphasis on benign prostatic hyperplasia (BPH). Inappropriate AHR activation has recently been associated with a decreased risk of symptomatic BPH in humans and has been shown to impair prostate development and disrupt endocrine signaling in rodents. We highlight known physiological responses to AHR activation in prostate and other tissues and discuss potential mechanisms by which it may act in adult human prostate to protect against symptomatic BPH.

Mehta, Vatsal; Vezina, Chad M.

2011-01-01

79

Effect of Boerhaavia diffusa in experimental prostatic hyperplasia in rats  

PubMed Central

Objective: Present investigation was undertaken to study the effectiveness of hydroalcoholic extract of roots of Boerhaavia diffusa in experimental benign prostatic hyperplasia (BPH) in rats using various animal models. Materials and Methods: BPH in rats was induced by subcutaneous injection of testosterone (5 mg/kg) daily for 28 days. Rats were divided in to five groups (six rats each). A negative control group received arachis oil (1 ml/kg s.c.) and four groups were injected testosterone. These four groups were further divided into reference group (finasteride 1 mg/kg), model group (testosterone), study group A (B. diffusa 100 mg/kg), and study group B (B. diffusa 250 mg/kg). On the 29th day, rats were sacrificed and body weight, prostate weight, bladder weight, and serum testosterone level were measured and histological studies were carried out. Further in vitro analysis of B. diffusa extract on contractility of isolated rat vas deferens and prostate gland, produced by exogenously administered agonists were carried out. All results were expressed as mean ± SEM. 0 Data were analyzed by one-way analysis of variance followed by Tukey's test. Results: B. diffusa (100 mg/kg) treatment for 28 days resulted in significant inhibition of prostate growth (P < 0.05). Drug extract did not have significant change on serum testosterone level. Histopathological analysis of prostate gland supported above results. Results of in vitro experiment suggest that extracts had attenuated the contractile responses of isolated vas deferens and prostate gland to exogenously applied agonists. Conclusion: The results suggested that treatment with B. diffusa may improve symptoms of disease and inhibit the increased prostate size. In vitro study implies that herbal extracts has the machinery to produce beneficial effect on prostatic smooth muscle, which would relieve the urinary symptoms of disease. B. diffusa could be a potential source of new treatment of prostatic hyperplasia.

Vyas, Bhavin A.; Desai, Niket Y.; Patel, Paras K.; Joshi, Shrikant V.; Shah, Dinesh R.

2013-01-01

80

Estrogen and androgen signaling in the pathogenesis of BPH  

Microsoft Academic Search

Estrogens and androgens have both been implicated as causes of benign prostatic hyperplasia (BPH). Although epidemiological data on an association between serum androgen concentrations and BPH are inconsistent, it is generally accepted that androgens play a permissive role in BPH pathogenesis. In clinical practice, inhibitors of 5?-reductase (which converts testosterone to the more potent androgen dihydrotestosterone) have proven effective in

Clement K. M. Ho; Fouad K. Habib

2011-01-01

81

[Evalution of benign prostatic hyperplasia].  

PubMed

Benign prostatic hyperplasia is a disorder of aging men and according to reasons for consultation its incidence is continually increasing in parallel with the constant increase in life expectancy. Recommendations about its management have been made by numerous national and international, scientific authorities and those responsible for public health. However, despite a rationale based on regularly published data, there are many disparities between them and they are only partially followed up in routine practice. The purpose of a working group during the "2nd Interfaces in Urology" was to make a new assessment on this disorder with regard to the most recent data and existing recommendations, in order to offer clinicians a clearer attitude for the prescription of the initial evaluation of benign prostatic hyperplasia. PMID:16425735

Desgrandchamps, François

2005-11-01

82

Randomised Prospective Trial of Contact Laser Prostatectomy (CLAP) versus Visual Laser Coagulation of the Prostate (VLAP) for the Treatment of Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objective: To determine the long–term efficacy and complications of visual laser coagulation/ ablation, VLAP (side–firing fibre) and direct contact laser ablation, CLAP (sapphire–tipped fibre) of the prostate in the treatment of benign prostatic hyperplasia (BPH).Patients and Methods: Patients with clinical BPH, obstructed at voiding cystometry, were recruited and randomised to undergo either CLAP (21 patients) or VLAP (17 patients). At

N. P. Bryan; K. J. Hastie; C. R. Chapple

2000-01-01

83

Association of the Serum Vascular Endothelial Growth Factor Levels With Benign Prostate Hyperplasia and Prostate Malignancies  

PubMed Central

Background: Recently, the development of new biomarkers as prognostic and predictive markers in prostate cancer has been crucial. Objectives: This study was aimed to determine whether serum vascular endothelial growth factor (VEGF) levels would be a prognostic marker or risk assessment factor in patients with prostate cancer and to investigate whether it could differentiate cancerous tissue from benign prostate hyperplasia (BPH). Patients and Methods: We enrolled 44 patients with prostate cancer, 57 patients with BPH, and 57 healthy individuals. Serum VEGF levels was measured by ELISA and was compared among all groups; then, its correlation with PSA and Gleason score in cancerous group was assessed. In addition, by using receiver operating characteristic (ROC) curve and area under curve (AUC), we determined the sensitivity and specificity of VEGF as well as combined variable of VEGF and PSA as a diagnostic marker of prostate cancer. Results: Serum VEGF level was significantly higher in patients with prostate cancer in comparison to the other groups (P value < 0.001); however, it was not different between BPH and control groups. Only in cancerous group a significant correlation between VEGF and PSA was found (r = 0.425, P = 0.004). Assessing the risk of prostate cancer, we found a powerful correlation between the VEGF alone as well as the combination of VEGF and PSA with prostate cancer. Conclusions: VEGF may be a diagnostic biomarker of prostate cancer. In addition, it may differentiate the cancerous tissue from BPH. We suggest that VEGF combined with PSA may be used as a screening test of prostate cancer.

Sharif, Mohammad Reza; Shaabani, Amirreza; Mahmoudi, Hossein; Nikoueinejad, Hassan; Akbari, Hossein; Einollahi, Behzad

2014-01-01

84

Medical treatment of benign prostatic hyperplasia  

PubMed Central

Pharmaceutical preparations are commonly used for benign prostate hyperplasia. This article reviews the current understanding of the natural history of the condition and the literature regarding medical treatment.

Connolly, Stephen S; Fitzpatrick, John M

2007-01-01

85

Medical and minimally invasive therapies for the treatment of benign prostatic hyperplasia  

Microsoft Academic Search

Over the last decade, management of benign prostatic hyperplasia (BPH) has changed with a substantial decrease in the use of transurethral prostatectomy (TURP) and a simultaneous increase in the use of medical therapy and minimally invasive surgical therapy (MIST). The goal of management of this chronic progressive condition is not only to provide relief of lower urinary tract symptoms (LUTS)

R C Harkaway; M M Issa

2006-01-01

86

The role of phytotherapy in treating lower urinary tract symptoms and benign prostatic hyperplasia  

Microsoft Academic Search

Despite their traditional popularity in many European countries and their increasing use as dietary supplements in the United States, the role of phytotherapeutic agents in treating lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) is continuously debated. If strict criteria of evidence-based medicine are applied, the available data have not yet provided clear evidence of efficacy for most

Kurt Dreikorn

2002-01-01

87

The precursor form of the human kallikrein 2, a kallikrein homologous to prostate-specific antigen, is present in human sera and is increased in prostate cancer and benign prostatic hyperplasia  

Microsoft Academic Search

Prostate-specific antigen (PSA, hK3) is a diagnostic marker for prostatic cancer but lacks the specificity to sufficiently distinguish between prostatic cancer and benign prostatic hyperplasia (BPH). Human glandular kallikrein 2 (hK2) has been proposed as a potential diagnostic marker for prostate cancer that could comple- ment the current PSA test. Recently we demonstrated that proPSA is present in prostate cancer

Mohammad S. Saedi; Timothy M. Hill; Kristine Kuus-Reichel; Abhay Kumar; Janice Payne; Stephen D. Mikolajczyk; Robert L. Wolfert; Harry G. Rittenhouse

88

Enlarged prostate  

MedlinePLUS

BPH; Benign prostatic hyperplasia (hypertrophy); Prostate - enlarged ... The actual cause of prostate enlargement is unknown. Factors linked to aging and changes in the cells of the testicles may have a role in ...

89

Autoantibody Signatures as Biomarkers to Distinguish Prostate Cancer from Benign Prostatic Hyperplasia in Patients with Increased Serum Prostate Specific Antigen  

PubMed Central

Background Serum prostate specific antigen (PSA) concentrations lack the specificity to differentiate prostate cancer from benign prostate hyperplasia (BPH), resulting in unnecessary biopsies. We identified 5 autoantibody signatures to specific cancer targets which might be able to differentiate prostate cancer from BPH in patients with increased serum PSA. Methods To identify autoantibody signatures as biomarkers, a native antigen reverse capture microarray platform was used. Briefly, well-characterized monoclonal antibodies were arrayed onto nanoparticle slides to capture native antigens from prostate cancer cells. Prostate cancer patient serum samples (n=41) and BPH patient samples (collected starting at the time of initial diagnosis) with a mean follow-up of 6.56 y without the diagnosis of cancer (n=39) were obtained. One hundred micrograms of IgGs were purified and labeled with a Cy3 dye and incubated on the arrays. The arrays were scanned for fluorescence and the intensity was quantified. Receiver operating characteristic curves were produced and the area under the curve (AUC) was determined. Results Using our microarray platform, we identified autoantibody signatures capable of distinguishing between prostate cancer and BPH. The top 5 autoantibody signatures were TARDBP, TLN1, PARK7, LEDGF/PSIP1, and CALD1. Combining these signatures resulted in an AUC of 0.95 (sensitivity of 95% at 80% specificity) compared to AUC of 0.5 for serum concentration PSA (sensitivity of 12.2% at 80% specificity). Conclusion Our preliminary results showed that we were able to identify specific autoantibody signatures that can differentiate prostate cancer from BPH, and may result in the reduction of unnecessary biopsies in patients with increased serum PSA.

O'Rourke, Dennis J.; DiJohnson, Daniel A.; Caiazzo, Robert J.; Nelson, James C.; Ure, David; O'Leary, Michael P.; Richie, Jerome P.; Liu, Brian C.-S.

2011-01-01

90

[Pharmacologic treatment of benign prostatic hyperplasia].  

PubMed

Medical treatment for benign prostatic hyperplasia is reviewed by the author. Experiences with herbal extracts have been known for more than 2 decades. Treating benign prostatic hyperplasia with these extracts are recommended in initial phase. Effectiveness of these drugs are approved by some placebo controlled double blind studies. However effectiveness of these are not as good as medical drugs'. It is well known that they have no side effects and are cheaper than medicines. Prostate volume is decreased and mechanical component of dysuria is improved by treating for long time (months, years) with 5 alfa reductase finasterid which contain hormone. This drug is indicated when volume of the prostate is over 40 g. Dynamical component of benign prostatic hyperplasia is treated with a receptor blockers which act on the bladder neck. These medicines effect earlier and are recommended for all benign prostatic hyperplasia patients independently of prostate volume. These might have some side effect like hypotension. PMID:14596018

Romics, Imre

2003-09-14

91

Linking pre-diabetes with benign prostate hyperplasia. IGFBP-3: a conductor of benign prostate hyperplasia development orchestra?  

PubMed

Benign prostatic hyperplasia (BPH) represents a pattern of non-malignant growth of prostatic fibromuscular stroma. Metabolic disturbances such us pre-diabetes and metabolic syndrome may have a role in BPH pathophysiology. A potential explanation for the above relationship involves the insulin-like growth factor (IGF) axis as well as IGF binding proteins, (IGFBPs) of which the most abundant form is IGFBP-3. Therefore, the aim of the present study was to investigate the association between intra-prostatic levels of IGF-1, IGF-2 as well as to evaluate the role of locally expressed IGFBP-3 in BPH development in pre-diabetes. A total of 49 patients admitted to the Urology department of a tertiary urban Greek hospital, for transurethral prostate resection, or prostatectomy and with pre-diabetes [impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) or both] were finally included. The majority of the sample consisted of subjects with IGT (51.0%), followed by IFG and IGT (32.7%) and isolated IFG (16.3%). For all participants a clinical examination was performed and blood samples were collected. In addition, total prostate (TP) volume or transitional zone (TZ) volume were estimated by transrectal ultrasonography. The results of the multivariate analysis regarding TP volume showed that higher PSA (p<0.001), larger waist circumference (p=0.007) and higher IGFBP-3 expression levels (p<0.001) independently predicted higher TP volume. The results regarding the volume of the TZ showed that higher PSA (p<0.001), larger waist circumference (p<0.001) and higher IGFBP-3 expression levels (p=0.024) were independently associated with higher TZ volume. Our findings show that intra-prostatic levels of IGFBP-3, PSA and waist circumference, but not overall obesity, are positively associated with prostate volume. IGFBP-3 seems to be a multifunctional protein, which can potentiate or inhibit IGF activity. PMID:24367483

Protopsaltis, Ioannis; Ploumidis, Achilles; Sergentanis, Theodoros N; Constantoulakis, Padelis; Tzirogiannis, Kostantinos; Kyprianidou, Chrysoula; Papazafiropoulou, Athanasia K; Melidonis, Andreas; Delakas, Dimitrios

2013-01-01

92

[A new method of radiofrequency needle ablation of the prostate in the treatment of benign hyperplasia].  

PubMed

The authors present the results of a new transvesical approach for radiofrequency needle ablation of the prostate in 29 patients with benign prostatic hyperplasia (BPH). The ablation has been done using a new radiofrequency generator ESHFG-440-40-1 made in Russia. Upon 12-month follow-up urination normalized in 23 patients. This result is better than that after transurethral needle ablation. The transvesical needle ablation has no contradictions and can be used in a wide range of patients with BPH both in hospital and outpatient settings. PMID:12077813

Mukhtarov, Sh T; Arustamov, D L

2002-01-01

93

Clinical Uroselectivity of Alfuzosin in the Treatment of Benign Prostatic Hyperplasia  

Microsoft Academic Search

The efficacy of alfuzosin in improving lower urinary tract symptoms and relieving bladder outlet obstruction has been demonstrated in numerous short- and long-term placebo-controlled studies and large-scale open studies, involving over 16,000 patients with symptomatic benign prostatic hyperplasia (BPH). Treatment with sustained release alfuzosin (5 mg twice daily) for 3 months resulted in a 5-point reduction in the International Prostate

Roger S. Kirby

1998-01-01

94

[Results of the effectiveness of long-term treatment of patients with benign prostatic hyperplasia].  

PubMed

A long-term proskar (finasterid, MSD) treatment was given to 428 patients with benign prostatic hyperplasia (BPH). The response was achieved in 93.8-95.8% patients. The duration of the course should be at least 12 months. Side effects were rare: libido, erection, ejaculate volume diminished in 5.1, 5.6 and 4.2% patients, respectively. 20 patients were operated on after proskar therapy. Such pretreatment reduced glandular prostatic tissue. PMID:12077812

Tkachuk, V N; Al'-Shukri, S Kh; Luk'ianov, A E

2002-01-01

95

Management of benign prostatic hyperplasia: role of phosphodiesterase-5 inhibitors.  

PubMed

Several studies have highlighted a strong association between benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) and erectile dysfunction (ED), particularly in elderly men. Many epidemiological trials, such as in vitro and in vivo studies, have reported the emerging role of metabolic syndrome, including abdominal obesity, impaired glucose metabolism, hypertriglyceridemia, low high-density lipoprotein cholesterol, and hypertension, in the development and progression of urinary and sexual symptoms. Moreover, many authors have focused their studies on the identification of all the shared pathogenetic mechanisms of LUTS/BPH and ED, including alteration of cyclic guanosine monophosphate and RhoA-ROCK pathways or vascular and neurogenic dysfunction. All these are potential targets for proposed phosphodiesterase type 5 inhibitors (PDE5-Is). Therefore, several trials have recently been designed to evaluate the role of PDE5-Is alone or in combination with conventional treatment for BPH, such as ?-adrenergic blockers, in men affected by LUTS/BPH, with or without ED. Different PDE5-Is are in clinical use worldwide and currently six of them are licensed for the oral treatment of ED. All these compounds differ in pharmacokinetic factors, with influence on drug action, and subsequently in the overall safety and efficacy profile. PMID:24811735

Gacci, M; Carini, M; Salvi, M; Sebastianelli, A; Vignozzi, L; Corona, G; Maggi, M; McVary, K T; Kaplan, S A; Oelke, M; Serni, S

2014-06-01

96

Energy Delivery Systems for Treatment of Benign Prostatic Hyperplasia  

PubMed Central

Executive Summary Objective The Ontario Health Technology Advisory Committee asked the Medical Advisory Secretariat (MAS) to conduct a health technology assessment on energy delivery systems for the treatment of benign prostatic hyperplasia (BPH). Clinical Need: Target Population and Condition BPH is a noncancerous enlargement of the prostate gland and the most common benign tumour in aging men. (1) It is the most common cause of lower urinary tract symptoms (LUTS) and bladder outlet obstruction (BOO) and is an important cause of diminished quality of life among aging men. (2) The primary goal in the management of BPH for most patients is a subjective improvement in urinary symptoms and quality of life. Until the 1930s, open prostatectomy, though invasive, was the most effective form of surgical treatment for BPH. Today, the benchmark surgical treatment for BPH is transurethral resection of the prostate (TURP), which produces significant changes of all subjective and objective outcome parameters. Complications after TURP include hemorrhage during or after the procedure, which often necessitates blood transfusion; transurethral resection (TUR) syndrome; urinary incontinence; bladder neck stricture; and sexual dysfunction. A retrospective review of 4,031 TURP procedures performed by one surgeon between 1979 and 2003 showed that the incidence of complications was 2.4% for blood transfusion, 0.3% for TUR syndrome, 1.5% for hemostatic procedures, 2.8% for bladder neck contracture, and 1% for urinary stricture. However, the incidence of blood transfusion and TUR syndrome decreased as the surgeon’s skills improved. During the 1990s, a variety of endoscopic techniques using a range of energy sources have been developed as alternative treatments for BPH. These techniques include the use of light amplification by stimulated emission of radiation (laser), radiofrequency, microwave, and ultrasound, to heat prostate tissue and cause coagulation or vaporization. In addition, new electrosurgical techniques that use higher amounts of energy to cut, coagulate, and vaporize prostatic tissue have entered the market as competitors to TURP. The driving force behind these new treatment modalities is the potential of producing good hemostasis, thereby reducing catheterization time and length of hospital stay. Some have the potential to be used in an office environment and performed under local anesthesia. Therefore, these new procedures have the potential to rival TURP if their effectiveness is proven over the long term. The Technology Being Reviewed The following energy-based techniques were considered for assessment: transurethral electrovaporization of the prostate (TUVP) transurethral electrovapor resection of the prostate (TUVRP) transurethral electrovaporization of the prostate using bipolar energy (plasmakinetic vaporization of the prostate [PKVP]) visual laser ablation of the prostate (VLAP) transurethral ultrasound guided laser incision prostatectomy (TULIP) contact laser vaporization of the prostate (CLV) interstitial laser coagulation (ILC) holmium laser resection of the prostate (HoLRP) holmium laser enucleation of the prostate (HoLEP) holmium laser ablation of the prostate (HoLAP) potassium titanyl phosphate (KTP) laser transurethral microwave thermotherapy (TUMT) transurethral needle ablation (TUNA) Review Strategy A search of electronic databases (OVID MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, The Cochrane Library, and the International Agency for Health Technology Assessment [INAHTA] database) was undertaken to identify evidence published from January 1, 2000 to June 21, 2006. The search was limited to English-language articles and human studies. The literature search identified 284 citations, of which 38 randomized controlled trials (RCTs) met the inclusion criteria. Since the application of high-power (80 W) KTP laser (photoselective vaporization of the prostate [PVP]) has been supported in the United States and has resulted in a rapid diffusion of this technology in the absence of any RCTs, th

2006-01-01

97

Involvement of fibroblast growth factor receptor genes in benign prostate hyperplasia in a Korean population.  

PubMed

Fibroblast growth factors (FGFs) and their receptors (FGFRs) have been implicated in prostate growth and are overexpressed in benign prostatic hyperplasia (BPH). In this study, we investigated whether single nucleotide polymorphisms (SNPs) of the FGFR genes (FGFR1 and FGFR2) were associated with BPH and its clinical phenotypes in a population of Korean men. We genotyped four SNPs in the exons of FGFR1 and FGFR2 (rs13317 in FGFR1; rs755793, rs1047100, and rs3135831 in FGFR2) using direct sequencing in 218 BPH patients and 213 control subjects. No SNPs of FGFR1 or FGFR2 genes were associated with BPH. However, analysis according to clinical phenotypes showed that rs1047100 of FGFR2 was associated with prostate volume in BPH in the dominant model (GA/AA versus GG, P = 0.010). In addition, a significant association was observed between rs13317 of FGFR1 and international prostate symptom score (IPSS) in the additive (TC versus CC versus TT, P = 0.0022) and dominant models (TC/CC versus TT, P = 0.005). Allele frequency analysis also showed significant association between rs13317 and IPSS (P = 0.005). These results suggested that FGFR genes could be related to progression of BPH. PMID:24385678

Park, Hae Jeong; Kim, Su Kang; Kim, Jong Woo; Lee, Sang Hyub; Yoo, Koo Han; Chung, Joo-Ho

2013-01-01

98

Involvement of Fibroblast Growth Factor Receptor Genes in Benign Prostate Hyperplasia in a Korean Population  

PubMed Central

Fibroblast growth factors (FGFs) and their receptors (FGFRs) have been implicated in prostate growth and are overexpressed in benign prostatic hyperplasia (BPH). In this study, we investigated whether single nucleotide polymorphisms (SNPs) of the FGFR genes (FGFR1 and FGFR2) were associated with BPH and its clinical phenotypes in a population of Korean men. We genotyped four SNPs in the exons of FGFR1 and FGFR2 (rs13317 in FGFR1; rs755793, rs1047100, and rs3135831 in FGFR2) using direct sequencing in 218 BPH patients and 213 control subjects. No SNPs of FGFR1 or FGFR2 genes were associated with BPH. However, analysis according to clinical phenotypes showed that rs1047100 of FGFR2 was associated with prostate volume in BPH in the dominant model (GA/AA versus GG, P = 0.010). In addition, a significant association was observed between rs13317 of FGFR1 and international prostate symptom score (IPSS) in the additive (TC versus CC versus TT, P = 0.0022) and dominant models (TC/CC versus TT, P = 0.005). Allele frequency analysis also showed significant association between rs13317 and IPSS (P = 0.005). These results suggested that FGFR genes could be related to progression of BPH.

Park, Hae Jeong; Kim, Su Kang; Kim, Jong Woo

2013-01-01

99

Comparison between prostate volume and intravesical prostatic protrusion in detecting bladder outlet obstruction due to benign prostatic hyperplasia.  

PubMed

The objectives of this study were to determine and compare the correlation of intravesical prostatic protrusion (IPP) and prostate volume (PV) with bladder outlet obstruction (BOO). This study was conducted in the department of urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2009 to September 2010. Fifty benign prostatic hyperplasia (BPH) patients were included in the study. Their evaluation consisted of history along with International Prostate Symptoms Score (IPSS), digital rectal examination (DRE), transabdominal ultrasonography to measure prostate volume, intravesical prostatic protrusion & post voidal residual (PVR) urine and pressure-flow studies to detect bladder outflow obstruction (BOO). Statistical analysis included Unpaired 't' test, Chi-square test and Spearman's Rank correlation test. Receiver Operator Characteristic (ROC) curves were used to compare the correlation of PV and IPP with BOO. Mean prostate volume was significantly larger in bladder outlet obstructed patients (P<0.05). Mean IPP was significantly greater in obstructed patients (P<0.001). Area under ROC curve was 0.700 for PV and 0.821 for IPP. Prostate volume & intravesical prostatic protrusion measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with bladder outlet obstruction in patients with benign prostatic hyperplasia and the correlation of IPP is much more stronger than that of prostate volume. PMID:22545345

Hossain, A K M S; Alam, A K M K; Habib, A K M K; Rashid, M M; Rahman, H; Islam, A K M A; Jahan, M U

2012-04-01

100

[Transvesical radiofrequency needle ablation on prostatic benign hyperplasia].  

PubMed

Transurethral needle ablation (TUNA) of the prostate is an effective method of thermal treatment of patients with benign prostatic hyperplasia (BPH). Suprapubic transvesical access was used in order to extend indications for interstitial application of radiofrequency energy. Transvesical needle ablation (TVNA) was performed in 89 patients with BPH under conditions of chronic ischuria or in the presence of a suprapubic cystostoma. A cystoscope with an attachment for fixation and insertion of a needle electrode into prostatic tissue is inserted into the bladder through a newly created or adapted suprapubic access. The position of the needle is monitored by transurethral sonography. The ablation protocol is virtually the same as transurethral. Spontaneous urination normalized in 63 (70.8%) patients within 12 months. I-PSS, Qol, Qmax, RU, and PQmax improved. The prostate volume decreased by 1-.5%. TVNA is more effective than TUNA as a less invasive method which allows interventions under local anesthesia; there are virtually no contraindications to the use of TVNA and in many patients it can be performed in an outpatient setting. PMID:11186320

Arustamov, D L; Mukhtarov, Sh T; Arustamov, L D

2000-01-01

101

[Dutasteride: main results in the treatment of benign prostatic hyperplasia].  

PubMed

Benign prostatic hyperplasia (BPH) is a progressive disease characterized by an increase in prostatic volume. The resulting urinary irritative and/or obstructive symptoms, when present, often reduce the patient's quality of life. Prostatic dihydrotestosterone, the androgen produced following transformation of testosterone by the enzyme 5-alpha-reductase, is responsible for these changes. Among various products used for drug therapy, 5-alpha-reductase inhibitors play a specific role in the long-term management of BPH. Between the two currently available products, dutasteride is the only dual 5-alpha-reductase inhibitor (types 1 and 2). The efficacy of dutasteride was tested in several scientific studies and the cumulative results of three controlled, double-blind pivotal studies, showed at 2-year a clear improvement in all parameters modified during this disorder. A significant decrease in the severity and frequency of the urinary symptoms, in prostate volume, the risk of urine retention, the necessity to resort to surgery and an increase in peak urinary flow were observed with dutasteride. These results were confirmed in the 4-year-open label extension of these pivot studies both for tolerability of the product and the maintenance of its efficacy over time. PMID:15651494

Le-Coent, R

2004-12-01

102

Micro and bulk analysis of prostate tissues classified as hyperplasia  

NASA Astrophysics Data System (ADS)

BPH (Benign Prostatic Hyperplasia) is the most common benign neoplasm (non cancerous enlargement of the prostate gland), whose prevalence increases with age. The gland, when increased in size, exerts pressure on the urethra, causing obstruction to urine flow. The latter may result in severe urinary tract and kidney conditions. In this work prostate samples from patients diagnosed with BPH were analyzed using synchrotron radiation. Micro-analysis of the hyperplastic samples was carried out on the L-beam line at HASYLAB, DESY (Germany), while bulk analysis on selected samples was performed at the DRX2 beamline at LNF, Frascati (Italy). Microanalysis with a mono-energetic beam 15 ?m in diameter confirmed that concentrations of certain elements, such as S, Mn, Cu, Fe and Zn, are good indicators of pathological disorders in prostate tissue that may be considered effective tracers of developing compliant. The concentrations of Mn, Cu, Fe and Zn are higher in hyperplastic tissues, as compared to normal ones, while for sulphur the opposite is observed. Additionally, Fe and S K-edge XANES (X-ray Absorption Near Edge Structure) spectroscopy experiments were carried out in order to determine the chemical speciation of these elements in our samples.

Kwiatek, W. M.; Bana?, A.; Bana?, K.; Cinque, G.; Dyduch, G.; Falkenberg, G.; Kisiel, A.; Marcelli, A.; Podgórczyk, M.

2007-07-01

103

??spinasterol from Melandrium firmum attenuates benign prostatic hyperplasia in a rat model.  

PubMed

Spinasterol, a biologically active compound, exhibits a number of pharmacological activities, including antitumor, antiulcerogenic and anticarcinogenic activity, and originates from the aerial parts of Aster scaber Thunb (Asteraceae). The present study investigated whether ??spinasterol isolated from Melandrium firmum Rohrbach could prevent benign prostatic hyperplasia (BPH) induced by testosterone propionate (TP) in rats. Male Wistar rats were randomly divided into four groups of eight rats following castration. A negative control group received subcutaneous injections of corn oil. Treatments were administered orally 1 h prior to TP injection. All the rats were sacrificed at the scheduled termination time and their prostates were removed, cleaned and weighed. The prostate size ratio (prostate weight/rat body weight) was then calculated. Additional histopathological examinations were conducted, and the levels of TP and dihydrotestosterone (DHT) in the serum and prostate were measured. TP significantly increased the prostate size ratio (P<0.01), and DHT and testosterone levels in the serum and prostate. The TP?induced increase was significantly inhibited in ??spinasterol?treated rats when compared with the negative controls (P<0.05). In addition, histopathological examination demonstrated that ??spinasterol treatment suppressed TP?induced prostatic hyperplasia. It is concluded that ??spinasterol can prevent TP?induced prostatic hyperplasia and may be beneficial in the management of BPH. PMID:24682042

Lee, Mee-Young; Shin, In-Sik; Kyoung, Hwangbo; Seo, Chang-Seob; Son, Jong-Keun; Shin, Hyeun-Kyoo

2014-06-01

104

Clinical application of contrast enhanced ultrasound to diagnose benign prostatic hyperplasia  

PubMed Central

Abstract Background This study aimed to investigate the clinical significance of contrast enhanced ultrasound (CEUS) in diagnosis of benign prostatic hyperplasia (BPH) through comparing CEUS parameters between BPH and normal person. Methods A retrospective study of sixty BPH patients (aged 73.5?±?20.5 years old) and thirty normal controls without prostate diseases (aged 75.3?±?19.7 years old) who had accepted CEUS detection were performed. Time-intensity curves were obtained for all tests in regions of interest. Images were processed using ACQ software and the following parameters were obtained: arrival time (AT), peak intensity (P), time to peak (TP), area under the curve (AUC), mean transit time (MTT) and extinction time (ET). Differences in inner and outer gland of prostate between BPH and the normal tissue were evaluated. Results There was a clear boundary between the inner and outer gland of BPH prostate. AT, TP, MTT, ET and P in BPH outer gland were significantly higher than the control group. In inner gland, MTT, ET, AUC and P were also significantly higher than the controls. The accurate rate to diagnose BPH using CEUS was 95.6%, and the sensitivity and specificity were 95.0% and 96.7%, respectively. Conclusions Among these significantly changed parameters, the increases of MTT, ET and AUC in inner gland and AT, TP in outer gland were most likely related to BPH. These parameters provide an objective visual assessment to diagnosis of BPH. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4852383312229155

2014-01-01

105

Serenoa repens for benign prostatic hyperplasia  

PubMed Central

Background Benign prostatic hyperplasia (BPH), a nonmalignant enlargement of the prostate, can lead to obstructive and irritative lower urinary tract symptoms (LUTS). The pharmacologic use of plants and herbs (phytotherapy) for the treatment of LUTS associated with BPH is common. The extract of the berry of the American saw palmetto, or dwarf palm plant, Serenoa repens (also known by its botanical name of Sabal serrulatum), is one of several phytotherapeutic agents available for the treatment of BPH. Objectives This systematic review aimed to assess the effects of Serenoa repens in the treatment of LUTS consistent with BPH. Search strategy Trials were searched in computerized general and specialized databases (MEDLINE, EMBASE, and The Cochrane Library), by checking bibliographies, and by handsearching the relevant literature. Selection criteria Trials were eligible if they (1) randomized men with symptomatic BPH to receive preparations of Serenoa repens (alone or in combination) for at least four weeks in comparison with placebo or other interventions, and (2) included clinical outcomes such as urologic symptom scales, symptoms, and urodynamic measurements. Eligibility was assessed by at least two independent observers. Data collection and analysis Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. The main outcome measure for comparing the effectiveness of Serenoa repens with placebo or other interventions was the change in urologic symptom-scale scores. Secondary outcomes included changes in nocturia and urodynamic measures. The main outcome measure for side effects or adverse events was the number of men reporting side effects. Main results In this update 9 new trials involving 2053 additional men (a 64.8% increase) have been included. For the main comparison - Serenoa repens versus placebo - 3 trials were added with 419 subjects and 3 endpoints (IPSS, peak urine flow, prostate size). Overall, 5222 subjects from 30 randomized trials lasting from 4 to 60 weeks were assessed. Twenty-six trials were double blinded and treatment allocation concealment was adequate in eighteen studies. Serenoa repens was not superior to placebo in improving IPSS urinary symptom scores, (WMD (weighted mean difference) ?0.77 points, 95% CI ?2.88 to 1.34, P > 0.05; 2 trials), finasteride (MD (mean difference) 0.40 points, 95% CI ?0.57 to 1.37, P > 0.05; 1 trial), or tamsulosin (WMD ?0.52 points, 95% CI ?1.91 to 0.88, P > 0.05; 2 trials). For nocturia, Serenoa repens was significantly better than placebo (WMD ?0.78 nocturnal visits, 95% CI ?1.34 to ?0.22, P < 0.05; 9 trials), but with the caveat of significant heterogeneity (I2 = 66%). A sensitivity analysis, utilizing higher quality, larger trials (? 40 subjects), demonstrated no significant difference (WMD ?0.31 nocturnal visits, 95% CI ?0.70 to 0.08, P > 0.05; 5 trials) (I2 = 11%). Serenoa repens was not superior to finasteride (MD ?0.05 nocturnal visits, 95% CI ?0.49 to 0.39, P > 0.05; 1 trial), or to tamsulosin (per cent improvement) (RR) (risk ratio) 0.91, 95% CI 0.66 to 1.27, P > 0.05; 1 trial). Comparing peak urine flow, Serenoa repens was not superior to placebo at trial endpoint (WMD 1.02 mL/s, 95% CI ?0.14 to 2.19, P > 0.05; 10 trials), or by comparing mean change (WMD 0.31 mL/s, 95% CI ?0.56 to 1.17, P > 0.05; 2 trials). Comparing prostate size at endpoint, there was no significant difference between Serenoa repens and placebo (MD ?1.05 cc, 95% CI ?8.84 to 6.75, P > 0.05; 2 trials), or by comparing mean change (MD ?1.22 cc, 95% CI ?3.91 to 1.47, P > 0.05; 1 trial). Authors’ conclusions Serenoa repens was not more effective than placebo for treatment of urinary symptoms consistent with BPH.

Tacklind, James; MacDonald, Roderick; Rutks, Indy; Wilt, Timothy J

2011-01-01

106

Characterisation of inflammatory cells in benign prostatic hyperplasia.  

PubMed

Inflammation is a common finding in benign prostatic hyperplasia (BPH) and may be classified as acute, chronic active or chronic inactive prostatitis. The aim of the present study was to localise the different types of inflammatory cells in prostatic lesions to determine the sequence of events in the cellular reaction. We have carried out immunohistological characterisation of the inflammatory cells, using CD45RO and CD3 antibodies to detect T-lymphocytes, CD20 antibodies to detect B-lymphocytes, CD68 to detect macrophages, kappa and lambda immunoglobulin light chains, and antibodies against prostate specific antigen (PSA) and prostate specific acid phosphatase (PSAP). Macrophages accumulated in the lumen and glandular epithelial layers of damaged prostatic glands and were found in the periglandular cuff of inflammatory cells in acute and chronic active prostatitis. Lymphocytes also accumulated in large numbers in the glandular epithelial layers and around the glands, indicating an association with macrophages. B-lymphocytes were scanty, if at all present, in acute and chronic active prostatitis, but were prominent within well-organised follicle centres in chronic active prostatitis. Cells positive for light chains were few and scattered in prostatic tissue. PSA and PSAP activity was lost in recently damaged prostatic glandular epithelium and reappeared only in regenerating secretory epithelium, indicating leakage as a result of damage. We suggest that the initial response to prostatic injury is cellular, and probably related to leakage into the periglandular tissues of PSA, PSAP and other antigenic molecules normally present in prostatic secretion. Macrophages respond, followed by recruitment of T-lymphocytes which participate in the inflammatory response and accumulate around the damaged glands. B-cell activity appears to be a late event. PMID:9842422

Anim, J T; Udo, C; John, B

1998-11-01

107

Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients.  

PubMed

Symptomatic benign prostatic hyperplasia (BPH) typically occurs in the sixth and seventh decades, and the most frequent obstructive urinary symptoms are hesitancy, decreased urinary stream, sensation of incomplete emptying, nocturia, frequency, and urgency. Various medications, specifically 5-alpha-reductase inhibitors and selective alpha-blockers, can decrease the severity of the symptoms secondary to BPH, but prostatectomy is still considered to be the traditional method of management. We report the preliminary results for two patients with acute urinary retention due to BPH, successfully treated by prostate artery embolization (PAE). The patients were investigated using the International Prostate Symptom Score, by digital rectal examination, urodynamic testing, prostate biopsy, transrectal ultrasound (US), and magnetic resonance imaging (MRI). Uroflowmetry and postvoid residual urine volume complemented the investigation at 30, 90, and 180 days after PAE. The procedure was performed under local anesthesia; embolization of the prostate arteries was performed with a microcatheter and 300- to 500-microm microspheres using complete stasis as the end point. One patient was subjected to bilateral PAE and the other to unilateral PAE; they urinated spontaneously after removal of the urethral catheter, 15 and 10 days after the procedure, respectively. At 6-month follow-up, US and MRI revealed a prostate reduction of 39.7% and 47.8%, respectively, for the bilateral PAE and 25.5 and 27.8%, respectively, for the patient submitted to unilateral PAE. The early results, at 6-month follow-up, for the two patients with BPH show a promising potential alternative for treatment with PAE. PMID:19908092

Carnevale, Francisco Cesar; Antunes, Alberto Azoubel; da Motta Leal Filho, Joaquim Mauricio; de Oliveira Cerri, Luciana Mendes; Baroni, Ronaldo Hueb; Marcelino, Antonio Sergio Zafred; Freire, Geraldo Campos; Moreira, Airton Mota; Srougi, Miguel; Cerri, Giovanni Guido

2010-04-01

108

Transurethral resection of the prostate  

MedlinePLUS

TURP; Prostate resection - transurethral ... used to remove the inside part of your prostate gland using electricity. ... if you have benign prostatic hyperplasia ( BPH ). The prostate gland often grows larger as men get older. ...

109

VAT-1 is a novel pathogenic factor of progressive benign prostatic hyperplasia.  

PubMed

BACKGROUND: Benign prostatic hyperplasia (BPH), arising from prostatic stromal hyperplasia (STH), is a progressive disease associated with bothersome lower urinary tract symptoms (LUTS). The mechanism of this STH remains unclear because there is no suitable model to study BPH pathology. Previously, we reported a new experimental BPH model that is clinically relevant to STH (the STH model). To elucidate prostatic STH mechanism, we used a compound found to be effective in the STH model. METHODS: A binding protein specific for the effective compound in the STH model was pulled down using a compound-conjugated affinity matrix and identified by mass spectrometry. The RNA interference (RNAi) method was used to confirm the participation of the binding protein in cell proliferation. The binding protein expression in the prostate was assessed by immunohistochemistry. RESULTS: A benzimidazole derivative (Benz) significantly suppressed growth of implanted urogenital sinuses (UGS; 37.1%) in the STH model and inhibited the proliferation of human prostate stromal cells (PrSC) in a concentration-dependent manner (IC(50) ?=?0.43?µM). Vesicle amine transport protein-1 (VAT-1) was identified as a specific binding protein of Benz. Immunohistochemical analysis showed that the VAT-1 expression level was higher in both epithelial and stromal cells of rat UGS and human BPH tissue than in normal prostate. VAT-1 siRNA markedly inhibited proliferation of PrSC, two androgen-independent prostate cancer cell lines (PC3 and DU145), and suppressed UGS growth (28.2%) in the STH model. CONCLUSIONS: Here, we demonstrate that VAT-1 is a novel pathogenic factor in BPH associated with cell proliferation. Prostate © 2011 Wiley-Liss, Inc. PMID:21394740

Mori, Fumitaka; Tanigawa, Kiyoshi; Endo, Kanji; Minamiguchi, Kazuhisa; Abe, Masaaki; Yamada, Shizuo; Miyoshi, Kazuhisa

2011-03-10

110

[The use of laser vaporization for the treatment of benign prostatic hyperplasia].  

PubMed

Results of use of UroBeam laser diode in 72 patients with benign prostatic hyperplasia (BPH) were analyzed. Average prostate volume was 67.29 +/- 26.72 cm3, the duration of vaporization--69.2 +/- 23.7 min. Blood loss was minimal. In the period from 2 weeks to 4 months after surgery, 9 patients have developed acute urinary retention. In the early postoperative period, acute prostatitis was diagnosed in 7 patients and was jugulated using drug treatment. The laser vaporization of BPH led to a three-fold reduction in the severity of urinary disorders and increase the urinary flow rate. The combination of laser vaporization of the prostate with transurethral resection of the prostate allow to improve the recovery of urination after surgery. PMID:24159771

Ustinov, D V; Kholtobin, D P; Kul'chavenia, E V; A?zikovich, B I

2013-01-01

111

Voltage-gated sodium channels were differentially expressed in human normal prostate, benign prostatic hyperplasia and prostate cancer cells  

PubMed Central

Voltage-gated sodium channels (VGSCs) are expressed not only in excitable cells but also in numerous metastatic cells, particularly in certain types of cancer cells. In some types of cancer, including prostate cancer, the expression of VGSCs is associated with cancer migration, invasion and metastasis in vivo. However, the detailed expression profiles of VGSC ? subunits in normal human prostate, in prostatic hyperplasia and prostatic cancer remain controversial. In the present study, quantitative polymerase chain reaction was used to systematically detect all subtypes of VGSC ? subunits in normal human prostate, benign prostatic hyperplasia (BPH) and prostate cancer cells. The expression profile of VGSC ? subunits was observed to differ between these cell types. Nav1.5 was the major isoform expressed in normal human prostate tissue, while Nav1.5 and Nav1.2 were the predominant isoforms in BPH tissue. However, in PC-3 and LNCaP cells, two typical prostate cancer cell lines, Nav1.6 and Nav1.7 were abundantly expressed. By comparing the relative expression levels of Nav1.5, Nav1.6 and Nav1.7 in these cells, the mRNA levels of Nav1.6 and Nav1.7 were identified to be 6- to 27-fold higher in PC-3 and LNCaP cells than in either normal or BPH samples (P<0.05); however, Nav1.5 mRNA levels were relatively lower compared with those of Nav1.6 or Nav1.7 in all cells analyzed. To confirm whether Nav1.6 and Nav1.7 expression in cancer cells was functional, a patch-clamp technique was used to record whole-cell currents. A tetrodotoxin-sensitive sodium current was successfully recorded in PC-3 cells, but not in LNCaP cells. It was concluded that although all types of VGSC ? subunits exhibited low expression levels in normal prostate and BPH cells, both Nav1.6 and Nav1.7 were significantly upregulated in the prostate cancer cell lines, suggesting these subtypes may be potential diagnostic markers and therapeutic targets for certain types of prostate cancer in humans.

SHAN, BIN; DONG, MEI; TANG, HE; WANG, NA; ZHANG, JIN; YAN, CHANGQING; JIAO, XIAOCUI; ZHANG, HAILIN; WANG, CHUAN

2014-01-01

112

Association of a Common Variant at 10q26 and Benign Prostatic Hyperplasia Aggressiveness in Han Chinese Descent  

PubMed Central

Recent studies reported that rs2252004 at 10q26 was significantly associated with prostate cancer (PCa) risk in a Japanese population and was subsequently confirmed in a Chinese population. We aimed to assess the relationship between this locus and risk/aggressiveness of benign prostatic hyperplasia (BPH). The current study included 426 BPH cases and 1,008 controls from Xinhua Hospital in Shanghai, China. All BPH patients were treated with ?-adrenergic blockers and 5?-reductase inhibitors for at least 9 months. Associations between rs2252004 and BPH risk/aggressiveness were tested using logistic regression. Associations between rs2252004 and clinical parameters including International Prostate Symptom Score (IPSS), total prostate volume (TPV), total PSA (tPSA), and free PSA (fPSA) were evaluated by linear regression. Allele “A” in rs2252004 was significantly associated with increased risk for aggressiveness of BPH in a Chinese population (OR?=?1.42, 95% CI: 1.04–1.96, P = 0.03). Patients with the genotype “A/A” (homozygous minor allele) had an increase of IPSS and TPV after treatment (P = 0.045 and 0.024, resp.). No association was observed between rs2252004, BPH risk, and baseline clinicopathological traits (All P > 0.05). Our study is the first to show that rs2252004 at 10q26 was associated with BPH aggressiveness and efficacy of BPH treatment.

Gu, Xin; Huang, Tao; Xu, Ding; Duan, Liujian; Jiao, Yang; Kang, Jian; Zheng, S. Lilly; Xu, Jianfeng; Sun, Jielin; Qi, Jun

2013-01-01

113

Mitochondrial D-Loop polymorphism and microsatellite instability in prostate cancer and benign hyperplasia patients.  

PubMed

In this study mitochondrial D-Loop variations in Iranian prostate cancer and benign prostatic hyperplasia (BPH) patients were investigated. Tumour samples and corresponding non-cancerous prostate tissue from 40 prostate cancer patients and 40 age-matched BPH patients were collected. The entire mtD-loop region (16024-576) was amplified using the PCR method and products were gel-purified and subjected to direct nucleotide sequencing. A total of 129 variations were found, the most frequent being 263A-G and 310T-C among both BPH and prostate cancer patients. Variation of 309 C-T was significantly more frequent in prostate cancer patients (P value<0.05). Four novel variations were observed on comparison with the MITOMAP database. Novel variations were np16154delT, np366G-A, np389G-A and 56insT. There was no correspondence between the different variations and the age of subjects. Considering that D-loop variations were frequent in both BPH and prostate cancer patients in our study, the fact that both groups had high average age can be a possible contributing factor. D-loop polymorphisms and microsatellite instability can influence cell physiology and result in a benign or malignant phenotype. Significantly higher frequency of 309 C-T variation in cancer patients is a notable finding and must be a focus of attention in future studies. PMID:23098484

Ashtiani, Zahra Ousati; Heidari, Mansour; Hasheminasab, Sayed-Mohammad; Ayati, Mohsen; Rakhshani, Naser

2012-01-01

114

[Transurethral laser coagulation of benign prostatic hyperplasia].  

PubMed

37 patients with BHPG (average age 76) underwent transurethral laser coagulation of the prostate 23 of these had acute retention of urine. In all the patients urination was restored by the 5-th day after the operation. Thus the laser coagulation should be considered a method of choice in BPH patents with grave recurring pathology including urgent cases. PMID:9123752

Goriachev, I A; Gomberg, V G; Parkhomchuk, N A

1996-01-01

115

Basal Cell Hyperplasia in the Peripheral Zone of the Prostate  

Microsoft Academic Search

Basal cell hyperplasia in the prostate is often viewed as a transition zone proliferation, related to usual, nodular glandular, and stromal hyperplasia. Basal cell hyperplasia in the prostatic peripheral zone, the most common site for development of prostatic intraepithelial neoplasia and carcinoma, has not been previously characterized. We characterized the incidence and histomorphological attributes of basal cell hyperplasia in a

Phataraporn Thorson; Paul E. Swanson; Robin T. Vollmer; Peter A. Humphrey

2003-01-01

116

Microwave applicators for BPH thermotherapy  

NASA Astrophysics Data System (ADS)

Paper deals with new results in the field of intracavitary microwave applicators used for Benign Prostatic Hyperplasia (BPH) treatment. We demonstrate here that it is necessary to use more sophisticated applicators than a simple monopole radiating structure. One of the good possibilities for safe and efficient treatments we propose here is a helix structure.

Vrba, Jan; Hlavac, R.; Herza, Jan; Chovanec, Roman; Cvek, Jakub; Oppl, L.

2004-04-01

117

Mortality trends for benign prostatic hyperplasia and prostate cancer in English populations 1979-2006.  

PubMed

OBJECTIVE To determine mortality trends for benign prostatic hyperplasia (BPH) and prostate cancer in English populations, between 1979 and 2006. SUBJECTS AND METHODS Analysis of datasets that include both the underlying cause and all other mentioned causes on death certificates (together, termed 'mentions'): the Oxford Record Linkage Study, 1979-2006, and English national data, 1995-2006. RESULTS In the Oxford region, underlying-cause mortality from BPH fell from 45 deaths per million in 1979 to 2.4 in 2006. For mentions, the respective rates were 93 and 7.1. In England, underlying-cause mortality reduced from 9.2 deaths per million in 1995 to 4.5 deaths per million in 2006. For mentions, the rates were 20 and 9.9 deaths per million. When BPH was certified on death certificates, it was selected as the underlying cause of death on fewer than half. Underlying-cause mortality for prostate cancer in Oxford increased from 213 deaths per million in 1979 to 335 by 1991, and thereafter declined to 253 deaths per million in 2006. Mentions-mortality in Oxford followed a similar pattern. In later years, when there were comparable data for Oxford and England, the pattern of decline in England was similar to that in Oxford. Where mentioned, prostate cancer was coded as the underlying cause of death on three-quarters of death certificates. CONCLUSIONS The fall in BPH mortality, evident in statistics on underlying cause, was confirmed by statistics on all certified causes of death. The fall is dramatic in scale, likely to be attributable to clinical care, and could be regarded as an indicator of improving standards of care. Mortality for prostate cancer increased, peaking in the 1990s, then decreased in recent years in rates as measured both by underlying cause and by mentions. PMID:20590542

Duncan, Marie E; Goldacre, Michael J

2011-01-01

118

A prospective randomized comparison of transurethral resection to visual laser ablation of the prostate for the treatment of benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesTransurethral resection of the prostate (TURP) represents the accepted standard of surgical therapy for the management of symptomatic bladder outlet obstruction due to benign prostatic hyperplasia (BPH). However, this is a major operative procedure associated with significant perioperative morbidity. Visual laser ablation of the prostate (VLAP) utilizing a neodymium:yttrium-aluminum-garnet laser represents a new technologic approach to the surgical management of

Robert S. Cowles; John N. Kabalin; Stacy Childs; Herbert Lepor; Christopher Dixon; Barry Stein

1995-01-01

119

Benign prostate hyperplasia: evaluation of treatment response with DCE MRI.  

PubMed

Benign prostate hyperplasia (BPH) is a major disease and its non-surgical therapy a major area of interest. The purpose of this study was to establish perfusion parameters in beagles with BPH using dynamic contrast-enhanced (DCE) MRI and to investigate changes due to the effects of finasteride treatment. Twelve male beagles (mean age 4.4 +/- 0.9,years) were divided into a control and treatment group that received a daily dose of 1 mg/kg finasteride. DCE MRI was carried out in a clinical scanner using a 3D spoiled gradient echo sequence prior to and during treatment. 0.2 mmol/kg contrast agent (gadoteridol) was administered with an injection rate of 0.2 ml/s followed by a 15 ml flush of saline. Contrast enhancement was evaluated by pharmacokinetic mapping of a two-compartment model with colour overlay images in addition to regional ROI analysis. Quantitative parameters were defined by the amplitude of contrast enhancement A, the exchange rate k(ep) and the time to maximum signal enhancement. Dynamic contrast-enhanced MRI investigations of the prostate revealed two distinct zones, an inner, periurethral zone and an outer, parenchymal zone. The periurethral zone is highly vascularized, whereas the parenchymal zone is moderately vascularized when compared to other parenchymal organs. During treatment, in the parenchymal zone the intensity of enhancement (amplitude A) and the time to maximum signal enhancement increased, while the exchange rate k(ep) decreased. Dynamic contrast-enhanced MRI of BPH reveals distinct differences between individual zones within the prostate. Moreover, changes during successful treatment suggest increased blood volume per volume of tissue and decreased vessel leakiness. PMID:15221660

Heverhagen, J T; von Tengg-Kobligk, H; Baudendistel, K T; Jia, G; Polzer, H; Henry, H; Levine, A L; Rosol, T J; Knopp, M V

2004-09-01

120

Serum Adiponectin, C-peptide and Leptin and Risk of Symptomatic Benign Prostatic Hyperplasia: Results From the Prostate Cancer Prevention Trial  

PubMed Central

Background Recent epidemiologic studies have identified obesity as a risk factor for benign prostatic hyperplasia (BPH). We examined whether adiponectin, leptin and C-peptide were associated with incident, symptomatic BPH and whether these factors mediate the relationship between obesity and BPH risk. Methods Data are from Prostate Cancer Prevention Trial placebo arm participants who were free of BPH at baseline. Incident BPH (n=698) was defined as treatment, two International Prostate Symptom Score (IPSS) values >14, or an increase of ?5 in IPSS from baseline documented on at least two occasions plus at least one score ?12. Controls (n=709) were selected from men reporting no BPH treatment or IPSS >7 during the seven-year trial. Baseline serum was analyzed for adiponectin, C-peptide, and leptin concentrations. Results Neither C-peptide nor leptin was associated with BPH risk. The odds ratio [95% CI] contrasting highest to lowest quartiles of adiponectin was 0.65[0.47, 0.87] ptrend=0.004. Findings differed between levels of physical activity: there was a strong inverse association between adiponectin and BPH among moderately/very active men OR=0.43[0.29, 0.63], and no association among sedentary/minimally active men OR=0.92[0.65, 1.30] pinteraction=0.005. Adiponectin concentrations explained only a moderate amount of the relationship between obesity and BPH risk. Conclusions High adiponectin concentrations were associated with reduced risk of incident, symptomatic BPH. This association was limited to moderately/very active men; suggesting the relationship between obesity and BPH involves a complex interaction between factors affecting glucose uptake and insulin sensitivity. However, adiponectin is likely not the only mechanism through which obesity affects BPH risk.

Schenk, Jeannette M.; Kristal, Alan R.; Neuhouser, Marian L.; Tangen, Catherine M.; White, Emily; Lin, Daniel W.; Thompson, Ian M.

2010-01-01

121

5{alpha}-reductase expression by prostate cancer cell lines and benign prostatic hyperplasia in vitro  

SciTech Connect

5{alpha}-Reductase (5{alpha}R) activity in two human prostate cancer cell lines was compared to that in benign prostatic hyperplasia (BPH) tissue and COS cells transfected with and expressing the human genes for 5{alpha}-reductase type 1 (5{alpha}R1) and type 2 (5{alpha}R2). Comparisons were based on pH profiles and sensitivities to selective inhibitors of 5{alpha}-reductase. In the cancer lines, activity was greatest over the pH range 7-8, compared to a sharp peak of activity between pH 5-5.5 in BPH tissue and COS cells expressing 5{alpha}R2. Finasteride and SKF105,657 were potent inhibitors of 5{alpha}-reductase activity in BPH tissue and COS cells expressing 5{alpha}R2, but weak inhibitors in the cancer lines and in COS cells expressing 5{alpha}R1. In contrast, LTK1 17,026 was a more potent inhibitor of 5{alpha}-reductase activity in the prostate cancer cell lines and in COS cells expressing 5{alpha}R1. These data indicate that human prostate cancer cell lines express 5{alpha}-reductase activity similar to that in COS cells transfected with 5{alpha}R1, but different from that in BPH tissue. This may be a consequence of in vitro culture. Alternatively, it may reflect a change occurring as a result of neoplastic transformation, in which case it will be important to select appropriate inhibitors in the clinic. 29 refs., 3 figs., 2 tabs.

Smith, C.M.; Masters, J.R.W. [Univ. College of London (United Kingdom)] [Univ. College of London (United Kingdom); [Pfizer Central Research, Kent (United Kingdom); Ballard, S.A.; Worman, N. [Pfizer Central Research, Sandwich (United Kingdom)] [Pfizer Central Research, Sandwich (United Kingdom)

1996-04-01

122

Histotripsy of the Prostate for the Treatment of BPH: Chronic Results From a Canine Model  

NASA Astrophysics Data System (ADS)

Histotripsy was evaluated as a non-invasive BPH treatment. The prostates of 21 canine subjects were targeted with one of three histotripsy doses. Prostates were harvested immediately, 7 days, or 28 days after treatment and assessed for changes. Lower treatment doses were found to produced scattered cellular disruption and hemorrhage that was sometimes reversible. Higher doses perforated the urethra and produced cavities in the glandular prostate that healed to leave an enlarged urinary channel.

Hall, Timothy L.; Hempel, Chris R.; Lake, Alison M.; Kieran, Kathy; Ives, Kim; Fowlkes, J. Brian; Cain, Charles A.; Roberts, William W.

2009-04-01

123

The role of combination medical therapy in benign prostatic hyperplasia.  

PubMed

To review key trials of monotherapy and combination therapy of alpha(1)-adrenergic receptor antagonists (alpha(1)-ARAs), 5alpha-reductase inhibitors (5alphaRIs) and anti-muscarinic agents in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). To assess the safety and efficacy of combination therapies for LUTS associated with BPH, a search of the MEDLINE and Cochrane databases (1976-2008) was conducted for relevant trials and reviews using the terms benign prostatic hyperplasia, lower urinary tract symptoms, alpha(1)-adrenergic receptor antagonists, 5alpha-reductase inhibitors, anti-muscarinics, anticholinergics, combination therapy, alfuzosin, doxazosin, tamsulosin, terazosin, dutasteride, finasteride, tolterodine, flavoxate, propiverine, oxybutynin, erectile dysfunction, sildenafil, vardenafil and tadalafil. Data from the Medical Therapy of Prostatic Symptoms (MTOPS) study indicated a role for long-term use of alpha(1)-ARAs and 5alphaRIs in combination. In the MTOPS study, combination therapy with the alpha(1)-ARA doxazosin and the 5alphaRI finasteride was significantly more effective than either component alone in reducing symptoms (P=0.006 vs doxazosin monotherapy; P<0.001 vs finasteride monotherapy) and in lowering the rate of clinical progression (P<0.001 vs either monotherapy). These findings were confirmed by the 2-year preliminary results of the Combination of Avodart and Tamsulosin study. In this study, combination therapy of the alpha(1)-ARA tamsulosin and the 5alphaRI dutasteride resulted in a significantly greater decrease in International Prostate Symptom Score (IPSS) when compared with either monotherapy. Several recent trials have studied the efficacy of combining alpha(1)-ARAs and anti-muscarinic agents in the treatment of BPH. These studies have found this combination to result in statistically significant benefits in quality of life scores, patient satisfaction, urinary frequency, storage symptoms and IPSS scores. Studies have not shown an increased risk of urinary retention associated with the use of anti-muscarinics in a highly select cohort of men with BPH. The available data suggest that combination therapy can be beneficial in the treatment of BPH and associated LUTS. The greatest efficacy for the alpha(1)-ARA and 5alphaRI combination was shown in patients with larger prostate size and more severe symptoms. The combination of alpha(1)-ARAs and 5alphaRIs appears to prevent disease progression in these patients. The combination of alpha(1)-ARAs with anti-muscarinic agents is useful for relieving symptoms of bladder outlet obstruction and detrusor overactivity. Theoretic concerns regarding the risk of acute urinary retention have been refuted in several recent clinical trials; however, it must be noted that the patients in these trials were a highly select cohort of men. Men with overactive bladder and BPH who are not receiving adequate alleviation of symptoms from the first-line alpha(1)-ARAs may benefit from the addition of an anti-muscarinic agent. PMID:19002123

Greco, K A; McVary, K T

2008-12-01

124

Transurethral microwave thermotherapy for management of benign prostatic hyperplasia: durability of response  

Microsoft Academic Search

Objectives. The durability of clinical efficacy of transurethral microwave thermotherapy (TUMT) by Prostatron using a low-energy protocol (maximum power, 50 W) was evaluated on an outpatient basis in patients with symptomatic benign prostatic hyperplasia (BPH).Methods. One hundred eighteen patients were followed up for longer than 3 months (13.4 ± 9.5 months; mean ± SD). All evaluations were made at baseline

Shiro Baba; Kaoru Nakamura; Masaaki Tachibana; Masaru Murai

1996-01-01

125

[Zinc, calcium and sodium values in secretions of patients with benign prostatic hyperplasia].  

PubMed

In two randomized patients groups suffering from benign prostatic hyperplasia (BPH) two exprimate samples were drawn at a seven-day interval. In the untreated control group no changes in the values of Ca, Na and Zn were found. In the other group the patients have been treated with ERU capsules (Radicis urticae) for 7 days and thereafter a significant decrease of Zn values were found. PMID:1712524

Romics, I; Bach, D

1990-12-01

126

New trends in the treatment of benign prostatic hyperplasia and carcinoma of the prostate.  

PubMed

Benign prostatic hyperplasia (BPH) is a very common condition affecting over 800,000 American males each year. A standard, effective, and well-proven therapy is prostatectomy. This surgical procedure is used to treat, in the United States, approximately 400,000 BPH patients annually. Major treatment benefit is expected in 70% to 80% of patients. Complications are seen in 20% of the surgically treated patients. Due to the advanced age of BPH patients and the presence of other serious coexisting medical problems, surgical therapy may be difficult to utilize. These patients, who present a high risk for surgery, are in need of alternative treatments. Alternative therapy in BPH patients with clinically important symptoms and signs of urinary outflow obstruction include treatment with pharmacological agents, balloon dilatation, laser beam therapy, transurethral thermal therapy, transrectal microwave hyperthermia, and transurethral microwave hyperthermia. These alternative treatment modalities are currently under intensive study. These new treatment modalities ultimately must be compared with the standard treatment, which is prostatectomy. Due to the unpredictable natural history of BPH, it is desirable that each Phase III study should contain a no-treatment observation-only arm. Adenocarcinoma of the prostate (CaP) has become a tumor, which first in frequency, and second in importance in cancer mortality statistics of American males. Local tumor control rates and long-term survivals, with radical prostatectomy or radiation therapy, have been excellent. There was, however, recent concern regarding a high incidence of microscopic local tumor recurrence following a definitive course of irradiation. Deep regional or intracavitary hyperthermia (HT) with phase steering may be of value as an adjuvant treatment to radiotherapy. This HT may increase the incidence of local tumor control obtained with radiotherapy. Phase I-II clinical studies are currently underway. PMID:7687817

Petrovich, Z; Ameye, F; Baert, L; Bichler, K H; Boyd, S D; Brady, L W; Bruskewitz, R C; Dixon, C; Perrin, P; Watson, G M

1993-06-01

127

Benign prostatic hyperplasia and male lower urinary tract symptoms (LUTS)  

PubMed Central

Introduction Lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) and bladder outlet obstruction may affect up to 30% of men in their early 70s. Symptoms can improve without treatment, but the usual course is a slow progression of symptoms, with acute urinary retention occurring in 1% to 2% of men with BPH per year. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical, herbal, and surgical treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 63 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: 5 alpha-reductase inhibitors, alpha-blockers, beta-sitosterol plant extract, Pygeum africanum, rye grass pollen extract, saw palmetto plant extracts, transurethral electrovaporisation, transurethral Holmium laser enucleation of the prostate, transurethral microwave thermotherapy, transurethral needle ablation, and transurethral resection (including transurethral resection versus transurethral incision, and transurethral resection versus visual laser ablation/laser vaporisation).

2011-01-01

128

The Effect of Intraprostatic Chronic Inflammation on Benign Prostatic Hyperplasia Treatment  

PubMed Central

Purpose Asymptomatic chronic inflammation of the prostate is a common finding in benign prostatic hyperplasia (BPH). We investigated how the chronic inflammation affects medical treatment for BPH. Materials and Methods One pathologist reviewed the chronic inflammation of 82 BPH patients who underwent transrectal ultrasonography (TRUS)-guided needle biopsy. The extent of chronic inflammation was classified into 4 grades, categorized into two groups: the low-grade group and the high-grade group. We compared total, voiding, and storage International Prostate Symptom Score (IPSS) and quality of life (QoL) between the groups at baseline and 1, 3, 6, and 12 months after medical treatment for BPH. Results There were no significant differences in total IPSS or QoL between the groups during the follow-up period. The low-grade group showed continuous improvement of storage symptoms until 12 months; however, the high-grade group showed improvement until 3 months. Maximal improvements of QoL were observed at 6 months in the high-grade group and at 3 months in the low-grade group. There was no episode of surgery in the low-grade group, but four patients in the high-grade group (9.1%) underwent surgical treatment due to acute urinary retention or insufficient therapeutic response. Conclusions Although there was no statistical significance, improvements in IPSS were higher and lasted longer in the low-grade group. We might suggest medical treatment for intraprostatic chronic inflammation in BPH patients.

Kwon, Young Kee; Choe, Mi Sun; Seo, Kyung Won; Park, Chol Hee; Chang, Hyuk Soo; Kim, Byung Hoon

2010-01-01

129

Effect of Obesity on Prostate-Specific Antigen, Prostate Volume, and International Prostate Symptom Score in Patients with Benign Prostatic Hyperplasia  

PubMed Central

Purpose We examined the correlation between body mass index (BMI) as a marker of obesity and prostate-specific antigen (PSA), prostate volume (PV), and International Prostate Symptom Score (IPSS) in patients with benign prostatic hyperplasia (BPH). Materials and Methods From January 2008 to December 2008, we examined 258 patients diagnosed with BPH. Patients taking 5?-reductase inhibitors or those diagnosed with prostate cancer were excluded from this study. BPH was defined as PV?25 ml and IPSS?8. BMI (kg/m2) was categorized into 4 groups as follows: BMI<18.5 (underweight), BMI 18.5-23.0 (normal), BMI 23.0-27.5 (overweight), and BMI>27.5 (obese). The relationships between PSA, PV, IPSS, and BMI were analyzed by correlation analysis and one-way ANOVA. Results The mean age of the patients was 65.19±9.13 years and their mean BMI was 23.7±4.4 kg/m2. The mean PSA values of each BMI group were as follows: 3.42±1.53, 3.07±1.88, 2.74±1.75, and 2.60±1.44 ng/ml. The PSA value was lowest in the obese group. The correlation analysis showed a negative correlation between BMI and PSA (Pearson's correlation coefficient=-0.142, p=0.023) and positive correlations between BMI and PV (Pearson's correlation coefficient=0.32, p=0.001) and IPSS (Pearson's correlation coefficient=0.470, p=0.02). These correlations were also confirmed by one-way ANOVA. Conclusions Patients with an elevated BMI tended to have lower PSA values, larger PVs, and a higher IPSS. We suggest that weight loss could be helpful for BPH symptom relief as well as for detection of coexisting prostate cancer in BPH patients.

Kim, Jong Min; Song, Phil Hyun; Kim, Hyun Tae

2011-01-01

130

Intra-prostatic injection of botulinum toxin type A in treatment of dogs with spontaneous benign prostatic hyperplasia.  

PubMed

Benign prostatic hyperplasia (BPH) is a common, naturally developing, age-related condition in dogs. The pathogenesis of BPH is not completely known; however, DHT is a hormone involved in enlargement of the prostate. Recently, the effect of botulinum toxin A (BT-A) was investigated in the rat and human prostate and has shown to induce atrophy of the gland on the canine prostate. This study investigated the effect of BT-A in the canine prostate and on the semen. Eight sexually intact male dogs with BPH (detected radiographically and ultrasonographically), and with clinical signs of BPH (e.g. hematuria or tenesmus) were used. Each lobe of the prostate received an injection of 125 U of BT-A with one-needle pass under transabdominal ultrasound guidance. The clinical results were evaluated at baseline and after treatment. No local complications or systemic adverse effects were reported. At 4 weeks, the mean prostate volume (PV) was not significantly changed after BT-A (from 17.70 ± 6.34 to 16.48 ± 5.98 cm(3)). At 8 weeks the PV had further decreased to 16.04 ± 5.80 cm(3), reaching its maximum effect, but that change was not significant. The results were maintained at 16 weeks. All dogs had normal libido, erection, and ejaculation during semen collection. No significant difference was observed in all seminal parameters. Results suggest that the administration of 250 U of BT-A do not contribute to PV reduction and do not adversely affect the semen quality of dogs with BPH. PMID:22819377

Mostachio, Giuliano Queiroz; Apparício, Maricy; Motheo, Tathiana Ferguson; Alves, Aracélle Elisane; Vicente, Wilter Ricardo Russiano

2012-08-01

131

Evaluation of molecular species of prostate-specific antigen complexed with immunoglobulin M in prostate cancer and benign prostatic hyperplasia.  

PubMed

This study was aimed at defining molecular species of prostate-specific antigen (PSA) in immune complexes with immunoglobulin M (IgM). Having in mind the oligoreactivity of IgM and its preference for carbohydrate antigens, there is the possibility that it can selectively recognize known PSA glycoisoforms. PSA-IgM complexes and free PSA fractions were separated from the sera of subjects with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) by gel filtration and subjected to on-chip immunoaffinity and ion-exchange chromatography. PSA-immunoreactive species were detected using surface-enhanced laser desorption/ionization time of flight mass spectrometry. The obtained spectra were analyzed for protein and glycan composition. The general pattern of the molecular species of PCa PSA and BPH PSA found in complexes with IgM was similar. It comprised major peaks at 17 kDa and minor peaks at 28 kDa, corresponding to the entire mature glycosylated PSA. The main difference was the presence of incompletely glycosylated 26.8 kDa species, having putative paucimannosidic structures, observed in PCa PSA-IgM, but not in BPH PSA-IgM. Characteristic PCa PSA-IgM glycoforms pose the question of the possible role of glycosylation as a framework for immune surveillance and may be of interest in light of recent data indicating mannose-containing glycans as cancer biomarker. PMID:24367138

Go?, Sanja; Jankovi?, Miroslava

2013-01-01

132

Serenoa Repens, lycopene and selenium: a triple therapeutic approach to manage benign prostatic hyperplasia.  

PubMed

Benign prostatic hyperplasia (BPH) is a major health concern that is likely to have an increasing impact in line with the gradual aging of the population. BPH is characterized by smooth muscle and epithelial proliferation primarily within the prostatic transition zone that can cause a variety of problems for patients, the most frequent are the lower urinary tract symptoms. BPH is thought to involve in disruption of dihydrotestosterone (DHT)-supported homeostasis between cell proliferation and cell death, and, as a result, proliferative processes predominate and apoptotic processes are inhibited. Phytotherapeutic supplements, mainly based on Saw Palmetto-derived Serenoa Repens (SeR), are numerous and used frequently. Serenoa Repens reduces inflammation and decreases in vivo the androgenic support to prostatic cell growth. Furthermore, SeR stimulates the apoptotic machinery; however, data supporting efficacy is limited, making treatment recommendations difficult. Besides SeR, selenium (Se), an essential trace element mainly functioning through selenoproteins and able to promote an optimal antioxidant/oxidant balance, and lycopene (Ly), a dietary carotenoid synthesized by plants, fruits, and microorganisms with a strong antioxidant activity, has been shown to exert beneficial effects in prostate disease. SeR is frequently associated with Ly and Se, in order to increase its therapeutic activity in benign prostatic hyperplasia (BPH). It has been shown that the Ly-Se-SeR association has a greater and enhanced antiinflammatory activity that might be of particular interest in the treatment of BPH. The Ly-Se-SeR association is also more effective than SeR alone in reducing prostate weight and hyperplasia, in augmenting the pro-apoptotic Bax and caspase-9 and blunting the anti-apoptotic Bcl-2 mRNA. In addition, Ly-Se-SeR more efficiently suppresses the EGF and Vascular Endothelial Growth Factor (VEGF) expressions in hyperplastic prostates. Therefore, SeR particularly when combined with Se and Ly may have a greater potential for the management of benign prostate hyperplasia. PMID:23432584

Minutoli, L; Bitto, A; Squadrito, F; Marini, H; Irrera, N; Morgia, G; Passantino, A; Altavilla, D

2013-01-01

133

The expression of androgen-responsive genes is up-regulated in the epithelia of benign prostatic hyperplasia  

PubMed Central

BACKGROUND Benign prostatic hyperplasia (BPH) is one of the most common diseases among aging men in the United States. In addition to aging, the presence of androgens is another major risk factor in BPH development. However, whether androgen signaling is altered in BPH remains unclear. To determine androgen signaling in BPH, we characterized the expression of 4 different androgen-responsive genes, Eaf2/U19, ELL2, FKBP5, and PSA, in BPH and adjacent normal glandular epithelial cells. METHODS A set of 17 BPH specimens were from patients over 60 years of age with clinical symptoms of BPH. Laser-capture microdissection (LCM) was used to isolate glandular epithelial cells from BPH areas and adjacent normal areas, separately. LCM isolated cells from individual specimens were lysed and RNA isolation, reverse transcription, and real-time PCR were performed using CellsDirect™ One-Step qRT-PCR Kit (Invitrogen, Carlsbad, CA). RESULTS All of the assayed genes displayed increased expression from ~2-fold to ~6-fold, in BPH as compared to the adjacent normal epithelial cells. We also generated a composite androgen response index based on the expression levels of the 4 genes, which provides a reliable readout for overall androgen action. Our study showed that the composite androgen response index in BPH is ~4-fold as compared to that in the adjacent normal tissues. CONCLUSIONS Androgen signaling is significantly elevated in BPH relative to the adjacent normal prostate. Understanding the mechanisms causing elevated androgen signaling may lead to novel approaches for prevention and/or treatment of BPH.

O'Malley, Katherine J.; Dhir, Rajiv; Nelson, Joel; Bost, James; Lin, Yan; Wang, Zhou

2009-01-01

134

Protective effects of seahorse extracts in a rat castration and testosterone-induced benign prostatic hyperplasia model and mouse oligospermatism model.  

PubMed

This study investigated the effects of seahorse (Hippocampus spp.) extracts in a rat model of benign prostatic hyperplasia (BPH) and mouse model of oligospermatism. Compared to the sham operated group, castration and testosterone induced BPH, indicated by increased penile erection latency; decreased penis nitric oxide synthase (NOS) activity; reduced serum acid phosphatase (ACP) activity; increased prostate index; and epithelial thickening, increased glandular perimeter, increased proliferating cell nuclear antigen (PCNA) index and upregulation of basic fibroblast growth factor (bFGF) in the prostate. Seahorse extracts significantly ameliorated the histopathological changes associated with BPH, reduced the latency of penile erection and increased penile NOS activity. Administration of seahorse extracts also reversed epididymal sperm viability and motility in mice treated with cyclophosphamide (CP). Seahorse extracts have potential as a candidate marine drug for treating BPH without inducing the side effects of erectile dysfunction (ED) or oligospermatism associated with the BPH drug finasteride. PMID:24607683

Xu, Dong-Hui; Wang, Li-Hong; Mei, Xue-Ting; Li, Bing-Ji; Lv, Jun-Li; Xu, Shi-Bo

2014-03-01

135

Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH  

PubMed Central

Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA???S-2 Introduction???S-2 Benign Prostatic Hyperplasia (BPH)???S-3 •?Overview???S-3•?Current BPH Treatment Paradigm???S-4•?BPH Continuum of Care: Bladder Health???S-5 New Treatment Option for BPH???S-5 •?The UroLift® System???S-6•?Positioning of UroLift® in BPH Treatment Paradigm???S-7 New Value Proposition???S-8 •?Addressing Bladder Health: Breaking the Cycle???S-8•?Cost Benefit Analysis: The Big Picture???S-8 Patient and Family Engagement???S-10 Summary???S-11

2013-01-01

136

Inhibitors of apoptosis proteins in experimental benign prostatic hyperplasia: effects of serenoa repens, selenium and lycopene  

PubMed Central

Background The apoptosis machinery is a promising target against benign prostatic hyperplasia (BPH). Inhibitors of apoptosis proteins (IAPs) modulate apoptosis by direct inhibition of caspases. Serenoa Repens (SeR) may be combined with other natural compounds such as Lycopene (Ly) and Selenium (Se) to maximize its therapeutic activity in BPH. We investigated the effects of SeR, Se and Ly, alone or in association, on the expression of four IAPs, cIAP-1, cIAP-2, NAIP and survivin in rats with experimental testosterone-dependent BPH. Moreover, caspase-3, interleukin-6 (IL-6) and prostate specific membrane antigen (PSMA) have been evaluated. Rats were administered, daily, with testosterone propionate (3 mg/kg/sc) or its vehicle for 14 days. Testosterone injected animals (BPH) were randomized to receive vehicle, SeR (25 mg/kg/sc), Se (3 mg/kg/sc), Ly (1 mg/kg/sc) or the SeR-Se-Ly association for 14 days. Animals were sacrificed and prostate removed for analysis. Results BPH animals treated with vehicle showed unchanged expression of cIAP-1 and cIAP-2 and increased expression of NAIP, survivin, caspase-3, IL-6 and PSMA levels when compared with sham animals. Immunofluorescence studies confirmed the enhanced expression of NAIP and survivin with a characteristic pattern of cellular localization. SeR-Se-Ly association showed the highest efficacy in reawakening apoptosis; additionally, this therapeutic cocktail significantly reduced IL-6 and PSMA levels. The administration of SeR, Se and Ly significantly blunted prostate overweight and growth; moreover, the SeR-Se-Ly association was most effective in reducing prostate enlargement and growth by 43.3% in treated animals. Conclusions The results indicate that IAPs may represent interesting targets for drug therapy of BPH.

2014-01-01

137

Urethral lift for benign prostatic hyperplasia: a comprehensive review of the literature.  

PubMed

Current treatments for benign prostatic hyperplasia (BPH) include watchful waiting, medical therapy, and interventional procedures. The post-surgical complication profile and the early discontinuation of medical therapy are significant drawbacks of the established approach and stimulate the search for less-invasive approaches. Our aim is to provide a comprehensive review all available literature on prostatic urethral lift (PUL), presenting an overview of safety, indications, surgical technique and results of the procedure, and to evaluate the potential role it could play in the treatment of BPH. A comprehensive search was conduct on PubMed and Scopus database to identify original articles in English dealing with PUL without any limit to publication date. Keywords used were prostatic urethral lift, urethral lifting, Urolift, benign prostatic hyperplasia and minimally invasive therapy. The PUL seems to offer a better IPSS improvement when compared to medical therapy, but the result is inferior when compared to surgical therapy. Published studies report an absence of degradation of erectile or ejaculatory function after treatment, which appears a noteworthy benefit of PUL. Additional advantages of the PUL are a better complication profile in comparison to other surgical therapies and the use of a local anesthesia, sometimes without postoperative catheterization. The PUL, a novel, minimally invasive treatment option for men affected by BPH, presents a promising potential although it is clear that PUL is not a substitute for traditional ablative surgical approach, as this procedure requires a scrupulous selection of the patient. PMID:23794125

Larcher, Alessandro; Broglia, Luigi; Lughezzani, Giovanni; Mistretta, Francesco; Abrate, Alberto; Lista, Giuliana; Fossati, Nicola; Sangalli, Mattia; Kuefner, Dana; Cestari, Andrea; Buffi, Nicolomaria; Lazzeri, Massimo; Guazzoni, Giorgio; Montorsi, Francesco

2013-12-01

138

Preventive effects of ACTICOA powder, a cocoa polyphenolic extract, on experimentally induced prostate hyperplasia in Wistar-Unilever rats.  

PubMed

Plant extracts are useful in the management of benign prostatic hyperplasia (BPH). This study investigates whether ACTICOA (Barry Callebaut France, Louviers, France) powder (AP), a cocoa polyphenolic extract, could prevent prostate hyperplasia induced by testosterone propionate (TP) in rats. Male Wistar-Unilever rats were randomly divided in four groups of 12 rats: one negative control group receiving subcutaneous injections of corn oil and treated with vehicle and three groups injected subcutaneously with TP and treated with the vehicle (positive control) or AP at 24 (AP24) and 48 (AP48) mg/kg/day. Treatments were given orally and started 2 weeks before the induction of prostate hyperplasia. The influence of TP and AP on body weights and food and water consumption of rats was examined. On day 36, rats were sacrificed, and the prostates were removed, cleaned, and weighed. The prostate size ratio (prostate weight/rat body weight) was then calculated. TP significantly influenced the body weight gain of the rats and their food and water consumption, while AP at both doses tested reduced significantly these differences. TP significantly increased prostate size ratio (P < .001), and this induced increase was significantly inhibited in AP-treated rats in comparison with positive controls (P < .001) in a dose-dependent manner. We conclude that AP can prevent TP-induced prostate hyperplasia and therefore may be beneficial in the management of BPH. PMID:18158832

Bisson, Jean-François; Hidalgo, Sophie; Rozan, Pascale; Messaoudi, Michaël

2007-12-01

139

Increased Risk of Benign Prostate Hyperplasia in Sleep Apnea Patients: A Nationwide Population-Based Study  

PubMed Central

Background Sleep apnea (SA) is a common sleep disorder characterized by chronic intermittent hypoxia (IH). Chronic IH induces systemic inflammatory processes, which can cause tissue damage and contribute to prostatic enlargement. The purpose of this study was to evaluate the association between benign prostate hyperplasia (BPH) and SA in a Taiwanese population. Methods The study population was identified from Taiwan’s National Health Insurance Research Database (NHIRD) and contained 202 SA patients and 1010 control patients. The study cohort consisted of men aged ?30 years who were newly diagnosed with SA between January 1997 and December 2005. Each patient was monitored for 5 years from the index date for the development of BPH. A Cox regression analysis was used to calculate the hazard ratios (HRs) for BPH in the SA and control patients. Results During the 5-year follow-up, 18 SA patients (8.9%) and 32 non-SA control patients (3.2%) developed BPH. The adjusted HR for BPH was 2.35-fold higher in the patients with SA than in the control patients (95% confidence interval (CI) 1.28–4.29, P<.01). We further divided the SA patients into 4 age groups. After adjusting for potential confounding factors, the highest adjusted HR for BPH in the SA patients compared with the control patients was 5.59 (95% CI?=?2.19–14.31, P<.001) in the patients aged between 51 and 65 years. Conclusion Our study results indicate that patients with SA are associated with increased longitudinal risk of BPH development, and that the effects of SA on BPH development are age-dependent.

Chou, Wei-Po; Liu, Mu-En; Lai, Chiou-Lian; Liu, Ching-Kuan; Ku, Yan-Chiou; Tsai, Shih-Jen; Chou, Yii-Her; Chang, Wei-Pin

2014-01-01

140

Water-induced thermotherapy for benign prostatic hyperplasia.  

PubMed

Water-induced thermotherapy (WIT), administered by the Thermoflex System, represents a novel minimally invasive technique for the treatment of benign prostatic hyperplasia (BPH). The Thermoflex System consists of an extracorporeal heat source and a proprietary closed-loop catheter system. Water, heated to 60 degrees C, is continuously circulated through the catheter to a treatment balloon, which conducts thermal energy to targeted prostatic tissue. The combination of heat and compression reduces the heat sink effect of the circulating blood, thus enhancing the thermal energy transfer to the compressed tissue. WIT treatment is performed using only topical urethral anesthetic, in a single 45-minute session. The 2-year follow-up data from a European multicenter study consisting of 125 patients showed an improvement in peak urine flow of 87.4% (from baseline 8.7 +/- 1.9 to 16.3 +/- 9.1 mL/s) and in the International Prostate Symptom Score (IPSS) of -54.2% (from baseline 24 +/- 5 to 11 +/- 5). Patient tolerance of WIT was rated as "excellent" or "good" in 91.8% of the procedures. WIT is efficacious, simple, and inexpensive, has few side effects, and does not need special probes to monitor prostate or rectum temperature; thus, it can be used in hospitals, outpatient clinics, and doctors' offices. PMID:11108569

Cioanta, I; Muschter, R

2000-12-01

141

[Serenoa repens in benign prostatic hyperplasia].  

PubMed

Serenoa repens is one of many herbal products used to treat benign prostatic hyperplasia. The treatment has been studied extensively, but the methodological quality has often been poor. Metaanalysis of early studies indicate that the treatment may have favourable effects on patients with benign prostatic hyperplasia, but more recent investigations of better methodological quality have questioned these results. The available documentation does not support use of products containing serenoa repens for these patients. Serenoa repens is associated with mild adverse effects comparable to that of placebo. PMID:18511974

Log, Tomas

2008-05-29

142

Effects of flavocoxid, a dual inhibitor of COX and 5-lipoxygenase enzymes, on benign prostatic hyperplasia  

PubMed Central

BACKGROUND AND PURPOSE Inflammation plays a key role in the development of benign prostatic hyperplasia (BPH). Eicosanoids derived from the COX and 5-lipoxygenase (5-LOX) pathways are elevated in the enlarging prostate. Flavocoxid is a novel flavonoid–based ‘dual inhibitor’ of the COX and 5-LOX enzymes. This study evaluated the effects of flavocoxid in experimental BPH. EXPERIMENTAL APPROACH Rats were treated daily with testosterone propionate (3 mg·kg?1 s.c.) or its vehicle for 14 days to induce BPH. Animals receiving testosterone were randomized to receive vehicle (1 mL·kg?1, i.p.) or flavocoxid (20 mg·kg?1, i.p.) for 14 days. Histological changes, eicosanoid content and mRNA and protein levels for apoptosis-related proteins and growth factors were assayed in prostate tissue. The effects of flavocoxid were also tested on human prostate carcinoma PC3 cells. KEY RESULTS Flavocoxid reduced prostate weight and hyperplasia, blunted inducible expression of COX-2 and 5-LOX as well as the increased production of PGE2 and leukotriene B4 (LTB4), enhanced pro-apoptotic Bax and caspase-9 and decreased the anti-apoptotic Bcl-2 mRNA. Flavocoxid also reduced EGF and VEGF expression. In PC3 cells, flavocoxid stimulated apoptosis and inhibited growth factor expression. Flavocoxid-mediated induction of apoptosis was inhibited by the pan-caspase inhibitor, Z-VAD-FMK, in PC3 cells, suggesting an essential role of caspases in flavocoxid-mediated apoptosis during prostatic growth. CONCLUSION AND IMPLICATIONS Our results show that a ‘dual inhibitor’ of the COX and 5-LOX enzymes, such as flavocoxid, might represent a rational approach to reduce BPH through modulation of eicosanoid production and a caspase-induced apoptotic mechanism.

Altavilla, D; Minutoli, L; Polito, F; Irrera, N; Arena, S; Magno, C; Rinaldi, M; Burnett, BP; Squadrito, F; Bitto, A

2012-01-01

143

Therapeutic effect of ACTICOA powder, a cocoa polyphenolic extract, on experimentally induced prostate hyperplasia in Wistar-Unilever rats.  

PubMed

Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate that results in obstructive lower urinary tract symptoms. Plant extracts are frequently used to treat BPH rather than therapeutics that can cause severe side effects. ACTICOA() (Ba0rry Callebaut France, Louviers, France) powder (AP) is a cocoa polyphenolic extract, and we have shown in a previous study that oral treatment with AP prevented prostate hyperplasia. This study investigated whether AP could improve established prostate hyperplasia using the same testosterone propionate (TP)-induced prostate hyperplasia model in rats. Male Wistar-Unilever rats were randomly divided in four groups of 12 rats: one group injected with corn oil and orally treated with the vehicle (negative control) and three groups injected subcutaneously with TP and orally treated with the vehicle (positive control) or AP at 24 (AP24) and 48 (AP48) mg/kg/day. Treatments started 1 week after the start of the induction of prostate hyperplasia and lasted for 2 weeks. The influence of TP and AP on body weights, food and water consumptions, plasma polyphenolic concentration, and serum dihydrotestoterone (DHT) level of rats was examined. At completion of the study, rats were sacrificed, and the prostates were removed, cleaned, and weighed. The prostate size ratio (prostate weight/rat body weight) was then calculated. TP significantly influenced the body weight gain of the rats and their food and water consumptions, while AP reduced significantly these differences in a dose-dependent manner. AP significantly reduced serum DHT level and prostate size ratio in comparison with positive controls also dose-dependently. In conclusion, AP orally administered was effective for reducing established prostate hyperplasia, especially at the dose of 48 mg/kg/day. PMID:18158833

Bisson, Jean-François; Hidalgo, Sophie; Rozan, Pascale; Messaoudi, Michaël

2007-12-01

144

Dietary supplements for benign prostatic hyperplasia: an overview of systematic reviews.  

PubMed

Benign prostatic hyperplasia (BPH) is a common chronic condition in older men. The aim of this overview of systematic reviews (SRs) is to summarise the current evidence on the efficacy and adverse effects of dietary supplements for treating BPH with lower urinary tract symptoms. We searched 5 electronic databases and relevant overviews without limitations on language or publication status. Six SRs of 195 articles were included in this overview. Serenoa repens was reviewed in 3 studies and no specific effect on BPH symptoms and urinary flow measures was observed. However, ?-sitosterol, Pygeum africannum and Cernilton were reviewed in one study each, and significant improvement was observed for all three. All the included compounds have mild and infrequent adverse effects. SRs on ?-sitosterol, Pygeum africannum and Cernilton have not been updated since 2000, thus an update of reviews on these compounds will be necessary in the future. PMID:22883375

Kim, Tae-Hun; Lim, Hyun-Ja; Kim, Myung-Sunny; Lee, Myeong Soo

2012-11-01

145

Relationship between Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia and Metabolic Syndrome in Korean Men  

PubMed Central

Purpose To investigate any associations between lower urinary tract symptoms (LUTS)/benign prostate hyperplasia (BPH) and metabolic syndrome (MetS). Materials and Methods In all, 1,224 male police officers in their 50s who had participated in health examinations were included. LUTS/BPH was assessed by serum prostate-specific antigen, International Prostate Symptom Score (IPSS), transrectal ultrasonography, maximum urinary flow rate (Q max), and postvoid residual urine volume (PVR). In addition, testosterone was also examined. The MetS was defined using NCEP-ATP III guidelines. We used the multiple linear regression test and logistic regression analyses to examine the relationships. Results MetS was diagnosed in 29.0% of participants. There was no significant difference in the percentage of cases of BPH (IPSS >7, Q max <15 ml/sec, and prostate gland volume ? 20 ml) (14.2% in the non-MetS group vs. 17.2 in the MetS group; p value=0.178). The total IPSS score and the Q max were not significantly different. The prostate volume and PVR were significantly greater in the subjects with MetS. After adjusting for age and testosterone, the presence of MetS was not associated with BPH (multivariate odds ratio, 1.122; 95% confidence interval, 0.593~2.120). Additionally, MetS was not related to IPSS (Beta, -0.189; p value=0.819), prostate volume (Beta, 0.815; p value=0.285), Q max (Beta, -0.827; p value=0.393), or PVR (Beta, 0.506; p value=0.837). Conclusions According to our results, the MetS was not clearly correlated with LUTS/BPH in Korean men in their 50s.

Park, Yeon Won; Min, Seung Ki

2012-01-01

146

Inhibitory effect of rape pollen supercritical CO2 fluid extract against testosterone-induced benign prostatic hyperplasia in rats  

PubMed Central

Benign prostatic hyperplasia (BPH) can lead to lower urinary tract symptoms. Rape pollen is an apicultural product that is composed of nutritionally valuable and biologically active substances. The aim of the present study was to investigate the protective effect of rape pollen supercritical CO2 fluid extract (SFE-CO2) in BPH development using a testosterone-induced BPH rat model. BPH was induced in the experimental groups by daily subcutaneous injections of testosterone for a period of 30 days. Rape pollen SFE-CO2 was administered daily by oral gavage concurrently with the testosterone injections. Animals were sacrificed at the scheduled termination and the prostates were weighed and subjected to histopathological examination. Testosterone, dihydrotestosterone (DHT), 5?-reductase and cyclooxygenase-2 (COX-2) levels were also measured. BPH-induced animals exhibited an increase in prostate weight with increased testosterone, DHT, 5?-reductase and COX-2 expression levels. However, rape pollen SFE-CO2 treatment resulted in significant reductions in the prostate index and testosterone, DHT, 5?-reductase and COX-2 levels compared with those in BPH-induced animals. Histopathological examination also demonstrated that rape pollen SFE-CO2 treatment suppressed testosterone-induced BPH. These observations indicate that rape pollen SFE-CO2 inhibits the development of BPH in rats and these effects are closely associated with reductions in DHT, 5?-reductase and COX-2 levels. Therefore, the results of the present study clearly indicate that rape pollen SFE-CO2 extract may be a useful agent in BPH treatment.

YANG, BI-CHENG; JIN, LI-LI; YANG, YI-FANG; LI, KUN; PENG, DAN-MING

2014-01-01

147

Intraprostatic testosterone and dihydrotestosterone. Part II: concentrations after androgen hormonal manipulation in men with benign prostatic hyperplasia and prostate cancer.  

PubMed

Androgen deprivation therapy (ADT) and 5-?-reductase (5AR) inhibition are used in the treatment of men with advanced or metastatic prostate cancer and benign prostatic hyperplasia (BPH), respectively. These drugs exert their effect by lowering androgen levels in the serum and allegedly, the prostate gland. It is, however, unknown whether (increased) intraprostatic androgen levels are associated with the pathogenesis of BPH and with the initiation and progression of prostate cancer. Also, it is unclear whether intraprostatic dihydrotestosterone (DHT) levels correlate with a response to initial hormonal therapy or with patient outcome. These uncertainties have resulted from the finding that serum testosterone levels do not necessarily reflect those in the prostate gland. Intraprostatic DHT levels of men being treated with 5AR inhibition, of those treated with ADT for hormone-naive prostate cancer, and of those with castration-resistant prostate cancer are all altered in an equivalent manner because of hormonal manipulation. Increased knowledge of the mechanisms of the androgenic steroid pathways in prostatic diseases, with a special focus on intraprostatic androgen levels, may lead to treatment that is tailored to the needs of the individual patient, and probably to new therapeutic targets as well. PMID:21992404

van der Sluis, Tim M; Meuleman, Eric J H; van Moorselaar, R Jeroen A; Bui, Hong N; Blankenstein, Marinus A; Heijboer, Annemieke C; Vis, André N

2012-01-01

148

Thermosensitive stent (Memotherm) for the treatment of benign prostatic hyperplasia.  

PubMed

Recently, more and more alternative therapeutic methods have been used for the treatment of benign prostatic hyperplasia (BPH). We will report on therapeutic results with a new thermosensitive stent system (Memotherm). This wire mesh stent has been designed especially for urological purposes. It is made of Nitinol, a thermoreactive material, and gains its maximum expansion force al body temperature. Due to the properties of the material the stent is flexible and can adapt to the anatomical conditions of the prostatic part of the urethra. Because of individual variations in the length of the prostatic part of the urethra, the system is available in lengths from 2 to 8 cm. The knitted structure for the first time allows atraumatic removal. Between April, 1992, and September, 1993, we treated a total of 54 BPH patients with the stent system. Mean patient age was 76.1 +/- 7.6 years (61-98). Mean prostatic volume was 51.9 +/- 25 ml (20-150), and the length of the applicated stents was 32.3 +/- 9.5 mm (20-70). Patient selection for stent treatment was carried out with regard to the preoperative risk status of this patient group. Fourteen (26%) of the patients treated were able to micturate before operation; in 40 (74%) urinary drainage was accomplished by means of an indwelling catheter. Following stent application, 53 out of 54 patients were able to micturate. With the first group (preoperative voiding ability), maximum flow had increased from 4.5 ml/s to a mean of 15.8 ml/s, while residual urine volume had decreased from 194.4 ml to 11.8 ml and the AUA 6 Symptoms Score had improved from 24 points to 3.5 points 6 months after stent application. All differences were statistically significant (P < 0.02). With the second group (no preoperative voiding ability), the AUA 6 Symptoms Score had improved from 25 points to 3.9 points (P < 0.02) 6 months after the operation, at which time the mean maximum flow rate was 14.8 ml/s and residual urine volume 14.8 ml. There was no statistically significant difference between the patients who were able and those who were unable to micturate before operation. One case of epididymitis was the only major complication observed after stent placement. Frequent urgency symptoms (30 out of 54 patients; 55.5%) subsided after a mean period of 1 week. The Memotherm stent offers an interesting therapeutic alternative for BPH risk patients. PMID:7530951

Gottfried, H W; Schlmers, H P; Gschwend, J; Brändle, E; Hautmann, R E

1994-11-01

149

Safety and efficacy of silodosin for the treatment of benign prostatic hyperplasia  

PubMed Central

Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS associated with BPH. Mainstays in the treatment of male LUTS and clinical BPH are the ?1-adrenergic receptor antagonists. Silodosin is a new ?1-adrenergic receptor antagonist that is selective for the ?1A-adrenergic receptor. By antagonizing ?1A-adrenergic receptors in the prostate and urethra, silodosin causes smooth muscle relaxation in the lower urinary tract. Since silodosin has greater affinity for the ?1A-adrenergic receptor than for the ?1B-adrenergic receptor, it minimizes the propensity for blood pressure-related adverse effects caused by ?1B-adrenergic receptor blockade. In the clinical studies, patients receiving silodosin at a total daily dose of 8 mg exhibited significant improvements in the International Prostate Symptom Score and maximum urinary flow rate compared with those receiving placebo. Silodosin showed early onset of efficacy for both voiding and storage symptoms. Furthermore, long-term safety of silodosin was also demonstrated. Retrograde or abnormal ejaculation was the most commonly reported adverse effect. The incidence of orthostatic hypotension was low. In conclusion, silodosin, a novel selective ?1A-adrenergic receptor antagonist, was effective in general and without obtrusive side effects. This review provides clear evidence in support of the clinical usefulness of silodosin in the treatment of LUTS associated with BPH.

Yoshida, Masaki; Kudoh, Junzo; Homma, Yukio; Kawabe, Kazuki

2011-01-01

150

Holmium Laser Enucleation of Prostate for Benign Prostatic Hyperplasia: Seoul National University Hospital Experience  

PubMed Central

Purpose The objective of this study was to report the experience acquired at the Seoul National University Hospital with Holmium Laser Enucleation of Prostate (HoLEP), combined with mechanical morcellation for symptomatic benign prostatic hyperplasia (BPH). Methods A retrospective review was performed on the clinical data of 309 consecutive patients who underwent HoLEP at our institution between July 2008 and June 2010. All patients were evaluated preoperatively for prostate volume by transrectal ultrasound, maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS) and quality of life (QoL) score. Peri- and postoperative parameters were evaluated and patients were followed-up at 1-, 3-, 6-, and 12- months with the aforementioned investigations. Results The patients' mean age was 68.3 (±6.5) years and mean prostate volume was 55.6 (±23.6) mL. Mean enucleation time was 56.2 (±25.1) minutes, mean morcellation time was 11.3 (±9.5) minutes, and the mean resected weight of the prostate was 20.8 (±16.9) g. The mean catheter indwelling period was 1.9 (±1.7) days and mean hospital stay was 2.9 (±1.5) days. Significant improvement was noted in Qmax, IPSS, and QoL at the 1-year follow-up compared with baseline (P<0.01). At 1 month 17.2% of patients complained of irritative urinary symptoms, which were typically self-limiting within 3 months. Transient stress incontinence was reported in 15.2% of patients. No patient experienced persistent obstructive symptoms that required reoperation. Conclusions Our study showed that HoLEP is a safe and effective therapeutic modality for BPH.

Bae, Jungbum; Choo, Minsoo; Park, Ji Hyun; Oh, Jin Kyu; Paick, Jae-Seung

2011-01-01

151

Construct validation of the USA-Spanish version of the SF36 health survey in a Cuban-American population with benign prostatic hyperplasia  

Microsoft Academic Search

This study examined the USA-Spanish version of the SF-36 health survey (validated in Mexican- Americans) and tested its construct validity in Cuban-Americans with benign prostatic hyperplasia (BPH). The study evaluated the SF-36 and American Urological Association (AUA) Symptom Index scores of 264 individuals with BPH. Individuals were assigned to one of the following groups: non-Hispanics who received the English version,

R. Arocho; C. A. McMillan; P. Sutton-Wallace

1998-01-01

152

Effects of retrospective quality control on pressure-flow data with computer-based urodynamic systems from men with benign prostatic hyperplasia  

Microsoft Academic Search

Aim:To evaluate the effects of retrospective quality control on pressure-flow data with computer-based urodynamic systems from men with benign prostatic hyperplasia (BPH).Methods:A total of 582 traces of pressure-flow study from 181 men with BPH was included in the study. For each trace, maximum urinary flow rate (Qmax) and detrusor pressure at Qmax (pdet.Qmax) were, respectively, read from manually smoothed and

Li-Min Liao; Werner Schaefer

2007-01-01

153

Cactus flower extracts may prove beneficial in benign prostatic hyperplasia due to inhibition of 5? reductase activity, aromatase activity and lipid peroxidation  

Microsoft Academic Search

The cactus flower is deemed to be helpful in benign prostatic hyperplasia (BPH) therapy, although there is no published information\\u000a regarding its clinical effect in patients and on the mechanism of its biological activity. The present study evaluated the\\u000a ability of cactus flower extracts to exert an effect on BPH through possible inhibition of such processes as lipid peroxidation,\\u000a androgen

Adi Jonas; Gennady Rosenblat; Daniel Krapf; William Bitterman; Ishak Neeman

1998-01-01

154

High-Intensity Focused Ultrasound (HIFU) Using Sonablate® Devices for the Treatment of Benign Prostatic Hyperplasia and Localized Prostate Cancer: 18-year experience  

NASA Astrophysics Data System (ADS)

From 1993 to 2010, we have treated 156 patients benign prostatic hyperplasia (BPH) and 1,052 patients localized prostate cancer high-intensity focused ultrasound (HIFU). Four different HIFU devices, SonablateR-200, SonablateR-500, SonablateR-500 version 4 and Sonablate® TCM, have been used for this study. Clinical outcome of HIFU for BPH did not show any superior effects to transurethral resection of the prostate, laser surgery or transurethral vapolization of the prostate. However, HIFU appears to be a safe and minimally invasive therapy for patients with localized prostate cancer, especially low- and intermediate-risk patients. The rate of clinical outcome has significantly improved over the years due to technical improvements in the device.

Uchida, Toyoaki

2011-09-01

155

Preventive effects of lignan extract from flax hulls on experimentally induced benign prostate hyperplasia.  

PubMed

Abstract Consumption of diet rich in lignans may decrease the risk of some chronic hormonal conditions such as benign prostatic hyperplasia (BPH). This study investigated whether a lignan-rich extract from flaxseed hulls, LinumLife EXTRA (LLE), could prevent BPH using the testosterone propionate (TP)-induced BPH rat model. Male Wistar-Unilever rats were randomly divided into four groups of 12 rats each: a negative control group fed with control diet and receiving daily subcutaneous injections of corn oil without TP, and three groups fed with control diet (positive control), diet containing 0.5% LLE (LLE 0.5) or 1.0% LLE (LLE 1.0) and receiving daily subcutaneous injections of TP in corn oil. Treatments with diets started 2 weeks before the induction of BPH and were carried out for 5 consecutive weeks. The influence of TP and LLE on body weight (BW), food and water consumptions, and enterolactone (ENL) levels in serum and urine of rats was examined at the end of the 5-week treatment period. TP significantly diminished the mean body weight gain (MBWG) of positive control rats and their food and water consumptions while LLE reduced significantly this MBWG reduction in a dose-dependent manner. The lignan-rich extract significantly inhibited TP-induced prostate size ratio (prostate weight/rat BW) increase in comparison with positive controls (P<.001). This effect was dose dependent. Higher serum and urine levels of ENL correlated well with the dose of extract provided to rats. It was concluded that the lignan-rich flaxseed hull extract prevented the TP-induced BPH indicating it might be beneficial in the prevention of BPH. PMID:24460407

Bisson, Jean-François; Hidalgo, Sophie; Simons, Rudy; Verbruggen, Marian

2014-06-01

156

Benign prostatic hyperplasia: a new metabolic disease of the aging male and its correlation with sexual dysfunctions.  

PubMed

Metabolic syndrome (MetS) is a well-recognized cluster of cardiovascular (CV) risk factors including obesity, hypertension, dyslipidemia, and hyperglycaemia, closely associated with an increased risk of forthcoming cardiovascular disease and type 2 diabetes mellitus. Emerging evidence indicates that benign prostate hyperplasia (BPH) and its related lower urinary tract symptoms (LUTS) represent other clinical conditions frequently observed in subjects with MetS. Several modifiable factors involved in MetS determinism, such as inadequate diet, lack of physical exercise, and smoking and drinking behaviours are emerging as main contributors to the development of BPH. The pathogenetic mechanisms underlying the connection between MetS and BPH have not been completely clarified. MetS and its components, hypogonadism, and prostate inflammation probably play an important role in inducing BPH/LUTS. Although historically considered as a "normal" consequence of the aging process, BPH/LUTS should now be faced proactively, as a preventable disorder of the elderly. Type of diet and level of physical activity are now considered important factors affecting prostate health in the aging male. However, whether physical exercise, weight loss, and modifications of dietary habit can really alter the natural history of BPH/LUTS remains to be determined. Further research is advisable to better clarify these points. PMID:24688539

Corona, Giovanni; Vignozzi, Linda; Rastrelli, Giulia; Lotti, Francesco; Cipriani, Sarah; Maggi, Mario

2014-01-01

157

Impact of Treatment With Statins on Prostate-Specific Antigen and Prostate Volume in Patients With Benign Prostatic Hyperplasia  

PubMed Central

Purpose We investigated the impact on prostate-specific antigen (PSA) and prostate volume (PV) of statin medication for 1 year in patients with benign prostatic hyperplasia (BPH). Materials and Methods We retrospectively investigated 791 patients in whom BPH was diagnosed. For analysis, the patients were divided into four groups according to their medications: group A, ?-blocker; group B, ?-blocker+statin; group C, ?-blocker+dutasteride; group D, ?-blockers+statin+dutasteride. To investigate changes in serum PSA, PV, and total cholesterol, we analyzed the data at the time of initial treatment and after 1 year of medication. Results After 1 year, group A showed a 1.3% increase in PSA and a 1.0% increase in PV. Group B showed a 4.3% decrease in PSA and a 1.8% decrease in PV. The difference in PV reduction between groups A and B was statistically significant (p<0.001). Group C showed a 49.1% reduction in PSA and a 22.9% reduction in PV. Group D showed a 51.6% reduction in PSA and a 24.5% reduction in PV. The difference in PV reduction between groups C and D was not statistically significant (p=0.762). By use of a multivariate logistic regression model, we found that the probability of PV reduction after 1 year was more than 14.8 times in statin users than in statin nonusers (95% confidence interval, 5.8% to 37.6%; p<0.001). Conclusions Statin administration reduced PSA and PV in BPH patients. This finding may imply the improvement of lower urinary tract symptoms and prevention of cardiovascular disease and chemoprevention of prostate cancer with statin treatment.

Lee, Sang Hun; Park, Tae Ju; Bae, Min Ho; Choi, Sung Ho; Cho, Young Sam; Joo, Kwan Joong; Kwon, Chil Hun

2013-01-01

158

Effect of 5-alpha Reductase Inhibitor on Storage Symptoms in Patients with Benign Prostatic Hyperplasia  

PubMed Central

Purpose Many patients with benign prostatic hyperplasia (BPH) have storage symptoms. The aim of this study was to evaluate the effects of treatment with a 5-alpha reductase inhibitor (5ARI) on storage symptoms in patients with BPH. Methods This study was conducted in 738 patients with lower urinary tract symptoms secondary to BPH. Patients with a prostate volume of higher than 30 mL on the transrectal ultrasound were classified into two groups: group A, in which an alpha blocker was solely administered for at least 12 months, and group B, in which a combination treatment regimen of an alpha blocker plus 5ARI was used. This was followed by an analysis of the changes in parameters such as the total International Prostate Symptom Score (IPSS), voiding symptom subscore, and storage symptom subscore between the two groups. In addition, we examined whether there was a significant difference between the two groups in the degree of change in storage symptoms between before and after the pharmacological treatment. Results Of the 738 men, 331 had a prostate volume ?30 mL, including 150 patients in group A and 181 patients in group B. Total IPSS, the voiding symptom subscore, and the storage symptom subscore were significantly lower after treatment than before treatment in both groups (P<0.05). A comparison of the degree of change between before and after treatment, however, showed no significant differences in the storage symptom subscore between the two groups (P>0.05). Conclusions Alpha blocker and 5ARI combination treatment is effective for patients with BPH including storage symptoms. However, 5ARI does not exert a significant effect on storage symptoms in BPH patients.

Cho, Kang Jun; Kang, Se Hee; Kim, Hyo Sin; Koh, Jun Sung

2011-01-01

159

Expression of ?-catenin and mesenchymal markers in canine prostatic hyperplasia and carcinoma.  

PubMed

?-catenin is a nuclear signalling molecule that is associated with human prostatic neoplasia and the epithelial-mesenchymal transition (EMT) process. The present study evaluates immunohistochemically the expression of ?-catenin and the mesenchymal markers vimentin, desmin, calponin and smooth muscle actin (SMA) in four normal canine prostates and prostate samples from 15 dogs with benign prostatic hyperplasia (BPH) and six with prostatic carcinoma (PC). ?-catenin was located on the membrane of normal epithelial cells, while the same marker had both cytoplasmic and membrane expression in hyperplastic cells and a nuclear redistribution in PC. Vimentin-positive luminal cells were observed in two of the 15 cases of BPH and in all PC samples, suggesting the conversion of neoplastic epithelial cells to a mesenchymal type. SMA was consistently negative in PC, but there was mild desmin and calponin immunoreactivity in these lesions. As in men, ?-catenin is involved in canine prostatic carcinogenesis, thus further validating the use of this animal model to study human prostatic disease. PMID:24529514

Lean, F Z X; Kontos, S; Palmieri, C

2014-05-01

160

Giant Prostatic Hyperplasia: Fourth largest prostate reported in medical literature.  

PubMed

A giant prostatic hyperplasia (GPH) weighing more than 700 g is a rare entity. It is believed that only eight such cases have been previously reported in the medical literature. This case report concerns a patient with a GPH weighing 740 g which was successfully removed by suprapubic prostatectomy. To our knowledge, this is the fourth largest benign prostatic enlargement ever reported in the literature. PMID:24790752

Maliakal, Joseph; Mousa, Emad E; Menon, Varna

2014-05-01

161

Drug-related problems in patients with benign prostatic hyperplasia: a cross sectional retrospective study.  

PubMed

Benign Prostatic Hyperplasia (BPH) patients are at risk of acquiring drug-related problems (DRPs), as it is present in the majority of aging men. To date, DRPs among BPH patients have not been well studied. We conducted this retrospective study in a tertiary hospital in Malaysia from January 2009 to June 2012 with the aim of identifying the factors associated with DRPs among BPH patients. The Pharmaceutical Care Network Europe Classification Version (PCNE) 5.01 was used as a tool to classify DRPs. We enrolled 203 patients from 259 hospital admissions. A total of 390 DRPs were found and there was an average of 1.5±1.3 problems per hospitalization. 76.1% of hospital admissions included at least one DRP. The most common DRP categories encountered were drug choice problems (45.9%), drug interactions (24.9%), and dosing problems (13.3%). Factors such as advanced age (p?=?0.005), a hospital stay of more than 6 days (p?=?0.001), polydrug treatments (p<0.001), multiple comorbidities (p<0.001), and comorbid cardiovascular disease (p?=?0.011), diabetes mellitus(p?=?0.001), hypertension (p<0.001) and renal impairment (p?=?0.011) were significantly associated with the occurrence of DRPs. These data indicated that the prevalence of DRPs is high among BPH patients. The identification of different subtypes of DRPs and the factors associated with DRPs may facilitate risk reduction for BPH patients. PMID:24475089

Zaman Huri, Hasniza; Hui Xin, Chong; Sulaiman, Che Zuraini

2014-01-01

162

Drug-Related Problems in Patients with Benign Prostatic Hyperplasia: A Cross Sectional Retrospective Study  

PubMed Central

Benign Prostatic Hyperplasia (BPH) patients are at risk of acquiring drug-related problems (DRPs), as it is present in the majority of aging men. To date, DRPs among BPH patients have not been well studied. We conducted this retrospective study in a tertiary hospital in Malaysia from January 2009 to June 2012 with the aim of identifying the factors associated with DRPs among BPH patients. The Pharmaceutical Care Network Europe Classification Version (PCNE) 5.01 was used as a tool to classify DRPs. We enrolled 203 patients from 259 hospital admissions. A total of 390 DRPs were found and there was an average of 1.5±1.3 problems per hospitalization. 76.1% of hospital admissions included at least one DRP. The most common DRP categories encountered were drug choice problems (45.9%), drug interactions (24.9%), and dosing problems (13.3%). Factors such as advanced age (p?=?0.005), a hospital stay of more than 6 days (p?=?0.001), polydrug treatments (p<0.001), multiple comorbidities (p<0.001), and comorbid cardiovascular disease (p?=?0.011), diabetes mellitus(p?=?0.001), hypertension (p<0.001) and renal impairment (p?=?0.011) were significantly associated with the occurrence of DRPs. These data indicated that the prevalence of DRPs is high among BPH patients. The identification of different subtypes of DRPs and the factors associated with DRPs may facilitate risk reduction for BPH patients.

Zaman Huri, Hasniza; Hui Xin, Chong; Sulaiman, Che Zuraini

2014-01-01

163

Long-Term Effects of Finasteride in Patients with Benign Prostatic Hyperplasia: A Double-Blind, Placebo-Controlled, Multicenter Study 1 1 A complete list of the PROWESS Study Group appears in the Appendix A  

Microsoft Academic Search

Objectives. To compare the long-term effects of finasteride (5 mg\\/day) and placebo in patients with moderate symptoms of benign prostatic hyperplasia (BPH).Methods. Patients aged 50 to 75 years, with at least two urinary symptoms indicating moderate BPH, and an enlarged prostate, were followed in a 2-year double-blind, randomized, placebo-controlled multicenter study. The effects of finasteride versus placebo were assessed by

Michael J Marberger

1998-01-01

164

Ejaculatory Disorders Caused by Alpha1 Blockers for Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: Comparison of Naftopidil and Tamsulosin in a Randomized Multicenter Study  

Microsoft Academic Search

Introduction: To investigate the incidence of ejaculatory disorders caused by naftopidil and tamsulosin in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Materials and Methods: Ninety-five patients with LUTS\\/BPH who had International Prostate Symptom Scores (IPSS) of 8 or more were randomly assigned to receive naftopidil (50 mg\\/day, n = 48) or tamsulosin (0.2 mg\\/day,

Naoya Masumori; Taiji Tsukamoto; Akihiko Iwasawa; Ryoji Furuya; Tomoko Sonoda; Mitsuru Mori

2009-01-01

165

Gokshuradi Vati and Dhanyaka-Gokshura Ghrita Matra Basti in the management of Benign Prostatic Hyperplasia  

PubMed Central

Benign Prostatic Hyperplasia (BPH) is a burning senile problem of elderly men and no definitive conservative cure is available. The present available surgical and minimal invasive methods have their own limitations. Hence, to find out a suitable Ayurvedic approach, an effort has been made towards the management of BPH, In this study, 32 selected patients of Mootraghata at par to BPH were divided into three groups randomly and treated accordingly. In group A, Gokshuradi compound (GC) Vati (GV) 500 mg was given three times a day with luke-warm water after food; while in group B, Dhanyaka-Gokshura Ghrita (DGG) as Matra Basti (MB) of 60 ml, once in a day, just after lunch and combined therapy of both formulations in group C was administered. Out of 32 patients, total 30 patients (10 in each group) were completed the treatment course of 21 days. In results, 54.09% improvement was seen in group C, 45.67% in group A and 47.99% in group B. The size of prostate gland was found reduced highly significant in group C. Hence, it is concluded that combined therapy of GV and DGG MB is beneficial without developing any adverse drug reactions and can be prescribed safely for Mootraghata (BPH).

Bhalodia, Shreyas G.; Bhuyan, Chaturbhuj; Gupta, Sanjay Kumar; Dudhamal, Tukaram S.

2012-01-01

166

Saw Palmetto for Benign Prostatic Hyperplasia  

Microsoft Academic Search

In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The pri- mary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal

Stephen Bent; Christopher Kane; Katsuto Shinohara; John Neuhaus; Esther S. Hudes; Harley Goldberg; Andrew L. Avins

2006-01-01

167

Promising molecular targets and biomarkers for male BPH and LUTS.  

PubMed

Benign prostatic hyperplasia (BPH) is a major health concern for aging men. BPH is associated with urinary voiding dysfunction and lower urinary tract symptoms (LUTS), which negatively affects quality of life. Surgical resection and medical approaches have proven effective for improving urinary flow and relieving LUTS but are not effective for all men and can produce adverse effects that require termination of the therapeutic regimen. Thus, there is a need to explore other therapeutic targets to treat BPH/LUTS. Complicating the treatment of BPH/LUTS is the lack of biomarkers to effectively identify pathobiologies contributing to BPH/LUTS or to gauge successful response to therapy. This review will briefly discuss current knowledge and will highlight new studies that illuminate the pathobiologies contributing to BPH/LUTS, potential new therapeutic strategies for successfully treating BPH/LUTS, and new approaches for better defining these pathobiologies and response to therapeutics through the development of biomarkers and phenotyping strategies. PMID:23913202

Gharaee-Kermani, Mehrnaz; Macoska, Jill A

2013-12-01

168

Medical Management of BPH: Role of Plant Extracts  

Microsoft Academic Search

ObjectivesSince decades plant extracts belong to the most popular drugs for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH)\\/benign prostatic enlargement (BPE). Herein we review biological mechanisms, the placebo effect, results of clinical trials, the role of meta-analyses and guideline recommendations.

Stephan Madersbacher; Anton Ponholzer; Ingrid Berger; Martin Marszalek

2007-01-01

169

Validation of a model to develop a symptom index for benign prostatic hyperplasia in dogs.  

PubMed

Benign prostatic hyperplasia (BPH) is a spontaneous and age-related condition in humans and intact male dogs. A symptom index for BPH in men was created by the American Urological Association. In this study, it has been developed and statistically validated as a model to assign an objective score to canine BPH severity based on clinical signs observed and/or subjectively reported to the veterinarian by dog owners. The medical records of the Animal Reproduction Unit of University of Bologna (Italy) were used to select dogs with a clinical diagnosis of BPH. A data set was built up, and the animals were included in the statistical analysis as dependent variables. A score of 1-3 was assigned to the disease severity of each case based on signs annotated, graded using a scale ranging from 1 to 4. Signs of BHP were entered as predictors while disease severity as dependent variable to generate the predictive model. The model was finally used to re-classify each case of the data set, and the percentage of corrected predictions calculated. Overall, 373 subjects were entered in the model. Between them, 243, 107 and 23 animals have been represented based on medical records with a BPH severity score of 1, 2 and 3, respectively. The model correctly predicted the response variable in 97.3% of the cases. In this study, a BPH symptom index was created for the first time in dogs, which may be useful to standardize BPH severity with an objective score and to evaluate the necessity, the kind and the effectiveness of treatment. PMID:23279506

Zambelli, D; Cunto, M; Gentilini, F

2012-12-01

170

Should modest elevations in prostate-specific antigen, International Prostate Symptom Score, or their rates of increase over time be used as surrogate measures of incident benign prostatic hyperplasia?  

PubMed

Although surrogate measures of benign prostatic hyperplasia (BPH) are often used in epidemiologic studies, their performance characteristics are unknown. Using data from the Prostate Cancer Prevention Trial (n = 5,986), we evaluated prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), and their rates of change as predictors of incident BPH. BPH (n = 842 cases) was defined as medical or surgical treatment or at least 2 IPSS of 15 or higher. Proportional hazards models were used to measure the associations of baseline PSA, IPSS, and their velocities over 2 years with BPH risk, and time-dependent receiver-operating characteristic curves were used to measure their discriminatory performance. Unit increases in PSA, IPSS, and IPSS velocity were associated with 34%, 35%, and 29% (all P < 0.001) increases in BPH risk, respectively. The areas under the receiver-operating characteristic curves were significantly greater than 0.5 for PSA (0.58, 95% confidence interval (CI): 0.56, 0.60), IPSS (0.77, 95% CI: 0.75, 0.78), and IPSS velocity (0.63, 95% CI: 0.61, 0.65); however there were no cut points at which sensitivity and specificity were both above 75%. We concluded that moderate elevations in PSA, IPSS, or their rates of change should not be used as surrogate measures of incident BPH. PMID:23813705

Schenk, Jeannette M; Hunter-Merrill, Rachel; Zheng, Yingye; Etzioni, Ruth; Gulati, Roman; Tangen, Catherine; Thompson, Ian M; Kristal, Alan R

2013-09-01

171

Heat shock protein 90 is associated with hyperplasia and neoplastic transformation of canine prostatic epithelial cells.  

PubMed

Heat shock protein 90 (HSP90) is a molecular chaperone that regulates critical signalling proteins of cancer development and progression. Abnormal levels of HSP90 have been observed in human prostatic carcinoma (PC), with prognostic and therapeutic implications. Since spontaneously arising canine PC is a valuable model for the human disease, the aim of this study was to evaluate the immunohistochemical expression of HSP90 in two normal canine prostates, 17 canine prostates with benign prostatic hyperplasia (BPH) and five canine prostates with PC. HSP90 was expressed in the cytoplasm of epithelial cells in all samples, with a significant increase in labelled cells in PCs. Nuclear labelling was observed occasionally in normal tissue, but was increased in BPH and PC. HSP90 immunoreactivity in preneoplastic lesions (proliferative inflammatory atrophy and prostatic intraepithelial neoplasia) was similar to that in PCs. Increased HSP90 expression in canine PCs suggests the involvement of this molecule in carcinogenesis and tumour progression, supporting HSP90 as a potential target for therapeutic intervention. PMID:24679854

Palmieri, C; Mancini, M; Benazzi, C; Della Salda, L

2014-05-01

172

Indications for and use of nonsteroidal antiinflammatory drugs and the risk of incident, symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial.  

PubMed

The authors conducted a cohort study of nonsteroidal antiinflammatory drug (NSAID) use and risk of symptomatic benign prostatic hyperplasia (BPH), using data from 4,735 men without BPH at baseline in the placebo arm of the Prostate Cancer Prevention Trial (1993-2003). Incident BPH (n = 471) was defined as medical or surgical treatment or at least 2 International Prostate Symptom Score (I-PSS) values greater than or equal to 15. Proportional hazards models using time-dependent exposure for NSAID use were employed to estimate covariate-adjusted associations of NSAID-related medical conditions and NSAID use with BPH risk. Arthritis, other inflammation-related musculoskeletal conditions, and headaches were associated with increased BPH risk (hazard ratio (HR) = 1.77 (95% confidence interval (CI): 1.37, 2.29), HR = 1.57 (95% CI: 1.14, 2.17), and HR = 1.40 (95% CI: 1.09, 1.80), respectively). Use of any NSAID, use of aspirin, and use of nonaspirin NSAIDs were associated with significant increases in BPH risk (HR = 1.21 (95% CI: 1.01, 1.46), HR = 1.20 (95% CI: 1.00, 1.45), and HR = 1.34 (95% CI: 1.07, 1.69), respectively). Control for indications for NSAID use, including baseline I-PSS, attenuated the associations slightly, but all became nonsignificant. Among men with no indications for NSAID use, the hazard ratio for any NSAID use was 1.06 (95% CI: 0.82, 1.38). The modest associations of NSAID use with BPH risk in this cohort were probably due to confounding by indication, and NSAID use was not associated with BPH risk. PMID:22759721

Schenk, Jeannette M; Calip, Gregory S; Tangen, Catherine M; Goodman, Phyllis; Parsons, J Kellogg; Thompson, Ian M; Kristal, Alan R

2012-07-15

173

Changes in Initial Expenditures for Benign Prostatic Hyperplasia Evaluation in the Medicare Population: A Comparison to Overall Medicare Inflation  

PubMed Central

Introduction Benign prostatic hyperplasia (BPH) creates significant expenses for the Medicare program. We sought to determine trends in expenditures for BPH evaluative testing after urologist consultation, and place these trends in the context of overall Medicare expenditures. Methods Using a 5% national sample of Medicare beneficiaries from 2000 to 2007, we developed a cohort of men with claims for new visits to urologists for diagnoses consistent with symptomatic BPH (n=40,253). We assessed trends in initial expenditures (within 12 months of diagnosis; inflation and geography adjusted) by categories of evaluative tests derived from the 2003 AUA Guideline on the Management of BPH. Using governmental reports on Medicare expenditures, trends in BPH expenditures were compared to overall and imaging-specific Medicare expenditures. Comparisons were assessed by Z-tests and regression analysis for linear trends as appropriate. Results Between 2000 and 2007 inflation adjusted total Medicare expenditure per patient for the initial evaluation of BPH patients seen by urologists increased from $255.44 to $343.98 (p<0.0001). Increases in BPH related imaging (55%), were significantly less than increases in overall Medicare expenditures on imaging (104%; p<0.001). The 35% increase in per patient expenditures for BPH was significantly lower than the increase in overall Medicare expenditure per enrollee (45%; p=0.0.0015). Conclusion From 2000 to 2007, inflation adjusted expenditures on BPH related evaluations increased. This growth was slower than overall growth in Medicare expenditures, and increases in imaging expenditures related to BPH were restrained compared to the Medicare program as a whole.

Bellinger, Adam S.; Elliott, Sean P.; Yang, Liu; Wei, John T.; Saigal, Christopher S.; Smith, Alexandria; Wilt, Timothy J.; Strope, Seth A.

2012-01-01

174

Association of GSTM1 and GSTT1 polymorphism with lipid peroxidation in benign prostate hyperplasia and prostate cancer: a pilot study.  

PubMed

Association of glutathione S-transferase (GST) M1 and T1 deletions with benign prostate hyperplasia (BPH) and prostate cancer is well reported. These enzymes metabolize numerous toxins thus protecting from oxidative injury. Oxidative stress has been associated with development of BPH and prostate cancer. The present study was designed to analyze role of GST deletions in development of oxidative stress in these subjects. GSTs are responsible for metabolism of toxins present in tobacco therefore effect of tobacco usage in study groups was also studied. Three groups of subjects: BPH (53 patients), prostate cancer (57 patients) and controls (46 subjects) were recruited [corrected]. Genotyping was done using a multiplex polymerase chain reaction (PCR) method. Malondialdehyde (MDA) levels as marker of oxidative stress were estimated by measuring thiobarbituric acid reactive substance (TBARS) in plasma. Based on genotyping, subjects were categorized into: GSTM1+/GSTT1+, GSTM1-/GSTT1+, GSTM1+/GSTT1- and GSTM1-/GSTT1-. Significantly higher plasma MDA levels were noticed in GSTM1-/GSTT1- as compared to GSTM1+/GSTT1+ in all study groups. Double deletion (GSTM1-/GSTT1-) is associated with higher oxidative stress which might play a role in the pathogenesis of BPH and prostate cancer. However, other markers of oxidative stress should be analyzed before any firm conclusion. PMID:21694442

Kumar, Vivek; Yadav, Chandra Shekhar; Datta, Sudip Kumar; Singh, Satyender; Ahmed, Rafat S; Goel, Sanjay; Gupta, Sanjay; Mustafa, Md; Grover, Rajesh Kumar; Banerjee, Basu Dev

2011-01-01

175

[The anti-androgen flutamide in the treatment of prostatic hyperplasia].  

PubMed

The authors treated 23 benign prostatic hyperplasia (BPH) patients with antiandrogen flutamide. Half of the patients were treated with 500 mg, the another part with 750 mg flutamide for three months, and after 3 months brake again for 3 months. The decrease of the residual urine and an increase of the flow were observed. The subjective parameters were improved, too. In some patients side effects (gynecomastia, loss of appetite and potency) were observed. There was no different in the effect of the two doses. PMID:1279497

Romics, I; Bach, D

1992-11-22

176

Who Should Be Treated and How? Evidence-Based Medicine in Symptomatic BPH  

Microsoft Academic Search

The management of benign prostatic hyperplasia (BPH), although based on the best available evidence, should be individualised to patients’ circumstances and personal choices. Subjective symptoms (LUTS), bothersomeness and negative impact on the quality of life are the main reasons for the patient to seek treatment for BPH. Therefore, the improvement of this subjective discomfort ought to be an important treatment

Mark J. Speakman

1999-01-01

177

The pathogenesis of benign prostatic hyperplasia.  

PubMed

Development of prostatic hyperplasia is an almost universal feature of the aging man and dog, and in both species the process develops only in males with intact testes. As the result of studies of plasma hormone levels as a function of age, measurements of the concentration of androgen and of androgen receptor proteins within the prostate, and studies of the effects of the administration of various hormones on growth of the prostate in the castrated dog, it is possible to provide a working hypothesis as to the pathogenesis. Dihydrotestosterone accumulation within the gland serves as the hormonal mediator for the hyperplasia in both species; the accumulation probably occurs in part because of decreased catabolism of the molecule and in part because of enhanced intracellular binding of the molecule. The process is accelerated by estrogen, which enhances the level of the androgen receptor in the gland; increase in the androgen receptor allows for androgen-mediated growth even in the face of declining androgen production in advanced age. On theoretic grounds the therapeutic implications of this model are exciting; several potential medical treatments may be feasible that do not involve a chemical castration. PMID:6155068

Wilson, J D

1980-05-01

178

Lovastatin-Induced Apoptosis in Prostate Stromal Cells  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) is a common disease of aging men. Current medical treatment for this condition is only partially effective, therefore many patients must undergo surgery for symp- tomatic relief. BPH is caused by an increase in prostate epithelial and stromal cells, especially the latter. Since BPH stromal cells have a long life span and are not very responsive

S. J. PADAYATTY; M. MARCELLI; T. C. SHAO; G. R. CUNNINGHAM

2010-01-01

179

Insulin-Like Growth Factor-I, Insulin-Like Growth Factor Binding Protein-3 and Risk of Benign Prostate Hyperplasia in the Prostate Cancer Prevention Trial  

PubMed Central

Background We investigated whether peptides involved in cellular proliferation and apoptosis, [insulin-like growth factor I (IGFI) and its major binding protein (insulin-like growth factor binding protein 3)], predicted risk of benign prostate hyperplasia (BPH). Methods We conducted a nested-case control study in the placebo arm of the Prostate Cancer Prevention Trial (PCPT). Cases (n= 727) were men with surgical or medical treatment for BPH; two or more IPSS scores > 14; or two scores of at least five points over baseline one of which was ? 12. Controls (n=727) were frequency matched by age to cases, reported no BPH treatment, and no IPSS score > 8. Cases and controls remained on the PCPT placebo and were followed closely until their 7-year PCPT anniversary. Baseline serum was analyzed for IGFI and IGFBP3. Unconditional logistic regression and polytomous regression estimated the multivariate-adjusted odds ratio for BPH risk. Results IGFBP3 was inversely and the IGFI:IGFBP3 ratio was positively associated with BPH risk, but findings were statistically significant only for men with severe symptoms (OR=0.60, 95% CI = 0.40–0.90 for the fifth vs. first quintile of IGFBP3, p, trend = 0.01). Associations did not differ by age (< 65 or ? 65 years), and there was a suggestion that the IGFI:IGFBP3 – BPH risk association may be stronger among overweight men. Conclusions A high IGFI:IGFBP3 ratio was associated with increased BPH risk, and high serum IGFBP3 was associated with decreased BPH risk among men with severe symptoms. These results confirm findings from other recent studies.

Neuhouser, Marian L.; Schenk, Jeannette; Song, YoonJu; Tangen, Catherine M.; Goodman, Phyllis J.; Pollak, Michael; Penson, David F.; Thompson, Ian M.; Kristal, Alan R.

2008-01-01

180

Current status of 5?-reductase inhibitors in the management of lower urinary tract symptoms and BPH  

Microsoft Academic Search

Purpose  Benign prostatic hyperplasia (BPH) is a progressive disease that is commonly associated with bothersome lower urinary tract\\u000a symptoms (LUTS) and might result in complications, such as acute urinary retention and BPH-related surgery. Therefore, the\\u000a goals of therapy for BPH are not only to improve LUTS in terms of symptoms and urinary flow, but also to identify those patients\\u000a at a

Stavros Gravas; Matthias Oelke

2010-01-01

181

Serum Steroid and Sex Hormone-Binding Globulin Concentrations and the Risk of Incident Benign Prostatic Hyperplasia: Results From the Prostate Cancer Prevention Trial  

PubMed Central

The authors conducted a nested case-control study of serum steroid concentrations and risk of benign prostatic hyperplasia (BPH), using data from the placebo arm of the Prostate Cancer Prevention Trial (1993–2003). Incident BPH over 7 years (n?=?708) was defined as receipt of treatment, a report of 2 International Prostate Symptom Score (IPSS) values greater than 14, or 2 increases of 5 or more from baseline IPSS values with at least 1 value greater than or equal to 12. Controls (n?=?709) were selected from men who reported no BPH treatment or any IPSS greater than 7. Baseline serum was analyzed for testosterone, estradiol, estrone, 5?-androstane-3?, 17?-diol-glucuronide, and sex hormone-binding globulin. Covariate-adjusted odds ratios contrasting the highest quartiles with the lowest quartiles of testosterone, estradiol, and testosterone:17?-diol-glucuronide ratio were 0.64 (95% confidence interval (CI): 0.43, 0.95; Ptrend?=?0.04), 0.72 (95% CI: 0.53, 0.98; Ptrend?=?0.09), and 0.64 (95% CI: 0.46, 0.89; Ptrend?=?0.004), respectively. Findings did not differ by age, body mass index, time to BPH endpoint, or type of BPH endpoint. High testosterone levels, estradiol levels, and testosterone:17?-diol-glucuronide ratio are associated with reduced BPH risk, which may reflect decreased activity of 5-?-reductase. Genetic or environmental factors that affect the activity of 5-?-reductase may be important in the development of symptomatic BPH.

Schenk, Jeannette M.; Song, YoonJu; Arnold, Kathryn B.; Neuhouser, Marian L.; Goodman, Phyllis J.; Stanczyk, Frank Z.; Thompson, Ian M.

2008-01-01

182

The Effect of Finasteride on Prostate Specific Antigen: Review of Available Data  

Microsoft Academic Search

PurposeWe reviewed the available data on the effect of finasteride on serum levels of prostate specific antigen (PSA), PSA velocity and PSA density in men with benign prostatic hyperplasia (BPH) and prostate cancer.

Harry A. Guess; Glenn J. Gormley; Elizabeth Stoner; Joseph E. Oesterling

1996-01-01

183

Prostatectomy using different lasers for the treatment of benign prostate hyperplasia in aging males  

PubMed Central

Purpose Endoscopic lasers have become a treatment option for benign prostate hyperplasia (BPH). The study reported here sought to elucidate the benefits and drawbacks of different laser systems in the treatment of patients with BPH. Methods The study enrolled 741 patients diagnosed with lower urinary tract symptoms secondary to BPH during the period January 2005 to December 2011. The techniques used in the study were photoselective vaporization of the prostate, thulium laser prostatectomy, and diode laser prostatectomy. Patients were assigned to one of three groups according to the type of laser treatment they received. Outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life, maximal urinary flow rate, post-voiding residual urine volume, and prostate-specific antigen (PSA) level. Results The baseline characteristics of patients who received diode laser prostatectomy show a significant elevated risk and high American Society of Anesthesiology score (P=0.001). Operative time and catheter removal time differed significantly between the three groups (P=0.001). No cases were converted to transurethral resection of the prostate intraoperatively due to bleeding (P=0.142). Among the three groups, there were no significant differences in maximal flow rate, lower post-void residual urine, and postoperative PSA level during the entire follow-up period (P<0.05). Further, no significant differences in postoperative IPSS, quality of life, or bladder neck contracture (P=0.23) were observed. However, a significant difference was observed with regard to prolonged use of Foley catheters and prolonged hospital stay among patients in the diode laser group (P=0.001). Conclusion Laser prostatectomies are effective in dealing with lower urinary tract symptoms. Early subjective functional results (maximal flow rate, IPSS, and post-void residual urine) appeared the same as those obtained following laser prostatectomy. Thus, it appears that lasers are safe and effective as long as the patients are carefully selected for treatment.

Lee, Wei-Chang; Lin, Yu-Hsiang; Hou, Chen-Pang; Chang, Phei-Lang; Chen, Chien-Lun; Juang, Horng-Heng; Tsui, Ke-Hung

2013-01-01

184

Salvage Holmium laser enucleation of prostate to treat residual benign prostatic hyperplasia  

PubMed Central

Introduction: The Holmium laser enucleation of the prostate (HoLEP) technique to remove residual adenoma has not been reported. Salvage HoLEP enables anatomical enucleation of residual adenoma in patients who have previously undergone surgical treatment. We describe not only anatomical insights into the frequent location of adenoma recurrence, but also the feasibility of the salvage HoLEP technique. Methods: We retrospectively reviewed a database containing HoLEP video records for 35 patients out of a total of 535 individuals on whom HoLEP was performed by 2 surgeons (SJO & JSP) between July 2008 and June 2011. Group 1 consisted of patients who underwent salvage HoLEP due to recurring adenoma and Group 2 of patients who underwent HoLEP as an initially surgical management to treat benign prostate hyperplasia (BPH). We compared the dataset of pre-, intra- and postoperative parameters between Groups 1 and 2. Results: In the analysis of the video records of Group 1 (n = 35), there was significant remnant tissue around the verumontanum and the lateral lobes were also incompletely removed by previous conventional procedures. When we compared pre-, intra- and postoperative parameters between the 2 groups, there were no significant differences, including operation time, duration of hospital stay. However, the duration of the catheterization of Group 1 was shorter than that of Group 2 (1.38 ± 0.55 vs. 1.90 ± 1.81 days, p < 0.001). Conclusions: Even for cases of residual BPH, salvage HoLEP is a feasible and effective procedure for treating residual adenoma along the anatomical plane.

Oh, Jin Kyu; Bae, Jungbum; Jeong, Chang Wook; Paick, Jae-Seung; Oh, Seung-June

2014-01-01

185

PSA velocity in conservatively managed BPH: can it predict the need for BPH-related invasive therapy?  

Microsoft Academic Search

OBJECTIVE: To study the value of PSA velocity (PSAV) to predict benign prostatic hyperplasia (BPH) progression in patients managed with alpha(1)-blockers or watchful waiting (WW). METHODS: Nine hundred and forty two BPH patients treated with alpha(1)-blocker or WW were reviewed. PSAV was defined as: (PSA(t)-PSA(b))\\/(t\\/12); where PSA(t) = PSA at time of follow-up (t, in months), PSA(b) = PSA at

Chaidir A. Mochtar; Lambertus A. L. M. Kiemeney; M. Pilar Laguna; Frans M. J. Debruyne; Jean J. M. C. H. de la Rosette

2006-01-01

186

Uroflowmetric assessment of acute effects of sildenafil on the voiding of men with erectile dysfunction and symptomatic benign prostatic hyperplasia  

Microsoft Academic Search

Purpose  To evaluate the acute effects of sildenafil (50 mg) on the micturation of men with erectile dysfunction (ED) and concomitant\\u000a benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) using uroflowmetric parameters.\\u000a \\u000a \\u000a \\u000a Materials and methods  A total of 68 male patients randomized into two groups (36 treatment, 32 control groups) with International Prostate Symptom\\u000a Score (IPSS) greater than 7 and International

Esref O. Guven; Mevlana D. Balbay; Kilciler Mete; Ege C. Serefoglu

2009-01-01

187

Clinical Effects of Discontinuing 5-Alpha Reductase Inhibitor in Patients With Benign Prostatic Hyperplasia  

PubMed Central

Purpose To assess changes in lower urinary tract symptoms (LUTS), prostate volume, and serum prostate-specific antigen (PSA) after discontinuation of 5-alpha reductase inhibitor (5ARI) combination therapy in patients with benign prostatic hyperplasia (BPH). Materials and Methods From December 2003 to December 2012, data were collected retrospectively from 81 men more than 40 years of age with moderate to severe BPH symptoms (International Prostate Symptom Score [IPSS]?8). The men were classified into group 1 (n=42) and group 2 (n=39) according to the use of 5ARI therapy. A combination of dutasteride 0.5 mg with tamsulosin 0.2 mg was given daily to all patients for 1 year. For the next 1 year, group 1 (n=42) received the combination therapy and group 2 (n=39) received tamsulosin 0.2 mg monotherapy only. The IPSS, prostate volume, and PSA level were measured at baseline and at 12 and 24 months according to the use of dutasteride. Results Discontinuation of dutasteride led to significant deterioration of LUTS, increased prostate volume, and increased PSA level. The repeated-measures analysis of variance showed that the changes in IPSS, prostate volume, and PSA level over time also differed significantly between groups 1 and 2 (p<0.001). Conclusions Withdrawal of 5ARI during combination therapy resulted in prostate regrowth and deterioration of LUTS. The PSA level is also affected by the use of 5ARI. Therefore, regular check-up of the IPSS and PSA level may be helpful for all patients who either continue or discontinue the use of 5ARI.

Kim, Won; Jung, Jae Hung; Kang, Tae Wook; Song, Jae Mann

2014-01-01

188

[The association of Serenoa repens, lycopene and selenium is superior to Serenoa repens alone in reducing benign prostatic hyperplasia].  

PubMed

Serenoa repens (SeR) is frequently associated with other natural compounds, such as lycopene (Ly), a carotenoid, and selenium (Se), an essential trace element, to increase its therapeutic activity in benign prostatic hyperplasia (BPH). The LY-Se-SeR association has a greater and stronger anti-inflammatory activity than SeR alone. In addition, the LY-Se-SeR combination is more effective than SeR alone in reducing prostate weight and hyperplasia, augmenting apoptosis, and reducing cell proliferation and growth factor expression. This experimental evidence suggests that Ly-Se-SeR association is superior to SeR alone in reducing benign prostate growth. PMID:21786236

Squadrito, Francesco; Morgia, Giuseppe

2011-01-01

189

Management of experimental benign prostatic hyperplasia in rats using a food-based therapy containing Telfairia occidentalis seeds.  

PubMed

The usefulness of diet containing Telfairia occidentalis seeds, in managing benign prostatic hyperplasia (BPH) in rats was studied. Twenty male Wistar rats were divided into four equal groups. BPH was induced by sub-cutaneous injection of dihydrotestosterone (DHT) and estradiol valerate (ratio, 10:1) every other day for 28 days. Rats in the test group were placed on the test diet for 7 days following disease induction. One control group (DC) was fed on a normal diet for 7 days following disease induction. Two other control groups, HC and HDC, were given sub-cutaneous olive oil (vehicle) for the same duration, and placed on the test diet and normal diet, respectively. Markers of BPH, and hormone profile were determined using standard methods. The results show that relative prostate weight and protein content of the prostates were lower [albeit not significantly (p>0.05)] in the test group, relative to the DC group. Serum prostatic acid phosphatase concentrations (U/L) decreased significantly (p<0.05) from 2.9 ± 0.2 in the DC group to 2.1 ± 0.7 in the test group. Histological findings corroborate these data. The testosterone: estradiol ratio (× 10(3)) was increased from 4.0 ± 0.2 in the DC group to 4.6 ± 0.2 in the test group. The test diet reduced the mass and secretory activity of the enlarged prostate and may act by increasing the testosterone: estradiol ratio. PMID:22654217

Ejike, Chukwunonso E C C; Ezeanyika, Lawrence U S

2011-01-01

190

Serum Dioxin, Testosterone, and Subsequent Risk of Benign Prostatic Hyperplasia: A Prospective Cohort Study of Air Force Veterans  

PubMed Central

Background Operation Ranch Hand veterans were involved in spraying herbicides, including Agent Orange, during the Vietnam War in 1962–1971; Agent Orange was contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). It has been hypothesized that dioxins may be partially responsible for an increase of male reproductive tract disorders such as testicular cancer, cryptorchidism, and hypospadias. Objectives In this study, our objective was to assess the effect of serum TCDD concentration on the risk of development of benign prostatic hyperplasia (BPH) and on serum testosterone levels. Methods This study was a longitudinal, prospective cohort study made up of U.S. Air Force veterans involved in Operation Ranch Hand. Other Air Force veterans who did not spray herbicides were included as comparisons. BPH was determined by medical record review and by medical examinations conducted during the study. Data were available for 971 Ranch Hand and 1,266 comparison veterans. We investigated the relationship between BPH and serum TCDD level using the Cox proportional hazards models adjusted for testosterone levels, body mass index (BMI), and the percentage change in BMI per year. Results In univariate and multivariate analyses, the risk of BPH decreased with increasing serum TCDD in the comparison group. The multivariate risk ratio for BPH in the comparison group was 0.84 (95% confidence interval, 0.73–0.98). Excluding men with prostate cancer, inflammatory or other prostatic diseases did not substantially alter the association. Serum testosterone levels were inversely associated with serum TCDD levels in both Ranch Hand and comparison groups. Conclusions TCDD exposure at general population levels is associated with a decreasing risk of BPH with higher exposure levels. TCDD exposure is also negatively associated with serum testosterone levels.

Gupta, Amit; Ketchum, Norma; Roehrborn, Claus G.; Schecter, Arnold; Aragaki, Corinne C.; Michalek, Joel E.

2006-01-01

191

Evaluation of oxidative stress and DNA damage in benign prostatic hyperplasia patients and comparison with controls.  

PubMed

In the present study, oxidative stress and lymphocytic DNA damage in both pre-op and post-op benign prostrate hyperplasia (BPH) patients with age >50 years was evaluated and compared with normal healthy subjects (controls- without any evidence of disease) of the same sex and age group. From December 2007 to November 2009, oxidative stress in 45 BPH patients were evaluated both before (pre-op patients) and after 7 days of surgery (post-op patients) in terms of measurements of plasma levels of (1) various anti-oxidative enzymes, (2) non-enzymatic antioxidants and (3) malondialdehyde which is a product of lipid peroxidation. The lymphocyte DNA damage was also evaluated by single cell alkaline gel electrophoresis in terms of tail length migration in these patients. These values were compared with their respective control subjects of similar sex and age group. The activities of antioxidant enzymes and the levels of antioxidant, reduced glutathione were found significantly decreased (p < 0.05) in serum samples of pre-operative group of BPH patients as compared to the controls. These altered parameters increased significantly (p < 0.05) and returned to their near normal control values, but not up to baseline values, in post operative patients i.e. after the cancer load was decreased by surgery. Lymphocytic DNA damage was found to be significantly increased in pre-op group as compared to controls and was reduced after surgery in post-op group. The present study therefore, shows significantly increased levels of oxidative stress and DNA damage in BPH patients which were reduced after removal of tumour load. Thus oxidative damage plays an important role in prostate tumourogenesis and timely management of oxidative stress can be of importance in preventing the occurrence of BPH. PMID:24082465

Ahmad, Manzoor; Suhail, Nida; Mansoor, Tariq; Banu, Naheed; Ahmad, Shamshad

2012-10-01

192

Enlarged prostate - after care  

MedlinePLUS

... Levitra), and tadalafil (Cialis) with alpha-1- blockers. Finasteride and dutasteride (5 alpha-reductase-bph inhibitors) may ... Fink HA, Macdonald R, Rutks I, Wilt TJ. Finasteride for benign prostatic hyperplasia. Cochrane Database Syst Rev . ...

193

The use of a single daily dose of tadalafil to treat signs and symptoms of benign prostatic hyperplasia and erectile dysfunction  

PubMed Central

A strong and independent association between lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and erectile dysfunction (ED) has been widely evidenced in several clinical epidemiologic studies. Preclinical animal models have provided a great deal of information on potential common pathogenic mechanisms underlying these two clinical identities. Although the efficacy of the most commonly used treatments for LUTS/BPH is well defined, the negative impact of these treatments on sexual function – in particular, on ED – has triggered the search for new treatment options. In this regard, a new role for phosphodiesterase type 5 inhibitors in the treatment of LUTS/BPH and ED has been claimed. Tadalafil is one of the most extensively investigated phosphodiesterase type 5 inhibitors for this new indication. All evidence reported to date suggests that tadalafil 5 mg once daily is a safe and effective treatment option for both LUTS/BPH and ED.

Gacci, Mauro; Salvi, Matteo; Sebastianelli, Arcangelo; Vignozzi, Linda; Corona, Giovanni; McVary, Kevin T; Kaplan, Steven A; Maggi, Mario; Carini, Marco; Oelke, Matthias

2013-01-01

194

Efficacy and safety of the doxazosin gastrointestinal therapeutic system for the treatment of benign prostate hyperplasia.  

PubMed

This study was carried out to obtain information on the efficacy and safety of the controlled release formulation of the doxazosin Gastrointestinal Therapeutic System (GITS) in Taiwanese subjects with benign prostatic hyperplasia (BPH). Studies of doxazosin in Asian populations for this indication have lacked data particularly from Taiwan. This was an 8-week, post-marketing, open-label, non-comparative study. Eighty male subjects (mean age=64 years) with BPH received doxazosin GITS 4 mg once daily. At week 4, subjects who achieved an increase in maximum urinary flow rate (Qmax) of ?3mL/s and a ?30% reduction in the total International Prostate Symptom Score (IPSS) continued on doxazosin GITS 4 mg for the remaining 4 weeks; all other subjects were up-titrated to 8 mg once daily. Change from baseline at weeks 4 and 8 (primary endpoint) in IPSS and Qmax was evaluated using two-sided paired t tests for the intent-to-treat population. Safety was assessed throughout the study. A total of 53 (66.3%) subjects completed the study. Baseline Qmax and IPSS were 10.7+3.4 mL/s and 20.6+5.4, respectively. At week 8, a significant increase from baseline in Qmax of 3.3+4.6 mL/s (95% confidence interval = 2.2-4.4, p< 0.001) and a significant decrease in total IPSS of -8.9 + 7.0 (95% confidence interval=-10.5 to -7.3, p< 0.001) was observed. The most common treatment-related adverse event was dizziness. Doxazosin GITS 4 mg per day (with an 8-mg titration step) effectively improved symptoms of BPH. The results from this study provide further information for clinicians on the use of doxazosin GITS for the treatment of BPH, particularly in Taiwanese patients. PMID:20950778

Sun, Guang-Huan; Tsui, Ke-Hung; Wu, Tony T; Chang, Chao-Hsiang; Cheng, Chen-Li; Schou, Manjula

2010-10-01

195

Effect of obesity on prostatic hyperplasia: its relation to sex steroid levels.  

PubMed

In 68 men with benign prostatic hyperplasia, we evaluated the association between obesity and prostatic enlargement, as well as changes in serum levels of oestradiol, testosterone, dihydroepiandrosterone and dihydroepiandrosterone sulphate. Despite the larger adenomas, no increase in the symptom score for BPH was observed with increasing obesity. Average specimen weights increased with increasingly obesity and increasing host age from 46 to 80 g. We also found the serum oestradiol level significantly elevated in obese men who were 140% or over recommended weight compared to underweight men younger than 60 years (51.3 pg/ml versus 26.8 pg/ml, p < 0.01). This pattern was present in all age groups. These results indicate that obesity is a risk factor for prostatic enlargement but not for obstruction. Also the degree of obesity appears to have a direct effect on oestradiol levels through transformation of androgens in adipose tissue to oestrogens. In conclusion, further studies to evaluate the pathogenesis, pathophysiology, natural history and symptomatology of BPH would be of great interest and should help to define better the associations that we have recognized. PMID:8738620

Soygür, T; Küpeli, B; Aydos, K; Küpeli, S; Arikan, N; Müftüo?lu, Y Z

1996-01-01

196

[The effects of dutasteride on voiding and storage symptoms in men with benign prostatic hyperplasia].  

PubMed

We investigated the effects of dutasteride on voiding and storage symptoms by a post-hoc analysis from two randomized, placebo-controlled, parallel-group studies (Japanese phase II study and phase III study) which assessed the efficacy and safety of dutasteride in Japanese men with benign prostatic hyperplasia (BPH). Men aged 50 years and older, with a prostate volume of 30 cc or greater, an International Prostate Symptom Score (IPSS) of 8 or higher and maximal urinary flow rate of 15 ml/sec or lower were randomized to placebo or dutasteride groups. The number of subjects for the placebo and dutasteride groups was respectively 72 and 72 in the phase II study, and 185 and 193 in the phase III study. Questions 1, 3, 5 and 6 of IPSS were related to voiding symptoms, and Questions 2, 4 and 7 were related to storage symptoms. Changes between pre- and post-treatments were evaluated. In the phase II study, dutasteride significantly improved voiding symptoms and numerically improved storage symptoms compared with the placebo at week 24. In the phase III study, dutasteride significantly improved voiding and storage symptoms compared with the placebo after 52 weeks. These consistent results suggest that dutasteride is effective for both voiding and storage symptoms in Japanese men with BPH. PMID:21273805

Tsukamoto, Taiji; Shirai, Takashi; Sakamoto, Sadaaki; Akiyama, Akihito; Takeuchi, Hiroyuki; Yajima, Michitaka; Terao, Takumi; Endo, Yukihiro

2010-12-01

197

The Current Role of Open Surgery in BPH  

Microsoft Academic Search

ObjectiveOpen prostatectomy has been one of the distinctive features of our specialty and the gold standard treatment of benign prostatic hyperplasia (BPH) for over 50 years. The operation is almost abandoned in some western countries although it is still relatively commonly performed in others. This article reviews the evidence for open prostatectomy and discusses its current role in our daily

Andrea Tubaro; Cosimo de Nunzio

2006-01-01

198

Protective effect of 2-hydroxy-4-methoxy benzoic acid on testosterone induced benign prostatic hyperplasia in Wister rats.  

PubMed

Oxidative stress is one of the major causative factors for development of benign prostatic hyperplasia (BPH). The aim of the present study is to evaluate the effect of 2-hydroxy-4-methoxy benzoic acid (HMBA), a potential antioxidant on testosterone induced BPH in rats. Male Wistar rats were divided into five groups (n=6), Group I--received saline, Group II--received testosterone (3mg/kg/s.c.), Group III-received testosterone+finasteride (5mg/kg/oral), Group IV and V received testosterone+HMBA (200 and 400 ?g/kg/i.p.), respectively, for 21 days. Animals were weighed before and after the study period. On 22nd day, animals were humanly killed by cervical dislocation. Prostates were excised and weighed, and used for biochemical and histological studies. As a result, testosterone treated rats showed increased prostate weight; prostatic index accompanied with depleted antioxidant enzymes levels, elevated lipid peroxides and total nitrite and associated histology disruption. HMBA treatment at 200 ?g/kg/i.p. and 400 ?g/kg/i.p. significantly restored (P<0.05) antioxidant enzyme levels, lipid peroxide and total nitrite when compared to disease control animals. It also ameliorated the testosterone induced histological changes. The present study suggests the protective role of HMBA on testosterone induced BPH by virtue of its antioxidant potential. PMID:23123055

Ali, Mohd Ismail; Kondreddi, Hari Durga Prasad; Veeresh, B

2013-01-01

199

Dihydrotestosterone and the Concept of 5?–Reductase Inhibition in Human Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objective:The development of the human benign prostatic hyperplasia clearly requires a combination of testicular androgens and aging. Although the role of androgens as the causative factor for human benign prostatic hyperplasia is debated, they undoubtedly have at least a permissive role. The principal prostatic androgen is dihydrotestosterone (DHT). Although not elevated in human benign prostatic hyperplasia, DHT levels in the

G. Bartsch; R. S. Rittmaster; H. Klocker

2000-01-01

200

Clinical efficacy of the GnRH agonist (deslorelin) in dogs affected by benign prostatic hyperplasia and evaluation of prostatic blood flow by Doppler ultrasound.  

PubMed

In six German Shepherds dogs, GnRH agonist implants (Deslorelin) were inserted subcutaneously one month after histological confirmation of benign prostatic hyperplasia (BPH). Prostatic volume (PV), characteristics of ejaculate, serum testosterone concentrations and Doppler parameters of prostatic and subcapsular arteries were detected at different time intervals, for 6 month. The prostatic volume showed a significantly reduction starting at day 37. The decrease in sperm concentration, motility and increase in morphological abnormal sperm were observed from day 22 to day 37, when it was no longer possible to obtain the ejaculate. The values of peak systolic velocity and end-diastolic velocity in prostatic and subcapsular arteries showed from day 11 a gradual decrease, significant at day 22 until day 37 and reaching the lowest values at day 52 until the end of observation. The power Doppler pixel intensity of both arteries showed a gradual decrease from day 5 until day 52. In particular, a significant decrease was observed for both arteries from day 11. Testosterone serum concentration decreased to undetectable levels by day 11 until the end of the observations. All these Doppler parameters and testosterone values were positively correlated with the prostatic volume. Furthermore, testosterone values were positively correlated with peak systolic velocity, end diastolic velocity and pixel numbers. The use of implants containing GnRH analogues, even in asymptomatic subjects, is effective for the control of BPH and the application of Doppler exam of prostatic blood flow represent an non-invasive tool for monitoring the response of medical treatment. PMID:23320475

Polisca, A; Orlandi, R; Troisi, A; Brecchia, G; Zerani, M; Boiti, C; Zelli, R

2013-08-01

201

Elastic Modulus of the Prostate: A New Non-invasive Feature to Diagnose Bladder Outlet Obstruction in Patients with Benign Prostatic Hyperplasia.  

PubMed

The purpose of our study was to develop a reliable method for the non-invasive evaluation of bladder outlet obstruction (BOO) caused by benign prostate hyperplasia (BPH). In our study, the International Prostate Symptom Score was assessed in, and trans-rectal ultrasound (TRUS) and shear wave sonoelastography (SWE) were performed on, 55 patients with BPH who had undergone urodynamic evaluation (the gold standard diagnostic procedure for BOO). The results indicated that the elastic modulus of the transitional zone was the indicator most strongly correlated with BOO stage (r = 0.666, p < 0.001), and had the largest area under the receiver operating characteristic curve, 0.826 (95% confidence interval: 0.717-0.934, p = 0.001). An elastic modulus of the transitional zone ?32.4 kPa or a total prostate volume ?54.4 mL was diagnostic of BOO, with a sensitivity, specificity, positive predictive value, negative predictive value and accuracy for BOO of 97.2%, 62.5%, 85.4%, 90.9% and 86.5%, respectively. The elastic modulus of the transitional zone is a promising indicator in the assessment of the severity of BOO. In addition, the combination of elastic modulus and total prostate volume was the most accurate indicator in the non-invasive diagnosis of BOO in patients with BPH. PMID:24785437

Zhang, Mingbo; Fu, Shuai; Zhang, Yan; Tang, Jie; Zhou, Yun

2014-07-01

202

Systematic review and meta-analysis of Transurethral Needle Ablation in symptomatic Benign Prostatic Hyperplasia  

PubMed Central

Background Benign prostatic hyperplasia (BPH) constitutes a major clinical problem. Minimally invasive therapies for the treatment of symptomatic BPH include Transurethral Needle Ablation (TUNA), but it is unclear what impact this technique has on the disease and its role among other currently available therapeutic options. The objective of this study is to ascertain the efficacy and safety of TUNA in the treatment of BPH. Methods Systematic review of the literature until January 2005 and meta-analysis of clinical studies assessing TUNA in symptomatic BPH. Studies were critically appraised. Estimates of effect were calculated according to the random-effects model. Results 35 studies (9 comparative, 26 non-comparative) were included. Although evidence was limited by methodological issues, the analysis of relevant outcomes indicates that while TUNA significantly improves BPH parameters with respect to baseline, it does not reach the same level of efficacy as TURP in respect to all subjective and objective variables. Further, its efficacy declines in the long-term with a rate of secondary-treatment significantly higher than of TURP [OR: 7.44 (2.47, 22.43)]. Conversely, TUNA seems to be a relatively safe technique and shows a lower rate of complications than TURP [OR:0.14 (0.05, 0.14)] with differences being particularly noteworthy in terms of postoperative bleeding and sexual disorders. Likewise, TUNA has fewer anesthetic requirements and generates a shorter hospital stay than TURP [WMD: -1.9 days (-2.75, -1.05)]. Scarce data and lack of replication of comparisons hinder the assessment of TUNA vs. other local therapies. No comparisons with medical treatment were found. Conclusion The body of evidence on which TUNA has been introduced into clinical practice is of only moderate-low quality. Available evidence suggest that TUNA is a relatively effective and safe technique that may eventually prove to have a role in selected patients with symptomatic BPH. TUNA significantly improves BPH parameters with respect to baseline values, but it does not reach the same level of efficacy and long-lasting success as TURP. On the other hand, TUNA seems to be superior to TURP in terms of associated morbidity, anesthetic requirements and length of hospital stay. With respect to the role of TUNA vis-à-vis other minimally invasive therapies, the results of this review indicate that there are insufficient data to define this with any degree of accuracy. Overall cost-effectiveness and the role of TUNA versus medical treatment need further evaluation.

Bouza, Carmen; Lopez, Teresa; Magro, Angeles; Navalpotro, Lourdes; Amate, Jose Maria

2006-01-01

203

An open, comparative, multicentre clinical study of combined oral therapy with sildenafil and doxazosin GITS for treating Chinese patients with erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia  

Microsoft Academic Search

This study sought to investigate the clinical efficacy and safety of combined oral therapy with sildenafil and doxazosin GITS compared to sildenafil monotherapy in treating Chinese patients with erectile dysfunction (ED) and lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH\\/LUTS). The trial was conducted in hospitals in Beijing, Shanghai, Changsha, Wuhan and Guangzhou, five major cities in China.

Zhe Jin; Zhi-Chao Zhang; Ji-Hong Liu; Jun Lu; Yu-Xin Tang; Xiang-Zhou Sun; Wei-Dong Song; Bing Gao; Ying-Lu Guo; Zhong-Cheng Xin

2011-01-01

204

Association of IL10, IL10RA, and IL10RB Polymorphisms with Benign Prostate Hyperplasia in Korean Population  

PubMed Central

Cytokines such as interleukin 10 (IL10) may play an important role in the process of inflammation. The aim of this study was to analyze the association between IL10, IL10RA and IL10RB single nucleotide polymorphisms (SNPs), and benign prostate hyperplasia (BPH) in Korean population. All patients with BPH were divided into two groups according to international porostate symptom score (IPSS), prostate specific antigen (PSA) level, Qmax, and prostate volume. We selected two IL10 SNPs (rs1518111 and rs1554286), three IL10RA SNPs (rs2256111, rs4252243, and rs2228054), and two IL10RB SNPs (rs999788 and rs2834167). Genotypes of seven SNPs were determined through direct sequencing. The G/G genotype of IL10RB polymorphism (rs2834167) was associated with a high PSA level compared with the A/G + A/A genotypes (P = 0.009). Of IL10 SNP, the A/A genotype of rs1518111 and T/T genotype of rs1554286 were associated with small prostate volume, respectively (P = 0.011, P = 0.014). Moreover, the T/T genotype of IL10RB polymorphism (rs999788) was associated with high prostatic volume compared with the T/C + C/C genotypes (P = 0.033). The linkage disequilibrium (LD) blocks were formed in IL10 and IL10RA. However, haplotypes in the LD block were not associated with BPH. It is concluded that there is a strong association between the IL10 and IL10RB SNPs, and BPH in Korean population.

Yoo, Koo Han; Kim, Su Kang; Chung, Joo-Ho

2011-01-01

205

Therapeutic effect of D-004, a lipid extract from Roystonea regia fruits, on prostate hyperplasia induced in rats.  

PubMed

Benign prostatic hyperplasia (BPH) is a nonmalignant growth of prostate leading to difficulty in urinating. Drug therapy, phytotherapy included, is frequently used to treat BPH. D-004 is a lipid extract from Roystonea regia fruits, and previous studies have shown that oral treatment with D-004 for 14 days prevented prostate hyperplasia (PH) induced by testosterone in rats. No information is available, however; about the effects of D-004 in reverting already established PH. This study investigated whether D-004 could improve PH after oral dosing with testosterone in rats. Rats were distributed in five groups (10 rats/group). One group was injected with soy oil (negative control) and four groups were injected with testosterone: one was orally treated with the vehicle (positive control), two with D-004 (200 and 400 mg/kg) and the other with Saw palmetto (400 mg/kg). At study completion, the rats were sacrificed and the prostates were removed and weighed. D-004 (200 and 400 mg/kg) significantly and dose-dependently decreased prostate enlargement by 85% and 98%, respectively, versus the positive control. Likewise, Saw palmetto (400 mg/kg) significantly reduced prostate weight by 73% versus the positive control. D-004 (400 mg/kg) was more effective (p < 0.05) than Saw palmetto (400 mg/kg) in lowering prostate enlargement. D-004 and Saw palmetto also decreased the prostate weight to body weight ratio, but did not affect body weight. In conclusion, D-004 (200 and 400 mg/kg) orally administered was effective for reducing PH after testosterone dosing. D-004 (400 mg/kg) was more effective than Saw palmetto (400 mg/kg). Further studies, however, are needed to corroborate the present results. PMID:16425975

Carbajal, D; Molina, V; Mas, R; Arruzazabala, M L

2005-01-01

206

Differential adoption of laser prostatectomy for treatment of benign prostatic hyperplasia  

PubMed Central

OBJECTIVE To evaluate whether socioeconomic environment affects the adoption of new laser technology for treatment of benign prostatic hyperplasia (BPH). METHODS Using all payer data, we identified all discharges for laser prostatectomy or transurethral resection of the prostate (TURP) performed in Florida (2001–2009). We determined whether or not each of 114 healthcare markets (Hospital Service Areas) offered laser prostatectomy or TURP and assessed the market-level socioeconomic environment using a previously described ZIP code based summary score. We used generalized estimating equations to examine the association of socioeconomic environment with offering laser prostatectomy or TURP, adjusting for additional market characteristics. RESULTS Better socioeconomic environment was associated with offering laser prostatectomy (odds ratio 1.21 for each 1 point increase in summary score, 95% confidence interval 1.08–1.35, P <.001). Adoption of laser prostatectomy over time was more rapid in markets with superior socioeconomic environment (P <.001 for interaction of socioeconomic summary score with year), such that by study midpoint, 82% of advantaged vs 54% of disadvantaged markets had adopted this new technology. In contrast, socioeconomic environment had only minimal effects on whether or not a market offered TURP. CONCLUSION We found delayed access to new laser technology in more disadvantaged socioeconomic environments, which may translate into disparities in certain outcomes after transurethral surgery for BPH.

Schroeck, Florian R.; Hollingsworth, John M.; Hollenbeck, Brent K.; Jacobs, Bruce L.; Suskind, Anne M.; Sarma, Aruna V.; Wei, John T.

2013-01-01

207

Altered metabolism of androgens in elderly men with benign prostatic hyperplasia.  

PubMed

Kinetics of testosterone, dihydrotestosterone (DHT) and 5alpha-androstane-3alpha,17beta-diol (3alpha-diol) were studied in 7 elderly healthy men (ages 61 to 80 years) with benign prostatic hyperplasia (BPH). Clearance rates were determined by the constant infusion technique with labeled testosterone and DHT. Metabolic clearance rate (MCR), conversion ratio (CR), the transfer constants (rho) and production rates (PB) were calculated. Plasma androgens were measured by specific radioimmunoassay. Plasma testosterone was 516 +/- 314 (SD) ng/dl, plasma DHT was 74.6 +/- 19.6 (SD) ng/dl and plasma 3alpha-diol was 16.4 +/- 4.1 (SD) ng/dl. An elevated DHT level in elderly men with BPH wasconfirmed. MCRT was 620 +/- 65 (SD) liter/day and MCRDHT was 393 +/- 50 (SD) liter/day. Both MCRT and MCRDHT in elderly men were significantly lower than in young men. PBT was 3.2 +/- 2.1 (SD) mg/day and PBDHT was 291 +/- 87 (SD)migrogram/day. PBDHT was the same in elderly and young men. DHT production is maintained in elderly men despite reduction of testosterone production. From the data, it was claculated that in contrast to young men where greater than 80% of blood DHT is from secreted testosterone, over 50% in elderly men is derived from secretion or production of DHT by the testis or even more likely the prostate. PMID:72074

Ishimaru, T; Pages, L; Horton, R

1977-10-01

208

[Absorption and scattering characteristics of human benign prostatic hyperplasia tissue with Ti: sapphire laser irradiation in vitro].  

PubMed

The optical properties and their differences of human benign prostatic hyperplasia (BPH) tissues removed using transurethral plasma kinetic resection of the prostate (PKRP) and transurethral vaporization of the prostate (TUVP) at 640, 660, 680, 700, 720, 740, 760, 780, 800, 820, 840, 860 and 880 nm of Ti: Sapphire laser were studied in vitro. The measurements were performed using a double-integrating-sphere setup, and the absorption and scattering properties were assessed using the inverse adding-doubling method. The results of measurement showed that the absorption coefficients and reduced scattering coefficients of BPH tissues removed using PKRP and TURP obviously decreased with the increase in the wavelength for thirteen different laser wavelengths. The absorption coefficient and reduced scattering coefficient of BPH tissues removed using PKRP at a certain laser wavelength were obviously smaller than that of BPH tissues removed using TUVP at the same laser wavelength. The maximum absorption coefficient and maximum reduced scattering coefficient of BPH tissues removed using PKRP and TURP were respectively (0. 885 +/- 0. 022) and (0.955 +/- 0.024)mm(-1), and (1.564 +/- 0.039) and (1.658 +/- 0.042)mm(-1) at 640 nm, their differences were respectively 7.91% and 6.01%, and the minimum absorption coefficient and minimum reduced scattering coefficient of BPH tissues removed using PKRP and TURP were respectively (0.443 +/- 0.011) and (0.455 +/- 0.011) mm(-1), and (1.117 +/- 0.028) and (1.197 +/- 0.030)mm(-1) at 640 nm, their differences were respectively 2.71% and 9.13%. The maximum difference in the absorption coefficients of BPH tissues removed using PKRP and TURP is 8.95% at 660 nm, and the minimum difference is 1.75% at 860 nm. The maximum difference in the reduced scattering coefficients of BPH tissues removed using PKRP and TURP is 9.13% at 800 nm, and the minimum difference is 6.01% at 640 nm. PMID:18422108

Wei, Hua-Jiang; Xing, Da; He, Bo-Hua; Wu, Rong-Hai; Gu, Huai-Min; Wu, Guo-Yong; Chen, Xue-Mei

2008-01-01

209

New Developments in the Pathobiology of Prostate Disease  

Microsoft Academic Search

Our understanding of the cellular and molecular basis of prostate disease has increased substantially in the last decade. This review discusses the most recent advances in five key areas: ontogeny of prostate cancer, differential gene expression in prostate cancer, biomarkers for prostate cancer and benign prostatic hyperplasia (BPH), role of the androgen receptor in prostate cancer, and 5?-reductase isoenzyme expression

Jack Schalken

2006-01-01

210

Efficacy and safety of Chinese herbal medicine for benign prostatic hyperplasia: systematic review of randomized controlled trials  

PubMed Central

Chinese herbal medicine is commonly used as a treatment for benign prostatic hyperplasia (BPH), but its efficacy and safety remain to be examined. To compare the efficacy and adverse events of Chinese herbal medicine alone or used adjuvantly with Western medications for BPH. Two independent reviewers searched the major electronic databases for randomized controlled trials comparing Chinese herbal medicine, either in single or adjuvant use with Western medication, with placebo or Western medication. Relevant journals and grey literature were also hand-searched. The outcome measures included changes in urological symptoms, urodynamic measures, prostate volume and adverse events. The frequency of commonly used herbs was also identified. Out of 13 922 identified citations of publications, 31 studies were included. Eleven studies with a Jadad score ?3 were selected for meta-analysis. Chinese herbal medicine was superior to Western medication in improving quality of life and reducing prostate volume. The frequency of adverse events in Chinese herbal medicine was similar to that of placebo and less than that of Western medication. The evidence is too weak to support the efficacy of Chinese herbal medicine for BPH due to the poor methodological quality and small number of trials included. The commonly used herbs identified here should provide insights for future clinical practice and research. Larger randomized controlled trials of better quality are needed to truly evaluate the efficacy of Chinese herbal medicine.

Ma, Chun Ho; Lin, Wai Ling; Lui, Sing Leung; Cai, Xun-Yuan; Wong, Vivian Taam; Ziea, Eric; Zhang, Zhang-Jin

2013-01-01

211

Can 80 W KTP Laser Vaporization Effectively Relieve the Obstruction in Benign Prostatic Hyperplasia?: A Nonrandomized Trial  

PubMed Central

Purpose There is little data evaluating the changes of severity of bladder outlet obstruction after 80 W-potassium-titanyl-phosphate (KTP) photoselective laser vaporization prostatectomy (PVP) by pressure-flow study. We evaluated the efficacy of PVP to relieve the obstruction in benign prostate hyperplasia (BPH) compared with transurethral resection of the prostate (TURP). Materials and Methods This is a prospective, non-randomized single center study. The inclusion criteria were as follows: Men suffering from lower urinary tract symptoms (LUTS) secondary to BPH, age ?50 years, International Prostatic Symptom Score (IPSS) ?13, maximum flow rate (Qmax) ?15 ml/s, and ability to give fully informed consent. Patients with neurogenic cause or detrusor underactivity were excluded. The IPSS, bother score, Qmax, postvoid residual volume (PVR), detrusor pressure at maximum flow rate (PdetQmax), bladder outlet obstruction index (BOOI), and prostate volume were measured before and 6 months after surgery and compared between PVP and TURP. Results Sixty-seven patients (53 in PVP, 14 in TURP) were evaluable. In both groups, the IPSS, bother score, Qmax, and PVR had significantly improved (p<0.05), and there were no differences between the changes in those parameters. PVP could effectively reduce the PdetQmax, prostate volume, and BOOI from baseline (from 68.7±23.3 to 40.6±11.2 cmH2O, 49.5±16.3 to 31.3±12.1 ml, 49.8±25.6 to 9.8±20.7), similar to TURP. There were no differences in postoperative PdetQmax, prostate volume, or BOOI between the two groups. The percentage of patients with BOOI ?40 was decreased from 64% to 4% in the PVP group and from 86% to 14% in the TURP group. Conclusions PVP could reduce the prostate volume effectively and relieve bladder outlet obstruction similar to TURP by the 6-month follow up in men with BPH.

Han, Deok Hyun; Choo, Seol Ho; Chung, Jin Woo; Hong, Jeong Hee

2012-01-01

212

Comparison of outpatient versus inpatient transurethral prostate resection for benign prostatic hyperplasia: Comparative, prospective bi-centre study  

PubMed Central

Introduction: We compare the symptomatic relief with urodynamic parameter change and operative safety of the outpatient transurethral resection in saline (TURIS-V) technique with inpatient transurethral resection of the prostate (TURP) for the management of benign prostatic hyperplasia (BPH). Methods: This prospective cohort comparison study enrolled patients who needed BPH surgery. Between January 2010 and June 2011, outpatient TURIS-V was performed at 1 centre and the results of the treatment were compared with inpatient TURP performed at a separate hospital. Preoperative characteristics, including prostate volume, were similar in both groups. Perioperative data and any treatment complications were recorded. The analysis compared postoperative outcomes, including a 6-month postoperative International Prostate Symptom Score (IPSS), a quality of life (QoL) evaluation and a record of any changes in uroflowmetry findings, between the 2 groups. Results: In the TURIS-V patient group, 75 patients agreed to be in the study. Of these, 69 ultimately complete the study. In the TURP group, 76 patients agreed and 71 of these completed the study. Both study groups were well-matched for age, IPSS, QoL and uroflowmetry findings. The TURIS-V group experienced both shorter operation times (54.6 vs. 74.8 minutes) and shorter catheterization times (2.2 vs. 4.2 days) when compared to the TURP group. There were comparable improvements in the 6-month postoperative IPSS, QoL, and uroflowmetry findings between the 2 groups. There were also equally low incidence rates of procedural complications. Conclusions: Both TURIS-V and TURP relieve lower urinary tract symptoms in a similar way, with great efficacy and safety. Overall, TURIS-V had shorter operative and catheterization times compared to TURP. Notwithstanding the paper’s limitations (non- randomized cohort comparison with possible selection or surgeon bias and small heterogeneous sample size), TURIS-V can be performed safely even in an outpatient setting.

Kim, Jae Heon; Park, Jae Young; Shim, Ji Sung; Lee, Jeong Gu; Moon, Du Geon; Yoo, Jeong woo; Choi, Hoon; Bae, Jae Hyun

2014-01-01

213

Recruitment of Participants to a Clinical Trial of Botanical Therapy for Benign Prostatic Hyperplasia  

PubMed Central

Abstract Objectives The timely recruitment of study participants is a critical component of successful trials. Benign prostatic hyperplasia (BPH), a common nonmalignant urologic condition among older men, is characterized by lower urinary tract symptoms (LUTS). Successful recruitment methods for a trial of medical therapy for BPH, Medical Therapy of Prostate Symptoms (MTOPS), were mass mailing and advertising. The Complementary and Alternative Medicines Trial for Urological Symptoms (CAMUS) was designed to evaluate a botanical therapy, saw palmetto, for the treatment of BPH. The objective of this study was to evaluate recruitment strategies for CAMUS and to contrast the baseline characteristics of CAMUS participants with those recruited to a similar trial using conventional medical therapy. Design CAMUS is a randomized, double-blind, placebo-controlled trial designed to evaluate the effects of saw palmetto given at escalating doses over an 18-month period on relief from LUTS. Subjects The target enrollment goal was 350 men with LUTS from 11 clinical centers over a 12-month period. The recruitment techniques used and participants contacted, screened, and randomized through each technique were obtained from the clinical centers. Baseline characteristics of the CAMUS participants were compared with participants in the MTOPS trial who met the CAMUS eligibility criteria for LUTS. Results The target enrollment goal was achieved in 11 months. The overall monthly recruitment rate per site was 3.7 and ranged from 2.4 to 8.0. The most successful recruitment methods were mass mailing and advertising, which accounted for 39% and 35% of the study participants, respectively. In comparison to MTOPS participants, CAMUS participants were younger, more highly educated, more diverse, and had less severe urinary symptoms. Conclusions Successful recruitment methods for CAMUS were similar to those in MTOPS. The use of botanical therapy attracted a less symptomatic and more educated study population.

Foster, Harris E.; McVary, Kevin T.; Meleth, Sreelatha; Stavris, Karen; Downey, Joe; Kusek, John W.

2011-01-01

214

Electroacupuncture for Moderate and Severe Benign Prostatic Hyperplasia: A Randomized Controlled Trial  

PubMed Central

Purpose To evaluate the effects of electroacupuncture (EA) on the International Prostate Symptom Score (IPSS), postvoid residual urine (PVR), and maximum urinary flow rate (Qmax), and explore the difference between EA at acupoints and non-acupoints in patients with moderate to severe benign prostate hyperplasia (BPH). Subjects and Methods Men with BPH and IPSS ?8 were enrolled. Participants were randomly allocated to receive EA at acupoint (treatment group, n?=?50) and EA at non-acupoint (control group, n?=?50). The primary outcome measure includes the change of IPSS at the 6th week and the secondary outcome measures include changes of PVR and Qmax at the 6th week and change of IPSS at the 18th week. Results 100/192 patients were included. At the 6th week, treatment group patients had a 4.51 (p<0.001) and 4.12 (p<0.001) points greater decline in IPSS than the control group in the intention to treat (ITT) and per-protocol (PP) populations. At the 18th week, a 3.2 points (p?=?0.001) greater decline was found in IPSS for the treatment. No significant differences were found between the two groups in Qmax at the 6th week (p?=?0.819). No significant difference was observed in PVR (P?=?0.35). Conclusion Acupoint EA at BL 33 had better effects on IPSS, but no difference on PVR and Qmax as compared with non-acupoint EA. The results indicate that EA is effective in improving patient's quality of life and acupoint may have better therapeutic effects than non-acupoints in acupuncture treatments of BPH. Trial Registration ClinicalTrials.gov NCT01218243.

Wang, Yang; Liu, Baoyan; Yu, Jinna; Wu, Jiani; Wang, Jing; Liu, Zhishun

2013-01-01

215

[Problems of so-called atypical hyperplasia of the prostate].  

PubMed

In search of a precancerous morphological correlate for the carcinoma of the prostate gland becoming more and more frequent with growing age the prostate glands of 450 males from the current autopsy material were investigated by means of large sections according to the so-called serial section technique. The appearance of cellular atypias was discovered for the time being in the various form of hyperplasia of the prostate gland and their corresponding correlations to the latent carcinoma of the prostate gland. In all hyperplasias examined cellular atypias of different degrees of severity and a good correlation to the carcinoma were found, so that they can be regarded as precancerous in the narrower sense. The notion of the "atypical hyperplasia" should not be used, since in it too many different hyperplastic lesions are comprised. On the other hand, in every form of hyperplasia the presence of corresponding cellular atypias should be mentioned. The evidence of a hyperplasia with moderate and severe cellular atypias in the biopsy and TUR-material requires a careful treatment of the residual material by the pathologist and a search for carcinoma by the urologist. In no case it is the cause for an invasive diagnostics or surgical consequences. PMID:2444040

Mehlhorn, J

1987-07-01

216

Relationship between lower urinary tract symptoms and urinary ATP in patients with benign prostatic hyperplasia or overactive bladder.  

PubMed

We investigated whether the improvement of lower urinary tract symptoms (LUTS) and urinary adenosine triphosphate (ATP) level were related. Fifty-seven patients and 13 normal controls were enrolled in this study. All of the male patients had benign prostatic hyperplasia (BPH), and all of the female patients had overactive bladder (OAB). We administered an alpha-1 adrenergic receptor antagonist (tamsulosin hydrochloride) for BPH, while OAB patients received an anti-muscarinic agent (propiverine hydrochloride). Before and after treatment, we examined LUTS and urinary ATP/creatinine ratio. The urinary ATP/creatinine ratio was lower in males than females in both controls and patients. In the BPH patients, administration of the alpha-1 receptor antagonist decreased LUTS and urinary ATP/creatinine ratio, and improvement of LUTS was greater in patients with a high baseline urinary ATP level. In the OAB patients, administration of the anti-muscarinic agent decreased LUTS and urinary ATP/creatinine ratio, and improvement of LUTS was greater in patients with a high baseline urinary ATP level. Improvement of LUTS by treatment with the alpha-1 receptor antagonist or the anti-muscarinic agent was related to the decrease of urinary ATP/creatinine ratio in patients with BPH or OAB. Measurement of urinary ATP can be used as a marker of pathologic bladder function. PMID:19887725

Sugaya, Kimio; Nishijima, Saori; Kadekawa, Katsumi; Miyazato, Minoru; Mukouyama, Hideki

2009-10-01

217

Management of male lower urinary tract symptoms suggestive of benign prostatic hyperplasia by general practitioners in Jakarta  

PubMed Central

Purpose: This study was performed to describe and evaluate the management of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) by general practitioners (GPs) in Jakarta. Methods: This observational cross-sectional study was peformed between January 2013 and August 2013 in Jakarta. We developed a questionnaire consisting of 10 questions describing the management of male LUTS suggestive of BPH by GPs in their daily practice in the previous month. We collected questionnaires from 200 GPs participating in 4 urology symposiums held in Cipto Mangunkusumo Hospital, Jakarta. Results: Most GPs were aged between 25 and 35 years (71.5%) and had worked for more than 1 year (87.5%). One to 5 cases of male LUTS suggestive of BPH were treated by 81% of GPs each month. At diagnosis, the most common symptoms found were urinary retention (55.5%), frequency (48%), and nocturia (45%). The usual diagnostic workup included digital rectal examination (65%), scoring system (44%), measurement of prostate-specific antigen (PSA) level (23.5%), and renal function assessment (20%). Most GPs referred their male patients with LUTS suggestive of BPH to a urologist (59.5%) and 46.5% of GPs prescribed drugs as an initial therapy. Alpha-adrenergic antagonist monotherapy (71.5%) was the most common drug prescribed. Combination therapy with ?-adrenergic antagonists and 5?-reductase inhibitors was not routinely prescribed (13%). Thirty-eight percent of GPs referred their patients when recurrent urinary retention was present and 33% when complications were present. Conclusions: Our study provides evidence that the management of male LUTS suggestive of BPH by GPs in Jakarta suggests referral in part to available guidelines in terms of diagnostic methods and initial therapy. However, several aspects of the guidelines, such as PSA level measurement, renal function assessment, urinalysis, ultrasound examination, and prescription of combination therapies, are still infrequently performed.

Matondang, Faisal Abdi; Rahardjo, Harrina Erlianti

2014-01-01

218

Toll-Like Receptor 10-1-6 Gene Cluster Polymorphisms Are Not Associated With Benign Prostatic Hyperplasia in Korean Population  

PubMed Central

Purpose Inflammation and infection have been associated with the pathogenesis of benign prostatic hyperplasia (BPH). Toll-like receptors (TLRs) play key roles in the innate immune system and initiate the inflammatory response to foreign pathogens. We investigated the relationship between TLR10-1-6 gene cluster polymorphisms and BPH. Methods We genotyped four promoter single nucleotide polymorphisms (SNPs) (TLR10, rs10004195; TLR1, rs5743557; and TLR6, rs1039560 and rs1039559) by directly sequencing (233 BPH patients and 214 control subjects). SNPStats and Haploview version 4.02 were used to analyze the data. Multiple logistic regression models (log-additive, dominant, and recessive) were performed to determine odds ratios (ORs), 95% confidence intervals (CIs), and P-values. Results The genotype and allele frequencies of each SNP was not different between the BPH and control groups (P>0.05). Haplotype analysis showed no association between the haplotype in the linkage disequilibrium (LD) block and BPH (P>0.05), although the LD block was constructed. Conclusions These results indicate that the TLR10-1-6 gene cluster may be not associated with the development of BPH in the Korean population.

Kim, Su Kang; Kim, Young Ock; Lee, Byung-Cheol; Yoo, Koo Han

2014-01-01

219

Association of CYP1A1, CYP1B1 and CYP17 gene polymorphisms and organochlorine pesticides with benign prostatic hyperplasia.  

PubMed

It is well established that steroidal hormones (testosterone and estrogen) increase benign prostatic hyperplasia (BPH) risk. Cytochrome P450 (CYP) enzymes especially CYP1A1, CYP1B1 and CYP17 metabolize these hormones. Apart from that, several endocrine disrupting organochlorine pesticides (OCPs) are reported to mimic the activity of these steroidal hormones. Therefore, functional polymorphisms in these genes and exposure to such pesticides may increase BPH risk further. Our study included 100 newly diagnosed BPH subjects and 100 age-matched healthy male controls. CYP1A1, CYP1B1 and CYP17 polymorphisms were studied using PCR-RFLP and allele-specific PCR method. OCP levels in blood were analyzed by gas chromatography (GC). Levels of p,p'-DDE and endosulfan ? were found to be significantly higher amongst BPH subjects as compared to controls (p-values=0.001 and 0.03 respectively) and CYP17 polymorphism was observed to be significantly associated with BPH subjects as compared to controls (p-values=0.03), indicating that these factors may be important risk factors for BPH. However, further studies are required before unequivocal conclusion. PMID:24875910

Kumar, Vivek; Banerjee, Basu Dev; Datta, Sudip Kumar; Yadav, Chandra Shekhar; Singh, Satyender; Ahmed, Rafat Sultana; Gupta, Sanjay

2014-08-01

220

The impact of transurethral procedures for benign prostate hyperplasia on male sexual function: a meta-analysis.  

PubMed

The effect of transurethral procedures for benign prostate hyperplasia (BPH) on male sexual function is still controversial, and we conducted this meta-analysis to compare the effects of different transurethral surgical procedures for the treatment of symptomatic BPH on male erectile function (EF) and ejaculatory function (EJF). Databases, including MEDLINE, EMBASE, and the Cochrane Controlled Trial Register, were searched to identify randomized controlled trials (RCT) that compared watchful waiting, transurethral electrovaporization (TUEVP) or holmium laser treatment (HLT) with transurethral resection of the prostate (TURP). Trials were included if they were RCTs, contained fully available data, compared with conventional TURP for BPH, and referred to male EF and EJF. A total of 12 RCTs involving a total of 1889 subjects were selected for analysis, including 2 trials comparing TURP and watchful waiting, 6 comparing TURP with TUEVP, and 4 comparing TURP with HLT. TURP was associated with a higher occurrence of retrograde ejaculation compared with watchful waiting but not to TUEVP (P = .95) or HLT (P = .37) and associated with a lower incidence of male erectile dysfunction compared with TUEVP (P = .04) but not HLT. According to the analysis, TURP lead to a higher prevalence of retrograde ejaculation compared with watchful waiting but had less of an effect on EF than TUEVP. TURP did not have a significantly different effect on EF or EJF compared with HLT. PMID:21868751

Zong, Huan-Tao; Peng, Xiao-Xia; Yang, Chen-Chen; Zhang, Yong

2012-01-01

221

Dutasteride Reduces Prostate Size and Prostate Specific Antigen in Older Hypogonadal Men With Benign Prostatic Hyperplasia Undergoing Testosterone Replacement Therapy  

PubMed Central

Purpose Benign prostatic hyperplasia and hypogonadism are common disorders in aging men. There is concern that androgen replacement in older men may increase prostate size and symptoms of benign prostatic hyperplasia. We examined whether combining dutasteride, which inhibits testosterone to dihydrotestosterone conversion, with testosterone treatment in older hypogonadal men with benign prostatic hyperplasia reduces androgenic stimulation of the prostate compared to testosterone alone. Materials and Methods We conducted a double-blind, placebo controlled trial of 53 men 51 to 82 years old with symptomatic benign prostatic hyperplasia, prostate volume 30 cc or greater and serum total testosterone less than 280 ng/dl (less than 9.7 nmol/l). Subjects were randomized to daily transdermal 1% T gel plus oral placebo or dutasteride for 6 months. Testosterone dosing was adjusted to a serum testosterone of 500 to 1,000 ng/dl. The primary outcomes were prostate volume measured by magnetic resonance imaging, serum prostate specific antigen and androgen levels. Results A total of 46 subjects completed all procedures. Serum testosterone increased similarly into the mid-normal range in both groups. Serum dihydrotestosterone increased in the testosterone only but decreased in the testosterone plus dutasteride group. In the testosterone plus dutasteride group prostate volume and prostate specific antigen (mean ± SEM) decreased 12% ± 2.5% and 35% ± 5%, respectively, compared to the testosterone only group in which prostate volume and prostate specific antigen increased 7.5% ± 3.3% and 19% ± 7% (p = 0.03 and p = 0.008), respectively, after 6 months of treatment. Prostate symptom scores improved in both groups. Conclusions Combined treatment with testosterone plus dutasteride reduces prostate volume and prostate specific antigen compared to testosterone only. Coadministration of a 5?-reductase inhibitor with testosterone appears to spare the prostate from androgenic stimulation during testosterone replacement in older, hypogonadal men with symptomatic benign prostatic hyperplasia.

Page, Stephanie T.; Hirano, Lianne; Gilchriest, Janet; Dighe, Manjiri; Amory, John K.; Marck, Brett T.; Matsumoto, Alvin M.

2012-01-01

222

Benign Prostatic Hyperplasia Treatment Outcomes Pilot Study.  

National Technical Information Service (NTIS)

The report summarizes a pilot study originally designed to address the question of increased mortality following transurethral resection of the prostate (TURP) and the relative effectiveness of different treatment strategies for benign prostatic hyperplas...

A. T. K. Cockett M. J. Barry

1993-01-01

223

Naftopidil for the treatment of urinary symptoms in patients with benign prostatic hyperplasia  

PubMed Central

Naftopidil, approved only in Japan, is an ?1-adrenergic receptor antagonist (?1-blocker) used to treat lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Different from tamsulosin hydrochloride and silodosin, in that it has higher and extremely higher affinity respectively, for the ?1A-adrenergic receptor subtype than for the ?1D type, naftopidil has distinct characteristics because it has a three times greater affinity for the ?1D-adrenergic receptor subtype than for the ?1A subtype. Although well-designed large-scale randomized controlled studies are lacking and the optimal dosage of naftopidil is not always completely determined, previous reports from Japan have shown that naftopidil has superior efficacy to a placebo and comparable efficacy to other ?1-blockers such as tamsulosin. On the other hand, the incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may be lower than for tamsulosin and silodosin having high affinity for the ?1A-adrenergic receptor subtype. However, it remains unknown if the efficacy and safety of naftopidil in Japanese is applicable to white, black and Hispanic men having LUTS/BPH in western countries.

Masumori, Naoya

2011-01-01

224

A systematic review of the effects and mechanisms of preoperative 5?-reductase inhibitors on intraoperative haemorrhage during surgery for benign prostatic hyperplasia  

PubMed Central

5?-reductase inhibitors (5?-RIs), including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia (BPH). Many studies reported that preoperative 5?-RI had impact on intraoperative haemorrhage during surgery for BPH, but it was still in controversial. So, we conducted a systematic review of the effects and mechanisms of 5?-RIs on intraoperative bleeding for BPH. MEDLINE, EMBASE, the Cochrane Controlled Trail Register of Controlled Trials and the reference lists of retrieved studies were searched in the analysis. Sixteen publications involving 15 different randomized controlled trials (RCTs) and a total of 1156 patients were used in the analysis, including 10 RCTs for finasteride and five RCTs for dutasteride. We found that preoperative finasteride treatment decreases microvessel density (MVD) in resected prostate specimens. Total blood loss, blood loss per gram of resected prostate tissue and decreases in haemoglobin were all greatly reduced in the finasteride group as compared to controls. Dutasteride appeared to have no effect on bleeding. This meta-analysis shows that preoperative finasteride treatment could decrease intraoperative haemorrhage during surgery for BPH. Preoperative dutasteride had no effect on intraoperative haemorrhage, but further high-quality prospective studies are still needed to confirm this observation.

Zong, Huan-Tao; Peng, Xiao-Xia; Yang, Chen-Chen; Zhang, Yong

2011-01-01

225

Treatment patterns in alpha-blocker therapy for benign prostatic hyperplasia.  

PubMed

This study examined treatment patterns and patient characteristics of men initiating alpha adrenergic blocker therapy (alpha-blocker) for benign prostatic hyperplasia (BPH). The 2009 Thomson Reuters MarketScan® Database was used to identify the newly initiated alpha-blocker: men ?40 years old with continuous medical and pharmacy coverage for 12 months before and after alpha-blocker initiation, with no alpha-blocker or 5-alpha-reductase inhibitors in the previous year, and with ?1 BPH diagnosis within 1 month before and 6 months after alpha-blocker initiation. This study analyzed patient demographics, clinical characteristics, adherence (percentage of men achieving medication possession ratio [MPR] ? 0.8), restarting the same alpha-blocker after discontinuation, switching to another BPH medication, and type of alpha-blocker (alpha 1 type selective or alpha 1 subtype selective agents). T tests and chi-square tests compared differences at the .05 significance level. A total of 13,474 men met the study criteria (mean age of 63.1 years). Two thirds of the men discontinued alpha-blocker in the 12-month period, among which restarts or switches were statistically different (p = .036) but numerically similar across cohorts. Adherence for alpha 1 type selective agents versus alpha 1 subtype selective agents at 6 months was 43.3% versus 38.1% (p < .01); at 12 months, 34.4% versus 30.5% (p < .01). Alpha-blocker discontinuation rates were high, which confirms low medication adherence reported among medications for several other chronic conditions; therefore, it is necessary to understand the reasons for alpha-blocker discontinuation. PMID:24262787

Schoenfeld, Michael J; Shortridge, Emily F; Gelwicks, Steven C; Cui, Zhanglin; Wong, David G

2014-05-01

226

Expression and Localization of Aquaporins in Benign Prostate Hyperplasia and Prostate Cancer  

PubMed Central

The aquaporin (AQP) families of water channels are intrinsic membrane proteins that facilitate selective water and small solute movement across the plasma membrane. The purposes of this study were to determine the expression and localization of AQPs in benign prostatic hyperplasia and prostate cancer. Prostatic tissue was collected from patients with benign prostatic hyperplasia or prostate cancer by transurethral resection of the prostate. The expression and cellular localization of the AQPs were determined in the human prostate by Western blot and immunohistochemistry. AQP1, 3, and 9 were expressed in the human prostate. Western blot analysis revealed bands at 28-36 kDa for the AQP1, 3, and 9 proteins. Of these proteins, AQP3 and 9 were expressed in the epithelium. Immunolabeling showed that AQP1 was mainly expressed in the capillaries and venules of the prostate, AQP9 was expressed in the cytoplasm of the epithelium, and AQP3 was mainly associated with the plasma membrane of the prostatic epithelium. Only AQP3 expression was localized in the cell membrane, and expressed AQP3 was translocated to the cytoplasm in prostate cancer. The epithelium in the human prostate expresses AQP3 and 9 proteins, and the capillaries and venules of the prostate express AQP1. Characterizing or modifying the expression of AQP3 may lead to an understanding of the role of the AQPs in human prostatic disease.

Hwang, Insang; Hwang, Eu-Chang; Song, Seung Hee; Lee, Hyun-Suk; Kim, Sun-Ouck; Kang, Taek-Won; Kwon, Dongdeuk; Park, Kwangsung

2012-01-01

227

Promoter Polymorphism (rs12770170, -184C/T) of Microseminoprotein, Beta as a Risk Factor for Benign Prostatic Hyperplasia in Korean Population  

PubMed Central

Purpose Benign prostatic hyperplasia (BPH) is the most common prostate disease in aging men. Microseminoprotein-beta (MSMB) is abundant in semen. In this study, we investigated association between single nucleotide polymorphisms (SNPs) at the promoter of the MSMB gene and the risk for developing BPH in a Korean population. Methods We genotyped two promoter polymorphisms (rs12770171, -184C/T and rs10993994, -2C/T) of the MSMB gene by direct sequencing. Ninety-five BPH patients and 78 control subjects were recruited for this study. SNPStats and Haploview version 4.2 were used for genetic analyses. Multiple logistic regression models (codominant, dominant, recessive, and log-additive models) were applied to determine the odds ratio (OR), 95% confidence interval (CI), and P-value. Results Genotype frequency of the rs12770171 SNP showed significant difference between BPH patients and controls (OR, 2.14; 95% CI, 1.07-4.27; P=0.032 in the codominant 1 model; OR, 2.31; 95% CI, 1.19-4.47; P=0.011 in the dominant model; and OR, 2.05; 95% CI, 1.17-3.61; P=0.009 in the log-additive model). Moreover, the SNP also showed association between the two groups (OR, 2.05; 95% CI, 1.19-3.52; P=0.009). The rs10993994 SNP was not associated with BPH. In haplotype analysis, CC and TT haplotypes were associated with BPH (P<0.05). Conclusions This result indicates that a promoter polymorphism (rs12770170, -184C/T) in the MSMB gene may be associated with BPH development in a Korean population.

Ban, Ju Yeon

2014-01-01

228

Cost analysis of fixed-dose combination of dutasteride and tamsulosin compared with concomitant dutasteride and tamsulosin monotherapy in patients with benign prostatic hyperplasia in Canada  

PubMed Central

Introduction: We estimate the lifetime cost of treatment for moderate/severe symptoms associated with benign prostatic hyperplasia (BPH) in a cohort of Canadian men aged 50 to 59, and we evaluate the costs of 2 daily bioequivalent treatment options: fixed-dose combination (FDC) of dutasteride (0.5 mg) and tamsulosin (0.4 mg), or concomitant administration of dutasteride (0.5 mg) and tamsulosin (0.4 mg) monotherapies. Methods: The expected lifetime costs were estimated by modelling the incidence of acute urinary retention (AUR), BPH-related surgery and clinical progression over a patient’s lifetime (up to 25 years). A model was developed to simulate clinical events over time, based on a discrete Markov process with 6 mutually exclusive health states and annual cycle length. Results: The estimated lifetime budget cost for the cohort of 374 110 men aged 50 to 59 in Canada is between $6.35 billion and $7.60 billion, equivalent to between $16 979 and $20 315 per patient with moderate/severe symptoms associated with BPH. Costs are lower for FDC treatment, with the net difference in lifetime budget impact between the 2 treatment regimens at $1.25 billion. In this analysis, the true costs of BPH in Canada are underestimated for 2 main reasons: (1) to make the analysis tractable, it is restricted to a cohort aged 50 to 59, whereas BPH can affect all men; and (2) a closed cohort approach does not include the costs of new (incident) cases. Conclusion: Canadian clinical guidelines recommend the use of the combination of tamsulosin and dutasteride for men with moderate/severe symptoms associated with BPH and enlarged prostate volume. This analysis, using a representational patient group, suggests that the FDC is a more cost-effective treatment option for BPH.

Sayani, Amyn; Ismaila, Afisi; Walker, Anna; Posnett, John; Laroche, Bruno; Nickel, J. Curtis; Su, Zhen

2014-01-01

229

Serum antibodies against genitourinary infectious agents in prostate cancer and benign prostate hyperplasia patients: a case-control study  

PubMed Central

Background Infection plays a role in the pathogenesis of many human malignancies. Whether prostate cancer (PCa) - an important health issue in the aging male population in the Western world - belongs to these conditions has been a matter of research since the 1970 s. Persistent serum antibodies are a proof of present or past infection. The aim of this study was to compare serum antibodies against genitourinary infectious agents between PCa patients and controls with benign prostate hyperplasia (BPH). We hypothesized that elevated serum antibody levels or higher seroprevalence in PCa patients would suggest an association of genitourinary infection in patient history and elevated PCa risk. Methods A total of 434 males who had undergone open prostate surgery in a single institution were included in the study: 329 PCa patients and 105 controls with BPH. The subjects' serum samples were analysed by means of enzyme-linked immunosorbent assay, complement fixation test and indirect immunofluorescence for the presence of antibodies against common genitourinary infectious agents: human papillomavirus (HPV) 6, 11, 16, 18, 31 and 33, herpes simplex virus (HSV) 1 and 2, human cytomegalovirus (CMV), Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Neisseria gonorrhoeae and Treponema pallidum. Antibody seroprevalence and mean serum antibody levels were compared between cases and controls. Tumour grade and stage were correlated with serological findings. Results PCa patients were more likely to harbour antibodies against Ureaplasma urealyticum (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.08-4.28). Men with BPH were more often seropositive for HPV 18 and Chlamydia trachomatis (OR 0.23; 95% CI 0.09-0.61 and OR 0.45; 95% CI 0.21-0.99, respectively) and had higher mean serum CMV antibody levels than PCa patients (p = 0.0004). Among PCa patients, antibodies against HPV 6 were associated with a higher Gleason score (p = 0.0305). Conclusions Antibody seropositivity against the analyzed pathogens with the exception of Ureaplasma does not seem to be a risk factor for PCa pathogenesis. The presence or higher levels of serum antibodies against the genitourinary pathogens studied were not consistently associated with PCa. Serostatus was not a predictor of disease stage in the studied population.

2011-01-01

230

Laser Prostatectomy: Holmium Laser Enucleation and Photoselective Laser Vaporization of the Prostate  

PubMed Central

Historically, transurethral resection of the prostate has been the gold standard for the treatment of benign prostatic hyperplasia (BPH). Laser technology has been used to treat BPH for > 15 years. Over the past decade, it has gained wide acceptance by experienced urologists. This review provides an evidence-based update on laser surgery for BPH with a focus on photoselective laser vaporization and holmium laser enucleation of the prostate surgeries and assesses the safety, efficacy, and durability of these techniques.

Bostanci, Yakup; Kazzazi, Amir; Djavan, Bob

2013-01-01

231

Preoperative Clinical Factors for Diagnosis of Incidental Prostate Cancer in the Era of Tissue-Ablative Surgery for Benign Prostatic Hyperplasia: A Korean Multi-Center Review  

PubMed Central

Purpose To identify potential predictive factors of incidental prostate cancer (IPca) in patients considering tissue-ablation treatment for benign prostatic hyperplasia (BPH). Materials and Methods From the 11 centers, 1,613 men who underwent transurethral resection of the prostate (TURP) or open prostatectomy were included. Before surgery, prostate biopsy was performed in all patients with prostate-specific antigen (PSA) ?4.0 ng/ml or with abnormal digital rectal examination (DRE) findings. The patients with prostate cancer preoperatively or with PSA >20 ng/ml were excluded. As predictive factors of IPca, age, body mass index, PSA, DRE, and transrectal ultrasonography (TRUS) findings, including total prostate volume (TPV), transition zone volume (TZV), and the presence of hypoechoic lesions, were reviewed. PSA density (PSAD) and PSAD in the transition zone (PSAD-TZV) were calculated. Results IPca was diagnosed in 78 patients (4.8%). DRE findings, PSA, and TZV were independent predictive factors in the multivariate analysis. In the receiver operating characteristic curve analysis of PSA, PSAD, and PSAD-TZV, the area under the curve (AUC) was the largest for PSAD-TZV (AUC, 0.685). Conclusions IPca was detected in 4.8% of the population studied. In addition to DRE findings, the combination of TZV and PSA can be useful predictive factors of IPca in patients considering tissue-ablation treatment as well as TURP.

Yoo, Changhee; Oh, Cheol Young; Kim, Se Joong; Kim, Sun Il; Kim, Young Sig; Park, Jong Yeon; Seong, Do Hwan; Song, Yun Seob; Yang, Won Jae; Chung, Hyun Chul; Cho, In Rae; Cho, Sung Yong; Cheon, Sang Hyeon; Hong, Sungjoon

2012-01-01

232

Clinical, Laboratorial, and Urodynamic Findings of Prostatic Artery Embolization for the Treatment of Urinary Retention Related to Benign Prostatic Hyperplasia. A Prospective Single-Center Pilot Study  

SciTech Connect

PurposeThis study was designed to describe the clinical, laboratorial, and urodynamic findings of prostatic artery embolization (PAE) in patients with urinary retention due to benign prostatic hyperplasia (BPH).MethodsA prospective study of 11 patients with urinary retention due to BPH was conducted. Patients underwent physical examination, prostate specific antigen (PSA) measurement, transrectal ultrasound, and magnetic resonance imaging. International prostate symptom score (IPSS), quality of life (QoL), and urodynamic testing were used to assess the outcome before and after 1 year.ResultsClinical success was 91 % (10/11 patients) with a mean follow-up of 22.3 months (range, 12-41 months). At the first year follow-up, the mean IPSS score was 2.8 points (p = 0.04), mean QoL was 0.4 points (p = 0.001), mean PSA decreased from 10.1 to 4.3 ng/mL (p = 0.003), maximum urinary flow (Qmax) improved from 4.2 to 10.8 mL/sec (p = 0.009), and detrusor pressure (Pdet) decreased from 85.7 to 51.5 cm H{sub 2}O (p = 0.007). Before PAE, Bladder Outlet Obstruction Index (BOOI) showed values >40 in 100 % of patients. After PAE, 30 % of patients were >40 (obstructed), 40 % were between 20 and 40 (undetermined), and 30 % were <20 (unobstructed). Patients with a BOOI <20 had higher PSA values at 1-day after PAE.ConclusionsClinical and urodynamic parameters improved significantly after PAE in patients with acute urinary retention due to BPH. Total PSA at day 1 after PAE was higher in patients with unobstructed values in pressure flow studies.

Antunes, Alberto A. [University of Sao Paulo Medical School, Division of Urology (Brazil); Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br; Motta Leal Filho, Joaquim M. da [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Yoshinaga, Eduardo M. [University of Sao Paulo Medical School, Division of Urology (Brazil); Cerri, Luciana M. O. [University of Sao Paulo Medical School, Ultrasound Unit (Brazil); Baroni, Ronaldo H. [University of Sao Paulo Medical School, Magnetic Resonance Unit (Brazil); Marcelino, Antonio S. Z. [University of Sao Paulo Medical School, Ultrasound Unit (Brazil); Cerri, Giovanni G. [University of Sao Paulo Medical School, Radiology Department (Brazil); Srougi, Miguel [University of Sao Paulo Medical School, Division of Urology (Brazil)

2013-08-01

233

Molecular profiling of human prostate tissues: insights into gene expression patterns of prostate development during puberty  

Microsoft Academic Search

Testosterone production surges during puberty and orchestrates massive growth and reorganization of the prostate gland, and this glandular architecture is maintained thereafter throughout adulthood. Benign prostatic hyperplasia (BPH) and prostate adenocarcinoma (PCA) are common diseases in adulthood that do not develop in the absence of androgens. Our objective was to gain insight into gene expression changes of the prostate gland

Saravana Mohan Dhanasekaran; Atreya Dash; Ira P. Maine; Bharathi Laxman; Scott A. Tomlins; Anjana Menon; Mark A. Rubin; Arul M. Chinnaiyan

2004-01-01

234

SERUM MALONDIALDEHYDE, GAMMA GLUTAMYL TRANSFERASE AND PROSTATE SPECIFIC ANTIGEN AS MARKERS OF CANCER OF THE PROSTATE  

Microsoft Academic Search

OBJECTIVE: Prostate specific antigen (PSA) has been found not to be specific for the screening of cancer of the prostate (CaP). We determined serum levels of prostate specific antigen, malondialdehyde (MDA) and gamma glutamyl transferase in patients with newly diagnosed CaP and benign prostatic hyperplasia (BPH) DESIGN: A cross sectional study SETTING: It was carried out in the urology clinic

Dolapo Pius OPARINDE; Adeniran Samuel ATIBA; Patrick Temi ADEGUN; Temitope Adeola' Niran-Atiba

2013-01-01

235

Finasteride in the treatment of clinical benign prostatic hyperplasia: A systematic review of randomised trials  

Microsoft Academic Search

BACKGROUND: Benign prostatic hyperplasia affects older men. This systematic review determined efficacy and adverse effects of finasteride. REVIEW METHODS: PubMed, the Cochrane Library, reference lists of reports, and reviews were searched for randomised, double-blind trials of finasteride in benign prostatic hyperplasia. Outcomes included symptom score, urinary flow rate, prostate volume, discontinuation, and adverse effects. Relative risk and NNT or NNH

Jayne E Edwards; R Andrew Moore

2002-01-01

236

Florid basal cell hyperplasia of the prostate: a histological, ultrastructural, and immunohistochemical analysis  

Microsoft Academic Search

Basal cell proliferation is a common finding in a benign hyperplastic prostate gland. Occasionally, basal cell hyperplasia is so florid that it can be mistaken for prostatic adenocarcinoma. We characterized histological, ultrastructural, and immunohistochemical features of florid basal cell hyperplasia from transurethral resections (n = 11) and prostatectomy specimens (n = 4). Fifteen cases of prostatic adenocarcinoma were used as

Ximing J Yang; Maria S Tretiakova; Elizabeth Sengupta; Can Gong; Zhong Jiang

2003-01-01

237

Preventive effects of D-004, a lipid extract from Cuban royal palm (Roystonea regia) fruits, on testosterone-induced prostate hyperplasia in intact and castrated rodents.  

PubMed

Benign prostatic hyperplasia (BPH) is the noncancerous, uncontrolled growth of prostate gland cells and stroma that can cause difficulty urinating. Fruit lipid extracts from saw palmetto, a palm from the Arecaceae family, are used for BPH management. The Cuban royal palm, Roystonea regia, is also a member of the Arecaceae family and therefore it was appropriate to investigate the protective effects of Roystonea regia fruit lipid extracts on prostatic hyperplasia. The aim of this study was to investigate whether D-004, a lipid extract from Roystonea regia fruits, prevented testosterone-induced PH in castrated and intact rodents. Two series of experiments were performed. The first one was conducted in castrated and intact rats, distributed into five groups of 10 rats per group. The negative control group was injected with soy oil and treated orally with vehicle, while the four testosterone-injected groups were treated with vehicle (positive control), D-004 100, 200 and 400 mg/kg, respectively. The other experiment was conducted in castrated and intact mice. These were distributed into four groups of 10 mice per group: a negative control group and three testosterone-injected groups, of which one was a positive control, while two received D-004 200 and 400 mg/kg, respectively. At study completion, the rodents were sacrificed and prostates removed and weighed. D-004 at doses of 100, 200 and 400 mg/kg significantly and dose-dependently prevented prostate enlargement in intact and castrated rats and mice. The percentage inhibitions obtained in mice were greater: 77% and 84% for intact and castrated mice, respectively. D-004 therapy did not affect body weight. It is concluded that D-004 administered orally significantly prevented testosterone-induced prostate enlargement in both intact and castrated rodents, indicating that an endogenous supply of testosterone is not necessary to observe such an effect The results of the present investigation support further studies of D-004 on experimental models of prostatic hyperplasia. PMID:15700750

Arruzazabala, M L; Carbajal, D; Más, R; Molina, V; Rodríguez, E; González, V

2004-01-01

238

Long-Term Effects on BPH of Medical and Instrumental Therapies  

Microsoft Academic Search

A variety of methods are available that provide relief of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). This paper reviews approaches for assessing treatment outcomes, along with morbidity and long-term reintervention rates for different mechanical treatments. Symptom scores do not necessarily correlate with the severity of bladder outlet obstruction, whereas reintervention rates provide a reliable objective

P. Puppo

2001-01-01

239

Characterization of prostate cancer, benign prostatic hyperplasia and normal prostates using transrectal 31phosphorus magnetic resonance spectroscopy: a preliminary report  

SciTech Connect

We assessed the ability of 31phosphorus (31P) transrectal magnetic resonance spectroscopy to characterize normal human prostates as well as prostates with benign and malignant neoplasms. With a transrectal probe that we devised for surface coil spectroscopy we studied 15 individuals with normal (5), benign hyperplastic (4) and malignant (6) prostates. Digital rectal examination, transrectal ultrasonography and magnetic resonance imaging were used to aid in accurate positioning of the transrectal probe against the region of interest within the prostate. The major findings of the in vivo studies were that normal prostates had phosphocreatine-to-adenosine triphosphate (ATP) ratios of 1.2 +/- 0.2, phosphomonoester-to-beta-ATP ratios of 1.1 +/- 0.1 and phosphomonoester-to-phosphocreatine ratios of 0.9 +/- 0.1. Malignant prostates had phosphocreatine-to-beta-ATP ratios that were lower (0.7 +/- 0.1) than those of normal prostates (p less than 0.02) or prostates with benign hyperplasia. Malignant prostates had phosphomonoester-to-beta-ATP ratios (1.8 +/- 0.2) that were higher than that of normal prostates (p less than 0.02). Using the phosphomonoester-to-phosphocreatine ratio, it was possible to differentiate metabolically malignant (2.7 +/- 0.3) from normal prostates (p less than 0.001), with no overlap of individual ratios. The mean phosphomonoester-to-phosphocreatine ratio (1.5 +/- 0.5) of prostates with benign hyperplasia was midway between the normal and malignant ratios, and there was overlap between individual phosphomonoester-to-phosphocreatine ratios of benign prostatic hyperplasia glands with that of normal and malignant glands. To verify the in vivo results, we performed high resolution magnetic resonance spectroscopy on perchloric acid extracts of benign prostatic hyperplasia tissue obtained at operation and on a human prostatic cancer cell line DU145.

Narayan, P.; Jajodia, P.; Kurhanewicz, J.; Thomas, A.; MacDonald, J.; Hubesch, B.; Hedgcock, M.; Anderson, C.M.; James, T.L.; Tanagho, E.A. (Univ. of California School of Medicine, San Francisco (USA))

1991-07-01

240

Possible relations between oxidative damage and apoptosis in benign prostate hyperplasia and prostate cancer patients.  

PubMed

Cancer has been described as the twentieth century plague, and is a very common health problem. It has been reported that ROS and ROS products play a key role in cancer and that oxidative damage is effective in apoptosis initiation. In this study we aimed to evaluate the relationship between MDA (malondialdehyde), DNA damage (8-hydroxyguanine, 8-OH-dG), and caspase-3 in BHP and prostate cancer patients. Twenty male patients with prostate cancer and 20 male patients with benign prostate hyperplasia were included into this study. The MDA (nanomole), DNA damage (nanograms per millilitre), and caspase-3 (nanograms per millilitre) levels were measured in prostate cancer and benign prostate hyperplasia using Elisa kits (Millipore Corporation, Billerica, MA, USA). In the prostate cancer group, serum MDA (30.96?±?9.25) and DNA damage (4.42?±?0.36) levels were significantly raised (p?prostate hyperplasia group (24.05?±?8.06, 3.99?±?0.54). However, in the prostate cancer group, serum caspase-3 (2.36?±?0.82) levels were statistically significantly lowered (p?prostate hyperplasia group (3.15?±?1.04). We observed that altered prooxidant, DNA damage levels may lead to an increase in oxidative damage and may consequently play an important role in prostate carcinogenesis. These findings indicate that, although the triggering of these changes is unknown, changes in the levels of MDA, DNA damage, and caspase-3 in the blood are related to prostatic carcinoma development. In addition, it would be appropriate to conduct new studies with a large number of patients at different stages. PMID:24375255

Kosova, Funda; Temelta?, Gökhan; Ar?, Zeki; Lekili, Murat

2014-05-01

241

Hematuria Secondary to Benign Prostatic Hyperplasia: Retrospective Analysis of 166 Men Identified in a Single One Stop Hematuria Clinic  

PubMed Central

Introduction Hematuria secondary to benign prostatic hyperplasia (BPH) can occur due to a vascular primary gland itself or due to the vascular re-growth of the prostate following a transurethral resection of the prostate (TURP). We aim to evaluate the clinical presentation and management in patients within both these groups. Materials and Methods We retrospectively archived the data of 166 men diagnosed with hematuria secondary to BPH from our hematuria clinic database from March 2003 and March 2006. The 166 patients were divided into 2 groups: Group I (n = 94) hematuria with no previous TURP; Group II (n = 72) hematuria with previous TURP. The clinical management in both groups included reassurance, commencement of a 5-alpha reductase inhibitor (finasteride) or a primary TURP in Group I or re-do TURP in Group II. Results The median age was 73 years (range 45–94 years) for both groups. Outcomes combined for both groups included: reassurance alone in 26% (n = 43), finasteride in 51% (n = 84) and TURP in 12% (n = 19). Patients managed with reassurance alone or TURP had no further episodes of hematuria. At a mean follow-up was 18 months (range 7–22 months), 2 patients treated with finasteride re-bled but did require further intervention. A further 2 men elected to stop finasteride due to erectile dysfunction and gynecomastia respectively. Conclusion BPH can present with hematuria. Following re-evaluation in a hematuria clinic, the lack of any subsequent cancer diagnosis in these patients suggests that repeat hematuria investigations should be carefully re-considered.

Vasdev, Nikhil; Kumar, Ashish; Veeratterapillay, Rajan; Thorpe, Andrew C.

2013-01-01

242

Applicators for MR-Guided Ultrasonic Ablation of BPH  

PubMed Central

Objectives To evaluate in a canine model, applicators designed for ablation of human benign prostatic hyperplasia (BPH) in vivo under MRI guidance, including magnetic resonance thermal imaging (MRTI). To determine the ability of MRI techniques to visualize ablative changes in prostate, and to evaluate the acute and longer term histologic appearances of prostate tissue ablated during these studies. Materials and Methods A MRI-compatible transurethral device incorporating a tubular transducer array with dual 120 sectors was employed to ablate canine prostate tissue in vivo, in zones similar to regions of human BPH (enlarged transition zones (TZ)). MRTI was used for monitoring of ablation in a 3T environment, and post-ablation MRI's were performed to determine visibility of ablated regions. Three canine prostates were ablated in acute studies, and 2 animals were rescanned prior to sacrifice at 31 days post ablation. Acute and chronic appearances of ablated prostate tissue were evaluated histologically, and correlated with the MRTI and post ablation MRI scans. Results It was possible to ablate regions similar in size to enlarged TZ in human BPH in 5 to 15 minutes. Regions of acute ablation showed a central “heat fixed” region surrounded by a region of more obvious necrosis with complete disruption of tissue architecture. After 31 days, ablated regions demonstrated complete apparent resorption of ablated tissue with formation of cystic regions containing fluid. The inherent cooling of the urethra using the technique resulted in complete urethral preservation in all cases. Conclusions Prostatic ablation of zones of size and shape corresponding to human BPH is possible using appropriate transurethral applicators using MRTI, and ablated tissue may be depicted clearly in contrast-enhanced MR images. The ability accurately to monitor prostate tissue heating, the apparent resorption of ablated regions over one month, and the inherent urethral preservation suggest the MR guided technques described are highly promising for the in vivo ablation of symptomatic human BPH.

Sommer, Graham; Pauly, Kim Butts; Holbrook, Andrew; Plata, Juan; Daniel, Bruce; Bouley, Donna; Gill, Harcharan; Prakash, Punit; Salgaonkar, Vasant; Jones, Peter; Diederich, Chris

2014-01-01

243

Interstitial Laser Therapy of Benign Prostatic Hyperplasia  

Microsoft Academic Search

The objective of interstitial laser coagulation (ILC) of benign prostatic enlargement is to achieve a marked volume reduction and to decrease bladder outlet obstruction and lower urinary tract symptoms with minimal morbidity. Coagulation necrosis is generated well inside the adenoma by means of specifically designed laser applicators combined with either a Nd:YAG laser or a diode laser. Because the laser

Rolf Muschter; Hugh Whitfield

1999-01-01

244

Neuroendocrine cells in benign prostatic hyperplasia and prostatic carcinoma: effect of hormonal treatment.  

PubMed

The present study was undertaken to analyze the changes in neuroendocrine cells of the human prostate induced by neoplasms and the effect of hormonal treatment. Samples of human prostate (n = 47) were obtained during surgery or removal of organs for transplantation. The cases analyzed represent normal prostates (n = 4); benign prostatic hyperplasias (n = 10; prostatic carcinomas with Gleason scores of 2-4 (n = 5), 5-7 (n = 10), and 8-10 (n = 3), and prostatic carcinomas treated with hormonal therapy (n = 15). Immunohistochemistry for chromogranin A was performed, and the density of neuroendocrine cells as well as the intensity of the immunostaining within their cytoplasms were evaluated using image analysis. Neuroendocrine cells showing chromogranin A immunoreactivity were identified in all cases studied. They were localized scattered in the acini, and no differences in their morphology were observed among groups. Interestingly, chromogranin A immunoreactivity was also present in typical epithelial cells of prostatic cancer with Gleason scores ranging from 8 to 10. The density of chromogranin A immunoreactive cells was higher in neoplastic tissue with respect to the normal prostate, reaching maximal values in prostatic carcinomas with Gleason scores of 8-10 which were hormonally treated. Regarding the intensity of immunostaining in the prostatic carcinomas with Gleason scores of 8-10 only, a significant increase in relation to the other groups was found. The present results demonstrate that the neuroendocrine cells have similar morphological features and distribution in normal prostate, benign prostatic hyperplasia, and prostatic carcinoma. Their density in prostatic cancer increases following hormonal therapy and varies in relation to the tumoral degree or histological evaluation, suggesting a role of neuroendocrine cells in human prostatic cancer. PMID:9428430

Guate, J L; Escaf, S; Menendez, C L; del Valle, M; Vega, J A

1997-01-01

245

Design and evaluation of a 63 element 1.75-dimensional ultrasound phased array for treating benign prostatic hyperplasia  

NASA Astrophysics Data System (ADS)

Focused ultrasound surgery (FUS) is a clinical method for treating benign prostatic hyperplasia (BPH) in which tissue is noninvasively necrosed by elevating the temperature at the focal point above 60°C using short sonications. With 1.75-dimensional (1.75-D) arrays, the power and phase to the individual elements can be controlled electronically for focusing and steering. This research describes the design, construction and evaluation of a 1.75-D ultrasound phased array to be used in the treatment of benign prostatic hyperplasia. The array was designed with a steering angle of +/-13.5 deg in the transverse direction, and can move the focus in three parallel planes in the longitudinal direction with a relatively large focus size. A piezoelectric ceramic (PZT-8) was used as the material of the transducer and two matching layers were built for maximum acoustic power transmission to tissue. To verify the capability of the transducer for focusing and steering, exposimetry was performed and the results correlated well with the calculated fields. In vivo experiments were performed to verify the capability of the transducer to ablate tissue using short sonications. [Work supported by the Whitaker Foundation and the Department of Defense Congressionally Directed Medical Prostate Cancer Research Program.

Saleh, Khaldon Y.; Smith, Nadine B.

2003-10-01

246

Roles of autophagy-related genes Beclin-1 and LC3 in the development and progression of prostate cancer and benign prostatic hyperplasia  

PubMed Central

Prostate cancer (PCa) is common in Western populations and the second leading cause of cancer-related mortality among males in North America, with an increasing morbidity in China and other Asian countries. The aim of this study was to evaluate the protein expression of autophagy-related genes Beclin-1 and LC3 in patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) and elucidate their association with p53 and Bcl-2. The total protein of 34 PCa and 50 BPH samples was extracted and the expression of Beclin-1 and LC3 was analyzed by western blotting assay. Subsequently, a total of 96 paraffin-embedded BPH tissue samples was subdivided into 2 groups, one group in which patients had received 5?-reductase inhibitor, due to its effect of androgen ablation, and the control group, in which patients had not received the 5?-reductase inhibitor. The samples were randomly collected and examined using immunohistochemical (IHC) analysis. The western blot analysis demonstrated that Beclin-l and LC3 expression was higher in BPH tissues compared to PCa tissues (P<0.001). There was no statistically significant difference between PCas of different Gleason scores (P>0.05). The result of IHC revealed that Beclin-l and LC3 expression in the group of patients who had received the 5?-reductase inhibitor was significantly higher compared to that in the control group; however, the expression of Bcl-2 and p53 was lower (P<0.05). Beclin-1 expression exhibited a negative correlation with Bcl-2 (r=?0.402, P<0.001), whereas LC3 expression exhibited a positive correlation with Beclin-1 (r=0.345, P=0.001) and a negative correlation with Bcl-2 (r=?0.216, P=0.035). It was suggested that autophagy-related genes Beclin-l and LC3 may be involved in the development and progression of PCa. In addition, the expression of these genes was higher in patients with BPH who had received a 5?-reductase inhibitor, due to androgen reduction. As a result, the induced autophagy may reduce the risk of PCa.

LIU, CHENGYI; XU, PENGCHENG; CHEN, DEGANG; FAN, XINHUAN; XU, YIPENG; LI, MENGQIANG; YANG, XU; WANG, CONGFEI

2013-01-01

247

BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE.  

PubMed

Benign prostatic hyperplasia (BPH) represents a significant burden in ageing men due to frequently associated lower urinary tract symptoms (LUTS), which may impair quality of life. BPH is also a progressive disease, mainly characterized by a deterioration of LUTS over time, and in some patients by the occurrence of serious outcomes such as acute urinary retention (AUR) and need for BPH-related surgery. The goals of therapy for BPH are not only to improve bothersome LUTS but also to identify those patients at risk of unfavourable outcomes, to optimize their management. In selected patients, combination of an alpha(1)-blocker and a 5alpha-reductase inhibitor is the most effective form of BPH medical therapy to reduce the risk of clinical progression and relieve LUTS. Monotherapy also significantly reduces the risk of BPH clinical progression, mainly through a reduction of LUTS deterioration for alpha(1)-blockers while 5alpha-reductase inhibitors also reduce the risk of AUR and need for BPH-related surgery. Enlarged prostate and high serum prostate-specific antigen levels have been consistently found to be good clinical predictors of AUR and BPH-related surgery in longitudinal population-based studies and placebo arms of controlled studies. High post-void residual urine (PVR) is also associated with an increased risk of LUTS deterioration and should thus be reconsidered in practice as a predictor of BPH progression. Conversely, baseline LUTS severity and low peak flow rate, initially identified as predictors of unfavourable outcomes in community setting, behave paradoxically in controlled trials, probably as a consequence of strict inclusion criteria and subsequent regression to the mean and glass ceiling effects. Lastly, there is increasing evidence that dynamic variables, such as LUTS and PVR worsening, and lack of symptomatic improvement with alpha(1)-blockers are important predictors of future LUTS/BPH-related events, allowing better identification and management of patients at risk of BPH progression. PMID:18307681

Roehrborn, Claus G

2008-03-01

248

In vitro comparison of the vaporesection of human benign prostatic hyperplasia using 70- and 120-W 2-um lasers  

PubMed Central

The purpose of the current ex vivo study was to compare the speed of vaporesection of human prostatic tissue with benign prostatic hyperplasia (BPH) and the depth of tissue damage using 70- and 120-W 2-µm laser devices. Fresh prostatic tissue specimens were obtained from five patients by open prostatectomy, and were divided into separate groups (70 and 120 W) based on the energy of the laser output (70 and 120 W, respectively). The vaporesection speed, coagulation zone depth and the necrotic tissue layer in the prostatic tissue were evaluated. The current result showed that the speeds (mean±s.d.) of vaporesection were 5.21±0.66 and 10.39±1.15 g/5 min for the 70 and 120 W groups, respectively (P=0.000). There was no difference in the depth of necrosis/coagulation (0.98±0.13/0.30±0.09 and 0.99±0.12/0.31±0.08 mm) for the 70 and 120 W groups, respectively. In conclusion, both 70- and 120-W 2-µm laser devices had superficial tissue damage during the vaporesection of human prostate tissue; moreover, the 120-W laser offers a higher vaporesection speed than the 70-W laser.

Luo, Guang-Heng; Xia, Shu-Jie; Sun, Zhao-Lin

2011-01-01

249

On chip immuno-affinity profiling of cancer- and benign hyperplasia-associated free prostate specific antigen.  

PubMed

Prostate specific antigen (PSA) exhibits pronounced heterogeneity in both primary structure and glycan composition, resulting in the existence of different molecular forms. Investigation of PSA structure is a demanding task facing limitations due to inadequate sensitivity of analytical techniques and low concentrations of the different forms. This study aimed to profile free PSA (fPSA), especially lower molecular mass species lacking detailed classification, in normal seminal plasma and in sera from subjects with benign hyperplasia (BPH) or cancer of the prostate (PCa) as samples of known clinical relevance. fPSA forms were separated from complex proteomes on chips with immobilized anti-fPSA antibody followed by detection using surface-enhanced laser desorption/ionization time of flight mass spectrometry. At least 39 fPSA-immunoreactive species, ranging from 3-29 kDa were detected in seminal plasma. General fPSA profiles in seminal plasma and sera were similar, but differed in the abundance and presence of particular peaks/clusters of the lower molecular mass species. No striking difference in fPSA forms was observed between BPH and PCa samples, but some distinct peaks varied in intensity and frequency within or between groups. Obtained data verify fPSA heterogeneity that might be important for better exploration of all their molecular and marker potentials. PMID:21897005

Kosanovic, Maja M; Goc, Sanja R; Potpara, Goran S; Jankovic, Miroslava M

2011-01-01

250

[5-alpha-reductase inhibitors in benign prostatic hyperplasia].  

PubMed

Sixteen patients presenting benign prostate gland hyperplasia undergo conservative treatment with Finasterid over the period 1992 through 1995. Prior to treatment, in all patients the subjective complaints are assayed on the basis of the IPSS rating system for severity of complaints. Uroflowmetry along with evaluating the quantity of residual urine using an isotope method, and echographic determination of the prostate gland volume, are performed. During the six- to nine-month follow-up study, an increase in maximal urinary output by 3.2 ml/sec, as well as reduction of the prostate gland volume by 24.5 per cent are documented in 78 per cent of the patients against the background of alleviated subjective complaints in 69 per cent. PMID:9379618

Panchev, P; Ne?kov, K

1997-01-01

251

Contact laser vaporization techniques for benign prostatic hyperplasia.  

PubMed

Contact laser applications for the relief of bladder outlet obstruction caused by an enlarged prostate are different from the noncontact Nd:YAG laser methods. The noncontact techniques rely on coagulation necrosis or high power-density vaporization. The pure contact Nd:YAG laser allows cutting, coagulation, and vaporization of tissue with minimal penetration beyond the contact surface. In the contact laser prostatectomy technique, the laser probe directly touches and vaporizes the prostatic tissue. This results in immediate removal of the obstructing tissue, in a manner similar to the standard electrosurgical transurethral resection (TURP), and offers the patient the potential for decreased catheter time and a more rapid resolution of symptoms. Our initial experience suggests that the contact technique (contact laser ablation of the prostate or CLAP) may be better suited for the smaller prostate gland (i.e., less than 20-30 g). For prostates larger than 30 g, a newly described procedure known as coagulation and hemostatic resection of the prostate (CHRP) can be used. This method combines initial noncontact coagulation of the prostate with vaporization of a channel. The goal of CHRP is to allow more rapid removal of the catheter with a continued improvement in urine flow secondary to the coagulation effects. The contact laser is specifically designed to vaporize tissue such as the prostate and allows immediate observation of a TUR defect. Improvements in the delivery system and in the size of the contact laser probes have made CLAP a useful modality for the treatment of symptomatic benign prostatic hyperplasia. PMID:7543321

Gomella, L G; Lotfi, M A; Rivas, D A; Chancellor, M B

1995-04-01

252

Morbidity and mortality after benign prostatic hyperplasia surgery: data from the american college of surgeons national surgical quality improvement program.  

PubMed

Abstract Background and Purpose: With the aging population, it is becoming increasingly important to identify patients at risk for postsurgical complications who might be more suited for conservative treatment. We sought to identify predictors of morbidity after surgical treatment of benign prostatic hyperplasia (BPH) using a large national contemporary population-based cohort. Methods: Relying on the American College of Surgeons National Surgical-Quality Improvement Program (ACS-NSQIP; 2006-2011) database, we evaluated outcomes after transurethral resection of the prostate (TURP), laser vaporization of the prostate (LVP), and laser enucleation of the prostate (LEP). Outcomes included blood-transfusion rates, length of stay, complications, reintervention rates, and perioperative mortality. Multivariable logistic-regression analysis evaluated the predictors of perioperative morbidity and mortality. Results: Overall, 4794 (65.2%), 2439 (33.1%), and 126 (1.7%) patients underwent TURP, LVP, and LEP, respectively. No significant difference in overall complications (P=0.3) or perioperative mortality (P=0.5) between the three surgical groups was found. LVP was found to be associated with decreased blood transfusions (odds ratio [OR]=0.21; P=0.001), length of stay (OR=0.12; P<0.001) and reintervention rates (OR=0.63; P=0.02). LEP was found to be associated with decreased prolonged length of stay (OR=0.35; P=0.01). Men with advanced age at surgery and non-Caucasians were at increased risk of morbidity and mortality. In contrast, normal preoperative albumin and higher preoperative hematocrit (>30%) levels were the only predictors of lower overall complications and perioperative mortality. Conclusions: All three surgical modalities for BPH management were found to be safe. Advanced age and non-Caucasian race were independent predictors of adverse outcomes after BPH surgery. In patients with these attributes, conservative treatment might be a reasonable alternative. Also, preoperative hematocrit and albumin levels represent reliable predictors of adverse outcomes, suggesting that these markers should be evaluated before BPH surgery. PMID:24517323

Bhojani, Naeem; Gandaglia, Giorgio; Sood, Akshay; Rai, Arun; Pucheril, Daniel; Chang, Steven L; Karakiewicz, Pierre I; Menon, Mani; Olugbade, Kola; Ruhotina, Nedim; Sammon, Jesse D; Sukumar, Shyam; Sun, Maxine; Ghani, Khurshid R; Schmid, Marianne; Varda, Briony; Kibel, Adam S; Zorn, Kevin C; Trinh, Quoc-Dien

2014-07-01

253

Interstitial laser coagulation therapy for benign prostatic hyperplasia  

NASA Astrophysics Data System (ADS)

Alternatives to the side-firing laser method include controlled destruction of prostatic adenoma by an atraumatic saline cooled laser fiber introduced endoscopically into the prostate under visual and transrectal ultrasound (TRUS) control. Laser light produces intense heating and interstitial laser coagulation (ILC) occurs with characteristic TRUS changes which are used to control the volume of tissue destruction. The prostatic urethral lining is preserved which may reduce laser side effects). Thirty-six men with symptomatic BPH were treated by ILC between April 1994 and September 1995. All were discharged home on the first post-operative day and reviewed periodically to 12 months post-treatment with measurement of IPSS, flow rate (FR), residual volume, complications, potency and TRUS. Seventeen men (47%) voided immediately, 15 (42%) performed intermittent self-catheterization (ISC) for 3.5 days (2 - 5). Four men (11%) required catheterization for 1/52. Thirty-five men tolerated the treatment well, requiring only mild oral analgesia. One man developed dysuria and required early transurethral resection revealing a large volume of coagulative necrosis. Improvement in symptoms and flow rate developed from 1 - 30 days later. There were no significant complications. Hyperechoic and cystic zones developed at the ILC site which persisted to 12 months. This clinical study indicates the feasibility and safety of intense heating by ILC with visible and ultrasound control to coagulate the adenoma while preserving the urethra. Changes are easily seen on TRUS, symptomatic improvement is good and there have been minimal urethral symptoms or complications.

McNicholas, Thomas A.; Alsudani, Mohammed

1996-05-01

254

Effect of Mahayavanala Roma Kshara and Dhanyaka Gokshura Ghrita in benign prostatic hyperplasia.  

PubMed

Vatastheela is a disease of Mutravahasrotasa, one among the 12 types of Mutraghata disorders elaborated by Sushruta in his seminal work, the Sushruta Samhita. Vatastheela, as described in Ayurveda, closely resembles benign prostatic hyperplasia (BPH) of modern medicine in its signs and symptoms. It is a senile disorder and chiefly affects individuals above the age of 40 years. The symptoms are those of bladder outflow obstruction, with increased frequency of micturition, dribbling, hesitancy, and the features of chronic urinary retention. Surgical management has been accepted as the standard management but is associated with many disadvantages as well as complications, which may not be acceptable at this age. Conservative management with modern medicines is also not free from side effects. So, in this age-group, there is a need for much safer alternative method of management. In this regard, many works have been carried out and shown that the Ayurvedic approach, using natural medicines, is a far better approach. We carried out a comparative study of Mahayavanala Roma Kshara (MRK) and Dhanyaka Gokshura Ghrita (DGG), which are the compounds prescribed for Mutraghata in Ayurvedic literature. The patients were randomly selected from the OPD and IPD of IPGT and RA hospital, Jamnagar, Gujarat, and divided into two groups. In first group, one (500 mg) capsule of MRK was given twice a day with lukewarm water for 45 days; in second group, 10 gm of DGG was given orally twice a day with lukewarm water for 45 days. DGG showed significantly greater relief in the subjective parameters as per International Prostate Symptoms Score (IPSS) than MRK. However, reduction in the size of the prostate and in the volume of the post-void residual urine was found much better in the MRK group. PMID:22131735

Vasava, Yogesh R; Bhuyan, Chaturbhuja; Rajagopala, Manjusha; Gupta, S K; Dudhamal, T S

2010-07-01

255

Effect of an integral suspension of Lepidium latifolium on prostate hyperplasia in rats.  

PubMed

This paper studies the effect of an integral suspension of Lepidium latifolium on experimental induced prostate hyperplasia, in rats. Oral treatment with 0.86 mg kg(-1) day(-1) for 6 months, significantly reduced prostate size and volume in castrated rats where the hyperplasia were induced by steroid treatment. PMID:15030923

Martínez Caballero, S; Carricajo Fernández, C; Pérez-Fernández, R

2004-03-01

256

Effect of an integral suspension of Lepidium latifolium on prostate hyperplasia in rats  

Microsoft Academic Search

This paper studies the effect of an integral suspension of Lepidium latifolium on experimental induced prostate hyperplasia, in rats. Oral treatment with 0.86 mg kg?1 day?1 for 6 months, significantly reduced prostate size and volume in castrated rats where the hyperplasia were induced by steroid treatment.

S. Mart??nez Caballero; C. Carricajo Fernández; R. Pérez-Fernández

2004-01-01

257

International registry results for an interstitial laser BPH treatment device  

NASA Astrophysics Data System (ADS)

Benign prostatic hyperplasia (BPH) can significantly impair quality of life in older men. Most men over 60 experience some symptoms due to BPH and it is thought that essentially all men would eventually be affected by it if they lived long enough. At present, transurethral resection of the prostate (TURP), a surgical treatment for BPH, is one of the more common procedures performed in the developed world, particularly in the United States. A number of other treatments are also often used, including open prostatectomy, side-firing lasers, and drug therapy. With the population in the developed world rapidly aging, BPH is expected to affect an even larger group of men in the future. Current methods of therapy carry significant disadvantages. Open prostatectomy carries a fairly high risk of impotence and incontinence, as well as sometimes significant risk of death depending on the patient's age and medical conditions. TURP also carries similar risks, albeit reduced, including the risk of substantial blood loss and a small but meaningful risk of death. Side-firing lasers are thought to have a reduced risk of death compared to TURP due to significantly reduced bleeding; however, patients often experience an extended period of pain during voiding due to prolonged tissue sloughing. Drug treatment, although useful for some patients, does not strongly improve symptoms in the majority of patients. Even with the current range of treatments, many patients with symptomatic BPH elect to avoid any current treatment due to risks and side effects. As a possible solution to this problem, previous writers have suggested the possibility of treating BPH through interstitial thermotherapy. In this treatment, prostatic tissue is heated from within the prostate to the point of irreversible necrosis. Healing processes then reduce the volume of the affected tissue, even in the absence of sloughing. This study covers initial human use of such a device, using an 810 nm wavelength diode laser not previously used for such therapy.

Conn, Richard L.; Muschter, Rolf; Adams, Curtis S.; Esch, Victor C.

1996-05-01

258

A novel equation and nomogram including body weight for estimating prostate volumes in men with biopsy-proven benign prostatic hyperplasia  

PubMed Central

Anthropometric measurements, e.g., body weight (BW), body mass index (BMI), as well as serum prostate-specific antigen (PSA) and percent-free PSA (%fPSA) have been shown to have positive correlations with total prostate volume (TPV). We developed an equation and nomogram for estimating TPV, incorporating these predictors in men with benign prostatic hyperplasia (BPH). A total of 1852 men, including 1113 at Tokyo Medical and Dental University (TMDU) Hospital as a training set and 739 at Cancer Institute Hospital (CIH) as a validation set, with PSA levels of up to 20 ng ml?1, who underwent extended prostate biopsy and were proved to have BPH, were enrolled in this study. We developed an equation for continuously coded TPV and a logistic regression-based nomogram for estimating a TPV greater than 40 ml. Predictive accuracy and performance characteristics were assessed using an area under the receiver operating characteristics curve (AUC) and calibration plots. The final linear regression model indicated age, PSA, %fPSA and BW as independent predictors of continuously coded TPV. For predictions in the training set, the multiple correlation coefficient was increased from 0.38 for PSA alone to 0.60 in the final model. We developed a novel nomogram incorporating age, PSA, %fPSA and BW for estimating TPV greater than 40 ml. External validation confirmed its predictive accuracy, with AUC value of 0.764. Calibration plots showed good agreement between predicted probability and observed proportion. In conclusion, TPV can be easily estimated using these four independent predictors.

Nakanishi, Yasukazu; Masuda, Hitoshi; Kawakami, Satoru; Sakura, Mizuaki; Fujii, Yasuhisa; Saito, Kazutaka; Koga, Fumitaka; Ito, Masaya; Yonese, Junji; Fukui, Iwao; Kihara, Kazunori

2012-01-01

259

Technical Aspects of Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia  

PubMed Central

Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure and a size-independent treatment for benign prostatic hyperplasia with excellent long-term surgical outcome. HoLEP has become an alternative to conventional transurethral resection of the prostate or open prostatectomy owing to its efficacy and safety. Although HoLEP is known to have a steep learning curve, very few articles have addressed the technical aspects of HoLEP. Herein, we described detailed techniques and tips for HoLEP as performed at Seoul National University Hospital in a step-by-step manner with extensive review of the literature.

Kim, Myong; Lee, Hahn-Ey

2013-01-01

260

Associations of polymorphisms in HPC2/ELAC2 and SRD5A2 genes with benign prostate hyperplasia in Turkish men.  

PubMed

Benign prostate hyperplasia (BPH) is the most common benign tumor in elderly men for which the HPC2/ELAC2 and SRD5A2 genes are known genetic factors. The HPC2/ELAC2 gene features Ser217Leu and Ala541Thr polymorphisms and the SRD5A2 gene Ala49Thr and Val89Leu polymorphisms. The aim of this study was to examine relationships between these polymorphisms and BPH in Turkish men using amplification by the polymerase chain reaction (PCR) method. Polymorphisms were determined by using restriction fragment length polymorphism (RFLP) with suitable restriction: TaqI?, Fnu4HI, Mwo I and Rsa I. We found statistically significant relationship between the SRD5A2 gene Ala49Thr (OR=2.3; CI 95%, 1.04-5.1; p=0.01<0.05) , but not the other polymorphisms, and BPH. For the first time, our data demonstrate that the correlation between SRD5A2 gene Ala49Thr and polymorphisms is statistically significant in Turkish men with BPH. PMID:21627373

Izmirli, Muzeyyen; Arikan, Burhan; Bayazit, Yildirim; Alptekin, Davut

2011-01-01

261

Experience of Long-Term Afala Treatment in Benign Prostatic Hyperplasia  

Microsoft Academic Search

The use of ultralow doses of antibodies to prostate-specific antigen (afala) for long-term treatment of benign prostatic hyperplasia\\u000a in patients with moderate symptoms rapidly and effectively reduces irritative and obstructive symptoms, significantly decreases\\u000a residual urine volume, and increases the rate of urination. Afala therapy is indicated for patients with stage I-II benign\\u000a prostatic hyperplasia of moderately pronounced symptoms.

A. V. Gudkov

2009-01-01

262

A review of the use of tadalafil in the treatment of benign prostatic hyperplasia in men with and without erectile dysfunction  

PubMed Central

Epidemiological data link erectile dysfunction (ED) and benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS), two highly prevalent conditions in aging men, assuming common pathophysiological pathways. Tadalafil 5 mg once daily has been approved for the treatment of men with LUTS with or without comorbid ED. The aim of this review is to provide an overview of current knowledge on the epidemiological and pathophysiological links between ED and LUTS and to focus on tadalafil as a new treatment option in men with BPH-associated LUTS. A Medline search was completed using the Medical Subject Headings (MESH® keywords) ‘prostatic hyperplasia’ and ‘phosphodiesterase inhibitors’. This search revealed 125 relevant references (entire Medline database up to 11 March 2014). The efficacy of tadalafil 5 mg once daily for the treatment of LUTS has been reported by several well-designed studies. Tadalafil improves significantly the total International Prostate Symptom Score (IPSS), the voiding and storage subscores, the IPSS Quality of Life (QoL) and the BPH Impact Index (BII). Its efficacy is irrelevant to the erectile function status of the patients. However, in the majority of these studies tadalafil is not associated with improvement in maximum urine flow or post-void residual volume (PVR). Its safety profile is well established and no new or unexpected adverse events other than those reported in ED studies have been recorded. Tadalafil is today a new treatment alternative to other established drugs for LUTS such as the ?-adrenergic antagonists or 5?-reductase inhibitors. However, it is not just an alternative, since sexual adverse events associated with these drugs are avoided and tadalafil is the only drug that can treat both ED and LUTS at the same time.

2014-01-01

263

Electrovaporization of the Prostate versus Laser Ablation of the Prostate in Men with Benign Prostatic Hypertrophy:A Pressure-Flow Analysis  

Microsoft Academic Search

Purpose: To urodynamically assess the outcome results in a prospective cohort study of electrovaporization of the prostate (TVP) versus laser ablation of the prostate (LAP) in men with benign prostatic hyperplasia (BPH). Materials and Methods: A randomized cohort of 10 men were enrolled to undergo a TVP procedure and a second cohort of 10 patients to undergo LAP. Preoperatively and

W. Bruce Shingleton; John Kolski; D. L. Renfroe

1998-01-01

264

Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trial.  

PubMed

In elderly men, benign prostatic hyperplasia (BPH) is a major risk factor for sexual dysfunctions (SDys). Additionally, the standard treatments for BPH symptoms, alpha blockers and 5-alpha-reductase inhibitors, cause SDys themselves. Preparations from saw palmetto berries are an efficacious and well-tolerated symptomatic treatment for mild to moderate BPH and have traditionally been used to treat SDys. We conducted an open multicentric clinical pilot trial to investigate whether the saw palmetto berry preparation Prostasan® influenced BPH symptoms and SDys. Eighty-two patients participated in the 8-week trial, taking one capsule of 320?mg saw palmetto extract daily. At the end of the treatment, the International Prostate Symptom Score was reduced from 14.4?±?4.7 to 6.9?±?5.2 (p?BPH QoL-9 sex total improved from 137.3?±?47.9 to 195.0?±?56.3 (p?BPH symptoms and reduced SDys. This was the first trial with saw palmetto to show improvement in BPH symptoms and SDys as well. [Corrections made here after initial online publication.] PMID:22522969

Suter, Andreas; Saller, Reinhard; Riedi, Eugen; Heinrich, Michael

2013-02-01

265

PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE: A VOLUME REDUCTION ANALYSIS IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS SECONDARY TO BENIGN PROSTATIC HYPERPLASIA AND CARCINOMA OF THE PROSTATE  

Microsoft Academic Search

Purpose:In this study preoperative and postoperative transrectal ultrasound prostate volume was evaluated in patients undergoing photoselective vaporization of prostate using an 80 W potassium-titanyl-phosphate (KTP) laser (Greenlight PV Laser System, Laserscope, San Jose, California) for obstructive uropathy secondary to benign prostatic hyperplasia or carcinoma of the prostate.

SURENDRA M. KUMAR

2005-01-01

266

Population based trends in the surgical treatment of benign prostatic hyperplasia  

PubMed Central

Purpose Laser prostatectomy has increased in popularity over the last decade. However, traditional transurethral resection of the prostate (TURP) remains common. In an effort to understand decisions surrounding use of laser prostatectomy versus TURP, we evaluated trends in transurethral surgery for benign prostatic hyperplasia (BPH) in an all payer dataset, focusing on patient and provider factors that are associated with receipt of laser prostatectomy. Methods Using the State Inpatient and Ambulatory Surgery Databases for Florida, we identified subjects undergoing laser prostatectomy or TURP (2001 to 2009). We calculated rates of surgery over time, stratified by procedure type. We used multilevel regression to examine patient (age, race, level of comorbidity) and provider (surgeon volume) factors associated with receipt of laser prostatectomy versus TURP. Results While the overall rates of transurethral surgery remained stable (p=0.227) over the study period, use of laser prostatectomy rose 400% (from 25 to 114 procedures per 100,000 men, p<0.001), replacing about half of all TURPs. Patients were less likely to undergo laser prostatectomy if they were older (OR 0.65, 95% CI 0.61–0.70) and less healthy (OR 0.48, 95% CI 0.45–0.51). While these factors were predictive of surgery type, the majority of the variation in laser prostatectomy use (69%) was explained by the urologist a patient saw. Conclusions Laser prostatectomy utilization has increased over the last decade at the expense of TURP, driven largely by provider effects. However, the elderly and more infirm patients are the least likely to receive it, raising concerns about underuse in this population.

Schroeck, Florian R.; Hollingsworth, John M.; Kaufman, Samuel R.; Hollenbeck, Brent K.; We, John T.

2014-01-01

267

Ramelteon combined with an alpha1-blocker might decreases nocturia in men with benign prostatic hyperplasia.  

PubMed

BACKGROUND: Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to alpha1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study. METHODS: Subjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received alpha1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the alpha1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon. RESULTS: The mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P = 0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P = 0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P = 0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events. CONCLUSIONS: Ramelteon in combination with an alpha1-blocker might be a treatment option for reducing nocturia in men with BPH. PMID:23758651

Kawahara, Takashi; Morita, Satoshi; Ito, Hiroki; Terao, Hideyuki; Sakata, Ryoko; Ishiguro, Hitoshi; Tanaka, Katsuyuki; Miyamoto, Hiroshi; Matsuzaki, Junichi; Kubota, Yoshinobu; Uemura, Hiroji

2013-06-12

268

Ramelteon combined with an ?1-blocker decreases nocturia in men with benign prostatic hyperplasia  

PubMed Central

Background Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to ?1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study. Methods Subjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received ?1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the ?1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon. Results The mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P?=?0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P?=?0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P?=?0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events. Conclusions Ramelteon in combination with an ?1-blocker could be a treatment option for reducing nocturia in men with BPH.

2013-01-01

269

Serenoa repens extract in the treatment of benign prostatic hyperplasia.  

PubMed

We are experiencing a revival of interest in phytotherapeutic agents, both in Europe and North America, especially as a consequence of patients' dissatisfaction with the adverse effects of the medical alternatives. One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review the most important published data regarding this type of treatment for benign prostatic hyperplasia. A review of the existing articles regarding the use of Serenoa repens extracts for benign prostatic hyperplasia was performed. The articles were analysed with regard to their relevance, scientific value and the size of the evaluated series. Multiple mechanisms of action have been attributed to this extract, including antiandrogenic action, an anti-inflammatory/anti-oedematous effect, prolactin signal modulation, and an antiproliferative effect exerted through the inhibition of growth factors. Regarding efficacy, European Association of Urology guidelines state that Serenoa repens extracts significantly reduce nocturia in comparison with placebo. However, the guideline committee is unable to make specific recommendations about phytotherapy of male lower urinary tract symptoms owing to the heterogeneity of the products and the methodological problems associated with meta-analyses. Most of the published trials regarding Serenoa repens phytotherapy demonstrate a significant improvement of urinary status and a favourable safety profile. Also, some authors have credited it with giving a significant improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding. The results of phytotherapy with Serenoa repens extracts are very promising. More high-quality, randomized, placebo-controlled studies are required in order to demonstrate without doubt the true therapeutic value of these products. Particular attention must be focused on differentiating between registered preparations, which are regulated as drugs, and those considered to be food supplements. PMID:21969849

Geavlete, Petrisor; Multescu, Razvan; Geavlete, Bogdan

2011-08-01

270

Serenoa repens extract in the treatment of benign prostatic hyperplasia  

PubMed Central

We are experiencing a revival of interest in phytotherapeutic agents, both in Europe and North America, especially as a consequence of patients’ dissatisfaction with the adverse effects of the medical alternatives. One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review the most important published data regarding this type of treatment for benign prostatic hyperplasia. A review of the existing articles regarding the use of Serenoa repens extracts for benign prostatic hyperplasia was performed. The articles were analysed with regard to their relevance, scientific value and the size of the evaluated series. Multiple mechanisms of action have been attributed to this extract, including antiandrogenic action, an anti-inflammatory/anti-oedematous effect, prolactin signal modulation, and an antiproliferative effect exerted through the inhibition of growth factors. Regarding efficacy, European Association of Urology guidelines state that Serenoa repens extracts significantly reduce nocturia in comparison with placebo. However, the guideline committee is unable to make specific recommendations about phytotherapy of male lower urinary tract symptoms owing to the heterogeneity of the products and the methodological problems associated with meta-analyses. Most of the published trials regarding Serenoa repens phytotherapy demonstrate a significant improvement of urinary status and a favourable safety profile. Also, some authors have credited it with giving a significant improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding. The results of phytotherapy with Serenoa repens extracts are very promising. More high-quality, randomized, placebo-controlled studies are required in order to demonstrate without doubt the true therapeutic value of these products. Particular attention must be focused on differentiating between registered preparations, which are regulated as drugs, and those considered to be food supplements.

Geavlete, Petrisor; Multescu, Razvan; Geavlete, Bogdan

2011-01-01

271

Evolution of the use of the holmium laser for the treatment of benign prostatic hyperplasia  

NASA Astrophysics Data System (ADS)

The holmium laser is becoming an important tool in the urologists' armamentarium. In this manuscript the evolution of laser resection of the prostate using the holmium wavelength is described. This technique represents a significant advance in the surgical management of benign prostatic hyperplasia and allows even very large prostates to be safely and efficiently managed transurethrally.

Gilling, Peter J.; Cass, Carol B.; Cresswell, Michael D.; Kennett, Katie M.; Mackey, Michael; Fraundorfer, Mark R.; Kabalin, John N.

1997-05-01

272

Against the motion: Lasers are superfluous for the surgical management of benign prostatic hyperplasia in the developing world  

PubMed Central

Lasers have arrived in a big way for the management of benign prostatic hyperplasia. The most common ones in use are holmium, potassium titanyl phosphate (KTP) and thulium. They remove the prostatic adenoma either by way of enucleation or ablation. Backed by numerous studies that prove their safety, efficacy and durability, lasers score over TURP in several ways. Their use is associated with less blood loss, shorter catheter time and decreased hospital stay. The fluid absorption during laser prostatectomy is negligible and thus makes it safer for use in cardiac patients. Also there is no chance of a transurethral resection syndrome, the incidence of which is approximately 2% with TURP. Due to superior hemostatic capabilities and non interference lasers can be used in patients on anti coagulants, cardiac pacemaker. Another advantage of laser over TURP is its ability to deal with prostates that are larger in size especially holmium laser which has been used to enucleate glands more than 300 g in size thus completely avoiding the need for open prostatectomy. The amount of tissue removed with enucleation is more thus retreatment rates are less than that of TURP. The initial cost of laser is higher but its capability to treat stones, its use in high risk situations, less morbidity, short hospital stay, and durable results make it an attractive option to treat BPH even in the developing world.

Varshney, Anil; Agarwal, Anshuman

2009-01-01

273

Low Intraprostatic DHT Promotes the Infiltration of CD8+ T Cells in BPH Tissues via Modulation of CCL5 Secretion  

PubMed Central

Clinical studies suggested thatandrogen might be associated with infiltrating T cells in prostate of benign prostatic hyperplasia (BPH) patients, but detail of T-cell subset and mechanism still remained unclear. The present study tested the hypothesis that intraprostatic 5?-dihydrotestosterone (DHT) exerts effects on T cells recruitment by BPH epithelial cells. Prostate tissues from 64 cases of BPH patients after transurethral resection of prostate (TURP) were divided into 2 groups: (1) no medication history; (2) administration of 5?-reductase type II inhibitor-finasteride 5?mg daily for at least 6 months before surgery. Group 2 presented significantly higher CD8+ T cells infiltration than group 1, but no changes in CD4+ T cells (immunohistochemistry and flow cytometry). In vitro study more CD8+ T cell migrated to the prostate tissue lysates from group 2 and BPH-1 cells in low DHT condition. Transcription of chemokine (C-C motif) Ligand 5 (CCL5) mRNA in BPH-1 cells and chemokine (C-C motif) receptor 5 (CCR5) mRNA in CD8+ T cells were upregulated in low DHT condition (q-PCR). CCL5 expression was also identified to be higher in group 2 prostate tissues by IHC. This study suggested that intraprostatic DHT may participate in regulating inflammatory response which was induced by human prostatic epithelial cell, via modulating CCL5 secretion.

Fan, Yu; Liu, Jie; Xiao, Fei; Li, Xin; Yu, Wei; Cui, Yun; Sun, Mengkui; Lv, Tianjing; Jin, Jie

2014-01-01

274

Low Intraprostatic DHT Promotes the Infiltration of CD8+ T Cells in BPH Tissues via Modulation of CCL5 Secretion.  

PubMed

Clinical studies suggested thatandrogen might be associated with infiltrating T cells in prostate of benign prostatic hyperplasia (BPH) patients, but detail of T-cell subset and mechanism still remained unclear. The present study tested the hypothesis that intraprostatic 5 ? -dihydrotestosterone (DHT) exerts effects on T cells recruitment by BPH epithelial cells. Prostate tissues from 64 cases of BPH patients after transurethral resection of prostate (TURP) were divided into 2 groups: (1) no medication history; (2) administration of 5 ? -reductase type II inhibitor-finasteride 5?mg daily for at least 6 months before surgery. Group 2 presented significantly higher CD8+ T cells infiltration than group 1, but no changes in CD4+ T cells (immunohistochemistry and flow cytometry). In vitro study more CD8+ T cell migrated to the prostate tissue lysates from group 2 and BPH-1 cells in low DHT condition. Transcription of chemokine (C-C motif) Ligand 5 (CCL5) mRNA in BPH-1 cells and chemokine (C-C motif) receptor 5 (CCR5) mRNA in CD8+ T cells were upregulated in low DHT condition (q-PCR). CCL5 expression was also identified to be higher in group 2 prostate tissues by IHC. This study suggested that intraprostatic DHT may participate in regulating inflammatory response which was induced by human prostatic epithelial cell, via modulating CCL5 secretion. PMID:24808637

Fan, Yu; Hu, Shuai; Liu, Jie; Xiao, Fei; Li, Xin; Yu, Wei; Cui, Yun; Sun, Mengkui; Lv, Tianjing; He, Qun; Jin, Jie

2014-01-01

275

Photoselective vaporization of the prostate using GreenLight 120-W lithium triborate laser to treat symptomatic benign prostatic hyperplasia: A single-centre prospective study  

PubMed Central

Objective: We evaluated the safety and efficacy of photoselective vaporization of the prostate (PVP) using GreenLight 120-W lithium triborate (LBO) laser to treat symptomatic small-to-medium sized benign prostatic hyperplasia (BPH). Methods: This prospective non-controlled observational study included symptomatic BPH men ?50 years with international prostate symptom score (IPSS) ?14, prostate volume (PV) ?80 cc and maximum flow rate (Q-max) ?15 mL/s. PVP was performed using the GreenLight 120-W LBO laser machine. Patients were assessed at baseline and postoperatively at discharge, 2 weeks, and 3, 6 and 12 months. We measured changes in IPSS, PV, PSA, Q-max, post-void residual (PVR), hemoglobin (Hb), serum sodium (Na+) and reported complications. Statistical significance was p < 0.05. Results: The study included 103 men with mean age of 67 (±standard deviation)±9.7 years. Thirty patients were on indwelling urethral catheters for refractory urinary retention and 12 on ongoing anticoagulants. The mean baseline IPSS, PV, PSA, Q-max and PVR parameters significantly improved at follow-up (p < 0.001; each). Mean measurements at baseline versus at six months were: IPSS 25.6 ± 4.2 vs. 7.4±2.3; PV 44.6 ± 9.2 vs. 21.6 ± 6.3 cc (51.6% reduction); Q-max 5.8 ± 3.4 vs. 20.4 ± 4.8 mL/s; PVR 110 ± 40 vs. 35 ± 9 cc. Mean baseline Hb and serum Na+ declined non-significantly (p > 0.05) at discharge and at 2 weeks. No patient needed a blood transfusion. Secondary procedures were needed in 2 patients for urethral and bladder neck strictures. The re-treatment rate for residual adenoma was 0.97%. Conclusion: PVP using the GreenLight 120-W LBO laser to treat small-to-medium sized symptomatic BPH demonstrated significant improvements in efficacy parameters and high safety profile within 12 months of follow-up. The procedure entails good hemostasis with minimal blood loss even in patients receiving ongoing anticoagulants.

Mosli, Hisham A.; Abdel-Meguid, Taha A.; Abdulwahhab, Mohammad H.; Al-Sayyad, Ahmad; Farsi, Hasan M.; Tayib, Abdulmalik

2013-01-01

276

Genetic Analysis of Prostatic Atypical Adenomatous Hyperplasia (Adenosis)  

PubMed Central

Atypical adenomatous hyperplasia (AAH) of the prostate, a small glandular proliferation, is a putative precursor lesion to prostate cancer, in particular to the subset of well-differentiated carcinomas that arise in the transition zone, the same region where AAH lesions most often occur. Several morphological characteristics of AAH suggest a relationship to cancer; however, no definitive evidence has been reported. In this study, we analyzed DNA from 25 microdissected AAH lesions for allelic imbalance as compared to matched normal DNA, using one marker each from chromosome arms 1q, 6q, 7q, 10q, 13q, 16q, 17p, 17q, and 18q, and 19 markers from chromosome 8p. We observed 12% allelic imbalance, with loss only within chromosome 8p11–12. These results suggest that genetic alterations in transition zone AAH lesions may be infrequent. This genotypic profile of AAH will allow for comparisons with well-differentiated carcinomas in the transition zone of the prostate.

Doll, Jennifer A.; Zhu, Xiaopei; Furman, Jaime; Kaleem, Zahid; Torres, Carlos; Humphrey, Peter A.; Donis-Keller, Helen

1999-01-01

277

[Treatment of elderly and senile patients suffering from benign prostatic hyperplasia and chronic prostatitis].  

PubMed

In the clinical settings and in animal experiments the research was conducted on effectiveness and safety of treatment the benign prostatic hyperplasia, chronic prostatitis in the stage of active inflammation in elderly and senile patients. The method of treatment including transrectal fonoforez of the Russian preparation of Tisol (Tisolium, gel, the company "Olympus" Yekaterinburg) in combination with diclofenac sodium protected by patents of the Russian Federation was used. The developed method of treatment has shown high efficiency and safety, which is confirmed by experimental, clinical, laboratory and instrumental studies. PMID:24738261

Miakotnykh, V S; Tret'iakov, V V; Borovkova, T A

2013-01-01

278

A Negative Finding from a Single Center Study Led to Re-Design of a Large-Scale Clinical Trial of Phytotherapy for Benign Prostatic Hyperplasia: the CAMUS study  

PubMed Central

Background Benign prostatic hyperplasia (BPH), a common condition among older men, confers its morbidity through potentially bothersome lower urinary tract symptoms. Treatments for BPH include drugs such as alpha adrenergic receptor blockers and 5-alpha reductase inhibitors, minimally invasive therapies that use heat to damage or destroy prostate tissue, and surgery including transurethral resection of the prostate. Complementary and alternative medicines are gaining popularity in the U.S. Two phytotherapies commonly used for BPH are extracts of the fruit of Serenoa repens, the Saw palmetto dwarf palm that grows in the Southeastern U.S., and extracts of the bark of Pygeum africanum, the African plum tree. Purpose The objective of the Complementary and Alternative Medicines for Urological Symptoms (CAMUS) clinical trial is to determine if phytotherapy is superior to placebo in the treatment of BPH. Methods CAMUS was originally designed as a 3300-participant, four-arm trial of Serenoa repens, Pygeum africanum, an alpha adrenergic blocking drug, and placebo with time to clinical progression of BPH, a measure of long-term efficacy, as the primary endpoint. Before enrollment started, a randomized, double-blind, placebo-controlled, single institution clinical trial showed that Serenoa repens at the usual dose did not demonstrate any benefit over placebo with respect to symptom relief at one year. Consequently, the focus of CAMUS shifted from evaluating long-term efficacy to determining if any short-term (6-18 month) symptom relief could be achieved with increasing doses of Serenoa repens, the phytotherapy most commonly used in the U.S. for BPH. Results Results are anticipated in 2011. Conclusions Trial design occurs in an environment of continually evolving information. In this case, emerging results from another trial suggested that a study of long-term efficacy was premature, and that an effective dose and preparation of Serenoa repens had to be established before proceeding to a long-term clinical trial.

Lee, Jeannette Y.; Andriole, Gerald; Avins, Andrew; Crawford, E. David; Foster, Harris; Kaplan, Steven; Kreder, Karl; Kusek, John W.; McCullough, Andrew; McVary, Kevin; Meleth, Sreelatha; Naslund, Michael; Nickel, J. Curtis; Nyberg, Leroy M.; Roehrborn, Claus; Williams, O. Dale; Barry, Michael J.

2010-01-01

279

Photoselective Vaporization for the Treatment of Benign Prostatic Hyperplasia  

PubMed Central

Background As an alternative to transurethral resection of the prostate (TURP), photoselective vaporization of the prostate (PVP) provides a bloodless, relatively painless relief of lower urinary tract symptoms for men with benign prostatic hyperplasia. Following a review of the evidence in 2006, the Ontario Health Technology Advisory Committee recommended that a study be conducted to evaluate PVP in Ontario. Objectives To compare the clinical effectiveness, safety, cost-effectiveness, and budget impact of PVP compared to conventional TURP for the treatment of benign prostatic hyperplasia in Ontario. Methods A prospective, nonrandomized trial was conducted in 3 Ontario centres. Consenting subjects were assessed at baseline and 1, 3, and 6 months following surgery. Outcome measures included International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), post-void residual (PVR) volume, prostate-specific antigen (PSA), health-related quality of life (HRQOL) using the EuroQol 5 Domain questionnaire, and the Sexual Health Inventory for Men (SHIM) score. Adverse events, resource utilization, and productivity losses were also assessed. Cost-effectiveness and budget impact analyses were completed using data from the study. Results Between February 2008 and August 2010, 164 subjects were enrolled in the study (n = 140 for PVP and n = 24 for TURP). Treatment outcomes were similar between the 2 groups at 6 months, with the IPSS decreasing similarly over time (P = 0.718). For other treatment outcomes (Qmax, PSA, HRQOL, SHIM) both treatments provided similar benefit over time; only changes in PVR volume favoured PVP (P = 0.018). The majority of PVP patients were managed on an outpatient basis, with only 7.1% requiring admission (all TURP subjects were inpatients). At 6 months, PVP was less costly than TURP ($3,891 versus $4,863; P = 0.001), with similar quality-adjusted life-years (0.448 versus 0.441; P = 0.658). PVP remained the most cost-effective treatment across all decision-making thresholds, with the technology costing less and providing similar clinical outcomes. Extrapolating the results to a provincial level indicated (based on an estimated case volume of 12,335 TURPs) that there is an opportunity to reallocate just over $14 million (Cdn), primarily related to the reduced need for hospital admission. Limitations This study was nonrandomized, and the results should be interpreted with some caution, despite generally similar baseline characteristics between the 2 groups. Recruiting individuals to the TURP arm was a challenge, resulting in a size imbalance between treatment arms. Conclusions Based on this analysis, PVP appears to be a cost-effective alternative to TURP, providing similar clinical benefit at a lower cost to the health system. Plain Language Summary For men with lower urinary tract symptoms due to an enlarged prostate, a laser treatment called photoselective vaporization of the prostate (or PVP) is just as effective as surgery. PVP does not require an overnight stay in the hospital for most men, and it costs almost $1,000 less. This report describes the results of a study that collected information about treatment outcomes, quality of life, and health care use related to PVP and surgery in Ontario.

Bowen, James M.; Whelan, J. Paul; Hopkins, Robert B.; Burke, Natasha; Woods, Edward A.; McIsaac, Gary P.; O'Reilly, Daria J.; Xie, Feng; Sehatzadeh, Shayan; Levin, Leslie; Mathew, Suja P.; Patterson, Lisa L.; Goeree, Ron; Tarride, Jean-Eric

2013-01-01

280

Twelve-Month Follow-up Results of Photoselective Vaporization of the Prostate With a 980-nm Diode Laser for Treatment of Benign Hyperplasia  

PubMed Central

Purpose This study was conducted with the use of 12 months of follow-up data to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 980-nm diode laser for the treatment of symptomatic benign prostatic hyperplasia (BPH). Materials and Methods The clinical data of 84 men with symptomatic BPH who underwent PVP with the 980-nm K2 diode laser between March 2010 and October 2011 were retrospectively analyzed. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR), were assessed and compared with preoperative baseline values. Results Mean patient age was 72.4±6.5 years, and mean preoperative prostate volume was 47.2±16.3 g. Mean operative time was 23.3±19.1 minutes, and total amount of energy was 128±85 kJ. Mean catheterization time was 23.7±5.9 hours. At 1 month, significant improvements were noted in IPSS (11.5±6.8), QoL score (2.2±1.3), Qmax (12.9±6.5 mL/s), and PVR (41.2±31.3 mL). Three months after surgery, all postoperative follow-up parameters showed significant improvements, and the 6- and 12-month data showed sustained improvement of postoperative follow-up parameters. Bladder neck strictures were observed in 10.7% of the patients and urge incontinence in 16.6%. Conclusions PVP using a K2 diode laser is an effective procedure for the treatment of lower urinary tract symptoms secondary to BPH. PVP leads to an immediate and sustained improvement of subjective and objective voiding parameters. Surgeons should be vigilant for postoperative bladder neck stricture and urge incontinence.

Kim, Youngho; Kim, In Gon; Han, Bo Hyun

2013-01-01

281

A Primary Care Physician's Perspective on Benign Prostatic Hyperplasia  

PubMed Central

Primary care clinicians are generally the first point of contact for men who suffer troublesome symptoms of benign prostatic hyperplasia. Although a subset of these patients will ultimately require referral to a urologist for an invasive procedure to provide symptom control, the majority can be appropriately managed in the ambulatory setting. Most symptomatic men respond favorably to ?-blockers, which provide prompt improvement in symptoms such as nocturia. Although ?-blockers may control troublesome lower urinary tract symptoms, there is no suggestion that they forestall the need for surgery or reduce the likelihood of development of acute urinary retention. Therefore, clinicians need to become familiar with use of 5-?-reductase inhibitors, as this is the only class of pharmacotherapy that has been shown to have a diseasemodifying effect.

Kuritzky, Louis

2003-01-01

282

Transurethral Resection of Prostate Abscess: Is It Different from Conventional Transurethral Resection for Benign Prostatic Hyperplasia?  

PubMed Central

Purpose. To present our experience of prostate abscess management by modified transurethral resection (TUR) technique. Methods. Seventeen men with prostate abscess undergoing TUR between 2003 and 2011 were retrospectively analyzed. Details of demography, surgical procedures, complications, and followup were noted. Results. With a mean age of 61.53 ± 8.58 years, all patients had multifocal abscess cavities. Initially, 6 men underwent classical TUR similar to the technique used for benign prostatic enlargement (group 1). Next, 11 men underwent modified TUR (group 2) in which bladder neck and anterior zone were not resected. The abscess cavities resolved completely, and no patient required a second intervention. One patient in group 1 and three in group 2 had postoperative fever requiring parenteral antibiotics (P = 0.916). Three patients in group 1 had transient urinary incontinence, whereas none of the patients in group 2 had this complication (P = 0.055). Four and five men in group 1 and 2 reported retrograde ejaculation, respectively (P = 0.740). Conclusion. The modified technique of prostate resection edges over conventional TURP in the form of reduced morbidity but maintains its high success rate for complete abscess drainage. It alleviates the need for secondary procedures, having an apparent advantage over limited drainage techniques. Use of this technique is emphasized in cases associated with BPH and lack of proper preoperative imaging.

Sankhwar, Satyanarayan

2013-01-01

283

Transurethral resection of prostate abscess: is it different from conventional transurethral resection for benign prostatic hyperplasia?  

PubMed

Purpose. To present our experience of prostate abscess management by modified transurethral resection (TUR) technique. Methods. Seventeen men with prostate abscess undergoing TUR between 2003 and 2011 were retrospectively analyzed. Details of demography, surgical procedures, complications, and followup were noted. Results. With a mean age of 61.53 ± 8.58 years, all patients had multifocal abscess cavities. Initially, 6 men underwent classical TUR similar to the technique used for benign prostatic enlargement (group 1). Next, 11 men underwent modified TUR (group 2) in which bladder neck and anterior zone were not resected. The abscess cavities resolved completely, and no patient required a second intervention. One patient in group 1 and three in group 2 had postoperative fever requiring parenteral antibiotics (P = 0.916). Three patients in group 1 had transient urinary incontinence, whereas none of the patients in group 2 had this complication (P = 0.055). Four and five men in group 1 and 2 reported retrograde ejaculation, respectively (P = 0.740). Conclusion. The modified technique of prostate resection edges over conventional TURP in the form of reduced morbidity but maintains its high success rate for complete abscess drainage. It alleviates the need for secondary procedures, having an apparent advantage over limited drainage techniques. Use of this technique is emphasized in cases associated with BPH and lack of proper preoperative imaging. PMID:23840969

Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan; Dalela, Divakar

2013-01-01

284

Long-term 6-year experience with finasteride in patients with benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesTo summarize the 6-year clinical trial data with finasteride. Benign prostatic hyperplasia is a chronic and progressive disease and therefore assessment of long-term safety and efficacy is important.

Franklin C Lowe; John D McConnell; Perry B Hudson; Nicholas A Romas; Rex Boake; Michael Lieber; Mostafa Elhilali; Jack Geller; Juliane Imperto-McGinely; Gerald L Andriole; Reginald C Bruskewitz; Patrick C Walsh; Georg Bartsch; John N Nacey; Sukrut Shah; Frances Pappas; Amy Ko; Thomas Cook; Elizabeth Stoner; Joanne Waldstreicher

2003-01-01

285

Non-Hormonal treatment of BPH/BOO  

PubMed Central

Objectives: To review the use of non-hormonal pharmacotherapies in the treatment of lower urinary tract symptoms (LUTS) due to presumed benign prostatic hyperplasia (BPH). Materials and Methods: A search of the PUBMED database was conducted for the terms BPH, LUTS, bladder outlet obstruction, alpha-adrenoceptor blockers, anti-muscarinics, and phosphodiesterase-5-inhibitors. Results: Medical therapy has long been established as the accepted standard of care in the treatment of male LUTS. The aim of treatment is improvement in symptoms and quality of life whilst minimizing adverse effects. The agents most widely used as 1st line therapy are alpha-blockers (AB), as a standalone or in combination with 2 other classes of drug; 5-? reductase inhibitors and anti-muscarinics. AB have rapid efficacy, improving symptoms and flow rate in a matter of days, these effects are then maintained over time. AB do not impact on prostate size and do not prevent acute urinary retention or the need for surgery. Anti-mucarinics, alone or in combination with an AB are safe and efficacious in the treatment of bothersome storage symptoms associated with LUTS/BPH. Phosphodiesterase-5 inhibitors are an emerging treatment option that improve LUTS without improving flow rates. Conclusions: AB are the most well-established pharmacotherapy in the management of men with LUTS/BPH. The emergence of different classes of agent offers the opportunity to target underlying pathophysiologies driving symptoms and better individualize treatment.

Osman, Nadir I.; Mangera, Altaf; Chapple, Christopher R.

2014-01-01

286

Long-term drug treatment of benign prostatic hyperplasia - results of a prospective 3-year multicenter study using Sabal extract IDS 89.  

PubMed

A 3-year prospective multicenter study on Sabal extract IDS 89 was carried out to evaluate its potential and limitations as phytotherapy in the treatment of benign prostatic hyperplasia (BPH). The results obtained from 435 patients confirm its sustained therapeutic efficacy. A marked symptomatic improvement, that included a 50% reduction in residual urine and a 6.1 ml/sec increase in peak urinary flow rate due to therapy was observed. Both physicians and patients voted its efficacy as good or very good in over 80% of the cases, and the drug was well tolerated by 98% of the patients. The clinical status of BPH and thus the quality of life of 4 out of 5 patients was markedly improved by long-term IDS 89 therapy. Furthermore, the deterioration rate at the end of the 3-year treatment period was significantly lower than in untreated BPH subjects. It is therefore concluded that long-term IDS 89 therapy can also reduce the incidence of surgery. PMID:23194957

Bach, D; Ebeling, L

1996-09-01

287

Etiopathogenesis of benign prostatic hypeprlasia  

PubMed Central

Benign prostatic hyperplasia (BPH) is the most common condition affecting men older than 50 years of age. It affects about 10 percent of men under the age of 40, and increases to about 80 percent by 80 years of age. BPH is a hyperplastic process of the fibromuscular stromal and glandular epithelial elements of the prostate. Aging and the presence of the functional testes are the two established risk factors for the development of BPH. The etiopathogenesis of BPH is still largely unresolved, but multiple partially overlapping and complementary theories have been proposed, all of which seem to be operative at least to some extent. This review is focused on recent progress in this area and on the growing consensus for the important mechanisms underlying the etiology and pathogenesis of BPH.

Tang, Jie; Yang, JingChun

2009-01-01

288

[Zinc levels in prostatic fluid of patients with prostate pathologies].  

PubMed

The prostate is a gland that surrounds the posterior urethra in man and, along with seminal vesicles, produces prostatic and seminal fluids. Prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer are the most frequent pathologies of this gland. Zinc is an important element in the makeup of prostatic fluid and plays an important role in the immunology of the infectious and neoplastic pathologies of the prostate. The aim of this study was to determine zinc concentrations in prostatic fluid of patients with prostate pathologies and to use this measurement as a diagnostic parameter. Thirty patients with prostatic pathologies and ten healthy controls were studied. Prostatic fluid samples were collected using prostatic massage. Zinc concentration was determined using electrothermal atomizeratomic absorption spectrometry (ETA-AAS). The mean zinc concentrations obtained in the studied population were as follows: 11 patients with BPH: 15.087,78 micromol/dL, 10 patients with prostatis: 863,33 micromol/dL, 9 patients with prostate cancer: 1.027,60 micromol/dL and 10 healthy subjects: 7.467,52 micromol/dL. The low zinc concentrations obtained in patients with prostatitis and prostate cancer, in contrast to the control group, led us to consider the possibility of recommending zinc supplements as a coadjuvant therapy in patients with prostatitis and also, to use zinc measurements as another diagnostic tool, for cases in which it is necessary to differentiate benign prostatic hyperplasia from prostate cancer. PMID:17853788

Gómez, Yenny; Arocha, Francisco; Espinoza, Fabiola; Fernández, Denny; Vásquez, Aracelis; Granadillo, Victor

2007-09-01

289

A multicenter, randomized, prospective study of endoscopic laser ablation versus transurethral resection of the prostate  

Microsoft Academic Search

ObjectivesTo assess the safety and efficacy of endoscopic laser ablation of the prostate (ELAP), performed with the Urolase fiber and the neodymium:yttrium-aluminum-garnet laser, compared to transurethral resection of the prostate (TURP) in patients with bladder outflow obstruction secondary to benign prostatic hyperplasia (BPH).

Ken Anson; Jan Nawrocki; John Buckley; Chris Fowler; Roger Kirby; William Lawrence; Peter Paterson; Graham Watson

1995-01-01

290

Long-term testosterone stimulation induces hyperplasia in the guinea-pig prostate  

Microsoft Academic Search

The relation between supraphysiologic circulating testosterone levels and prostatic diseases is unclear and difficult to study in men. Animal models may be advantageous. Based on a pilot study, testosterone enantate 50 mg (n=12) or 25 mg (n=12) was administered to guinea-pigs intramuscularly every 3 weeks, for either 7 or 14 months. The histopathology of the prostate was described. Epithelial hyperplasia

S Acosta; N Dizeyi; R Feinstein; S Pierzynowski; P-A Abrahamsson

2004-01-01

291

Long-term testosterone stimulation induces hyperplasia in the guinea-pig prostate.  

PubMed

The relation between supraphysiologic circulating testosterone levels and prostatic diseases is unclear and difficult to study in men. Animal models may be advantageous. Based on a pilot study, testosterone enantate 50 mg (n=12) or 25 mg (n=12) was administered to guinea-pigs intramuscularly every 3 weeks, for either 7 or 14 months. The histopathology of the prostate was described. Epithelial hyperplasia was found in 14/21 animals receiving testosterone and in 7/12 very old animals, but no such changes were found in the sham or castrated animals. Testosterone stimulation seems to induce epithelial hyperplasia, but not cancer, in the guinea-pig prostate. PMID:15289812

Acosta, S; Dizeyi, N; Feinstein, R; Pierzynowski, S; Abrahamsson, P A

2004-01-01

292

[Antiproliferative effect of polar lipids of maral antlers and peat in prostate benign hyperplasia model].  

PubMed

Lipids isolated from maral antlers and peat decreased the prostate posterior and lateral lobule mass and normalized its acinar and stromal histological structure, reduced protein content, decreased formation of lipid peroxidation products, and intensified antioxidant protection in homogenates, decreased prolactine and 5a-dihydrotestosterone blood level, and increased testosterone blood content in male rats of late reproductive age with prostate benign hyperplasia model caused by sulpiride injections. Polar lipids of maral antlers and peat more effectively suppress prostate hyperplasia and hyperprolactinemia development in comparison to the action of Serenoa repens extract (permixon). PMID:23901466

Vengerovski?, A I; Burkova, V N; Iudina, N V; Iatsenkov, A I

2013-01-01

293

Investigation of granulomatous prostatitis incidence following intravesical BCG therapy  

PubMed Central

In the present manuscript, we studied the incidence of granulomatous prostatitis in the prostatectomy specimen of the patients who underwent transurethral resection of the prostate (TURP) after superficial bladder cancer treatment with intravesical Bacillus Calmette-Guerin (BCG) and were diagnosed with benign prostate hyperplasia (BPH). The clinical data and histopathological specimen records of 472 patients who underwent TUR-P due to BPH diagnosis, obtained over a period of 6 years in the urology department of Private Konya Hospital, Konya, Turkey, were studied retrospectively. The cases were divided into two groups as (Group I) who did not undergo any treatment and as (Group II) who underwent BCG treatment. The frequency and the clinical course of the cases with granulomatous prostatitis were studied histopathologically. There were in total 472 patients who underwent TUR-P. Out of the 459 patients who did not undergo BCG treatment (Group I), the histopathological specimen records of 262 (57%) was BPH, of 197 (43%) BPH + chronic prostatitis. Of the second group, 13 cases underwent intravesical BCG treatment before surgical intervention due to superficial bladder CA diagnosis. In this group 4 of the cases were diagnosed as (30%) BPH, 9 as (70%) chronic prostatitis + BPH. 6 out of the 9 chronic prostatitis cases were chronic prostatitis, 2 caseous granulomatous prostatitis, 1 non-caseous granulomatous prostatitis. Granulomatous prostatitis cases should require no specific therapy. Conclusion: In patients with obstruction complaints following intravesical BCG treatment, granulomatous prostatitis should also be considered and treatment plans should be made accordingly.

Balasar, Mehmet; Dogan, Metin; Kandemir, Abdulkadir; Taskapu, Hakan Hakki; Cicekci, Faruk; Toy, Hatice; Gurbuz, Recai

2014-01-01

294

Prostatic artery embolization in the treatment of benign prostatic hyperplasia: short and medium follow-up.  

PubMed

To evaluate the short and mid-term results of prostatic artery embolization in patients with benign prostatic embolization. Retrospective study between March 2009 and June 2011 with 103 patients (mean age 66.8 years, 50-85) that met our inclusion criteria with symptomatic benign prostatic hyperplasia. The clinical outcome was evaluated by the International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function, prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow (Q(max)), and post-void residual volume (PVR) measurements at 3 and 6 months, 1 year, 18 months, and 2 years after PAE and comparison with baseline values was made. Technical and clinical successes, as well as poor clinical outcome definitions, were previously defined. In this review, we evaluate the short and mid-term clinical outcomes and morbidity of patients treated only with non-spherical polyvinyl alcohol. Six months after the procedure, the PV decreased about 23%, IPSS changed to a mean value of 11.95 (almost 50% reduction), the QoL improved slightly more than 2 points, the Q(max) changed to a mean value of 12.63 mL/s, the PVR underwent a change of almost half of the baseline value, and the PSA decreased about 2.3 ng/mL. In the mid-term follow-up and comparing to the baseline values, we still assisted to a reduction in PV, IPSS, QoL, PVR, and PSA, and an increase in Q(max). Prostatic Artery Embolization is a safe procedure with low morbidity that shows good short- and mid-term clinical outcome in our institution. PMID:23244726

Rio Tinto, Hugo; Martins Pisco, João; Bilhim, Tiago; Duarte, Marisa; Fernandes, Lúcia; Pereira, José; Campos Pinheiro, L

2012-12-01

295

Laser-induced interstitial thermotherapy of benign prostatic hyperplasia and prostate cancer  

NASA Astrophysics Data System (ADS)

Urinary outflow obstruction by prostatic enlargement is usually treated by resection or, recently, less invasively by thermal `ablation' of tissue through the urethra. With the latter technique, the amount of tissue that can be removed is limited by the limited penetration depth of suitable radiation sources, e.g. lasers, or conduction of heat. Interstitial thermotherapy was expected to overcome this problem. Our initial in vitro and animal studies with different light guides for interstitial application of Nd:YAG laser radiation showed small carbonized lesions with bare fibers, but large homogeneous coagulation zones with special `ITT' (interstitial thermotherapy) fibers. Further studies using these applicators resulted in a technique to be apt for clinical routine in the treatment of symptomatic prostatic enlargement. The tip of the light guide was repeatedly inserted into the prostate either transurethrally through a cystoscope under direct vision or percutaneously from the perineum under transrectal ultrasound guidance. The number of fiber placements depended on the size and configuration of the gland. Irradiation was performed either for 10 min with 5 or 7 W or in the advanced `turbo'- mode for 5 or 3 min per fiber placement using automatically stepwise reduced power (20 W for 30 s, 15 W for 30 s, 10 W for 30 s, and 7 W for 210 or 90 s). By optical feedback control the laser was switched off automatically in the case of carbonization to avoid fiber damage. From July 15, 1991 to October 1, 1993 239 patients with BPH and 14 patients with advanced prostate cancer, suffering from severe urinary outflow obstruction, were treated by laser induced interstitial thermotherapy. The results and complications of treatment are reported.

Muschter, Rolf

1994-12-01

296

Cholesterol and Benign Prostate Disease  

PubMed Central

The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly understood. Patients suffering from benign prostatic symptoms report a substantially reduced quality of life, and the relationship between benign prostate conditions and prostate cancer is uncertain. Epidemiologic data for BPH and CP/CPPS are limited, however an apparent association bet ween BPH symptoms and cardiovascular disease (CVD) has been consistently reported. The prostate synthesizes and stores large amounts of cholesterol and prostate tissues may be particularly sensitive to perturbations in cholesterol metabolism. Hypercholesterolemi, a major risk factor for CVD, is also a risk factor for BPH. Animal model and clinical trial findings suggest that agents that inhibit cholesterol absorption from the intestine, such as the class of compounds known as polyene macrolides, can reduce prostate gland size and improve lower urinary tract symptoms (LUTS). Observational studies indicate that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer, while prostate cancer cell growth and survival pathways depend in part on cholesterol-sensitive biochemical mechanisms. Here we review the evidence that cholesterol metabolism plays a role in the incidence of benign prostate disease and we highlight possible therapeutic approaches based on this concept.

Freeman, Michael R.; Solomon, Keith R.

2014-01-01

297

Potential efficacy of some african plants in benign prostatic hyperplasia and prostate cancer.  

PubMed

Traditional medicine is very popular in Africa and it is considered as an alternative form of health care. Plants and vegetables used in folk and traditional medicine have gained wide acceptance as one of the main sources of prophylactic and chemopreventive drug discovery and this is due to the evidence of particular biological and biochemical characteristics of each plants extracts. The role of these compounds in urological field may be explained by the antiinflammatory effect through interference with prostaglandin metabolism, alteration of lipid peroxidation, direct inhibition of prostate growth and moreover through an antiandrogenic or antiestrogenic effect and a decrease of the availability of sex hormone-binding globulin. Since Benign Prostatic Hyperplasia and Prostate Cancer are two of the most diffuse diseases of aging male and considering that standard medical therapy is accompanied with different side effects, the emerging use of African plants may be justified. This review takes a look at some African plants extracts properties and their relative urological application. Different biomolecular mechanisms of action are promising, suggesting a real application in reducing prostate cells proliferation. PMID:23713889

Russo, Giorgio I; Cimino, Sebastiano; Salamone, Costanza; Madonia, Massimo; Favilla, Vincenzo; Castelli, Tommaso; Morgia, Giuseppe

2013-10-01

298

A study of the efficacy and safety of transurethral needle ablation (TUNA) treatment for benign prostatic hyperplasia.  

PubMed

The objective of this early phase III study was to determine the efficacy and safety of transurethral needle ablation (TUNA) in patients presenting in acute urinary retention due to benign prostatic hyperplasia (BPH). Between September 1993 and August 1994, 20 patients of mean age 68.8 years were entered into a two-center study and treated with TUNA after presenting in acute urinary retention and having failed at least one trial of voiding. A mean of 5.4 lesions at shield temperatures of 54.6 degrees C were produced. Patients were reviewed at 1, 3, 6, and 12 months (mean, 6.2 months). In 17 of 20 patients, voiding was reestablished in a mean of 2.6 days. Three patients required TURP for persistent retention, and 2 patients had delayed TURP for bothersome symptoms. Two voiders died later of unrelated causes. Five patients were lost to follow-up at 6 months but were voiding when last reviewed. Symptom scores decreased from a mean of 19.0 (range 4-35) to 8.25 (range 1-20) at 12 months (p = 0.06). Mean peak flow rate was 11.4 ml/sec (range 6.6-16.8) at 12 months (p = 0.001). Mean prostatic volume at baseline was 65.8 cc and decreased to 56 cc at 12 months (p = 0.111). The treatment was well tolerated by all patients, and side effects were mild, including urinary tract infection and epididymo-orchitis. This study demonstrates the safety and effectiveness of TUNA procedure in patients with urinary retention due to benign prostatic hypertrophy. PMID:8916114

Millard, R J; Harewood, L M; Tamaddon, K

1996-01-01

299

The Efficacy and Safety of Tadalafil 5 mg Once Daily in Korean Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: An Integrated Analysis  

PubMed Central

Purpose This post hoc integrated analysis assessed the efficacy and safety of tadalafil 5 mg once daily in a large Korean population with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH-LUTS). Materials and Methods Individual Korean participant data were integrated from three 12-week, randomized, double-blind, placebo-controlled studies in Asian men with BPH-LUTS, wherein 177 Korean men received placebo and 177 received tadalafil 5 mg once daily. The primary objective was to compare the change from baseline to week 12 in total International Prostate Symptom Score (IPSS) after treatment with tadalafil versus placebo. Results A significantly greater improvement (p<0.001) in total IPSS from baseline to week 12 was observed for tadalafil compared to placebo (least squares mean: tadalafil=-5.97; placebo=-3.94 ). Total IPSS at weeks 4 and 12, IPSS voiding and storage subscores at weeks 4, 8, and 12, and IPSS quality of life index at weeks 8 and 12 were also significantly improved (p<0.05) for tadalafil compared to placebo. There was significant improvement (p<0.001) in the patient global Impression of improvement responses and numerical improvement in the clinician global impression of improvement responses with tadalafil compared to placebo. There were no significant treatment differences for peak urine flow rate or postvoid residual volume. Few participants had treatment-emergent adverse events and there were no unexpected safety findings. Conclusions This integrated analysis of three randomized, placebo-controlled Asian studies confirmed tadalafil 5 mg once daily as an efficacious and well-tolerated treatment for Korean men with BPH-LUTS.

Lee, Sung Won; Paick, Jae Seung; Park, Hyun Jun; Morisaki, Yoji; Sorsaburu, Sebastian; Viktrup, Lars

2014-01-01

300

Nonspecific Genitourinary Pain Improves after Prostatectomy Using Holmium Laser Enucleation of Prostate in Patients with Benign Prostatic Hyperplasia: A Prospective Study  

PubMed Central

Objective To investigate changes in nonspecific genitourinary discomfort or pain (GUDP) before and after holmium laser enucleation of prostate (HoLEP). GUDP associated with lower urinary tract symptoms (LUTS) is a common complaint among benign prostatic hyperplasia (BPH) patients, but very little is known about this clinical entity. Methods From February 2010 to August 2011, 100 HoLEP patients with complete clinical data at a single institution were enrolled in the study to analyze the degree of GUDP with a visual analog scale (VAS) from 0 to 10 points at baseline and at 3 and 6 months postoperatively, and to investigate any relationships between GUDP and urodynamics, uroflowmetry, and scores from the International Prostate Symptom Score (IPSS) questionnaire. Results Fifty-six patients had LUTS only, while the remaining 44 had both LUTS and GUDP. Pain was located in the suprapubic (42.0%), perineal/penile (33.0%), back (17.0%), and perianal (8.0%) regions. During the post-operative period, at six months, the VAS, IPSS, peak flow rate and post-void residual volume had improved significantly in 44 GUDP patients (p<0.010). GUDP had completely resolved in 40 (90.9%) patients and had decreased in four (9.1%) patients, while seven (12.5%) patients developed GUDP with voiding in the urethral and perineal areas by the third month postoperatively. When compared to patients with complete resolution, those with persistent GUDP were found to have a significantly higher preoperative presence of bladder outlet obstruction (BOO) as an independent risk factor (OR 6.173, 95% CI 1.132–1.323). Conclusion Both GUDP and LUTS improved significantly after HoLEP. Patients with significant preoperative BOO tended to have persistent GUDP after surgery.

Kim, Sung Han; Oh, Seung-June

2014-01-01

301

Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH-LUTS.  

PubMed

Benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) and erectile dysfunction commonly coexist, and both respond to phosphodiesterase (PDE) 5 inhibitors, suggesting a shared pathophysiological mechanism. We propose that both BPH-LUTS and erectile dysfunction are caused by microvascular dysfunction within the pelvic organs, and we present an overview of preclinical and clinical studies supporting the hypothesis that, within both the penis and the lower urinary tract, a combination of endothelial and neural dysfunction leads to a vicious cycle of hypoxia, vasoconstriction, altered smooth muscle contractility, and degeneration of autonomic neurons and ganglia. This hypothesis explains much of the preclinical and clinical research relating to these two conditions, and provides a rationale for further investigation into the effects of PDE5 inhibitors on the pathophysiology and symptoms of BPH-LUTS. PMID:24619381

Cellek, Selim; Cameron, Norman E; Cotter, Mary A; Fry, Christopher H; Ilo, Dapo

2014-04-01

302

Outcome of Vaportrode Transurethral Vaporization of the Prostate Using Pressure-Flow Urodynamic Criteria  

Microsoft Academic Search

Objectives. To use pressure-flow urodynamic parameters to evaluate the outcome of patients with benign prostatic hyperplasia (BPH) who were treated with transurethral vaporization of the prostate (TUVP) using the Vaportrode.Methods. Forty consecutive patients (mean age 71.7 years) undergoing TUVP for treatment of symptomatic obstructive BPH or urinary retention were evaluated preoperatively and postoperatively with American Urological Association (AUA) Symptom Score,

Michael G Desautel; Tracy L Burney; Patricia A Diaz; Alphonso Austria; Gopal H Badlani

1998-01-01

303

Holmium laser for treatment of benign prostatic hyperplasia: old wine in a new bottle?  

NASA Astrophysics Data System (ADS)

Urinary tract symptoms related to benign prostatic hyperplasia affect 70% of men older than 70 years. Complications are common problems and a significant cause of morbidity in this population, placing a considerable burden on health services. In the early 1990s laser treatment of benign prostatic hyperplasia became widely used after the introduction of the side-firing neodym: YAG laser. However, because of technical limitations and inferior results compared to classical transurethral resection of the prostate many Urologists became desinterested in this device. With the introduction of the holmium: YAG laser a new laser generation became available for use in Urology. Beside several other applications the holmium: YAG laser can be used for incision, ablation, resection, and more recently enucleation of the prostate. In this paper we reviewed the current literature regarding the holmium: YAG laser resection and enucleation of the prostate compared to transurethral resection of the prostate and open prostatectomy. The holmium: YAG laser technique is an effective and durable surgical alternative to standard transurethral resection of the prostate. Interestingly, enucleation of the prostate with this device seems to be a safe and effective procedure for large prostatic adenomas, it may become an attractive alternative to open prostatectomy.

Nelius, Thomas; de Riese, Werner T. W.

2003-06-01

304

Does long-term finasteride therapy affect the histologic features of benign prostatic tissue and prostate cancer on needle biopsy?  

Microsoft Academic Search

Objectives. Finasteride, a common agent used to treat benign prostatic hyperplasia (BPH), inhibits 5-alpha-reductase. Testosterone is converted by 5-alpha-reductase to the more potent dihydrotestosterone, which is the primary androgen in the prostate. Leuprolide is a stronger antiandrogen that is used to downstage prostate cancer before radical prostatectomy. Leuprolide induces marked atrophy of prostate carcinoma cells, which sometimes makes pathologic diagnosis

Ximing J. Yang; Kristen Lecksell; Kerry Short; James Gottesman; Lloyd Peterson; John Bannow; Paul F. Schellhammer; William P. Fitch; G. Byron Hodge; Raul Parra; Stephen Rouse; Joanne Waldstreicher; Jonathan I. Epstein

1999-01-01

305

Morning vs evening dosing with doxazosin in benign prostatic hyperplasia: efficacy and safety  

Microsoft Academic Search

Three hundred and fifty-three patients with symptomatic benign prostatic hyperplasia were randomized to doxazosin or placebo, with morning or evening dosing, to compare the effect of dosing time on the efficacy and safety of doxazosin treatment. After 24 weeks of treatment, the mean International Prostate Symptom Score had decreased by 6.8 units in the doxazosin group compared with 4.5 units

RS Kirby; CR Chapple; K Sethia; M Flannigan; EJG Milroy; P Abrams

1998-01-01

306

FOXA1 deletion in luminal epithelium causes prostatic hyperplasia and alteration of differentiated phenotype.  

PubMed

The forkhead box (Fox) superfamily of transcription factors has essential roles in organogenesis and tissue differentiation. Foxa1 and Foxa2 are expressed during prostate budding and ductal morphogenesis, whereas Foxa1 expression is retained in adult prostate epithelium. Previous characterization of prostatic tissue rescued from embryonic Foxa1 knockout mice revealed Foxa1 to be essential for ductal morphogenesis and epithelial maturation. However, it is unknown whether Foxa1 is required to maintain the differentiated status in adult prostate epithelium. Here, we employed the PBCre4 transgenic system and determined the impact of prostate-specific Foxa1 deletion in adult murine epithelium. PBCre4/Foxa1(loxp/loxp) mouse prostates showed progressive florid hyperplasia with extensive cribriform patterning, with the anterior prostate being most affected. Immunohistochemistry studies show mosaic Foxa1 KO consistent with PBCre4 activity, with Foxa1 KO epithelial cells specifically exhibiting altered cell morphology, increased proliferation, and elevated expression of basal cell markers. Castration studies showed that, while PBCre4/Foxa1(loxp/loxp) prostates did not exhibit altered sensitivity in response to hormone ablation compared with control prostates, the number of Foxa1-positive cells in mosaic Foxa1 KO prostates was significantly reduced compared with Foxa1-negative cells following castration. Unexpectedly, gene expression profile analyses revealed that Foxa1 deletion caused abnormal expression of seminal vesicle-associated genes in KO prostates. In summary, these results indicate Foxa1 expression is required for the maintenance of prostatic cellular differentiation. PMID:24840332

DeGraff, David J; Grabowska, Magdalena M; Case, Tom C; Yu, Xiuping; Herrick, Mary K; Hayward, William J; Strand, Douglas W; Cates, Justin M; Hayward, Simon W; Gao, Nan; Walter, Michael A; Buttyan, Ralph; Yi, Yajun; Kaestner, Klaus H; Matusik, Robert J

2014-07-01

307

Stromal Response to Prostate Cancer: Nanotechnology-Based Detection of Thioredoxin-Interacting Protein Partners Distinguishes Prostate Cancer Associated Stroma from That of Benign Prostatic Hyperplasia  

PubMed Central

Histological staining of reactive stroma has been shown to be a predictor of biochemical recurrence in prostate cancer, however, molecular markers of the stromal response to prostate cancer have not yet been fully delineated. The objective of this study was to determine whether or not the stromal biomarkers detected with a thioredoxin-targeted nanodevice could be used to distinguish the stroma associated with benign prostatic hyperplasia from that associated with PCA. In this regard, we recently demonstrated that a thioredoxin-targeted nanodevice selectively binds to reactive stroma in frozen prostate tumor tissue sections. To accomplish this, random frozen prostate tissue sections from each of 35 patients who underwent resection were incubated with the nanodevice and graded for fluorescent intensity. An adjacent section from each case was stained with Hematoxylin & Eosin to confirm the diagnosis. Select cases were stained with Masson's Trichrome or immunohistochemically using antibodies to thioredoxin reductase 1, thioredoxin reductase 2 or peroxiredoxin 1. Our results demonstrate that the graded intensity of nanodevice binding to the stroma associated with PCA was significantly higher (p?=?0.0127) than that of benign prostatic hyperplasia using the t-test. Immunohistochemical staining of adjacent sections in representative cases showed that none of the two commonly studied thioredoxin interacting protein partners mirrored the fluorescence pattern seen with the nanodevice. However, thioredoxin reductase 2 protein was clearly shown to be a biomarker of prostate cancer-associated reactive stroma whose presence distinguishes the stroma associated with benign prostatic hyperplasia from that associated with prostate cancer. We conclude that the signal detected by the nanodevice, in contrast to individual targets detected with antibodies used in this study, originates from multiple thioredoxin interacting protein partners that distinguish the M2 neutrophil and macrophage associated inflammatory response in prostate cancer-associated stroma from the CD4+ T-Lymphocyte linked inflammation in benign prostatic hyperplasia.

Singer, Elizabeth; Linehan, Jennifer; Babilonia, Gail; Imam, S. Ashraf; Smith, David; Loera, Sofia; Wilson, Timothy; Smith, Steven

2013-01-01

308

Chronic caffeine intake increases androgenic stimuli, epithelial cell proliferation and hyperplasia in rat ventral prostate.  

PubMed

Coffee intake has been associated with a low risk of developing cancer, including prostate cancer, which is one of the most commonly diagnosed cancer in men. However, few studies have evaluated the chronic effects of caffeine, which is the most abundant methylxanthine in coffee, on prostate morphology and physiology. In the present study, we investigated the effects of chronic, low-dose caffeine intake on rat prostate morphology from puberty to adulthood. Five-week-old male Wistar rats were randomized into two experimental groups: caffeine-treated (20 ppm in drinking water, n = 12) and control (n = 12). The ventral and dorsolateral prostates were dissected, weighted and submitted to morphological, morphometrical and immunohistochemical analysis of cellular proliferation, apoptosis and androgen receptor (AR) tissue expression. The testosterone (T) and dihydrotestosterone (DHT) concentrations were measured in the plasma. Our results show that caffeine intake increased the concentrations of T and DHT, organ weight, epithelial cell proliferation and AR tissue expression in the ventral prostatic lobe. All the ventral prostates from the caffeine-treated animals presented various degrees of epithelial and stromal hyperplasia. Our results suggest that chronic caffeine intake from puberty increases androgenic signalling and cell proliferation in the rat prostate gland and can be related to the development of benign prostatic hyperplasia. PMID:23136995

Sarobo, Carolina; Lacorte, Lívia M; Martins, Marcela; Rinaldi, Jaqueline C; Moroz, Andrei; Scarano, Wellerson R; Delella, Flavia K; Felisbino, Sérgio L

2012-12-01

309

Chronic caffeine intake increases androgenic stimuli, epithelial cell proliferation and hyperplasia in rat ventral prostate  

PubMed Central

Coffee intake has been associated with a low risk of developing cancer, including prostate cancer, which is one of the most commonly diagnosed cancer in men. However, few studies have evaluated the chronic effects of caffeine, which is the most abundant methylxanthine in coffee, on prostate morphology and physiology. In the present study, we investigated the effects of chronic, low-dose caffeine intake on rat prostate morphology from puberty to adulthood. Five-week-old male Wistar rats were randomized into two experimental groups: caffeine-treated (20 ppm in drinking water, n = 12) and control (n = 12). The ventral and dorsolateral prostates were dissected, weighted and submitted to morphological, morphometrical and immunohistochemical analysis of cellular proliferation, apoptosis and androgen receptor (AR) tissue expression. The testosterone (T) and dihydrotestosterone (DHT) concentrations were measured in the plasma. Our results show that caffeine intake increased the concentrations of T and DHT, organ weight, epithelial cell proliferation and AR tissue expression in the ventral prostatic lobe. All the ventral prostates from the caffeine-treated animals presented various degrees of epithelial and stromal hyperplasia. Our results suggest that chronic caffeine intake from puberty increases androgenic signalling and cell proliferation in the rat prostate gland and can be related to the development of benign prostatic hyperplasia.

Sarobo, Carolina; Lacorte, Livia M; Martins, Marcela; Rinaldi, Jaqueline C; Moroz, Andrei; Scarano, Wellerson R; Delella, Flavia K; Felisbino, Sergio L

2012-01-01

310

C-Peptide, Testosterone, Estrogen, Cortisol and Zinc in Patients with Benign Hyperplasia of the Prostate  

Microsoft Academic Search

Patients with benign hyperplasia of the prostate (BHP) were studied in relation to aberrant serum c-peptide, testosterone, estrone, cortisol and morning fasting glucose, to analyze the syntropy of diabetes and BHP. The results were compared to patients with bladder cancer without BHP and, after correction of the patients’ weights and ages, the control failed to prove any significance. This is

U. Dunzendorfer; D. Drahovsky

1980-01-01

311

Clinical study of the efficiency and safety of afala in patients with benign prostatic hyperplasia.  

PubMed

The use of afala in patients with benign prostatic hyperplasia and moderate urination disturbances reduced the symptoms of the disease, improved urodynamic parameters, and increased quality of life. Clinical efficiency of afala was comparable with the efficiency of Serenoa repens extract (reference preparation). PMID:20027354

Savel'eva, K V; Kachanova, M V; Pavlov, V N; Kazikhinurov, R A; Frolov, M Yu; Mukhin, A B; Udut, V V; Yurmazov, Z A; Dugina, Yu L; Sergeeva, S A; Epshtein, O I

2009-08-01

312

Diagnostic Approach to Prostate Cancer using Total Prostate Specific Antigen-Based Parameters Together  

Microsoft Academic Search

This prospective study investigated the value of serum total prostate specific antigen (tPSA)- based parameters in the diagnosis of prostate cancer (PCa). Serum tPSA, free to tPSA ratio (f\\/tPSA), PSA density (PSAD), and PSA transition zone (PSAT) were evaluated in 110 patients with histologically confirmed benign prostate hyperplasia (BPH) and 98 patients with PCa. Once the serum tPSA was elevated

Muhittin A. Serdar; Ozkan Oguz; Abdullah Olgun; Bedrettin Seçkin; Seyfettin Ilgan; Adnan Hasimi; Mustafa Salih; Fuat Peker; Turker Kutluay

2002-01-01

313

CYP1B1 Polymorphism as a Risk Factor for Race-Related Prostate Cancer.  

National Technical Information Service (NTIS)

We utilized 97 healthy, 77 benign prostatic hyperplasia (BPH) and 156 prostate cancer (PC) samples that are pre-existing from African-American and Caucasian patients. Due to human subjects issues, the project has been on hold from Dec 2005 till Jan 2008 a...

Y. Tanaka

2008-01-01

314

[The treatment of benign prostatic hyperplasia using the Mumie-Vitas preparation].  

PubMed

Overall thirty-eight patients presenting with stage I-II benign prostate hyperplasia received treatment with a new local drug preparation Mumiyo-Vitas, 0.2 g on a once- or twice-daily basis over six months. Effects were studied of the drug on the urologic symptomatology and quality of life of patients presenting with ongoing micturitional disturbances, functional state of detrusor vesicae, prostate volume and urethral resistance. Efficiency of the treatment given was assessed by the International system, uroflowmetry, ultrasonic investigation. Mumiyo-Vitas appeared to be of therapeutic benefit in those patients with subjective and objective symptoms of the urinary bladder obstruction who had innocent prostate hyperplasia. PMID:9589956

Andriukhova, N N

1997-01-01

315

Antioxidant Effects of Lycopene in African American Men with Prostate Cancer or Benign Prostate Hyperplasia: A Randomized Controlled Trial  

PubMed Central

Consumption of tomato products is associated with a decreased risk of prostate cancer, and lycopene, the red carotenoid in the tomato, is a potent antioxidant that might contribute to this chemoprevention activity. A double-blind, randomized, placebo-controlled trial of 105 African American men veterans, recommended for prostate biopsy to detect cancer was carried out to investigate whether oral administration of lycopene increases lycopene levels in blood and prostate tissue and lowers markers of oxidative stress. Urology patients were randomly assigned to receive 30 mg/d of lycopene as a tomato oleoresin or placebo for 21-days prior to prostate biopsy for possible diagnosis of prostate cancer. A total of 47 men were diagnosed with prostate cancer and 58 were diagnosed with benign prostate hyperplasia. Diet, smoking, and drinking habits were assessed. For the men receiving lycopene, the mean lycopene concentration increased from 0.74 ± 0.39 to 1.43 ± 0.61 ?mol/L in plasma (P <0.0001) and from 0.45 ± 0.53 to 0.59 ± 0.47 pmol/mg in prostate tissue (P = 0.005). No significant changes in the DNA oxidation product 8-oxo-deoxyguanosine or the lipid peroxidation product malondialdehyde were observed in prostate tissue or plasma, respectively, as a result of lycopene administration.

van Breemen, Richard B.; Sharifi, Roohollah; Viana, Marlos; Pajkovic, Natasa; Zhu, Dongwei; Yuan, Long; Yang, Yanan; Bowen, Phyllis E.; Stacewicz-Sapuntzakis, Maria

2011-01-01

316

Transurethral diode (810 nm) laser application for treatment of benign prostatic hyperplasia: a clinical study  

NASA Astrophysics Data System (ADS)

The objective of this study was to evaluate the effectiveness and safety of diode laser for the treatment of human BPH. The study included 11 patients with significant BPH that were treated with diode laser 15 watts for 180 seconds (Diomed, Inc., Gallium-Aluminum- Arsenide, 810 nm). Mean age was 69 years (range 59 to 84). Mean prostatic volume was 64.5 cc (range 30 to 96). In all cases the procedure was uncomplicated, the blood loss was minimal (< 100 cc) and all patients were discharged within the first 24 hours. On average, patients voided spontaneously after 4 days (range 1 to 11). There were no postoperative complications. At 6 months follow up the mean AUA-7 symptom score decreased from 24.27 to 8.12, the peak flow rate increased from 7.12 cc/sec, to 13.85 cc/sec, and the post void residual diminished from 58.5 cc to 38 cc. Our study suggests that diode laser therapy may offer a safe and effective alternative for the treatment of BPH.

Pow-Sang, Mariela; Orihuela, Eduardo; Motamedi, Massoud

1995-05-01

317

Using Clinical Practice Guidelines: Building and Applying a Guideline-Based Performance Measurement System. Volume 1. Benign Prostatic Hyperplasia.  

National Technical Information Service (NTIS)

AMRRC evaluated the AHCPR-supported practice guidelines for benign prostatic hyperplasia through the development of performance measurement systems for this guideline. The objective of the project were to (1) determine whether the guideline could be trans...

C. J. Magoffin W. Cohen C. S. Beavert M. Biderman R. A. Hadley C. H. Han D. Klingman D. Lee A. Hardy

1995-01-01

318

Using Clinical Practice Guidelines: Building and Applying a Guideline-Based Performance Measurement System. Volume 2. Appendices. Benign Prostatic Hyperplasia.  

National Technical Information Service (NTIS)

AMRRC evaluated the AHCPR-supported practice guidelines for benign prostatic hyperplasia through the development of performance measurement systems for this guideline. This volume contains the technical appendix materials for the project. This includes in...

C. J. Magoffin W. Cohen C. S. Beavert M. Biderman R. A. Hadley C. H. Han D. Klingman D. Lee A. Hardy

1995-01-01

319

The inflammatory microenvironment of the aging prostate facilitates cellular proliferation and hypertrophy  

Microsoft Academic Search

Benign Prostatic Hypertrophy (BPH, also known as benign prostatic hyperplasia or benign prostatic enlargement), is one of the most common benign proliferative conditions associated with aging in men and is pathologically characterized by the proliferation of fibroblast\\/myofibroblast and epithelial cell types in the prostate. Previous studies from our laboratory have shown that the CXC-type chemokines, CXCL5 and CXCL12, are secreted

L. A. Begley; S. Kasina; J. MacDonald; J. A. Macoska

2008-01-01

320

Metabolism and tissue distribution study of Vaccaria seeds (Wang-Bu-Liu-Xing) in benign prostatic hyperplasia model rat: toward an in-depth study for its bioactive components.  

PubMed

Vaccaria seeds (Wang-Bu-Liu-Xing), a well-known traditional Chinese medicine (TCM), has been used as an emperor herb of many ancient formulas to treat benign prostatic hyperplasia (BPH) in clinic. However, its metabolism and tissue distribution, especially in the target tissue, had not been investigated so far. Based on the hypothesis that the components which exert effect against BPH of Vaccaria seeds would be measureable in target tissue (prostate), in vivo metabolism and tissue distribution of Vaccaria seeds in rats were profiled using a specific and sensitive high performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight mass spectrometry (LC-QTOF-MS/MS). As a result, 19 major constituents in the Vaccaria seeds decoction and 19 constituents in rat plasma, feces and tissues after oral administration of Vaccaria seeds decoction were identified. Accurate mass measurement for molecular ions and characteristic fragment ions could represent reliable identification criteria for these compounds. Two prototypes were detected in prostate. An in vitro metabolism analysis of them was studied after incubation with rat intestinal flora and rat liver microsome (RLM) in this paper, which is helpful for further investigation of the potential effect of these two components. The result of this study provided meaningful information for further pharmacology research on Vaccaria seeds. PMID:23973757

Qi, Peng; Li, Zhixiong; Chen, Mingcang; Sun, Zhaolin; Huang, Chenggang

2013-11-01

321

Evidence-based guidelines for the treatment of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary from AURO.it  

PubMed Central

Background: The first Italian national guidelines were developed by the Italian Association of Urologists and published in 2007. Since then, a number of new drugs or classes of drugs have emerged for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. Consequently, a new update of the guidelines has become necessary. Methods: A structured literature review was conducted to identify relevant papers published between 1 August 2006 and 12 December 2010. Publications before or after this timeframe were considered only if they were recognised as important milestones in the field or if the literature search did not identify publications within this timeframe. The quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation framework. Main findings: Decisions on therapeutic intervention should be based on the impact of symptoms on quality of life (QoL) rather than the severity of symptoms (International Prostate Symptom Score (IPSS) score). A threshold for intervention was therefore based on the IPSS Q8, with intervention recommended for patients with a score of at least 4. Several differences in clinical recommendations have emerged. For example, combination therapy with a 5?-reductase inhibitor plus ? blocker is now the recommended option for the treatment of patients at risk of BPH progression. Other differences include the warning of potential worsening of cognitive disturbances with use of anticholinergics in older patients, the distinction between Serenoa repens preparations (according to the method of extraction), and the clearly defined threshold of prostate size for performing open surgery (>80 g). While the recommendations included in these guidelines are evidence based, clinical decisions should also be informed by patients’ clinical and physical circumstances, as well as patients’ preferences and actions. Conclusions: These guidelines are intended to assist physicians and patients in the decision-making process regarding the management of LUTS/BPH, and support the process of continuous improvement of the quality of care and services to patients.

Casarico, Antonio; Fandella, Andrea; Galetti, Caterina; Hurle, Rodolfo; Mazzini, Elisa; Niro, Ciro; Perachino, Massimo; Sanseverino, Roberto; Pappagallo, Giovanni Luigi

2012-01-01

322

A prospective randomized study comparing alfuzosin and tamsulosin in the management of patients suffering from acute urinary retention caused by benign prostatic hyperplasia.  

PubMed

Objective : Prospective randomized study to compare the efficacy and safety of alfuzosin and tamsulosin in patients suffering from acute urinary retention caused by benign prostatic hyperplasia (BPH). Methods : Patients with acute urinary retention (AUR) due to BPH (total 150) were catheterized and randomized into three groups: Group A: alfuzosin 10 mg (50 patients), Group B: tamsulosin 0.4 mg (50 patients), Group C: placebo (50 patients). After three days, catheter was removed, and patients were put on trial without catheter (TWOC). Patients with successful TWOC were followed up for three months, taking into account the prostate symptom score (AUA Score), post-void residual urine volume (PVRV), and peak flow rate (PFR). ANOVA was used for statistical analysis. Results : Both group A (alfuzosin) and group B (tamsulosin) had similar results of TWOC (group A - 66%, group B - 70%), which were significantly superior than group C (placebo) - 36%. In follow up, three (9.1%) patients in group A, three (8.6%) patients in group B and eight (44.4%) patients in group C had retention of urine, requiring recatheterization. These patients were withdrawn from the study. After three months, alfuzosin- or tamsulosin-treated patients showed a significant decrease in AUA score and PVRV; and a significant increase in PFR as compared to placebo. Conclusions : TWOC was more successful in men treated with either alfuzosin or tamsulosin and the subsequent need for recatheterization was also reduced. Tamsulosin was comparable to alfuzosin in all respects, except a small but significant side effect of retrograde ejaculation. PMID:19955671

Agrawal, Madhu S; Yadav, Abhishek; Yadav, Himanshu; Singh, Amit K; Lavania, Prashant; Jaiman, Richa

2009-01-01

323

Efficacy and safety of finasteride therapy for benign prostatic hyperplasia: results of a 2-year randomized controlled trial (the PROSPECT study). PROscar Safety Plus Efficacy Canadian Two year Study.  

PubMed Central

OBJECTIVE: To evaluate the efficacy and safety of 2 years' treatment of moderate benign prostatic hyperplasia (BPH) with finasteride. DESIGN: Double-blind, parallel-group, placebo-controlled, multicentre, prospective randomized study. SETTING: Outpatient care in 28 centres across Canada. PARTICIPANTS: Men aged 45 to 80, in good health, with moderate BPH and no evidence of prostate cancer. A total of 613 men were entered into the study; 472 completed the 2 years of treatment. INTERVENTION: After 1 month of receiving a placebo (run-in period), patients were given either finasteride (5 mg/d) or a placebo for 2 years. OUTCOME MEASURES: Efficacy: changes from baseline in BPH symptom scores, maximum urinary flow rates and prostate volume. Safety: onset, course and resolution of all adverse events during the treatment period. RESULTS: In the efficacy analyses the mean BPH symptom scores decreased 2.1 points (from 15.8 to 13.7) in the finasteride group, as compared with a decrease of 0.7 points (from 16.6 to 15.9) in the placebo group (P < or = 0.01). The maximum urinary flow rate increased by a mean of 1.4 mL/s (from 11.1 to 12.5 mL/s) in the finasteride group, as compared with an increase of 0.3 mL/s (from 10.9 to 11.2 mL/s) in the placebo group (p < or = 0.01). The mean prostate volume decreased by 21% (from a mean volume of 44.1 cm3 at baseline) in the treatment group; it increased by 8.4% (from a mean volume of 45.8 cm3 at baseline) in the placebo group (p < or = 0.01). In the safety analysis, the proportion of patients who experienced any adverse event was similar in the two groups (81.0% in the treatment group and 81.2% in the placebo group). However, the incidence of adverse events related to sexual dysfunction were significantly higher in the finasteride group than in the placebo group (ejaculation disorder 7.7% v. 1.7% and impotence 15.8% v. 6.3%; p < or = 0.01 for both parameters). CONCLUSION: Finasteride is a well-tolerated and effective alternative to watchful waiting in the treatment of moderate BPH.

Nickel, J C; Fradet, Y; Boake, R C; Pommerville, P J; Perreault, J P; Afridi, S K; Elhilali, M M

1996-01-01

324

Diet and Its Preventive Role in Prostatic Disease  

Microsoft Academic Search

Asian men have much lower incidences of prostate cancer and possibly of benign prostatic hyperplasia (BPH) than their Western counterparts. Vegetarian men also have a lower incidence of prostate cancer than omnivorous males. Both Asian and vegetarian men consume low-fat, high-fibre diets which provide a rich supply of weak dietary oestrogens. These plant or phyto-oestrogens have been proposed as chemopreventive

L. Denis; M. S. Morton; K. Griffiths

1999-01-01

325

Potentiometric sensors enabling fast screening of the benign prostatic hyperplasia drug alfuzosin in pharmaceuticals, urine and serum.  

PubMed

The construction and characterization of potentiometric membrane electrodes are described for the quantification of alfuzosin, a drug used in a mono- and combined therapy of benign prostatic hyperplasia (BPH). The membranes of these electrodes consist of alfuzosin hydrochloride-tetraphenyl borate, (Az-TPB), chlorophenyl borate (Az-ClPB), and phosphotungstate (Az(3)-PT) ion associations as molecular recognition reagent dispersed in PVC matrix with dioctylpthalate as plasticizer. The performance characteristics of these electrodes, which were evaluated according to IUPAC recommendations, revealed a fast, stable and liner response for alfuzosin over the concentration ranges of 8.3 x 10(-6) to 1.0 x 10(-2) M, 3.8 x 10(-6) to 1.0 x 10(-2) M, 7.5 x 10(-7) to 1.0 x 10(-2) M AzCl with cationic slopes of 57.0, 56.0 and 58.5 mV/decade, respectively. The solubility product of the ion-pair and the formation constant of the precipitation reaction leading to the ion-pair formation were determined conductometrically. The electrodes, fully characterized in terms of composition, life span and usable pH range, were applied to the potentiometric determination of alfuzosin hydrochloride ion in different pharmaceutical preparations and biological fluids without any interference from excipients or diluents commonly used in drug formulations. The potentiometric method was also used in the determination of alfuzosin hydrochloride in pharmaceutical preparations in four batches with different expiration dates. Validation of the method showed suitability of the proposed electrodes for use in the quality control assessment of alfuzosin hydrochloride. This potentiometric method offers the advantages of high-throughput determination, simplicity, accuracy, automation feasibility, and applicability to turbid and colored sample solutions. PMID:17979639

Gupta, Vinod K; Singh, Ashok K; Gupta, Barkha

2007-08-01

326

[The long-term treatment of patients with benign prostatic hyperplasia using Proscar].  

PubMed

The drug proskar (finasterid) has been developed and synthetized in "Merck Sharp & Dohme" research laboratories and tried initially in healthy male volunteers. Proskar is highly active as a blocker of 5-alpha-reductase blocking conversion of testosteron in dehydrotestosteron (DHT). The assessment of proskar effect on the prostate has been performed in 2000 patients throughout the world, including Russia. Follow-up studies (up to 5 years) demonstrate that proskar in the dose 5 mg/day produces a reduction in the levels of specific prostatic antigen, serum DHT and prostatic size, an increase in urination rate, life quality. In benign prostatic hyperplasia proskar realizes its effect in hormonal nature of the disease. The advantages are also safety and rare occurrence of side effects. The response became noticeable on the treatment month 6. PMID:8659035

Lopatkin, N A; Roilans, P J; Stoner, E

1996-01-01

327

Experience with Uroflowmetry in Evaluation of Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia  

PubMed Central

Introduction: Uroflowmetry is a non- invasive urodynamic tool which is widely used for most of the patients with suspected lower urinary tract dysfunction. The severity of lower urinary tract symptoms (LUTS) can be measured reliably by using a number of validated questionnaires, like International Prostate Symptom Score (IPSS). This study was designed to determine the relationship between the parameters of uroflowmetry and symptom severity. Materials and Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation. The correlations between these parameters were quantified by means of Spearman correlation co-efficients. Results: Statistically significant correlations were found between the IPSS and results of uroflowmetry (peak flow rate and average flow rate) and post void residual urine. No correlation was found between the IPSS and results of prostate volume measurements. Conclusion: There was a positive correlation between peak flow rate, as was measured by uroflowmetry and lower urinary tract symptom severity.

Singla, Sanjeev; Singla, Ankit; Sharma, Sandeep; Singh, Jasdeep; Sethi, Pulkit

2014-01-01

328

Experience with uroflowmetry in evaluation of lower urinary tract symptoms in patients with benign prostatic hyperplasia.  

PubMed

Introduction: Uroflowmetry is a non- invasive urodynamic tool which is widely used for most of the patients with suspected lower urinary tract dysfunction. The severity of lower urinary tract symptoms (LUTS) can be measured reliably by using a number of validated questionnaires, like International Prostate Symptom Score (IPSS). This study was designed to determine the relationship between the parameters of uroflowmetry and symptom severity. Materials and Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation. The correlations between these parameters were quantified by means of Spearman correlation co-efficients. Results: Statistically significant correlations were found between the IPSS and results of uroflowmetry (peak flow rate and average flow rate) and post void residual urine. No correlation was found between the IPSS and results of prostate volume measurements. Conclusion: There was a positive correlation between peak flow rate, as was measured by uroflowmetry and lower urinary tract symptom severity. PMID:24959473

Singla, Sanjeev; Garg, Ramneesh; Singla, Ankit; Sharma, Sandeep; Singh, Jasdeep; Sethi, Pulkit

2014-04-01

329

Ganoderma lucidum is an inhibitor of testosterone-induced prostatic hyperplasia in rats.  

PubMed

The aim of the present study was to find out whether Ganoderma lucidum (GL) can be used as a clinically effective medicine for the management of prostatic hyperplasia. In vitro studies were conducted to assess the 5?-reductase inhibitory potential of GL. A biochemical marker viz. ?-sitosterol was identified and characterised in the extracts utilising high-performance thin-layer chromatography. Testosterone (3 mg kg(-1) s.c.) was administered to the rats along with the test extracts (10, 20 and 50 mg kg(-1) p.o.) and ?-sitosterol (10 and 20 mg kg(-1) p.o.) for a period of 28 days. Finasteride was used as a positive control (1 mg kg(-1) p.o.). GL extracts attenuated the increase in the prostate/body weight ratio induced by testosterone. Petroleum ether extract exhibiting the best activity. Ethanolic extract also exhibited significant activity. The urine output also improved significantly, which emphasise the clinical implications of the study. Testosterone levels measured weekly and prostate-specific antigen (PSA) levels measured at the end of the study also support our claims. The PSA levels decreased in the extract-treated groups, indicating their usefulness in the treatment of benign prostatic hyperplasia. Histological studies have shown a considerable improvement in the prostatic histoarchitecture in the extract-treated groups when compared to the testosterone-treated group. PMID:21651601

Nahata, A; Dixit, V K

2012-05-01

330

Efficacy and Safety of Low-Dose Propiverine in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia with Storage Symptoms: A Prospective, Randomized, Single-Blinded and Multicenter Clinical Trial  

PubMed Central

Purpose The aim of this study was to evaluate whether low-dose anticholinergics combined with an ?1-receptor antagonist would continue the effect of an alpha-blocker, decrease the side effects of anticholinergics, and improve the symptoms of lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). Materials and Methods Two hundred nine men with LUTS/BPH with storage symptoms (International Prostate Symptom Score [IPSS] ?12; storage symptoms ?4) were randomly assigned in a prospective, multicentered, and single-blind fashion to either the control group (alfuzosin 10 mg, once daily) or the combined group (alfuzosin 10 mg, once daily, and propiverine 10 mg, once daily) for 2 months. IPSS, maximal urinary flow rate (Qmax), and postvoid residual volume (PVR) were used to grade symptoms, side effects, and the impact on quality of life (QoL) at the start of the study and after 1 and 2 months. Results There were no significant differences in patient background, including age, prostate size, Qmax, and PVR, between the control group and the combined group. In the combined group, the IPSS total score and the IPSS storage symptom score were significantly improved compared with the control group. The IPSS voiding symptom score, QoL, Qmax, and PVR did not differ significantly. There were no serious side effects in either group. Conclusions Management with an ?1-receptor antagonist combined with a low-dose anticholinergic improved the total score and storage symptom score of the IPSS compared with ?1-receptor antagonist only group without causing serious side effects. This initial combination medication can be considered an effective and safe treatment modality for LUTS/BPH patients with storage symptoms.

Bae, Jae Hyun; Kim, Sun Ouck; Yoo, Eun Sang; Moon, Kyung Hyun; Kyung, Yoon Soo

2011-01-01

331

Interstitial Laser Coagulation in Benign Prostatic Hyperplasia: A Critical Evaluation after 2 Years of Follow-Up  

Microsoft Academic Search

Since 1993 we have prospectively followed a cumulative cohort of males with benign prostatic hyperplasia and symptomatic bladder outlet obstruction who underwent interstitial laser coagulation (ILC) of the prostate. We evaluated the safety and efficacy of ILC with respect to relief of symptoms and bladder outlet obstruction. In addition to the critical evaluation of our clinical results, the perineal and

A. W. Krautschick; K. U. Köhrmann; T. O. Henkel; M. S. Michel; P. Alken

1999-01-01

332

TRANSGENIC EXPRESSION OF 15-LIPOXYGENASE 2 (15-LOX2) IN MOUSE PROSTATE LEADS TO HYPERPLASIA AND CELL SENESCENCE  

PubMed Central

15-Lipoxygenase 2 (15-LOX2), a lipid-peroxidizing enzyme, is mainly expressed in the luminal compartment of the normal human prostate and often decreased or lost in prostate cancer. Previous studies from our lab implicate 15-LOX2 as a functional tumor suppressor. To better understand the biological role of 15-LOX2 in vivo, we established prostate-specific 15-LOX2 transgenic mice using the ARR2PB promoter. Unexpectedly, transgenic expression of 15-LOX2 or 15-LOX2sv-b, a splice variant that lacks the arachidonic acid metabolizing activity, resulted in age-dependent prostatic hyperplasia and enlargement of the prostate. Prostatic hyperplasia induced by both 15-LOX2 and 15-LOX2sv-b was associated with an increase in luminal and Ki-67+ cells; however, 15-LOX2-transgenic prostates also showed a prominent increase in basal cells. Microarray analysis revealed distinct gene expression profiles that could help explain the prostate phenotypes. Strikingly, 15-LOX2, but not 15-LOX2sv-b, transgenic prostate showed upregulation of several well-known stem/progenitor cell molecules including Sca-1, Trop2, p63, Nkx3.1 and Psca. Prostatic hyperplasia caused by both 15-LOX2 and 15-LOX2sv-b did not progress to prostatic intraprostate neoplasia (PIN) or carcinoma and, mechanistically, prostate lobes (especially those of the 15-LOX2 mice) showed a dramatic increase in senescent cells as revealed by increased SA-?gal, p27Kip1 and HP1? staining. Collectively, our results suggest that 15-LOX2 expression in mouse prostate leads to hyperplasia and also induces cell senescence, which may, in turn, function as a barrier to tumor development.

Suraneni, MV; Schneider-Broussard, R; Moore, JR; Davis, T Calhoun; Maldonado, CJ; Li, H; Newman, RA; Kusewitt, D; Hu, J; Yang, P; Tang, DG

2010-01-01

333

The safety and efficacy of aspirin intake in photoselective vaporization laser treatment of benign prostate hyperplasia  

PubMed Central

Endoscopic surgical treatment has become an option to treat benign prostate hyperplasia. We evaluated the safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients. We evaluated preoperative and perioperative parameters, functional outcomes, and adverse events up to 12 months postoperatively of patients on oral anticoagulation therapy undergoing PVP, and compared the results with patients who did not take anticoagulation therapy. A total of 89 patients who received photoselective vaporization laser for benign prostate hyperplasia from May 2006 to February 2011 in our hospital were enrolled in our study. The patients were divided into two groups based on whether or not they were taking oral aspirin; 23 (25.8%) patients were taking aspirin derivatives (aspirin group), and 66 (74.2%) were not taking aspirin derivatives (control group). The mean prostate volume (58.8 mL vs 51 mL; P = 0.16) and mean energy consumption (235,268 J vs 289,793 J; P = 0.097) were comparable between the aspirin group and control group. The average postoperative results of hemoglobin were 13.4 mg/ dL for the aspirin group versus 13.9 mg/dL for the control group (P = 0.327). A significantly higher maximum flow rates and 80% improved post-void residual urine were noted during the followup. Postoperatively all variable showed significant improvement starting at month 1 of followup and remained improved for the 12 month followup. Postoperative complications were low and comparable between groups. PVP was characterized by excellent hemostatic properties and a very low intraoperative complication rate, even in the patients who were taking aspirin. On the basis of our perioperative results, we recommend PVP as a safe and effective procedure for patients with symptomatic benign prostate hyperplasia when taking an aspirin derivative.

Shao, I-Hung; Hou, Chen-Pang; Chen, Shao-Ming; Chen, Chien-Lun; Lin, Yu-Hsiang; Chang, Phei-Lang; Tsui, Ke-Hung

2013-01-01

334

Hypertension in the elderly with coexisting benign prostatic hyperplasia  

Microsoft Academic Search

The treatment of hypertension in the elderly can be safely achieved with low-dose diuretic therapy. Men with prostatism may benefit from peripheral ?-blocking drugs. However, drugs such as doxazosin or terazosin may further lower blood pressure and at times may be associated with orthostatic hypotension, especially if diuretics are given concomitantly. Tamsulosin achieves relaxation of the smooth muscle of the

Javier Maruenda; Vineesh Bhatnagar; David T Lowenthal

1999-01-01

335

Finasteride in the treatment of clinical benign prostatic hyperplasia: A systematic review of randomised trials  

PubMed Central

Background Benign prostatic hyperplasia affects older men. This systematic review determined efficacy and adverse effects of finasteride. Review methods PubMed, the Cochrane Library, reference lists of reports, and reviews were searched for randomised, double-blind trials of finasteride in benign prostatic hyperplasia. Outcomes included symptom score, urinary flow rate, prostate volume, discontinuation, and adverse effects. Relative risk and NNT or NNH were calculated for dichotomous data. Sensitivity analyses assessed influences of baseline symptom severity, initial prostate volume, a dominating trial, and previous interventions. Results Three trials had active controls and 19 had placebo. In placebo-controlled trials, 8820 patients received finasteride 5 mg and 5909 placebo over 3–48 months. Over 48 months finasteride produced greater improvements in total symptom score, maximum urinary flow rate, and prostate volume. Significantly more sexual dysfunction, impotence, ejaculation disorder and decreased libido occurred with finasteride at 12 months; the NNH for any sexual dysfunction at 12 months was 14. Significantly fewer men treated with finasteride experienced acute retention or had surgery at 24 or 48 months than with placebo; at 12 months the NNT was 49 (31 to 112) to avoid one acute urinary retention and 31 (21 to 61) to avoid one surgery. Sensitivity analyses showed benefit with finasteride 5 mg to be constant irrespective of the initial prostate volume. Conclusions Information from many patients in studies of high quality showed beneficial effects of finasteride in terms of symptoms, flow rate and prostate volume. More utility would result if patient centred outcomes were reported in dichotomous form.

Edwards, Jayne E; Moore, R Andrew

2002-01-01

336

Transcriptional Activity of Heparan Sulfate Biosynthetic Machinery is Specifically Impaired in Benign Prostate Hyperplasia and Prostate Cancer  

PubMed Central

Heparan sulfates (HSs) are key components of mammalian cells surface and extracellular matrix. Structure and composition of HS, generated by HS-biosynthetic system through non-template-driven process, are significantly altered in cancer tissues. The aim of this study was to investigate the involvement of HS-metabolic machinery in prostate carcinogenesis. Transcriptional patterns of HS-metabolic enzymes (EXT1, EXT2, NDST1, NDST2, GLCE, 3OST1/HS3ST1, SULF1, SULF2, HPSE) were determined in normal, benign, and cancer human prostate tissues and cell lines (PNT2, LNCaP, PC3, DU145). Stability of the HS-metabolic system patterns under the pressure of external or internal stimuli was studied. Overall impairment of transcriptional activity of HS-metabolic machinery was detected in benign prostate hyperplasia, while both significant decrease in the transcriptional activity and changes in the expression patterns of HS metabolism-involved genes were observed in prostate tumors. Prostate cancer cell lines possessed specific transcriptional patterns of HS metabolism-involved genes; however, expression activity of the system was similar to that of normal prostate PNT2 cells. HS-metabolic system was able to dynamically react to different external or internal stimuli in a cell type-dependent manner. LNCaP cells were sensitive to the external stimuli (5-aza-deoxycytidin or Trichostatin A treatments; co-cultivation with human fibroblasts), whereas PC3 cells almost did not respond to the treatments. Ectopic GLCE over-expression resulted in transcriptional activation of HS-biosynthetic machinery in both cell lines, suggesting an existence of a self-regulating mechanism for the coordinated transcription of HS metabolism-involved genes. Taken together, these findings demonstrate impairment of HS-metabolic system in prostate tumors in vivo but not in prostate cancer cells in vitro, and suggest that as a potential microenvironmental biomarker for prostate cancer diagnostics and treatment.

Suhovskih, Anastasia V.; Tsidulko, Alexandra Y.; Kutsenko, Olesya S.; Kovner, Anna V.; Aidagulova, Svetlana V.; Ernberg, Ingemar; Grigorieva, Elvira V.

2014-01-01

337

Efficacies of osaterone and delmadinone in the treatment of benign prostatic hyperplasia in dogs.  

PubMed

A multicentre randomised clinical trial was performed to compare the therapeutic potential of osaterone acetate with that of delmadinone acetate in the treatment of benign prostatic hyperplasia in dogs. The osaterone was administered orally at 0.25 mg/kg bodyweight once a day for seven days to 73 dogs. The delmadinone was administered by a single intramuscular or subcutaneous injection at 3 mg/kg bodyweight to 69 dogs. During the 180-day trial, the dogs were monitored five times for their clinical signs and prostate volume. The two drugs were similarly effective in reducing the clinical signs and inducing complete clinical remission, and both induced a similar level of minor, mostly transitory adverse effects. Osaterone reduced the volume of the prostate glands of the dogs significantly more quickly than delmadinone. PMID:18689779

Albouy, M; Sanquer, A; Maynard, L; Eun, H M

2008-08-01

338

[Up-to-date on the treatment of benign prostatic hyperplasia. Which adenoma to treat and how to do it?].  

PubMed

Benign prostatic hyperplasia is a state of the nature rather than a disease. It affects mainly men over 50 years and represents a public health problem. A literature review on the therapeutic management of benign prostatic hyperplasia was carried out from a selection of publications with the highest level of evidence. Medical treatment is based on herbal medicine, alpha-blockers and 5-alpha-reductase inhibitors. Surgical treatment is used in case of complications or failure of medical management. Surgical options are numerous. Transurethral prostate resection and prostate adenomectomy are the most usual procedures. Due to their significant morbidity, other less invasive procedures have recently been developed. The choice of treatment will depend on prostate volume and anatomy and patient's comorbidities. PMID:24262410

Lahlaidi, K; Ariane, M M; Fontaine, E

2014-03-01

339

Post-Void Residual Urine Volume is Not a Good Predictor of the Need for Invasive Therapy Among Patients With Benign Prostatic Hyperplasia  

Microsoft Academic Search

PURPOSE: We assessed the value of baseline PVR as predictor of the need for invasive therapy during long-term followup of patients with clinical BPH treated initially with alpha1-blockers or WW. MATERIALS AND METHODS: The records of a cohort of 942 patients with BPH treated with alpha(1)-blockers or WW were reviewed. Baseline I-PSS scores, PSA, prostate volume, uroflowmetry, pressure flow parameters

C. A. Mochtar; L. A. L. M. Kiemeney; M. M. van Riemsdijk; M. P. Laguna; F. M. J. Debruyne; J. J. M. C. H. de la Rosette

2006-01-01

340

An open, comparative, multicentre clinical study of combined oral therapy with sildenafil and doxazosin GITS for treating Chinese patients with erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia.  

PubMed

This study sought to investigate the clinical efficacy and safety of combined oral therapy with sildenafil and doxazosin GITS compared to sildenafil monotherapy in treating Chinese patients with erectile dysfunction (ED) and lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH/LUTS). The trial was conducted in hospitals in Beijing, Shanghai, Changsha, Wuhan and Guangzhou, five major cities in China. A total of 250 patients diagnosed with ED and BPH/LUTS aged 50-75 years, and who had International Index of Erection Function-5 (IIEF-5) scores ?21 and International Prostate Symptom Score (IPSS) ?10 points, were enrolled and randomly divided into Group A (168 cases; doxazosin GITS 4 mg once daily plus sildenafil 25-100 mg on demand) and Group B (82 cases; sildenafil 25-100 mg on demand). Efficacies were evaluated by IIEF-5 and IPSS scores and a quality of life (QoL) questionnaire, and adverse effects were evaluated during the treatment period. There were no statistically significant differences in mean age, and IIEF-5, IPSS and QoL scores pre-treatment between the two groups. After treatment, IIEF-5, IPSS and QoL scores were significantly improved in Group A, while only IIEF-5 scores were significantly improved in Group B compared with pre-treatment. There were no significant differences in side effects between the two groups. The results indicated that combined therapy with sildenafil and doxazosin GITS for the treatment of ED and BPH/LUTS is safe and effective compared to sildenafil monotherapy. PMID:21602833

Jin, Zhe; Zhang, Zhi-Chao; Liu, Ji-Hong; Lu, Jun; Tang, Yu-Xin; Sun, Xiang-Zhou; Song, Wei-Dong; Gao, Bing; Guo, Ying-Lu; Xin, Zhong-Cheng

2011-07-01

341

Prostate Hyperplasia in a Transgenic Mouse with Prostate-Specific Expression of Prolactin  

Microsoft Academic Search

Prolactin (PRL) is one of several polypeptide factors known to exert trophic effects on the prostate. We have previously re- ported a dramatic prostate enlargement with concurrent chronic hyperprolactinemia and elevated serum androgen levels in a PRL transgenic mouse (Mt-PRL) with ubiquitous expression of the transgene. To address the role of local PRL action in the prostate, a new transgenic

JON KINDBLOM; KARIN DILLNER; LENA SAHLIN; FIONA ROBERTSON; CHRISTOPHER ORMANDY; JAN TORNELL; HÅKAN WENNBO

2003-01-01

342

Initial clinical results of laser prostatectomy procedure for symptomatic BPH using a new 50-watt diode laser (wavelength 1000 nm)  

NASA Astrophysics Data System (ADS)

Lasers have been used for symptomatic Benign Prostatic Hyperplasia (BPH) in both contact and non-contact modes with reported success rates equivalent to that of Transurethral Resection of Prostate (TURP). A new high power diode laser (Phototome), capable of delivering up to 50 watts of 1000 nm wavelength laser power via a 1 mm quartz fiber, was used to treat 15 patients with symptomatic BPH. Five patients had acute retention, 3 had long term catheter (7 - 48 months), and 8 had severe prostatism. Spinal anesthesia was used in 11 patients, and 4 patients had local anesthesia and intravenous sedation. Four quadrant coagulation with an angle firing probe delivering 50 watts of laser power for 60 seconds in one quadrant was used as the core of the treatment in 11 patients, contact vaporization of BPH tissue was performed in one patient using a 4.5 mm ball tip was used in one patient and three patients with bladder neck stenosis had bladder neck incision performed using a 1 mm quartz fiber delivering 30 watts of laser power. A foley catheter was left indwelling and removed after 5 - 7 days. All patients except one were catheter free after a mean of 8 days. One patient continued to have severe prostatism and had a TURP performed with good results after 3 months of his laser prostatectomy procedure. AUA symptom scores available in 11 patients was found to be 4 after 1 - 3 months of the initial procedure.

Bhatta, Krishna M.

1995-05-01

343

Silodosin versus naftopidil for the treatment of benign prostatic hyperplasia: a multicenter randomized trial.  

PubMed

This was a multicenter randomized trial to investigate the clinical efficacy and the impact on sexual function of alpha-1A selective silodosin and alpha-1D selective naftopidil for treatment of benign prostatic hyperplasia. A total of 97 patients with lower urinary tract symptoms/benign prostatic hyperplasia who had an International Prostate Symptom Score of 8 or more were randomly assigned to receive silodosin (8?mg/day, n?=?53) or naftopidil (75?mg/day, n?=?44). Before and 4, 8 and 12?weeks after treatment, International Prostate Symptom Score and its quality of life score were used to assess lower urinary tract symptoms. Also, International Index of Erectile Function-5, and an original questionnaire were used to evaluate erectile function and ejaculation for sexually active patients, respectively. The silodosin group showed advantages in terms of voiding symptoms and quality of life of International Prostate Symptom Score when compared with the naftopidil group. Both silodosin and naftopidil showed no significant effect on International Index of Erectile Function-5. A total of 23 sexually active patients in the silodosin group experienced more ejaculatory impairment than 21 patients in the naftopidil group, with a decrease of ejaculation volume (87% vs 40%, P?=?0.003), prolonged time to ejaculation (56% vs 33%, P?=?0.027) and decrease of orgasm (50% vs 39%, P?=?0.027). These results suggest that alpha-1A selective blockers are more effective for voiding symptoms, whereas alpha-1D selective blockers offer a minor degree of ejaculatory dysfunction. PMID:23731168

Yamaguchi, Kenya; Aoki, Yutaka; Yoshikawa, Tetsuo; Hachiya, Takahiko; Saito, Tadanori; Takahashi, Satoru

2013-12-01

344

Serum protein fingerprinting coupled with a pattern-matching algorithm distinguishes prostate cancer from benign prostate hyperplasia and healthy men.  

PubMed

The prostate-specific antigen test has been a major factor in increasing awareness and better patient management of prostate cancer (PCA), but its lack of specificity limits its use in diagnosis and makes for poor early detection of PCA. The objective of our studies is to identify better biomarkers for early detection of PCA using protein profiling technologies that can simultaneously resolve and analyze multiple proteins. Evaluating multiple proteins will be essential to establishing signature proteomic patterns that distinguish cancer from noncancer as well as identify all genetic subtypes of the cancer and their biological activity. In this study, we used a protein biochip surface enhanced laser desorption/ionization mass spectrometry approach coupled with an artificial intelligence learning algorithm to differentiate PCA from noncancer cohorts. Surface enhanced laser desorption/ionization mass spectrometry protein profiles of serum from 167 PCA patients, 77 patients with benign prostate hyperplasia, and 82 age-matched unaffected healthy men were used to train and develop a decision tree classification algorithm that used a nine-protein mass pattern that correctly classified 96% of the samples. A blinded test set, separated from the training set by a stratified random sampling before the analysis, was used to determine the sensitivity and specificity of the classification system. A sensitivity of 83%, a specificity of 97%, and a positive predictive value of 96% for the study population and 91% for the general population were obtained when comparing the PCA versus noncancer (benign prostate hyperplasia/healthy men) groups. This high-throughput proteomic classification system will provide a highly accurate and innovative approach for the early detection/diagnosis of PCA. PMID:12097261

Adam, Bao-Ling; Qu, Yinsheng; Davis, John W; Ward, Michael D; Clements, Mary Ann; Cazares, Lisa H; Semmes, O John; Schellhammer, Paul F; Yasui, Yutaka; Feng, Ziding; Wright, George L

2002-07-01

345

Transurethral microwave thermotherapy for benign prostatic hyperplasia. Subjective response and urodynamic changes.  

PubMed

Results of transurethral microwave thermotherapy for benign prostatic hyperplasia were good after 1 year in 68% of 66 cases. Despite good correlation between subjective assessment of results and improvement in urodynamic parameters, no predictive factors for probably successful outcome could be identified. Diminution in frequency of micturition (diurnal from 8.8 to 6.8 times, nocturnal from 3.0 to 1.6 times), increased flow rates (Q max from 8.8 to 14.2 ml/s) and reduction of detrusor pressures during voiding (Pdet max from 86.9 to 75.0 cm H2O) were significant, but the change in residual volume (from 52 to 37 ml) was of lesser degree (all mean values). Transurethral microwave thermotherapy can be tried for relief of moderate obstruction when transurethral prostatic resection involves risk, or the patient himself requests noninvasive treatment. PMID:8908654

Brehmer, M; Kinn, A C

1996-08-01

346

Review of Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia  

PubMed Central

The gold standard for symptomatic relief of bladder outlet obstruction secondary to benign prostatic hyperplasia has traditionally been a transurethral resection of the prostate (TURP). Over the past decade, however, novel laser technologies that rival the conventional TURP have multiplied. As part of the ongoing quest to minimize complications, shorten hospitalization, improve resection time, and most importantly reduce mortality, laser prostatectomy has continually evolved. Today, there are more variations of laser prostatectomy, each with several differing surgical techniques. Although abundant data are available confirming the safety and feasibility of the various laser systems, future randomized-controlled trials will be necessary to verify which technique is superior. In this review, we describe the most common modalities used to perform a laser prostatectomy, mainly, the holmium laser and the potassium-titanyl-phosphate lasers. We also highlight the physical and clinical characteristics of each technology with a review of the most current and highest-quality literature.

Choi, Benjamin B.

2013-01-01

347

Long-term effects of finasteride on prostate tissue composition  

Microsoft Academic Search

Objectives. To determine the long-term effects of finasteride treatment on prostate tissue composition; to relate these effects to clinical outcomes; and to test the hypothesis that finasteride exerts a selective or preferential action on the transition zone.Methods. Nineteen men with symptomatic benign prostatic hyperplasia (BPH) who completed a 6-month double-blind trial of finasteride were enrolled in a 24-month open-label extension

Leonard S. Marks; Alan W. Partin; Frederick J. Dorey; Glenn J. Gormley; Jonathan I. Epstein; Joel B. Garris; Maria Luz Macairan; Erlinda D. Shery; Paul Bryan Santos; Elizabeth Stoner; Jean B. deKernion

1999-01-01

348

Effect of finasteride on bother and other health-related quality of life aspects associated with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To investigate the long-term effects of finasteride on bother and health-related quality of life (HRQOL) in men with symptomatic benign prostatic hyperplasia.Methods. A large prospective 4-year placebo-controlled trial (PLESS) of 3040 men with moderate to severe lower urinary tract symptoms and an enlarged prostate was performed that included self-administered questionnaires assessing HRQOL.Results. Significantly greater reductions in bother score were

Reginald Bruskewitz; Cynthia J. Girman; Jackson Fowler; Odell F. Rigby; Michael Sullivan; R. Bruce Bracken; Harold A. Fusilier; Douglas Kozlowski; Scott D. Kantor; Edward Lee Johnson; Daniel Z. Wang; Joanne Waldstreicher

1999-01-01

349

Effects of pumpkin seed oil and saw palmetto oil in Korean men with symptomatic benign prostatic hyperplasia  

PubMed Central

This study was to investigate the role of complementary and alternative medicine in the prevention and treatment of benign prostatic hyperplasia. For this purpose, a randomized, double-blind, placebo-controlled trial was performed over 12 months on 47 benign prostatic hyperplasia patients with average age of 53.3 years and international prostate symptom score over 8. Subjects received either sweet potato starch (group A, placebo, 320 mg/day), pumpkin seed oil (group B, 320 mg/day), saw palmetto oil (group C, 320 mg/day) or pumpkin seed oil plus saw palmetto oil (group D, each 320 mg/day). International prostate symptom score, quality of life, serum prostate specific antigen, prostate volume and maximal urinary flow rate were measured. In groups B, C and D, the international prostate symptom score were reduced by 3 months. Quality of life score was improved after 6 months in group D, while those of groups B and C were improved after 3 months, compared to the baseline value. Serum prostate specific antigen was reduced only in group D after 3 months, but no difference was observed in prostate volume in all treatment groups. Maximal urinary flow rate were gradually improved in groups B and C, with statistical significance after 6 months in group B and after 12 months in group C. None of the parameters were significantly improved by combined treatment with pumpkin seed oil and saw palmetto oil. From these results, it is suggested that administrations of pumpkin seed oil and saw palmetto oil are clinically safe and may be effective as complementary and alternative medicine treatments for benign prostatic hyperplasia.

Hong, Heeok; Kim, Chun-Soo

2009-01-01

350

Nanostructured systems containing babassu (Orbignya speciosa) oil as a potential alternative therapy for benign prostatic hyperplasia  

PubMed Central

The oil of babassu tree nuts (Orbignya speciosa) is a potential alternative for treatment and prophylaxis of benign prostatic hyperplasia. Improved results can be obtained by drug vectorization to the hyperplastic tissue. The main objective of this work was the preparation and characterization of poly(lactic-co-glycolic acid) (PLGA) nanoparticle and clay nanosystems containing babassu oil (BBS). BBS was extracted from the kernels of babassu tree nuts and characterized by gas chromatography-mass spectrometry as well as 1H and 13C nuclear magnetic resonance. BBS-clay nanosystems were obtained by adding polyvinylpyrrolidone, Viscogel B8®, and BBS at a 2:1:1 mass ratio and characterized by X-ray diffraction, thermogravimetric analysis, infrared spectroscopy, and laser diffraction. The PLGA-BBS nanoparticles were prepared by the precipitation-solvent evaporation method. Mean diameter, polydispersity, zeta potential, and scanning electron microscopic images of the nanosystems were analyzed. Thermogravimetric analysis showed successful formation of the nanocomposite. PLGA nanoparticles containing BBS were obtained, with a suitable size that was confirmed by scanning electron microscopy. Both nanostructured systems showed active incorporation yields exceeding 90%. The two systems obtained represent a new and potentially efficient therapy for benign prostatic hyperplasia.

de Sousa, Valeria Pereira; Crean, Joanne; de Almeida Borges, Vinicius Raphael; Rodrigues, Carlos Rangel; Tajber, Lidia; Boylan, Fabio; Cabral, Lucio Mendes

2013-01-01

351

A PROSPECTIVE STUDY OF THE NATURAL HISTORY OF HEMATURIA ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA AND THE EFFECT OF FINASTERIDE  

Microsoft Academic Search

Purpose: We prospectively studied the effect of finasteride on chronic hematuria associated with benign prostatic hyperplasia. Materials and Methods: We prospectively evaluated 57 patients with chronic intermittent hematuria who were randomized to a finasteride treated or a control arm. Results: In the untreated control group hematuria recurred in 17 patients (63%) within a year but in only 4 (14%) in

STEPHEN J. FOLEY; LEMKIE Z. SOLOMAN; ANDREW W. WEDDERBURN; KASHIF M. KASHIF; DUNCAN SUMMERTON; VANESSA BASKETTER; SIMON A. V. HOLMES

2000-01-01

352

Effect of combination treatment on patient-related outcome measures in benign prostatic hyperplasia: clinical utility of dutasteride and tamsulosin  

PubMed Central

Background: Benign prostatic hyperplasia, the fourth most commonly diagnosed medical condition in the elderly, is a major underlying cause of lower urinary tract symptoms in men. Medical therapy is usually the first therapeutic option. Combination therapy is increasingly used for better symptom relief and outcome. Methods: We searched the literature using the MEDLINE database for the efficacy of combination therapy in men with benign prostatic hyperplasia in terms of symptom improvement and impact on quality of life. Results: Combination therapy with dutasteride and tamsulosin not only provides better symptom improvement and improved urinary flow rate, but is also associated with a more favorable impact on quality of life and patient satisfaction with treatment than monotherapy. Combination therapy also reduces the risk of events related to disease progression, such as acute urinary retention and benign prostatic hyperplasia-related surgery. Conclusion: Combination therapy with dutasteride and tamsulosin is highly efficacious as medical therapy for benign prostatic hyperplasia in patients with moderate-to-severe lower urinary tract symptoms.

Djavan, Bob; Dianat, Seyed Saeid; Kazzazi, Amir

2011-01-01

353

Nutraceuticals in Prostate Disease: The Urologist's Role  

PubMed Central

Interest in and use of complementary and alternative therapies, especially nutraceuticals, is high in prostate disease. These therapies have shown potential in benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer. Some have produced results equal to or better than pharmaceuticals currently prescribed for BPH. In category III prostatitis, some nutraceuticals may offer relief to patients who get little from standard therapy. Because it is becoming apparent that inflammation may play a role in the progression of BPH and development of prostate cancer, nutraceuticals, which commonly have anti-inflammatory properties, may play a role. These therapies have also shown potential in prostate cancer treatment and prevention, especially those that also reduce cardiovascular events or risk. Nevertheless, uses of some nutraceuticals in prostate disease have had less desirable consequences, showing lack of efficacy, adulteration, and/or severe side effects or drug interactions. By ensuring that these therapies undergo careful study for effectiveness, quality, and safety, urologists can look forward to adding them to their evidence-based armamentarium for prostate disease.

Curtis Nickel, J; Shoskes, Daniel; Roehrborn, Claus G; Moyad, Mark

2008-01-01

354

Oxytocin and prostatic function.  

PubMed

It is now well established that oxytocin is present in the mammalian testis and there is growing evidence that the peptide plays a role in the male reproductive tract by both assisting sperm transport and modulating steroidogenesis. In the testis, oxytocin has been shown not only to modulate testosterone production but also to increase the activity of the enzyme 5 alpha-reductase which converts testosterone to dihydrotestosterone (DHT). The prostate is an androgen-dependent organ with DHT being the active steroid. Oxytocin is present in the mammalian prostate. We have shown in the rat that levels of the peptide can be regulated by androgens, prostatic oxytocin concentrations being decreased by testosterone and increased following castration or treatment with an antiandrogen. Oxytocin treatment increases 5 alpha-reductase activity in the prostate of healthy young rats but, unlike the testis, this rise in enzyme activity is only transient. We thus propose that a local feedback mechanism may act to control prostatic levels of DHT and hence prostatic growth. Benign prostatic hyperplasia (BPH) is a common disease which affects both men and dogs. The aetiology of the disease is complex but both DHT and aging are important factors. Oxytocin levels are raised in prostatic tissue from dogs with BPH and the increase in peptide is accompanied by increased 5 alpha-reductase activity. Preliminary findings also suggest that prostatic oxytocin levels are raised in tissue from men with BPH. These data lead us to suggest that oxytocin may be involved in the pathophysiology of the prostate gland. PMID:8714010

Nicholson, H D; Jenkin, L

1995-01-01

355

Symptomatic BPH and hypertension: does comorbidity affect quality of life?  

PubMed

Most alpha 1-adrenoceptor antagonists are non-subtype selective and act on smooth muscle in the prostate, as well as in the vascular system and, as such, have effects on blood pressure as well as relieving LUTS (lower urinary tract symptoms) in symptomatic benign prostatic hyperplasia (BPH). As many elderly patients with LUTS also take concomitant antihypertensive therapy, it has been suggested by some that these patients should be treated with an alpha 1-adrenoceptor antagonist that targets both symptomatic BPH and hypertension simultaneously. However, an alternative school of thought believes that hypertension, as a malignant disease, should be treated optimally first, before the LUTS are controlled. Many different classes of antihypertensive drugs have been developed and evidence, with regard to reduction of cardiovascular morbidity and mortality, supports the use of diuretics and beta-blockers in this indication. However, from this point of view, few data support the use of alpha 1-adrenoceptor antagonists in antihypertensive therapy, and studies indicate that elderly patients in particular are prone to orthostatic hypotension and its effects when treated with alpha 1-adrenoceptor antagonists. This, together with the fact that hypertension is such a potentially morbid disease, suggests that alpha 1-adrenoceptor antagonists should not be used as a first line treatment for the treatment of hypertension. Rather, patients with comorbidity should be treated optimally for both diseases, being treated initially for hypertension with the optimal agent available and then with an alpha 1-adrenoceptor antagonist that is not haemodynamically active to target their LUTS. Tamsulosin, a selective alpha 1A-adrenoceptor antagonist, has no clinically significant effect on blood pressure compared with placebo, thus posing less risk for the patient, especially with regard to symptomatic orthostatic hypotension. PMID:9732826

Man in't Veld, A J

1998-01-01

356

Leukocytic Promotion of Prostate Cellular Proliferation  

PubMed Central

BACKGROUND Histological evidence of pervasive inflammatory infiltrate has been noted in both benign prostatic hyperplasia/hypertrophy (BPH) and prostate cancer (PCa). Cytokines known to attract particular leukocyte subsets are secreted from prostatic stroma consequent to aging and also from malignant prostate epithelium. Therefore, we hypothesized that leukocytes associated with either acute or chronic inflammation attracted to the prostate consequent to aging or tumorigenesis may promote the abnormal cellular proliferation associated with BPH and PCa. METHODS An in vitro system designed to mimic the human prostatic microenvironment incorporating prostatic stroma (primary and immortalized prostate stromal fibroblasts), epithelium (N15C6, BPH-1, LNCaP, and PC3 cells), and inflammatory infiltrate (HL-60 cells, HH, and Molt-3 T-lymphocytes) was developed. Modified Boyden chamber assays were used to test the ability of prostate stromal and epithelial cells to attract leukocytes and to test the effect of leukocytes on prostate cellular proliferation. Antibody arrays were used to identify leukocyte-secreted cytokines mediating prostate cellular proliferation. RESULTS Leukocytic cells migrated towards both prostate stromal and epithelial cells. CD4+ T-lymphocytes promoted the proliferation of both transformed and non-transformed prostate epithelial cell lines tested, whereas CD8+ T-lymphocytes as well as dHL-60M macrophagic and dHL-60N neutrophilic cells selectively promoted the proliferation of PCa cells. CONCLUSIONS The results of these studies show that inflammatory cells can be attracted to the prostate tissue microenvironment and can selectively promote the proliferation of non-transformed or transformed prostate epithelial cells, and are consistent with differential role(s) for inflammatory infiltrate in the etiologies of benign and malignant proliferative disease in the prostate.

McDowell, Kristy L.; Begley, Lesa A.; Mor-Vaknin, Nirit; Markovitz, David M.; Macoska, Jill A.

2011-01-01

357

Prostate-specific membrane antigen levels in sera from healthy men and patients with benign prostate hyperplasia or prostate cancer.  

PubMed

Prostate-specific membrane antigen (PSMA) serum levels have been proposed to be of prognostic significance in patients with advanced prostate disease. The objective of the present study was to confirm PSMA serum expression by Western blot techniques, to determine whether such data could assist in the differentiation of benign from malignant prostatic disease, and to determine the suitability of serum PSMA measurements in predicting recurrent or progressive prostate malignancies. We measured PSMA, a transmembrane glycoprotein identified in prostate epithelial cells, in the sera of 236 normal individuals and cancer patients by Western blot analysis. Within the normal male population, PSMA levels increase with age and were found to be significantly elevated in subjects more than 50 years of age when compared to those of younger men. We did not confirm previous reports that serum PSMA measurements could distinguish late-stage prostate carcinoma from early-stage prostate carcinoma, nor did we find PSMA to be more effective than prostate-specific antigen in monitoring prostate cancer patient prognosis. Furthermore, we found elevated serum PSMA in healthy females, and, similar to the healthy male population, the levels increased with age, with the highest levels found in the sera from breast cancer patients. These latter observations further support that PSMA is not a specific biomarker for prostate cancer and that a variety of normal and diseased tissue may contribute to the serum levels of PSMA. PMID:10632336

Beckett, M L; Cazares, L H; Vlahou, A; Schellhammer, P F; Wright, G L

1999-12-01

358

Vascular Endothelial Growth Factor (VEGF) Expression in Prostate Cancer and Benign Prostatic Hyperplasia  

Microsoft Academic Search

PurposeVascular endothelial growth factor (VEGF) is a potent inducer of endothelial cell growth and is expressed at elevated levels in several tumor types. In this study immunohistochemical localization and distribution of isoforms of VEGF were examined in malignant and non-malignant human prostatic tissues.

Michael W. Jackson; Jacqueline M. Bentel; Wayne D. Tilley

1997-01-01

359

Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial  

Microsoft Academic Search

ObjectivesTo evaluate the efficacy and tolerability of the selective alpha1-adrenergic antagonist doxazosin and the 5-alpha-reductase inhibitor finasteride, alone and in combination, for the symptomatic treatment of benign prostatic hyperplasia.

Roger S Kirby; Claus Roehrborn; Peter Boyle; Georg Bartsch; Alain Jardin; Margaret M Cary; Michael Sweeney; Eric B Grossman

2003-01-01

360

A 63 element 1.75 dimensional ultrasound phased array for the treatment of benign prostatic hyperplasia  

PubMed Central

Background Prostate cancer and benign prostatic hyperplasia are very common diseases in older American men, thus having a reliable treatment modality for both diseases is of great importance. The currently used treating options, mainly surgical ones, have numerous complications, which include the many side effects that accompany such procedures, besides the invasive nature of such techniques. Focused ultrasound is a relatively new treating modality that is showing promising results in treating prostate cancer and benign prostatic hyperplasia. Thus this technique is gaining more attention in the past decade as a non-invasive method to treat both diseases. Methods In this paper, the design, construction and evaluation of a 1.75 dimensional ultrasound phased array to be used for treating prostate cancer and benign prostatic hyperplasia is presented. With this array, the position of the focus can be controlled by changing the electrical power and phase to the individual elements for electronically focusing and steering in a three dimensional volume. The array was designed with a maximum steering angle of ± 13.5° in the transverse direction and a maximum depth of penetration of 11 cm, which allows the treatment of large prostates. The transducer piezoelectric ceramic, matching layers and cable impedance have been designed for maximum power transfer to tissue. Results To verify the capability of the transducer for focusing and steering, exposimetry was performed and the results correlated well with the calculated field. Ex vivo experiments using bovine tissue were performed with various lesion sizes and indicated the capability of the transducer to ablate tissue using short sonications. Conclusion A 1.75 dimensional array, that overcame the drawbacks associated with one-dimensional arrays, has been designed, built and successfully tested. Design issues, such as cable and ceramic capacitances, were taken into account when designing this array. The final prototype overcame also the problem of generating grating lobes at unwanted locations by tapering the array elements.

Saleh, Khaldon Y; Smith, Nadine Barrie

2005-01-01

361

Efficacy and Safety of the Selective ?1A-Adrenoceptor Blocker Silodosin for Severe Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Prospective, Single-Open-Label, Multicenter Study in Korea  

PubMed Central

Purpose To evaluate the efficacy and safety of silodosin 8 mg once daily in a 12-week treatment of subjects with severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Materials and Methods A total of 100 subjects from 10 urology centers in Korea were included in this study. The inclusion criteria were as follows: age ?50 years, International Prostate Symptom Score (IPSS) ?20, quality of life (QoL) score ?3, urine volume ?120 mL and maximal urinary flow rate (Qmax) <15 mL/s, and postvoid residual volume (PVR) <100 mL. We assessed the improvement of LUTS with change in IPSS, QoL score, Qmax, PVR, and adverse events at baseline and 4 and 12 weeks after treatment with silodosin 8 mg once daily. Results The IPSS values were 23.27±3.34, 15.89±6.26, and 13.80±6.31 at baseline, 4, and 12 weeks, respectively, with significant improvements (p<0.0001, p=0.0214, respectively). QoL scores were 4.44±0.85, 3.38±1.20, and 3.04±1.20 at baseline, 4, and 12 weeks, respectively, and the differences were statistically significant (p<0.0001). There was a significant difference in Qmax between baseline and 12 weeks (p<0.0001) but not in PVR (p=0.9404) during the clinical trial. The most frequent adverse event in this study was ejaculation failure with 13 cases. However, no subject dropped out because of ejaculation failure, and in 12 of the 13 cases it was fully resolved without further treatment. Conclusions Silodosin 8 mg once daily may be effective and safe in Korean patients with severe LUTS associated with BPH.

Moon, Ki Hak; Song, Phil Hyun; Yang, Dae Yul; Park, Nam Cheol; Kim, Soo Woong; Lee, Sung Won; Kim, Sae Woong; Moon, Du Geon; Park, Jong Kwan; Ahn, Tai Young

2014-01-01

362

GEOPHYSICS, ASTRONOMY AND ASTROPHYSICS: Second-harmonic generation as a DNA malignancy indicator of prostate glandular epithelial cells  

NASA Astrophysics Data System (ADS)

This paper first demonstrates second-harmonic generation (SHG) in the intact cell nucleus, which acts as an optical indicator of DNA malignancy in prostate glandular epithelial cells. Within a scanning region of 2.7 ?m×2.7 ?m in cell nuclei, SHG signals produced from benign prostatic hyperplasia (BPH) and prostate carcinoma (PC) tissues (mouse model C57BL/6) have been investigated. Statistical analyses (t test) of a total of 405 measurements (204 nuclei from BPH and 201 nuclei from PC) show that SHG signals from BPH and PC have a distinct difference (p < 0.05), suggesting a potential optical method of revealing very early malignancy in prostate glandular epithelial cells based upon induced biochemical and/or biophysical modifications in DNA.

Zhuang, Zheng-Fei; Liu, Han-Ping; Guo, Zhou-Yi; Zhuo, Shuang-Mu; Yu, Bi-Ying; Deng, Xiao-Yuan

2010-04-01

363

Expression of a flt-4 (VEGFR3) splicing variant in primary human prostate tumors. VEGF D and flt-4t?773–1081 overexpression is diagnostic for sentinel lymph node metastasis  

Microsoft Academic Search

Utilizing a cDNA expression library established from human prostate PC-3ML tumor cells, we have cloned a truncated flt-4 gene, termed flt-4t?773–1081. We have then utilized RNase protection and ELISA to measure the relative levels of VEGF B, C, D and flt-1, KDR, flt-4 and flt-4t?773–1081 expression in freshly isolated benign prostatic hyperplasia or BPH tissue (n=21), primary prostate cancers (n=82)

Mark E Stearns; Min Wang; Youji Hu; Greq Kim; Fernando U Garcia

2004-01-01

364

Importance of prostate volume and urinary flow rate in prediction of bladder outlet obstruction in men with symptomatic benign prostatic hyperplasia  

PubMed Central

Objectives To predict bladder outlet obstruction with parameters of non-invasive investigations for patients with symptomatic benign prostatic hyperplasia. Patients and methods A sample of 122 men with moderate to severe lower urinary tract symptoms suggestive of benign prostatic hyperplasia was selected. Transrectal prostate ultrasound, free flow measurement, and transabdominal ultrasound for residual urine were carried out together with digital rectal examination for all patients. All patients underwent urodynamic pressure/flow test. Two groups of obstructed (91 patient) and equivocal/unobstructed (31 patient) were analyzed. Probabilistic model based on logistic regression was developed for prediction of obstruction. Results Various parameters were compared in obstructed and non-obstructed/equivocal groups, highlighting important parameters for obstruction. Correlation analysis indicates higher obstruction dependence on average and peak flow rates and lower dependence on total prostate and transition zone volumes, transition zone index. Binary logistic regression model suggests that average flow rate combined with total prostate volume is the best predictor of obstruction (83% of correct predictions; PPV = 92%; NPV = 52%) in the analyzed sample. The analyzed model suggests that peak flow rate could also be almost equally important parameter instead of average flow rate. Conclusions The study suggests that average/peak flow rate combined with total prostate volume can be used for prediction of obstruction. The developed probabilistic model helps to determine patients who need invasive urodynamic testing for decision on surgical treatment.

Milonas, Daimantas; Jievaltas, Mindaugas; Matjosaitis, Aivaras Jonas; Kincius, Marius; Grybas, Aivaras; Kopustinskas, Vytis

2011-01-01

365

Inflammatory Mechanisms Associated with Prostatic Inflammation and Lower Urinary Tract Symptoms  

PubMed Central

Inflammation is a common finding in histologic prostate specimens obtained from aging men, and accumulating data suggest that inflammation may play an important role in the development of benign prostatic hyperplasia (BPH), and the development and progression of lower urinary tract symptoms (LUTS). Inflammatory processes may contribute to prostatic enlargement directly through stimulation of prostate growth, or, alternatively, through decreasing prostatic apoptosis. Additionally, inflammatory processes may impact other components of the urogenital tract, such as the bladder, and contribute to the LUTS that may be experienced both in the presence and in the absence of prostate enlargement. Current research therefore offers clues about converging inflammatory pathways which may be targeted to improve treatment of BPH and/or LUTS as well as identifying potential targets for prevention of these syndromes.

St. Sauver, Jennifer L.; Jacobsen, Steven J.

2009-01-01

366

A hybrid fuzzy-ontology based intelligent system to determine level of severity and treatment recommendation for Benign Prostatic Hyperplasia.  

PubMed

This paper deals with application of fuzzy intelligent systems in diagnosing severity level and recommending appropriate therapies for patients having Benign Prostatic Hyperplasia. Such an intelligent system can have remarkable impacts on correct diagnosis of the disease and reducing risk of mortality. This system captures various factors from the patients using two modules. The first module determines severity level of the Benign Prostatic Hyperplasia and the second module, which is a decision making unit, obtains output of the first module accompanied by some external knowledge and makes an appropriate treatment decision based on its ontology model and a fuzzy type-1 system. In order to validate efficiency and accuracy of the developed system, a case study is conducted by 44 participants. Then the results are compared with the recommendations of a panel of experts on the experimental data. Then precision and accuracy of the results were investigated based on a statistical analysis. PMID:24184111

Torshizi, Abolfazl Doostparast; Zarandi, Mohammad Hossein Fazel; Torshizi, Ghazaleh Doostparast; Eghbali, Kamyar

2014-01-01

367

Sustained-Release Alfuzosin, Finasteride and the Combination of Both in the Treatment of Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objectives: To assess the additive benefit of combining an ?1-blocker and a 5?-reductase inhibitor. Methods: This European, randomized, double-blind, multicenter trial involved 1.051 patients with lower urinary tract symptoms related to benign prostatic hyperplasia. Patients received sustained release (SR) alfuzosin (n = 358), a selective ?1-blocker given at a dose of 5 mg twice daily without dose titration; finasteride (n

F. M. J. Debruyne; A. Jardin; D. Colloi; L. Resel; W. P. J. Witjes; M. C. Delauche-Cavallier; C. McCarthy; C. Geffriaud-Ricouard

1998-01-01

368

SELECTIVITY OF FINASTERIDE AS AN IN VIVO INHIBITOR OF 5 alpha-REDUCTASE ISOZYME ENZYMATIC ACTIVITY IN THE HUMAN PROSTATE  

Microsoft Academic Search

The type II 5 alpha-reductase inhibitor finasteride is used in the treatment of benign prostatic hyperplasia (BPH), reducing local production of the growth promoting androgen dihydrotestosterone (DHT). The effect of prolonged treatment with this time-dependent irreversible inhibitor on the recently described prostatic type I 5 alpha-reductase, however, is not clear. Therefore, we assessed the effects of 5 mg. finasteride per

PAUL N. SPAN; MAUREEN C. W. VOLLER; ANTHONY G. H. SMALS; FRED G. J. SWEEP; JACK A. SCHALKEN; MARK R. FENELEY; ROGER S. KIRBY

1999-01-01

369

Non-Invasive Evaluation of Bladder Outlet Obstruction in Men Suspected of Benign Prostatic Hyperplasia: Usefulness of the D Index  

PubMed Central

Objective To compare a new index of voiding dysfunction (D) based purely on free uroflow vs. Abrams-Griffiths (A-G) number obtained from intubated flow, for classification of bladder outlet obstruction in men. Patients and Methods Urodynamic tracings of 60 non-neurological patients (30 before transurethral resection of the prostate and of 30 men suspected of benign prostatic hyperplasia included in a medical therapy trial) were retrospectively analyzed. The Valentini-Besson-Nelson model was used to evaluate the value of the D index. A-G was obtained from intubated flows. Obstruction was defined as D > 32.5 cm H2O (translation of A-G criterion). Results D showed 82.05% sensitivity with 66.66% specificity; the positive predictive value was 82.05% and the negative predictive value 66.66% for the whole population, 83.3 vs. 80.9% sensitivity with 58.3 vs. 77.7% specificity for pre- transurethral resection of the prostate vs. medical therapy group. Conclusion D index which can be obtained from a free uroflow appears as a valuable alternative to invasive urodynamic investigations when the diagnosis of bladder outlet obstruction needs to be more solidly established before a treatment decision or in men suspected of benign prostatic hyperplasia who elect for watchful waiting.

Valentini, Francoise A.; Nelson, Pierre P.; Zimmern, Philippe E.

2013-01-01

370

Transurethral laser coagulation of the prostate  

NASA Astrophysics Data System (ADS)

We describe the laser coagulation of the prostate using a conventional bare fiber inserted in a modified Albarran bridge which presents at the distal tip, a newly designed gold-plated reflector, connected by a deflecting mechanism. This allows delivery of laser energy (40 - 80 W) by direct reflection of the Nd:YAG laser light, an angularity more accentuated compared with other systems. Transurethral laser coagulation was performed on 25 patients for prostatic obstruction benign prostatic hyperplasia (BPH) and 6 selected patients for carcinoma of the prostate (December 91 - January 93). Patient selection (BPH) was limited to median lobe (range 50 - 55 years), small prostates, older and high-risk patients. Successful results were noted in 20 of the 25 cases of BPH group (80%). A significant reduction of obstructive symptoms was associated with an increase of maximal a medium flow rates. In the early prostate cancer group, the method has resulted in 3 patients with no evidence of disease, despite repeated biopsy, biochemical, and clinical investigations (PSA range level > 20 ng/ml to < 0.5 ng/ml at one year). The results are encouraging at this stage.

Mattioli, Stefano; Cremona, M.

1994-02-01

371

Holmium Laser Enucleation versus Transurethral Resection in Patients with Benign Prostate Hyperplasia: An Updated Systematic Review with Meta-Analysis and Trial Sequential Analysis  

PubMed Central

Background Holmium laser enucleation (HoLEP) in surgical treatment of benign prostate hyperplasia (BPH) potentially offers advantages over transurethral resection of the prostate (TURP). Methods Published randomized controlled trials (RCTs) were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Library up to October 10, 2013 (updated on February 5, 2014). After methodological quality assessment and data extraction, meta-analysis was performed using STATA 12.0 and Trial Sequential Analysis (TSA) 0.9 software. Results Fifteen studies including 8 RCTs involving 855 patients met the criteria. The results of meta-analysis showed that: a) efficacy indicators: there was no significant difference in quality of life between the two groups (P>0.05), but compared with the TURP group, Qmax was better at 3 months and 12 months, PVR was less at 6, 12 months, and IPSS was lower at 12 months in the HoLEP, b) safety indicators: compared with the TURP, HoLEP had less blood transfusion (RR 0.17, 95% CI 0.06 to 0.47), but there was no significant difference in early and late postoperative complications (P>0.05), and c) perioperative indicators: HoLEP was associated with longer operation time (WMD 14.19 min, 95% CI 6.30 to 22.08 min), shorter catheterization time (WMD ?19.97 h, 95% CI ?24.24 to ?15.70 h) and hospital stay (WMD ?25.25 h, 95% CI ?29.81 to ?20.68 h). Conclusions In conventional meta-analyses, there is no clinically relevant difference in early and late postoperative complications between the two techniques, but HoLEP is preferable due to advantage in the curative effect, less blood transfusion rate, shorter catheterization duration time and hospital stay. However, trial sequential analysis does not allow us to draw any solid conclusion in overall clinical benefit comparison between the two approaches. Further large, well-designed, multicentre/international RCTs with long-term data and the comparison between the two approaches remain open.

Ruan, Xiao-Lan; Weng, Hong; Liu, Tong-Zu; Wang, Xiao; Zhang, Chao; Meng, Zhe; Wang, Xing-Huan

2014-01-01

372

Development of a doxazosin and finasteride transdermal system for combination therapy of benign prostatic hyperplasia.  

PubMed

The treatment of benign prostatic hyperplasia can be accomplished by the use of different drugs including, doxazosin, an ?-1 adrenergic antagonist, and finasteride (FIN), a 5-? reductase inhibitor. Traditionally, treatments using these drugs have been administered as either a mono or combination therapy by the oral route. A transdermal delivery system optimized for doxazosin and FIN combination therapy would provide increased patient adherence and facilitate dose adjustment. Doxazosin base (DB) was prepared from doxazosin mesylate and characterized together with FIN, by X-ray powder diffraction (XRD), differential scanning calorimetry (DSC), and nuclear magnetic resonance (NMR). The permeation enhancers, azone and lauric acid, and the gelling agents, hydroxypropyl cellulose (HPC) and Poloxamer 407 (P407), were evaluated to determine their ability to promote in vitro permeation of drugs through the pig ear epidermis. Successful preparation of DB was confirmed by evaluating the XRD, DSC, and NMR patterns and in vitro studies revealed that 3% (w/w) azone was the best permeation enhancer. When P407 gel was compared with HPC gel, it showed reduced lag time and promoted higher permeation of both drugs. This may be because of the interactions of the former with the stratum corneum, which disorganizes the lipid structure and consequently promotes higher drug permeation. PMID:23983168