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1

Benign prostate hyperplasia (BPH) - resources  

MedlinePLUS

Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... The following organizations provide information on benign prostatic hyperplasia ( prostate enlargement ... Urology Care Foundation - www. ...

2

Role of laser therapy in benign prostate hyperplasia (BPH)  

Microsoft Academic Search

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

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

2001-01-01

3

Increased Infiltrated Macrophages in Benign Prostatic Hyperplasia (BPH)  

PubMed Central

Infiltrated macrophages may play important roles in the development and progression of benign prostatic hyperplasia (BPH), but the underlying mechanisms remain largely unknown. We found increased macrophages infiltration in human and mouse BPH tissues. By establishing a co-culture transwell system, we found increased migration of macrophages and proliferation of prostate stromal cells during co-culture. Importantly, stromal androgen receptor (AR) could enhance the migration of macrophages and macrophage-mediated stromal cell proliferation. We identified CCL3 as an AR downstream player, and found CCL3 levels were notably increased in human and mouse BPH prostates. Ablation of prostate stromal AR in a mouse BPH model significantly reduced CCL3 expression levels in prostates. Consistently, targeting AR via an AR degradation enhancer, ASC-J9§, or neutralization of CCL3 with an antibody, resulted in suppression of macrophage migration and prostate stromal cell growth. Our study provides mechanistic insights on the regulation of prostate stromal cells by macrophages via stromal AR/CCL3 signaling pathways, which could potentially allow the development of therapeutic approaches for battling BPH with persistent inflammation. PMID:22474290

Wang, Xiaohai; Lin, Wen-Jye; Izumi, Kouji; Jiang, Qi; Lai, Kuo-Pao; Xu, Defeng; Fang, Lei-Ya; Lu, Tianjing; Li, Lei; Xia, Shujie; Chang, Chawnshang

2012-01-01

4

Targeting Stromal Androgen Receptor Suppresses Prolactin-Driven Benign Prostatic Hyperplasia (BPH)  

PubMed Central

Stromal-epithelial interaction plays a pivotal role to mediate the normal prostate growth, the pathogenesis of benign prostatic hyperplasia (BPH), and prostate cancer development. Until now, the stromal androgen receptor (AR) functions in the BPH development, and the underlying mechanisms remain largely unknown. Here we used a genetic knockout approach to ablate stromal fibromuscular (fibroblasts and smooth muscle cells) AR in a probasin promoter-driven prolactin transgenic mouse model (Pb-PRL tg mice) that could spontaneously develop prostate hyperplasia to partially mimic human BPH development. We found Pb-PRL tg mice lacking stromal fibromuscular AR developed smaller prostates, with more marked changes in the dorsolateral prostate lobes with less proliferation index. Mechanistically, prolactin mediated hyperplastic prostate growth involved epithelial-stromal interaction through epithelial prolactin/prolactin receptor signals to regulate granulocyte macrophage-colony stimulating factor expression to facilitate stromal cell growth via sustaining signal transducer and activator of transcription-3 activity. Importantly, the stromal fibromuscular AR could modulate such epithelial-stromal interacting signals. Targeting stromal fibromuscular AR with the AR degradation enhancer, ASC-J9®, led to the reduction of prostate size, which could be used in future therapy. PMID:23893956

Lai, Kuo-Pao; Huang, Chiung-Kuei; Fang, Lei-Ya; Izumi, Kouji; Lo, Chi-Wen; Wood, Ronald; Kindblom, Jon; Yeh, Shuyuan

2013-01-01

5

Effect of Pumpkin Seed (Cucurbita pepo L.) Diets on Benign Prostatic Hyperplasia (BPH): Chemical and Morphometric Evaluation in Rats  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) is a common disease in elderly men. Although it is a non - malignant disease, it can have a significant impact on the quality of life of elderly men. The pumpkin seed is claimed to be useful in the management of BPH. This investigation analysed the chemical composition of pumpkin seeds and examined its effect on

Manal K Abdel-Rahman

2006-01-01

6

BPH and prostate cancer risk  

PubMed Central

Introduction: With the exclusion of non-melanomatous skin malignancy, prostate cancer (PCa) is the second most prevalent cancer in men globally. It has been reported that the majority of men will develop benign prostatic hyperplasia (BPH) by the time they reach their 60s. Together, these prostatic diseases have a significant morbidity and mortality affecting over a billion men throughout the world. The risk of developing prostate cancer of men suffering BPH is one that has resulted in a healthy debate amongst the urological community. Here, we try to address this conundrum with clinical and basic science evidence. Materials and Methods: Data from an online search and contemporary data presented at international urological congresses was reviewed. Results: BPH and PCa can be linked together at a molecular and cellular level on genetic, hormonal, and inflammatory platforms suggesting that these prostatic diseases have common pathophysiological driving factors. Epidemiological studies are weighted towards the presence of BPH having a greater risk for a man to develop PCa in his lifetime; however, a conclusion of causality cannot be confidently stated. Conclusion: The future workload healthcare practitioners will face regarding BPH, and PCa will substantially increase. Further basic science and large epidemiological studies using a global cohort of men are required prior to the urological community confidently counseling their patients with BPH with regards to their PCa risk. PMID:24744523

Miah, Saiful; Catto, James

2014-01-01

7

Androgen Concentrations and Their Receptors in the Periurethral Region Are Higher Than Those of the Subcapsular Zone in Benign Prostatic Hyperplasia (BPH)  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) is an androgen- dependent disease that initially develops in the inner prostate, where the highest concentrations of testosterone (T) and dihydrotestoster- one (DHT) are found. In this study, we have evaluated the cytosolic androgen receptors (ARc), the nuclear androgen receptors (ARn), and the concentrations of T, DHT, and 3cs-androstanediol (3cxDiol) in BPH tissue to verify the

SALVATORE MONTI; FRANCO DI SILVERIO; VINCENZO TOSCANO; CHIARA MARTINI; STEFANIA LANZARA; PAOLA A. VARASANO; FRANCESCO SCIARRA

8

The Impact of Nocturia on Health Status and Quality of Life in Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia (LUTS\\/BPH)  

Microsoft Academic Search

Nocturia (nocturnal voiding) is a common condition in the older population and its prevalence increases with age. Although the aetiology of nocturia may be multifactorial, a main cause in older men is benign prostatic hyperplasia\\/bladder outlet obstruction (BPH\\/BOO). Nocturia is experienced as one of the most bothersome symptoms of lower urinary tract symptoms (LUTS) suggestive of BPH\\/BOO by the patient

Claude C. Schulman; Ragnar Asplund; François Desgrandchamps; Udo Jonas

2005-01-01

9

Prostate . Author manuscript Inflammation in benign prostatic hyperplasia: a 282 patients'  

E-print Network

Prostate . Author manuscript Page /1 7 Inflammation in benign prostatic hyperplasia: a 282 patients be a key component in prostate enlargement and benign prostatic hyperplasia (BPH) progression. Our aim Analysis ; Middle Aged ; Prostatic Hyperplasia ; complications ; pathology ; Prostatitis ; complications

Boyer, Edmond

10

TREATMENT OF BENIGN PROSTATIC HYPERPLASIA  

Microsoft Academic Search

The treatment of benign prostatic hyperplasia (BPH) has implications which affect the majority of the adult male population. Although benign compared to prostate cancer, clinical symptoms can dramatically alter the quality of life. The hyperplastic tissue can cause constriction of the urethra and thus affect voiding of urine. Factors to consider for thermally-based treatments of the prostate include minimization of

Jonathan W. Valvano; David Y. Yuan; Eric N. Rudie; Steven J. Clark

11

Enlarged Prostate (BPH)  

MedlinePLUS

... is weak, slow, or stops and starts several times The feeling that you still have to go, ... urine Severe BPH can cause serious problems over time, such as urinary tract infections, and bladder or ...

12

Androgen concentrations and their receptors in the periurethral region are higher than those of the subcapsular zone in benign prostatic hyperplasia (BPH).  

PubMed

Benign prostatic hyperplasia (BPH) is an androgen-dependent disease that initially develops in the inner prostate, where the highest concentrations of testosterone (T) and dihydrotestosterone (DHT) are found. In this study, we have evaluated the cytosolic androgen receptors (ARc), the nuclear androgen receptors (ARn), and the concentrations of T, DHT, and 3alpha-androstanediol (3alphaDiol) in BPH tissue to verify the existence of a possible correlation between androgens and their receptor concentrations. Prostatic samples, removed by suprapubic prostatectomy in 15 untreated patients, were sectioned in periurethral, intermediate, and subcapsular zones. Testosterone, DHT, and 3alphaDiol were evaluated by radioimmunoassay after extraction and purification on celite microcolumns, and ARc and ARn were evaluated by means of dextran-coated charcoal method. In total tissue, mean levels of DHT, T, and 3alphaDiol were 2,531+/-308, 260+/-36, and 403+/-35 pg/mg of DNA (mean+/-SE), respectively. Cytosolic androgen receptors, detectable in all cases, were 16+/-2.8 fmol/mg of protein (mean+/-SE), and ARn, detectable in 12 cases, were 108+/-15 fmol/mg of DNA (mean+/-SE). A linear correlation between DHT and 3alphaDiol, T and DHT, and 3alphaDiol and ARn was found. If the different regions are considered, the periurethral zone, site of the primitive BPH nodule, presents the highest levels of androgens and ARn with respect to the other regions. This relative hyperandrogenism may be responsible for the growth-promoting processes of this area, leading to urinary obstruction. PMID:9733145

Monti, S; Di Silverio, F; Toscano, V; Martini, C; Lanzara, S; Varasano, P A; Sciarra, F

1998-01-01

13

Benign Prostatic Hyperplasia: An Overview  

PubMed Central

Despite the deceptively simple description of benign prostatic hyperplasia (BPH), the actual relationship between BPH, lower urinary tract symptoms (LUTS), benign prostatic enlargement, and bladder outlet obstruction is complex and requires a solid understanding of the definitional issues involved. The etiology of BPH and LUTS is still poorly understood, but the hormonal hypothesis has many arguments in its favor. There are many medical and minimally invasive treatment options available for affected patients. In the intermediate and long term, minimally invasive treatment options are superior to medical therapy in terms of symptom and flow rate improvement; tissue ablative surgical treatment options are superior to both minimally invasive and medical therapy. PMID:16985902

Roehrborn, Claus G

2005-01-01

14

Laser treatment of symptomatic benign prostatic hyperplasia  

Microsoft Academic Search

The treatment of lower urinary symptoms secondary to benign prostatic hyperplasia (BPH) after failure of medical therapies remains controversial for most urologic surgeons. The complications of traditional surgery are the driving force behind the development of several minimally invasive treatments of symptomatic BPH. Laser prostatectomy is one of the most investigated such modalities. In this article we reviewed the results

Ehab A. Elzayat; Mostafa M. Elhilali

2006-01-01

15

New concepts in tissue specificity for prostate cancer and benign prostatic hyperplasia  

Microsoft Academic Search

Of the hundreds of species of mammals, all of which have prostate glands, only humans and dogs are known to suffer from benign prostatic hyperplasia (BPH) and prostate carcinoma. In humans, prostate carcinoma is common, yet carcinomas of other sex accessory tissues are rare. In addition, different anatomic regions within the prostate gland have very different rates of BPH and

Angelo M De Marzo; Donald S Coffey; William G Nelson

1999-01-01

16

Recent Developments in the Surgical Management of Benign Prostatic Hyperplasia  

Microsoft Academic Search

A new era in the surgical management of benign prostatic hyperplasia (BPH) has emerged in the past decade. A variety of less invasive treatment modalities have been introduced and well-established surgical treatments are being reassessed. Although progress has been made in the management of BPH, the substantial economic burden to the healthcare system caused by BPH emphasizes the importance of

Jan V Jepsen; Reginald C Bruskewitz

1998-01-01

17

Laser Treatment of Benign Prostatic Hyperplasia: Dosimetric and Thermodynamic Considerations  

Microsoft Academic Search

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

Bahman Anvari

1993-01-01

18

Benign prostatic hyperplasia: age-related tissue-remodeling  

Microsoft Academic Search

Aging and androgens are the two established risk factors for the development of benign prostatic hyperplasia (BPH) and benign prostatic enlargement (BPE), which can lead to lower urinary tract symptoms (LUTS) in elderly men. BPH, consisting of a nodular overgrowth of the epithelium and fibromuscular tissue within transition zone and periurethral areas, is first detectable around the fourth decade of

Gerold Untergasser; Stephan Madersbacher; Peter Berger

2005-01-01

19

A Randomized Study Comparing Visual Laser Ablation and Transurethral Evaporation of Prostate in the Management of Benign Prostatic Hyperplasia  

Microsoft Academic Search

PurposeWe evaluated the safety, efficacy, failure and complications of 2 techniques of laser prostatectomy for benign prostatic hyperplasia (BPH): transurethral evaporation of the prostate (evaporation) versus visual laser ablation of the prostate (coagulation) in a randomized trial.

Ashutosh Tewari; Sherif Aboseif; Christopher Evans

1995-01-01

20

Laser application of the benign prostatic hyperplasia  

Microsoft Academic Search

Summary form only given. Most urologists still think that a fundamental treatment method for the BPH (benign prostatic hyperplasia) is the TUR (transurethral resection). However, a group of urologists and medical engineers have developed a variety of equipment that were designed to cover the demerits of the TUR based on the concept of thermotherapy. Though much of the equipment has

Sung Won Kwon

1999-01-01

21

Hormonal manipulation of benign prostatic hyperplasia  

Microsoft Academic Search

PURPOSE OF REVIEW: We provide new viewpoints of hormonal control of benign prostatic hyperplasia (BPH). The latest treatment findings with 5-alpha reductase inhibitors (5-ARIs) finasteride and dutasteride, refined indications, efficacy, and safety are discussed and compared. We also discuss potential new 5-ARIs and other hormonal treatments. RECENT FINDINGS: Finasteride and dutasteride have equal efficacy and safety for the treatment and

F. G. Rick; S. H. Saadat; L. Szalontay; N. L. Block; A. Kazzazi; B. Djavan; A. V. Schally

2013-01-01

22

Dihydrotestosterone and the concept of 5a-reductase inhibition in human benign prostatic hyperplasia  

Microsoft Academic Search

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

G. Bartsch; R. Rittmaster; H. Klocker

2002-01-01

23

Interstitial low-power diode laser treatment for benign prostatic hyperplasia  

Microsoft Academic Search

Summary form only given. Benign Prostatic Hyperplasia (BPH) is one of the most common medical problem in older men. Growth in prostatic tissue obstructs the outflow of urine, slowing urination and making it impossible to completely void the bladder. The existing approved treatments for BPH are not satisfactory in many sufferers of BPH. The device in this discussion is a

R. L. Conn; C. S. Adams; V. Esch

1995-01-01

24

Synergistic interaction of benign prostatic hyperplasia and prostatitis on prostate cancer risk  

PubMed Central

Background: The incidence of prostate cancer is much lower in Asian men than in Western men. This study investigated whether prostate cancer is associated with prostatitis, benign prostatic hyperplasia (BPH), and other medical conditions in the low-incidence population. Methods: From the claims data obtained from the universal National Health Insurance of Taiwan, we identified 1184 patients with prostate cancer diagnosed from 1997 to 2008. Controls comprised 4736 men randomly selected from a cancer-free population. Both groups were 50 years of age or above. Medical histories between the two groups were compared. Results: Multivariate logistic regression analysis showed that prostatitis and BPH had stronger association with prostate cancer than the other medical conditions tested. Compared with men without prostatitis and BPH, a higher odds ratio (OR) for prostate cancer was associated with BPH (26.2, 95% confidence interval (CI) 20.8–33.0) than with prostatitis (10.5, 95% CI=3.36–32.7). Men with both conditions had an OR of 49.2 (95% CI=34.7–69.9). Conclusion: Men with prostate cancer have strong association with prostatitis and/or BPH. Prostatitis interacts with BPH, resulting in higher estimated relative risk of prostate cancer in men suffering from both conditions. PMID:23612451

Hung, S-C; Lai, S-W; Tsai, P-Y; Chen, P-C; Wu, H-C; Lin, W-H; Sung, F-C

2013-01-01

25

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. PMID:20027305

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

26

KTP laser selective vaporization of the prostate in the management of urinary retention due to BPH  

NASA Astrophysics Data System (ADS)

High-powered photoselective vaporization of the prostate (PVP) is a relatively new addition in the armamentarium against bladder outlet obstruction due to BPH. With BPH, the prostate undergoes stromal and epithelial hyperplasia, particularly in the transitional zone, mediated by dihydrotestosterone (DHT). This periurethral enlargement can compress the prostatic urethra leading to bladder outlet obstruction and eventually urinary retention. Treatment of uncomplicated symptomatic BPH has evolved from the standard transurethral resection of the prostate (TURP) to multiple medical therapies and the putative minimally invasive surgical procedures. These include microwave ablation, needle ablation, balloon dilation, stents, as well as fluid based thermo-therapy, ultrasound therapy and cryotherapy. Different forms of lasers have been applied to treat BPH with variable short and long term benefits of urinary symptoms. However, the controversy remains about each laser regarding its technical applicability and efficacy.

Kleeman, M. W.; Nseyo, Unyime O.

2003-06-01

27

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

28

Serum prostate-specific antigen as a predictor of prostate volume in men with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To assess the utility of prostate-specific antigen (PSA) as a predictor of prostate volume by characterizing the relationship between prostate volume and serum PSA in men with symptomatic benign prostatic hyperplasia (BPH) and no evidence of prostate cancer, stratified by decade of life.Methods. Placebo-controlled multicenter trials in patients with BPH and a safety study in normal young men provided

Claus G. Roehrborn; Peter Boyle; A. Lawrence Gould; Joanne Waldstreicher

1999-01-01

29

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

30

Prostate Enlargement: Benign Prostatic Hyperplasia (BPH)  

MedlinePLUS

... care provider’s office or a commercial facility. A health care provider tests the sample during an office visit or sends ... bladder and urethra store and release urine. A health care provider performs urodynamic tests during an office visit or in an outpatient ...

31

Laser treatment of benign prostatic hyperplasia  

Microsoft Academic Search

To evaluate the role of lasers that allow acute removal of obstructing tissue in the surgical treatment of benign prostatic\\u000a hyperplasia (BPH). A MEDLINE search over the last 6 years focused on randomized trials, large case series and review articles.\\u000a A total of more than 4,000 patients were analyzed with respect to the morbidity and outcome, and the advantages and disadvantages

Rainer M. Kuntz

2007-01-01

32

Citrate as an in vivo marker to discriminate prostate cancer from benign prostatic hyperplasia and normal prostate peripheral zone: Detection via localized proton spectroscopy  

Microsoft Academic Search

ObjectivesThis study was designed to determine whether citrate levels detected by localized 1H spectroscopy could reliably discriminate regions of prostate adenocarcinoma from surrounding regions of normal peripheral zone and benign prostatic hyperplasia (BPH).

John Kurhanewicz; Daniel B. Vigneron; Sarah J. Nelson; Hedvig Hricak; Jeffrey M. MacDonald; Badrinath Konety; Perinchery Narayan

1995-01-01

33

Historical Aspects of Laser Therapy for Benign Prostatic Hyperplasia  

Microsoft Academic Search

The gold standard treatment of benign prostatic hyperplasia (BPH) has been the transurethral resection of the prostate (TURP). However, this procedure is associated with a number of complications, and other surgical therapies, including laser prostatectomy, have been developed to overcome these issues. Laser prostatectomy involves tissue coagulation or vaporization. Coagulation of the tissue results in debulking of the gland through

Jean de la Rosette; Edward Collins; Alexander Bachmann; Benjamin Choi; Gordon Muir; Oliver Reich; Fernando Gómez Sancha; Shahin Tabatabaei; Henry Woo

2008-01-01

34

Photoselective vaporization of the prostate for treating benign prostatic hyperplasia.  

PubMed

Benign prostatic hyperplasia (BPH) commonly occurs in older men. Traditionally, the gold standard for treatment of BPH has been the electrocautery-based transurethral resection of the prostate (TURP). However, TURP is associated with several complications and side effects. Therefore, there is an interest in a number of emerging minimally invasive therapies as alterative treatment options. Advancements in laser technology have led to the introduction of photoselective vaporization of the prostate (PVP) using the GreenLight™ laser (American Medical Systems, MN, USA). PVP uses a 532-nm laser to remove obstructive prostatic tissue. The laser energy is selectively absorbed by hemoglobin in the prostate tissue and results in tissue destruction. The GreenLight PVP laser system has gone through several evolutions from the original 60-W laser to the most recent 180-W GreenLight XPS™ system with MoXy™ Fiber. With the increasing use of GreenLight to treat BPH, there is a need to review the evidence regarding its use. We review the clinical implications of using GreenLight laser therapy for the treatment of BPH. PMID:22026624

Chughtai, Bilal; Te, Alexis

2011-09-01

35

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

36

Holmium Laser Approaches to Symptomatic Benign Prostatic Hyperplasia  

Microsoft Academic Search

The holmium laser is a well-established instrument in the treatment of a variety of urologic conditions. Treatment of benign\\u000a prostatic hyperplasia (BPH) with the holmium laser has grown steadily over the past decade, with multiple studies demonstrating\\u000a its role as an effective alternative to other transurethral and open surgical treatments of BPH. This review describes current\\u000a surgical techniques that employ

Andrew C. Boylan; Lori B. Lerner

37

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). PMID:23092781

Elhilali, Mostafa M.

2012-01-01

38

Laser Treatment of Benign Prostatic Hyperplasia in Patients on Oral Anticoagulant Therapy  

Microsoft Academic Search

Because the number of patients requiring oral anticoagulation (OA) is steadily growing, more and more patients requiring surgical\\u000a treatment of benign prostatic hyperplasia (BPH) are on OA. Laser treatment of BPH was said to offer a higher quality of hemostasis\\u000a than transurethral resection of the prostate (TURP). Thus, laser was considered an interesting tool for BPH surgery in patients\\u000a on

Julien Berger; Gregoire Robert; Aurelien Descazeaud

2010-01-01

39

Initial human clinical experience with diode laser interstitial treatment of benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesTo report the initial results of treatment of outlet obstruction induced by benign prostatic hyperplasia (BPH) using interstitial laser coagulation performed with the Indigo 830 nm diode laser system.

Rolf Muschter; Jean J. M. C. H. De La Rosette; Hugh Whitfield; Jean-Pierre Pellerin; Stephan Madersbacher; David Gillatt

1996-01-01

40

Antagonists of growth hormone-releasing hormone (GHRH) reduce prostate size in experimental benign prostatic hyperplasia  

Microsoft Academic Search

Growth hormone-releasing hormone (GHRH), a hypothalamic polypeptide, acts as a potent autocrine\\/paracrine growth factor in many cancers. Benign prostatic hyperplasia (BPH) is a pathologic proliferation of prostatic glandular and stromal tissues; a variety of growth factors and inflammatory processes are inculpated in its pathogenesis. Previously we showed that potent synthetic antagonists of GHRH strongly inhibit the growth of diverse experimental

F. G. Rick; A. V. Schally; N. L. Block; M. Nadji; K. Szepeshazi; M. Zarandi; I. Vidaurre; R. Perez; G. Halmos; L. Szalontay

2011-01-01

41

Estimated costs of treatment of benign prostate hyperplasia in Brazil  

Microsoft Academic Search

Introduction: The treatment of benign prostate hyperplasia (BPH) presents 2 options: medi- cal or surgical, and there are doubts about what is the best treatment since 80% of patients who undergo surgery become asymptomatic and 10 to 40% of those under medical regimen undergo sur- gery within a 5 years period. It is difficult to assess the actual costs of

Haylton J. Suaid; Marco A. Gonçalves; Antonio A. Rodrigues Jr; João P Cunha; Adauto J. Cologna; Antonio C. P. Martins

2003-01-01

42

Differences in stress response between patients undergoing transurethral resection versus endoscopic laser ablation of the prostate for benign prostatic hyperplasia  

Microsoft Academic Search

The objective of the study was to determine the differences in systemic stress response in patients undergoing transurethral\\u000a resection of the prostate (TURP) versus endoscopic laser ablation of the prostate (ELAP) for benign prostatic hyperplasia\\u000a (BPH). The study included 48 patients with BPH (24 treated by TURP and 24 by ELAP). Blood samples were taken from each patient\\u000a before and

Goran Bedalov; Zeljko Bartolin; Damir Puskar; Ivan Savi?; Ivana Bedalov; Marija Rudolf; Drago Batini?

2008-01-01

43

Simple case definition of clinical benign prostatic hyperplasia, based on International Prostate Symptom Score, predicts general practitioner consultation rates  

Microsoft Academic Search

ObjectivesTo determine which case-definition of clinical benign prostatic hyperplasia (BPH) has the best predictive value for general practitioner visits for lower urinary tract symptoms (LUTS) suggestive of BPH. The incidence and prevalence rates of general practitioner visits for LUTS were also determined.

Esther T. Kok; Arthur M. Bohnen; Rikkert Jonkheijm; Jochem Gouweloos; Frans P. M. J. Groeneveld; Siep Thomas; J. L. H. Ruud Bosch

2006-01-01

44

New laser treatment approaches for benign prostatic hyperplasia  

Microsoft Academic Search

The recent introduction of higher power 100 W holmium: yttrium-aluminum-garnet (Ho:YAG) and 80 W potassium titanyl phosphate\\u000a lasers for rapid incision and vaporization of the prostate has resulted in renewed interest in the use of lasers for treatment\\u000a of benign prostatic hyperplasia (BPH). Although long-term studies are still lacking, short-term results demonstrate that these\\u000a procedures are at least as safe

Nathaniel M. Fried

2007-01-01

45

The natural history of benign prostatic hyperplasia: what have we learned in the last decade?  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) frequently has a significant detrimental impact on a patient’s quality of life. If the disease is left untreated, it may progress in severity, leading to recurrent bladder infections, bladder calculi, and acute urinary retention (AUR), necessitating surgical treatment. The Forth Valley, Scotland, study reported that 14% of men aged 40 to 50 years have BPH. This

Roger S Kirby

2000-01-01

46

Current Trends in Management of Men With Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia  

Microsoft Academic Search

Management of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) has been central to urology for decades. The urologic community has increasingly come to realize that many men with LUTS do not have prostate enlargement and do not need their prostates debulked surgically. Of all the factors that have emerged to alter the trends associated with management of

H. Logan Holtgrewe

1998-01-01

47

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. PMID:21455413

Dhingra, Neelima; Bhagwat, Deepak

2011-01-01

48

Androgens and estrogens in benign prostatic hyperplasia: past, present and future  

PubMed Central

Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are common clinical problems in urology. While the precise molecular etiology remains unclear, sex steroids have been implicated in the development and maintenance of BPH. Sufficient data exists linking androgens and androgen receptor pathways to BPH and use of androgen reducing compounds, such as 5?-reductase inhibitors which block the conversion of testosterone into dihydrotestosterone, are a component of the standard of care for men with LUTS attributed to an enlarged prostate. However, BPH is a multifactorial disease and not all men respond well to currently available treatments, suggesting factors other than androgens are involved. Testosterone, the primary circulating androgen in men, can also be metabolized via CYP19/aromatase into the potent estrogen, estradiol-17?. The prostate is an estrogen target tissue and estrogens directly and indirectly affect growth and differentiation of prostate. The precise role of endogenous and exogenous estrogens in directly affecting prostate growth and differentiation in the context of BPH is an understudied area. Estrogens and selective estrogen receptor modulators (SERMs) have been shown to promote or inhibit prostate proliferation signifying potential roles in BPH. Recent research has demonstrated that estrogen receptor signaling pathways may be important in the development and maintenance of BPH and LUTS; however, new models are needed to genetically dissect estrogen regulated molecular mechanisms involved in BPH. More work is needed to identify estrogens and associated signaling pathways in BPH in order to target BPH with dietary and therapeutic SERMs. PMID:21620560

Nicholson, Tristan M.; Ricke, William A.

2011-01-01

49

About the Prostate  

MedlinePLUS

... Wellness PCF Spotlight Glossary African American Men Understanding Prostate Cancer About the Prostate About the Prostate What Can ... Prostate? Benign Prostatic Hyperplasia (BPH) Prostatitis What is Prostate Cancer? English | Español The more you know about the ...

50

Holmium laser enucleation of the prostate combined with mechanical morcellation in 155 patients with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To report our experience with holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation for the treatment of symptomatic benign prostatic hyperplasia (BPH).Methods. From January 2000 to May 2001, 155 consecutive patients with BPH underwent HoLEP combined with mechanical morcellation and were followed up for at least 6 months. A pulsed high-powered 80-W holmium-neodymium:yttrium-aluminum-garnet laser was used

Rodolfo Hurle; Ivano Vavassori; Alessandro Piccinelli; Alberto Manzetti; Sergio Valenti; Alberto Vismara

2002-01-01

51

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

52

Effects of pulsed electromagnetic fields on benign prostate hyperplasia  

Microsoft Academic Search

Introduction  Benign prostate hyperplasia (BPH) has been treated with various types of electromagnetic radiation methods such as transurethral\\u000a needle ablation (TUNA), interstitial laser therapy (ILC), holmium laser resection (HoLRP). In the present study, the effects\\u000a of a noninvasive method based on the exposure of patients with BPH to a pulsative EM Field at radiofrequencies have been investigated.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Twenty patients

Xenophon K. Giannakopoulos; Christos Giotis; Spyridon Ch. Karkabounas; Ioannis I. Verginadis; Yannis V. Simos; Dimitrios Peschos; Angelos M. Evangelou

53

Three-year follow-up of laser prostatectomy versus transurethral resection of the prostate in men with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To present our 3-year data comparing laser prostatectomy and transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). Laser prostatectomy was one of the first new minimally invasive treatment modalities for BPH, and few reports of the long-term results of this treatment regimen have been published.Methods. One hundred men with BPH in whom medical therapy had failed

W. Bruce Shingleton; Paul Farabaugh; Warren May

2002-01-01

54

Postoperative MRI in patients undergoing interstitial laser coagulation thermotherapy of benign prostatic hyperplasia  

Microsoft Academic Search

We conducted MRI of the effects of laser-induced thermal therapy (LITT) in benign prostatic hyperplasia (BPH). Eighteen patients (average age 64 years) were examined with MRI 24-48 h before and after LITT of BPH. Sagittal and axial T2-weighted FSE MR images were evaluated for signs of coagulation necrosis in the prostate gland and the presence of intra- and extraprostatic edema.

U. G. Mueller-Lisse; A. F. Heuck; H. J. Scheidler; M. F. Reiser

1996-01-01

55

Redesigning a large-scale clinical trial in response to negative external trial results: the CAMUS study of Phytotherapy for Benign Prostatic Hyperplasia  

Microsoft Academic Search

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

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

2009-01-01

56

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. PMID:21664759

Schauer, Isaiah G.; Rowley, David R.

2011-01-01

57

Activation of innate anti-viral immune response genes in symptomatic benign prostatic hyperplasia  

PubMed Central

Benign Prostatic Hyperplasia (BPH)is the most common urologic disease in men over age 50. Symptoms include acute urinary retention, urgency to urinate and nocturia. For patients with severe symptoms, surgical treatment is used to remove the affected tissue. Interestingly, the presence of histologic BPH does not always correlate with symptoms. The molecular basis of symptomatic BPH and how it differs from asymptomatic BPH is unknown. Investigation into the molecular players involved in symptomatic BPH will likely give insight into novel therapeutic, and potentially preventative, targets. We determined the expression of genes involved in the innate anti-viral immune response in tissues from patients undergoing surgery to alleviate the symptoms of BPH, and compared the results to prostate tissue with histologic BPH, but from patients with few urinary issues (asymptomatic BPH). We found that expression of CFI, APOBEC3G, OAS2, and IFIT1, four genes whose protein products are involved in the innate anti-viral immune response, were significantly transcriptionally upregulated in symptomatic BPH. Additionally we observe hypomethylation and concomitant expression of ancient retroviral-like sequences, the LINE-1 retrotransposons, in symptomatic BPH when compared to normal prostate tissue. These findings merit further investigation into the anti-viral immune response in symptomatic BPH. PMID:22952051

Madigan, Allison A.; Sobek, Kathryn M.; Cummings, Jessica L.; Green, William R.; Bacich, Dean J.; O'Keefe, Denise S.

2012-01-01

58

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. PMID:24876834

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

2014-01-01

59

Current state of the art photoselective vaporization prostatectomy: laser therapy for benign prostatic hyperplasia  

Microsoft Academic Search

Since the beginning of this millennium, laser technology for prostatectomy, specifically the 532 nm green light wavelength has steadily gained clinical utility, potentially replacing trans urethral resection of the prostate (TURP). Multiple clinical studies demonstrate that its unique features of minimal invasiveness with minimal morbidity are combined in a desirable, safe and efficacious procedure to treat benign prostatic hyperplasia (BPH).

A E Te

2007-01-01

60

INTERSTITIAL LASER COAGULATION FOR MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA: A JAPANESE EXPERIENCE  

Microsoft Academic Search

PurposeThe principle of interstitial laser coagulation is to shrink the prostate by generating intraprostatic necrosis without damaging the urethra or causing tissue sloughing. The clinical efficacy and durability of interstitial laser coagulation in the treatment of benign prostatic hyperplasia (BPH) were evaluated.

YOICHI ARAI; KAZUTOSHI OKUBO; TAKASHI OKADA; SHINYA MAEKAWA; YOSHITAKA AOKI; HIROSHI MAEDA

1998-01-01

61

Safety and Efficacy of the Potassium-Titanyl-Phosphate Laser and Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia  

PubMed Central

The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate in men with lower urinary tract symptoms and benign prostatic hyperplasia (BPH) is a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Efficacy data from multicenter prospective studies, comparative studies against other interventions, and single-center long-term outcomes suggest the efficacy to be at least equivalent to that of transurethral resection of the prostate, with a very good safety profile. New technological developments promise to further enhance the utility of this laser for application in BPH and urology. PMID:17173098

Roehrborn, Claus G

2006-01-01

62

Benign Prostatic Hyperplasia Specific Health Status Measures in Clinical Research: How Much Change in the American Urological Association Symptom Index and the Benign Prostatic Hyperplasia Impact Index is Perceptible to Patients?  

Microsoft Academic Search

PurposeWe assessed the relationship between changes in scores for the American Urological Association (AUA) symptom index and benign prostatic hyperplasia (BPH) impact index with patient global ratings of improvement in a large Veterans Affairs trial comparing different pharmacological therapies for BPH.

Michael J. Barry; William O. Williford; Yuchiao Chang; Madeline Machi; Karen M. Jones; Elizabeth Walker-Corkery; Herbert Lepor

1995-01-01

63

Minimally invasive therapies for benign prostatic hyperplasia.  

PubMed

Currently, 3 categories of treatment are available for men with benign prostatic hyperplasia (BPH): (1) medicine, such as alpha-blockers and finasteride; (2) minimally invasive treatment, such as transurethral microwave thermotherapy and interstitial ablation using either radiofrequency or laser; and (3) surgical therapy. The 1990s have seen an explosion of transurethral technology to treat symptoms caused by bladder outlet obstruction secondary to BPH. Unlike surgical debulking procedures, the minimally invasive therapies attempt to treat patients without general or regional anesthesia, and even ambulatory procedures are performed in the office. Because of the demographics of patients with BPH, it is hoped that these minimally invasive options will relieve symptoms without any surgical complications and the side effects and compliance issues associated with medical therapy. It is important that urologists have a clear understanding of the clinical usefulness of these devices, so that the overall role of such treatment may be determined by science rather than marketing. Clinically, the degree of symptom score, peak flow, and quality-of-life improvement seen with all the minimally invasive techniques are similar. The techniques may differ in their ability to reach the maximum number of responders and achieve an acceptable duration of response, and the need for analgesia/sedation associated with each technique. This study will define the minimally invasive therapies and present the differences in catheter design and technique. The pathologic basis for these therapeutic options and the advantages and disadvantages of each will be discussed. Urologists must decide which therapy can be used in their office practice. The maximum numbers of responders and enhanced durability of the treatment can be achieved based on realistic expectations, proper selection of patients, and complete information on the potential of these devices. PMID:11750248

Blute, M L; Larson, T

2001-12-01

64

Characterizing Prostiva RF treatments of the prostate for BPH with gadolinium-enhanced MRI.  

PubMed

Transurethral needle ablation (TUNA) is an accepted and effective therapy for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Prostiva (Medtronic, Shoreview, MN) is the newest-generation device, which includes a new needle design and radio frequency (RF) generator. This device creates temperatures of 120 degrees C and necrotic lesions in less than 2.5 min. Using previously described techniques, we analyzed dynamic, gadolinium-enhanced MRIs to characterize the ablative properties of the new Prostiva RF device. Ten men with LUTS due to BPH were treated with the standard Prostiva manufacturer-recommended protocol. The bladder neck and lateral lobes received treatment based on prostate volume and prostatic urethral length. Gadolinium-enhanced MRI sequences were obtained prior to and 1 week post-treatment. Analyze software (Mayo Clinic Biomedical Imaging Resource, Rochester, MN) was used to evaluate MRIs. New gadolinium defects were seen in all patients following Prostiva treatments. All lesions coalesced within the prostate. No defects were seen beyond the prostate, and the urethra was spared in all patients. The mean volume of necrosis was 7.56 cc, representing a mean of 11.28% of total prostate volume. Dynamic, gadolinium-enhanced MRIs demonstrate new vascular defects representing necrosis caused by Prostiva RF therapy of the prostate. The standard Prostiva RF protocol produces lesions that coalesce to create larger lesions in the bladder neck and lateral lobes. Compared to the TUNA Precision Plus device, the ablative lesions appear comparable while produced with a shorter burn time. PMID:19151893

Huidobro, Christian; Larson, Benjamin; Mynderse, Samuel; Myers, James J; Busel, David; Acevedo, Cristian; Larson, Thayne R; Mynderse, Lance A

2009-01-01

65

Testosterone metabolism of fibroblasts grown from prostatic carcinoma, benign prostatic hyperplasia and skin fibroblasts  

SciTech Connect

The metabolism of (1,2,6,7-3H)testosterone was assessed in fibroblast monolayers derived from tissue of 5 prostates with benign hyperplasia (BPH), 4 prostates with carcinoma (PC), and 3 biopsy samples of skin, 2 nongenital skin (NG) and 1 genital skin. The following metabolites could be identified: androstanedione androstenedione, dihydrotestosterone, androsterone, epiandrosterone, androstane-3 alpha, 17 beta-diol and androstane-3 beta, 17 beta-diol. Testosterone was metabolized much more rapidly in fibroblasts originating from prostatic tissue than in fibroblasts derived from NG. A significantly higher formation of 5 alpha-androstanes and 3 alpha-hydroxysteroids could be observed in fibroblasts from BPH as compared to PC. 17-ketosteroid formation exceeded 5 alpha-androstane formation in BPH, whereas 5 alpha-reduction was the predominant pathway in fibroblasts grown from PC and NG. Since testosterone metabolism in fibroblasts of prostatic origin therefore resembles in many aspects that in whole prostatic tissue, fibroblasts grown from prostatic tissues might be a valuable tool for further investigation of the pathogenesis of human BPH and PC.

Schweikert, H.U.; Hein, H.J.; Romijn, J.C.; Schroeder, F.H.

1982-02-01

66

Development of a rapidly computable descriptor of prostate tissue temperature during transurethral conductive heat therapy for benign prostate hyperplasia  

Microsoft Academic Search

Benign prostate hyperplasia (BPH) is a condition in older men in which the mass of tissue in the prostate gland gradually\\u000a increases over the course of many years, ultimately leading to urinary outflow obstruction. Current treatment of this condition\\u000a is to surgically remove the obstructing tissue. One novel alternative therapy being studied is transurethral thermocoagulation\\u000a of excessive prostatic mass. In

U. H. Patel; C. F. Babbs

1993-01-01

67

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

68

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. PMID:24744516

Patel, Nishant D.; Parsons, J. Kellogg

2014-01-01

69

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

70

Transurethral needle ablation of the prostate for treatment of benign prostatic hyperplasia: Early clinical experience  

Microsoft Academic Search

Objectives.Many attempts have been made to develop a method for treatment of benign prostatic hyperplasia (BPH) that is minimally invasive, efficacious, and low-cost. Transurethral needle ablation (TUNA) is a new, fast outpatient anesthesia-free procedure, using interstitial low-level radio frequency energy to produce a temperature above 100°C. We describe our early clinical experience with TUNA as an outpatient procedure.

Claude C. Schulman; Alexandre R. Zlotta

1995-01-01

71

Antagonists of growth hormone-releasing hormone (GHRH) reduce prostate size in experimental benign prostatic hyperplasia.  

PubMed

Growth hormone-releasing hormone (GHRH), a hypothalamic polypeptide, acts as a potent autocrine/paracrine growth factor in many cancers. Benign prostatic hyperplasia (BPH) is a pathologic proliferation of prostatic glandular and stromal tissues; a variety of growth factors and inflammatory processes are inculpated in its pathogenesis. Previously we showed that potent synthetic antagonists of GHRH strongly inhibit the growth of diverse experimental human tumors including prostate cancer by suppressing various tumoral growth factors. The influence of GHRH antagonists on animal models of BPH has not been investigated. We evaluated the effects of the GHRH antagonists JMR-132 given at doses of 40 ?g/d, MIA-313 at 20 ?g/d, and MIA-459 at 20 ?g/d in testosterone-induced BPH in Wistar rats. Reduction of prostate weights was observed after 6 wk of treatment with GHRH antagonists: a 17.8% decrease with JMR-132 treatment; a 17.0% decline with MIA-313 treatment; and a 21.4% reduction with MIA-459 treatment (P < 0.05 for all). We quantified transcript levels of genes related to growth factors, inflammatory cytokines, and signal transduction and identified significant changes in the expression of more than 80 genes (P < 0.05). Significant reductions in protein levels of IL-1?, NF-??/p65, and cyclooxygenase-2 (COX-2) also were observed after treatment with a GHRH antagonist. We conclude that GHRH antagonists can lower prostate weight in experimental BPH. This reduction is caused by the direct inhibitory effects of GHRH antagonists exerted through prostatic GHRH receptors. This study sheds light on the mechanism of action of GHRH antagonists in BPH and suggests that GHRH antagonists should be considered for further development as therapy for BPH. PMID:21321192

Rick, Ferenc G; Schally, Andrew V; Block, Norman L; Nadji, Mehrdad; Szepeshazi, Karoly; Zarandi, Marta; Vidaurre, Irving; Perez, Roberto; Halmos, Gabor; Szalontay, Luca

2011-03-01

72

Characterization of Fibrillar Collagens and Extracellular Matrix of Glandular Benign Prostatic Hyperplasia Nodules  

PubMed Central

Objective Recent studies have associated lower urinary tract symptoms (LUTS) in men with prostatic fibrosis, but a definitive link between collagen deposition and LUTS has yet to be demonstrated. The objective of this study was to evaluate ECM and collagen content within normal glandular prostate tissue and glandular BPH, and to evaluate the association of clinical parameters of LUTS with collagen content. Methods Fibrillar collagen and ECM content was assessed in normal prostate (48 patients) and glandular BPH nodules (24 patients) using Masson's trichrome stain and Picrosirius red stain. Second harmonic generation (SHG) imaging was used to evaluate collagen content. Additional BPH tissues (n?=?47) were stained with Picrosirius red and the association between clinical parameters of BPH/LUTS and collagen content was assessed. Results ECM was similar in normal prostate and BPH (p?=?0.44). Total collagen content between normal prostate and glandular BPH was similar (p?=?0.27), but a significant increase in thicker collagen bundles was observed in BPH (p?=?0.045). Using SHG imaging, collagen content in BPH (mean intensity?=?62.52; SEM?=?2.74) was significantly higher than in normal prostate (51.77±3.49; p?=?0.02). Total collagen content was not associated with treatment with finasteride (p?=?0.47) or ?-blockers (p?=?0.52), pre-TURP AUA symptom index (p?=?0.90), prostate-specific antigen (p?=?0.86), post-void residual (PVR; p?=?0.32), prostate size (p?=?0.21), or post-TURP PVR (p?=?0.51). Collagen content was not associated with patient age in patients with BPH, however as men aged normal prostatic tissue had a decreased proportion of thick collagen bundles. Conclusions The proportion of larger bundles of collagen, but not total collagen, is increased in BPH nodules, suggesting that these large fibers may play a role in BPH/LUTS. Total collagen content is independent of clinical parameters of BPH and LUTS. If fibrosis and overall ECM deposition are associated with BPH/LUTS, this relationship likely exists in regions of the prostate other than glandular hyperplasia. PMID:25275645

Bauman, Tyler M.; Nicholson, Tristan M.; Abler, Lisa L.; Eliceiri, Kevin W.; Huang, Wei; Vezina, Chad M.; Ricke, William A.

2014-01-01

73

Association of cadmium and lead with antioxidant status and incidence of benign prostatic hyperplasia in patients of Western India.  

PubMed

The association of cadmium (Cd) and lead (Pb) in the pathophysiology and progression of benign prostate hyperplasia (BPH) has been evaluated in an epidemiological study with 116 BPH patients of the western part of India. The prostatic acid phosphatase activity, prostate-specific antigen, maximum urinary flow rate (Q max), and redox status of BPH patients were correlated with Cd and Pb contents. Additionally, patients were also separated on the basis of their age, genetic lineage, and additive habits and correlated with the Cd, Pb, and Q max levels. Our results suggest that the accumulation of toxic metals in prostate tissue has a significant positive correlation with the pathogenesis of BPH. Cd and Pb exert their effects through altered antioxidant defense mechanisms, ultimately leading to increased BPH severity. Progression of the pathogenesis also depends on other factors such as additive habits, genetic lineage, and age of the patients. PMID:23479318

Pandya, Chirayu; Gupta, Sharad; Pillai, Prakash; Bhandarkar, Ajay; Khan, Arif; Bhan, Arunodhay; Prajapati, Akhilesh; Gupta, Sarita

2013-06-01

74

Efficacy of Doxazosin in the Treatment of Acute Urinary Retention due to Benign Prostate Hyperplasia  

Microsoft Academic Search

Objective: To evaluate the efficacy of modified-release doxazosin 4 mg in the treatment of patients with acute urinary retention (AUR) due to benign prostate gland hyperplasia (BPH). An evaluation is made of the number of patients recovering spontaneous micturition after catheter removal, micturition quality, and the number of patients suffering new AUR episodes or who require surgery in the 2

Luis Prieto; Jesús Romero; Cristóbal López; Manuel Ortiz; Juan Jose Pacheco

2008-01-01

75

Suppression of benign prostate hyperplasia by Kaempferia parviflora rhizome  

PubMed Central

Background: Kaempferia parviflora rhizome is used as a folk medicine in Thailand for the treatment of various symptoms. In the present study, the inhibitory activities of extract from K. parviflora rhizome against 5?-reductase (5?R) were subjected. Furthermore, the effects of the extract from K. parviflorar hizome in benign prostate hyperplasia (BPH) were studied using the model mice. Materials and Methods: Preparations of extracts from the rhizomes of K. parviflora, Curcuma zedoaria and Zingiber officinale, and methoxyflavones isolated from K. parviflora was used for 5?R inhibition assay. The effects of K. parviflora extract on growth suppression for the prostates and seminal vesicles were performed based on the Hershberger's method. The K. parviflora extract was administered to castrated mice for 14 days. Results: K. parviflora extract showed more potent inhibitory activity on 5?R than C. zedoaria and Z. officinale extracts. The active principles were identified as 3,5,7,3’,4’-pentamethoxyflavone and 5,7,3’,4’-tetramethoxyflavone by activity guided fractionation. Furthermore, K. parviflora extract suppressed the weights of prostates and seminal vesicles in BPH model rats by daily administration for 14 days. Conclusion: These results indicate that K. parviflora extract can be a promising agent for the treatment of BPH. PMID:24174827

Murata, Kazuya; Hayashi, Hirotaka; Matsumura, Shinichi; Matsuda, Hideaki

2013-01-01

76

Shrinkage of experimental benign prostatic hyperplasia and reduction of prostatic cell volume by a gastrin-releasing peptide antagonist.  

PubMed

Gastrin releasing-peptide (GRP) is a potent growth factor in many malignancies. Benign prostatic hyperplasia (BPH) is a progressive age-related proliferation of glandular and stromal tissues; various growth factors and inflammatory processes are involved in its pathogenesis. We have demonstrated that potent antagonists of GRP inhibit growth of experimental human tumors including prostate cancer, but their effect on models of BPH has not been studied. Here, we evaluated the effects of GRP antagonist RC-3940-II on viability and cell volume of BPH-1 human prostate epithelial cells and WPMY-1 prostate stromal cells in vitro, and in testosterone-induced BPH in Wistar rats in vivo. RC-3940-II inhibited the proliferation of BPH-1 and WPMY-1 cells in a dose-dependent manner and reduced prostatic cell volume in vitro. Shrinkage of prostates was observed after 6 wk of treatment with RC-3940-II: a 15.9% decline with 25 ?g/d; and a 18.4% reduction with 50 ?g/d (P < 0.05 for all). Significant reduction in levels of proliferating cell nuclear antigen, NF-??/p50, cyclooxygenase-2, and androgen receptor was also seen. Analysis of transcript levels of genes related to growth, inflammatory processes, and signal transduction showed significant changes in the expression of more than 90 genes (P < 0.05). In conclusion, GRP antagonists reduce volume of human prostatic cells and lower prostate weight in experimental BPH through direct inhibitory effects on prostatic GRP receptors. GRP antagonists should be considered for further development as therapy for BPH. PMID:23359692

Rick, Ferenc G; Abi-Chaker, Andrew; Szalontay, Luca; Perez, Roberto; Jaszberenyi, Miklos; Jayakumar, Arumugam R; Shamaladevi, Nagarajarao; Szepeshazi, Karoly; Vidaurre, Irving; Halmos, Gabor; Krishan, Awtar; Block, Norman L; Schally, Andrew V

2013-02-12

77

Pygeum africanum extract for the treatment of patients with benign prostatic hyperplasia: A review of 25 years of published experience  

Microsoft Academic Search

Pygeum africanum bark extract has been used to treat mild and moderate symptomatic benign prostatic hyperplasia (BPH) in France since 1969. The extract has several potentially relevant pharmacologic properties: modulation of age-related hypercontractility of the bladder detrusor muscle; anti-inflammatory activity, including inhibition of chemotactic activity of leukotrienes; inhibition of fibroblast proliferation; and improvement of prostatic histology and secretion. The constituents

Marie-Christine Andro; Jean-Pierre Riffaud

1995-01-01

78

Linking Pre-Diabetes with Benign Prostate Hyperplasia. IGFBP-3: A Conductor of Benign Prostate Hyperplasia Development Orchestra?  

PubMed Central

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

79

Prostate Vaporization in the Treatment of Benign Prostatic Hyperplasia by Using a 200-W High-Intensity Diode Laser  

Microsoft Academic Search

The recent introduction of high-power 200-W diode laser vaporization of the prostate has resulted in new interest in minimally\\u000a invasive surgery for the treatment of benign prostatic hyperplasia (BPH). Although clinical reports are still limited, experimental\\u000a ex vivo or in vivo models have demonstrated that this laser device offers improved ablative and hemostatic abilities. Some\\u000a preliminary clinical results have proven

Po-Hui Chiang; Chien-Hsu Chen

2010-01-01

80

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 the growth ...

81

A Comprehensive Approach Toward Novel Serum Biomarkers for Benign Prostatic Hyperplasia: The MPSA Consortium  

PubMed Central

Purpose Clinical benign prostatic hyperplasia (BPH) is primarily diagnosed based on a diverse array of progressive lower urinary tract symptoms (LUTS) and is likely distinct from histological BPH, which is detected by the presence of non-malignant proliferation of prostate cells but may or may not be associated with symptoms. Pharmacological management of LUTS has emerged as an effective initial treatment for clinical BPH due to the introduction of new drug therapies shown to be effective in recent large clinical trials. Despite advances in symptom management and research into BPH pathology, diagnostic strategies for prediction of BPH progression and response to drug modalities are lacking and questions remain as to the molecular differences underlying clinical (symptomatic) versus histological (non-symptomatic) BPH. Materials and Methods As part of the Medical Therapy of Prostatic Symptoms (MTOPS) clinical trial, which demonstrated the effectiveness of combination drug therapy in slowing BPH progression, an archive of biological specimens linked to clinical data were collected for future profiling of disease pathology and changes associated with response to drug therapy. The MTOPS Prostatic Samples Analysis (MPSA) Consortium was established to identify and validate molecular markers that may better define BPH-related pathologies, identify risk for progression of LUTS, and predict response to drug therapy, using this MTOPS archive. The cooperating MPSA Biomarker Discovery Sites and Pathology Coordinating Center employ diverse methodologies and scientific approaches and unique expertise in addressing the goals of the consortium. Results To date the MPSA has identified a number of promising biomarkers and other molecular and cellular changes associated with BPH. Conclusions These findings and ongoing consortium discovery efforts have the potential to provide a greater understanding of the defects underlying disease pathology and may lead to the development of early and more effective pharmacological treatment strategies for BPH. PMID:18280515

Mullins, Chris; Lucia, M. Scott; Hayward, Simon W.; Lee, Jeannette Y.; Levitt, Jonathan M.; Lin, Victor K.; Liu, Brian C.-S.; Chinnaiyan, Arul M.; Rubin, Mark A.; Slawin, Kevin; Star, Robert A.; Getzenberg, Robert H.

2011-01-01

82

BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... Urologic History Museum Awards Job Opportunities Contact Us Urology A - Z Find everything you need to know ... Search All A - Z Patient Information What is Urology? Find a Urologist Healthy Living Tips Common Conditions ...

83

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

MedlinePLUS

... Urologic History Museum Awards Job Opportunities Contact Us Urology A - Z Find everything you need to know ... Search All A - Z Patient Information What is Urology? Find a Urologist Healthy Living Tips Common Conditions ...

84

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

MedlinePLUS

... April 2013 You are leaving UrologyHealth.org. The Urology Care Foundation has no control over the content of this site. Click OK to proceed. Urology A - Z A Adrenal Gland Disorders Adrenal Medulla ...

85

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

MedlinePLUS

... July 2013 You are leaving UrologyHealth.org. The Urology Care Foundation has no control over the content of this site. Click OK to proceed. Urology A - Z A Adrenal Gland Disorders Adrenal Medulla ...

86

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

87

Interstitial laser coagulation of benign prostatic hyperplasia: a minimally invasive treatment alternative  

NASA Astrophysics Data System (ADS)

The use of minimally invasive treatments for benign prostatic hyperplasia (BPH) have been introduced into the medical community. Over the last decade several minimally invasive treatment techniques have been approved for use. In particular, interstitial laser coagulation (ILC) has shown pomise as an alternative to the current gold standard, transurethral resection of prostate (TURP). Studies show ILC to have equal efficacy as TURP while causing less side effects. Future technical advances as well as increased physician experience with ILC could lead to the replacement of TURP as the gold standard in trestment of BPH.

Ordonez, Robert F.; Mittemeyer, Bernhard T.; Aronoff, David R.; de Riese, Werner T. W.

2003-06-01

88

The Holmium Laser for the Treatment of Benign Prostatic Hyperplasia: A Brief Review  

Microsoft Academic Search

.   At a wavelength of 2140?nm, the holmium:YAG (Ho:YAG) laser can be used for incision, ablation and resection of prostatic\\u000a tissue. This laser has revolutionised the surgical management of benign prostatic hyperplasia (BPH) in our institution. Five\\u000a different techniques have been utilised in evolving the current techniques using the Ho:YAG laser either alone or in combination\\u000a with neodymium:YAG (Nd:YAG laser

A. Das; M. Fraundorfer; P. Gilling

1999-01-01

89

Storage (Irritative) and Voiding (Obstructive) Symptoms as Predictors of Benign Prostatic Hyperplasia Progression and Related Outcomes  

Microsoft Academic Search

Objectives: To assess the utility of voiding and filling symptom subscores in predicting features of benign prostatic hyperplasia (BPH) progression, including acute urinary retention (AUR) and prostate surgery.Methods: The Proscar Long-term Efficacy and Safety Study (PLESS) was a 4-year study designed to evaluate the effects of finasteride versus placebo in men with lower urinary tract symptoms (LUTS), clinical evidence of

Claus G Roehrborn; John D McConnell; Brian Saltzman; Donald Bergner; Todd Gray; Perinchery Narayan; Thomas J Cook; Amy O Johnson-Levonas; Wilson A Quezada; Joanne Waldstreicher

2002-01-01

90

Mortality from benign prostatic hyperplasia: worldwide trends 1950-92.  

PubMed Central

STUDY OBJECTIVE--To provide a systematic overview of worldwide trends in mortality from benign prostatic hyperplasia (BPH) over the past four decades. DESIGN--This was a descriptive analysis based on age adjusted mortality rates for BPH between 1950 and 1992 for 41 countries from five continents. SETTING--Official death certifications from the World Health Organization database. MAIN RESULTS--In the 1950s, the highest age adjusted (on the world standard population) mortality rates for BPH in Europe were in Denmark (22.8/100,000) and Germany (18.1), followed by Scandinavian countries, the UK, and Switzerland. Italy had rates around 10/100,000, and rates were lower in eastern and southern Europe (5-8/100,000). Between 1950 and 1990, a fall of over 90%, or even 95%, was observed in most western European countries. Thus, in the early 1980s, overall mortality from BPH ranged between 0.5 and 1.5/100,000 in most western European countries. In proportional terms, similar reductions were registered in other developed countries of North America, Asia (that is, Japan or Singapore), and Oceania. A fall in rates was also observed in eastern Europe and in Latin America, particularly from the late 1970s onwards, although these reductions were generally much smaller. Thus, in the early 1990s, most countries in these areas had BPH rates between 1 and 5/100,000. The pattern of trends was, at least qualitatively, similar at younger ages, although most falls were proportionally greater. CONCLUSIONS--The most probable interpretation of these trends is that therapeutic improvements--including more widespread and timely surgery, introduction of less invasive techniques, such as transurethral prostatectomy, and possibly the development of medical treatments--have had a favourable and substantial impact on BPH mortality. There are, however, areas of the world, including several countries of western Europe and South America, where rates are still very high. PMID:7544392

La Vecchia, C; Levi, F; Lucchini, F

1995-01-01

91

The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review  

Microsoft Academic Search

A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia (BPH) on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy (TUMT), transurethral needle ablation of the

Ryan W. Frieben; Hao-Cheng Lin; Peter P. Hinh; Francesco Berardinelli; Steven E. Canfield; Run Wang

2010-01-01

92

Relevance of anti-reactive oxygen species activity to anti-inflammatory activity of components of Eviprostat ®, a phytotherapeutic agent for benign prostatic hyperplasia  

Microsoft Academic Search

Inflammation is a common finding in benign prostatic hyperplasia (BPH). The phytotherapeutic agent eviprostat is a popular treatment for BPH in Japan and Germany. This agent consists of five components; four are extracted from Chimaphila umbellata, Populus tremula, Pulsatilla pratensis and Equisetum arvense (coded as EVI-1, EVI-2, EVI-3 and EVI-4, respectively) and the fifth is germ oil from Triticum aestivum

Michiko Oka; Masaki Tachibana; Kumiko Noda; Naoki Inoue; Mitsushi Tanaka; Kenji Kuwabara

2007-01-01

93

[Transurethral rotoresection - a new method of benign prostatic hyperplasia treatment].  

PubMed

Karl Storz company (Germany) offers a novel endoscopic technology in the treatment of benign prostatic hyperplasia (BPH) i.e. rotoresection which combined mechanic and electrosurgical methods of removal of the hyperplastic tissue. The operation is performed with application of a special rotoresectoscope connected with a rotor electrode which, in its turn, is connected with mechanical rotor generator making it to rotate and with powerful electrogenerator (radiotome). The hyperplastic tissue is removed both mechanically (by high-frequency rotation of the rotor tip) and due to electrovaporization with simultaneous coagulation of the underlying tissue layers. Transurethral rotoresection was performed in 40 patients with BPH. Intraoperative and postoperative complications were not observed. Examination at discharge and 1 month after surgery showed a 4-fold decrease in the prostatic symptoms by IPSS scale, residual urine decreased 3-fold, maximal urine flow rate rose 2.5-fold. Transurethral rotoresection combines effective removal of BPH tissue with minimal intraoperative bleeding. It is a good alternative to conventional TUR. For more detailed evaluation further studied are needed. PMID:11186699

Martov, A G; Merinov, D S; Aboian, I A; Pavlov, S V; Drozhzheva, V V

2000-01-01

94

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

95

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. PMID:19370565

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

2011-01-01

96

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

SciTech Connect

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-{mu}m 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.

Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.b [University of Sao Paulo Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil); Antunes, Alberto Azoubel [University of Sao Paulo Medical School, Urology Department, Hospital das Clinicas (Brazil); Motta Leal Filho, Joaquim Mauricio da [University of Sao Paulo Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil); Oliveira Cerri, Luciana Mendes de [University of Sao Paulo Medical School, Ultrasound Unit, Radiology Institute, Hospital das Clinicas (Brazil); Baroni, Ronaldo Hueb [University of Sao Paulo Medical School, Magnetic Resonance Unit, Radiology Institute, Hospital das Clinicas (Brazil); Marcelino, Antonio Sergio Zafred [University of Sao Paulo Medical School, Ultrasound Unit, Radiology Institute, Hospital das Clinicas (Brazil); Freire, Geraldo Campos [University of Sao Paulo Medical School, Urology Department, Hospital das Clinicas (Brazil); Moreira, Airton Mota [University of Sao Paulo Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil); Srougi, Miguel [University of Sao Paulo Medical School, Urology Department, Hospital das Clinicas (Brazil); Cerri, Giovanni Guido [University of Sao Paulo Medical School, Radiology Department, Radiology Institute, Hospital das Clinicas (Brazil)

2010-04-15

97

Prostate Diseases  

MedlinePLUS

Aging & Health A to Z Prostate Diseases Basic Facts & Information What are Prostate Diseases? The prostate—one of the components of a man's sex organs—is a ... out anything serious. The Most Common Types of Prostate Diseases Benign prostatic hyperplasia (BPH) Prostatitis Prostate cancer ...

98

Treatment options for benign prostatic hyperplasia.  

PubMed Central

OBJECTIVE: To examine current treatment options for benign prostatic hyperplasia with emphasis on randomized, clinical trials and our current management approach. QUALITY OF EVIDENCE: Benign prostatic hyperplasia remains difficult to define clinically or measure objectively. As a result, research has been fairly weak. With newer treatments, however, more definitive studies have been reported. MAIN FINDINGS: Transurethral resection of the prostate remains the criterion standard for severe disease. Watchful waiting, medical management, or early surgical intervention are all valid options for moderate disease and should be tailored to the characteristics and desires of individual patients. Recent minimally invasive surgical techniques, such as microwave and laser surgery, have not yet achieved the quality of evidence to be generally recommended. CONCLUSIONS: Management of benign prostatic hyperplasia should be individualized to patients' circumstances and personal choices. PMID:9266125

Portis, A. J.; Mador, D. R.

1997-01-01

99

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

100

Phase III Multicenter Placebo-Controlled Study of Tamsulosin in Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objectives. To evaluate the efficacy and safety of two once-daily doses of tamsulosin, the first selective alpha1A-antagonist studied in clinical trials.Methods. Patients with benign prostatic hyperplasia (BPH) were randomized to receive either tamsulosin (0.4 and 0.8 mg\\/day) or placebo (n = 756). Primary efficacy parameters were improvement in the total American Urological Association (AUA) symptom score and peak urinary flow

Herbert Lepor

1998-01-01

101

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

102

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

SciTech Connect

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 [University of Michigan Department of Urology, Ann Arbor, MI (United States); Ives, Kim; Cain, Charles A. [University of Michigan Department of Biomedical Engineering, Ann Arbor, MI (United States); Fowlkes, J. Brian [University of Michigan Department of Radiology, Ann Arbor, MI (United States); University of Michigan Department of Biomedical Engineering, Ann Arbor, MI (United States); Roberts, William W. [University of Michigan Department of Urology, Ann Arbor, MI (United States); University of Michigan Department of Biomedical Engineering, Ann Arbor, MI (United States)

2009-04-14

103

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

104

?1-Blockers for BPH: Are There Differences?  

Microsoft Academic Search

?1-blockers are well established for the treatment of lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO), previously referred to as benign prostatic hyperplasia (BPH). The various available ?1-blockers do not differ in terms of their clinical efficacy, but there are several indications that ?1-blockers differ qualitatively with regard to their cardiovascular safety and tolerability, albeit the quantification

Christian de Mey

1999-01-01

105

Dietary patterns, supplement use, and the risk of benign prostatic hyperplasia.  

PubMed

It has long been appreciated that a healthy lifestyle plays a critical role in cardiovascular health. It is now apparent that the same is true in the development of benign prostatic hyperplasia (BPH). Prospective cohort data originating from recently published randomized trials on the medical treatment of BPH and prevention of prostate cancer have been invaluable. A growing body of evidence suggests that exercise and the intake of specific macronutrients and micronutrients through regular diet play a beneficial role. Most strikingly, the magnitude of these effects is similar to medical therapies using alpha-blockers and 5-alpha-reductase inhibitors. The use of supplements for prostate disease is a multibillion dollar business in the United States, and supplements are more commonly prescribed than medical therapy in many countries. In contrast to consumption of micronutrients through regular diet, supplemental intake of micronutrients and phytotherapies currently lack evidence to support their efficacy. PMID:19570489

Poon, Kenneth S; McVary, Kevin T

2009-07-01

106

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. PMID:19676094

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

2009-01-01

107

New Treatments for Benign Prostatic Hyperplasia  

PubMed Central

Benign prostatic hyperplasia is the most common of all neoplasms. The most common treatment is prostatectomy, but other available therapies include androgen antagonists, ?-adrenergic blockers, anticholinergic agents, prostate dilation with a ballon, and urethral stents. Prostatectomy is likely to remain the standard of care for the foreseeable future because it is safe and much more effective than all other current and experimental forms of therapy. PMID:21229073

Skepasts, Peter K.; Lee, Laurence M.

1991-01-01

108

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

109

Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia 1 1 A complete list of the members of the PLESS Study Group is given in the Appendix  

Microsoft Academic Search

Objectives. Prostate-specific antigen (PSA) is produced exclusively in the prostate gland and is currently the most useful clinical marker for the detection of prostate cancer. In this report, we examine whether serum PSA is also a predictor of important benign prostatic hyperplasia (BPH)-related outcomes, acute urinary retention (AUR), and the need for BPH-related surgery.Methods. Three thousand forty men were treated

Claus G Roehrborn; John D McConnell; Michael Lieber; Steven Kaplan; Jack Geller; Gholem H Malek; Ronald Castellanos; Scott Coffield; Brian Saltzman; Martin Resnick; Thomas J Cook; Joanne Waldstreicher

1999-01-01

110

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. PMID:22471974

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

2012-01-01

111

Comparative Analysis of the Efficacy and Safety of Photoselective Vaporization of the Prostate for Treatment of Benign Prostatic Hyperplasia according to Prostate Size  

PubMed Central

Purpose This study was conducted to perform a comparative analysis of the efficacy and safety of photoselective vaporization of the prostate (PVP) for treatment of benign prostatic hyperplasia (BPH) in men with a prostate volume greater than 60 cc. Materials and Methods The clinical data of 249 men with symptomatic BPH who underwent PVP between January 2006 and June 2008 were retrospectively analyzed. All patients were classified into two groups according to their prostate volume (group A, <60 cc; group B, ?60 cc). The preoperative evaluation included a digital rectal exam, urinalysis, prostate-specific antigen levels, International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximal flow rate (Qmax), postvoid residual urine volume (PVR), and transrectal ultrasonography. The total operative time, used energy (kJ), urethral Foley catheter indwelling period, and the number of hospital days were recorded afterward. The IPSS, QoL score, Qmax, and PVR were evaluated at 1, 3, 6, and 12 months postoperatively. Results In both groups, significant improvements in the subjective and objective voiding parameters were achieved and these improvements were sustainable for at least 1 year with minimal complications. During the follow-up period, the PVR in group B significantly increased. Retrograde ejaculation and urethral stricture were the common complications in both groups. There was no significant difference in the incidence rate. Conclusions PVP is safe and efficacious, with durable results for men with symptomatic BPH and large prostate volumes. PMID:20414424

Park, Ju Hyun; Paick, Jae-Seung

2010-01-01

112

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. PMID:24944593

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

2014-01-01

113

Postoperative MRI in patients undergoing interstitial laser coagulation thermotherapy of benign prostatic hyperplasia  

SciTech Connect

We conducted MRI of the effects of laser-induced thermal therapy (LITT) in benign prostatic hyperplasia (BPH). Eighteen patients (average age 64 years) were examined with MRI 24-48 h before and after LITT of BPH. Sagittal and axial T2-weighted FSE MR images were evaluated for signs of coagulation necrosis in the prostate gland and the presence of intra- and extraprostatic edema. Coagulation areas showed as a hypointense central core with a hyperintense rim. Intraprostatic edema led to a volume increase of 18-108% both in the central and in the total gland. Periprostatic edema was severe in preprostatic and prevesical tissue as well as lateral to the prostate, moderate in the presacral space, and mild perirectally and dorsal to the prostate. Follow-up examinations 2 weeks to 6 months after LITT in five patients showed decrease of coagulation necrosis volume, prostate size, and edema. MRI appears to be a reliable method to monitor LITT effects in patients with BPH. 22 refs., 5 figs., 4 tabs.

Mueller-Lisse, U.G.; Heuck, A.F.; Scheidler, H.J.; Reiser, M.F. [Univ. of Munich (Germany)] [and others] [Univ. of Munich (Germany); and others

1996-03-01

114

The Evolution of Laser Therapy in the Treatment of Benign Prostatic Hyperplasia  

PubMed Central

The 2 basic principles of laser therapy for benign prostatic hyperplasia (BPH), based on the final tissue effect, are laser vaporization and laser coagulation. In laser vaporization techniques, higher-density laser thermal energy is used; effects range from complete tissue vaporization to incision, resection, or enucleation of the obstructing prostatic tissue. Interstitial laser coagulation (ILC) requires lower therapeutic temperatures. The urethral preservation and lack of tissue evaporation/resection with ILC make this treatment different from conventional transurethral free-beam laser prostatectomy. The Indigo® Optima Laser treatment system is the most widely used ILC system. Unlike other BPH laser therapies, Indigo ILC can be satisfactorily performed using pure local anesthesia in an office or outpatient setting. Favorable treatment outcomes are seen in a large percentage of patients, with minimal adverse events. Such favorable results depend on proper surgical technique and operator experience. PMID:16985899

Issa, Muta M

2005-01-01

115

A Randomised, Placebo-Controlled Study to Assess the Efficacy of Twice-Daily Vardenafil in the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia  

Microsoft Academic Search

IntroductionBenign prostatic hyperplasia (BPH) is associated with bothersome lower urinary tract symptoms (LUTS) and reduced patient quality of life (QoL). Phosphodiesterase (type) 5 (PDE5) inhibitors such as vardenafil are commonly used for the treatment of erectile dysfunction (ED), but have also been shown to improve the symptoms of BPH. This randomised, double-blind, placebo-controlled study investigated the effects of vardenafil on

Christian G. Stief; Hartmut Porst; Dieter Neuser; Manfred Beneke; Ernst Ulbrich

2008-01-01

116

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

117

Benign Prostatic Hyperplasia: A New Metabolic Disease of the Aging Male and Its Correlation with Sexual Dysfunctions  

PubMed Central

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; Lotti, Francesco; Cipriani, Sarah

2014-01-01

118

[Pikamilone treatment of benign prostatic hyperplasia].  

PubMed

Pikamilone is an original drug of Russian produce having a central (vegetotropic and vascular) and peripheral (vasodilating) mechanisms of action. The drug was tried as monotherapy in elderly patients with benign prostatic hyperplasia who had symptoms of the lower urinary tracts to estimate its effect on local and general mechanisms of nervous and vascular regulation of detruzor function in infravesical obstruction. A positive trend in the clinical symptoms was observed (by IPSS scale), especially irritative symptoms. Urodynamics has also improved: maximal and mean urinary flow rate and total amount of urination increased. However, the residual urine volume remained the same. Further placebo-controlled and randomized studies are needed for precise estimation of pikamilone effects. Meanwhile, the drug can be used as a component of combined therapy of benign prostatic hyperplasia. PMID:11150159

Tolstova, S S

1999-01-01

119

Mechanisms of synergism between antagonists of growth hormone-releasing hormone and antagonists of luteinizing hormone-releasing hormone in shrinking experimental benign prostatic hyperplasia  

Microsoft Academic Search

BACKGROUND: Benign prostatic hyperplasia (BPH) affects aging men. Combined therapy with antagonists of growth hormone-releasing hormone (GHRH) and of luteinizing hormone-releasing hormone (LHRH or GnRH) induces prostate shrinkage in rat models. We investigated the mechanisms of action of this combination on cell cycle traverse and expression of prostatic genes. METHODS: Effects of GHRH antagonist, JMR-132 (40 microg\\/day), the LHRH antagonist,

F. G. Rick; A. V. Schally; N. L. Block; A. Abi-Chaker; A. Krishan; L. Szalontay

2013-01-01

120

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

121

How Do Symptoms Indicative of BPH Progress in Real Life Practice? The UK Experience  

Microsoft Academic Search

Objective: Lower urinary tract symptoms (LUTS) are usually, but not exclusively associated with benign prostatic hyperplasia (BPH). Using a population identified from the UK General Practice Research Database (GPRD), we describe the changes in the management of LUTS\\/BPH and assess the effectiveness of medical therapy between 1992 and 1998. Methods: 61,364 men with LUTS\\/BPH and without a record of prostatic

G. M. Clifford; J. Logie; R. D. T. Farmer

2000-01-01

122

Silodosin for the treatment of clinical benign prostatic hyperplasia: safety, efficacy, and patient acceptability  

PubMed Central

?1-Adrenergic receptor antagonists are commonly used to treat male lower urinary tract symptoms and benign prostatic hyperplasia (BPH). We performed a literature search using PubMed, Medline via Ovid, Embase, and the Cochrane Library databases to identify studies on the treatment of BPH by silodosin. Silodosin is a novel ?1-adrenergic receptor antagonist whose affinity for the ?1A-adrenergic receptor is greater than that for the ?1B-adrenergic receptor. Therefore, silodosin does not increase the incidence of blood pressure-related side effects, which may result from the inhibition of the ?1B-adrenergic receptor. Patients receiving silodosin at a daily dose of 8 mg showed a significant improvement in the International Prostate Symptom Score and maximum urinary flow rate compared with those receiving a placebo. Silodosin also improved both storage and voiding symptoms, indicating that silodosin is effective, even during early phases of BPH treatment. Follow-up extension studies performed in the United States, Europe, and Asia demonstrated its long-term safety and efficacy. In the European study, silodosin significantly reduced nocturia compared to the placebo. Although retrograde or abnormal ejaculation was the most commonly reported symptom in these studies, only a few patients discontinued treatment. The incidence of adverse cardiovascular events was also very low. Evidence showing solid efficacy and cardiovascular safety profiles of silodosin will provide a good solution for the treatment of lower urinary tract symptoms associated with BPH in an increasingly aging society. PMID:25328864

Cho, Hee Ju; Yoo, Tag Keun

2014-01-01

123

Zinc and cadmium plasma and erythrocyte levels in prostatic carcinoma, BPH, urological malignancies, and inflammations.  

PubMed

Zinc and cadmium in both serum and erythrocytes from patients with prostatic carcinoma of different histologies, BPH, other urological tumors, and pyelonephritis were analyzed by atomic absorption spectrometry. The variance of the results obtained was very high for each group. No significant differences in the Zn or Cd concentration in either the blood plasma or the erythrocytes could be found between any of the different groups of patients. There were also no trends to be seen in the concentrations of these elements in human blood over a period of months. We conclude that the concentration of Zn and Cd in serum or erythrocytes are not an index for the diagnosis or therapy of prostatic carcinoma, BPH, urological malignancy, or inflammations. PMID:2418432

Feustel, A; Wennrich, R

1986-01-01

124

Optical characterization and coagulation performance of side-emitting fiber delivery systems for laser therapy of benign prostatic hyperplasia: A comparative study  

Microsoft Academic Search

ObjectivesCurrently, various side-emitting optical fibers with different tip geometry are used transurethrally to deliver laser radiation for treatment of benign prostatic hyperplasia (BPH). Since fiber tip design could profoundly affect the size and profile of the emitted laser beam, and consequently the tissue response and the extent of tissue coagulation, we evaluated commercially available fibers in regard to their optical

Dmitry Protsenko; Jorge H. Torres; Pradip Chakrabarti; Brent Bell; Eduardo Orihuela; Massoud Motamedi

1996-01-01

125

Finasteride significantly reduces acute urinary retention and need for surgery in patients with symptomatic benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. A pooled analysis of all available randomized trials with 2-year follow-up data with finasteride and placebo was undertaken to further investigate recent observations that finasteride use may reduce the occurrence of acute urinary retention (AUR) and benign prostatic hyperplasia (BPH)-related surgical intervention.Methods. Occurrences of AUR and surgical intervention were examined by treatment group in a pooled series of 4222

Jens T. Andersen; J. Curtis Nickel; Villis R. Marshall; Claude C. Schulman; Peter Boyle

1997-01-01

126

Comparison of the efficacy and safety of finasteride in older versus younger men with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To compare the efficacy and safety of finasteride 5 mg in older (65 years old or older) versus younger (45 to younger than 65 years old) men with benign prostatic hyperplasia (BPH).Methods. The Proscar Long-Term Efficacy and Safety Study (PLESS) was a 4-year, randomized, double-blind, placebo-controlled trial assessing the efficacy and safety of finasteride 5 mg in 3040 men

Steven A Kaplan; H. Logan Holtgrewe; Reginald Bruskewitz; Brian Saltzman; David Mobley; Perinchery Narayan; Robert H Lund; Steven Weiner; Glen Wells; Thomas J Cook; Alan Meehan; Joanne Waldstreicher

2001-01-01

127

Action Mechanism of Ginkgo biloba Leaf Extract Intervened by Exercise Therapy in Treatment of Benign Prostate Hyperplasia  

PubMed Central

Benign prostatic hyperplasia (BPH), an imbalance between androgen/estrogen, overexpression of stromal, and epithelial growth factors associated with chronic inflammation, has become an atypical direct cause of mortality of aged male diseases. Ginkgo possesses anti-inflammatory, blood flow-enhancing, and free radical scavenging effects. Considering strenuous exercise can reduce BPH risks, we hypothesize Ginkgo + exercise (Ginkgo + Ex) could be beneficial to BPH. To verify this, rat BPH model was induced by s.c. 3.5?mg testosterone (T) and 0.1?mg estradiol (E2) per head per day successively for 8 weeks, using mineral oil as placebo. Cerenin® 8.33??L/100?g was applied s.c. from the 10th to the 13th week, and simultaneously, Ex was applied (30?m/min, 3 times/week). In BPH, Ginkgo alone had no effect on T, 5?-reductase, and dihydrotestosterone (DHT), but suppressed androgen receptor (AR), aromatase, E2 and estrogen receptor (ER), and the proliferating cell nuclear antigen (PCNA); Ex alone significantly reduced T, aromatase, E2, ER, AR, and PCNA, but highly raised DHT. While Ginkgo + Ex androgenically downregulated T, aromatase, E2, and ER, but upregulated DHT, AR, and PCNA, implying Ginkgo + Ex tended to worsen BPH. Conclusively, Ginkgo or Ex alone may be more beneficial than Ginkgo + Ex for treatment of BPH. PMID:23690843

Peng, Chiung-Chi; Liu, Jia-Hong; Chang, Chi-Huang; Chung, Jin-Yuan; Chen, Kuan-Chou

2013-01-01

128

Should all specimens taken during surgical treatment of patients with benign prostatic hyperplasia be assessed by a pathologist?  

PubMed Central

Introduction In some patients submitted to transurethral resection of the prostatic (TURP) or prostatectomy (OAE) due to benign prostate hyperplasia (BPH), pathological evaluations (PE) revealed coexistence of prostate cancer (PCa) and BPH. The aim of the study is to evaluate the incidence of PCa diagnosed incidentally in prostate specimens taken during BPH surgery, to assess the need of routine PE and to define the group of patients in whom PE could be abandoned without the risk of omitting clinically significant PCa. Material and methods 968 consecutive men were subjected to surgical treatment due to BPH in Jan. 2004–Sep. 2010. Results 823 (85%) underwent TURP and 145 (15%) OAE. Incidental (Inc) PCa was diagnosed in 34(3.5%) pts. T1a and T1b stages were determined in 19 (2%) and 15 (1.5%) cases. Preoperative prostate biopsy due to abnormal prostate specific antigen (PSA) or digital rectal exam (DRE) was performed in 85 (8.8%) pts. Of PCa pts, 7 (20.58%) had undergone a cancer negative biopsy preoperatively. In BPH pts, 78 (8.35%) had undergone a prostate biopsy previously (p <0.01). Univariate and logit regression analyses had not revealed any correlations between age, Pv, serum PSA and frequency of IncPCa. The difference in rate of PCa diagnosed in patients with PSAD ?0.15 and <0.15 was 8 pts (14.04%) and 20 pts (4.05%), respectively (p <0.001). Gls in those pts was >6 only in 4 cases. Conclusions Despite the fact of low PCa detection rate observed in our study, this condition was clinically relevant in 15 (1.5%) subjects. It is difficult to establish any cut off values of pts’ age, Pv, serum PSA level suggestive of negligible risk for prostate cancer. PMID:25247076

Dobruch, Jakub; Nyk, Lukasz; Szostek, Przemyslaw; Szemplinski, Stanislaw; Borowka, Andrzej

2014-01-01

129

Detection of TMPRSS2-ERG fusion gene in benign prostatic hyperplasia.  

PubMed

The Ets-related gene fusions are among the most common molecular alterations in prostate cancer (PCa) and are detected in more than 50 % of PCas. Transmembrane protease serine 2 and Ets-related gene fusion (TMPRSS2-ERG) is the most frequently identified chimeric gene and has been associated with undifferentiated and invasive phenotypes. TMPRSS2-ERG has also been detected in prostate intraepithelial neoplasia (PIN) lesions and more rarely in benign prostatic hyperplasia (BPH) regions mainly in PCa-bearing glands. The possibility that the fusion TMPRSS2-ERG may be present in BPH samples in the absence of apparent PCa was addressed. Out of 115 BPH samples, three were found positive employing RT-PCR. The presence of the fusion gene was confirmed by FISH for these samples, and an additional four samples were found to carry the TMPRSS2-ERG fusion out of 43 tested by the later approach. The presence of the TMPRSS2-ERG fusion did not result in altered expression of 12 putative downstream targets. These findings indicate that TMPRSS2-ERG may or may not lead to PCa development. PMID:24961351

Velaeti, S; Dimitriadis, E; Kontogianni-Katsarou, K; Savvani, A; Sdrolia, E; Pantazi, G; Stefanakis, S; Trangas, T; Pandis, N; Petraki, K

2014-10-01

130

Changes in Nocturia after Photoselective Vaporization of the Prostate for Patients with Benign Prostatic Hyperplasia  

PubMed Central

Purpose To investigate changes in nocturia and predictive factors for improvement after photoselective vaporization of the prostate (PVP) for patients with benign prostatic hyperplasia (BPH). Materials and Methods A total of 103 patients who complained of nocturia of ?2 times per night on baseline frequency-volume chart (FVC) and who underwent PVP were included in this retrospective study. All patients underwent a preoperative evaluation for BPH including multichannel video urodynamics. The efficacy of the PVP was evaluated at 1, 3, 6, and 12 months postoperatively by use of the International Prostate Symptom Score (IPSS) and FVC. Subjective and objective improvement of nocturia were defined as a reduction of ?50% in nocturnal frequency compared with baseline on the IPSS and FVC, respectively. Results As shown by the IPSS and FVC, nocturia was significantly reduced starting from 1 month after PVP. The percentage of patients with improvement in nocturia was 20.0%, 20.7%, 36.2%, and 27.9% on the IPSS, and 30.1%, 48.6%, 52.2%, and 54.5% on the FVC at 1, 3, 6, and 12 months after PVP, respectively. None of the baseline parameters, including the presence or absence of nocturnal polyuria (NPU), reduced nocturnal bladder capacity (NBC), and detrusor overactivity (DO), were associated with improvement of nocturia. Conclusions Nocturnal frequency was significantly reduced from the early postoperative period after PVP. Improvement in nocturia after PVP was not affected by baseline nocturnal frequency, the presence or absence of preoperative NPU, or reduced NBC or DO on baseline urodynamics. PMID:20733958

Lee, Chang Ju; Cho, Min Chul; Ku, Ja Hyeon; Kim, Soo Woong

2010-01-01

131

The Study About Physical Activity for Subjects With Prevention of Benign Prostate Hyperplasia  

PubMed Central

Purpose The number of benign prostatic hyperplasia (BPH) subjects has been increasing worldwide, and many studies have been conducted to determine the treatment that can delay drug therapy or surgery. Subsequently, most of these studies involved physical activity (PA) and associated factors. Therefore, we aimed to determine factors associated with BPH prevalence based on a review of past and present studies and to investigate the effect of a healthy lifestyle as a protective factor of BPH occurrence. Methods We selected 582 subjects aged ?40 years from an initial 779 subjects recruited from Gyeonggi, Yangpyeong, South Korea, during August 2009 to August 2011. Trained investigators surveyed International Prostate Symptom Score and demographic information, including PA and lifestyle questionnaire during face-to-face interviews; further, they performed digital rectal examination, rectal ultrasonography, and measured prostate-specific antigen levels. The statistical association between PA and BPH was analyzed by logistic regression analysis using multivariable regression models which use categorical variables by the Cochran-Mantel-Haenszel test and continuous variables by the general linear model. Results Seven statistically significant variables for PA were selected. Regular exercise, frequency of exercise, sedentary time, nonsedentary time, leisure time PA (metabolic equivalent, hr/wk) were not statistically associated with prostate volume but sedentary time (hr/day) was the only factor that showed a significant association in the multivariable model, including a linear effect relationship. Subjects with lower levels of sedentary time (4.5-7.0 hr/day) had a significantly lower risk of BPH (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.52-1.67) than those with a higher sedentary time (>7 hr/day) (OR, 1.72; 95% CI, 0.96-3.09) (P for trend=0.05). Conclusions Our study showed that reducing sedentary time could have a protective effect and reduce the prevalence of BPH. Further prospective studies with a larger sample size are needed to assess the impact of reducing sedentary time on BPH risk. PMID:25279244

Lee, Ho Won; Nam, Ji Won; Kim, Mi Kyung; Choi, Bo Youl; Moon, Hong Sang

2014-01-01

132

Transurethral photodynamic therapy in benign prostatic hyperplasia : a canine pilot study using benzoporphyrin derivative  

NASA Astrophysics Data System (ADS)

Photodynamic therapy (PDT) principles were evaluated in management of benign prostatic hyperplasia (BPH) in a canine model. Five dogs were injected with benzoporphyrin derivative (BPD) and samples of prostate, bladder, urethra and rectum were taken at 1, 2, 3 and 4 hours and analyzed for BPD. Next, 16 dogs were treated with 100 Joules at 690 nm light form argon dye laser 1 hour after administration of BPD at 0.5 mg/kg using cylindrical diffuser tip fiber passed transurethrally. The prostates were harvested weekly up to 4 weeks and the size of the lesion was measured and the prostates were examined. Prostate had the highest BPD levels. Hemorrhagic lesion of 2.5 cm in diameter was noted at 1 week after PDT. At 3 and 4 weeks there were changes of glandular atrophy in the periurethral region. Minimally invasive technique of transurethral PDT causes glandular and stromal changes in the periurethral zone and has potential in the treatment of BPH.

Shetty, Sugandh D.; Peabody, James O.; Beck, Elsa R.; Cerny, Joseph C.; Amin, Mahul B.; Richter, Anna M.

1999-06-01

133

The University of Tennessee experience with the Indigo 830e laser device for the minimally invasive treatment of benign prostatic hyperplasia: interim analysis  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) is the most common benign tumor in men and is responsible for urinary symptoms in the\\u000a majority of men older than 50 years of age. Although transurethral resection of the prostate (TURP) is the gold standard,\\u000a its complications have impacted upon its utility. As a consequence, new pharmacologic and minimally invasive approaches to\\u000a the management of

Mark Greenberger; Mitchell S. Steiner

1998-01-01

134

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

135

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. PMID:24839489

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

2014-01-01

136

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

137

Holmium Laser Enucleation of the Prostate is Effective in the Treatment of Symptomatic Benign Prostatic Hyperplasia of Any Size Including a Small Prostate  

PubMed Central

Purpose Although transurethral resection of the prostate (TURP) is considered the standard surgical treatment for benign prostatic hyperplasia (BPH), Holmium laser enucleation of the prostate (HoLEP) is replacing TURP. We compared TURP with HoLEP with matching for prostate size. Materials and Methods We retrospectively reviewed the medical charts of patients who underwent TURP and HoLEP performed by one surgeon at our institute. All patients were categorized into 3 groups on the basis of prostate size (group 1, <40 g; group 2, 40-79 g; and group 3, >80 g), and 45 patients were selected for each method. Results No major intraoperative complications were encountered. The mean resected tissue weight was 6.3, 18.3, and 28.0 g for groups 1, 2, and 3, respectively, for TURP and 8.7, 25.0, and 39.8 g, respectively, for HoLEP. The mean operation time was 51.8, 89.3, and 101.9 minutes for TURP and 83.6, 122.8, and 131.2 minutes for HoLEP in groups 1, 2, and 3, respectively. HoLEP had better resection efficacy than TURP for any size prostate, but there was no statistical difference between the methods. Both methods resulted in an immediate and significant improvement of International Prostate Symptom Score, peak urinary flow rates, and postvoid residual urine volume. Conclusions HoLEP is effective for BPH treatment, regardless of prostate size, even in a small prostate. The perioperative morbidity of HoLEP is also comparable to that of TURP.

Lee, Min Ho; Yang, Hee Jo; Kim, Doo Sang; Lee, Chang Ho

2014-01-01

138

Meta-analysis of vitamin D receptor gene polymorphisms and benign prostatic hyperplasia risk.  

PubMed

The association between vitamin D receptor (VDR) gene polymorphisms and risk of benign prostatic hyperplasia (BPH) has been investigated in numerous publications, but published results remain inconclusive. Hence, we conducted this meta-analysis to derive a more precise conclusion. Four polymorphisms (Taq-I, Bsm-I, Apa-I, and Fok-I) of the VDR gene with risk of BPH from six case-control studies and one cohort study involving 2,248 individuals were identified from PubMed and China National Knowledge Internet databases up to November 20, 2013 (updated on March 5, 2014). After data extraction, the meta-analysis was performed using Comprehensive Meta-Analysis software. All four VDR polymorphisms were not associated with the risk of BPH [Taq-I: OR 0.61, 95 % CI (0.38-1.24) for tt vs. TT; Bsm-I: OR 1.27, 95 % CI (0.96-1.69) for bb vs. BB; Apa-I: OR 1.26, 95 % CI (0.64-2.46) for aa vs. AA; Fok-I: OR 0.95, 95 % CI (0.60-1.50) for ff vs. FF]. Subgroup analysis according to ethnicity for Taq-I polymorphism also showed that the polymorphism was not associated with risk of BPH for either Caucasians [OR 0.74, 95 % CI (0.31-1.78) for tt vs. TT] or Asians [OR 0.35, 95 % CI (0.11-1.11) for tt vs. TT]. However, results of this meta-analysis should be treated with caution because this meta-analysis has several limitations. We propose to conduct a high-quality study with large sample size to further identify the association between VDR gene polymorphisms and BPH susceptibility. PMID:24990700

Zeng, Xian-Tao; Yao, Qi-Sheng; Weng, Hong; Li, Sheng; Huang, Jing-Yu; Wang, Xing-Huan

2014-10-01

139

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

140

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 . ...

141

Initial Experiences with a 980 nm Diode Laser for Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia  

PubMed Central

Purpose This study was conducted to analyze the efficacy of photoselective vaporization of the prostate (PVP) with the use of a 980 nm diode laser for benign prostatic hyperplasia (BPH) according to postoperative period. Materials and Methods Data were collected from 96 patients who were diagnosed with BPH and who underwent PVP with the 980 nm K2 diode laser. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and post-void residual volume (PVR), were assessed and compared with preoperative baseline values. Results The mean prostate volume was 45.3±15.6 g, the mean operative time (lasing time) was 22.9±18.3 minutes, the total amount of energy was 126±84 kJ, and the Foley catheter maintenance period after PVP was 24.8±5.6 hours. At 1 month, significant improvements were noted in IPSS (11.7±6.6), QoL score (2.3±1.1), Qmax (12.7±6.1 ml/sec), and PVR (41.9±30.5 ml). After 3 months, all follow-up parameters showed significant improvements that were sustained throughout a period of 6 months after PVP. Conclusions PVP using a K2 diode laser is a minimally invasive and effective surgical method for improvement of BPH and is associated with minimal morbidity. PMID:22195264

Yang, Ki Su; Kim, In Gon; Han, Bo Hyun; Kong, Geun Soo

2011-01-01

142

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. PMID:16790044

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

2006-01-01

143

Comparison of spontaneous and experimentally induced canine prostatic hyperplasia.  

PubMed Central

Spontaneous prostatic hyperplasia in the beagle appears to progress with age from a glandular to a cystic histological appearance. Prostatic hyperplasia can be induced in young beagles with intact testes by treatment for 4 mo with either dihydrotestosterone or 5 alpha-androstane-3 alpha, 17 beta-diol, alone, or with either of these steroids in combination with 17 beta-estradiol. In contrast, the induction of prostatic hyperplasia in young castrated beagles, in which the gland had been allowed to involute for 1 mo, requires the administration of both 17 beta-estradiol and either 5 alpha-androstane-3 alpha, 17 beta-diol or dihydrotestosterone. Testosterone and 17 beta-estradiol, either singly or in combination, did not produce the hyperplastic condition in intact or castrated beagles. The experimentally induced prostatic hyperplasia is identical in pathology to the glandular hyperplasia that occurs naturally in the aging dog with intact testes. However, cystic hyperplasia was not produced by any of the treatments tested in young animals. Images PMID:89121

DeKlerk, D P; Coffey, D S; Ewing, L L; McDermott, I R; Reiner, W G; Robinson, C H; Scott, W W; Strandberg, J D; Talalay, P; Walsh, P C; Wheaton, L G; Zirkin, B R

1979-01-01

144

Randomized clinical trial comparing low power-slow heating versus high power-rapid heating noncontact neodymium:yttrium-aluminum-garnet laser regimens for the treatment of benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesTo evaluate and compare the safety and effectiveness of two noncontact laser regimens for the treatment of human benign prostatic hyperplasia (BPH), and to assess the impact of the spatial distribution of the laser-induced lesions on treatment outcome.

Eduardo Orihuela; Thomas Cammack; Motamedi Massoud; Lahaye Marcel; Pow-Sang Mariela; Torres Jorge; DeAngelis Adrienne; Michael M. Warren

1995-01-01

145

Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique  

Microsoft Academic Search

This study examined efficacy and safety of the 980 nm side-firing diode laser operating at a power of 100 W in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). Patients were selected for surgery on the basis of maximum urinary flow rate (Qmax) ?15 ml\\/s or transvesically measured post-voiding residual volume (PVR) >100 ml in conjunction

R Leonardi

2009-01-01

146

Comparison of artificial intelligence and machine learning algorithms as a predictor of surgical outcomes in benign prostatic hyperlasia cases (BPH)  

NASA Astrophysics Data System (ADS)

Predicting the clinical outcome prior to minimally invasive treatments for Benign Prostatic Hperlasia (BPH) cases would be very useful. However, clinical prediction has not been reliable in spite of multiple assessment parameters such as symptom indices and flow rates. In this study, Artificial Intelligence (AI) algorithms are used to train computers to predict the surgical outcome in BPH patients treated by TURP or VLAP. Our aim is to investigate whether AI can reproduce the clinical outcome of known cases and assist the urologist in predicting surgical outcomes. Four different AI algorithms are used.

Megherbi, Dalila B.; Boulenouar, A. J.; Kaula, N.; Tracy, D.; Lodhi, S. M.; Dixon, C.

2001-07-01

147

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. PMID:23596606

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

2012-01-01

148

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. PMID:23728585

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

2013-01-01

149

The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review.  

PubMed

A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia (BPH) on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy (TUMT), transurethral needle ablation of the prostate (TUNA), transurethral ethanol ablation of the prostate (TEAP) and high-intensity frequency ultrasound (HIFU), in comparison with traditional transurethral resection of the prostate (TURP) or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction (EjD) is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies (> 33.6%). TUMT, TUNA and neodymium:yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP. PMID:20473318

Frieben, Ryan W; Lin, Hao-Cheng; Hinh, Peter P; Berardinelli, Francesco; Canfield, Steven E; Wang, Run

2010-07-01

150

The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review  

PubMed Central

A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia (BPH) on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy (TUMT), transurethral needle ablation of the prostate (TUNA), transurethral ethanol ablation of the prostate (TEAP) and high-intensity frequency ultrasound (HIFU), in comparison with traditional transurethral resection of the prostate (TURP) or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction (EjD) is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies (> 33.6%). TUMT, TUNA and neodymium:yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP. PMID:20473318

Frieben, Ryan W.; Lin, Hao-Cheng; Hinh, Peter P.; Berardinelli, Francesco; Canfield, Steven E.; Wang, Run

2010-01-01

151

New Advances in Benign Prostatic Hyperplasia: Laser Therapy  

Microsoft Academic Search

Throughout the past decade, numerous techniques for the treatment of benign prostatic hyperplasia have emerged. Laser therapy,\\u000a in particular, has gained widespread popularity among urologists. Since its inception in 1996, holmium laser enucleation of\\u000a the prostate (HoLEP) has been evaluated rigorously in the treatment of glands of all sizes. HoLEP has produced superior relief\\u000a of bladder outlet obstruction as compared

Jessica Mandeville; Ehud Gnessin; James E. Lingeman

2011-01-01

152

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. PMID:25032196

Matondang, Faisal Abdi; Rahardjo, Harrina Erlianti

2014-01-01

153

Canadian trend in surgical management of benign prostatic hyperplasia and laser therapy from 2007-2008 to 2011-2012  

PubMed Central

Introduction: Clinically benign prostatic hyperplasia (BPH) is classically associated by the progressive development of lower urinary tract symptoms (LUTS). The incidence of bothersome LUTS is associated with age and may vary in patients over 50 years old. In many developing countries with an aging population, BPH associated with LUTS has become a major health issue. To optimize quality of care and control of cost, there is an imperative need to examine the pattern of BPH management. The goal of this study is to capture the Canadian trend in surgical management of BPH and the use of laser therapy during the last 5 years from 2007–2008 to 2011–2012. Methods: We collected the number of transurethral resection of the prostate (TURP) procedures performed in each province in Canada from the Canadian Institute for Health Information (CIHI) reports for the fiscal years (April 1st–March 31st) of 2007–2008, 2008–2009, 2009–2010, 2010–2011 and 2011–2012. Results: Overall, the total number of TURP procedures remained stable from 20 294 procedures per year in 2007 to 20 629 in 2011. In terms of distribution according to provinces, in 2011, about 40% of procedures were performed in Ontario, 20% in BC, 18 in Quebec and 8% in Alberta. These proportions between provinces have remained similar and stable between 2007 and 2011. In contrast, the number of alternative minimally invasive procedures has slowly grown from 767 interventions in 2007 to 1559 in 2011. Overall, laser procedures represented 7.6% of the total number of BPH surgeries in Canada in 2011. The contribution of laser therapy to the amount of total BPH procedures largely varied between provinces. Conclusions: The use of minimally invasive laser procedure alternatives to TURP is progressively growing. Among the novel laser therapies, HoLEP and GreenLight vaporization are the only procedures that have demonstrated equivalent outcomes compared to TURP in randomized clinical trials. Furthermore, due to shorter hospital stay, these novel laser modalities have the potential to reduce healthcare expenses for the treatment of BPH. We can infer that following the trend observed in the United States, the number of laser therapies for BPH in Canada may increase significantly during the coming years. PMID:24069100

Hueber, Pierre-Alain; Zorn, Kevin C.

2013-01-01

154

Inhibition of prostate cell growth by BXL-628, a calcitriol analogue selected for a phase II clinical trial in patients with benign prostate hyperplasia  

Microsoft Academic Search

Objective: Calcitriol analogues might represent an interesting new therapy for benign prostate hyper- plasia (BPH). We here report the preclinical characterization of BXL-628, an analogue selected for an ongoing double-blind, randomized, placebo-controlled phase II trial in BPH. Design: Experiments with BXL-628 were carried out in human BPH cells and in the ventral prostate of intact and castrated rats. Methods: BPH

C Crescioli; P Ferruzzi; A Caporali; M Scaltriti; S Bettuzzi; R Mancina; S Gelmini; M Serio; D Villari; G B Vannelli; E Colli; L Adorini; M Maggi

2004-01-01

155

Is There a Role for ?-Blockers for the Treatment of Voiding Dysfunction Unrelated to Benign Prostatic Hyperplasia?  

PubMed Central

?-Adrenoreceptor antagonists have become the primary medical treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). It was presumed that the primary mechanism by which ?-blockers reduced lower urinary tract symptoms (LUTS) was by relaxation of smooth muscle in the prostate through a sympathetic response. Reduction of outlet resistance leads to changes in bladder function, thus improving both storage and voiding symptoms. However, it was observed that many patients with BPH-associated LUTS had significant improvement in storage symptoms without subjective or objective improvement in voiding. Storage symptoms associated with detrusor overactivity (frequency, urgency, and urge incontinence) are typically thought of as being parasympathetically mediated, and therefore anticholinergic medications have been the mainstay of pharmacological treatment, but recent work has suggested that several nonparasympathetic-mediated mechanisms may cause detrusor overactivity. Because ? receptors appear to play a role in lower urinary tract function at multiple sites and levels, ?-blockers could be used to treat voiding dysfunction not related to BPH. In addition, these nonprostate effects should be gender-independent, making the use of ?-blockers plausible in women with specific types of voiding dysfunction. PMID:16986055

Nitti, Victor W

2005-01-01

156

Transitional Zone Index and Intravesical Prostatic Protrusion in Benign Prostatic Hyperplasia Patients: Correlations according to Treatment Received and Other Clinical Data  

PubMed Central

Purpose The aim of this research was to assess the value of the transitional zone index (TZI) and intravesical prostatic protrusion (IPP) from transrectal ultrasonography in evaluating the severity and progression of disease by analyzing the relationship between the 2 parameters and symptoms, clinical history, and urodynamics in benign prostatic hyperplasia (BPH) patients undergoing different treatment. Materials and Methods A total of 203 patients receiving medication and 162 patients who underwent transurethral resection of the prostate because of BPH were enrolled in this retrospective analysis. The clinical history and subjective and objective examination results of all patients were recorded and compared after being classified by TZI and IPP level. Linear regression was used to find correlations between IPP, TZI, and urodynamics. Results The 2 parameters were found to differ significantly between patients receiving medication and patients undergoing surgical therapy (p<0.05). PSA, maximum flow rate (Qmax), detrusor pressure at Qmax (PdetQmax), and the bladder outlet obstruction index (BOOI) differed according to various TZI levels (p<0.05). In addition, the voiding symptom score, Qmax, and BOOI of subgroups with various IPP levels were also significantly different (p<0.05). Both TZI and IPP had significant effects on Qmax, BOOI, and PdetQmax (p<0.05) and the incidence of acute urinary retention (p=0.000). Conclusions The results demonstrated that both TZI and IPP had favorable value for assessing severity and progression in patients with BPH. Further studies are needed to confirm whether the two parameters have predictive value in the efficacy of BPH treatment and could be considered as factors in the selection of therapy. PMID:22536468

Huang, Tao; Yu, YongJiang; Xu, Ding; Jiao, Yang; Kang, Jian; Zhu, YunKai; Chen, YaQing

2012-01-01

157

[New developments in the diagnosis of benign prostatic hyperplasia].  

PubMed

The first phase in the diagnosis of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is to exclude another disease. This initial evaluation consist of anamnesis, including the quantification of symptoms according to the International Prostatic Symptom Score, physical examination--with digital rectal examination playing a central role, urinalysis, and renal function assessment; the prostate-specific antigen may suggest prostate cancer or may predict the volume of the prostate and the natural evolution of the disease. If, after the initial evaluation, the diagnosis is still uncertain, further investigations are necessary: imagistic exploration of the urinary tract, urodynamic tests or urethro-cystoscopy. The authors review current knowledge. PMID:19292085

Vaida, M; Novac, B; Gheorghiu, V; Novac, C

2006-01-01

158

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

Microsoft Academic Search

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

Mariela Pow-Sang; Eduardo Orihuela; Massoud Motamedi

1995-01-01

159

Components of the metabolic syndrome—risk factors for the development of benign prostatic hyperplasia  

Microsoft Academic Search

The purpose of the present study was to perform a BPH risk factor analysis in men, relating the prostate gland volume to components of the metabolic syndrome and to identify clues to the etiology of BPH.Our material comprised a consecutive series of 158 patients with lower urinary tract symptoms with or without manifestations of the metabolic syndrome. In this group,

J Hammarsten; B Högstedt; N Holthuis; D Mellström

1998-01-01

160

A randomized prospective study of laser ablation of the prostate versus transurethral resection of the prostate in men with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To compare the safety and efficacy of laser ablation of the prostate, one of the minimally invasive treatments available for men with benign prostatic hyperplasia, to transurethral resection of the prostate (TURP).Methods. A prospective randomized study of 100 men with benign prostatic hyperplasia, with 50 patients in each treatment arm, was conducted. All patients met the entry criteria: age

W. Bruce Shingleton; F Terrell; D. L Renfroe; John M Kolski; Jackson E Fowler

1999-01-01

161

Clinical evaluation of free PSA\\/Total PSA (Prostate-specific Antigen) ratio in the diagnosis of prostate cancer  

Microsoft Academic Search

The objective of this study was to evaluate the utility of the free\\/total prostate-specific antigen (PSA) ratio (per cent free PSA) in the diagnosis of prostate cancer. Serum total PSA and free PSA concentrations were measured in 156 patients with benign prostate hyperplasia (BPH) and 74 patients with prostate cancer using Hybritech Tandem immunoradiometric assays. Patients with prostate cancer had

X Filella; J Alcover; R Molina; A Rodríguez; P Carretero; A. M Ballesta

1997-01-01

162

Influence of Intravesical Prostatic Protrusion on Preoperative Lower Urinary Tract Symptoms and Outcomes after 120 W High Performance System Laser Treatment in Men with Benign Prostatic Hyperplasia  

PubMed Central

Purpose To evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 120 W Greenlight high performance system (HPS) laser for the treatment of benign prostatic hyperplasia (BPH) with intravesical prostatic protrusion (IPP). Materials and Methods This study was conducted on 389 BPH patients who underwent PVP with the 120 W HPS laser from April 2009 to August 2011. The patients were divided into groups according to IPP: group I was defined as IPP of 0 to 5 mm (n=216), group II as IPP of 5 to 10 mm (n=135), and group III as IPP above 10 mm (n=38). Prostate volume, prostate-specific antigen, International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), and postvoid residual volume (PVR) were assessed and checked at postoperative 1, 3, 6, and 12 months. Results There was a significant difference in the mean prostate size in each group (p<0.05). The preoperative total IPSS score, IPSS voiding symptom score, and quality of life score were not significantly different. However, the IPSS storage symptom score was significantly different between groups 1 and 2 and group 3. IPSS scores, Qmax, and PVR at postoperative 1, 3, 6, and 12 months showed significant improvement compared with preoperative values. Conclusions The degree of IPP can affect storage symptoms. However, there is no significant correlation between the degree of IPP and postoperative results. Also, the degree of IPP does not affect short- and long-term PVP results. Proper elimination of bladder outlet obstruction is important for symptomatic relief. PMID:22866218

Wee, Jang Ho; Choi, Yong Sun; Bae, Woong Jin; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl

2012-01-01

163

Initial clinical results of laser prostatectomy procedure for symptomatic BPH using a new 50-watt diode laser (wavelength 1000 nm)  

Microsoft Academic Search

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

Krishna M. Bhatta

1995-01-01

164

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

165

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

166

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

167

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. PMID:23671400

Bostanci, Yakup; Kazzazi, Amir; Djavan, Bob

2013-01-01

168

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

169

Is Increased Prostatic Urethral Angle Related to Lower Urinary Tract Symptoms in Males with Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms?  

PubMed Central

Purpose The prostatic urethra is a bent tube, and the clinical significance of the prostatic urethral angle (PUA) was recently reported. We investigated the statistical significance of an increased PUA on the International Prostate Symptom Score (IPSS) in men with benign prostatic hyperplasia (BPH)/lower urinary tract symptom (LUTS). Materials and Methods A retrospective analysis was done of 270 men with BPH/LUTS from July 2009 to June 2011. Prostate volume, PUA, and intravesical prostatic protrusion (IPP) were measured by transrectal ultrasonography (TRUS). The IPSS was analyzed separately as storage and voiding symptom score. In order to minimize the effect of prostate size on voiding, patients with prostate size over 40 ml were excluded. Results The mean age was 62.0±9.3 years. The mean prostate volume was 29.0±5.5 ml (range, 20 to 40 ml), and median PUA and IPP were 34° (range, 12 to 52°) and 1.7 mm (range, 0 to 5.3 mm), respectively. The mean IPSS, mean IPSS-ss, and mean IPSS-vs were 19.0±8.2, 7.3±4.0, and 11.6±5.5, respectively. The prostate volume had no statistically significant correlation with IPSS, IPSS-ss, or IPSS-vs. IPP had a statistically significant correlation with IPSS (p<0.001), IPSS-ss (p<0.001), and IPSS-vs (p<0.001). PUA had no statistically significant correlation with IPSS or IPSS-ss. However, PUA had a significant correlation with IPSS-vs (p=0.047). Comparing a higher PUA (?34°) with a lower PUA (<34°), patients with a higher PUA had a higher IPSS (p=0.001) and a higher IPSS-vs (p=0.001). There was no significant difference in IPSS-ss, prostate volume, or PSA between the two groups. Conclusions IPP showed significantly correlated with the IPSS and voiding symptom score was affected by the PUA but not by the prostate volume. As the PUA increased, the patients' voiding symptoms worsened. Further study may be needed. PMID:22741050

Park, Yoo Jun; Bae, Kwon Ho; Jin, Byung Soo; Jung, Hyun Jin

2012-01-01

170

[Assessment of clinical usefulness of Eviprostat for benign prostatic hyperplasia--comparison of Eviprostat tablet with a formulation containing two-times more active ingredients].  

PubMed

We compared the usefulness of Eviprostat tablet, a therapeutic agent for benign prostatic hyperplasia (BPH), and EVI-F tablet, a new formulation of Eviprostat containing two times more active ingredients (Chimaphila umbellata extract, Populus tremula extract, Pulsatilla pratensis extract, Equisetum arvense extract and purified wheat germ oil) and consequently designed to reduce the number of tablets per dose by half. In this study, patients with BPH were randomly assigned to either Eviprostat group (6 tabs/day) or EVI-F group (3 tabs/day) using the envelope method. The clinical efficacy of these two drugs were evaluated by the International Prostate Symptom Score (IPSS) and QOL score at the end of the treatment period, and their safety was evaluated by the incidence of side effects. Based on the clinical study guidelines for dysuria, the change in the IPSS total score and QOL score were comparable to the previously reported data for other treatment agents for BPH, and these indices showed gradual improvement with the treatment period. Both treatments were well tolerated. The clinical usefulness of the monotherapy with EVI-F tablet or Eviprostat tablet was reasonably demonstrated in this study. Furthermore, both treatments reduced nocturia, which has an impact on the QOL of patients with BPH. PMID:18634442

Tamaki, Masahiro; Nakashima, Masakazu; Nishiyama, Ryuichi; Ikeda, Hiroki; Hiura, Masaru; Kanaoka, Toshio; Nakano, Tadasu; Hayashi, Tadashi; Ogawa, Osamu

2008-06-01

171

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

172

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. PMID:21572447

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

2011-01-01

173

Management of Symptomatic BPH in the US: Who Is Treated and How?  

Microsoft Academic Search

Objective: To review the contemporary management of symptomatic benign prostatic hyperplasia (BPH) in North America. Methods: Information was obtained from published scientific articles, lay press articles, Medicare outcomes data, IMS market analysis data and surveys among primary care practitioners and urologists. Results: A survey in Olmsted County in the US identified the number of men with an I-PSS score >7

Reginald Bruskewitz

1999-01-01

174

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. PMID:24649042

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

2013-01-01

175

Increased cell-free DNA in plasma of patients with metastatic spread in prostate cancer  

Microsoft Academic Search

We compared the plasma DNA concentrations in patients with different prostate cancer (PCa) stages and with benign prostate hyperplasia (BPH) and in healthy persons. Patients with localized cancer had DNA plasma within the reference interval. Increased plasma DNA was found in patients with lymph node and distant metastases and also in BPH. The association between plasma DNA and the survival

Klaus Jung; Carsten Stephan; Michaela Lewandowski; Silke Klotzek; Monika Jung; Glen Kristiansen; Michael Lein; Stefan A Loening; Dietmar Schnorr

2004-01-01

176

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

177

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

178

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. PMID:23462673

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

179

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. PMID:24044089

Kim, Myong; Lee, Hahn-Ey

2013-01-01

180

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up  

PubMed Central

Introduction: We evaluate the efficacy and outcomes of plasma-kinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH). Methods: A total of 183 patients with BPH underwent plasma-kinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization. Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 ± 3.819 and Group 2 had a 18.15 ± 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 ± 1.049 days, and in Group 2 it was 2.64 ± 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR). Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year. PMID:25295128

Karadag, Mert Ali; Cecen, Kursat; Demir, Aslan; Kocaaslan, Ramazan; Altunrende, Fatih

2014-01-01

181

Modulatory effect of silymarin on inflammatory mediators in experimentally induced benign prostatic hyperplasia: emphasis on PTEN, HIF-1?, and NF-?B.  

PubMed

The current study aimed to investigate the potential role of the anti-inflammatory effects of silymarin (SIL) in inhibiting experimentally induced benign prostatic hyperplasia (BPH) in rats. Rats were injected testosterone (3 mg/kg/day, subcutaneously (s.c.)) for 2 weeks. In the treatment group, SIL (50 mg/kg, per orally (p.o.)) was administered daily to rats concomitantly with testosterone. Rats were killed 72 h after the last testosterone injection. Then, prostate tissues were dissected out, weighed, and subjected to histological, immunohistochemical, and biochemical examinations. Rats treated with testosterone showed marked increase in prostate weight and prostate weight/body weight with histopathological picture of inflammation and hyperplasia as well as increased collagen deposition. Co-treatment with SIL significantly alleviated these pathological changes. Further, SIL attenuated testosterone-induced nuclear factor-kappa B (NF-?B), cyclooxygenase-II (COX-II), and inducible nitric oxide synthase (iNOS) upregulation, and blunted testosterone-mediated increase in nitric oxide level and messenger RNA (mRNA) expression of interleukin-6 (IL-6) and IL-8. Testosterone-induced downregulation of phosphatase and tensin homolog (PTEN) and upregulation of hypoxia-inducible factor 1? (HIF-1?) were alleviated by SIL. Our findings highlight the anti-inflammatory properties of SIL as a crucial mechanism of its preventive actions against experimental BPH. This can be attributed to, at least partly, attenuating the expression of NF-kB and the subsequent inflammatory cascade, ameliorating the expression of PTEN, and mitigating that of HIF-1?. These data warrant further investigations for the potential use of SIL in the management of BPH. PMID:25164963

Atawia, Reem T; Mosli, Hala H; Tadros, Mariane G; Khalifa, Amani E; Mosli, Hisham A; Abdel-Naim, Ashraf B

2014-12-01

182

The Effects of Chlormadinone Acetate on Lower Urinary Tract Symptoms and Erectile Functions of Patients with Benign Prostatic Hyperplasia: A Prospective Multicenter Clinical Study  

PubMed Central

Purpose. To evaluate the effects of chlormadinone acetate (CMA), progesterone-derived antiandrogen, on lower urinary tract symptoms (LUTS) and erectile functions of benign prostatic hyperplasia (BPH). Methods. A multicenter, single-cohort prospective study was conducted. A total of 114 patients received CMA for 16 weeks. The endpoints were changes in International Prostate Symptom Scores (IPSS), IPSS-QOL, International Index of Erectile Function-5, Qmax prostate volume, and residual urine volume. Results. Significant improvements were observed in IPSS from week 8 to week 48 (32 weeks after treatment). IPSS-QOL improvements were also significant from week 8 to week 48. Qmax increased to a maximum at Week 16 and remained elevated throughout the study. Moreover, a decrease of 25% in prostate volume was observed at Week 16. IPSS, QOL, and Qmax changes during the study were not different between the previously treated and untreated patients. IPSS storage subscore changes differed between the age groups. Few severe adverse reactions were observed, except for erectile dysfunction. Conclusions. CMA rapidly and significantly reduced prostate volume and improved voiding and storage symptoms and QOL. Our results suggest that CMA is safe and beneficial, especially for elderly patients with LUTS associated with BPH. PMID:23762042

Fujimoto, Kiyohide; Hirao, Yoshihiko; Ohashi, Yasuo; Fuji, Kohzo; Tsuji, Hidenori; Miyazawa, Katsuhito; Ohtani, Mikinobu; Furuya, Ryoji; Boku, Eitetsu

2013-01-01

183

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

184

Prostate brachytherapy in patients with median lobe hyperplasia.  

PubMed

Our aim was to document the technical and clinical course of prostate brachytherapy patients with radiographic evidence of median lobe hyperplasia (MLH). Eight patients with MLH were identified during our routine brachytherapy practice, representing 9% of the 87 brachytherapy patients treated during a 6-month period. No effort was made to avoid brachytherapy in patients noted to have MLH on diagnostic work-up. Cystoscopic evaluation was not routinely performed. Postimplant axial computed tomographic (CT) images of the prostate were obtained at 0.5 cm intervals. Preimplant urinary obstructive symptoms were quantified by the criteria of the American Urologic Association (AUA). Each patient was contacted during the writing of this report to update postimplant morbidity information. There was no apparent association between the degree of MLH and preimplant prostate volume or AUA score. Intraoperatively, we were able to visualize MLH by transrectal ultrasound and did not notice any particular difficulty placing sources in the MLH tissue or migration of sources out of the tissue. The prescription isodose covered from 81% to 99% of the postimplant CT-defined target volume, achieving adequate dose to the median lobe tissue in all patients. Two of the eight patients developed acute, postimplant urinary retention. The first patient required intermittent self-catheterization for 3 months and then resumed spontaneous urination. MLH does not appear to be a strong contraindication to prostate brachytherapy, and prophylactic resection of hypertrophic tissue in such patients is probably not warranted. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 152-156 (2000). PMID:10900427

Wallner, K; Smathers, S; Sutlief, S; Corman, J; Ellis, W

2000-06-20

185

International Prostate Symptom Score and Quality of Life Assessment Versus Urodynamic Parameters in Men with Benign Prostatic Hyperplasia Symptoms  

Microsoft Academic Search

In 207 men with symptomatic benign prostatic hyperplasia the international prostate symptom score and score on quality of life were collected. Cystometric tests with pressure-flow studies were performed in these patients with special attention to the assessment of obstruction grade. Of the men 24 percent appeared not to have obstruction. A significant correlation was found between size of the prostate

G. E. P. M. van Venrooij; T. A. Boon; R. P. E. de Gier

1995-01-01

186

A comparison of the free fraction of serum prostate specific antigen in men with benign and cancerous prostates: the best case scenario  

Microsoft Academic Search

PurposeIn most previous studies of free-to-total serum prostate specific antigen (PSA) ratios, the specimens from patients with prostate cancer or those with benign prostatic hyperplasia (BPH) have not been highly characterized. We compared preoperative sera from post-radical prostatectomy patients with clinically significant cancers of at least 2 cm.3 to sera from those with BPH and large, biopsy negative prostates.

Anthony F. Prestigiacomo; Hans Lilja; Kim Pettersson; Robert L. Wolfert; Thomas A. Stamey

1996-01-01

187

Can simple tests performed in the primary care setting provide accurate and efficient diagnosis of benign prostatic hyperplasia? Rationale and design of the Diagnosis Improvement in Primary Care Trial.  

PubMed

Effective treatment of benign prostatic hyperplasia (BPH) improves lower urinary tract symptoms (LUTS) and patient quality of life, and reduces the risk of complications arising from disease progression. However, treatment can only be initiated when men with BPH are identified by accurate diagnostic tests. Current evidence suggests that diagnostic procedures employed by primary care physicians vary widely across Europe. The expected increases in BPH prevalence accompanying the gradual aging of the population, coupled with greater use of medical therapy, mean that general practitioners (GPs) are likely to have an increasingly important role in managing the condition. The GP/primary care clinic is therefore an attractive target location for strategies designed to improve the accuracy of BPH diagnosis. The Diagnosis Improvement in Primary Care Trial (D-IMPACT) is a prospective, multicentre, epidemiological study that aims to identify the optimal subset of simple tests applied by GPs in the primary care setting to diagnose BPH in men who spontaneously report obstructive (voiding) and/or irritative (storage) LUTS. These tests comprise medical history, symptom assessment with the International Prostate Symptom Score questionnaire, urinalysis, measurement of serum levels of prostate-specific antigen and subjective GP diagnosis after completing all tests including digital rectal examination. GP diagnoses and all other tests will be compared with gold-standard diagnoses provided by specialist urologists following completion of additional diagnostic tests. D-IMPACT will establish the diagnostic performance using a non-subjective and reproducible algorithm. An adjusted and multivariate analysis of the results of D-IMPACT will allow identification of the most efficient combination of tests that facilitate accurate BPH diagnosis in the primary care setting. In addition, D-IMPACT will estimate the prevalence of BPH in patients who present spontaneously to GPs with LUTS. PMID:19558487

Carballido, J; Fourcade, R; Pagliarulo, A; Cricelli, C; Brenes, F; Pedromingo-Marino, A; Castro, R

2009-08-01

188

Efficacy of Alpha Blocker Treatment According to the Degree of Intravesical Prostatic Protrusion Detected by Transrectal Ultrasonography in Patients with Benign Prostatic Hyperplasia  

PubMed Central

Purpose To analyze the effectiveness of tamsulosin 0.2 mg once daily for 3 months according to the degree of intravesical prostatic protrusion (IPP) in patients with benign prostatic hyperplasia (BPH). Materials and Methods A total of 134 BPH patients over 40 years of age treated with tamsulosin 0.2 mg between January 2007 and January 2009 were enrolled retrospectively. The patients were classified into three groups according to the degree of IPP: below 5 mm (group A), between 5 and 10 mm (group B), and over 10 mm (group C). Prostate volume, prostate-specific antigen (PSA), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were evaluated before treatment. International Prostate Symptom Score and Quality of Life (IPSS/QoL), maximal urine flow rate (Qmax), and postvoid residual (PVR) volume were measured before treatment, and improvement in the three groups was compared after 3 months. Results The mean age of the patients was 65.01±7.38 years. Mean IPPs were 0.90±1.39 mm (group A, n=90), 6.92±1.10 mm (group B, n=24), and 16.60±4.06 mm (group C, n=20). Prostate volume, PUL, PAUL, PSA, Qmax, and PVR showed significant correlations with IPP (p<0.05), but not with IPSS/QoL score (p>0.05). Comparison of parameters before and after 3 months showed that medication improved total IPSS and subscores (p<0.001), QoL (p<0.001), Qmax (p<0.001), and PVR (p=0.030) in group A. In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03). In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved. Conclusions Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP. PMID:22379587

Park, Hee Young; Lee, Joo Yong; Park, Sung Yul; Lee, Seung Wook; Kim, Yong Tae; Choi, Hong Yong

2012-01-01

189

The Efficacy and Safety of Photoselective Vaporization of the Prostate with a Potassium-titanyl-phosphate Laser for Symptomatic Benign Prostatic Hyperplasia according to Prostate Size: 2-Year Surgical Outcomes  

PubMed Central

Purpose We investigated 2-year follow-up outcomes of patients who underwent potassium-titanyl-phosphate (KTP)-photoselective vaporization of the prostate (PVP) laser therapy for symptomatic benign prostatic hyperplasia (BPH). Materials and Methods Of a total of 169 patients who underwent 80 W KTP-PVP by a single surgeon, we retrospectively analyzed the clinical data of 74 patients who completed 2 years of follow-up. The efficacy of the PVP was assessed at 1, 3, 6, 12, and 24 months postoperatively by use of the International Prostate Symptom Score (IPSS) and uroflowmetry with postvoid residual urine volume (PVR). Safety, including complications, was evaluated at each visit. Results Mean preoperative total prostate and transitional zone volumes were 42.3 ml (range, 34.0-59.0 ml) and 18.6 ml (range, 10.1-28.6 ml) respectively. According to both IPSS and uroflowmetry, compared with baseline, the improvement in each parameter was sustained significantly at both 1 and 2 years postoperatively (p<0.05). There were no serious intraoperative complications, such as massive hemorrhage requiring transfusion or transurethral resection syndrome. Transient gross hematuria occurred in 16 (21.6%) cases, urgency incontinence in 6 (8.1%) cases, bladder neck contracture (BNC) in 3 (4.1%) cases, and urethral stricture in 1 (2.7%) case. The cases of urethral stricture and BNC developed only in the group with a prostate size of less than 45 ml. No cases required reoperation due to re-growing prostatic tissue. Conclusions PVP seems to be a safe and effective procedure for the surgical treatment of symptomatic BPH. After PVP, the subjective and objective improvements in the micturition parameters were sustainable up to 2 years, with minimal complications. PMID:20495696

Kim, Hyung Suk; Cho, Min Chul; Ku, Ja Hyeon; Kim, Soo Woong

2010-01-01

190

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

Microsoft Academic Search

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.

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

1997-01-01

191

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

192

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

193

The difference in oxidative stress of the blood between using 5% glucose water and distilled water as the irrigant for BPH patients undergoing transurethral resection of the prostate  

Microsoft Academic Search

Introduction  To evaluate the difference in oxidative stress in the blood between using 5% glucose water and using distilled water as the\\u000a irrigant for BPH patients receiving transurethral resection of the prostate (TURP), we conducted this prospective study, on\\u000a a total of 38 patients with symptomatic BPH. \\u000a \\u000a \\u000a \\u000a Materials and methods  All the patients were randomly divided into 2 groups. Distilled water in

Shiou-Sheng Chen; Shi-Bei Wu; Yau-Huei Wei

2010-01-01

194

Profiling molecular targets of TGF-?1 in prostate fibroblast-to-myofibroblast transdifferentiation  

Microsoft Academic Search

The development of age-related proliferative disorders of the prostate gland is supported by transdifferentiation and cellular senescence processes in the stroma. Both processes are involved in remodeling of stromal tissue, as observed in benign prostatic hyperplasia (BPH), and in “reactive stroma” adjacent to prostate cancer (PCa). It has been assumed that TGF-?1 plays a key role in the aging prostate

Gerold Untergasser; Roland Gander; Claudia Lilg; Günter Lepperdinger; Eugen Plas; Peter Berger

2005-01-01

195

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

PubMed

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. PMID:19881144

Varshney, Anil; Agarwal, Anshuman

2009-07-01

196

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. PMID:24019857

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

197

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. PMID:22630338

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

2013-01-01

198

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

PubMed

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. PMID:22630338

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

2012-05-15

199

The high-powered holmium laser to treat benign prostatic hyperplasia  

Microsoft Academic Search

Since 1994, the high-powered holmium laser has been used to treat benign prostatic hyperplasia with various techniques. The\\u000a current technique of holmium laser enucleation of the prostate is a true surgical enucleation of the adenoma, as evidenced\\u000a by prostate-specific antigen data, pathologic tissue weight, and urodynamic parameters compared with transurethral resection\\u000a of the prostate and, more importantly, open prostatectomy. The

Liam C. Wilson; Peter J. Gilling

2008-01-01

200

Holmium laser enucleation versus open prostatectomy for benign prostatic hyperplasia: An inpatient cost analysis  

Microsoft Academic Search

ObjectivesTo compare the cost of open transvesical prostatectomy (OP) with that of holmium laser enucleation (HoLEP) in the treatment of bladder outlet obstruction (BOO) attributed to benign prostatic hyperplasia.

Andrea Salonia; Nazareno Suardi; Richard Naspro; Bruno Mazzoccoli; Giuseppe Zanni; Andrea Gallina; Lina Bua; Vincenzo Scattoni; Patrizio Rigatti; Francesco Montorsi

2006-01-01

201

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

202

Percentage of free serum prostate-specific antigen: A new tool in the early diagnosis of prostatic cancer  

Microsoft Academic Search

Prostate-specific antigen (PSA) is a protease able to bind to serum antiproteases as alpha 1 antichymotrypsin (ACT). Free PSA (FPSA) corresponds to the fraction of total PSA (TPSA) which is unbound to ACT. Specific detection of the FPSA seems to be a valuable tool in the distinction between prostatic cancer (PCa) and benign prostatic hyperplasia (BPH). Our aim was to

M.-E. Toubert; J. Guillet; M. Chiron; P. Meria; C. Role; M.-H. Schlageter; H. Francois; C. Borschneck; F. Nivelon; F. Desgrandchamps; D. Rastel; O. Cussenot; P. Teillac; A. Le Duc; Y. Najean

1996-01-01

203

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. PMID:24175041

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

2013-01-01

204

Hyperplasia  

MedlinePLUS

Hyperplasia is increased cell production in a normal tissue or organ. Hyperplasia may be a sign of abnormal or precancerous changes. This is called pathologic hyperplasia. It can also be due to the growth ...

205

Interleukin-driven insulin-like growth factor promotes prostatic inflammatory hyperplasia.  

PubMed

Prostatic inflammation is of considerable importance to urologic research because of its association with benign prostatic hyperplasia and prostate cancer. However, the mechanisms by which inflammation leads to proliferation and growth remain obscure. Here, we show that insulin-like growth factors (IGFs), previously known as critical developmental growth factors during prostate organogenesis, are induced by inflammation as part of the proliferative recovery to inflammation. Using genetic models and in vivo IGF receptor blockade, we demonstrate that the hyperplastic response to inflammation depends on interleukin-1-driven IGF signaling. We show that human prostatic hyperplasia is associated with IGF pathway activation specifically localized to foci of inflammation. This demonstrates that mechanisms of inflammation-induced epithelial proliferation and hyperplasia involve the induction of developmental growth factors, further establishing a link between inflammatory and developmental signals and providing a mechanistic basis for the management of proliferative diseases by IGF pathway modulation. PMID:25292180

Hahn, Alana M; Myers, Jason D; McFarland, Eliza K; Lee, Sanghee; Jerde, Travis J

2014-12-01

206

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. PMID:24808637

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

2014-01-01

207

Botulinum toxin for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia  

Microsoft Academic Search

Botulinum toxin (BTX) is the most potent biological toxin used for the treatment of urologic conditions. During the last 3 years, the use of BTX has been extended to the treatment of symptomatic benign prostatic hyperplasia, however, the actual mechanism through which BTX can reduce prostate volume and infravesical resistance is not well understood. This article reviews the main effects

Alberto A Antunes; Rafael F Coelho; Geraldo de Campos Freire; Miguel Srougi

2007-01-01

208

From coagulation to enucleation: the use of lasers in surgery for benign prostatic hyperplasia  

Microsoft Academic Search

The application of lasers for the treatment of benign prostatic hyperplasia has evolved over the past 15 years. Early-generation neodymium: yttrium aluminum garnet lasers were used to coagulate and ablate prostatic tissue, but significant postoperative irritative symptoms and high reoperation rates meant that this approach did not seriously challenge the status quo for long. Ablative techniques have recently become popular

Liam C Wilson; Peter J Gilling

2005-01-01

209

Rationale and assessment of minimally invasive approaches to benign prostatic hyperplasia therapy  

Microsoft Academic Search

Benign prostatic hyperplasia affects quality of life, with most patients complaining of symptoms related to urination. For this reason, successful treatments can be defined by (1) their effect on lower urinary tract symptoms, (2) their impact on quality of life, and (3) their ability to unobstruct the flow of urine through the prostate. Minimally invasive therapy (MIT), which includes transurethral

Thayne R Larson

2002-01-01

210

GreenLight HPS 120-W Laser for Benign Prostatic Hyperplasia: Comparative Complications and Technical Recommendations  

Microsoft Academic Search

The most common surgical procedure for symptomatic benign prostatic hyperplasia is transurethral resection of the prostate. However, this procedure has complications, including bleeding, erectile dysfunction, and retrograde ejaculation. Alternative therapies have been developed with the aim of reducing the level of complications while maintaining efficacy. These include microwave therapy, transurethral needle ablation, and a range of laser procedures. Recently, photoselective

Benjamin Choi; Shahin Tabatabaei; Alexander Bachmann; Edward Collins; Jean de la Rosette; Fernando Gómez Sancha; Gordon Muir; Oliver Reich; Henry Woo

2008-01-01

211

Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery  

PubMed Central

Holmium laser enucleation (HoLEP) was developed in the 1990s as a more efficient and cost effective method of benign prostatic hyperplasia surgery than laser vaporization and resection techniques. As a true anatomical enucleation it mimics open prostatectomy and is as durable. There is a significant body of level 1 evidence in support of HoLEP, including 2 meta-analyses and 14 randomized trials which compare HoLEP with a number of other procedures. This review describes the development of and summarizes the evidence for HoLEP. PMID:24082919

2013-01-01

212

HOLMIUM LASER ENUCLEATION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE: RESULTS FROM A 2CENTER, PROSPECTIVE, RANDOMIZED TRIAL IN PATIENTS WITH OBSTRUCTIVE BENIGN PROSTATIC HYPERPLASIA  

Microsoft Academic Search

Purpose:To our knowledge we report the first multicenter, prospective, randomized study comparing holmium laser enucleation (HoLEP) and transurethral prostate resection (TURP) for obstructive benign prostatic hyperplasia.

FRANCESCO MONTORSI; RICHARD NASPRO; ANDREA SALONIA; NAZARENO SUARDI; ALBERTO BRIGANTI; MATTEO ZANONI; SERGIO VALENTI; IVANO VAVASSORI; PATRIZIO RIGATTI

2004-01-01

213

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

214

Molecular Heterogeneity of Free PSA in Sera of Patients with Benign and Malignant Prostate Tumors  

Microsoft Academic Search

Objective: To analyze free prostate-specific antigen (f-PSA) in sera from patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH), and to detect possible differences in subtypes as potential diagnostic parameters. Materials and Methods: PSA was purified from sera by an immunoaffinity procedure developed on the basis of oriented antibody immobilization, and subjected to size exclusion chromatography (SEC), Western blotting,

Helmuth Hilz; Joachim Noldus; Peter Hammerer; Fritz Buck; Martina Lück; Hartwig Huland

1999-01-01

215

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. PMID:25035779

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

2014-01-01

216

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. PMID:24901224

Kim, Sung Han; Oh, Seung-June

2014-01-01

217

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. PMID:21862201

Freeman, Michael R.; Solomon, Keith R.

2014-01-01

218

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

219

MRI findings after prostatic artery embolization for treatment of benign hyperplasia.  

PubMed

OBJECTIVE. The purpose of this article is to assess and describe the MRI findings after prostatic artery embolization for treatment of benign prostatic hyperplasia. MATERIALS AND METHODS. We retrospectively evaluated 17 patients who underwent prostatic artery embolization as part of different prospective studies to evaluate this alternative treatment of benign prostatic hyperplasia. Clinical results were evaluated by assessment of urinary catheterization and International Prostate Symptom Score (IPSS). Serial MRI examinations were performed, and the prostatic central gland and peripheral zone were evaluated for signal intensity changes and the presence and characteristics of infarcted areas. Statistical analysis was performed with ANOVA for repeated measures and Student t test. RESULTS. All patients had clinical success, as defined by the removal of indwelling urinary catheter or decreased IPSS after embolization. Infarcts were seen in 70.6% of the subjects, exclusively in the central gland, were almost always characterized by hyperintensity on T1-weighted images and predominant hypointensity on T2-weighted images, and became smaller (mean reduction, p < 0.001) and isointense to the remaining of the central gland over time. Volume reduction of the prostate after embolization was significant (averaging 32.0% after 12-18 months; p < 0.001) only in patients with infarcts. No statistically significant association was seen between the development of infarcts and IPSS. CONCLUSION. MRI can be used for assessing the development of infarcts and volume reduction in the prostate after embolization. Further studies are needed to correlate these findings to clinical outcome. PMID:25247946

Frenk, Nathan E; Baroni, Ronaldo H; Carnevale, Francisco C; Gonçalves, Octavio M G; Antunes, Alberto A; Srougi, Miguel; Cerri, Giovanni G

2014-10-01

220

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. PMID:23136995

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

2012-01-01

221

Clinical decision support system for early detection of prostate cancer from benign hyperplasia of prostate.  

PubMed

There has been a growing research interest in the use of intelligent methods in medical informatics studies. Intelligent computer programs were implemented to aid physicians and other medical professionals in making difficult medical decisions. Prostate Neoplasia problems including benign hyperplasia and cancer of prostate are very common and cause significant delay in recovery and often require costly investigations before coming to its diagnosis. The conventional approach to build medical diagnostic system requires the formulation of rules by which the input data can be analyzed. But the formulation of such rules is very difficult with large sets of input data. Realizing the difficulty, a number of quantitative mathematical and statistical models including pattern classification technique such as Artificial neural networks (ANN), rolled based system, discriminate analysis and regression analysis has been applied as an alternative to conventional clinical and medical diagnostic. Among the mathematical and statistical modeling techniques used in medical decision support, Artificial neural networks attract many attentions in recent studies and in the last decade, the use of neural networks has become widely accepted in medical applications. This is manifested by an increasing number of medical devices currently available on the market with embedded AI algorithms, together with an accelerating pace of publication in medical journals, with over 500 academic publications year featuring Artificial Neural Networks (ANNs). PMID:23920702

Ghaderzadeh, Mustafa

2013-01-01

222

Evaluating the efficacy, safety, and cost of lasers for the treatment of benign prostatic hyperplasia  

Microsoft Academic Search

This review highlights some of the caveats assessing the available clinical data base for determining the efficacy, safety, and cost of laser systems used to treat benign prostatic hyperplasia. Many new minimally invasive devices have recently been advanced in spite of the limited data base and the lack of properly designed clinical trials. There have been many claims regarding the

C. M. Dixon

1995-01-01

223

Relevance of anti-reactive oxygen species activity to anti-inflammatory activity of components of eviprostat, a phytotherapeutic agent for benign prostatic hyperplasia.  

PubMed

Inflammation is a common finding in benign prostatic hyperplasia (BPH). The phytotherapeutic agent eviprostat is a popular treatment for BPH in Japan and Germany. This agent consists of five components; four are extracted from Chimaphila umbellata, Populus tremula, Pulsatilla pratensis and Equisetum arvense (coded as EVI-1, EVI-2, EVI-3 and EVI-4, respectively) and the fifth is germ oil from Triticum aestivum (coded as EVI-5). In this study, the effects of each component on the reactive oxygen species (ROS), superoxide anion (O2-) and hydroxyl radical (OH*) generated in cell-free systems and human neutrophils, and on carrageenin-induced paw edema in rats were investigated. EVI-1, EVI-2 and EVI-4 suppressed the O2- levels in the xanthine/xanthine oxidase system, and EVI-1, EVI-2, EVI-3 and EVI-4 abolished the OH* produced in a Fenton-type reaction system, so that EVI-1, EVI-2 and EVI-4 possessed inhibitory action with respect to both O2- and OH*. EVI-1, EVI-2 and EVI-4 also reduced ROS levels in phorbol myristate acetate-stimulated neutrophils. The paw swelling was inhibited by a mixture of EVI-1, EVI-2, EVI-3, EVI-4 and EVI-5 (a mixture which is equivalent to eviprostat) or by a mixture of EVI-1, EVI-2 and EVI-4, even though each component alone did not significantly inhibit the swelling. These findings suggest that the suppression of ROS by EVI-1, EVI-2 and EVI-4 may partly contribute to the anti-inflammatory action of eviprostat, and this action may be implicated in its therapeutic effect on BPH. PMID:17583488

Oka, Michiko; Tachibana, Masaki; Noda, Kumiko; Inoue, Naoki; Tanaka, Mitsushi; Kuwabara, Kenji

2007-08-01

224

Differential expression of 5-alpha reductase isozymes in the prostate and its clinical implications  

PubMed Central

The development of human benign or malignant prostatic diseases is closely associated with androgens, primarily testosterone (T) and dihydrotestosterone (DHT). T is converted to DHT by 5-alpha reductase (5-AR) isozymes. Differential expression of 5-AR isozymes is observed in both human benign and malignant prostatic tissues. 5-AR inhibitors (5-ARI) are commonly used for the treatment of benign prostatic hyperplasia (BPH) and were once promoted as chemopreventive agents for prostate cancer (PCa). This review discusses the role of the differential expression of 5-AR in the normal development of the human prostate and in the pathogenesis and progression of BPH and PCa. PMID:24457841

Wang, Kai; Fan, Dong-Dong; Jin, Song; Xing, Nian-Zeng; Niu, Yi-Nong

2014-01-01

225

Interstitial laser coagulation in the treatment of benign prostatic hyperplasia using a diode laser system: results of an evolving technology  

Microsoft Academic Search

Interstitial laser coagulation (ILC) treatment is a recent technique in the treatment of BPH that is evolving rapidly. The results of a prospective randomised study vs transurethral resection of the prostate (TURP) is presented as well as results of patients treated with a temperature sensing laser system. The first study included 44 patients treated in a prospective randomised study (randomisation

AC Mårtenson; JJMCH de la Rosette; J JMCH de la Rosette

1999-01-01

226

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

227

[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

228

Laser therapy for the treatment of benign prostatic hyperplasia: A review  

Microsoft Academic Search

Laser therapies for the treatment of benign prostatic hyperplasia have progressed significantly over the past decade. The\\u000a main treatment types are coagulation, vaporization, and cutting techniques. Their appeal compared with the transurethral prostatectomy\\u000a (TURP) is that many laser treatments have equal efficacy, with decreased side effects such as bleeding and irrigant absorption.\\u000a Disadvantages are increased cost and the need for

Edward D. Kim; Fatih Altunrende

2003-01-01

229

Effects of finasteride on the vascular surface density, number of microvessels and vascular endothelial growth factor expression of the rat prostate  

Microsoft Academic Search

Introduction: Finasteride is a 5-alpha-reductase inhibitor used in the medical treatment of benign prostatic hyperplasia (BPH) and appears\\u000a to be effective in treating prostatic bleeding secondary to BPH. The exact mechanism of this effect is not known. The aim\\u000a of this study was to evaluate the effects of finasteride on the vascular surface density (VSD), number of microvessels (NVES)\\u000a and

A. Erdem Canda; M. Ugur Mungan; Osman Yilmaz; Kutsal Yorukoglu; Emre Tuzel; Ziya Kirkali

2006-01-01

230

Central Diabetes Insipidus Masquerading as Benign Prostatic Hyperplasia in a Native Hawaiian  

PubMed Central

Introduction: Central diabetes insipidus (DI) develops when production or release of antidiuretic hormone is disrupted. A large number of cases are idiopathic with the vast majority of all remaining adult cases a result of primary or secondary hypothalmic tumor, infiltrative disease, neurosurgery, or trauma. Pituitary adenoma is not typically a cause of central diabetes insipidus. We present a case of previously undiagnosed pituitary macroadenoma resulting in central diabetes insipidus that presented critically after months of polyuria and nocturia that had previously been attributed to benign prostatic hyperplasia. Case Presentation: A 67-year-old man with a history of hypertension and taking no medications initially presented to the Hilo Medical Center with headache, nausea, nocturia, and polyuria. He had had symptoms for a year and presented to the ED after acute worsening. He was hypotensive and tachycardic with an initial sodium of 145. He quickly became hemodynamically unstable, unresponsive to fluid resuscitation, and was admitted to the ICU, briefly requiring vasopressors for blood pressure support. He was noted to have large volume output of dilute urine and elevated serum sodium. An MRI demonstrated a concentric sellar mass, with lymphocytic hypophysitis as a resultant working diagnosis. He was transferred to TAMC for Neurosurgical evaluation and further management. He was started on corticosteroids but after no improvement a follow up MRI showed a 2.0 × 1.3 × 2.5 cm lobulated, heterogeneously enhancing mass seen centered within the sella with T2 hyperintensity concerning for necrosis. After stabilization the patient underwent a transspenoidal excision of the mass. Pathology was consistent with nonsecreting pituitary adenoma. He responded appropriately to treatment with PO and nasal desmopressin. Discussion: Central diabetes insipidus is frequently seen with tumors that involve the hypothalamus such as craniopharyngiomas. It is also frequently seen in metastatic spread of lung or breast cancer to the posterior pituitary or hypothalamus. However, tumors originating from the anterior pituitary very rarely cause DI. This led to a working diagnosis of lymphocytic hypophysitis in this patient but a lack of response to therapy with corticosteroids led to excision and final diagnosis of adenoma. There is also an interesting cultural twist to this case. The patient was working as a construction worker on the Big Island of Hawai‘i and noted that there was significant social pressure to avoid drinking water while at work. Several coworkers were in this patient's age range and had similar symptoms of frequent urination and nocturia and had been diagnosed with BPH. They managed their symptoms with decreased PO water intake at work and the patient felt pressure to do the same. As a result the patient had developed a significant ability to ignore his thirst response and this contributed to his not seeking medical care for his persistent symptoms before becoming very ill. The patient required coaching prior to discharge in order to adequately respond to his thirst response to achieve stable serum sodium levels with scheduled PO and intranasal desmopressin.

Stitt, Rodger; Guerrero, Arthur; Ishida, Warren

2014-01-01

231

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

232

Keratinocyte-Derived Chemokine Induces Prostate Epithelial Hyperplasia and Reactive Stroma in a Novel Transgenic Mouse Model  

PubMed Central

Background Interleukin-8 (IL-8) is upregulated in fibrotic and malignant diseases and is a key mediator of proliferative responses. Elevated IL-8 was recently correlated with benign prostatic hyperplasia epithelium and a myofibroblast reactive stroma. Thus, we sought to determine whether overexpressed IL-8 and keratinocyte-derived chemokine (KC), the functional murine homolog of IL-8, induce prostate epithelial hyperplasia and a reactive phenotype. Methods Transgenic mice that overexpress KC within prostate epithelia and xenograft models with engineered human cells that overexpress IL-8 were developed. Results Overexpression of KC in transgenic mice produced hyperplastic prostate epithelial acini associated with a periacinar reactive stroma. KC induced an altered epithelial/stroma proliferation index ratio, increased acini diameter, epithelial infolding, and expression of prototypical reactive stroma markers. Overexpression of IL-8 in normal human prostate epithelial xenografts correlated with elevated epithelial proliferation index and altered morphology. Elevated human prostate stromal and epithelial cell proliferation, nodule-like morphology and increased xenograft survival were observed in IL-8-overexpressing orthotopic xenografts. Conclusions Together, these data demonstrate that overexpression of IL-8/KC results in a prostate epithelial hyperplasia with an associated reactive stroma phenotype. The novel transgenic mouse and human xenograft models described here may be useful in dissecting key mechanisms of IL-8 induced prostate hyperplasia and reactive stroma. PMID:19021203

Schauer, Isaiah G.; Ressler, Steven J.; Rowley, David R.

2009-01-01

233

The "PErFecTED Technique": Proximal Embolization First, Then Embolize Distal for Benign Prostatic Hyperplasia.  

PubMed

Prostatic artery embolization requires a refined technique to achieve good imaging and clinical success. The PErFecTED (Proximal Embolization First, Then Embolize Distal) technique has produced greater prostate ischemia and infarction than previously described methods with clinical improvement of lower urinary symptoms and lower recurrence rates. The microcatheter should cross any collateral branch to the bladder, rectum, corpus cavernosum, gonad, or penis and be placed distally into the prostatic artery before its branching to the central gland and peripheral zone. This technique allows better distribution of embolic material in the intraprostatic arteries and reduces risk of spasm or thrombus. Because benign prostatic hyperplasia develops primarily in the periurethral region of the prostate, the urethral group of arteries should be embolized first. Subsequent distal investigation and embolization completes occlusion and stasis of blood flow to the prostatic parenchyma. Since we added the second step to the PErFecTED technique, we have observed infarcts in all patients submitted to prostatic artery embolization. PMID:24943914

Carnevale, Francisco C; Moreira, Airton Mota; Antunes, Alberto A

2014-12-01

234

Clinicopathological Study of Prostatic Biopsies  

PubMed Central

Introduction: Prostatism is a common malady in the geriatric age group. Benign prostatic hyperplasia and Carcinoma of the prostate are increasingly frequent with advancing age. The aim of the present study is to study the spectrum of prostatic lesions among the biopsies received in a rural hospital. Materials and Methods: One hundred and six cases of prostatic biopsies received in the Department of Pathology, Rajah Muthiah Medical College and Hospital – Annamalai University were included in the present study. There were 44 needle biopsies and 62 TURP specimens. All the specimens were fixed in 10% neutral buffered formalin and 5? sections were stained with Hematoxylin and Eosin stain (H & E stain). Relevant clinical data including age, the presenting complaints and S.PSA values in suspected cases of carcinoma prostate were recorded. Results: Among the 106 biopsies received, 79 (74.52%) cases were of Benign prostatic hyperplasia, two cases (1.89%) were Prostatic intraepithelial neoplasia and 25 cases (23.58%) were Carcinoma of Prostate. Prostatitis was the most common associated lesion in cases of benign prostatic hyperplasia presenting in 25.31% patients. Among the Carcinoma patients, 20 cases (80%) were of Adenocarcinoma of prostate and 5 cases (20%) were Small cell carcinoma of prostate. Both Benign prostatic hyperplasia and Carcinoma prostate were common in the seventh decade. Most common clinical presentation was difficulty in micturition. Most common histological type of Carcinoma prostate was Adenocarcinoma. Serum PSA estimation was done in 49 cases of prostate biopsies. Elevations of serum PSA levels were noted in both BPH and Carcinoma prostate patients.Eight cases of BPH, had serum PSA values in the range of 0-4ng/ml. Six cases of Carcinoma prostate ,had serum PSA values in the range of >80 ng/ml. Conclusion: Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. Although, investigations like transrectal ultrasonogram and serum PSA estimation aids in diagnosis, a definitive diagnosis of benign and malignant lesions of prostate can be made by histopathological study of prostatic biopsies. PMID:25386437

2014-01-01

235

Increased Serum C-Reactive Protein Level Is Associated with Increased Storage Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia  

PubMed Central

Objective Chronic inflammation is considered as one of the contributing mechanisms of lower urinary tract symptoms (LUTS). Serum C-reactive protein (CRP) level is the widely used biomarker of inflammatory status. This study investigated the association between serum CRP level in men with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) before and after medical treatment. Methods A total of 853 men with BPH and LUTS were enrolled. All patients completed the International Prostate Symptoms Score (IPSS) questionnaire and urological examinations. The parameters of uroflowmetry (maximum flow rate, Qmax; voided volume, VV), post-void residual (PVR), total prostate volume (TPV) and transition zone index (TZI), serum prostate specific antigen (PSA), and serum CRP levels were obtained. All patients were treated with alpha-blocker or antimuscarinic agent based on the IPSS voiding to storage subscore ratio (IPSS-V/S). Correlation analyses were performed between serum CRP levels with age, IPSS, TPV, TZI, Qmax, PVR, VV, PSA and between baseline and post treatment. Results The mean age was 66.9±11.6 years old and the mean serum CRP levels were 0.31±0.43 mg/dL. Univariate analyses revealed serum CRP levels were significantly associated with age (p<0.001), PSA levels (p?=?0.005) and VV (p?=?0.017), but not significantly associated with TPV (p?=?0.854) or PVR (p?=?0.068). CRP levels were positively associated with urgency (p<0.001) and nocturia (p<0.001) subscore of IPSS, total IPSS (p?=?0.008) and storage IPSS (p<0.001) and negatively associated with IPSS- V/S ratio (p?=?0.014). Multivariate analyses revealed that serum CRP levels were significantly associated with age (p?=?0.004) and storage IPSS subscore p<0.001). Patients with IPSS-V/S<1 and treated with tolterodine for 3 months had significant decrease of CRP levels after treatment. Conclusion Serum CRP levels are associated with storage LUTS and sensory bladder disorders, suggesting chronic inflammation might play a role in the patients with storage predominant LUTS. PMID:24454896

Hung, Shun-Fa; Chung, Shiu-Dong; Kuo, Hann-Chorng

2014-01-01

236

[Prospects for differentiated conservative treatment of patients with benign prostatic hyperplasia].  

PubMed

The results of conservative therapy of 30 patients aged from 50 to 79 years with benign hyperplasia of prostate according to the IPSS scale from 7 to 30 points were analyzed. Under the influence of treatment in all the patients the clinical symptoms severity, according to the monitoring data using the IPSS tables, had reduced by 72% at average and quality of life improve no less than by 50%. Average efficacy of the volume and volumetric of urination had enhanced according to uroflowmetry data. PMID:11482194

Danilov, V V; Borshchenko, S A; Danilova, T I; Medvedeva, I A

2001-04-01

237

Transurethral microwave thermotherapy for benign prostatic hyperplasia--experience with the Prostcare.  

PubMed

Transurethral microwave thermotherapy for benign prostatic hyperplasia with the Prostcare has been used in our department since April 1992. Our research has mainly been focused on strategies for development of the apparatus, accessories, and treatment performance to find an optimal means of treatment. The development to high-power thermotherapy has demonstrated a significant improvement in symptom and quality-of-life scores, maximal flow rate, and residual and voided urinary volume after 6 months. Pressure-flow data have additionally demonstrated a significant decrease in the minimal urethral opening pressure. The improvement in outcome after high-power thermotherapy is associated with an increased short-term morbidity as compared with low-power treatment. The outcome is dependent on several factors: power and intraprostatic temperatures, treatment performance technique, configuration of heat distribution of the antennae, and the localization of maximal heat in the prostatic urethra. PMID:12073223

Eliasson, T; Teriö, H; Damber, J E

1998-01-01

238

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. PMID:23789041

Choi, Benjamin B.

2013-01-01

239

Holmium laser enucleation of the prostate: A size-independent new “gold standard”  

Microsoft Academic Search

We report our experience with holmium laser enucleation of the prostate (HoLEP) for treatment of 552 patients with symptomatic benign prostatic hyperplasia (BPH) and their long-term outcome. Between March 1998 and January 2005, a retrospective review was conducted at our institution of 552 cases in which patients underwent HoLEP. Patient characteristics, indications for surgery, preoperative and postoperative International Prostate Symptom

Ehab A. Elzayat; Enmar I. Habib; Mostafa M. Elhilali

2005-01-01

240

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

241

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. PMID:23990721

de Sousa, Valeria Pereira; Crean, Joanne; de Almeida Borges, Vinicius Raphael; Rodrigues, Carlos Rangel; Tajber, Lidia; Boylan, Fabio; Cabral, Lucio Mendes

2013-01-01

242

Impact of prostate size on the outcome of transurethral laser evaporation of the prostate for benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesThe aim of this study was to evaluate efficacy and safety of transurethral evaporation of the prostate (TUEP) using neodymium:yttrium-aluminumgarnet (Nd:YAC) laser in prostate glands of various sizes.

Perinchery Narayan; Ashutosh Tewari; George Fournier; Anitha Toke

1995-01-01

243

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

244

Transurethral electrovaporization of the prostate: A novel method for treating men with benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesTo determine the preliminary safety and efficacy of transurethral vaporization of the prostate (TVP) using the VaporTrode as a therapeutic alternative in the management of men with bladder outlet obstruction.

Steven A. Kaplan; Alexis E. Te

1995-01-01

245

Transurethral ultrasound array for prostate thermal therapy: initial studies  

Microsoft Academic Search

This study presents the initial evaluation of an applicator designed for transurethral ultrasound thermotherapy (TUST) of prostate tissue in the treatment of benign prostatic hyperplasia (BPH) and cancer. A tubular multitransducer applicator, consisting of four piezoceramic tubes (2.5 mm diameter, 6 mm long, 6.8 MHz) under separate power control, was designed to fit within a semiflexible water-cooled temperature-regulated delivery catheter

Chris J. Diederich; Everette C. Burdette

1996-01-01

246

An evidence-based review of NX1207 and its potential in the treatment of benign prostatic hyperplasia  

PubMed Central

In elderly men, benign prostatic hyperplasia is often associated with lower urinary tract symptoms, and its prevalence rises with age. Lower urinary tract symptoms can be very bothersome and lead to a decrease in health-related quality of life. Furthermore, benign prostatic hyperplasia is a progressive disease that can lead to serious complications like acute urinary retention. Medical treatment with ?1-blockers or 5?-reductase inhibitors is recommended by the European Association of Urology. On the other hand, there are some new innovations such as NX1207. The aim of this review is to summarize the published data. NX1207 is a new drug that is administered by transrectal intraprostatic injection under ultrasound guidance. The substance leads to prostate volume reduction and symptomatic improvement. However, patient numbers are still low and currently treatment with NX1207 is still experimental. PMID:25157337

Kunit, Thomas; Lusuardi, Lukas

2014-01-01

247

A Randomized Trial Comparing Holmium Laser Enucleation of the Prostate with Transurethral Resection of the Prostate for the Treatment of Bladder Outlet Obstruction Secondary to Benign Prostatic Hyperplasia in Large Glands (40 to 200 Grams)  

Microsoft Academic Search

PurposeHolmium laser enucleation of the prostate (HoLEP) is a surgical treatment for bladder outlet obstruction secondary to benign prostatic hyperplasia. HoLEP is a transurethral procedure that uses the holmium laser fiber (wavelength 2,140 nm) to dissect whole prostatic lobes off of the surgical capsule in retrograde fashion, while maintaining excellent hemostasis. The lobes are removed from the bladder by a

A. H. H. TAN; P. J. GILLING; K. M. KENNETT; C. FRAMPTON; A. M. WESTENBERG; M. R. FRAUNDORFER

2003-01-01

248

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

249

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

Microsoft Academic Search

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.

Rolf Muschter

1994-01-01

250

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. PMID:18836556

Curtis Nickel, J; Shoskes, Daniel; Roehrborn, Claus G; Moyad, Mark

2008-01-01

251

MoXy fiber with active cooling cap for bovine prostate vaporization with high power 200W 532 nm laser  

Microsoft Academic Search

A novel MoXyTM fiber delivery device with Active Cooling Cap (ACCTM) is designed to transmit up to 180W of 532 nm laser light to treat benign prostatic hyperplasia (BPH). Under such high power tissue ablation, effective cooling is key to maintaining fiber power transmission and ensuring the reliability of the fiber delivery device To handle high power and reduce fiber

Steven Y. Peng; Hyun Wook Kang; Homa Pirzadeh; Douglas Stinson

2011-01-01

252

Minimally Invasive Procedures and Medical Management--Their Relative Merits in Treating Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia  

PubMed Central

Evidence is reviewed supporting the safety and efficacy of minimally invasive transurethral microwave thermotherapy and medical management in patients with benign prostatic hyperplasia. Recent data indicate more pronounced long-term beneficial effects of microwave treatment. ?-Blockade, however, offers more rapid onset of action than does microwave treatment. Neoadjuvant and adjuvant ?-blocker therapy can accelerate symptom and flow rate improvement in patients undergoing microwave treatment. Compared with medical management, microwave treatment also appears to possess greater versatility, allowing patients who fall within a broad range of baseline symptom severities and prostate sizes to be treated with a high probability of success. PMID:16985749

Djavan, Bob; Marberger, Michael

2000-01-01

253

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

254

Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy  

Microsoft Academic Search

Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either 90° sectored tubular (3.5 mm OD × 10 mm) or planar transducers (3.5 mm × 10 mm). They were constructed to be MRI compatible,

Anthony B. Ross; Chris J. Diederich; William H. Nau; Harcharan Gill; Donna M. Bouley; Bruce Daniel; Viola Rieke; R. Kim Butts; Graham Sommer

2004-01-01

255

Laser prostatectomy for patients with benign prostatic hyperplasia: a prospective randomized study comparing two different techniques using the Prolase-II fiber  

Microsoft Academic Search

Laser prostatectomy for patients with complaints due to benign prostatic hyperplasia is a relatively new treatment option. The most effective procedure for coagulation and vaporization of the prostate is not yet known. In a prospective randomized study of 30 patients, 2 techniques for the delivery of laser energy were compared at 40 W for 90 s. The complications were minimal

T. A. Boon; C. F. P. Swol; G. E. R M. van Venrooij; H. R BeerlageL; R. M. Verdaasdonk

1995-01-01

256

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

257

Lonidamine: Basic Science and Rationale for Treatment of Prostatic Proliferative Disorders  

PubMed Central

Normal and hyperplastic prostatic tissues concentrate citrate within the epithelium; however, a unique biochemical property within prostate epithelial cells renders them dependent on glycolysis, rather than the citric acid cycle, for energy production. Lonidamine, an orally administered small molecule that inhibits glycolysis by the inactivation of hexokinase, may represent a unique and novel approach to the treatment of benign prostatic hyperplasia (BPH). Results of a phase II trial of lonidamine in BPH (described elsewhere in this supplement) are encouraging. Lonidamine is already used in the treatment of several cancers in other countries. Its target-specific nature renders it a safe compound for administration; in cancer therapy, patients have been treated with 40 times the daily dose used in the BPH trial, with negligible toxicity. PMID:16986057

Brawer, Michael K

2005-01-01

258

Ratio of prostate specific antigen to the outer gland volume of prostrate as a predictor for prostate cancer  

PubMed Central

Objective: As a definite diagnosis of prostate cancer, puncture biopsy of the prostate is invasive method. The aim of this study was to evaluate the value of OPSAD (the ratio of PSA to the outer gland volume of prostate) as a non-invasive screening and diagnosis method for prostate cancer in a select population. Methods: The diagnosis data of 490 subjects undergoing ultrasound-guided biopsy of the prostate were retrospectively analyzed. This included 133 patients with prostate cancer, and 357 patients with benign prostate hyperplasia (BPH). Results: The OPSAD was significantly greater in patients with prostate cancer (1.87 ± 1.26 ng/ml2) than those with BPH (0.44 ± 0.21 ng/ml2) (P < 0.05). Receiver operating characteristic (ROC) curve analysis revealed that the performance of OPSAD as a diagnostic tool is superior to PSA and PSAD for the diagnosis of prostate cancer. In the different groups divided according to the Gleason score of prostate cancer, OPSAD is elevated with the rise of the Gleason score. Conclusion: OPSAD may be used as a new indicator for the diagnosis and prognosis of prostate cancer, and it can reduce the use of unnecessary puncture biopsy of the prostate. PMID:25337254

Zhang, Hai-Min; Yan, Yang; Wang, Fang; Gu, Wen-Yu; Hu, Guang-Hui; Zheng, Jun-Hua

2014-01-01

259

Lipidosterolic extract of serenoa repens modulates the expression of inflammation related-genes in benign prostatic hyperplasia epithelial and stromal cells.  

PubMed

Despite the high prevalence of histological Benign Prostatic Hypeplasia (BPH) in elderly men, little is known regarding the molecular mechanisms and networks underlying the development and progression of the disease. Here, we explored the effects of a phytotherapeutic agent, Lipidosterolic extract of the dwarf palm plant Serenoa repens (LSESr), on the mRNA gene expression profiles of two representative models of BPH, BPH1 cell line and primary stromal cells derived from BPH. Treatment of these cells with LSESr significantly altered gene expression patterns as assessed by comparative gene expression profiling on gene chip arrays. The expression changes were manifested three hours following in vitro administration of LSESr, suggesting a rapid action for this compound. Among the genes most consistently affected by LSESr treatment, we found numerous genes that were categorized as part of proliferative, apoptotic, and inflammatory pathways. Validation studies using quantitative real-time PCR confirmed the deregulation of genes known to exhibit key roles in these biological processes including IL1B, IL1A, CXCL6, IL1R1, PTGS2, ALOX5, GAS1, PHLDA1, IL6, IL8, NFkBIZ, NFKB1, TFRC, JUN, CDKN1B, and ERBB3. Subsequent analyses also indicated that LSESr treatment can impede the stimulatory effects of certain proinflammatory cytokines such as IL6, IL17, and IL15 in these cells. These results suggest that LSESr may be useful to treat BPH that manifest inflammation characteristics. This also supports a role for inflammation in BPH presumably by mediating the balance between apoptosis and proliferation. PMID:23846725

Sirab, Nanor; Robert, Grégoire; Fasolo, Virginie; Descazeaud, Aurélien; Vacherot, Francis; Taille, Alexandre de la; Terry, Stéphane

2013-01-01

260

Intraprostatic Botulinum Toxin injection in patients with benign prostatic enlargement  

PubMed Central

Histological evidence of benign prostatic hyperplasia (BPH) exceeded 50% in men over 50 years of age and rose to 75% as men entered the eighth decade. Therapeutic options for BPH generally fall into one of the three categories: watchful waiting, medical treatment and surgery. Excluding watchful waiting, the other forms of intervention directed at modifying the physiologic effects of BPH with or without directly altering the prostatic mass or its configuration come with varying effectiveness and risk. Botulinum toxin (BTX–A) produce inhibition of acethylcholine release at the neuromuscular junction causes paralyzing effects and atrophy of striated as well as the smooth muscle fiber. BTX–A also causes inhibitory effects on the ganglionic and post– ganglionic fibres of autonomic nervous system inducing diffuse atrophy and apoptosis of nasal and prostate glands. Clinical series demonstrates efficacy of BTX–A in alleviating symptoms induced by BPH. Larger randomized clinical trials studies are necessary in order to identify the mechanisms by which BTX–A affects the prostate, the ideal dose and the duration of effect. BTX–A injected into prostate appears safe and effective PMID:20108746

Chancellor, MB; Chuang, YC; Mischianu, D

2009-01-01

261

Prostate Cancer Jonathan Hagopian  

E-print Network

2007 #12;Overview · The Prostate Gland · Non-Malignant Hyperplasia · Adenocarcinoma · Grading and Staging · Metastasis #12;The Prostate Gland #12;Non-Malignant Hyperplasia #12;Non-Malignant Hyperplasia

Gleeson, Joseph G.

262

Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To study the efficacy and safety of dutasteride, a dual inhibitor of the 5-alpha-reductase isoenzymes types I and II.Methods. A total of 4325 men (2951 completed) with clinical benign prostatic hyperplasia, moderate to severe symptoms (American Urological Association-Symptom Index score of 12 points or greater), a peak flow rate of 15 mL\\/s or less, a prostate volume of 30

Claus G Roehrborn; Peter Boyle; J. Curtis Nickel; Klaus Hoefner; Gerald Andriole

2002-01-01

263

5-ALA-assisted photodynamic therapy in canine prostates  

NASA Astrophysics Data System (ADS)

Photodynamic therapy (PDT) and interstitial thermotherapy are well known treatment modalities in urology. The approach of this study is to combine both to achieve a selective treatment procedure for benign prostatic hyperplasia (BPH) and prostate carcinoma. Measurements of thy in-vivo pharmacokinetics of 5-ALA induced porphyrins by means of fiber assisted ratiofluorometry showed a maximum fluorescence intensity at time intervals of 3 - 4 h post administration. Fluorescence microscopy at that time showed bright fluorescence in epithelial cells while in the stroma fluorescence could not be observed. Interstitial PDT using a 635-nm dye laser with an irradiation of 50 J/cm2 resulted in a nonthermic hemorrhagic lesion. The lesion size did not change significantly when an irradiation of 100 J/cm2 was used. The usefulness of PDT for treating BPH as well as prostate carcinoma has to be proven in further studies.

Sroka, Ronald; Muschter, Rolf; Knuechel, Ruth; Steinbach, Pia; Perlmutter, Aaron P.; Martin, Thomas; Baumgartner, Reinhold

1996-05-01

264

Long-Term Follow-Up Results of Photoselective Vaporization of the Prostate with the 120 W Greenlight HPS Laser for Treatment of Benign Prostatic Hyperplasia  

PubMed Central

Purpose With the use of 12 months of follow-up data, this study was conducted to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 120 W Greenlight high performance system (HPS) laser for the treatment of symptomatic benign prostatic hyperplasia. Materials and Methods Data were collected from 104 patients who were diagnosed with benign prostatic hyperplasia and who underwent PVP with the 120 W Greenlight HPS Laser. 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 The mean age of the patients was 71.1±7.7. The baseline mean prostate-specific antigen level was 3.8±2.7 ng/ml, the mean prostate size was 43.9±20.6 g, the mean preoperative IPSS was 18.4±8.5, the mean QoL score was 4.1±1.0, the mean Qmax was 9.9±5.5 ml/sec, and the mean PVR was 89.6±207.1 ml. During surgery, the mean operation time was 21.8±11.3 minutes, the mean lasing time was 16.9±10.5 minutes, and the mean total applied energy was 170,068±63,181 J. At 1 month, significant improvements were observed in total IPSS (11.5±6.7, p<0.05), voiding symptom score (6.1±5.4, p<0.05), and QoL score (2.2±1.5, p<0.05); however, there were no significant improvements in storage symptom score (4.8±3.8, p=0.06), Qmax (12.6±10.2, p=0.06), and PVR (40.1±30.5, p=0.41). However, 3 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. Conclusions Significant improvements were observed in subjective and objective voiding parameters, which were evident at 3 months after PVP and were sustained throughout a period of 12 months after PVP. PMID:21556212

Kang, Se-Hee; Choi, Yong Sun; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl; Hwang, Tae-Kon

2011-01-01

265

E4, a new monoclonal antibody identifying a human prostatic cell surface antigen  

PubMed

The monoclonal antibody E4 (IgG2a, kappa) was raised by immunizing mice with dispersed cells obtained from human benign prostatic hyperplasia (BPH). The antibody identifies an antigen abundantly expressed in normal prostate epithelial cells, in benign epithelial prostatic cells and in well- and moderately well differentiated adenocarcinomas of the prostate, whereas poorly differentiated prostatic adenocarcinomas display somewhat less expression. Investigation of the human prostatic adenocarcinoma cell line DU 145 revealed E4 immunoreactivity localized to the cell surface. SDS-PAGE analysis under reducing conditions demonstrated an approximate molecular weight of 70,000 for the antigen. The highly specific reactivity with prostate tissue, as well as intense surface staining, especially in well- and moderately well differentiated prostatic adenocarcinomas, makes the E4 antibody a useful immunohistochemical marker and a possible candidate for future immunoscintigraphy and/or targeted radiotherapy. PMID:10851493

Nilsson; Essand; Logdahl; Larson; Nordgren; Juhlin

1997-12-01

266

Double–Blind Trial of the Efficacy and Tolerability of Doxazosin in the Gastrointestinal Therapeutic System, Doxazosin Standard, and Placebo in Patients with Benign Prostatic Hyperplasia  

Microsoft Academic Search

Background: The ?1–blocker doxazosin mesylate is an established efficacious and welltolerated treatment for benign prostatic hyperplasia (PBH). However, its clinical utility can be limited by the need for multiple titration steps, starting at an initial dose of 1 mg, increased up to 8 mg once daily, to achieve optimal therapeutic response. A new controlled–release gastrointestinal therapeutic system (GITS) formulation of

Morten Andersen; Christer Dahlstrand; Kjetil Høye

2000-01-01

267

Dutasteride plus Tamsulosin fixed-dose combination first-line therapy versus Tamsulosin Monotherapy in the treatment of benign prostatic hyperplasia: a budget impact analysis in the Greek healthcare setting  

PubMed Central

Background The purpose of this study was to explore the budget impact of dutasteride plus tamsulosin fixed-dose combination (DUT?+?TAM FDC) versus tamsulosin monotherapy, in the treatment of patients with benign prostatic hyperplasia (BPH) from the perspective of the Greek healthcare insurance system. Methods A Microsoft Excel-based model was developed to estimate the financial consequences of adopting DUT + TAM FDC within the Greek healthcare setting. The model, compared six mutually exclusive health states in two alternative treatment options: current standard of care and the introduction of DUT + TAM FDC in the market. The model used clinical inputs from the CombAT study; data on resource use associated with the management of BPH in Greece were derived from expert panel, and unit cost data were derived from official reimbursement tariffs. A payer perspective was taken into account. As patient distribution data between public and private sectors are not available in Greece two scenarios were investigated, considering the whole eligible population in each scenario. A 4 year time horizon was taken into account and included treatment costs, number of transurethral resections of the prostate (TURPs) and acute urinary retention (AUR) episodes avoided. Results The clinical benefit from the market adoption of DUT?+?TAM FDC in Greece was 1,758 TURPs and 972 episodes of AUR avoided cumulatively in a four year period. The increase in total costs from the gradual introduction of DUT?+?TAM FDC to the Greek healthcare system ranges from €1.3 million in the first year to €5.8 million in the fourth year, for the public sector, and €1.2 million to €4.0 million, for the private sector. This represents an increase of 1.91% to 7.94% for the public sector and 1.10% 3.29% in the private sector, during the 4-year time horizon. Conclusions Budget impact analysis (BIA) results indicated that the gradual introduction of DUT?+?TAM FDC, would increase the overall budget of the disease, however providing better clinical outcomes. DUT?+?TAM FDC drug acquisition cost is partly offset by the reduction in the costs associated with the treatment of the disease. PMID:25255740

2014-01-01

268

In vivo estimation of relaxation processes in benign hyperplasia and carcinoma of the prostate gland by magnetic resonance imaging  

SciTech Connect

Tissue characterization for separating malignant from benign tissue is a clinically very important potential of magnetic resonance imaging (MRI). In this study quantitative determination of T1- and T2-relaxation processes was accomplished in five healthy volunteers, 10 patients with benign hyperplasia of the prostate gland and eight patients with prostatic carcinoma. Histological verification was obtained in all the patients. The measurements were performed on a wholebody MR-scanner operating at 1.5 T using six inversion recovery sequences (TR = 4000 msec) for T1-determination and a 32 spin-echo sequence (TR = 3000 or 2000 msec) for T2-estimation. The T1-relaxation curves all appeared monoexponential, whereas the T2-curves in most cases showed a multiexponential behavior. A considerable overlap of the relaxation curves was seen. Consequently, we found no statistically significant differences between the T1- or the T2-relaxation times of the three groups investigated. It is concluded that tissue characterization based on relaxation time measurements with MRI does not seem to have a clinically useful role in prostatic disease.

Kjaer, L.; Thomsen, C.; Iversen, P.; Henriksen, O.

1987-01-01

269

HoLEP does not affect the overall sexual function of BPH patients: a prospective study  

PubMed Central

We aimed to prospectively evaluate the influence of holmium laser enucleation of the prostate (HoLEP) on the overall postoperative sexual function of benign prostatic hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS) and to explore the relationship between sexual function and LUTS. From January 2010 to December 2011, sixty sexually active consecutive patients with BPH who underwent HoLEP were prospectively enrolled in the study. All patients filled out the Male Sexual Health Questionnaire (MSHQ) for evaluation of their overall sexual function and the International Prostatic Symptom Score (IPSS) for pre- and post-operative 6 months evaluation of their voiding symptoms. The LUTS and sexual function changes were statistically analyzed. The preoperative and 6 months postoperative status of the patients was compared using uroflowmetry and IPSS questionnaires. The analysis revealed significant improvements following HoLEP. Among the sub-domains of the MSHQ, postoperative sexual function, including erection, ejaculation, sexual satisfaction, anxiety or sexual desire, did not significantly change after HoLEP (P > 0.05), whereas satisfaction scores decreased slightly due to retrograde ejaculation in 38 patients (63.3%). Sexual satisfaction improved significantly and was correlated with the improvements of all LUTS and the quality-of-life (QoL) domains in IPSS after surgery (QoL; relative risk [RR]: ?0.293; total symptoms, RR: ?0.411; P < 0.05). The nocturia score was associated with the erectile function score (odds ratio 0.318, P = 0.029). The change in ejaculatory scores did not show significant association with IPSS scores. HoLEP did not influence overall sexual function, including erectile function. In addition, sexual satisfaction improved in proportion with the improvement of LUTS. PMID:25038179

Kim, Sung Han; Yang, Hyung-Kook; Lee, Hahn-Ey; Paick, Jae-Seung; Oh, Seung-June

2014-01-01

270

Photoselective green-light laser vaporisation vs. TURP for BPH: meta-analysis  

PubMed Central

This study sought to evaluate the efficacy and safety of photoselective vaporisation (PVP) vs. transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia (BPH). Eligible studies were identified from electronic databases (Cochrane Library, PubMed and EMBASE). The database search, quality assessment and data extraction were performed independently by two reviewers. Efficacy (primary outcomes: maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), postvoid residual urine (PVR) and quality of life (QoL); secondary outcomes: operative time, hospital time and catheter removal time) and safety (complications, such as transfusion and capsular perforation) were explored by using Review Manager 5.0. Six randomized controlled trials (RCTs) and five case-controlled studies of 1398 patients met the inclusion criteria. A meta-analysis of the extractable data showed that there were no differences in IPSS, Qmax, QoL or PVR between PVP and TURP (mean difference (MD): prostate sizes <70 ml, Qmax at 24 months, MD=0.01, P=0.97; IPSS at 12 months, MD=0.18, P=0.64; QoL at 12 months, MD=?0.00, P=0.96; PVR at 12 months, MD=0.52, P=0.43; prostate sizes >70 ml, Qmax at 6 months, MD=?3.46, P=0.33; IPSS at 6 months, MD=3.11, P=0.36; PVR at 6 months, MD=25.50, P=0.39). PVP was associated with a shorter hospital time and catheter removal time than TURP, whereas PVP resulted in a longer operative time than TURP. For prostate sizes <70 ml, there were fewer transfusions, capsular perforations, incidences of TUR syndrome and clot retentions following PVP compared with TURP. These results indicate that PVP is as effective and safe as TURP for BPH at the mid-term patient follow-up, in particular for prostate sizes <70 ml. Due to the different energy settings available for green-light laser sources and the higher efficiency and performance of higher-quality lasers, large-sample, long-term RCTs are required to verify whether different energy settings affect outcomes. PMID:22902908

Ding, Hui; Du, Wan; Lu, Ze-Ping; Zhai, Zhen-Xing; Wang, Han-Zhang; Wang, Zhi-Ping

2012-01-01

271

A Preliminary Analysis of Calcifying Particles in the Serum and Prostates of Patients with Prostatic Inflammation  

NASA Technical Reports Server (NTRS)

Chronic diseases of the prostate such as benign prostatic hyperplasia (BPH) & chronic pelvic pain syndrome (CPPS) have associated findings of chronic inflammation, despite a lack of causal relationship. Numerous attempts to define an infectious agent responsible for the clinical findings have been inconsistent. The possibility of an infectious agent, that has not been uncovered with routine culturing methods, forms the basis for this study. Serum from 940 healthy Finnish men were compared with serum from 40 Crohn's, 40 path dx prostatitis, & 40 with path dx carcinoma, using an enzyme-linked immunosorbant assay (ELISA), to detect antigens specific to Nanobacteria(NB) utilizing monoclonal antibodies (Ab) 5/3 and 8D10. This ELISA has not been validated for detecting NB-associated with clinical prostatic disease, yet cross-reactivity with other bacterial species is low. Immunohistochemistry was performed on de-paraffinized prostatic tissue slides, de-calcified with EDTA and stained with the DAKO Catalyzed Signal Amplification kit, employing 8D10 as the primary (target/antigen-detecting) Ab. The mean (plus or minus SD) & median concentrations of NB antigen (U/50 L) were 379.59 (plus or minus 219.28) & 640.00 for patients with prostatitis (BPH) vs 3.31 (plus or minus 3.55) & 2.94 for prostate adenocarcinoma, 1.88 (plus or minus 2.94) & 0.80 for Crohn's disease, & 7.43 (plus or minus 25.57) & 0.00 for patients with no clinical prostatic disease. Unpaired t-tests revealed statistically significant differences between the prostatitis (BPH) sera & each of the other groups with p less than 0.005, but no differences between the other groups themselves. Preliminary studies with immunohistochemistry & 3-D confocal microscopy reveal 16/24 tissue sections + for NB Ag in BPH vs. only 2/22 tissue sections with prostate cancer. The preliminary findings of this serum screening study suggest that NB antigen may be commonly found in the serum of patients with the pathological diagnosis of prostatitis. Preliminary immunohistologic studies, suggest that NB may be found within the gland itself at a higher rate in patients with BPH relative to patients with adenocarcinoma, however confirmatory studies with a more specific ELISA technique, primary cultures, & with larger numbers of patients in a prospective design are required to determine if 1) NB are a causative organism for clinical hyperplastic and inflammatory disease, & if 2) serological testing can be used to discriminate patients with nanobacterial-associated prostatic disease.

Jones, Jeffrey A.; Carlson, Grant; Kajander, E. Olavi; Warmflash, David; Taylor, Karen; Ayala, Gustavo; Shoskes, Daniel; Everett, Meg; Feedback, Dan; Ciftcioglu, Neva

2006-01-01

272

Effects of two different medical treatments on dihydrotestosterone content and androgen receptors in human benign prostatic hyperplasia.  

PubMed

In order to evaluate the biochemical modifications induced by hormonal treatments on human prostatic tissue, the intracellular distribution of tissue DHT and AR were investigated in BPH patients untreated and treated (25-30 days before surgery) with the association of cyproterone acetate (CPA), 100 mg p.o./day plus tamoxifen (TAM), 100 mg p.o./day, or with flutamide (FLU) alone, 750 mg p.o./day. Dextran-coated charcoal and exchange assay in the presence of sodium molybdates (0.2 M) were used for AR determination, employing methyltrienolone as radioligand in the presence of triamcinolone acetonide. Endogenous DHT was measured by RIA, after ether extraction and purification on celite microcolumns. The treatment with CPA plus TAM led to a detection of cytosol AR (ARc) in 50% of the specimens, while nuclear AR (ARn) were never measurable. The FLU treatment did not modify the incidence of ARc, while ARn was not detectable. The cytosolic and nuclear compartmentalization of DHT was scarcely affected by the combined CPA plus TAM treatment, while FLU treatment induced a prevalent cytosolic localization of DHT (DHTc = 283.2 +/- 24.6 S.E. and DHTn = 1138.4 +/- 98.7 S.E. pg/mg DNA in untreated patients; DHTc = 350.4 +/- 97.7 S.E. and DHTn = 589.7 +/- 154.4 S.E. pg/mg DNA in CPA plus TAM treated patients; DHTc = 1101.7 +/- 165.7 S.E. and DHTn = 733.0 +/- 93.9 S.E. pg/mg DNA in FLU treated patients). Both medical treatments, therefore, were able to reduce prostatic growth on account of the reduced value of nuclear DHT content. PMID:2455099

Petrangeli, E; Sciarra, F; Di Silverio, F; Toscano, V; Lubrano, C; Conti, C; Concolino, G

1988-01-01

273

Correlation of American Urological Association symptom index with obstructive and nonobstructive prostatism.  

PubMed

The precise role of the American Urological Association (AUA) symptom index in the management of benign prostatic hyperplasia (BPH) is not well established. The AUA symptom index has been recommended only for quantifying the symptoms of BPH but not for its diagnosis. However, to our knowledge the ability to discriminate obstructive from nonobstructive BPH using the AUA symptom index has never been investigated. To establish the relationship between the AUA symptom index and prostatic obstruction 125 men (mean age 67.7 +/- 8.4 years) with voiding dysfunction presumably related to BPH were analyzed. Patients were given the AUA symptom questionnaire, following which video urodynamic studies were done, including micturitional urethral pressure profilometry for specifically diagnosing outlet obstruction. The patients were divided into 2 groups: group 1-78 with primary BPH dysfunction and group 2-47 with prostatism of ambiguous etiology. The mean AUA symptom index in group 1 (15.5 +/- 7.1) was not statistically different from that in group 2 (14.8 +/- 7.9). In both groups the mean AUA symptom index in the patients with obstruction (15.3 +/- 7.2 for group 1 and 13.9 +/- 7.9 for group 2) was not statistically different from that in the nonobstructed group (17.0 +/- 5.4 and 16.1 +/- 7.9, respectively). Of the severely symptomatic patients 22% did not have obstruction whereas all mildly symptomatic patients did. No significant correlations were found between the severity of obstruction and the AUA symptom index in either group. These observations indicate that the AUA symptom index cannot discriminate obstructed from nonobstructed BPH cases, not all severely symptomatic BPH patients will have outlet obstruction, a significant proportion of mildly symptomatic BPH patients can have outlet obstruction and voiding dysfunctions in elderly men, regardless of the etiology, produce similar symptoms. PMID:7532231

Yalla, S V; Sullivan, M P; Lecamwasam, H S; DuBeau, C E; Vickers, M A; Cravalho, E G

1995-03-01

274

Cleveland Clinic experience with interstitial laser coagulation of the prostate  

NASA Astrophysics Data System (ADS)

Transurethral resection of the prostate (TURP) has long been considered the gold standard therapy for benign prostatic hyperplasia (BPH). The problems associated with the TURP, which have been extensively described, include significant bleeding, TUR syndrome, incontinence, stricture, bladder neck contracture, and sexual dysfunction. The desire for simpler, less morbid alternative therapies to TURP has led to an eruption of research and development in the last decade. This is fueled by the continued research for more economical alternatives in our current high cost health care system.

Ulchaker, James C.; Ng, Christopher S.; Palone, David; Angie, Michelle; Kursh, Elroy D.

2000-05-01

275

Computer-assisted interstitial laser coagulation for BPH  

NASA Astrophysics Data System (ADS)

Interstitial laser thermotherapy is a minimally invasive surgical procedure that utilizes laser to coagulate and treat benign prostatic hyperplasia. This study explores the use of a computer-assisted interstitial laser coagulation system to aid surgeons in performing this procedure.

Ho, Gideon; Barrett, Adrian R. W.; Ng, Wan S.; Lim, Liam G.; Cheng, Wai S.

2001-06-01

276

A hybrid particle swarm and neural network approach for detection of prostate cancer from benign hyperplasia of prostate.  

PubMed

In present paper, we propose a Hybrid classifier based particle swarm optimization (PSO) and Neural Network method for supporting the diagnosis of prostate cancer. algorithm combining particle swarm optimization algorithm with back propagation neural network (BPNN) algorithm, also referred to as BPNN-PSO algorithm, is proposed to train the feed forward neural network (FNN). The results show that the proposed BP based PSO algorithm can achieve very high diagnosis accuracy (98%) and it proving its usefulness in support of clinical decision process of prostate cancer. PMID:25160231

Sadoughi, Farhnaz; Ghaderzadeh, Mustafa

2014-01-01

277

Nd:YAG laser thermal effect in the prostate: application to laser treatment of benign prostatic hyperplasia  

Microsoft Academic Search

The aim of our study was to systematically determine the effect of Nd:YAG laser in the prostatic tissue of a canine animal model and to define the correlation of laser dose with the depth of coagulation necrosis. This study was carried out with a right angle non contact laser delivery system.

Eduardo Orihuela; Massoud Motamedi; Mariela Pow-Sang; Thomas Cammack; Michael M. Warren

1994-01-01

278

Histopathological Evaluation of Laser Thermocoagulation in the Human Prostate: Optimization of Laser Irradiation for Benign Prostatic Hyperplasia  

Microsoft Academic Search

We have previously shown in a canine prostate model that a noncontact low power neodymium: YAG laser regimen of 15 watts for 180 seconds yields a larger volume of coagulation necrosis than the currently recommended high power regimen of 50 watts for 60 seconds. These 2 regimens have not yet been compared in humans. The objective of this study was

Eduardo Orihuela; Massoud Motamedi; Mariela Pow-Sang; Marcellus LaHaye; Daniel F. Cowan; Michael M. Warren

1995-01-01

279

Management options for the treatment of benign prostatic hyperplasia with or without erectile dysfunction: a focus on tadalafil and patient considerations  

PubMed Central

Lower urinary tract symptoms (LUTS) and erectile dysfunction increase with age. Several studies have identified a true association between these two disorders. Basic research studies have shown a significant decrease in the nitric oxide/cyclic guanosine monophosphate pathway with age that leads to decreased relaxation of the bladder wall and prostate and worsening LUTS. In this review article, we will focus on the potential use and clinical significance of phosphodiesterase-5 inhibitors in the treatment of LUTS secondary to benign prostate hyperplasia. PMID:24959092

Alsaikhan, Bader; Alrabeeah, Khalid; Carrier, Serge

2014-01-01

280

Free-beam and contact laser ablation of benign prostatic hyperplasia with the KTP\\/Nd:YAG laser: efficacy and versatility  

Microsoft Academic Search

This report details the use of the free-beam Nd: YAG laser alone and in combination with contact vaporization for treatment of benign prostatic hyperplasia. Improvements in urinary flow rates and symptoms were noted along with a high degree of patient satisfaction. The portable KTP\\/Nd:YAG laser wavelengths and the variety of optical fiber configurations provide versatility to the surgeon. This study

M. J. Manyak; G. P. Aulisi

1995-01-01

281

Detection of pre-neoplastic and neoplastic prostate disease by MADI profiling of urine  

PubMed Central

The heterogeneous progression to the development of prostate cancer (PCa) has precluded effective early detection screens. Existing prostate cancer screening paradigms have relatively poor specificity for cancer relative to other prostate diseases, commonly benign prostatic hyperplasia (BPH). A method for discrimination of BPH, HGPIN, and PCa urine proteome was developed through testing 407 patient samples using matrix assisted laser desorption-mass spectrometry time of flight (MALDI-TOF). Urine samples were adsorbed to reverse phase resin, washed, and the eluant spotted directly for MALDI-TOF analysis of peptides. The processing resolved over 130 verifiable signals of a mass range of 1000-5000 m/z to suggest 71.2% specificity and 67.4% sensitivity in discriminating PCa vs. BPH. Comparing BPH and HGPIN resulted in 73.6% specificity and 69.2% sensitivity. Comparing PCa and HGPIN resulted in 80.8% specificity and 81.0% sensitivity. The high throughput, low-cost assay method developed is amenable for large patient numbers required for supporting biomarker identification. PMID:17194448

M'Koma, Amosy E.; Blum, David L.; Norris, Jeremy L.; Koyama, Tatsuki; Billheimer, Dean; Motley, Saundra; Ghiassi, Mayshan; Ferdowsi, Nika; Bhowmick, Indrani; Chang, Sam S.; Fowke, Jay H.; Caprioli, Richard M.; Bhowmick, Neil A.

2007-01-01

282

Detection of pre-neoplastic and neoplastic prostate disease by MALDI profiling of urine.  

PubMed

The heterogeneous progression to the development of prostate cancer (PCa) has precluded effective early detection screens. Existing prostate cancer screening paradigms have relatively poor specificity for cancer relative to other prostate diseases, commonly benign prostatic hyperplasia (BPH). A method for discrimination of BPH, HGPIN, and PCa urine proteome was developed through testing 407 patient samples using matrix assisted laser desorption-mass spectrometry time of flight (MALDI-TOF). Urine samples were adsorbed to reverse phase resin, washed, and the eluant spotted directly for MALDI-TOF analysis of peptides. The processing resolved over 130 verifiable signals of a mass range of 1000-5000 m/z to suggest 71.2% specificity and 67.4% sensitivity in discriminating PCa vs. BPH. Comparing BPH and HGPIN resulted in 73.6% specificity and 69.2% sensitivity. Comparing PCa and HGPIN resulted in 80.8% specificity and 81.0% sensitivity. The high throughput, low-cost assay method developed is amenable for large patient numbers required for supporting biomarker identification. PMID:17194448

M'Koma, Amosy E; Blum, David L; Norris, Jeremy L; Koyama, Tatsuki; Billheimer, Dean; Motley, Saundra; Ghiassi, Mayshan; Ferdowsi, Nika; Bhowmick, Indrani; Chang, Sam S; Fowke, Jay H; Caprioli, Richard M; Bhowmick, Neil A

2007-02-16

283

Modeling of intraluminal heating of biological tissue: implications for treatment of benign prostatic hyperplasia  

Microsoft Academic Search

A computer model for predicting the thermal response of a biological tissue to different intraluminal heating modalities is presented. A practical application of the model is to calculate the temperature distributions during thermal coagulation of prostate by contact heating and radiative heating. The model uses a two-dimensional axisymmetric diffusion approximation method to calculate the light distribution during radiative heating. The

Bahman Anvari; Sohi Rastegar; Massoud Motamedi

1994-01-01

284

TREATMENT OF BENIGN PROSTATIC HYPERPLASIA Jonathan W. Valvano, David Y. Yuan  

E-print Network

away from seeking treatments. MICROWAVE INSTRUMENTATION The Urologix® Transurethral Thermal Therapy (T3 affect voiding of urine. Factors to consider for thermally-based treatments of the prostate include minimization of thermal injury to the urethra and rectum, and maximal delivery of thermal energy to target

285

?–blockade, apoptosis, and prostate shrinkage: how are they related?  

PubMed Central

Purpose The ?1–adrenoreceptor antagonists, such as terazosin and doxazosin, induce prostate programmed cell death (apoptosis) within prostate epithelial and stromal cells in vitro. This treatment should cause prostate volume decrease, However, this has never been observed in clinical conditions. The aim of this paper is to review the disconnect between these two processes. Methods PubMed and DOAJ were searched for papers related to prostate, apoptosis, and stem cell death. The following key words were used: prostate, benign prostate hyperplasia, programmed cell death, apoptosis, cell death, ?1–adrenoreceptor antagonist, ?–blockade, prostate epithelium, prostate stroma, stem cells, progenitors, and in vitro models. Results We have shown how discoveries related to stem cells can influence our understanding of ?–blockade treatment for BPH patients. Prostate epithelial and mesenchymal compartments have stem (progenitors) and differentiating cells. These compartments are described in relation to experimental in vitro and in vivo settings. Conclusions Apoptosis is observed within prostate tissue, but this effect has no clinical significance and cannot lead to prostate shrinkage. In part, this is due to stem cells that are responsible for prostate tissue regeneration and are resistant to apoptosis triggered by ?1–receptor antagonists. PMID:24579025

Ch?osta, Piotr; Kaplan, Steven

2013-01-01

286

Subcellular concentrations of calcium, zinc, and magnesium in benign nodular hyperplasia of the human prostate: X-ray microanalysis of freeze-dried cryosections  

SciTech Connect

Biopsies from human prostates were obtained from normal and hyperplastic glands. The intracellular concentrations of calcium, zinc, and magnesium were analyzed using X-ray microanalysis of freeze-dried cryosections. Two prostate biopsies were obtained from kidney donors, ages 19 and 50 years, without any sign of benign nodular hyperplasia. The normal tissues were frozen within 15 min after circulatory arrest. The central part of biopsies from eight elderly men suffering from benign nodular hyperplasia were frozen within 30 s after excision. Adjacent tissue was processed for light microscopy and histopathological diagnosis. All samples were fresh-frozen using liquid nitrogen cooled pliers, without the use of any freeze-protection, fixation, or staining. In both the normal and the hyperplastic prostates high concentrations (up to above 100 mmol/kg dry weight) of zinc were present in electron dense bodies in the cytoplasm of the epithelial cells. Together with zinc, about equal concentrations of magnesium were found. Calcium was detected in 4 to 8 times the concentration of zinc. Significant, positive correlation between calcium and zinc as well as between calcium and magnesium in the cytoplasm was a typical finding in both normal and hyperplastic glands. In six of eight patients, older than 60 years of age, high levels of calcium (17.0-38.8 mmol/kg dry weight) were observed in the nuclei of the epithelial cells, while very low values were found in the remaining two. In the two younger cases (19 and 50 years of age), the nuclear calcium level in prostatic epithelium was relatively low (about 10 mmol/kg dry weight). These observations suggest that an increase of intranuclear calcium with advancing age may be of pathogenetic significance to growth disturbances in the prostate.

Tvedt, K.E.; Kopstad, G.; Haugen, O.A.; Halgunset, J.

1987-01-01

287

A multiscale, mechanism-driven, dynamic model for the effects of 5?-reductase inhibition on prostate maintenance.  

PubMed

A systems-level mathematical model is presented that describes the effects of inhibiting the enzyme 5?-reductase (5aR) on the ventral prostate of the adult male rat under chronic administration of the 5aR inhibitor, finasteride. 5aR is essential for androgen regulation in males, both in normal conditions and disease states. The hormone kinetics and downstream effects on reproductive organs associated with perturbing androgen regulation are complex and not necessarily intuitive. Inhibition of 5aR decreases the metabolism of testosterone (T) to the potent androgen 5?-dihydrotestosterone (DHT). This results in decreased cell proliferation, fluid production and 5aR expression as well as increased apoptosis in the ventral prostate. These regulatory changes collectively result in decreased prostate size and function, which can be beneficial to men suffering from benign prostatic hyperplasia (BPH) and could play a role in prostate cancer. There are two distinct isoforms of 5aR in male humans and rats, and thus developing a 5aR inhibitor is a challenging pursuit. Several inhibitors are on the market for treatment of BPH, including finasteride and dutasteride. In this effort, comparisons of simulated vs. experimental T and DHT levels and prostate size are depicted, demonstrating the model accurately described an approximate 77% decrease in prostate size and nearly complete depletion of prostatic DHT following 21 days of daily finasteride dosing in rats. This implies T alone is not capable of maintaining a normal prostate size. Further model analysis suggests the possibility of alternative dosing strategies resulting in similar or greater effects on prostate size, due to complex kinetics between T, DHT and gene occupancy. With appropriate scaling and parameterization for humans, this model provides a multiscale modeling platform for drug discovery teams to test and generate hypotheses about drugging strategies for indications like BPH and prostate cancer, such as compound binding properties, dosing regimens, and target validation. PMID:22970204

Zager, Michael G; Barton, Hugh A

2012-01-01

288

Determination of prostate adenoma weight reduction due to vaporisation process occurring during transurethral resection of the prostate  

PubMed Central

Introduction Transurethral resection of the prostate (TURP) is regarded as the gold standard surgical treatment for benign prostatic hyperplasia (BPH). The completeness of TURP may be assessed indirectly by estimation of the weight of glandular tissue removed. This parameter is often lower than expected. Tissue vaporisation in the course of TURP could be a contributory cause. Aim To quantitatively evaluate tissue vaporisation occurring in the course of transurethral resection of the prostate and electrovaporisation of the prostate (EVAP) performed under experimental conditions. Material and methods The study was performed on 26 prostate glands removed during retropubic prostatectomy. Immediately following surgery all adenomas were halved and TURP or EVAP were carried out on both halves of each gland for period of 5 min. The amount of prostate tissue which vaporised during EVAP and TURP were calculated. Results The mean weight (± standard deviation) of the adenoma lost due to resection and vaporisation in the TURP group was 10.00 ±2.92 g and 4.26 ±1.59 g, respectively. The latter accounted for 30.10 ±7.71% of total prostate weight reduction. The mean prostate weight lost in the course of EVAP was 5.03 ±1.58 g. Conclusions The vaporisation significantly contributes to the prostate tissue loss occurring during transurethral resection of the prostate. PMID:25337165

Szopinski, Tomasz; Chlosta, Piotr; Borowka, Andrzej

2014-01-01

289

BAX-INTERACTING FACTOR-1 (BIF-1) EXPRESSION IN PROSTATE CANCER  

PubMed Central

Background Bif-1 protein is a member of the endophilin B family that binds to and activates the pro-apoptotic Bax protein in response to apoptotic signals. Loss of Bif-1 suppresses the intrinsic pathway of apoptosis and promotes tumorigenesis. We examined the expression levels of Bif-1 protein in human prostate cancer. Methods Thirty-nine archival tissues specimens of human prostate cancer, and a human prostate cancer tissue microarray containing 19 samples of normal prostate (NR), 26 samples of benign prostatic hyperplasias (BPH), 30 samples of high grade prostatic intraepithelial neoplasia (PIN), and 153 samples of prostate cancer (CA), were selected for immuno-histochemical staining with Bif-1 antibody. The slides were scored by two independent observers. Results Non TMA samples: moderate to strong Bif-1 staining was identified in 38 of 39 CA. In 32 cases foci of PIN were identified adjacent to CA. Of these, twenty-nine (91%) showed strong and diffuse Bif-1 staining. BPH, identified in 27 cases, was weakly Bif-1 positive in 89% of cases. TMA samples: 38.6% (59/153) of CA showed moderate-strong Bif-1 expression, and 21.5% (33/153) were Bif-1 negative. Bif-1 expression was moderate-strong in 76.6% (23/30) of PIN. Bif-1 was weak-moderate in 53.8% (14/26) of BPH and negative in 46.1% (12/26) of them. Low-moderate Bif-1 was seen in 89.5% of NR. Conclusions The loss of Bif-1 expression in a subset of CAs is in agreement with the proapoptotic function of Bif-1. The significance of the increased Bif-1 in a subgroup of CA and in PIN remains to be determined. It seems that Bif-1 has a role in prostate cancer, providing the rationale for using Bif-1 as a target for prostate anticancer therapy. PMID:18824435

Coppola, Domenico; Oliveri, Cecilia; Sayegh, Zena; Boulware, David; Takahashi, Yoshinori; Pow–Sang, Julio; Djeu, Julie Y.; Wang, Hong-Gang

2009-01-01

290

An overview of prostate diseases and their characteristics specific to Asian men  

PubMed Central

In this paper, we reviewed the features of common prostate diseases, such as benign prostatic hyperplasia (BPH), prostate cancer (PCa) and chronic prostatitis (CP) that are specific to Asian men. Compared to the Westerners, Asians exhibit particular characteristics of prostate diseases. Through summarizing the epidemiology, symptomatology, diagnostics and therapeutics of these diseases, we find that Asians have a lower incidence of PCa than whites, but the incidences of BPH and CP are similar. Asian men with CP often suffer from fewer disease sites, but have a higher frequency of pain during urination rather than after sexual climax. Prostate-specific antigen (PSA) is a widely used marker for the diagnosis of PCa in both Asian and Western countries. Although the PSA level may be lower in Asians, the threshold used is based on whites. After reviewing the treatments available for these diseases, we did not find a fundamental difference between Asians and whites. Furthermore, the selection for the most appropriate treatment based on the individual needs of patients remains a challenge to urologists in Asia. After considering the traits of prostate diseases that are specific to Asian men, we hope to pave the way for the development of specific diagnostic and therapeutic strategies targeted specifically to Asian men. PMID:22306914

Xia, Shu-Jie; Cui, Di; Jiang, Qi

2012-01-01

291

Identification of candidate prostate cancer biomarkers in prostate needle biopsy specimens using proteomic analysis.  

PubMed

Although serum prostate specific antigen (PSA) is a well-established diagnostic tool for prostate cancer (PCa) detection, the definitive diagnosis of PCa is based on the information contained in prostate needle biopsy (PNBX) specimens. To define the proteomic features of PNBX specimens to identify candidate biomarkers for PCa, PNBX specimens from patients with PCa or benign prostatic hyperplasia (BPH) were subjected to comparative proteomic analysis. 2-DE revealed that 52 protein spots exhibited statistically significantly changes among PCa and BPH groups. Interesting spots were identified by MALDI-TOF-MS/MS. The 2 most notable groups of proteins identified included latent androgen receptor coregulators [FLNA(7-15) and FKBP4] and enzymes involved in mitochondrial fatty acid beta-oxidation (DCI and ECHS1). An imbalance in the expression of peroxiredoxin subtypes was noted in PCa specimens. Furthermore, different post-translationally modified isoforms of HSP27 and HSP70.1 were identified. Importantly, changes in FLNA(7-15), FKBP4, and PRDX4 expression were confirmed by immunoblot analyses. Our results suggest that a proteomics-based approach is useful for developing a more complete picture of the protein profile of PNBX specimen. The proteins identified by this approach may be useful molecular targets for PCa diagnostics and therapeutics. PMID:17722004

Lin, Jian-Feng; Xu, Jun; Tian, Hong-Yu; Gao, Xia; Chen, Qing-Xi; Gu, Qi; Xu, Gen-Jun; Song, Jian-da; Zhao, Fu-Kun

2007-12-15

292

Sex Steroid Metabolism in Benign and Malignant Intact Prostate Biopsies: Individual Profiling of Prostate Intracrinology  

PubMed Central

In vitro studies reveal that androgens, oestrogens, and their metabolites play a crucial role in prostate homeostasis. Most of the studies evaluated intraprostatic hormone metabolism using cell lines or preprocessed specimens. Using an ex vivo model of intact tissue cultures with preserved architecture, we characterized the enzymatic profile of biopsies from patients with benign prostatic hyperplasia (BPH) or cancer (PC), focusing on 17?-hydroxy-steroid-dehydrogenases (17?-HSDs) and aromatase activities. Samples from 26 men who underwent prostate needle core biopsies (BPH n = 14; PC n = 12) were incubated with radiolabeled 3H-testosterone or 3H-androstenedione. Conversion was evaluated by TLC separation and beta-scanning of extracted supernatants. We identified three major patterns of conversion. The majority of BPHs revealed no active testosterone/oestradiol conversion as opposed to prostate cancer. Conversion correlated with histology and PSA, but not circulating hormones. Highest Gleason scores had a higher androstenedion-to-testosterone conversion and expression of 17?-HSD-isoenzymes-3/5. Conclusions. We developed an easy tool to profile individual intraprostatic enzymatic activity by characterizing conversion pathways in an intact tissue environment. In fresh biopsies we found that 17?-HSD-isoenzymes and aromatase activities correlate with biological behaviour allowing for morphofunctional phenotyping of pathology specimens and clinical monitoring of novel enzyme-targeting drugs. PMID:25184140

Gianfrilli, Daniele; Pierotti, Silvia; Leonardo, Costantino; Ciccariello, Mauro

2014-01-01

293

Identification of FISH biomarkers to detect chromosome abnormalities associated with prostate adenocarcinoma in tumour and field effect environment  

PubMed Central

Background To reduce sampling error associated with cancer detection in prostate needle biopsies, we explored the possibility of using fluorescence in situ hybridisation (FISH) to detect chromosomal abnormalities in the histologically benign prostate tissue from patients with adenocarcinoma of prostate. Methods Tumour specimens from 33 radical prostatectomy (RP) cases, histologically benign tissue from 17 of the 33 RP cases, and 26 benign prostatic hyperplasia (BPH) control cases were evaluated with Locus Specific Identifier (LSI) probes MYC (8q24), LPL (8p21.22), and PTEN (10q23), as well as with centromere enumerator probes CEP8, CEP10, and CEP7. A distribution of FISH signals in the tumour and histologically benign adjacent tissue was compared to that in BPH specimens using receiver operating characteristic curve analysis. Results The combination of MYC gain, CEP8 Abnormal, PTEN loss or chromosome 7 aneusomy was positive in the tumour area of all of the 33 specimens from patients with adenocarcinomas, and in 88% of adjacent histologically benign regions (15 out of 17) but in only 15% (4 out of 26) of the benign prostatic hyperplasia control specimens. Conclusions A panel of FISH markers may allow detection of genomic abnormalities that associate with adenocarcinoma in the field adjacent to and surrounding the tumour, and thus could potentially indicate the presence of cancer in the specimen even if the cancer focus itself was missed by biopsy and histology review. PMID:24568597

2014-01-01

294

Effects of 100 and 300 Units of Onabotulinum Toxin A on Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia: A Phase II Randomized Clinical Trial  

PubMed Central

Purpose We conducted a 2-stage, multicenter, double-blind, randomized phase II clinical trial of 100 and 300 unit doses of onabotulinum toxin A to treat the lower urinary tract symptoms of benign prostatic hyperplasia. Materials and Methods Men 50 years old or older with clinically diagnosed benign prostatic hyperplasia, American Urological Association symptom index 8 or greater, maximum urinary flow rate less than 15 ml per second, voided volume 125 ml or greater, and post-void residual 350 ml or less were randomized to prostatic transrectal injection of 100 or 300 units of onabotulinum toxin A. The primary outcome was at least 30% improvement from baseline to 3 months in American Urological Association symptom index and/or maximum urinary flow rate and safety. The men were followed for 12 months. Results A total of 134 men were randomized and treated (68 with 100 units, 66 with 300 units), with 131 assessed at 3 months and 108 assessed at 12 months. Each dose met the 3-month primary outcome criteria. In the 100 unit arm the mean baseline American Urological Association symptom index of 18.8 decreased by 7.1 and 6.9 at 3 and 12 months, respectively. In the 300 unit arm the baseline of 19.5 decreased by 8.9 and 7.1, respectively. In the 100 unit arm the mean baseline maximum urinary flow rate of 10.0 ml per second increased by 2.5 and 2.2, respectively, and in the 300 unit arm the baseline of 9.6 increased by 2.6 and 2.3, respectively. Conclusions The intraprostatic injection of 100 or 300 units of onabotulinum toxin A passed predetermined criteria for treatment efficacy and safety, and a randomized trial with either dose is warranted. The 100 unit dose may be preferable due to similar efficacy with reduced costs and adverse effects. PMID:21791356

Crawford, E. David; Hirst, Kathryn; Kusek, John W.; Donnell, Robert F.; Kaplan, Steven A.; McVary, Kevin T.; Mynderse, Lance A.; Roehrborn, Claus G.; Smith, Christopher P.; Bruskewitz, Reginald

2013-01-01

295

Numerical simulations of a diode laser BPH treatment system  

Microsoft Academic Search

Numerical simulations are presented of the laser-tissue interaction of a diode laser system for treating benign prostate hyperplasia. The numerical model includes laser light transport, heat transport, cooling due to blood perfusion, thermal tissue damage, and enthalpy of tissue damage. Comparisons of the stimulation results to clinical data are given. We report that a reasonable variation from a standard set

Richard A. London; Victor C. Esch; Stephanos Papademetriou

1999-01-01

296

Lymphofollicular hyperplasia  

MedlinePLUS

Lymphofollicular hyperplasia is an increase in the size of the lymph node follicles. These follicles contain normal white blood ... the bloodstream. See also: Lymphadenitis and lymphangitis Lymphoid hyperplasia

297

[Use of Xanthii spinosi herba in treatment of benign prostate hypertrophia].  

PubMed

The aim of our study was to asses the efficacy of Xanthii spinosi herba in the treatment of rats with benign prostate hypertrophia induced under experimental conditions. Benign prostate hypertrophia (BPH) was induced by per oral (p.o.) administration of testosterone undecanoate (40 mg Undestor capsules) in concentrations of 15 mg/ kg/day and 35 mg/ kg/day. Drug induced BPH was treated with Xanthii spinosi herba as infusion and tincture. Drug induced benign prostate hyperplasia in rats was accompanied by a series of physical changes, like weight increase and shinier fur, and also by behavioral changes (increased appetite, aggression, increased libido). Prostate size was higher in all groups of animals treated with testosterone undecanoate compared to the control group. The morphopathological study of the organs taken from slaughtered animals, showed some microscopic changes in the prostate. In animals treated with Xanthii spinosi herba (infusion and tincture) we observed a decrease in volume of the prostate, while the microscopic changes were absent. PMID:25167701

Varga, Erzsébet; Marcu, Simona Tünde; Adoryan, Boglarka

2014-01-01

298

Benign Prostatic Hyperplasia  

MedlinePLUS

... drugs I can take? Drug treatments are available. Finasteride and dutasteride block a natural hormone that makes ... not help all patients. The side effects of finasteride are rare and mild, but they usually have ...

299

Is There a Relationship between the Amount of Tissue Removed at Transurethral Resection of the Prostate and Clinical Improvement in Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objective: To assess in a prospective trial the influence of the amount of tissue resected at transurethral resection of the prostate (TURP) for benign prostatic enlargement on the symptom improvement as assessed by symptom scores.Methods: Between December 1996 and August 1998 a total of 138 men (mean age 68.2, range 53–89) with symptomatic benign prostatic enlargement who underwent TURP participated

Oliver W. Hakenberg; Christian Helke; Andreas Manseck; Manfred P. Wirth

2001-01-01

300

Application of a high-power diode laser (810 nm) for treatment of benign prostatic hyperplasia: theoretical and experimental analysis  

Microsoft Academic Search

This paper examines the potential effectiveness of a high power, 810 nm diode laser in inducing thermal coagulation of prostatic tissue. A theoretical study is performed to compare the effectiveness of the diode laser with the currently used Nd:YAG laser (1064 nm) for prostate coagulation. Transurethral diode laser irradiation in a canine model is also performed to examine the efficacy

Bahman Anvari; Massoud Motamedi; Mariela Pow-Sang; Marcellus LaHaye; Eduardo Orihuela; Steven L. Jacques; Sohi Rastegar

1994-01-01

301

Testosterone regulates smooth muscle contractile pathways in the rat prostate: emphasis on PDE5 signaling  

PubMed Central

Testosterone (T) plays a permissive role in the development of benign prostatic hyperplasia (BPH), and phosphodiesterase 5 inhibitors (PDE5is) have been found to be effective for BPH and lower urinary tract symptoms (LUTS) in clinical trials. This study investigated the effect of T on smooth muscle (SM) contractile and regulatory signaling pathways, including PDE5 expression and functional activity in prostate in male rats (sham-operated, surgically castrated, and castrated with T supplementation). In vitro organ bath studies, real-time RT-PCR, Western blot analysis, and immunohistochemistry were performed. Castration heavily attenuated contractility, including sensitivity to phenylephrine with SM myosin immunostaining revealing a disrupted SM cell arrangement in the stroma. PDE5 was immunolocalized exclusively in the prostate stroma, and orchiectomy signficantly reduced PDE5 immunopositivity, mRNA, and protein expression, along with nNOS and ROK? mRNA, whereas it increased eNOS plus ?1a and ?1b adrenoreceptor expression in castrated animals. The PDE5i zaprinast significantly increased prostate strip relaxation to the nitric oxide donor sodium nitroprusside (SNP) in control but not castrated rats. But SNP alone was more effective on castrated rats, comparable with sham treated with SNP plus zaprinast. T supplementation prevented or restored all above changes, including SNP and zaprinast in vitro responsiveness. In conclusion, our data show that T positively regulates PDE5 expression and functional activities in prostate, and T ablation not only suppresses prostate size but also reduces prostatic SM contractility, with several potential SM contraction/relaxation pathways implicated. Zaprinast findings strongly suggest a major role for PDE5/cGMP in this signaling cascade. PDE5 inhibition may represent a novel mechanism for treatment of BPH. PMID:22028410

Zhang, Xinhua; Zang, Ning; Wei, Yu; Yin, Jin; Teng, Ruobing; Seftel, Allen

2012-01-01

302

Serum Protein Fingerprinting Coupled with a Pattern-matching Algorithm Distinguishes Prostate Cancer from Benign Prostate Hyperplasia and Healthy Men1  

Microsoft Academic Search

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 bio- markers for early detection of PCA using protein profiling technologies that can

Bao-Ling Adam; Yinsheng Qu; John W. Davis; Michael D. Ward; Lisa H. Cazares; O. John Semmes; Paul F. Schellhammer; Yutaka Yasui; Ziding Feng; George L. Wright

2002-01-01

303

Application of a high-power diode laser (810 nm) for treatment of benign prostatic hyperplasia: theoretical and experimental analysis  

NASA Astrophysics Data System (ADS)

This paper examines the potential effectiveness of a high power, 810 nm diode laser in inducing thermal coagulation of prostatic tissue. A theoretical study is performed to compare the effectiveness of the diode laser with the currently used Nd:YAG laser (1064 nm) for prostate coagulation. Transurethral diode laser irradiation in a canine model is also performed to examine the efficacy of inducing thermal coagulation in vivo. Model results show that comparable tissue effects can be obtained with both diode and Nd:YAG lasers. The in vivo results indicate that considerable amount of coagulation necrosis of prostatic tissue can be induced by the high power diode laser.

Anvari, Bahman; Motamedi, Massoud; Pow-Sang, Mariela; LaHaye, Marcellus; Orihuela, Eduardo; Jacques, Steven L.; Rastegar, Sohi

1994-05-01

304

Theoretical analysis of transurethral laser-induced thermo-therapy for treatment of benign prostatic hyperplasia. Evaluation of a water-cooled applicator  

NASA Astrophysics Data System (ADS)

A mathematical model for predicting the temperature rise in transurethral laser-induced thermo-therapy for benign prostatic hyperplasia was developed. In the model an optical line source emitting light from an Nd:YAG laser isotropically was placed in the urethra. Water cooling of the urethral epithelium was modelled using a two-tube system. The relationship between the difference in outlet and inlet water temperatures and the highest tissue temperature level reached was theoretically investigated. It was found that the water temperature difference was linearly dependent on the steady-state maximum tissue temperature. The theoretical calculations suggest that the water-cooled applicator can be used to measure the maximum tissue temperature. With temperature control, the prostatic tissue temperature can be prevented from exceeding the boiling point of water, excluding tissue carbonization. The model was also used to evaluate the influence of a number of different parameters on the damaged tissue volume. Increasing the urethral lumen radius by a factor of two by means of inserting different sized tubes was found to augment the tissue volume raised to therapeutic temperatures by up to 50%. The calculations showed that cooling of the urethral epithelium can result in an increase in the damaged volume by 80% as compared to not applying any cooling. The temperature of the cooling water was found to influence the tissue temperature only to a small extent.

Sturesson, C.; Andersson-Engels, S.

1996-03-01

305

The Dark Side of 5?-Reductase Inhibitors' Therapy: Sexual Dysfunction, High Gleason Grade Prostate Cancer and Depression  

PubMed Central

With aging, abnormal benign growth of the prostate results in benign prostate hyperplasia (BPH) with concomitant lower urinary tract symptoms (LUTS). Because the prostate is an androgen target tissue, and transforms testosterone into 5?-dihydrotestosterone (5?-DHT), a potent androgen, via 5?-reductase (5?-R) activity, inhibiting this key metabolic reaction was identified as a target for drug development to treat symptoms of BPH. Two drugs, namely finasteride and dutasteride were developed as specific 5?-reductase inhibitors (5?-RIs) and were approved by the U.S. Food and Drug Administration for the treatment of BPH symptoms. These agents have proven useful in the reducing urinary retention and minimizing surgical intervention in patients with BPH symptoms and considerable literature exists describing the benefits of these agents. In this review we highlight the adverse side effects of 5?-RIs on sexual function, high grade prostate cancer incidence, central nervous system function and on depression. 5?-Rs isoforms (types 1-3) are widely distributed in many tissues including the central nervous system and inhibition of these enzymes results in blockade of synthesis of several key hormones and neuro-active steroids leading to a host of adverse effects, including loss of or reduced libido, erectile dysfunction, orgasmic dysfunction, increased high Gleason grade prostate cancer, observed heart failure and cardiovascular events in clinical trials, and depression. Considerable evidence exists from preclinical and clinical studies, which point to significant and serious adverse effects of 5?-RIs, finasteride and dutasteride, on sexual health, vascular health, psychological health and the overall quality of life. Physicians need to be aware of such potential adverse effects and communicate such information to their patients prior to commencing 5?-RIs therapy. PMID:24955220

Mulgaonkar, Ashwini; Giordano, Nicholas

2014-01-01

306

Photoselective Vaporization of the Prostate: Initial Experience with a New 80 W KTP Laser for the Treatment of Benign Prostatic Hyperplasia  

Microsoft Academic Search

Purpose: To study the safety and efficacy of a new high-power potassium-titanyl-phosphate laser (KTP\\/532; Niagara PV™ laser system; Laserscope, San Jose, CA) for transurethral photoselective vaporization of be- nign obstructive prostate tissue. Patients and Methods: The KTP\\/532 laser energy at 80 W was delivered by a 6F side-firing fiber through a 23F continuous-flow cystoscope. Photoselective vaporization of the prostate (PVP)

Mahmood A. Hai; Reza S. Malek

2003-01-01

307

[Efficacy of a high-power laser vaporization in comparison with a monopolar transurethral resection in the treatment of benign prostatic hyperplasia: results of a 6-months follow-up].  

PubMed

Prospective investigation was conducted in 120 patients, operated on for benign prostatic hyperplasia, including 60--using transurethral prostatic resection (TUPR), and in 60--fotoselective vaporization (FSV). The operation duration was shorter while the TUPR application--(62 +/- 13) min than in FSV--(89 +/- 18) min. Although, duration of catheterization in FSV have had constituted at average (1.4 +/- 0.6) days and in TUPR--(3.0 +/- 0.6) days; the hospital stay was less after FSV--at average (2.4 +/- 1.3) days, and after TUPR--(4.2 +/- 0.5) days. PMID:24283044

Holovko, S V; Savyts'ky?, O F

2013-07-01

308

High-power diode laser at 980 nm for the treatment of benign prostatic hyperplasia: ex vivo investigations on porcine kidneys and human cadaver prostates  

Microsoft Academic Search

Diode laser systems at 980 nm have been introduced for the treatment of lower-urinary-tract-symptoms (LUTS) suggestive of\\u000a benign prostatic enlargement (BPE). However, the coagulation and vaporization properties are unknown. We therefore aimed to\\u000a evaluate these properties in ex vivo models in comparison with the kalium-titanyl-phosphate-(KTP) laser. The diode laser treatment\\u000a was applied to isolated, blood-perfused porcine kidneys and fresh human cadaver prostates

Michael Seitz; Oliver Reich; Christian Gratzke; Boris Schlenker; Alexander Karl; Markus Bader; Wael Khoder; Florian Fischer; Christian Stief; Ronald Sroka

2009-01-01

309

Efficacy of Repeated Transrectal Prostate Biopsy in Men Younger Than 50 Years With an Elevated Prostate-Specific Antigen Concentration (>3.0 ng/mL): Risks and Benefits Based on Biopsy Results and Follow-up Status  

PubMed Central

Purpose Prostate cancer is rare in men younger than 50 years. Digital rectal examination (DRE) and measurement of prostate-specific antigen (PSA) concentrations are standard screening methods for detecting prostate cancer. We retrospectively investigated the risks and benefits of repeated transrectal ultrasonography-guided prostate needle biopsies in relation to the follow-up status of men younger than 50 years with a consistently high PSA concentration (>3.0 ng/mL). Materials and Methods During the period from January 2000 through February 2013, we reviewed patient's ages, dates of procedures, DRE results, frequencies of biopsies, results of the biopsies, periods of follow-up, PSA concentrations, and prostate volumes in Chonbuk National University Hospital records. We conducted telephone interviews in patients who did not undergo regular follow-up. Results The mean age of the patients was 44.7 years, and the mean PSA concentration was 8.59 ng/mL (range, 3.04-131 ng/mL) before biopsy. The PSA concentration was significantly different (p<0.001) between the patients with prostate cancer and those with benign prostatic hyperplasia (BPH). Nineteen patients underwent repeated prostate biopsy; however, in only one patient did the pathologic findings indicate a change from BPH to prostate cancer. We identified several complications after transrectal biopsy through an evaluation of follow-up data. Conclusions All patients with benign prostatic disease based on their first biopsy were shown to have benign disease based on all repeated biopsies (15.83%), except for one patient; however, several complications were noted after biopsy. Therefore, the risks and benefits of repeated biopsy in young patients should be considered because of the low rate of change from benign to malignant disease despite continuously high PSA concentrations (>3.0 ng/mL). PMID:24741413

Park, Ho Gyun; Ko, Oh Seok; Kim, Young Gon

2014-01-01

310

Complications following combined transrectal ultrasound-guided prostate needle biopsies and transurethral resection of the prostate.  

PubMed

In order to evaluate safety and morbidity aspects of additional systematic prostate biopsies, we have conducted a retrospective review of patients who had undergone transurethral resection of the prostate (TUR-P) combined with additional systemic prostate needle biopsies at the Chang Gung Memorial Hospital. To this end, the records of 80 men presenting consecutively at our institution between February 2001 and January 2004 inclusively were examined. These 80 individuals included patients experiencing obstructive voiding symptoms and those featuring suspicious screening parameters, all of whom were to undergo transurethral resection of the prostate for symptomatic benign prostatic hyperplasia (BPH), all procedures being performed by a single surgeon. A total of 20 (25%) specimens were found to be positive for prostate cancer. Cancer was detected in the transrectal prostate biopsy specimen of 16 of 57 men (28%) who had not undergone a previous prostate biopsy, and for four of 23 (17%) who had undergone at least one previous (benign) biopsy. Mild complications associated with transurethral prostrate resection, such as hematuria and hemospermia, were reported frequently, featuring rates of 10% and 2.5%, respectively; more severe complications being noted far less frequently. Fever, usually of a low grade, was observed post-operatively for six (7.5%) patients, but a prompt return to normal temperature following antibiotic treatment for one day was revealed. Four (5%) patients remained admitted to the hospital for a prolonged period following surgery. A review of the literature concerning transrectal biopsies and TUR-P has shown that surgery-associated complication rates are slightly lower than was the case for our study. Additional systematic prostate biopsies for patients undergoing TUR-P would appear to be a relatively safe treatment procedure. Identification of risk factors for post-surgery complications might further improve the safety of the screening procedure. PMID:16443589

Shen, B-Y; Chang, P-L; Lee, S-H; Chen, C-L; Tsui, K-H

2006-01-01

311

Prostate resection - minimally invasive  

MedlinePLUS

... Whelan JP, Goeree L. Systematic review and meta-analysis of transurethral resection of the prostate versus minimally ... invasive treatments of benign prostatic hyperplasia: a cross-analysis of the literature. Can J Urol . 2010;17( ...

312

Significance of atypical small acinar proliferation and extensive high-grade prostatic intraepithelial neoplasm in clinical practice  

PubMed Central

Introduction Prostate cancer (PCa) is one of the most commonly diagnosed neoplasms in elderly men. The precancerous lesion of PCa is considered a high-grade prostate intraepithelial neoplasm (HG-PIN), while atypical small acinar proliferation (ASAP) is commonly considered as an under-diagnosed cancer. The aim of the study was to establish the impact of ASAP and extensive HG-PIN on pre-biopsy prostate-specific antigen (PSA) levels and the risk of cancer development in subsequent biopseis. Material and methods The 1,010 men suspected for PCa were included in the study based on elevated PSA, and/or positive rectal examination. Transrectal ultrasound (TRUS) guided 10 core biopsy was performed. In those with extensive HG-PIN or ASAP on the first biopsy, and/or elevated PSA value, a second biopsy was performed. Results In the second biopsy, PCa was diagnosed in 6 of 19 patients (31.57%) with extensive HG-PIN, in four of 40 (10%) with BPH, and in 4 of 18 (22.22%) with ASAP. There was a statistically significant difference between the values of PSA in the group of patients with ASAP in comparison to those with benign prostate hyperplasia (BPH) (p = 0.005) as well as in patients with HG-PIN in comparison to BPH (p = 0.02). Conclusions A precancerous lesion diagnosed upon biopsy causes a statistically significant increase in the values of PSA in relation to BPH, as well as in the case of ASAP and extensive HG-PIN. The estimate of risk of PCa diagnosis in patients with ASAP and those with extensive HG-PIN in the first biopsy is comparable, which is why there are no reasons for different treatment of patients with the above-mentioned diagnoses. Both should be subjected to urgent second biopsy in around the 4-6 weeks following the initial biopsy. PMID:25140226

Wolski, Zbigniew; Butkiewicz, Romuald; Nussbeutel, Joanna; Drewa, Tomasz

2014-01-01

313

Fluorescence of prostate-specific antigen as measured with a portable 1D scanner  

NASA Astrophysics Data System (ADS)

Prostate-specific antigen (PSA) is an androgen-dependent glycoprotein protease (M.W. 33 kDa) and a member of kallikrein super-family of serine protease, and has chymotrypsin-like enzymatic activity. It is synthesized by the prostate epithelial cells and found in the prostate gland and seminal plasma as a major protein. It is widely used as a clinical marker for diagnosis, screening, monitoring and prognosis of prostate cancer. In normal male adults, the concentration of PSA in the blood is below 4 ng/ml and this value increases in patients with the prostate cancer or the benign prostatic hyperplasia (BPH) due to its leakage into the circulatory system. As such, systematic monitoring of the PSA level in the blood can provide critical information about the progress of the prostatic disease. We have developed a compact integral system that can quantitatively measure the concentration of total PSA in human blood. This system utilizes the fluorescence emitted from the dye molecules attached to PSA molecules after appropriate immunoassay-based processing. Developed for the purpose of providing an affordable means of fast point-of-care testing of the prostate cancer, this system proved to be able to detect the presence of the PSA at the level of 0.18 ng/ml in less than 12 minutes, with the actual measurement taking less than 2 minutes. The design concept for this system is presented together with the result for a few representative samples.

Kim, Byeong C.; Jeong, Jin H.; Jeong, Dong S.; Kim, Young M.; Oh, Sang W.; Choi, Eui Y.; Kim, Jae H.; Nahm, Kie B.

2005-01-01

314

Development and characterization of japonica rice lines carrying the brown planthopper-resistance genes BPH12 and BPH6.  

PubMed

The brown planthopper (Nilaparvata lugens Stål; BPH) has become a severe constraint on rice production. Identification and pyramiding BPH-resistance genes is an economical and effective solution to increase the resistance level of rice varieties. All the BPH-resistance genes identified to date have been from indica rice or wild species. The BPH12 gene in the indica rice accession B14 is derived from the wild species Oryza latifolia. Using an F(2) population from a cross between the indica cultivar 93-11 and B14, we mapped the BPH12 gene to a 1.9-cM region on chromosome 4, flanked by the markers RM16459 and RM1305. In this population, BPH12 appeared to be partially dominant and explained 73.8% of the phenotypic variance in BPH resistance. A near-isogenic line (NIL) containing the BPH12 locus in the background of the susceptible japonica variety Nipponbare was developed and crossed with a NIL carrying BPH6 to generate a pyramid line (PYL) with both genes. BPH insects showed significant differences in non-preference in comparisons between the lines harboring resistance genes (NILs and PYL) and Nipponbare. BPH growth and development were inhibited and survival rates were lower on the NIL-BPH12 and NIL-BPH6 plants compared to the recurrent parent Nipponbare. PYL-BPH6 + BPH12 exhibited 46.4, 26.8 and 72.1% reductions in population growth rates (PGR) compared to NIL-BPH12, NIL-BPH6 and Nipponbare, respectively. Furthermore, insect survival rates were the lowest on the PYL-BPH6 + BPH12 plants. These results demonstrated that pyramiding different BPH-resistance genes resulted in stronger antixenotic and antibiotic effects on the BPH insects. This gene pyramiding strategy should be of great benefit for the breeding of BPH-resistant japonica rice varieties. PMID:22038433

Qiu, Yongfu; Guo, Jianping; Jing, Shengli; Zhu, Lili; He, Guangcun

2012-02-01

315

Elemental concentration analysis in prostate tissues using total reflection X-ray fluorescence  

NASA Astrophysics Data System (ADS)

Prostate cancer (PCa) currently represents the second most prevalent malignant neoplasia in men, representing 21% of all cancer cases. Benign Prostate Hyperplasia (BPH) is an illness prevailing in men above the age of 50, close to 90% after the age of 80. The prostate presents a high zinc concentration, about 10-fold higher than any other body tissue. In this work, samples of human prostate tissues with cancer, BPH and normal tissue were analyzed utilizing total reflection X-ray fluorescence spectroscopy using synchrotron radiation technique (SR-TXRF) to investigate the differences in the elemental concentrations in these tissues. SR-TXRF analyses were performed at the X-ray fluorescence beamline at Brazilian National Synchrotron Light Laboratory (LNLS), in Campinas, São Paulo. It was possible to determine the concentrations of the following elements: P, S, K, Ca, Fe, Cu, Zn and Rb. By using Mann-Whitney U test it was observed that almost all elements presented concentrations with significant differences (?=0.05) between the groups studied.

Leitão, R. G.; Palumbo, A.; Souza, P. A. V. R.; Pereira, G. R.; Canellas, C. G. L.; Anjos, M. J.; Nasciutti, L. E.; Lopes, R. T.

2014-02-01

316

G?s Protein Expression Is an Independent Predictor of Recurrence in Prostate Cancer  

PubMed Central

Background. T393C polymorphism in the gene GNAS1, which encodes the G-protein alpha s subunit (G?s) of heterotrimeric G protein, is significantly associated with the clinical outcome of patients suffering from several cancers. However, studies on the role and protein expression of G?s subunit in prostate cancer were still unavailable. Methods. The immunohistochemical staining was used to assess G?s expression through tissue microarray procedure of 56 metastatic PCas, 291 localized PCas, and 67 benign hyperplasia (BPH). G?s expression was semiquantitatively scored and evaluated the correlation with pathologic parameters and biochemical recurrence of prostate-specific antigen (PSA). Results. G?s expression was localized in nuclear and cytoplasm in prostate cancer cells and downregulated in metastatic PCa compared to localized PCa and BPH (P < 0.001). G?s was inversely associated with PSA level and Gleason scores; patients with low expression of G?s had adverse clincopathological features. In multivariable Cox regression analysis, high G?s expression and Gleason scores were independent predictors of both PSA progression-free and overall survival. Conclusions. G?s down-expression is associated with adverse pathologic features and clinical PSA biochemical recurrence of prostate cancer. G?s is an independent predictor to help determine the risk of PSA progression and death. PMID:24741584

Wang, Lijuan; Jin, Guihua; He, Chenchen; Guo, Xijing; Zhou, Xia; Li, Meng; Ying, Xia; Wang, Le; Wu, Huili; Zhu, Qing

2014-01-01

317

Diagnostic and prognostic utility of a DNA hypermethylated gene signature in prostate cancer.  

PubMed

We aimed to identify a prostate cancer DNA hypermethylation microarray signature (denoted as PHYMA) that differentiates prostate cancer from benign prostate hyperplasia (BPH), high from low-grade and lethal from non-lethal cancers. This is a non-randomized retrospective study in 111 local Asian men (87 prostate cancers and 24 BPH) treated from 1995 to 2009 in our institution. Archival prostate epithelia were laser-capture microdissected and genomic DNA extracted and bisulfite-converted. Samples were profiled using Illumina GoldenGate Methylation microarray, with raw data processed by GenomeStudio. A classification model was generated using support vector machine, consisting of a 55-probe DNA methylation signature of 46 genes. The model was independently validated on an internal testing dataset which yielded cancer detection sensitivity and specificity of 95.3% and 100% respectively, with overall accuracy of 96.4%. Second validation on another independent western cohort yielded 89.8% sensitivity and 66.7% specificity, with overall accuracy of 88.7%. A PHYMA score was developed for each sample based on the state of methylation in the PHYMA signature. Increasing PHYMA score was significantly associated with higher Gleason score and Gleason primary grade. Men with higher PHYMA scores have poorer survival on univariate (p?=?0.0038, HR?=?3.89) and multivariate analyses when controlled for (i) clinical stage (p?=?0.055, HR?=?2.57), and (ii) clinical stage and Gleason score (p?=?0.043, HR?=?2.61). We further performed bisulfite genomic sequencing on 2 relatively unknown genes to demonstrate robustness of the assay results. PHYMA is thus a signature with high sensitivity and specificity for discriminating tumors from BPH, and has a potential role in early detection and in predicting survival. PMID:24626295

Goh, Liang Kee; Liem, Natalia; Vijayaraghavan, Aadhitthya; Chen, Gengbo; Lim, Pei Li; Tay, Kae-Jack; Chang, Michelle; Low, John Soon Wah; Joshi, Adita; Huang, Hong Hong; Kalaw, Emarene; Tan, Puay Hoon; Hsieh, Wen-Son; Yong, Wei Peng; Alumkal, Joshi; Sim, Hong Gee

2014-01-01

318

Diagnostic and Prognostic Utility of a DNA Hypermethylated Gene Signature in Prostate Cancer  

PubMed Central

We aimed to identify a prostate cancer DNA hypermethylation microarray signature (denoted as PHYMA) that differentiates prostate cancer from benign prostate hyperplasia (BPH), high from low-grade and lethal from non-lethal cancers. This is a non-randomized retrospective study in 111 local Asian men (87 prostate cancers and 24 BPH) treated from 1995 to 2009 in our institution. Archival prostate epithelia were laser-capture microdissected and genomic DNA extracted and bisulfite-converted. Samples were profiled using Illumina GoldenGate Methylation microarray, with raw data processed by GenomeStudio. A classification model was generated using support vector machine, consisting of a 55-probe DNA methylation signature of 46 genes. The model was independently validated on an internal testing dataset which yielded cancer detection sensitivity and specificity of 95.3% and 100% respectively, with overall accuracy of 96.4%. Second validation on another independent western cohort yielded 89.8% sensitivity and 66.7% specificity, with overall accuracy of 88.7%. A PHYMA score was developed for each sample based on the state of methylation in the PHYMA signature. Increasing PHYMA score was significantly associated with higher Gleason score and Gleason primary grade. Men with higher PHYMA scores have poorer survival on univariate (p?=?0.0038, HR?=?3.89) and multivariate analyses when controlled for (i) clinical stage (p?=?0.055, HR?=?2.57), and (ii) clinical stage and Gleason score (p?=?0.043, HR?=?2.61). We further performed bisulfite genomic sequencing on 2 relatively unknown genes to demonstrate robustness of the assay results. PHYMA is thus a signature with high sensitivity and specificity for discriminating tumors from BPH, and has a potential role in early detection and in predicting survival. PMID:24626295

Vijayaraghavan, Aadhitthya; Chen, Gengbo; Lim, Pei Li; Tay, Kae-Jack; Chang, Michelle; Low, John Soon Wah; Joshi, Adita; Huang, Hong Hong; Kalaw, Emarene; Tan, Puay Hoon; Hsieh, Wen-Son; Yong, Wei Peng; Alumkal, Joshi

2014-01-01

319

Potential role of the OPG/RANK/RANKL axis in prostate cancer invasion and bone metastasis.  

PubMed

Receptor activator of NF-?B (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG) are key regulators of bone metabolism under both normal and pathological conditions, including prostate cancer (PCa) bone metastases. However, little is known concerning the expression and function of these regulators in prostate tumor samples and PCa cells and their correlation with invasion and bone metastasis. In the present study, we determined the expression of RANK, RANKL and OPG in 3 human PCa cell lines and 40 PCa patient samples by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA). As controls, samples from 20 patients with benign prostate hyperplasia (BPH) and normal prostate epithelial RWPE2 cells were also included in the analyses. The effects of soluble RANKL (sRANKL) and OPG as well as RANK knockdown on PCa invasion were examined in Transwell assays. Immunohistochemical staining detected little RANK, OPG and RANKL expression in hyperplasia prostate while the percentages of positivity were increased to 50, 45 and 52.5%, respectively, in prostate tumor tissues. OPG and sRANKL levels in the prostate tumor samples as measured by ELISA were ~10-fold that in the BPHs (P<0.01) and the levels were higher in aggressive tumors than non-aggressive ones (P<0.05). The sRANKL level in the serum of PCa patients was the same as that in the patients with BPH, yet the serum OPG levels correlated with the tissue levels (R2=0.620, P<0.01, which both showed a 10-fold increase in PCa over BPH (P<0.01) with higher levels in aggressive PCa than non-aggressive ones (P<0.05). Consistent with the tissue analyses, expression levels of RANK mRNA and protein were detected in multiple human PCa cell lines by RT-PCR and western blotting, respectively. The treatment of PCa cells with RANKL significantly increased the number of invaded cells (P<0.01), which was suppressed by the decoy receptor OPG. RANK siRNA transfection dramatically dampened the stimulatory effect of RANKL on PCa cell invasion. Our findings indicate that the expression of RANK, RANKL and OPG may be used as diagnostic markers to identify patients at high risk for aggressive PCa and that the effective suppression of PCa cell migration by OPG via the blockage of RANKL activity represents a potential therapeutic strategy for interfering with prostate tumor metastasis and progression to bone. PMID:25333856

Li, Xiaoming; Liu, Yaoming; Wu, Bin; Dong, Zhilong; Wang, Yichen; Lu, Jianzhong; Shi, Ping; Bai, Wenlong; Wang, Zhiping

2014-12-01

320

Prostatitis  

PubMed Central

The laboratory diagnosis of acute bacterial prostatitis is straightforward and easily accomplished in clinical laboratories. Chronic bacterial prostatitis, and especially chronic idiopathic prostatitis (most often referred to as abacterial prostatitis), presents a real challenge to the clinician and clinical microbiologist. Clinically, the diagnosis of chronic idiopathic prostatitis is differentiated from that of acute prostatitis by a lack of prostatic inflammation and no “significant” (controversial) leukocytes or bacteria in the expressed prostatic secretions. Despite these diagnostic criteria, the etiology of chronic idiopathic prostatitis is unknown. While this review covers the entire spectrum of microbially caused acute prostatitis (including common and uncommon bacteria, viruses, fungi, and parasites) and microbially associated chronic prostatitis, a special focus has been given to chronic idiopathic prostatitis. The idiopathic syndrome is commonly diagnosed in men but is poorly treated. Recent data convincingly suggests a possible bacterial etiology for the condition. Provocative molecular studies have been published reporting the presence of 16S rRNA bacterial sequences in prostate biopsy tissue that is negative for ordinary bacteria by routine culture in men with chronic idiopathic prostatitis. Additionally, special culture methods have indicated that difficult-to-culture coryneforms and coagulase-negative staphylococci are present in expressed prostatic secretions found to be negative by routine culture techniques. Treatment failures are not uncommon in chronic prostatitis. Literature reports suggest that antimicrobial treatment failures in chronic idiopathic prostatitis caused by organisms producing extracellular slime might result from the virulent properties of coagulase-negative staphylococci or other bacteria. While it is difficult to definitively extrapolate from animal models, antibiotic pharmokinetic studies with a murine model have suggested that treatment failures in chronic prostatitis are probably a result of the local microenvironment surrounding the persistent focal and well-protected small bacterial biofilms buried within the prostate gland. These conclusions support the molecular and culture data implicating bacteria as a cause of chronic idiopathic prostatitis. PMID:9767058

Domingue, Gerald J.; Hellstrom, Wayne J. G.

1998-01-01

321

The Combination of Human Glandular Kallikrein and Free Prostate-specific Antigen (PSA) Enhances Discrimination Between Prostate Cancer and Benign Prostatic Hyperplasia in Patients with Moderately Increased Total PSA  

Microsoft Academic Search

Background: Prostate-specific antigen (PSA) is the most reliable tumor marker available and is widely used for the diagnosis and management of prostate cancer. Un- fortunately, PSA cannot distinguish efficiently between benign and malignant disease of the prostate, especially within the range of 4 -10 mg\\/L. Among the refinements developed to enhance PSA specificity is the free\\/total PSA ratio, which is

Angeliki Magklara; Andreas Scorilas; William J. Catalona; Eleftherios P. Diamandis

322

Percentage of free serum prostate-specific antigen: a new tool in the early diagnosis of prostatic cancer.  

PubMed

Prostate-specific antigen (PSA) is a protease able to bind to serum antiproteases as alpha 1 antichymotrypsin (ACT). Free PSA (FPSA) corresponds to the fraction of total PSA (TPSA) which is unbound to ACT. Specific detection of the FPSA seems to be a valuable tool in the distinction between prostatic cancer (PCa) and benign prostatic hyperplasia (BPH). Our aim was to evaluate retrospectively the FPSA/TPSA ratio in comparison to TPSA or FPSA determination, using two new immunoradiometric assays (PSA-RIACT and FPSA-RIACT, CIS bio international, Gif Sur Yvette, France) in the early diagnosis of PCa. 256 men, with TPSA levels between 0.7 and 44.7 ng/ml (median age = 69 years), including 164 sera obtained from patients with BPH and 92 sera from patients with untreated PCa were assayed. All diagnoses were histologically confirmed and patients tested before any adjuvant treatment. The evaluation of the median FPSA/TPSA ratio in the two groups showed significantly different values (BPH group: 24.2%, PCa group: 12.1%, P < 0.0001). By R.O.C. (Receiver-Operating-Characteristics) analysis, we show that the FPSA/TPSA ratio is the method of choice for discriminating BPH and PCa, since the area under curve is the greatest for the FPSA/TPSA ratio curve, as compared to the TPSA or FPSA curves (P < 0.0001). The best accuracy (number of true positive + true negative/total = 82.4%) was obtained with a FPSA/TPSA ratio < or = 15% with high odds ratio (20.5; confidence interval (CI): 11.2; 37.7). Of interest, similar results were also confirmed even in the subpopulation with serum TPSA levels between 2.5 and 10 ng/ml (161 patients including 99 BPH and 62 PCa). We thus confirm that combined serum measurement of FPSA and TPSA is of particular interest in the early diagnosis of PCa for patients with non-suspicious digital rectal examination and a TPSA value between 2.5 and 10 ng/ml. In those patients, biopsy should be reserved to the cases with FPSA/TPSA below 15%, which allows significant odds ratio (12.8; CI: 5.2; 31.4). Otherwise, to avoid the risk of missing any PCa, usual follow-up with combined TPSA and FPSA determination would be required with the same criteria of biopsy (i.e. FPSA/TPSA ratio < or = 15% when TPSA value is between 2.5 and 10 ng/ml; or TPSA > 10 ng/ml). PMID:9014750

Toubert, M E; Guillet, J; Chiron, M; Meria, P; Role, C; Schlageter, M H; Francois, H; Borschneck, C; Nivelon, F; Desgrandchamps, F; Rastel, D; Cussenot, O; Teillac, P; Le Duc, A; Najean, Y

1996-11-01

323

Defining the Degree of Intravesical Prostatic Protrusion in Association With Bladder Outlet Obstruction  

PubMed Central

Purpose The present study was done to define the degree of intravesical prostatic protrusion (IPP) causing bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms. Materials and Methods We retrospectively evaluated 239 patients with BPH, analyzing age, IPP, prostate volume, International Prostate Symptom Score (IPSS), and the results from a pressure-flow study. Urethral resistance was quantified by using the BOO index (BOOI), according to the formula BOOI=PdetQmax-2×Qmax (where Pdet is detrusor pressure at the peak flow rate and Qmax is peak flow rate). BOO was defined by a BOOI above 40. Patients with a BOOI below 20 were excluded. Patients were classified into two groups (obstructed and unobstructed groups) by the BOOI. Correlations were determined by logistic regression analysis, and receiver operating characteristic curves were plotted to estimate the optimal cutoff for IPP. Results There were significant differences in total prostate volume, postvoiding residual urine (PVR), IPP, and Qmax (p<0.001, p<0.001, p<0.001, and p=0.026, respectively) between the obstructed and unobstructed groups, but there were no significant differences in age (p=0.653), IPSS total score (p=0.624), or quality of life score (p=0.138). IPP had a significant prognosis (p<0.001) but was weakly correlated with prostate volume (p=0.026). The correlation coefficients between IPP and Qmax, PVR, prostate volume, and BOO were 0.551, -0.159, 0.225, and 0.391, respectively. For IPP, the area under the curve was 0.759 (95% confidence interval, 0.657 to 0.861) and the cutoff to indicate BOO was 5.5 mm with 66.7% sensitivity and 80.5% specificity. Conclusions An IPP exceeding 5.5 mm was significantly associated with BOO. PMID:23789044

Shin, Su Hwan; Kim, Jong Wook; Kim, Jin Wook; Oh, Mi Mi

2013-01-01

324

In The News Monday, May 21, 2012  

E-print Network

Lumenis Aligns with Globally Renowned Urologists at AUA to Review Benign Prostatic Hyperplasia (BPH) (Joel Prostatic Hyperplasia (BPH) 05/19/2012 KATV-TV - Online View Clip Lumenis Aligns with Globally Renowned Urologists at AUA to Review Benign Prostatic Hyperplasia (BPH) 05/19/2012 KEYC-TV - Online View Clip #12

Arizona, University of

325

Prognostication of prostate cancer based on NUCB2 protein assessment: NUCB2 in prostate cancer  

PubMed Central

Background Nucleobindin 2 (NUCB2) protein, a novel oncoprotein, is overexpressed in breast cancer. To date, there have been no published data regarding the role of NUCB2 protein expression in prostate cancer (PCa). Therefore, this study was performed to investigate the correlations between NUCB2 protein expression and prognosis in patients with PCa. Methods Through immunohistochemistry, NUCB2 protein expression was evaluated in 60 benign prostatic hyperplasia (BPH) specimens and 180 PCa specimens. The correlation of NUCB2 protein expression with clinicopathological parameters was assessed using ?2 analysis. Kaplan-Meier analysis and Cox proportional hazards regression models were used to investigate the correlation between NUCB2 protein expression and prognosis of PCa patients. Results The immunohistochemistry results showed that the expression level of NUCB2 in PCa cases was significantly higher than that in BPH tissues (P < 0.001). Moreover, statistical analysis also showed that high NUCB2 protein expression was positively related to seminal vesicle invasion, lymph node metastasis, angiolymphatic invasion, higher Gleason score, biochemical recurrence (BCR), and higher preoperative prostate-specific antigen (PSA). Furthermore, it was also shown that patients with high NUCB2 protein expression had significantly poorer overall survival and BCR- free survival compared with patients with low expression of NUCB2 protein. Multivariate Cox regression analysis revealed that high NUCB2 protein expression level was an independent prognostic factor for overall survival and BCR-free survival of patients with PCa. Conclusions NUCB2 protein expression showed a strong association with the potencies of BCR and progression of PCa, and that may be applied as a novel biomarker for the prediction of BCR, and helpful for improving the diagnosis, prognosis and treatment of PCa. PMID:24422979

2013-01-01

326

Characteristics of separated epithelial and stromal subfractions of prostate: I. Rat ventral prostate.  

PubMed

These studies were initiated with the objective of isolating epithelial and stromal cells of human prostatic tissue in undamaged state, in order to study the cellular distribution of steroid receptors in benign prostatic hyperplasia (BPH) relative to normal prostate. Initial experiments showed that when BPH tissue immersed in tissue culture media was progressively fragmented by various cutting procedures, epithelial elements were selectively released as clumps of variable size and individual cells, but that a large percentage of these cells were damaged, as evidenced by their failure to exclude trypan blue (TB). These observations suggested that if tissue fragmentation were carried out under defined conditions that minimize cell damage, BPH subfractions might be obtained containing a large percentage of undamaged cells. To determine conditions of tissue fragmentation which result in maximal recovery of epithelial cells which exclude TB, rat ventral prostate (RVP) was chosen as a model system. Experiments with RVP revealed that maximal yields of such cells were obtained in "large" epithelial clumps (greater than 30 cells per clump) released under the following conditions: (1) chopping the tissue with razor blades in a large volume (2 ml/100 mg RVP) of a Ca2+-free tissue culture medium ( Joklik 's-MEM) containing 1% casein, (2) carrying out the entire fractionation procedure in the cold, and (3) maintaining a 1% casein concentration in the medium during chopping, as well as in subsequent washing procedures, to protect cells from proteolytic activity. In large epithelial clumps, cells in the interior of the clump were not stained by TB but the cells at the periphery of the clump were freely permeable to TB. Single epithelial cells and small epithelial clumps (3-10 cells) released by razor blade fragmentation were also permeable to TB. When large epithelial clumps were incubated at 20 degrees C for 90 min, the clumps disaggregated into smaller clumps and morphologically intact single cells, which did not exclude TB. The residual tissue fragments remaining after chopping contained the bulk of stromal cells plus some epithelial elements. The latter could be removed by gentle rubbing of the fragments on a sieve in the presence of medium. The stromal fraction thus obtained consisted of stromal cells, embedded in mesenchymal matrix, which were not stained by TB and appeared normal when examined histologically by light microscopy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6374638

Bruner-Lorand, J; Mechaber, D; Zwick, A; Hechter, O; Eychenne, B; Baulieu, E E; Robel, P

1984-01-01

327

Preferential Autoimmune Response in Prostate Cancer to Cyclin B1 in a Panel of Tumor-Associated Antigens  

PubMed Central

Previous studies have demonstrated that sera from patients with prostate cancer (PCa) contain autoantibodies that react with tumor-associated antigens (TAAs). Autoantibodies to cyclin B1 and fourteen other TAAs were detected by enzyme-linked immunosorbent assay (ELISA) and Western blotting in 464 sera from patients with PCa, benign prostatic hyperplasia (BPH), and other controls. Autoantibodies to cyclin B1 were detected in 31.0% of sera from randomly selected patients with PCa versus 4.8% in sera with BPH. In the further analysis, 31.4% of sera from PCa patients at the early stage contained anti-cyclin B1 autoantibody, and even 29.4% of patients who had normal prostate-specific antigen (PSA) levels in their serum samples were observed anti-cyclin B1 positive. The cumulative positive rate of autoantibodies against seven selected TAAs (cyclin B1, survivin, p53, DFS70/LEDGFp75, RalA, MDM2, and NPM1) in PCa reached 80.5%, significantly higher than that in normal control sera. In summary, autoantibody to cyclin B1 might be a potential biomarker for the immunodiagnosis of early stage PCa, especially useful in patients with normal PSA level. This study further supports the hypothesis that a customized TAA array can be used for enhancing anti-TAA autoantibody detection, and it may constitute a promising and powerful tool for immunodiagnosis of PCa. PMID:24860838

Dai, Liping; Ortega, Rosalia; Casiano, Carlos A.; Zhang, Jian-Ying

2014-01-01

328

Safety and Efficacy of Combined Transrectal Ultrasound-Guided Prostate Needle Biopsy and Transurethral Resection of the Prostate  

PubMed Central

Purpose This study was conducted to examine whether simultaneous transrectal prostate needle biopsy (TPNB) owing to an increase in prostate-specific antigen (PSA) levels is safe and effective in patients who are scheduled for transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). Materials and Methods Combined TPNB and TURP was performed in a total of 42 patients aged 60 years and older who had gray-zone PSA values (4-10 ng/ml) and PSA density (PSAD) values of 0.12 and less. The frequencies of fever, sepsis, and epididymitis were assessed after surgery. The diagnostic accuracy was assessed, and the results of histologic examination were evaluated in terms of TPNB or TURP. In addition, the diagnostic accuracy was assessed according to age. Results Prostate cancer was diagnosed in 6 (14.3%) of the 42 patients: 2 patients were diagnosed with prostate cancer by TPNB only, 3 patients by TURP only, and 1 patient by combined TPNB and TURP. Four (25%) of the 16 patients aged under 70 years and 2 (7.8%) of the 26 patients aged 70 years and older were diagnosed with prostate cancer. Fever was observed in 9 patients (21.4%), 4 (9.5%) of whom had a fever of higher than 38?. The fever normalized the day after surgery in all 9 patients. No septicemia was noted. There were no serious complications related to combined TPNB and TURP. Conclusions The results of this study suggest that combined TPNB and TURP may be safe and effective in patients who require TURP. PMID:20414421

Cho, Jeong Man; Lee, Seung Wook; Kang, Jung Yoon

2010-01-01

329

Critical and Reciprocal Regulation of KLF4 and SLUG in Transforming Growth Factor ?-Initiated Prostate Cancer Epithelial-Mesenchymal Transition  

PubMed Central

Epithelial-mesenchymal transition (EMT) is implicated in various pathological processes within the prostate, including benign prostate hyperplasia (BPH) and prostate cancer progression. However, an ordered sequence of signaling events initiating carcinoma-associated EMT has not been established. In a model of transforming growth factor ? (TGF?)-induced prostatic EMT, SLUG is the dominant regulator of EMT initiation in vitro and in vivo, as demonstrated by the inhibition of EMT following Slug depletion. In contrast, SNAIL depletion was significantly less rate limiting. TGF?-stimulated KLF4 degradation is required for SLUG induction. Expression of a degradation-resistant KLF4 mutant inhibited EMT, and furthermore, depletion of Klf4 was sufficient to initiate SLUG-dependent EMT. We show that KLF4 and another epithelial determinant, FOXA1, are direct transcriptional inhibitors of SLUG expression in mouse and human prostate cancer cells. Furthermore, self-reinforcing regulatory loops for SLUG-KLF4 and SLUG-FOXA1 lead to SLUG-dependent binding of polycomb repressive complexes to the Klf4 and Foxa1 promoters, silencing transcription and consolidating mesenchymal commitment. Analysis of tissue arrays demonstrated decreased KLF4 and increased SLUG expression in advanced-stage primary prostate cancer, substantiating the involvement of the EMT signaling events described in model systems. PMID:22203039

Liu, Yen-Nien; Abou-Kheir, Wassim; Yin, Juan Juan; Fang, Lei; Hynes, Paul; Casey, Orla; Hu, Dong; Wan, Yong; Seng, Victoria; Sheppard-Tillman, Heather; Martin, Philip

2012-01-01

330

Critical and reciprocal regulation of KLF4 and SLUG in transforming growth factor ?-initiated prostate cancer epithelial-mesenchymal transition.  

PubMed

Epithelial-mesenchymal transition (EMT) is implicated in various pathological processes within the prostate, including benign prostate hyperplasia (BPH) and prostate cancer progression. However, an ordered sequence of signaling events initiating carcinoma-associated EMT has not been established. In a model of transforming growth factor ? (TGF?)-induced prostatic EMT, SLUG is the dominant regulator of EMT initiation in vitro and in vivo, as demonstrated by the inhibition of EMT following Slug depletion. In contrast, SNAIL depletion was significantly less rate limiting. TGF?-stimulated KLF4 degradation is required for SLUG induction. Expression of a degradation-resistant KLF4 mutant inhibited EMT, and furthermore, depletion of Klf4 was sufficient to initiate SLUG-dependent EMT. We show that KLF4 and another epithelial determinant, FOXA1, are direct transcriptional inhibitors of SLUG expression in mouse and human prostate cancer cells. Furthermore, self-reinforcing regulatory loops for SLUG-KLF4 and SLUG-FOXA1 lead to SLUG-dependent binding of polycomb repressive complexes to the Klf4 and Foxa1 promoters, silencing transcription and consolidating mesenchymal commitment. Analysis of tissue arrays demonstrated decreased KLF4 and increased SLUG expression in advanced-stage primary prostate cancer, substantiating the involvement of the EMT signaling events described in model systems. PMID:22203039

Liu, Yen-Nien; Abou-Kheir, Wassim; Yin, Juan Juan; Fang, Lei; Hynes, Paul; Casey, Orla; Hu, Dong; Wan, Yong; Seng, Victoria; Sheppard-Tillman, Heather; Martin, Philip; Kelly, Kathleen

2012-03-01

331

Prostate specific antigen levels following transurethral resection of the prostate  

Microsoft Academic Search

Objective: Determine how serum prostate-specific antigen (t-PSA) levels and free PSA (f\\/t PSA) ratio change following transurethral resection of the prostate (TURP). Materials and Methods: Thirty men with a mean age of 67.0 ± 4.2 years (range 46 to 84 years) underwent TURP for BPH between May 2005 and October 2005. Preoperative assessment included symptom evaluation with the International Prostate

Roberto C. Fonseca; Cristiano M. Gomes; Elton B. Meireles; Geraldo C. Freire; Miguel Srougi

2008-01-01

332

Safety and efficacy of tolterodine extended release in men with overactive bladder symptoms and presumed non-obstructive benign prostatic hyperplasia  

Microsoft Academic Search

Patients with presumed non-obstructive BPH (Q\\u000a max ? 15 ml\\/s) treated with tolterodine ER 4 mg\\/day for OAB symptoms, alone or added to unsuccessful alpha-blocker treatment of\\u000a ?6 weeks duration, were observed for 12 weeks in a non-interventional study to generate real-life efficacy and safety data.\\u000a Patients completed the IPSS, the OAB-q and a 2-day micturition diary at baseline and 12 weeks. PVR was determined sonographically.\\u000a Seven

K. Höfner; M. Burkart; G. Jacob; U. Jonas

2007-01-01

333

The simultaneous detection of free and total prostate antigen in serum samples with high sensitivity and specificity by using the dual-channel surface plasmon resonance.  

PubMed

Free/total prostate antigen (f/t-PSA) ratio in serum as a promising parameter has been used to improve the differentiation of benign and malignant prostate disease. In order to obtain the accurate and reliable f/t-PSA ratio, the simultaneous detection of f-PSA and t-PSA with high sensitivity and specificity is required. In this work, the dual-channel surface plasmon resonance (SPR) has been employed to meet the requirement. In one channel, t-PSA was directly measured with a linear range from 1.0 to 20.0 ng/mL. In another channel, due to the low concentration of f-PSA in serum, the asynchronous competitive inhibition immunoassay with f-PSA@Au nanoparticles (AuNPs) was developed. As expected, the detection sensitivity of f-PSA was greatly enhanced, and a linear correlation with wider linear range from 0.010 to 0.40 ng/mL was also achieved. On the other hand, a simple method was explored for significantly reducing the non-specific adsorption of co-existing proteins. On basis of this, the f/t-PSA ratios in serum samples from prostate cancer (PCa) or benign prostatic hyperplasia (BPH) patients were measured. And it was found that there was significant difference between the distributions of f/t-PSA ratio in BPH patients (16.44±1.77%) and those in PCa patients (24.53±4.97%). This present work provides an effective method for distinguishing PCa from BPH, which lays a potential foundation for the early diagnosis of PCa. PMID:25016334

Jiang, Zhongxiu; Qin, Yun; Peng, Zhen; Chen, Shenghua; Chen, Shu; Deng, Chunyan; Xiang, Juan

2014-12-15

334

Numerical simulations of a diode laser BPH treatment system  

SciTech Connect

Numerical simulations are presented of the laser-tissue interaction of a diode laser system for treating benign prostate hyperplasia. The numerical model includes laser light transport, heat transport, cooling due to blood perfusion, thermal tissue damage, and enthalpy of tissue damage. Comparisons of the simulation results to clinical data are given. We report that a reasonable variation from a standard set of input data produces heating times which match those measured in the clinical trials. A general trend of decreasing damage volume with increasing heating time is described. We suggest that the patient-to- patient variability seen in the data can be explained by differences in fundamental biophysical properties such as the optical coefficients. Further work is identified, including the measurement and input to the model of several specific data parameters such as optical coefficients, blood perfusion cooling rate, and coagulation rates.

Esch, V; London, R A; Papademetriou, S

1999-02-23

335

Numerical simulations of a diode laser BPH treatment system  

NASA Astrophysics Data System (ADS)

Numerical simulations are presented of the laser-tissue interaction of a diode laser system for treating benign prostate hyperplasia. The numerical model includes laser light transport, heat transport, cooling due to blood perfusion, thermal tissue damage, and enthalpy of tissue damage. Comparisons of the stimulation results to clinical data are given. We report that a reasonable variation from a standard set of input data produces heating times which match those measured in the clinical trials. A general trend of decreasing damage volume with increasing heating time is described. We suggest that the patient-to-patient variability seen in the data can be explained by differences in fundamental biophysical properties such as the optical coefficients. Further work is identified, including the measurement and input to the model of several specific data parameters such as optical coefficients, blood perfusion cooling rate, and coagulation rates.

London, Richard A.; Esch, Victor C.; Papademetriou, Stephanos

1999-06-01

336

Treating Enlarged Prostate (BPH): Which Drugs Work Best  

MedlinePLUS

... review by the Oregon Health and Science University-based Drug Effectiveness Review Project. This is a summary of a longer, more ... Consumer Reports Best Buy Drugs, a public information project supported by grants ... and Prescriber Education Grant Program which is funded by the multi- ...

337

The hytrin community assessment trial study: A one-year study of terazosin versus placebo in the treatment of men with symptomatic benign prostatic hyperplasia  

Microsoft Academic Search

ObjectivesTo determine the clinical effectiveness and safety of alpha,-blockade therapy versus placebo in the treatment of men with moderate to severe symptoms of prostatism in a community-based population under usual care conditions.

Claus G. Roehrborn; Joseph E. Oesterling; Stephen Auerbach; Stephen A. Kaplan; L. Keith Lloyd; Douglas F. Milam; Robert J. Padley

1996-01-01

338

Giant prostatic calculi  

PubMed Central

Prostatic parenchymal calculi are common, usually incidental, findings on morphological examinations. They are typically asymptomatic and may be present in association with normal glands, benign prostatic hyperplasia, and prostate cancer. However giant prostatic calculi are rare. Less than 20 cases have been reported in the literature. We present the case of a 35-year-old man with two giant prostatic calculi that replaced the entire gland. He underwent an open cystolithotomy, two giant stones were removed from the prostate, and we used a lithotripsy in situ for extraction of stone fragments. PMID:23565316

Najoui, Mohammed; Qarro, Abdelmounaim; Ammani, Abdelghani; Alami, Mohammed

2013-01-01

339

Prognostic value of tissue and circulating levels of IMP3 in prostate cancer.  

PubMed

Tissue levels of the oncofetal protein insulin-like growth factor 2 (IGF2) messenger RNA-binding protein 3 (IMP3) have been associated with poor prognosis in multiple human malignancies. However, its circulating levels have not yet been analyzed. Therefore, the aim of this study was to assess the prognostic value of both serum and tissue levels of IMP3 in prostate cancer (PC). IMP3 protein expression was analyzed in 124 PC and 13 benign prostate hyperplasia (BPH) patients using immunohistochemistry. Gene expression levels of IMP3 and its molecular target IGF2 were analyzed in 29 frozen and 26 paraffin-embedded PC tissues using real-time polymerase chain reaction and immunohistochemistry. Serum IMP3 levels were assessed in 94 PC and 20 BPH patients as well as in 20 controls using enzyme-linked immunosorbent assay. IMP3 immunostaining was present in 0% (0/13) of BPHs, 15% (15/101) of clinically localized PCs and 65% (15/23) of palliatively treated metastatic PCs (p < 0.001). Accordingly, serum IMP3 concentrations were significantly higher in PC compared to BPH patients which were higher than those in controls (p < 0.001 each). The highest concentrations were detected in metastatic PC patients (p = 0.036). In patients who underwent radical prostatectomy high IMP3 serum levels were independently associated with poor cancer-specific survival. IMP3 gene and protein expressions were not correlated with those of IGF2. In conclusion, we found enhanced IMP3 levels in tissue and serum samples of PC patients compared to non-PC men. Moreover, IMP3 was associated with metastasis and PC-specific survival. The tumor promoting effect of IMP3 appears to be independent from its regulatory role on IGF2 in PC. PMID:24615121

Szarvas, Tibor; Tschirdewahn, Stephan; Niedworok, Christian; Kramer, Gero; Sevcenco, Sabina; Reis, Henning; Shariat, Shahrokh F; Rübben, Herbert; vom Dorp, Frank

2014-10-01

340

N-glycan Cryptic Antigens as Active Immunological Targets in Prostate Cancer Patients  

PubMed Central

Although tumor-associated abnormal glycosylation has been recognized for decades, information regarding host recognition of the evolving tumor glycome remains elusive. We report here a carbohydrate microarray analysis of a number of tumor-associated carbohydrates for their serum antibody reactivities and potential immunogenicity in humans. These are the precursors, cores and internal sequences of N-glycans. They are usually masked by other sugar moieties and belong to a class of glyco-antigens that are normally “cryptic”. However, viral expression of these carbohydrates may trigger host immune responses. For examples, HIV-1 and SARS-CoV display Man9 clusters and tri- or multi-antennary type II (Gal?1?4GlcNAc) chains (Tri/m-II), respectively; viral neutralizing antibodies often target these sugar moieties. We asked, therefore, whether prostate tumor expression of corresponding carbohydrates triggers antibody responses in vivo. Using carbohydrate microarrays, we analyzed a panel of human sera, including 17 samples from prostate cancer patients and 12 from men with Benign Prostatic Hyperplasia (BPH). We observed that IgG antibodies targeting the Man9- or Tri-/m-II-autoantigens are readily detectable in the sera of men with BPH, as well as those with cancer. Importantly, these antibody activities were selectively increased in prostate cancer patients. Thus, human immune systems actively recognize these N-glycan cryptic carbohydrates and produce targeting antibodies. This finding shads a light on a class of previously less studied immunological targets of human cancers. Identifying the diagnostic, prognostic and therapeutic values of these targets will require further investigation.

Wang, Denong

2014-01-01

341

MoXy fiber with active cooling cap for bovine prostate vaporization with high power 200W 532 nm laser  

NASA Astrophysics Data System (ADS)

A novel MoXyTM fiber delivery device with Active Cooling Cap (ACCTM) is designed to transmit up to 180W of 532 nm laser light to treat benign prostatic hyperplasia (BPH). Under such high power tissue ablation, effective cooling is key to maintaining fiber power transmission and ensuring the reliability of the fiber delivery device To handle high power and reduce fiber degradation, the MoXy fiber features a larger core size (750 micrometer) and an internal fluid channel to ensure better cooling of the fiber tip to prevent the cap from burning, detaching, or shattering during the BPH treatment. The internal cooling channel was created with a metal cap and tubing that surrounds the optical fiber. In this study MoXy fibers were used to investigate the effect of power levels of 120 and 200 W on in-vitro bovine prostate ablation using a 532 nm XPSTM laser system. For procedures requiring more than 100 kJ, the MoXy fiber at 200W removed tissue at twice the rate of the current HPS fiber at 120W. The fiber maintained a constant tissue vaporization rate during the entire tissue ablation process. The coagulation at 200W was about 20% thicker than at 120W. In conclusion, the new fibers at 200W doubled the tissue removal rate, maintained vaporization efficiency throughout delivery of 400kJ energy, and induced similar coagulation to the existing HPS fiber at 120W.

Peng, Steven Y.; Kang, Hyun Wook; Pirzadeh, Homa; Stinson, Douglas

2011-03-01

342

Characterizing components of the Saw Palmetto Berry Extract (SPBE) on prostate cancer cell growth and traction  

SciTech Connect

Saw Palmetto Berry Extract (SPBE) is applied for prostate health and treatment of urinary tract infections, nonbacterial prostitis and Benign Prostatic Hyperplasia (BPH) in man. An assumption is that SPBE affects tumor cell progression and migration in breast and prostate tissue. In this work, DU-145 cells were used to demonstrate that SPBE and its sterol components, {beta}-sitosterol and stigmasterol, inhibit prostate cancer growth by increasing p53 protein expression and also inhibit carcinoma development by decreasing p21 and p27 protein expression. In the presence of cholesterol, these features are not only reversed but increased significantly. The results show for the first time the potential of SPBE, {beta}-sitosterol and stigmasterol as potential anti-tumor agents. Since the protein p53 is also regarded as nuclear matrix protein facilitating actin cytoskeletal binding, 2D tractions were measured. The cell adhesion strength in the presence of SPBE, {beta}-sitosterol and cholesterol and the observation was that the increase in p53 expression triggered an increase in the intracellular force generation. The results suggest a dual function of p53 in cells.

Scholtysek, Carina; Krukiewicz, Aleksandra A. [Center for Medical Physics and Technology, Biophysics Group, Friedrich-Alexander-University of Erlangen-Nuremberg, Henke Str. 91, Erlangen 91052 (Germany); Alonso, Jose-Luis [Massachusetts General Hospital/Harvard Medical School, Charlestown, MA 02129 (United States); Sharma, Karan P.; Sharma, Pal C. [Boston BioProducts, Inc., Worcester, MA 01604 (United States); Goldmann, Wolfgang H. [Center for Medical Physics and Technology, Biophysics Group, Friedrich-Alexander-University of Erlangen-Nuremberg, Henke Str. 91, Erlangen 91052 (Germany)], E-mail: wgoldmann@biomed.uni-erlangen.de

2009-02-13

343

Noninvasive surgery of prostate tissue by high-intensity focused ultrasound: an updated report  

NASA Astrophysics Data System (ADS)

High Intensity Focused Ultrasound (HIFU) has been clinically used for the treatment of benign prostatic hyperplasia (BPH) and it is experimentally applied for the treatment of localized prostate caner (PC). Recent advances in the transducer material and technology have permitted to combine the ultrasound visualization capability and HIFU on the same ceramic crystal. Also, the transducer efficiency has increased to a level that a smaller size intracavity probe can be made to produce sufficient acoustic power required for the focused ultrasound surgery of the prostate. Using this technology, 4 MHz mechanically scanning transrectal ultrasound probes has been designed. The transrectal probes are used with Sonablate (SB-200, manufactured by Focus Surgery, Inc., Indianapolis, IN) device. The SB-200 produces both transverse and longitudinal images of the prostate. The transverse and longitudinal images are used for selection of tissue volume, treatment planning and monitoring of tissue during the HIFU treatment cycle. The paper reviews the present operation of the device and recent clinical protocol that has improved efficiency, efficacy and safety of the device. The two years follow-up clinical results from the multi-site US Pilot Study (USPS) and The Male Health Centre are compared with the Kitasato-study (Kitasato School of Medicine, Sagamihara, Japan).

Sanghvi, Narendra T.; Syrus, J.; Foster, Richard S.; Bihrle, Richard; Casey, Richard W.; Uchida, Toyoak

2000-05-01

344

Biothermal modeling of transurethral ultrasound applicators for MR-guided prostate thermal therapy (Invited Paper)  

NASA Astrophysics Data System (ADS)

Thermal ablation is a minimally-invasive treatment option for benign prostatic hyperplasia (BPH) and localized prostate cancer. Accurate spatial control of thermal dose delivery is paramount to improving thermal therapy efficacy and avoiding post-treatment complications. We have recently developed three types of transurethral ultrasound applicators, each with different degrees of heating selectivity. These applicators have been evaluated in vivo in coordination with magnetic resonance temperature imaging, and demonstrated to accurately ablate specific regions of the canine prostate. A finite difference biothermal model of the three types of transurethral ultrasound applicators (sectored tubular, planar, and curvilinear transducer sections) was developed and used to further study the performance and heating capabilities of each these devices. The biothermal model is based on the Pennes bioheat equation. The acoustic power deposition pattern corresponding to each applicator type was calculated using the rectangular radiator approximation to the Raleigh Sommerfield diffraction integral. In this study, temperature and thermal dose profiles were calculated for different treatment schemes and target volumes, including single shot and angular scanning procedures. This study also demonstrated the ability of the applicators to conform the cytotoxic thermal dose distribution to a predefined target area. Simulated thermal profiles corresponded well with MR temperature images from previous in vivo experiments. Biothermal simulations presented in this study reinforce the potential of improved efficacy of transurethral ultrasound thermal therapy of prostatic disease.

Ross, Anthony B.; Diederich, Chris J.; Nau, William H.; Tyreus, Per D.; Gill, Harcharan; Bouley, Donna; Butts, R. K.; Rieke, Viola; Daniel, Bruce; Sommer, Graham

2005-04-01

345

Epidemiology of prostatitis  

PubMed Central

Background Prostatitis describes a combination of infectious diseases (acute and chronic bacterial prostatitis), chronic pelvic pain syndrome, and asymptomatic inflammation. Materials and methods We employed evidence-based methods to review the epidemiology of prostatitis syndromes. Results The prevalence of prostatitis symptoms could be compared in five studies surveying 10 617 men. Overall, 873 participants met various criteria for prostatitis, representing an overall rate of 8.2%, with prevalence ranging from 2.2 to 9.7%. A history of sexually transmitted diseases was associated with an increased risk for prostatitis symptoms. Men reporting a history of prostatitis symptoms had a substantially increased rate of benign prostatic hyperplasia, lower urinary tract symptoms and prostate cancer. In one study, the incidence of physician-diagnosed prostatitis was 4.9 cases per 1000 person-years. Two studies suggest that about one-third of men reporting prostatitis symptoms had resolution after 1 year. Patients with previous episodes and more severe symptoms are at higher risk for chronic pelvic pain. Discussion The prevalence of prostatitis symptoms is high, comparable to rates of ischamic heart disease and diabetes. Clinical evaluation appears necessary to verify that prostatitis is responsible for patients’ symptoms. Prostatitis symptoms may increase a man’s risk for benign prostate hypertrophy, lower urinary tract symptoms and prostate cancer. We need to define natural history and consequences of prostatitis, develop better algorithms for diagnosis and treatment, and develop strategies for prevention. PMID:18164907

Krieger, John N.; Lee, Shaun Wen Huey; Jeon, Jeonseong; Cheah, Phaik Yeong; Liong, Men Long; Riley, Donald E.

2008-01-01

346

Expression analysis of thirty one Y chromosome genes in human prostate cancer.  

PubMed

Rapid advances in positional cloning studies have identified most of the genes on the human Y chromosome, thereby providing resources for studying the expression of its genes in prostate cancer. Using a semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) procedure, we had examined the expression of the Y chromosome genes in a panel of prostate samples diagnosed with benign prostatic hyperplasia (BPH), low and/or high grade carcinoma, and the prostatic cell line, LNCaP, stimulated by androgen treatment. Results from this expression analysis of 31 of the 33 genes, isolated so far from the Y chromosome, revealed three types of expression patterns: i) specific expression in other tissues (e.g., AMELY, BPY1, BPY2, CDY, and RBM); ii) ubiquitous expression among prostate and control testis samples, similar to those of house-keeping genes (e.g., ANT3, XE7,ASMTL, IL3RA, SYBL1, TRAMP, MIC2, DBY, RPS4Y, and SMCY); iii) differential expression in prostate and testis samples. The last group includes X-Y homologous (e.g., ZFY, PRKY, DFFRY, TB4Y, EIF1AY, and UTY) and Y-specific genes (e.g., SRY, TSPY, PRY, and XKRY). Androgen stimulation of the LNCaP cells resulted in up-regulation of PGPL, CSFR2A, IL3RA, TSPY, and IL9R and down regulation of SRY, ZFY, and DFFRY. The heterogeneous and differential expression patterns of the Y chromosome genes raise the possibility that some of these genes are either involved in or are affected by the oncogenic processes of the prostate. The up- and down-regulation of several Y chromosome genes by androgen suggest that they may play a role(s) in the hormonally stimulated proliferation of the responsive LNCaP cells. PMID:10747295

Lau, Y F; Zhang, J

2000-04-01

347

Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy  

NASA Astrophysics Data System (ADS)

Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either 90° sectored tubular (3.5 mm OD × 10 mm) or planar transducers (3.5 mm × 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n = 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the 90° tubular applicator (9-15 W, 12 min, 8 MHz) produced coagulated zones covering an 80° wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, ~8 MHz) generated thermal lesions of ~30° extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30° each) demonstrated controllable coagulation of a 270° contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

Ross, Anthony B.; Diederich, Chris J.; Nau, William H.; Gill, Harcharan; Bouley, Donna M.; Daniel, Bruce; Rieke, Viola; Butts, R. Kim; Sommer, Graham

2004-01-01

348

Serial Changes in Sexual Function Following Holmium Laser Enucleation of the Prostate: A Short-term Follow-up Study  

PubMed Central

Purpose To evaluate the serial changes in sexual function in the short-term period after holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH) and to investigate whether a change in each domain of the International Index of Erectile Function (IIEF) is associated with improvement of micturition. Materials and Methods Thirty-eight potent men who underwent HoLEP and in whom complete 12-month follow-up data on the IIEF were available were included in this retrospective study. All patients underwent a baseline evaluation for BPH. The surgical outcome was evaluated at 1, 3, 6, and 12 months postoperatively by use of the International Prostate Symptom Score, IIEF, and uroflowmetry. Results The mean age and body mass index of the patients was 64.5±6.2 years and 24.2±2.6 kg/m2, respectively. Mean total prostate volume and transitional zone volume were 48.8±18.8 ml and 24.2±16.1 ml, respectively. Most IIEF domain scores showed a slight decrease at 1, 3, and 6 months after surgery but recovered to the baseline or showed a marginal but nonsignificant increase at 12 months postoperatively compared with baseline. Orgasmic function and the overall sexual satisfaction domain score remained slightly reduced up to 12 months postoperatively. There was no significant correlation between improvement of micturition and change in sexual function throughout the follow-up period after surgery. Conclusions Although HoLEP achieves significant improvements in micturition, overall sexual function decreases slightly in the early postoperative period, but recovers to the baseline at 12 months postoperatively. Our data suggest that changes in sexual function after HoLEP are not associated with improvement of micturition. PMID:22379589

Jeong, Min Su; Ha, Seung Beom; Lee, Chang Ju; Cho, Min Chul; Kim, Soo Woong

2012-01-01

349

[Transurethral resection of the prostate for patients with dementia].  

PubMed

During the period from July 1995 to June 1996 we performed transurethral resection of the prostate (TURP) on 824 patients with benign prostatic hyperplasia (BPH). Among them, 13 were dementia patients between 74 and 96 years old; they presented with urinary hesitancy in 6, retention in 4, frequency in 2 and incontinence in 1 patient. Past history included stroke in 7, hypertension in 6, pulmonary tuberculosis in 4, diabetes in 3, asthma in 2, angina pectoris in 1, Parkinson's disease in 1, pneumonia in 1, and hepatitis in 1. Careful preoperative examination revealed that they were proper candidates for TURP. They underwent TURP under spinal anesthesia. The mean operative time was 34 min, ranging from 20 to 60 min. The adenoma resected weighed 24 g on the average, ranging from 7.5 to 48 g. During surgery, although hypotension was noted in 2 patients, there was no serious morbidity. Their mental condition was well controlled with ketamine and diazepam during and after surgery. Postoperative complications included acute myocardial infarction in 1, multiple gastric ulcer in 1, and decubitus in 1. None died within 3 months after TURP, 3 died there after, and 10 patients were alive at the mean follow-up period of 26 months. Six patients reported good urination, 3 reported some improvement in urination after surgery, although requiring intermittent catheterization and 1 developed mild incontinence. In conclusion, TURP appears to provide some benefit in selected patients with dementia and should not be considered to be a contraindication for such patients. PMID:10363142

Yonou, H; Kagawa, H; Oda, A; Nagano, M; Gakiya, M; Niimura, K; Hatano, T; Ogawa, Y

1999-04-01

350

Prostatic relaxation induced by loperamide is mediated through activation of opioid ?-2 receptors in vitro  

PubMed Central

The merit of opioid ?-receptor activation in the improvement of benign prostatic hyperplasia (BPH) remains obscure. In the present study, we used loperamide to identify the subtype of opioid ?-receptors involved in prostatic relaxation and investigate the possible mechanism of this relaxation. Prostate strips were isolated from 12-week-old male Wistar rats for identification of isometric tension. The prostate strips were precontracted with either 1 ?mol/l phenylephrine or 50 mmol/l KCl. The decrease in muscle tone (relaxation) was then characterized after cumulative administration of loperamide (0.1 to 10 ?mol/l) into the organ bath for the concentration-dependent study. Pretreatment with specific blockers or antagonists was carried out to compare the changes in loperamide-induced relaxation. Loperamide produced a marked relaxation in the isolated prostates precontracted with phenylephrine or KCl in a dose-dependent manner. This relaxation was abolished by cyprodime, a selective opioid ?-receptor antagonist, but was not modified by naloxonazine at a dose sufficient to block the opioid ?-1 receptors. Treatment with an agonist for opioid ?-1 receptors also failed to modify the muscle tone. Moreover, the relaxation by loperamide was attenuated by glibenclamide at a dose sufficient to block ATP-sensitive K+ channels. In addition, this action of loperamide was abolished by protein kinase A (PKA) inhibitor and enhanced by the inhibitor of phosphodiesterase for cyclic AMP (cAMP). Our results suggest that loperamide induces prostatic relaxation through activation of opioid ?-2 receptors via the cAMP-PKA pathway to open ATP-sensitive K+ channels. PMID:22977498

LU, CHIH-CHENG; CHUNG, HSIEN-HUI; CHENG, JUEI-TANG

2011-01-01

351

DNA Aptamer Evolved by Cell-SELEX for Recognition of Prostate Cancer  

PubMed Central

Morbidity and mortality of prostate cancer (PCa) have increased in recent years worldwide. Currently existing methods for diagnosis and treatment do not make the situation improve, especially for hormone refractory prostate cancer (HRPC). The lack of molecular probes for PCa hindered the early diagnosis of metastasis and accurate staging for PCa. In this work, we have developed a new aptamer probe Wy-5a against PCa cell line PC-3 by cell-SELEX technique. Wy-5a shows high specificity to the target cells with dissociation constants in the nanomolar range, and does not recognize other tested PCa cell lines and other tested tumor cell lines. The staining of clinical tissue sections with fluorescent dye labeled Wy-5a shows that sections from high risk group with metastasis exhibited stronger fluorescence and sections from Benign Prostatic Hyperplasia (BPH) did not exhibit notable fluorescence, which suggests that aptamer Wy-5a may bind to protein related to the progression of PCa. The high affinity and specificity of Wy-5a makes this aptamer hold potential for application in diagnosis and target therapy of PCa. PMID:24956390

Bing, Tao; Chen, Zheng; Lu, Minhua; Zhang, Nan; Shangguan, Dihua; Gao, Xin

2014-01-01

352

Photoselective vaporization for prostatic obstruction with the 120-W lithium triborate laser: 1-year clinical outcomes.  

PubMed

There are few reports of the clinical outcomes of photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) using the 120-W lithium triborate (LBO) laser. The present study evaluates clinical outcomes of 76 men treated with the 120-W LBO laser by an experienced PVP surgeon with 12 months follow up. The International Prostate Symptom Score (IPSS), peak flow rate (Qmax) and post-void residual (PVR) were examined at baseline and at 3 and 12 months. These parameters at baseline and 12 months were 20 ± 7.0, 7.6 ± 3.5 mL/s, 155 ± 155 mL and 8.1 ± 6.1, 22.5 ± 10.3 mL/s, 59 ± 87 mL, respectively. Clinically, meaningful improvements in IPSS, Qmax and PVR were observed at 3 months and sustained at 12 months. There were few adverse events, with only 5.3% of patients requiring recatheterization. Clinical outcome at 12 months was similar to that at 3 months and to other published series. PMID:21272087

Woo, Henry Hyunshik; Hossack, Tania Anne

2011-02-01

353

Incontinence after Surgery for Benign Prostatic Hypertrophy: The Case for Complex Approach and Treatment  

Microsoft Academic Search

Objective: Whether incontinence after surgery for benign prostatic hypertrophy (BPH) requires simple workup and treatment or being a more complex condition and multifactorial in etiology requiring combined surgical techniques should be investigated in more detail. Methods: We retrospectively reviewed the records of 56 patients referred to us for post-prostatectomy incontinence after surgery for BPH. All patients were subjected to urodynamics.

Ch. Theodorou; G. Moutzouris; D. Floratos; D. Plastiras; Ch. Katsifotis; N. Mertziotis

1998-01-01

354

Distinguishing prostate cancer from benign confounders via a cascaded classifier on multi-parametric MRI  

NASA Astrophysics Data System (ADS)

Learning how to separate benign confounders from prostate cancer is important because the imaging characteristics of these confounders are poorly understood. Furthermore, the typical representations of the MRI parameters might not be enough to allow discrimination. The diagnostic uncertainty this causes leads to a lower diagnostic accuracy. In this paper a new cascaded classifier is introduced to separate prostate cancer and benign confounders on MRI in conjunction with specific computer-extracted features to distinguish each of the benign classes (benign prostatic hyperplasia (BPH), inflammation, atrophy or prostatic intra-epithelial neoplasia (PIN). In this study we tried to (1) calculate different mathematical representations of the MRI parameters which more clearly express subtle differences between different classes, (2) learn which of the MRI image features will allow to distinguish specific benign confounders from prostate cancer, and (2) find the combination of computer-extracted MRI features to best discriminate cancer from the confounding classes using a cascaded classifier. One of the most important requirements for identifying MRI signatures for adenocarcinoma, BPH, atrophy, inflammation, and PIN is accurate mapping of the location and spatial extent of the confounder and cancer categories from ex vivo histopathology to MRI. Towards this end we employed an annotated prostatectomy data set of 31 patients, all of whom underwent a multi-parametric 3 Tesla MRI prior to radical prostatectomy. The prostatectomy slides were carefully co-registered to the corresponding MRI slices using an elastic registration technique. We extracted texture features from the T2-weighted imaging, pharmacokinetic features from the dynamic contrast enhanced imaging and diffusion features from the diffusion-weighted imaging for each of the confounder classes and prostate cancer. These features were selected because they form the mainstay of clinical diagnosis. Relevant features for each of the classes were selected using maximum relevance minimum redundancy feature selection, allowing us to perform classifier independent feature selection. The selected features were then incorporated in a cascading classifier, which can focus on easier sub-tasks at each stage, leaving the more difficult classification tasks for later stages. Results show that distinct features are relevant for each of the benign classes, for example the fraction of extra-vascular, extra-cellular space in a voxel is a clear discriminator for inflammation. Furthermore, the cascaded classifier outperforms both multi-class and one-shot classifiers in overall accuracy for discriminating confounders from cancer: 0.76 versus 0.71 and 0.62.

Litjens, G. J. S.; Elliott, R.; Shih, N.; Feldman, M.; Barentsz, J. O.; Hulsbergen-van de Kaa, C. A.; Kovacs, I.; Huisman, H. J.; Madabhushi, A.

2014-03-01

355

Impact of radical prostatectomy and TURP on the hypothalamic-pituitary-gonadal hormone axis  

Microsoft Academic Search

ObjectivesTo assess the impact of prostate cancer (PCa) and benign prostatic hyperplasia (BPH) on the hypothalamic-pituitary hormone axis, we determined the endocrine changes after radical prostatectomy (RP) and transurethral resection of the prostate (TURP) for BPH and in a group of men with BPH followed up conservatively.

Stephan Madersbacher; Georg Schatzl; Christian Bieglmayer; Werner J Reiter; Christa Gassner; Peter Berger; Thomas Zidek; Michael Marberger

2002-01-01

356

Steroid receptor profile and receptor stability in subfractions of human prostatic tissues  

Microsoft Academic Search

Androgen (AR), progesterone (PR), and estrogen (ER) receptor contents in cytosol and salt-extractable nuclear subcompartments from 6 normal, 39 benign hyperplastic (BPH), and 7 malignant prostatic tissue specimens were analyzed by radioligand-binding assay techniques. In addition, the temperature stability of AR and PR was measured in another three BPH specimens. Five punch-needle biopsy samples from prostate cancers were also analyzed

J. Brolin; L. Andersson; P. Ekman

1991-01-01

357

Evaluation of the Effect of Photoselective Vaporization of the Prostate on Sexual Function in a Prospective Study: A Single Center Experience of 150 Patients.  

PubMed

Abstract Background and Purpose: Photoselective vaporization of the prostate (PVP) has emerged as a minimally invasive alternative to transurethral resection of the prostate for treatment of benign prostate hyperplasia (BPH) with lower urinary tract symptoms (LUTS). Very few prospective studies have addressed the effect of PVP on sexual function. We performed this prospective study to assess the short-term effect of PVP on erectile function in patients who present with LUTS secondary to BPH. Patients and Methods: There were 150 consecutive patients who presented with LUTS secondary to BPH who underwent PVP and who were enrolled prospectively in this study. Patients were categorized in two groups: Group A, International Index of Erectile Function (IIEF) ?19; group B, IIEF <19. PVP was performed by using an 80?W GreenLight laser. Patients preoperative, perioperative, and follow-up data were recorded. Erectile function was assessed preoperatively and postoperatively at 1, 3, 6, and 12 months using IIEF-5. In follow-up, Ultrasonography of the kidneys, ureters, and bladder for residual prostate and postvoid residual urine, uroflowmetry, kidney function tests, and urine culture were performed at each visit. Cystoscopy was performed at 3 months. Data were analyzed statistically. Results: The two patient groups were comparable in their preoperative and perioperative data. Both groups showed improvement in International Prostate Symptom Score, maximum flow rate, quality of life, and decrease in postvoid residual urine at 1, 3, 6, and 12 months with no statistical significance. IIEF-5 scores in Group A, however, were 21.1, 19.2, 17.1, 16.2, and 16.1, respectively, at preoperative, postoperative month 1, 3, 6, and 12, respectively (P=0.02). IIEF-5 scores in Group B were 13.2, 12.1, 11.3, 11.2, and 10.9, respectively, at preoperative, postoperative month 1, 3, 6, and 12, respectively (P=0.45). Conclusions: In patients with normal preoperative erectile function, PVP resulted in significant decrease in EF up to follow-up of 1 year. In patients with preoperative ED, however, PVP did not significantly decrease EF. PMID:22849319

Kumar, Anup; Vasudeva, Pawan; Kumar, Niraj; Nanda, Biswajit; Mohanty, Nayan K

2012-10-01

358

aallll IIrreell aanndd ccaanncceerr ssttaattiissttiiccss sseeccoonndd rreeppoorrtt 11999988--22000000 Prostate cancer Prostate cancer Prostate cancer  

E-print Network

--22000000 58 Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer Prostate cancer

Paxton, Anthony T.

359

Antiproliferative and cytotoxic activity of extracts from Cistus incanus L. and Cistus monspeliensis L. on human prostate cell lines  

Microsoft Academic Search

Benign prostatic hypertrophy (BPH) is a common condition in elderly men that impairs quality of life and leads to a number of medical complications. The use of phytotherapeutic compounds in patients with relatively moderate BPH symptoms has been growing steadily. In the present study, acute toxicity of lyophilised aqueous extracts of Cistus incanus L. and Cistus monspeliensis L., collected in

Federica Vitali; Giuseppa Pennisi; Giuseppa Attaguile; Francesca Savoca; Beatrice Tita

2011-01-01

360

Clinical and Urodynamic Significance of Morphological Differences in Intravesical Prostatic Protrusion  

PubMed Central

Purpose The objectives of this study were to evaluate whether morphologic differences correlated with urodynamic and clinical characteristics in patients with benign prostatic hyperplasia (BPH) with intravesical prostatic protrusion (IPP) of trilobar or bilobar adenoma. Materials and Methods Between January 2008 and June 2009, 72 male patients who had undergone transurethral resection (TUR) owing to BPH with IPP were included in this study. They underwent preoperative urodynamic studies, the International Prostate Symptom Score (IPSS)/quality of life (QoL), maximal flow rate (Qmax), post-voiding residual urine volume (PVR), transrectal ultrasonography (TRUS), and serum prostate-specific antigen (PSA) measurement. The patients were classified into 2 groups (the trilobar and bilobar adenoma groups) on the basis of video findings during the TUR operation. Results The trilobar and bilobar adenoma groups consisted of 37 patients and 35 patients, respectively. The Mean±SD IPP, prostate volume (PV), and transition zone volume of the trilobar and bilobar adenoma groups were 11.8±5.2 mm and 9.0±3.8 mm (p=0.014), 81.1±25.8 g and 59.3±22.5 g (p<0.001), and 49.6±20.6 g and 34.8±19.4 g (p=0.003), respectively. The Mean±SD PSA, bladder contractility index (BCI), and bladder outlet obstruction index (BOOI) were 4.6±2.5 ng/ml and 3.5±1.7 ng/ml (p=0.042), 119.8±33.4 and 87.7±24.4 (p<0.001), and 62.6±29.5 and 44.6±20.4 (p=0.005), respectively. There were no significant differences in IPSS/QoL, Qmax, PVR, acute urinary retention, or detrusor overactivity in the 2 groups. Conclusions IPP has two morphologic types of trilobar or bilobar enlargement. The PV, BOOI, and BCI were significantly smaller in the bilobar adenoma group than in the trilobar adenoma group. PMID:21031089

Lee, Seung Wook; Cho, Jeong Man; Kang, Jung Yoon

2010-01-01

361

Preliminary results on diode-laser assisted vaporization of prostate tissue  

NASA Astrophysics Data System (ADS)

Introduction and objectives: The aim was to identify the capability and the laser parameter of under water tissue vaporisation by means of a diode laser (1470 nm). Afterwards the feasibility and postoperative clinical outcome of vaporization of the prostate was investigated. Method: After acquiring suitable laser parameters in in-vitro experiments using a perfused tissue model patients (n=10) suffering from bladder outlet obstruction due to benign prostatic hyperplasia (BPH) were treated by diode laser. Their clinical outcome, in terms of acceptance and post-operatively voiding were evaluated. The diode laser emitted light of the wavelength of 1470 nm at 50 W (Biolitec GmbH) and delivered to the tissue by means of a side-fire fibre introduced through a 24F continuous-flow cystoscope. Normal saline was used for irrigation with an additive of 1% ethanol. The prostatic lobes (volume range 35-80ml) were vaporized within the prostatic capsular using sweeping and push and pull technique. The mean time of laser application was 2400 sec (1220-4000 sec) resulting in applied energies of 121 kJ in the mean (range: 61-200kJ). Results: During laser treatment none of the 10 patients showed any significant blood loss or any fluid absorption (no ethanol uptake). Foley catheters were removed between 18 and 168 hours postoperatively (mean: 49.8h+/-46h). After removal of the catheter the mean peak urine flow rate increased from 8.9ml/s +/- 2.9ml/s pre-operatively in comparison to 15.7ml/s +/- 5 ml/s (p=0.049) post-operatively. 8/10 patients were satisfied with their voiding outcome. None of the patients showed appearance of urgency, dysuria, hematuria, or incontinence but two patients required re-catheterization. After a follow-up of 1month, 8/10 patients showed evidence of good results and are satisfied with the outcome. Two patients required consecutive TUR-P. After a follow-up of 6-month the 8 patients are still satisfied. Conclusions: This very early and limited experience using a 50W-Diode laser emitting at 1470 nm indicates a safe and effective treatment modality for quickly relieving bladder outlet obstruction due to BPH. Larger randomized clinical trials to compare this technique with standard transurethral resection of the prostate and increased follow-up data are needed to determine its long-term efficacy and durability.

Sroka, Ronald; Seitz, Michael; Reich, Oliver; Bachmann, Alexander; Steinbrecher, Verena; Ackermann, Alexander; Stief, Christian

2007-07-01

362

Doxazosin  

MedlinePLUS

... treat the symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH), which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and ... the bladder and prostate. It lowers blood pressure by relaxing the blood ...

363

Terazosin  

MedlinePLUS

... treat the symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH), which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and ... the bladder and prostate. It lowers blood pressure by relaxing the blood ...

364

Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction  

PubMed Central

Monopolar transurethral resection of the prostate (TURP) with endoscopic electrocautery remains the gold standard surgical technique for benign prostatic hypertrophy (BPH) by which all new procedures are compared. We reviewed the current literature, and international urological guidelines and consensus opinion on various surgical options for BPH and present a brief overview of alternative techniques including bipolar TURP, transurethral incision of the prostate, transurethral vaporization of the prostate, laser prostatectomy (with holmium, thulium and potassium titanyl phosphate greenlight lasers) and open prostatectomy (with mention of new techniques including laparoscopic and robotic prostatectomy). Emerging, experimental and less established techniques are also described including endoscopic heat generation (transurethral microwave thermotherapy, radiofrequency transurethral needle ablation of the prostate, high intensity focused ultrasound, hot water induced thermotherapy, pulsed electromagnetic radiofrequency), injection therapy (transurethral ethanol ablation and botulinum toxin) and mechanical devices (intraprostatic stents and urethral lift devices). Despite a plethora of surgical options, none have realistically improved outcomes in the long-term compared with TURP. Improvements have been made on improving surgical morbidity and time in hospital. Questions remain in this area, including what specific elements of bladder outflow obstruction (BOO) result in damage to the urinary tract, how does BPH contribute to BOO and how much prostate volume reduction is necessary to relieve BOO or lower urinary tract symptoms. Given these unanswered questions and the multitude of procedures available, it is clear that appropriate counselling is necessary in all men who undergo BPH surgery. PMID:24744521

Thiruchelvam, Nikesh

2014-01-01

365

Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials  

Microsoft Academic Search

Objectives. To comprehensively evaluate clinical predictors of spontaneous acute urinary retention (AUR) across pooled data of placebo-treated patients from clinical trials conducted in men with lower urinary tract symptoms and clinically diagnosed benign prostatic hyperplasia.Methods. Data from the placebo-treatment groups of several prospective, randomized clinical trials conducted in the United States (n = 3040), Scandinavia, Canada, and worldwide (n =

Claus G Roehrborn; Marie-Pierre Malice; Thomas J Cook; Cynthia J Girman

2001-01-01

366

Congenital adrenal hyperplasia.  

PubMed

An autosomal recessive disorder, congenital adrenal hyperplasia, results from a deficiency in the activity of one of the five enzymes required for cortisol biosynthesis. More than 90% of cases are related to deficiency in 21-hydroxylase enzyme activity, which is required for the conversion of 17OH-progesterone to 11-deoxycortisol. Treatment of congenital adrenal hyperplasia consists of steroid replacement to ensure normal growth and reproductive potential. PMID:18411104

Hughes, I A

1990-01-01

367

Diagnostic performance of microRNAs expression in prostate cancer.  

PubMed

MicroRNAs (miRNAs) have been proposed as ideal diagnostic indicators of prostate cancer (CaP). However, previous studies have reported conflicting results. Therefore, we conducted this meta-analysis to assess the potential diagnostic value of miRNAs for CaP. A systematic literature search was conducted in PubMed and other databases. Results from different studies were pooled using random effects models. The pooled sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the overall test performance. Between-study heterogeneity was tested using the chi-squared test and the I (2) test. Meta-regression and subgroup analyses were performed to explore the potential sources of heterogeneity. Fifty-eight studies from ten articles, including 669 patients with CaP and 404 controls composed of healthy individuals and patients with benign prostatic hyperplasia (BPH), were included in this meta-analysis. The pooled SEN and SPE were 0.74 (95 % confidence interval (CI) 0.70-0.78) and 0.73 (95 % CI 0.70-0.76), respectively. The pooled PLR was 2.7 (95 % CI 2.4-3.1); NLR was 0.35 (95 % CI 0.30-0.42); and DOR was 8 (95 % CI 6-10). The pooled AUC was 0.79 (95 % CI 0.76-0.83). Subgroup analyses indicated that multiple miRNAs yielded a better diagnostic accuracy. This systematic review suggests that miRNA analysis can significantly improve the overall accuracy of CaP diagnosis. Moreover, using multiple miRNA-based assays could achieve significantly higher accuracy in diagnosing CaP than single miRNA-based assays. PMID:25060180

Yang, Qinfeng; Zheng, Yushan; Zhu, Dequan

2014-10-01

368

Benign phyllodes tumour of the prostate: An extremely rare entity.  

PubMed

Benign phyllodes tumour (BPT) of the prostate is a very rare neoplasm. It is composed of hyperplastic and neoplastic glandular stromal proliferation. Patients with BPT of the prostate generally present with lower urinary tract symptoms and hematuria. BPT of the prostate can potentially cause recurrent obstructive symptoms. Complete transurethral resection (TUR) and close postoperative follow-up is recommended. A 59-year-old man presented with dysuria and obstructive urinary symptoms. Flexible cystoscopy revealed prostatic hyperplasia and a polypoidal lesion originating from the right lateral lobe of the prostate. Magnetic resonance imaging revealed a 3 × 2.5-cm mass lesion in the right lateral lobe of the prostate. TUR of the prostate was performed and the pathological examination revealed benign prostatic hyperplasia and benign phyllodes tumour of the prostate. PMID:25210561

Aydogdu, Ozgu; Atesci, Yusuf Ziya; Karakose, Ayhan; Demirtas, Eren

2014-07-01

369

IRM de diffusion de la prostate  

Microsoft Academic Search

Functional imaging complements T2-weighted imaging in the evaluation of the prostate. The most frequently used techniques are diffusion-weighted imaging and perfusion imaging following the intravenous administration of contrast material. Perfusion imaging has high sensitivity and moderate specificity, even when using a quantitative technique, because contrast kinetics in some cases of peripheral zone prostatitis and benign transition zone hyperplasia may simulate

F. Cornud; M. Liberatore; F. Beuvon; N. Barry

2010-01-01

370

Effects of oxybutynin transdermal system on health-related quality of life and safety in men with overactive bladder and prostate conditions  

PubMed Central

Aims Overactive bladder (OAB) is common in men and may exist concomitantly with benign prostatic hyperplasia (BPH) and obstruction. We present a subanalysis of results from men with OAB in a 6-month, open-label study of treatment with the oxybutynin transdermal system (OXY-TDS). Broad entry criteria were incorporated to yield a clinically representative population. Methods All participants received OXY-TDS 3.9 mg/day. Effectiveness was assessed by changes in scores on validated questionnaires, which included the single-item Patient Perception of Bladder Condition (PPBC), the King's Health Questionnaire (KHQ) and the Beck Depression Inventory-II (BDI-II). Results The proportion of men (n = 369; mean age = 69.6 years) who reported that their bladder condition caused moderate, severe or many severe problems (PPBC ? 4) improved from 77.3% at baseline to 38.1–53.6% in subsequent months. Mean KHQ scores decreased significantly (p ? 0.0196) from baseline to study end in eight of 10 domains, indicating improved health-related quality of life. The proportion of men with BDI-II score > 12 (associated with a diagnosis of depression) decreased from 23.9% to 17.9% (p = 0.0055). Men with a history of ‘prostate problems’ or use of ‘BPH medication’ (32.2%) had KHQ domain changes that were similar (p ? 0.1016) to those of other men. Most men (76.2%) reported no treatment-related adverse events; two men (0.5%) experienced symptoms of mild urinary retention, but neither required catheterisation. Conclusions Oxybutynin transdermal system treatment of men with OAB was effective and well tolerated, regardless of history of prostate condition. What's known Combined treatment of men with and without BPH is an evolving paradigm. What's new This article contributes significant safety data, from the largest study to date, in a community use situation, where anticholinergics are commonly used. The study provides significant quality of life benefit data in a large population. The community usage design did not employ inclusion or exclusion criteria that would restrict the primary care physician from administrating the medication in a ‘real life’ setting. PMID:17983434

Staskin, D R; Rosenberg, M T; Dahl, N V; Polishuk, P V; Zinner, N R

2008-01-01

371

Prostate Adenocarcinoma  

Cancer.gov

Home Cancers Selected for Study Prostate Adenocarcinoma Prostate Adenocarcinoma Last Updated: April 01, 2013 What is prostate cancer? Prostate cancer is a disease of the prostate, a walnut-size gland in the male reproductive system.  Nearly all prostate

372

Conductive heat: hot water-induced thermotherapy for ablation of prostatic tissue.  

PubMed

Water-Induced Thermotherapy (WIT trade mark ) was developed to treat lower urinary tract symptoms (LUTS) and to reduce bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH). The principle is to produce heat-induced coagulative necrosis and secondary ablation of the obstructing hyperplastic tissue. The source of thermal energy is heated water circulated in a proprietary closed-loop system, which includes a specially designed catheter. To date, few papers on WIT have been published in peer-reviewed journals. The initial studies focused on feasibility and safety, while later ones were designed to demonstrate tissue and pathologic effects. In a prospective international study, 125 patients were enrolled at eight study centers and evaluated both short term (3, 6, and 12 months) and long term (24 and 36 months). The duration of indwelling catheterization was as follows: 45.5% of patients were catheter free after 1 week (the minimum required by the protocol), 30.5% after 2 weeks, and the remaining 24.0% after 3 to 5 weeks. No patients were asked to do intermittent catheterization. Adverse events were those commonly seen after manipulation of the lower urinary tract. International Prostate Symptom Score, Quality of Life score, peak uroflow rate (Q(max)), and postvoiding residual urine volume had improved significantly at 12, 24, and 36 months. Data reported in a more recent abstract indicate that favorable effects on symptoms and voiding parameters continue to at least 36 months. The WIT procedure was also associated with statistically significant post-treatment prostate shrinkage (median 3.2 cc) at 12 months compared with baseline. The reported failure rate and the rate of subsequent transurethral resection was 5.6% after 12 months, 9.6% after 24 months, and 11.2% after 36 months. According to the literature, WIT is a useful technique to treat BPH-related LUTS and BOO, with a success rate on an intention-to-treat basis of approximately 90% after 12 months and 75% after 24 months. PMID:14622480

Muschter, Rolf

2003-10-01

373

Functional analyses of Bph-Tod hybrid dioxygenase, which exhibits high degradation activity toward trichloroethylene.  

PubMed

Biphenyl dioxygenase (BphDox) in Pseudomonas pseudoalcaligenes KF707 is a multicomponent enzyme consisting of an iron-sulfur protein (ISP) that is composed of alpha (BphA1) and beta (BphA2) subunits, a ferredoxin (FD(BphA3)), and a ferredoxin reductase (FDR(BphA4)). A recombinant Escherichia coli strain expressing hybrid Dox that had replaced BphA1 with TodC1 (alpha subunit of toluene dioxygenase (TolDox) of Pseudomonas putida) exhibited high activity toward trichloroethylene (TCE) (Furukawa, K., Hirose, J., Hayashida, S., and Nakamura, K. (1994) J. Bacteriol. 176, 2121-2123). In this study, ISP, FD, and FDR were purified and characterized. Reconstitution of the dioxygenase components consisting of purified ISP(TodC1BphA2), FD(BphA3), and FDR(BphA4) exhibited oxygenation activities toward biphenyl, toluene, and TCE. Native polyacrylamide gel electrophoresis followed by the Ferguson plot analyses demonstrated that ISP(TodC1BphA2) and ISP(BphA1A2) were present as heterohexamers, whereas ISP(TodC1C2) was present as a heterotetramer. The molecular activity (k(0)) of the hybrid Dox for TCE was 4.1 min(-1), which is comparable to that of TolDox. The K(m) value of the hybrid Dox for TCE was 130 microm, which was lower than 250 microm for TolDox. These results suggest that the alpha subunit of ISP is crucial for the determination of substrate specificity and that the change in the alpha subunit conformation of ISP from alpha(2)beta(2) to alpha(3)beta(3) results in the acquisition of higher affinity to TCE, which may lead to high TCE degradation activity. PMID:11390387

Maeda, T; Takahashi, Y; Suenaga, H; Suyama, A; Goto, M; Furukawa, K

2001-08-10

374

PSA Test: What's It for?  

MedlinePLUS

... of prostate cancer? Benign prostatic hyperplasia (BPH) Bladder outlet obstruction Increased PSA levels Show more Show less ... Better Hearing and Balance The Mayo Clinic Diet Online — Eat well. Enjoy life. Lose weight. Other Topics ...

375

Design and construction of porous metal-organic frameworks based on flexible BPH pillars  

NASA Astrophysics Data System (ADS)

Three metal-organic frameworks (MOFs), [Co2(BPDC)2(4-BPH)·3DMF]n (1), [Cd2(BPDC)2(4-BPH)2·2DMF]n (2) and [Ni2(BDC)2(3-BPH)2 (H2O)·4DMF]n (3) (H2BPDC=biphenyl-4,4'-dicarboxylic acid, H2BDC=terephthalic acid, BPH=bis(pyridinylethylidene)hydrazine and DMF=N,N'-dimethylformamide), have been solvothermally synthesized based on the insertion of heterogeneous BPH pillars. Framework 1 has "single-pillared" MOF-5-like motif with inner cage diameters of up to 18.6 Å. Framework 2 has "double pillared" MOF-5-like motif with cage diameters of 19.2 Å while 3 has "double pillared" 8-connected framework with channel diameters of 11.0 Å. Powder X-ray diffraction (PXRD) shows that 3 is a dynamic porous framework.

Hao, Xiang-Rong; Yang, Guang-sheng; Shao, Kui-Zhan; Su, Zhong-Min; Yuan, Gang; Wang, Xin-Long

2013-02-01

376

Prostate cancer incidence among finasteride and alpha-blocker users in the Finnish Prostate Cancer Screening Trial  

Microsoft Academic Search

Background:The Prostate Cancer Prevention Trial has shown a protective effect of finasteride on prostate cancer in low-risk men. It is uncertain whether similar results can be expected when finasteride is used to treat benign prostatic hyperplasia.Methods:We performed an observational cohort study within the Finnish Prostate Cancer Screening Trial. Using a comprehensive prescription database on medication reimbursements during 1995–2004 of men

T J Murtola; T L J Tammela; L Määttänen; M Ala-opas; U H Stenman; A Auvinen

2009-01-01

377

E-, N- And P-cadherin, and ?-, ?- and ?-catenin Protein Expression in Normal, Hyperplastic and Carcinomatous Human Prostate  

Microsoft Academic Search

The expression of E-, N- and P-cadherin, -, - and -catenin, and actin was studied by immunohistochemistry, ELISA, and Western blot analysis in normal prostates, and in the prostates of men with benign prostatic hyperplasia and men with prostatic carcinoma, in order to evaluate their possible role in the pathogenesis of these diseases. Present results reveal that the immunophenotype of

María I. Arenas; Eva Romo; Mar Royuela; Benito Fraile; Ricardo Paniagua

2000-01-01

378

UW MEDICINE | MEN'S HEALTH FREE MEN'S HEALTH SEMINARS  

E-print Network

Enlarged Prostate (BPH) Bruce Dalkin, M.D. March 28th Erectile Dysfunction (ED) & Urinary Incontinence on important men's health issues. Benign prostate hyperplasia (BPH) (also known as enlarged prostate), erectile dysfunction (ED) and urinary incontinence are serious, yet treatable conditions that affect millions of men

Kaminsky, Werner

379

Combinations of maximum urinary flow rate and American Urological Association symptom index that are more specific for identifying obstructive and non-obstructive prostatism.  

PubMed

Uroflowmetry and the American Urological Association symptom index (AUASI) are often used clinically to evaluate patients with benign prostatic hyperplasia (BPH). Since results from these tests may be used to determine a treatment course, including surgical intervention, we investigated if specific combinations of uroflowmetry and AUASI parameters could better predict urodynamically confirmed prostatic obstruction. Data from 134 men (mean age: 67.8 +/- 8.9 years) with prostatism were analyzed. The patients underwent uroflowmetry in the standing position after completing the AUASI; the post-void residual volume (PVR) was determined. The presence and severity of prostatic obstruction was assessed by video urodynamics, which included micturitional urethral pressure profilometry (MUPP). Of the 134 total patients, 66 were found to be obstructed by MUPP. Correlations of maximum urinary flow rate (Qmax), PVR, and AUASI with the degree of obstruction were poor and not substantially improved using combinations of these parameters. Threshold values of Qmax and AUASI, when used in combination, allowed accurate prediction of obstruction or non-obstruction in a small subset of the patient population. Of 14 men with both Qmax < 10 ml/s and AUASI > or = 20, 13 were obstructed (specificity = 98%). Eight of 9 men with both Qmax > or = 15 ml/s and AUASI < 10 were non-obstructed. The combined Qmax and AUASI criteria categorized only 20% of the patients as obstructed or non-obstructed. Once other causes of urinary dysfunction are ruled out, use of these criteria will enable the urologist to make an accurate diagnosis of obstruction, select a treatment more likely to benefit the patient, and make further diagnostic testing unnecessary in this small subset of patients. In a large volume clinical practice of adult male voiding dysfunctions, diagnosis of even this small proportion of patients using this simple approach can reduce patient care costs. PMID:8857614

Schacterle, R S; Sullivan, M P; Yalla, S V

1996-01-01

380

Optical characters of prostate using nonlinear optical microscopy  

NASA Astrophysics Data System (ADS)

The incidence rate of the prostatic hyperplasia is increasing in near decade, early detection is important for preventing the prostatic cancer (PCa). In this study, the images of prostate and cavernous nerves were carried out using intrinsic fluorescence and scattering properties of the tissues without any exogenous dye or contrast agent based on nonlinear optical microscope. The texture feature and optical property of the interfibrillar substance in prostate tissue were extracted and analyzed for charactering the prostate structure. It will be the feature parameter to differentiate the normal, the inflammation or cancer of prostate tissue in clinical with the application of miniature endoscope nonlinear optical microscope in vivo.

Wu, Shulian; Li, Hui; Zhang, Xiaoman; Wang, Yunxia; Peng, Dongqing

2012-12-01

381

Dimerization properties of the RpBphP2 chromophore-binding domain crystallized by homologue-directed mutagenesis.  

PubMed

Bacteriophytochromes (BphPs) are biliverdin IX?-containing photoreceptors that photoconvert between red (Pr) and far-red (Pfr) absorbing states. BphPs are one half of a two-component system that transmits a light signal to a histidine kinase domain and then to a gene-response regulator. In Rhodopseudomonas palustris, synthesis of a light-harvesting complex (LH4) is controlled by two BphPs (RpBphP2 and RpBphP3). Despite their high sequence identity (52%), their absorption spectra are very different. The spectra of RpBphP2 exhibit classic Pr-to-Pfr photoconversion, whereas RpBphP3 quenches and a high-energy Pnr state emerges [Giraud et al. (2005), J. Biol. Chem. 280, 32389-32397]. Crystallization of the chromophore-binding domain (CBD) of RpBphP2 (RpBphP2-CBD) proved to be difficult and the structure of RpBphP3-CBD was used to crystallize RpBphP2-CBD* using homologue-directed mutagenesis. The structure shows that dimerization is an important factor in successful crystallization of RpBphP2-CBD* and arises from an N136R mutation. Mutations at this site correlate with an ability to dimerize in other truncated BphPs and may also be important for full-length dimer formation. Comparison of the RpBphP3-CBD and RpBphP2-CBD* biliverdin IX? pockets revealed that the former has additional hydrogen bonding around the B and D pyrrole rings that may constrain photoconversion to Pfr, resulting in a strained photoexcited Pnr state. PMID:22868772

Bellini, Dom; Papiz, Miroslav Z

2012-08-01

382

bph genes of the thermophilic PCB degrader, Bacillus sp. JF8: characterization of the divergent ring-hydroxylating dioxygenase and hydrolase genes upstream of the Mn-dependent BphC.  

PubMed

Bacillus sp. JF8 is a thermophilic polychlorinated biphenyl (PCB) degrader, which utilizes biphenyl and naphthalene. A thermostable, Mn-dependent 2,3-dihydroxybiphenyl 1,2-dioxygenase, BphC_JF8, has been characterized previously. Upstream of bphC are five ORFs exhibiting low homology with, and a different gene order from, previously characterized bph genes. From the 5' to 3' direction the genes are: a putative regulatory gene (bphR), a hydrolase (bphD), the large and small subunits of a ring-hydroxylating dioxygenase (bphA1A2), and a cis-diol dehydrogenase (bphB). Hybridization studies indicate that the genes are located on a plasmid. Ring-hydroxylating activity of recombinant BphA1A2_JF8 towards biphenyl, PCB, naphthalene and benzene was observed in Escherichia coli cells, with complementation of non-specific ferredoxin and ferredoxin reductase by host cell proteins. PCB degradation by recombinant BphA1A2_JF8 showed that the congener specificity of the recombinant enzyme was similar to Bacillus sp. JF8. BphD_JF8, with an optimum temperature of 85 degrees C, exhibited a narrow substrate preference for 2-hydroxy-6-oxo-6-phenylhexa-2,4-dienoic acid. The Arrhenius plot of BphD_JF8 was biphasic, with two characteristic energies of activation and a break point at 47 degrees C. PMID:16339959

Mukerjee-Dhar, Gouri; Shimura, Minoru; Miyazawa, Daisuke; Kimbara, Kazuhide; Hatta, Takashi

2005-12-01

383

The Detrusor Muscle: An Innocent Victim of Bladder Outlet Obstruction  

Microsoft Academic Search

Objectives: Benign prostatic hyperplasia (BPH) is considered a frequent cause of bladder outlet obstruction (BOO) and lower urinary tract symp- toms (LUTS), although the physiopathologic mechanism through which BPH causes LUTS is not clear. Several morphologic and functional modifications of the bladder detrusor have been described in patients with BPH and could play a direct role in determining symptoms. The

Vincenzo Mirone; Ciro Imbimbo; Nicola Longo; Ferdinando Fusco

2007-01-01

384

Tobacco Exposure by Various Modes May Alter Proinflammatory (IL-12) and Anti-Inflammatory (IL-10) Levels and Affects the Survival of Prostate Carcinoma Patients: An Explorative Study in North Indian Population  

PubMed Central

Objective. Inflammation is an important hallmark of all cancers and net inflammatory response is determined by a delicate balance between pro- and anti-inflammatory cytokines, which may be affected by tobacco exposure, so the present study was designed to explore the effect of various modes of tobacco exposure on interleukin-12 (IL-12) and interleukin-10 (IL-10) inflammatory cytokine levels and survival in prostate carcinoma (PCa) patients. Methods. 285 cancer patients and equal controls with 94 BPH (benign prostatic hyperplasia) were recruited; baseline levels of serum IL-12 and IL-10 were measured and analyzed in various tobacco exposed groups by appropriate statistical tool. Five-year survivals of patients were analyzed by Log-rank (Mantel-Cox) test (graph pad version 5). Results. The expression of serum proinflammatory (IL-12) and anti-inflammatory (IL-10) cytokines was correlated with tobacco exposed group as smokers, chewers, and alcohol users have shown significantly higher levels (P < 0.001) with significantly lower median survivals (27.1 months, standard error = 2.86, and 95% CI: 21.4–32.62); than nonusers. Stages III and IV of tobacco addicted patients have also shown significantly increased levels of IL-12 and IL-10. Conclusions. IL-12 and IL-10 seem to be affected by various modes of tobacco exposure and inflammation also affects median survival of cancer patients.

Khattri, Sanjay; Mandhani, Anil; Sharma, Praveen; Pant, Kamlesh Kumar

2014-01-01

385

Thermocoagulation effect of diode laser radiation in the human prostate: Acute and chronic study  

Microsoft Academic Search

ObjectivesTo evaluate the safety and efficacy of low-power slow-heating diode laser-induced photocoagulation of prostatic tissue for treatment of benign prostatic hyperplasia, we conducted a series of acute and chronic studies using a diode laser (810 nm) to irradiate human prostate.

Mariela Pow-Sang; Daniel F. Cowan; Eduardo Orihuela; Richard Dyer; Massoud Motamedi; Michael M. Warren; Julio E. Pow-Sang

1995-01-01

386

Transurethral radio frequency ablation of the prostate  

NASA Astrophysics Data System (ADS)

Since 1993, radiofrequency ablation of the prostate has been studied as a potential treatment for symptomatic bladder outlet obstruction due to benign prostatic hyperplasia. Two transurethral radiofrequency delivery systems have been developed to the point of undergoing initial human clinical trials. The TUNATM system involves focal interstitial radiofrequency energy application, while the TURAPYTM system involves a circumferential application of radiofrequency energy to the prostatic urethra via a simple delivery catheter. Experimental studies in animal models and human prostate tissue have demonstrated the nature of radiofrequency induced tissue heating and thermal injury. Observed thermal effects are relatively focused, with steep temperature gradients occurring over a few millimeters from the radiofrequency emission source. This allows precise and focused tissue treatment with little or no danger of injury to surrounding structures. Early human clinical experience in the treatment of benign prostatic hyperplasia has demonstrated efficacy in the relief of voiding symptoms and safety and minimal morbidity associated with this technology. The existing operative approaches are relatively simple. Ongoing development of more versatile delivery systems for radiofrequency ablation of the prostate is expected. Results from larger clinical trials with longer term followup will eventually allow adequate assessment of the role of radiofrequency ablation in the surgical management of benign prostatic hyperplasia.

Kabalin, John N.

1996-05-01

387

Laser- and electrosurgery as a treatment modality of BPH: urodynamic evaluation of seven different techniques in 280 patients  

NASA Astrophysics Data System (ADS)

Laser treatment of the prostate as an alternative for transurethral resection of the prostate (TURP) has evolved from a complicated troublesome procedure to a single office procedure. In this study, we compared the efficacy of different electrosurgical and laser techniques. The data of seven prospective studies in 280 patients were evaluated. The patients were treated for bladder outlet obstruction due to benign prostatic hyperplasia during the period from 1992 until 1998. Five procedures were offered using Nd:YAG laser light, including ultrasound-guided free beam, a free beam technique applying either a predetermined energy dose or a visually-guided energy does, contact laser prostatectomy and a hybrid method where free beam coagulation was followed by contact laser. Two procedures were offered using electrosurgery comprising transurethral resection and transurethral electrovaporization. The clinical outcome was assessed pre-operatively and 6 months post-operatively by free flowmetry, post-void residual, and Shaeffer obstruction grade. Results after 6 months are shown in the table below.

van Swol, Christiaan F. P.; van Venrooij, Ger E. P. M.; Eckhardt, Mardy D.; Grimbergen, Matthijs C. M.; Verdaasdonck, Rudolf M.; Boon, Tom A.

1999-06-01

388

Validez de las pruebas utilizadas en el diagnóstico inicial y su concordancia con el diagnóstico final en pacientes con sospecha de hiperplasia benigna de próstata  

Microsoft Academic Search

VALIDITY OF TESTS FOR INITIAL DIAGNOSIS AND ITS CONCORDANCE WITH FINAL DIAGNOSIS IN PATIENTS WITH SUS- PECTED BENIGN PROSTATIC HYPERPLASIA. Objective: To assess the validity of diagnostic tools available at the primary care setting (medical history (MH), I-PSS ques- tionnaire, digital rectal examination (DRE) and prostate specific antigen (PSA) evaluation) for the diagnosis of benign prostatic hyperplasia (BPH). Subjects and

Carballido Rodríguez J; Badia Llach X; Gimeno Collado A; Regadera Sejas L; Dal-Ré Saavedra R

2006-01-01

389

Prostate Problems  

MedlinePLUS

... a combination of medicines, surgery, and lifestyle changes. Prostate Cancer Prostate cancer is common among American men. Your ... fruits and vegetables may raise your risk. Diagnosing Prostate Cancer At the start, prostate cancer does not cause ...

390

High-power (80-w) KTP laser vaporization of the prostate in the management of urinary retention: long-term follow up  

NASA Astrophysics Data System (ADS)

Introduction and Objectives: We have previously reported the use of high-powered photoselective vaporization of the prostate (PVP) for patients in urinary retention due to benign prostatic hyperplasia (BPH). PVP is a relatively new treatment for bladder outlet obstruction due to BPH, using laser energy to vaporize obstructing prostatic tissue. This study investigates the long-term follow up of patients treated with PVP for urinary retention. Materials and Methods: All participants signed informed consent, and were treated with high power 80 W quasi-continuous wave potassium-titanyl-phosphate (KTP) laser. Ten patients underwent the procedure from December 2001 until the present. One patient was excluded from the study for failure to return for follow-up. Mean patient follow-up was nine months, maximum of twelve months. Results: The mean pre-operative gland size by trans-rectal ultrasound was 48 grams. Mean urethral length was 3.2 cm. Mean laser time was 48.2 minutes and the mean energy usage was 82.2 kJoules. There were no peri-operative complications such as sepsis or measurable postoperative bleeding. The preoperative AUA Symptom Score (AUASS) decreased from a mean of 22.6 preoperatively to 17 at nine months postoperatively (p = 0.032). The Quality of Life Score (QOL) decreased from 4.6 preoperatively to 3.25 at 12 months postoperatively (p = 0.26). The maximum urine flow rate increased from a mean of 7.7 cc/sec preoperatively to 14.5 cc/sec at six months follow-up (p = 0.03). Conclusions: This follow-up study suggests that HP-KTP has a durable response in patients treated specifically for retention. It significantly improved urine flow rate and symptom score, and had a trend towards improvement in subjective quality of life. HP-KTP prostatectomy should be considered in treating patients in retention, especially those with significant co-morbidities or taking anticoagulation.

Kleeman, M.; Nseyo, Unyime O.

2004-07-01

391

BMI1, Stem Cell Factor Acting as Novel Serum-biomarker for Caucasian and African-American Prostate Cancer  

PubMed Central

Background Lack of reliable predictive biomarkers is a stumbling block in the management of prostate cancer (CaP). Prostate-specific antigen (PSA) widely used in clinics has several caveats as a CaP biomarker. African-American CaP patients have poor prognosis than Caucasians, and notably the serum-PSA does not perform well in this group. Further, some men with low serum-PSA remain unnoticed for CaP until they develop disease. Thus, there is a need to identify a reliable diagnostic and predictive biomarker of CaP. Here, we show that BMI1 stem-cell protein is secretory and could be explored for biomarker use in CaP patients. Methodology/Principal Findings Semi-quantitative analysis of BMI1 was performed in prostatic tissues of TRAMP (autochthonous transgenic mouse model), human CaP patients, and in cell-based models representing normal and different CaP phenotypes in African-American and Caucasian men, by employing immunohistochemistry, immunoblotting and Slot-blotting. Quantitative analysis of BMI1 and PSA were performed in blood and culture-media of siRNA-transfected and non-transfected cells by employing ELISA. BMI1 protein is (i) secreted by CaP cells, (ii) increased in the apical region of epithelial cells and stromal region in prostatic tumors, and (iii) detected in human blood. BMI1 is detectable in blood of CaP patients in an order of increasing tumor stage, exhibit a positive correlation with serum-PSA and importantly is detectable in patients which exhibit low serum-PSA. The clinical significance of BMI1 as a biomarker could be ascertained from observation that CaP cells secrete this protein in higher levels than cells representative of benign prostatic hyperplasia (BPH). Conclusions/Significance BMI1 could be developed as a dual bio-marker (serum and biopsy) for the diagnosis and prognosis of CaP in Caucasian and African-American men. Though compelling these data warrant further investigation in a cohort of African-American patients. PMID:23308129

Siddique, Hifzur Rahman; Parray, Aijaz; Zhong, Weixiong; Karnes, R. Jeffery; Bergstralh, Eric J.; Koochekpour, Shahriar; Rhim, Johng S.; Konety, Badrinath R.; Saleem, Mohammad

2013-01-01

392

Introduction and Concluding Remarks  

Microsoft Academic Search

Symptomatic benign prostatic hyperplasia (BPH) as characterised by lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) is a common condition in the elderly male population. It is difficult to estimate the prevalence and incidence of symptomatic BPH, as no unified definition exists for this condition. Community-based surveys performed in Scotland, France, The Netherlands, Spain, the United States

Christopher R. Chapple

1999-01-01

393

5Alpha Reductase Inhibition Provides Superior Benefits to Alpha Blockade by Preventing AUR and BPH-Related Surgery  

Microsoft Academic Search

Objectives: This analysis examines the relative effectiveness of current medical therapies for BPH in preventing AUR, AUR-related catheterisation and surgery in real-life clinical practice.Methods: This is a retrospective analysis of observational data from the General Practice Research Database (UK) (GPRD). The cohort contains 4500 patients experiencing BPH or lower urinary tract symptoms strongly suggestive of BPH, aged over 50 years,

P. Boyle; C. Roehrborn; R. Harkaway; J. Logie; J. de la Rosette; M. Emberton

2004-01-01

394

A Multi-Arm Hand-Held Robotic System for Transurethral Laser Prostate Surgery  

E-print Network

intervention for BPH is to remove prostate tissue surrounding the urethra and thereby enable normal urine flowLEP, the only way to aim the laser and/or manipulate tissue is to move the entire endoscope, stretching a large quantity of tissue. In contrast, our new robotic approach provides the surgeon with two concentric tube

Simaan, Nabil

395

Amlodipine-induced gingival hyperplasia.  

PubMed

Drug-induced gingival hyperplasia is a serious concern both for the patient and the clinician. A 45 year-old Caucasian male patient with hypertension, who received amlodipine (10 mg/day, single dose orally) for two months, sought medical attention because of the new-onset gingival enlargement. On clinical examination a generalized and firm overgrowth of the gingival throughout the maxilla and the mandible were evident. The lack of gingival inflammation and purulent discharge were other features of the clinical scenario. Histological assessment of the biopsy specimen revealed the hyperplasia of connective tissue, epithelial acanthosis, and elongated rete ridges along with few inflammatory cells. The histological and the clinical evidences were consistent with amlodipine-induced gingival hyperplasia. We believe that the present report indicates the most rapidly developed case of amlodipine-induced gingival hyperplasia reported to date. The related literature is reviewed and the underlying pathogenic mechanisms of this rare side-effect are discussed here. PMID:17072250

Lafzi, Ardeshir; Farahani, Ramin Mostofi Zadeh; Shoja, Mohammad Ali Mohajjel

2006-01-01

396

A New Technique of Intraprostatic Fiber Placement To Minimize Thermal Injury To Prostatic Urothelium During Indigo Interstitial Laser Thermal Therapy  

Microsoft Academic Search

A new technique of cystoscopic insertion of laser fiber into the prostate is described for interstitial laser thermal therapy in the treatment of benign prostatic hyperplasia. The technique uses the inherent physical properties of the fused silica laser fiber with the assistance of a standard cystoscope to insert the laser fiber into the inner region of the prostate gland. Laser

Muta M Issa; Murphy Townsend; V. Keith Jiminez; L. Elayne Miller; Katrina Anastasia

1998-01-01

397

Design and construction of porous metal-organic frameworks based on flexible BPH pillars  

SciTech Connect

Three metal-organic frameworks (MOFs), [Co{sub 2}(BPDC){sub 2}(4-BPH){center_dot}3DMF]{sub n} (1), [Cd{sub 2}(BPDC){sub 2}(4-BPH){sub 2}{center_dot}2DMF]{sub n} (2) and [Ni{sub 2}(BDC){sub 2}(3-BPH){sub 2} (H{sub 2}O){center_dot}4DMF]{sub n} (3) (H{sub 2}BPDC=biphenyl-4,4 Prime -dicarboxylic acid, H{sub 2}BDC=terephthalic acid, BPH=bis(pyridinylethylidene)hydrazine and DMF=N,N Prime -dimethylformamide), have been solvothermally synthesized based on the insertion of heterogeneous BPH pillars. Framework 1 has 'single-pillared' MOF-5-like motif with inner cage diameters of up to 18.6 A. Framework 2 has 'double pillared' MOF-5-like motif with cage diameters of 19.2 A while 3 has 'double pillared' 8-connected framework with channel diameters of 11.0 A. Powder X-ray diffraction (PXRD) shows that 3 is a dynamic porous framework. - Graphical abstract: By insertion of flexible BPH pillars based on 'pillaring' strategy, three metal-organic frameworks are obtained showing that the porous frameworks can be constructed in a much greater variety. Highlights: Black-Right-Pointing-Pointer Frameworks 1 and 2 have MOF-5 like motif. Black-Right-Pointing-Pointer The cube-like cages in 1 and 2 are quite large, comparable to the IRMOF-10. Black-Right-Pointing-Pointer Framework 1 is 'single-pillared' mode while 2 is 'double-pillared' mode. Black-Right-Pointing-Pointer PXRD and gas adsorption analysis show that 3 is a dynamic porous framework.

Hao, Xiang-Rong; Yang, Guang-sheng; Shao, Kui-Zhan [Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun 130024, Jilin (China)] [Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun 130024, Jilin (China); Su, Zhong-Min, E-mail: zmsu@nenu.edu.cn [Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun 130024, Jilin (China)] [Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun 130024, Jilin (China); Yuan, Gang; Wang, Xin-Long [Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun 130024, Jilin (China)] [Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun 130024, Jilin (China)

2013-02-15