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  1. Benign prostate hyperplasia (BPH) - resources

    MedlinePlus

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

  2. Prostate Enlargement: Benign Prostatic Hyperplasia (BPH)

    MedlinePlus

    ... the surface of the prostate and transmits an electric current that vaporizes prostate tissue. The vaporizing effect penetrates ... a cystoscope and an instrument that uses an electric current or a laser beam through the urethra to ...

  3. Benign prostatic hyperplasia (BPH) management in the primary care setting.

    PubMed

    Kapoor, Anil

    2012-10-01

    Benign prostate hyperplasia (BPH) occurs in up to 50% of men by age 50, and the incidence increases with age. This common clinical problem is diagnosed by history, including the International Prostate Symptom Score (IPSS) questionnaire, and physical examination by digital rectal examination (DRE). Initial management for BPH includes lifestyle modification, and smooth muscle relaxant alpha blocker therapy. Alpha blockers usually take effect quickly within 3-5 days, and have minimal side effects. Current commonly used alpha blockers include the selective alpha blockers tamsulosin (Flomax), alfusosin (Xatral), and silodosin (Rapaflo). For patients with larger prostates, the 5-alpha reductase inhibitor class (finasteride (Proscar) and dutasteride (Avodart)) work effectively to shrink prostate stroma resulting in improved voiding. The 5-ARI class of drugs, in addition to reducing prostate size, also reduce the need for future BPH-related surgery, and reduce the risk of future urinary retention. Drugs from the phosphodiesterase-5 (PDE-5) inhibitor class may now be considered for treating BPH. Once daily 5 mg tadalafil has been shown to improve BPH-related symptoms and is currently approved to treat patients with BPH. Referral to a urologist can be considered for patients with a rising prostate-specific antigen (PSA), especially while on 5-ARI, failure of urinary symptom control despite maximal medical therapy, suspicion of prostate cancer, hematuria, recurrent urinary infections, urinary retention, or renal failure. Currently the primary care physician is armed with multiple treatment options to effectively treat men with symptomatic BPH. PMID:23089343

  4. Role of laser therapy in benign prostate hyperplasia (BPH)

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

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

  5. Outcomes and quality of life issues in the pharmacological management of benign prostatic hyperplasia (BPH)

    PubMed Central

    Cambio, Angelo J; Evans, Christopher P

    2007-01-01

    Background Benign prostatic hyperplasia (BPH) is a common disease of the aging male population. BPH treatment includes a variety of pharmacological and surgical interventions. The goal of this paper is to review the natural history of BPH, outcomes of pharmacological management, effects on quality of life (QoL), future pharmacotherapies, and associated patient-focused perspectives. Materials and methods Medline searches for the keywords benign prostatic hyperplasia, BPH, alpha blockers, 5 alpha-reductase, and quality of life were performed. Relevant literature was reviewed and analyzed. Results Alpha blockers, 5 alpha-reductase inhibitors, and phytotherapy are the three categories of pharmaceutical interventions currently available for BPH. Various clinical trials have shown that alpha blockers and 5 alpha-reductase inhibitors are safe, efficacious, and improve QoL in patients with BPH. The evidence for phytotherapeutics is not as convincing. The current armamentarium of pharmaceutical interventions are encompassed in these three classes of medications. New pharmacotherapies based on novel mechanisms are on the horizon. Conclusion There are a variety of safe and efficacious medical therapies available for the management of BPH and it is important for the practicing physician to have an understanding of these pharmacotherapies and their potential impact on the patient. There is not enough evidence to make a recommendation regarding phytotherapy use. New classes of drugs for BPH will likely find their way into routine use. PMID:18360626

  6. Inflammatory Responses in a Benign Prostatic Hyperplasia Epithelial Cell Line (BPH-1) Infected with Trichomonas vaginalis.

    PubMed

    Kim, Sang-Su; Kim, Jung-Hyun; Han, Ik-Hwan; Ahn, Myoung-Hee; Ryu, Jae-Sook

    2016-04-01

    Trichomonas vaginalis causes the most prevalent sexually transmitted infection worldwide. Trichomonads have been detected in prostatic tissues from prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Chronic prostatic inflammation is known as a risk factor for prostate enlargement, benign prostatic hyperplasia symptoms, and acute urinary retention. Our aim was to investigate whether T. vaginalis could induce inflammatory responses in cells of a benign prostatic hyperplasia epithelial cell line (BPH-1). When BPH-1 cells were infected with T. vaginalis, the protein and mRNA of inflammatory cytokines, such as CXCL8, CCL2, IL-1β, and IL-6, were increased. The activities of TLR4, ROS, MAPK, JAK2/STAT3, and NF-κB were also increased, whereas inhibitors of ROS, MAPK, PI3K, NF-κB, and anti-TLR4 antibody decreased the production of the 4 cytokines although the extent of inhibition differed. However, a JAK2 inhibitor inhibited only IL-6 production. Culture supernatants of the BPH-1 cells that had been incubated with live T. vaginalis (trichomonad-conditioned medium, TCM) contained the 4 cytokines and induced the migration of human monocytes (THP-1 cells) and mast cells (HMC-1 cells). TCM conditioned by BPH-1 cells pretreated with NF-κB inhibitor showed decreased levels of cytokines and induced less migration. Therefore, it is suggested that these cytokines are involved in migration of inflammatory cells. These results suggest that T. vaginalis infection of BPH patients may cause inflammation, which may induce lower urinary tract symptoms (LUTS). PMID:27180569

  7. Inflammatory Responses in a Benign Prostatic Hyperplasia Epithelial Cell Line (BPH-1) Infected with Trichomonas vaginalis

    PubMed Central

    Kim, Sang-Su; Kim, Jung-Hyun; Han, Ik-Hwan; Ahn, Myoung-Hee; Ryu, Jae-Sook

    2016-01-01

    Trichomonas vaginalis causes the most prevalent sexually transmitted infection worldwide. Trichomonads have been detected in prostatic tissues from prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Chronic prostatic inflammation is known as a risk factor for prostate enlargement, benign prostatic hyperplasia symptoms, and acute urinary retention. Our aim was to investigate whether T. vaginalis could induce inflammatory responses in cells of a benign prostatic hyperplasia epithelial cell line (BPH-1). When BPH-1 cells were infected with T. vaginalis, the protein and mRNA of inflammatory cytokines, such as CXCL8, CCL2, IL-1β, and IL-6, were increased. The activities of TLR4, ROS, MAPK, JAK2/STAT3, and NF-κB were also increased, whereas inhibitors of ROS, MAPK, PI3K, NF-κB, and anti-TLR4 antibody decreased the production of the 4 cytokines although the extent of inhibition differed. However, a JAK2 inhibitor inhibited only IL-6 production. Culture supernatants of the BPH-1 cells that had been incubated with live T. vaginalis (trichomonad-conditioned medium, TCM) contained the 4 cytokines and induced the migration of human monocytes (THP-1 cells) and mast cells (HMC-1 cells). TCM conditioned by BPH-1 cells pretreated with NF-κB inhibitor showed decreased levels of cytokines and induced less migration. Therefore, it is suggested that these cytokines are involved in migration of inflammatory cells. These results suggest that T. vaginalis infection of BPH patients may cause inflammation, which may induce lower urinary tract symptoms (LUTS). PMID:27180569

  8. New surgical treatment options in patients with benign prostate hyperplasia (BPH)

    NASA Astrophysics Data System (ADS)

    de Riese, Werner T. W.; Nelius, Thomas; Aronoff, David R.; Mittemeyer, Bernhard T.

    2003-06-01

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

  9. A Review of Laser Treatment for Symptomatic BPH (Benign Prostatic Hyperplasia).

    PubMed

    Nair, Shiva Madhwan; Pimentel, Marie Adrianne; Gilling, Peter John

    2016-06-01

    Benign prostatic hyperplasia (BPH) is the predominant cause of bladder outflow obstruction and is associated with significant morbidity. Surgical removal of adenoma has been a key treatment principle for alleviation of obstruction. Lasers have been used as an alternative to transurethral resection of the prostate (TURP), due to the higher complications of the latter procedure, since the early 1990s. Early generations of lasers utilized coagulative and ablative techniques to dis-obstruct the bladder. Ablative techniques have remained popular with the resurgence of 532-nm vaporization (commonly known as GreenLight). Enucleation techniques especially with the holmium laser have shown durable efficacy in randomized controlled trials whilst new modalities such as thulium still require long-term data. This review examines the most common types of laser technology used in BPH surgery, with a focus on efficacy and side effect profile. PMID:27053186

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

    PubMed Central

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

    2011-01-01

    Benign prostatic hyperplasia (BPH) is the major cause of lower urinary tract symptoms in men aged 50 or older. Symptoms are not normally life threatening, but often drastically affect the quality of life. The number of men seeking treatment for BPH is expected to grow in the next few years as a result of the ageing male population. Estimates of annual pharmaceutical sales of BPH therapies range from $US 3 to 10 billion, yet this market is dominated by two drug classes. Current drugs are only effective in treating mild to moderate symptoms, yet despite this, no emerging contenders appear to be on the horizon. This is remarkable given the increasing number of patients with severe symptoms who are required to undergo invasive and unpleasant surgery. This review provides a brief background on prostate function and the pathophysiology of BPH, followed by a brief description of BPH epidemiology, the burden it places on society, and the current surgical and pharmaceutical therapies. The recent literature on emerging contenders to current therapies and novel drug targets is then reviewed, focusing on drug targets which are able to relax prostatic smooth muscle in a similar way to the α1-adrenoceptor antagonists, as this appears to be the most effective mechanism of action. Other mechanisms which may be of benefit are also discussed. It is concluded that recent basic research has revealed a number of novel drug targets such as muscarinic receptor or P2X-purinoceptor antagonists, which have the potential to produce more effective and safer drug treatments. PMID:21410684

  11. Phenomenological model of laser-tissue interaction with application to Benign Prostatic Hyperplasia (BPH) simulation.

    PubMed

    Zhou, Xiangmin; Zhang, Nan; Shen, Yunhe; Burke, Dan; Konchada, Vamsi; Sweet, Robert

    2011-01-01

    Laser-tissue interaction is a multi-physics phenomenon not yet mathematically describable and computationally predictable. It is a challenge to model the laser-tissue interaction for real time laser Benign Prostatic Hyperplasia (BPH) simulation which requires the laser-tissue interaction model to be computationally efficient and accurate. Under the consideration and enforcement of the thermodynamic first law and treating the laser-tissue interaction as a gray-box, utilizing the sensitivity analysis of some key parameters that will affect the laser intensity on the tissue surface with respect to the tissue vaporization rate, a phenomenological model of laser-tissue interaction is developed. The developed laser-tissue interaction model has been implemented for a laser BPH simulator and achieves real time performance (more than 30 frames per second). The model agrees well with the available experimental data. PMID:21335893

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

    PubMed Central

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

    2014-01-01

    In the light of increasing evidence that benign prostatic hyperplasia is associated with cardiovascular disease, we have investigated the relationship between prostatic blood flow and prostatic hyperplasia in the spontaneously-hypertensive-rat (SHR). Twelve-week-old male SHRs were treated with nicorandil for six weeks. Wistar-Kyoto rats were used as controls. Six weeks after nicorandil treatment, blood pressure and the prostatic blood flow were estimated, and tissue levels of malondialdehyde, HIF-1α, TGF-β1, bFGF, dihydrotestosterone, and α-SMA were measured. SHRs showed significant increases in blood pressure, tissue levels of malondialdehyde, HIF-1α, TGF-β1, bFGF, α-SMA and a significant decrease in the prostatic blood flow. Although treatment with nicorandil failed to alter the blood-pressure and α-SMA, it significantly ameliorated the increased levels of malondialdehyde, HIF-1α, TGF-β1, and bFGF. There were no significant differences in tissue levels of dihydrotestosterone among any groups. These data indicate that development of prostatic hyperplasia may be associated with prostatic hypoxia, which nicorandil prevents via its effect to increase the blood flow. PMID:24448152

  13. [Clinical effects of allylestrenol on patients with benign prostatic hyperplasia (BPH) evaluated with criteria for treatment efficacy in BPH].

    PubMed

    Noguchi, Kazumi; Takeda, Mitsumasa; Hosaka, Masahiko; Kubota, Yoshinobu

    2002-05-01

    One hundred and twenty-nine patients with benign prostatic hypertrophy (BPH) were registered and treated with allylestrenol. Allylestrenol was administered at a dose of 50 mg/day given twice a day for 16 weeks. Out of 129 patients with a mean age of 67.8 years old, 92 cases completed the study and 48 cases with moderate symptoms were objectively evaluated with "Criteria for Treatment Efficacy in BPH" proposed by The Japanese Urological Association in 1997. Prostate volume was significantly decreased from 32.7 +/- 11.9 to 27.4 +/- 11.2 ml (mean +/- SD), and maximum flow rate was significantly increased from 8.4 +/- 3.4 to 10.8 +/- 5.0 ml/sec. Residual urine volume was significantly decreased from 62.4 +/- 57.4 to 37.0 +/- 38.7 ml. IPSS was significantly decreased from 15.3 +/- 4.9 to 9.9 +/- 4.0, and QOL index was significantly decreased from 4.4 +/- 0.8 to 2.7 +/- 1.2. The efficacy of allylestrenol was shown by its effects on prostate volume (anatomy), maximum urinary flow rate (function), and symptom scores (symptom) at the end of 16 weeks of treatment. The rates of improvement for symptoms, QOL, function, and anatomy are 68.7% (N = 48), 79.2% (N = 48), 50.0% (N = 48), and 61.0% (N = 41), respectively. Overall efficacy (Good and Fair) was 70.9% (N = 48). During this study, 5 patients (3.9%) complained of loss of libido and 2 patients dropped out. In conclusion, allylestrenol was demonstrated to be a quite effective and safe medical treatment for patients with symptomatic BPH based on the criteria for treatment efficacy in BPH. PMID:12094708

  14. Treating Enlarged Prostate (BPH): Which Drugs Work Best

    MedlinePlus

    ... the prostate gets larger. This is called prostate enlargement, or BPH (benign prostatic hyperplasia). Why should I ... alpha-blocker doxazosin for a first treatment. Prostate enlargement affects millions of men, including about half of ...

  15. Safety and efficacy of a novel Prunus domestica extract (Sitoprin, CR002) on testosterone-induced benign prostatic hyperplasia (BPH) in male Wistar rats.

    PubMed

    Swaroop, Anand; Bagchi, Manashi; Kumar, Pawan; Preuss, Harry G; Bagchi, Debasis

    2015-11-01

    The efficacy of a novel Prunus domestica bark extract (Sitoprin, CR002) was investigated on testosterone propionate (TP)-induced benign prostatic hyperplasia (BPH) in male Wistar rats. BPH was induced by daily subcutaneous administration of TP (3.0 mg/kg) over a period of 15 days (interim sacrifice group) and for an additional 21 days (terminal sacrifice group). We evaluated the dose-dependent efficacy (0, 50, 100 and 200 mg/kg body weight/day) of CR002 and a control group against BPH, and compared with a reference standard Prunus africana extract (CR001). Extensive clinical examinations were carried out on days 1, 7, 14, 21, 28 and 35 of treatment period to determine the onset, duration and severity of clinical signs. Clinical pathology, hematology, biochemistry and histopathology were performed on days 15 and 35, prior to necropsy. Animals were fasted overnight prior to blood collection. Prostate glands and tissues were examined. On day 36, histopathology of ventral prostrate of control rats demonstrates single layer of columnar mucin secreting epithelial cells along with a lumen occupied with eosinophilic secretion. In contrast, CR002 and CR001 groups (100 and 200 mg/kg/day) exhibited no hyperplasia and proliferation of epithelial cells. Prostate histopathology of these treated groups was comparable with control rats. The hyperplasia and hypertrophy of prostrate was reduced to single-layered cell indicating the efficacy of CR002 and CR001. Overall, results demonstrate that CR002 exhibits therapeutic efficacy/activity in TP-induced BPH in rats, which is comparable to CR001. PMID:26337762

  16. Benign prostatic hyperplasia.

    PubMed

    Chughtai, Bilal; Forde, James C; Thomas, Dominique Dana Marie; Laor, Leanna; Hossack, Tania; Woo, Henry H; Te, Alexis E; Kaplan, Steven A

    2016-01-01

    Benign prostatic hyperplasia (BPH), which causes lower urinary tract symptoms (LUTS), is a common diagnosis among the ageing male population with increasing prevalence. Many risks factors, both modifiable and non-modifiable, can increase the risk of development and progression of BPH and LUTS. The symptoms can be obstructive (resulting in urinary hesitancy, weak stream, straining or prolonged voiding) or irritative (resulting in increased urinary frequency and urgency, nocturia, urge incontinence and reduced voiding volumes), or can affect the patient after micturition (for example, postvoid dribble or incomplete emptying). BPH occurs when both stromal and epithelial cells of the prostate in the transitional zone proliferate by processes that are thought to be influenced by inflammation and sex hormones, causing prostate enlargement. Patients with LUTS undergo several key diagnostic investigations before being diagnosed with BPH. Treatment options for men with BPH start at watchful waiting and progress through medical to surgical interventions. For the majority of patients, the starting point on the treatment pathway will be dictated by their symptoms and degree of bother. PMID:27147135

  17. Enlarged Prostate (BPH)

    MedlinePlus

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

  18. Management of Benign Prostatic Hyperplasia.

    PubMed

    Kim, Eric H; Larson, Jeffrey A; Andriole, Gerald L

    2016-01-01

    Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) commonly affect older men. Age-related changes associated with metabolic disturbances, changes in hormone balance, and chronic inflammation may cause BPH development. The diagnosis of BPH hinges on a thorough medical history and focused physical examination, with attention to other conditions that may be causing LUTS. Digital rectal examination and urinalysis should be performed. Other testing may be considered depending on presentation of symptoms, including prostate-specific antigen, serum creatinine, urine cytology, imaging, cystourethroscopy, post-void residual, and pressure-flow studies. Many medical and surgical treatment options exist. Surgery should be reserved for patients who either have failed medical management or have complications from BPH, such as recurrent urinary tract infections, refractory urinary retention, bladder stones, or renal insufficiency as a result of obstructive uropathy. PMID:26331999

  19. Pathology of benign prostatic hyperplasia.

    PubMed

    Roehrborn, C G

    2008-12-01

    The epidemiology of benign prostatic hyperplasia (BPH) is complex and not fully understood. The androgenic hormones testosterones and dihydrotestosterone play at least a permissive and important role. Growth factors and other hormones including estrogens may also play a role. BPH is a truely hyperplastic process resulting in growth of glandular-epithelial and stromal/muscle tissue in the prostate, leading to often measurable growth taking on different shapes and configurations which may impact symptoms and secondary outcomes. It is important to recognize that BPH is a histological conditions, which is one but not the only cause of lower urinary tract symptoms, and may or may not be associated with prostate enlargement and bladder outlet obstruction. Recognizing the different entities and determining their presence in individual patients may help with therapeutic decision making. PMID:19002119

  20. Magnetic resonance imaging of benign prostatic hyperplasia.

    PubMed

    Guneyli, Serkan; Ward, Emily; Thomas, Stephen; Yousuf, Ambereen Nehal; Trilisky, Igor; Peng, Yahui; Antic, Tatjana; Oto, Aytekin

    2016-01-01

    Benign prostatic hyperplasia (BPH) is a common condition in middle-aged and older men and negatively affects the quality of life. An ultrasound classification for BPH based on a previous pathologic classification was reported, and the types of BPH were classified according to different enlargement locations in the prostate. Afterwards, this classification was demonstrated using magnetic resonance imaging (MRI). The classification of BPH is important, as patients with different types of BPH can have different symptoms and treatment options. BPH types on MRI are as follows: type 0, an equal to or less than 25 cm3 prostate showing little or no zonal enlargements; type 1, bilateral transition zone (TZ) enlargement; type 2, retrourethral enlargement; type 3, bilateral TZ and retrourethral enlargement; type 4, pedunculated enlargement; type 5, pedunculated with bilateral TZ and/or retrourethral enlargement; type 6, subtrigonal or ectopic enlargement; type 7, other combinations of enlargements. We retrospectively evaluated MRI images of BPH patients who were histologically diagnosed and presented the different types of BPH on MRI. MRI, with its advantage of multiplanar imaging and superior soft tissue contrast resolution, can be used in BPH patients for differentiation of BPH from prostate cancer, estimation of zonal and entire prostatic volumes, determination of the stromal/glandular ratio, detection of the enlargement locations, and classification of BPH types which may be potentially helpful in choosing the optimal treatment. PMID:27015442

  1. Medical Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Lepor, Herbert

    2011-01-01

    Medical therapy for the treatment of benign prostatic hyperplasia (BPH) became an accepted standard of care in the 1990s following the reports of randomized, double-blind, placebo-controlled studies showing that finasteride, a 5-α reductase inhibitor, and terazosin, an α-blocker, significantly improved lower urinary tract symptoms and increased peak urinary flow rates in men with BPH. This article reviews novel approaches to the pharmacological treatment of BPH. PMID:21826125

  2. The link between benign prostatic hyperplasia and prostate cancer.

    PubMed

    Ørsted, David D; Bojesen, Stig E

    2013-01-01

    Benign prostatic hyperplasia (BPH) and prostate cancer are among the most common diseases of the prostate gland and represent significant burdens for patients and health-care systems in many countries. The two diseases share traits such as hormone-dependent growth and response to antiandrogen therapy. Furthermore, risk factors such as prostate inflammation and metabolic disruption have key roles in the development of both diseases. Despite these commonalities, BPH and prostate cancer exhibit important differences in terms of histology and localization. Although large-scale epidemiological studies have shown that men with BPH have an increased risk of prostate cancer and prostate-cancer-related mortality, it remains unclear whether this association reflects a causal link, shared risk factors or pathophysiological mechanisms, or detection bias upon statistical analysis. Establishing BPH as a causal factor for prostate cancer development could improve the accuracy of prognostication and expedite intervention, potentially reducing the number of men who die from prostate cancer. PMID:23165396

  3. Selective Transurethral Resection of the Prostate Combined with Transurethral Incision of the Bladder Neck for Bladder Outlet Obstruction in Patients with Small Volume Benign Prostate Hyperplasia (BPH): A Prospective Randomized Study

    PubMed Central

    Li, Xin; Pan, Jin-hong; Liu, Qi-gui; He, Peng; Song, Si-ji; Jiang, Tao; Zhou, Zhan-song

    2013-01-01

    Purpose Transurethral resection of the prostate (TURP) has a high failure rate in patients with small volume benign prostate hyperplasia (BPH) with bladder outlet obstruction (BOO). We describe and report the results of an alternative surgical method, selective transurethral resection of the prostate (STURP) in combination with transurethral incision of the bladder neck (TUIBN). Methods Patients were randomized to receive TURP or STRUP+TUIBN in combination with TUIBN. Maximum urinary flow rate (Qmax), voided volume, and post voiding residual volume (PVR) were assessed at baseline and at 1, 3, and 6 months after surgery. Efficacy of treatment was assessed by lower urinary tract symptoms and IPSS. Results Sixty three patients received STRUP+TUIBN and 61 received TURP. Surgical time, amount of prostate tissue resected, and blood loss was the same in both groups (all, p>0.05). The mean duration of follow-up was 9.02 and 8.53 months in patients receiving TURP and STRUP+TUIBN, respectively. At 6 months postoperatively, IPSS was 4.26±1.22 and 4.18±1.47 in patients receiving TURP and STRUP+TUIBN, respectively (p>0.05), and the Qmax in patients receiving STRUP+TUIBN was markedly higher than in those receiving TURP (28.28±6.46 mL/s vs. 21.59±7.14 mL/s; p<0.05). Bladder neck contracture and urinary tract infections were observed in 3 and 5 patients receiving TURP, respectively, and none in STURP. Conclusions STRUP+TUIBN may offer a more effective and safer alternative to TURP for small volume BPH patients. PMID:23691002

  4. The overlooked cause of benign prostatic hyperplasia: prostatic urethral angulation.

    PubMed

    Cho, Kang Su; Kim, Joohan; Choi, Young Deuk; Kim, Jang Hwan; Hong, Sung Joon

    2008-01-01

    Benign prostatic hyperplasia (BPH) is one of the most common problems faced by aging men and can be associated with bothersome lower urinary tract symptoms that affect quality of life by interfering with normal daily activities and sleep patterns. Despite the clinical importance of BPH, its pathogenesis is still poorly understood. Previously, our understanding of BPH was centered on bladder outlet obstruction being secondary to benign prostatic enlargement. However, prostate size itself is not correlated with the urine flow rate and symptomatology. The prostatic urethra is a bend tube and the increased prostatic urethral angulation shows a higher bladder neck on cystoscopic examination. Although some urologists suspected that the higher bladder neck might be a causal factor for BPH, the clinical significance of prostatic urethral angulation was previously underestimated. In this study, we propose a new hypothesis that prostatic urethral angulation is a causal factor for BPH. By applying the concept of fluid dynamics to the process of urination in the prostatic urethra, we show that the energy loss in this bending tube (the prostatic urethra) can occur during micturition and it increases proportionally to prostatic urethral angulation; this energy loss results in a decrease of the urine velocity and accordingly, the urine flow rate is inversely associated with prostatic urethral angulation. We also propose that BPH involves prostatic urethral angulation as well as the classical BPH triad of prostatic enlargement, bladder outlet obstruction, and symptomatology. Our hypothesis suggests that prostatic urethral angulation is an overlooked cause of bladder outlet obstruction and is a causal factor of BPH, and provides novel insight into the pathogenesis of BPH. Ultimately, the relationship between prostatic urethral angulation and urine flow rate, and other clinical factors including urodynamic parameters, the symptomatology, the response to treatment, and disease progression, need to be investigated in a clinical setting. PMID:17761390

  5. [Erectile disfunction and benign prostatic hyperplasia - causal relation or coincidence?].

    PubMed

    Gasser, Thomas

    2010-03-01

    There is increasing evidence of causal relation between benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). BPH appears to have a negative impact on sexual function. Drugs commonly used for the treatment of BPH (i.e. alphablockers, 5-alpha reductase inhibitors) may cause retrograde ejaculation, ED and reduced libido. Physicians should be aware of these adverse events and inform their patients accordingly. Conversely, phosphodiestease-5-inhibitors may have a beneficial effect on BPH symptoms. PMID:20235043

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

    PubMed Central

    Garvey, Brian; Türkbey, Barış; Truong, Hong; Bernardo, Marcelino; Periaswamy, Senthil; Choyke, Peter L.

    2014-01-01

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

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

    PubMed Central

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

    2002-01-01

    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. PMID:12032329

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

    NASA Astrophysics Data System (ADS)

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

    2002-05-01

    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.

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

    PubMed Central

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

    2013-01-01

    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

  10. Recent advances in treatment for Benign Prostatic Hyperplasia

    PubMed Central

    van Rij, Simon; Gilling, Peter

    2015-01-01

    Clinical benign prostatic hyperplasia (BPH), often identified as a worsening ability of a male to pass urine, is a significant problem for men in our society. In 2015, the use of personalised medicine is tailoring treatment to individual patient needs and to genetic characteristics. Technological advances in surgical treatment are changing the way BPH is treated and are resulting in less morbidity. The future of BPH treatments is exciting, and a number of novel techniques are currently under clinical trial. PMID:26918132

  11. Recent advances in treatment for Benign Prostatic Hyperplasia.

    PubMed

    van Rij, Simon; Gilling, Peter

    2015-01-01

    Clinical benign prostatic hyperplasia (BPH), often identified as a worsening ability of a male to pass urine, is a significant problem for men in our society. In 2015, the use of personalised medicine is tailoring treatment to individual patient needs and to genetic characteristics. Technological advances in surgical treatment are changing the way BPH is treated and are resulting in less morbidity. The future of BPH treatments is exciting, and a number of novel techniques are currently under clinical trial. PMID:26918132

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

    NASA Astrophysics Data System (ADS)

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

    2003-06-01

    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.

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

    PubMed Central

    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

    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

  14. Chromosomal aberrations in benign prostatic hyperplasia patients

    PubMed Central

    Bağcı, Özkan; Umul, Mehmet; Güneş, Mustafa; Akyüz, Mehmet; Uruç, Fatih; Uz, Efkan; Soyupek, Sedat

    2016-01-01

    Purpose To investigate the chromosomal changes in patients with benign prostatic hyperplasia (BPH). Materials and Methods A total of 54 patients diagnosed with clinical BPH underwent transurethral prostate resection to address their primary urological problem. All patients were evaluated by use of a comprehensive medical history and rectal digital examination. The preoperative evaluation also included serum prostate-specific antigen (PSA) measurement and ultrasonographic measurement of prostate volume. Prostate cancer was detected in one patient, who was then excluded from the study. We performed conventional cytogenetic analyses of short-term cultures of 53 peripheral blood samples obtained from the BPH patients. Results The mean (±standard deviation) age of the 53 patients was 67.8±9.4 years. The mean PSA value of the patients was 5.8±7.0 ng/mL. The mean prostate volume was 53.6±22.9 mL. Chromosomal abnormalities were noted in 5 of the 53 cases (9.4%). Loss of the Y chromosome was the most frequent chromosomal abnormality and was observed in three patients (5.7%). There was no statistically significant relationship among age, PSA, prostate volume, and chromosomal changes. Conclusions Loss of the Y chromosome was the main chromosomal abnormality found in our study. However, this coexistence did not reach a significant level. Our study concluded that loss of the Y chromosome cannot be considered relevant for the diagnosis of BPH as it is for prostate cancer. Because BPH usually occurs in aging men, loss of the Y chromosome in BPH patients may instead be related to the aging process. PMID:26966725

  15. Phytotherapy of benign prostatic hyperplasia. A minireview.

    PubMed

    Pagano, Ester; Laudato, Massimiliano; Griffo, Michele; Capasso, Raffaele

    2014-07-01

    Benign prostate hyperplasia (BPH) is a common condition affecting older men, with an incidence that is age-dependent. Histological BPH, which typically develops after the age of 40 years, ranges in prevalence from >50% at 60 years to as high as 90% by 85 years of age. Typical symptoms include increased frequency of urination, nocturia, urgency, hesitancy, and weak urine stream. Conventional medicines used for the treatment of BPH include alpha blockers and 5-alpha reductase inhibitors. This articles review the mode of action, the efficacy, and the safety, including herb-drug interactions of the most common botanicals (Serenoa repens, Pygeum africanum, Urtica dioica, and Cucurbita pepo) and nutraceuticals (isoflavones, lycopene, selenium, and β-Sitosterol) in controlling the lower urinary tract symptoms associated to BPH. PMID:25165780

  16. Microwave Treatment of Prostate Cancer and Hyperplasia

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

    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.

  17. Therapeutic options in the treatment of benign prostatic hyperplasia

    PubMed Central

    Sandhu, Jaspreet S

    2009-01-01

    Current theraputic options for the treatment of symptomatic benign prostatic hyperplasia (BPH) are reviewed. Therapeutic options for mild lower urinary tract symptoms (LUTS), as defined by the American Urological Association, are generally treated medically. Moderate to severe LUTS can be treated medically or with surgical therapy. Current medical and surgical treatments for LUTS secondary to BPH are reviewed and evolving treatments are explored. PMID:19936164

  18. Is there a link between BPH and prostate cancer?

    PubMed

    Chang, R T M; Kirby, Roger; Challacombe, B J

    2012-04-01

    BPH is one of the most common diseases of older men, with more than 70% of men over 70 years affected, and prostate cancer is the most common cancer in men in the UK. Prostate cancer generally presents in one of three ways: asymptomatic patients who are screened (usually by a PSA test); men with LUTS who are investigated and undergo prostate biopsy; or patients with symptoms of metastasis such as bone pain. Men can be reassured that the main cause of LUTS is BPH. Only a small proportion of men have LUTS that are directly attributable to prostate cancer. Digital rectal examination (DRE) gives an evaluation of prostate size, which is relevant in particular to BPH management, and along with PSA testing it is one of the only ways of differentiating clinically between BPH and prostate cancer. If a nodular abnormality is present there is around a 50% chance of a diagnosis of prostate cancer being made on biopsy. Raised levels of serum PSA may be suggestive of prostate cancer, but diagnosis requires histological confirmation in almost every case. A normal PSA, PSA density and DRE can give reasonable confidence with regards to excluding clinically significant prostate cancer. BPH is not a known risk factor for prostate cancer, although the two frequently coexist. Age is the strongest predictor of prostate cancer risk, along with family history. BPH is not considered to be a precursor of prostate cancer. It is likely that although BPH may not make prostate cancer more likely to occur, it may increase the chance of diagnosing an incidental cancer. PMID:22792684

  19. Effect of Phellius linteus water extract on benign prostatic hyperplasia

    PubMed Central

    Kim, Yu-Na; Kim, Min-Sun; Chun, Sung-Sik

    2013-01-01

    Benign prostatic hyperplasia (BPH) is one of the most common diseases among elderly men. As the old-age population is increasing recently, it is to our interest to observe the growing BPH within them. In BPH, the dihydrotestosterone (DHT) acts as promotes prostate growth. It inhibits enzyme 5α-reductase that is involved in the conversion of testosterone to the DHT activity which reduces the excessive prostate growth. Through experiments, the effects of Phellius linteus water extract performed on the BPH rats were induced by testosterone treatments. For 12 weeks, Sprague-Dawley rats were treated with testosterone for the induction of BPH. Rats were divided into four experimental groups: the not treated group (N), the testosterone injection and D.W treatment group (TN), the testosterone injection and Phellinus linteus treatment group (TP) and testosterone injection and finasteride treatment group (TF). Prostate weight, volume and weight ratio in the TP group and the TF group were significantly lower than the TN group. Testosterone and DHT levels in the TN group were significantly higher than that of the N group. And the TP group was significantly decreased than that of the TN group. While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation; the TP and TF groups showed trophic symptoms and were lined by flattened epithelial cells, thus, the stromal proliferation is relatively low as compared to the TN group. These suggest that Phellinus linteus water extracts may be an useful remedy for treating the benign prostatic hyperplasia. PMID:23766877

  20. Stromal androgen receptor roles in the development of normal prostate, benign prostate hyperplasia, and prostate cancer.

    PubMed

    Wen, Simeng; Chang, Hong-Chiang; Tian, Jing; Shang, Zhiqun; Niu, Yuanjie; Chang, Chawnshang

    2015-02-01

    The prostate is an androgen-sensitive organ that needs proper androgen/androgen receptor (AR) signals for normal development. The progression of prostate diseases, including benign prostate hyperplasia (BPH) and prostate cancer (PCa), also needs proper androgen/AR signals. Tissue recombination studies report that stromal, but not epithelial, AR plays more critical roles via the mesenchymal-epithelial interactions to influence the early process of prostate development. However, in BPH and PCa, much more attention has been focused on epithelial AR roles. However, accumulating evidence indicates that stromal AR is also irreplaceable and plays critical roles in prostate disease progression. Herein, we summarize the roles of stromal AR in the development of normal prostate, BPH, and PCa, with evidence from the recent results of in vitro cell line studies, tissue recombination experiments, and AR knockout animal models. Current evidence suggests that stromal AR may play positive roles to promote BPH and PCa progression, and targeting stromal AR selectively with AR degradation enhancer, ASC-J9, may allow development of better therapies with fewer adverse effects to battle BPH and PCa. PMID:25432062

  1. Stromal Androgen Receptor Roles in the Development of Normal Prostate, Benign Prostate Hyperplasia, and Prostate Cancer

    PubMed Central

    Wen, Simeng; Chang, Hong-Chiang; Tian, Jing; Shang, Zhiqun; Niu, Yuanjie; Chang, Chawnshang

    2016-01-01

    The prostate is an androgen-sensitive organ that needs proper androgen/androgen receptor (AR) signals for normal development. The progression of prostate diseases, including benign prostate hyperplasia (BPH) and prostate cancer (PCa), also needs proper androgen/AR signals. Tissue recombination studies report that stromal, but not epithelial, AR plays more critical roles via the mesenchymal-epithelial interactions to influence the early process of prostate development. However, in BPH and PCa, much more attention has been focused on epithelial AR roles. However, accumulating evidence indicates that stromal AR is also irreplaceable and plays critical roles in prostate disease progression. Herein, we summarize the roles of stromal AR in the development of normal prostate, BPH, and PCa, with evidence from the recent results of in vitro cell line studies, tissue recombination experiments, and AR knockout animal models. Current evidence suggests that stromal AR may play positive roles to promote BPH and PCa progression, and targeting stromal AR selectively with AR degradation enhancer, ASC-J9, may allow development of better therapies with fewer adverse effects to battle BPH and PCa. PMID:25432062

  2. Current Laser Treatments for Benign Prostatic Hyperplasia

    PubMed Central

    Son, Hwancheol; Song, Sang Hoon

    2010-01-01

    The latest technical improvements in the surgical armamentarium are remarkable. In particular, advancements in the urologic field are so exceptional that we could observe the flare-up of robot-assisted laparoscopic radical prostatectomy for prostate cancer and laser prostatectomy for benign prostatic hyperplasia (BPH). Photoselective vaporization of the prostate (PVP) and holmium laser prostatectomy are the most generalized options for laser surgery of BPH, and both modalities have shown good postoperative results. In comparison to transurethral prostatectomy (TURP), they showed similar efficacy and a much lower complication rate in randomized prospective clinical trials. Even in cases of large prostates, laser prostatectomy showed comparable efficacy and safety profiles compared to open prostatectomy. From a technical point of view, PVP is considered to be an easier technique for the urologist to master. Furthermore, patients can be safely followed up in an outpatient clinic. Holmium laser enucleation of the prostate (HoLEP) mimics open prostatectomy because the adenomatous tissue is peeled off the surgical capsule in both procedures. Therefore, HoLEP shows notable volume reduction of the prostate similar to open prostatectomy with fewer blood transfusions, shorter hospital stay, and cost reduction regardless of prostate size. Outcomes of laser prostatectomy for BPH are encouraging but sometimes are unbalanced because safety and feasibility studies were reported mainly for PVP, whereas long-term data are mostly available for HoLEP. We need longer-term randomized clinical data to identify the reoperation rate of PVP and to determine which procedure is the ideal alternative to TURP and open prostatectomy for each patient. PMID:21165192

  3. Various treatment options for benign prostatic hyperplasia: A current update

    PubMed Central

    Shrivastava, Alankar; Gupta, Vipin B.

    2012-01-01

    In benign prostatic hyperplasia (BPH) there will be a sudden impact on overall quality of life of patient. This disease occurs normally at the age of 40 or above and also is associated with sexual dysfunction. Thus, there is a need of update on current medications of this disease. The presented review provides information on medications available for BPH. Phytotherapies with some improvements in BPH are also included. Relevant articles were identified through a search of the English-language literature indexed on MEDLINE, PUBMED, Sciencedirect and the proceedings of scientific meetings. The search terms were BPH, medications for BPH, drugs for BPH, combination therapies for BPH, Phytotherapies for BPH, Ayurveda and BPH, BPH treatments in Ayurveda. Medications including watchful waitings, Alpha one adrenoreceptor blockers, 5-alpha reductase inhibitors, combination therapies including tamsulosin-dutasteride, doxazosin-finasteride, terazosin-finasteride, tolterodine-tamsulosin and rofecoxib-finasteride were found. Herbal remedies such as Cernilton, Saxifraga stolonifera, Zi-Shen Pill (ZSP), Orbignya speciosa, Phellodendron amurense, Ganoderma lucidum, Serenoa Repens, pumpkin extract and Lepidium meyenii (Red Maca) have some improvements on BPH are included. Other than these discussions on Ayurvedic medications, TURP and minimally invasive therapies (MITs) are also included. Recent advancements in terms of newly synthesized molecules are also discussed. Specific alpha one adrenoreceptor blockers such as tamsulosin and alfuzosin will remain preferred choice of urologists for symptom relief. Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery. Due to lack of proper evidence Phytotherapies are not gaining much advantage. MITs and TURP are expensive and are rarely supported by healthcare systems. PMID:22923974

  4. Various treatment options for benign prostatic hyperplasia: A current update.

    PubMed

    Shrivastava, Alankar; Gupta, Vipin B

    2012-01-01

    In benign prostatic hyperplasia (BPH) there will be a sudden impact on overall quality of life of patient. This disease occurs normally at the age of 40 or above and also is associated with sexual dysfunction. Thus, there is a need of update on current medications of this disease. The presented review provides information on medications available for BPH. Phytotherapies with some improvements in BPH are also included. Relevant articles were identified through a search of the English-language literature indexed on MEDLINE, PUBMED, Sciencedirect and the proceedings of scientific meetings. The search terms were BPH, medications for BPH, drugs for BPH, combination therapies for BPH, Phytotherapies for BPH, Ayurveda and BPH, BPH treatments in Ayurveda. Medications including watchful waitings, Alpha one adrenoreceptor blockers, 5-alpha reductase inhibitors, combination therapies including tamsulosin-dutasteride, doxazosin-finasteride, terazosin-finasteride, tolterodine-tamsulosin and rofecoxib-finasteride were found. Herbal remedies such as Cernilton, Saxifraga stolonifera, Zi-Shen Pill (ZSP), Orbignya speciosa, Phellodendron amurense, Ganoderma lucidum, Serenoa Repens, pumpkin extract and Lepidium meyenii (Red Maca) have some improvements on BPH are included. Other than these discussions on Ayurvedic medications, TURP and minimally invasive therapies (MITs) are also included. Recent advancements in terms of newly synthesized molecules are also discussed. Specific alpha one adrenoreceptor blockers such as tamsulosin and alfuzosin will remain preferred choice of urologists for symptom relief. Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery. Due to lack of proper evidence Phytotherapies are not gaining much advantage. MITs and TURP are expensive and are rarely supported by healthcare systems. PMID:22923974

  5. Computed Tomography of the Prostate Gland in Healthy Intact Dogs and Dogs with Benign Prostatic Hyperplasia.

    PubMed

    Pasikowska, J; Hebel, M; Niżański, W; Nowak, M

    2015-10-01

    To date, there is only scarce data on the evaluation of the prostate gland in dogs using computed tomography (CT). The aims of our study were to describe CT features of BPH in dogs and to determine the size of the prostate gland in healthy male dogs and dogs with benign prostatic hyperplasia (BPH) through CT. Additionally, we aimed to compare and establish the most useful parameters for CT measurements of the prostate in patients with BPH. The study population consisted of 20 healthy intact male dogs and 20 male intact dogs with confirmed BPH. Pre- and post-contrast CT studies were evaluated. The most common CT features in dogs with recognized BPH were symmetrical prostatomegaly and heterogeneity of the prostatic parenchyma. The mean prostatic density (D) was 56HU (±4.39) in pre-contrast CT images and 84HU (±8) in post-contrast images in dogs with BPH. The mean prostatic length (L) was 43.87 mm (±11), the mean width (W) amounted to 48.95 mm (±8.76) and the mean height (H) reached 44.9 mm (±9.48) in clinically affected patients. The mean ratios were: rL - 2,12 (±0.5); rW - 2.39 (±0.53) and rH - 2.16 (±0.39) in the BPH group. The prostate should be considered to be enlarged when rL exceeds 3.05; rW exceeds 3.38 and rH exceeds 2.94. Our findings indicated that CT is a useful tool in diagnosing prostate disorders, including BPH. The heterogeneity, density and ratios of prostatic length, width and height can be useful parameters in the diagnosis of BPH. PMID:26303126

  6. Androgen receptor and immune inflammation in benign prostatic hyperplasia and prostate cancer

    PubMed Central

    Izumi, Kouji; Li, Lei; Chang, Chawnshang

    2014-01-01

    Both benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are frequent diseases in middle-aged to elderly men worldwide. While both diseases are linked to abnormal growth of the prostate, the epidemiological and pathological features of these two prostate diseases are different. BPH nodules typically arise from the transitional zone, and, in contrast, PCa arises from the peripheral zone. Androgen deprivation therapy alone may not be sufficient to cure these two prostatic diseases due to its undesirable side effects. The alteration of androgen receptor-mediated inflammatory signals from infiltrating immune cells and prostate stromal/epithelial cells may play key roles in those unwanted events. Herein, this review will focus on the roles of androgen/androgen receptor signals in the inflammation-induced progression of BPH and PCa. PMID:26594314

  7. [Treatment of benign prostatic hyperplasia with tamsulosin].

    PubMed

    Kumanov, H; Mladenov, D; Nikolov, S; Penkov, R; Stratev, S; Kotzev, R; Petkova, L; Ganev, T; Uzunov, A; Uzunov, N

    1998-01-01

    The past few decades mark a rejuvenation of the contingent of benign prostate hyperplasia (BPH) patients. The condition affects mainly the active age in men, with the substantial financial burden of treatment leading to a surge of interest in the disease. The hazards of postoperative complications development constrain modern urologists to seek for new, safer and more effective methods of conservative management. The task undertaken is to assay the effect of application and possible side phenomena of Tamsulosin treatment in BPH patients, administered at dose 0.4 mg a single time on a daily basis over 12 to 24 weeks. A nationwide multicenter, parallel, randomized study is conducted in seven urological clinical units throughout the country, covering a one year period. For the purpose a total of 310 men, aged 52 to 68 years, presenting moderately expressed BPH symptomatology are investigated. IPSS improvement is documented in 229 patients (74%), and a significant MUD improvement is observed in 115 patients (37%), with the residual urine quantity decreasing significantly in 108 patients (35%). In conclusion, it is believed that Tamsulosin administration as a superselective alpha-1-A adrenoblocker is one of major achievements in the conservative therapeutic approach to prostate adenoma. PMID:11247067

  8. Relationship of neuroendocrine cells of prostate and serotonin to benign prostatic hyperplasia.

    PubMed

    Cockett, A T; di Sant'Agnese, P A; Gopinath, P; Schoen, S R; Abrahamsson, P A

    1993-11-01

    Neuroendocrine (NE) cells containing neurosecretory granules, rich in various peptide hormones and biogenic amines such as serotonin (5-HT), are components of the human prostate epithelium. The NE cells probably subserve a paracrine or local regulatory role in both prostatic growth and differentiation as well as the exocrine secretory process. Neuroendocrine cells may be involved in the etiology of benign prostatic hyperplasia (BPH). In this study the number of NE cells in areas of BPH was compared with normal tissue using 5-HT immunocytochemistry. In addition, using high-performance liquid chromatography with electrochemical detection (HPLC-ECD), tissue levels of 5-HT and its metabolite 5-hydroxy-indoleacetic acid (5-HIAA) were analyzed in prostatic tissue extracts including 25 cases of BPH and 16 cases of normal tissue verified by adjacent histologic sections. Compared with normal prostate our results demonstrated a marked decrease in 5-HT immunoreactive NE cells in the vast majority of larger hyperplastic nodules of BPH. These findings were corroborated by quantitative analysis where a significant reduction in the tissue 5-HT levels in BPH (0.539 +/- 0.09 SE) compared with normal (1.75 +/- 0.22 SE) (p < 0.05) was found. When smaller nodules of BPH were studied, abundant NE cells, equal or increased in number compared with those in adjacent normal prostatic tissue, were seen. The small apparently developing BPH nodules and ductal-like structures contained NE cells which may be growth foci near the periphery of some hyperplastic nodules. These findings particularly in small hyperplastic nodules suggest that NE cells and their products involved in controlling cell proliferation through a paracrine hormonal mechanism and may be involved in the pathogenesis of BPH. Serotonin (5-HT) and NE peptides may represent that elusive local "missing link" often alluded to in various theories relating to the development of early nodular hyperplasia in BPH. PMID:7694415

  9. SPINK1 Promoter Variants Are Associated with Prostate Cancer Predisposing Alterations in Benign Prostatic Hyperplasia Patients

    PubMed Central

    WINCHESTER, DANYELLE; RICKS-SANTI, LUISEL; MASON, TSHELA; ABBAS, MUNEER; COPELAND, ROBERT L.; BEYENE, DESTA; JINGWI, EMMANUEL Y.; DUNSTON, GEORGIA M.; KANAAN, YASMINE M.

    2015-01-01

    Background/Aim Several studies reported that patients with benign prostatic hyperplasia (BPH) experienced a 10% increased incidence of prostate cancer (PCa) after the first 5 years of diagnosis. We investigated the association between single nucleotide polymorphisms (SNPs) in the promoter of Serine Protease Inhibitor Kazal Type 1 (SPINK1) and the increased risk of BPH and PCa. Materials and Methods We genotyped three SNPs in a cases-control study, including BPH and PCa cases. Multiple logistic regression models were applied to analyze clinical and genotypic data. Results We found an inverse association between SNP rs10035432 and BPH under the log-additive (p=0.007) model. No association was found between these SNPs and PCa risk. However, we observed a possible association between rs1432982 and lower-grade PCa (p=0.05) under the recessive model. Conclusion SPINK1 promoter variants are likely to be associated with the risk of BPH. PMID:26124326

  10. How is BPH Treated? (Benign Prostatic Hyperplasia)

    MedlinePlus

    ... Urology? The Urinary Tract System Free Patient Education Materials We provide free patient education materials on urologic ... Health Care Providers Browse Through Our Free Educational Materials We provide free patient education materials on many ...

  11. Prostate Diseases

    MedlinePlus

    ... Types of Prostate Diseases Benign prostatic hyperplasia (BPH) Prostatitis Prostate cancer For men over the age of ... treatment. For men under the age of 50, prostatitis (inflammation of the prostate) is the most common ...

  12. Anoctamin 1 (TMEM16A) is essential for testosterone-induced prostate hyperplasia

    PubMed Central

    Cha, Joo Young; Wee, Jungwon; Jung, Jooyoung; Jang, Yongwoo; Lee, Byeongjun; Hong, Gyu-Sang; Chang, Beom Chul; Choi, Yoon-La; Shin, Young Kee; Min, Hye-Young; Lee, Ho-Young; Na, Tae-Young; Lee, Mi-Ock; Oh, Uhtaek

    2015-01-01

    Benign prostatic hyperplasia (BPH) is characterized by an enlargement of the prostate, causing lower urinary tract symptoms in elderly men worldwide. However, the molecular mechanism underlying the pathogenesis of BPH is unclear. Anoctamin1 (ANO1) encodes a Ca2+-activated chloride channel (CaCC) that mediates various physiological functions. Here, we demonstrate that it is essential for testosterone-induced BPH. ANO1 was highly amplified in dihydrotestosterone (DHT)-treated prostate epithelial cells, whereas the selective knockdown of ANO1 inhibited DHT-induced cell proliferation. Three androgen-response elements were found in the ANO1 promoter region, which is relevant for the DHT-dependent induction of ANO1. Administration of the ANO1 blocker or Ano1 small interfering RNA, inhibited prostate enlargement and reduced histological abnormalities in vivo. We therefore concluded that ANO1 is essential for the development of prostate hyperplasia and is a potential target for the treatment of BPH. PMID:26153424

  13. Anoctamin 1 (TMEM16A) is essential for testosterone-induced prostate hyperplasia.

    PubMed

    Cha, Joo Young; Wee, Jungwon; Jung, Jooyoung; Jang, Yongwoo; Lee, Byeongjun; Hong, Gyu-Sang; Chang, Beom Chul; Choi, Yoon-La; Shin, Young Kee; Min, Hye-Young; Lee, Ho-Young; Na, Tae-Young; Lee, Mi-Ock; Oh, Uhtaek

    2015-08-01

    Benign prostatic hyperplasia (BPH) is characterized by an enlargement of the prostate, causing lower urinary tract symptoms in elderly men worldwide. However, the molecular mechanism underlying the pathogenesis of BPH is unclear. Anoctamin1 (ANO1) encodes a Ca(2+)-activated chloride channel (CaCC) that mediates various physiological functions. Here, we demonstrate that it is essential for testosterone-induced BPH. ANO1 was highly amplified in dihydrotestosterone (DHT)-treated prostate epithelial cells, whereas the selective knockdown of ANO1 inhibited DHT-induced cell proliferation. Three androgen-response elements were found in the ANO1 promoter region, which is relevant for the DHT-dependent induction of ANO1. Administration of the ANO1 blocker or Ano1 small interfering RNA, inhibited prostate enlargement and reduced histological abnormalities in vivo. We therefore concluded that ANO1 is essential for the development of prostate hyperplasia and is a potential target for the treatment of BPH. PMID:26153424

  14. Benign prostatic hyperplasia: An overview of existing treatment

    PubMed Central

    Dhingra, Neelima; Bhagwat, Deepak

    2011-01-01

    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. 5α-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. α1-adrenergic receptor (α1-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 5α-reductase inhibitor or α1-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

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

    PubMed Central

    Nicholson, Tristan M.; Ricke, William A.

    2011-01-01

    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 5α-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-17β. 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

  16. Korean clinical practice guideline for benign prostatic hyperplasia

    PubMed Central

    Yeo, Jeong Kyun; Choi, Hun; Bae, Jae Hyun; Kim, Jae Heon; Yang, Seong Ok; Oh, Chul Young; Cho, Young Sam; Kim, Kyoung Woo

    2016-01-01

    In 2014, the Korean Urological Association organized the Benign Prostatic Hyperplasia Guideline Developing Committee composed of experts in the field of benign prostatic hyperplasia (BPH) with the participation of the Korean Academy of Family Medicine and the Korean Continence Society to develop a Korean clinical practice guideline for BPH. The purpose of this clinical practice guideline is to provide current and comprehensive recommendations for the evaluation and treatment of BPH. The committee developed the guideline mainly by adapting existing guidelines and partially by using the de novo method. A comprehensive literature review was carried out primarily from 2009 to 2013 by using medical search engines including data from Korea. Based on the published evidence, recommendations were synthesized, and the level of evidence of the recommendations was determined by using methods adapted from the 2011 Oxford Centre for Evidence-Based Medicine. Meta-analysis was done for one key question and four recommendations. A draft guideline was reviewed by expert peer reviewers and discussed at an expert consensus meeting until final agreement was achieved. This evidence-based guideline for BPH provides recommendations to primary practitioners and urologists for the diagnosis and treatment of BPH in men older than 40 years. PMID:26966724

  17. Korean clinical practice guideline for benign prostatic hyperplasia.

    PubMed

    Yeo, Jeong Kyun; Choi, Hun; Bae, Jae Hyun; Kim, Jae Heon; Yang, Seong Ok; Oh, Chul Young; Cho, Young Sam; Kim, Kyoung Woo; Kim, Hyung Ji

    2016-01-01

    In 2014, the Korean Urological Association organized the Benign Prostatic Hyperplasia Guideline Developing Committee composed of experts in the field of benign prostatic hyperplasia (BPH) with the participation of the Korean Academy of Family Medicine and the Korean Continence Society to develop a Korean clinical practice guideline for BPH. The purpose of this clinical practice guideline is to provide current and comprehensive recommendations for the evaluation and treatment of BPH. The committee developed the guideline mainly by adapting existing guidelines and partially by using the de novo method. A comprehensive literature review was carried out primarily from 2009 to 2013 by using medical search engines including data from Korea. Based on the published evidence, recommendations were synthesized, and the level of evidence of the recommendations was determined by using methods adapted from the 2011 Oxford Centre for Evidence-Based Medicine. Meta-analysis was done for one key question and four recommendations. A draft guideline was reviewed by expert peer reviewers and discussed at an expert consensus meeting until final agreement was achieved. This evidence-based guideline for BPH provides recommendations to primary practitioners and urologists for the diagnosis and treatment of BPH in men older than 40 years. PMID:26966724

  18. Prostate Artery Embolization as a New Treatment for Benign Prostate Hyperplasia: Contemporary Status in 2016.

    PubMed

    Noor, Amir; Fischman, Aaron M

    2016-07-01

    The gold standard treatment for benign prostate hyperplasia (BPH) is transurethral resection of the prostate (TURP) or open prostatectomy (OP). Recently, there has been increased interest and research in less invasive alternative treatments with less morbidity including prostate artery embolization (PAE). Several studies have shown PAE to be an effective alternative to TURP to treat lower urinary tract symptoms (LUTS) associated with BPH with decreased morbidity. Specifically, PAE has been advantageous in selected patient populations such as those with prostates too large for TURP or unsuitable surgical candidates, showing a promising potential for the future care of patients with BPH. Further studies are being done to demonstrate the clinical applications and advantages of this therapy in reduction of LUTS. PMID:27146488

  19. [Pharmacological treatment of benign prostatic hyperplasia].

    PubMed

    Oelke, M; Martinelli, E

    2016-01-01

    The pharmacological treatment of benign prostatic hyperplasia (BPH) is indicated when men suffer from lower urinary tract symptoms (LUTS) but there are no absolute indications for prostate surgery or severe bladder outlet obstruction. Phytotherapy can be used in men with mild to moderate LUTS and alpha-blockers can quickly and effectively decrease the LUTS and symptomatic disease progression. Phosphodiesterase type 5 inhibitors (PDE5-I) are an alternative to alpha-blockers when men experience bothersome side effects from alpha-blockers or erectile dysfunction. If patients predominantly have bladder storage symptoms and a small prostate, muscarinic receptor antagonists are a viable treatment option. The combination of alpha-blocker plus muscarinic receptor antagonist is more efficacious in reducing LUTS than the single drugs alone. The 5 alpha-reductase inhibitors (5ARI) can significantly decrease LUTS and disease progression (e.g. acute urinary retention and need for prostate surgery) in men with larger prostates (> 30-40 ml). The combination of 5ARI plus alpha-blocker can reduce LUTS and disease progression more effectively than drug monotherapy. Combination therapy with PDE5-I (tadalafil) plus 5ARI (finasteride) reduces LUTS more substantially than 5ARI alone and, additionally, PDE5-Is reduce the sexual side effects during 5ARI treatment. PMID:26676726

  20. A phytosterol enriched refined extract of Brassica campestris L. pollen significantly improves benign prostatic hyperplasia (BPH) in a rat model as compared to the classical TCM pollen preparation Qianlie Kang Pule'an Tablets.

    PubMed

    Wang, Ruwei; Kobayashi, Yuta; Lin, Yu; Rauwald, Hans Wilhelm; Fang, Ling; Qiao, Hongxiang; Kuchta, Kenny

    2015-01-15

    In Qinghai Province, the Brassica campestris L. pollen preparation Qianlie Kang Pule'an Tablet (QKPT) is traditionally used for BPH therapy. However, in QKPT the content of supposedly active phytosterols is relatively low at 2.59%, necessitating high doses for successful therapy. Therefore, a phytosterol enriched (4.54%) refined extract of B. campestris pollen (PE) was developed and compared with QKPT in a BPH rat model. Six groups of rats (n=8 each), namely sham-operated distilled water control, castrated distilled water control, castrated QKPT 2.0g/kg, castrated PE 0.1g/kg, castrated PE 0.2g/kg, and castrated PE 0.4g/kg, were intragastrically treated with the respective daily doses. Testosterone propionate (0.3mg/day) was administered to all castrated rats, while the sham-operated group received placebo injections. After 30 days, the animals were sacrificed and prostates as well as seminal vesicles excised and weighted in order to calculate prostate volume index (PVI) as well as prostate index (PI) and seminal vesicle index (SVI), defined as organ weight in g per 100g body weight. Compared with sham-operated controls, PI (p<0.01), PVI (p<0.01), and SVI (p<0.01) were all significantly increased in all castrated, testosterone treated rats. After treatment with PE at 0.4 and 0.2g/kg or QKPT at 2.0g/kg per day, both indices were significantly reduced (p<0.01) as compared to the castrated distilled water control. For PE at 0.1g/kg per day only PI was significantly reduced (p<0.05). At the highest PE concentration of 0.4g/kg per day both PI and SVI were also significantly reduced when compared to the QKPT group (p<0.05). Both PE and QKPT demonstrated curative effects against BPH in the applied animal model. In its highest dose at 0.4g/kg per day, PE was clearly superior to QKPT. PMID:25636883

  1. Beta-catenin is elevated in human benign prostatic hyperplasia specimens compared to histologically normal prostate tissue

    PubMed Central

    Bauman, Tyler M; Vezina, Chad M; Huang, Wei; Marker, Paul C; Peterson, Richard E; Ricke, William A

    2014-01-01

    Benign prostatic hyperplasia (BPH) is linked to lower urinary tract symptoms (LUTS) such as incomplete bladder emptying, urinary frequency and urgency. Mechanisms responsible for BPH are not fully known. Here, we tested whether beta-catenin (CTNNB1) immunostaining intensity and distribution differ in human glandular BPH tissue specimens compared to normal prostate tissue. Multiplex immunostaining of CTNNB1, its putative transcriptional target gene lymphoid enhancer binding factor 1 (LEF1), and the epithelial marker E-cadherin were examined in clinical human prostate specimens with or without histological BPH (pure epithelial or mixed stromal-epithelial nodules). BPH specimens were obtained from 24 men who experienced LUTS and underwent transurethral resection of the prostate surgery. Control specimens were tumor-adjacent histologically normal prostate tissue from 48 patients who underwent radical prostatectomy. The resulting multispectral images were unmixed and optical densities recorded to quantify staining abundance, cellular (membranous, cytoplasmic, and nuclear) and tissue localization (stromal versus epithelial), and determination of percentage of CTNNB1-positive cells. The following CTNNB1 indices were significantly higher in BPH compared to normal prostate tissue: overall staining intensity, staining intensity in prostate stromal cell membranes, cytoplasm and nuclei, and prostate epithelial cell nuclei. The following LEF1 indices were significantly lower in BPH compared to tumor-adjacent normal prostate tissue: stromal LEF1 staining intensity, percentage of LEF1-positive stromal cells, and intensity of LEF1 staining in stromal cell membranes, cytoplasm, and nuclei. The percentage of stromal cells with CTNNB1+/LEF1- nuclei was higher and percentage of stromal cells with CTNNB1-/LEF1+ nuclei was lower in BPH compared to tumor-adjacent normal prostate tissues. These results support the hypothesis that CTNNB1 expression increases in specific BPH tissue compartments. Further, since nuclear LEF1 staining does not coincide with cytoplasmic or nuclear CTNNB1 staining, it does not appear to be a reliable index of CTNNB1 activity in adult human prostate. PMID:25606577

  2. Urinary microbiota in patients with prostate cancer and benign prostatic hyperplasia

    PubMed Central

    Yu, Haining; Meng, Hongzhou; Zhou, Feng; Ni, Xiaofeng

    2015-01-01

    Introduction Inflammation is associated with promotion of the initiation of various malignancies, partly due to bacterial infection-induced microenvironmental changes. However, the exact association between microbiota in urine, seminal fluid and the expressed prostatic secretions and benign prostatic hypertrophy and prostate cancer is not clear. Material and methods In the present study, we investigated the type of microbiota in the expressed prostatic secretions (EPS) of patients with prostate cancer and benign prostatic hyperplasia (BPH) by the polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) method using universal bacterial primers. In order to understand the possible association between various bacteria and prostate cancer, quantitative real-time PCR assay was performed to quantify the amount of strains of bacteria in urine, EPS and seminal fluid. Results The prostate cancer group had a significantly increased number of Bacteroidetes bacteria, Alphaproteobacteria, Firmicutes bacteria, Lachnospiraceae, Propionicimonas, Sphingomonas, and Ochrobactrum, and a decrease in Eubacterium and Defluviicoccus compared to the BPH group. The number of Escherichia coli in the prostate cancer group was significantly decreased in urine and increased in the EPS and seminal fluid, while the number of Enterococcus was significantly increased in the seminal fluid with little change in urine and EPS. Conclusions Based on these results, we suggest that there are significant changes in the microbial population in EPS, urine and seminal fluid of subjects with prostate cancer and BPH, indicating a possible role for these bacteria in these two conditions. PMID:25995756

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

    PubMed Central

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

    2013-01-01

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

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

    SciTech Connect

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

    1982-02-01

    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.

  5. Benign prostatic hyperplasia - progress in pathophysiology and management.

    PubMed

    Dobrek, Łukasz; Thor, Piotr Jan

    2015-11-01

    Benign prostatic hyperplasia (BPH) is a common disease of the aging male population, in affected individuals often accompanied by metabolic syndrome. BPH is manifested by a complex range of symptoms originating from the lower urinary tract (LUTS - lower urinary tract symptoms), including disturbances resulting from impaired bladder compliance and bladder overactivity (e.g. frequency, nocturia, urinary incontinence, dysuria) and symptoms associated with the bladder outlet obstruction (e.g. the difficulty in voiding initiating, intermittency, involuntary interruption of voiding, weak urinary stream, straining to void). Despite numerous studies, the pathogenesis of BPH remains not completely understood, and the condition awaits a comprehensive description. The current pathophysiological view emphasizes the role of hormonal dysregulation, locally released in the prostate growth factors action and a complex inflammatory, BPH-associated process with the release of a number of pro-proliferative mediators. The current BPH pharmacotherapy involves administration of α-1-blockers, 5-α-reductase inhibitors, antimuscarinic drugs (cholinolytics) and phosphodiesterase- 5-inhibitors. Progress in the BPH pathophysiology allows the disclosure of additional, potential targets of pharmacological intervention, such as β-3 adrenoreceptor or CB1 cannabinoid receptor agonists, P2X1 purinergic or ETA endothelin receptors antagonists, RhoA/Rho kinase system inhibitors, nitric oxide donors, drugs indirectly (luteinizing hormone - releasing hormone antagonists) or directly (antiandrogens) abolishing the effect of testosterone and its derivatives or agents blocking the action of proinflammatory cytokines. The article briefly discusses the pathophysiology of the aforementioned issues and the current BPH management along with the future, potential opportunities for pharmacotherapy of the. PMID:26637089

  6. Antiproliferative and Antioxidant Effects of Withania coagulans Extract on Benign Prostatic Hyperplasia in Rats

    PubMed Central

    Sarbishegi, Maryam; Khani, Mohaddeseh; Salimi, Saeedeh; Valizadeh, Mohharam; Sargolzaei Aval, Fereydoon

    2016-01-01

    Background: Benign prostate hyperplasia (BPH) is a common urological disorder in elderly men. Phytotherapy is frequently used to alleviate the symptoms of this condition. Objectives: The present study investigated the effect of Withania coagulans extract (WCE), which is known to have antioxidant, anti-inflammatory, antihyperglycemic, and anti-cancer properties, on testosterone-induced BPH in rats. Materials and Methods: Forty Wistar rats were divided into five groups (each n = 8): the control group, the untreated BPH group, and three WCE-treated groups (WCE250, 500, and 1000). BPH was induced with 3 mg/kg subcutaneous injections of testosterone propionate for four weeks. WCE was concomitantly administrated by oral gavage. At the end of the induction schedule, the animals were sacrificed and their prostate glands were dissected, weighed, and fixed for histological examination (H&E and proliferating cell nuclear antigen [PCNA] staining). Half of each sample was prepared for measurement of malondialdehyde (MDA) and total antioxidant capacity (TAC) levels in the prostate. Results: The present study revealed that BPH caused elevation of MDA levels, suppression of TAC levels, and increased PCNA expression in the prostate gland. Interestingly, in a dose-dependent manner, WCE caused decreased MDA levels and increased TAC levels in the prostate gland, compared to the untreated BPH group. Histopathological examinations showed a reduction in PCNA expression in the prostate epithelium of the WCE animals. Conclusions: W. coagulans inhibits the development of BPH can be useful for the treatment of this condition. PMID:26981498

  7. Anti-proliferation effects of Cistanches salsa on the progression of benign prostatic hyperplasia.

    PubMed

    Jeon, Hyo-Jin An; Chung, Kyung-Sook; An, Hyo-Jin

    2016-01-01

    Cistanche salsa has been used in traditional medicine for the treatment of kidney deficiency, neurasthenia, sexual dysfunction diseases, and benign prostatic hyperplasia (BPH). The aim of this study was to investigate the mechanism by which C. salsa extract (CSE) elicits an anti-proliferative effect on the prostate tissue of BPH-induced rats. The effects of CSE on BPH were evaluated in terms of prostate weight, production of serum dihydrotestosterone (DHT), and the mRNA expression of 5α-reductase type 1 and type 2 in the prostate tissue of BPH-induced rats. In addition, hematoxylin and eosin (H&E) staining was performed for histological examination of prostate gland morphology, and protein expression levels in prostate tissue were investigated by western blot analysis. CSE treatment decreased prostate weight, serum DHT concentration, and the mRNA expression of 5α-reductase type 1 and type 2 in prostate tissue of BPH-induced rats. In addition, CSE treatment suppressed cell proliferation by regulating the expression levels of inflammatory-related proteins (inducible nitric oxide synthase and cyclooxygenase 2) and apoptosis-associated proteins (caspase-3 and Bcl-2 family proteins). CSE may be a potential therapeutic candidate for BPH owing to its ability to regulate the expression of inflammatory and apoptosis-related proteins. PMID:27123496

  8. Biased α-adrenergic receptor and βarrestin signaling in a cell culture model of benign prostatic hyperplasia.

    PubMed

    Wang, Mindy; Daaka, Yehia; Dey, Anindya

    2016-02-26

    Benign prostatic hyperplasia (BPH) is a common disease in older men that involves the enlargement of the prostate gland. This occurs in response to signal transduction initiated by α-adrenergic receptors (α-ARs). When bound to ligands, α-ARs stimulate the mitogenic extracellular signal-regulated kinases 1 and 2 (ERK) pathway, ultimately promoting stromal and epithelial cell hyperplasia in the prostate. Current knowledge of how α-ARs promote prostate cell growth remains incomplete, and despite decades of research, there is no cure for BPH. In this study, we aimed to exploit an in vitro model system of BPH in order to better understand the mechanisms of α-AR signaling in prostatic hyperplasia. PMID:26850854

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

    SciTech Connect

    Carnevale, Francisco C.; Antunes, Alberto A.

    2013-12-15

    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.

  10. PPARγ: A Molecular Link between systemic metabolic disease and benign prostate hyperplasia

    PubMed Central

    Jiang, Ming; Strand, Douglas W.; Franco, Omar E.; Clark, Peter E.; Hayward, Simon W.

    2011-01-01

    The emergent epidemic of metabolic syndrome and its complex list of sequelae mandate a more thorough understanding of benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) in the context of systemic metabolic disease. Here we discuss the nature and origins of BPH, examine its role as a component of LUTS and review retrospective clinical studies that have drawn associations between BPH/LUTS and type II diabetes, inflammation and dyslipidemia. PPARγ signaling, which sits at the nexus of systemic metabolic disease and BPH/LUTS through its regulation of inflammation and insulin resistance is proposed as a candidate for molecular manipulation in regard to BPH/LUTS. Finally, we introduce new cell and animal models that are being used to study the consequences of obesity, diabetes and inflammation on benign prostatic growth. PMID:21645960

  11. Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction.

    PubMed

    Patel, Nishant D; Parsons, J Kellogg

    2014-04-01

    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

  12. Measurement of benign prostatic hyperplasia treatment effects on male sexual function

    PubMed Central

    Skolarus, TA; Wei, JT

    2010-01-01

    Benign prostatic hyperplasia (BPH) is the leading cause of lower urinary tract symptoms among the aging male population. Epidemiological, pathophysiological and clinical studies indicate that many of these men also suffer from declining sexual function, especially those undergoing treatment for their BPH-related urinary symptoms. Although urinary symptoms and quality of life may improve with BPH therapy, the resulting effects on sexual function vary by medical, surgical and minimally invasive approaches and have not been consistently reported. As comprehensive, validated instruments to measure male sexual function are now available for routine use in the clinical setting, urologists and primary care providers caring for patients with BPH have the opportunity to monitor both urinary and sexual function before, during and after BPH therapy. Herein, we describe the relationship between BPH and its treatments on male sexual function, the role of new measures for sexual functioning and opportunities for future work to improve the care of men suffering from both maladies. PMID:19536125

  13. Laser Treatment of Benign Prostatic Hyperplasia: Dosimetric and Thermodynamic Considerations

    NASA Astrophysics Data System (ADS)

    Anvari, Bahman

    1993-01-01

    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.

  14. Personalized Medicine for Management of Benign Prostatic Hyperplasia

    PubMed Central

    Bechis, Seth K.; Otsetov, Alexander G.; Ge, Rongbin; Olumi, Aria F.

    2014-01-01

    Purpose Benign prostatic hyperplasia (BPH) affects over 50 percent of men by age 60 and is the cause of millions of dollars of healthcare expenditure for treatment of lower urinary tract symptoms (LUTS) and urinary obstruction. Despite the widespread use of medical therapy, there is no universal therapy that treats all men with symptomatic BPH, and at least 30% of patients do not respond to medical management and a subset require surgery. Significant advances have been made in understanding the natural history and development of the prostate, such as elucidating the role of the enzyme 5α reductase Type 2 (5AR2), and advances in genomics and biomarker discovery offer the potential for a more targeted approach to therapy. We review the current understanding of BPH progression as well as key genes and signaling pathways implicated in the process such as 5α reductase. We also explore the potential of biomarker screening and gene-specific therapies as tools to risk stratify BPH patients and identify those with symptomatic or medically resistant forms. Materials and Methods A PubMed® literature search of current and past peer-reviewed literature on prostate development, lower urinary tract symptoms, BPH pathogenesis, targeted therapy, biomarkers, epigenetics, 5AR2 and personalized medicine was performed. An additional Google Scholar™ search was conducted to broaden the scope of the review. Relevant reviews and original research articles were examined as well as their cited references, and a synopsis of original data was generated with the goal of informing the practicing urologist of these advances and their implications. Results BPH is associated with a state of hyperplasia of both the stromal and epithelial compartments, with 5AR2 and androgen signaling playing key roles in development and maintenance of the prostate. Chronic inflammation, multiple growth factor and hormonal signaling pathways, and medical comorbidities play an intricate role in prostate tissue homeostasis as well as its evolution into the clinical state of BPH. Resistance to medical therapy with finasteride may occur through silencing of the 5AR2 gene by DNA methylation, leading to a state in which 30% of adult prostates do not express 5AR2. Novel biomarkers such as single nucleotide polymorshisms may be used to risk stratify patients with symptomatic BPH and identify those at risk of progression or failure of medical therapy. Several inhibitors of the androgen receptor and other signaling pathways have recently been identified which appear to attenuate BPH progression and may offer alternative targets for medical therapy. Conclusions Progressive worsening of LUTS and bladder outlet obstruction secondary to BPH is the result of multiple pathways including androgen receptor signaling, pro-inflammatory cytokines and growth factor signals. New techniques in genomics, proteomics and epigenetics have led to the discovery of aberrant signaling pathways, novel biomarkers, DNA methylation signatures and potential gene-specific targets. As personalized medicine continues to grow, the ability to risk stratify patients with symptomatic BPH, identify those at higher risk of progression, and seek alternative therapies for those likely to fail conventional options will become the standard of targeted therapy. PMID:24582540

  15. What do we know about phytotherapy of benign prostatic hyperplasia?

    PubMed

    Allkanjari, Olta; Vitalone, Annabella

    2015-04-01

    Benign prostatic hyperplasia (BPH) is one of the most common urological diseases in aging men. Because of its long latency, BPH is a good target for prevention. The aim of the study has been to review the various options of treatment, currently available, in the field of phytotherapy. Watchful waiting, pharmacological therapy, and surgery are also helpful, depending on the severity of the disease. Although drug therapy (alpha1-blockers, 5alpha-reductase inhibitors) and surgery (prostatectomy, transurethral resection, etc.) seem to be most effective for patients with moderate-severe BPH, herbal medicines (i.e., Serenoa repens, Pygeum africanum, Urtica dioica) are also commonly used in patients with mild-moderate symptoms. On the basis of preclinical studies several mechanisms of action have been postulated, including 5alpha-reductase inhibition, alpha-adrenergic antagonism, dihydrotestosterone and estrogen receptor inhibition. Randomized clinical trials indicate significant efficacy in improving urinary symptoms and mild adverse effects for some phytotherapeutic agents, while further clinical evidence is needed for others (e.g., Epilobium spp., Secale cereale, Roystonea regia). Healthcare professionals should be constantly informed about BPH phytotherapy, taking into account the risk/benefit profile of the use of medicinal plants in the management of BPH. PMID:25703069

  16. Pathogenic role of HIF-1α in prostate hyperplasia in the presence of chronic inflammation.

    PubMed

    Kim, Hye-Jin; Park, Jong-Wan; Cho, Young-Suk; Cho, Chung-Hyun; Kim, Ji-Seon; Shin, Hyun-Woo; Chung, Doo Hyun; Kim, Sang Jeong; Chun, Yang-Sook

    2013-01-01

    Benign prostatic hyperplasia (BPH) commonly occurs in older men with chronic prostatitis. Although BPH is frequently accompanied by inflammation, it is unclear whether inflammation underlies prostate enlargement. Recently, we reported that hypoxia-inducible factor 1α (HIF-1α), which is known to be induced by proinflammatory cytokines, is involved in testosterone-induced prostate hyperplasia. Therefore, we hypothesized that cytokines secreted from infiltrated macrophages under inflammatory conditions stimulate prostate enlargement by up-regulating HIF-1α. In the present study, we injected lipopolysaccharide (LPS) into rat prostates to mimic prostatitis and evaluated prostate hyperplasia 14days later. Epithelial cells of LPS-treated prostates were found to be highly proliferative and HIF-1α levels in prostate tissues to be elevated. When prostate epithelial cells were incubated in conditioned medium from macrophages activated with LPS, they robustly expressed HIF-1α, and under these conditions IL-1β, IL-6, and TNF-α cytokines were found to mediate HIF-1α induction. In addition, HIF-1α was found to enhance the expression of Twist, which initiates epithelial-mesenchymal transition (EMT). Furthermore, profound EMT features were observed in LPS-treated rat prostates, and the natural HIF-1α inhibitors ascorbate and curcumin were found to attenuate EMT and prostate hyperplasia both in vivo and in vitro. Based on these results, we propose that HIF-1α mediates prostate enlargement under inflammatory conditions, and we suggest that HIF-1α be viewed as a promising target for blocking the transition from prostatitis to BPH. PMID:22986049

  17. Acupuncture for benign prostatic hyperplasia: a systematic review protocol

    PubMed Central

    Zhang, Wei; Yu, Jinna; Liu, Zhishun; Peng, Weina

    2015-01-01

    Introduction Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate commonly encountered in older men. BPH has been treated with acupuncture inside and outside China, but its effects are uncertain. This review aims to assess the efficacy and safety of acupuncture therapy for BPH. Methods and analysis Seven databases will be searched from their inception: the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Chinese Biomedical Database, the China National Knowledge Infrastructure, the VIP Database and Wanfang Database. Randomised controlled clinical trials using acupuncture to treat BPH will be included. Outcome measures included urological symptom scores, urodynamic measures and quality-of-life scales. Adverse events will be assessed and reported for safety evaluation. Study selection and data extraction will be performed by two independent reviewers. Quality assessment (assessment of risk of bias) and data synthesis will be implemented using Review Manager (RevMan) software (V.5.2.3). Ethics and dissemination Ethical approval is not necessary because this systematic review will not include specific patient data. Updates will be conducted if there is enough new evidence that may cause any change in review conclusions. Trial registration number PROSPERO CRD42014013645. PMID:25838507

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

    PubMed

    Mehta, Vatsal; Vezina, Chad M

    2011-01-01

    The aryl hydrocarbon receptor (AHR) is an evolutionarily conserved ligand activated transcription factor best known for its role in mediating toxic responses to dioxin-like environmental contaminants. However, AHR signaling has also emerged as an active participant in processes of normal development and disease progression. Here, we review the role of AHR signaling in prostate development and disease processes, with a particular emphasis on benign prostatic hyperplasia (BPH). Inappropriate AHR activation has recently been associated with a decreased risk of symptomatic BPH in humans and has been shown to impair prostate development and disrupt endocrine signaling in rodents. We highlight known physiological responses to AHR activation in prostate and other tissues and discuss potential mechanisms by which it may act in adult human prostate to protect against symptomatic BPH. PMID:21684673

  19. Clinical Significance of the Resistive Index of Prostatic Blood Flow According to Prostate Size in Benign Prostatic Hyperplasia

    PubMed Central

    2016-01-01

    Purpose: The authors evaluated the relationships between the clinical factors and resistive indexes (RIs) of prostate and urethral blood flows by using power Doppler transrectal ultrasonography (PDUS) in men with benign prostatic hyperplasia (BPH). Methods: The data of 110 patients with BPH and lower urinary tract symptoms (LUTS) treated between January 2015 and July 2015 were prospectively collected. PDUS was used to identify the capsular and urethral arteries of the prostate in order to measure RIs. International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), total prostate volume (TPV), transition zone volume (TZV), transition zone index (=TZV/TPV), presence of intravesical prostatic protrusion (IPP), and the RIs of capsular and urethral arteries were evaluated for all of the patients by one urologist. Results: The 110 patients were categorized according to IPSS (mild symptoms, 0–7; moderate symptoms, 8–19; and severe symptoms, 20–35), Qmax (<10 and ≥10 mL/sec), TPV (<30 and ≥30 mL), and presence or absence of IPP. No significant relationship was found between the mean RI of any artery and IPSS or Qmax. The mean RIs of the urethral artery, and left and right capsular arteries were significantly dependent on prostate size and the presence of IPP. Conclusions: RI obtained by using PDUS correlated with the presence of IPP and prostate size. The RI of prostate blood flow can be used as a noninvasive diagnostic tool for BPH with LUTS. PMID:27032561

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

    PubMed Central

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

    2014-01-01

    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 α-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

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

    PubMed Central

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

    2014-01-01

    Background: Recently, the development of new biomarkers as prognostic and predictive markers in prostate cancer has been crucial. Objectives: This study was aimed to determine whether serum vascular endothelial growth factor (VEGF) levels would be a prognostic marker or risk assessment factor in patients with prostate cancer and to investigate whether it could differentiate cancerous tissue from benign prostate hyperplasia (BPH). Patients and Methods: We enrolled 44 patients with prostate cancer, 57 patients with BPH, and 57 healthy individuals. Serum VEGF levels was measured by ELISA and was compared among all groups; then, its correlation with PSA and Gleason score in cancerous group was assessed. In addition, by using receiver operating characteristic (ROC) curve and area under curve (AUC), we determined the sensitivity and specificity of VEGF as well as combined variable of VEGF and PSA as a diagnostic marker of prostate cancer. Results: Serum VEGF level was significantly higher in patients with prostate cancer in comparison to the other groups (P value < 0.001); however, it was not different between BPH and control groups. Only in cancerous group a significant correlation between VEGF and PSA was found (r = 0.425, P = 0.004). Assessing the risk of prostate cancer, we found a powerful correlation between the VEGF alone as well as the combination of VEGF and PSA with prostate cancer. Conclusions: VEGF may be a diagnostic biomarker of prostate cancer. In addition, it may differentiate the cancerous tissue from BPH. We suggest that VEGF combined with PSA may be used as a screening test of prostate cancer. PMID:25032132

  2. Relationship Between Second to Fourth Digit Ratios and Benign Prostatic Hyperplasia in Aging Men

    PubMed Central

    Sudhakar, Hanumanthaiah Honnamachanahalli; Madhusudhana, Heragu Rangegowda

    2015-01-01

    Introduction Benign prostatic hyperplasia (BPH) is the most common prostate disease, characterized by benign enlargement of the prostate gland in aging men. Testosterone is said to be the major factor in development of BPH. The relative length of 2nd and 4th digit (2D:4D) is a marker for prenatal androgen exposure. A low 2D:4D ratio is associated with a high prenatal androgen exposure. The main objective of this study was to assess the causal relationship between the 2D:4D ratio and incidence of BPH. Materials and Methods Thirty five patients with BPH were compared with 35 non BPH subjects and 35 controls recruited from general population for measures of 2D:4D ratio. BPH status was determined by clinical & radiological evaluation. Both hands of all the participants were scanned and their second and fourth digit lengths were measured and the ratio calculated. Results In the present study, 2D:4D ratio was lower in BPH patients compared to non BPH subjects in both hands. Compared with controls, BPH patients had lower 2D:4D ratio in the right hand, but the difference between the groups in left hand 2D:4D ratios was not significant. Compared with controls, non BPH subjects had higher 2D:4D ratio in the left hand, but the difference between the groups in right hand 2D:4D ratios was not significant. Conclusion Results of the present study indicate that individuals with lower 2D:4D ratios are at a higher risk of developing BPH and those with higher 2D:4D ratios are at a lower risk of developing BPH compared to the general population. PMID:26155515

  3. What Tests Can Detect Prostate Cancer?

    MedlinePlus

    ... Document Topics GO » SEE A LIST » Prostate cancer risk factors Can prostate cancer be prevented? Finding prostate cancer ... enlarged prostate: Conditions such as benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that ...

  4. Economic issues and the management of benign prostatic hyperplasia.

    PubMed

    Holtgrewe, H L

    1995-09-01

    Enormous financial resources are expended worldwide on the treatment of the urologic complications and symptoms induced by benign prostatic hyperplasia (BPH). Even for its surgical management, where the best data exist, current international accounting of these expenditures remains very poorly documented. On February 8, 1994, the Department of Health and Human Services of the US government released clinical guidelines for the diagnosis and management of BPH. Imaging of the upper urinary tract as a routine diagnostic procedure is not recommended in these guidelines unless a comorbidity indicating its need exists. Diagnostic cystoscopy to assist in the decision of the need to treat is not recommended. Adherence to these two principles along with adherence to the strategies of management presented in the guidelines and discussed herein has the potential of achieving profound financial savings without impairing quality of care worldwide. PMID:7544513

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

    PubMed Central

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

    2013-01-01

    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

  6. Regulation of Prostate Development and Benign Prostatic Hyperplasia by Autocrine Cholinergic Signaling via Maintaining the Epithelial Progenitor Cells in Proliferating Status.

    PubMed

    Wang, Naitao; Dong, Bai-Jun; Quan, Yizhou; Chen, Qianqian; Chu, Mingliang; Xu, Jin; Xue, Wei; Huang, Yi-Ran; Yang, Ru; Gao, Wei-Qiang

    2016-05-10

    Regulation of prostate epithelial progenitor cells is important in prostate development and prostate diseases. Our previous study demonstrated a function of autocrine cholinergic signaling (ACS) in promoting prostate cancer growth and castration resistance. However, whether or not such ACS also plays a role in prostate development is unknown. Here, we report that ACS promoted the proliferation and inhibited the differentiation of prostate epithelial progenitor cells in organotypic cultures. These results were confirmed by ex vivo lineage tracing assays and in vivo renal capsule recombination assays. Moreover, we found that M3 cholinergic receptor (CHRM3) was upregulated in a large subset of benign prostatic hyperplasia (BPH) tissues compared with normal tissues. Activation of CHRM3 also promoted the proliferation of BPH cells. Together, our findings identify a role of ACS in maintaining prostate epithelial progenitor cells in the proliferating state, and blockade of ACS may have clinical implications for the management of BPH. PMID:27167157

  7. Diabetes, growth hormone-insulin-like growth factor pathways and association to benign prostatic hyperplasia.

    PubMed

    Wang, Zongwei; Olumi, Aria F

    2011-01-01

    Diabetes significantly increases the risk of benign prostatic hyperplasia (BPH) and low urinary tract symptoms (LUTS). The major endocrine aberration in connection with the metabolic syndrome is hyperinsulinemia. Insulin is an independent risk factor and a promoter of BPH. Insulin resistance may change the risk of BPH through several biological pathways. Hyperinsulinemia stimulates the liver to produce more insulin-like growth factor (IGF), another mitogen and an anti-apoptotic agent which binds insulin receptor/IGF receptor and stimulates prostate growth. The levels of IGFs and IGF binding proteins (IGFBPs) in prostate tissue and in blood are associated with BPH risk, with the regulation of circulating androgen and growth hormone. Stromal-epithelial interactions play a critical role in the development and growth of the prostate gland and BPH. Previously, we have shown that the expression of c-Jun in the fibroblastic stroma can promote secretion of IGF-I, which stimulates prostate epithelial cell proliferation through activating specific target genes. Here, we will review the epidemiologic, clinical, and molecular findings which have evaluated the relation between diabetes and development of BPH. PMID:21536370

  8. Finasteride in the treatment of patients with benign prostatic hyperplasia: a review

    PubMed Central

    Smith, Angela B; Carson, Culley C

    2009-01-01

    Benign prostatic hyperplasia (BPH) is a complex and progressive disease common in aging men. While associated with bothersome lower urinary tract symptoms, it may also result in additional serious complications such as refractory hematuria, acute urinary retention, and BPH-related surgery. Medical therapy has been offered as an approach to halt this progression and perhaps reverse the pathophysiology of BPH. While alpha-blockers provide rapid relief in the form of improved flow rate, their effects may not reduce the overall risk of BPH-related complications. 5α-reductase inhibitors were therefore introduced to affect the underlying disease process by inhibiting the enzyme which converts testosterone to dihydrotesterone, the primary androgen involved in normal and abnormal prostate growth. Through this inhibition, prostate size is decreased, thereby reducing the risk of acute urinary retention and BPH-related surgery while providing symptom control. These effects are most pronounced in men with enlarged prostates (>25 mL) who are at the greatest risk of disease progression. This article reviews the literature for finasteride used in the treatment of BPH and provides evidence for its efficacy, safety and tolerability, applicability for combination therapy, and considerations of its effects on prostate cancer risk. PMID:19707263

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

    PubMed Central

    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

    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

  10. Physical Activity and Benign Prostatic Hyperplasia-Related Outcomes and Nocturia

    PubMed Central

    WOLIN, KATHLEEN Y.; GRUBB, ROBERT L.; PAKPAHAN, RATNA; RAGARD, LAWRENCE; MABIE, JEROME; ANDRIOLE, GERALD L.; SUTCLIFFE, SIOBHAN

    2015-01-01

    ABSTRACT Introduction Benign prostatic hyperplasia (BPH) and its associated lower urinary tract symptoms (LUTS), including nocturia, are extremely common among middle- and older-age American men. Although studies on physical activity (PA) and prevalent BPH-related outcomes suggest that PA may protect against the development of this common condition, only a few studies have examined the relation between PA and incident BPH-related outcomes and LUTS with mixed findings. In addition, although nocturia is the most commonly reported and most bothersome LUTS in men with or without evidence of BPH, few studies have examined the association of PA and nocturia independent of BPH. The purpose of this analysis was to examine the association of PA with BPH-related outcomes and nocturia in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial. Methods We examined this association with both prevalent (n = 28,404) and incident (n = 4710) BPH-related outcomes (measured by self-report of physician diagnosis, BPH surgery, finasteride use, and clinical indicators) and nocturia. Poisson regression with robust variance was used to calculate prevalence ratios and relative risks. Results PA was weakly positively associated with several prevalent BPH-related outcomes and was strongly inversely associated with prevalent nocturia. In incident analyses, PA was only associated with nocturia. Men who were active ≥1 h·wk−1 were 13% less likely (95% confidence interval, 2%–22%) to report nocturia and 34% less likely (95% confidence interval, 15%–49%) to report severe nocturia as compared with men who reported no PA. The associations were similar for men with and without additional BPH-related outcomes, except for prevalent nocturia, where the association was stronger for men without other BPH-related outcomes. Conclusions Combined with other management strategies, PA may provide a strategy for the management of BPH-related outcomes, particularly nocturia. PMID:25010403

  11. Inhibitory effect of Yukmijihwang-tang, a traditional herbal formula against testosterone-induced benign prostatic hyperplasia in rats

    PubMed Central

    2012-01-01

    Background Yukmijihwang-tang, a traditional herbal formula, has been used for treating disorder, diabetic mellitus and neurosis in China (Liu-wei-di-huang-tang in Chinese), Japan (Lokumijio-to in Japanese) and Korea for many years. In this study, we investigated the effects of Yukmijihwang-tang water extract (YJT) on the development of benign prostatic hyperplasia (BPH) using a rat model of testosterone propionate (TP)-induced BPH. Methods A total of 30 rats were divided into five groups. One group was used as a control and the other groups received subcutaneous injections of TP for 4 weeks to induce BPH. YJT (200 or 400 mg/kg) was administered daily for 4 weeks to two groups by oral gavage concurrently with the TP. The animals were euthanized, the prostate and body weights were recorded, and tissues were subjected to hormone assays and histomorphology. In addition, we investigated proliferating cell nuclear antigen (PCNA) expression in the prostate using immunoblotting. Results Animals with BPH showed significantly increased absolute and relative prostate weights, increased dihydrotestosterone levels in the serum or prostate and increased PCNA expression in the prostate; however, YJT-treated animals showed significant reductions compared with the animals with TP-induced BPH. Histomorphology also showed that YJT inhibited TP-induced prostatic hyperplasia. Conclusions These findings indicate that YJT effectively inhibited the development of BPH and might be a useful drug clinically. PMID:22520510

  12. Tadalafil: a phosphodiesterase-5 inhibitor for benign prostatic hyperplasia.

    PubMed

    Cantrell, Matthew A; Baye, Jordan; Vouri, Scott Martin

    2013-06-01

    Tadalafil is a phosphodiesterase (PDE)-5 inhibitor recently approved by the United States Food and Drug Administration for lower urinary tracts symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). The mechanism for improved LUTS is thought to be related to three principal theories: alterations in nitric oxide levels, Rho-associated protein kinase deactivation, and reductions in pelvic atherosclerosis. The efficacy of PDE-5 inhibitors for the treatment of LUTS associated with BPH has been demonstrated in several randomized placebo-controlled trials. Tadalafil is thought to be superior based on an extended half-life; however, other PDE-5 inhibitors have positive results in BPH and have not been proved to be inferior to tadalafil. Before administration, concomitant use of medications such as nonselective α-adrenergic antagonists, nitrates, and cytochrome P450 inhibitors should be assessed for possible drug interactions. Potential adverse drug events seen in Food and Drug Administration-approved tadalafil include back pain, dyspepsia, headache, and dizziness. Given the efficacy and safety data currently available, the PDE-5 inhibitor tadalafil represents a reasonable alternative for selected male patients with LUTS associated with BPH, especially with concomitant erectile dysfunction. PMID:23529917

  13. Controversies about the clinical assessment of benign prostatic hyperplasia.

    PubMed

    Riehmann, M; Jønler, M

    1995-01-01

    Benign prostatic hyperplasia (BPH) is a common disorder which places a considerable burden on older men and health care expenses. With advances in medical technologies and the foreseeable demographic changes in the Western world, the financial and epidemiological impact of this chronic disease is expected to increase further. The management of BPH is controversial, and this article critically reviews the clinical applicability and validity of the various measures available for assessment. Few objective modalities are indicated in the routine evaluation of BPH. There is a poor correlation between objective and subjective indicators and both measures reveal a substantial variation over time. This fluctuation is mainly attributed to the natural history of the disease. The clinical value of combining objective and subjective parameters into an analytic process seems small. Disagreements about the clinical value of BPH assessment modalities have caused inconsistent practices and consequently provision of changeable health care quality. Patients seek urological counseling and relief because of burden of illness. Quality care is provided by clinicians being perceptive to patients' preferences. Provision of quality care does not inevitably generate increasing health service expenses. PMID:8578261

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

    NASA Astrophysics Data System (ADS)

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

    2003-06-01

    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.

  15. BPH: After Treatment (Benign Prostatic Hyperplasia /Enlarged Prostate)

    MedlinePlus

    ... Urology? The Urinary Tract System Free Patient Education Materials We provide free patient education materials on urologic ... Health Care Providers Browse Through Our Free Educational Materials We provide free patient education materials on many ...

  16. BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate)

    MedlinePlus

    ... Urology? The Urinary Tract System Free Patient Education Materials We provide free patient education materials on urologic ... Health Care Providers Browse Through Our Free Educational Materials We provide free patient education materials on many ...

  17. LILRA3 is associated with benign prostatic hyperplasia risk in a Chinese Population.

    PubMed

    Jiao, Yang; Wang, Li; Gu, Xin; Tao, Sha; Tian, Lu; Na, Rong; Chen, Zhuo; Kang, Jian; Zheng, Siqun L; Xu, Jianfeng; Sun, Jielin; Qi, Jun

    2013-01-01

    A recent prostate cancer (PCa) genome-wide association study (GWAS) identified rs103294, a single nucleotide polymorphism (SNP) located on LILRA3, a key component in the regulation of inflammatory inhibition, to be significantly associated with PCa risk in a Chinese population. Because inflammation may be a common etiological risk factor between PCa and benign prostatic hyperplasia (BPH), the current study was conducted to investigate the association of rs103294 with BPH risk. rs103294 was genotyped in a Chinese population of 426 BPH cases and 1,008 controls from Xinhua Hospital in Shanghai, China. Association between rs103294, BPH risk and clinicopathological traits were tested with adjustment for age. rs103294 was significantly associated with BPH risk with a p-value of 0.0067. Individuals with risk allele "C" had increased risk for BPH (OR = 1.34, 95% CI: 1.09-1.66). Stratified analysis revealed a stronger association risk for younger patients who are below 72 years old (OR = 1.51, 95% CI: 1.06-2.16). Our study represents the first effort to demonstrate that LILRA3 gene is significantly associated with BPH risk in a Chinese population. Our results support a common role of inflammation in the development of PCa and BPH. Additional studies are needed to further evaluate our results. PMID:23615473

  18. Bee venom suppresses testosterone-induced benign prostatic hyperplasia by regulating the inflammatory response and apoptosis.

    PubMed

    Chung, Kyung-Sook; An, Hyo-Jin; Cheon, Se-Yun; Kwon, Ki-Rok; Lee, Kwang-Ho

    2015-12-01

    Benign prostatic hyperplasia (BPH), which is a common disorder in aging men, involves inflammation that is associated with an imbalance between cell proliferation and cell death. Because current BPH drug treatments have undesirable side effects, the development of well-tolerated and effective alternative medicines to treat BPH is of interest. Bee venom (BV) has been used in traditional medicine to treat conditions, such as arthritis and rheumatism, and pain. Although inflammation has been associated with BPH and BV has strong anti-inflammatory effects, the effects of BV on BPH are not fully understood. Therefore, in this study, we evaluated the efficacy of BV against testosterone-induced BPH in rats. BV decreased prostate weight compared to the untreated group. In addition, BV suppressed serum dihydrotestosterone concentration levels and the levels of proliferating cell nuclear antigen in the histological analysis. Furthermore, BV significantly decreased the levels of the apoptotic suppressors, Bcl-2 and Bcl-xL, and increased the levels of the proapoptotic factors, Bax and caspase-3 activation. These results suggested that BV suppressed the development of BPH and has good potential as a treatment for BPH. PMID:26085572

  19. 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 ...

  20. [Rebound of prostate specific antigen after discontinuation of antiandrogen therapy for benign prostatic hyperplasia].

    PubMed

    Noguchi, K; Uemura, H; Takeda, M; Sekiguchi, Y; Ogawa, K; Hosaka, M

    2000-09-01

    We compared the prostate specific antigen (PSA) levels in benign prostatic hyperplasia (BPH) patients with antiandrogen chlormadinone acetate (CMA) or allylestrenol (AE) before and during the treatment. We also investigated the serial change of PSA levels before, during and after discontinuation of antiandrogen therapy. Fifty-one BPH patients with normal PSA levels were treated with CMA or AE for 16 weeks. The mean serum PSA level significantly decreased after the treatment from 1.9 +/- 1.0 ng/ml to 1.1 +/- 0.7 ng/ml (M +/- SD). We discontinued medication with informed consent and the patients were carefully monitored for another 16 weeks. Nineteen patients were followed for 32 weeks. The mean serum PSA level decreased significantly from 2.0 +/- 1.0 ng/ml to 1.1 +/- 0.5 ng/ml (M +/- SD) and recovered approximately to the pretreatment level (1.7 +/- 1.1 ng/ml) at the end of this study. We found only one patient whose PSA was slightly elevated to a subnormal range (4.3 ng/ml) after discontinuation of therapy. The other BPH patients with normal PSA levels showed no excessive increase in PSA levels beyond the normal limit after discontinuation of antiandrogen therapy compared with the pretreatment baseline. In conclusion, BPH patients with a marked increase in PSA after discontinuation of antiandrogen therapy should be checked for prostate cancer. PMID:11107528

  1. Oxidative stress in benign prostate hyperplasia.

    PubMed

    Zabaiou, N; Mabed, D; Lobaccaro, J M; Lahouel, M

    2016-02-01

    To assess the status of oxidative stress in benign prostate hyperplasia, a very common disease in older men which constitutes a public health problem in Jijel, prostate tissues were obtained by transvesical adenomectomy from 10 men with benign prostate hyperplasia. We measured the cytosolic levels of malondialdehyde (MDA) and glutathione (GSH) and cytosolic enzyme activities of superoxide dismutase, catalase, glutathione peroxidase and glutathione S-transferase. The development of benign prostate hyperplasia is accompanied by impaired oxidative status by increasing levels of MDA, depletion of GSH concentrations and a decrease in the activity of all the antioxidant enzymes studied. These results have allowed us to understand a part of the aetiology of benign prostate hyperplasia related to oxidative stress. PMID:25959539

  2. Micro and bulk analysis of prostate tissues classified as hyperplasia

    NASA Astrophysics Data System (ADS)

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

    2007-07-01

    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 μm 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.

  3. Update in minimal invasive therapy in benign prostatic hyperplasia.

    PubMed

    Van Hest, P; D'Ancona, F

    2009-09-01

    Last decade several new treatment modalities for minimal invasive therapy of benign prostatic hyperplasia have been developed, both ablative and non-ablative. In this review the authors describe the different techniques and clinical studies of bipolar transurethral resection of the prostate (TURP), transurethral resection in saline (TURis), the different laser therapies for the prostate, transurethral microwave thermotherapy (TUMT), high intensity focused ultrasound (HIFU), transurethral needle ablation (TUNA), hot water induced thermotherapy (WIT), prostatic stents, intraprostatic ethanol injections and botulinum toxin A injections. The different bipolar systems and photoselective vaporisation might replace the ''gold standard'', monopolar TURP, in the near future. The holmium laser enucleation of the prostate is also a real challenger of the ''gold standard'', but the technique is difficult to learn. The TUMT definitively found its place as alternative to TURP, especially because it can be performed in an outpatient setting without the need of anaesthesia. Therefore it is also suitable in patients at high risk. The long-term data on TUNA and HIFU is disappointing and therefore these treatment modalities did not stand the test of time. WIT seemed to be a promising therapy, but durability is questionable. Intraprostatic ethanol injections are safe and effective in small series, but larger series are needed to confirm its efficacy. Intraprostatic botulinum toxin A injections are the first treatment of BPH to target both the increase in smooth muscle tone (dynamic component) and the excessive growth (static component) of BPH. This approach of BPH is very promising but more studies with long-term follow up are needed. PMID:19773727

  4. α-Spinasterol from Melandrium firmum attenuates benign prostatic hyperplasia in a rat model.

    PubMed

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

    2014-06-01

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

  5. miRNA Regulation Network Analysis in Qianliening Capsule Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Liu, Liya; Wan, Yun; Shen, Aling; Zhao, Jinyan; Lin, Jiumao; Zhong, Xiaoyong; Zhang, Yuchen; Hong, Zhenfeng

    2015-01-01

    Objective. The objective of this study was to evaluate the molecular mechanism by which Qianliening capsule (QC) treats benign prostatic hyperplasia (BPH). Methods. Benign prostatic hyperplasia epithelial cell line BPH-1 was treated with 0, 1.25, 2.5, and 5 mg/mL QC for 48 h, respectively. Evaluation of cell viability and observation of morphologic changes of BPH-1 cell gene expression and miRNA expression profiles were analyzed. Real-time quantitative PCR was used to confirm changes in miRNA and gene expression. GO and KEGG pathway-based approaches were used to investigate biological functions and signaling pathways affected by differentially expressed mRNAs. Results. QC inhibited BPH-1 cell proliferation. Differential expression of 19 upregulated and 2 downregulated miRNAs was observed in QC-treated BPH-1 cells compared to untreated control cells. 107 upregulated and 71 downregulated genes were identified between the two groups. Significantly enriched signaling pathways based on deregulated mRNAs were mainly involved in regulation of cell proliferation, apoptosis, and so on. Additionally, miRNA-mRNA network analysis integrated these miRNAs and genes by outlining interactions of miRNA and related genes. Conclusion. The study was the first report of differentially expressed miRNA and mRNA in QC-treated BPH-1 cells. PMID:26294924

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

    SciTech Connect

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

    2010-04-15

    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.

  7. Sperm quality and selected biochemical parameters of seminal fluid in dogs with benign prostatic hyperplasia.

    PubMed

    Krakowski, L; Wąchocka, A; Brodzki, P; Wrona, Z; Piech, T; Wawron, W; Chałabis-Mazurek, A

    2015-09-01

    Benign prostatic hyperplasia (BPH) in dogs is most commonly associated with age and increasing concentrations of dihydrotesterone, a hormone that stimulates growth and secretion of the prostatic epithelial cells. During this process, the biochemical composition of prostatic secretion changes, which can affect the quality of semen and limit the ability of the sperm to contribute to fertilization. Therefore, the present study was conducted to examine possible correlation between BPH and biological quality of semen. The study was performed in 11 sexually mature dogs of various breeds. Animals were divided into two groups: healthy dogs (Group I; n = 5; mean age 4.32; SEM = 1.28) and dogs with BPH (Group II n = 6; mean age 6.16; SEM = 0.65). Semen and prostate secretions were collected and evaluated in this study. Standard semen examinations were conducted in the ejaculates collected; moreover, the extent of apoptosis and DNA defragmentation was determined. The selected biochemical parameters were determined in the prostate secretion. According to the examination results, there were no significant differences in standard semen parameters between the two groups of dogs. Nevertheless, morphological tests of semen in dogs with BPH demonstrated elevated percentages of primary defects in spermatozoa. A significant increase (P = 0.01) in DNA defragmentation of sperm was found in dogs with BPH. Moreover, changes in the biochemical composition of prostate secretion were demonstrated. In dogs with BPH, pH of prostate secretions was greater (P = 0.03), concentrations of cholesterol increased while concentrations of Zn and Cu decreased. The study findings reveal that BPH does not change semen quality in dogs. PMID:26275963

  8. The GnRH Antagonist Degarelix Directly Inhibits Benign Prostate Hyperplasia Cell Growth.

    PubMed

    Sakai, M; Elhilali, M; Papadopoulos, V

    2015-11-01

    Gonadotropin-releasing hormone receptors (GnRHR) have been found in extrapituitary tissues, including the prostate, where they might exert a local effect on tissue growth. Degarelix is a GnRHR antagonist approved for use in patients with prostate cancer (PCa) who need androgen deprivation therapy. The slowing of prostate cell growth is a common goal shared by PCa and benign prostate hyperplasia (BPH) patients, and the effect of degarelix on BPH cells has not yet been investigated. We wanted to evaluate the direct effect of degarelix on human BPH primary cell growth. Gene expression studies performed with BPH (n=11), stage 0 (n=15), and PCa (n=65) human specimens demonstrated the presence of GNRHR1 and GNRHR2 and their respective endogenous peptide ligands. BPH-isolated epithelial and stromal cells were either cultured alone or co-cultured (1:4 or 4:1 ratio of epithelial to stromal cells) and subsequently treated with increasing concentrations of degarelix. Degarelix treatment induced a decrease in cell viability and cell proliferation rates, which occurred in parallel to an increase in apoptosis. Both epithelial and stromal BPH cells are sensitive to degarelix treatment and, interestingly, degarelix is also effective when the cells were growing in a co-culture microenvironment. In contrast to degarelix, the GnRHR agonists, leuprolide and goserelin, exerted no effect on the viability of BPH epithelial or stromal cells. In conclusion, (i) prostate tissues express GNRHR and are a potential target for degarelix; and (ii) degarelix directly inhibits BPH cell growth through a decrease in cell proliferation and an increase in apoptosis. Supporting information for this article is available online at http://www.thieme-connect.de/products. PMID:26197852

  9. Influence of Panax ginseng on Alpha-Adrenergic Receptor of Benign Prostatic Hyperplasia

    PubMed Central

    Kim, Su Kang; Chung, Joo-Ho; Lee, Byung-Cheol; Lee, Sang Won; Lee, Kang Hyo

    2014-01-01

    Purpose Benign prostatic hyperplasia (BPH) is the most common prostate problem in older men. The present study aimed to investigate the inhibitory effect of Panax ginseng C.A. Meyer (P. ginseng) on a rat model of testosterone-induced BPH. Methods The rats were divided into 3 groups (each group, n=10): control, testosterone-induced BPH (20 mg/kg, subcutaneous injection), and P. ginseng (200 mg/kg, orally) groups. After 4 weeks, all animals were sacrificed to examine the blood biochemical profiles, prostate volume, weight, histopathological changes, alpha-1D adrenergic receptor (Adra1d) mRNA expression, and epidermal growth factor receptor (EGFR) and B-cell CLL/lymphoma 2 (BCL2) protein expression. Results The group treated with P. ginseng showed significantly lesser prostate size and weight than the testosterone-induced BPH group. In addition, P. ginseng decreased the mRNA expression of Adra1d as well as the expression of EGFR and BCL2 in prostate tissue. Conclusions These results suggest that P. ginseng may inhibit the alpha-1-adrenergic receptor to suppress the development of BPH. PMID:25558416

  10. Effect of red maca (Lepidium meyenii) on prostate zinc levels in rats with testosterone-induced prostatic hyperplasia.

    PubMed

    Gonzales, C; Leiva-Revilla, J; Rubio, J; Gasco, M; Gonzales, G F

    2012-05-01

    Lepidium meyenii (maca) is a plant that grows exclusively above 4000 m in the Peruvian central Andes. Red maca (RM) extract significantly reduced prostate size in rats with benign prostatic hyperplasia (BPH) induced by testosterone enanthate (TE). Zinc is an important regulator of prostate function. This study aimed to determine the effect of RM on prostate zinc levels in rats with BPH induced by TE. Also, the study attempted to determine the best marker for the effect of RM on sex accessory glands. Rats treated with RM extract from day 1 to day 14 reversed the effect of TE administration on prostate weight and zinc levels. However, RM administered from day 7 to day 14 did not reduce the effect of TE on all studied variables. Finasteride (FN) reduced prostate, seminal vesicle and preputial gland weights in rats treated with TE. Although RM and FN reduced prostate zinc levels, the greatest effect was observed in TE-treated rats with RM from day 1 to day 14. In addition, prostate weight and zinc levels showed the higher diagnosis values than preputial and seminal vesicle weights. In conclusion, RM administered from day 1 to day 14 reduced prostate size and zinc levels in rats where prostatic hyperplasia was induced with TE. Also, this experimental model could be used as accurately assay to determine the effect of maca obtained under different conditions and/or the effect of different products based on maca. PMID:21762188

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

    PubMed Central

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

    2014-01-01

    Voltage-gated sodium channels (VGSCs) are expressed not only in excitable cells but also in numerous metastatic cells, particularly in certain types of cancer cells. In some types of cancer, including prostate cancer, the expression of VGSCs is associated with cancer migration, invasion and metastasis in vivo. However, the detailed expression profiles of VGSC α subunits in normal human prostate, in prostatic hyperplasia and prostatic cancer remain controversial. In the present study, quantitative polymerase chain reaction was used to systematically detect all subtypes of VGSC α subunits in normal human prostate, benign prostatic hyperplasia (BPH) and prostate cancer cells. The expression profile of VGSC α subunits was observed to differ between these cell types. Nav1.5 was the major isoform expressed in normal human prostate tissue, while Nav1.5 and Nav1.2 were the predominant isoforms in BPH tissue. However, in PC-3 and LNCaP cells, two typical prostate cancer cell lines, Nav1.6 and Nav1.7 were abundantly expressed. By comparing the relative expression levels of Nav1.5, Nav1.6 and Nav1.7 in these cells, the mRNA levels of Nav1.6 and Nav1.7 were identified to be 6- to 27-fold higher in PC-3 and LNCaP cells than in either normal or BPH samples (P<0.05); however, Nav1.5 mRNA levels were relatively lower compared with those of Nav1.6 or Nav1.7 in all cells analyzed. To confirm whether Nav1.6 and Nav1.7 expression in cancer cells was functional, a patch-clamp technique was used to record whole-cell currents. A tetrodotoxin-sensitive sodium current was successfully recorded in PC-3 cells, but not in LNCaP cells. It was concluded that although all types of VGSC α subunits exhibited low expression levels in normal prostate and BPH cells, both Nav1.6 and Nav1.7 were significantly upregulated in the prostate cancer cell lines, suggesting these subtypes may be potential diagnostic markers and therapeutic targets for certain types of prostate cancer in humans. PMID:24959274

  12. The prevalence of benign prostatic hyperplasia in mainland China: evidence from epidemiological surveys

    PubMed Central

    Wang, Wenying; Guo, Yuwen; Zhang, Daoxin; Tian, Ye; Zhang, Xiaonan

    2015-01-01

    The epidemiological characteristics of benign prostate hyperplasia (BPH) in mainland China are not completely understood. We performed this meta-analysis to assess the prevalence of BPH from 1989 through 2014. A total of 14 articles and 19 datasets were included. The pooled overall prevalence of BPH among men aged 40 years and older was 36.6% [95% CI, 32.344.8]. The occurrence rate of BPH in the age groups 4049 years, 5059 years, 6069 years, 7079 years and 80 years and older was 2.9%, 29.0%, 44.7%, 58.1% and 69.2%, respectively. The pooled occurrence rate of BPH was 41.5% [95% CI, 34.548.4] in urban areas and 38.6% [95% CI, 22.754.6] in rural areas; this difference in prevalence was not statistically significant [OR, 1.51; 95% CI, 0.972.36]. BPH is highly prevalent in mainland China, and its prevalence increased with age. The trend in the prevalence of BPH in mainland China was not steady; the prevalence map based on a geographic information system (GIS) showed an unequal geographic distribution. High-quality surveys on BPH with a larger sample size are needed throughout mainland China to confirm these findings. PMID:26306721

  13. Hydrodynamic cavitation kills prostate cells and ablates benign prostatic hyperplasia tissue.

    PubMed

    Itah, Zeynep; Oral, Ozlem; Perk, Osman Yavuz; Sesen, Muhsincan; Demir, Ebru; Erbil, Secil; Dogan-Ekici, A Isin; Ekici, Sinan; Kosar, Ali; Gozuacik, Devrim

    2013-11-01

    Hydrodynamic cavitation is a physical phenomenon characterized by vaporization and bubble formation in liquids under low local pressures, and their implosion following their release to a higher pressure environment. Collapse of the bubbles releases high energy and may cause damage to exposed surfaces. We recently designed a set-up to exploit the destructive nature of hydrodynamic cavitation for biomedical purposes. We have previously shown that hydrodynamic cavitation could kill leukemia cells and erode kidney stones. In this study, we analyzed the effects of cavitation on prostate cells and benign prostatic hyperplasia (BPH) tissue. We showed that hydrodynamic cavitation could kill prostate cells in a pressure- and time-dependent manner. Cavitation did not lead to programmed cell death, i.e. classical apoptosis or autophagy activation. Following the application of cavitation, we observed no prominent DNA damage and cells did not arrest in the cell cycle. Hence, we concluded that cavitation forces directly damaged the cells, leading to their pulverization. Upon application to BPH tissues from patients, cavitation could lead to a significant level of tissue destruction. Therefore similar to ultrasonic cavitation, we propose that hydrodynamic cavitation has the potential to be exploited and developed as an approach for the ablation of aberrant pathological tissues, including BPH. PMID:24047796

  14. Treatment options for benign prostatic hyperplasia.

    PubMed Central

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

    1997-01-01

    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

  15. Analysis of Urinary Prostate-Specific Antigen Glycoforms in Samples of Prostate Cancer and Benign Prostate Hyperplasia

    PubMed Central

    Hsiao, Chun-Jen; Tzai, Tzong-Shin; Chen, Chein-Hung; Yang, Wen-Horng; Chen, Chung-Hsuan

    2016-01-01

    Glycans of prostate-specific antigen (PSA) in prostate cancer were found to be different from that in benign disease. It is difficult to analyze heterogeneous PSA glycoforms in each individual specimen because of low protein abundance and the limitation of detection sensitivity. We developed a method for prostate cancer diagnosis based on PSA glycoforms. Specific glycoforms were screened in each clinical sample based on liquid chromatography-tandem mass spectrometry with ion accumulation. To look for potential biomarkers, normalized abundance of each glycoform in benign prostate hyperplasia (BPH) and in prostate cancer was evaluated. The PSA glycoform, Hex5HexNAc4NeuAc1dHex1, and monosialylated, sialylated, and unfucosylated glycoforms differed significantly between the prostate cancer and BPH samples. The detection sensitivity (87.5%) and specificity (60%) for prostate cancer identification are higher than those of the serum PSA marker. As low as 100 amol PSA could be detected with the ion accumulation method which has not been reported before. The improved detection specificity can help reduce unnecessary examinations. PMID:27065039

  16. Antrodan, a ?-glucan obtained from Antrodia cinnamomea mycelia, is beneficial to benign prostate hyperplasia.

    PubMed

    Peng, Chiung-Chi; Lin, Yi-Ting; Chen, Kuan-Chou; Chyau, Charng-Cherng; Peng, Robert Y

    2015-02-01

    Benign prostatic hyperplasia (BPH), one of the most common disease usually occurring in men in their 50s, has now become an atypical direct cause of mortality. Currently, phytotherapeutic agents are emerging and are frequently used as a complementary alternative treatment of BPH. ?-glucan has shown a diversity of bioactivities involving anticancer, immunomodulatory and anti-inflammatory effects. Antrodia cinnamomea exhibits a diversity of biological activities. Only a few literature references have cited the biomedicinal effects of antrodan, which is a unique ?-glucan present in A. cinnamomea mycelia. We hypothesized that antrodan could be beneficial to BPH. Using the Sprague-Dawley rat model, we performed this present experiment. Results indicated that antrodan alleviated most of the pathophysiological manifestations that can be elicited by BPH, by alleviating the prostatic epithelial hyperplasia and collagen deposition, increasing the total cholesterol biosynthesis and conversion into HDL, and suppressing the production of LDL and ROS and the upregulation of IL-1, COX-2 and CD68. Antrodan also effectively suppressed the serum level testosterone and DHT and downregulated aromatase, estradiol and the expression of the androgen receptor. More importantly, antrodan downregulated N-cadherin and vimentin and upregulated E-cadherin, underlying the effective inhibition on the epithelial-mesenchymal transition (EMT). Conclusively, the ?-glucan antrodan present in the A. cinamomea mycelia is beneficial to the BPH therapy. PMID:25537160

  17. Cyclooxygenase 2 (rs2745557) Polymorphism and the Susceptibility to Benign Prostate Hyperplasia and Prostate Cancer in Egyptians.

    PubMed

    Fawzy, Mohamed S; Elfayoumi, Abdel-Rahman; Mohamed, Randa H; Fatah, Ihab R Abdel; Saadawy, Sara F

    2016-06-01

    Cyclooxygenase-2 (COX-2), an inducible isoform of cyclooxygenase, has been reported to be correlated with tumorigenesis, tumor progression, and metastasis. We aimed to evaluate the association between COX-2 (rs2745557) polymorphism and prostate cancer (PCa), benign prostate hyperplasia (BPH) risk. We also assessed the influence of other risk factors such as obesity, smoking, diabetes in modulating the risk of PCa in Egyptian men. COX-2 (rs2745557) was genotyped in 112 PC patients, 111 BPH and 120 subjects as a control group. COX-2 and PSA levels were measured by ELISA. We found that GG genotype was associated with a 17-fold increased risk for PCa and 20-fold increased the risk for BPH more than AA genotype. Also, G allele carriers of COX-2 were associated with metastatic cancer (OR = 1.3, P < 0.05) and disease aggressiveness (OR = 3.5, P < 0.001). The coexistence of obesity, smoking, or diabetes with GG genotype may lead to increasing the risk of developing BPH (OR = 3.3, 4, and 2.7, respectively) and of developing PCa (OR = 2.9, 4.9, and 3.2, respectively). Our results showed evidence suggesting the involvement of the COX-2 (rs2745557) polymorphism and its protein in PCa or BPH initiation and progression. Also, the coexistence of COX-2 (rs2745557) and obesity, smoking, or diabetes may lead to the development of PCa or BPH. PMID:26920155

  18. Enhanced expression of parathyroid hormone-related protein in prostate cancer as compared with benign prostatic hyperplasia.

    PubMed

    Asadi, F; Farraj, M; Sharifi, R; Malakouti, S; Antar, S; Kukreja, S

    1996-12-01

    Parathyroid hormone-related protein (PTHrP) has been shown to be the primary factor responsible for humoral hypercalcemia of malignancy. Recently PTHrP has been shown to be an early-response gene that may be involved in cellular proliferation or differentiation. In addition, PTHrP has been implicated in the pathogenesis of bone metastases. Bone metastases are a significant complication in patients with prostate cancer. We compared the expression of PTHrP by immunohistochemical staining using a monoclonal antibody directed against epitope between amino acids [53-64] in benign prostatic hyperplasia (BPH) with that in various stages of prostate cancer. Tissue sections were obtained on formalin-fixed paraffin-embedded blocks from BPH, well-differentiated prostate cancer, poorly differentiated prostate cancer, lymph node metastases (n = 15 each), and normal prostate (n = 2). In the normal prostate tissue there was no staining observed. In BPH, 13 of 15 tissue samples were positive for PTHrP immunoreactivity. An average of 33% of the cells stained positive with 1+ intensity. All samples from prostate cancer stained positive for PTHrP. In the samples from well-differentiated prostate cancer, an average of 87% of cells stained positive for PTHrP, whereas 100% of cells were positive in poorly differentiated and metastatic tumors. The intensity of staining was 3+ in well-differentiated tumors and 4+ in poorly differentiated tumors. Therefore, the expression of PTHrP is enhanced in prostate cancer as compared with BPH and is greater in poorly differentiated carcinoma as compared with the well-differentiated tumors. The role of PTHrP in the pathogenesis of prostate cancer deserves further study. PMID:8958305

  19. Therapeutic efficacy of Cernilton in benign prostatic hyperplasia patients with histological prostatitis after transurethral resection of the prostate

    PubMed Central

    Qian, Xiaoqiang; Kong, Xiangjie; Qian, Yu; Xu, Ding; Liu, Hailong; Zhu, Yunkai; Guan, Wenbing; Zheng, Junhua; Wang, Zhong; Qi, Jun

    2015-01-01

    Objective: This study was to prospectively evaluate the therapeutic efficacy of Cernilton in benign prostatic hyperplasia (BPH) patients with histological prostatitis after transurethral resection of the prostate (TURP). Materials and methods: One hundred patients with histological prostatitis were recruited from January 2007 to January 2013. All patients were divided into groups A (mild), B (moderate), and C (severe) based on symptom severity, and then randomly subgrouped into Cernilton group and control group. Patients in Cernilton group were treated with Cernilton for 3 months after TURP, while patients in control group received placebo. A series of patient indicators were evaluated before, perioperatively (peri), and after TURP. Results: The assessed indicators remained unchanged peri-TURP as compared to those before surgery. 6 months after TURP, indicators remained stable in group A, and significant differences were observed in the International Index of Erectile Function-5 (IIEF-5) in group B and in the storage symptom score (Ss), quality of life (QoL) and IEFF-5 in group C. In addition, there were significant differences in Ss, QoL and IEFF-5 between Cernilton group and control group. Conclusion: In BPH patients with histological prostatitis after TURP, Cernilton can improve the lower urinary tract symptoms and sexual dysfunction depending on the grade of prostatitis. PMID:26379934

  20. Antiinflammatory effect of androgen receptor activation in human benign prostatic hyperplasia cells.

    PubMed

    Vignozzi, Linda; Cellai, Ilaria; Santi, Raffaella; Lombardelli, Letizia; Morelli, Annamaria; Comeglio, Paolo; Filippi, Sandra; Logiodice, Federica; Carini, Marco; Nesi, Gabriella; Gacci, Mauro; Piccinni, Marie-Pierre; Adorini, Luciano; Maggi, Mario

    2012-07-01

    Progression of benign prostatic hyperplasia (BPH) involves chronic inflammation and immune dysregulation. Preclinical studies have demonstrated that prostate inflammation and tissue remodeling are exacerbated by hypogonadism and prevented by testosterone supplementation. We now investigated whether, in humans, hypogonadism was associated with more severe BPH inflammation and the in vitro effect of the selective androgen receptor agonist dihydrotestosterone (DHT) on cultures of stromal cells derived from BPH patients (hBPH). Histological analysis of inflammatory infiltrates in prostatectomy specimens from a cohort of BPH patients and correlation with serum testosterone level was performed. Even after adjusting for confounding factors, hypogonadism was associated with a fivefold increased risk of intraprostatic inflammation, which was also more severe than that observed in eugonadal BPH patients. Triggering hBPH cells by inflammatory stimuli (tumor necrosis factor α, lipopolysaccharide, or CD4(+)T cells) induced abundant secretion of inflammatory/growth factors (interleukin 6 (IL6), IL8, and basic fibroblast growth factor (bFGF)). Co-culture of CD4(+)T cells with hBPH cells induced secretion of Th1 inducer (IL12), Th1-recruiting chemokine (interferon γ inducible protein 10, IP10), and Th2 (IL9)- and Th17 (IL17)-specific cytokines. Pretreatment with DHT inhibited NF-κB activation and suppressed secretion of several inflammatory/growth factors, with the most pronounced effects on IL8, IL6, and bFGF. Reduced inflammatory cytokine production by T-cells, an increase in IL10, and a significant reduction of T cells proliferation suggested that DHT exerted a broad anti inflammatory effect on testosterone cells [corrected]. In conclusion, our data demonstrate that DHT exerts an immune regulatory role on human prostatic stromal cells, inhibiting their potential to actively induce and/or sustain autoimmune and inflammatory responses. PMID:22562653

  1. Medical management of benign prostatic hyperplasia: Results from a population-based study

    PubMed Central

    Bishr, Mohamed; Boehm, Katharina; Trudeau, Vincent; Tian, Zhe; Dell’Oglio, Paolo; Schiffmann, Jonas; Jeldres, Claudio; Sun, Maxine; Shariat, Sharokh F.; Graefen, Markus; Saad, Fred; Karakiewicz, Pierre I.

    2016-01-01

    Introduction: In men with bothersome lower urinary tract symptoms (LUTS), medical treatment usually represents the first line. We examined the patterns of medical management of benign prostatic hyperplasia (BPH) in the Montreal metropolitan area, within the context of a case control study focusing on incident prostate cancer. Methods: Cases were 1933 men with incident prostate cancer. Population controls included 1994 age-matched men. In-person interviews collected sociodemographic characteristics and medical history, including BPH diagnosis, its duration, and type of medical treatment received. Baseline characteristics were compared by the chi-square likelihood test for categorical variables and by the students t-test for continuously coded variables. Results: Overall, 1120 participants had history of BPH; of those 53.7% received medical treatment for BPH. Individuals with medically treated BPH, compared to individuals with medically untreated BPH, were older at index date [mean: 66.9 vs. 64.9 years, p<0.001)] and at diagnosis of BPH [mean: 62.3 vs. 60.3 years, p<0.001]. They also had a longer duration of BPH-history [mean: 4.7 vs. 4.0 years, p=0.02]. Regarding medical treatment, mono-therapy was more often used than combination therapy [87.6% vs. 12.4%, p<0.001]. Alpha-blockers (69.9%) were most commonly used as monotherapy, followed by 5alpha-reductase inhibitors (5ARIs) (26.6%). Alpha-blockers plus 5ARIs were the most common combination therapy (97.3%). Conclusions: Despite evidence from randomized, controlled trials for better efficacy with use of combination therapy, monotherapy consisting of alpha-blockers or 5ARI, in that order, is most frequently used. Additionally, 5ARI use was more common than previously reported (27% vs. 15%). PMID:26977208

  2. Prostate size correlates with fasting blood glucose in non-diabetic benign prostatic hyperplasia patients with normal testosterone levels.

    PubMed

    Kim, Won Tae; Yun, Seok Joong; Choi, Young Deuk; Kim, Gi-Young; Moon, Sung-Kwon; Choi, Yung Hyun; Kim, Isaac Yi; Kim, Wun-Jae

    2011-09-01

    We evaluated the correlations between BMI, fasting glucose, insulin, testosterone level, insulin resistance, and prostate size in non-diabetic benign prostatic hyperplasia (BPH) patients with normal testosterone levels. Data from 212 non-diabetic BPH patients with normal testosterone levels, who underwent transurethral resection of the prostate (TURP) due to medical treatment failure, were evaluated retrospectively. Patients with prostate specific antigen (PSA) levels of ≥ 3 ng/mL underwent multicore transrectal prostate biopsy before TURP to rule out prostate cancer. Patients with diabetes mellitus (DM) or serum testosterone levels of < 3.50 ng/mL were excluded from analysis. Correlations between clinical and laboratory parameters were determined. Prostate size correlated positively with age (r = 0.227, P < 0.001), PSA (r = 0.510, P < 0.001), and fasting glucose level (r = 0.186, P = 0.007), but not with BMI, testosterone, insulin level, or insulin resistance (each P > 0.05). Testosterone level inversely correlated with BMI (r = -0.327, P < 0.001), insulin level (r = -0.207, P = 0.003), and insulin resistance (r = -0.221, P = 0.001), but not with age, prostate size, PSA, or fasting glucose level (each P > 0.05). Upon multiple adjusted linear regression analysis, prostate size correlated with elevated PSA (P < 0.001) and increased fasting glucose levels (P = 0.023). In non-DM BPH patients with normal testosterone levels, fasting glucose level is an independent risk factor for prostate hyperplasia. PMID:21949470

  3. [Antiandrogen therapy of benign prostatic hyperplasia--review of the agents evaluation of the clinical results].

    PubMed

    Kanimoto, Y; Okada, K

    1991-11-01

    Various non-surgical therapeutic modalities such as balloon dilation of the prostatic urethra, hyperthermia of the prostate and medication with antiandrogens and/or adrenergic blockade have been attempted for the patients with benign prostatic hyperplasia (BPH) especially in an early stage or in a poor operative risk. The observation that androgen deprivation induces shrinkage of the hyperplastic prostate represents the basis for the treatment of BPH with antiandrogen. Although several antiandrogens are now in clinical use in our country, there still remain problems to be solved. We reviewed the mechanism of action and the clinical results of antiandrogens in the treatment of BPH. The improvement following antiandrogen therapy occurred among the patients with symptomatic BPH, in 50-80% subjectively and in 40-50% objectively. The therapy appeared to be more effective in an early stage of the disease. However, the limitation of the duration of the effects and unfavorable side effects should also be noticed. The progestational agents such as gestonorone caproate, chlormadinone acetate and allylestrenol suppress more or less sexual function by interference of the pituitary-gonadal axis. Besides, coincidental prostate cancer must be excluded since antiandrogen therapy might hinder the natural course of the cancer. PMID:1722627

  4. Microwave applicators for BPH thermotherapy

    NASA Astrophysics Data System (ADS)

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

    2004-04-01

    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.

  5. Anti-proliferative effects of qianliening capsules on prostatic hyperplasia in vitro and in vivo

    PubMed Central

    ZHONG, XIAOYONG; LIN, JIUMAO; ZHOU, JIANHENG; XU, WEI; HONG, ZHENFENG

    2015-01-01

    Previous studies by our group showed that Qianliening capsules (QC), a clinically proven effective traditional Chinese formulation that has long been used in the treatment of benign prostatic hyperplasia (BPH), is capable of inhibiting BPH in vivo and in vitro via the promotion of apoptosis, suppression of the EGFR/STAT3 signaling pathway and regulating the expression of sex hormones as well as their receptors. However, the mechanism of its anti-BPH activity has remained to be fully elucidated. The present study aimed to investigate the mechanism underlying the anti-proliferative effect of QC in vivo and in vitro. Castrated male Sprage-Dawley (SD) rats where subcutaneously injected with testosterone propionate and the WPMY-1 cell line was stimulated with basic fibroblast growth factor in order to generate BPH in vivo and in vitro separately, both of which were then subjected to QC treatment. Finasteride was used as a positive control drug for the in vivo study. In the present study, it was found that treatment with QC or finasteride significantly reduced the prostatic index (PI=prostate wet weight/body weight × 100) in a rat model of BPH (P<0.05). In addition, reverse transcription quantitative polymerase chain reaction (RT-PCR) and western blot analyses showed that QC or finasteride treatment significantly inhibited model construction-induced upregulation of expression of proliferating cell nuclear antigen, cyclin D1 and cyclin-dependent kinase 4 in prostatic tissues of rats with BPH (P<0.05). The in vitro study further proved that QC exhibited anti-proliferative properties via G1/S cell cycle arrest in the WPMY-1 cell line, as evidenced by colony formation, flow cytometric cell cycle, immunoblot and RT-PCR analyses. In conclusion, the present study demonstrated that inhibition of cell proliferation via G1/S cell cycle arrest may be one of the underlying mechanisms of the effect of QC on BPH. PMID:25825141

  6. Common questions about the diagnosis and management of benign prostatic hyperplasia.

    PubMed

    Pearson, Ryan; Williams, Pamela M

    2014-12-01

    Benign prostatic hyperplasia (BPH) is a common condition that increases in prevalence with age. A history should include onset, duration, and severity of lower urinary tract symptoms and medication use to rule out other causes of symptoms. Physical examination includes a digital rectal examination and assessment for bladder distention or neurologic impairment. Recommended tests include serum prostate-specific antigen measurement and urinalysis to help identify infection, genitourinary cancer, or calculi as an alternative cause of lower urinary tract symptoms. BPH severity is assessed using validated, self-administered symptom questionnaires such as the American Urological Association Symptom Index or International Prostate Symptom Score. Mild or nonbothersome symptoms do not require treatment. Bothersome symptoms are managed with lifestyle modifications, medications, and surgery. Alpha blockers are first-line medications for BPH. Surgical referral is indicated if BPH-related complications develop, medical therapy fails, or the patient chooses it. Dietary supplements, such as saw palmetto, pygeum, cernilton, and beta sitosterols, and acupuncture are not recommended for the management of BPH. PMID:25611711

  7. Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia

    PubMed Central

    Carmignani, Luca; Bozzini, Giorgio; Macchi, Alberto; Maruccia, Serena; Picozzi, Stefano; Casellato, Stefano

    2015-01-01

    Treatment of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of thulium laser enucleation of the prostate (ThuLEP) on sexual function and retrograde ejaculation in patients with LUTS secondary to BPH. We performed a prospective study in 110 consecutive patients who had undergone ThuLEP to analyze changes in sexual function and urinary symptoms. To evaluate changes in erection and ejaculation, and the effect of urinary symptoms on the quality of life (QoL), five validated questionnaires were used: the ICIQ-MLUTSsex, MSHQ-EjD, International Index of Erectile Function 5, International Prognostic Scoring System (IPSS) questionnaire, and QoL index of the intraclass correlation coefficients. Patients also underwent IPSS and flowmetry to assess the outcome of flow. Patients were evaluated before surgery and 3–6 months after ThuLEP, whereas those with previous abdominal surgery were excluded. The patients’ mean age was 67.83 years. Postoperative urinary symptoms improved after surgery. No significant differences in erectile function before and after surgery were observed. As compared with other techniques described in the literature, the percentage of patients with conserved ejaculation increased by 52.7% after ThuLEP. ThuLEP positively affects urinary symptoms and their effect on the QoL of patients as assessed by questionnaire scores. While endoscopic management of BPH (e.g. transurethral resection of the prostate) causes retrograde ejaculation in most patients, those who undergo ThuLEP have conserved ejaculation and erectile function. PMID:25652616

  8. Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia.

    PubMed

    Carmignani, Luca; Bozzini, Giorgio; Macchi, Alberto; Maruccia, Serena; Picozzi, Stefano; Casellato, Stefano

    2015-01-01

    Treatment of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of thulium laser enucleation of the prostate (ThuLEP) on sexual function and retrograde ejaculation in patients with LUTS secondary to BPH. We performed a prospective study in 110 consecutive patients who had undergone ThuLEP to analyze changes in sexual function and urinary symptoms. To evaluate changes in erection and ejaculation, and the effect of urinary symptoms on the quality of life (QoL), five validated questionnaires were used: the ICIQ-MLUTSsex, MSHQ-EjD, International Index of Erectile Function 5, International Prognostic Scoring System (IPSS) questionnaire, and QoL index of the intraclass correlation coefficients. Patients also underwent IPSS and flowmetry to assess the outcome of flow. Patients were evaluated before surgery and 3-6 months after ThuLEP, whereas those with previous abdominal surgery were excluded. The patients' mean age was 67.83 years. Postoperative urinary symptoms improved after surgery. No significant differences in erectile function before and after surgery were observed. As compared with other techniques described in the literature, the percentage of patients with conserved ejaculation increased by 52.7% after ThuLEP. ThuLEP positively affects urinary symptoms and their effect on the QoL of patients as assessed by questionnaire scores. While endoscopic management of BPH (e.g. transurethral resection of the prostate) causes retrograde ejaculation in most patients, those who undergo ThuLEP have conserved ejaculation and erectile function. PMID:25652616

  9. Benign Prostatic Hyperplasia and the Risk of Prostate Cancer and Bladder Cancer: A Meta-Analysis of Observational Studies.

    PubMed

    Dai, Xiaoyu; Fang, Xiangming; Ma, Ying; Xianyu, Jianbo

    2016-05-01

    Benign prostatic hyperplasia (BPH) has been suggested to be a risk factor for certain urologic cancers, but the current evidence is inconsistent.The aim of this study was to investigate the association between BPH and urologic cancers.MEDLINE, EMBASE, Cochrane Library, and Web of Science were searched for potential eligible studies.We included case-control studies or cohort studies, which evaluated the association between BPH and urologic cancers (including prostate cancer, bladder cancer, kidney cancer, testicular cancer, or penile cancer).Overall effect estimates were calculated using the DerSimonian-Laird method for a random-effects model. Summary effect-size was calculated as risk ratio (RR), together with the 95% confidence interval (CI).This systematic review included 16 case-control studies and 10 cohort studies evaluating the association of BPH and prostate or bladder cancer; we did not identify any study about other urologic cancers. Meta-analyses demonstrated that BPH was associated with an increased incidence of prostate cancer (case-control study: RR = 3.93, 95% CI = 2.18-7.08; cohort-study: RR = 1.41, 95% CI = 1.00-1.99) and bladder cancer (case-control study: RR = 2.50, 95% CI = 1.63-3.84; cohort-study: RR = 1.58, 95% CI = 1.28-1.95). Subgroup analysis by ethnicity suggested that the association between BPH and prostate cancer was much stronger in Asians (RR = 6.09, 95% CI = 2.96-12.54) than in Caucasians (RR = 1.54, 95% CI = 1.19-2.01). Egger's tests indicated low risk of publication bias (prostate cancer: P = 0.11; bladder cancer: P = 0.95).BPH is associated with an increased risk of prostate cancer and bladder cancer. The risk of prostate cancer is particularly high in Asian BPH patients. Given the limitations of included studies, additional prospective studies with strict design are needed to confirm our findings. PMID:27149447

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

    SciTech Connect

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

    2009-04-14

    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.

  11. Effect of Pulsed Electromagnetic Field Therapy on Prostate Volume and Vascularity in the Treatment of Benign Prostatic Hyperplasia: A Pilot Study in a Canine Model

    PubMed Central

    Leoci, Raffaella; Aiudi, Giulio; Silvestre, Fabio; Lissner, Elaine; Lacalandra, Giovanni Michele

    2014-01-01

    BACKGROUND Benign prostatic hyperplasia (BPH) is a result of urogenital aging. Recent studies suggest that an age-related impairment of the blood supply to the lower urinary tract plays a role in the development of BPH and thus may be a contributing factor in the pathogenesis of BPH. The canine prostate is a model for understanding abnormal growth of the human prostate gland. We studied the efficacy of pulsed electromagnetic field therapy (PEMF) in dogs to modify prostate blood flow and evaluated its effect on BPH. METHODS PEMF (5 min, twice a day for 3 weeks) was performed on 20 dogs affected by BPH. Prostatic volume, Doppler assessment by ultrasonography, libido, semen quality, testosterone levels, and seminal plasma volume, composition and pH were evaluated before and after treatment. RESULTS The 3 weeks of PEMF produced a significant reduction in prostatic volume (average 57%) without any interference with semen quality, testosterone levels or libido. Doppler parameters showed a reduction of peripheral resistances and a progressive reduction throughout the trial of the systolic peak velocity, end-diastolic velocity, mean velocity, mean, and peak gradient of the blood flow in the dorsal branch of the prostatic artery. The pulsatility index and the resistance index did not vary significantly over time. CONCLUSIONS The efficacy of PEMF on BPH in dogs, with no side effects, suggests the suitability of this treatment in humans and supports the hypothesis that impairment of blood supply to the lower urinary tract may be a causative factor in the development of BPH. Prostate 74:1132–1141, 2014. © 2014 The Authors. The Prostate published by Wiley Periodicals, Inc. PMID:24913937

  12. Association between polymorphisms of estrogen receptor 2 and benign prostatic hyperplasia

    PubMed Central

    KIM, SU KANG; CHUNG, JOO-HO; PARK, HYUN CHUL; KIM, JUN HO; ANN, JAE HONG; PARK, HUN KUK; LEE, SANG HYUP; YOO, KOO HAN; LEE, BYUNG-CHEOL; KIM, YOUNG OCK

    2015-01-01

    Estrogens and estrogen receptors (ESRs) have been implicated in the stimulation of aberrant prostate growth and the development of prostate diseases. The aim of the present study was to investigate four single nucleotide polymorphisms (SNPs) of the ESR2 gene in order to examine whether ESR2 is a susceptibility gene for benign prostatic hyperplasia (BPH). In order to evaluate whether an association exists between ESR2 and BPH risk, four polymorphisms [rs4986938 (intron), rs17766755 (intron), rs12435857 (intron) and rs1256049 (Val328Val)] of the ESR2 gene were genotyped by direct sequencing. A total of 94 patients with BPH and 79 control subjects were examined. SNPStats and Haploview version 4.2 we used for the genetic analysis. Multiple logistic regression models (codominant1, codominant2, dominant, recessive and log-additive) were produced in order to obtain the odds ratio, 95% confidence interval and P-value. Three SNPs (rs4986938, rs17766755 and rs12435857) showed significant associations with BPH (rs4986938, P=0.015 in log-additive model; rs17766755, P=0.033 in codominant1 model, P=0.019 in dominant model and P=0.020 in log-additive model; rs12435857, P=0.023 in dominant model and P=0.011 in log-additive model). The minor alleles of these SNPs increased the risk of BPH, and the AAC haplotype showed significant association with BPH (χ2=6.34, P=0.0118). These data suggest that the ESR2 gene may be associated with susceptibility to BPH. PMID:26640585

  13. Microvascular density and immunohistochemical expression of VEGF, VEGFR-1 and VEGFR-2 in benign prostatic hyperplasia, high-grade prostate intraepithelial neoplasia and prostate cancer

    PubMed Central

    Goussia, Anna; Stefanou, Dimitrios; Giannakis, Dimitrios

    2016-01-01

    Introduction The aim of our study was to determine and compare angiogenesis in benign prostatic hyperplasia (BPH), high-grade prostate intraepithelial neoplasia (HGPIN) and prostate cancer (Pca). Moreover, we evaluated its role as a prognostic factor for Pca. Material and methods We examined 39, 12 and 51 samples of BPH, HGPIN and Pca, respectively. Immunohistochemical methods were applied in order to evaluate the expression of VEGF and its receptors (VEGFR-1, VEGFR-2), while microvascular density (MVD) was determined using CD105. In Pca samples, we recorded stage, differentiation, perineural invasion, adjuvant radiotherapy and their correlation with angiogenesis. Results 225 The expression of VEGF, VEGFR-1 and VEGFR-2 was significantly higher in Pca than compared to BPH (p <0.001, p <0.001 and p <0.001, respectively) and HGPIN (p <0.001, p <0.001 and p = 0.04, respectively), while there was no difference between BPH and HGPIN. MVD was higher in Pca compared to BPH (p <0.001) and HGPIN (p <0.01), while there was no difference between BPH and HGPIN. VEGF expression and MVD were significantly greater in Pca samples with poor differentiation (p = 0.044 and p = 0.038, respectively) and perineural invasion (p <0.001 and p = 0.019, respectively), while overexpression of VEGF was associated with advanced pathological stage (p = 0.047). Conclusions Angiogenesis is more prominent in Pca than in BPH and HGPIN, while there is no difference between BPH and HGPIN. Pharmaceutical inhibition of angiogenesis could be a valuable therapeutic option for Pca in the near future. PMID:27123329

  14. Open prostatectomy in benign prostatic hyperplasia: 10-year experience in Italy.

    PubMed

    Mearini, E; Marzi, M; Mearini, L; Zucchi, A; Porena, M

    1998-12-01

    This study reports the experience of 47 Italian urology units together with the urology unit at the University of Perugia concerning open surgery in the management of benign prostatic hyperplasia (BPH). Until 20-25 years ago, open surgery was the most common approach. In the late 1970s the development of endoscopes and their methodology has led to a gradual reduction in open surgery operations, which decreased rapidly with the introduction of mini-invasive endoscopic techniques. Therefore, open surgery for BPH is declining, though still performed. Skill in traditional surgery is mandatory because, until an alternative is devised, indications for open surgery still exist and cannot be ignored. The survey shows the indications and contraindications, complications and results of a 10-year nationwide experience. Guidelines for open surgery in patients with BPH have been drawn up. PMID:9831789

  15. Shrinkage of Prostate and Improved Quality of Life: Management of BPH Patients with Croton membranaceus Ethanolic Root Extract

    PubMed Central

    Asare, George Awuku; Afriyie, Daniel; Ngala, Robert A.; Appiah, Alfred A.; Anang, Yvonne; Musah, Iddi; Adjei, Samuel; Bamfo-Quaicoe, Kwabena; Sule, Derick; Gyan, Ben A.; Arhin, Peter; Edoh, Dominic A.

    2015-01-01

    Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The study aimed at validating the use of freeze-dried Croton membranaceus ethanolic root extract for BPH management. Thirty-three patients were observed before and after 3-month administration of 20 mg t.i.d orally. The International Prostate Symptom Score (IPSS), and the International Index of Erectile Function (IIEF) questionnaires were used. Total/free PSA (tPSA, fPSA), renal, liver function, lipid tests, and ultrasonographic imaging were performed. Thirty (30) patients (66 ± 11 years) completed the study. IPSS results showed 37% had severe, 40% moderate, and 23% mild symptoms before; 57% and 43% had moderate and mild symptoms, respectively, after treatment. IIED of patients' results showed 30% with severe, 40% moderate, 24% mild-moderate, 3% mild, and 3% no erectile dysfunction before treatment and 20% severe, 43% moderate, and 37% mild-moderate dysfunction, after treatment. Quality of life (QoL) improved (P = 0.001). Significant but non-pathological increases in total and indirect bilirubin as well as apolipoprotein A occurred. Mean tPSA reduced from 27.9 ± 19.0 to 16.2 ± 11.8 ng/mL (P = 0.002); fPSA from 6.1 ± 4.8 to 3.9 ± 2.9 ng/mL (P = 0.045); and prostate volume from 101.8 ± 41.3 to 54.5 ± 24.8 cm3  (P = 0.023). C. membranaceus shrinks the prostate and improves QoL. PMID:26106434

  16. [Benign prostatic hyperplasia: medical therapy].

    PubMed

    Schlenker, B; Gratzke, C; Weidlich, P; Seitz, M; Reich, O; Stief, C G

    2007-08-16

    Primary aims of the medical therapy for BPH are improvement of subjective symptoms and quality of life as well as the prevention of long-term complications such as acute urinary retention and renal failure. Secondary goal is inhibition of disease progression. The medical therapy should be tailored to each patient according to the individual complaints and risk of progression. Plant extracts, alpha-blockers and 5-alpha reductase inhibitors represent the most common prescribed substances. Recent data suggest beneficial effects for the use of antimuscarinic agents and phosphodiesterase type 5 inhibitors. PMID:17912863

  17. The histological and histometrical effects of Urtica dioica extract on rat's prostate hyperplasia.

    PubMed

    Moradi, Hamid Reza; Erfani Majd, Naeem; Esmaeilzadeh, Saleh; Fatemi Tabatabaei, Sayed Reza

    2015-01-01

    Benign prostatic hyperplasia (BPH) is a common disease in human that gradual overgrowth of the prostate gland leads to impinge on the urethra with impairment in urinary function. Numerous plants improve uncontrolled growth of the prostate gland and improve urinary tract symptoms associated with BPH. In this study, 25 healthy adult male Wistar rats were divided randomly in five groups: G1 (Control group) received ordinary feed without any treatment, G2 received 10 mg kg(-1) testosterone subcutaneously, G3 received 50 mg kg(-1) nettle root extract orally, G4 received 50 mg kg(-1) nettle root extract orally and 10 mg kg(-1) testosterone, G5 received 10 mg kg(-1) almond oil (Almond oil was used as testosterone solvent) subcutaneously. After six weeks, volume and weight of each lobe were measured and samples were taken. The 5 to 6 µm thickness sections were made using paraffin embedding method and stained by hematoxylin and eosin and periodic acid-Schiff. The results showed that prostate volume and ratio of prostate to body weight were increased significantly in the testosterone. Histological and histometrical results showed that dorsal and lateral type 1 and 2 lobes were not changed significantly but the ventral and anterior lobes have changed significantly. Over all, the nettle root could prevent from some of prostatic hyperplasia effects, so that percentage of folded alveoli in ventral lobe reduced insignificantly. PMID:25992248

  18. Relationship Between Depression and Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

    PubMed Central

    Dunphy, Claire; Laor, Leanna; Te, Alexis; Kaplan, Steven; Chughtai, Bilal

    2015-01-01

    This article provides an overview of current data on the relationship between depression and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), with a focus on pathophysiology and patient management implications. Review of the literature indicated a clear relationship between LUTS secondary to BPH and depression. It is unknown whether this relationship is bidirectional or unidirectional. Depression is associated with the impact of LUTS on quality of life in men with BPH. Research suggests that depression alters the experience of LUTS in this population. Medical and surgical treatments for BPH may impact quality of life and, therefore, depression. Results conflict on the exact nature of the relationship examined, and on the extent to which the relationship may be attributed to physiological factors such as inflammation. Practicing clinicians should consider using a brief self-administered scale to assess for depression in patients with BPH. There is a clear need for additional research to decisively determine the nature of the relationship between LUTS secondary to BPH and depression, as well as the extent to which change in either condition may be affected by the other.

  19. Recovery of serum prostate specific antigen value after interruption of antiandrogen therapy with allylestrenol for benign prostatic hyperplasia.

    PubMed

    Noguchi, Kazumi; Suzuki, Kotaro; Teranishi, Jun-ichi; Kondo, Keiichi; Kishida, Takeshi; Saito, Kazuo; Uemura, Hiroji; Kubota, Yoshinobu

    2006-07-01

    Decrease in serum prostate specific antigen (PSA) concentration is inevitably associated with antiandrogen therapy for benign prostatic hyperplasia (BPH), and might mask the presence of prostate cancer or delay its diagnosis. To determine the appropriate timepoint for determination of correct PSA value, we sequentially measured serum PSA and testosterone levels after discontinuation of antiandrogen therapy for BPH. With informed consent, 12 patients (72.8 +/- 12.2* years old) with BPH were treated with allylestrenol 50 mg/day for 4 months. Serum testosterone and PSA concentrations were determined before and just after treatment, as well as every month after treatment up to 3 months. After treatment with allylestrenol for 4 months, mean serum testosterone and PSA levels were significantly decreased from 408 +/- 136* to 87.9 +/- 76.2* ng/dl, and from 2.81 +/- 0.87* to 2.04 +/- 0.82* ng/ml, respectively. The mean serum PSA level recovered to the pretreatment level within 2 months and mean serum testosterone concentration within one month after discontinuation of administration. In conclusion, during treatment of BPH with antiandrogen allylestrenol, a two-month washout is adequate for determination of correct PSA value (*: M +/- SD). PMID:16910584

  20. Benign Prostatic Hyperstatic Hyperplasia (BPH) (Beyond the Basics)

    MedlinePlus

    ... done as an open simple prostatectomy or by robotic assisted (DaVinci) laparoscopic simple prostatectomy. Recovery is much easier for the patient after the robotic assisted laparoscopic procedure. ● Suprapubic catheter – A catheter placed ...

  1. Benign prostatic hyperplasia as a progressive disease: a guide to the risk factors and options for medical management

    PubMed Central

    Emberton, M; Cornel, E B; Bassi, P F; Fourcade, R O; Gómez, J M F; Castro, R

    2008-01-01

    Benign prostatic hyperplasia (BPH) is a complex disease that is progressive in many men. BPH is commonly associated with bothersome lower urinary tract symptoms; progressive disease can also result in complications such as acute urinary retention (AUR) and BPH-related surgery. It is therefore important to identify men at increased risk of BPH progression to optimise therapy. Several factors are associated with progression, including age and prostate volume (PV). Serum prostate-specific antigen level is closely correlated with PV, making it useful for determining the risk of BPH progression. Medical therapy is the most frequently used treatment for BPH. 5-alpha-reductase inhibitors impact the underlying disease and decrease PV; this results in improved symptoms, urinary flow and quality of life, and a reduced risk of AUR and BPH-related surgery. Alpha-blockers achieve rapid symptom relief but do not reduce the overall risk of AUR or BPH-related surgery, presumably because they have no effect on PV. Combination therapy provides greater and more durable benefits than either monotherapy and is a recommended option in treatment guidelines. The Combination of Avodart® and Tamsulosin (CombAT) study is currently evaluating the combination of dutasteride with tamsulosin over 4 years in a population of men at increased risk of BPH progression. A preplanned 2-year analysis has shown sustained symptom improvement with combination therapy, significantly greater than with either monotherapy. CombAT is also the first study to show benefit in improving BPH symptoms for combination therapy over the alpha-blocker, tamsulosin, from 9 months of treatment. PMID:18479366

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

    PubMed Central

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

    2014-01-01

    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), 5α-reductase and cyclooxygenase-2 (COX-2) levels were also measured. BPH-induced animals exhibited an increase in prostate weight with increased testosterone, DHT, 5α-reductase and COX-2 expression levels. However, rape pollen SFE-CO2 treatment resulted in significant reductions in the prostate index and testosterone, DHT, 5α-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, 5α-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

  3. Monocyte Chemotactic Protein-1 (MCP-1/CCL2) Is Associated With Prostatic Growth Dysregulation and Benign Prostatic Hyperplasia

    PubMed Central

    Fujita, Kazutoshi; Ewing, Charles M.; Getzenberg, Robert H.; Parsons, J. Kellogg; Isaacs, William B.; Pavlovich, Christian P.

    2016-01-01

    BACKGROUND Chronic inflammation is commonly observed in benign prostate hyperplasia (BPH), and prostate tissue often contains increased inflammatory infiltrates, including T cells and macrophages. Cytokines are not only key mediators of inflammation but may also play important roles in the initiation and progression of BPH. METHODS In order to determine what cytokines might be involved in prostatic enlargement, expressed prostatic secretions (EPS) from ex vivo prostates were analyzed by human cytokine antibody microarray and ELISA. Prostate epithelial cells (PrEC) and prostate stromal cells (PrSC) were used for ELISA, proliferation, and Western blot assays. RESULTS Monocyte chemotactic protein-1 (MCP-1/CCL2) was one of the most elevated proteins in secretions from large prostate glands. PrSC were found to secrete MCP-1; Western blotting showed that both PrSC and PrEC express the MCP-1 receptor CCR2 which by RT-PCR was the CCR2b isoform. Proliferation assays showed that MCP-1 stimulates the proliferation of PrEC, but not PrSC, and that a specific MCP-1 antagonist (RS102895) suppressed this effect. Conditioned medium from PrSC stimulated the proliferation of PrEC as well, an effect completely inhibited by both RS102895 and a neutralizing anti-MCP-1 monoclonal antibody. The inflammatory cytokines interleukin (IL)-1β, interferon-γ, and IL-2 enhanced the secretion of MCP-1 from PrEC and PrSC. In addition, MCP-1 levels in EPS correlated with mRNA levels of the macrophage marker CD68 in the same secretions. CONCLUSIONS The cytokine MCP-1, of apparent prostatic stromal cell origin, may play an important role in prostatic enlargement and BPH, and is a candidate biomarker for these pathologic processes. PMID:19902472

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

    SciTech Connect

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

    1996-03-01

    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.

  5. Are phosphodiesterase type 5 inhibitors effective for the management of lower urinary symptoms suggestive of benign prostatic hyperplasia?

    PubMed Central

    Zhang, Li Tao; Park, Jong Kwan

    2015-01-01

    AIM: To review the efficacy of phosphodiesterase type 5 inhibitors (PDE5-Is) in lower urinary tract symptoms (LUTS) suggestive of benign prostate hyperplasia (LUTS/BPH). METHODS: A comprehensive research was conducted to identify all publications relating to benign prostate hyperplasia and treatment with sildenafil, vardenafil and tadalafil. To assess the efficacy, the changes in total international prostate symptom score (IPSS), IPSS subscore including voiding, storage and quality of life (QoL), Benign prostatic hyperplasia Impact Index (BII), maximum urinary flow rate (Qmax) and the International Index of Erectile Function (IIEF) were extracted. A meta-analytical technique was used for the analysis of integrated data from the included studies to evaluate the mean difference in the results. RESULTS: Total IPSS score, IIEF and BII showed a significant improvement in trials in which LUTS/BPH with or without erectile dysfunction (ED) were compared with the placebo. For LUTS/BPH, the mean differences of total IPSS score, IIEF and BII are -2.17, 4.88 and -0.43, P < 0.00001, respectively. For LUTS/BPH with comorbid ED, the mean difference are -1.97, 4.54 and -0.52, P < 0.00001, respectively. PDE5-Is appear to improve IPSS storage, voiding and QoL subscore (mean difference = -0.71, -1.23 and -0.33, P < 0.00001, respectively). Although four doses of tadalafil (2.5, 5, 10 and 20 mg) failed to reach significance in Qmax (mean difference = 0.22, P = 0.10), the 5 mg dose of tadalafil significantly improved the Qmax (mean difference = 0.33, P = 0.03). CONCLUSION: PED5-Is demonstrated efficacy for improving LUTS in BPH patients with or without ED and could be considered to be the first line treatment for LUTS/BPH. PMID:25664256

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

    PubMed Central

    Issa, Muta M

    2005-01-01

    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

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

    PubMed

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

    2014-06-01

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

  8. 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)

    Uchida, Toyoaki

    2011-09-01

    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.

  9. Differential nuclear matrix-intermediate filament expression in human prostate cancer in respect to benign prostatic hyperplasia.

    PubMed

    Alberti, I; Parodi, S; Barboro, P; Sanna, P; Nicolò, G; Allera, C; Patrone, E; Galli, S; Balbi, C

    1996-12-01

    We have characterized the changes in composition of the nuclear matrix-intermediate filament complex (NM-IF) isolated from prostate cancer (PCa), compared with benign prostatic hyperplasia (BPH). We prepared the NM-IF from ten patients undergoing radical retropubic prostectomy; the benign hyperplastic tissue was obtained from the prostate lobe contralateral to the cancer zone. Several quantitative and qualitative changes have been identified. Three new proteins of molecular weight 48, 47 and 29 kDa and isoelectric point 6.0, 4.9 and 6.4, respectively, were detected in PCa, referred to here as P8, P5 and NM-1, P8 was present in all ten of the tumors examined, P5 was expressed in 9/10 PCa; conversely, they were present in only one and two BPH, respectively; NM-1 was found in eight tumors out of nine and never in BPH. These proteins are expressed in moderately differentiated malignant cells, suggesting that the proteins of the NM-IF complex can be interesting biomarkers for prostate cancer. Immunoblot analysis shows that P8 and P5 proteins belong to the IF superfamily. This observation, taken together with previous data obtained by our and other groups, suggests that the characterization of NM-IF protein changes could also shed light on mechanistic aspects of cancer progression. PMID:9020920

  10. Evaluation of silodosin in comparison to tamsulosin in benign prostatic hyperplasia: A randomized controlled trial

    PubMed Central

    Pande, Satabdi; Hazra, Avijit; Kundu, Anup Kumar

    2014-01-01

    Objectives: Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms in elderly men. Selective alfa1-adrenergic antagonists are now first-line drugs in the medical management of BPH. We conducted a single-blind, parallel group, randomized, controlled trial to compare the effectiveness and safety of the new alfa1-blocker silodosin versus the established drug tamsulosin in symptomatic BPH. Materials and Methods: Ambulatory male BPH patients, aged above 50 years, were recruited on the basis of International Prostate Symptom Score (IPSS). Subjects were randomized in 1:1 ratio to receive either tamsulosin 0.4 mg controlled release or silodosin 8 mg once daily after dinner for 12 weeks. Primary outcome measure was reduction in IPSS. Proportion of subjects who achieved IPSS <8, change in prostate size as assessed by ultrasonography and changes in peak urine flow rate and allied uroflowmetry parameters, were secondary effectiveness variables. Treatment emergent adverse events were recorded. Results: Data of 53 subjects – 26 on silodosin and 27 on tamsulosin were analyzed. Final IPSS at 12-week was significantly less than baseline for both groups. However, groups remained comparable in terms of IPSS at all visits. There was a significant impact on sexual function (assessed by IPSS sexual function score) in silodosin arm compared with tamsulosin. Prostate size and uroflowmetry parameters did not change. Both treatments were well-tolerated. Retrograde ejaculation was encountered only with silodosin and postural hypotension only with tamsulosin. Conclusions: Silodosin is comparable to tamsulosin in the treatment of BPH in Indian men. However, retrograde ejaculation may be troublesome for sexually active patients. PMID:25538330

  11. Minimally invasive devices for treating lower urinary tract symptoms in benign prostate hyperplasia: technology update

    PubMed Central

    Aoun, Fouad; Marcelis, Quentin; Roumeguère, Thierry

    2015-01-01

    Benign prostatic hyperplasia (BPH) represents a spectrum of related lower urinary tract symptoms (LUTS). The cost of currently recommended medications and the discontinuation rate due to side effects are significant drawbacks limiting their long-term use in clinical practice. Interventional procedures, considered as the definitive treatment for BPH, carry a significant risk of treatment-related complications in frail patients. These issues have contributed to the emergence of new approaches as alternative options to standard therapies. This paper reviews the recent literature regarding the experimental treatments under investigation and presents the currently available experimental devices and techniques used under local anesthesia for the treatment of LUTS/BPH in the vast majority of cases. Devices for delivery of thermal treatment (microwaves, radiofrequency, high-intensity focused ultrasound, and the Rezum system), mechanical devices (prostatic stent and urethral lift), fractionation of prostatic tissue (histotripsy and aquablation), prostate artery embolization, and intraprostatic drugs are discussed. Evidence for the safety, tolerability, and efficacy of these “minimally invasive procedures” is analyzed. PMID:26317083

  12. Enlarged prostate - after care

    MedlinePlus

    BPH - self-care; Benign prostatic hypertrophy - self-care; Benign prostatic hyperplasia - self-care ... Your health care provider may have you take a medicine called alpha-1- blocker. Most people find that these drugs help ...

  13. Association of BID SNPs (rs8190315 and rs2072392) and clinical features of benign prostate hyperplasia in Korean population

    PubMed Central

    Seok, Hosik; Kim, Su Kang; Yoo, Koo Han; Lee, Byung-Cheol; Kim, Young Ock; Chung, Joo-Ho

    2014-01-01

    Exercise has beneficial effect on cancer apoptosis and benign prostatic hyperplasia (BPH). The BH3 interacting domain death agonist (BID) gene expression is associated with apoptosis or cell proliferation. In this study, we investigated the association between BID single nucleotide polymorphisms (SNPs) and the development, prostate volume, and international prostate symptom score (IPSS) of BPH. In 222 BPH males and 214 controls, two SNPs in BID [rs8190315 (Ser56Gly), and rs2072392 (Asp106Asp)] were genotyped and analyzed using multiple logistic regression models. In the result, the genotype and allele frequencies of rs8190315 and rs2072392 were not associated with BPH development or IPSS, however, the allele frequencies [odd ratio (OR)= 1.90, 95% confidence interval (CI)= 1.07–3.41, P= 0.03] and genotype frequencies (in dominant model, OR= 1.94, 95% CI= 1.01–3.74, P= 0.42) of rs8190315, and the genotype frequencies of rs2072392 (in dominant model, OR= 1.94, 95% CI= 1.01–3.74, P= 0.42) were associated with increased prostate volume. We propose that rs8190315 and rs2072392 of BID may contribute to the disease severity of BPH. PMID:25610824

  14. Fixed-dose combination therapy with dutasteride and tamsulosin in the management of benign prostatic hyperplasia

    PubMed Central

    Dimitropoulos, Konstantinos; Gravas, Stavros

    2016-01-01

    Despite their multifactorial etiology, male lower urinary tract symptoms (LUTS) have been traditionally associated with benign prostatic enlargement (BPE) because of benign prostatic hyperplasia (BPH). Several pharmaceutical therapies have been used to manage LUTS, with α1-adrenergic receptor antagonists (α1-blockers) and inhibitors of 5α-reductase (5α-RIs) representing the most commonly prescribed agents currently in use for LUTS treatment. Due to their different modes of action, combined use of α1-blockers and 5α-RIs has been proven to offer more optimal control of symptoms and better associated quality of life, even though higher rates of adverse events have been shown. Following previous studies on the separate administration of dutasteride and tamsulosin, a fixed-dose combination capsule of tamsulosin 0.4 mg and dutasteride 0.5 mg has been approved and released for clinical use in men with BPH. The present review aims to discuss the rationale behind the combined use of tamsulosin and dutasteride for treating male LUTS, and to present the available data on the role of combination therapy in the management of BPH-related symptoms in terms of efficacy and safety. Special attention is given to the impact of combination treatment on the prevention of clinical progression of BPH. Cost-effectiveness of fixed-dose combination and patients’ adherence to treatment are also discussed. PMID:26834837

  15. Fixed-dose combination therapy with dutasteride and tamsulosin in the management of benign prostatic hyperplasia.

    PubMed

    Dimitropoulos, Konstantinos; Gravas, Stavros

    2016-02-01

    Despite their multifactorial etiology, male lower urinary tract symptoms (LUTS) have been traditionally associated with benign prostatic enlargement (BPE) because of benign prostatic hyperplasia (BPH). Several pharmaceutical therapies have been used to manage LUTS, with α1-adrenergic receptor antagonists (α1-blockers) and inhibitors of 5α-reductase (5α-RIs) representing the most commonly prescribed agents currently in use for LUTS treatment. Due to their different modes of action, combined use of α1-blockers and 5α-RIs has been proven to offer more optimal control of symptoms and better associated quality of life, even though higher rates of adverse events have been shown. Following previous studies on the separate administration of dutasteride and tamsulosin, a fixed-dose combination capsule of tamsulosin 0.4 mg and dutasteride 0.5 mg has been approved and released for clinical use in men with BPH. The present review aims to discuss the rationale behind the combined use of tamsulosin and dutasteride for treating male LUTS, and to present the available data on the role of combination therapy in the management of BPH-related symptoms in terms of efficacy and safety. Special attention is given to the impact of combination treatment on the prevention of clinical progression of BPH. Cost-effectiveness of fixed-dose combination and patients' adherence to treatment are also discussed. PMID:26834837

  16. Giant benign prostatic hyperplasia in a young adult male.

    PubMed

    Georgiades, Fanourios; Demosthenous, Sotiris; Antoniades, George; Kouriefs, Chryssanthos

    2014-08-01

    A 27-year-old Caucasian male presented with lower urinary tract symptoms and hemospermia. Magnetic resonance imaging revealed a prostate of 180 mL. The patient underwent open transvesical prostatic enucleation with preoperative and postoperative histopathologic examinations consistent with benign prostatic hyperplasia. Benign prostatic hyperplasia is a very rare condition at this age group, with this patient being the youngest non-Asian confirmed case in the literature. PMID:24958475

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

    PubMed

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

    2014-05-01

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

  18. Bipolar versus monopolar transurethral resection of the prostate for benign prostatic hyperplasia: safe in patients with high surgical risk

    PubMed Central

    Yang, Er J.; Li, Hao; Sun, Xin B.; Huang, Li; Wang, Li; Gong, Xiao X.; Yang, Yong

    2016-01-01

    Here, we compared the effects of bipolar and monopolar transurethral resection of the prostate (B-TURP, M-TURP) for treating elderly patients (≥75 years) with benign prostatic hyperplasia(BPH) who had internal comorbidities. Eligible BPH patients were aged ≥75 years and had at least one internal comorbidity. In this open-label, prospective trial, patients were assigned to B-TURP (n = 75) and M-TURP (n = 88) groups. Data on prostate volume (PV), urination, and time during perioperative period were compared; data associated with urination and complications at one year postoperatively were also compared. Finally, follow-up data were available for 68 and 81 patients in the B-TURP and M-TURP group, respectively. No deaths were recorded. Intraoperative bleeding was lower and irrigation time, indwelling catheter time, and hospital stay were shorter in the B-TURP group than in the M-TURP group (p < 0.001). No difference was observed with respect to operation time (p = 0.058). At one year after the operation, differences with respect to urination and complications were not significant. In conclusion, Short-term efficacy of B-TURP or M-TURP was satisfactory for elderly patients with BPH who had internal comorbidities. Besides, B-TURP is a more sensible choice because it has a lower prevalence of adverse effects. PMID:26892901

  19. Energy Delivery Systems for Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    2006-01-01

    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, the MAS decided that any comparative studies on PVP should be identified and evaluated. Hence, the literature was searched and one prospective cohort study (3) was identified but evaluated separately. Findings of Literature Review and Analysis Meta-analysis of the results of RCTs shows that monopolar electrovaporization is as clinically effective as TURP for the relief of urinary symptoms caused by BPH (based on 5-year follow-up data). Meta-analysis of the results of RCTs shows that bipolar electrovaporization (PKVP) is clinically as effective as TURP for the relief of urinary symptoms caused by BPH (based on 1-year follow-up data). Two of the three RCTs on VLAP have shown that patients undergoing VLAP had a significantly lesser improvement in urinary symptom scores compared with patients undergoing TURP. RCTs showed that the time to catheter removal was significantly longer in patients undergoing VLAP compared with patients undergoing TURP. Meta-analysis of the rate of reoperation showed that patients undergoing VLAP had a significantly higher rate of reoperation compared with patients undergoing TURP. Meta-analysis showed that patients undergoing CLV had a significantly lesser improvement in urinary symptom scores compared with TURP at 2 years and at 3 or more years of follow-up. Two RCTs with 6-month and 2-year follow-up showed similar improvement in symptom scores for ILC and TURP. Time to catheter removal was significantly longer in patients undergoing ILC compared with patients undergoing TURP. The results of RCTs on HoLEP with 1-year follow-up showed excellent clinical outcomes with regard to the urinary symptom score and peak urinary flow. Meta-analysis showed that at 1-year follow-up, patients undergoing HoLEP had a significantly greater improvement in urinary symptom scores and peak flow rate compared with patients undergoing TURP. Procedural time is significantly longer in HoLEP compared with TURP. The results of one RCT with 4-year follow-up showed that HoLRP and TURP provided equivalent improvement in urinary symptom scores. The results of one RCT with 1-year follow-up showed that patients undergoing KTP had a lesser improvement in urinary symptom scores than did patients undergoing TURP. However, the results were not significant at longer-term follow-up periods. Two RCTs that provided 3-year follow-up data reported that patients undergoing TUMT had a significantly lesser improvement in symptom score compared with patients undergoing TURP. RCTs reported a longer duration of catheterization for TUMT compared with TURP (P values are not reported). The results of a large RCT with 5-year follow-up showed a significantly lesser improvement in symptom scores in patients undergoing TUNA compared with patients undergoing TURP. Meta-analysis of the rate of reoperation showed that patients undergoing TUNA had a significantly higher rate of reoperation compared with patients undergoing TURP. Based on the results of RCTs, TURP is associated with a 0.5% risk of TUR syndrome, while no cases of TUR syndrome have been reported in patients undergoing monopolar or bipolar electrovaporization, laser-based procedures, TUMT, or TUNA. Based on the results of RCTs, the rate of blood transfusion ranges from 0% to 8.3% in patients undergoing TURP. The rate is about 1.7% in monopolar electrovaporization, 1.4% in bipolar electrovaporization, and 0.4% in the VLAP procedure. No patients undergoing CLV, ILC, HoLEP, HoLRP, KTP, TUMT, and TUNA required blood transfusion. The mean length of hospital stay is between 2 and 5 days for patients undergoing TURP, about 3 days for electrovaporization, about 2 to 4 days for Nd:YAG laser procedures, and about 1 to 2 days for holmium laser procedures. TUMT and TUNA can each be performed as a day procedure in an outpatient setting (0.5 and 1 day respectively). Based on a prospective cohort study, PVP is clinically as effective as TURP for the relief of urinary symptoms caused by BPH (based on 6-month follow-up data). Time to catheter removal was significantly shorter in patients undergoing PVP than in those undergoing TURP. Operating room time was significantly longer in PVP than in TURP. PVP has the potential to reduce health care expenses due to shorter hospital stays. Economic Analysis In the three most recent fiscal years (FY) reported, an average of approximately 5,000 TURP procedures per year were performed in Ontario. From FY 2002 to FY 2004, the total number of surgical interventions decreased by approximately 500 procedures. During this time, the increase in costs of drugs to the government was estimated at approximately $10 million (Cdn); however, there was a concurrent decrease in costs due to a decline in the total number of surgical procedures, estimated at approximately $1.9 million (Cdn). From FY 2002 to FY 2004, the increase in costs associated with the increase in utilization of drugs for the treatment of BPH translates into $353 (Cdn) per patient while the cost savings associated with a decrease in the total number of surgical procedures translates into a savings of $3,906 (Cdn) per patient. The following table summarizes the change in the current budget, depending on various estimates of the total percentage of the 5,000 TURP procedures that might be replaced by other energy-based interventions for the treatment of BPH in the future. Executive Summary Table 1: Budget Impact With Various Estimates of the Percentage of TURP Procedures Captured by Energy-based Interventions for the Treatment of BPH Technology Cost perprocedure, $ Budget Impact of 25% diffusion, $M Budget Impact of 50% diffusion, $M Budget Impact of 75% diffusion, $M Budget Impact of 100% diffusion, $M Incremental Budget Impact, $M TURP 3,887 19.4 Bipolar Electrovaporization 4,011 19.6 19.7 19.9 20.0 0.6 Monopolar Electrovaporization 4,130 19.7 20.0 20.3 20.6 1.2 TUMT 1,529 16.5 13.5 10.6 7.6 (11.8)  TUNA 4,804 20.6 21.7 22.9 24.0 4.6 PVP 1,184 16.0 12.7 9.3 5.9 (13.5)   Holmium Laser 3,892 19.4 19.4 19.4 19.4 0.02 VLAP Nd:YAG 4,663 20.4 21.4 22.3 23.3 3.9 CLAP Nd:YAG 4,615 20.3 21.2 22.4 23.0 3.6 * All costs are in Canadian currency. Parentheses indicative of cost reduction. PMID:23074487

  20. Phosphodiesterase type 5 inhibitors for treating erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia: A comprehensive review

    PubMed Central

    Haddad, Albert; Jabbour, Michel; Bulbul, Muhammad

    2015-01-01

    Many men have coexistent erectile dysfunction (ED) and lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). Phosphodiesterase type 5 (PDE5) inhibitors are effective for treating both of these conditions independently. In this review we summarise the evidence supporting a link between ED and LUTS/BPH, and the results from key clinical studies related to the use of PDE5 inhibitors for treating both conditions. The results from these studies suggest that men who have both ED and LUTS/BPH, and are concerned about their sexual dysfunction, might benefit from single-agent, holistic treatment with a PDE5 inhibitor. PMID:26413339

  1. Morphological Changes of Benign Prostatic Hyperplasia in Culture

    PubMed Central

    McMahon, M. J.; Thomas, G. H.

    1973-01-01

    A technique is described for the culture of slices of benign prostatic hyperplasia (BPH) for periods of a week in organ culture. Under these conditions tissue repair took place, resulting in a covering layer of transitional epithelium which formed around the explant and spread out laterally as a monolayer. Autoradiography and studies with [3H]thymidine uptake suggested that the repair activity, which reached a peak at Day 3 in culture, was the centre of biochemical activity, overshadowing that of the rest of the explant. Necrosis of the explant base tended to develop abruptly during the first day of culture but thereafter remained stable. The epithelium was well preserved morphologically, but explant acid phosphatase activity fell progressively. No morphological response to testosterone (10-5 mol/l) or stilboestrol diphosphate (10-5 mol/l) was seen. Attention is drawn to a possible source of misinterpretation of results offered by the uptake of [3H]thymidine into DNA in organ culture. ImagesFig. 5Fig. 6Fig. 10Fig. 11Fig. 3Fig. 4Fig. 12Fig. 13Fig. 1 PMID:4121823

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

    NASA Astrophysics Data System (ADS)

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

    1999-06-01

    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.

  3. Medical Therapy for Benign Prostatic Hyperplasia: New Terminology, New Concepts, Better Choices

    PubMed Central

    Kaplan, Steven A

    2006-01-01

    This article discusses 3 areas of medical therapy for benign prostatic hyperplasia (BPH) that are undergoing extensive research and evaluation: 1) the use of muscarinic receptor antagonists to treat lower urinary tract symptoms (LUTS) in men with BPH; 2) the definition of an “enlarged prostate”; and 3) sexual function and LUTS. Fears of worsening obstructive symptoms or causing acute urinary retention often keep practitioners from prescribing muscarinic receptor antagonists to men who might have concomitant bladder outlet obstruction; a multicenter, multinational, double-blind study showed that tolterodine is safe for men with low postvoid residual volumes. Most urologists accept that a prostate volume of more than 40 mL is consistent with an enlarged prostate; there is more debate regarding prostate volumes of 30 to 40 mL. Recently presented data suggest that combination medical therapy might be effective for men having prostates with volumes of more than 25 mL. The association between voiding and sexual function has been increasingly recognized and investigated, and there seem to be common pathophysiologic mechanisms governing both conditions. Targeted treatment algorithms addressing both conditions seem warranted. PMID:16985556

  4. Terazosin. A pharmacoeconomic evaluation of its use in benign prostatic hyperplasia.

    PubMed

    Plosker, G L; Goa, K L

    1997-02-01

    Benign prostatic hyperplasia (BPH) is a common disorder in elderly men which carries a substantial economic burden. Urinary symptoms associated with moderate to severe disease can significantly interfere with daily activities and reduce quality of life. Obstruction of urine flow in men with BPH can result from nonmalignant enlargement of the prostate gland (static component of BPH) and from alpha 1 receptor-mediated increased smooth muscle tone of the bladder neck and prostate (dynamic component of BPH). Transurethral resection of the prostate (TURP) is generally very effective and has traditionally been the standard treatment for men with moderate to severe BPH. However, response to therapy with TURP is not universal and the procedure is associated with a number of potential complications. Moreover, many men prefer to avoid or are not suitable candidates for this invasive procedure. Thus, there is an increasing role for less invasive treatment, including drug therapy, in men with moderate to severe BPH. Terazosin is an alpha 1 receptor antagonist which has been shown in placebo-controlled trials to significantly improve American Urology Association (AUA) symptom and quality-of-life scores and symptom problem index ('bother' score), as well as increase peak urinary flow rate, in men with BPH. In a recent large randomised US trial, treatment for 1 year with terazosin titrated to 10 mg/day improved mean AUA symptom score and peak urinary flow rate to a significantly greater extent than finasteride 5 mg/day in men with moderate to severe BPH. The most frequently reported adverse events associated with terazosin include dizziness, asthenia, postural hypotension, somnolence, headache, peripheral oedema, nasal congestion/rhinitis and syncope. Approximately 5% of men with BPH discontinue terazosin because of adverse events. Results of an economic evaluation of terazosin, in which both clinical and economic data were collected prospectively in a randomised placebo-controlled study design, showed similar total direct treatment costs per 1000 patients associated with 1 year of therapy with terazosin ($US3.57 million) and placebo ($US3.78 million) in men with moderate to severe BPH (1992 dollars). The analysis, which was conducted from the perspective of a managed care organisation in the US, demonstrated that the lower medication costs in the placebo group relative to the terazosin group were offset by increased inpatient care costs. Thus, terazosin (titrated to response up to a maximum of 10 mg/day) was significantly more effective than placebo in improving disease-specific symptoms and quality of life, but at a similar overall cost to placebo. Another economic analysis, also conducted from a third-party payer perspective in the US, modelled direct treatment costs associated with terazosin, finasteride and TURP during the first 2 years after initiating therapy in men with moderate to severe BPH. Results of the study favoured terazosin; the private insurance cost per patient undergoing primary treatment with TURP was $US6411, compared with $US2860 with finasteride (45% of the cost of TURP) and $US2422 with terazosin (38% of the cost of TURP). Medicare costs were lower for all 3 treatment groups but the relative comparisons were similar; corresponding costs per patient were $US3874, $US2161 and $US1820 (1992 dollars). A companion break-even cost analysis used a hypothetical cohort of men with BPH starting treatment at age 67 years. Private insurance costs associated with terazosin remained lower then those associated with TURP for approximately 15 years (the corresponding break-even point was 10 years for finasteride vs TRUP). Medicare costs associated with terazosin would not exceed those of TURP for approximately 7 years (5.5 years for finasteride vs TURP). In conclusion, a limited number of detailed pharmacoeconomic analysis of terazosin have been conducted to date, although it has not been compared with other a1 receptor antagonists. PMID:10165827

  5. Management of Benign Prostatic Hyperplasia Larger than 100 ml: Simple Open Enucleation Versus Transurethral Laser Prostatectomy.

    PubMed

    Elkoushy, Mohamed A; Elhilali, Mostafa M

    2016-06-01

    Benign prostatic hyperplasia (BPH) is one of the most common causes of lower urinary tract symptoms (LUTS) in aging men. Over the age of 60, more than a half of men have BPH and/or bothersome LUTS. Contemporary guidelines advocate surgery as the standard of care for symptomatic BPH after failure of medical therapy, where the choice of the appropriate surgical procedure depends on the prostate size. Transurethral resection of the prostate (TURP) and simple open prostatectomy (OP) have been considered for decades the reference-standard techniques for men with prostate smaller and larger than 80 ml, respectively. However, both procedures are potentially associated with considerable perioperative morbidity which prompted the introduction of a variety of minimally invasive surgical techniques with comparable long-term outcomes compared to TURP and OP. Nevertheless, the management of prostates larger than 100 ml remains a clinical challenge. Transurethral anatomical enucleation of the prostate utilizing different laser energy represents an excellent alternative concept in transurethral BPH surgery. These procedures gained popularity and demonstrated similar outcomes to OP with the advantages of favorable morbidity profiles and shorter catheter time and hospital stay. Despite the fact that OP remains a viable treatment option for patients with bothersome LUTS secondary to very large prostates, this procedure has been to a large extent replaced by these emerging enucleation techniques. Given the advent of surgical alternatives, the current review presents an evidence-based comparison of the efficacy and safety profile of the currently available transurethral laser techniques with the standard OP for the management of BPH due to adenomas larger than 100 ml. PMID:27048160

  6. Metformin Attenuates Testosterone-Induced Prostatic Hyperplasia in Rats: A Pharmacological Perspective

    PubMed Central

    Mosli, Hala H.; Esmat, Ahmed; Atawia, Reem T.; Shoieb, Sherif M.; Mosli, Hisham A.; Abdel-Naim, Ashraf B.

    2015-01-01

    Benign prostatic hyperplasia (BPH) is uncontrolled proliferation of prostate tissue. Metformin, a widely prescribed anti-diabetic agent, possesses anticancer activity through induction of apoptotic signaling and cell cycle arrest. This study aimed to investigate the protective effect of metformin against experimentally-induced BPH in rats. Treatment with 500 and 1000 mg/kg metformin orally for 14 days significantly inhibited testosterone-mediated increase in the prostate weight & prostate index (prostate weight/body weight [mg/g]) and attenuated the pathological alterations induced by testosterone. Mechanistically, metformin significantly protected against testosterone-induced elevation of estrogen receptor-α (ER-α) and decrease of estrogen receptor-β (ER-β) expression, with no significant effect of androgen receptor (AR) and 5α-reductase expression. It decreased mRNA expression of IGF-1 and IGF-1R and protein expression ratio of pAkt/total Akt induced by testosterone. Furthermore, it significantly ameliorated testosterone–induced reduction of mRNA expression Bax/Bcl-2 ratio, P21 and phosphatase and tensin homolog (PTEN) and AMPK [PT-172] activity. In conclusion, these findings elucidate the effectiveness of metformin in preventing testosterone-induced BPH in rats. These results could be attributed, at least partly, to its ability to enhance expression ratio of ER-β/ER-α, decrease IGF-1, IGF-1R and pAkt expressions, increase P21, PTEN, Bax/Bcl-2 expressions and activate AMPK with a subsequent inhibition of prostate proliferation. PMID:26492952

  7. AB100. Modified techniques and clinical results of high power green laser in the treatment of benign prostatic hyperplasia

    PubMed Central

    Ge, Yong-Chao; Feng, Jin-Shun; Duan, Kun; Chen, Shi-Lin; Zhang, Li; Qin, Fen; Chang, Bao-Dong; Yuan, Zhi-Hao

    2015-01-01

    Objective To investigate the safety and clinical efficacy of high power green laser in the treatment of benign prostatic hyperplasia (BPH). Methods Thirty cases of BPH patients accepted the lateral jet type high power green laser enucleation of prostate leaf drawing block chopped. The time of operation, bleeding volume, hemoglobin (Hb) before and after surgery, indwelling catheter time, perioperative complications, changes of IPSS, Qmax and PVR 1 month after operation were assessed. Results All the operations were successfully. The average operative time was (59+16.1) min, amount of bleeding during operation was (36.3+18.5) mL, catheter time was (35.1+20.6) h. IPSS, Qmax and PVR compared with preoperative were statistically better with statistic significant (P<0.01). Conclusions High power green laser enucleation of prostate leaf drawing block chopped technology is safe and reliable, the effect is satisfied.

  8. Promising Molecular Targets and Biomarkers for Male BPH and LUTS

    PubMed Central

    Gharaee-Kermani, Mehrnaz; Macoska, Jill A.

    2013-01-01

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

  9. Diagnostic investigations of canine prostatitis incidence together with benign prostate hyperplasia, prostate malignancies, and biochemical recurrence in high-risk prostate cancer as a model for human study.

    PubMed

    Shafiee, Radmehr; Shariat, Alireza; Khalili, Soheil; Malayeri, Hamed Zamankhan; Mokarizadeh, Aram; Anissian, Ali; Ahmadi, Mohammad Reza Hafezi; Hosseini, Ehsan; Naderafif, Mostafa; Mohsenzadeh, Siamak; Rasoulian, Mohammad Hosein; Rezapour, Reza; Pourzaer, Maryam

    2015-04-01

    The aim of this study was to evaluate the prevalence of acute and chronic inflammation, benign prostatic hyperplasia (BPH), and cancer of the prostate glands in the canine as a human model in prostate disorders. The study was carried out on 12 cases of different male dogs of terrier (50%), German shepherd (25%) breeds, and Greden (25%), and the age of the dogs ranged from 6 to 13 years (average age 7.8 ± 3.6). The bodyweight ranged from 3.6 to 7.9 kg. Signalment, clinical signs, and diagnostic tools such as ultrasonography, urinary cytology, and histopathology are presented. Dysuria was the most common clinical sign in this study and occurred in 10/12 canine (83.3%) included. Other clinical signs included lameness (5/12 canine, 41.6%) and constipation (3/12 canine, 25%). The range of duration of clinical signs was 5 days to 7 months. Moreover, in the present study, the urinary biochemical markers of different prostate lesions include blood, protein, and glucose and were detected in 11/12 cases (91.6%), 5/12 cases (41.6%), and 2/12 cases (16.6%), respectively. Taken together, sonographic data were classified into four groups based on histological diagnosis. In 7/12 cases (58.4%), the prostate appeared to have BPH lesions, and the remaining lesions included inflammation (3/12 cases, 25%), abscess (1 case, 8.3%), and adenocarcinoma (1 case, 8/3%) on ultrasound. In all cases, prostate tissue had an irregular echotexture. None of the dogs had sonographic evidence of sublumbar lymph node enlargement. Histopathologically, we looked at the prevalence of inflammation (33.3% chronic and 8.3% acute) and BPH (58.4%) in dogs of different ages and breeds, and also, we observed chronic inflammation in >20% of dogs, which was about 25% in 3 cases of the 12 cases referred. More chronic inflammation was associated with more BPH. The majority of the asymptomatic inflammation that is detected in the prostate is classified as chronic inflammation (i.e., as evidenced by the presence of monocytic and/or lymphoplasmacytic inflammatory cell infiltrates); however, acute inflammation is also observed to a lesser degree. Acute inflammation, as is typically evidenced by the infiltration of neutrophils, is classically an indicator of an infectious process. Finally, the patients included seven castrated, four castrated together with antibiotic therapy, and one castrated together with chemotherapy intact male dogs, which were treated with the mentioned cases. In conclusion, chronic prostatic inflammation could be a central mechanism in BPH progression, but the pathological features of tissue inflammation were different between BPH and prostate cancer (PCa). Nevertheless, the histological examination of prostate biopsies remains the only way to diagnose prostatic disorders. PMID:25420908

  10. Expression of Heat Shock Protein 27 in Benign Prostatic Hyperplasia with Chronic Inflammation

    PubMed Central

    Jiang, Yuqing; Wang, Xiuli; Guo, Yuexian; Li, Wenping; Yang, Shijie; Li, Wei; Cai, Wenqing

    2015-01-01

    Background Heat shock protein 27 (HSP 27) is known as a mediator in immune response and has been recently found to be expressed in prostate cancer. This study aimed to investigate the role of HSP27 in inflammatory BPH. Material/Methods Hospitalized BPH patients who received TURP were divided into 4 groups by the presence and degrees of chronic inflammation: non-inflammatory BPH (NI BPH), mild-inflammatory BPH (MI BPH), moderate-inflammatory BPH (MOI BPH), and severe-inflammatory BPH (SI BPH). Expressions of HSP 27, TNF-α, IL-6, and CD3 in prostate tissues and serum of patients were detected by immunohistochemistry and ELISA. Results Expression of HSP27 in BPH with histological inflammation was significantly higher than in non-inflammatory BPH. In inflammatory BPH groups, HSP27 expression gradually increased along with increasing inflammation. There was a significant correlation between the expression of TNF-α, IL-6, CD3 and HSP27 among different inflammatory BPH groups. Conclusions HSP27 expression level is associated with the degree of chronic inflammation in BPH and may participate in the pathological process in inflammatory BPH. PMID:26434601

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

    PubMed Central

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

    2014-01-01

    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

  12. A multilingual evaluation of current health information on the Internet for the treatments of benign prostatic hyperplasia

    PubMed Central

    Chen, Emily C; Manecksha, Rustom P; Abouassaly, Robert; Bolton, Damien M; Reich, Oliver; Lawrentschuk, Nathan

    2014-01-01

    Purpose To compare the quality of current Internet information on benign prostatic hyperplasia (BPH) and its surgical and medical managements across four Western languages and a comparative analysis of website sponsors. BPH Internet information quality is particularly relevant in an era of expanding, minimally invasive and surgical therapies. However, no comprehensive analysis exists. Methods World Health Organization Health on the Net (HON) principles may be applied to websites using an automated toolbar function. Using a search engine (www.google.com), 9,000 websites were assessed using keywords related to BPH and its medical and surgical treatment in English, French, German, and Spanish. The first 150 websites in each language had HON principles measured whilst a further analysis of site sponsorship was undertaken. Results Very few BPH websites had greater than ten per cent HON accredited with significant differences (P<0.001) based on terms used for BPH, its medical and surgical management. Tertiles (thirds) of the first 150 websites returned differences in accredited websites (P<0.0001). English language had most accredited websites. Odds ratios for different terms returning accredited websites also were significantly different across terms (P<0.001). Websites were largely commercially sponsored. Conclusions A lack of validation of most BPH sites should be appreciated with discrepancies in quality and number of websites across diseases, languages and also between medical and alternate terms. Physicians should participate in and encourage the development of informative, ethical and reliable health websites on the Internet and direct patients to them. PMID:25599071

  13. Medical therapy options for aging men with benign prostatic hyperplasia: focus on alfuzosin 10 mg once daily

    PubMed Central

    Roehrborn, Claus G; Rosen, Raymond C

    2008-01-01

    Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are common in aging men and can significantly affect quality of life. Men with bothersome LUTS/BPH often present with various other age-related conditions, including sexual dysfunction, heart disease, hypertension, diabetes, and the metabolic syndrome, which can complicate management decisions. Therefore, healthcare providers should be familiar with first-line treatment options for LUTS/BPH and their differing safety profiles, particularly with respect to cardiovascular and sexual function side effects. This article presents a review of first-line medical therapy options for managing aging men with LUTS/BPH and patient considerations when evaluating and selecting these therapies, with a focus on the clinical efficacy and cardiovascular and sexual function safety profiles of the uroselective α1-adrenergic receptor antagonist alfuzosin 10 mg once daily. Alfuzosin improves LUTS, peak urinary flow rates, and disease-specific quality of life, reduces the long-term risk of overall BPH progression, and is well tolerated in aging men, with minimal vasodilatory and sexual function side effects, even in those with comorbidities. Alfuzosin is well tolerated when used in combination with antihypertensive medications and phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction. The long-term clinical efficacy and good cardiovascular and sexual function safety profile of alfuzosin can contribute to an improved quality of life for aging men with LUTS/BPH. PMID:18982921

  14. Labda-8(17),12,14-trien-19-oic acid contained in fruits of Cupressus sempervirens suppresses benign prostatic hyperplasia in rat and in vitro human models through inhibition of androgen and STAT-3 signaling.

    PubMed

    Verma, Vikas; Sharma, Vikas; Singh, Vishal; Kumar, Rajeev; Khan, Mohammad F; Singh, Anil K; Sharma, Rolee; Arya, Kamal R; Maikhuri, J P; Dalela, Diwakar; Maurya, Rakesh; Gupta, Gopal

    2014-08-01

    Fruit extract of Cupressus sempervirens (CS), which is used traditionally to treat Benign Prostatic Hyperplasia (BPH)-like urinary symptoms in patients, was scientifically validated for anti-BPH activity. The ethanolic fruit extract of CS inhibited proliferation of human BPH-stromal cells and the activity was localized to its chloroform-soluble, diterpene-rich fraction. Eight major diterpenes isolated from this fraction exhibited moderate to potent activity and the most active diterpene (labda-8(17),12,14-trien-19-oic acid) exhibited an IC50 of 37.5 μM (antiproliferative activity against human BPH-stromal cells). It significantly inhibited activation (phosphorylation) of Stat-3 in BPH-stromal cells and prevented transactivation of androgen sensitive KLK3/PSA and TMPRSS2 genes in LNCaP cells. Labda-8(17),12,14-trien-19-oic acid-rich CS fraction prevented prostatic hyperplasia in rat model and caused TUNEL labeling of stromal cells with lower expressions of IGF-I, TGF-ß and PCNA, and bcl-2/bax ratio. Human BPH tissues exhibited precise lowering of stromal component after incubation in labda-8(17),12,14-trien-19-oic acid, ex vivo. We conclude that labda-8(17),12,14-trien-19-oic acid contained in CS exhibits anti-BPH activity through inhibition of stromal proliferation and suppression of androgen action in the prostate, presenting a unique lead structure for further optimization of anti-BPH activity. PMID:24399792

  15. Dutasteride: an evidence-based review of its clinical impact in the treatment of benign prostatic hyperplasia

    PubMed Central

    Thomson, Andrew

    2005-01-01

    Introduction: Benign prostatic hyperplasia (BPH) is a common condition affecting older men. Bothersome symptoms can progress to serious complications such as acute urinary retention (AUR) requiring surgical intervention. Dutasteride, a dual 5-alfa-reductase (5AR) inhibitor (5ARI), is a recently introduced therapy for the treatment of BPH. Aims: The objective of this article is to review the evidence for the treatment of BPH with dutasteride. Evidence review: Evidence from large clinical studies shows that men with an enlarged prostate achieve a measurable decrease in prostate volume by up to 26% after 4 years of treatment with dutasteride and urinary symptoms improve after 6 months of treatment. This is achieved by rapid suppression (through inhibition of 5AR) of the principal androgen (dihydrotestosterone or DHT) responsible for stimulating prostatic growth. Evidence suggests that dutasteride treatment results in a reduction in risk (rather than delay) of the most serious complications including episodes of AUR and the need for BPH-related surgery. Early symptom relief has been achieved with the combination of an alfa blocker and dutasteride. There is good evidence that dutasteride is well tolerated; side effects limited to sexual dysfunction (reduced libido, impotence, and gynecomastia) are more common compared with placebo but occur with a similar incidence to finasteride, another 5ARI. No pharmacoeconomic evidence from studies with dutasteride has so far been published. Clinical value: In conclusion, dutasteride is a valuable treatment option in men with moderate to severe BPH. Reductions in prostate volume lead to symptom relief and serious complications appear to be reduced. PMID:22500150

  16. 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

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

    2014-01-01

    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. PMID:25405016

  17. Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis.

    PubMed

    Zhang, Xingming; Shen, Pengfei; He, Qiying; Yin, Xiaoxue; Chen, Zhibin; Gui, Haojun; Shu, Kunpeng; Tang, Qidun; Yang, Yaojing; Pan, Xiuyi; Wang, Jia; Chen, Ni; Zeng, Hao

    2016-01-01

    All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions. PMID:27009501

  18. Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis

    PubMed Central

    Zhang, Xingming; Shen, Pengfei; He, Qiying; Yin, Xiaoxue; Chen, Zhibin; Gui, Haojun; Shu, Kunpeng; Tang, Qidun; Yang, Yaojing; Pan, Xiuyi; Wang, Jia; Chen, Ni; Zeng, Hao

    2016-01-01

    All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions. PMID:27009501

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

    PubMed Central

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

    2013-01-01

    A strong and independent association between lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and erectile dysfunction (ED) has been widely evidenced in several clinical epidemiologic studies. Preclinical animal models have provided a great deal of information on potential common pathogenic mechanisms underlying these two clinical identities. Although the efficacy of the most commonly used treatments for LUTS/BPH is well defined, the negative impact of these treatments on sexual function – in particular, on ED – has triggered the search for new treatment options. In this regard, a new role for phosphodiesterase type 5 inhibitors in the treatment of LUTS/BPH and ED has been claimed. Tadalafil is one of the most extensively investigated phosphodiesterase type 5 inhibitors for this new indication. All evidence reported to date suggests that tadalafil 5 mg once daily is a safe and effective treatment option for both LUTS/BPH and ED. PMID:24400241

  20. The effect of immediate surgical bipolar plasmakinetic transurethral resection of the prostate on prostatic hyperplasia with acute urinary retention

    PubMed Central

    He, Le-Ye; Zhang, Yi-Chuan; He, Jing-Liang; Li, Liu-Xun; Wang, Yong; Tang, Jin; Tan, Jing; Zhong, Kuangbaio; Tang, Yu-Xin; Long, Zhi

    2016-01-01

    In the present study, we evaluated the safety and efficacy of immediate surgical bipolar plasmakinetic transurethral resection of the prostate (PK-TURP) for patients with benign prostatic hyperplasia (BPH) with acute urinary retention (AUR). We conducted a retrospective analysis of clinical data of BPH patients who received PK-TURP. A total of 1126 BPH patients were divided into AUR (n = 348) and non-AUR groups (n = 778). After the urethral catheters were removed, the urine white blood cell (WBC) count in the AUR group significantly increased compared with the non-AUR group (P < 0.01). However, there was no significant difference in international prostate symptom score, painful urination, and maximal urinary flow rate. The duration of hospitalization of the AUR group was longer than that of the non-AUR group (P < 0.001). A total of 87.1% (303/348) patients in the AUR group and 84.1% (654/778) patients in the non-AUR group completed all of the postoperative follow-up visits. The incidence of urinary tract infection in the AUR group within 3 months after surgery was significantly higher than that in the non-AUR group (P < 0.01). The incidence of temporary urinary incontinence in the AUR group did not exhibit significant difference. During 3–12 months after surgery, there were no significant differences in major complications between the two groups. Multivariate regression analyses showed that age, postvoid residual, maximal urinary flow rate, diabetes, and hypertension, but not the presence of AUR, were independent predictors of IPSS post-PK-TURP. In conclusion, immediate PK-TURP surgery on patients accompanied by AUR was safe and effective. PMID:26178398

  1. In vivo characterization of a prostate-specific antigen promoter-based suicide gene therapy for the treatment of benign prostatic hyperplasia.

    PubMed

    Park, H S; Cheon, J; Cho, H Y; Ko, Y H; Bae, J H; Moon, D G; Kim, J J

    2003-07-01

    To develop a novel gene therapeutic modality for the effective treatment of benign prostatic hyperplasia (BPH), we investigated the properties of toxic gene therapy utilizing prostate-specific antigen (PSA) promoter driving herpes simplex virus thymidine kinase (HSV-TK) suicide gene to induce highly selective molecular ablation of epithelial cells with minimal systemic toxicity in canine prostate. Replication-defective recombinant adenoviral vectors containing HSV-TK gene under transcriptional control of long PSA promoter (Ad-PSA-HSV-TK) were developed and delivered in an situ manner. Briefly, laparotomies were performed and Ad-PSA-HSV-TK (1 x 10(9) PFUs) was injected into the left lateral lobe of prostate only on days 1 and 7 with appropriate prodrug acyclovir in adult Beagle dogs. The therapeutic efficacy was evaluated on the 56th experimental day. The striking apoptosis of epithelial cells was identified in the treated left half of canine prostate on TUNEL assay. On immunohistochemical studies, there was markedly decreased number of PSA-secreting epithelial cells compared to control. Also significant atrophy of prostate glands, associated with dense infiltration of lymphocytes and plasma cells, was identified in the treated side. The PSA promoter-based suicide gene therapy induced highly selective and definite ablation of epithelial cells in benign canine prostate. Our novel approach could open opportunity of gene therapeutic modality for the treatment of clinical BPH. PMID:12808443

  2. Tadalafil for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a review of clinical data in Asian men and an update on the mechanism of action.

    PubMed

    Yokoyama, Osamu; Igawa, Yasuhiko; Takeda, Masayuki; Yamaguchi, Takafumi; Murakami, Masahiro; Viktrup, Lars

    2015-10-01

    Tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, is approved worldwide for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH-LUTS). The purpose of this narrative review is to summarize the clinical data on tadalafil 5 mg once-daily, primarily focusing on Asian men with BPH-LUTS, and to update the current understanding of the mechanism of action underlying PDE5 inhibition. Findings from studies have demonstrated that PDE5 is highly expressed in the lower urinary tract and supporting vasculature, and that PDE5 inhibition potentially decreases smooth muscle cell proliferation in the prostate, relaxes smooth muscle in the prostate, bladder neck and supporting vasculature, increases blood perfusion to the lower urinary tract, and modulates bladder afferent nerve activity. A total of 11 larger, 12-week, double-blind, randomized, placebo-controlled studies of tadalafil, including four Asian studies, have been conducted globally, enrolling >3000 men with BPH-LUTS. In addition, two long-term (42- and 52-week) studies enrolled 394 Japanese and 428 North American men, respectively, with BPH-LUTS. Overall, tadalafil 5 mg once-daily resulted in significant improvements in the change from baseline to endpoint in total International Prostate Symptom Scores (IPSS), IPSS storage and voiding subscores, and IPSS quality of life index compared with placebo. Tadalafil was well tolerated and had a favorable safety profile. These findings support tadalafil 5 mg once-daily for treating men, including Asian men, with BPH-LUTS. PMID:26425140

  3. Tadalafil for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a review of clinical data in Asian men and an update on the mechanism of action

    PubMed Central

    Igawa, Yasuhiko; Takeda, Masayuki; Yamaguchi, Takafumi; Murakami, Masahiro; Viktrup, Lars

    2015-01-01

    Tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, is approved worldwide for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH-LUTS). The purpose of this narrative review is to summarize the clinical data on tadalafil 5 mg once-daily, primarily focusing on Asian men with BPH-LUTS, and to update the current understanding of the mechanism of action underlying PDE5 inhibition. Findings from studies have demonstrated that PDE5 is highly expressed in the lower urinary tract and supporting vasculature, and that PDE5 inhibition potentially decreases smooth muscle cell proliferation in the prostate, relaxes smooth muscle in the prostate, bladder neck and supporting vasculature, increases blood perfusion to the lower urinary tract, and modulates bladder afferent nerve activity. A total of 11 larger, 12-week, double-blind, randomized, placebo-controlled studies of tadalafil, including four Asian studies, have been conducted globally, enrolling >3000 men with BPH-LUTS. In addition, two long-term (42- and 52-week) studies enrolled 394 Japanese and 428 North American men, respectively, with BPH-LUTS. Overall, tadalafil 5 mg once-daily resulted in significant improvements in the change from baseline to endpoint in total International Prostate Symptom Scores (IPSS), IPSS storage and voiding subscores, and IPSS quality of life index compared with placebo. Tadalafil was well tolerated and had a favorable safety profile. These findings support tadalafil 5 mg once-daily for treating men, including Asian men, with BPH-LUTS. PMID:26425140

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

    PubMed Central

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

    2011-01-01

    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

  5. The Relationship between Depression, Anxiety, Somatization, Personality and Symptoms of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia.

    PubMed

    Koh, Jun Sung; Ko, Hyo Jung; Wang, Sheng-Min; Cho, Kang Joon; Kim, Joon Chul; Lee, Soo-Jung; Pae, Chi-Un

    2015-04-01

    This study investigated the relationship of personality, depression, somatization, anxiety with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the International Prostate Symptom Score (IPSS), 44-item Big Five Inventory (BFI), the Patient Health Questionnaire-9 (PHQ-9), the PHQ-15, and 7-item Generalized Anxiety Disorder Scale (GAD-7). The LUTS/BPH symptoms were more severe in patients with depression (p=0.046) and somatization (p=0.024), respectively. Neurotic patients were associated with greater levels of depression, anxiety and somatisation (p=0.0059, p=0.004 and p=0.0095, respectively). Patients with high extraversion showed significantly low depression (p=0.00481) and anxiety (p=0.035) than those with low extraversion. Our exploratory results suggest patients with LUTS/BPH may need careful evaluation of psychiatric problem including depression, anxiety and somatization. Additional studies with adequate power and improved designs are necessary to support the present exploratory findings. PMID:25866530

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

    PubMed Central

    Bouza, Carmen; López, Teresa; Magro, Angeles; Navalpotro, Lourdes; Amate, José María

    2006-01-01

    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

  7. The Changes of Psychometric Profiles after Medical Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

    PubMed Central

    Cho, Kang Jun; Lee, Nam Suk; Lee, Yong Seok; Jeong, Woon Jin; Suh, Hong Jin; Kim, Joon Chul; Koh, Jun Sung

    2015-01-01

    Objective To investigate the relationship of somatization and depression with the degree of lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) and changes in psychometric profiles including somatization and depression after treatment of LUTS/BPH. Methods Subjects were evaluated at baseline and at week 12 following routine treatment for LUTS/BPH using the International Prostate Symptom Score (IPSS) to measure the severity of LUTS/BPH, the Overactive Bladder Symptom Score (OABSS) to measure the severity of OAB, the Patient Health Questionnaire-9 (PHQ-9) to assess depression, and the Patient Health Questionnaire-15 (PHQ-15) to evaluate somatization. The correlation of somatization and depression with the degree of LUTS/BPH symptoms at baseline and changes in somatization and depression after LUTS/BPH treatment were assessed using relevant statistical analyses. Results One hundred and twenty patients agreed to participate in this study, and 101 (84.2%) completed the 12-week trial and responded to the study questionnaires. At baseline, total IPSS score was correlated with PHQ-9 (r=0.475, p=0.005) and PHQ-15 (r=0.596, p<0.001) scores. The results after the 12-week treatment clearly show significant improvement in both PHQ-9 (p <0.001) and PHQ-15 (p=0.019) scores, and the PHQ-9 (r=0.509, p=0.048) and PHQ-15 (r=0.541, p=0.016) scores were positively correlated with total IPSS. Conclusion Our preliminary results indicated that severity of LUTS is correlated with severity of somatization and depression. Further, the improvement of LUTS after treatment may have positive impacts on somatization and depression. PMID:26598585

  8. A risk-benefit assessment of treatment with finasteride in benign prostatic hyperplasia.

    PubMed

    Ekman, P

    1998-03-01

    As an androgen target organ, the prostate gland has the almost unique characteristic of being less sensitive to testosterone than to its metabolite 5 alpha-dihydrotestosterone (5 alpha-DHT). The conversion of testosterone to 5 alpha-DHT is induced by the enzyme 5 alpha-reductase. By blocking the activity of 5 alpha-reductase, the androgenic stimulation of the prostate gland can be significantly reduced. The first drug with such capacity to be introduced on the market was finasteride. Following the administration of this drug to men, serum 5 alpha-DHT levels were reduced by approximately 80%. Large phase III trials have demonstrated the efficacy of finasteride in treating benign prostatic hyperplasia (BPH). While in some patients the drug was poorly effective, other patients showed significant improvements. The mean reduction in size of the prostate gland was 20 to 25% after 6 months of therapy, and this effect was maintained as long as the patient was on the drug, at least up to the end of a 6-year follow-up period. Prostatic symptom scores were improved by a mean of 30%, while urinary flow was only improved by a mean of 1.5 ml/sec (15%). In a recent double-blind, placebo-controlled study comparing the alpha-blocker terazosin with finasteride, significant improvement was demonstrated for the alpha-blocker, while finasteride produced little improvement overall and was not significantly more effective than placebo in treating moderately symptomatic BPH. However, a subanalysis of this study showed that while finasteride was poorly effective in patients with small prostate glands, a significant improvement was apparent in those with glands larger than 40 ml. There is some evidence that early intervention with finasteride can reduce the number of surgical procedures that are required, at least over a 2-year period. Finasteride is very well tolerated. However, since 5 alpha-DHT potentiates erectile capacity, a 3 to 4% incidence of impotence has been reported, as well as a decreased ejaculatory volume. Gynaecomastia has been noted in a few patients (0.4%). In conclusion, finasteride appears to be a very well tolerated drug to treat outflow obstruction in patients with moderately symptomatic BPH caused by large prostate glands. PMID:9530536

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

    PubMed Central

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

    2014-01-01

    Introduction: We compare the symptomatic relief with urodynamic parameter change and operative safety of the outpatient transurethral resection in saline (TURIS-V) technique with inpatient transurethral resection of the prostate (TURP) for the management of benign prostatic hyperplasia (BPH). Methods: This prospective cohort comparison study enrolled patients who needed BPH surgery. Between January 2010 and June 2011, outpatient TURIS-V was performed at 1 centre and the results of the treatment were compared with inpatient TURP performed at a separate hospital. Preoperative characteristics, including prostate volume, were similar in both groups. Perioperative data and any treatment complications were recorded. The analysis compared postoperative outcomes, including a 6-month postoperative International Prostate Symptom Score (IPSS), a quality of life (QoL) evaluation and a record of any changes in uroflowmetry findings, between the 2 groups. Results: In the TURIS-V patient group, 75 patients agreed to be in the study. Of these, 69 ultimately complete the study. In the TURP group, 76 patients agreed and 71 of these completed the study. Both study groups were well-matched for age, IPSS, QoL and uroflowmetry findings. The TURIS-V group experienced both shorter operation times (54.6 vs. 74.8 minutes) and shorter catheterization times (2.2 vs. 4.2 days) when compared to the TURP group. There were comparable improvements in the 6-month postoperative IPSS, QoL, and uroflowmetry findings between the 2 groups. There were also equally low incidence rates of procedural complications. Conclusions: Both TURIS-V and TURP relieve lower urinary tract symptoms in a similar way, with great efficacy and safety. Overall, TURIS-V had shorter operative and catheterization times compared to TURP. Notwithstanding the paper’s limitations (non- randomized cohort comparison with possible selection or surgeon bias and small heterogeneous sample size), TURIS-V can be performed safely even in an outpatient setting. PMID:24454598

  10. [PCA3 AND TMPRSS2:ERG GENES EXPRESSION IN BIOPSIES OF BENIGN PROSTATE HYPERPLASIA, INTRAEPITHELIAL NEOPLASIA, AND PROSTATE CANCER].

    PubMed

    Mikhaylenko, D S; Perepechin, D V; Grigoryeva, M V; Zhinzhilo, T A; Safronova, N Yu; Efremov, G D; Sivkov, A V

    2015-01-01

    Morphological analysis of the biopsies for prostate cancer (PCa) often is a difficult task due to heterogeneity and multifocality of tumors. At the same time, a lot of data exist about the potential molecular genetic markers of PCa. The aim of our study is to determine of PCA3 and TMPRSS2:ERG genes expression in benign hyperplasia (BPH), low and high grade intraepithelial neoplasia (PIN), PCa for revealing of diagnostic value of those genes expression in benign and precancerous changes in prostate. Total RNA was isolated from 53 biopsies, reverse transcription was performed, gene expression was determined by real time PCR (RT-PCR) then deltaCt index was determined as Ct(PCA3)--Ct(KLK3). Average deltaCt and its SD in BPH were 8.28 ± 3.13, low PIN--8.56 ± 2.64, high PIN--8.98 ±1.69, PCa--1.08 ± 2.36. We have demonstarted that deltaCt did not differ in patients with BPH, low and high grade PIN, whereas significantly increased in PCa relative to any of the three groups listed above (p < 0.0001). Expression of TMPRSS2:ERG was absent in BPH, PIN, but it was detected in 40% (4/10) of PCa cases. ROC-analysis showed that the AUC (area under ROC-curve with 95% CI, p < 0.0001) was 0.98 ± 0.02 in the analysis of a combination of overexpression of PCA3 and TMPRSS2:ERG. Thus, the expression analysis of the PCA3 and chimeric oncogene TMPRSS2:ERG in biopsy cannot be used for differential diagnosis of BPH, low and high grade PIN. However, overexpression of PCA3 and expression of TMPRSS2:ERG are characteristic in PCa. Expression analysis of these genes by the proposed RT-PCR modification at the threshold level deltaCt 3,22 has diagnostic accuracy 90% to detect PCa in biopsy specimens. PMID:26859937

  11. Economic Evaluation Study (Cheer Compliant) Laser Prostatectomy for Benign Prostatic Hyperplasia: Outcomes and Cost-effectiveness

    PubMed Central

    Hsu, Yu-Chao; Lin, Yu-Hsiang; Chou, Chih-Yuan; Hou, Chen-Pang; Chen, Chien-Lun; Chang, Phei-Lang; Tsui, Ke-Hung

    2016-01-01

    Abstract To determine which surgical treatment for lower urinary tract symptoms, which is suggestive of benign prostatic hyperplasia (BPH), is more cost-effective and yields a better patient's preference. Treatment outcome, cost, and perioperative complications to assess the treatment effectiveness of using laser prostatectomy as a treatment for BPH were investigated in this study. This retrospective study included 100 patients who underwent transurethral resection of prostate (TUR-P) and another 100 patients who received high-powered 120 W (GreenLight HPS) laser prostatectomy between 2005 and 2011. International Prostate Symptom Score and uroflow parameters were collected before the surgery and the uroflow and postvoiding residual volumes were evaluated before treatment and at 3, 6, 12, and 24 months after treatment. The results of 100 treatments after HPS laser prostatectomy were compared with the results of 100 patients who received TUR-P from the same surgeon. Complication rates and admission costs were analyzed. From 2005 to 2011, 200 consecutive patients underwent endoscopic surgery. Study participants were men with BPH with mean age of 71.3 years old. The peak flow rate went from 8.47 to 15.83 mL/s for 3 months after laser prostatectomy. Laser therapy groups showed better improvement in symptom score, shortened length of stay, and quality of life score when compared with those of TUR-P procedures. The estimated cost for laser prostatectomy was high when compared with cost of any other TUR-P procedural option at Chang Gung Hospital (P = 0.001). All admission charges were similar except for the cost of the laser equipment and accessories (mainly the laser fiber) (P = 0.001). Due to this cost of equipment, it increased the total admission charges for the laser group and therefore made the cost for the laser group higher than that of the TUR-P group. Perioperative complications, such as the need for checking for bleeding, urinary retention rate or urosepsis rate within 30 days after the surgery, held no significant differences between both groups. Compared with alternative treatment options, laser prostatectomy of the prostate is clinically effective but yields a high cost of treatment for symptomatic BPH. PMID:26844483

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

    PubMed Central

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

    2013-01-01

    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

  13. Elocalcitol, a vitamin D3 analog for the potential treatment of benign prostatic hyperplasia, overactive bladder and male infertility.

    PubMed

    Tiwari, Atul

    2009-06-01

    Elocalcitol, which had been under development by BioXell SpA, is a synthetic derivative of vitamin D3 that regulates cell proliferation and apoptosis via its binding to the vitamin D receptor. In preclinical studies, elocalcitol inhibited the androgen-dependent and androgen-independent proliferation of benign prostatic hyperplasia (BPH) cells more potently than finasteride, a 5alpha-reductase inhibitor. In a phase IIb trial in patients with BPH, treatment with elocalcitol resulted in a significantly reduced prostate volume compared with placebo; irritative urinary symptoms (frequency, urgency and nocturia) and urodynamic parameters were comparable to the alpha1-adrenoceptor antagonist tamsulosin. In a phase IIa trial in patients with prostatitis, elocalcitol significantly reduced levels of IL-8 in semen, suggesting improved quality and forward motility of sperm. However, phase IIb trial data from patients with overactive bladder (OAB) were less promising: elocalcitol failed to meet the primary endpoint despite demonstrating good efficacy in a phase IIa trial. Based largely on these disappointing data, BioXell decided to terminate all further clinical development of elocalcitol, including an uncompleted phase IIa trial in patients with male infertility. Given the novel mechanism of action, efficacy profile and improved tolerability of elocalcitol over existing classes of drugs, the compound could have potentially added to the armamentarium in the expanding therapeutic markets of BPH, OAB and male infertility. This possibility appears to have been negated by BioXell's recent decision to terminate all further development of elocalcitol. PMID:19517319

  14. A huge benign prostatic hyperplasia presenting with renal failure

    PubMed Central

    Basatac, Cem; Cicek, Mehmet Cagatay

    2015-01-01

    Although transurethral resection of the prostate is still standard of care in many patients suffering from benign prostatic hyperplasia, traditional open prostatectomy (OP) seems as a widely applied method in larger glands. In spite of the fact that holmium laser enucleation can be performed in large glands, upper limits of prostate size in this method are not clearly identified in the current literature. In this case, we aim to report feasibility and efficacy of OP in huge prostate size measured as 680 ml by transrectal ultrasound and review the current literature. PMID:26034239

  15. Increased expression of CYR61, an extracellular matrix signaling protein, in human benign prostatic hyperplasia and its regulation by lysophosphatidic acid.

    PubMed

    Sakamoto, Shinji; Yokoyama, Masahiro; Zhang, Xianghua; Prakash, Kulkarni; Nagao, Kaori; Hatanaka, Takashi; Getzenberg, Robert H; Kakehi, Yoshiyuki

    2004-06-01

    Lysophosphatidic acid (LPA) is an endogenous lipid growth factor that is thought to play important roles in cell proliferation and antiapoptosis and therefore may have roles in the development and progression of benign prostatic hyperplasia (BPH). CYR61 (CCN1), on the other hand, is a growth factor-inducible immediate early gene that functions in cell proliferation, differentiation, and extracellular matrix synthesis. Here we show the close relationship between LPA-induced expression of CYR61 and prostate enlargement. CYR61 mRNA and protein were dramatically up-regulated by 18:1 LPA (oleoyl-LPA) within 1 and 2 h, respectively, in both stromal and epithelial prostatic cells. G protein-coupled receptors, i.e. Edg-2, Edg-4, and Edg-7, for LPA were also expressed in both stromal and epithelial prostatic cells. Furthermore, on DNA microarray analysis for normal and BPH patients, CYR61 was found to be related to the development and progression of BPH, regardless of symptoms. Although CYR61 mRNA was synthesized in hyperplastic epithelial cells, in many cases of BPH, CYR61 protein was detected in both the epithelial and stromal regions of BPH patient tissues. The functional contribution of CYR61 to prostatic cell growth was demonstrated by recombinant CYR61 protein and anti-CYR61 neutralizing antibodies, which inhibited CYR61-dependent cell spreading and significantly diminished cell proliferation, respectively. In conclusion, these data support the hypothesis that LPAs induce the expression of CYR61 by activating G proteincoupled receptors and that CYR61 acts as a secreted autocrine and/or paracrine mediator in stromal and epithelial hyperplasia, demonstrating the potential importance of this signaling mechanism in the disease. PMID:14988385

  16. Opening the floodgates: benign prostatic hyperplasia may represent another disease in the compendium of ailments caused by the global sympathetic bias that emerges with aging.

    PubMed

    Yun, Anthony J; Doux, John D

    2006-01-01

    We have previously posited that the global sympathetic bias that emerges with aging may constitute the common etiologic thread that links a myriad of ailments associated with aging. Recent data suggests that benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) may also be caused by sympathetic bias as an independent etiology from androgen dysfunction. The association of BPH with heart disease, independent of other variables, supports the view that both entities represent downstream manifestations of global sympathetic bias. The risk for development of BPH increases with caffeine intake and decreases with alcohol consumption, factors which wield opposing effects on autonomic balance. Heavy smoking, which induces chronic sympathetic bias, also increases the risk of BPH, a link also previously attributed to hormonal alterations. Sympathetic dysfunction appears to have a mitogenic effect on the prostate. The high prevalence of prostate cancer, a condition detected in the autopsy of many elderly men, may arise from this activity combined with a Th2 shift induced by sympathetic bias, leading to decreased cancer surveillance by the immune system. Exercise may improve BPH by restoring autonomic balance and normalizing the sympathovagal ratio. The benefits of alpha-adrenergic blockers on BPH, generally felt to achieve symptomatic relief afforded by bladder wall and sphincter remodeling, may independently exert a direct effect on prostate growth and enlargement. Sympathetic bias may play a role in adaptive enlargement of other organs such as the salivary glands, heart, liver, spleen, and skeletal muscles in response to stress. We envision novel pharmacologic and device-based neuromodulation therapies for BPH and related urologic dysfunctions based on these principles. PMID:16427746

  17. Efficacy of Kanchanara Guggulu and Matra Basti of Dhanyaka Gokshura Ghrita in Mootraghata (benign prostatic hyperplasia)

    PubMed Central

    Patel, Joyal Kumar K.; Dudhamal, Tukaram S.; Gupta, Sanjay Kumar; Mahanta, Vyasadeva

    2015-01-01

    Background: Benign prostatic hyperplasia (BPH), a senile disorder affects male of and above 40 years characterized by retention, incomplete voiding, dribbling, hesitancy, and incontinence of urine. This condition is comparable with Mootraghata in Ayurveda. Surgical intervention has been accepted as standard management, but has acute cystitis, acute epididymitis, erectile dysfunction, retrograde ejaculation, etc. as complications. Conservative treatment with modern medicine is also associated with side effects. Hence, to avoid such complications and improve the quality of life in senile age, conservative management with Ayurveda is attempted. Aim: To evaluate clinical efficacy of Kanchanara Guggulu and Dhanyaka Gokshura Ghrita Matra Basti in Mootraghata. Materials and Methods: Total 30 patients having signs and symptoms of BPH were selected from OPD and IPD of Shalya Tantra and enrolled equally into three groups (n = 10). Patients of Group A were administered with Kanchanara Guggulu (500 mg, 3 times a day orally), Group B were with Dhanyaka Gokshura Ghrita Matra Basti, while patients of Group C were administered both the drugs for 21 days. International prostate symptom score (IPSS) was used to assess the efficacy. paired and unpaired “t” test, Chi-square test were applied for significance. Results: In IPSS, Group B had shown the better results (84.27%) than the Group A (72.68%) and Group C (82.10%). In all objective parameters, Group C had shown better effect (23.60%) than Group A (15.70%) and Group B (18.24%). Symptomatic relief was better in Group B than Groups A and C. Comparison between three groups on objective parameters was better in Group C than in Group A and B. Conclusion: Kanchanara Guggulu orally and Dhanyaka Gokshura Ghrita Matra Basti is effective conservative management for symptomatic relief in BPH of senile age. PMID:27011713

  18. Transurethral plasmakinetic resection of the prostate is a reliable minimal invasive technique for benign prostate hyperplasia: a meta-analysis of randomized controlled trials

    PubMed Central

    Wang, Kai; Li, Yao; Teng, Jing-Fei; Zhou, Hai-Yong; Xu, Dan-Feng; Fan, Yi

    2015-01-01

    To evaluate the efficacy and safety of plasmakinetic resection of the prostate (PKRP) versus transurethral resection of the prostate (TURP) for the treatment of patients with benign prostate hyperplasia (BPH), a meta-analysis of randomized controlled trials was carried out. We searched PubMed, Embase, Web of Science and the Cochrane Library. The pooled estimates of maximum flow rate, International Prostate Symptom Score, operation time, catheterization time, irrigated volume, hospital stay, transurethral resection syndrome, transfusion, clot retention, urinary retention and urinary stricture were assessed. There was no notable difference in International Prostate Symptom Score between TURP and PKRP groups during the 1-month, 3 months, 6 months and 12 months follow-up period, while the pooled Qmax at 1-month favored PKRP group. PKRP group was related to a lower risk rate of transurethral resection syndrome, transfusion and clot retention, and the catheterization time and operation time were also shorter than that of TURP. The irrigated volume, length of hospital stay, urinary retention and urinary stricture rate were similar between groups. In conclusion, our study suggests that the PKRP is a reliable minimal invasive technique and may anticipatorily prove to be an alternative electrosurgical procedure for the treatment of BPH. PMID:25337839

  19. Age and Obesity Promote Methylation and Suppression of 5-Alpha Reductase 2–Implications for Personalized Therapy in Benign Prostatic Hyperplasia

    PubMed Central

    Bechis, Seth K.; Otsetov, Alexander G.; Ge, Rongbin; Wang, Zongwei; Vangel, Mark G.; Wu, Chin-Lee; Tabatabaei, Shahin; Olumi, Aria F.

    2016-01-01

    Purpose 5α reductase inhibitors (5ARIs) are a main modality of treatment for men suffering from symptomatic benign prostatic hyperplasia (BPH). Over 30% of men do not respond to the therapeutic effects of 5ARIs. We have found that 1/3 of adult prostate samples do not express 5AR2 secondary to epigenetic modifications. We sought to evaluate whether 5AR2 expression in BPH specimens of symptomatic men was linked to methylation of the 5AR2 gene promoter and identify associations with age, obesity, cardiac risk factors, and prostate specific antigen (PSA). Materials and Methods Prostate samples from men undergoing transurethral prostate resection were used. 5AR2 protein expression and gene promoter methylation status were determined by common assays. Clinical variables included age, body mass index (BMI), hypertension, hyperlipidemia, diabetes, PSA, and prostate volume. Univariate and multivariate statistical analyses were performed, followed by stepwise logistic regression modeling. Results BMI and age were significantly correlated with methylation of the 5AR2 gene promoter (p<0.05), whereas prostate volume, PSA, or use of BPH medication were not. Methylation was highly correlated with 5AR protein expression (p<0.0001). In a predictive model, both increasing age and BMI significantly predicted methylation status and protein expression (p<0.01). Conclusions Increasing age and BMI correlate with increased 5AR2 gene promoter methylation and decreased protein expression in men with symptomatic BPH. These results highlight the interplay between age, obesity and gene regulation. Our findings suggest the presence of an individualized epigenetic signature for symptomatic BPH, which may be important for choosing appropriate personalized treatment options. PMID:25916673

  20. Surgical Intervention for Symptomatic Benign Prostatic Hyperplasia is Correlated With Expression of the AP-1 Transcription Factor Network

    PubMed Central

    Lin-Tsai, Opal; Clark, Peter E.; Miller, Nicole L.; Fowke, Jay H.; Hameed, Omar; Hayward, Simon W.; Strand, Douglas W.

    2014-01-01

    BACKGROUND Approximately one-third of patients fail medical treatment for benign prostatic hyperplasia and associated lower urinary tract symptoms (BPH/LUTS) requiring surgical intervention. Our purpose was to establish a molecular characterization for patients undergoing surgical intervention for LUTS to address therapeutic deficiencies. METHODS Clinical, molecular, and histopathological profiles were analyzed in 26 patients undergoing surgery for severe LUTS. Incidental transitional zone nodules were isolated from 37 patients with mild symptoms undergoing radical prostatectomy. Clinical parameters including age, prostate volume, medication, prostate specific antigen, symptom score, body mass index, and incidence of diabetes were collected. Multivariate logistic regression analysis with adjustments for potential confounding variables was used to examine associations between patient clinical characteristics and molecular targets identified through molecular profiling. RESULTS Compared to incidental BPH, progressive symptomatic BPH was associated with increased expression of the activating protein-1 transcription factor/chemokine network. As expected, inverse correlations were drawn between androgen receptor levels and age, as well as between 5α-reductase inhibitor (5ARI) treatment and tissue prostate specific antigen levels; however, a novel association was also drawn between 5ARI treatment and increased c-FOS expression. CONCLUSIONS This study provides molecular evidence that a network of pro-inflammatory activating protein-1 transcription factors and associated chemokines are highly enriched in symptomatic prostate disease, a profile that molecularly categorizes with many other chronic autoimmune diseases. Because 5ARI treatment was associated with increased c-FOS expression, future studies should explore whether increased activating protein-1 proteins are causal factors in the development of symptomatic prostate disease, inflammation or resistance to traditional hormonal therapy. PMID:24500928

  1. Hypovitaminosis D is associated with lower urinary tract symptoms and benign prostate hyperplasia in type 2 diabetes.

    PubMed

    Caretta, N; Vigili de Kreutzenberg, S; Valente, U; Guarneri, G; Pizzol, D; Ferlin, A; Avogaro, A; Foresta, C

    2015-11-01

    Lower urinary tract symptoms (LUTS) may develop more commonly in men with type 2 diabetes mellitus (T2DM). LUTS are often associated with benign prostate hyperplasia (BPH), in general population. An association between LUTS and hypovitaminosis D, and between hypovitaminosis D and type 2 diabetes (T2DM), has also been suggested. Thus, we aim to evaluate possible relationships between hypovitaminosis D, LUTS, and BPH in T2DM men. In this prospective observational study, 67 T2DM males (57.9 ± 9.28 years) underwent medical history collection, International Prostate Symptom Score (IPSS) questionnaire, that allows the identification and grading of LUTS, physical examination, biochemical/hormonal blood tests (fasting plasma glucose, glycated haemoglobin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, creatinine, LH, total testosterone, estradiol (E2 ), 25-OH-vitamin D, PTH, calcium, phosphate, and PSA) and ultrasound transrectal prostate examination. Subdividing patients into three groups, on the base of 25-OH-vitamin D concentration (sufficiency ≥50; insufficiency >25 < 50; and deficiency ≤25 nm), a significant progressive increase of prostate volume (p = 0.037), IPSS score (p = 0.019), diastolic blood pressure (p = 0.018), and a significant decrease in HDL cholesterol (p = 0.038) were observed. 25-OH-Vitamin D levels were inversely correlated with both IPSS (R = -0.333; p = 0.006) and prostate volume (R = -0.311; p = 0.011). At multivariate analysis, hypovitaminosis D remained an independent predictor of both IPSS and prostate volume. In conclusion, we showed, for the first time, an association between 25-OH-vitamin D deficiency, LUTS, and BPH in T2DM men. PMID:26339755

  2. Recent advances in the surgical treatment of benign prostatic hyperplasia

    PubMed Central

    Rocco, Bernardo; Ferreira, Rafael Coelho; Spinelli, Matteo; Cozzi, Gabriele; Dell’Orto, Paolo; Patel, Vipul; Rocco, Francesco

    2011-01-01

    TURP for many years has been considered the gold standard for surgical treatment of BPH. Symptoms relief, improvement in Maximum flow rate and reduction of post void residual urine have been reported in several experiences. Notwithstanding a satisfactory efficacy, concerns have been reported in terms of safety outcomes:intracapsular perforation, TUR syndrome, bleeding with a higher risk of transfusion particularly in larger prostates have been extensivelyreported in the literature. In the recent years the use of new forms of energy and devices suchas bipolar resector, Ho: YAG and potassium-titanyl-phosphate laserare challenging the role of traditional TURP for BPH surgical treatment. In 1999 TURP represented the 81% of surgical treatment for BPHversus 39% of 2005. Is this a marketing driven change or is there areal advantage in new technologies? We analyzed guidelines and higher evidence studies to evaluate therole of the most relevant new surgical approaches compared to TURPfor the treatment of BPH. In case of prostates of very large size the challenge is ongoing, withminimally invasive laparoscopic approach and most recently roboticapproach. We will evaluate the most recent literature on thisemerging field. PMID:22164196

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

    PubMed Central

    Matondang, Faisal Abdi; Rahardjo, Harrina Erlianti

    2014-01-01

    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 α-adrenergic antagonists and 5α-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

  4. Comparative Effectiveness and Safety of Monodrug Therapies for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia

    PubMed Central

    Yuan, Jin-Qiu; Mao, Chen; Wong, Samuel Yeung-Shan; Yang, Zu-Yao; Fu, Xiao-Hong; Dai, Xiao-Yu; Tang, Jin-Ling

    2015-01-01

    Abstract A wide array of drugs are available for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH), but the evidence for the comparative effectiveness is controversial. The objective of this study is to evaluate the comparative effectiveness and safety of monodrug therapies for BPH. Data sources are MEDLINE, EMBASE, and the Cochrane Library. We included randomized controlled trials that compared α-blockers, 5-alpha reductase inhibitors (5ARIs), muscarinic receptor antagonists (MRAs), phosphodiesterase-5 inhibitor (PDE5-Is), or placebo for the treatment of BPH. Comparative effectiveness and safety were pooled by both traditional meta-analysis and network meta-analysis. Summary effect size was calculated as mean difference (MD) and relative risk (RR), together with the 95% confidence intervals (CIs). This study included 58,548 participants from 124 trials in total. When compared with placebo, α-blockers, 5ARIs, and PDE5-Is reduced International Prostate Symptom Score (IPSS) by −1.35 to −3.67 points and increased peak urinary flow rate (PUF) by −0.02 to 1.95 mL/s, with doxazosin (IPSS: MD, −3.67[−4.33 to −3.02]; PUF: MD, 1.95[1.61 to 2.30]) and terazosin (IPSS: MD, −3.37 [−4.24 to −2.50]; PUF: MD, 1.21[0.74 to 1.66]) showing the greatest improvement. The improvement in the IPSS was comparable among tamsulosin, alfuzosin, naftopidil, silodosin, dutasteride, sildenafil, vardenafil, and tadalafil. The incidence of total adverse events and withdraws due to adverse events were generally comparable among various agents. In conclusion, α-blockers, 5ARIs, and PDE5-Is are effective for BPH, with doxazosin and terazosin appearing to be the most effective agents. Drug therapies for BPH are generally safe and well-tolerated, with no major difference regarding the overall safety profile. PMID:26166130

  5. Comparative analysis of benign prostatic hyperplasia management by urologists and nonurologists: A Korean nationwide health insurance database study

    PubMed Central

    Park, Juhyun; Lee, Young Ju; Lee, Jeong Woo; Yoo, Tag Keun; Chung, Jae Il; Yun, Seok-Joong; Hong, Jun Hyuk; Seo, Seong Il; Cho, Sung Yong

    2015-01-01

    Purpose To compare the current management of benign prostatic hyperplasia (BPH) by urologists and nonurologists by use of Korean nationwide health insurance data. Materials and Methods We obtained patient data from the national health insurance system. New patients diagnosed with BPH in 2009 were divided into two groups depending on whether they were diagnosed by a urologist (U group) or by a nonurologist (NU group). Results A total of 390,767 individuals were newly diagnosed with BPH in 2009. Of these, 240,907 patients (61.7%) were in the U group and 149,860 patients (38.3%) were in the NU group. The rate of all initial evaluation tests, except serum creatinine, was significantly lower in the NU group. The initial prescription rate was higher in the U group, whereas the prescription period was longer in the NU group. Regarding the initial drugs prescribed, the use of alpha-blockers was common in both groups. However, the U group was prescribed combination therapy of an alpha-blocker and 5-alpha-reductase inhibitor as the second choice, whereas the NU group received monotherapy with a 5-alpha-reductase inhibitor. During the 1-year follow-up, the incidence of surgery was significantly different between the U group and the NU group. Conclusions There are distinct differences in the diagnosis and treatment of BPH by urologists and nonurologists in Korea. These differences may have adverse consequences for BPH patients. Urological societies should take a leadership role in the management of BPH and play an educational role for nonurologists as well as urologists. PMID:25763128

  6. [The conservative treatment of early-stage benign prostatic hypertrophy].

    PubMed

    Kumanov, Kh; Stoianova, V; Lilov, A; Kaloianov, D

    1993-01-01

    After outlining the methods currently used in benign prostate hyperplasia (BPH) treatment, data defining some etiological aspects of the disease are briefly analyzed. Initial experience had with the treatment of early stage BPH using Permixon--a drug exerting effect on alpha-2 reductase--is described. The results in a series of twenty-seven patients presenting BPH are encouraging. PMID:7527092

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

    PubMed Central

    Hueber, Pierre-Alain; Zorn, Kevin C.

    2013-01-01

    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

  8. Ex vivo efficacy evaluation of laser vaporization for treatment of benign prostatic hyperplasia using a 300-W high-power laser diode with a wavelength of 980 nm

    PubMed Central

    Takada, Junya; Honda, Norihiro; Hazama, Hisanao

    2014-01-01

    Background and Objective: Laser vaporization of the prostate is considered to be a promising treatment for benign prostatic hyperplasia (BPH), and efficiency of vaporization and hemostasis are both important parameters for such treatment. In this study, we used a high-power laser diode with a wavelength of 980 nm to obtain high vaporization efficiency with good hemostasis. The objective of this study is to evaluate the efficacy of laser vaporization for treatment of BPH in ex vivo experiments using a 300-W high-power laser diode with a wavelength of 980 nm quantitatively. Materials and Methods: An ex vivo experimental setup simulating clinical treatment situation was constructed. Bovine prostate tissue was used as a sample. The power setting was 100, 150, 200, 250, or 300 W, and the irradiation time was 0.5, 1, or 2 s. After laser irradiation, vaporized and coagulated depths were measured. Results: The vaporized depth increased with the laser power and irradiation time, and the results confirmed that the high-power laser diode could efficiently vaporize the prostate tissue. Coagulated depth increased as the laser power became higher. Conclusions: Laser vaporization of prostate tissue using a high-power laser diode with a wavelength of 980 nm represents a promising treatment for BPH; this method exhibits high vaporization efficiency and good hemostasis. However, operators must be aware of the risk of postoperative perforation of the prostatic capsule caused by coagulation of deep regions that cannot be visualized by endoscopic observation. PMID:25368442

  9. Effectiveness of Solifenacin and Trospium for Managing of Severe Symptoms of Overactive Bladder in Patients With Benign Prostatic Hyperplasia.

    PubMed

    Kosilov, Kirill Vladimirovich; Loparev, Sergay A; Ivanovskaya, Marina A; Kosilova, Liliya V

    2016-03-01

    This research is aimed to study the possibility of management of severe symptoms of overactive bladder (OAB) with solifenacin and trospium in patients who receive treatment with tamsulosin due to benign prostatic hyperplasia (BPH). The 338 men more than 50 years old (average age 58.4 years) diagnosed with BPH and severe symptoms of OAB were enrolled in the study. Over three episodes of urinary incontinence per day (registration according to bladder diaries), INTERNATIONAL PROSTATE SYMPTOM SCORE: over 19, OAB-V8 questionnaire score over 32, and urodynamic disorders diagnosed using cystometry and uroflowmetry were taken as a criterion of severe symptoms of OAB. Patients of the main group during 2 months received treatment with daily combination of solifenacin 5 mg and trospium 5 mg simultaneously with tamsulosin 0.4 mg. Patients of the control group were treated only with tamsulosin. First endpoint is a quantitative assessment of patients with BPH having severe symptoms of OAB. Second endpoint is a state of the patients' lower urinary tract after the treatment. In the main group, most of urodynamic indices normalized significantly. Number of episodes of incontinence reduced from middle level 3.4 (0.8) per day to 0.9 (0.7) per day. In the control group changes of urodynamic indices were not significant. Quantity of side effects did not exceed the level which is common for antimuscarinic monotherapy. Therefore, percentage of patients with severe symptoms of OAB is not less than 44% of all cases of prostatic hyperplasia accompanied by OAB symptoms. Combination of trospium and solifenacin in standard doses is an efficient and safe method of management of severe symptoms of OAB in the course of the treatment of with tamsulosin in patients more than 50 years of age. PMID:26186951

  10. Combination of tadalafil and finasteride for improving the symptoms of benign prostatic hyperplasia: critical appraisal and patient focus

    PubMed Central

    Elkelany, Osama O; Owen, Ryan C; Kim, Edward D

    2015-01-01

    The evidence suggests that combination therapy for benign prostatic hyperplasia (BPH)-lower urinary tract symptoms (LUTS) using an α-blocker and a 5α-reductase inhibitor has become well accepted. The combination of daily tadalafil and an α-blocker has also demonstrated benefit. This paper addresses combination therapy with daily tadalafil and finasteride for the treatment of BPH-LUTS. Our results demonstrate that use of tadalafil and finasteride represents a logical extension of combination therapies. We analyze a landmark study by Casabé et al that demonstrates improved voiding symptoms as assessed by International Prostate Symptom Scores with a combination of tadalafil and finasteride compared with finasteride and placebo. Study patients had moderate to severe LUTS and prostate volumes >30 g. The additional benefit of improved erectile function as assessed by International Index of Erectile Function-erectile function domain scores with the addition of tadalafil was a secondary benefit. We propose that the ideal patient for combination therapy with tadalafil and finasteride has a prostate volume >30 g and desires additional benefit over monotherapy. For these men, improved erectile function without sexual side effects was a secondary benefit. PMID:25848297

  11. An Analytical Comparison of Short-term Effectiveness and Safety Between Thulium:YAG Laser Vaporesection of the Prostate and Bipolar Transurethral Resection of the Prostate in Patients With Benign Prostatic Hyperplasia

    PubMed Central

    Kim, Joon Woo; Kim, Yeon Joo; Lee, Yoon Hyung; Kwon, Joon Beom; Cho, Sung Ryong

    2014-01-01

    Purpose In recent years, laser surgery has been widely used to treat benign prostatic hyperplasia (BPH). A thulium:yttrium-aluminium-garnet (Tm:YAG) laser was recently introduced for BPH surgery. We compared the effectiveness and safety of Tm:YAG laser vaporesection of the prostate (ThuVaRP) with that of bipolar transurethral resection of the prostate (TURP). Materials and Methods From January 2010 to December 2012, 86 patients underwent surgical treatment for symptomatic BPH by a single surgeon. We retrospectively analyzed and compared the medical records of 43 patients who underwent ThuVaRP and 43 patients who underwent bipolar TURP. All patients were assessed by using the International Prostate Symptom Score, transrectal ultrasonography, the serum prostate-specific antigen (PSA) level, uroflowmetry, and postvoid residual volume before and 1 month after surgery. All complications were compared between the two groups. Results ThuVaRP was superior to TURP in catheterization time (p<0.001) and length of hospital stay (p<0.001). However, operation time was longer with ThuVaRP than with TURP (p<0.001). In patients with a large prostate (>50 g), operation time was much longer with ThuVaRP. One month after surgery, the decrease in PSA was greater (p=0.045) with ThuVaRP than with TURP, and the increase in maximal urine flow rate was greater (p<0.001) with ThuVaRP than with TURP. The postoperative complication transient urinary incontinence was significantly different between the ThuVaRP group (nine cases, 20.9%) and the TURP group (two cases, 4.7%). Other complications were comparable between groups. Conclusions The effectiveness and safety of ThuVaRP and TURP were comparable. ThuVaRP is a promising alternative surgical technique to TURP for BPH. PMID:24466396

  12. The role of muscarinic receptor subtypes on carbachol-induced contraction of normal human detrusor and overactive detrusor associated with benign prostatic hyperplasia.

    PubMed

    Yamanishi, Tomonori; Kaga, Kanya; Fuse, Miki; Shibata, Chiharu; Kamai, Takao; Uchiyama, Tomoyuki

    2015-06-01

    The aim of this study was to compare the effect of antimuscarinic antagonists on carbachol-induced contraction of normal human bladder and detrusor overactivity associated with benign prostatic hyperplasia (DO/BPH). Samples of human bladder muscle were obtained from patients undergoing total cystectomy for bladder cancer (normal bladder), and those undergoing retropubic prostatectomy for BPH. All of the patients with DO/BPH had detrusor overactivity according to urodynamic studies. Detrusor muscle strips were mounted in 10-ml organ baths containing Krebs solution, and concentration-response curves for carbachol were obtained in the presence of antimuscarinic antagonists (4-DAMP, methoctramine, pirenzepine, tolterodine, solifenacin, trospium, propiverine, oxybutynin, and imidafenacin) or vehicle. All antagonists competitively antagonized concentration-response curves to carbachol with high affinities in normal bladder. The rank order of mean pA2 values was as follows: trospium (10.1) > 4-DAMP (9.87), imidafenacin (9.3) > solifenacin (8.8) > tolterodine (8.6) > oxybutynin (8.3) > propiverine (7.7) > pirenzepine (7.4) > methoctramine (6.6). The effects of these antimuscarinic antagonists did not change when tested with DO/BPH bladder, suggesting that each antimuscarinic antagonist has a similar effect in this condition. Schild plots showed a slope corresponding to unity, except for propiverine with DO/BPH detrusor. In conclusion, M3-receptors mainly mediate contractions in human bladder strips with normal state and DO/BPH. PMID:26084660

  13. The role of inflammatory mediators in the development of prostatic hyperplasia and prostate cancer

    PubMed Central

    Elkahwaji, Johny E

    2013-01-01

    Benign prostatic hyperplasia and prostate cancer remain the most prevalent urologic health concerns affecting elderly men in their lifetime. Only 20% of benign prostatic hyperplasia and prostate cancer cases coexist in the same zone of the prostate and require a long time for initiation and progression. While the pathogenesis of both diseases is not fully understood, benign prostatic hyperplasia and prostate cancer are thought to have a multifactorial etiology, their incidence and prevalence are indeed affected by age and hormones, and they are associated with chronic prostatic inflammation. At least 20% of all human malignancies arise in a tissue microenvironment dominated by chronic or recurrent inflammation. In prostate malignancy, chronic inflammation is an extremely common histopathologic finding; its origin remains a subject of debate and may in fact be multifactorial. Emerging insights suggest that prostate epithelium damage potentially inflicted by multiple environmental factors such as infectious agents, dietary carcinogens, and hormones triggers procarcinogenic inflammatory processes and promotes cell transformation and disease development. Also, the coincidence of chronic inflammation and tumorigenesis in the peripheral zone has recently been linked by studies identifying so-called proliferative inflammatory atrophy as a possible precursor of prostatic intraepithelial neoplasia and prostate cancer. This paper will discuss the available evidence suggesting that chronic inflammation may be involved in the development and progression of chronic prostatic disease, although a direct causal role for chronic inflammation or infection in prostatic carcinogenesis has yet to be established in humans. Further basic and clinical research in the area, trying to understand the etiology of prostatic inflammation and its signaling pathway may help to identify new therapeutic targets and novel preventive strategies for reducing the risk of developing benign and malignant tumors of the prostate. PMID:24400229

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

    PubMed Central

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

    2011-01-01

    5α-reductase inhibitors (5α-RIs), including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia (BPH). Many studies reported that preoperative 5α-RI had impact on intraoperative haemorrhage during surgery for BPH, but it was still in controversial. So, we conducted a systematic review of the effects and mechanisms of 5α-RIs on intraoperative bleeding for BPH. MEDLINE, EMBASE, the Cochrane Controlled Trail Register of Controlled Trials and the reference lists of retrieved studies were searched in the analysis. Sixteen publications involving 15 different randomized controlled trials (RCTs) and a total of 1156 patients were used in the analysis, including 10 RCTs for finasteride and five RCTs for dutasteride. We found that preoperative finasteride treatment decreases microvessel density (MVD) in resected prostate specimens. Total blood loss, blood loss per gram of resected prostate tissue and decreases in haemoglobin were all greatly reduced in the finasteride group as compared to controls. Dutasteride appeared to have no effect on bleeding. This meta-analysis shows that preoperative finasteride treatment could decrease intraoperative haemorrhage during surgery for BPH. Preoperative dutasteride had no effect on intraoperative haemorrhage, but further high-quality prospective studies are still needed to confirm this observation. PMID:21892196

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

    PubMed Central

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

    2014-01-01

    Introduction: We estimate the lifetime cost of treatment for moderate/severe symptoms associated with benign prostatic hyperplasia (BPH) in a cohort of Canadian men aged 50 to 59, and we evaluate the costs of 2 daily bioequivalent treatment options: fixed-dose combination (FDC) of dutasteride (0.5 mg) and tamsulosin (0.4 mg), or concomitant administration of dutasteride (0.5 mg) and tamsulosin (0.4 mg) monotherapies. Methods: The expected lifetime costs were estimated by modelling the incidence of acute urinary retention (AUR), BPH-related surgery and clinical progression over a patient’s lifetime (up to 25 years). A model was developed to simulate clinical events over time, based on a discrete Markov process with 6 mutually exclusive health states and annual cycle length. Results: The estimated lifetime budget cost for the cohort of 374 110 men aged 50 to 59 in Canada is between $6.35 billion and $7.60 billion, equivalent to between $16 979 and $20 315 per patient with moderate/severe symptoms associated with BPH. Costs are lower for FDC treatment, with the net difference in lifetime budget impact between the 2 treatment regimens at $1.25 billion. In this analysis, the true costs of BPH in Canada are underestimated for 2 main reasons: (1) to make the analysis tractable, it is restricted to a cohort aged 50 to 59, whereas BPH can affect all men; and (2) a closed cohort approach does not include the costs of new (incident) cases. Conclusion: Canadian clinical guidelines recommend the use of the combination of tamsulosin and dutasteride for men with moderate/severe symptoms associated with BPH and enlarged prostate volume. This analysis, using a representational patient group, suggests that the FDC is a more cost-effective treatment option for BPH. PMID:24454593

  16. Efficacy and Safety of 120-W Thulium:Yttrium-Aluminum-Garnet Vapoenucleation of Prostates Compared with Holmium Laser Enucleation of Prostates for Benign Prostatic Hyperplasia

    PubMed Central

    Hong, Kai; Liu, Yu-Qing; Lu, Jian; Xiao, Chun-Lei; Huang, Yi; Ma, Lu-Lin

    2015-01-01

    Background: This study compared the efficacy and safety between 120-W thulium:yttrium-aluminum-garnet (Tm:YAG) vapoenucleation of prostates (ThuVEP) and holmium laser enucleation of prostates (HoLEP) for patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Methods: A retrospective analysis of 88 consecutive patients with symptomatic BPH was carried out, who underwent either 120-W ThuVEP or HoLEP nonrandomly. Patient demographics and peri-operative and 12-month follow-up data were analyzed with the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum flow rate (Qmax), postvoid residual urine volume (PVR), and rates of peri-operative and late complications. Results: The patients in each group showed no significant difference in preoperative parameters. Compared with the HoLEP group, patients in the 120-W ThuVEP group required significantly shorter time for laser enucleation (58.3 ± 12.8 min vs. 70.5 ± 22.3 min, P = 0.003), and resulted in a significant superiority in laser efficiency (resected prostate weight/laser enucleation time) for 120-W Tm:YAG laser compared to holmium:YAG laser (0.69 ± 0.18 vs. 0.61 ± 0.19, P = 0.048). During 1, 6, and 12 months of follow-ups, the procedures did not demonstrate a significant difference in IPSS, QoL score, Qmax, or PVR (P > 0.05). Mean peri-operative decrease of hemoglobin in the HoLEP group was similar to the ThuVEP group (17.1 ± 12.0 g/L vs. 15.2 ± 10.1 g/L, P = 0.415). Early and late incidences of complications were low and did not differ significantly between the two groups of 120-W ThuVEP and HoLEP patients (P > 0.05). Conclusions: 120-W ThuVEP and HoLEP are potent, safe and efficient modalities of minimally invasive surgeries for patients with LUTS due to BPH. Compared with HoLEP, 120-W ThuVEP offers advantages of reduction of laser enucleation time and improvement of laser efficiency. PMID:25836607

  17. [Disorders of kidney function in patients with benign prostatic hyperplasia].

    PubMed

    Rodoman, V E; Avdoshin, V P; Andriukhin, M I

    1997-01-01

    The examination of 648 males aged 50 to 86 to conduct an early outpatient detection of renal dysfunction in the elderly men employed an original technique of renal function assessment based on the kinetics of urinary 5-NOK elimination. Renal dysfunctions were revealed in 165 patients, in 159 of them the underlying cause was benign prostatic hyperplasia. The results were compared with those obtained at radionuclide tracing and Reberg-Tareev test. The correlation found indicated the authors' technique informative value and its compatibility with the above methods. Identification of renal dysfunction at early stages of benign prostatic hyperplasia allowed their timely hospitalization and operative treatment which enables the physicians to prevent progression of chronic renal failure in these patients. PMID:9461783

  18. AB070. Comparison of photoselective vaporization versus holmium laser enucleation for treatment of benign prostate hyperplasia in a small prostate volume

    PubMed Central

    Bae, Woong Jin; Bashraheel, Fahad; Choi, Sae Woong; Kim, Su Jin; Yoon, Byung Il; Kim, Sae Woong

    2016-01-01

    Objective Photoselective vaporization of the prostate (PVP) using GreenLight and Holmium laser enucleation of the prostate (HoLEP) is an important surgical technique for management of benign prostate hyperplasia (BPH). We aimed to compare the effectiveness and safety of PVP using a 120 W GreenLight laser with HoLEP in a small prostate volume. Methods Patients who underwent PVP or HoLEP surgery for BPH at our institutions were reviewed from May 2009 to December 2014 in this retrospective study. Among them, patients with prostate volumes <40 mL based on preoperative trans-rectal ultrasonography were included in this study. Peri-operative and post-operative parameters—such as International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and complications—were compared between the groups. Results PVP was performed in 176 patients and HoLEP in162 patients. Preoperative demographic data were similar in both groups, with the exception of PVR. Operative time and catheter duration did not show significant difference. Significant improvements compared to preoperative values were verified at the postoperative evaluation in both groups in terms of IPSS, QoL, Qmax, and PVR. Comparison of the postoperative parameters between the PVP and HoLEP groups demonstrated no significant difference, with the exception of IPSS voiding subscore at one month postoperatively (5.9 vs. 3.8, P<0.001). There was no significant difference in postoperative complications between the two groups. Conclusions Our data suggest that PVP and HoLEP are efficient and safe surgical treatment options for patients with small prostate volume.

  19. Plasmakinetic resection technology for the treatment of benign prostatic hyperplasia: evidence from a systematic review and meta-analysis

    PubMed Central

    Li, Sheng; Kwong, Joey S.W.; Zeng, Xian-Tao; Ruan, Xiao-Lan; Liu, Tong-Zu; Weng, Hong; Guo, Yi; Xu, Chang; Yan, Jin-Zhu; Meng, Xiang-Yu; Wang, Xing-Huan

    2015-01-01

    The aim of this study was to compare plasmakinetic resection of the prostate (PKRP) with transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) in terms of efficacy and safety. Published RCTs were searched from PubMed, Embase, Science Citation Index, and Cochrane Library up to April 10, 2014. After methodological quality assessment and data extraction, meta-analysis was performed using the STATA 12.0 software. 18 reports of 16 RCTs were included in this analysis. Meta-analyses showed that PKRP significantly improved Qmax at 12 months, but no significant difference was found for other efficacy outcomes. In terms of safety, treatment of PKRP was associated with reduced drop in serum sodium, lower TUR syndrome, reduced need of blood transfusion, clot retention, and shorter catheterization time and hospital stay; in contrast, there were no significant differences in the analysis of operative time, postoperative fever, and long-term postoperative complications. In summary, current evidence suggests that, although PKRP and TURP are both effective for BPH, PKRP is associated with additional potential benefits in efficacy and more favorable safety profile. It may be possible that PKRP may replace the TURP in the future and become a new standard surgical procedure. PMID:26156138

  20. Solifenacin/tamsulosin fixed-dose combination therapy to treat lower urinary tract symptoms in patients with benign prostatic hyperplasia.

    PubMed

    Dimitropoulos, Konstantinos; Gravas, Stavros

    2015-01-01

    Treatment of male lower urinary tract symptoms (LUTS) has traditionally focused on the management of benign prostatic obstruction, but the contribution of bladder dysfunction has been recently recognized. Therefore, it is well understood that LUTS have multifactorial etiology and often occur in clusters and not in isolation. Voiding LUTS are highly prevalent in men, but storage LUTS have been proved to be more bothersome. α1-Blockers are the most widely used pharmacologic agents for the treatment of symptoms relating to benign prostatic enlargement due to benign prostatic hyperplasia (BPH), while antimuscarinics are the drug class of choice for overactive bladder symptoms. A combination of the two drug classes would be a reasonable approach to treat men with both storage and voiding symptoms, and several short-term studies have proved the efficacy and safety of different combinations with an α1-blocker and an antimuscarinic. Following previous studies on the separate administration of solifenacin and tamsulosin, a fixed-dose combination tablet of tamsulosin oral controlled absorption system (OCAS) 0.4 mg and solifenacin succinate 6 mg has been recently introduced, and the current review evaluates the available data on the use of this fixed-dose combination in the treatment of LUTS in men with BPH. PMID:25834406

  1. Solifenacin/tamsulosin fixed-dose combination therapy to treat lower urinary tract symptoms in patients with benign prostatic hyperplasia

    PubMed Central

    Dimitropoulos, Konstantinos; Gravas, Stavros

    2015-01-01

    Treatment of male lower urinary tract symptoms (LUTS) has traditionally focused on the management of benign prostatic obstruction, but the contribution of bladder dysfunction has been recently recognized. Therefore, it is well understood that LUTS have multifactorial etiology and often occur in clusters and not in isolation. Voiding LUTS are highly prevalent in men, but storage LUTS have been proved to be more bothersome. α1-Blockers are the most widely used pharmacologic agents for the treatment of symptoms relating to benign prostatic enlargement due to benign prostatic hyperplasia (BPH), while antimuscarinics are the drug class of choice for overactive bladder symptoms. A combination of the two drug classes would be a reasonable approach to treat men with both storage and voiding symptoms, and several short-term studies have proved the efficacy and safety of different combinations with an α1-blocker and an antimuscarinic. Following previous studies on the separate administration of solifenacin and tamsulosin, a fixed-dose combination tablet of tamsulosin oral controlled absorption system (OCAS) 0.4 mg and solifenacin succinate 6 mg has been recently introduced, and the current review evaluates the available data on the use of this fixed-dose combination in the treatment of LUTS in men with BPH. PMID:25834406

  2. Application of two micron laser vaporesection combined with transurethral resection of the prostate in treatment of benign prostatic hyperplasia: analysis of 340 cases

    PubMed Central

    Yao, Zhiyong; Sun, Bin; Zhou, Gaobiao; Yang, Yonghong; Zhang, Lei; Liu, Lanlan; Sheng, Haibo; Guo, Heqing

    2015-01-01

    Purpose: To evaluate clinical efficacy and safety of two micron laser vaporesection combined with transurethral resection of the prostate (TURP) in treating benign prostatic hyperplasia (BPH). Methods: In total, 340 BPH patients aged 62-86 years, were treated with two micron laser vaporesection plus TURP. Mean prostatic volume was measured as 38-182 ml. Operative time, intraoperative hemorrhage volume, time of postoperative bladder irrigation, time of indwelling urinary catheter and surgical complications were examined. International Prostate Symptom Score (IPSS), quality of life score (QOL), maximal urinary flow rate (Qmax) and post void residual urine volume (PVR) were analyzed. Results: All cases underwent the surgery successfully. No transurethral resection syndrome was noted. Mean operative time was (72±15) min. Mean intra operative hemorrhage volume was (48.4±13.0) ml. Four patients were transfused with 2 U of suspended red blood cells. Time of postoperative bladder irrigation ranged from 0.5-2.5 d. Time of indwelling urinary catheter was 3-6 d. After removing urinary catheter, mild urinary irritation symptoms were noted in 19 cases. Ten patients developing urinary infection were recovered following anti-infection therapy. One with secondary urethral stenosis was healed after urethral dilatation for three times. Postoperative IPSS, QOL, Qmax and PVR were (6.0±2.0), (2.0±0.2), (18.5±1.6) ml/s and (11.0±4.0) ml, significantly improved compared with preoperative levels (all P<0.05). Fifty eight cases with normal sexual function retained sexual function postoperatively and had no retrograde ejaculation. Conclusions: Two micron laser vaporesection plus TURP is efficacious and safe in treating BPH with mild lower urinary tract symptoms and perioperative complications. PMID:26770585

  3. 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

    Antunes, Alberto A.; Carnevale, Francisco C. Motta Leal Filho, Joaquim M. da; Yoshinaga, Eduardo M.; Cerri, Luciana M. O.; Baroni, Ronaldo H.; Marcelino, Antonio S. Z.; Cerri, Giovanni G.; Srougi, Miguel

    2013-08-01

    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.

  4. Maternal Obesity, Cage Density, and Age Contribute to Prostate Hyperplasia in Mice.

    PubMed

    Benesh, Emily C; Gill, Jeff; Lamb, Laura E; Moley, Kelle H

    2016-02-01

    Identification of modifiable risk factors is gravely needed to prevent adverse prostate health outcomes. We previously developed a murine precancer model in which exposure to maternal obesity stimulated prostate hyperplasia in offspring. Here, we used generalized linear modeling to evaluate the influence of additional environmental covariates on prostate hyperplasia. As expected from our previous work, the model revealed that aging and maternal diet-induced obesity (DIO) each correlated with prostate hyperplasia. However, prostate hyperplasia was not correlated with the length of maternal DIO. Cage density positively associated with both prostate hyperplasia and offspring body weight. Expression of the glucocorticoid receptor in prostates also positively correlated with cage density and negatively correlated with age of the animal. Together, these findings suggest that prostate tissue was adversely patterned during early life by maternal overnutrition and was susceptible to alteration by environmental factors such as cage density. Additionally, prostate hyperplasia may be acutely influenced by exposure to DIO, rather than occurring as a response to worsening obesity and comorbidities experienced by the mother. Finally, cage density correlated with both corticosteroid receptor abundance and prostate hyperplasia, suggesting that overcrowding influenced offspring prostate hyperplasia. These results emphasize the need for multivariate regression models to evaluate the influence of coordinated variables in complicated animal systems. PMID:26243546

  5. Prostatic Arterial Embolization with Small Sized Particles for the Treatment of Lower Urinary Tract Symptoms Due to Large Benign Prostatic Hyperplasia: Preliminary Results

    PubMed Central

    Li, Qiang; Duan, Feng; Wang, Mao-Qiang; Zhang, Guo-Dong; Yuan, Kai

    2015-01-01

    Background: The clinical failure after prostatic artery embolization (PAE) with conventional particles was relatively high, in treatment for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). We reported the results of PAE with combined polyvinyl alcohol particles 50 μm and 100 μm in size as a primary treatment in 24 patients with severe LUTS secondary to large BPH. Methods: From July 2012 to June 2014, we performed PAE in 24 patients (65–85 years, mean 74.5 years) with severe LUTS due to large BPH (≥80 cm3) and refractory to medical therapy. Embolization was performed using combination of 50 μm and 100 μm in particles size. Clinical follow-up was performed using the International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow (Qmax), postvoid residual (PVR) volume, the International Index of Erectile Function (IIEF), prostatic specific antigen (PSA), and prostatic volume measured by magnetic resonance imaging at 1, 3, 6, and every 6-month thereafter. Technical success was defined when PAE was completed in at least one pelvic side. Clinical success was defined as the improvement of both symptoms and QoL. A Student's t-test for paired samples was used. Results: PAE was technically successful in 22 patients (92%). Bilateral PAE was performed in 19 (86%) patients and unilateral in 3 (14%) patients. Follow-up data were available for 22 patients observed for mean of 14 months. The clinical improvement at 1, 3, 6, and 12-month was 91%, 91%, 88%, and 83%, respectively. At 6-month follow-up, the mean IPSS, QoL, PVR, and Qmax were from 27 to 8 (P = 0.001), from 4.5 to 2.0 (P = 0.002), from 140.0 ml to 55.0 ml (P = 0.002), and from 6.0 ml/s to 13.0 ml/s (P = 0.001), respectively. The mean prostate volume decreased from 110 cm3 to 67.0 cm3 (mean reduction of 39.1%; P = 0.001). The PSA and IIEF improvements after PAE did not differ from pre-PAE significantly. No major adverse events were noted. Conclusions: The combination of 50 μm and 100 μm particles for PAE is a safe and effective treatment method for patients with severe LUTS due to large BPH, which further improves the clinical results of PAE. PMID:26228221

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

    PubMed Central

    Bostanci, Yakup; Kazzazi, Amir; Djavan, Bob

    2013-01-01

    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

  7. Thulium laser enucleation of the prostate is a safe and a highly effective modality for the treatment of benign prostatic hyperplasia - Our experience of 236 patients

    PubMed Central

    Ketan, P. Vartak; Prashant, H. Salvi

    2016-01-01

    Context: Thulium LASER is fast emerging as a safe and effective modality for benign prostatic hyperplasia (BPH). Still, compared to holmium laser transurethral enucleation of the prostate (HoLEP) the number of institutes all over the world using Thulium LASER are limited. This is our effort to bring the statistical facts about the safety and effectivity of Thulium LASER. Aims: To study the efficacy of thulium laser enucleation of the prostate (ThuLEP). Settings and Design: All patients in the stipulated period were documented for all parameters and were evaluated. The results were tabulated. Subjects and Materials: (1) Two hundred and thirty-six patients with symptomatic BPH were treated with ThuLEP between March 2010 and September 2014 at our institute by a single surgeon. (2) The inclusion criteria were maximum urinary flow rate (Qmax) <15 ml/s, International Prostate Symptoms Score (IPSS) >15 or acute retention of urine with the failure of catheter trial or Acute retention of urine with prior history of severe bladder outlet obstruction. (3) Patients evaluated by: Digital rectal examination, uroflowmetry, IPSS, prostate-specific antigen (PSA), blood and urine routine tests, abdominal usage with trains rectal ultrasonography (TRUS), TRUS guided biopsies. Statistical Analysis Used: Not used. Results: (1) ThuLEP was a highly effective procedure as compared to all other procedures like HOLEP, TURP in terms of catheterization time, hospital stay, and drop in hemoglobin (Hb). (2) Catheterization time: 25.22 h (224 patients within 24 h and 12 patients within 48 h). (3) Hospital stay: 24–36 h 218 patients (92.3%), 36–48 h 18 patients (7.6%). (4) Drop in Hb: 0.8 ± 0.42 g/dl. (5) Average operative time: 56.91 min. Conclusions: Thulium LASER is a safe and highly effective LASER in terms of blood loss, speed of tissue resection, drop in serum PSA, and versatility of prostatic resection. PMID:26834407

  8. A randomized, comparative, open-label study of efficacy and tolerability of alfuzosin, tamsulosin and silodosin in benign prostatic hyperplasia

    PubMed Central

    Manjunatha, R.; Pundarikaksha, H. P.; Madhusudhana, H. R.; Amarkumar, J.; Hanumantharaju, B. K.

    2016-01-01

    Objectives: Benign prostatic hyperplasia (BPH) is a common and progressive disease affecting elderly males, often associated with lower urinary tract symptoms (LUTS). α1-blockers are the mainstay in symptomatic therapy of BPH. Because of their greater uroselectivity and minimal hemodynamic effects, alfuzosin, tamsulosin, and silodosin are generally preferred. The aim of this study was to compare the efficacy and tolerability of alfuzosin, tamsulosin, and silodosin in patients with BPH and LUTS. Methods: Ninety subjects with BPH and LUTS were randomized into three groups of thirty in each, to receive alfuzosin sustained release (SR) 10 mg, tamsulosin 0.4 mg, or silodosin 8 mg for 12 weeks. The primary outcome measure was a change in the International Prostate Symptom Score (IPSS), and the secondary outcome measures were changes in individual subjective symptom scores, quality of life score (QLS), and peak flow rate (Qmax) from baseline. The treatment response was monitored at 2, 4, 8, and 12 weeks. Results: IPSS improved by 88.18%, 72.12%, and 82.23% in alfuzosin SR, tamsulosin and silodosin groups (P < 0.001) at 12 weeks. Improvement in QLS was >75% in all the three groups (P < 0.001). A significant improvement in Qmax was seen with alfuzosin and tamsulosin (P = 0.025 and P < 0.001) but not with silodosin (P = 0.153). However, the intergroup differences in IPSS, QLS, and Qmax were not significant. Ejaculatory dysfunction was more common with silodosin and corrected QT (QTc) prolongation occurred only with alfuzosin (two subjects) and tamsulosin (three subjects). Conclusion: Alfuzosin, tamsulosin, and silodosin showed similar efficacy in improvement of LUTS secondary to BPH, with good tolerability, acceptability, and minimum hemodynamic adverse effects. Alfuzosin, tamsulosin, and silodosin are comparable in efficacy in symptomatic management of BPH. The occurrence of QTc prolongation in three subjects with tamsulosin in the present study is an unexpected adverse event as there are no reports of QTc prolongation with tamsulosin in any of the previous studies. PMID:27127315

  9. Testosterone Replacement Therapy and BPH/LUTS. What is the Evidence?

    PubMed

    Baas, Wesley; Köhler, Tobias S

    2016-06-01

    Contrary to the previous dogma that prostatic growth is directly proportional to testosterone levels, emerging research has suggested a lack of testosterone may be a risk factor for lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Within this review article, we have demonstrated the current understanding of the physiology of hypogonadism and its interplay with prostatic and lower urinary tract physiology. The current evidence suggests that not only does testosterone replacement therapy (TRT) not worsen LUTS, but that hypogonadism itself is an important risk factor for LUTS/BPH. PMID:27068735

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

    NASA Astrophysics Data System (ADS)

    Saleh, Khaldon Y.; Smith, Nadine B.

    2003-10-01

    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.

  11. Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

    PubMed Central

    2013-01-01

    Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA   S-2 Introduction   S-2 Benign Prostatic Hyperplasia (BPH)   S-3 • Overview   S-3• Current BPH Treatment Paradigm   S-4• BPH Continuum of Care: Bladder Health   S-5 New Treatment Option for BPH   S-5 • The UroLift® System   S-6• Positioning of UroLift® in BPH Treatment Paradigm   S-7 New Value Proposition   S-8 • Addressing Bladder Health: Breaking the Cycle   S-8• Cost Benefit Analysis: The Big Picture   S-8 Patient and Family Engagement   S-10 Summary   S-11 PMID:22823180

  12. Interstitial laser coagulation therapy for benign prostatic hyperplasia

    NASA Astrophysics Data System (ADS)

    McNicholas, Thomas A.; Alsudani, Mohammed

    1996-05-01

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

  13. Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

    PubMed Central

    Dobrowolski, Dariusz; Wylegala, Edward

    2011-01-01

    The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature published on this topic and provides recommendations on how to reduce incidence of iatrogenic IFIS or its severity and outcomes in patients with BPH. PMID:24578865

  14. Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers.

    PubMed

    Jan Teper, Slawomir; Dobrowolski, Dariusz; Wylegala, Edward

    2011-01-01

    The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature published on this topic and provides recommendations on how to reduce incidence of iatrogenic IFIS or its severity and outcomes in patients with BPH. PMID:24578865

  15. Serum PSA and PAP measurements discriminating patients with prostate carcinoma from patients with nodular hyperplasia.

    PubMed Central

    Shih, W. J.; Collins, J.; Mitchell, B.; Wierzbinski, B.

    1994-01-01

    Prostatic specific antigen (PSA) and prostatic acid phosphatase (PAP) are the tumor markers for monitoring disease progression or improvement in patients with prostate adenocarcinoma. The clinical utility of PSA and PAP for early detection of prostate adenocarcinoma, however, requires distinction between prostate adenocarcinoma and prostate nodular hyperplasia. The serum PSA and PAP levels were measured in 20 men with histologically proven prostate adenocarcinoma and 28 men with histologically proven prostate nodular hyperplasia. Patients' blood samples were collected 1 to 7 days prior to the prostate examination, which included a rectal digital examination, transurethral resection, cytoscopy, and prostate biopsy. Sensitivity, specificity, and predictive values of positive and negative results for the discrimination of prostate adenocarcinoma from prostate nodular hyperplasia were 85%, 89%, 85%, and 29%, respectively, for serum PSA (cutoff level: 10 ng/mL) and 40%, 96%, 89%, and 69%, respectively, for serum PAP (cutoff level: 10 ng/mL). Results indicate that marked elevation of serum PSA suggests prostate adenocarcinoma and that serum PSA can discriminate prostate adenocarcinoma from prostate nodular hyperplasia better than serum PAP. PMID:7525979

  16. Technical aspects of holmium laser enucleation of the prostate for benign prostatic hyperplasia.

    PubMed

    Kim, Myong; Lee, Hahn-Ey; Oh, Seung-June

    2013-09-01

    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

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

    PubMed Central

    Kim, Myong; Lee, Hahn-Ey

    2013-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  19. Expression of leukemia/lymphoma related factor (LRF/Pokemon) in human benign prostate hyperplasia and prostate cancer.

    PubMed

    Aggarwal, Himanshu; Aggarwal, Anshu; Hunter, William J; Yohannes, Paulos; Khan, Ansar U; Agrawal, Devendra K

    2011-04-01

    Leukemia/lymphoma related factor (LRF), also known as Pokemon, is a protein that belongs to the POK family of transcriptional repressors. It has an oncogenic role in many different solid tumors. In this study, the expression of LRF was evaluated in benign prostate hyperplastic (BPH) and prostate cancer (PC) tissues. The functional expression of LRF was studied using multiple cellular and molecular methods including RT-PCR, western blotting, immunohistochemistry, and immunofluorescence. Paraffin-embedded human tissues of BPH and PC were used to examine LRF expression. Histological staining of the BPH and PC tissue sections revealed nuclear expression of LRF with minimal expression in the surrounding stroma. The semi-quantitative RT-PCR and western immunoblot analyses demonstrated significantly higher mRNA transcripts and protein expression in PC than BPH. High expression of LRF suggests that it may have a potential role in the pathogenesis of both BPH and prostate cancer. Further studies will help elucidate the mechanisms and signaling pathways that LRF may follow in the pathogenesis of prostate carcinoma. PMID:21251909

  20. Applicators for MR-Guided Ultrasonic Ablation of BPH

    PubMed Central

    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

    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

  1. 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

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

    2013-01-01

    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

  2. Does Metabolic Syndrome or its Components Correlate With Lower Urinary Tract Symptoms in Benign Prostatic Hyperplasia Patients?

    PubMed Central

    Telli, Onur; Demirbas, Arif; Kabar, Mucahit; Karagoz, Mehmet Ali; Sarici, Hasmet; Resorlu, Berkan

    2015-01-01

    Background: Metabolic Syndrome (MS) has become a global public health and has been suggested to be a risk factor for Lower Urinary Tract Symptoms (LUTS). Studies evaluating the association between the rate of the MS and LUTS often showed controversial results. Objectives: The purpose of this study was to reveal the relevance of MS and its components on the frequency and severity of the LUTS that were seen with Benign Prostate Hyperplasia (BPH) in Turkish men or not. Patients and Methods: In this study, 237 patients referred to urology policlinic with BPH were retrospectively scanned between April 2009 and April 2013. Patients with normal digital rectal examination and the Prostate Specific Antigen (PSA) level of ≤ 4 ng/mL were evaluated using the International Prostate Symptom Score (IPSS) and all the data of the patients' body, including Body Mass Index (BMI), lipid parameters, preprandial blood glucose, and waist circumference. Seventy-four patients (31.3%) with mild IPSS (0-7) was group 1; 97 patients (40.9%) with moderate IPSS (8 - 19) group 2 and 66 patients (27.8%) with severe IPSS (20-35) were defined as group 3. group 4 consisted of 117 healthy controls. Three groups and controls were compared about MS and its components. The diagnosis criteria of The Society of Endocrinology and Metabolism of Turkey were used in MS diagnosis. Also, BMI, lipid parameters, preprandial blood glucose, waist circumference, and blood pressure were used as MS parameters. Results: The average age of patients in group 1 was 69.8 ± 7.2; in group 2, 69.1 ± 7.4; 68.3 ± 7.1 in group 3 and 70.2 ± 7.2 in the control group. Metabolic syndrome was determined at 37 patients (50%) in group 1, 45 patients (46.5%) in group 2, 32 patients (48%) in group 3 and 52 patients (44.4%) in controls and no statistically significant correlation was detected between LUTS and MS in BPH (P = 0.113). In the comparison of the four groups in the point of MS parameters, no significant correlation was detected in the levels of total cholesterol (P = 0.337), fasting glucose (P = 0.291), BMI (P = 0.452), Low Density Lipoprotein (LDL, P = 0.069) and triglyceride (P = 0.307). Conclusions: In our study, the evidence is not enough to support the hypothesis of the relevance between MS and LUTS. Wide-ranging, prospective and multicentric studies are needed to research the relevance between MS and LUTS in BPH. PMID:26290850

  3. Effect of obesity and hyperglycemia on benign prostatic hyperplasia in elderly patients with newly diagnosed type 2 diabetes

    PubMed Central

    Chen, Zhe; Miao, Li; Gao, Xia; Wang, Guang; Xu, Yuan

    2015-01-01

    Purpose: To investigate the relationship between blood glucose levels, age, body mass index (BMI), and benign prostatic hyperplasia (BPH) in patients with newly diagnosed type 2 diabetes. Methods: A total of 141 BPH patients with newly diagnosed type 2 diabetes participated in this study. Their glucose level, international prostate symptom score (IPSS), prostate volume (PV), and maximum urinary flow rate (Qmax) were determined and analyzed. Results: Compared to patients in 60-69 years of age, those in 70-79 years of age had higher IPSS and PV values (11.10±2.68 vs. 16.09±2.64, respectively; P<0.01; 38.67±4.65 vs. 44.76±2.84, respectively; P<0.01) as did patients ≥80 y (11.10±2.68 vs. 19.87±3.35, respectively; P<0.01; 38.67±4.65 vs. 51.38±3.74, respectively; P<0.01). The Qmax was lower in the ≥80 y group compared to the 60-69 y group (7.91±2.13 vs. 13.50±1.75, respectively; P<0.01). IPSS, PV, and insulin resistance index (HOMA-IR) were higher in patients with a BMI ≥28 kg/m2 group as compared to those with a BMI <24 kg/m2 group. IPSS and PV values were higher in patients with HbA1c levels ≥6.5% than in those with HbA1c<6.5% (16.30±3.31 vs. 9.87±1.07, respectively; P<0.01; 45.69±3.97 vs. 36.64±3.30, respectively; P<0.01), and the Qmax was lower (10.61±1.98 vs. 14.40±0.82, respectively; P<0.01). Conclusions: Aging, obesity, high glucose level, and insulin resistance increase the risk of BPH progression in elderly patients with newly diagnosed type 2 diabetes. Managing body weight and lowering the level of glycosylated hemoglobin may slow the progression of BPH in people with type 2 diabetes. PMID:26379937

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

    PubMed

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

    2011-01-01

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

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

    PubMed

    Roehrborn, Claus G

    2008-03-01

    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

  6. Serenoa repens extract in the treatment of benign prostatic hyperplasia

    PubMed Central

    Geavlete, Petrisor; Multescu, Razvan; Geavlete, Bogdan

    2011-01-01

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

  7. Comparative Effectiveness and Safety of Monodrug Therapies for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Network Meta-analysis.

    PubMed

    Yuan, Jin-Qiu; Mao, Chen; Wong, Samuel Yeung-Shan; Yang, Zu-Yao; Fu, Xiao-Hong; Dai, Xiao-Yu; Tang, Jin-Ling

    2015-07-01

    A wide array of drugs are available for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH), but the evidence for the comparative effectiveness is controversial.The objective of this study is to evaluate the comparative effectiveness and safety of monodrug therapies for BPH.Data sources are MEDLINE, EMBASE, and the Cochrane Library.We included randomized controlled trials that compared α-blockers, 5-alpha reductase inhibitors (5ARIs), muscarinic receptor antagonists (MRAs), phosphodiesterase-5 inhibitor (PDE5-Is), or placebo for the treatment of BPH.Comparative effectiveness and safety were pooled by both traditional meta-analysis and network meta-analysis. Summary effect size was calculated as mean difference (MD) and relative risk (RR), together with the 95% confidence intervals (CIs).This study included 58,548 participants from 124 trials in total. When compared with placebo, α-blockers, 5ARIs, and PDE5-Is reduced International Prostate Symptom Score (IPSS) by -1.35 to -3.67 points and increased peak urinary flow rate (PUF) by -0.02 to 1.95 mL/s, with doxazosin (IPSS: MD, -3.67[-4.33 to -3.02]; PUF: MD, 1.95[1.61 to 2.30]) and terazosin (IPSS: MD, -3.37 [-4.24 to -2.50]; PUF: MD, 1.21[0.74 to 1.66]) showing the greatest improvement. The improvement in the IPSS was comparable among tamsulosin, alfuzosin, naftopidil, silodosin, dutasteride, sildenafil, vardenafil, and tadalafil. The incidence of total adverse events and withdraws due to adverse events were generally comparable among various agents.In conclusion, α-blockers, 5ARIs, and PDE5-Is are effective for BPH, with doxazosin and terazosin appearing to be the most effective agents. Drug therapies for BPH are generally safe and well-tolerated, with no major difference regarding the overall safety profile. PMID:26166130

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

    NASA Astrophysics Data System (ADS)

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

    1997-05-01

    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.

  9. Transurethral needle ablation (TUNA): histopathological, radiological and clinical studies of a new office procedure for treatment of benign prostatic hyperplasia.

    PubMed

    Schulman, C C; Zlotta, A R

    1994-01-01

    Many attempts have been made to develop a method for treating benign prostatic hyperplasia (BPH) that is minimally invasive, efficacious, and low cost. The transurethral needle ablation (TUNA) device has recently been developed to treat BPH by selectively ablating hyperplastic prostatic tissue. A special catheter incorporates needles that deliver low-level radiofrequency power directly to a very localized area of the prostate. The needles have adjustable shields to protect the urethra if desired or necessary. It is positioned via transrectal ultrasound or direct vision. A pilot study was performed in patients to evaluate TUNA feasibility via histopathological measurement of the size of the thermal lesion and TUNA safety. Fifty patients have been treated, twenty-five patients were treated using TUNA prior to scheduled retropubic prostatectomy. The surgical prostatic specimens were recovered from 1 day to 1 month after TUNA, were step-sectioned, and examined histologically. Patients were 69 years old on average with a prostate weight varying from 14 to 88 g. The TUNA procedure averaged 30 minutes, 4 lesion treatments per prostate, and 4-15 W of power applied for 3 to 5 minutes. Proximal lesion temperature was about 40-70 degrees C with central lesion temperatures of about 110 degrees C. Urethral temperature averaged 37-42 degrees C and rectal temperature remained unchanged. Macroscopic examination of the specimens demonstrated localized lesions averaging 12 x 7 mm for 3 mins. and 10 x 17 for 5 mins. treatment. Microscopic examination showed larger lesions of extensive coagulative necrosis up to 35 x 15 mm. Specific immunohistochemical staining showed destruction of all tissue components. Preservation of the urethra and capsule integrity were noted. Magnetic resonance imaging performed in vivo and ex vivo showed lesions in the prostate corresponding to the recovered surgical specimen. All patients were treated without anesthesia and tolerated the procedure well. Of the 9 patients treated for chronic retention, 6 recovered voiding within 48 hours. Three month follow-up in 11 patients showed significant improvement in both objective and subjective parameters. Because of good lesion localization and maintenance of a normal rectal temperature TUNA appears to be safe. The feasibility of its widespread use was shown by the creation and sustainability of adequately sized lesions and good tolerance as an outpatient treatment. Ongoing clinical studies are evaluating the sustained efficacy of the procedure. PMID:7528418

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

    PubMed

    Varshney, Anil; Agarwal, Anshuman

    2009-07-01

    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

  11. AB40. Sexual side effects of medical treatment of BPH

    PubMed Central

    Park, Hyun Jun

    2014-01-01

    The medical and surgical management of BPH/LUTS can affect erectile function (EF), cause ejaculatory dysfunction (EjD) or affect libido. Five alpha reductase inhibitors, such as finasteride and dutasteride have good efficacy for benign prostatic hyperplasia, however they have also sexual side effects including loss of libido, erectile dysfunction and decreased ejaculatory volume. Also, alpha adrenergic blockers are well known and standard medical treatment options for BPH/LUTS, and in spite of their high efficacy and low adverse effects, retrograde and diminished ejaculation are potential sexual side effects. Although the prevalence of five alpha reductase inhibitors and alpha adrenergic blockers are not high, their impact on the patients’ quality of life must be regarded as important as their efficacy for BPH/LUTS. This lecture will review the effects of these therapies on sexual function.

  12. International registry results for an interstitial laser BPH treatment device

    NASA Astrophysics Data System (ADS)

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

    1996-05-01

    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.

  13. Immunogenetics of prostate cancer and benign hyperplasia - the potential use of an HLA-G variant as a tag SNP for prostate cancer risk.

    PubMed

    Zambra, F M B; Biolchi, V; de Cerqueira, C C S; Brum, I S; Castelli, E C; Chies, J A B

    2016-02-01

    Human leukocyte antigen G (HLA-G) is an immunomodulatory molecule with important roles both physiologically as well as an escape mechanism of cancer cells. In this study, we evaluated the impact of eight polymorphisms at the 3' untranslated region (3'UTR) of the HLA-G gene in the development of prostate cancer (PCa) and benign prostatic hyperplasia (BPH). A total of 468 DNA samples of Brazilian men predominantly Euro-descendant with PCa (N = 187), BPH (N = 152) and healthy control individuals (N = 129) were evaluated. The HLA-G 3'UTR region was amplified by polymerase chain reaction (PCR), sequenced and genotyped to identify the 14 bp insertion/deletion (rs371194629), +3003T/C (rs1707), +3010C/G (rs1710), +3027A/C (rs17179101), +3035C/T (rs17179108), +3142G/C (rs1063320), +3187A/G (rs9380142) and +3196C/G (rs1610696) polymorphisms. Regression logistic and chi-square tests were performed to verify the influence of single nucleotide polymorphisms (SNPs) in PCa and/or BPH susceptibility, as well as in PCa progression (clinicopathological status). Our data showed the UTR-4 haplotype as a risk factor to PCa in comparison with control [odds ratio (OR) 2.35, 95% confidence interval (CI) 1.39-3.96, Padjusted = 0.003) and BPH groups (OR 1.82, 95% CI 1.15-2.86, Padjusted = 0.030). Further, the 'non-14bp Ins_ + 3142G_+3187A' haplotype (OR 1.56, 95% CI 1.10-2.20, Padjusted = 0.036), the +3003CT genotype (OR 4.44, 95% CI 1.33-4.50, Padjusted = 0.032) and the +3003C allele (OR 2.33, 95% CI 1.38-3.92, Padjusted = 0.016) also conferred susceptibility to PCa. Our data suggest an important influence of HLA-G 3'UTR polymorphisms in PCa susceptibility and support the use of the +3003 variant as a tag SNP for PCa risk. PMID:26889902

  14. Androgen- and Estrogen-Receptor Content in Spontaneous and Experimentally Induced Canine Prostatic Hyperplasia

    PubMed Central

    Trachtenberg, John; Hicks, L. Louise; Walsh, Patrick C.

    1980-01-01

    To gain insight into the mechanism by which steroidal hormones influence the development of canine prostatic hyperplasia, nuclear and cytosolic androgen- and estrogen-receptor content, as measured under exchange conditions by the binding of [3H]R1881 (methyltrienolone) and [3H]estradiol, respectively, were quantitated in the prostates of purebred beagles of known age. In young dogs with spontaneously arising and experimentally induced (androstanediol plus estradiol treatment) prostatic hyperplasia, nuclear, but not cytosolic, prostatic androgen-receptor content was significantly greater than that determined in the normal prostates of age-matched dogs (3,452±222 and 4,035±274 fmol/mg DNA vs. 2,096±364 fmol/mg DNA, respectively). No differences were observed between the androgen-receptor content of the normal prostates of young dogs and the hyperplastic prostates of old dogs. The cytosolic and nuclear estrogen-receptor content of spontaneously arising prostatic hyperplasia in both young and old animals was similar to that found in normal prostates. The administration of estradiol plus androstanediol to castrate dogs significantly increased the prostatic nuclear androgen-receptor content over that found in dogs treated only with androstanediol. This estradiol-associated increase in nuclear androgen-receptor content was accompanied by the development of benign prostatic hyperplasia. Estradiol treatment of castrate dogs resulted in an increase in prostatic nuclear estrogen-receptor content, in the appearance of a putative prostatic cytosolic progesterone receptor, and in an alteration of the epithelium of the prostate to one characterized by squamous metaplasia. Treatment of castrate dogs with both estradiol and androstanediol resulted in a reduction in prostatic nuclear estrogen-receptor content, disappearance of the progesterone receptor, and loss of squamous metaplasia. An increase in nuclear androgen-receptor content, thus, appears to be an important event in the development of both spontaneously arising and experimentally induced canine prostatic hyperplasia. The mechanism of androgen-estrogen synergism in the experimental induction of canine benign prostatic hyperplasia may be explained by estradiol-mediated increases in nuclear androgen-receptor content. Because androstanediol blocked certain estradiol-mediated events within the prostate, a negative feedback mechanism may exist in which the response of the canine prostate to estrogens is modulated by rising levels of androgen. PMID:6154062

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

    PubMed Central

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

    2013-01-01

    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

  16. The role of phosphodiesterase type-5 inhibitors in treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.

    PubMed

    Umul, Mehmet; Serel, Tekin Ahmet

    2013-12-01

    Phosphodiesterase type-5 (PDE-5) inhibitors are approved as the first line of therapy for the treatment of erectile dysfunction. However, different studies have been performed to study the use of these agents in other areas of urology. There are many studies related to the use of PDE-5 inhibitors as a monotherapy or combination therapy with alpha-blockers for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). It has been shown that contractions induced by various agents or electrical field stimulation in organ bath models of prostatic tissue can be reversed by PDE-5 inhibitors. Age, body mass index and the severity of LUTS are important factors for the selection of patients suitable for this treatment. It has also been reported that the use of PDE-5 inhibitors can relieve the chronic pelvic ischemia and endothelial dysfunction associated with metabolic syndrome. Most of the side effects observed with PDE-5 inhibitors are minimal and tolerable. The use of PDE-5 inhibitors is absolutely contraindicated in patients taking nitrate preparations. A significant interaction has not been observed even when a patient is taking several antihypertensive agents concurrently. Co-administration of alpha-blockers and PDE-5 inhibitors may result in orthostatic hypotension; therefore, patients should be stable on α-blocker therapy before the initiation of the combination therapy, and the initial PDE-5 inhibitor dose should be the lowest possible. In this review, our aim was to evaluate the role of PDE-5 inhibitors in the treatment of LUTS associated with BPH by analyzing the current literature. PMID:26328121

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

    PubMed Central

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

    2010-01-01

    Background Benign prostatic hyperplasia (BPH), a common condition among older men, confers its morbidity through potentially bothersome lower urinary tract symptoms. Treatments for BPH include drugs such as alpha adrenergic receptor blockers and 5-alpha reductase inhibitors, minimally invasive therapies that use heat to damage or destroy prostate tissue, and surgery including transurethral resection of the prostate. Complementary and alternative medicines are gaining popularity in the U.S. Two phytotherapies commonly used for BPH are extracts of the fruit of Serenoa repens, the Saw palmetto dwarf palm that grows in the Southeastern U.S., and extracts of the bark of Pygeum africanum, the African plum tree. Purpose The objective of the Complementary and Alternative Medicines for Urological Symptoms (CAMUS) clinical trial is to determine if phytotherapy is superior to placebo in the treatment of BPH. Methods CAMUS was originally designed as a 3300-participant, four-arm trial of Serenoa repens, Pygeum africanum, an alpha adrenergic blocking drug, and placebo with time to clinical progression of BPH, a measure of long-term efficacy, as the primary endpoint. Before enrollment started, a randomized, double-blind, placebo-controlled, single institution clinical trial showed that Serenoa repens at the usual dose did not demonstrate any benefit over placebo with respect to symptom relief at one year. Consequently, the focus of CAMUS shifted from evaluating long-term efficacy to determining if any short-term (6-18 month) symptom relief could be achieved with increasing doses of Serenoa repens, the phytotherapy most commonly used in the U.S. for BPH. Results Results are anticipated in 2011. Conclusions Trial design occurs in an environment of continually evolving information. In this case, emerging results from another trial suggested that a study of long-term efficacy was premature, and that an effective dose and preparation of Serenoa repens had to be established before proceeding to a long-term clinical trial. PMID:20007408

  18. AB069. The effect of Seoritae extract in men with mild-to-moderate lower urinary tract symptoms suggestive of benign prostatic hyperplasia

    PubMed Central

    Bae, Woong Jin; Bashraheel, Fahad; Choi, Sae Woong; Kim, Su Jin; Yoon, Byung Il; Kim, Sae Woong

    2016-01-01

    Objective We evaluated the effects of Seoritae extract (SE) on mild-to-moderate lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Methods Seventy-six subjects with mild to moderate LUTS suggestive of BPH were prospectively recruited from the urology outpatient clinic, and assigned to either SE (4,200 mg or 6 tablets 3 times a day) or matching placebo. The primary outcome variable, the International Prostatic Symptom Score (IPSS), was evaluated at baseline and at 4 and 12 weeks. Post-void residual (PVR) volume, maximum urine flow rate (Qmax), and prostate-specific antigen (PSA) levels, were evaluated. Results IPSSs decreased significantly from baseline to 12 weeks within the SE group. Significant improvements in IPSS voiding scores at 4 and 12 weeks were also observed in the SE group compared to the placebo group. IPSS storage and quality of life scores were also significantly decreased at 12 weeks in the SE group. There was no change in Qmax or PVR in both groups after 12 weeks. Conclusions Administration of SE for 12 weeks led to significant improvements in LUTS, and it could be safely and effectively recommended for men with LUTS.

  19. Predictors of Individual Response to Placebo or Tadalafil 5mg among Men with Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: An Integrated Clinical Data Mining Analysis

    PubMed Central

    Fusco, Ferdinando; D’Anzeo, Gianluca; Henneges, Carsten; Rossi, Andrea; Büttner, Hartwig; Nickel, J. Curtis

    2015-01-01

    Background A significant percentage of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) achieve clinically meaningful improvement when receiving placebo or tadalafil 5mg once daily. However, individual patient characteristics associated with treatment response are unknown. Methods This integrated clinical data mining analysis was designed to identify factors associated with a clinically meaningful response to placebo or tadalafil 5mg once daily in an individual patient with LUTS-BPH. Analyses were performed on pooled data from four randomized, placebo-controlled, double-blind, clinical studies, including about 1,500 patients, from which 107 baseline characteristics were selected and 8 response criteria. The split set evaluation method (1,000 repeats) was used to estimate prediction accuracy, with the database randomly split into training and test subsets. Logistic Regression (LR), Decision Tree (DT), Support Vector Machine (SVM) and Random Forest (RF) models were then generated on the training subset and used to predict response in the test subset. Prediction models were generated for placebo and tadalafil 5mg once daily Receiver Operating Curve (ROC) analysis was used to select optimal prediction models lying on the ROC surface. Findings International Prostate Symptom Score (IPSS) baseline group (mild/moderate vs. severe) for active treatment and placebo achieved the highest combined sensitivity and specificity of 70% and ~50% for all analyses, respectively. This was below the sensitivity and specificity threshold of 80% that would enable reliable allocation of an individual patient to either the responder or non-responder group Conclusions This extensive clinical data mining study in LUTS-BPH did not identify baseline clinical or demographic characteristics that were sufficiently predictive of an individual patient response to placebo or once daily tadalafil 5mg. However, the study reaffirms the efficacy of tadalalfil 5mg once daily in the treatment of LUTS-BPH in the majority of patients and the importance of evaluating individual patient need in selecting the most appropriate treatment. PMID:26284523

  20. Lack of association between prostate-specific acid phosphatase RFLP genotypes and prostatic cancer or benign prostatic hyperplasia.

    PubMed

    Leskelä, S; Virkkunen, P; Lukkarinen, O; Winqvist, R; Vihko, P

    1991-01-01

    We have previously reported the identification and basic characterization of two biallelic TaqI RFLPs, A and B, of the 3' end of the human ACPP locus in an unselected Finnish population (Winqvist et al., 1989). In the present investigation, a similar allelic distribution was observed in patients with prostatic cancer or benign hyperplasia. In addition, it was found that the DNA sequences generating RFLP-B are located further downstream from the RFLP-A sequences. PMID:1713142

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

    PubMed

    Vengerovskiĭ, A I; Burkova, V N; Iudina, N V; Iatsenkov, A I

    2013-01-01

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

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

    PubMed Central

    2013-01-01

    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

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

    PubMed

    Aho, Tevita F

    2013-10-01

    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

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

    PubMed Central

    2014-01-01

    Epidemiological data link erectile dysfunction (ED) and benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS), two highly prevalent conditions in aging men, assuming common pathophysiological pathways. Tadalafil 5 mg once daily has been approved for the treatment of men with LUTS with or without comorbid ED. The aim of this review is to provide an overview of current knowledge on the epidemiological and pathophysiological links between ED and LUTS and to focus on tadalafil as a new treatment option in men with BPH-associated LUTS. A Medline search was completed using the Medical Subject Headings (MESH® keywords) ‘prostatic hyperplasia’ and ‘phosphodiesterase inhibitors’. This search revealed 125 relevant references (entire Medline database up to 11 March 2014). The efficacy of tadalafil 5 mg once daily for the treatment of LUTS has been reported by several well-designed studies. Tadalafil improves significantly the total International Prostate Symptom Score (IPSS), the voiding and storage subscores, the IPSS Quality of Life (QoL) and the BPH Impact Index (BII). Its efficacy is irrelevant to the erectile function status of the patients. However, in the majority of these studies tadalafil is not associated with improvement in maximum urine flow or post-void residual volume (PVR). Its safety profile is well established and no new or unexpected adverse events other than those reported in ED studies have been recorded. Tadalafil is today a new treatment alternative to other established drugs for LUTS such as the α-adrenergic antagonists or 5α-reductase inhibitors. However, it is not just an alternative, since sexual adverse events associated with these drugs are avoided and tadalafil is the only drug that can treat both ED and LUTS at the same time. PMID:25083163

  5. Transvesical open prostatectomy for benign prostatic hyperplasia in the era of minimally invasive surgery: Perioperative outcomes of a contemporary series

    PubMed Central

    Elshal, Ahmed M.; El-Nahas, Ahmed R.; Barakat, Tamer S.; Elsaadany, Mohamed M.; El-Hefnawy, Ahmed S.

    2013-01-01

    Objective To assess the perioperative morbidity of transvesical open prostatectomy (OP) and its predictors as a treatment for benign prostatic hyperplasia (BPH), and to update knowledge about the morbidity of OP using a standardised morbidity scale (Clavien), thus providing a platform for comparison with the newly developed techniques. Patients and methods We retrospectively review men with BPH who were treated with transvesical OP between April 2002 and December 2012. Preoperative patients’ data were reviewed for relevant variables. Operative details, the postoperative course, and 30-day relevant data were assessed. The study cohort was stratified based on the resected prostate weight, with group 1 having a resected weight of ⩽120 g and group 2 >120 g. Results The review identified 163 patients. The mean (SD, range) duration of catheterisation after OP was 7.9 (2.2, 5–20) days and the duration of hospitalisation after OP was 8.1 (1.8, 5–15) days; both were significantly longer in group 2. All patients were able to void spontaneously by the first follow-up visit. Of 163 OP procedures, there were 106 perioperative complications in 69 (42.3%). Low-grade complications (grade ⩽2) included 38 (45.2%) and 53 (67%) in groups 1 and 2, respectively (P = 0.8). High-grade complications (⩾3) included 3 (3.5%) and 12 (15.1%) in groups 1 and 2, respectively (P = 0.02). The blood transfusion rate was 24.5%, the perioperative mortality rate was 1.2% and the re-admission rate within the first 30 days after OP was 1.2%. High-grade complications were significantly associated with a greater resected prostate weight (odds ratio 1.08, 95% CI 1.001–1.17, P = 0.046). Conclusion The OP procedure is associated with a significant perioperative morbidity that correlated significantly with the resected prostate weight, especially for high-grade complications. PMID:26558107

  6. Antagonistic effect of Lepidium meyenii (red maca) on prostatic hyperplasia in adult mice.

    PubMed

    Gonzales, G F; Gasco, M; Malheiros-Pereira, A; Gonzales-Castañeda, C

    2008-06-01

    The plants from the Lepidium gender have demonstrated to have effect on the size of the prostate. Lepidium meyenii (Maca) is a Peruvian plant that grows exclusively over 4000 m above sea level. The present study was designed to determine the effect of red maca (RM) in the prostate hyperplasia induced with testosterone enanthate (TE) in adult mice. Prostate hyperplasia was induced by administering TE, and then these animals (n = 6, each group) were treated with RM or Finasteride (positive control) for 21 days. There was an additional group without prostate hyperplasia (vehicle). Mice were killed on days 7, 14 and 21 after treatment with RM. Testosterone and oestradiol levels were measured on the last day of treatment. Prostatic stroma, epithelium and acini were measured histologically. RM reduced prostate weight at 21 days of treatment. Weights of seminal vesicles, testis and epididymis were not affected by RM treatment. The reduction in prostate size by RM was 1.59 times. Histological analysis showed that TE increased 2-fold the acinar area, effect prevented in the groups receiving TE + RM for 14 (P < 0.05) and 21 (P < 0.05) days and the group receiving TE + Finasteride for 21 days (P < 0.05). TE increased prostatic stroma area and this effect was prevented by treatment with RM since 7 days of treatment or Finasteride. The reduction in prostatic stroma area by RM was 1.42 times. RM has an anti-hyperplastic effect on the prostate of adult mice when hyperplasia was induced with TE acting first at prostatic stromal level. PMID:18477205

  7. Hyperglycemia and Insulin Resistance and the Risk of BPH/LUTS: an Update of Recent Literature

    PubMed Central

    Breyer, Benjamin N.

    2015-01-01

    Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are highly prevalent in older men and represent a substantial challenge to public health. Increasing epidemiologic evidence suggests that diabetes and associated hyperglycemia and insulin resistance significantly increase the risks of BPH and LUTS. Plausible pathophysiologic mechanisms to explain these associations include increased sympathetic tone, stimulation of prostate growth by insulin and related trophic factors, alterations in sex steroid hormone expression, and induction of systemic inflammation and oxidative stress. This article presents a comprehensive update of the current understanding of clinical and epidemiologic research on diabetes and BPH/LUTS, describes hypothesized pathophysiologic mechanisms linking these conditions, and recommends future directions for research. PMID:25287259

  8. The Effect of LUTS/BPH and Treatments on Ejaculatory Function.

    PubMed

    Herberts, Michelle; Butcher, Michael; Köhler, Tobias

    2016-07-01

    As men age, there is an increased incidence of lower urinary tract symptoms (LUTS), often from benign prostatic hyperplasia (BPH) which can adversely affect sexual function. There are many different treatments for these symptoms; however, many of the treatments also affect sexual quality of life, specifically in the realm of ejaculation. Our paper will review the medications, surgical procedures, minimally invasive procedures, and even investigational procedures used to treat LUTS/BPH and the effect they have on ejaculation. The aim of this paper is to help practitioners counsel patients more effectively on treatment options when ejaculation is a concern. PMID:27105993

  9. Lower urinary tract symptoms, benign prostatic hyperplasia and metabolic syndrome.

    PubMed

    Vignozzi, Linda; Gacci, Mauro; Maggi, Mario

    2016-02-01

    Epidemiological studies have shown that age is the principal unmodifiable risk factor of lower urinary tract symptoms (LUTS). Until the past decade, the process of lower urinary tract ageing was, therefore, considered unmodifiable - as ageing per se. However, the traditional dogma that BPH-related LUTS (BPH-LUTS) is an immutable consequence of old age is no longer acceptable. Results from multiple preclinical and clinical studies indicate that several modifiable, age-related metabolic aberrations (metabolic syndrome, obesity, dyslipidaemia, diabetes) are important determinants in both the development and the progression of BPH-LUTS. Metabolic syndrome and its related comorbidities, such as sex steroid alterations and low-grade inflammation, have been related to BPH-LUTS development and progression. With the correct treatment and recommended lifestyle changes, many individuals with metabolic syndrome might be able to prevent or delay the onset of metabolic-syndrome-related complications; however, whether promoting healthier lifestyles can really alter a man's propensity to develop BPH-LUTS remains to be clarified. PMID:26754190

  10. Efficacy and Safety of Silodosin and Dutasteride Combination Therapy in Acute Urinary Retention due to Benign Prostatic Hyperplasia: A Single-Arm Prospective Study

    PubMed Central

    Hagiwara, Kazuhisa; Koie, Takuya; Iwamura, Hiromichi; Imai, Atsushi; Hatakeyama, Shingo; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Ohyama, Chikara

    2016-01-01

    This study aimed to assess the efficacy of combination therapy with dutasteride and silodosin in patients with acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH). Eighty consecutive patients with a first episode of AUR were enrolled in this study. All patients received silodosin 8 mg and dutasteride 0.5 mg daily. Trial without catheter (TWOC) was attempted every 2 weeks until 12 weeks after the initiation of medication. The primary endpoint was the rate of catheter-free status at 12 weeks. Voided volume (VV), postvoid residual urine (PVR), uroflowmetry, International Prostatic Symptoms Score (IPSS), and quality of life due to urinary symptoms (IPSS-QOL) were also measured. All patients were followed up for more than 12 weeks and were included in this analysis. The success rate of TWOC at 12 weeks was 88.8%. VV and maximum urinary flow rate were significantly higher at 2, 4, 8, and 12 weeks compared with the time of AUR (P < 0.001). IPSS and IPSS-QOL were significantly lower at 2, 4, 8, and 12 weeks compared with the time of AUR (P < 0.001). In conclusion, a combination of dutasteride and silodosin therapy may be effective and safe for patients with AUR due to BPH. PMID:27195288

  11. Efficacy and safety of a flaxseed hull extract in the symptomatic management of benign prostatic hyperplasia: a parallel, randomized, double-blind, placebo-controlled, pilot study.

    PubMed

    Simons, Rudy; Sonawane, Navneet; Verbruggen, Marian; Chaudhary, Jayesh

    2015-02-01

    This exploratory study was designed to assess the effectiveness of a lignan-rich extract of flaxseed hulls (LinumLife EXTRA(®)) in alleviating symptoms in subjects with benign prostatic hyperplasia (BPH) compared with placebo. Two dosages of extract were compared against placebo in a double-blinded, randomized, parallel, multicenter study. Newly diagnosed cases of BPH in patients aged 45-75 years with an American Urological Association Symptom Index (AUASI) score of ≥13 were included. Study treatment consisted of 500 or 1000 mg of extract containing 100 mg (low-dose active [LDA] group, n=26) or 200 mg (high-dose active [HDA] group, n=26) of secoisolariciresinol diglucoside (SDG), respectively. The placebo (P) group (n=28) received matching maltodextrin capsules. Sixty subjects (LDA [n=19], HDA [n=20], and P [n=21]) completed the study as per the protocol requirements. Change in the AUASI score within a period of 8 weeks, from baseline to end of treatment, was assessed. Significant improvement of obstructive symptoms and management of irritable BPH symptoms was achieved in all groups after treatment. Due to a strong placebo effect, there was no statistical difference between the groups that were treated with flaxseed hull extract as compared with the placebo group. Treatment with flaxseed hull extract did not lead to adverse effects compared with placebo. Supplementation with flaxseed hull extract was found to be safe and well-tolerated and may have improved the quality of life of individuals with BPH. The significant placebo effect as well as the number of subjects per treatment group and the relative short duration of the study may explain the lack of statistical significance between groups. PMID:25546379

  12. [Development of a High Power Green Laser Therapeutic Equipment for Hyperplasia of Prostate].

    PubMed

    Liang, Jie; Kang, Hongxiang; Shen, Benjian; Zhao, Lusheng; Wu, Xinshe; Chen, Peng; Chang, Aihong; Guo Hua; Guo, Jiayu

    2015-09-01

    The basic theory of high power green laser equipment for prostate hyperplasia therapy and the components of the system developed are introduced. Considering the requirements of the clinical therapy, the working process of the high power green laser apparatus are designed and the laser with stable output at 120 W is achieved. The controlling hardware and application software are developed, and the safety step is designed. The high power green laser apparatus manufactured with characteristics of stable output, multifunctional and friendly interface provides a choices of prostate hyperplasia therapy for using nationalization instrument. PMID:26904875

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

    PubMed Central

    Kim, Sung Han; Oh, Seung-June

    2014-01-01

    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

  14. Comparative Effectiveness of Oral Drug Therapies for Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia: A Systematic Review and Network Meta-Analysis

    PubMed Central

    Li, Sheng; Meng, Zhe; Liu, Tao; Zhang, Xinhua

    2014-01-01

    Introduction Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are common in elder men and a number of drugs alone or combined are clinically used for this disorder. But available studies investigating the comparative effects of different drug therapies are limited. This study was aimed to compare the efficacy of different drug therapies for LUTS/BPH with network meta-analysis. Materials and Methods An electronic search of PubMed, Cochrane Library and Embase was performed to identify randomized controlled trials (RCTs) comparing different drug therapies for LUTS/BPH within 24 weeks. Comparative effects were calculated using Aggregate Data Drug Information System. Consistency models of network meta-analysis were created and cumulative probability was used to rank different therapies. Results A total 66 RCTs covering seven different therapies with 29384 participants were included. We found that α-blockers (ABs) plus phosphodiesterase 5 inhibitors (PDE5-Is) ranked highest in the test of IPSS total score, storage subscore and voiding subscore. The combination therapy of ABs plus 5α-reductase inhibitors was the best for increasing maximum urinary flow rate (Qmax) with a mean difference (MD) of 1.98 (95% CI, 1.12 to 2.86) as compared to placebo. ABs plus muscarinic receptor antagonists (MRAs) ranked secondly on the reduction of IPSS storage subscore, although monotherapies including MRAs showed no effect on this aspect. Additionally, PDE5-Is alone showed great effectiveness for LUTS/BPH except Qmax. Conclusions Based on our novel findings, combination therapy, especially ABs plus PDE5-Is, is recommended for short-term treatment for LUTS/BPH. There was also evidence that PDE5-Is used alone was efficacious except on Qmax. Additionally, it should be cautious when using MRAs. However, further clinical studies are required for longer duration which considers more treatment outcomes such as disease progression, as well as basic research investigating mechanisms involving PDE5-Is and other pharmacologic agents alleviate the symptoms of LUTS/BPH. PMID:25216271

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

    NASA Astrophysics Data System (ADS)

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

    2003-06-01

    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.

  16. PDE-5 Inhibitors for BPH-Associated LUTS.

    PubMed

    Brousil, Philip; Shabbir, Majid; Zacharakis, E; Sahai, Arun

    2015-01-01

    Lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH-LUTS) are a highly prevalent problem, and with considerable burden to quality of life. Evidence has emerged that a strong correlation exists in men suffering both BPH-LUTS and erectile dysfunction (ED). Phosphodiesterase type 5 inhibitors (PDE5i) have been shown to be highly effective in treating ED and more recently there is evidence that men with LUTS also benefit. In this review article we discuss the common pathogenic pathways of ED and LUTS, the scientific basis of PDE5i use, the efficacy of PDE5i in LUTS either as monotherapy or in combination with other established medications used in LUTS. PMID:26470799

  17. Cholesterol and benign prostate disease.

    PubMed

    Freeman, Michael R; Solomon, Keith R

    2011-01-01

    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 between 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. Hypercholesterolemia, 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

  18. Stromal response to prostate cancer: nanotechnology-based detection of thioredoxin-interacting protein partners distinguishes prostate cancer associated stroma from that of benign prostatic hyperplasia.

    PubMed

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

    2013-01-01

    Histological staining of reactive stroma has been shown to be a predictor of biochemical recurrence in prostate cancer, however, molecular markers of the stromal response to prostate cancer have not yet been fully delineated. The objective of this study was to determine whether or not the stromal biomarkers detected with a thioredoxin-targeted nanodevice could be used to distinguish the stroma associated with benign prostatic hyperplasia from that associated with PCA. In this regard, we recently demonstrated that a thioredoxin-targeted nanodevice selectively binds to reactive stroma in frozen prostate tumor tissue sections. To accomplish this, random frozen prostate tissue sections from each of 35 patients who underwent resection were incubated with the nanodevice and graded for fluorescent intensity. An adjacent section from each case was stained with Hematoxylin & Eosin to confirm the diagnosis. Select cases were stained with Masson's Trichrome or immunohistochemically using antibodies to thioredoxin reductase 1, thioredoxin reductase 2 or peroxiredoxin 1. Our results demonstrate that the graded intensity of nanodevice binding to the stroma associated with PCA was significantly higher (p = 0.0127) than that of benign prostatic hyperplasia using the t-test. Immunohistochemical staining of adjacent sections in representative cases showed that none of the two commonly studied thioredoxin interacting protein partners mirrored the fluorescence pattern seen with the nanodevice. However, thioredoxin reductase 2 protein was clearly shown to be a biomarker of prostate cancer-associated reactive stroma whose presence distinguishes the stroma associated with benign prostatic hyperplasia from that associated with prostate cancer. We conclude that the signal detected by the nanodevice, in contrast to individual targets detected with antibodies used in this study, originates from multiple thioredoxin interacting protein partners that distinguish the M2 neutrophil and macrophage associated inflammatory response in prostate cancer-associated stroma from the CD4+ T-Lymphocyte linked inflammation in benign prostatic hyperplasia. PMID:23762225

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

    PubMed Central

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

    2013-01-01

    Histological staining of reactive stroma has been shown to be a predictor of biochemical recurrence in prostate cancer, however, molecular markers of the stromal response to prostate cancer have not yet been fully delineated. The objective of this study was to determine whether or not the stromal biomarkers detected with a thioredoxin-targeted nanodevice could be used to distinguish the stroma associated with benign prostatic hyperplasia from that associated with PCA. In this regard, we recently demonstrated that a thioredoxin-targeted nanodevice selectively binds to reactive stroma in frozen prostate tumor tissue sections. To accomplish this, random frozen prostate tissue sections from each of 35 patients who underwent resection were incubated with the nanodevice and graded for fluorescent intensity. An adjacent section from each case was stained with Hematoxylin & Eosin to confirm the diagnosis. Select cases were stained with Masson's Trichrome or immunohistochemically using antibodies to thioredoxin reductase 1, thioredoxin reductase 2 or peroxiredoxin 1. Our results demonstrate that the graded intensity of nanodevice binding to the stroma associated with PCA was significantly higher (p = 0.0127) than that of benign prostatic hyperplasia using the t-test. Immunohistochemical staining of adjacent sections in representative cases showed that none of the two commonly studied thioredoxin interacting protein partners mirrored the fluorescence pattern seen with the nanodevice. However, thioredoxin reductase 2 protein was clearly shown to be a biomarker of prostate cancer-associated reactive stroma whose presence distinguishes the stroma associated with benign prostatic hyperplasia from that associated with prostate cancer. We conclude that the signal detected by the nanodevice, in contrast to individual targets detected with antibodies used in this study, originates from multiple thioredoxin interacting protein partners that distinguish the M2 neutrophil and macrophage associated inflammatory response in prostate cancer-associated stroma from the CD4+ T-Lymphocyte linked inflammation in benign prostatic hyperplasia. PMID:23762225

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

    PubMed

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

    2012-12-01

    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

  1. The impact of obesity towards prostate diseases

    PubMed Central

    Parikesit, Dyandra; Mochtar, Chaidir Arief; Umbas, Rainy; Hamid, Agus Rizal Ardy Hariandy

    2015-01-01

    Evidence has supported obesity as a risk factor for both benign prostate hyperplasia (BPH) and prostate cancer (PCa). Obesity causes several mechanisms including increased intra-abdominal pressure, altered endocrine status, increased sympathetic nervous activity, increased inflammation process, and oxidative stress, all of which are favorable in the development of BPH. In PCa, there are several different mechanisms, such as decreased serum testosterone, peripheral aromatization of androgens, insulin resistance, and altered adipokine secretion caused by inflammation, which may precipitate the development of and even cause high-grade PCa. The role of obesity in prostatitis still remains unclear. A greater understanding of the pathogenesis of prostate disease and adiposity could allow the development of new therapeutic markers, prognostic indicators, and drug targets. This review was made to help better understanding of the association between central obesity and prostate diseases, such as prostatitis, BPH, and PCa. PMID:27014656

  2. The impact of obesity towards prostate diseases.

    PubMed

    Parikesit, Dyandra; Mochtar, Chaidir Arief; Umbas, Rainy; Hamid, Agus Rizal Ardy Hariandy

    2016-03-01

    Evidence has supported obesity as a risk factor for both benign prostate hyperplasia (BPH) and prostate cancer (PCa). Obesity causes several mechanisms including increased intra-abdominal pressure, altered endocrine status, increased sympathetic nervous activity, increased inflammation process, and oxidative stress, all of which are favorable in the development of BPH. In PCa, there are several different mechanisms, such as decreased serum testosterone, peripheral aromatization of androgens, insulin resistance, and altered adipokine secretion caused by inflammation, which may precipitate the development of and even cause high-grade PCa. The role of obesity in prostatitis still remains unclear. A greater understanding of the pathogenesis of prostate disease and adiposity could allow the development of new therapeutic markers, prognostic indicators, and drug targets. This review was made to help better understanding of the association between central obesity and prostate diseases, such as prostatitis, BPH, and PCa. PMID:27014656

  3. Inhibition of spontaneous canine benign prostatic hyperplasia by an Urtica fissa polysaccharide fraction.

    PubMed

    Xiaocheng, Chen; Shan, He; Yuxing, Lu; Lizhen, Yuan; Linmao, Ding; Shoujun, Yuan; Qinglin, Zhang

    2015-01-01

    In this study, we investigated the inhibition of spontaneous canine benign prostatic hyperplasia by a crude polysaccharide fraction extracted from Urtica fissa roots and stems. After oral administration of U. fissa polysaccharide fraction for 3 months, the dog prostatic volume reduced significantly when compared to that before treatment using CT examination. The high-dosage U. fissa polysaccharide fraction (120 mg/kg body weight/day) and finasteride (0.5 mg/kg body weight/day) treatments showed both almost 30 % reduction of the initial prostatic volume. At the end of the administration of U. fissa polysaccharide fraction, the prostates were excised, and the volumes were measured by water displacement. The prostatic volume showed significant decrease by 11 %, 15 %, and 21 % for the 30, 60, and 120 mg/kg/day U. fissa polysaccharide fraction treatment groups, respectively, compared to the control group. Histological observation found that U. fissa polysaccharide fraction inhibited the dog prostatic epithelial cells proliferation and enlarged glandular lumen diameter. The crude polysaccharide fraction of U. fissa is a possible new candidate for the treatment of benign prostatic hyperplasia. PMID:25473922

  4. Combination of Autoantibody Signature with PSA Level Enables a Highly Accurate Blood-Based Differentiation of Prostate Cancer Patients from Patients with Benign Prostatic Hyperplasia.

    PubMed

    Leidinger, Petra; Keller, Andreas; Milchram, Lisa; Harz, Christian; Hart, Martin; Werth, Angelika; Lenhof, Hans-Peter; Weinhusel, Andreas; Keck, Bastian; Wullich, Bernd; Ludwig, Nicole; Meese, Eckart

    2015-01-01

    Although an increased level of the prostate-specific antigen can be an indication for prostate cancer, other reasons often lead to a high rate of false positive results. Therefore, an additional serological screening of autoantibodies in patients' sera could improve the detection of prostate cancer. We performed protein macroarray screening with sera from 49 prostate cancer patients, 70 patients with benign prostatic hyperplasia and 28 healthy controls and compared the autoimmune response in those groups. We were able to distinguish prostate cancer patients from normal controls with an accuracy of 83.2%, patients with benign prostatic hyperplasia from normal controls with an accuracy of 86.0% and prostate cancer patients from patients with benign prostatic hyperplasia with an accuracy of 70.3%. Combining seroreactivity pattern with a PSA level of higher than 4.0 ng/ml this classification could be improved to an accuracy of 84.1%. For selected proteins we were able to confirm the differential expression by using luminex on 84 samples. We provide a minimally invasive serological method to reduce false positive results in detection of prostate cancer and according to PSA screening to distinguish men with prostate cancer from men with benign prostatic hyperplasia. PMID:26039628

  5. Nfib Regulates Transcriptional Networks That Control the Development of Prostatic Hyperplasia.

    PubMed

    Grabowska, Magdalena M; Kelly, Stephen M; Reese, Amy L; Cates, Justin M; Case, Tom C; Zhang, Jianghong; DeGraff, David J; Strand, Douglas W; Miller, Nicole L; Clark, Peter E; Hayward, Simon W; Gronostajski, Richard M; Anderson, Philip D; Matusik, Robert J

    2016-03-01

    A functional complex consisting of androgen receptor (AR) and forkhead box A1 (FOXA1) proteins supports prostatic development, differentiation, and disease. In addition, the interaction of FOXA1 with cofactors such as nuclear factor I (NFI) family members modulates AR target gene expression. However, the global role of specific NFI family members has yet to be described in the prostate. In these studies, chromatin immunoprecipitation followed by DNA sequencing in androgen-dependent LNCaP prostate cancer cells demonstrated that 64.3% of NFIB binding sites are associated with AR and FOXA1 binding sites. Interrogation of published data revealed that genes associated with NFIB binding sites are predominantly induced after dihydrotestosterone treatment of LNCaP cells, whereas NFIB knockdown studies demonstrated that loss of NFIB drives increased AR expression and superinduction of a subset of AR target genes. Notably, genes bound by NFIB only are associated with cell division and cell cycle. To define the role of NFIB in vivo, mouse Nfib knockout prostatic tissue was rescued via renal capsule engraftment. Loss of Nfib expression resulted in prostatic hyperplasia, which did not resolve in response to castration, and an expansion of an intermediate cell population in a small subset of grafts. In human benign prostatic hyperplasia, luminal NFIB loss correlated with more severe disease. Finally, some areas of intermediate cell expansion were also associated with NFIB loss. Taken together, these results show a fundamental role for NFIB as a coregulator of AR action in the prostate and in controlling prostatic hyperplasia. PMID:26677878

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

    PubMed

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

    2014-04-01

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

  7. The evaluation of tissue mass loss in the incision line of prostate with benign hyperplasia performed using holmium laser and cutting electrode

    PubMed Central

    Szewczyk, Mariusz; Jesionek–Kupnicka, Dorota; Lipinski, Piotr; Różański, Waldemar

    2014-01-01

    Introduction The aim of this study is to compare the changes in the incision line of prostatic adenoma using a monopolar cutting electrode and holmium laser, as well as the assessment of associated tissue mass and volume loss of benign prostatic hyperplasia (BPH). Material and methods The material used in this study consisted of 74 preparations of prostatic adenoma obtained via open retropubic adenomectomy, with an average volume of 120.7 ml. The material obtained cut in vitro before fixation in formaldehyde. One lobe was cut using holmium laser, the other using a monopolar cutting electrode. After the incision was made, tissue mass and volume loss were evaluated. Thermocoagulation changes in the incision line were examinedunder light microscope. Results In the case of the holmium laser incision, the average tissue mass loss was 1.73 g, tissue volume loss 3.57 ml and the depth of thermocoagulation was 1.17 mm. When the monopolar cutting electrode was used average tissue mass loss was 0.807 g, tissue volume loss 2.48 ml and the depth of thermocoagulation was 0.19 mm. Conclusions Where holmium laser was used, it was observed that the layer of tissue with thermocoagulation changes was deeper than in the case of the monopolar cutting electrode. Moreover, it was noticed that holmium laser caused bigger tissue mass and volume loss than the cutting electrode. PMID:25247088

  8. Endoscopic Enucleation versus Open Prostatectomy for Treating Large Benign Prostatic Hyperplasia: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Hou, Qi; Wang, Dejuan; Huang, Wentao; Hu, Cheng; Li, Ke; Gao, Xin

    2015-01-01

    Objectives To evaluate the overall efficacy and safety of endoscopic enucleation of the prostate (EP) vs open prostatectomy (OP) for large benign prostatic hyperplasia (BPH). Methods We conducted an electronic search of PubMed/Medline, EMBASE, The Cochrane Library, and Web of Science to detect all relevant randomized controlled trials (RCTs) comparing EP with OP. A meta-analysis was performed using Review Manager 5.3. Results Seven RCTs (735 patients) were included. At the 3-, 6- and 12-month follow-up, there were no significant differences in the International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), quality of life (QoL) score and post-void residual urine volume (PVR) between EP and OP. The International Index of Erectile Function (IIEF-5) was higher with EP (weighted mean difference [WMD]: 1.00, 95% confidence interval [CI]: 0.21 to 1.78, p=0.01) at the 12-month follow-up. The catheterization time (WMD: 3.80 d, 95%CI: -5.11 to -2.48, P<0.00001) and hospital stay (WMD: 4.93 d, 95%CI: -5.96 to -3.89, P<0.00001) were shorter with EP. The duration of operation was longer for EP compared with OP (WMD: 16.21 min, 95%CI: 3.72 to 28.70, P=0.01). The resected tissue weight (WMD: -9.63 g, 95%CI: -14.46 to -4.81, P<0.0001) and decrease in hemoglobin (WMD: -1.14 g/dL, 95%CI: -1.81 to -0.47, P=0.0008) were less with EP. EP was associated with fewer blood transfusions (risk ratio: 0.22, 95%CI: 0.10 to 0.47, P=0.0001). There were no significant differences between EP and OP when comparing other complications. Conclusions Although only a limited number of RCTs with relatively limited follow-up are available, EP is shown to have a similar postoperative profile and comparable safety to OP. By contrast, EP may have a more desirable perioperative profile. EP appears to be an effective and safe minimally invasive option for treating large prostates that requires only brief convalescence. PMID:25826453

  9. Preventive effect of Pueraria mirifica on testosterone-induced prostatic hyperplasia in Sprague Dawley rats.

    PubMed

    Masrudin, S S; Mohamad, J

    2015-12-01

    Pueraria mirifica (PM) extract contains phytoestrogen daidzein and genistein. In this study, we investigated the protective effect of PM extract, daidzein and genistein on a testosterone-induced prostatic hyperplasia in rats. Testosterone was administered at 3 mg kg(-1) to rats followed by the PM extract, daidzein and genistein for a period of 30 days with finasteride as positive control. The testosterone level was increased, indicating inhibition of 5α-reductase converting testosterone to dihydrotestosterone. This was confirmed by prostate-specific antigen level that significantly decreased when treated with PM extract, daidzein and genistein. The PM extract, daidzein and genistein reduced the increase in the prostate/body weight ratio in testosterone-induced rats. This gives indication that PM extract, daidzein and genistein possessed protective activity for the treatment of benign prostatic hyperplasia. The analysis of histoarchitechture of the prostate has also shown that there was a significant improvement in prostatic cells of the testosterone-induced rats when treated with PM extract, daidzein and genistein. PMID:25600492

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

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

    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.

  11. Changing patients’ profile presenting for surgical management of benign prostatic hyperplasia over the past 16 years: A single-centre perspective

    PubMed Central

    Elkoushy, Mohamed A.; Elshal, Ahmed M.; Elhilali, Mostafa M.

    2015-01-01

    Introduction: We assessed the change of patients’ profile presenting for symptomatic benign prostatic hyperplasia (BPH) over 16 years and its impact on surgical outcomes over this time. Methods: We reviewed a prospectively maintained database of patients treated with laser for symptomatic BPH since March 1998. Patients were divided into 3 consecutive time-based groups: Group 1 for patients who underwent surgery before April 2004; Group 2, between April 2004 and March 2009; and for Group 3 from April 2009 to August 2014. We reviewed demographic and preoperative data, including prostate volume; international prostate symptoms score (IPSS), quality of life (QoL), and peak flow rate (Qmax). We also recorded any perioperative and long-term complications. Results: A total of 1835 patients were included in our study, including 542 (29.5%) in Group 1, 614 (33.5%) in Group 2, and 679 (37%) in Group 3. Preoperative prostate volume was positively correlated with age at surgery (r = 0.62, p < 0.001), total energy used (r = 0.47, p < 0.001), and total operative time (r = 0.47, p < 0.001). Patients in Group 3 were significantly older (75.28 ± 8.47 in Group 3 vs. 71.11 ± 8.9 in Group 2 vs. 65.3 ± 9.04 years in Group 1, p <0.001), were more coagulopathic (18.7% Group 3 vs. 12.3% Group 2 vs. 5.9% Group 1, p < 0.001), and had significantly larger prostates (87.96 ± 49.80 in Group 3 vs. 78.44 ± 50.84 in Group 2 vs. 74.50 ± 46.53 Group 1, p < 0.001). Preoperative prostatic medications significantly increased over time (72.6% in Group 1 vs. 85.5% in Group 2, vs. 87.4% Group 3, p < 0.001). IPSS, QoL and Qmax were significantly abnormal in patients in Group 3 (p < 0.001). After a mean follow-up of 3 years, the number of patients who did not require reoperation progressively increased (94.1% Group 1 vs. 96.1% Group 2 vs. 98.3% Group 3). Age (>72 years), prostate volume (>80 cc), operative time (>95 minutes), and preoperative PSA (>6 ng/dL) were significantly associated with postoperative urinary incontinence. Conclusions: Patients presenting for surgery due to symptomatic BPH over the last 16 years were significantly older, more morbid, and had larger prostates and more abnormal voiding parameters. Over time, patients used prostatic medications more frequently. Despite the changes in patient profiles, perioperative safety and complication rates between groups were comparable, likely due to advancements in laser technology and techniques. Age (>72 years), prostate volume (>80 cc), operative time (>95 minutes), and preoperative PSA (>6 ng/dL) were significantly associated with reversible postoperative urinary incontinence. PMID:26788224

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

    PubMed Central

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

    2014-01-01

    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

  13. Increase in prostate stem cell antigen expression in prostatic hyperplasia induced by testosterone and 17β-estradiol in C57BL mice.

    PubMed

    Fujimoto, Nariaki; Kanno, Jun

    2016-04-01

    Estradiol (E2) is known to act synergistically with testosterone (T) for the development of prostatic hyperplasia in rats and dogs, but murine prostate is less responsive to hormonal stimulation. However, a recent study revealed that the combined administration of E2 and T induced prostatic hyperplasia with bladder outlet obstruction in C57BL mice. To understand the mechanisms underlying the hormonal induction of prostatic hyperplasia, the expression of growth factors and their receptors, androgen receptor, estrogen receptor (ER), and prostatic secretory proteins was investigated. Ten-week-old male C57BL mice were treated with T (30mg) or T+E2 (0.5mg) for 10 weeks, and prostatic lobes were dissected and subjected to quantitative RT-PCR and immunoblotting analysis. T administration appeared to induce glandular prostatic growth, while with T+E2 administration this growth was greater and accompanied by extreme bladder enlargement. The expression of prostate stem cell antigen (PSCA) mRNA and protein was increased in prostate tissue in the T group. The combined administration of E2 with T prominently enhanced PSCA expression, along with increased insulin growth factor 1 mRNA levels and decreased estrogen receptor β mRNA expression. The synergistic effect of E2 on the expression of PSCA suggests that this protein may play an important role in the hormone-induced development of prostatic hyperplasia. PMID:26815912

  14. Experience with Uroflowmetry in Evaluation of Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

    PubMed Central

    Singla, Sanjeev; Singla, Ankit; Sharma, Sandeep; Singh, Jasdeep; Sethi, Pulkit

    2014-01-01

    Introduction: Uroflowmetry is a non- invasive urodynamic tool which is widely used for most of the patients with suspected lower urinary tract dysfunction. The severity of lower urinary tract symptoms (LUTS) can be measured reliably by using a number of validated questionnaires, like International Prostate Symptom Score (IPSS). This study was designed to determine the relationship between the parameters of uroflowmetry and symptom severity. Materials and Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation. The correlations between these parameters were quantified by means of Spearman correlation co-efficients. Results: Statistically significant correlations were found between the IPSS and results of uroflowmetry (peak flow rate and average flow rate) and post void residual urine. No correlation was found between the IPSS and results of prostate volume measurements. Conclusion: There was a positive correlation between peak flow rate, as was measured by uroflowmetry and lower urinary tract symptom severity. PMID:24959473

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

    PubMed Central

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

    2012-01-01

    Background: The first Italian national guidelines were developed by the Italian Association of Urologists and published in 2007. Since then, a number of new drugs or classes of drugs have emerged for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. Consequently, a new update of the guidelines has become necessary. Methods: A structured literature review was conducted to identify relevant papers published between 1 August 2006 and 12 December 2010. Publications before or after this timeframe were considered only if they were recognised as important milestones in the field or if the literature search did not identify publications within this timeframe. The quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation framework. Main findings: Decisions on therapeutic intervention should be based on the impact of symptoms on quality of life (QoL) rather than the severity of symptoms (International Prostate Symptom Score (IPSS) score). A threshold for intervention was therefore based on the IPSS Q8, with intervention recommended for patients with a score of at least 4. Several differences in clinical recommendations have emerged. For example, combination therapy with a 5α-reductase inhibitor plus α blocker is now the recommended option for the treatment of patients at risk of BPH progression. Other differences include the warning of potential worsening of cognitive disturbances with use of anticholinergics in older patients, the distinction between Serenoa repens preparations (according to the method of extraction), and the clearly defined threshold of prostate size for performing open surgery (>80 g). While the recommendations included in these guidelines are evidence based, clinical decisions should also be informed by patients’ clinical and physical circumstances, as well as patients’ preferences and actions. Conclusions: These guidelines are intended to assist physicians and patients in the decision-making process regarding the management of LUTS/BPH, and support the process of continuous improvement of the quality of care and services to patients. PMID:23205056

  16. Bilateral spontaneous urinary extravasation shown by computed tomography urography in a patient with benign prostatic hyperplasia

    PubMed Central

    Pang, Haopeng; Dang, Xuefei; Yao, Zhenwei; Feng, Xiaoyuan; Wu, Guangyao

    2015-01-01

    Spontaneous extravasation of urine (SUE) is a rare urologic manifestation. Predisposing conditions of SUE include ureteric calculus, retrograde pyelography, pregnancy, abdominal aorta aneurysm, tumors, or enlargement of the prostate gland. Usually, SUE is a self-limiting condition that mandates differentiaton from other catastrophic conditions of pelviureteric ruptures. Most reported cases of SUE based on urograms are unilateral in presentation. Herein, we report a case of bilateral SUE evident on computed tomography urography in a patient with benign prostatic hyperplasia. We also review the literature briefly. PMID:26649120

  17. Ganoderma lucidum is an inhibitor of testosterone-induced prostatic hyperplasia in rats.

    PubMed

    Nahata, A; Dixit, V K

    2012-05-01

    The aim of the present study was to find out whether Ganoderma lucidum (GL) can be used as a clinically effective medicine for the management of prostatic hyperplasia. In vitro studies were conducted to assess the 5α-reductase inhibitory potential of GL. A biochemical marker viz. β-sitosterol was identified and characterised in the extracts utilising high-performance thin-layer chromatography. Testosterone (3 mg kg(-1) s.c.) was administered to the rats along with the test extracts (10, 20 and 50 mg kg(-1) p.o.) and β-sitosterol (10 and 20 mg kg(-1) p.o.) for a period of 28 days. Finasteride was used as a positive control (1 mg kg(-1) p.o.). GL extracts attenuated the increase in the prostate/body weight ratio induced by testosterone. Petroleum ether extract exhibiting the best activity. Ethanolic extract also exhibited significant activity. The urine output also improved significantly, which emphasise the clinical implications of the study. Testosterone levels measured weekly and prostate-specific antigen (PSA) levels measured at the end of the study also support our claims. The PSA levels decreased in the extract-treated groups, indicating their usefulness in the treatment of benign prostatic hyperplasia. Histological studies have shown a considerable improvement in the prostatic histoarchitecture in the extract-treated groups when compared to the testosterone-treated group. PMID:21651601

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

    PubMed

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

    2013-02-01

    In elderly men, benign prostatic hyperplasia (BPH) is a major risk factor for sexual dysfunctions (SDys). Additionally, the standard treatments for BPH symptoms, alpha blockers and 5-alpha-reductase inhibitors, cause SDys themselves. Preparations from saw palmetto berries are an efficacious and well-tolerated symptomatic treatment for mild to moderate BPH and have traditionally been used to treat SDys. We conducted an open multicentric clinical pilot trial to investigate whether the saw palmetto berry preparation Prostasan® influenced BPH symptoms and SDys. Eighty-two patients participated in the 8-week trial, taking one capsule of 320 mg saw palmetto extract daily. At the end of the treatment, the International Prostate Symptom Score was reduced from 14.4 ± 4.7 to 6.9 ± 5.2 (p < 0.0001); SDys measured with the brief Sexual Function Inventory improved from 22.4 ± 7.2 to 31.4 ± 9.2 (p < 0.0001), and the Urolife BPH QoL-9 sex total improved from 137.3 ± 47.9 to 195.0 ± 56.3 (p < 0.0001). Investigators' and patients' assessments confirmed the good efficacy, and treatment was very well tolerated and accepted by the patients. Correlation analyses confirmed the relationship between improved BPH symptoms and reduced SDys. This was the first trial with saw palmetto to show improvement in BPH symptoms and SDys as well. [Corrections made here after initial online publication.] PMID:22522969

  19. [S2e guideline of the German urologists : Conservative and pharmacologic treatment of benign prostatic hyperplasia].

    PubMed

    Höfner, K; Bach, T; Berges, R; Dreikorn, K; Gratzke, C; Madersbacher, S; Michel, M-S; Muschter, R; Oelke, M; Reich, O; Tschuschke, C; Bschleipfer, T

    2016-02-01

    This report summarizes the relevant aspects of the S2e guideline of the German Urologists for the conservative and pharmacological treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Recommendations are given regarding watchful waiting, behavioral therapy, phytotherapy and pharmacological mono- and combination therapy. The influence of the different therapeutic options on bladder outlet obstruction (BOO) is described in detail. PMID:26518303

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

    PubMed Central

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

    1996-01-01

    OBJECTIVE: To evaluate the efficacy and safety of 2 years' treatment of moderate benign prostatic hyperplasia (BPH) with finasteride. DESIGN: Double-blind, parallel-group, placebo-controlled, multicentre, prospective randomized study. SETTING: Outpatient care in 28 centres across Canada. PARTICIPANTS: Men aged 45 to 80, in good health, with moderate BPH and no evidence of prostate cancer. A total of 613 men were entered into the study; 472 completed the 2 years of treatment. INTERVENTION: After 1 month of receiving a placebo (run-in period), patients were given either finasteride (5 mg/d) or a placebo for 2 years. OUTCOME MEASURES: Efficacy: changes from baseline in BPH symptom scores, maximum urinary flow rates and prostate volume. Safety: onset, course and resolution of all adverse events during the treatment period. RESULTS: In the efficacy analyses the mean BPH symptom scores decreased 2.1 points (from 15.8 to 13.7) in the finasteride group, as compared with a decrease of 0.7 points (from 16.6 to 15.9) in the placebo group (P < or = 0.01). The maximum urinary flow rate increased by a mean of 1.4 mL/s (from 11.1 to 12.5 mL/s) in the finasteride group, as compared with an increase of 0.3 mL/s (from 10.9 to 11.2 mL/s) in the placebo group (p < or = 0.01). The mean prostate volume decreased by 21% (from a mean volume of 44.1 cm3 at baseline) in the treatment group; it increased by 8.4% (from a mean volume of 45.8 cm3 at baseline) in the placebo group (p < or = 0.01). In the safety analysis, the proportion of patients who experienced any adverse event was similar in the two groups (81.0% in the treatment group and 81.2% in the placebo group). However, the incidence of adverse events related to sexual dysfunction were significantly higher in the finasteride group than in the placebo group (ejaculation disorder 7.7% v. 1.7% and impotence 15.8% v. 6.3%; p < or = 0.01 for both parameters). CONCLUSION: Finasteride is a well-tolerated and effective alternative to watchful waiting in the treatment of moderate BPH. PMID:8911291

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

    PubMed Central

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

    2009-01-01

    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

  2. Prepubertal exposure to bisphenol-A induces ERα upregulation and hyperplasia in adult gerbil female prostate.

    PubMed

    Campos, Mônica S; Galvão, André L V; Rodríguez, Daniel A O; Biancardi, Manoel F; Marques, Mara R; Vilamaior, Patrícia S L; Santos, Fernanda C A; Taboga, Sebastião R

    2015-06-01

    Prostate physiology is highly dependent on oestrogenic and androgenic homeostasis. Interferences in this equilibrium, especially in early periods of life, may disrupt the prostate and increase the susceptibility to the development of diseases with ageing. Taking this into account, and considering the increase of environmental chemicals with endocrine-disrupting potential such as bisphenol-A (BPA), this study aimed to evaluate the prostates of adult female gerbils exposed to BPA and BPA plus testosterone from pubertal to adult periods. Morphological, stereological and chemical analyses revealed that long-term BPA exposure, even in environmental dosages, increases the proliferative status of the prostate, increases the number of ERα-positive stromal cells and elicits the development of prostatic hyperplasia in adult female gerbils. Moreover, we also observed that the association with testosterone did not increase the proliferative status of the gland, which shows that low levels of BPA are enough to cause an oestrogenic disruption of the prostate in young adults. This evidence suggests that this oestrogenic endocrine disruptor may increase the susceptibility to prostatic disorders with ageing. PMID:26098999

  3. Effect of testicular irradiation on established BPH in the dog: evidence of a non-steroidal testicular factor for BPH maintenance

    SciTech Connect

    Grayhack, J.T.; Lee, C.; Brand, W.

    1985-12-01

    Irradiation of the testes of four to 13-year-old male beagles with benign prostatic hyperplasia (BPH) was undertaken to attempt to evaluate the possibility that the testes secrete a non-androgenic accessory sex gland-stimulating substance that may have a critical role in the development of BPH. Thirteen non-irradiated and shoulder irradiated control and 16 beagles subjected to 1500 to 2200 rads single dose testis irradiation had pre-irradiation, interval post-irradiation and terminal caliper measurements of prostatic length, width and depth, prostatic and testicular biopsies, and determination of serum testosterone and estradiol levels. Four beagles survived in a group observed for 109 weeks post testis irradiation, 12 in a group observed for 51 and 10 in a group observed for 59 weeks. The wet weight of the prostate was determined at sacrifice. Ratios of the final/initial length and width and final actual/initial calculated weight of the prostate were significantly decreased in testis-irradiated as compared to control beagles. Histologic evaluation also demonstrated a significant difference in degree of prostatic stimulation in control and testis-irradiated groups. The serum testosterone and estradiol levels were not significantly different in the testis-irradiated and control beagles.

  4. Construct validation of patient global impression of severity (PGI-S) and improvement (PGI-I) questionnaires in the treatment of men with lower urinary tract symptoms secondary to benign prostatic hyperplasia

    PubMed Central

    2012-01-01

    Background Lower urinary tract symptoms (LUTS) in aging men are often associated with benign prostatic hyperplasia (BPH). While regulatory evaluations of treatment benefit require an assessment of specific symptoms, a simpler approach to measuring patients perceptions of severity and symptom change may be particularly useful for clinical practice. The aim of this study was to provide evidence of the validity of the 1-item Patient Global Impression of Severity (PGI-S) and Improvement (PGI-I) questionnaires for use as outcome measures in the treatment of BPH-LUTS. Methods This was a secondary analysis of data from 4 randomized placebo-controlled 12-week trials evaluating tadalafil for the treatment of BPH-LUTS (N=1694). Visit 2 (V2 [beginning of a 4-week placebo lead-in period]) and endpoint assessments included International Prostate Symptom Score (IPSS), IPSS Quality of Life Index (IPSS-QoL), BPH Impact Index (BII), and peak urine flow (Qmax). PGI-S was only administered at V2 and PGI-I only at endpoint. Associations between the PGI-S or the PGI-I and the other assessments were analyzed by calculating Spearman rank correlation coefficients and performing analysis of variance (ANOVA). Results Spearman correlation coefficients were 0.43, 0.43, 0.53, and ?0.09, between the PGI-S and IPSS, IPSS-QoL, BII, and Qmax baseline results (all P<0.001). Similar results were seen across race, ethnicity, and baseline severity (moderate LUTS versus severe LUTS). IPSS, IPSS-QoL, BII baseline scores (P <0.001) and Qmax values (P=0.003) were significantly different among the 4 PGI-S severity levels. Spearman correlation coefficients were 0.56, 0.53, 0.47 and ?0.15 between the PGI-I and change in IPSS, IPSS-QoL, BII scores, and Qmax values from baseline to endpoint (all P<0.001). Similar results were seen across race, ethnicity, and baseline severity. Change in IPSS, IPSS-QoL, BII scores, and Qmax values (P<0.001) were significantly different among the PGI-I levels (i.e., patient perception of change in urinary symptoms). Conclusions This study demonstrated patients overall perceptions of their severity and change in BPH-LUTS can be captured in a way that is simple, valid, and easily administered in a research setting or clinical practice. Clinical parameters are weakly associated with patients perception of urinary symptoms, emphasizing the importance of a patient-reported assessment in the evaluation of BPH-LUTS treatment benefit. PMID:23134716

  5. Prostatic disease and sexual dysfunction.

    PubMed

    Kim, Sae Woong

    2011-06-01

    Prostatitis and benign prostatic hyperplasia (BPH) are common prostatic diseases. Furthermore, the incidence of prostate cancer has recently shown a rapid increase, even in Korea. Pain caused by prostatitis may induce sexual dysfunction, including erectile dysfunction and ejaculatory disturbance. And BPH itself, or treatments for BPH, may affect sexual function. In addition, with increased detection of localized prostate cancer, surgical treatments and radiation therapy have also increased, and the treatments may cause sexual dysfunction. Aging is also an important factor in the deterioration of the quality of life of men. Deterioration of quality of life caused by prostate diseases may be affected not only by the prostate diseases themselves but also by the sexual dysfunction caused by the prostate diseases secondarily. Thus, consideration of these points at the time of treatment of prostate disease is required. Therapies suitable to each condition should be selected with an understanding of the close association of prostate diseases and associated sexual dysfunction with the quality of life of males. PMID:21750746

  6. Prostatic Disease and Sexual Dysfunction

    PubMed Central

    2011-01-01

    Prostatitis and benign prostatic hyperplasia (BPH) are common prostatic diseases. Furthermore, the incidence of prostate cancer has recently shown a rapid increase, even in Korea. Pain caused by prostatitis may induce sexual dysfunction, including erectile dysfunction and ejaculatory disturbance. And BPH itself, or treatments for BPH, may affect sexual function. In addition, with increased detection of localized prostate cancer, surgical treatments and radiation therapy have also increased, and the treatments may cause sexual dysfunction. Aging is also an important factor in the deterioration of the quality of life of men. Deterioration of quality of life caused by prostate diseases may be affected not only by the prostate diseases themselves but also by the sexual dysfunction caused by the prostate diseases secondarily. Thus, consideration of these points at the time of treatment of prostate disease is required. Therapies suitable to each condition should be selected with an understanding of the close association of prostate diseases and associated sexual dysfunction with the quality of life of males. PMID:21750746

  7. A Study of Molecular Signals Deregulating Mismatch Repair Genes in Prostate Cancer Compared to Benign Prostatic Hyperplasia

    PubMed Central

    Basu, Sanmitra; Majumder, Subhadipa; Bhowal, Ankur; Ghosh, Alip; Naskar, Sukla; Nandy, Sumit; Mukherjee, Subhabrata; Sinha, Rajan Kumar; Basu, Keya; Karmakar, Dilip; Banerjee, Soma; Sengupta, Sanghamitra

    2015-01-01

    Prostate cancer is one of the leading causes of mortality among aging males. There is an unmet requirement of clinically useful biomarkers for early detection of prostate cancer to reduce the liabilities of overtreatment and accompanying morbidity. The present population-based study investigates the factors disrupting expression of multiple functionally related genes of DNA mismatch repair pathway in prostate cancer patients to identify molecular attributes distinguishing adenocarcinoma from benign hyperplasia of prostate. Gene expression was compared between tissue samples from prostate cancer and benign prostatic hyperplasia using real-time-PCR, western blot and immunohistochemistry. Assessment of genotypes of seven single-nucleotide-polymorphisms of three MMR genes was conducted using PCR-coupled RFLP and sequencing. Promoter methylation was interrogated by methylation-specific-PCR and bisulfite-sequencing. Interaction between microRNAs and MMR genes was verified by 3'UTR-based dual luciferase assays. Concurrent reduction of three MMR genes namely hMLH1, hMSH6 and hMSH2 (34-85%, P<0.05) was observed in prostate cancer tissues. hMSH6 polymorphism rs1800932(Pro92Pro) conferred a borderline protection in cancer patients (OR = 0.33, 95% CI = 0.15-0.75). Relative transcript level of hMLH1 was inversely related (r = -0.59, P<0.05) with methylation quotient of its promoter which showed a significantly higher methylation density (P = 0.008, Z = -2.649) in cancer patients. hsa-miR-155, hsa-miR-141 and hsa-miR-21 gene expressions were significantly elevated (66-85%, P<0.05) in tumor specimens and negatively correlated (r = -0.602 to -0.527, P<0.05) with that of MMR genes. hsa-miR-155 & hsa-miR-141 and hsa-miR-155 & hsa-miR-21 were demonstrated to bind to their putative seed sequences in hMLH1 and hMSH6 3’UTRs respectively. Relatively higher expression of DNA methyl-transferases (DNMT1 and DNMT3b) and HIF-1α genes (34-50%, P<0.05) were also detected in tumor tissues. This study provides statistical evidence that MMR deficiency is correlated with hypermethylation of hMLH1 promoter and upregulation of hsa-miR-155, hsa-miR-141 and hsa-miR-21 in prostate cancer. This comparative study reflects that microRNA expression level, particularly hsa-miR-155, exhibits predictive signature of prostate adenocarcinoma. PMID:25938433

  8. Transurethral microwave hyperthermia for benign prostatic hyperplasia: the Leuven clinical experience

    NASA Astrophysics Data System (ADS)

    Baert, Luc; Ameye, Filip; Willemen, Patrick; Petrovich, Zbigniew P.

    1991-07-01

    Transurethral microwave hyperthermia is a new conservative treatment modality for benign prostatic hyperplasia. From April 1989 until July 1990, 104 patients were treated using this method, with a mean post-treatment follow-up of 6 months. Seventy-four patients were admitted with subjective and objective low outflow obstructive parameters. Thirty were admitted because of acute urinary retention. Five to 10 hyperthermia sessions were administered on an outpatient basis during which 915 MHz microwaves were delivered to the prostate. In the group of patients with a bilobular hyperplasia, an improvement of the total FDA symptom scale with at least 5 points was noted in 60% after 6 months. Major improvement was noted in obstructive symptoms. Those patients with a trilobular hypertrophy showed an improvement in 40%, for a median bar obstruction 28.6% and for medium lobe hyperplasia 41.1%. The most important improvement in the mean average flow and mean peak flow was also noted in the patients with bilobular or trilobular hypertrophy. In both groups a slight decrease of postvoiding residual urine was noted. In those patients with acute urinary retention, 17 out of 23 with a bilobular hypertrophy regained spontaneous micturition. All of those with a median lobe or median bar obstruction required operation. During treatment the patients experienced bladder spasms, perineal pain, and minor urethral bleeding. Approximately 10% of patients had symtomatic urinary infection, which responded well to an appropriate therapy. Post hyperthermia histologic examination of the prostate revealed myonecrosis and thrombosis of the superficial blood vessels with fibrotic reorganization which seemed to be completed three weeks after the end of treatment. This suggests that transurethral microwave hyperthermia induces shrinking of the periurethral prostatic tissue and lowers the static outflow obstruction component.

  9. Effect of Silodosin, an Alpha1A-Adrenoceptor Antagonist, on Ventral Prostatic Hyperplasia in the Spontaneously Hypertensive Rat

    PubMed Central

    Shimizu, Shogo; Shimizu, Takahiro; Tsounapi, Panagiota; Higashi, Youichirou; Martin, Darryl T.; Nakamura, Kumiko; Honda, Masashi; Inoue, Keiji; Saito, Motoaki

    2015-01-01

    Background A decreased prostatic blood flow could be one of the risk factors for benign prostatic hyperplasia/benign prostatic enlargement. The spontaneously hypertensive rat (SHR) shows a chronic prostatic ischemia and hyperplastic morphological abnormalities in the ventral prostate. The effect of silodosin, a selective alpha1A-adrenoceptor antagonist, was investigated in the SHR prostate as a prostatic hyperplasia model focusing on prostatic blood flow. Methods Twelve-week-old male SHRs were administered perorally with silodosin (100 μg/kg/day) or vehicle once daily for 6 weeks. Wistar Kyoto (WKY) rats were used as normotensive controls and were treated with the vehicle. The effect of silodosin on blood pressure and prostatic blood flow were estimated and then the prostates were removed and weighed. The tissue levels of malondialdehyde (MDA), interleukin-6 (IL-6), chemokine (C-X-C motif) ligand 1/cytokine-induced neutrophil chemoattractant 1 (CXCL1/CINC1), tumor necrosis factor-alpha (TNF-α), transforming growth factor beta 1 (TGF-β1), basic fibroblast growth factor (bFGF) and alpha-smooth muscle actin (α-SMA) were measured. The histological evaluation was also performed by hematoxylin and eosin staining. Results There was a significant increase in blood pressure, prostate weight, prostate body weight ratio (PBR), tissue levels of MDA, IL-6, CXCL1/CINC1, TNF-α, TGF-β1, bFGF and α-SMA in the SHR compared to the WKY rat. The ventral prostate in the SHR showed the morphological abnormalities compared to the WKY rat. Prostatic blood flow was decreased in the SHR. However, treatment with silodosin significantly restored the decreased prostatic blood flow in the SHR. Moreover, silodosin normalized tissue levels of MDA, IL-6, CXCL1/CINC1, TNF-α, TGF-β1, bFGF and α-SMA, and it ameliorated ventral prostatic hyperplasia in the SHR excluding blood pressure. Silodosin decreased PBR but not prostate weight in the SHR. Conclusions Silodosin can inhibit the progression of prostatic hyperplasia through a recovery of prostatic blood flow. PMID:26308715

  10. Disturbed homeostasis of zinc and other essential elements in the prostate gland dependent on the character of pathological lesions.

    PubMed

    Sapota, Andrzej; Darago, Adam; Taczalski, Jan; Kilanowicz, Anna

    2009-12-01

    Pathophysiological changes in the prostate take the form of benign prostate hyperplasia (BPH) and prostate adenocarcinoma (PCa). In prostate, zinc is particularly important to its normal functioning, especially in terms of the consequences of hormone disturbance. The aim of this study was to assess the levels of Zn, Cu, Ca, Mg, and Se in the prostate dependent on the character of patological changes. Zinc, copper, magnesium and calcium were determined by AAS and selenium with spectrofluorometric method. Zn levels in BPH patients were over twofold higher than in controls. On the other hand, in the patients with PCa, the levels of Zn were found almost three times lower than in BPH patients and by almost 50% lower than in controls. In this study, significant changes in the levels of other essential elements were observed. The results apparently confirm the disturbed homeostasis of zinc and other essential elements in the etiology of BPH and PCa. PMID:19629715

  11. [S2e guideline of the German urologists : Instrumental treatment of benign prostatic hyperplasia].

    PubMed

    Bschleipfer, T; Bach, T; Berges, R; Dreikorn, K; Gratzke, C; Madersbacher, S; Michel, M-S; Muschter, R; Oelke, M; Reich, O; Tschuschke, C; Höfner, K

    2016-02-01

    This report summarizes the relevant aspects of the S2e guideline of the German Urologists for the instrumental treatment of the lower urinary tract symptoms due to benign prostatic hyperplasia. Recommendations are given regarding open and transurethral procedures (TUR-P, bipolar TUR-P, TUI-P, HE-TUMT, TUNA, and the different Laser techniques). Recommendations are also given concerning intraprostatic stents and injection therapies. The influence of the different therapeutic options on bladder outlet obstruction (BOO) is described in detail. PMID:26518304

  12. Review of Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Choi, Benjamin B.

    2013-01-01

    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

  13. AB133. Xanthogranulomatous prostatitis with benign prostatic hyperplasia: a case report and review of the literature

    PubMed Central

    Wang, Anxi

    2016-01-01

    Objective To improve the level of diagnosis and treatment of xanthogranulomatous prostatitis. Methods The clinical data of a case of xanthogranulomatous prostatitis were analyzed retrospectively and discussed with relative literature review. Results A 56-year-old man presented with a 1 month history of difficult urination, which was exacerbated for 10 days. The patient was confirmed with xanthogranulomatous prostatitis with chronic suppurative inflammation and abscess by pathologic diagnosis after plasmakinetic resection of the prostate (PKRP). The patient achieved smooth voiding and was discharged after operation for one week. Urination was normal during two months follow up. Conclusions Xanthogranulomatous prostatitis is rare clinical disease, which should be excluded from prostate cancer and can be confirmed by pathobiology. According to the degree of lower urinary tract obstruction, it is treated by medicine or surgical operation. Examination of PSA regularly and long-term follow-up must be performed.

  14. Nanostructured systems containing babassu (Orbignya speciosa) oil as a potential alternative therapy for benign prostatic hyperplasia

    PubMed Central

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

    2013-01-01

    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

  15. Transurethral microwave thermotherapy for benign prostatic hyperplasia: patient characteristics in good and poor responders.

    PubMed

    Arai, Y; Terai, A; Onishi, H; Oishi, K; Takeuchi, H; Yoshida, O

    1994-09-01

    Transurethral microwave thermotherapy (TUMT) has been shown to produce a clinical benefit in patients with symptomatic benign prostatic hyperplasia. In order to identify the features of the ideal candidate, a retrospective analysis was conducted in 32 patients who were followed for 2 mo or more. Good responders (GR) were defined as having their Siroky peak flow rate (PFR) standard deviation (SD) increase by < 0.5 or a decrease in the International Prostatic Symptom Score (I-PSS) of > 10 (22 patients). Poor responders (PR) were defined as having their PFR SD increase by < or = 0.5 and their I-PSS decrease by < or = 10 (10 patients). The prostate volume, pre-TUMT I-PSS and intravesical opening pressure were significantly greater in the GR group, while there were no significant differences between the 2 groups for the other baseline patient characteristics: age, prostate length, PFR, PFR SD, post-voiding residual volume and quality of life. Concerning the operational parameters, significantly more total energy was delivered to the prostate in the GR group (mean 131 kJ) than in the PR group (mean 101 kJ). Moreover, the 7 patients with anti-androgen therapy pre-TUMT received less total energy and 5 of the 7 were poor responders. These results suggest that patients with apparent obstructive symptoms and with moderate enlargement of prostate could benefit more from this less invasive therapy. Clinical response seems to be dose-dependent and patients with a history of recent anti-androgen treatment may have a less favorable response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7542156

  16. Effect of combination treatment on patient-related outcome measures in benign prostatic hyperplasia: clinical utility of dutasteride and tamsulosin

    PubMed Central

    Djavan, Bob; Dianat, Seyed Saeid; Kazzazi, Amir

    2011-01-01

    Background: Benign prostatic hyperplasia, the fourth most commonly diagnosed medical condition in the elderly, is a major underlying cause of lower urinary tract symptoms in men. Medical therapy is usually the first therapeutic option. Combination therapy is increasingly used for better symptom relief and outcome. Methods: We searched the literature using the MEDLINE database for the efficacy of combination therapy in men with benign prostatic hyperplasia in terms of symptom improvement and impact on quality of life. Results: Combination therapy with dutasteride and tamsulosin not only provides better symptom improvement and improved urinary flow rate, but is also associated with a more favorable impact on quality of life and patient satisfaction with treatment than monotherapy. Combination therapy also reduces the risk of events related to disease progression, such as acute urinary retention and benign prostatic hyperplasia-related surgery. Conclusion: Combination therapy with dutasteride and tamsulosin is highly efficacious as medical therapy for benign prostatic hyperplasia in patients with moderate-to-severe lower urinary tract symptoms. PMID:22915969

  17. Effect of weight reduction on the severity of lower urinary tract symptoms in obese male patients with benign prostatic hyperplasia: A randomized controlled trial

    PubMed Central

    Yee, Chi-Hang; So, Wing-Yee; Yip, Sidney KH; Wu, Edwin; Yau, Phyllis

    2015-01-01

    Purpose We assessed whether weight reduction is an effective intervention for the management of lower urinary tract symptoms (LUTS) and investigated the relationship between obesity and LUTS. Materials and Methods This was a prospective randomized controlled trial that enrolled obese men older than 50 years with LUTS. The study period was 52 weeks. All patients received standardized alpha-adrenergic blocker therapy for the treatment of benign prostatic hyperplasia (BPH) during the run-in period. Patients were randomized to receive either a standardized prerecorded video program on the general principle of weight reduction or a comprehensive weight reduction program. Patients were assessed at different time points with symptom assessment, uroflowmetry, transrectal ultrasound, and metabolic assessment. Results Sixty-five patients were allocated to each study arm. After the study period, no significant difference in weight reduction was found between the two arms. When the pre- and postintervention parameters were compared, none were statistically different between the 2 arms, namely nocturia, International Prostate Symptom Score, quality of life assessment, and uroflowmetry parameters. When the whole study population was taken as a single cohort, these parameters were also not significantly different between the group with a body mass index of 25 to <30 kg/m2 and the group with a BMI of 30 to 35 kg/m2. Conclusions We found no association between obesity and LUTS. This could have been due to the less marked weight difference in our cohort. Whereas weight reduction may be an effective measure to improve LUTS, the implementation of a successful program remains a challenge. PMID:25763129

  18. The Medical Therapy of Prostatic Symptoms Study: What Will We Learn?

    PubMed Central

    Slawin, Kevin M

    2003-01-01

    Until recently, benign prostatic hyperplasia (BPH) was thought of as a relatively uncomplicated disease process resulting from age-related enlargement of the prostate gland, which was thought to cause all of the symptoms associated with the disease. Prostatectomy was considered the state-of-the art treatment of BPH. Advances in our understanding of the pathogenesis of BPH and the relationship among clinical signs and symptoms has allowed for the development of pharmacologic therapies for this disorder, namely, selective α-blockers and 5-α-reductase inhibitors. These 2 classes of drugs have been demonstrated to be safe and effective for the treatment of BPH. Evidence supports different mechanisms of action, suggesting that, when used in combination, these therapies may act synergistically. The Medical Therapy of Prostatic Symptoms study was designed, in part, to test this hypothesis. Initial results of the trial are presented in this article. PMID:16985969

  19. The Medical Therapy of Prostatic Symptoms Study: What Will We Learn?

    PubMed Central

    Slawin, Kevin M

    2003-01-01

    Until recently, benign prostatic hyperplasia (BPH) was thought of as a relatively uncomplicated disease process resulting from age-related enlargement of the prostate gland, which was thought to cause all of the symptoms associated with the disease. Prostatectomy was considered the state-of-the art treatment of BPH. Advances in our understanding of the pathogenesis of BPH and the relationship among clinical signs and symptoms has allowed for the development of pharmacologic therapies for this disorder, namely, selective α-blockers and 5-α-reductase inhibitors. These 2 classes of drugs have been demonstrated to be safe and effective for the treatment of BPH. Evidence supports different mechanisms of action, suggesting that, when used in combination, these therapies may act synergistically. The Medical Therapy of Prostatic Symptoms study was designed, in part, to test this hypothesis. Initial results of the trial are presented in this article. PMID:16985963

  20. 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)

    Bhatta, Krishna M.

    1995-05-01

    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.

  1. Postoperative Infectious Complications in Our Early Experience With Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

    PubMed Central

    Tanaka, Kazushi; Haraguchi, Takahiro; Yamamichi, Fukashi; Muramaki, Mototsugu; Miyake, Hideaki; Fujisawa, Masato

    2013-01-01

    Purpose The objective of this study was to retrospectively investigate postoperative infectious complications (PICs) in our early experience with holmium laser enucleation of the prostate (HoLEP) followed by mechanical morcellation for symptomatic benign prostatic hyperplasia. Materials and Methods A retrospective review was performed of the clinical data for 90 consecutive patients who underwent HoLEP at our institution between February 2008 and March 2011. All patients were evaluated for the emergence of PICs, including prophylactic antibiotic administration (PAA) and the influence of the kind or duration of PAA on PIC. The details of cases with PICs were also examined. Results The patients' mean age was 71 years (range, 50 to 95 years), and their mean prostate volume was 60 mL (range, 2 to 250 mL). There were 7 cases (7.78%) with PICs; in detail, 3 patients were diagnosed with prostatitis, 2 with pyelonephritis, and 2 with epididymitis. Three patients had positive urine cultures: 1 had Serratia marcescens/Proteus mirabilis, 1 had S. marcescens, and 1 had Klebsiella pneumonia; only one case had urological sepsis. Our statistical data showed no significant differences between 2 or fewer days and 3 or more days of PAA and PIC occurrence. There was also no significant effect on PIC occurrence of sulbactam/ampicillin compared with other antibiotics. Conclusions The results of this retrospective study showed that PIC occurrence did not depend on the duration or the kind of PAA. Further prospective study is necessary for the evaluation and establishment of prophylactic measures for PICs. PMID:23526729

  2. Upregulation of Phosphodiesterase type 5 in the Hyperplastic Prostate

    PubMed Central

    Zhang, Wenhao; Zang, Ning; Jiang, Yaoming; Chen, Ping; Wang, Xinghuan; Zhang, Xinhua

    2015-01-01

    Both erectile dysfunction (ED) and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) are common in the aging male. Numerous clinical trials have demonstrated the efficacy and safety of phosphodiesterase type 5 inhibitors (PDE5-Is) for treating LUTS/BPH with/without ED. However, the influence of BPH on prostatic PDE5 expression has never been studied. A testosterone-induced rat model of BPH was developed and human hyperplastic prostate specimens were harvested during cystoprostatectomy. PDE5, nNOS, eNOS and α1-adrenoreceptor subtypes (α1aARs, α1bARs and α1dARs) were determined with real-time RT-PCR for rat tissues whilst PDE5 and α1-adrenoreceptor subtypes were determined in human samples. PDE5 was further analyzed with Western-blot and histological examination. Serum testosterone was measured with ELISA. The rat BPH model was validated as having a significantly enlarged prostate. PDE5 localized mainly in fibromuscular stroma in prostate. Our data showed a significant and previously undocumented upregulation of PDE5 in both rat and human BPH, along with increased expression of nNOS and α1dARs for rat tissues and α1aARs for human BPH. The upregulation of PDE5 in the hyperplastic prostate could explain the mechanism and contribute to the high effectiveness of PDE5-Is for treating LUTS/BPH. Fibromuscular stroma could be the main target for PDE5-Is within prostate. PMID:26657792

  3. Effect of Serenoa Repens on Oxidative Stress, Inflammatory and Growth Factors in Obese Wistar Rats with Benign Prostatic Hyperplasia.

    PubMed

    Iii Colado-Velázquez, Juventino; Mailloux-Salinas, Patrick; Medina-Contreras, Jml; Cruz-Robles, David; Bravo, Guadalupe

    2015-10-01

    Serenoa repens has been widely used to treat benign prostatic hyperplasia and lower urinary tract symptoms; however, most of the studies have been conducted in individuals with normal weight and not obese. In this study, the effects of a lipidic extract of S. repens, in markers of oxidative stress, inflammation, and growth factors, in obese rats with testosterone-induced prostatic hyperplasia, were investigated. Total nitrites, malondialdehyde, total glutathione, superoxide dismutase (SOD), and catalase activity were measured; in addition, assays for inflammatory cytokines TNF-α, IL-1β, IL-6 and the growth factors basic fibroblast growth factor (FGFb) and vascular endothelial growth factor (VEGF) were performed. The obese rats had a higher prostate weight compared with controls. S. repens significantly decreased prostate weight, total nitrites, and malondialdehyde; improved total glutathione, SOD, and catalase activity; and significantly reduced inflammatory (TNF-α, IL-1β and IL-6) and growth factors (VEGF and FGFb). S. repens showed high antioxidant and antiinflammatory activity in obese rats, suggesting that their use could be beneficial in the treatment of benign prostatic hyperplasia. PMID:26104840

  4. Efficacy and safety of holmium laser enucleation of the prostate for extremely large prostatic adenoma in patients with benign prostatic hyperplasia

    PubMed Central

    Kim, Myong; Piao, Songzhe; Lee, Hahn-Ey; Kim, Sung Han

    2015-01-01

    Purpose To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for extremely large prostates. Materials and Methods Patients undergoing HoLEP between July 2008 and December 2013 from the Seoul National University Hospital Benign Prostatic Hyperplasia Database Registry were retrospectively analyzed. The patients were divided into three groups according to their total prostate volume (TPV): group A (TPV<100 mL), group B (100 mL≤TPV<200 mL), and group C (TPV≥200 mL); the clinical data of the three groups were compared. All patients were followed up 2 weeks, 3 months, and 6 months after surgery. Results A total of 502 patients (group A, 426; group B, 70; group C, 6) with a mean age of 69.0 (standard deviation, ±7.3) years were included in our analysis. The mean prostate volume and prostate-specific antigen level were 68.7±36.9 mL and 4.15±4.24 ng/mL, respectively. The enucleation and morcellation times were longer in group C (p<0.001), and the enucleation efficacy was higher in this group (p<0.001, R2=0.399). Moreover, the mean postoperative catheterization and hospitalization periods were significantly longer in group C (p=0.004 and p=0.011, respectively). However, there were no significant differences between the groups in any other postoperative events, including recatheterization, reoperation, urinary tract infection, clot retention, and bladder neck contracture (p range, 0.516-0.913). One patient in group C experienced recurrence of the urethral stricture. Conclusions HoLEP in patients with an extremely large prostate can be performed efficiently and safely. PMID:25763126

  5. Current Pharmacological Treatment for Male LUTS due to BPH: Dutasteride or Finasteride?

    PubMed

    Pirozzi, Luisella; Sountoulides, Petros; Castellan, Pietro; Presicce, Fabrizio; Lombardo, Riccardo; Romero, Marilena; De Nunzio, Cosimo; Tubaro, Andrea; Schips, Luigi; Cindolo, Luca

    2015-01-01

    Benign prostatic hyperplasia (BPH) is a potentially progressive disease which is commonly associated with bothersome lower urinary tract symptoms (LUTS) and might result in complications, such as acute urinary retention and BPH-related surgery. In the current medical therapy scenario for LUTS attributed to BPH, only one class of drugs, 5-α reductase inhibitors (5ARIs), has been found to be effective in reducing the risk of disease progression. The two 5ARIs that are currently available include finasteride and dutasteride. These two drugs have different pharmacokinetic and pharmacodynamic properties. Greater suppression of dehydrotestosterone is achieved by dutasteride (>90% dutasteride vs 70% finasteride) which theoretically should correlate with greater efficacy in alleviating urinary symptoms. Unfortunately, this hypothesis has not yet been clinically demonstrated. The pertinent literature is scarce and heterogeneous and produces low scientific levels of evidence. The present review article aims to evaluate the comparative head-to-head studies in order to evaluate if the hypothetical clinical differences between dutasteride and finasteride do exist. Pharmacological treatment with either drug results in similar symptom improvements; however dutasteride seems to have a better profile in reducing the risk of prostate surgery and acute urinary retention (AUR). More studies are necessary to better evaluate both the clinical and pharmacoeconomic profile of the two 5ARIs. PMID:25981606

  6. Fibre Diffraction Analysis of Skin Offers a Very Early and Extremely Accurate Diagnostic Test for Prostate Cancer

    DOE PAGESBeta

    James, Veronica J.; O’Malley Ford, Judith M.

    2014-01-01

    Double blind analysis of a batch of thirty skin tissue samples from potential prostate cancer sufferers correctly identified all “control” patients, patients with high and low grade prostate cancers, the presence of benign prostate hyperplasia (BPH), perineural invasions, and the one lymphatic invasion. Identification was by analysis of fibre diffraction patterns interpreted using a schema developed from observations in nine previous studies. The method, schema, and specific experiment results are reported in this paper, with some implications then drawn.

  7. The QT Interval and Selection of Alpha-Blockers for Benign Prostatic Hyperplasia

    PubMed Central

    Lepor, Herbert; Lepor, Norman E; Hill, Lawrence A; Trohman, Richard G

    2008-01-01

    The QT interval is the electrocardiographic manifestation of ventricular depolarization and repolarization. Drug-induced long QT syndrome is characterized by acquired, corrected QT (QTc) interval prolongation that is associated with increased risk of torsade de pointes. Every physician must recognize if the drugs he or she prescribes prolongs the QTc interval, especially if the drug is prescribed for a chronic condition in older patients who are on polypharmacy. The evolution of alpha-blockers for the treatment of benign prostatic hyperplasia has allowed the development of drugs that are easier to administer and better tolerated. Because alpha-blockers generally have equivalent efficacy, this class of drugs is typically differentiated by safety and side effects. Studies suggest that alpha-blockers may vary in regard to their effect on the QT interval, and, therefore, on their predisposition to cause potentially life-threatening ventricular arrhythmias. PMID:18660858

  8. A 63 element 1.75 dimensional ultrasound phased array for the treatment of benign prostatic hyperplasia

    PubMed Central

    Saleh, Khaldon Y; Smith, Nadine Barrie

    2005-01-01

    Background Prostate cancer and benign prostatic hyperplasia are very common diseases in older American men, thus having a reliable treatment modality for both diseases is of great importance. The currently used treating options, mainly surgical ones, have numerous complications, which include the many side effects that accompany such procedures, besides the invasive nature of such techniques. Focused ultrasound is a relatively new treating modality that is showing promising results in treating prostate cancer and benign prostatic hyperplasia. Thus this technique is gaining more attention in the past decade as a non-invasive method to treat both diseases. Methods In this paper, the design, construction and evaluation of a 1.75 dimensional ultrasound phased array to be used for treating prostate cancer and benign prostatic hyperplasia is presented. With this array, the position of the focus can be controlled by changing the electrical power and phase to the individual elements for electronically focusing and steering in a three dimensional volume. The array was designed with a maximum steering angle of ± 13.5° in the transverse direction and a maximum depth of penetration of 11 cm, which allows the treatment of large prostates. The transducer piezoelectric ceramic, matching layers and cable impedance have been designed for maximum power transfer to tissue. Results To verify the capability of the transducer for focusing and steering, exposimetry was performed and the results correlated well with the calculated field. Ex vivo experiments using bovine tissue were performed with various lesion sizes and indicated the capability of the transducer to ablate tissue using short sonications. Conclusion A 1.75 dimensional array, that overcame the drawbacks associated with one-dimensional arrays, has been designed, built and successfully tested. Design issues, such as cable and ceramic capacitances, were taken into account when designing this array. The final prototype overcame also the problem of generating grating lobes at unwanted locations by tapering the array elements. PMID:15963237

  9. Role of adhesion molecules and proliferation hyperplasic, pre neoplastic and neoplastic lesions in canine prostate.

    PubMed

    Rodrigues, M M P; Rema, A; Gartner, M F; Laufer-Amorim, R

    2013-11-01

    E-cadherin and beta-catenin are component of adherens junctions in epithelial cells. Loss of these proteins have been associated with progression of prostatic diseases. We performed immunohistochemistry for E-cadherin, beta-catenin and Ki-67 on canine prostatic lesions. We analyzed the expression of these antibodies in benign prostatic hyperplasia (BPH, n = 22), in pre neoplastic lesions Prostatic Intra-epithelial Neoplasia (PIN), n = 3 and Prostatic Inflammatory Atrophy (PIA), n = 7 and prostate carcinoma (PC, n = 10). In this study, a membranous expression of E-cadherin and beta-catenin and nuclear expression of Ki-67 antigen were demonstrated. The proliferative index was statistically different between carcinomas and BPH and carcinomas and pre-neoplastic lesions. Like in men, the reduction of E-cadherin and increase of Ki-67 expression in neoplastic lesions in dog prostate may be related to the carcinogenic process in this gland. PMID:24511741

  10. Augmented immunoexpression of survivin correlates with parameters of aggressiveness in prostate cancer.

    PubMed

    Danilewicz, Marian; Stasikowska-Kanicka, Olga; Wągrowska-Danilewicz, Malgorzata

    2015-03-01

    The clinical significance of the immunoexpression of survivin in prostate cancer and its correlation with the biological aggressiveness of prostate cancer remains unclear. Therefore, the present study was undertaken to compare the immunoexpression of survivin in prostate cancer (PCa) and benign prostatic hyperplasia (BPH) as well as to determine whether this immunoexpression could correlate with Gleason score, proliferation activity and prostate specific antigen (PSA) levels. The prostate needle biopsies from 28 patients with elevated serum PSA levels were studied. As a control, 12 needle biopsies of prostate diagnosed as BPH were used. The immunoexpression of survivin was evaluated semiquantitatively, whereas the Ki-67 index was assessed quantitatively. The immunoexpression of survivin and Ki-67 in epithelial cells in the prostate cancer group was significantly increased as compared to BPH cases. In the prostate cancer group there were positive significant correlations between the immunoexpression of survivin and Gleason score as well as Ki‑67 antigen. The correlation between the immunoexpression of survivin and PSA levels was also positive, but it did not reach statistical significance. In conclusion, we can confirm that in prostate cancer the immunoexpression of survivin is augmented as compared to BPH and positively correlated with parameters of tumor aggressiveness. PMID:26017879

  11. Establishment of a pregnancy following intravaginal insemination with epididymal semen from a dog castrated due to benign prostatic hyperplasia.

    PubMed

    Klinc, P; Majdic, G; Sterbenc, N; Cebulj-Kadunc, N; Butinar, J; Kosec, M

    2005-12-01

    Benign prostatic hyperplasia was diagnosed in an American Staffordshire Terrier of high breeding value presenting concurrent haematuria. Castration as a treatment was synchronized with the oestrus cycle of a bitch selected for insemination. After castration the cauda epididymis was flushed with Gent semen extender and collected spermatozoa were filtered and analysed by Hamilton Thorn computer assisted sperm analysis. A total of 7 ml semen containing 742 x 10(6) spermatozoa with 76.5% mean motility was used for insemination. Intravaginal insemination of the bitch was performed with an insemination catheter for dogs (Kruuse, Marslev, Denmark) on the day when plasma progesterone levels reached 9.9 ng/ml. Normal pregnancy without complications resulted in eight live-born puppies 63 days after insemination. This is the first report of a normal pregnancy and birth of puppies from a bitch inseminated with epididymal semen obtained from a dog affected by benign prostate hyperplasia. PMID:16324084

  12. A hybrid fuzzy-ontology based intelligent system to determine level of severity and treatment recommendation for Benign Prostatic Hyperplasia.

    PubMed

    Torshizi, Abolfazl Doostparast; Zarandi, Mohammad Hossein Fazel; Torshizi, Ghazaleh Doostparast; Eghbali, Kamyar

    2014-01-01

    This paper deals with application of fuzzy intelligent systems in diagnosing severity level and recommending appropriate therapies for patients having Benign Prostatic Hyperplasia. Such an intelligent system can have remarkable impacts on correct diagnosis of the disease and reducing risk of mortality. This system captures various factors from the patients using two modules. The first module determines severity level of the Benign Prostatic Hyperplasia and the second module, which is a decision making unit, obtains output of the first module accompanied by some external knowledge and makes an appropriate treatment decision based on its ontology model and a fuzzy type-1 system. In order to validate efficiency and accuracy of the developed system, a case study is conducted by 44 participants. Then the results are compared with the recommendations of a panel of experts on the experimental data. Then precision and accuracy of the results were investigated based on a statistical analysis. PMID:24184111

  13. Multispectral Photoacoustic Imaging of Prostate Cancer: Preliminary Ex-vivo Results

    PubMed Central

    Dogra, Vikram S.; Chinni, Bhargava K.; Valluru, Keerthi S.; Joseph, Jean V.; Ghazi, Ahmed; Yao, Jorge L.; Evans, Katie; Messing, Edward M.; Rao, Navalgund A.

    2013-01-01

    Objective: The objective of this study is to validate if ex-vivo multispectral photoacoustic (PA) imaging can differentiate between malignant prostate tissue, benign prostatic hyperplasia (BPH), and normal human prostate tissue. Materials and Methods: Institutional Review Board's approval was obtained for this study. A total of 30 patients undergoing prostatectomy for biopsy-confirmed prostate cancer were included in this study with informed consent. Multispectral PA imaging was performed on surgically excised prostate tissue and chromophore images that represent optical absorption of deoxyhemoglobin (dHb), oxyhemoglobin (HbO2), lipid, and water were reconstructed. After the imaging procedure is completed, malignant prostate, BPH and normal prostate regions were marked by the genitourinary pathologist on histopathology slides and digital images of marked histopathology slides were obtained. The histopathology images were co-registered with chromophore images. Region of interest (ROI) corresponding to malignant prostate, BPH and normal prostate were defined on the chromophore images. Pixel values within each ROI were then averaged to determine mean intensities of dHb, HbO2, lipid, and water. Results: Our preliminary results show that there is statistically significant difference in mean intensity of dHb (P < 0.0001) and lipid (P = 0.0251) between malignant prostate and normal prostate tissue. There was difference in mean intensity of dHb (P < 0.0001) between malignant prostate and BPH. Sensitivity, specificity, positive predictive value, and negative predictive value of our imaging system were found to be 81.3%, 96.2%, 92.9% and 89.3% respectively. Conclusion: Our preliminary results of ex-vivo human prostate study suggest that multispectral PA imaging can differentiate between malignant prostate, BPH and normal prostate tissue. PMID:24228210

  14. Holmium Laser Enucleation of the Prostate With Percutaneous Nephrostomy Into the Transplanted Kidney in Patient With Severe Benign Prostatic Hyperplasia With Vesicoureteral Reflux - A Case Report.

    PubMed

    Nohara, Takahiro; Matsuyama, Satoko; Shima, Takashi; Kawaguchi, Shohei; Seto, Chikashi

    2016-01-01

    A 66-year-old male, who had received renal transplantation 10 years before, was admitted to our hospital with urinary retention. The prostate volume was 169.2 ml. Furthermore, grade 5 vesicoureteral reflux (VUR) was shown in the cystography. Holmium laser enucleation of prostate (HoLEP) was performed, and percutaneous nephrostomy to the transplanted kidney was performed simultaneously to prevent from severe perioperative infection. After that, renal graft function improved and no urinary retention reoccurred, although surgical repair against VUR was necessary 10 months after HoLEP. We conclude that surgical treatment for BPH after kidney transplantation should be strongly considered with care for infections. PMID:26793574

  15. Holmium Laser Enucleation of the Prostate With Percutaneous Nephrostomy Into the Transplanted Kidney in Patient With Severe Benign Prostatic Hyperplasia With Vesicoureteral Reflux – A Case Report

    PubMed Central

    Nohara, Takahiro; Matsuyama, Satoko; Shima, Takashi; Kawaguchi, Shohei; Seto, Chikashi

    2015-01-01

    A 66-year-old male, who had received renal transplantation 10 years before, was admitted to our hospital with urinary retention. The prostate volume was 169.2 ml. Furthermore, grade 5 vesicoureteral reflux (VUR) was shown in the cystography. Holmium laser enucleation of prostate (HoLEP) was performed, and percutaneous nephrostomy to the transplanted kidney was performed simultaneously to prevent from severe perioperative infection. After that, renal graft function improved and no urinary retention reoccurred, although surgical repair against VUR was necessary 10 months after HoLEP. We conclude that surgical treatment for BPH after kidney transplantation should be strongly considered with care for infections. PMID:26793574

  16. Greenlight high-performance system (HPS) 120-W laser vaporization versus transurethral resection of the prostate for the treatment of benign prostatic hyperplasia: a meta-analysis of the published results of randomized controlled trials.

    PubMed

    Zhou, Yan; Xue, Boxin; Mohammad, Nadeem Ahmed; Chen, Dong; Sun, Xiaofei; Yang, Jinhui; Dai, Guangcheng

    2016-04-01

    To assess the efficacy and the safety of Greenlight(TM) high-performance system (HPS) 120-W laser photoselective vaporization of the prostate (PVP) compared with transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia (BPH). The related original studies only including randomized controlled trials were searched by databases MEDLINE, EMBASE, Google Scholar, and the Cochrane Controlled Trial Register. The databases were updated till July 2014. The risk ratio, mean difference, and their corresponding 95 % confidence intervals were calculated. Risk of bias of the enrolled trials were assessed according to Cochrane Handbook. A total of four trials involving 559 patients were enrolled. Statistical analysis was performed by software Review Manager (V5.3.3). There was no significant difference in International Prostate Symptom Score (IPSS) and maximum flow rate (Qmax) between PVP and TURP at 6-, 12-, and 24-month follow-up. Patients in the PVP group were associated with significantly lower risk of capsule perforation (risk ratio (RR) = 0.06, 95 % confidence interval (95%CI) = 0.01 to 0.46; p = 0.007), significantly lower transfusion requirements (RR = 0.12, 95%CI = 0.03 to 0.43; p = 0.001), a shorter catheterization time (mean difference (MD) = -41.93, 95%CI = -54.87 to -28.99; p < 0.00001), and a shorter duration of hospital stay (MD = -2.09, 95%CI = -2.58 to -1.59; p < 0.00001) than that in the TURP group. In the TURP group, the patients were associated with a lower risk of re-operation (RR = 3.68, 95%CI = 1.04 to 13.00; p = 0.04) and a shorter operative time (MD = 9.28, 95%CI = 2.80 to 15.75; p = 0.005) than those in the PVP group. In addition, no statistically significant differences were detected between groups in terms of the rates of transurethral resection syndrome, urethral stricture, bladder neck contracture, incontinence, and infection. Greenlight(TM) 120-W laser PVP is as effective as TURP for symptom reduction and improvement of the quality of life. Laser PVP shows advantages over TURP in terms of intraoperative safety, whereas TURP is found to have a shorter operative time and lower re-operative risk. PMID:26868032

  17. HoLEP: the gold standard for the surgical management of BPH in the 21st Century

    PubMed Central

    Michalak, John; Tzou, David; Funk, Joel

    2015-01-01

    Introduction: For many years, transurethral resection of the prostate (TURP) has been accepted as the gold standard to surgically alleviate obstructive voiding dysfunction in men with benign prostatic hyperplasia (BPH). This historical standard has been challenged repeatedly over the last decade by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). This review summarizes the literature comparing HoLEP and traditional therapies for BPH that are widely used and have long term efficacy data, primarily TURP, open prostatectomy (OP), and alternative laser therapies (PVP, ThuLEP, etc). Results: Patients undergoing HoLEP have greater improvements in post-operative Qmax, greater reduction in post-operative subjective symptom scores, and lower rates of repeat endoscopic procedures for recurrent symptoms at 5-10 year follow up compared with TURP, OP, and other laser therapies. Furthermore, patients undergoing HoLEP benefit from significantly shortened catheterization times, decreased length of hospital stay (LOS), and fewer serious post-operative complications. In particular, randomized controlled trials (RCT) have demonstrated that HoLEP can be used to resect adenomas greater than 100 grams with equivalent efficacy to open prostatectomy, but with radically decreased morbidity. Conclusion: Numerous large, RCTs demonstrate HoLEP to be objectively superior to other surgical therapies for BPH. The urologic community should embrace HoLEP as the new gold standard for surgical BPH therapy, especially in men with large prostates who would otherwise be considered for an OP or staged TURP. The only obstacle to widespread implementation of HoLEP remains its difficult learning curve when compared with traditional transurethral resection. Further allocation of resources towards appropriate mentoring and teaching of HoLEP is warranted, particularly in residency training programs. PMID:26069886

  18. Evaluation of the effects of androgen receptor gene trinucleotide repeats and prostate-specific antigen gene polymorphisms on prostate cancer.

    PubMed

    Alptekin, D; Izmirli, M; Bayazit, Y; Luleyap, H U; Yilmaz, M B; Soyupak, B; Erkoc, M A; Tansug, Z

    2012-01-01

    The number of trinucleotide repeats [CAG (coding for polyglutamine), GGC (coding for polyglycine)] in the first exon of the androgen receptor (AR) gene and prostate-specific antigen (PSA) gene androgen response element I A/G polymorphism are both related to prostate cancer prognosis. We investigated whether these genomic changes occur in the AR and PSA genes, which are usually found in individuals with prostate cancer, of Turkish patients and to find out their distribution in the population. We used PCR and PCR-RFLP assays for AR and PSA genes, respectively, to detect molecular changes in 44 prostate cancer patients. Our findings indicate that individuals with prostate cancer tend to have around 18 CAG trinucleotide repeats. We observed significant differences between 22 controls, 33 benign prostate hyperplasia (BPH) patients and 44 adenocarcinoma patients for long CAG repeats. However, we did not find any significant differences in GGC repeats between controls, BPH and adenocarcinoma patients (P = 0.408). We also did not observe significant differences in the PSA A/G polymorphism frequency between controls, BPH and adenocarcinoma patients (P = 0.483). In conclusion, CAG and GGC repeats in the AR and PSA gene polymorphisms may be associated with prostate cancer risk and BPH in the Turkish population. PMID:22653589

  19. GEOPHYSICS, ASTRONOMY AND ASTROPHYSICS: Second-harmonic generation as a DNA malignancy indicator of prostate glandular epithelial cells

    NASA Astrophysics Data System (ADS)

    Zhuang, Zheng-Fei; Liu, Han-Ping; Guo, Zhou-Yi; Zhuo, Shuang-Mu; Yu, Bi-Ying; Deng, Xiao-Yuan

    2010-04-01

    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 μm×2.7 μm 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.

  20. Inflammatory Mechanisms Associated with Prostatic Inflammation and Lower Urinary Tract Symptoms

    PubMed Central

    St. Sauver, Jennifer L.; Jacobsen, Steven J.

    2009-01-01

    Inflammation is a common finding in histologic prostate specimens obtained from aging men, and accumulating data suggest that inflammation may play an important role in the development of benign prostatic hyperplasia (BPH), and the development and progression of lower urinary tract symptoms (LUTS). Inflammatory processes may contribute to prostatic enlargement directly through stimulation of prostate growth, or, alternatively, through decreasing prostatic apoptosis. Additionally, inflammatory processes may impact other components of the urogenital tract, such as the bladder, and contribute to the LUTS that may be experienced both in the presence and in the absence of prostate enlargement. Current research therefore offers clues about converging inflammatory pathways which may be targeted to improve treatment of BPH and/or LUTS as well as identifying potential targets for prevention of these syndromes. PMID:19809538

  1. Holmium Laser Enucleation versus Transurethral Resection in Patients with Benign Prostate Hyperplasia: An Updated Systematic Review with Meta-Analysis and Trial Sequential Analysis

    PubMed Central

    Ruan, Xiao-Lan; Weng, Hong; Liu, Tong-Zu; Wang, Xiao; Zhang, Chao; Meng, Zhe; Wang, Xing-Huan

    2014-01-01

    Background Holmium laser enucleation (HoLEP) in surgical treatment of benign prostate hyperplasia (BPH) potentially offers advantages over transurethral resection of the prostate (TURP). Methods Published randomized controlled trials (RCTs) were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Library up to October 10, 2013 (updated on February 5, 2014). After methodological quality assessment and data extraction, meta-analysis was performed using STATA 12.0 and Trial Sequential Analysis (TSA) 0.9 software. Results Fifteen studies including 8 RCTs involving 855 patients met the criteria. The results of meta-analysis showed that: a) efficacy indicators: there was no significant difference in quality of life between the two groups (P>0.05), but compared with the TURP group, Qmax was better at 3 months and 12 months, PVR was less at 6, 12 months, and IPSS was lower at 12 months in the HoLEP, b) safety indicators: compared with the TURP, HoLEP had less blood transfusion (RR 0.17, 95% CI 0.06 to 0.47), but there was no significant difference in early and late postoperative complications (P>0.05), and c) perioperative indicators: HoLEP was associated with longer operation time (WMD 14.19 min, 95% CI 6.30 to 22.08 min), shorter catheterization time (WMD −19.97 h, 95% CI −24.24 to −15.70 h) and hospital stay (WMD −25.25 h, 95% CI −29.81 to −20.68 h). Conclusions In conventional meta-analyses, there is no clinically relevant difference in early and late postoperative complications between the two techniques, but HoLEP is preferable due to advantage in the curative effect, less blood transfusion rate, shorter catheterization duration time and hospital stay. However, trial sequential analysis does not allow us to draw any solid conclusion in overall clinical benefit comparison between the two approaches. Further large, well-designed, multicentre/international RCTs with long-term data and the comparison between the two approaches remain open. PMID:25003963

  2. Prostatic diseases under focus in a university hospital in Eastern Saudi Arabia

    PubMed Central

    Nemer, Areej M. Al; Aldamanhori, Reem B.

    2015-01-01

    Objectives: To explore the spectrum of pathologies diagnosed in prostatic biopsies of Saudi men, and test whether the frequency of diagnosing the malignant fraction has been changed over the last 15 years, and assess the association between chronic inflammation (CI) with both benign prostatic hyperplasia (BPH) and cancer (PCa), and investigate the histological findings of cases presented with acute urinary retention (AUR) clinically. Methods: This is a retrospective cohort study including all prostatic biopsies accessed in the files in the Surgical Pathology Laboratory of King Fahd University Hospital, Alkhobar, Kingdom of Saudi Arabia over 15 years (1999-2013) for Saudi men. Age, procedure indication, and final diagnoses were retrieved and slides were reviewed. Results: There were 360 cases included in this study with a median age of 65 year-old. The BPH comprised the most (64.7%), while PCa accounted for 89 cases, 13.5% of which were incidental. Most cases of both BPH and PCa were diagnosed in the seventh decade. The frequency of diagnosing PCa did not show a solid rise or fall over time. Chronic inflammation is more related to BPH than to PCa. Only CI showed a significant statistical association with AUR. Conclusion: Prostatic diseases show a stable trend over time. While CI is a common dominator for both BPH and PCa, it is associated more with BPH. Among all histological findings, only CI is related to the clinical presentation of AUR. PMID:26593165

  3. Nutraceuticals in Prostate Disease: The Urologist’s Role

    PubMed Central

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

    2008-01-01

    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

  4. Evaluation of neutrophil-to-lymphocyte ratio prior to prostate biopsy to predict biopsy histology: Results of 1836 patients

    PubMed Central

    Gokce, Mehmet Ilker; Hamidi, Nurullah; Suer, Evren; Tangal, Semih; Huseynov, Adil; Ibiş, Arif

    2015-01-01

    Introduction: We evaluate the role of NLR prior to prostate biopsy to predict biopsy histology and Gleason score in patients with prostate cancer. Methods: In this retrospective study, we evaluated data of patients underwent prostate biopsy between May 2005 and March 2015. We collected the following data: age, prostate-specific antigen (PSA), biopsy histology, Gleason score (GS) in prostate cancer patients, neutrophil counts, and lymphocyte counts. Patients were grouped as benign prostatic hyperplasia (BPH), prostate cancer, and prostatitis. The Chi square test was used to compare categorical variables and analysis of variance (ANOVA) was applied for continuous variables. Results: Data of 1836 patients were investigated. The mean age, total PSA and neutrophil-lymphocyte ratio (NLR) of the population were 66.8 ± 8.17 years, 9.38 ± 4.7 ng/dL, and 3.11 ± 1.71, respectively. Patients were divided as follows: 625 in the group with BPH history, 600 in the prostatitis group, and 611 in the prostate cancer histology group. The mean NLR of the prostatitis group was higher compared to the prostate cancer and BPH groups (p = 0.0001). The mean NLR of the prostate cancer group was significantly higher compared to the BPH group (p = 0.002). The GS 8–10 group had a significantly higher mean NLR compared to GS 5–6 (3.64 vs. 2.54, p = 0.0001) and GS 7 (3.64 vs. 2.58, p = 0.0001) patients. Conclusions: NLR was found to differ with regard to histology of prostate biopsy and higher GS was associated with higher NLR in patients with prostate cancer. However prostatitis prevents the use of NLR in predicting prostate cancer before a prostate biopsy. Also, the retrospective nature and lack of multivariate analysis in this study somewhat limits the relevance of these results. PMID:26600880

  5. The use of PDE-5 inhibitors in the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia.

    PubMed

    Lythgoe, Casey; McVary, Kevin T

    2013-12-01

    The relationship between lower urinary tract symptoms secondary to BPH and ED has recently been the subject of significant research due to the prevalence of both conditions concomitantly existing in older men. Many large-scale studies have demonstrated an association between erectile dysfunction and lower urinary tract symptoms. Although the mechanisms underlying the relationship between LUTS and ED are not fully elucidated, several theories are currently proposed in literature: the nitric oxide/cGMP pathway, RhoA/Rho-kinase signaling, pelvic atherosclerosis associated with chronic hypoxia, and autonomic adrenergic hyperactivity. The mechanisms by which these pathways affect the bladder, prostate, pelvic vasculature and spinal cord are also the subject of current research. In this chapter, we examine the randomized, placebo-controlled trials that have evaluated the use of PDE-5Is in LUTS, as well as randomized, controlled trials (RCTs) researching combination PDE-5Is and alpha blockers. PMID:24136683

  6. Update on the use of dutasteride in the management of benign prostatic hypertrophy

    PubMed Central

    Miller, Joe; Tarter, Thomas H

    2007-01-01

    Benign prostatic hyperplasia (BPH) is a frequent cause of lower urinary symptoms, with a prevalence of 50% by the sixth decade of life. Hyperplasia of stromal and epithelial prostatic elements that surround the urethra cause lower urinary tract symptoms (LUTS), urinary tract infection, and acute urinary retention. Medical treatments of symptomatic BPH include; 1) the 5α-reductase inhibitors, 2) the α1-adrenergic antagonists, and 3) the combination of a 5α-reductase inhibitor and a α1-adrenergic antagonist. Selective α1-adrenergic antagonists relax the smooth muscle of the prostate and bladder neck without affecting the detrussor muscle of the bladder wall, thus decreasing the resistance to urine flow without compromising bladder contractility. Clinical trials have shown that α1-adrenergic 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. Inhibitors of 5α-reductase decrease production of dihydrotestosterone within the prostate resulting in decreased prostate volumes, increased peak urinary flow rates, improvement of symptoms, and decreased risk of acute urinary retention and need for surgical intervention. The combination of a 5α-reductase inhibitor and a α1-adrenergic antagonist reduces the clinical progression of BPH over either class of drug alone. PMID:18044081

  7. Application of the Modified Clavien Classification System to 402 Cases of Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

    PubMed Central

    Choi, Jong In; Moon, Kyung Young; Yoon, Jong Hyun; Na, Woong

    2014-01-01

    Purpose We attempted to evaluate the perioperative complications of holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia by using the modified Clavien classification system (MCCS). Materials and Methods Targeting 402 patients who underwent HoLEP for benign prostatic hyperplasia performed by a single surgeon between July 2008 and January 2011, we investigated complications that occurred during and within 1 month after surgery and classified them into grade I to grade V on the basis of the MCCS. If two or more complications occurred in one patient, each complication was graded and counted. Results The mean age, prostate volume, operation time, hospital stay, and average follow-up period of 402 patients who underwent HoLEP were 68.8 years (range, 52-84 years), 53.2 g (range, 23-228 g), 58.2 minutes (range, 20-230 minutes), 4.5 days (range, 2-7 days), and 9 months (range, 4-27 months), respectively; 78 complications occurred in 71 of the patients (morbidity rate, 17.6%). In MCCS grade I, complications occurred in 54 cases (69.2%); in grade II, complications occurred in 19 cases (24.3%); in grade III, complications occurred in 4 cases (5.1%); and in grade IV, 1 patient required intensive care unit care because of cerebral infarction (1.2%). There were no grade V complications. Conclusions The HoLEP-based MCCS complications classification was performed very quickly. However, MCCS, when compared with other measures of endoscopic prostate surgery experiences, including HoLEP, exposed the lack of accuracy in low grade classification and the inability to include late complications. PMID:24648872

  8. Benign Conditions That Mimic Prostate Carcinoma: MR Imaging Features with Histopathologic Correlation.

    PubMed

    Kitzing, Yu Xuan; Prando, Adilson; Varol, Celi; Karczmar, Gregory S; Maclean, Fiona; Oto, Aytekin

    2016-01-01

    Multiparametric magnetic resonance (MR) imaging combines anatomic and functional imaging techniques for evaluating the prostate and is increasingly being used in diagnosis and management of prostate cancer. A wide spectrum of anatomic and pathologic processes in the prostate may masquerade as prostate cancer, complicating the imaging interpretation. The histopathologic and imaging findings of these potential mimics are reviewed. These entities include the anterior fibromuscular stroma, surgical capsule, central zone, periprostatic vein, periprostatic lymph nodes, benign prostatic hyperplasia (BPH), atrophy, necrosis, calcification, hemorrhage, and prostatitis. An understanding of the prostate zonal anatomy is helpful in distinguishing the anatomic entities from prostate cancer. The anterior fibromuscular stroma, surgical capsule, and central zone are characteristic anatomic features of the prostate with associated low T2 signal intensity due to dense fibromuscular tissue or complex crowded glandular tissue. BPH, atrophy, necrosis, calcification, and hemorrhage all have characteristic features with one or more individual multiparametric MR imaging modalities. Prostatitis constitutes a heterogeneous group of infective and inflammatory conditions including acute and chronic bacterial prostatitis, infective and noninfective granulomatous prostatitis, and malacoplakia. These entities are associated with variable clinical manifestations and are characterized by the histologic hallmark of marked inflammatory cellular infiltration. In some cases, these entities are indistinguishable from prostate cancer at multiparametric MR imaging and may even exhibit extraprostatic extension and lymphadenopathy, mimicking locally advanced prostate cancer. It is important for the radiologists interpreting prostate MR images to be aware of these pitfalls for accurate interpretation. Online supplemental material is available for this article. (©)RSNA, 2015. PMID:26587887

  9. [History of laser in BPH therapy].

    PubMed

    Grande, Marco; Facchini, Francesco; Moretti, Matteo; Larosa, Michelangelo; Leone, Marco; Ziglioli, Francesco; Pozzoli, Gian Luigi; Frattini, Antonio

    2014-01-01

    Laser technology has been used in the treatment of BPH for more than 15-20 years in order to challenge transurethral resection of the prostate. The aim of this review article is to analyze the evolution of laser in BPH therapy, from early coagulative techniques - progressively abandoned for their elevated postoperative morbidity and unfavorable outcomes - to the newer techniques of vaporization, resection and enucleation of the prostate. A better comprehension of tissue-laser interactions, the improvement of laser technology and a growing clinical experience have lead to the development of different laser systems (Holmium, KTP, Thulium laser) that challenge TURP. Today, HoLEP and, secondarily, PVP are the laser techniques supported by more clinical evidences and represent valid alternatives to TURP. PMID:24665033

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

    PubMed Central

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

    2014-01-01

    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

  11. 4-Aminopyridine Improves Lower Urinary Tract Symptoms in a Patient With Benign Prostatic Hyperplasia and Downbeat Nystagmus Syndrome

    PubMed Central

    Feil, Katharina; Bardins, Stanislavs; Waidelich, Raphaela

    2014-01-01

    Aminopyridines are potassium channel blockers that increase the excitability of nerve cells and axons; therefore, they are widely used to treat different neurological disorders. Here we present a patient with idiopathic downbeat nystagmus and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia who was treated with the sustained-release form of 4-aminopyridine (4-AP). During treatment with 4-AP, the LUTS improved. This improvement was monitored by using uroflowmetry and the International Prostate Symptom Score. A significant improvement of symptoms was observed in relation to the voided volume. This included an improved emptying of the bladder without an increase in residual urine. In animal studies, both nonselective K+ channel blockade and selective voltage-sensitive potassium blockade by 4-AP resulted in increased contraction on rat detrusor strips. To our knowledge, this is the first clinical observation of the mode of action of 4-AP in urological symptoms in humans. PMID:25558420

  12. Intraprostatic Botulinum Neurotoxin Type A Injection for Benign Prostatic Hyperplasia—A Spotlight in Reality

    PubMed Central

    Hsu, Yu-Chao; Wang, Hung-Jen; Chuang, Yao-Chi

    2016-01-01

    Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum. It inhibits the release of acetylcholine and other neurotransmitters from the nerve terminal. Botulinum toxin, specifically toxin type A (BoNT-A) has been used since the 1970s to reduce the muscular hypercontraction disorders. The application of BoNT-A in urology field started from intra-bladder injection for overactive bladder, which has been recognized as third line therapy in many countries. Since prostate gland as well as bladder is under the influence of autonomic innervation, theorectically, injection of BoNT-A into the prostate induces chemo-denervation and modulation of prostate function, and reduces lower urinary tract symptoms (LUTS). This article reviews the application of BoNT-A in patients with LUTS/ benign prostatic hyperplasia (BPH) from mechanisms of action to clinical results. BoNT-A has been shown to induce prostate apoptosis, downregulation of alpha 1A receptors, and reduce contractile function of prostate in animal studies. Open studies of intraprostate BoNT-A injection have demonstrated promising results of reducing LUTS and improvement of voiding function in human LUTS/BPH, however, intraprostatic BoNT-A injection did not perform better than the placebo group in recent publications of placebo controlled studies. We suggested that BoNT-A prostate injection might benefit selected population of BPH/LUTS, but it is unlikely to be an effective therapy for general population of male LUTS/BPH. PMID:27128942

  13. Immunomodulatory Effect of Red Onion (Allium cepa Linn) Scale Extract on Experimentally Induced Atypical Prostatic Hyperplasia in Wistar Rats

    PubMed Central

    Elberry, Ahmed A.; Al-Maghrabi, Jaudah; Abdel Sattar, Essam; Ghareib, Salah A.; Mosli, Hisham A.; Gabr, Salah A.

    2014-01-01

    Red onion scales (ROS) contain large amounts of flavonoids that are responsible for the reported antioxidant activity, immune enhancement, and anticancer property. Atypical prostatic hyperplasia (APH) was induced in adult castrated Wistar rats by both s.c. injection of testosterone (0.5 mg/rat/day) and by smearing citral on shaved skin once every 3 days for 30 days. Saw palmetto (100 mg/kg) as a positive control and ROS suspension at doses of 75, 150, and 300 mg/kg/day were given orally every day for 30 days. All medications were started 7 days after castration and along with testosterone and citral. The HPLC profile of ROS methanolic extract displayed two major peaks identified as quercetin and quercetin-4′-β-O-D-glucoside. Histopathological examination of APH-induced prostatic rats revealed evidence of hyperplasia and inflammation with cellular proliferation and reduced apoptosis Immunohistochemistry showed increased tissue expressions of IL-6, IL-8, TNF-α, IGF-1, and clusterin, while TGF-β1 was decreased, which correlates with the presence of inflammation. Both saw palmetto and RO scale treatment have ameliorated these changes. These ameliorative effects were more evident in RO scale groups and were dose dependent. In conclusion, methanolic extract of ROS showed a protective effect against APH induced rats that may be attributed to potential anti-inflammatory and immunomodulatory effects. PMID:24829522

  14. 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

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

    2011-01-01

    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

  15. Systematic review of lower urinary tract symptoms/benign prostatic hyperplasia surgical treatments on men's ejaculatory function: Time for a bespoke approach?

    PubMed

    Marra, Giancarlo; Sturch, Paul; Oderda, Marco; Tabatabaei, Shahin; Muir, Gordon; Gontero, Paolo

    2016-01-01

    Although ejaculatory dysfunction is common for patients undergoing benign prostatic hyperplasia surgery, no clear evidence is present to counsel men seeking to preserve ejaculation. Our aim was to evaluate ejaculatory dysfunction in relation to benign prostatic hyperplasia surgery. We carried out a web and manual search using MEDLINE and Embase including randomized controlled trials reporting ejaculatory dysfunction after benign prostatic hyperplasia surgery: 42 randomized controlled trials comprising a total of 3857 patients were included. Only one study had ejaculatory dysfunction as a primary outcome, and just 10 evaluated ejaculatory dysfunction before and after surgery. The definition of ejaculatory dysfunction was not standardized. Similarly, just seven studies used internationally validated questionnaires to address ejaculatory dysfunction. The reported rates of ejaculatory dysfunction after resectional electrosurgery, laser procedures, coagulation, ablation and implant techniques were assessed and compared. Transurethral resection of the prostate and recent laser procedures including holmium, thulium and GreenLight cause similar rates of ejaculatory dysfunction, occurring in almost three out of four to five men. Although providing less symptomatic benefit compared with transurethral resection of the prostate, transurethral incision of the prostate, transurethral needle ablation and transurethral microwave thermotherapy should be considered for men aiming to maintain normal ejaculation. UroLift is also a recent promising option for this category of patients. The vast majority of studies reporting ejaculatory dysfunction after benign prostatic hyperplasia surgery used poor methodology to investigate this complication. Future studies able to address clear hypothesis and considering ejaculatory dysfunction anatomical and pathophysiological features are required to develop ejaculation preserving techniques and to increase the evidence to counsel men aiming to preserve ejaculation. PMID:26177667

  16. 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

    2014-01-01

    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

  17. Prostate gland development and adrenal tumor in a female with congenital adrenal hyperplasia: a case report and review from radiology perspective.

    PubMed

    Fang, Benjamin; Cho, Francis; Lam, Wendy

    2013-12-01

    We describe a case of a female with simple virilizing congenital adrenal hyperplasia (CAH) reared as a male diagnosed at the late age of 64. Computed Tomography (CT) demonstrated a large adrenal mass, bilateral diffuse adrenal enlargement, female pelvic organs as well as a clearly visualized prostate gland. This is to the best of our knowledge the first case of such a sizable prostate gland in a female CAH patient documented on CT. We review the literature regarding aspects where radiologists may encounter CAH and the finding of presence of a prostate gland in female CAH patients. PMID:24421935

  18. 5-ALA-assisted photodynamic therapy in canine prostates

    NASA Astrophysics Data System (ADS)

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

    1996-05-01

    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.

  19. [Primary candidate rna biomarker screening by RNA-seq for prostate cancer diagnostics].

    PubMed

    Nikitina, A S; Babenko, V V; Babalyan, K A; Vasiliev, A O; Govorov, A V; Prilepskaya, E A; Danilenko, S A; Selezneva, O V; Sharova, E I

    2015-01-01

    The RNA-seq approach for prostate cancer candidate RNA biomarkers screening in plasma and urine obtained by minimally invasive or noninvasive methods is proved to be feasible. Significant amount of RNA biomarkers associated with prostate cancer according to the literature were found in plasma and urine samples obtained from patients with benign prostatic hyperplasia (BPH). The number of detected markers was shown to vary in accordance with method of library preparation used for transcriptome profiling. The detection of known RNA biomarkers for prostate cancer in urine and plasma samples shows the feasibility of such method for minimally invasive diagnostics. The fact of presence of the same RNA biomarkers in samples from patients with BPH suggests their possible lack of specificity and confirms the need for further research in this area. PMID:26716753

  20. alpha(1)-blockers for BPH: are there differences?

    PubMed

    de Mey, C

    1999-01-01

    alpha(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 alpha(1)-blockers do not differ in terms of their clinical efficacy, but there are several indications that alpha(1)-blockers differ qualitatively with regard to their cardiovascular safety and tolerability, albeit the quantification of these differences is subject to several constraints and pitfalls. Clinical selectivity, i.e. the capacity of separating between desired urological and undesired (actually redundant) cardiovascular alpha(1)-blockade is not unlikely to relate to pharmacological selectivity (the relative preference to block the alpha(1A)- and alpha(1D)-adrenoceptor subtypes in vitro, whilst hardly blocking alpha(1B)-adrenoceptors). On the other hand, both clinical and pharmacological selectivity are not unequivocally reflected by experiments on so-called functional selectivity (in vivo experiments that differentiate urological and cardiovascular effects). Generally, alpha(1)-blockers that are efficacious in hypertension (doxazosin, terazosin, alfuzosin) are more likely to impair safety-relevant, physiological blood pressure control in normotensives with LUTS than tamsulosin, which does not reduce elevated blood pressure in comparison with placebo and has little effect on orthostatic blood pressure control. However, clinical selectivity and cardiovascular safety are also defined by the treatment regimen (dose, dosage interval, formulation, step-up dose-increments for treatment initiation, etc.) and by relevant patient-treatment interactions (co-morbidity and co-medication in particular). On the basis of the available information, tamsulosin administered once daily at a dose of 0.4 mg after breakfast (without step-up increments) can be accepted as a highly convenient and efficacious way to treat LUTS with a low cardiovascular safety risk, i.e. with a high level of clinically selectivity. Copyrightz1999S. KargerAG,Basel PMID:10559631

  1. [A Study of the Efficacy of the Additional Administration of Tadalafil in Japanese Men with α1-Blocker-Resistant LUTS/BPH].

    PubMed

    Hayashi, Keiichiro; Fukagai, Takashi; Sasaki, Haruaki; Morita, Masashi; Igarashi, Atsushi; Koshikiya, Atsushi

    2016-03-01

    Alpha 1-blockers are widely used at present for lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). However, some patients experience little improvement of symptoms, and it is difficult to provide additional treatment. We have additionally administered tadalafil to patients with inadequate symptom improvement, despite treatment with alpha-1 blockers. The subjects were 57 patients with a diagnosis of LUTS/BPH who showed a poor response to treatment with alpha-1 blockers for 1 month or more (international prostate symptom score [IPSS] ≥8 and/or quality of life [QOL] index ≥3). Tadalafil 5 mg was administered on consecutive days to patients orally receiving alpha-1 blockers. We determined IPSS, the QOL index, overactive bladder symptom scores (OABSS), maximum urine flow, residual urine volume, and the sexual health inventory for men (SHIM) before, and 4, 8, and 12 weeks after administration, and then evaluated improvement effects. IPSS, the QOL index, OABSS, and SHIM showed significant improvement (P <0.05) at 4 weeks after the start of treatment and onward. IPSS and the QOL index showed greater improvement effects at 8 and 12 weeks. Residual urinary volume was significantly improved only at 8 weeks. However, the maximum urine flow showed no improvement at any time point. Our results demonstrated the additional administration of tadalafil to patients with LUTS showing poor responses to alpha-1 blockers to improve LUTS/BPH symptoms as well as sexual function. PMID:27133883

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

    PubMed

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

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  4. Management of the complications of BPH/BOO

    PubMed Central

    Speakman, Mark J.; Cheng, Xi

    2014-01-01

    Most men will develop histological BPH if they live long enough. Approximately, half will develop benign prostatic enlargement (BPE) and about half of these will get BOO with high bladder pressures and low flow, this in turn leads to detrusor wall hypertrophy. Many of these men will only have lower urinary tract symptoms (LUTS) but a significant number will also suffer the other complications of BPH. These include urinary retention (acute and chronic), haematuria, urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Recognition of the complications of BPH/BOO early allows more effective management of these complications. This is particularly important for the more serious urinary infections and also for high-pressure chronic retention (HPCR). Complications of LUTS/BPH are very rare in clinical trials because of their strict inclusion and exclusion criteria but are more common in real life practice. PMID:24744522

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

    PubMed Central

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

    2012-01-01

    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

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

    NASA Technical Reports Server (NTRS)

    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

    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.

  7. 27-Hydroxycholesterol stimulates cell proliferation and resistance to docetaxel-induced apoptosis in prostate epithelial cells.

    PubMed

    Raza, Shaneabbas; Meyer, Megan; Schommer, Jared; Hammer, Kimberly D P; Guo, Bin; Ghribi, Othman

    2016-02-01

    Although the causes of prostate cancer (PCa) and benign prostatic hyperplasia (BPH) are not known, the role of oxidative stress, aging, and diet are suspected to increase the incidence of prostate complications. The cholesterol oxidation derivative (oxysterol) 27-hydroxycholesterol (27-OHC) is the most prevalent cholesterol metabolite in the blood. As aging, oxidative stress, and hypercholesterolemia are associated with increased risk of PCa and BPH, and because 27-OHC levels are also increased with aging, hypercholesterolemia, and oxidative stress, determining the role of 27-OHC in the progression of PCas and BPH is warranted. In this study, we determined the effect of 27-OHC in human prostate epithelial cells RWPE-1. We found that 27-OHC stimulates proliferation and increases androgen receptor (AR) transcriptional activity. 27-OHC also increased prostate-specific antigen expression and enhanced AR binding to the androgen response element compared to controls. Silencing AR expression with siRNA markedly reduced the 27-OHC-induced proliferation. Furthermore, 27-OHC blocked docetaxel-induced apoptosis. Altogether, our results suggest that 27-OHC may play an important role in PCa and BPH progression by promoting proliferation and suppressing apoptosis. PMID:26732475

  8. Cleveland Clinic experience with interstitial laser coagulation of the prostate

    NASA Astrophysics Data System (ADS)

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

    2000-05-01

    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.

  9. Computer-assisted interstitial laser coagulation for BPH

    NASA Astrophysics Data System (ADS)

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

    2001-06-01

    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.

  10. Relationship of Postoperative Recatheterization and Intraoperative Bladder Distention Volume in Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

    PubMed Central

    Kim, Hyeon Jun; Lee, Han Yi; Song, Sang Hun

    2013-01-01

    Purpose The purpose of this study was to identify the risk factors for recatheterization after holmium laser enucleation of the prostate (HoLEP). Materials and Methods A total of 166 consecutive patients treated with HoLEP by a single surgeon from January 2010 to June 2011 were enrolled in this study. We collected data on preoperative and intraoperative parameters, including intraoperative bladder distention volume. The patients were divided into two groups. Group 1 included patients who voided successfully after removal of the catheter, and group 2 included patients who required recatheterization. Analysis and comparison of the perioperative parameters of both groups was performed for identification of risk factors for recatheterization. Results Recatheterization was required in 9 of 166 (5.4%) patients. No significant differences in age or preoperative parameters, including prostate-specific antigen, prostate volume, International Prostate Symptom Score, peak flow rate, postvoid residual urine, maximal bladder capacity, and Abrahams Griffiths number, were observed between the two groups. Of the intraoperative parameters, intraoperative bladder distention volume was significantly smaller in group 1 than in group 2 (700.65 mL vs. 897.78 mL, p<0.001). In the multivariate logistic regression analysis, after adjustment for other variables, intraoperative bladder distention volume was found to be a statistically significant risk factor for postoperative recatheterization (hazard ratio, 1.006; confidence interval, 1.002 to 1.010; p=0.002). Conclusions Nine of 166 (5.4%) patients failed to void after HoLEP and required catheterization. Intraoperative bladder distention volume was found to be a statistically significant risk factor for recatheterization in this patient group. PMID:23549294

  11. Altered expression of p53, but not Rb, is involved in canine prostatic carcinogenesis.

    PubMed

    Pagliarone, Simone; Frattone, Luca; Pirocchi, Valeria; Della Salda, Leonardo; Palmieri, Chiara

    2016-04-01

    Abnormalities in the retinoblastoma (Rb) and p53 tumour suppressor gene have been frequently detected in human and canine cancers, but never investigated in canine prostate cancer, considered a good model for the advanced and aggressive androgen-resistant prostate cancer in men. Therefore, the aim of this study was to evaluate the immunohistochemical expression of Rb and p53 in 6 normal canine prostates, 15 canine prostates with benign prostatic hyperplasia (BPH) and 10 prostatic carcinomas (PCs). In all normal samples, p53 was expressed in low number of epithelial cells, while a greater number of positive cells were observed in BPH and PC. The mean number of positive cells was statistically significantly higher in PCs than normal and hyperplastic prostates. A cytoplasmic or nucleo-cytoplasmic staining was observed in 5 out of 10 PCs. Rb protein was expressed in high number of normal, hyperplastic and neoplastic cells without a statistically significant differences. Considering that Rb is frequently lost in human prostate cancer, we suggest that Rb is not involved in canine prostatic carcinogenesis. On the other hand, the increased expression of p53 that corresponds to genetic defects in the p53 gene may be associated with the malignant growth of canine prostate cancer, conferring an apoptosis-resistant phenotype. PMID:27033932

  12. Association of Diet With Prostate Specific Antigen and Prostate Volume

    PubMed Central

    Shirazi, Mehdi; Ariafar, Ali; Zeyghami, Shahryar; Hosseini, Mohammad Mehdi; Khezri, Abdol Aziz

    2014-01-01

    Background: Prostate is an important male reproductive system gland and its disorders can affect men's quality of life and health. Prostatitis, benign prostatic hyperplasia (BPH), and prostate adenocarcinoma are major disorders that can be found in all men in different ages. Objectives: The aim of this study was to investigate the association of diet with serum prostate specific antigen (PSA) level as well as prostate volume. Patients and Methods: In this cross-sectional study, 950 men older than 40 years of age who had attended our clinic for a screening program for prostate cancer were enrolled. Data was extracted from the program database. The eligible cases included all noncancerous subjects with available data concerning serum PSA level and prostate volume; the patients had completed a 50-item self-administered food frequency questionnaire about their diet during the preceding two year. Results: No overall association was found between the consumption of foods and prostate volume as well as serum PSA level. There was a significant correlations between age and serum PSA level (r = 0.24) as well as with prostate volume (r = 0.22) (P < 0.001). In addition, there was a significant correlation between serum PSA level and prostate volume (r = 0.41 and P < 0.001). Conclusions: The results of this study confirmed the previous reports regarding the serum PSA level correlation with prostate volume. There was no evidence that dietary patterns might have any important effect on prostate volume and serum PSA in this Iranian population. PMID:25695023

  13. Prostate Problems

    MedlinePlus

    ... surgery. • Other treatments . Sometimes radio waves, microwaves, or lasers are used to treat urinary problems caused by BPH. These methods use different kinds of heat to reduce extra prostate tissue. F Acute bacterial ...

  14. Clinical study on the application of a 2-μm continuous wave laser in transurethral vaporesection of the prostate

    PubMed Central

    XU, YONG; SUN, DONGCHONG; WEI, ZHITAO; HONG, BAOFA; YANG, YONG

    2013-01-01

    The present study aimed to evaluate the method and clinical effects of transurethral dividing vaporesection of the prostate in the management of benign prostatic hyperplasia (BPH) using the RevoIix 70 W 2-μm continuous wave (cw) laser. A total of 155 BPH patients were treated transurethrally under epidural or sacral anesthesia using the dividing vaporesection technique. Of these, 80 had a prostate volume of ≤80 ml and 75 had a prostate volume of >80 ml. Pre- and post-operative data were evaluated for prostate-specific antigens (PSAs), post-void residual volume (PVR), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS) and quality of life (QoL). Statistical analyses were performed using the SPSS 16.0 software. Treatment effectiveness evaluations were also conducted. In the ≤80 ml prostate volume group, the mean PSA level decreased from 3.8±0.9 to 2.6±1.3 ng/ml. The PVR, mean Qmax, IPSS and QoL score improved significantly (P<0.05) in each group but no statistically significant difference was identified between the two groups. With a shorter surgery duration, safe use and high cutting efficiency and rapid vaporization ability, the 2-μm laser vaporesection technique shows superiority compared to standard techniques in the treatment of BPH. PMID:23596476

  15. New Multi-target Antagonists of α1A-, α1D-Adrenoceptors and 5-HT1A Receptors Reduce Human Hyperplastic Prostate Cell Growth and the Increase of Intraurethral Pressure.

    PubMed

    Nascimento-Viana, Jéssica B; Carvalho, Aline R; Nasciutti, Luiz Eurico; Alcántara-Hernández, Rocío; Chagas-Silva, Fernanda; Souza, Pedro A R; Romeiro, Luiz Antonio S; García-Sáinz, J Adolfo; Noël, François; Silva, Claudia Lucia Martins

    2016-01-01

    Benign prostatic hyperplasia (BPH) is characterized by stromal cell proliferation and contraction of the periurethral smooth muscle, causing lower urinary tract symptoms. Current BPH treatment, based on monotherapy with α1A-adrenoceptor antagonists, is helpful for many patients, but insufficient for others, and recent reports suggest that stimulation of α1D-adrenoceptors and 5-hydroxytryptamine (serotonin) (5-HT)1A receptors contributes to cell proliferation. In this study, we investigated the potential of three N-phenylpiperazine derivatives (LDT3, LDT5, and LDT8) as multi-target antagonists of BPH-associated receptors. The affinity and efficacy of LDTs were estimated in isometric contraction and competition-binding assays using tissues (prostate and aorta) and brain membrane samples enriched in specific on- or off-target receptors. LDTs' potency was estimated in intracellular Ca(2+) elevation assays using cells overexpressing human α1-adrenoceptor subtypes. The antiproliferative effect of LDTs on prostate cells from BPH patients was evaluated by viable cell counting and 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyl tetrazolium bromide assays. We also determined LDTs' effects on rat intraurethral and arterial pressure. LDT3 and LDT5 are potent antagonists of α1A-, α1D-adrenoceptors, and 5-HT1A receptors (Ki values in the nanomolar range), and fully inhibited phenylephrine- and 5-HT-induced proliferation of BPH cells. In vivo, LDT3 and LDT5 fully blocked the increase of intraurethral pressure (IUP) induced by phenylephrine at doses (ED50 of 0.15 and 0.09 μg.kg(-1), respectively) without effect on basal mean blood pressure. LDT3 and LDT5 are multi-target antagonists of key receptors in BPH, and are capable of triggering both prostate muscle relaxation and human hyperplastic prostate cell growth inhibition in vitro. Thus, LDT3 and LDT5 represent potential new lead compounds for BPH treatment. PMID:26493747

  16. Vitamin K: the missing link to prostate health.

    PubMed

    Donaldson, Michael S

    2015-03-01

    Though age-related prostate enlargement is very common in Western societies, and the causes of benign prostate hyperplasia, BPH, have been diligently sought after, there is no biological, mechanistic explanation dealing with the root causes and progression of this very common disorder among men. All treatments to date are based on symptomatic relief, not a fundamental understanding of the cause of the disease. However, recent advances have shown that even subclinical varicoceles, which are more common than generally realized, cause retrograde blood flow from the testes past the prostate gland causing over a 130-fold increase in free testosterone in the veins near the prostate. By treating the varicoceles via embolization of the internal spermatic vein and its communicating and connected vessels the prostate enlargement can be reversed with corresponding symptomatic relief. So, varicose veins in the pampiniform venous plexus, varicoceles, are the direct cause of BPH. But what causes varicoceles? Recent research has uncovered the role of vitamin K in the calcification of varicose veins as well as a role in the proliferation of smooth muscle cells in the media layer of the vein wall. Vitamin K is intimately involved in the formation of varicose veins. The hypothesis is that poor prostate health is essentially a vitamin K insufficiency disorder. By providing vitamin K in the right form and quantity, along with other supporting nutrients and phytochemicals, it is likely that excellent prostate health can be extended much longer, and perhaps poor prostate health can be reversed. A protective role for vitamin K with respect to advanced prostate cancer was already found in the Heidelberg cohort of the EPIC study. This hypothesis can be further evaluated in studies examining the connection between vitamin K and varicoceles, and also by examining the connection between varicoceles and benign prostate hyperplasia. If this hypothesis is found to be true, management of prostate health will be radically altered. Rather than focusing on prostate health as a hormonal imbalance, prostate enlargement will be seen as a result of poor health of the veins in general and the internal spermatic veins in particular. Factors which promote the health of the veins will become a greater focus of research, including the role of vitamin K. Finally, the emerging understanding of the cause of BPH will empower men to take care of their bodies so they can enjoy much better health through their entire lifespan. PMID:25613567

  17. Moxibustion as an adjuvant for benign prostatic hyperplasia with lower urinary tract symptoms: a protocol for a parallel-group, randomised, controlled pilot trial

    PubMed Central

    Lee, Hye-Yoon; Nam, Jong-Kil; Lee, Sang-Don; Lee, Dong-Hoon; Han, Ji-Yeon; Yun, Young-Ju; Lee, Ji-Hye; Park, Hye-lim; Park, Seong-Ha; Kwon, Jung-Nam

    2015-01-01

    Introduction This study aims to explore the feasibility of using moxibustion as a supplementary intervention and to assess the sample size for verifying the effectiveness and safety of integrative treatment involving moxibustion compared with conventional treatment for patients with benign prostatic hyperplasia accompanying moderate to severe lower urinary tract symptoms. Methods and analysis A total of 60 patients diagnosed with benign prostatic hyperplasia by a urologist based on prostate size, prostate-specific antigen and clinical symptoms will participate of their own free will; urologists will monitor the patients and evaluate their symptoms. The patients will be randomised to either a conventional group or an integrative group with a 1:1 allocation according to computer-generated random numbers concealed in opaque, sealed, sequentially numbered envelopes. Watchful waiting or oral medication including α blocker, 5α-reductase inhibitors or antimuscarinic drugs will be offered as conventional treatment. Integrative treatment will include moxibustion therapy in addition to the conventional treatment. The moxibustion therapy will be conducted twice a week for 4 weeks on the bilateral acupoints SP6, LR3 and CV4 by a qualified Korean medical doctor. The primary outcome will be the International Prostate Symptom Score (IPSS) after eight sessions. The secondary outcomes will be the post-void residual urine volume, the maximum urinary flow rate, IPSS, the results of a Short-Form 36-Question Health Survey after 12 weeks, and the patients’ global impression of changes at each visit. Ethics and dissemination Written informed consent will be obtained from all participants. This study was approved by the institutional review boards of both Pusan National University Yangsan Hospital and Pusan National University Korean Medicine Hospital. The trial results will be disseminated through open-access journals and conferences. Trial registration number NCT02051036. PMID:26656981

  18. Testosterone and 17β-estradiol induce glandular prostatic growth, bladder outlet obstruction, and voiding dysfunction in male mice.

    PubMed

    Nicholson, Tristan M; Ricke, Emily A; Marker, Paul C; Miano, Joseph M; Mayer, Robert D; Timms, Barry G; vom Saal, Frederick S; Wood, Ronald W; Ricke, William A

    2012-11-01

    Benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO) are common in older men and can contribute to lower urinary tract symptoms that significantly impact quality of life. Few existing models of BOO and BPH use physiological levels of hormones associated with disease progression in humans in a genetically manipulable organism. We present a model of BPH and BOO induced in mice with testosterone (T) and 17β-estradiol (E(2)). Male mice were surgically implanted with slow-releasing sc pellets containing 25 mg T and 2.5 mg E(2) (T+E(2)). After 2 and 4 months of hormone treatment, we evaluated voiding patterns and examined the gross morphology and histology of the bladder, urethra, and prostate. Mice treated with T+E(2) developed significantly larger bladders than untreated mice, consistent with BOO. Some mice treated with T+E(2) had complications in the form of bladder hypertrophy, diverticula, calculi, and eventual decompensation with hydronephrosis. Hormone treatment caused a significant decrease in the size of the urethral lumen, increased prostate mass, and increased number of prostatic ducts associated with the prostatic urethra, compared with untreated mice. Voiding dysfunction was observed in mice treated with T+E(2), who exhibited droplet voiding pattern with significantly decreased void mass, shorter void duration, and fewer sustained voids. The constellation of lower urinary tract abnormalities, including BOO, enlarged prostates, and voiding dysfunction seen in male mice treated with T+E(2) is consistent with BPH in men. This model is suitable for better understanding molecular mechanisms and for developing novel strategies to address BPH and BOO. PMID:22948219

  19. Testosterone and 17β-Estradiol Induce Glandular Prostatic Growth, Bladder Outlet Obstruction, and Voiding Dysfunction in Male Mice

    PubMed Central

    Nicholson, Tristan M.; Ricke, Emily A.; Marker, Paul C.; Miano, Joseph M.; Mayer, Robert D.; Timms, Barry G.; vom Saal, Frederick S.; Wood, Ronald W.

    2012-01-01

    Benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO) are common in older men and can contribute to lower urinary tract symptoms that significantly impact quality of life. Few existing models of BOO and BPH use physiological levels of hormones associated with disease progression in humans in a genetically manipulable organism. We present a model of BPH and BOO induced in mice with testosterone (T) and 17β-estradiol (E2). Male mice were surgically implanted with slow-releasing sc pellets containing 25 mg T and 2.5 mg E2 (T+E2). After 2 and 4 months of hormone treatment, we evaluated voiding patterns and examined the gross morphology and histology of the bladder, urethra, and prostate. Mice treated with T+E2 developed significantly larger bladders than untreated mice, consistent with BOO. Some mice treated with T+E2 had complications in the form of bladder hypertrophy, diverticula, calculi, and eventual decompensation with hydronephrosis. Hormone treatment caused a significant decrease in the size of the urethral lumen, increased prostate mass, and increased number of prostatic ducts associated with the prostatic urethra, compared with untreated mice. Voiding dysfunction was observed in mice treated with T+E2, who exhibited droplet voiding pattern with significantly decreased void mass, shorter void duration, and fewer sustained voids. The constellation of lower urinary tract abnormalities, including BOO, enlarged prostates, and voiding dysfunction seen in male mice treated with T+E2 is consistent with BPH in men. This model is suitable for better understanding molecular mechanisms and for developing novel strategies to address BPH and BOO. PMID:22948219

  20. Farming, reported pesticide use, and prostate cancer.

    PubMed

    Ragin, Camille; Davis-Reyes, Brionna; Tadesse, Helina; Daniels, Dennis; Bunker, Clareann H; Jackson, Maria; Ferguson, Trevor S; Patrick, Alan L; Tulloch-Reid, Marshall K; Taioli, Emanuela

    2013-03-01

    Prostate cancer is the leading cancer type diagnosed in American men and is the second leading cancer diagnosed in men worldwide. Although studies have been conducted to investigate the association between prostate cancer and exposure to pesticides and/or farming, the results have been inconsistent. We performed a meta-analysis to summarize the association of farming and prostate cancer. The PubMed database was searched to identify all published case-control studies that evaluated farming as an occupational exposure by questionnaire or interview and prostate cancer. Ten published and two unpublished studies were included in this analysis, yielding 3,978 cases and 7,393 controls. Prostate cancer cases were almost four times more likely to be farmers compared with controls with benign prostate hyperplasia (BPH; meta odds ratio [OR], crude = 3.83, 95% confidence interval [CI] = 1.96-7.48, Q-test p value = .352; two studies); similar results were obtained when non-BPH controls were considered, but with moderate heterogeneity between studies (meta OR crude = 1.38, 95% CI = 1.16-1.64, Q-test p value = .216, I (2) = 31% [95% CI = 0-73]; five studies). Reported pesticide exposure was inversely associated with prostate cancer (meta OR crude = 0.68, 95% CI = 0.49-0.96, Q-test p value = .331; four studies), whereas no association with exposure to fertilizers was observed. Our findings confirm that farming is a risk factor for prostate cancer, but this increased risk may not be due to exposure to pesticides. PMID:22948300

  1. Widespread telomere instability in prostatic lesions.

    PubMed

    Tu, LiRen; Huda, Nazmul; Grimes, Brenda R; Slee, Roger B; Bates, Alison M; Cheng, Liang; Gilley, David

    2016-05-01

    A critical function of the telomere is to disguise chromosome ends from cellular recognition as double strand breaks, thereby preventing aberrant chromosome fusion events. Such chromosome end-to-end fusions are known to initiate genomic instability via breakage-fusion-bridge cycles. Telomere dysfunction and other forms of genomic assault likely result in misregulation of genes involved in growth control, cell death, and senescence pathways, lowering the threshold to malignancy and likely drive disease progression. Shortened telomeres and anaphase bridges have been reported in a wide variety of early precursor and malignant cancer lesions including those of the prostate. These findings are being extended using methods for the analysis of telomere fusions (decisive genetic markers for telomere dysfunction) specifically within human tissue DNA. Here we report that benign prostatic hyperplasia (BPH), high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer (PCa) prostate lesions all contain similarly high frequencies of telomere fusions and anaphase bridges. Tumor-adjacent, histologically normal prostate tissue generally did not contain telomere fusions or anaphase bridges as compared to matched PCa tissues. However, we found relatively high levels of telomerase activity in this histologically normal tumor-adjacent tissue that was reduced but closely correlated with telomerase levels in corresponding PCa samples. Thus, we present evidence of high levels of telomere dysfunction in BPH, an established early precursor (PIN) and prostate cancer lesions but not generally in tumor adjacent normal tissue. Our results suggest that telomere dysfunction may be a common gateway event leading to genomic instability in prostate tumorigenesis. © 2015 Wiley Periodicals, Inc. PMID:25917938

  2. ProNGF correlates with Gleason score and is a potential driver of nerve infiltration in prostate cancer.

    PubMed

    Pundavela, Jay; Demont, Yohann; Jobling, Phillip; Lincz, Lisa F; Roselli, Severine; Thorne, Rick F; Bond, Danielle; Bradshaw, Ralph A; Walker, Marjorie M; Hondermarck, Hubert

    2014-12-01

    Nerve infiltration is essential to prostate cancer progression, but the mechanism by which nerves are attracted to prostate tumors remains unknown. We report that the precursor of nerve growth factor (proNGF) is overexpressed in prostate cancer and involved in the ability of prostate cancer cells to induce axonogenesis. A series of 120 prostate cancer and benign prostate hyperplasia (BPH) samples were analyzed by IHC for proNGF. ProNGF was mainly localized in the cytoplasm of epithelial cells, with marked expression in cancer compared with BPH. Importantly, the proNGF level positively correlated with the Gleason score (n = 104, τB = 0.51). A higher level of proNGF was observed in tumors with a Gleason score of ≥8 compared with a Gleason score of 7 and 6 (P < 0.001). In vitro, proNGF was detected in LNCaP, DU145, and PC-3 prostate cancer cells and BPH-1 cells but not in RWPE-1 immortalized nontumorigenic prostate epithelial cells or primary normal prostate epithelial cells. Co-culture of PC12 neuronal-like cells or 50B11 neurons with PC-3 cells resulted in neurite outgrowth in neuronal cells that was inhibited by blocking antibodies against proNGF, indicating that prostate cancer cells can induce axonogenesis via secretion of proNGF. These data reveal that ProNGF is a biomarker associated with high-risk prostate cancers and a potential driver of infiltration by nerves. PMID:25285721

  3. [Drug therapy of benign prostatic hyperplasia. Is combination therapy with 5 alpha-reductase inhibitors and alpha-receptor blockers effective?].

    PubMed

    Horninger, W; Bartsch, G

    2002-09-01

    5 alpha-reductase inhibitors and alpha 1-receptor blockers are the two main drug therapies used in the management of symptomatic benign prostatic hyperplasia. As alpha-reductase inhibitors and alpha 1-receptor blockers act through different mechanisms, a combination of the two agents might be promising. The potential benefits of combination therapy with selective alpha 1-receptor blockers and finasteride, a 5 alpha-reductase inhibitor, are currently being evaluated in several placebo-controlled prospective multicenter studies (VA Study, ALFIN Study, PREDICT Study, and MTOPS Study). The data from these studies available so far demonstrate a statistically significant benefit for the study groups receiving alpha 1-receptor blockers and combination therapy vs placebo and finasteride monotherapy in terms of symptom scores and peak urine flow rates. However, none of the studies yielded a statistically significant advantage of combination therapy over treatment with alpha 1-receptor blockers. These results should be interpreted with reference to the prostatic volume, which in the studies mentioned above was relatively low. From the results of all these studies, it can be concluded that in symptomatic patients with prostate volumes of up to 40-45 ml a combination of 5 alpha-reductase inhibitors with alpha 1-receptor blockers does not appear to provide any benefit. Yet, it can be assumed that in symptomatic patients with prostate volumes of more than 60 ml combination therapy may indeed prove more effective. PMID:12426860

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

    PubMed Central

    Szopinski, Tomasz; Chlosta, Piotr; Borówka, Andrzej

    2014-01-01

    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

  5. Systematic review and meta-analysis on phosphodiesterase 5 inhibitors and α-adrenoceptor antagonists used alone or combined for treatment of LUTS due to BPH

    PubMed Central

    Wang, Xing-Huan; Wang, Xiao; Shi, Ming-Jun; Li, Sheng; Liu, Tao; Zhang, Xin-Hua

    2015-01-01

    The aim of this systematic review is to determine the comparative effectiveness and safety of phosphodiesterase 5 inhibitors (PDE5-Is) and α-blockers used alone or combined for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). An electronic search of PubMed, Cochrane Library and Embase up to January 2014 was performed to identify randomized controlled trials comparing the efficacy and safety of PDE5-Is and α-blockers for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia, which assessed IPSS score, maximum flow rate, postvoided residual urine, quality of life and Erectile Function (IIEF) score as outcomes. Data were analyzed by fixed or random effect models using Cochrane Collaboration review manager software. A total of 12 studies were included. Our novel data demonstrated that there was a trend that α-blockers were more efficacious than PDE5-Is on decreasing IPSS score and increasing maximum flow rate. α-blockers were significantly more effective than PDE5-Is on reduction of postvoided residual urine with a mean difference of 3.67 (95% CI 1.56 to 5.77, P = 0.0006) and PDE5-Is showed greater effect than α-blockers on increasing IIEF score with a mean difference of 9.82 (95% CI 3.80 to 15.85, P = 0.001). In conclusion, our novel data demonstrated that PDE5-Is plus ABs ranked the highest on the improvement of LUTS/BPH. PDE5-Is monotherapy was also effective in this kind of disorder except less reduction of PVR than ABs. In addition, both combined- or mono-therapy were safe. PMID:25994648

  6. AB13. Long-term results of thulium laser resection of the prostate: a prospective study at multiple centers

    PubMed Central

    Xia, Shu-Jie

    2014-01-01

    Purpose To evaluate the long-term durability and complication rates after thulium laser resection of prostate through a prospective multiple centers study. Materials and Methods From November 2004 to December 2011, we prospectively studied 2216 patients with symptomatic begin prostatic hyperplasia (BPH) treated with thulium laser resection of the prostate at four medical centers. Patients were assessed on International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax) and postvoid residual urine (PVR). Perioperative complications were classified according to the modified Clavien classification system (CCS). Results Mean follow-up was 5 years (range: 1 to 8 years). Postoperatively, IPSS, QoL, Qmax and PVR showed a significant improvement from 3 month after surgery and remained significantly improved during the entire follow-up period (P<0.01). Minor complications occurred in 526 (23.7%) of the 2216 patients (Clavien 1: 21.5%; Clavien 2: 2.3%). Major complications requiring re-interventions occurred in 48 (2.2%) of the 2216 patients (Clavien 3: 2.2%). No Clavien 4 or Clavien 5 complication had occurred. Urethral stricture and bladder neck contracture occurred in 2.6% [58] and 1.6% [35] patients, respectively. Re-operation as a result of BPH recurrence was required in 1.2% [27] patients. Conclusions Thulium laser resection of the prostate is a safe and effective procedure with excellent durability in the treatment of symptomatic BPH.

  7. Comparative study of serum zinc concentrations in benign and malignant prostate disease: A Systematic Review and Meta-Analysis.

    PubMed

    Zhao, Jiang; Wu, Qingjiang; Hu, Xiaoyan; Dong, Xingyou; Wang, Liang; Liu, Qian; Long, Zhou; Li, Longkun

    2016-01-01

    Many studies have investigated the relationship between serum zinc concentration and prostatic disease, but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the correlation between serum zinc concentration and prostate disease. Systematic literature searches were conducted with PubMed, EMBASE, Science Direct/Elsevier, MEDLINE, CNKI and the Cochrane Library up to June 2015 for studies that involved the relationship between serum zinc concentration and prostate disease. Fourteen studies were identified from the databases. Our results illustrated that the serum zinc concentrations in prostate cancer patients were significantly lower than those in Benign prostatic hyperplasia (BPH) patients and normal controls (SMD (95% CI), -0.94 [-1.57, -0.32]; -1.18 [-1.90, -0.45]). However, the serum zinc concentrations in BPH patients were significantly higher than those in normal controls (SMD (95% CI) 1.77 [0.15, 3.39]). The present study showed that different levels of serum zinc concentrations are correlated with different prostatic disease. Serum zinc concentration may be used as a tool for the diagnosis and screening of prostate disease. But, further studies with well-designed larger sample studies are needed in this field to further clarify the correlation between serum zinc concentration and prostate disease. PMID:27170414

  8. Comparative study of serum zinc concentrations in benign and malignant prostate disease: A Systematic Review and Meta-Analysis

    PubMed Central

    Zhao, Jiang; Wu, Qingjiang; Hu, Xiaoyan; Dong, Xingyou; Wang, Liang; Liu, Qian; Long, Zhou; Li, Longkun

    2016-01-01

    Many studies have investigated the relationship between serum zinc concentration and prostatic disease, but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the correlation between serum zinc concentration and prostate disease. Systematic literature searches were conducted with PubMed, EMBASE, Science Direct/Elsevier, MEDLINE, CNKI and the Cochrane Library up to June 2015 for studies that involved the relationship between serum zinc concentration and prostate disease. Fourteen studies were identified from the databases. Our results illustrated that the serum zinc concentrations in prostate cancer patients were significantly lower than those in Benign prostatic hyperplasia (BPH) patients and normal controls (SMD (95% CI), −0.94 [−1.57, −0.32]; −1.18 [−1.90, −0.45]). However, the serum zinc concentrations in BPH patients were significantly higher than those in normal controls (SMD (95% CI) 1.77 [0.15, 3.39]). The present study showed that different levels of serum zinc concentrations are correlated with different prostatic disease. Serum zinc concentration may be used as a tool for the diagnosis and screening of prostate disease. But, further studies with well-designed larger sample studies are needed in this field to further clarify the correlation between serum zinc concentration and prostate disease. PMID:27170414

  9. Hi-tech of the prostate: interstitial laser coagulation of benign prostatic hypertrophy

    NASA Astrophysics Data System (ADS)

    Muschter, Rolf; Hofstetter, Alfons G.; Hessel, Stefan F. F.; Keiditsch, Ernst; Rothenberger, Karl-Heinz; Schneede, Peter; Frank, Klaus H.

    1992-06-01

    We report on the new technique of interstitial laser coagulation of the prostate (ILCP) in the treatment of benign prostatic hyperplasia (BPH). Basic experiments by use of a Nd:YAG laser in combination with a newly designed fiber tip homogeneously distributing the laser irradiation have been performed in potato, muscle, liver, and surgically removed human BPH-tissue to determine the volume of coagulation. The coagulation zone surrounding the probe was well defined and homogeneous. The size was dependent on laser power and irradiation time. Carbonization was never present except in darker tissues irradiated with high energy. Volume and time resolved measurements correlated well with the size of coagulation. 10 W and 5 minutes, for example, resulted in a coagulation zone of 17 X 15 mm. Comparable results have been seen in in-vivo experiments in surgically exposed canine prostates. Specimen for macroscopic and microscopic examination were taken immediately after treatment and after 5 and 35 days. The well demarked coagulation necrosis of the early stage resulted in cystic degeneration and fibrosis in the later stages. This was combined with shrinkage and reduction in volume. The urothelium of the urethra, the external sphincter and the rectum showed no damage. Until now, 15 patients suffering from obstructive symptoms due to BPH have been treated with interstitial laser coagulation. The probes were inserted from the perineum into the center of each lateral lobe of the prostate by transrectal ultrasound guidance, while the median lobe was treated by urethroscopic guidance, while the median lobe was treated by urethroscopic control. Dependent on the size of the prostate irradiation, time was 5 to 10 minutes per lobe at a power setting of 5 to 10 W.

  10. Cardiovascular effects of alpha-blockers used for the treatment of symptomatic BPH: impact on safety and well-being.

    PubMed

    de Mey, C

    1998-01-01

    Alpha-adrenoceptor antagonists (alpha-blockers) are efficacious in treating lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO), also termed symptomatic benign prostatic hyperplasia (BPH), causing bladder outlet obstruction (BOO). There is little difference among the various alpha-blockers in terms of efficacy in treating LUTS. However, conventional quinazoline derivatives such as terazosin, doxazosin and alfuzosin, originally developed for hypertension, have inherent cardiovascular extension effects, which influence the well being and safety of patients with LUTS by impairing physiological blood pressure (BP) control, even when their effect on unchallenged BP may be quite low. Preclinically, tamsulosin, a sulphonamide-substituted phenethylamine, has a relative selectivity for the alpha 1-adrenoceptors of the lower urinary tract. Clinically, this is associated with fewer cardiovascular extension effects with tamsulosin (modified release capsule) 0.4 mg once daily. This allows the use of convenient regimens of 0.4 mg tamsulosin administered once daily after breakfast from initiation of treatment without the need for 'step-up' increases of dose to avoid 'first-dose' hypotension. Extensive investigation, including multiple orthostatic stress testing (which otherwise is unusual in the characterization of alpha-blockers because of their inherent safety), confirms that tamsulosin 0.4 mg definitely carries a lower risk of impaired BP control. PMID:9732825

  11. 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 ...

  12. Alpha 2 adrenergic receptors in hyperplastic human prostate: identification and characterization using (/sup 3/H) rauwolscine

    SciTech Connect

    Shapiro, E.; Lepor, H.

    1986-05-01

    (/sup 3/H)Rauwolscine ((/sup 3/H)Ra), a selective ligand for the alpha 2 adrenergic receptor, was used to identify and characterize alpha 2 adrenergic receptors in prostate glands of men with benign prostatic hyperplasia. Specific binding of (/sup 3/H)Ra to prostatic tissue homogenates was rapid and readily reversible by addition of excess unlabelled phentolamine. Scatchard analysis of saturation experiments demonstrates a single, saturable class of high affinity binding sites (Bmax = 0.31 +/- 0.04 fmol./microgram. DNA, Kd = 0.9 +/- 0.11 nM.). The relative potency of alpha adrenergic drugs (clonidine, alpha-methylnorepinephrine and prazosin) in competing for (/sup 3/H)Ra binding sites was consistent with the order predicted for an alpha 2 subtype. The role of alpha 2 adrenergic receptors in normal prostatic function and in men with bladder outlet obstruction secondary to BPH requires further investigation.

  13. Analytical Validation of Serum Proteomic Profiling for Diagnosis of Prostate Cancer: Sources of Sample Bias

    PubMed Central

    McLerran, Dale; Grizzle, William E.; Feng, Ziding; Bigbee, William L.; Banez, Lionel L.; Cazares, Lisa H.; Chan, Daniel W.; Diaz, Jose; Izbicka, Elzbieta; Kagan, Jacob; Malehorn, David E.; Malik, Gunjan; Oelschlager, Denise; Partin, Alan; Randolph, Timothy; Rosenzweig, Nicole; Srivastava, Shiv; Srivastava, Sudhir; Thompson, Ian M.; Thornquist, Mark; Troyer, Dean; Yasui, Yutaka; Zhang, Zhen; Zhu, Liu; Semmes, O. John

    2012-01-01

    BACKGROUND This report and a companion report describe a validation of the ability of serum proteomic profiling via SELDI-TOF mass spectrometry to detect prostatic cancer. Details of this 3-stage process have been described. This report describes the development of the algorithm and results of the blinded test for stage 1. METHODS We derived the decision algorithm used in this study from the analysis of serum samples from patients with prostate cancer (n = 181) and benign prostatic hyperplasia (BPH) (n = 143) and normal controls (n = 220). We also derived a validation test set from a separate, geographically diverse set of serum samples from 42 prostate cancer patients and 42 controls without prostate cancer. Aliquots were subjected to randomization and blinded analysis, and data from each laboratory site were subjected to the decision algorithm and decoded. RESULTS Using the data collected from the validation test set, the decision algorithm was unsuccessful in separating cancer from controls with any predictive utility. Analysis of the experimental data revealed potential sources of bias. CONCLUSION The ability of the decision algorithm to successfully differentiate between prostate cancer, BPH, and control samples using data derived from serum protein profiling was compromised by bias. PMID:17981926

  14. [Use of UroLume as an alternative to the treatment of recurrent stenosis of bulbar urethra and obstructive prostatic hyperplasia in patients with high surgical risk].

    PubMed

    Serrano-Brambila, Eduardo A; Camacho-Carvajal, Juan Carlos; Moreno-Aranda, Jorge; Martínez-Sánchez, Raul

    2003-01-01

    This device consists of a woven in a form of a tubular mesh, made up for the use in the urethra. We report the clinical and uroflujometric results in 10 patients with urethral stricture and 4 with obstructive prostatic hyperplasia. The study includes a 7 year period since October of 1993 up until June 2000. All patients were evaluated pre and post stent insertion with periodic follow ups to assess the prostatic symptoms score, quality of life assessment, peak urinary flow rate, mean flow rate and post-void residual urine volume. The results were the following: For the group with urethral stricture the I-PSS decreased from 26.8 to 5.4 points, the peak flow rate increased from 8.24 to 16.12 mL/sec and the post-void residual urine volume decreased from 42.7 to 31.6 mL. By 12-month follow-up most endoprostheses were 90% covered with urothelium, only one of these patients required stent extraction with no sphincter lesion. For the prosthatic hyperplasia group the I-PSS decreased from 20.2 to 8 points. The peak flow rate increased from 6.95 to 14.5 mL/sec and the post-void residual urine volume decreased from 49 to 18.3 mL. By 12-month follow-up two patients were 95% covered with epithelium, and the other two were 70%. There have not been significant problems related to infections, migration, incontinence or erectile disfunction. An 80% of patients have shown some irritative symptoms (urgency, frequency or dysuria) at least during the first month after stent insertion. These 7 year results suggest that Urolume urethral endoprostheses can be a long-term effective treatment alternative to these patients. PMID:14635562

  15. Alterations in mechanical properties are associated with prostate cancer progression.

    PubMed

    Wang, Xuejian; Wang, Jianbo; Liu, Yingxi; Zong, Huafeng; Che, Xiangyu; Zheng, Wei; Chen, Feng; Zhu, Zheng; Yang, Deyong; Song, Xishuang

    2014-03-01

    Cancer progression and metastasis have been shown to be accompanied by alterations in the mechanical properties of tissues, but the relationship between the mechanical properties and malignant behavior in prostate cancer (Pca) is less clear. The aims of this study were to detect the mechanical properties of benign prostatic hyperplasia (BPH) and Pca tissues on both the macro- and micro-scales, to explore the relationships between mechanical properties and malignant behavior and, finally, to identify the important molecules in the mechanotransduction signaling pathway. We demonstrated that the strain index of Pca tissue was significantly higher than that of BPH tissue on the macro-scale but the Young's modulus of the Pca tissues, especially in advanced Pca, was lower than that of BPH tissues on the micro-scale. These two seemingly contradictory results can be explained by the excessive proliferation of tumor cells (Ki-67) and the degradation of scaffold proteins (collagens). These data indicate that alterations of the macro- and micro-mechanical properties of Pca tissues with malignant behavior are contradictory. The mechanical properties of tissues might be useful as a new risk factor for malignancy and metastasis in Pca. Furthermore, collagens, matrix metalloproteinase, fibronectin, and integrins might be the important molecules in the mechanotransduction signaling pathway. PMID:24504844

  16. High Milk Consumption Does Not Affect Prostate Tumor Progression in Two Mouse Models of Benign and Neoplastic Lesions

    PubMed Central

    Boutillon, Florence; Verkarre, Virginie; Camparo, Philippe; Viltard, Mélanie; Méjean, Arnaud; Oudard, Stéphane; Souberbielle, Jean-Claude; Friedlander, Gérard; Goffin, Vincent

    2015-01-01

    Epidemiological studies that have investigated whether dairy (mainly milk) diets are associated with prostate cancer risk have led to controversial conclusions. In addition, no existing study clearly evaluated the effects of dairy/milk diets on prostate tumor progression, which is clinically highly relevant in view of the millions of men presenting with prostate pathologies worldwide, including benign prostate hyperplasia (BPH) or high-grade prostatic intraepithelial neoplasia (HGPIN). We report here a unique interventional animal study to address this issue. We used two mouse models of fully penetrant genetically-induced prostate tumorigenesis that were investigated at the stages of benign hyperplasia (probasin-Prl mice, Pb-Prl) or pre-cancerous PIN lesions (KIMAP mice). Mice were fed high milk diets (skim or whole) for 15 to 27 weeks of time depending on the kinetics of prostate tumor development in each model. Prostate tumor progression was assessed by tissue histopathology examination, epithelial proliferation, stromal inflammation and fibrosis, tumor invasiveness potency and expression of various tumor markers relevant for each model (c-Fes, Gprc6a, activated Stat5 and p63). Our results show that high milk consumption (either skim or whole) did not promote progression of existing prostate tumors when assessed at early stages of tumorigenesis (hyperplasia and neoplasia). For some parameters, and depending on milk type, milk regimen could even exhibit slight protective effects towards prostate tumor progression by decreasing the expression of tumor-related markers like Ki-67 and Gprc6a. In conclusion, our study suggests that regular milk consumption should not be considered detrimental for patients presenting with early-stage prostate tumors. PMID:25938513

  17. The prostate cancer immunome: In silico functional analysis of antigenic proteins from microarray profiling with IgG.

    PubMed

    Luna-Coronell, Johana A; Vierlinger, Klemens; Gamperl, Magdalena; Hofbauer, Johann; Berger, Ingrid; Weinhäusel, Andreas

    2016-04-01

    The study of the immunome of prostate cancer (PCa) and characterization of autoantibody signature from differentially reactive antigens can uncover disease stage proteins, reveal enriched networks and even expose aberrant cellular mechanisms during the disease process. By conducting plasma IgG profiling on protein microarrays presenting 5449 unique human proteins expressed in 15 417 E. coli human cDNA expression clones, we elucidated 471 (21 higher reactive in PCa) differentially reactive antigens in 50 PCa versus 49 patients with benign prostate hyperplasia (BPH) at initial diagnosis. Functional analyzes show that the immune-profile of PCa compared to BPH control samples is significantly enriched in features targeting Cellular assembly, Cell death and pathways involved in Cell cycle, translation, and assembly of proteins as EIF2 signaling, PCa related genes as AXIN1 and TP53, and ribosomal proteins (e.g. RPS10). An overlap of 61 (out of 471) DIRAGs with the published 1545 antigens from the SEREX database has been found, however those were higher reactive in BPH. Clinical relevance is shown when antibody-reactivities against eight proteins were significantly (p < 0.001) correlated with Gleason-score. Herewith we provide a biological and pathophysiological characterization of the immunological layer of cancerous (PCa) versus benign (BPH) disease, derived from antibody profiling on protein microarrays. PMID:27089054

  18. Enlarged prostate gland

    MedlinePlus

    ... enlarges in size in a process called benign hypertrophy, which means that the gland got larger without ... in several of the symptoms of benign prostatic hypertrophy, or BPH. Symptoms may include a slowed or ...

  19. The role of tumor suppressor gene SOX11 in prostate cancer.

    PubMed

    Yao, Zhiyong; Sun, Bin; Hong, Quan; Yan, Jingmin; Mu, Dawei; Li, Jianye; Sheng, Haibo; Guo, Heqing

    2015-08-01

    SOX genes play an important role in a number of developmental processes. The transcription factor SOX11 is one of the members of the SOX family emerging as important transcriptional regulators. The aim of this study was to investigate the role of SOX11 in prostate cancer (PCa) and its expression pattern and clinical significance. The gene expression of SOX11 in human PCa tissues compared with benign prostate hyperplasia (BPH) tissues was detected using real-time quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) analysis and immunohositochemistry. SOX11 overexpression cell model was used to examine the role of SOX11 in cell growth and metastasis in vitro. The results showed that the positive rate of SOX11 staining was 16.67 % (10/60) in cases of prostatic carcinoma and 81.67 % (49/60) in cases of BPH, and the difference of SOX11 expression between PCa and BPH was statistically significant (P < 0.001). SOX11 mRNA level was lowly expressed in PCa cell lines compared to RWPE-1. SOX11 overexpression suppresses PCa cell migration and invasion. In conclusion, our findings demonstrate that SOX11 could suppress cell proliferation, migration, and invasion of PCa in vitro. PMID:25773392

  20. 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)

    Sturesson, C.; Andersson-Engels, S.

    1996-03-01

    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.

  1. Effects of Low-Dose Tamsulosin on Sexual Function in Patients With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

    PubMed Central

    Kim, Sin Wook; Lee, Wan Cheol; Kim, Ma Tae; Ko, Kyungtae; Lee, Won Ki; Lee, Choong-Hyun; Kim, Je Jong

    2013-01-01

    Purpose The aim of the present study was to evaluate the effects of low-dose tamsulosin on sexual function in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia. Materials and Methods A total of 138 male LUTS patients aged more than 50 years with an International Prostate Symptom Score (IPSS) ≥8 were enrolled in this open-label, multicenter, prospective, noncomparative observational study. Clinical assessments included IPSS, quality of life (QoL) index, International Index of Erectile Function (IIEF), Danish Prostate Symptom Score (DAN-PSS), and an early morning erection questionnaire. The data were recorded at baseline and at 1 and 3 months after treatment with tamsulosin 0.2 mg/d. Adverse events were analyzed in all patients. Results During the study period of 3 months, the IPSS and QoL index significantly improved from baseline by -11.40±9.40 and -1.11±1.36, respectively (p<0.001). However, there were no clinically relevant changes in total IIEF score (mean difference, 1.63±15.50; p=0.406) or the 5 subdomains (p>0.05). Furthermore, DAN-PSS weighted scores (A×B) showed no clinically relevant changes (mean difference on Q1, Q2, and Q3: -0.45±2.94, 0.27±2.50, and -1.27±2.27, p>0.05). In addition, there were no clinically significant changes in responses on the early morning erection questionnaire. Conclusions Tamsulosin at the dose of 0.2 mg significantly improved the IPSS and the QoL index compared with baseline. However, tamsulosin did not exhibit any significant impact on sexual function or any negative impact on ejaculatory function. PMID:24175045

  2. Prospects for radiofrequency hyperthermia applicator research. I--Pre-optimised prototypes of endocavitary applicators with matching interfaces for prostate hyperplasia and cancer treatments.

    PubMed

    Franconi, Cafiero; Vrba, Jan; Micali, Francesco; Pesce, Francesco

    2011-01-01

    Inconsistency is observed in comparing assessment data of applicators for endocavitary hyperthermia (EHT) with microwaves (MW) and radiofrequency (RF) obtained using the standard method of inserting bare applicators in phantom tissues. MW antennae exhibit overall average penetration depths of approximately 6 mm, excluding hot spots. RF radiators exhibit penetration depths of not more than approximately 3 mm, a value too low considering the superior penetration of the RF plane wave radiation. Assuming that a mismatch at the RF radiator-tissue interface is causing the poor energy transfer of RF energy, we developed new RF radiators with controlled dielectric matching interfaces for evaluating the potential of RF radiation in EHT and in interstitial hyperthermia (IHT) treatments. We designed, developed and assessed 27.12 MHz, 8 mm OD inductive and capacitive devices of novel and existing designs, each provided an optimised bi-layer matching interface. The assessment results reveal features such as customisable length and shape, independence of insertion depth, uncritical air gap, longitudinal heating uniformity, outstanding penetration depths (19-20 mm) and high SAR gradients at both radiator ends--i.e. prostatic urethra ends--for added safety. These data clear the way for the development of pre-optimised EHT inductive and capacitive RF applicators. Evidence of positive effects of high near-fields density in cavity microenvironments is given. Such devices show potential for more effective prostatic hyperplasia treatments and for improving the feasibility of more adequate treatment planning and thermal dosimetry of interstitial and transurethral hyperthermia treatments of prostate carcinoma. PMID:21250898

  3. Goserelin acetate before transurethral resection of moderately enlarged benign prostatic hyperplasia: Prospective randomised-controlled clinical trial

    PubMed Central

    Abo El-Enen, Mohamed; Tawfik, Ahmed; El-Abd, Ahmed S.; Ragab, Maged; El-Abd, Sherin; Elrashidy, Mohamed; Elmashad, Nehal; Rasheed, Mohamed; El-Abd, Shawky

    2015-01-01

    Objective To evaluate the impact of a luteinising hormone-releasing hormone (LHRH) agonist, goserelin acetate (GA), on surgical blood loss during transurethral resection of the prostate (TURP), as well as its histopathological effect on prostatic microvessel density (MVD). Patients and methods Patients who underwent TURP due to benign prostatic enlargement (60–100 mL) were randomly subdivided into two equal groups according to whether they received preoperative GA administration (3.6 mg; group A) or not (group B). Evaluation parameters were operative time, weight of resected prostatic tissue, perioperative haematocrit (HCT) changes, estimation of intraoperative blood loss, and suburethral and stromal prostatic MVD. Effects of GA on prostate weight and any possible side-effects were also monitored. Results In all, 35 and 33 patients were included in groups A and B, respectively. Operative time and HCT values’ changes were significantly less in group A (P < 0.05). Also, operative blood loss (both total and adjusted per weight of resected tissue) was lower in group A, at a mean (SD) of 178.13 (77.71) mL and 3.74 (1.52) mL/g vs 371.75 (91.09) mL and 8.59 (2.42) mL/g (P < 0.001). The median MVD in both suburethral [8 vs 11 vessels/high-power field (HPF)] and stromal tissues (9 vs 17 vessels/HPF) were significantly lower in group A (P < 0.001). Side-effects were minimal. Conclusion A single dose of GA, a LHRH agonist, before TURP is safe and effective in reducing surgical blood loss. It significantly reduced MVD in both suburethral and stromal nodular prostatic tissues without regional discrepancy. PMID:26966595

  4. Genetic Determinants of Metabolism and Benign Prostate Enlargement: Associations with Prostate Volume.

    PubMed

    Giri, Ayush; Edwards, Todd L; Motley, Saundra S; Byerly, Susan H; Fowke, Jay H

    2015-01-01

    Prostate enlargement leading to clinical benign prostatic hyperplasia (BPH) is associated with metabolic dysregulation and obesity. The genetic basis of this association is unclear. Our objective was to evaluate whether single nucleotide polymorphisms (SNPs) previously associated with metabolic disorders are also associated with prostate volume (PV). Participants included 876 men referred for prostate biopsy and found to be prostate cancer free. PV was measured by transrectal ultrasound. Samples were genotyped using the Illumina Cardio-MetaboChip platform. Multivariable adjusted linear regression models were used to evaluate SNPs (additive coding) in relation to natural-log transformed (log) PV. We compared SNP-PV results from biopsy-negative men to 442 men with low-grade prostate cancer with similar levels of obesity and PV. Beta-coefficients from the discovery and replication samples were then aggregated with fixed effects inverse variance weighted meta-analysis. SNP rs11736129 (near the pseudo-gene LOC100131429) was significantly associated with log-PV (beta: 0.16, p-value 1.16x10(-8)) after adjusting for multiple testing. Other noteworthy SNPs that were nominally associated (p-value < 1x10(-4)) with log-PV included rs9583484 (intronic SNP in COL4A2), rs10146527 (intronic SNP in NRXN3), rs9909466 (SNP near RPL32P31), and rs2241606 (synonymous SNP in SLC12A7). We found several SNPs in metabolic loci associated with PV. Further studies are needed to confirm our results and elucidate the mechanism between these genetic loci, PV, and clinical BPH. PMID:26158673

  5. Genetic Determinants of Metabolism and Benign Prostate Enlargement: Associations with Prostate Volume

    PubMed Central

    Giri, Ayush; Edwards, Todd L.; Motley, Saundra S.; Byerly, Susan H.; Fowke, Jay H.

    2015-01-01

    Prostate enlargement leading to clinical benign prostatic hyperplasia (BPH) is associated with metabolic dysregulation and obesity. The genetic basis of this association is unclear. Our objective was to evaluate whether single nucleotide polymorphisms (SNPs) previously associated with metabolic disorders are also associated with prostate volume (PV). Participants included 876 men referred for prostate biopsy and found to be prostate cancer free. PV was measured by transrectal ultrasound. Samples were genotyped using the Illumina Cardio-MetaboChip platform. Multivariable adjusted linear regression models were used to evaluate SNPs (additive coding) in relation to natural-log transformed (log) PV. We compared SNP-PV results from biopsy-negative men to 442 men with low-grade prostate cancer with similar levels of obesity and PV. Beta-coefficients from the discovery and replication samples were then aggregated with fixed effects inverse variance weighted meta-analysis. SNP rs11736129 (near the pseudo-gene LOC100131429) was significantly associated with log-PV (beta: 0.16, p-value 1.16x10-8) after adjusting for multiple testing. Other noteworthy SNPs that were nominally associated (p-value < 1x10-4) with log-PV included rs9583484 (intronic SNP in COL4A2), rs10146527 (intronic SNP in NRXN3), rs9909466 (SNP near RPL32P31), and rs2241606 (synonymous SNP in SLC12A7). We found several SNPs in metabolic loci associated with PV. Further studies are needed to confirm our results and elucidate the mechanism between these genetic loci, PV, and clinical BPH. PMID:26158673

  6. Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial

    PubMed Central

    Carneiro, Arie; Sakuramoto, Paulo; Wroclawski, Marcelo Langer; Forseto, Pedro Herminio; Julio, Alexandre Den; Bautzer, Carlos Ricardo Doi; Lins, Leonardo Monte Marques; Kataguiri, Andre; Yamada, Fernanda Batistini; Teixeira, Gabriel Kushiyama; Tobias-Machado, Marcos; Pompeo, Antonio Carlos Lima

    2016-01-01

    ABSTRACT Purpose: This study compared the suprapubic (SP) versus retropubic (RP) prostatectomy for the treatment of large prostates and evaluated perioperative surgical morbidity and improvement of urinary symptoms. Materials and Methods: In this single centre, prospective, randomised study, 65 consecutive patients with LUTS and surgical indication with prostate volume greater than 75g underwent open prostatectomy to compare the RP (32 patients) versus SP (33 patients) technique. Results: The SP group exhibited a higher incidence of complications (p=0.002). Regarding voiding pattern analysis (IPSS and flowmetry), both were significantly effective compared to pre-treatment baseline. The RP group parameters were significantly better, with higher peak urinary flow (SP: 16.77 versus RP: 23.03mL/s, p=0.008) and a trend of lower IPSS score (SP: 6.67 versus RP 4.14, p=0.06). In a subgroup evaluation of patients with prostate volumes larger than 100g, blood loss was lower in those undergoing SP prostatectomy (p=0.003). Patients with prostates smaller than 100g in the SP group exhibited a higher incidence of low grade late complications (p=0.004). Conclusions: The SP technique was related to a higher incidence of minor complications in the late postoperative period. High volume prostates were associated with increased bleeding when the RP technique was utilized. The RP prostatectomy was associated with higher peak urinary flow and a trend of a lower IPSS Score.

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

    PubMed Central

    Mulgaonkar, Ashwini; Giordano, Nicholas

    2014-01-01

    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 5α-dihydrotestosterone (5α-DHT), a potent androgen, via 5α-reductase (5α-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 5α-reductase inhibitors (5α-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 5α-RIs on sexual function, high grade prostate cancer incidence, central nervous system function and on depression. 5α-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 5α-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 5α-RIs therapy. PMID:24955220

  8. Comparison between thulium laser resection of prostate and transurethral plasmakinetic resection of prostate or transurethral resection of prostate.

    PubMed

    DeCao, Hong; Wang, Jia; Huang, Yu; LiangLiu, Ren; JunLei, Hao; Gao, Liang; Tang, Zhuang; YingHu, Chun; Li, Xiang; JiuYuan, Hong; Dong, Qiang; Wei, Qiang

    2015-01-01

    Benign prostatic hyperplasia (BPH) is one of the most common diseases in middle-aged and elderly men. In the present study, we aimed to compare the efficacy and safety of thulium laser resection of the prostate (TMLRP) with either transurethral plasmakinetic resection of the prostate (TUPKP) or transurethral resection of the prostate (TURP). A literature search was performed, eventually, 14 studies involving 1587 patients were included. Forest plots were produced by using Revman 5.2.0 software. Our meta-analysis showed that operation time, decrease in hemoglobin level, length of hospital stay, catheterization time, and development of urethral stricture significantly differed, whereas the transitory urge incontinence rate, urinary tract infection rate, and recatheterization rate did not significantly differ between TMLRP and either TURP or TUPKP. The blood transfusion rate was significantly different between TMLRP and TURP, but not between TMLRP and TUPKP. In addition, the retrograde ejaculation rate between TMLRP and TURP did not significantly differ. At 1, 3, 6, and 12 months of postoperative follow-up, the maximum flow rate, post-void residual, quality of life, and International Prostate Symptom Score did not significantly differ among the procedures. Thus, the findings of this study indicate that TMLRP may be a safe and feasible alternative. PMID:26444930

  9. Comparison between thulium laser resection of prostate and transurethral plasmakinetic resection of prostate or transurethral resection of prostate

    PubMed Central

    DeCao, Hong; Wang, Jia; Huang, Yu; LiangLiu, Ren; JunLei, Hao; Gao, Liang; Tang, Zhuang; YingHu, Chun; Li, Xiang; JiuYuan, Hong; Dong, Qiang; Wei, Qiang

    2015-01-01

    Benign prostatic hyperplasia (BPH) is one of the most common diseases in middle-aged and elderly men. In the present study, we aimed to compare the efficacy and safety of thulium laser resection of the prostate (TMLRP) with either transurethral plasmakinetic resection of the prostate (TUPKP) or transurethral resection of the prostate (TURP). A literature search was performed, eventually, 14 studies involving 1587 patients were included. Forest plots were produced by using Revman 5.2.0 software. Our meta-analysis showed that operation time, decrease in hemoglobin level, length of hospital stay, catheterization time, and development of urethral stricture significantly differed, whereas the transitory urge incontinence rate, urinary tract infection rate, and recatheterization rate did not significantly differ between TMLRP and either TURP or TUPKP. The blood transfusion rate was significantly different between TMLRP and TURP, but not between TMLRP and TUPKP. In addition, the retrograde ejaculation rate between TMLRP and TURP did not significantly differ. At 1, 3, 6, and 12 months of postoperative follow-up, the maximum flow rate, post-void residual, quality of life, and International Prostate Symptom Score did not significantly differ among the procedures. Thus, the findings of this study indicate that TMLRP may be a safe and feasible alternative. PMID:26444930

  10. Transcriptomic profiling of urine extracellular vesicles reveals alterations of CDH3 in prostate cancer

    PubMed Central

    Sanchez-Mosquera, Pilar; Ugalde-Olano, Aitziber; González, Esperanza; Cortazar, Ana R.; Palomo, Laura; Fernández-Ruiz, Sonia; Lacasa-Viscasillas, Isabel; Berdasco, Maria; Sutherland, James D.; Barrio, Rosa; Zabala-Letona, Amaia; Martín-Martín, Natalia; Arruabarrena-Aristorena, Amaia; Valcarcel-Jimenez, Lorea; Caro-Maldonado, Alfredo; Gonzalez-Tampan, Jorge; Cachi-Fuentes, Guido; Esteller, Manel; Aransay, Ana M.; Unda, Miguel

    2016-01-01

    Extracellular vesicles (EV) are emerging structures with promising properties for intercellular communication. In addition, the characterization of EV in biofluids is an attractive source of non-invasive diagnostic, prognostic and predictive biomarkers. Here we show that urinary EV (uEV) from prostate cancer (PCa) patients exhibit genuine and differential physical and biological properties compared to benign prostate hyperplasia (BPH). Importantly, transcriptomics characterization of uEVs led us to define the decreased abundance of Cadherin 3, type 1 (CDH3) transcript in uEV from PCa patients. Tissue and cell line analysis strongly suggested that the status of CDH3 in uEVs is a distal reflection of changes in the expression of this cadherin in the prostate tumor. CDH3 was negatively regulated at the genomic, transcriptional, and epigenetic level in PCa. Our results reveal that uEVs could represent a non-invasive tool to inform about the molecular alterations in PCa. PMID:26771841

  11. Evaluation of glycophenotype in prostatic neoplasm by chemiluminescent assay

    PubMed Central

    da Silva, Lúcia Patrícia Bezerra Gomes; de Almeida, Sinara Mônica Vitalino; de Lima, Luiza Rayanna Amorim; Cavalcanti, Carmelita de Lima Bezerra; Lira, Mariana Montenegro de Melo; da Silva, Maria da Paz Carvalho; Beltrão, Eduardo Isidoro Carneiro; Júnior, Luiz Bezerra de Carvalho

    2014-01-01

    This work aimed to evaluate the glycophenotype in normal prostate, bening prostatic hyperplasia (BPH) and prostatic adenocarcinoma (PCa) tissues by a chemiluminescent method. Concanavalin A (Con A), Ulex europaeus agglutinin (UEA-I) and Peanut agglutinin (PNA) lectins were conjugated to acridinium ester (lectins-AE). These conjugates remained capable to recognize their specific carbohydrates. Tissue samples were incubated with lectins-AE. The chemiluminescence of the tissue-lectin-AE complex was expressed in relative light units (RLU). Transformed tissues (0.25 cm2 by 8 µm of thickness) showed statistical significant lower α-D-glucose/mannose (BPH: 226,931 ± 17,436; PCa: 239,520 ± 12,398) and Gal-β(1-3)-GalNAc (BPH: 28,754 ± 2,157; PCa: 16,728 ± 1,204) expression than normal tissues (367,566 ± 48,550 and 409,289 ± 22,336, respectively). However, higher α-L-fucose expression was observed in PCa (251,118 ± 14,193) in relation to normal (200,979 ± 21,318) and BHP (169,758 ± 10,264) tissues. It was observed an expressive decreasing of the values of RLU by inhibition of the interaction between tissues and lectins-AE using their specific carbohydrates. The relationship between RLU and tissue area showed a linear correlation for all lectin-AE in both transformed tissues. These results indicated that the used method is an efficient tool for specific, sensitive and quantitative analyses of prostatic glycophenotype. PMID:25120756

  12. Insulin-like growth factor (IgF)-I, IgF binding protein-3, and prostate cancer: correlation with gleason score

    PubMed Central

    Corrêa, Lívia L.; Vieira, Leonardo; Lima, Giovanna A. Balarini; Gabrich, Rafael; de Miranda, Luiz Carlos D.; Gadelha, Mônica R.

    2015-01-01

    Introduction Non-androgenic growth factors are involved in the growth regulation of prostate cancer (PCa). Objective This is the first Brazilian study to correlate, in a population of patients operated for PCa, PSA, total testosterone, insulin-like growth factor-I (IGF-I) and insulin-like growth factor-binding protein-3 (IGFBP-3) with Gleason score and to compare with a control group with benign prostate hyperplasia (BPH). Materials and Methods This retrospective single-center study included 49 men with previously diagnosed PCa and 45 with previously diagnosed BPH. PSA, testosterone, IGF-I, IGFBP-3 were determined in both groups. Results PSA and IGFBP-3 levels were significantly higher in the PCa group as compared to the BPH group (p<0.001 and p=0.004, respectively). There was a significant difference when we compared the PSA before surgery (p<0.001) and at the inclusion in the study (p<0.001) and IGFBP3 (0.016) among patients with Gleason <7, ≥7 and BPH. In the PCa group, PSA, testosterone, IGF-I and IGFBP-3 levels were comparable between Gleason <7 and ≥7. Conclusions Our data suggest that in localized PCa, the quantification of PSA and, not of IGF-1, may provide independent significant information in the aggressiveness. IGFBP-3 could be a biochemical marker of disease control in PCa patients. PMID:25928516

  13. Testosterone protects from metabolic syndrome-associated prostate inflammation: an experimental study in rabbit.

    PubMed

    Vignozzi, Linda; Morelli, Annamaria; Sarchielli, Erica; Comeglio, Paolo; Filippi, Sandra; Cellai, Ilaria; Maneschi, Elena; Serni, Sergio; Gacci, Mauro; Carini, Marco; Piccinni, Marie-Pierre; Saad, Farid; Adorini, Luciano; Vannelli, Gabriella B; Maggi, Mario

    2012-01-01

    Metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) are often associated. One of their common denominators is hypogonadism. However, testosterone supplementation is limited by concerns for potential prostatic side effects. The objective was to determine whether MetS-associated prostate alterations are prevented by testosterone supplementation. We used a previously described animal model of MetS, obtained by feeding male rabbits a high-fat diet (HFD) for 12 weeks. Subsets of HFD rabbits were treated with testosterone or with the farnesoid X receptor agonist INT-747. Rabbits fed a standard diet were used as controls. HFD-animals develop hypogonadism and all the MetS features: hyperglycemia, glucose intolerance, dyslipidemia, hypertension, and visceral obesity. In addition, HFD-animals show a prostate inflammation. Immunohistochemical analysis demonstrated that HFD-induced prostate fibrosis, hypoxia, and inflammation. The mRNA expression of several proinflammatory (IL8, IL6, IL1?, and TNF?), T lymphocyte (CD4, CD8, Tbet, Gata3, and ROR ?t), macrophage (TLR2, TLR4, and STAMP2), neutrophil (lactoferrin), inflammation (COX2 and RAGE), and fibrosis/myofibroblast activation (TGF?, SM22?, ?SMA, RhoA, and ROCK1/ROCK2) markers was significantly increased in HFD prostate. Testosterone, as well as INT-747, treatment prevented some MetS features, although only testosterone normalized all the HFD-induced prostate alterations. Interestingly, the ratio between testosterone and estradiol plasma level retains a significant, negative, association with all the fibrosis and the majority of inflammatory markers analyzed. These data highlight that testosterone protects rabbit prostate from MetS-induced prostatic hypoxia, fibrosis, and inflammation, which can play a role toward the development/progression of BPH/LUTS. PMID:22010203

  14. Urinary microRNA-based signature improves accuracy of detection of clinically relevant prostate cancer within the prostate-specific antigen grey zone.

    PubMed

    Salido-Guadarrama, Alberto Ivan; Morales-Montor, Jorge Gustavo; Rangel-Escareño, Claudia; Langley, Elizabeth; Peralta-Zaragoza, Oscar; Cruz Colin, Jose Luis; Rodriguez-Dorantes, Mauricio

    2016-06-01

    At present, prostate-specific antigen (PSA) is used as a clinical biomarker for prostate cancer (PCa) diagnosis; however, a large number of patients with benign prostate hyperplasia (BPH) with PSA levels in the 'gray area' (4-10 ng/ml) are currently subjected to unnecessary biopsy due to overdiagnosis. Certain microRNAs (miRs) have been proven to be useful biomarkers, several of which are detectable in bodily fluids. The present study identified and validated a urinary miR‑based signature to enhance the specificity of PCa diagnosis and to reduce the number of patients with benign conditions undergoing biopsy. Seventy‑three urine samples from Mexican patients with diagnosis of PCa with a Gleason score ≥7 and 70 patients diagnosed with BPH were collected after digital rectal examination (DRE) of the prostate. miR expression profiles were determined using TaqMan Low Density Array experiments, and normalized Ct values for the miRs were compared between PCa and BPH groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate whether miR detection in urine is suitable for distinguishing patients with PCa from those with BPH. The identified miR‑100/200b signature was significantly correlated with PCa. Using a multivariable logistic regression approach, a base model including the clinical variables age, prostate‑specific antigen (PSA), the percentage of free PSA and DRE was generated, and a second base model additionally contained the miR‑100/200b signature. ROC analysis demonstrated that the combined model significantly outperformed the capacity of PSA (P<0.001) and the base model (P=0.01) to discriminate between PCa and BPH patients. In terms of evaluation of the sub‑group of patients in the gray zone of PSA levels, the performance of the combined model for predicting PCa cases was significantly superior to PSA level determination (P<0.001) and the base model (P=0.009). In addition, decision curve analysis demonstrated that the use of the combined model increased the clinical benefit for patients and produced a substantial reduction in unnecessary biopsies across a range of reasonable threshold probabilities (10‑50%). Detection of the urinary miR signature identified in the present study as part of clinical diagnostic procedures will enhance the accuracy of PCa diagnosis and provide a clinical benefit for patients with BPH by sparing them from undergoing invasive biopsy. To the best of our knowledge, the present study was the first to describe the profiling of urinary miR100 and miR-200b levels for the clinical diagnosis of PCa. PMID:27081843

  15. 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

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

    2014-01-01

    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

  16. Application of purified botulinum type a neurotoxin to treat experimental trigeminal neuropathy in rats and patients with urinary incontinence and prostatic hyperplasia.

    PubMed

    Matsuka, Yoshizo; Yokoyama, Teruhiko; Yamamoto, Yumiko; Suzuki, Tomonori; Dwi Fatmawati, Ni Nengah; Nishikawa, Atsushi; Ohyama, Tohru; Watanabe, Toshihiro; Kuboki, Takuo; Nagai, Atsushi; Oguma, Keiji

    2012-01-01

    Type A neurotoxin (NTX) of Clostridium botulinum was purified by a simple procedure using a lactose gel column. The toxicity of this purified toxin preparation was retained for at least 1 year at -30C by supplementation with either 0.1% albumin or 0.05% albumin plus 1% trehalose. When purified NTX was used to treat 49 patients with urinary incontinence caused by either refractory idiopathic or neurogenic detrusor overactivity, 36 patients showed significant improvement in symptoms. These beneficial effects were also observed in cases of prostatic hyperplasia. The results obtained with NTX were similar to that of Botox. The effects of NTX on trigeminal neuralgia induced by infraorbital nerve constriction (IoNC) in rats were also studied. Trigeminal ganglion neurons from ipsilateral to IoNC exhibited significantly faster onset of FM4-64 release than sham-operated contralateral neurons. Intradermal injection of NTX in the area of IoNC alleviated IoNC-induced pain behavior and reduced the exaggerated FM4-64 release in trigeminal ganglion neurons. PMID:22745637

  17. Peripubertal aromatase inhibition in male rats has adverse long-term effects on bone strength and growth and induces prostatic hyperplasia.

    PubMed

    Bajpai, Anurag; Simm, Peter J; McPherson, Stephen J; Russo, Vincenzo C; Azar, Walid J; Wark, John D; Risbridger, Gail P; Werther, George A

    2010-10-01

    Aromatase inhibitors have been increasingly used in boys with growth retardation to prolong the duration of growth and increase final height. Multiple important roles of oestrogen in males point to potential adverse effects of this strategy. Although the deleterious effects of aromatase deficiency in early childhood and adulthood are well documented, there is limited information about the potential long-term adverse effects of peripubertal aromatase inhibition. To address this issue, we evaluated short-term and long-term effects of peripubertal aromatase inhibition in an animal model. Peripubertal male Wistar rats were treated with aromatase inhibitor letrozole or placebo and followed until adulthood. Letrozole treatment caused sustained reduction in bone strength and alteration in skeletal geometry, lowering of IGF1 levels, inhibition of growth resulting in significantly lower weight and length of treated animals and development of focal prostatic hyperplasia. Our observation of adverse long-term effects after peripubertal male rats were exposed to aromatase inhibitors highlights the need for further characterisation of long-term adverse effects of aromatase inhibitors in peripubertal boys before further widespread use is accepted. Furthermore, this suggests the need to develop more selective oestrogen inhibition strategies in order to inhibit oestrogen action on the growth plate, while beneficial effects in other tissues are preserved. PMID:20675302

  18. Integration of lipidomics and transcriptomics unravels aberrant lipid metabolism and defines cholesteryl oleate as potential biomarker of prostate cancer

    PubMed Central

    Li, Jia; Ren, Shancheng; Piao, Hai-long; Wang, Fubo; Yin, Peiyuan; Xu, Chuanliang; Lu, Xin; Ye, Guozhu; Shao, Yaping; Yan, Min; Zhao, Xinjie; Sun, Yinghao; Xu, Guowang

    2016-01-01

    In-depth delineation of lipid metabolism in prostate cancer (PCa) is significant to open new insights into prostate tumorigenesis and progression, and provide potential biomarkers with greater accuracy for improved diagnosis. Here, we performed lipidomics and transcriptomics in paired prostate cancer tumor (PCT) and adjacent nontumor (ANT) tissues, followed by external validation of biomarker candidates. We identified major dysregulated pathways involving lipogenesis, lipid uptake and phospholipids remodeling, correlated with widespread lipid accumulation and lipid compositional reprogramming in PCa. Specifically, cholesteryl esters (CEs) were most prominently accumulated in PCa, and significantly associated with cancer progression and metastasis. We showed that overexpressed scavenger receptor class B type I (SR-BI) may contribute to CEs accumulation. In discovery set, CEs robustly differentiated PCa from nontumor (area under curve (AUC) of receiver operating characteristics (ROC), 0.90–0.94). In validation set, CEs potently distinguished PCa and non-malignance (AUC, 0.84–0.91), and discriminated PCa and benign prostatic hyperplasia (BPH) (AUC, 0.90–0.96), superior to serum prostate-specific antigen (PSA) (AUC = 0.83). Cholesteryl oleate showed highest AUCs in distinguishing PCa from non-malignance or BPH (AUC = 0.91 and 0.96). Collectively, our results unravel the major lipid metabolic aberrations in PCa and imply the potential role of CEs, particularly, cholesteryl oleate, as molecular biomarker for PCa detection. PMID:26865432

  19. Overexpressed Rce1 is positively correlated with tumor progression and predicts poor prognosis in prostate cancer.

    PubMed

    Huang, Liangliang; Li, Meicai; Wang, Delin; He, Jiang; Wu, Wenqiang; Zeng, Qiangfeng; Li, Jianjun; Xiao, Maolin; Hu, Jie; He, Yunfeng; Li, Ying; Mai, Li; Liu, Wujiang

    2016-01-01

    Ras and a-factor-converting enzyme 1 (Rce1) have been reported to play a key role in the proteolysis processing of Ras proteins. The present study investigated the prognostic significance of Rce1 in patients with prostate cancer (PCa). The expressions of the mRNA and protein of Rce1 were analyzed in 12 pairs of PCa and benign prostatic hyperplasia (BPH) by quantitative real-time polymerase chain reaction and Western blotting, respectively. Immunohistochemistry was used to examine expression of Rce1 protein in 74 PCa tissues and 30 BPH tissues. The association between Rce1 expression and the specific clinicopathologic features was evaluated by χ(2) tests. Kaplan-Meier and Cox proportional hazards regression models were used to analyze the data. We found that expression of Rce1 mRNA and protein was markedly higher in PCa tissues than in paired BPH tissues. Expression of Rce1 in PCa was strongly associated with clinicopathologic features. It was detected in 69 (93.24%) of 74 PCa tissues by immunohistochemistry, and it was found to be associated with Gleason score (P = .013), T class (P = .015), and distant metastasis (P = .044). Patients with PCa having higher Rce1 expression had substantially shorter survival times than patients with lower Rce1 expression. Univariate and multivariate analysis revealed that Rce1 was an independent prognostic factor. In conclusion, our study suggests that expression of Rce1 can serve as an independent biomarker for the prognosis of PCa patients. PMID:26546252

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

    NASA Astrophysics Data System (ADS)

    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

    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.

  1. Genome Wide Expression Analysis of Recently Processed Formalin-fixed Paraffin Embedded Human Prostate Tissues

    PubMed Central

    Dunn, Thomas A.; Fedor, Helen; Isaacs, William B.; De Marzo, Angelo M.; Luo, Jun

    2008-01-01

    BACKGROUND Formalin fixation and paraffin embedding (FFPE) is the standard practice to process surgical specimens in preparation for pathological evaluation. The FFPE procedure is known to introduce adverse effects on RNA quality and the ensuing RNA based expression analysis. However, the overall impact of the FFPE procedure alone on the reliability and accuracy of expression data, without influences from additional compromising factors introduced during long-term storage, has not been vigorously assessed. METHODS The quality of RNA extracted from recently processed FFPE prostate tissues was examined. FFPE and frozen blocks were prepared from matched surgical specimens and processed in parallel for RNA extraction, two rounds of linear RNA amplification, and genome wide expression analysis. Expression ratios of prostate cancer versus benign prostatic hyperplasia (BPH) were compared between data derived from the paired FFPE tissues and frozen tissues. RESULTS RNA extracted from recently processed FFPE prostate tissues was of high quality and suitable for RNA expression analysis. An unbiased analysis of expression data revealed nearly 80% concordance between FFPE tissues and frozen tissues, in genome-wide gene expression differences of cancer vs. BPH, and across a wide spectrum of fold expression differences. CONCLUSIONS FFPE procedure itself does not lead to adverse effects on genome wide expression analysis. Prospective molecular archiving or modified long-term storage conditions should be implemented to expand the utility of FFPE tissues without compromising standard surgical pathology routines. PMID:18973134

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

    NASA Astrophysics Data System (ADS)

    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

    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 (α=0.05) between the groups studied.

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

    PubMed Central

    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

    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

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

    PubMed

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

    2014-12-01

    Receptor activator of NF-κB (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

  5. Increased oncogenic microRNA-18a expression in the peripheral blood of patients with prostate cancer: A potential novel non-invasive biomarker

    PubMed Central

    AL-KAFAJI, GHADA; AL-NAIEB, ZIAD TARIQ; BAKHIET, MOIZ

    2016-01-01

    MicroRNAs have been demonstrated to be stably detectable in peripheral blood, thus representing important sources of non-invasive biomarkers of various diseases, including cancer. Recently, microRNA-18a (miR-18a) has been revealed to be highly expressed in prostate cancer (PC) tissues, acting as an oncogenic miRNA. The present study evaluated miR-18a expression in the peripheral blood of patients with PC, patients with benign prostatic hyperplasia (BPH), and healthy individuals, to assess the feasibility of using peripheral blood miR-18a as a potential non-invasive biomarker for PC. Total RNA was extracted from peripheral whole blood samples from 24 PC patients, 24 BPH patients and 23 healthy control individuals. The expression of miR-18a was assessed by reverse transcription quantitative polymerase chain reaction. The results revealed that miR-18a expression was significantly higher in PC patients than in BPH patients and healthy controls [fold change (mean ± standard deviation), 5.5±1.4 for PC, 1.5±0.5 for BPH and 1.2±0.6 for controls; P<0.005]. Higher miR-18a expression was strongly associated with PC [odds ratio (OR), 4.602; 95% confidence interval (CI), 2.194–9.654; P=0.001], but was not significantly associated with BPH (OR, 1.2; 95% CI, 0.7–2.02; P=0.332). Despite the small number of patients, which limits the statistical power of the study, higher miR-18a expression was observed to be significantly correlated with certain clinicopathological parameters, including Gleason score >7 and pathological tumor stage 3/4 (P<0.005). A receiver operating characteristic (ROC) analysis revealed that miR-18a discriminated PC patients from BPH patients and healthy controls [area under the curve (AUC), 0.805; 95% CI, 0.704–0.906). Furthermore, use of the ROC curve to discriminate PC from BPH patients yielded an AUC of 0.878 (95% CI, 0.783–0.972). In summary, the present results indicate that miR-18a expression is significantly increased in peripheral blood of patients with PC compared with that of BPH patients and healthy individuals, and that higher miR-18a expression is associated with progression of PC. Peripheral blood oncogenic miR-18a may serve as a potential novel non-invasive biomarker for PC that also facilitates discrimination between PC and BPH. PMID:26893719

  6. In Search of the Molecular Mechanisms Mediating the Inhibitory Effect of the GnRH Antagonist Degarelix on Human Prostate Cell Growth

    PubMed Central

    Sakai, Monica; Martinez-Arguelles, Daniel B.; Patterson, Nathan H.; Chaurand, Pierre; Papadopoulos, Vassilios

    2015-01-01

    Degarelix is a gonadrotropin-releasing hormone (GnRH) receptor (GnRHR) antagonist used in patients with prostate cancer who need androgen deprivation therapy. GnRHRs have been found in extra-pituitary tissues, including prostate, which may be affected by the GnRH and GnRH analogues used in therapy. The direct effect of degarelix on human prostate cell growth was evaluated. Normal prostate myofibroblast WPMY-1 and epithelial WPE1-NA22 cells, benign prostatic hyperplasia (BPH)-1 cells, androgen-independent PC-3 and androgen-dependent LNCaP prostate cancer cells, as well as VCaP cells derived from a patient with castration-resistant prostate cancer were used. Discriminatory protein and lipid fingerprints of normal, hyperplastic, and cancer cells were generated by matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS). The investigated cell lines express GNRHR1 and GNRHR2 and their endogenous ligands. Degarelix treatment reduced cell viability in all prostate cell lines tested, with the exception of the PC-3 cells; this can be attributed to increased apoptosis, as indicated by increased caspase 3/7, 8 and 9 levels. WPE1-NA22, BPH-1, LNCaP, and VCaP cell viability was not affected by treatment with the GnRH agonists leuprolide and goserelin. Using MALDI MS, we detected changes in m/z signals that were robust enough to create a complete discriminatory profile induced by degarelix. Transcriptomic analysis of BPH-1 cells provided a global map of genes affected by degarelix and indicated that the biological processes affected were related to cell growth, G-coupled receptors, the mitogen-activated protein kinase (MAPK) pathway, angiogenesis and cell adhesion. Taken together, these data demonstrate that (i) the GnRH antagonist degarelix exerts a direct effect on prostate cell growth through apoptosis; (ii) MALDI MS analysis provided a basis to fingerprint degarelix-treated prostate cells; and (iii) the clusters of genes affected by degarelix suggest that this compound, in addition to its known use in the treatment of prostate cancer, may be efficacious in BPH. PMID:25811175

  7. Contrast-enhanced ultrasonographic characteristics of the diseased canine prostate gland.

    PubMed

    Troisi, Alessandro; Orlandi, Riccardo; Bargellini, Paolo; Menchetti, Laura; Borges, Paulo; Zelli, Riccardo; Polisca, Angela

    2015-11-01

    The work was carried out on a total of 26 male dogs that on the basis of clinical examination, prostate ultrasound and prostate biopsy, were divided prospectively into four groups: (1) normal dogs (control group; n = 8); (2) dogs with benign prostatic hyperplasia (group BPH; n = 8); (3) dogs suffering from prostatitis (group prostatitis; n = 4); (4) dogs with prostatic tumors (group tumors; n = 6). The examination of the prostate by means of contrast medium and dedicated ultrasound system allowed a detailed qualitative and quantitative analysis of prostatic vessels in normal and diseased conditions, enabling the detection and characterization of different disease states, and quantification of parameters such as peak intensity of perfusion (%), arrival time of the contrast medium to its maximum value of video intensity (time to peak [TTP; seconds]), regional blood volume, regional blood flow, and mean transit time (MTT [seconds]). The hemodynamic indices TTP (P < 0.01) and MTT (P < 0.001) of diseased prostate groups were significantly lower than those in the normal prostate group although there were no differences among diseases. Optimal cutoff values were 31 seconds (Sensitivity: 72%; Specificity: 88%) and 47 seconds (Sensitivity: 100%; Specificity: 88%) while area under receiver operating characteristic curves were 0.86 (P < 0.01) and 0.97 (P < 0.01) for TTP and MTT, respectively. The qualitative evaluation of vascular patterns showed differences between normal and diseased prostate glands. The latter were characterized by an alteration of the normal vascular appearance consisting of loss of the subcapsular arterioles and lack of a centripetal vascular pattern. The qualitative aspect of the study highlighted the different vascular architecture between BPH, prostatitis, adenocarcinoma, and lymphoma. This study shows how contrast-enhanced ultrasound represents a valid and noninvasive method for highlighting and characterizing prostatic vasculature. Furthermore, it allows the operator to obtain qualitative and quantitative data that are useful for the diagnosis of selected prostatic diseases. In conclusion, contrast-enhanced ultrasound can be a valuable noninvasive diagnostic tool to improve the diagnostic accuracy of prostate diseases in the dog. PMID:26277703

  8. Aberrant Protocadherin17 (PCDH17) Methylation in Serum is a Potential Predictor for Recurrence of Early-Stage Prostate Cancer Patients After Radical Prostatectomy.

    PubMed

    Lin, Ying-Li; Deng, Qiu-Kui; Wang, Yu-Hao; Fu, Xing-Li; Ma, Jian-Guo; Li, Wen-Ping

    2015-01-01

    BACKGROUND Prostate cancer is a one of the most common malignant diseases in men worldwide. Now it is a challenge to identify patients at higher risk for relapse and progression after surgery, and more novel prognostic biomarkers are needed. The aim of this study was to investigate the clinical significance of protocadherin17 (PCDH17) methylation in serum and its predictive value for biochemical recurrence (BCR) after radical prostatectomy. MATERIAL AND METHODS We evaluated the methylation status of PCDH17 in serum samples of 167 early-stage prostate cancer patients and 44 patients with benign prostatic hyperplasia (BPH) using methylation-specific PCR (MSP), and then evaluated the relationship between PCDH17 methylation and clinicopathologic features. Kaplan-Meier survival analysis and Cox analysis were used to evaluate its predictive value for BCR. RESULTS The ratio of PCDH17 methylation in prostate cancer patients was higher than in patients with BPH. Moreover, PCDH17 methylation was significantly associated with advanced pathological stage, higher Gleason score, higher preoperative PSA levels, and BCR. Kaplan-Meier survival analysis indicated that patients with methylated PCDH17 had shorter BCR-free survival time compared to patients with unmethylated PCDH17. Cox regression analysis indicated that PCDH17 methylation was an independent predictive factor for the BCR of patients after radical prostatectomy. CONCLUSIONS PCDH17 methylation in serum is a frequent event in early-stage prostate cancer, and it is an independent predictor of BCR after radical prostatectomy. PMID:26683656

  9. Aberrant Protocadherin17 (PCDH17) Methylation in Serum is a Potential Predictor for Recurrence of Early-Stage Prostate Cancer Patients After Radical Prostatectomy

    PubMed Central

    Lin, Ying-Li; Deng, Qiu-Kui; Wang, Yu-Hao; Fu, Xing-Li; Ma, Jian-Guo; Li, Wen-Ping

    2015-01-01

    Background Prostate cancer is a one of the most common malignant diseases in men worldwide. Now it is a challenge to identify patients at higher risk for relapse and progression after surgery, and more novel prognostic biomarkers are needed. The aim of this study was to investigate the clinical significance of protocadherin17 (PCDH17) methylation in serum and its predictive value for biochemical recurrence (BCR) after radical prostatectomy. Material/Methods We evaluated the methylation status of PCDH17 in serum samples of 167 early-stage prostate cancer patients and 44 patients with benign prostatic hyperplasia (BPH) using methylation-specific PCR (MSP), and then evaluated the relationship between PCDH17 methylation and clinicopathologic features. Kaplan-Meier survival analysis and Cox analysis were used to evaluate its predictive