Sample records for prostate hyperplasia bph

  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. Sexual Dysfunction and Lower Urinary Tract Symptoms (LUTS) Associated with Benign Prostatic Hyperplasia (BPH)

    Microsoft Academic Search

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

    2005-01-01

    Sexuality is an essential aspect of a couple's relationship and has a significant impact on life satisfaction. Benign prostatic hyperplasia (BPH) is a condition that commonly affects older men and is often associated with lower urinary tract symptoms (LUTS) and sexual dysfunction. Men with moderate-to-severe LUTS are at increased risk for sexual dysfunction, including moderate-to-severe erectile dysfunction (ED), ejaculatory dysfunction

  3. Interventional therapies for lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH).

    PubMed

    Seitz, M; Bader, M; Tilki, D; Stief, C; Gratzke, C

    2012-06-01

    Benign prostatic hyperplasia (BPH) is a common disease in older men that can lead to lower urinary tract symptoms (LUTS). After failure of medical treatment, surgical managements has to be considered. Surgical management of lower urinary tract symptoms attributed to BPH has progressed over time as urologic surgeons search for more innovative and less invasive forms of treatment. Transurethral resection of the prostate (TURP) has long been the "gold standard" to which all other forms of treatment are compared. There are several different methods of surgical treatment of BPH, including whole gland enucleation, laser vaporization, and induction of necrosis with delayed reabsorption as well as hybrid techniques. As with any form of surgical intervention, long-term results define success. Long-term follow-up consists of examining overall efficacy with attention to associated adverse events. TURP has the luxury of the longest follow-up, while less invasive forms of treatment starting to acquire long-term data. There are several surgical options for BPH; newer methods do show promise, while the "gold standard" continues to demonstrate excellent surgical results. PMID:22617306

  4. [Old and new interventional therapies in the treatment of symptomatic benign prostate hyperplasia (BPH)].

    PubMed

    Müller, R M; Thalmann, G N; Studer, U E

    2006-02-01

    Benign Prostatic Hyperplasia is a common entity among the aging male population. Its prevalence is increasing with age and is around 80% in the over 80-years old. The androgen-estrogen ratio changes in favor of the estrogens, which leads to a growth of prostatic tissue, presenting histologically as hyperplasia. BPH can cause irritative or obstructive symptoms or both. Nowadays we speak of bladder storage or bladder voiding symptoms, summarised as LUTS (Lower Urinary Tract Symptoms). LUTS has a structural and a functional component, the structural being caused by the size of the adenoma itself the functional depending on the muscle tone of the bladder neck and the prostatic urethra. To investigate LUTS, we use validated symptom scores, sonography for residual urine and eventually a urodynamic evaluation. There are 3 grades of BPH. The indication for an interventional therapy is relative in BPH II, and absolute in BPH III. Prior to treatment, other diseases mimicking the same symptoms, have to be ruled out and adequatly treated. Electro-resection of the prostate (TUR-P) remains the standard therapy and the benchmark any new technology has to compete with. TUR-P has good short- and longterm results, but can be associated with a considerable perioperative morbidity, and the learning curve for the operator is long. The most promising of the newer techniques is the Holmium-Laser-Enucleation of the prostate (Laser-TUR-P), showing at least identical short- and median-term results, but a lower perioperative morbidity than TUR-P For several minimally-invasive techniques, indications are limited. TUMT TUNA, WIT and laser-coagulation all produce a coagulation necrosis of the prostatic tissue by thermic damage with secondary tissue shrinking. Urodynamic results however, are not comparable to TUR-P or Laser-TUR-P, and significantly more secondary interventions within 2 to 5 years are required. Minimal-invasive techniques present a favorable alternative for younger patients without complications of BPH, and for older patients with relevant comorbidities, and can usually be performed under local anaesthesia. The morbidity is low and further therapies remain possible later, if necessary. PMID:16514965

  5. 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 ?1-adrenoceptor antagonists, as this appears to be the most effective mechanism of action. Other mechanisms which may be of benefit are also discussed. It is concluded that recent basic research has revealed a number of novel drug targets such as muscarinic receptor or P2X-purinoceptor antagonists, which have the potential to produce more effective and safer drug treatments. PMID:21410684

  6. 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

  7. Integrating Patient Risk Profiles in the Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia (LUTS\\/BPH) in Clinical Practice

    Microsoft Academic Search

    Mark J. Speakman

    2004-01-01

    Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS\\/BPH) is in the long term a slowly progressive disease. However, not all patients will progress although some patients will deteriorate more rapidly than others. This knowledge should be integrated into the decision when choosing the most appropriate treatment for an individual man suffering from LUTS\\/BPH. Although data from randomised controlled

  8. Transurethral ethanol ablation of the prostate (TEAP): an effective minimally invasive treatment alternative to traditional surgery for symptomatic benign prostatic hyperplasia (BPH) in high-risk comorbidity patients

    Microsoft Academic Search

    Carlo Magno; Giuseppe Mucciardi; Alessandro Galì; Giuseppina Anastasi; Antonino Inferrera; Giuseppe Morgia

    2008-01-01

    Objective  To evaluate the efficacy and safety of transurethral ethanol ablation of the prostate (TEAP) for patients with symptomatic\\u000a benign prostatic hyperplasia (BPH) and high-risk comorbidities.\\u000a \\u000a \\u000a \\u000a Materials and methods  Thirty-six patients (mean age 77.3 years) with symptomatic BPH or persistent urinary retention were assessed at baseline and\\u000a at 3, 6, and 12 months after treatment. All patients were affected by comorbidities (cardiovascular, respiratory,

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

    Microsoft Academic Search

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

    2001-01-01

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

  10. Diagn Mol Pathol . Author manuscript BPH gene expression profile associated to prostate gland volume

    E-print Network

    Boyer, Edmond

    -Regulation Introduction Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting aging men ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; pathology ; physiopathology ; Up urinary tract symptoms, benign prostatic enlargement, and bladder outlet obstruction ( ). Clinical

  11. Raveron versus placebo in the conservative treatment of benign prostatic hyperplasia (BPH).

    PubMed

    Bircan, K; Ozen, H A; Ergen, A; Ba?ar, I; Ozgür, S; Ilker, Y; Karaa?ao?lu, E; Remzi, D

    1990-01-01

    Thirty patients with BPH were randomized into two groups to receive Raveron and placebo for 6 weeks. The subjective and objective signs associated with BPH were evaluated before and after treatment. There was no significant difference between the effects of Raveron and placebo. PMID:1699907

  12. A multicenter, community-based study of doxazosin in the treatment of concomitant hypertension and symptomatic benign prostatic hyperplasia: the hypertension and BPH intervention trial (HABIT)

    Microsoft Academic Search

    Robert M. Guthrie; Richard L. Siegel

    1999-01-01

    As men age, the incidence of both benign prostatic hyperplasia (BPH) and hypertension increases. Concomitant occurrence of these conditions also increases with age, and the 2 are frequently encountered together in primary care practice. In addition, many patients with hypertension require >1 antihypertensive agent to adequately control blood pressure. In a multicenter, community-based, 8-week, uncontrolled, open-label study, we evaluated doxazosin,

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

    E-print Network

    Boyer, Edmond

    Prostate . Author manuscript Page /1 7 Inflammation in benign prostatic hyperplasia: a 282 patients Taille Abstract Introduction and objectives Prostatic inflammation could be a key component in prostate enlargement and benign prostatic hyperplasia (BPH) progression. Our aim

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

    PubMed

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

    2014-06-01

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

  15. Managing benign prostatic hyperplasia and prostate cancer – the challenges today

    Microsoft Academic Search

    Michael Marberger

    2010-01-01

    Many men who reach average life expectancy will experience benign prostatic hyperplasia (BPH) or prostate cancer and together these conditions account for a considerable amount of ill-health and distress for men and their partners. Although there is considerable overlap across BPH and prostate cancer in symptom and risk profiles, management approaches are very different for each condition and appropriate diagnostic

  16. 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 ...

  17. Phytotherapy for benign prostatic hyperplasia

    Microsoft Academic Search

    Glenn S. Gerber

    2002-01-01

    Phytotherapy has become a more popular treatment option among American men with benign prostatic hyperplasia (BPH). The most\\u000a popular herbal agent is saw palmetto (Serenoa repens), which is derived from the berry of the American dwarf palm tree. Pygeum africanum and beta-sitosterol are also used by many patients with BPH, either alone or in combination with saw palmetto. A significant

  18. INDUCTION OF PROSTATE APOPTOSIS BY DOXAZOSIN IN BENIGN PROSTATIC HYPERPLASIA

    Microsoft Academic Search

    NATASHA KYPRIANOU; JUAN P. LITVAK; ANDREW BORKOWSKI; RICHARD ALEXANDER; STEPHEN C. JACOBS

    1998-01-01

    PurposeThe molecular mechanisms underlying the therapeutic effect of the alpha 1 blocker, doxazosin, on benign prostatic hyperplasia (BPH) are poorly understood. We evaluated the effect of doxazosin on cell proliferation and apoptosis in the prostatic glandular epithelium and stroma of patients with BPH.

  19. Prostate: Benign Prostatic Hyperplasia (BPH)

    MedlinePLUS

    ... 1 : 10.4.5 404 Not Found The server has not found anything matching the Request-URI. ... the condition is temporary or permanent. If the server does not wish to make this information available ...

  20. 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-? reductase inhibitor, and terazosin, an ?-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

  1. 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

  2. Laser surgery simulation platform: toward full-procedure training and rehearsal for benign prostatic hyperplasia (BPH) therapy.

    PubMed

    Shen, Yunhe; Konchada, Vamsi; Zhang, Nan; Jain, Saurabh; Zhou, Xiangmin; Burke, Daniel; Wong, Carson; Carson, Culley; Roehrborn, Claus; Sweet, Robert

    2011-01-01

    Recently, photo-selective vaporization of the prostate (PVP) has been a popular alternative to the standard electrocautery - transurethral resection of prostate (TURP). Here we introduce a new training system for practicing the laser therapy by using a virtual reality (VR) simulator. To interactively and realistically simulate PVP on a virtual organ with an order of a quarter million elements, a few novel and practical solutions have been applied to handle the challenges in modeling tissue ablation, contact/collision and deformation; endoscopic instruments tracking, haptic rendering and a web/database curriculum management module are integrated into the system. Over 40 urologists and surgical experts have been invited nationally and participated in the system verification. PMID:21335859

  3. Long-term Treatment with Finasteride Resulted in a Significant Improvement Relative to Placebo in Clinical Progression of Benign Prostatic Hyperplasia (BPH) in Men with Enlarged Prostates (?30 mL), But Not in Those with Smaller Prostates (<30 mL): Data from the Medical Therapy of Prostatic Symptoms (MTOPS) Trial

    PubMed Central

    Kaplan, Steven A.; Lee, Jeannette Y.; Meehan, Alan G.; Kusek, John W.

    2013-01-01

    Purpose This post hoc analysis of the Medical Therapy of Prostatic Symptoms (MTOPS) trial examined the effect of finasteride alone compared to placebo on clinical progression of benign prostatic hyperplasia (BPH) in men with baseline prostate volume (PV) <30 mL and ?30 mL. Materials and Methods Men were randomized to placebo (n=737), doxazosin alone (4 to 8 mg) (n=756), finasteride alone (5 mg) (n=768), or doxazosin plus finasteride (n=786) (average duration of follow-up was 4.5 yrs); ~50% of patients had a baseline PV ?30 mL. The present analysis was based on the finasteride alone and placebo arms only and included patients for whom baseline and end of study data were available. We examined the effect of treatment on the cumulative percentage of men who did not experience clinical progression of BPH by study end. Results In men with baseline PV ?30 mL, treatment with finasteride produced a significant (p<0.001) increase relative to placebo in the cumulative percentage of patients who did not experience clinical progression of BPH (finasteride, 88.1%, versus placebo, 77.8%). There was no significant (p=0.441) between-group difference in men with baseline PV <30 mL (91.4% versus 89.1%, respectively). Conclusions Long-term treatment with finasteride led to a significant beneficial effect compared to placebo on clinical progression of BPH in LUTS patients with enlarged prostates (baseline PV ?30 mL). Finasteride had no significant effect, compared to placebo on clinical progression of BPH in LUTS patients with smaller prostates (baseline PV <30 mL). PMID:21334655

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

    Microsoft Academic Search

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

    2001-01-01

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

  5. Effectiveness and safety of doxazosin in hypertensive patients with benign prostatic hyperplasia

    Microsoft Academic Search

    E. Becerril; R. Jimenez; P. Astasio; P. Ortega; A. Gil

    2000-01-01

    To assess the safety and effectiveness of doxazosin in hypertensive patients with Benign Prostatic Hyperplasia (BPH). Open, prospective, non comparative, multicenter study. We included patients with BPH and hypertension. BPH was defined as having an International Prostatic Symptoms Score (I-PSS) above 7 and an increase in the prostate size. Patients were treated with doxazosin as monotherapy for 16 weeks. The

  6. Polymorphisms of MLH1 in benign prostatic hyperplasia and sporadic prostate cancer

    Microsoft Academic Search

    Yuichiro Tanaka; Mohd S. Zaman; Shahana Majid; Jan Liu; Kazumori Kawakami; Hiroaki Shiina; Takashi Tokizane; Angela V. Dahiya; Saunak Sen; Koichi Nakajima

    2009-01-01

    Mismatch repair is one of several DNA repair pathways of which defects may lead to cancer. We hypothesize that polymorphisms of the MLH1 gene can be a risk factor for benign prostatic hyperplasia (BPH) and prostate cancer. The genetic distribution of MLH1 polymorphisms that lead to amino acid changes at codons 132, 219, 384, and 723 were analyzed in BPH

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

    PubMed

    Garvey, Brian; Türkbey, Bar??; 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

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

    PubMed Central

    Garvey, Brian; Türkbey, Bar??; 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

  9. Optimizing the management of benign prostatic hyperplasia

    PubMed Central

    Elterman, Dean S.; Kaplan, Steven A.

    2012-01-01

    One of the challenges facing primary care physicians and specialists as the population ages is the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While as many as 18% of men in their 40s report bother from an enlarged prostate, that figure rises dramatically, whereby 50% of men in their 50s and 90% of men in their 90s will complain of bothersome symptoms related to an enlarged prostate. Studies have shown that BPH is a progressive disease, which if left untreated can result in worsening of symptoms, acute urinary retention and renal failure. Until about 20 years ago the only management option available to urologists was surgery. In the early 1990s medical therapy emerged as the predominant treatment for BPH. Therapy may be tailored to target symptoms and progression of disease. PMID:22496710

  10. Use of prostatic stents for the treatment of benign prostatic hyperplasia in high-risk patients

    Microsoft Academic Search

    John S. Lam; Michael A. Volpe; Steven A. Kaplan

    2001-01-01

    Benign prostatic hyperplasia (BPH) is a frequent disease in men and a major cause of lower urinary tract symptoms (LUTS).\\u000a Transurethral resection of the prostate (TURP) or open surgery remains the gold standard of treatment for symptomatic BPH.\\u000a However, 10% to 15% of patients with BPH cannot undergo surgery due to grave concomitant diseases. For patients presenting\\u000a with contraindications to

  11. 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

  12. 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 ?-Sitosterol) in controlling the lower urinary tract symptoms associated to BPH. PMID:25165780

  13. Laser treatment of benign prostatic hyperplasia

    Microsoft Academic Search

    Rainer M. Kuntz

    2007-01-01

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

  14. Microwave applicators for thermotherapy of benign prostatic hyperplasia: a primer.

    PubMed

    Bolmsjö, M B; Vrba, T

    2000-12-01

    Microwave thermotherapy for treatment of benign prostatic hyperplasia (BPH) is becoming increasingly more common. This article provides an introduction to the functional principles of microwave antennas for delivery of energy to the prostatic gland. Different antenna designs (monopole, dipole, and helical coil types) and impedance matching are discussed. PMID:11108559

  15. Apoptotic versus proliferative activities in human benign prostatic hyperplasia

    Microsoft Academic Search

    Natasha Kyprianou; Huacheng Tu; Stephen C Jacobs

    1996-01-01

    Cell growth in the normal prostate is regulated by a delicate balance between cell death and cell proliferation (ie, apoptotic v proliferative activity). Disruption of the molecular mechanisms that regulate these two processes may underline the abnormal growth of the gland leading to benign prostatic hyperplasia (BPH). In this study, the incidence of programmed cell death (apoptosis) and cell proliferation

  16. The Impact of Systematic Prostate Biopsy on Prostate Cancer Incidence in Men With Symptomatic Benign Prostatic Hyperplasia Undergoing Transurethral Resection of the Prostate

    Microsoft Academic Search

    David K. Ornstein; Ganesh S. Rao; Deborah S. Smith; Gerald L. Andriole

    1997-01-01

    PurposeWe determined the impact of 1 or more systematic (4 to 6 cores) needle biopsies of the prostate on the incidence of prostate cancer in men undergoing transurethral resection of the prostate for symptomatic benign prostatic hyperplasia (BPH) with elevated serum prostate specific antigen (PSA) and\\/or suspicious digital rectal examination.

  17. Prostate Enlargement: Benign Prostatic Hyperplasia (BPH)

    MedlinePLUS

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

  18. Androgen Receptor Roles in the Development of Benign Prostate Hyperplasia

    PubMed Central

    Izumi, Kouji; Mizokami, Atsushi; Lin, Wen-Jye; Lai, Kuo-Pao; Chang, Chawnshang

    2014-01-01

    Benign prostate hyperplasia (BPH) is a major cause of lower urinary tract symptoms, with an increased volume of transitional zone and associated with increased stromal cells. It is known that androgen/androgen receptor (AR) signaling plays a key role in development of BPH, and that blockade of this signaling decreases BPH volume and can relieve lower urinary tract symptoms, but the mechanisms of androgen/AR signaling in BPH development remain unclear, and the effectiveness of current drugs for treating BPH is still limited. The detailed mechanisms of androgen/AR signaling need to be clarified, and new therapies are needed for better treatment of BPH patients. This review focuses on roles of AR in epithelial and stromal cells in BPH development. In epithelial cells, AR may contribute to BPH development via epithelial cell–stromal cell interaction with alterations of epithelial–mesenchymal transition, leading to proliferation of stromal cells. Data from several mouse models with selective knockout of AR in stromal smooth-muscle cells and/or fibroblasts indicate that the AR in stromal cells can also promote BPH development. In prostatic inflammation, AR roles in infiltrating macrophages and epithelial and stromal cells have been linked to BPH development, which has led to discovery of new therapeutic targets. For example, targeting AR with the novel AR degradation enhancer, ASC-J9 offers a potential therapeutic approach against BPH development. PMID:23570837

  19. Photoselective vaporization of the prostate for treating benign prostatic hyperplasia.

    PubMed

    Chughtai, Bilal; Te, Alexis

    2011-09-01

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

  20. Drug Insight: 5?-reductase inhibitors for the treatment of benign prostatic hyperplasia

    Microsoft Academic Search

    Michael Marberger

    2006-01-01

    Benign prostatic hyperplasia (BPH) is a common problem among older men, which is characterized by an enlarged prostate, lower urinary tract symptoms, and decreased flow of urine. It is a progressive disease that can lead to complications such as acute urinary retention (AUR) or a need for BPH-related surgery in some men. Dihydrotestosterone is the primary androgen involved in both

  1. Sexual function in patients with benign prostatic hyperplasia

    Microsoft Academic Search

    Paul K. Hegarty; Nicholas J. Hegarty; John M. Fitzpatrick

    2001-01-01

    Sexual health has significant impact on quality of life among men with benign prostatic hyperplasia (BPH). The degree of sexual\\u000a dysfunction matches the severity of lower urinary tract symptoms (LUTS). Treatment of BPH affects not only LUTS, but sexual\\u000a function as well. Medical, surgical, and minimally invasive therapies differ in their effect on erectile function, ejaculation,\\u000a and sexual satisfaction. Choice

  2. The role of combination medical therapy in benign prostatic hyperplasia

    Microsoft Academic Search

    K A Greco; K T McVary

    2008-01-01

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

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

    Microsoft Academic Search

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

    2004-01-01

    Benign prostate hyperplasia (BPH) is a major disease and its non-surgical therapy a major area of interest. The purpose of this study was to establish perfusion parameters in beagles with BPH using dynamic contrast-enhanced (DCE) MRI and to investigate changes due to the effects of finasteride treatment. Twelve male beagles (mean age 4.4±0.9,years) were divided into a control and treatment

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

    PubMed Central

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

    2013-01-01

    Benign Prostate hyperplasia (BPH) and prostate cancer (PCa) are the most common prostatic disorders affecting elderly men. Multiple factors including hormonal imbalance, disruption of cell proliferation, apoptosis, chronic inflammation, and aging are thought to be responsible for the pathophysiology of these diseases. Both BPH and PCa are considered to be arisen from aberrant proliferation of prostate stem cells. Recent studies on BPH and PCa have provided significant evidence for the origin of these diseases from stem cells that share characteristics with normal prostate stem cells. Aberrant changes in prostate stem cell regulatory factors may contribute to the development of BPH or PCa. Understanding these regulatory factors may provide insight into the mechanisms that convert quiescent adult prostate cells into proliferating compartments and lead to BPH or carcinoma. Ultimately, the knowledge of the unique prostate stem or stem-like cells in the pathogenesis and development of hyperplasia will facilitate the development of new therapeutic targets for BPH and PCa. In this review, we address recent progress towards understanding the putative role and complexities of stem cells in the development of BPH and PCa. PMID:23936768

  5. Overview of interventional treatment options for benign prostatic hyperplasia.

    PubMed

    Elhilali, Mostafa M

    2012-10-01

    Transurethral resection of the prostate (TURP) remains the gold standard surgical intervention for men with benign prostatic hyperplasia (BPH). However, there are other, newer technologies that have also demonstrated safety and efficacy at least equivalent to that of TURP (e.g., Holmium laser, photoselective vaporization of the prostate). These minimally invasive techniques may be particularly useful for selected patient populations (e.g., those on anticoagulant therapy). PMID:23092781

  6. [Pathophysiology and therapy of benign prostatic hyperplasia].

    PubMed

    Sampson, Natalie; Madersbacher, Stephan; Berger, Peter

    2008-01-01

    Benign prostatic hyperplasia (BPH) and benign prostatic enlargement (BPE) are among the most frequent medical disorders of elderly men and cause a number of annoying symptoms of the lower urinary tract (LUTS), leading to reduced quality of life and severe complications, including acute urinary retention. Nodular overgrowth of the epithelium and in particular the fibromuscular tissue is observed in the transition zone and periurethral areas. In particular, functional and phenotypic transdifferentiation of fibroblasts into myofibroblasts is a hallmark of the tissue remodeling in the benign hyperplastic prostate. BPH/BPE have a complex pathophysiology with a multitude of endocrine and local factors involved. Two risk factors, namely aging and circulating androgens, contribute significantly to risk of BPH/BPE. One of the primary initiating mechanisms appears to be a consequence of age-related changes in systemic sex steroid hormone levels accompanied by alterations in local androgen metabolism. This results in the disruption of the delicate balance of interacting growth factor signaling pathways and stromal/epithelial interactions generating a growth promoting and tissue remodeling microenvironment that leads to an increase in prostate volume. Secondarily, altered cytokine and chemoattractant production by the remodeled stroma promotes local inflammation that may further contribute to disease progression via lymphocyte-derived inflammatory cytokines and reactive oxygen/nitrogen species. Local hypoxia as a result of increased oxygen demands of proliferating cells may induce low levels of reactive oxygen species promoting neovascularization and fibroblast-to-myofibroblast transdifferentiation. Medical therapies for LUTS due to BPH/BPE have changed little over the past 15 years with mainstay treatments being alpha-adrenoreceptor blockade and 5alpha-reductase inhibitors. We provide an in depth view of the mechanisms underlying BPH/BPE and relate new research findings to the clinical picture with the prospect of novel therapeutic targets, including selective hormone antagonists/agonists, anti-stromal therapy, vitamin-D analogues and approaches to redress the redox imbalance. PMID:18726663

  7. Transurethral microwave thermotherapy for benign prostatic hyperplasia.

    PubMed

    Rubeinstein, Jonathan N; McVary, Kevin T

    2003-01-01

    Transurethral resection of the prostate (TURP) remains the gold standard for treatment of benign prostatic hyperplasia (BPH). In general, while this procedure is safe, patients require a spinal, epidural, or general anesthesia and often several days of hospital stay; the potential morbidity and mortality limits the use of TURP in high-risk patients. Pharmacotherapy has been recommended as a first-line therapy for all patients with mild to moderate symptoms. Patients are often times enthusiastic if they are offered a one-time method to treat lower urinary tract symptoms secondary to BPH, provided that the method offers reduced risk and allows an efficacy equal to that of medical therapy. One such method is transurethral microwave thermotherapy (TUMT). TUMT involves the insertion of a specially designed urinary catheter with a microwave antenna, which heats the prostate and destroys hyperplastic prostate tissue. TUMT allows the avoidance of general or regional anesthesia, and results in minimal blood loss and fluid absorption. In this review, the authors discussed the current indications and outcome of TUMT, including the history of the procedure, the mechanism of action, the indications for TUMT, the pre-operative considerations, the patient selection, the results in terms of efficacy, by comparing TUMT vs. Sham, TUMT vs. Alpha-blocker and TUMT vs. TURP. Finally, the complications are presented, as well as other uses and future directions of the procedure. The authors concluded that TUMT is a safe and effective minimally invasive alternative to treatment of symptomatic BPH. PMID:15745533

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

    Microsoft Academic Search

    Julien Berger; Gregoire Robert; Aurelien Descazeaud

    2010-01-01

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

  9. Sex steroid receptor expression and localization in benign prostatic hyperplasia varies with tissue compartment

    PubMed Central

    Nicholson, Tristan M.; Sehgal, Priyanka D.; Drew, Sally A.; Huang, Wei; Ricke, William A.

    2013-01-01

    Androgens and estrogens, acting via their respective receptors, are important in benign prostatic hyperplasia (BPH). The goal of this study was to quantitatively characterize the tissue distribution and staining intensity of androgen receptor (AR) and estrogen receptor-alpha (ER?), and assess cells expressing both AR and ER?, in human BPH compared to normal prostate. A tissue microarray composed of normal prostate and BPH tissue was used and multiplexed immunohistochemistry was performed to detect AR and ER?. We used a multispectral imaging platform for automated scanning, tissue and cell segmentation and marker quantification. BPH specimens had an increased number of epithelial and stromal cells and increased percentage of epithelium. In both stroma and epithelium, the mean nuclear area was decreased in BPH relative to normal prostate. AR expression and staining intensity in epithelial and stromal cells was significantly increased in BPH compared to normal prostate. ER? expression was increased in BPH epithelium. However, stromal ER? expression and staining intensity was decreased in BPH compared to normal prostate. Double positive (AR & ER?) epithelial cells were more prevalent in BPH, and fewer double negative (AR & ER?) stromal and epithelial negative cells were observed in BPH. These data underscore the importance of tissue layer localization and expression of steroid hormone receptors in the prostate. Understanding the tissue-specific hormone action of androgens and estrogens will lead to a better understanding of mechanisms of pathogenesis in the prostate and may lead to better treatment for BPH. PMID:23792768

  10. Sex steroid receptor expression and localization in benign prostatic hyperplasia varies with tissue compartment.

    PubMed

    Nicholson, Tristan M; Sehgal, Priyanka D; Drew, Sally A; Huang, Wei; Ricke, William A

    2013-01-01

    Androgens and estrogens, acting via their respective receptors, are important in benign prostatic hyperplasia (BPH). The goals of this study were to quantitatively characterize the tissue distribution and staining intensity of androgen receptor (AR) and estrogen receptor-alpha (ER?), and assess cells expressing both AR and ER?, in human BPH compared to normal prostate. A tissue microarray composed of normal prostate and BPH tissue was used and multiplexed immunohistochemistry was performed to detect AR and ER?. We used a multispectral imaging platform for automated scanning, tissue and cell segmentation and marker quantification. BPH specimens had an increased number of epithelial and stromal cells and increased percentage of epithelium. In both stroma and epithelium, the mean nuclear area was decreased in BPH relative to normal prostate. AR expression and staining intensity in epithelial and stromal cells was significantly increased in BPH compared to normal prostate. ER? expression was increased in BPH epithelium. However, stromal ER? expression and staining intensity was decreased in BPH compared to normal prostate. Double positive (AR and ER?) epithelial cells were more prevalent in BPH, and fewer double negative (AR and ER?) stromal and epithelial negative cells were observed in BPH. These data underscore the importance of tissue layer localization and expression of steroid hormone receptors in the prostate. Understanding the tissue-specific hormone action of androgens and estrogens will lead to a better understanding of mechanisms of pathogenesis in the prostate and may lead to better treatment for BPH. PMID:23792768

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

    MedlinePLUS

    What is an enlarged prostate? The prostate makes the semen that carries sperm. It surrounds the urethra, the tube that carries urine out of the ... benign prostatic hyperplasia). Why should I have my prostate checked? When the prostate gets too large, it ...

  12. [Surgical options for benign prostatic hyperplasia: impact on sexual function and risk factors].

    PubMed

    Gu, Ren-Ze; Xia, Shu-Jie

    2011-09-01

    Benign prostatic hyperplasia (BPH) is a common problem among elderly males. Surgical resection of the hyperplastic tissue to relieve urinary tract obstruction remains a major option for the treatment of BPH. Operations, whether open prostatectomy, transurethral resection of the prostate, or transurethral laser resection of the prostate, will inevitably affect the sexual function of the patient. With the increased attention to patients' quality of life, more and more importance is being attached to the changes in post-BPH sexual function. This review covers the sexual function changes induced by different surgical methods and assesses the possible risk factors of BPH surgery. PMID:21961250

  13. The psychometric validation of a US English satisfaction measure for patients with benign prostatic hyperplasia and lower urinary tract symptoms

    Microsoft Academic Search

    Libby Black; Alyson Grove; Betsy Morrill

    2009-01-01

    BACKGROUND: The purpose of the current study was to validate the US English Patient Perception of Study Medication (PPSM) questionnaire, which measures patient satisfaction with Benign Prostatic Hyperplasia (BPH) treatment and was administered to men with BPH lower urinary tract symptoms (LUTS) enrolled in a multi-national clinical trial. METHODS: Patients with moderate to severe BPH symptoms completed three disease-specific measures:

  14. Reproducibility of uroflow measurement: experience during a double-blind, placebo-controlled study of doxazosin in benign prostatic hyperplasia

    Microsoft Academic Search

    Mark R. Feneley; William D. Dunsmuir; Jenny Pearce; Roger S. Kirby

    1996-01-01

    Objectives. To evaluate the interindividual and intraindividual variation of uroflow measurements in men with benign prostatic hyperplasia (BPH).Methods. A total of 147 men with clinical evidence of BPH underwent two uroflow measurements at each of two screening visits prior to recruitment into a placebo-controlled study of doxazosin in the treatment of BPH. The maximum and mean flow rates were determined

  15. The effect of Echinacea purpurea (L.) Moench extract on experimental prostate hyperplasia.

    PubMed

    Skaudickas, D; Kondrotas, A J; Kevelaitis, E; Venskutonis, P R

    2009-10-01

    The aim of this study was to examine the effect of purple coneflower (Echinacea purpurea L. Moench) on the prostate gland of rats using an experimental model of benign prostate hyperplasia (BPH). The animals were administered 50 mg/kg of extract preparation for 4 and 8 weeks and the prostate mass and structural degenerative changes were evaluated in the course of the experiment. The administration of E. purpurea extract to rats with hyperplasia for 4 and 8 weeks gradually and significantly reduced the prostate mass and reversed the degenerative changes in the structure of the prostate gland. The present investigation suggests extract of purple coneflower prevents the development of BPH. PMID:19288499

  16. Relationship between Urodynamic Type of Obstruction and Histological Component of the Prostate in Patients with Benign Prostatic Hyperplasia

    Microsoft Academic Search

    Osamu Ichiyanagi; Isoji Sasagawa; Manabu Ishigooka; Yasuhiro Suzuki; Teruhiro Nakada

    1999-01-01

    Objectives: This study was designed to compare urodynamic types of bladder outlet obstruction (BOO) and histological architecture of the prostate in patients with benign prostatic hyperplasia (BPH). Patients and Methods: Twenty-four patients with symptomatic BPH, who underwent transurethral resection of the prostate (TURP), were included in the study. Before surgery, a pressure-flow (P-F) study was performed in all patients. According

  17. Regulation of Prostatic Smooth Muscle Contractility by Intracellular Second Messengers: Implications for the Conservative Treatment of Benign Prostatic Hyperplasia

    Microsoft Academic Search

    R. E. Eckert; U. Schreier; P. Drescher; P. O. Madsen; H. Derouet; E. Becht; J. Steffens; M. Ziegler

    1995-01-01

    The increased sympathetic neurotransmission in benign prostatic hyperplasia (BPH) results in a ?1C-adrenoceptor-mediated increase in prostatic smooth muscle tone which seems to be responsible for the dynamic infravesical obstruction occurring in BPH. The prostatic smooth muscle contractions evoked by norepinephrine can be efficiently blocked by ?1-adrenoceptor blockers. Moreover, an impressive number of clinical trials illustrated the beneficial results of ?1-adrenoceptor

  18. Impact of prostate-specific antigen density in benign prostatic hyperplasia and prostate carcinoma. Preliminary results.

    PubMed

    Akda?, A; Dillio?lugil, O; Cevik, I; Ilker, Y

    1994-01-01

    In an attempt to enhance the success of prostate-specific antigen (PSA) in the diagnosis and staging of prostate carcinoma (PCa) the concept of PSA density (PSAD) has been introduced by Benson et al. Likewise a study to investigate the role of PSAD in 53 patients with PCa and 47 patients with benign prostatic hyperplasia (BPH) has been done. PSADs seemed to increase directly proportional to the grade in PCa and differed significantly between patient groups with BPH and localized+metastatic PCa, BPH and localized PCa, and localized PCa and metastatic PCa. Although 0.6 level for PSAD seemed to be a rational cut-off level in our study, this issue needs to be studied in multiple centers involving an increased number of patients for resolution. PMID:7519992

  19. The Senescence-Associated Secretory Phenotype Promotes Benign Prostatic Hyperplasia

    PubMed Central

    Vital, Paz; Castro, Patricia; Tsang, Susan; Ittmann, Michael

    2015-01-01

    Benign prostatic hyperplasia (BPH) is characterized by increased tissue mass in the transition zone of the prostate, which leads to obstruction of urine outflow and considerable morbidity in a majority of older men. Senescent cells accumulate in human tissues, including the prostate, with increasing age. Expression of proinflammatory cytokines is increased in these senescent cells, a manifestation of the senescence-associated secretory phenotype. Multiplex analysis revealed that multiple cytokines are increased in BPH, including GM-CSF, IL-1?, and IL-4, and that these are also increased in senescent prostatic epithelial cells in vitro. Tissue levels of these cytokines were correlated with a marker of senescence (cathepsin D), which was also strongly correlated with prostate weight. IHC analysis revealed the multifocal epithelial expression of cathepsin D and coexpression with IL-1? in BPH tissues. In tissue recombination studies in nude mice with immortalized prostatic epithelial cells expressing IL-1? and prostatic stromal cells, both epithelial and stromal cells exhibited increased growth. Expression of IL-1? in prostatic epithelial cells in a transgenic mouse model resulted in increased prostate size and bladder obstruction. In summary, both correlative and functional evidence support the hypothesis that the senescence-associated secretory phenotype can promote the development of BPH, which is the single most common age-related pathology in older men. PMID:24434012

  20. Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life

    Microsoft Academic Search

    DJ Carbone; S Hodges

    2003-01-01

    Therapies for benign prostatic hyperplasia (BPH) may either improve or exacerbate sexual function with an ensuing impact on quality of life. Here we review a total of 73 papers on medical therapies for BPH with a focus on the effects of different pharmacological agents on sexual function. For example, certain ?1-adrenergic receptor blockers may improve erectile function; however, ejaculatory dysfunction

  1. Effect of Doxazosin on Oxidative Stress-Related Proteins in Benign Prostatic Hyperplasia

    Microsoft Academic Search

    Lorenzo A. Calò; Elisa Pagnin; Paul A. Davis; Michele Lodde; Christine Mian; Andrea Semplicini; Armin Pycha

    2006-01-01

    Background and Objectives: Oxidative stress can induce cell mutations or proliferation which then can progress to carcinogenesis or remodeling. The same oxidative stress-mediated mechanism could participate in prostate cell proliferation and remodeling present in benign prostatic hyperplasia (BPH). Doxazosin induces prostate epithelial and stromal cell apoptosis through production of transforming growth factor-? (TGF-?), but cellular mechanisms are not completely clarified.

  2. Observational Multicentric Trial Performed with Doxazosin: Evaluation of Sexual Effects on Patients with Diagnosed Benign Prostatic Hyperplasia

    Microsoft Academic Search

    Aldo Franco De Rose; Giorgio Carmignani; Carlo Corbu; Matteo Giglio; Paolo Traverso; Angelo Naselli; Emanuele Belgrano; Costanzo Catuogno; Dario Fontana; Armando Maver; Vincenzo Mirone; Giovanni Muzzonigro; Daniele Di Trapani; Fabio Bonini

    2002-01-01

    Introduction: The aim of our study is to verify the effects of doxazosin on sexual function in patients with benign prostatic hyperplasia (BPH). Materials and Methods: We enrolled 102 patients with BPH, selected by nine Italian Urology Departments. Patients were evaluated with the International Prostatic Symptom Score (I-PSS) and divided into two groups: those with intact sexual activity and those

  3. Rapatar, a nanoformulation of rapamycin, decreases chemically-induced benign prostate hyperplasia in rats

    PubMed Central

    Antoshina, Elena E.; Trukhanova, Lubov S.; Gorkova, Tatiana G.; Shipaeva, Elena V.; Salimov, Ramiz M.; Belitsky, Gennady A.; Blagosklonny, Mikhail V.; Yakubovskaya, Marianna G.; Chernova, Olga B.

    2015-01-01

    Benign prostatic hyperplasia (BPH) is the most common age-related disease in men. Here we tested the efficacy of Rapatar, a micellar nanoformulation of rapamycin, in two rat models of BPH: testosterone-induced and sulpiride-induced hyperplasia in ventral lobes and lateral/dorsal lobes, respectively. We found that Rapatar prevented hypertrophic and hyperplastic abnormalities and degenerative alterations in both BPH models. Rapatar normalized weight of the lateral lobes in sulpiride-induced BPH, the most relevant animal model of human BPH. Unlike Finasteride, a standard therapy of BPH, Rapatar reduced inflammation caused by sulpiride. No obvious side effects of Rapatar were detected. Our data provide a rationale for clinical trials of Rapatar in patients suffering from BPH. PMID:25991667

  4. Benign prostatic hyperplasia evaluation, association with sexual dysfunction, treatment, and practice patterns according to physician specialty

    Microsoft Academic Search

    Boback M. Berookhim; Matthew L. Steinway; Natan Bar-Chama; Allen D. Seftel

    2009-01-01

    Recent evidence has indicated a significant link between benign prostatic hyperplasia (BPH) and sexual dysfunction (SD). Patients\\u000a presenting with lower urinary tracts symptoms (LUTS) secondary to BPH should also be evaluated for comorbid SD, especially\\u000a given the increasing basic science evidence demonstrating a common pathway for these two conditions. Therapy for BPH may exacerbate\\u000a SD and should be selected carefully,

  5. 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. 5?-reductase inhibitors decrease the production of dihydrotestosterone within the prostate, which results in decreased prostate volume, increased peak urinary flow rate, improvement of symptoms, decreased risk of acute urinary retention, and need for surgical intervention. ?1-adrenergic receptor (?1-AR) antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Clinical efficacy of either 5?-reductase inhibitor or ?1-AR antagonist has been further improved by using combination therapy; however, long-term outcomes are still awaited. Many more potential new therapies are under development that may improve the treatment of BPH. This article gives a brief account of rationale and efficacy of different treatment options presently available in the management of BPH. PMID:21455413

  6. Inhibitory effects of TripTripterygium wilfordii multiglycoside on benign prostatic hyperplasia in rats.

    PubMed

    Shen, Hai-Nan; Xu, Yuan; Jiang, Zhen-Zhou; Huang, Xin; Zhang, Lu-Yong; Wang, Tao

    2015-06-01

    The present study was designed to evaluate the inhibitory effects of Tripterygium wilfordii multiglycoside (GTW) against testosterone-induced benign prostatic hyperplasia (BPH) in rats. A total of 45 rats were randomly divided into five groups: Group I, vehicle control group (sham-operated and treated with vehicle); Group II, BPH group; Group III, BPH rats treated with finasteride at a dose of 5 mg·kg(-1); and Groups IV and V, BPH rats treated with GTW at dose levels of 10 and 20 mg·kg(-1), respectively. The drugs were administered orally once a day for 14 days. Prostate weight, prostatic index, and the testosterone and dihydrotestosterone (DHT) levels in serum and prostate, and the serum prostate specific antigen (PSA) levels were measured; prostate tissues were taken for histopathological examination; and serum biochemical analysis was also performed. The BPH rats displayed an increase in prostate weight, prostatic index with increased testosterone and DHT levels in both the serum and prostate, and increased serum PSA levels. GTW treatment at both doses resulted in significant reductions in prostate weight, prostatic index, testosterone and DHT levels in both the serum and prostate, and serum PSA levels, compared with BPH group. Histopathological examination also indicated that GTW treatment at both doses inhibited testosterone-induced prostatic hyperplasia. Serum biochemical analysis showed that the liver and renal functions were normal. In conclusion, GTW inhibited testosterone-induced prostatic hyperplasia in rats, without host toxicity, providing a basis for the development of GTW as a novel therapy for BPH. PMID:26073338

  7. [Interpretation of results of clinical trials in benign prostatic hyperplasia].

    PubMed

    Millán Rodríguez, F; Rodríguez Vallejo, J M; Carballido Rodríguez, J

    2002-01-01

    The random clinical trial (RCT) is the most suitable study to evaluate the treatment effectiveness in the benign prostatic hyperplasia (BPH). Although most of the urologists will not collaborate in a RCT development, they will treat BPH patients, so it is very important to know if a CRT in BPH is well designed and their conclusions are correct. The aim of this article is to give the basic elements of analysis that urologists need in order to evaluate the quality and the level of evidence of a RCT in BPH. This article emphasizes the three main elements of a RCT: to check if the study has been correctly performed (internal validity), to evaluate if the treatment achieves an important clinical improvement (relevance of the results) and the applicability of the results in our patients (external validity). The article shows that to analyse these elements common sense and clinical judgment are needed rather than statistical knowledge. PMID:11899738

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

    Microsoft Academic Search

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

    2002-01-01

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

  9. Prostatic stromal hyperplasia with atypia.

    PubMed

    Hutchinson, Ryan C; Wu, Kevin J; Cheville, John C; Thiel, David D

    2013-01-01

    Prostatic stromal hyperplasia with atypia (PSHA) is a rare histologic finding diagnosed incidentally on prostate biopsies, transurethral resection specimens, and radical prostatectomy specimens. PSHA has a bizarre histologic appearance and these lesions often raise concern for sarcoma; however, their clinical course is indolent and does not include extraprostatic progression. We discuss a case of PHSA discovered on prostate biopsy performed for an abnormal digital rectal examination and review the literature on this rare pathologic finding. PMID:23781384

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

    PubMed Central

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

    2014-01-01

    Angiogenesis plays an important role in the progression and development of benign prostatic hyperplasia (BPH), and has become a promising target for BPH treatment. The hypoxia-inducible factor-1? (HIF-1?) signaling pathway promotes the process of angiogenesis, contributing to the growth and progression of a number of hyperplasia diseases, including BPH. Qianliening capsule (QC) is a traditional Chinese formula that has been used clinically in China to treat BPH for a number of years. Recently, QC was demonstrated to inhibit prostatic cell growth and induce apoptosis in vivo and in vitro via regulating the epidermal growth factor/signal transducer and activator of transcription 3 signaling pathway and mitochondrion-dependent apoptosis pathway. However, the mechanisms underlying the anti-BPH effect remain largely unknown. To further elucidate the mechanism of QC activity in BPH treatment, a rat BPH model established by injecting testosterone following castration was established and the effect of QC on prostatic tissue angiogenesis was evaluated, as well as the underlying molecular mechanisms. QC was shown to reduce the prostatic index in BPH rats, but without affecting the body weight, demonstrating that QC is effective in the treatment of BPH and without apparent toxicity. In addition, QC treatment significantly reduced the intraprostatic microvessel density, indicating antiangiogenesis activity in vivo. In addition, treatment with QC inhibited the expression of HIF-1? in BPH rats, as well as the expression of vascular endothelial growth factor and basic fibroblast growth factor. Therefore, for the first time, the present study hypothesized that QC inhibits angiogenesis in prostatic tissue of BPH rats via the inhibition of the HIF-1? signaling pathway, which may be one of the mechanisms in which QC treats BPH. PMID:24944609

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

    Madigan, A A; Sobek, K M; Cummings, J L; Green, W R; Bacich, D J; O'Keefe, D S

    2012-10-01

    Benign prostatic hyperplasia (BPH) is the most common urologic disease in men over age 50. Symptoms include acute urinary retention, urgency to urinate and nocturia. For patients with severe symptoms, surgical treatment is used to remove the affected tissue. Interestingly, the presence of histologic BPH does not always correlate with symptoms. The molecular basis of symptomatic BPH and how it differs from asymptomatic BPH is unknown. Investigation into the molecular players involved in symptomatic BPH will likely give insight into novel therapeutic, and potentially preventative, targets. We determined the expression of genes involved in the innate anti-viral immune response in tissues from patients undergoing surgery to alleviate the symptoms of BPH, and compared the results with prostate tissue with histologic BPH, but from patients with few urinary issues (asymptomatic BPH). We found that expression of complement factor I, apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like protein 3G, oligoadenylate synthetase 2 and interferon-induced tetratricopeptide 1, four genes whose protein products are involved in the innate anti-viral immune response, was significantly transcriptionally upregulated in symptomatic BPH. Additionally, we observe hypomethylation and concomitant expression of ancient retroviral-like sequences, the long interspersed nuclear element 1 retrotransposons, in symptomatic BPH when compared with normal prostate tissue. These findings merit further investigation into the anti-viral immune response in symptomatic BPH. PMID:22952051

  13. Treatment of a Benign Prostatic Hyperplasia by Nd:YAG Laser – Own Experience

    Microsoft Academic Search

    W. Pypno; W. Husiatynski

    2000-01-01

    Objectives: To evaluate the effectiveness and safety of visual laser ablation (VLAP) and interstitial laser coagulation (ILCP) versus transurethral resection of the prostate (TURP).Patients and Methods: Altogether 259 consecutive patients with symptomatic benign prostatic hyperplasia (BPH) were treated by VLAP (n = 117), ILCP (n = 30) or TURP (n = 112). VLAP was carried out using both contact and

  14. Medical Therapy for Benign Prostatic Hyperplasia: A Review of the Literature

    Microsoft Academic Search

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

    2000-01-01

    Objective: To review the existing evidence regarding the efficacy and safety of medical therapy for lower urinary tract symptoms (LUTS) indicative of benign prostatic hyperplasia (BPH). To assess randomised controlled trials investigating the six ?–adrenergic receptor antagonists (?–blockers), prazosin, alfuzosin, indoramin, terazosin, doxazosin, and tamsulosin, that benefit patients by relaxing prostatic smooth muscle, and the anti–androgen, finasteride, that mediates its

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

    Microsoft Academic Search

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

    1995-01-01

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

  16. Doxazosin in the treatment of benign prostatic hyperplasia. A review of the safety profile in older patients

    Microsoft Academic Search

    R Kirby; A Jardin

    1997-01-01

    The objective of this paper is to review the safety of doxazosin in older patients (?65 y) with benign prostatic hyperplasia (BPH) as reported in seven international clinical trials. Data from seven double-blind, placebo-controlled, phase III trials, in both normotensive and hypertensive patients with BPH were collated and analysed. Data on doxazosin were available for 341 men 65 y and

  17. MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA IN HIGH RISK PATIENTS: LONG-TERM EXPERIENCE WITH THE MEMOTHERM STENT

    Microsoft Academic Search

    A. GESENBERG; R. SINTERMANN

    1998-01-01

    PurposeOf all patients with benign prostatic hyperplasia (BPH) 10 to 15% cannot undergo surgery due to grave concomitant diseases. Successful treatment should avoid catheterization to maintain quality of life. We report on our long-term experience with the Memotherm* stent implanted in high risk patients with BPH.

  18. Effect of doxazosin on stretch-activated adenosine triphosphate release in bladder urothelial cells from patients with benign prostatic hyperplasia

    Microsoft Academic Search

    Yan Sun; Jennifer MaLossi; Stephen C Jacobs; Toby C Chai

    2002-01-01

    Objectives. Recent data suggest that the bladder urothelium may have a sensory function by way of release of adenosine triphosphate (ATP) during stretch, which then acts as a sensory neurotransmitter. Because benign prostatic hyperplasia (BPH) can give rise to irritative (hypersensory) voiding patterns, we questioned whether the bladder urothelium from patients with BPH released more ATP during in vitro stretch

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

    Microsoft Academic Search

    Toyoaki Uchida

    2011-01-01

    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

  20. In vivo differential diagnosis of prostate cancer and benign prostatic hyperplasia: localized proton magnetic resonance spectroscopy using external-body surface coil

    Microsoft Academic Search

    Jong-Ki Kim; Duk-Youn Kim; Young-Hwan Lee; Nak-Kwan Sung; Duck-Soo Chung; Ok-Dong Kim; Kap-Byung Kim

    1998-01-01

    Localized proton-stimulated echo acquisition mode (STEAM) spectroscopy was performed in seven patients with benign prostatic hyperplasia (BPH), six patients with prostate cancer, and seven healthy volunteers to determine whether citrate levels detected using a saddle-type external-body surface coil (two loops of 13 cm ×17 cm) could reliably discriminate BPH from prostatic cancer. Relative area ratios of citrate level to choline

  1. [Benign prostatic hyperplasia and erectile dysfunction: an update].

    PubMed

    Fan, Yu

    2013-06-01

    Epidemiological studies have confirmed that benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes. Although researchers have not yet established a direct causal relationship between the two problems, several pathophysiological factors may serve to explain it, which include the alteration in nitric oxide bioavailability, increased autonomic activity, a1-adrenergic receptor hyperactivity, imbalance of RhoA/Rho-kinase, and metabolic syndrome X. Men seeking care for BPH should always be screened for sexual function and complaints of ED. PDE5 inhibitors show promise as a future treatment for lower urinary tract symptoms secondary to BPH. Further investigation is required for future therapies and possible preventative strategies. PMID:23862240

  2. Prostate histotripsy for BPH: initial canine results

    NASA Astrophysics Data System (ADS)

    Roberts, William W.; Hall, Timothy L.; Hempel, Christopher R.; Cain, Charles A.

    2009-02-01

    Histotripsy is an extracorporeal ablative technology that utilizes microsecond pulses of intense ultrasound (< 1% duty cycle) to produce nonthermal, mechanical fractionation of targeted tissue. We have previously demonstrated the feasibility of histotripsy prostate ablation. In this study we sought to assess the chronic tissue response, tolerability and safety of histotripsy in a chronic in vivo canine model. Five acute and thirteen chronic canine subjects were anesthetized and treated with histotripsy targeting the prostate. Pulses consisted of 3 cycle bursts of 750 kHz ultrasound at a repetition rate of 300 Hz delivered transabdominally from a highly focused 15 cm aperture array. Transrectal ultrasound imaging provided accurate targeting and real-time monitoring of histotripsy treatment. Prostates were harvested at 0, 7, 28, or 56 days after treatment. Consistent mechanical tissue fractionation and debulking of prostate tissue was seen acutely and at delayed time points without collateral injury. Urothelialization of the treatment cavity was apparent 28 days after treatment. Canine subjects tolerated histotripsy with minimal hematuria or discomfort. Only mild transient lab abnormalities were noted. Histotripsy is a promising non-invasive therapy for prostate tissue fractionation and debulking that appears safe and well tolerated without systemic side effects in the canine model.

  3. Effects of Melandrium firmum methanolic extract on testosterone-induced benign prostatic hyperplasia in Wistar rats

    PubMed Central

    Lee, Mee-Young; Shin, In-Sik; Seo, Chang-Seob; Lee, Nam-Hun; Ha, Hye-Kyung; Son, Jong-Keun; Shin, Hyeun-Kyoo

    2012-01-01

    Benign prostatic hyperplasia (BPH) is an age-related disease of unknown aetiology characterized by prostatic enlargement coincident with distinct alterations in tissue histomorphology. Instead of therapeutic agents that can cause severe side effects, plant extracts are frequently used to treat BPH. In this study, we investigated whether the Melandrium firmum methanolic extract (MFME) improves BPH, using the testosterone propionate (TP)-induced BPH rat model. Castration was performed via the scrotal route under sodium pentobarbital anaesthesia. BPH in castrated rats was generated via daily subcutaneous injections of TP (3 mg kg?1) dissolved in corn oil, for 4 weeks. MFME was administered daily by oral gavage at a dose of 200 mg kg?1 for 4 weeks, along with the TP injections. The control group received injections of corn oil subcutaneously. At the scheduled termination of the experiment, all rats were killed and their prostates weighed; the relative prostate weight (prostate/body weight ratio) was calculated, and histomorphological changes in the prostate were examined. Additionally, we measured the levels of testosterone and dihydrotestosterone (DHT) in the serum and the prostate. Experimentally induced BPH led to marked decreases in the relative prostate weight and the DHT levels in the serum and the prostate. Histologically, BPH was evident in the ventral lobe of the prostate, and MFME treatment suppressed the severity of the lesions. These results indicate that MFME effectively inhibits the development of BPH induced by testosterone in a rat model. Further studies will be needed to identify the compound(s) responsibility for inducing the protective effect against BPH and determine its mechanism of action. PMID:22231294

  4. alpha 1ADRENOCEPTOR ANTAGONISTS TERAZOSIN AND DOXAZOSIN INDUCE PROSTATE APOPTOSIS WITHOUT AFFECTING CELL PROLIFERATION IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

    Microsoft Academic Search

    JOANNA K. CHON; ANDREW BORKOWSKI; ALAN W. PARTIN; JOHN T. ISAACS; STEPHEN C. JACOBS; NATASHA KYPRIANOU

    1999-01-01

    PurposeRecent evidence indicated that an alpha1 blocker, doxazosin, induces prostate apoptosis in patients with benign prostatic hyperplasia (BPH).[1] in this study, to determine whether this apoptotic response was mediated by alpha1 adrenoceptor-dependent mechanism or was specific to doxazosin, we examined the effect of another alpha1 blocker, terazosin, in addition to doxazosin, on the dynamics of prostate cell growth.

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

    SciTech Connect

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

    2013-12-15

    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.

  6. Alpha adrenergic blockers in the treatment of benign hyperplasia of the prostate

    Microsoft Academic Search

    V. L. Kumar; S. Dewan

    2000-01-01

    Benign prostatic hyperplasia (BPH), a common benign tumor in men has been attributed to age and male androgen functions. Of\\u000a the various management options for treatment of BPH, medical therapy is the first line treatment modality involving either\\u000a blockade of alpha adrenergic receptors or inhibition of 5-alpha reductase. Amongst these, the alpha-1 blockers are used most\\u000a frequently. The association of

  7. Clinical significance of ? 1 -adrenoceptor selectivity in the management of benign prostatic hyperplasia

    Microsoft Academic Search

    James L. Pool; Roger S. Kirby

    2001-01-01

    Alpha1-adrenoceptor antagonists have beenshown to provide effective relief from symptomsof benign prostatic hyperplasia (BPH) withattendant improvements in quality of life.Although the a1A-adrenoceptorsubtype predominates over other subtypes ofa1 adrenoceptors in the prostategland, there is no evidence that a subselectivea-adrenoceptor antagonist provides aclinical advantage over a selectivea1-adrenoceptor antagonist in thetreatment of patients with BPH. Thepharmacokinetic profiles ofa1A-adrenoceptorantagonists and their documented penetration ofthe

  8. Effects of doxazosin in patients with mild, intermediate, and severe benign prostatic hyperplasia

    Microsoft Academic Search

    David F. Mobley; Norma Dias; Marcia Levenstein

    1998-01-01

    Traditionally, drug therapy for benign prostatic hyperplasia (BPH) has been reserved for patients with mild or moderate symptoms. The objective of this analysis was to compare responses to an alpha1-adrenergic receptor blocker, doxazosin, in patients with severe, intermediate, and mild disease. Data were analyzed from patients with symptomatic BPH who were enrolled in two 16-week, double-masked, placebo-controlled studies of doxazosin.

  9. Impact of interventional therapy for benign prostatic hyperplasia on quality of life and sexual function

    Microsoft Academic Search

    András Hoznek; Clément-Claude Abbou

    2001-01-01

    Considering the epidemiologic impact of benign prostatic hyperplasia (BPH), the use of minimally invasive surgery in the treatment\\u000a of this condition is one of the main ambitions of contemporary urology. Compared with the prevalence of BPH and LUTS in elderly\\u000a men, only a small percentage of patients requires surgery for indications such as renal insufficiency, chronic retention,\\u000a and infection. The

  10. PPAR?: 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. PPAR? 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. 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

  12. 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.

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

    PubMed Central

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

    2011-01-01

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

  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 5? 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 5? 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. Outline of JUA clinical guidelines for benign prostatic hyperplasia.

    PubMed

    Homma, Yukio; Gotoh, Momokazu; Yokoyama, Osamu; Masumori, Naoya; Kawauchi, Akihiro; Yamanishi, Tomonori; Ishizuka, Osamu; Seki, Narihito; Kamoto, Toshiyuki; Nagai, Atsushi; Ozono, Seiichiro

    2011-11-01

    The Japanese Urological Association has developed Clinical Guidelines for Benign Prostatic Hyperplasia (BPH) for men with suspected BPH, which have been abridged and translated into English. This article is a shortened version of the English translation. The Guidelines were formulated on the basis of evidence retrieved from the PubMed database between 1995 and 2009, as well as other relevant sources. The target patients of these Guidelines are men with suspected BPH, and the target users are urologists. A mandatory assessment should include a medical history, a physical examination, the completion of symptom and quality of life questionnaires, urinalysis, prostate ultrasonography, measurement of serum prostate specific antigen and postvoid residual urine, and an uroflowmetry. Optional tests include a bladder diary, the measurement of serum creatinine, and upper urinary tract ultrasonography. Care should be taken to not overlook coexisting diseases such as an infection or malignancy that may obscure the diagnosis. Treatment should consist of conservative therapy or the use of medications such as ?(1) -adrenoceptor antagonists, or both. The use of 5?-reductase inhibitors or anticholinergic agents should be considered in patients with an enlarged prostate (>30 mL) or overactive bladder symptoms (overactive bladder symptom score ? 6), respectively. Surgical intervention is indicated when non-surgical treatments fail to provide sufficient symptomatic relief and bladder outlet obstruction is highly suspected. PMID:22050351

  16. 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

  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. Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men

    Microsoft Academic Search

    James B. Meigs; Beth Mohr; Michael J. Barry; Mary McNaughton Collins; John B. McKinlay

    2001-01-01

    We defined risk factors for a clinical diagnosis of benign prostatic hyperplasia (BPH) among subjects of the population-based Massachusetts Male Aging Study. In 1987–89 1709 men aged 40–70 provided baseline risk factor data and were followed for a mean of 9 years; 1019 men without prostate cancer provided follow-up data. We classified men with clinical BPH at follow-up if they

  19. Combination 5-?-reductase inhibitors and ?-blockers for treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia

    Microsoft Academic Search

    Joseph C. Clarke; Timothy R. Yoost; Harry S. Clarke

    2007-01-01

    Open or transurethral resection of the prostate was once the only option for men afflicted with symptomatic benign prostatic\\u000a hyperplasia (BPH). In the past 10 to 15 years, however, medical management has become a common step in the treatment of BPH,\\u000a often postponing or eliminating the need for surgical intervention. The two drug classes used in the medical management of

  20. Open Prostatectomy in Benign Prostatic Hyperplasia: 10Year Experience in Italy

    Microsoft Academic Search

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

    1998-01-01

    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

  1. Doxazosin in the Treatment of Benign Prostatic Hyperplasia in Normotensive Patients: A Multicenter Study

    Microsoft Academic Search

    Ahmed Fawzy; Karl Braun; George P. Lewis; Michael Gaffney; Kathleen Ice

    1995-01-01

    A 16-week, double-blind, placebo controlled, dose titration study was done on 100 normotensive patients age 45 years or older to determine the efficacy and safety of doxazosin, a selective alpha 1-adrenoceptor antagonist, in the treatment of benign prostatic hyperplasia (BPH). Of the 41 efficacy evaluable patients 88 percent underwent dose titration to a maximum of 8 mg. doxazosin once daily.

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

    Microsoft Academic Search

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

    2008-01-01

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

  3. Update on the sexual impact of treatment for benign prostatic hyperplasia.

    PubMed

    Bell, John Roger; Laborde, Eric

    2012-12-01

    There is an established link between lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). The medical and surgical management of LUTS can affect erectile function (EF), cause ejaculatory dysfunction (EjD) or affect libido. This article will review the effects of these therapies on sexual function. PMID:23065462

  4. [Experience in the use of doxazosin in patients with benign hyperplasia of the prostate].

    PubMed

    Lopatkin, N A; Loran, O B; Pushkar', D Iu; Perepanova, T S; Tevlin, K P

    1998-01-01

    Selective alpha-1-adrenoblockers are thought promising in current conservative treatment of benign prostatic hyperplasia (BPH). The trial of doxazosin (cardura)--a selective alpha-blocker--included 78 BPH patients with obstructive urination. All the patients received a single daily dose of doxazosin 4-8 mg (mean 5.7 mg). 60 patients on placebo served as control. The comparison of the effects observed in the study vs control group has demonstrated that doxazosin has a favourable effect on BPH: it improved quality of life, relieved obstructive symptoms, reduced amount of residual urine. There is objective urodynamic evidence on decreased infravesical obstruction. PMID:9644978

  5. Serum sialic acid and prostate-specific antigen in differential diagnosis of benign prostate hyperplasia and prostate cancer.

    PubMed

    Romppanen, Jarkko; Haapalainen, Terhi; Punnonen, Kari; Penttilä, Ilkka

    2002-01-01

    In order to improve the diagnostic accuracy of the serum total and free prostate-specific antigen (PSA) in differential diagnosis between benign prostate hyperplasia (BPH) and prostate cancer, the serum total sialic acid (TSA) was measured and logistic regression (LR) models were built. Significantly higher serum PSA (p<0.001) concentrations were observed in patients with prostate cancer compared to control subjects, but no statistically significant differences were found in serum TSA concentrations between these groups. Serum PSA reliably discriminated patients with prostate cancer from control subjects, the area under the ROC curve (AUC) being 0.991 (0.010). When serum PSA was in the gray zone, from 4 to 10 microg/l, the diagnostic accuracy of PSA in discriminating patients with prostate cancer from BPH patients was very poor, AUC being 0.563 (0.132). However, using the same set of patients the LR model combining serum PSA, free to total PSA ratio and TSA values, as well as digital rectal examination results, had good diagnostic accuracy in discriminating the prostate cancer patients from patients with BPH, the area under the ROC curve being 0.895 (0.054). The present data suggest that the logistic regression model combining laboratory measurements and results of the clinical examination may be a useful adjunct in the differential diagnosis of benign and malignant prostate disease. PMID:12017325

  6. 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.

  7. Medical management of benign prostatic hyperplasia

    Microsoft Academic Search

    Andrew Chacon; Manoj Monga

    1999-01-01

    The management of benign prostatic hyperplasia has undergone a rapid evolution over the past decade from a surgical emphasis to a medical emphasis. Great strides in the development of a-adrenergic blockers, 5a-reductase inhibitors and a variety of phytotherapeutics have fueled this evolution. This article reviews the past, present and future of the medical management of benign prostatic hyperplasia.

  8. Proteomic analysis of patient tissue reveals PSA protein in the stroma of benign prostatic hyperplasia

    PubMed Central

    O’Malley, Katherine J.; Eisermann, Kurtis; Pascal, Laura E.; Parwani, Anil V.; Majima, Tsuyoshi; Graham, Lara; Hrebinko, Katherine; Acquafondata, Marie; Stewart, Nicolas A.; Nelson, Joel B.; Yoshimura, Naoki; Wang, Zhou

    2014-01-01

    BACKGROUND Benign prostatic hyperplasia (BPH) is an age-related disease frequently associated with lower urinary tract symptoms (LUTS) that involves hyperplasia of both epithelial and stromal cells. Stromal fibrosis is a distinctive feature of BPH, but the exact mechanisms underlying this phenomenon are poorly understood. METHODS In the current study, proteomics analyses were utilized to identify proteins altered in the BPH stromal compartment from patients with symptomatic BPH. Stromal cells were isolated from histological nodules of BPH by laser capture microdissection (LCM) and subjected to liquid chromatography/mass spectrometry. RESULTS Proteins identified included several stromal-specific proteins involved in extracellular matrix remodeling, focal adhesion and cellular junctions. Additionally, the proteomics array identified the presence of luminal epithelial secretory protein PSA. Immunostaining, ELISA, and in situ hybridization analyses of BPH tissues verified the presence of PSA protein but absence of PSA mRNA in the stromal compartment. E-cadherin was down-regulated in BPH epithelial cells compared to normal adjacent tissues, suggesting that alteration of cellular junctions could contribute to the presence of luminal epithelial secreted proteins PSA and KLK2 in the stromal compartment. CONCLUSIONS The above findings suggest that the presence of secreted proteins PSA and KLK2 from prostate luminal epithelial cells in BPH stroma is a hallmark of BPH nodules which could in part be due to alterations in cellular junction proteins and/or increased epithelial barrier permeability. Elucidating the cause and consequence of these secreted proteins in the stromal compartment of BPH may lead to new understanding of BPH pathogenesis as well as approaches to prevent and/or treat this common disease. PMID:24711254

  9. 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 ...

  10. Suppression of benign prostate hyperplasia by Kaempferia parviflora rhizome

    PubMed Central

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

    2013-01-01

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

  11. Soluble and nuclear type I and II androgen-binding sites in benign hyperplasia and cancer of the human prostate

    Microsoft Academic Search

    L. Castagnetta; G. Carruba; E. Fecarotta; M. Lo Casto; R. Cusimano; M. Pavone-Macaluso

    1992-01-01

    This paper presents an approach for the assessment of the androgen receptor (AR) status in benign prostatic hyperplasia (BPH) and prostate cancer (PCa) tissues. Evaluation of AR was carried out in both soluble and nuclear fractions by a standard competition method, using tritiated mibolerone as radioligand. Based on our experience with breast and endometrial cancer, this approach focused on both

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

    Microsoft Academic Search

    Marie-Christine Andro; Jean-Pierre Riffaud

    1995-01-01

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

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

    PubMed

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

    2013-02-12

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

  14. Benign prostatic hyperplasia and urinary symptoms: Evaluation and treatment.

    PubMed

    Mobley, David; Feibus, Allison; Baum, Neil

    2015-04-01

    Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting middle-aged men. This condition can be microscopic, macroscopic, symptomatic, or asymptomatic. Up to 15% to 25% of men aged 50-65 years have lower urinary tract symptoms (LUTS) consisting of nocturia, urgency, frequency, a sensation of not completely emptying the bladder, stop-start urination, straining to urinate, a need to urinate soon after voiding, and weak urinary stream. These symptoms usually are associated with benign enlargement of the prostate gland that is of sufficient severity to interfere with a man's quality of life. Although LUTS is often associated with BPH, LUTS can also be due to various unrelated syndromes such as heart failure, urinary tract infections, and diabetes. Most men will have benign hyperplasia of the prostate gland and this benign growth compresses the urethra resulting in LUTS. This article will discuss the evaluation, pharmacological management, minimally invasive treatment, and surgical therapy of this common condition affecting millions of American men. PMID:25823641

  15. 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. 5?-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

  16. Qianliening capsule treats benign prostatic hyperplasia via suppression of the EGF/STAT3 signaling pathway

    PubMed Central

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

    2013-01-01

    Benign prostatic hyperplasia (BPH) is a pathological overgrowth of the human prostate. It may cause increased resistance to urine flow through the urethra and occasionally kidney damage, bladder stones and urinary tract infections, and therefore affect the quality of life. Qianliening capsule (QC) is a traditional Chinese formula that has been used clinically in China to treat BPH for a number of years. However, the mechanism of its anti-BPH effect remains largely unknown. We evaluated the therapeutic effect of QC in a rat model of BPH, established by the injection of testosterone following castration, and investigated the underlying molecular mechanism of action. We observed that QC treatment significantly and dose-dependently decreased the prostatic volume (PV) and prostatic index (PI; P<0.05 or P<0.01), and ameliorated the histological damage of the prostate tissue in the BPH rats. In addition, treatment with QC inhibited the phosphorylation of signal transducer and activator of transcription 3 (STAT3), as well as the expression of epidermal growth factor (EGF), epidermal growth factor receptor (EGFR), cyclin D1 and Bcl-2. Our results suggest that suppression of the EGF/STAT3 pathway may be one of the mechanisms by which QC treats BPH. PMID:23737867

  17. 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

  18. 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

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

    Microsoft Academic Search

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

    2002-01-01

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

  20. Estrogen and androgen signaling in the pathogenesis of BPH

    Microsoft Academic Search

    Clement K. M. Ho; Fouad K. Habib

    2011-01-01

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

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

    PubMed

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

    2014-06-01

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

  2. Alfuzosin 10 mg Once Daily Increases the Chances of Successful Trial without Catheter after Acute Urinary Retention Secondary to Benign Prostate Hyperplasia

    Microsoft Academic Search

    H. Y. Tiong; M. J. B. Tibung; M. Macalalag; M. K. Li; D. Consigliere

    2009-01-01

    Objective: To compare the efficacy of Alfuzosin XL 10 mg once daily for the acute management of acute urinary retention (AUR) with placebo in patients with benign prostatic hyperplasia (BPH) and to determine the predictors that impact this. Methods: 67 patients presenting with an initial episode of spontaneous AUR secondary to BPH were catheterized and were then prospectively randomized to

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

    Microsoft Academic Search

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

    2007-01-01

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

  4. Pelvic ultrasound evaluation for benign prostatic hyperplasia: prediction of obstruction.

    PubMed

    Rukstalis, Daniel B

    2014-05-01

    Global improvements in water quality, management of infectious diseases, and other medical therapeutics have resulted in a growing population of healthy aging men. One obligate anatomic consequence of aging for these men is the development of benign prostatic hyperplasia (BPH) with secondary bladder outlet obstruction. Although the voiding symptoms associated with the change in bladder health over time predominantly impact the quality of a man's daily experience, there are also significant medical consequences of BPH that require intervention. It is a challenge to distinguish men who are at risk for these medical consequences from the much larger population of older men with voiding symptoms (lower urinary tract symptoms, LUTS). A variety of national guidelines have been developed to establish a diagnostic paradigm for meeting this challenge, but all suffer from inadequate sensitivity for the early identification of men at risk for permanent bladder injury. It is likely that the application of a thorough pelvic ultrasound designed to identify the pertinent anatomic aspects of both the bladder and prostate will improve the sensitivity of these diagnostic paradigms, with subsequent improvement in the outcomes for men with BPH/LUTS. PMID:24658830

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

    NASA Astrophysics Data System (ADS)

    Kwiatek, W. M.; Bana?, A.; Bana?, 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 ?m in diameter confirmed that concentrations of certain elements, such as S, Mn, Cu, Fe and Zn, are good indicators of pathological disorders in prostate tissue that may be considered effective tracers of developing compliant. The concentrations of Mn, Cu, Fe and Zn are higher in hyperplastic tissues, as compared to normal ones, while for sulphur the opposite is observed. Additionally, Fe and S K-edge XANES (X-ray Absorption Near Edge Structure) spectroscopy experiments were carried out in order to determine the chemical speciation of these elements in our samples.

  6. Randomized crossover comparison of tamsulosin and alfuzosin in patients with urinary disturbances caused by benign prostatic hyperplasia

    Microsoft Academic Search

    Erkan Karada?; Sedat Öner; Yasemin U. Budak; Özcan Atahan

    Purpose  The aim of this study was to compare the efficacy and safety of alfuzosin (Alf) and tamsulosin (Tam) in patients with lower\\u000a urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  One hundred men with benign prostatic hyperplasia (BPH) who were admitted to our urology department with lower urinary tract\\u000a symptoms (LUTS) were enrolled in this randomized

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

    MedlinePLUS

    ... in both print and download format. View Products Urology Care Foundation 1000 Corporate Boulevard Linthicum, MD 21090 ... Conditions Financials & Annual Report Leadership Privacy Statement © 2015 Urology Care Foundation | All Rights Reserved.

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

    MedlinePLUS

    ... in both print and download format. View Products Urology Care Foundation 1000 Corporate Boulevard Linthicum, MD 21090 ... Conditions Financials & Annual Report Leadership Privacy Statement © 2015 Urology Care Foundation | All Rights Reserved.

  9. Understanding patient and physician perceptions of benign prostatic hyperplasia in Europe: The Prostate Research on Behaviour and Education (PROBE) Survey

    PubMed Central

    Emberton, M; Marberger, M; de la Rosette, J

    2008-01-01

    Aims Benign prostatic hyperplasia (BPH) is a bothersome disease that can progress if left untreated. However, patient and urologist perspectives on BPH management are not fully understood. The aim of the Prostate Research on Behaviour and Education (PROBE) Survey was to assess healthcare-seeking behaviour and attitudes to BPH treatment in 502 BPH patients, and the beliefs and management practices of 100 urologists, from France, Germany, Italy, Spain and the UK. Results The principal concerns of patients seeking medical advice were fear of cancer, sleep disruption, discomfort or embarrassment. The majority of BPH patients recalled receiving a digital rectal examination (61%), routine prostate-specific antigen (PSA) tests (67%) and prescription medication (72%). Eighty per cent of 5?-reductase inhibitor (5ARI) users vs. 68% of ?-blocker users were satisfied with their treatment. More than half of the patients were concerned about requiring surgery or developing acute urinary retention, and > 75% would prefer a drug that provides reduction in the risk of surgery than one that provides rapid symptom relief. Most urologists performed digital rectal examinations (96%) and PSA tests (71%) on > 90% of patients presenting with BPH symptoms. Eighty-seven per cent of urologists believe that BPH progresses, and 78% believe that 5ARIs prevent BPH progression. However, most urologists prescribe ?-blockers while few prescribe 5ARIs. Conclusions This study highlights discrepancies between views and beliefs of patients and physicians regarding BPH and current practice in Europe. What's known There is increasing recognition of the importance of the role of the patient in clinical decision-making and the importance of consideration of patient perceptions and preferences in ensuring selection of the appropriate management strategy and treatment success.A recently reported US national survey indicated that currently there are significant differences in the beliefs and attitudes of patients and physicians towards benign prostatic hyperplasia (BPH) (also known as enlarged prostate) and its management. What's new This article provides information on the views and beliefs of both patients and urologists towards BPH and its management, and on current practice, across five European countries.This study confirms and extends the findings of the US survey and further highlights the need for improved communication between physicians and patients and greater involvement of the patient during clinical decision-making. PMID:18028388

  10. Transurethral resection of the prostate

    MedlinePLUS

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

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

  12. Noninvasive management of lower urinary tract symptoms and sexual dysfunction associated with benign prostatic hyperplasia in the primary care setting

    Microsoft Academic Search

    Louis Kuritzky

    2005-01-01

    Most men who live to middle age and beyond will ultimately develop lower urinary tract symptoms (LUTS) secondary to benign\\u000a prostatic hyperplasia (BPH), and many will also experience sexual dysfunction.\\u000a \\u000a Clinical studies indicate that most patients will experience improvement in BPH-related LUTS with ?-adrenergic blockade or\\u000a 5?-reductase inhibition. Recent studies suggest that ?-blockers and 5?-reductase inhibitors may help to slow

  13. The economic impact of introducing transurethral microwave thermotherapy in the treatment of benign prostatic hyperplasia: a scenario analysis

    Microsoft Academic Search

    R. M. P. M. Baltussen; G. Wielink; H. J. Stoevelaar; G. J. Van der Wilt; J. L. Severens; A. J. H. A. Ament

    1998-01-01

    The goal of this study was to assess the economic impact of introducing transurethral microwave thermotherapy (TUMT) in the\\u000a treatment of benign prostatic hyperplasia (BPH). Different scenarios were constructed using both randomized clinical trial\\u000a data and observational data on resource use related to BPH treatments. These include a baseline scenario, demand scenarios\\u000a reflecting the number of men who will be

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

    Microsoft Academic Search

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

    2003-01-01

    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

  15. Economics of different treatment options of benign prostatic hyperplasia in Turkey.

    PubMed

    Ilker, Y; Tarcan, T; Akda?, A

    1996-01-01

    Benign prostatic hyperplasia (BPH) has an important impact on the national health economics and can be managed in a large spectrum of modalities from simple follow-up to surgery. In this study, we aimed to compare different treatment options of BPH in terms of cost effectiveness in Turkey. The first evaluation of a BPH patient has a cost of $200. The cost of TURP or open prostatectomy (OP) in our hospital including all the expenses is $740. Finasteride has an annual cost nearly equal to TURP and OP. Considering the expenses of the close follow-up studies and regular visits, one-year lasting Finasteride treatment is two times more expensive than surgery. In comparison with medical treatment options, TURP as the gold standard of treatment of BPH is cost effective when long-term expenses are considered. PMID:9119638

  16. Transurethral grooving of the prostate in the treatment of patients with benign prostatic hyperplasia. An alternative to transurethral incision.

    PubMed

    Sim?ek, F; Türkeri, L N; Ilker, Y N; Akda?, A

    1993-07-01

    Various alternatives exist for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Incision of the bladder neck and prostate has proved its efficacy in many studies, especially in small prostates. The major drawback of the procedure is inability to obtain tissue specimens to exclude malignancy. We introduced a method to overcome this drawback by incising grooves at 5 and 7 o'clock with standard resection loops which created not only the incisions but also provided enough tissue for pathological examination. Twenty-five patients with BPH underwent transurethral grooving. Pre- and post-operative urodynamic studies revealed significant improvement in both maximum and average flow rates. The re-operation rate in the entire group was 12%. Transitional cell carcinoma of the prostatic urethra was detected in 1 patient, which proved its superiority to standard incision procedures. PMID:7511970

  17. 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

  18. What I Need to Know about Prostate Problems

    MedlinePLUS

    ... hyperplasia (BPH). Older men are at risk for prostate cancer as well, but this disease is much less common than BPH. More information about prostate cancer is available from the National Cancer Institute. For ...

  19. 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

  20. Distinct Altered Patterns of p27KIP1 Gene Expression in Benign Prostatic Hyperplasia and Prostatic Carcinoma

    Microsoft Academic Search

    Carlos Cordon-Cardo; Andrew Koff; Marija Drobnjak; Paola Capodieci; Iman Osman; S. Sean Millard; Paul B. Gaudin; Melissa Fazzari; Zuo-Feng Zhang; Joan Massague; Howard I. Scher

    Background: The p27KIP1 gene, whose protein product is a negative regulator of the cell cycle, is a potential tumor sup- pressor gene; however, no tumor-specific mutations of this gene have been found in humans. This study was undertaken to identify and to assess potential alterations of p27 KIP1 gene expression in patients with benign prostatic hyperplasia (BPH) and patients with

  1. What do I tell patients about saw palmetto for benign prostatic hyperplasia?

    PubMed

    Kane, Christopher J; Raheem, Omer A; Bent, Stephen; Avins, Andrew L

    2011-08-01

    Saw palmetto is widely used to treat lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). Although there is passionate support for herbal and complementary therapies for LUTS, clinical evidence is mixed. Because there is a well-recognized, profound placebo effect in tests of efficacy for agents treating LUTS, it is imperative that all therapies be tested in placebo-controlled trials. This article reviews evidence of the efficacy and safety of saw palmetto for men with LUTS caused by BPH, with particular emphasis on published randomized clinical trials and the upcoming Complementary and Alternative Medicine for Urologic Symptoms (CAMUS) trial. PMID:21798388

  2. 5{alpha}-reductase expression by prostate cancer cell lines and benign prostatic hyperplasia in vitro

    SciTech Connect

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

    1996-04-01

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

  3. [Serum metabolomics analysis on benign prostate hyperplasia in mice based on liquid chromatography-mass spectrometry].

    PubMed

    Geng, Yue; Sun, Fengxia; Ma, Yu; Deng, Ligang; Lü, Jianyun; Li, Teng; Wang, Congcong

    2014-12-01

    Benign prostatic hyperplasia (BPH) increasingly becomes a common factor affecting the quality of life of aging men. Its pathogenesis has not yet been fully elucidated. Ultra-high pressure liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) was employed to detect the changes of serum metabolites in normal mice, benign prostatic hyperplasia model mice and BPH model mice with finasteride intervention. The serum metabolite profiles of the three groups of mice were analyzed. Partial least squares-discriminant analysis (PLS-DA) was used for group differentiation and biomarker selection. The results showed good distinction among the three groups of mice serum metabolite spectra. Three potential biomarkers, 1-hexadecanoyl-SN-glycero-3-phosphocholine, 1-O-hexadecyl-2-O-acetyl-sn-glyceryl-3-phosphorylcholine and (Z)-13-docosenamide, were discovered and identified. They all indicated the occurrence of benign prostatic hypertrophy is closely related to the disorders of lipid metabolism. Coinpared with the control group, the contents of the first two substances were significantly increased in the serum of BPH model mice, and significantly decreased after intervened by finasteride. The contents of (Z)-13-docosenamide decreased significantly in the serum of model group, and increased after intervened by finasteride. Compared with the control group, the contents of three biomarkers in finasteride group did not recover completely and had significant differences. This study is conductive to open new avenues of diagnosis and medical treatment for BPH. PMID:25902635

  4. Hormonal treatment of patients with benign prostatic hyperplasia: Pros and cons

    Microsoft Academic Search

    Gilbert J. Wise; Edward Ostad

    2001-01-01

    The recognition that dihydrotestosterone is a “major player” in the development of benign prostatic hyperplasia (BPH) provided\\u000a an impetus for the development of a 5a-reductase inhibitor, finasteride. During the past 5 years, a number of publications\\u000a have noted that alpha blockers appear more efficacious than finasteride. This article reviews the role of hormones (particularly\\u000a finasteride) in the treatment of lower

  5. Selective alpha 1-adrenoceptor antagonists in benign prostatic hyperplasia: rationale and clinical experience.

    PubMed

    Chapple, C R

    1996-01-01

    Symptomatic benign prostatic hyperplasia (BPH) is a common condition in older men and has a significant impact on their daily lives. Transurethral resection of the prostate is currently the most effective remedy for BPH but is not suitable for all patients. There is now clear evidence for the efficacy of alpha-adrenoceptor antagonists, particularly selective alpha 1-adrenoceptor antagonists, in the treatment of BPH. Inhibition of alpha-adrenoceptors significantly increases urinary flow and improves symptoms in BPH. alpha 1-Adrenoceptor antagonists have a place in the management of BPH patients with mild to moderate disease, who are bothered by their symptoms, or for those awaiting or wishing to delay surgery. Treatment with selective alpha 1-adrenoceptor antagonists is generally better tolerated than nonselective-alpha-blockers. alpha 1-Selective adrenoceptor antagonists with a long half-life such as terazosin, doxazosin and tamsulosin, as a modified release formulation, permit once-daily dosing. Tamsulosin is the first subtype-specific (cloned alpha 1c/functional alpha 1A) adrenoceptor antagonist in clinical practice. Initial reports suggest that it gives no clinically relevant lowering of blood pressure and that its (vasodilatory) side effect profile is minimal. The scientific rationale behind the therapeutic use of alpha-adrenergic blockade as treatment for BPH and the trials data relating to the various agents which are available for clinical use are reviewed in the context of the contemporary literature. PMID:8647139

  6. 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 ?, 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 ? inducible protein 10, IP10), and Th2 (IL9)- and Th17 (IL17)-specific cytokines. Pretreatment with DHT inhibited NF-?B 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

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

    PubMed

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

    2013-01-01

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

  8. 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

  9. Impact of Metabolic Syndrome on Response to Medical Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Cyrus, Ali; Goodarzi, Davood; Talaei, Afsaneh; Moradi, Ali; Rafiee, Mohammad; Moghimi, Mehrdad; Shahbazi, Elham; Farmani, Elaheh

    2014-01-01

    Purpose To investigate the effect of metabolic syndrome (MetS) on the response to medical therapy of benign prostatic hyperplasia (BPH) after a 3-month period of treatment. Materials and Methods This was a cohort study of 100 patients, 47 with MetS and 53 without MetS, referred to either the primary care unit or referral hospital with BPH who had moderate lower urinary tract symptoms of prostate involvement and were candidates for medical treatment. Our main outcome was response to medical treatment with prazosin 1 mg twice a day and finasteride 5 mg daily in patients with BPH on the basis of International Prostate Symptom Score (IPSS). Multivariate analysis of covariance was used to compare BPH treatment response in patients with and without MetS before and after receiving treatment. Results The mean volume of the prostate was significantly higher in MetS patients than in patients without MetS (57±32.65 mL compared with 46.00±20.19 mL, p=0.036). The control group demonstrated an 11-unit reduction in IPSS, whereas those with MetS showed a reduction in the symptom score of only 6 units (p<0.001). Regarding the components of MetS separately, triglyceride (p<0.001), fasting blood sugar (p=0.001), and waist circumference (p=0.028) significantly affected the clinical progression of BPH. The observational nature of this study may be a limitation in comparison with an interventional study. Conclusions The results of the present study showed that MetS can negatively affect the response to medical treatment of BPH. Therefore, it is necessary to consider MetS in selecting patients with BPH for drug therapy. PMID:25512816

  10. 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

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

    Microsoft Academic Search

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

    1999-01-01

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

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

    PubMed Central

    2014-01-01

    Background The apoptosis machinery is a promising target against benign prostatic hyperplasia (BPH). Inhibitors of apoptosis proteins (IAPs) modulate apoptosis by direct inhibition of caspases. Serenoa Repens (SeR) may be combined with other natural compounds such as Lycopene (Ly) and Selenium (Se) to maximize its therapeutic activity in BPH. We investigated the effects of SeR, Se and Ly, alone or in association, on the expression of four IAPs, cIAP-1, cIAP-2, NAIP and survivin in rats with experimental testosterone-dependent BPH. Moreover, caspase-3, interleukin-6 (IL-6) and prostate specific membrane antigen (PSMA) have been evaluated. Rats were administered, daily, with testosterone propionate (3 mg/kg/sc) or its vehicle for 14 days. Testosterone injected animals (BPH) were randomized to receive vehicle, SeR (25 mg/kg/sc), Se (3 mg/kg/sc), Ly (1 mg/kg/sc) or the SeR-Se-Ly association for 14 days. Animals were sacrificed and prostate removed for analysis. Results BPH animals treated with vehicle showed unchanged expression of cIAP-1 and cIAP-2 and increased expression of NAIP, survivin, caspase-3, IL-6 and PSMA levels when compared with sham animals. Immunofluorescence studies confirmed the enhanced expression of NAIP and survivin with a characteristic pattern of cellular localization. SeR-Se-Ly association showed the highest efficacy in reawakening apoptosis; additionally, this therapeutic cocktail significantly reduced IL-6 and PSMA levels. The administration of SeR, Se and Ly significantly blunted prostate overweight and growth; moreover, the SeR-Se-Ly association was most effective in reducing prostate enlargement and growth by 43.3% in treated animals. Conclusions The results indicate that IAPs may represent interesting targets for drug therapy of BPH. PMID:24606563

  13. Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment.

    PubMed

    Xia, Shu-Jie

    2009-05-01

    Two-micron (thulium) laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. We recently reported the primary results. Here we introduce this procedure in detail. A 70-W, 2-microm (thulium) laser was used in continuous-wave mode. We joined the incision by making a transverse cut from the level of the verumontanum to the bladder neck, making the resection sufficiently deep to reach the surgical capsule, and resected the prostate into small pieces, just like peeling a tangerine. As we resected the prostate, the pieces were vaporized, sufficiently small to be evacuated through the resectoscope sheath, and the use of the mechanical tissue morcellator was not required. The excellent hemostasis of the thulium laser ensured the safety of TmLRP-TT. No patient required blood transfusion. Saline irrigation was used intraoperatively, and no case of transurethral resection syndrome was observed. The bladder outlet obstruction had clearly resolved after catheter removal in all cases. We designed the tangerine technique and proved it to be the most suitable procedure for the use of thulium laser in the treatment of benign prostatic hyperplasia (BPH). This procedure, which takes less operative time than standard techniques, is safe and combines efficient cutting and rapid organic vaporization, thereby showing the great superiority of the thulium fiber laser in the treatment of BPH. It has been proven to be as safe and efficient as transurethral resection of the prostate (TURP) during the 1-year follow-up. PMID:19398957

  14. Experience with the combination of dutasteride and tamsulosin in the long-term management of benign prostatic hyperplasia

    PubMed Central

    Chughtai, Bilal; Elterman, Dean S.; Lee, Richard; Te, Alexis E.

    2012-01-01

    Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) commonly affect older men. These bothersome symptoms can lead to a decreased quality of life. Currently, two classes of drugs – ?-adrenergic blockers and 5?-reductase inhibitors – are prescribed to treat LUTS secondary to BPH. Due to their different mechanisms of action, these medications work in a synergistic manner. Trials of combination therapy have been conducted to assess its effect compared with monotherapy. Current data support combination therapy in men with moderately enlarged prostates and moderate to severe symptoms. PMID:23024707

  15. 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

  16. Studies on antibacterial, anti-inflammatory and antioxidant activity of herbal remedies used in the treatment of benign prostatic hyperplasia and prostatitis

    Microsoft Academic Search

    V. Steenkamp; M. C. Gouws; M. Gulumian; E. E. Elgorashi; J. van Staden

    2006-01-01

    Crude water and ethanolic extracts of five herbal remedies reported in the literature for traditional treatment of benign prostatic hyperplasia (BPH) and\\/or prostatitis were investigated for their effect on hydroxyl scavenging activity, antibacterial activity and their ability to inhibit cyclooxygenase-1 and -2 (COX-1 and COX-2) catalysed prostaglandin biosynthesis. Both the water and ethanol extracts of Hypoxis hemerocallidea and Epilobium parviflorum

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

    NASA Astrophysics Data System (ADS)

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

    2009-04-01

    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.

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

    PubMed Central

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

    2014-01-01

    Background Sleep apnea (SA) is a common sleep disorder characterized by chronic intermittent hypoxia (IH). Chronic IH induces systemic inflammatory processes, which can cause tissue damage and contribute to prostatic enlargement. The purpose of this study was to evaluate the association between benign prostate hyperplasia (BPH) and SA in a Taiwanese population. Methods The study population was identified from Taiwan’s National Health Insurance Research Database (NHIRD) and contained 202 SA patients and 1010 control patients. The study cohort consisted of men aged ?30 years who were newly diagnosed with SA between January 1997 and December 2005. Each patient was monitored for 5 years from the index date for the development of BPH. A Cox regression analysis was used to calculate the hazard ratios (HRs) for BPH in the SA and control patients. Results During the 5-year follow-up, 18 SA patients (8.9%) and 32 non-SA control patients (3.2%) developed BPH. The adjusted HR for BPH was 2.35-fold higher in the patients with SA than in the control patients (95% confidence interval (CI) 1.28–4.29, P<.01). We further divided the SA patients into 4 age groups. After adjusting for potential confounding factors, the highest adjusted HR for BPH in the SA patients compared with the control patients was 5.59 (95% CI?=?2.19–14.31, P<.001) in the patients aged between 51 and 65 years. Conclusion Our study results indicate that patients with SA are associated with increased longitudinal risk of BPH development, and that the effects of SA on BPH development are age-dependent. PMID:24667846

  19. Evaluation of transurethral ethanol ablation of prostate for symptomatic benign prostatic hyperplasia.

    PubMed

    Faruque, M S; Alam, M K; Ullah, M A; Rahman, M H; Kibria, M G; Haque, M M; Haque, M A; Joarder, A I; Paul, B K

    2012-04-01

    Evaluating short-term (03 months) efficacy and safety of transurethral intraprostatic injection of absolute ethanol to treat benign prostatic hyperplasia (BPH). This intervention study was conducted to evaluate 30 patients with benign prostatic hyperplasia treated by transurethral injection of dehydrated ethanol. Mean age was 69.96 years. Endoscopic injection of 6-13.5 ml ethanol was carried out at 4-8 sites in the prostate. International Prostate Symptom Score (IPSS), maximum flow rate, prostate volume, postvoid residual and side effects or complications were measured postoperatively. Mean IPSS (SD) improved significantly from 18.43 ± 2.38 preoperatively to 6.80 ± 1.34 at 03 months of follow-up, mean peak urinary flow rate increased from 7.33 ± 1.19 ml/s to 16.31 ± 1.69 ml/s after 3 months, mean residual urine volume had decreased from 54.16 ± 30.93 ml to 17.01 ± 9.59 ml after 3 months (p<0.05). The prostate volume decreased from 44.66 ± 9.52 gm preoperatively to 32.46 ± 7.78 gm after 3 months (statistically significant at 5% level). There were no intra-operative complications but post-operative haematuria occurred in two patients, urinary retention occurred in two patients after removal of the catheter. Urinary tract infection developed in one patient. Transurethral ethanol ablation of prostate appears to be safe and cost effective. No occurrence of retrograde ejaculation was detected. The short-term effects of ethanol injection at prostate were satisfactory and acceptable as a minimally invasive therapeutic modality in selected patients. PMID:22561769

  20. Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia

    PubMed Central

    Stafinski, Tania; Menon, Devidas; Harris, Kevin; MD, Gary Gray; Jhangri, Gian

    2008-01-01

    Objective In recent years, laser treatments have re-emerged as options for treating benign prostatic hyperplasia (BPH). This paper reviews the safety, efficacy, effectiveness and economics of photoselective vapourization of the prostate (PVP), compared with transurethral resection of the prostate (TURP). Methods We conducted a comprehensive literature search to identify 14 studies comparing 80 W PVP and TURP. We then reviewed and pooled these studies. Results We identified 12 adverse events or complications; rates were similar in both groups. No PVP patient required a blood transfusion; 5%–11% of TURP patients did. PVP patients had a significantly lower likelihood of clot retention. Collectively, the 14 studies led to the conclusion that PVP is a safe procedure. PVP is favourable to TURP regarding length of hospitalization and catheterization times. There were no meaningful differences in operation times, reoperation rates, peak flow rates, postresidual volumes or quality of life scores. Sexual function and prostate specific antigen value changes were similar. Four economic evaluations of PVP and TURP (from Canada, Switzerland, Australia and the United States) concluded that PVP is less costly per case than TURP. Cost differences are attributable to disposables, capital equipment and hospitalization. Based on our analysis of limited Canadian data, the cost of PVP is estimated to be about one-half that of TURP, even after accounting for start-up costs. Conclusion The 80 W PVP laser appears to be a viable treatment for BPH. With the recent regulatory approval of the 120 W High Performance System (HPS), an additional option has become available. Therefore, it is anticipated that PVP will soon be considered part of a physician's repertoire for managing BPH. PMID:18542747

  1. The histological and histometrical effects of Urtica dioica extract on rat’s prostate hyperplasia

    PubMed Central

    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

  2. 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

  3. 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

  4. Current benign prostatic hyperplasia treatment: impact on sexual function and management of related sexual adverse events.

    PubMed

    Mirone, V; Sessa, A; Giuliano, F; Berges, R; Kirby, M; Moncada, I

    2011-09-01

    Benign prostatic hyperplasia (BPH) is a common disease in older men that can lead to lower urinary tract symptoms (LUTS). Male sexual dysfunction is also an age-related condition. Epidemiological studies have confirmed an association between BPH/LUTS and sexual dysfunction in ageing men that is independent of the effects of age, other co-morbidities and lifestyle factors. Proposed pathophysiological mechanisms for BPH/LUTS-associated sexual dysfunction include the nitric oxide/cyclic guanosine monophosphate (NO/cGMP) pathway, rho-kinase and endothelin-1 activity, autonomic nervous system overactivity and the metabolic syndrome, and pelvic organ atherosclerosis. Both BPH/LUTS and sexual dysfunction can have a substantial negative impact on a man's quality of life. However, urologists and primary care physicians appear to under-recognise sexual dysfunction in men with BPH/LUTS. Current guidelines recommend alpha-blockers and 5-alpha reductase inhibitors, either alone or in combination, among appropriate medical treatment options for BPH/LUTS. Randomised, controlled trials demonstrate that these therapies can be associated with sexual adverse effects (AEs) such as loss of libido, erectile dysfunction and ejaculatory disorders. Sexual dysfunction should be fully evaluated in men requiring treatment for BPH/LUTS using validated questionnaires. Management of sexual dysfunction in men treated for BPH/LUTS should involve assessment of co-morbidities and concomitant medications, consideration of lifestyle interventions such as weight loss and increased physical activity to improve risk factors and, if necessary, introduction of pharmacotherapies. In addition, physicians should provide patients with proper counselling on the possible sexual AEs of medical therapies for BPH/LUTS and their impact on sexual satisfaction, while being aware of the possibility that counselling in itself is likely to influence reported rates of sexual dysfunction. PMID:21718399

  5. 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.

  6. 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), 5?-reductase and cyclooxygenase-2 (COX-2) levels were also measured. BPH-induced animals exhibited an increase in prostate weight with increased testosterone, DHT, 5?-reductase and COX-2 expression levels. However, rape pollen SFE-CO2 treatment resulted in significant reductions in the prostate index and testosterone, DHT, 5?-reductase and COX-2 levels compared with those in BPH-induced animals. Histopathological examination also demonstrated that rape pollen SFE-CO2 treatment suppressed testosterone-induced BPH. These observations indicate that rape pollen SFE-CO2 inhibits the development of BPH in rats and these effects are closely associated with reductions in DHT, 5?-reductase and COX-2 levels. Therefore, the results of the present study clearly indicate that rape pollen SFE-CO2 extract may be a useful agent in BPH treatment. PMID:24944593

  7. 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. [Univ. of Munich (Germany)] [and others] [Univ. of Munich (Germany); and others

    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.

  8. 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

  9. Efficacy, tolerability, and effect on health-related quality of life of finasteride versus placebo in men with symptomatic benign prostatic hyperplasia: a community-based study

    Microsoft Academic Search

    Christine A Byrnes; Ann S Morton; Charles L Liss; Marguerite C Lippert; Jay Y Gillenwater

    1995-01-01

    This study sought to assess the efficacy, tolerability, and effect of finasteride on health-related quality of life (HRQL) in a diverse population of men with moderate-to-severe symptomatic benign prostatic hyperplasia (BPH). This double-blind study evaluated finasteride and placebo for 12 months in 2342 men with BPH (16.2% black, 14.5% Hispanic, 69.3% Caucasian\\/other) in a community-based setting. At 3-month intervals, urinary

  10. Human benign prostatic hyperplasia in organ culture: studies on iododeoxyuridine uptake

    SciTech Connect

    Masters, J.R.; O'Donoghue, E.P.

    1983-01-01

    Prostate tissue architecture and function may be retained in vitro using organ culture. However, the application of the technique is limited due to the lack of simple means for measuring tissue response, for instance to factors controlling cell growth. It is confirmed in this study that measuring the uptake of the radioactive precursor of DNA, 5-(/sup 125/I)-iodo-2'-deoxyuridine, is simple, rapid, and reproducible provided the heterogeneity of benign prostatic hyperplasia (BPH) is taken into account. Factors affecting the reproducibility (numbers of replicate explants and dishes), specificity (removal of unbound radioactivity and uptake into killed tissue), and sensitivity (radioactive concentration and exposure period) of this technique were investigated. A particular advantage of this approach is that histological assessments are made on the same tissue used for biochemical measurements. Furthermore, the method is sufficiently simple to permit serial investigations chronologically concerning factors, such as hormones, controlling BPH cell growth.

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

    PubMed Central

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

    2013-01-01

    Purpose We investigated the impact on prostate-specific antigen (PSA) and prostate volume (PV) of statin medication for 1 year in patients with benign prostatic hyperplasia (BPH). Materials and Methods We retrospectively investigated 791 patients in whom BPH was diagnosed. For analysis, the patients were divided into four groups according to their medications: group A, ?-blocker; group B, ?-blocker+statin; group C, ?-blocker+dutasteride; group D, ?-blockers+statin+dutasteride. To investigate changes in serum PSA, PV, and total cholesterol, we analyzed the data at the time of initial treatment and after 1 year of medication. Results After 1 year, group A showed a 1.3% increase in PSA and a 1.0% increase in PV. Group B showed a 4.3% decrease in PSA and a 1.8% decrease in PV. The difference in PV reduction between groups A and B was statistically significant (p<0.001). Group C showed a 49.1% reduction in PSA and a 22.9% reduction in PV. Group D showed a 51.6% reduction in PSA and a 24.5% reduction in PV. The difference in PV reduction between groups C and D was not statistically significant (p=0.762). By use of a multivariate logistic regression model, we found that the probability of PV reduction after 1 year was more than 14.8 times in statin users than in statin nonusers (95% confidence interval, 5.8% to 37.6%; p<0.001). Conclusions Statin administration reduced PSA and PV in BPH patients. This finding may imply the improvement of lower urinary tract symptoms and prevention of cardiovascular disease and chemoprevention of prostate cancer with statin treatment. PMID:24255756

  12. Effect of Transurethral Resection of the Prostate on Storage Symptoms in Patients with Benign Prostatic Hyperplasia of Less than 30 ml

    PubMed Central

    Kang, Yu Jin; Kim, Ki Ho; Seo, Youngjin

    2013-01-01

    Purpose Many patients with benign prostatic hyperplasia (BPH) have not only voiding symptoms but also storage symptoms. Despite the many types of treatment that have been developed for BPH, storage symptoms persist. We conducted an assessment of the efficacy of transurethral resection of the prostate (TURP) and the change in the International Prostate Symptoms Score (IPSS) storage sub-score after the procedure according to prostate size in patients with BPH. Materials and Methods Men aged 50 years or older who had BPH were enrolled in this study. 186 patients were divided into two groups according to prostate size measuring using transrectal ultrasonography: In group 1, prostate size was less than 30 ml (51 patients), and in group 2, prostate size was greater than 30 ml (135 patients). All of the patients underwent TURP. We examined whether the degree of change in the IPSS, voiding symptoms, storage symptoms, and quality of life (QoL) differed before and after TURP and according to prostate size. Results After three months of TURP, the subjects in both groups showed significant improvement in the IPSS, voiding symptoms, storage symptoms, QoL, and maximum flow rate (p<0.05). The scores for the IPSS, voiding symptoms, storage symptoms, and QoL of group 1 and 2 after three months of TURP were 16.36, 14.25 (p=0.233), 8.21, 8.24 (p=0.980), 8.11, 5.16 (p=0.014), 2.89, and 2.10 (p=0.030), respectively. Conclusions TURP is an effective treatment for patients with BPH, regardless of prostate size. However, while the improvement in the storage symptoms of patients with a prostate size of less than 30 ml was not significant, it was in patients with a prostate size greater than 30 ml. PMID:23658868

  13. 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

  14. Determination of alpha 1-antichymotrypsin-PSA complex in serum does not improve the differentiation between benign prostatic hyperplasia and prostate cancer compared with total PSA and percent free PSA 1 1 This study includes parts of the doctoral thesis of Angela Knäbich

    Microsoft Academic Search

    Klaus Jung; Brigitte Brux; Michael Lein; Angela Knäbich; Pranav Sinha; Birgit Rudolph; Dietmar Schnorr; Stefan A Loening

    1999-01-01

    Objectives. To evaluate the analytical performance and diagnostic utility of alpha1-antichymotrypsin (ACT)-prostate-specific antigen (PSA) complex in serum to improve the differentiation between benign prostatic hyperplasia (BPH) and prostate cancer (PCa).Methods. Serum concentrations of total PSA (tPSA), free PSA (fPSA), and ACT-PSA were measured in 112 untreated patients with PCa (median age 65 years), 34 patients with BPH (median age 66

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

    PubMed Central

    Corona, Giovanni; Vignozzi, Linda; Lotti, Francesco; Cipriani, Sarah

    2014-01-01

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

  16. Plasma-Derived Exosomal Survivin, a Plausible Biomarker for Early Detection of Prostate Cancer

    E-print Network

    2012-01-01

    2009) Biomarkers in prostate cancer diagnosis and prognosis:the diagnosis, staging and prognosis of prostate cancer].diagnosis of benign prostatic hyperplasia (BPH) and those diagnosed with prostate cancer (

  17. Saw Palmetto for Benign Prostatic Hyperplasia

    Microsoft Academic Search

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

    2006-01-01

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

  18. Prospective Factor Analysis of Alpha Blocker Monotherapy Failure in Benign Prostatic Hyperplasia

    PubMed Central

    Hong, Kyoung Pyo; Byun, Young Joon; Yoon, Hana; Park, Young Yo

    2010-01-01

    Purpose We aimed to determine the treatment of choice criteria for benign prostatic hyperplasia (BPH) by analyzing the factors causing alpha-adrenergic receptor blocker (?-blocker) monotherapy failure. Materials and Methods This retrospective study enrolled 129 patients with BPH who were prescribed an ?-blocker. Patients were allocated to a transurethral resection of prostate (TURP) group (after having at least a 6-month duration of medication) and an ?-blocker group. We compared the differences between the two groups for their initial prostate volume, serum prostate-specific antigen (PSA), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual urine volume (PVR). Results Of the 129 patients, 54 were in the TURP group and 75 were in the ?-blocker group. Statistically significant differences (p<0.05) between the two groups were found in the prostate volume (50.8 ml vs. 34.4 ml), PSA (6.8 ng/ml vs. 3.6 ng/ml), Qmax (6.84 ml/sec vs. 9.99 ml/sec), and IPSS (27.3 vs. 16.8). According to the multiple regression analysis, the significant factors in ?-blocker monotherapy failure were the IPSS (p<0.001) and prostate volume (p=0.015). According to the receiver operating characteristic (ROC) curve-based prediction regarding surgical treatment, the best cutoff value for the prostate volume and IPSS were 35.65 ml (sensitivity 0.722, specificity 0.667) and 23.5 (sensitivity 0.852, specificity 0.840), respectively. Conclusions At the initial diagnosis of BPH, patients with a larger prostate volume and severe IPSS have a higher risk of ?-blocker monotherapy failure. In this case, combined therapy with 5-alpha-reductase inhibitor (5-ARI) or surgical treatment may be useful. PMID:20664783

  19. The Development of Lonidamine for Benign Prostatic Hyperplasia and Other Indications

    PubMed Central

    Roehrborn, Claus G

    2005-01-01

    Lonidamine (LND) is a compound originally developed as an infertility drug. By capitalizing on the unique energy requirements of many solid tumors including benign prostatic hyperplasia (BPH), LND has shown efficacy as an adjunct to either radiation or chemotherapy in the treatment of several advanced solid organ malignancies such as lung, breast, head and neck, and liver metastases. It has an excellent safety profile in over 20 years of use in Italy in thousands of cancer patients. Preliminary data suggest that it is safe and effective in the treatment of lower urinary tract symptoms associated with BPH by metabolically targeting the unique dependency of the prostate on energy production by glycolysis instead of the aerobe Krebs cycle. The observed effects include a fast reduction in serum prostate-specific antigen and prostate volume, and simultaneous improvements in symptoms and urinary flow rate. The fact that prostate cancer and high-grade prostatic intraepithelial neoplasia have similar metabolic circumstances suggests that LND might also be effective in various stages of the prostate cancer carcinogenesis. PMID:16986056

  20. 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

  1. Combination therapy with dutasteride and tamsulosin in men with moderate-to-severe benign prostatic hyperplasia and prostate enlargement: the CombAT (Combination of Avodart® and Tamsulosin) trial rationale and study design

    Microsoft Academic Search

    Paul Siami; Claus G. Roehrborn; Jack Barkin; Ronaldo Damiao; Marek Wyczolkowski; Annette Duggan; Kim Major-Walker; Betsy B. Morrill

    2007-01-01

    Benign prostatic hyperplasia (BPH) is a highly prevalent condition in aging men, which can be progressive and lead to acute urinary retention (AUR) and the need for surgery. It is commonly treated with ?-blockers and 5?-reductase inhibitors (5ARIs), both of which improve the symptoms of BPH. Long-term treatment with 5ARIs can also reduce the risk of developing AUR and the

  2. Potential Urinary miRNA Biomarker Candidates for the Accurate Detection of Prostate Cancer among Benign Prostatic Hyperplasia Patients

    PubMed Central

    Haj-Ahmad, Taha A; Abdalla, Moemen AK; Haj-Ahmad, Yousef

    2014-01-01

    MicroRNAs (miRNAs) are a class of short (~22nt), single stranded RNA molecules that function as post-transcriptional regulators of gene expression. MiRNAs can regulate a variety of important biological pathways, including: cellular proliferation, differentiation and apoptosis. Profiling of miRNA expression patterns was shown to be more useful than the equivalent mRNA profiles for characterizing poorly differentiated tumours. As such, miRNA expression “signatures” are expected to offer serious potential for diagnosing and prognosing cancers of any provenance. The aim of this study was to investigate the potential of using deregulation of urinary miRNAs in order to detect Prostate Cancer (PCa) among Benign Prostatic Hyperplasia (BPH). To identify the miRNA signatures specific for PCa, miRNA expression profiling of 8 PCa patients, 12 BPH patients and 10 healthy males was carried out using whole genome expression profiling. Differential expression of two individual miRNAs between healthy males and BPH patients was detected and found to possibly target genes related to PCa development and progression. The sensitivity and specificity of miR-1825 for detecting PCa among BPH individuals was found to be 60% and 69%, respectively. Whereas, the sensitivity and specificity of miR-484 were 80% and 19%, respectively. Additionally, the sensitivity and specificity for miR-1825/484 in tandem were 45% and 75%, respectively. The proposed PCa miRNA signatures may therefore be of great value for the accurate diagnosis of PCa and BPH. This exploratory study has identified several possible targets that merit further investigation towards the development and validation of diagnostically useful, non-invasive, urine-based tests that might not only help diagnose PCa but also possibly help differentiate it from BPH. PMID:24563673

  3. 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

  4. Ameliorative effects of stinging nettle (Urtica dioica) on testosterone-induced prostatic hyperplasia in rats.

    PubMed

    Nahata, A; Dixit, V K

    2012-05-01

    The present study investigated the effects of stinging nettle (Urtica dioica L.) (UD) on benign prostatic hyperplasia (BPH) induced by testosterone. In vitro studies were conducted to assess the 5?-reductase inhibitory potential of UD. Two biochemical markers viz., ?-sitosterol and scopoletin, were isolated and characterised in the extracts utilising High-performance thin layer chromatographic, FTIR, NMR and overlain UV spectral studies. Hyperplasia was induced in rats by subcutaneous administration of testosterone (3 mg kg(-1) s.c.) for 28 days in all the groups except the vehicle-treated group. Simultaneous administration of petroleum ether and ethanolic extracts (10, 20 and 50 mg kg(-1) p.o.) and isolated ?-sitosterol (10 and 20 mg kg(-1) p.o.) was undertaken. Finasteride was used as a positive control (1 mg kg(-1) p.o.). Measurement of prostate/body weight ratio, weekly urine output and serum testosterone levels, prostate-specific antigen levels (on day 28) and histological examinations carried out on prostates from each group led us to conclude that UD can be used as an effective drug for the management of BPH. PMID:21806658

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

    PubMed Central

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

    2014-01-01

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

  6. Metabolic Syndrome and Benign Prostatic Hyperplasia: Evidence of a Potential Relationship, Hypothesized Etiology, and Prevention

    PubMed Central

    Briganti, Alberto; Suardi, Nazareno; Castiglione, Fabio; Gallina, Andrea; Capitanio, Umberto; Montorsi, Francesco

    2011-01-01

    Benign prostatic hyperplasia (BPH) is highly prevalent in older men and causes substantial adverse effects on health. The pathogenesis of this disease is not totally clear. Recent reports have suggested a possible relationship between metabolic syndrome (MetS) and BPH. Single components of MetS (obesity, dyslipidemia, hypertension, and insulin resistance) as well as the syndrome itself may predispose patients to a higher risk of BPH and lower urinary tract symptoms (LUTS). This may stem from changes in insulin resistance, increased autonomic activity, impaired nitrergic innervation, increased Rho kinase activity, pro-inflammatory status, and changes in sex hormones that occur in association with MetS. However, the exact underlying mechanisms that regulate the potential relationship between MetS and BPH/LUTS still need to be clarified. Increased physical activity and dietary strategies may help in decreasing the incidence of MetS and its impact on BPH/LUTS. However, differences in the definitions used to address the examined predictors and endpoints preclude the possibility of arriving at definitive conclusions. PMID:21927696

  7. The role of naftopidil in the management of benign prostatic hyperplasia

    PubMed Central

    Mizusawa, Takaki; Obara, Kenji; Takahashi, Kota

    2013-01-01

    Naftopidil, which to a certain extent shows an affinity to ?1D-adrenoceptor subtype in addition to a high affinity to ?1A-adrenoceptor, has been used for the treatment of benign prostatic obstruction and benign prostatic hyperplasia (BPH) associated lower urinary tract symptoms (LUTS). The aim of the present review is to systematically refer to the published studies on this unique agent for BPH. Based on a randomized prazosin-controlled study and another double-blind placebo-controlled study, which verified the dose-dependent effects of naftopidil, the Japanese Ministry of Health, Labor and Welfare approved naftopidil for treating men with BPH in 1996. Several tamsulosin-controlled studies have suggested treatment effects of naftopidil similar to those of tamsulosin and potentially higher efficacy for alleviating storage symptoms by naftopidil. Although well-designed, randomized studies are warranted to confirm the long-term outcomes and effector/target of naftopidil, the ?1A-antagonist naftopidil, which also blocks ?1D-adrenoceptor, improves voiding symptoms, and may also be useful for the management of men with storage symptoms represented by nocturia, retrieving their quality of life impaired by BPH-associated LUTS. PMID:23554846

  8. Long-term results of surgical techniques and procedures in men with benign prostatic hyperplasia.

    PubMed

    Metcalfe, Charles; Poon, Kenneth S

    2011-08-01

    Benign prostatic hyperplasia (BPH) is one of the most common conditions associated with the aging male. Surgical management of lower urinary tract symptoms attributed to BPH has progressed over time as urologic surgeons search for more innovative and less invasive forms of treatment. Transurethral resection of the prostate (TURP) has long been the "gold standard" to which all other forms of treatment are compared. There are several different methods of surgical treatment of BPH, including whole gland enucleation/intact removal, vaporization, and induction of necrosis with delayed reabsorption as well as hybrid techniques. As with any form of surgical intervention, long-term results define success. Long-term follow-up consists of examining overall efficacy with attention to associated adverse events. TURP has the luxury of the longest follow-up, while less invasive forms of treatment starting to acquire long-term data. There are several surgical options for BPH; newer methods do show promise, while the "gold standard" continues to demonstrate excellent surgical results. PMID:21484456

  9. Application of ultrasonography and the resistive index for evaluating bladder outlet obstruction in patients with benign prostatic hyperplasia.

    PubMed

    Shinbo, Hitoshi; Kurita, Yutaka

    2011-08-01

    Benign prostatic hyperplasia (BPH) is an extremely common and chronic condition that can lead to bladder outlet obstruction (BOO) in elderly men. Although pressure-flow studies are considered the most reliable method for evaluating BOO, they are invasive and complicated. Transrectal ultrasonography (TRUS) is a promising alternative because of its minimal invasiveness. Recently, TRUS imaging has been shown capable of measuring the resistive index, a useful parameter for evaluating BOO and for determining proper medical intervention in patients suffering from BPH. PMID:21475953

  10. 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

  11. Doxazosin—An alpha-1 receptor blocking agent in the long-term management of benign prostatic hyperplasia (Part one)

    Microsoft Academic Search

    S. Dutkiewicz; A. Witeska

    1995-01-01

    This is a controlled efficacy study with doxazosin (4 mg\\/day) in the long-term management of 64 ambulatory patients with benign\\u000a prostatic hyperplasia (BPH). Doxazosin was given for 72 weeks and is being continued. Twenty-three controls were treated with\\u000a prazosin (Minipress-4 mg\\/day) for 24 weeks, after which the results were similar in both the doxazosin (group 1) and prazosin\\u000a (group 2)

  12. Clinical correlation of maximal urinary flow rate and plasma doxazosin concentrations in the treatment of benign prostatic hyperplasia

    Microsoft Academic Search

    Ahmed Fawzy; Vijay Vashi; Menger Chung; Norma Dias; Michael Gaffney

    1999-01-01

    Objectives. To investigate the relationship among doxazosin dose, plasma concentration, and clinical response in 248 hypertensive men with benign prostatic hyperplasia (BPH) in a 16-week, placebo-controlled, double-blind study.Methods. After a 2-week placebo run-in period, patients were randomized to treatment with either doxazosin (titrated to doses of 2, 4, 8, or 12 mg once daily) or placebo. After 6, 10, and

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

    Microsoft Academic Search

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

    2001-01-01

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

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

    Microsoft Academic Search

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

    1997-01-01

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

  15. Red ginseng and 20(S)-Rg3 control testosterone-induced prostate hyperplasia by deregulating androgen receptor signaling.

    PubMed

    Bae, Jung-Soo; Park, Hyoung-Sook; Park, Jong-Wan; Li, Shan-Hua; Chun, Yang-Sook

    2012-07-01

    Since prostate growth is governed by the androgen signaling pathway, blockade of the pathway is regarded as an appropriate strategy for the treatment of benign prostatic hyperplasia (BPH). Panax ginseng is known to have various pharmacological activities. Of several products of its root, red ginseng, having many bioactive ginsenosides, is most popularly used in Korea, and recently has been reported to control the proliferation of cancer cells. We here tested the effect of a water extract of Korean red ginseng (WKRG) on testosterone-induced prostate hyperplasia. WKRG (daily intraperitoneal injection) prevented prostate overgrowth and epithelial thickening induced by testosterone in rats, and suppressed a rat prostate kallikrein-S3. In human prostate cells, WKRG inhibited testosterone-induced cell proliferation, arrested cell cycle by inducing p21 and p27, and induced apoptosis. Testosterone-induced expression of human kallikrein-3 mRNA and activation of androgen receptor (AR) were effectively inhibited by WKRG. Of the major ginsenosides included in WKRG, 20(S)-Rg3 was identified to repress AR activity and to attenuate prostate cell growth during testosterone stimulation. Moreover, 20(S)-Rg3 downregulated AR by facilitating the degradation of AR protein. WKRG and 20(S)-Rg3 were found to have new pharmacological activities against testosterone-induced prostate overgrowth. Given that red ginseng has been used safely in Asia for 1000 years, red ginseng and 20(S)-Rg3 could be potential therapeutic regimens for treating BPH. PMID:22101440

  16. Long-term outcome of prostatic stent treatment for benign prostatic hyperplasia

    Microsoft Academic Search

    Rei K. Chiou; Wen S. Chen; Ahmad Akbari; Sally Foley; Barlow Lynch; Rodney J. Taylor

    1996-01-01

    Objectives. To evaluate the long-term result of prostatic stent treatment for patients with benign prostatichyperplasia (BPH).Methods. We reviewed our experience with prostatic stents in 24 patients with bladder outlet obstruction caused by BPH for whom up to 63 months of follow-up data were available.Results. Prostatic stents were successfully placed in 24 of 25 patients enrolled in the study. All 9

  17. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL, VOL. 43, NO 6, NOVEMI3ER 1996 1099 Noninvasive Surgery of Prostate Tissue

    E-print Network

    Illinois at Urbana-Champaign, University of

    for clinical use in 1992 for noninvasive surgery aif the prostate to treat benign prostatic hyperplasia (BPH known as benign prostatic hyperplasia (BPH) using an HIFU device. The material pre- se 1996 1099 Noninvasive Surgery of Prostate Tissue by High-Intensity Focused Ultrasound Narendra T

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

    PubMed Central

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

    2013-01-01

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

  19. Semiquantitative RT-PCR method coupled to capillary electrophoresis to study 4?-reductase mRNA isozymes in rat ventral prostate in different androgen status

    Microsoft Academic Search

    Jesus M. Torres; José A. Gómez-Capilla; Estrella Ruiz; Esperanza Ortega

    2003-01-01

    The development and growth of the prostate gland depends on androgen stimulation. Dihydrotestosterone (DHT) is the primary androgen responsible for prostate development and also for the pathogenesis of benign prostatic hyperplasia (BPH). The incidence of prostate cancer (PCa) and benign prostatic hypertrophy (BPH) continues to rise in the Western world. DHT is synthesized in prostate from circulating testosterone (T) through

  20. Studies on antibacterial, anti-inflammatory and antioxidant activity of herbal remedies used in the treatment of benign prostatic hyperplasia and prostatitis.

    PubMed

    Steenkamp, V; Gouws, M C; Gulumian, M; Elgorashi, E E; van Staden, J

    2006-01-01

    Crude water and ethanolic extracts of five herbal remedies reported in the literature for traditional treatment of benign prostatic hyperplasia (BPH) and/or prostatitis were investigated for their effect on hydroxyl scavenging activity, antibacterial activity and their ability to inhibit cyclooxygenase-1 and -2 (COX-1 and COX-2) catalysed prostaglandin biosynthesis. Both the water and ethanol extracts of Hypoxis hemerocallidea and Epilobium parviflorum inhibited the growth of Escherichia coli. All 10 extracts scavenged the hydroxyl radical but with various potencies (32-93%). Ethanolic extracts were the most active in inhibiting COX-1 catalysed prostaglandin biosynthesis. The ethanolic extract of Epilobium parviflorum showed inhibitory effects on both the COX-1 and -2 catalysed prostaglandin biosynthesis, inhibited growth of Escherichia coli and exerted antioxidant activity. Although these results support the traditional use of Epilobium parviflorum for treatment of prostatitis and BPH, further investigation is required, for this promising plant. PMID:16122891

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

    Microsoft Academic Search

    Mark Greenberger; Mitchell S. Steiner

    1998-01-01

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

  2. Effects of coconut oil on testosterone-induced prostatic hyperplasia in Sprague-Dawley rats.

    PubMed

    de Lourdes Arruzazabala, María; Molina, Vivian; Más, Rosa; Carbajal, Daisy; Marrero, David; González, Víctor; Rodríguez, Eduardo

    2007-07-01

    Benign prostatic hyperplasia (BPH) is the benign uncontrolled growth of the prostate gland, leading to difficulty with urination. Saw palmetto lipid extracts (SPLE), used to treat BPH, have been shown to inhibit prostate 5a-reductase, and some major components, such as lauric, myristic and oleic acids also inhibit this enzyme. Coconut oil (CO) is also rich in fatty acids, mainly lauric and myristic acids. We investigated whether CO prevents testosterone-induced prostate hyperplasia (PH) in Sprague-Dawley rats. Animals were distributed into seven groups (10 rats each). A negative control group were injected with soya oil; six groups were injected with testosterone (3 mg kg(-1)) to induce PH: a positive control group, and five groups treated orally with SPLE (400 mg kg(-1)), CO or sunflower oil (SO) (400 and 800 mg kg(-1)). Treatments were given for 14 days. Rats were weighed before treatment and weekly thereafter. Rats were then killed and the prostates were removed and weighed. CO (400 and 800 mg kg(-1)), SPLE (400 mg kg(-1)) and SO at 800 mg kg(-1), but not at 400 mg kg(-1), significantly reduced the increase in prostate weight (PW) and PW:body weight (BW) ratio induced by testosterone (% inhibition 61.5%, 82.0%, 43.8% and 28.2%, respectively). Since CO and SPLE, but not SO, contain appreciable concentrations of lauric and myristic acids, these results could be attributed to this fact. In conclusion, this study shows that CO reduced the increase of both PW and PW:BW ratio, markers of testosterone-induced PH in rats. PMID:17637195

  3. 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

  4. 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

  5. Reversal of benign prostate hyperplasia by selective occlusion of impaired venous drainage in the male reproductive system: novel mechanism, new treatment.

    PubMed

    Gat, Y; Gornish, M; Heiblum, M; Joshua, S

    2008-10-01

    The prostate is an androgen-regulated exocrine gland producing over 30% of the noncellular components of the semen and promoting optimal conditions for survival and motility of sperm in the vagina. Benign prostate hyperplasia (BPH) is the most common benign neoplasm in men. Its aetiology is not clear, and therefore, current medical treatments are directed towards the symptoms. Though testosterone is known to be the promoter of prostate cell proliferation, no causal relation between serum testosterone levels and BPH has been found. In this study, we propose a novel and tested pathophysiological mechanism for the evolution of BPH and suggest a tested and effective treatment. We found that in all BPH patients, the one-way valves in the vertically oriented internal spermatic veins are destroyed (clinically manifested as varicocele), causing elevated hydrostatic pressure, some 6-fold greater than normal, in the venous drainage of the male reproductive system. The elevated pressure propagates to all interconnected vessels leading to a unique biological phenomenon: venous blood flows retrograde from the higher pressure in the testicular venous drainage system to the low pressure in the prostatic drainage system directly to the prostate (law of communicating vessels). We have found that free testosterone levels in this blood are markedly elevated, with a concentration of some 130-fold above serum level. Consequently, the prostate is exposed to: (i) increased venous pressure that causes hypertrophy; (ii) elevated concentration of free testosterone causing hyperplasia. We have treated 28 BPH patients using a technique that restores normal pressure in the venous drainage in the male reproductive system. The back-pressure and the back-flow of blood from the testicular to the prostate drainage system were eliminated and, consequently, a rapid reduction in prostate volume and a regression of prostate symptoms took place. PMID:18811916

  6. 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??M (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

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

    PubMed Central

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

    2013-01-01

    Purpose Endoscopic lasers have become a treatment option for benign prostate hyperplasia (BPH). The study reported here sought to elucidate the benefits and drawbacks of different laser systems in the treatment of patients with BPH. Methods The study enrolled 741 patients diagnosed with lower urinary tract symptoms secondary to BPH during the period January 2005 to December 2011. The techniques used in the study were photoselective vaporization of the prostate, thulium laser prostatectomy, and diode laser prostatectomy. Patients were assigned to one of three groups according to the type of laser treatment they received. Outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life, maximal urinary flow rate, post-voiding residual urine volume, and prostate-specific antigen (PSA) level. Results The baseline characteristics of patients who received diode laser prostatectomy show a significant elevated risk and high American Society of Anesthesiology score (P=0.001). Operative time and catheter removal time differed significantly between the three groups (P=0.001). No cases were converted to transurethral resection of the prostate intraoperatively due to bleeding (P=0.142). Among the three groups, there were no significant differences in maximal flow rate, lower post-void residual urine, and postoperative PSA level during the entire follow-up period (P<0.05). Further, no significant differences in postoperative IPSS, quality of life, or bladder neck contracture (P=0.23) were observed. However, a significant difference was observed with regard to prolonged use of Foley catheters and prolonged hospital stay among patients in the diode laser group (P=0.001). Conclusion Laser prostatectomies are effective in dealing with lower urinary tract symptoms. Early subjective functional results (maximal flow rate, IPSS, and post-void residual urine) appeared the same as those obtained following laser prostatectomy. Thus, it appears that lasers are safe and effective as long as the patients are carefully selected for treatment. PMID:24255595

  8. Impact of Changing Trends in Medical Therapy on Surgery for Benign Prostatic Hyperplasia Over Two Decades

    PubMed Central

    Choi, Se Young; Kim, Tae-Hyoung; Myung, Soon Chul; Moon, Young Tae; Kim, Kyung Do; Kim, Young Sun; Kim, Hye-Ryoun

    2012-01-01

    Purpose Following the introduction of medical therapy for benign prostatic hyperplasia (BPH), we determined the effect of the change in trends in medical therapy on the indication and outcome of surgical intervention for BPH. Materials and Methods We compared the basic characteristics of, weight of resected tissue of, transfusions in, and postoperative complications of patients who underwent surgery between 1985 and 1989 (before the advent of medical therapy for BPH), between 1995 and 1999 (when medical therapy was developed and became widely used as alternative treatment), and between 2005 and 2009 (when medical therapy superseded surgical intervention to become first-line treatment and when combination therapy became widely adopted). Results At our institution, the mean age and BMI of patients increased over the past two decades (p<0.001). Hypertension, operation history, and other comorbidities also increased significantly (p<0.001, p=0.005, and p<0.001, respectively). The indications for surgery in 1985 to 1989, 1995 to 1999, and 2005 to 2009 were as follows: acute urinary retention in 34.7%, 20.2%, and 15.1% of patients and symptomatic deterioration in 61.1%, 72.3%, and 73.0% of patients, respectively. Prostate volume and the weight of resected tissue increased from 34.4±14.5 ml to 61.3±32.4 ml and from 7.2±6.4 g to 10.8±7.6 g, respectively, over two decades. Patients who underwent surgery in 2005 to 2009 had their catheters removed earlier (p<0.001). Secondary hemorrhage within four postoperative weeks and repeat transurethral resection of the prostate within 1 year decreased significantly (p=0.03 and p=0.003, respectively). No statistically significant change in impaired detrusor contractility was found (p=0.523). Conclusions Although patients who underwent surgery were older after widespread use of medical therapy for BPH, advancements in surgical techniques have benefitted these patients. PMID:22323970

  9. Clinical ease of using doxazosin in BPH patients with and without hypertension

    Microsoft Academic Search

    W D Steers; R S Kirby

    2005-01-01

    Clinical studies have demonstrated that doxazosin therapy reduced blood pressure (BP) in patients with benign prostatic hyperplasia (BPH) who were hypertensive at baseline but not in patients who were physiologically or pharmacologically normotensive at baseline. In patients with BPH and uncontrolled hypertension, despite treatment with other antihypertensive drugs, the addition of doxazosin resulted in improved control with significant reductions in

  10. Do BPH Patients Have Neurogenic Detrusor Dysfunction? A Uro-Neurological Assessment

    Microsoft Academic Search

    Ryuji Sakakibara; Satoshi Hamano; Tomoyuki Uchiyama; Zhi Liu; Tomonori Yamanishi; Takamichi Hattori

    2005-01-01

    Introduction: Most men with benign prostatic hyperplasia (BPH) are middle- aged and elderly. Neurogenic detrusor dysfunction (NDD) may also occur in these populations. We made an uro-neurological assessment in such patients in order to investigate the possibility of a concurrent NDD in patients diagnosed with BPH, and to correlate the presence of NDD with treatment outcome. Materials and Methods: 28

  11. Subtype selective alpha1-adrenoceptor antagonists for the treatment of benign prostatic hyperplasia.

    PubMed

    Forray; Noble

    1999-12-01

    Benign prostatic hyperplasia (BPH) is highly prevalent in the male population beyond the age of 60. Impairment of urinary flow due to prostate enlargement gives rise to symptoms of 'prostatism' that have a detrimental impact on the quality of life. The current trend in the management of symptomatic BPH favours pharmacotherapy as a first line option, while the number of surgical procedures being performed has experienced a steady decline during the last ten years. Among the pharmacological treatments, the use of alpha1-adrenoceptor blockers has demonstrated to be an effective treatment option for BPH. These agents reduce the adrenergic tone to the prostate and increase urinary flow, with a concomitant reduction of lower urinary tract symptoms. The alpha1-blockers currently approved include compounds such as alfuzosin, terazosin and doxazosin, originally developed for the treatment of hypertension, and more recently tamsulosin, an alpha1-subtype selective drug. The blockade of alpha1-adrenoceptors present in vascular smooth muscle is largely responsible for the most prominent side effects of current drugs, which can be severe and require patients dose titration. The limitation imposed by side effects naturally raises the possibility that complete blockade of prostatic alpha1 receptors is not attained at the maximum tolerated dose. The extensive efforts by the pharmaceutical industry towards the development of uroselective alpha1-blockers, is the subject of this review. Advances in the molecular cloning of genes encoding three alpha1-adrenoceptors led to the identification of the alpha1A-subtype as the predominant receptor responsible for the contraction of prostate smooth muscle. In preclinical animal models, selective alpha1A-antagonists have consistently been found to have minimal cardiovascular effects, thus providing a pharmacological rationale for uroselectivity. It has also become apparent, however, that uroselectivity can emerge in a poorly understood manner from the pharmacodynamic properties of compounds without alpha1A-subtype selectivity. Clinical experience with tamsulosin, an alpha1A/alpha1D selective drug, has failed to demonstrate a significant improvement in efficacy beyond that demonstrated for non-subtype selective alpha1-blockers, and gives support to the notion that alpha1A-selective antagonists might achieve greater efficacy for the treatment of BPH. Given the demonstrated uroselectivity of alpha1A-selective antagonists in preclinical models, it is anticipated that third generation alpha1-blockers will exhibit improved urinary flow efficacy and be better tolerated than tamsulosin. The extent to which the improvement in urinary flow will translate to the relief of symptoms of prostatism, however, remains to be demonstrated in randomised placebo-controlled clinical trials of alpha1A-selective antagonists. PMID:11139841

  12. Fraction of Macroporous Resin from Smilax china L. Inhibits Testosterone Propionate–Induced Prostatic Hyperplasia in Castrated Rats

    PubMed Central

    Chen, Jing; Xiong, Chao-Mei; Song, Shan-Shan; Han, Pan

    2012-01-01

    Abstract The present study was conducted to evaluate the effect of a fraction of macroporous resin (FMR), a bioactive component of Smilax china L., on benign prostatic hyperplasia (BPH) in castrated rats induced by testosterone propionate. Rats were randomly divided into five groups: the negative control group (sham-operated), the model group, two FMR-treated groups (at doses of 300?mg/kg and 600?mg/kg of body weight), and the positive control group (treated with finasteride at the dose of 3?mg/kg). Drugs were administered once a day for three consecutive weeks by gastric gavage. Prostates were weighed, testosterone and dihydrotestosterone (DHT) levels in serum were determined, and histopathological examinations were carried out. FMR treatment inhibited prostatic hyperplasia, reducing the DHT level in serum and improving the prostate gland morphology compared with the model group. The overall results of this study suggest that FMR is effective at inhibiting experimentally induced prostate enlargement, and it presents a valuable resource for the treatment of human BPH. PMID:22510101

  13. Update on Phosphodiesterase Type 5 Inhibitors for the Treatment of Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia

    PubMed Central

    Elterman, Dean S; Chughtai, Bilal; Lee, Richard K; Te, Alexis E; Kaplan, Steven A

    2012-01-01

    Many aging men will experience both erectile dysfunction (ED) and benign prostatic hyperplasia (BPH), resulting in lower urinary tract symptoms (LUTS). Basic and clinical evidence suggests common pathogenic mechanisms underlying both LUTS and ED. Decreases in the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway with age result in decreased levels of intracellular cGMP and calcium, leading to diminished smooth muscle relaxation of the bladder and prostate and worsening LUTS. Phosphodiesterase type 5 inhibitors as monotherapy in combination with ?-blockers have shown efficacy in treating both LUTS and ED. Tadalafil has recently been approved by the US Food and Drug Administration for the treatment of LUTS secondary to BPH, with or without concomitant ED. PMID:23526698

  14. Establishment and characterization of an immortalized but non-transformed human prostate epithelial cell line: BPH1

    Microsoft Academic Search

    S. W. Hayward; R. Dahiya; G. R. Cunha; J. Bartek; N. Deshpande; P. Narayan

    1995-01-01

    Summary  This report describes the development and characterization of an epithelial cell line (BPH-1) from human prostate tissue obtained\\u000a by transurethral resection. Primary epithelial cell cultures were immortalized with SV40 large T antigen. One of the isolated\\u000a clones was designated BPH-1. These cells have a cobblestone appearance in monolayer culture and are non-tumorigenic in nude\\u000a mice following subcutaneous injection or subrenal

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

    PubMed

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

    2012-10-01

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

  16. Impact of alfuzosin on sexual function in Taiwanese men with benign prostatic hyperplasia.

    PubMed

    Hwang, Thomas I S; Chu, Sheng-Hsien; Lin, Mao-Sheng; Chen, Chih-Shou; Lee, Liang-Ming; Chang, Hong-Chiang; Yeh, Shauh-Der; Chen, Wen-Hsiang; Chiang, Po-Hui

    2012-08-01

    To assess the effect of alfuzosin (XATRAL) 10 mg once daily on sexual function in men with moderate to severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH), patients with suggestive symptomatic BPH, an International Prostate Symptom Score (IPSS) >8 (range of scores, 0-35), and sexual attempts at least once per month were enrolled. All patients received alfuzosin 10 mg once daily for 24 weeks and were asked to complete the IPSS test and Male Sexual Health Questionnaire at weeks 0 (baseline), 1, 4, 12, and 24. Other assessments included the International Index of Erectile Function-five-item version (range of scores: 5-25), as well as onset of action and peak urinary flow rate (Q(max)). From September 2006 to May 2008, 279 patients were enrolled from nine centers in Taiwan. At 24 weeks, alfuzosin effectively improved LUTS and quality of life, as demonstrated by a reduction in the IPSS total score (17.3 vs. 9.9, p < 0.001) and the IPSS bother score (3.8 vs. 2.5, p < 0.001). The majority (85%) of patients perceived an improvement of urinary symptoms within 1 month of administration. In patients with an International Index of Erectile Function-five-item version score of ?16, alfuzosin significantly improved erectile disorder and satisfaction subscores at each time point (p ? 0.02). Prolonged-release alfuzosin effectively improved LUTS, quality of life, erectile function, and sexual satisfaction in men with BPH and mild to severe erectile dysfunction. Alfuzosin is an effective treatment option for the management of patients with BPH/LUTS and concomitant sexual dysfunction. PMID:22892164

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

    PubMed

    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

  18. 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

  19. Histologic Influence of Doxazosin and Finasteride in Benign Prostatic Hyperplasia Accompanying Chronic Inflammation

    Microsoft Academic Search

    Dong Soo Park; Jeong Yun Shim

    2008-01-01

    Aim: To evaluate the influence of doxazosin and finasteride on histologic findings in benign prostatic hyperplasia accompanied by prostatitis, and to examine the factors related with prostate carcinogenesis. Materials and Methods: Prostate tissue from 17 cases of prostatic hyperplasia were divided into three groups; group 1: no medication history, group 2: both doxazosin and finasteride for at least 6 months

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

    Microsoft Academic Search

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

    2011-01-01

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

  1. Free and Total PSA in the Diagnosis of Prostate Cancer

    Microsoft Academic Search

    Xavier Filella; Juan Alcover; Rafael Molina; Alfredo Rodríguez; Pablo Carretero; Antonio Manuel Ballesta

    1997-01-01

    The use of PSA in the diagnosis of prostate cancer is controversial. This is due to false-positive results caused by benign prostatic hyperplasia (BPH). Different forms of circulating PSA have recently been described. Initial studies indicate that the fraction of free PSA is lower in prostate cancer than in BPH, therefore suggesting that its measurement could be of some diagnostic

  2. History of 7,093 Patients with Lower Urinary Tract Symptoms Related to Benign Prostatic Hyperplasia Treated with Alfuzosin in General Practice up to 3 Years

    Microsoft Academic Search

    B. Lukacs; J. C. Grange; D. Comet; C. McCarthy

    2000-01-01

    Objectives: As we have previously published 4 articles reporting the treatment of 7,093 clinical benign prostatic hyperplasia (BPH) patients treated with alfuzosin in a 3–month open–labelled study which was subsequently extended to 12, 24, and 36 months, the objective of this article is to provide additional data on dropouts, acute urinary retention (AUR), progression to surgery, and safety under the

  3. Doxazosin for the Treatment of Benign Prostatic Hyperplasia in Patients with Mild to Moderate Essential Hypertension: A Double-Blind, Placebo-Controlled, Dose-Response Multicenter Study

    Microsoft Academic Search

    Jay Y. Gillenwater; Richard L. Conn; Steven G. Chrysant; Johnny Roy; Michael Gaffney; Kathleen Ice; Norma Dias

    1995-01-01

    A total of 248 hypertensive patients 45 years old or older with benign prostatic hyperplasia (BPH) was included in this 16-week, multicenter, double-blind, placebo-controlled, parallel-group dose-response study. Doxazosin, a selective alpha 1-adrenoceptor antagonist, produced a significant increase in maximum urinary flow rate (2.3 to 3.6 ml. per second) at doses of 4 mg., 8 mg. and 12 mg., and in

  4. Peripheral mononuclear leukocyte DNA damage, plasma prolidase activity, and oxidative status in patients with benign prostatic hyperplasia.

    PubMed

    Gecit, Ilhan; Meral, Ismail; Aslan, Mehmet; Kocyigit, Abdurrahim; Celik, Hakim; Task?n, Abdullah; Kaba, Mehmet; Pirincci, Necip; Gunes, Mustafa; Taken, Kerem; Demir, Halit; Uyuklu, Mehmet; Ceylan, Kadir

    2015-07-01

    Objectives Prolidase plays a major role in collagen turnover, matrix remodeling, and cell growth. Benign prostatic hyperplasia (BPH) may be associated with an increased extracellular matrix deposition. Therefore, the present study was designed to investigate the plasma prolidase activity, oxidative status, and peripheral mononuclear leukocyte DNA damage in patients with BPH. Patients and methods Twenty-six male patients with BPH and 24 healthy male subjects were included in this study. Blood samples were collected from antecubital vein after an overnight fasting period, and the plasma was separated. Plasma prolidase activity, total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were determined. The peripheral lymphocyte oxidative DNA damage was determined using an alkaline single cell gel electrophoresis assay (comet assay). Results The plasma prolidase activity, TOS levels, OSI values, and peripheral mononuclear leukocyte DNA damage were significantly higher (P < 0.001), while the TAC levels were significantly lower (P < 0.001) in patients with BPH than controls. In BPH patients, the prolidase activity was significantly associated with TAC levels (r = -0.366, P < 0.05), TOS levels (r = 0.573, P < 0.001), and OSI (r = 0.618, P < 0.001) and peripheral mononuclear leukocyte DNA damage (r = 0.461, P < 0.001). Conclusions Our results showed that BPH might be associated with an increased oxidative stress, and also an increased plasma prolidase activity. Increased prolidase activity might play an important role in the etiopathogenesis and/or progression of BPH. PMID:25551736

  5. The Influence of Depression, Anxiety and Somatization on the Clinical Symptoms and Treatment Response in Patients with Symptoms of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

    PubMed Central

    2014-01-01

    This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (? 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH. Graphical Abstract PMID:25120327

  6. What patients take without telling you: holistic approach for BPH

    Microsoft Academic Search

    Jillian L. Capodice; Aaron E. Katz

    2006-01-01

    The use of botanicals and supplements have markedly increased in men that are seeking increased protection against the potential onset and symptomatic relief of lower urinary tract symptoms that are commonly experienced with benign prostatic hyperplasia (BPH). While this implies a positive trend and considers that men are taking a more active role in health and prevention, dialog between the

  7. 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

  8. 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

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

    PubMed

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

    2010-07-01

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

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

    PubMed Central

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

    2013-01-01

    Purpose To evaluate the effects of electroacupuncture (EA) on the International Prostate Symptom Score (IPSS), postvoid residual urine (PVR), and maximum urinary flow rate (Qmax), and explore the difference between EA at acupoints and non-acupoints in patients with moderate to severe benign prostate hyperplasia (BPH). Subjects and Methods Men with BPH and IPSS ?8 were enrolled. Participants were randomly allocated to receive EA at acupoint (treatment group, n?=?50) and EA at non-acupoint (control group, n?=?50). The primary outcome measure includes the change of IPSS at the 6th week and the secondary outcome measures include changes of PVR and Qmax at the 6th week and change of IPSS at the 18th week. Results 100/192 patients were included. At the 6th week, treatment group patients had a 4.51 (p<0.001) and 4.12 (p<0.001) points greater decline in IPSS than the control group in the intention to treat (ITT) and per-protocol (PP) populations. At the 18th week, a 3.2 points (p?=?0.001) greater decline was found in IPSS for the treatment. No significant differences were found between the two groups in Qmax at the 6th week (p?=?0.819). No significant difference was observed in PVR (P?=?0.35). Conclusion Acupoint EA at BL 33 had better effects on IPSS, but no difference on PVR and Qmax as compared with non-acupoint EA. The results indicate that EA is effective in improving patient's quality of life and acupoint may have better therapeutic effects than non-acupoints in acupuncture treatments of BPH. Trial Registration ClinicalTrials.gov NCT01218243. PMID:23593139

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

    PubMed

    Zhong, Xiaoyong; Lin, Jiumao; Zhou, Jianheng; Xu, Wei; Hong, Zhenfeng

    2015-08-01

    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 x 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

  12. Evaluation of thermal response of the prostate to ND:YAG laser photocoagulation

    E-print Network

    Bhattacharya, Atanu

    1996-01-01

    Laser treatment of Benign Prostatic Hyperplasia (BPH) has gained considerable attention as a safe and effective alternative to conventional Transurethral Resection of the Prostate (TURP). The present study tries to find the influence...

  13. 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

  14. New Advances in Benign Prostatic Hyperplasia: Laser Therapy

    Microsoft Academic Search

    Jessica Mandeville; Ehud Gnessin; James E. Lingeman

    2011-01-01

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

  15. 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

  16. 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

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

    PubMed Central

    Nitti, Victor W

    2005-01-01

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

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

    PubMed

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

    2012-01-01

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

  19. 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 ?-blocker and a 5?-reductase inhibitor has become well accepted. The combination of daily tadalafil and an ?-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

  20. Preliminary results of transurethral microwave thermotherapy in the treatment of benign prostatic hyperplasia in Turkey.

    PubMed

    Ersev, D; Ilker, Y; Simsek, F; Kuyumcuoglu, U; Akdas, A

    1992-01-01

    This prospective study was conducted in order to evaluate the efficacy of transurethral microwave thermotherapy (TUMT) in the treatment of benign prostatic hyperplasia (BPH). A single TUMT session of 55 min was delivered as an ambulatory procedure without anesthesia to 180 patients. 20 (69%) of the 29 patients who were catheterized due to urinary retention prior to the treatment were able to urinate freely after the treatment. In 91 patients with a follow-up of 3 months, the mean maximum flow rate (MFR) was 7.9 ml/s prior to the treatment and 12.1 ml/s after the treatment (p less than 0.02). The mean residual urine after voiding (PVR) of these patients was 104 and 54 ml before and after TUMT, respectively (p = 0.0001). The mean Madsen symptom score (SS) was 14 before and 7.5 after the treatment (p = 0.0001). The patients with pretreatment MFR higher than 7.0 ml/s, PVR less than 150 ml and SS lower than 15 benefited better from TUMT. As the findings indicated, TUMT is an alternative treatment modality in BPH in selected cases, although the number and the follow-up of our series are insufficient to draw a precise conclusion yet. PMID:1379925

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

    PubMed

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

    2014-08-01

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

  2. The importance of prostatic measuring by transrectal ultrasound in surgical management of patients with clinically benign prostatic hyperplasia

    Microsoft Academic Search

    Daimantas Milonas

    Summary. Objective. To study wheather transrectal ultrasound volume determination of the whole prostate and of the transition zone alone correlates to resected or enucleated weight in patients operated upon with transurethral resection of the prostate and retropubic or suprapubic prostatectomy because of presumed benign prostatic hyperplasia. Material and methods. The study comprised 120 patients with symptomatic benign pro- static hyperplasia.

  3. Change of Sexual Function in Patients Before and After Ho:YAG Laser Enucleation of the Prostate

    Microsoft Academic Search

    FANWEI MENG; BAOHUA GAO; QIANG FU; JUN CHEN; YUQIANG LIU; BENKANG SHI; ZHISHUN XU

    The aim of this study is to evaluate the effect of Ho:YAG laser enucleation of the prostate (HOLEP) to the sexual function of patients with benign prostatic hyperplasia (BPH). In the course of the study, 108 patients with BPH were recruited and accepted treatment with HOLEP. The effectiveness of treatment was evaluated by flow rate and the International Prostate Symptom

  4. Benign Prostatic Hyperplasia: Implications for Pharmacologic Treatment and Perioperative Care.

    PubMed

    Leedahl, David D; Vo, Phil H; Maxson, Pamela M; Lovely, Jenna K

    2012-07-13

    This review provides an update on the treatment of benign prostatic hyperplasia and the pharmacologic considerations for perioperative care. By age 85 years, approximately 90% of men have prostate histologic characteristics consistent with benign prostatic hyperplasia. Pharmacologic treatment with an alpha(1) receptor antagonist may reduce symptoms and, when given in combination with a 5-alpha-reductase inhibitor, may decrease the risk of urinary retention and the need for surgical intervention. Transurethral resection of the prostate has been the historical standard when surgical intervention is indicated. However, recent evidence suggests that Holmium laser enucleation of the prostate may have similar efficacy with less risk of complications and with decreased catheterization time. Prostatic urological operations may have perioperative complications, including urethral bleeding, acute urinary retention, urinary tract infection, urge incontinence, and venous thromboembolism. Pharmacist recommendations for the appropriate use of laxatives, antibiotics, anticoagulation, and urinary antispasmodics are key components of perioperative management. Surgical interventions improve symptoms but may have complications, providing the pharmacist an opportunity to improve perioperative care. PMID:22797835

  5. Potential Urinary Protein Biomarker Candidates for the Accurate Detection of Prostate Cancer among Benign Prostatic Hyperplasia Patients

    PubMed Central

    Haj-Ahmad, Taha A; Abdalla, Moemen AK; Haj-Ahmad, Yousef

    2014-01-01

    Globally, Prostate cancer (PCa) is the most frequently occurring non-cutaneous cancer, and is the second highest cause of cancer mortality in men. Serum prostate specific antigen (PSA) has been the standard in PCa screening since its approval by the American Food & Drug Administration (FDA) in 1994. Currently, PSA is used as an indicator for PCa - patients with a serum PSA level above 4ng/mL will often undergo prostate biopsy to confirm cancer. Unfortunately fewer than ~30% of these men will biopsy positive for cancer, meaning that the majority of men undergo invasive biopsy with little benefit. Despite PSA's notoriously poor specificity (33%), there is still a significant lack of credible alternatives. Therefore an ideal biomarker that can specifically detect PCa at an early stage is urgently required. The aim of this study was to investigate the potential of using deregulation of urinary proteins in order to detect Prostate Cancer (PCa) among Benign Prostatic Hyperplasia (BPH). To identify the protein signatures specific for PCa, protein expression profiling of 8 PCa patients, 12 BPH patients and 10 healthy males was carried out using LC-MS/MS. This was followed by validating relative expression levels of proteins present in urine among all the patients using quantitative real time-PCR. This was followed by validating relative expression levels of proteins present in urine among all the patients using quantitative real time-PCR. This approach revealed that significant the down-regulation of Fibronectin and TP53INP2 was a characteristic event among PCa patients. Fibronectin mRNA down-regulation, was identified as offering improved specificity (50%) over PSA, albeit with a slightly lower although still acceptable sensitivity (75%) for detecting PCa. As for TP53INP2 on the other hand, its down-regulation was moderately sensitive (75%), identifying many patients with PCa, but was entirely non-specific (7%), designating many of the benign samples as malignant and being unable to accurately identify more than one negative. PMID:24494028

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

    SciTech Connect

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

    1991-07-01

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

  7. 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

  8. Clinical and Economic Impact of Early Versus Delayed 5-Alpha Reductase Inhibitor Therapy in Men Taking Alpha Blockers for Symptomatic Benign Prostatic Hyperplasia

    PubMed Central

    Kruep, Eric J.; Hogue, Susan L.; Eaddy, Michael T.; Chandra, Monica D.

    2011-01-01

    Background and Objective: Recent clinical trials indicate that combining an alpha blocker for rapid symptom improvement and a 5-alpha reductase inhibitor (5-ARI) to reduce the risk of clinical progression of benign prostatic hyperplasia (BPH) may be an optimal approach to management; however, few studies have evaluated the effect of combination therapy on clinical progression in a real-world setting. The purpose of our study was to assess the clinical and economic impact of early versus delayed 5-ARI therapy in patients treated with an alpha blocker for BPH. Materials and Methods: A retrospective database analysis included men 50 years of age and older who were treated for BPH between 2003 and 2007. Clinical outcomes were evaluated for patients using 5-ARIs early (within 30 days of starting an alpha blocker) compared with those using delayed 5-ARI therapy (between 30 and 180 days after starting an alpha blocker). We assessed the likelihood of clinical progression (defined as the occurrence of acute urinary retention or prostate surgery) for each group over a one-year period following the start of alpha-blocker therapy. Data Source: The MarketScan Database, which was used to identify patients, contains medical and pharmacy claims data obtained directly from Medicare and commercial health plans and employers, representing 18 to 20 million lives annually. Results: Of 8,617 men included in the analysis, 64.5% began 5-ARI therapy within 30 days of alpha-blocker therapy (the early cohort). These patients were less likely than those receiving delayed 5-ARI treatment to have clinical progression (12.8% vs. 17.4% respectively; P < 0.0001), acute urinary retention (10.2% vs. 13.8%, P < 0.0001), and prostate surgery (5% vs. 7%, P = 0.0002). The early group also incurred lower BPH-related medical costs ($572 vs. $730, P < 0.0001). Even though BPH-related pharmacy costs were significantly higher ($1,137 vs. $1,263, P = 0.0313), their total BPH-related costs were lower ($1,834 vs. $1,867, P = 0.0068). Conclusion: These results suggest that early 5-ARI therapy for men with symptomatic BPH who receive an alpha blocker may significantly reduce the risk of clinical progression (i.e., acute urinary retention or prostate surgery) over the next 12 months as well as lower BPH-related medical costs and BPH-related total costs. PMID:21935297

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

    2013-08-01

    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.

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

    PubMed

    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

  11. 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

  12. 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. ?1-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 ?1-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

  13. Prostatic urethral lift: A minimally invasive treatment for benign prostatic hyperplasia

    PubMed Central

    Garcia, Cindy; Chin, Peter; Rashid, Prem; Woo, Henry H.

    2015-01-01

    Prostatic urethral lift (PUL) is a minimally invasive procedure for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. The procedure may be performed under local, spinal, or general anesthesia. The PUL procedure involves the delivery of implants that retract obstructing prostate lobes. Unlike other benign prostatic hyperplasia treatment options including pharmacological therapy, and the current invasive gold-standard transurethral resection of the prostate, the PUL procedure achieves quantifiable improvements in functional outcomes and quality of life, in the absence of major adverse events. Furthermore, improvement in LUTS may be attained while preserving erectile and ejaculatory function. Adverse effects associated with the PUL procedure are mild to moderate, and are transient in nature. The PUL procedure provides an alternative for men seeking treatment for bothersome LUTS, with fewer side-effects. PMID:26157759

  14. 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

  15. Management of Symptomatic BPH in France: Who Is Treated and How?

    Microsoft Academic Search

    Bertrand Lukacs

    1999-01-01

    Objective: To review the contemporary management of symptomatic benign prostatic hyperplasia (BPH) in France. Methods: Information was obtained from published scientific articles, IMS market analysis data and community-based surveys among older men. Results: The prevalence of symptomatic BPH in France is relatively high. About 15–20% of men over 50–60 years of age report moderate to severe lower urinary tract symptoms

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

    PubMed

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

    2008-06-01

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

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

    Microsoft Academic Search

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

    2011-01-01

    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

  18. [PSA in prostatic fluid].

    PubMed

    Lehmann, K; Simmler, F; Schmucki, O; Hauri, D

    1994-05-01

    Correct forecasting of prostatic carcinoma by means of serum PSA is limited. Prostatic carcinoma is said to increase PSA 10 times as much as prostatic adenoma. Therefore we evaluated whether PSA in the prostatic fluid is more specific for prostatic carcinoma than the level in the serum. In 31 consecutive patients with prostatic disease blood was taken for serum PSA first and then prostatic fluid (10 microliters) was expressed. The PSA was determined by the Pros-Check test in both the serum and in the prostatic fluid. The collection of the prostatic fluid failed in 7 (22.6%) patients. Of the remaining 24 patients, 5 had documented bacterial prostatitis, 4 had prostatic carcinoma and 15 had benign prostatic hyperplasia (BPH). The serum PSA was 5.6 +/- 5.0 micrograms/l in prostatitis, 148 +/- 208 micrograms/l in prostatic carcinoma and 6.9 +/- 6.8 micrograms/l in BPH. The serum PSA was significantly higher in prostatic cancer (P < or = 0.01) than in prostatitis and BPH. The PSA levels in the prostatic fluid were 14.0 +/- 25.7 x 10(6) micrograms/l in prostatitis, 7.6 +/- 9.7 x 10(6) micrograms/l in carcinoma and 14.0 +/- 14.6 x 10(6) micrograms/l in BPH. There were no statistically significant differences. In the expressed prostatic fluid no significantly different PSA was found in carcinoma, bacterial prostatitis or BPH. In contrast to this, the serum PSA was significantly higher in cancer patients than in prostatitis or BPH. Therefore PSA in the expressed prostatic fluid is no more specific than that in the serum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7519804

  19. Dutasteride: a potent dual inhibitor of 5-alpha-reductase for benign prostatic hyperplasia.

    PubMed

    Rabasseda, Xavier

    2004-08-01

    Dutasteride is a 5alpha-reductase inhibitor that inhibits both types 1 and 2 isozymes of 5alpha-reductase, the enzyme responsible for converting testosterone to dihydrotestosterone in the prostate and other tissues. Dihydrotestosterone is the primary cause of prostate growth and has been proven to play a key role in the development and progression of benign prostatic hyperplasia. Dutasteride has been investigated in three multicenter studies involving 4325 men aged 50 years and above with benign prostatic hyperplasia. Data from these two-year, placebo-controlled studies demonstrated that dutasteride 0.5 mg once daily reduced the risk of both acute urinary retention and the need for benign prostatic hyperplasia-related surgical intervention, improved benign prostatic hyperplasia-related symptoms, decreased prostate volume and increased maximum urinary flow rates with a low incidence of generally mild to moderate adverse events. PMID:15510237

  20. Integrating risk profiles for disease progression in the treatment choice for patients with lower urinary tract symptoms\\/benign prostatic hyperplasia: a combined analysis of external evidence and clinical expertise

    Microsoft Academic Search

    M Speakman; J Batista; R Berges; E Chartier-Kastler; G Conti; F Desgrandchamps; K Dreikorn; F Lowe; M O'Leary; M Perez; J Trachtenberg; A Tubaro; B Meesen; L Smets; H Stoevelaar

    2005-01-01

    The RAND appropriateness method was used to explore the relevance of risk factors for disease progression in the treatment choice for patients with lower urinary tract symptoms\\/benign prostatic hyperplasia (LUTS\\/BPH). A total of, 12 international experts assessed the appropriateness of various treatments for 243 risk profiles. Highest appropriateness rates were found for ?1-adrenoceptor antagonists (68% of profiles) and combination therapy

  1. Efficacy and Safety of a New Prolonged Release Formulation of Alfuzosin 10 mg Once Daily versus Alfuzosin 2.5 mg Thrice Daily and Placebo in Patients with Symptomatic Benign Prostatic Hyperplasia

    Microsoft Academic Search

    P. van Kerrebroeck; A. Jardin; K. U. Laval; P. van Cangh

    2000-01-01

    Objectives: To assess the efficacy and safety of a new prolonged release formulation of the uroselective ?1–blocker alfuzosin for a once–daily dosing regimen in patients with lower urinary tract symptoms (LUTS) suggestive of symptomatic benign prostatic hyperplasia (BPH).Methods: After a 1–month run–in period, 447 patients were randomly allocated in a double–blind placebo–controlled study to receive alfuzosin 10 mg once daily

  2. Targeted transurethral microwave thermotherapy versus alpha-blockade in benign prostatic hyperplasia: outcomes at 18 months

    Microsoft Academic Search

    Bob Djavan; Christian Seitz; Claus G Roehrborn; Mesut Remzi; Mitra Fakhari; Matthias Waldert; Ali Basharkhah; Bernhard Planz; Mike Harik; Michael Marberger

    2001-01-01

    Objectives. To compare directly the efficacy, safety, and durability of targeted transurethral microwave thermotherapy with that of alpha-blocker treatment for lower urinary tract symptoms of benign prostatic hyperplasia.Methods. In a randomized, controlled clinical trial, 52 patients with lower urinary tract symptoms due to benign prostatic hyperplasia received terazosin treatment and 51 underwent microwave treatment under topical anesthesia. The patient evaluation

  3. Other therapies for BPH patients: desmopressin, anti-cholinergic, anti-inflammatory drugs, and botulinum toxin

    Microsoft Academic Search

    Abdel-Rahmène Azzouzi; Marc Fourmarier; Francois Desgrandchamps; Charles Ballereau; Christian Saussine; Olivier Haillot; Bertrand Lukacs; Marian Devonec; Alexandre de la Taille

    2006-01-01

    The usual treatments of benign prostate hyperplasia (BPH) including the alpha-blockers, the inhibitors of the 5-alpha reductase and the phytotherapy drugs allow significant improvements of the lower urinary tracts symptoms (LUTS). However, some patients are not responders or have side effects due to the treatments. Other therapeutic approaches described in the literature are possible in order to alleviate the LUTS.

  4. Seminal Plasma Prostate-Specific Antigen Level in Benign Prostatic Hyperplasia

    Microsoft Academic Search

    Yavuz Narin; Kenan Karademir

    2004-01-01

    Introduction: We evaluated the role of the seminal plasma PSA level in the prediction of the response to ?-blocker treatment in patients with benign prostatic hyperplasia. Materials and Methods: 18 male patients with lower urinary tract symptoms were enrolled in the study. After their blood was sampled for PSA, ejaculates of all the subjects were obtained. Serum and seminal plasma

  5. Pharmacokinetic parameters as a potential predictor of response to pharmacotherapy in benign prostatic hyperplasia: a preclinical trial using dynamic contrast-enhanced MRI.

    PubMed

    Jia, Guang; Heverhagen, Johannes T; Henry, Hannes; Polzer, Hans; Baudendistel, Klaus T; von Tengg-Kobligk, Hendrik; Levine, Andrea L; Rosol, Thomas J; Knopp, Michael V

    2006-07-01

    We sought to assess the possibility of using pharmacokinetic parameters as a predictor of response to benign prostatic hyperplasia (BPH) pharmacotherapy via a randomized, placebo-controlled, animal preclinical trial using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Twelve male beagles with BPH were enrolled in a preclinical experimental drug trial and divided into two randomized groups with six beagles each: one drug (finasteride) group and one placebo (control) group. Two baseline MRI examinations and three follow-ups during treatment were performed on a clinical 1.5-T MRI system using axial T1- and T2-weighted magnetic resonance images for prostate volume measurement and DCE-MRI for the assessment of prostate microcirculation. A total of 0.2 mmol/kg body weight of the Gd-based contrast agent was administered with an injection rate of 0.2 ml/s. The pharmacokinetic parameters, maximum enhancement ratio (MER), transfer constant and rate constant, were assessed to characterize the microcirculation in the parenchymal zone. The time-signal intensity curve from the external iliac artery was used as the arterial input function. The correlation between baseline evaluations (prostate volume and pharmacokinetic parameters) and therapy-induced prostate volume changes under finasteride treatment were assessed. The changes in prostate volume at the end of the trial exhibited a significant linear correlation to the initial parenchymal MER (P < .02) in the finasteride group. Larger prostate volume reductions coincided with smaller initial parenchymal MER. These findings show considerable promise of using parenchymal MER as a predictor of response to BPH pharmacotherapy with finasteride. PMID:16824967

  6. Symptomatic and quality of life response to tolterodine in subgroups of men with overactive bladder symptoms and presumed non-obstructive benign prostatic hyperplasia

    Microsoft Academic Search

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

    2010-01-01

    Objectives  To investigate the symptomatic and quality of life (QoL) response to treatment with tolterodine extended release (ER) in subgroups\\u000a of male patients with Overactive Bladder Syndrome (OAB) and LUTS suggestive of non-obstructive benign prostatic hyperplasia\\u000a (BPH) according to age, symptom severity, diabetes mellitus status, and concomitant treatment for LUTS.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients treated with tolterodine ER 4 mg\\/day for OAB symptoms, alone or

  7. 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

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

    PubMed

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

    2014-12-01

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

  9. 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

  10. Combined tadalafil and ?-blocker therapy for benign prostatic hyperplasia in patients with erectile dysfunction: a multicenter, prospective study.

    PubMed

    Lee, Joo Yong; Park, Sung Yul; Jeong, Tae Yoong; Moon, Hong Sang; Kim, Yong Tae; Yoo, Tag Keun; Choi, Hong Yong; Park, Hae Young; Lee, Seung Wook

    2012-01-01

    This prospective study evaluated the safety of tadalafil 5 mg taken once a day in terms of hypotensive side effects and whether it improves lower urinary tract symptoms (LUTS) and restores sexual function in patients with erectile dysfunction who are receiving concomitant ?-blocker (AB) therapy for benign prostatic hyperplasia (BPH). A total of 158 LUTS/BPH patients receiving AB therapy for ?3 months were given tadalafil 5 mg once a day. Before treatment with tadalafil (V1), and 4 weeks (V2) and 12 weeks (V3) after starting tadalafil, blood pressure, heart rate, International Prostate Symptom Score (IPSS), maximal urine flow rate (Qmax), postvoiding residual urine volume, and International Index of Erectile Function (IIEF-5) score were measured. Of the 158 LUTS/BPH patients, a total of 119 completed the trial. Blood pressure (systolic and diastolic) and heart rate did not change. IPSS and IIEF-5 scores improved significantly, but Qmax and postvoiding residual urine volume did not; however, in the 39 men with a low baseline Qmax (?10 mL/s), Qmax rose significantly from 7.97 ± 1.44 mL/s (baseline) to 8.91 ± 1.60 mL/s (V3; P = .012). The remaining patients (baseline Qmax >10 mL/s) did not change. At V2 and V3, adverse side effects were observed in 10 men (7.30%) and 6 men (5.04%), respectively. Facial flushing was the most common adverse side effect (6 men at V2 and 4 men at V3), followed by headache (2 men each at V2 and V3) and dizziness (2 men at V2). Two patients dropped out of the study because of adverse side effects. In conclusion, tadalafil 5 mg once a day in combination with AB appeared to have few adverse effects on hypotensive events and can improve LUTS and restore sexual function. PMID:21868753

  11. 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

  12. 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

  13. Experience of Long-Term Afala Treatment in Benign Prostatic Hyperplasia

    Microsoft Academic Search

    A. V. Gudkov

    2009-01-01

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

  14. Investigation of ejaculatory disorder by silodosin in the treatment of prostatic hyperplasia

    PubMed Central

    2012-01-01

    Background To assess the ejaculatory disorder caused by silodosin in the prostatic hyperplasia patients who carry out sexual actions (sexual intercourse, masturbation). Method The subjects of this study were 91 patients who had been clinically diagnosed to have LUTS/BPH at this hospital, who were administered silodosin at 4 mg twice a day, and who gave response to a questionnaire survey related to ejaculatory disorder. Sexual intercourse and masturbation were regarded as sexual actions in this study. Results Ejaculatory disorder occurred in 38 (42%) of the 91 silodosin administration cases. Forty (44%) of the 91 patients answered that they carried out sexual actions after oral intake of silodosin. When the investigation was conducted only in those who exercised sexual actions, ejaculatory disorder was observed in 38 (95%) of these 40 patients, indicating a high incidence. When asked if disturbed by the ejaculatory disorder, 29 (76%) of the 38 patients who had ejaculatory disorder answered yes. Oral silodosin was discontinued due to the ejaculatory disorder in 2 (5%) of these patients. On the whole, the discontinuation rate of oral silodosin was 2% (2/91 patients). Conclusion It was demonstrated that the administration of silodosin induced ejaculatory disorder at a high incidence. Since it is possible that the high frequency of ejaculatory disorder by silodosin may reduce QOL, it is considered necessary to provide sufficient information related to ejaculatory disorder at the time of treatment with silodosin. PMID:23082785

  15. 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 ?-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, ?-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, ?-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

  16. 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

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

    PubMed

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

    2009-08-01

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

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

    PubMed

    Hatzimouratidis, Konstantinos

    2014-08-01

    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 ?-adrenergic antagonists or 5?-reductase inhibitors. However, it is not just an alternative, since sexual adverse events associated with these drugs are avoided and tadalafil is the only drug that can treat both ED and LUTS at the same time. PMID:25083163

  19. 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

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

    Microsoft Academic Search

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

    2003-01-01

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

  1. Local hyperthermia in the treatment of benign prostatic hyperplasia. Assessment of 100 patients.

    PubMed

    Serrate Aguilera, R; Ruis Espina, G; Regié Aldosa, R; Prats López, J; Franco de Castro, A

    1991-01-01

    This study includes our first 100 patients who received local prostatic hyperthermia treatment for benign prostatic hyperplasia. Subjective symptoms such as nycturia, stream, urgency, and objective facts like urine flow and postmicturition residue were monitored before treatment and 3 months after. The clinical (subjective) symptoms improved in 76 patients. Urinary flow increased in 63 patients, and the postmicturition urinary residue decreased in 32 patients. We were able to show that local prostatic hyperthermia is a valid option for the treatment of benign prostatic hyperplasia although it is still too early to assess the long-term results. PMID:1720737

  2. 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.

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

    PubMed

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

    2013-01-01

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

  4. 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

  5. [Changes in prostatic circulation in response to laser therapy and magnetic therapy in patients with benign prostatic hyperplasia].

    PubMed

    2005-01-01

    The results of preoperative preparation were analysed in 59 patients with prostatic benign hyperplasia (PBH) subjected to TUR. Treatment outcomes were assessed by transrectal ultrasound (color Doppler mapping) in two groups of patients. Group 1 received combined therapy including transrectal laser radiation of the prostate, group 2--transrectal magnetotherapy. The analysis showed that laser radiation reduced insignificantly the size of the prostate and adenomatous node, improved microcirculation and circulation in the prostate. This resulted in relief of inflammation and reduction of the number of postoperative inflammatory complications. Transrectal magnetotherapy has a positive effect on vascularization and hemodynamics of the prostate, local immunity, contamination of the tissues with pathogenic flora. PMID:16419474

  6. 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?BPH QoL-9 sex total improved from 137.3?±?47.9 to 195.0?±?56.3 (p?BPH symptoms and reduced SDys. This was the first trial with saw palmetto to show improvement in BPH symptoms and SDys as well. [Corrections made here after initial online publication.] PMID:22522969

  7. [Experience of the use of silodosin in acute urinary retention caused by benign prostatic hyperplasia].

    PubMed

    Ne?mark, A I; Nozdrachev, N A

    2013-01-01

    For the treatment of acute urinary retention (AUR) as one of the most serious complications of adenoma of the prostate (BPH), alpha-adrenoblockers are widely used. The article presents an experience of the use of the new uroselective alpha-adrenoblocker silodosin approved for the treatment of patients with urination disorders caused by BPH. Its pharmacological profile has a number of advantages, including the highest uroselectiveness at the present day, immediate action, the potential for the use of standard dose of 8 mg 1 time a day, which does not require a correction depending on the age, and the possibility of the simultaneous application with antihypertensive drugs. PMID:24159765

  8. Management of benign prostatic hyperplasia by transurethral laser ablation in patients treated with warfarin anticoagulation.

    PubMed

    Bolton, D M; Costello, A J

    1994-01-01

    Transurethral laser ablation of the prostate gland was used to treat benign prostatic hyperplasia in 10 patients on warfarin anticoagulant therapy who had either significant clinical symptoms or who were in urinary retention. Anticoagulant therapy did not require alteration at any stage during treatment. All patients noticed improvements in symptom score assessments, flow rates and residual urine volumes following this procedure, and no significant complications were encountered. The hemostatic nature of neodymium:YAG laser energy as applied in this procedure appears to result in a technical improvement upon conventional transurethral resection for the treatment of symptomatic benign prostatic hyperplasia in patients taking warfarin anticoagulant therapy. PMID:7504746

  9. 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

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

    Microsoft Academic Search

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

    2004-01-01

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

  11. Inactivation of LGI1 expression accompanies early stage hyperplasia of prostate epithelium in the TRAMP murine model of prostate cancer

    PubMed Central

    Cowell, John K; Head, Karen; Kunapuli, Padmaja; Vaughan, Mary; Karasik, Ellen; Foster, Barbara

    2009-01-01

    The LGI1 gene has been implicated in tumor cell invasion through regulation of the ERK pathway. To determine whether human prostate cancer cells (PC3, 22RV, Du145) are similarly affected by exposure to LGI1, we conducted scratch wound assays and demonstrated that the secreted LGI1 protein can reduce cell motility, an essential component of invasion and metastasis. These studies have now been extended to an in vivo mouse model of prostate cancer. Using a BAC transgenic mouse expressing a GFP reporter gene under the control of cis regulatory elements, we demonstrated that LGI1 is highly expressed in the normal prostate epithelium. To determine whether loss of LGI1 expression is associated with development and progression of murine prostate cancer, we bred the GFP reporter BAC transgenic mice with TRAMP mice which undergo early hyperplasia and progressive stages of prostate cancer. In the F1 animals, although the surrounding normal prostate epithelium expressed high levels of LGI1 in the double transgenic mice, the LGI1 gene had been inactivated even at the earliest stages of hyperplasia. This observation supports the suggestion that inactivation of LGI1 in certain cell types is related to tumor progression. Taken together these results suggest that LGI1 may be an important molecule for the arrest of prostate cancer cell invasion and possibly as a biomarker for early detection of prostate hyperplasia. PMID:19778537

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

    Microsoft Academic Search

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

    1995-01-01

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

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

    Microsoft Academic Search

    Carina Scholtysek; Aleksandra A. Krukiewicz; Jose´-Luis Alonso; Karan P. Sharma; Pal C. Sharma; Wolfgang H. Goldmann

    2009-01-01

    Saw Palmetto Berry Extract (SPBE) is applied for prostate health and treatment of urinary tract infections, nonbacterial prostitis and Benign Prostatic Hyperplasia (BPH) in man. An assumption is that SPBE affects tumor cell progression and migration in breast and prostate tissue. In this work, DU-145 cells were used to demonstrate that SPBE and its sterol components, ?-sitosterol and stigmasterol, inhibit

  14. Laser prostatic surgery: An update

    Microsoft Academic Search

    M. Elhilali; E. A. Elzayat

    2008-01-01

    This review presents an overview of the current state of the art of laser prostatic surgery. Several types of lasers have\\u000a been used in the treatment of benign prostatic hyperplasia (BPH) over the past 15 years. Vaporization techniques have recently\\u000a gained popularity and have been widely accepted by many urologists. Short-term results show that vaporization of a prostatic\\u000a adenoma with

  15. [Correction of erectile dysfunction in patients with benign prostate hyperplasia using daily administration of tadalafil 5 mg against the background of combined drug therapy].

    PubMed

    Volkov, A A; Petrichko, M I; Budnik, N V

    2013-01-01

    The study included 59 patients with benign prostate hyperplasia (BPH) and erectile dysfunction (ED), inhibited inflammation in the prostate gland and with normal or medically normalized levels of total testosterone. All the patients underwent conservative therapy using dutasteride and tamsulosin, 21 of them (group 2) additionally received tadalafil 5 mg daily. Efficacy of treatment was assessed by self-assessment questionnaire of patients before treatment and 12 weeks after therapy. In group 1 of patients, the dynamics of the erectile function, sexual satisfaction and quality of life for patients was not revealed. In the group 2, improvement in erectile function in an average of 19 points was shown (IIEF-5 questionnaire). According to the AMS questionnaire, improvement in sexual function was demonstrated; in patients with compensated androgen deficiency, however, response to the treatment with tadalafil was less pronounced. According to BSFI score after 3 months of therapy with tadalafil, indicator of overall satisfaction of sexual life improved to 2.4 points (p < 0.002). According to the Hospital Anxiety and Depression Scale, anxiety in patients was reduced to the permissible values (p < 0.0002), the level of depression was decreased by almost 2-fold (p < 0.0002). The total IPSS score decreased from 13 to 9 points in average. The inclusion of tadalafil in complex of combined conservative therapy of patients with BPH not only improves sexual function but has a positive effect on symptoms of the disease and the psychological state of the patient. PMID:24437241

  16. Prostate cancer antigen-1 as a potential novel marker for prostate cancer

    Microsoft Academic Search

    Bing-Qian Liu; Yu-Dong Wu; Pei-Huan Li; Jin-Xing Wei; Tong Zhang; Ran-Lu Liu

    2007-01-01

    Aim:To examine the expression of prostate cancer antigen-1 (PCA-1) in prostate cancer (PCa) and to validate it as a potential marker for diagnosis of PCa.Methods:In situ hybridization analysis of PCA-1 mRNA expression was performed on 40 benign prostate hyperplasia (BPH), 16 high-grade prostatic intraepithelial neoplasm (HG-PIN), 74 PCa and 34 other malignant carcinoma specimens. The level of PCA-1 expression was

  17. Cost-effectiveness of dutasteride-tamsulosin combination therapy for the treatment of symptomatic benign prostatic hyperplasia: A Canadian model based on the CombAT trial

    PubMed Central

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

    2013-01-01

    Introduction: Benign prostatic hyperplasia (BPH) is common in men 50 years old and older. The main treatment options are alpha-blockers (such as tamsulosin), which reduce symptoms, and 5-alpha reductase inhibitors (such as dutasteride), which reduce symptoms and slow disease progression. Clinical studies have demonstrated that dutasteride-tamsulosin combination therapy is more effective than either monotherapy to treat symptomatic BPH. We studied the cost-effectiveness in Canada of the dutasteride (0.5 mg/day) and tamsulosin (0.4 mg/day) combination compared with tamsulosin or dutasteride monotherapy. Methods: A Markov model was developed which follows a cohort of male BPH patients ?50 with moderate to severe lower urinary tract symptoms (LUTS). The model estimates costs to the Canadian health care system and outcomes (in terms of quality adjusted life years [QALYs]) at 10 years and over a patient’s lifetime. The dutasteride-tamsulosin combination was compared to each of tamsulosin monotherapy and dutasteride monotherapy. Results: Compared with tamsulosin, the combination was more costly and produced better patient outcomes. Over a lifetime, the incremental cost-effectiveness ratio was CAN$25 437 per QALY gained. At a willingness to pay CAN$50 000 per QALY, the probability of combination therapy being cost-effective was 99.6%. Compared with dutasteride, the combination therapy was the dominant option from year 2, offering improved patient outcomes at lower cost. The probability that combination therapy is more cost-effective than dutasteride was 99.8%. Conclusion: Combination therapy offers important clinical benefits for patients with symptomatic BPH, and there is a high probability that it is cost-effective in the Canadian health care system relative to either monotherapy. PMID:23826050

  18. Primary care physician versus urologist: How does their medical management of LUTS associated with BPH differ?

    Microsoft Academic Search

    Martin M. Miner

    2009-01-01

    Medical and surgical therapies for benign prostatic hyperplasia (BPH) are based largely on the results from adherence to the\\u000a 2003 American Urological Association Guidelines. However, with the emergence of medical therapies as first-line treatment\\u000a and the expansion of medical therapy for lower urinary tract symptoms (LUTS) into the primary care office, the evaluation\\u000a and management of men presenting with urinary

  19. 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.

  20. Concentration of Dihydrotestosterone and 3?-Androstanediol in Naturally Occurring and Androgen- Induced Prostatic Hyperplasia in the Dog

    PubMed Central

    Moore, Ronald J.; Gazak, John M.; Quebbeman, James F.; Wilson, Jean D.

    1979-01-01

    Previous studies have suggested that dihydrotestosterone accumulation in the prostate may be involved in the pathogenesis of prostatic hyperplasia in man and dog. However, the fact that the administration of 10 mg dihydrotestosterone/d to castrated, mongrel dogs (0.5 mg/kg body wt) causes little growth in the prostate, whereas identical doses of 3?- androstanediol regularly induce prostatic hyperplasia (> 14 g weight) has raised the possibility that the dihydrotestosterone accumulation may be the result rather than the cause of the pathology. To investigate the mechanism of this phenomenon, we measured the levels of dihydrotestosterone and 3?-androstanediol in prostates from 75 dogs. In both naturally occurring and 3?-androstanediol-induced prostatic hyperplasia, the levels of dihydrotestosterone were high (>5 ng/g), whereas in immature glands and glands from dihydrotestosterone-treated animals, levels were similar (2.1 and 2.6 ng/g, respectively). 3?-Androstanediol levels were no different in animals treated with dihydrotestosterone or 3?-androstanediol. Therefore, because exogenous 3?-androstanediol is a better precursor of prostatic dihydrotestosterone than exogenous dihydrotestosterone itself, the effects of treatment with larger doses (2.5 mg/kg per d) of dihydrotestosterone and 3?-androstanediol for 12 wk were examined. In these amounts, dihydrotestosterone was as effective as 3?-androstanediol in inducing the development of prostatic hyperplasia and in elevating prostatic dihydrotestosterone concentration. Because dihydrotestosterone accumulates in spontaneous prostatic hyperplasia, because the administration of sufficient amounts of dihydrotestosterone to the castrated dog can induce the development of prostatic hyperplasia, and because 3?-androstanediol induces the development of hyperplasia via conversion to dihydrotestosterone, we conclude that accumulation of dihydrotestosterone is the cause of canine prostatic hyperplasia. Images PMID:90055

  1. Pentraxin 3: a novel biomarker for predicting progression from prostatic inflammation to prostate cancer.

    PubMed

    Stallone, Giovanni; Cormio, Luigi; Netti, Giuseppe Stefano; Infante, Barbara; Selvaggio, Oscar; Fino, Giuseppe Di; Ranieri, Elena; Bruno, Francesca; Prattichizzo, Clelia; Sanguedolce, Francesca; Tortorella, Simona; Bufo, Pantaleo; Grandaliano, Giuseppe; Carrieri, Giuseppe

    2014-08-15

    Pentraxin-3 (PTX3) is a member of the pentraxin family of innate immune regulators, which includes C-reactive protein (CRP). PTX3 has been implicated in angiogenesis, proliferation, and immune escape in cancer. In the present study, we evaluated PTX3 tissue expression and serum concentration as a biomarker to discriminate prostatic inflammation and benign prostatic hyperplasia (BPH) from prostate cancer, and to determine whether PTX3 status may predict progression from BPH to prostate cancer. We analyzed 40 patients with biopsy-proven BPH who underwent a second prostate biopsy 12 to 36 months later when they were diagnosed with prostate cancer or inflammation/BPH (n = 20 patients each group). Furthermore, we evaluated PTX3 serum concentrations in an independent set of patients with biopsy-proven inflammation/BPH (n = 61) and prostate cancer (n = 56). We found reduced PTX3 tissue expression in patients with prostatic inflammation/BPH compared with patients who developed prostate cancer. In the latter group, there was an increase in PTX3 tissue expression between the first and second prostate biopsy. PTX3 serum levels were also higher in patients with prostate cancer than in patients with inflammation/BPH. In contrast, there was no difference in serum PSA or CRP levels in these two groups. ROC curve analysis confirmed the reliability of PTX3 serum levels in predicting prostate cancer development, identifying a cutoff value of 3.25 ng/mL with a sensitivity and a specificity of 89.3% and 88.5%, respectively. In summary, our results encourage further evaluation of PTX3 as a tissue biopsy and blood-borne biomarker to discriminate BPH from prostate cancer. PMID:24950910

  2. 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 ?-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 5?-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

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

    Microsoft Academic Search

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

    1998-01-01

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

  4. 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

  5. [Tadalafil in patients with benign prostatic hyperplasia during conservative combined therapy].

    PubMed

    Volkov, A A; Petrichko, M I; Budnik, N V; Dukhin, A R

    2013-01-01

    The article presents the results of treatment of 155 patients with BPH aged 48-65 years, who received conservative treatment for this disease. The patients were divided into three groups. Group 1 consisted of patients with BPH and erectile dysfunction (ED), who underwent conservative treatment (5alpha-reductase inhibitors in combination with alpha1-adrenoblocker) and phosphodiesterase inhibitor (tadalafil 20 mg) on demand. Group 2 consisted of patients with prostatic adenoma and ED, who received only conservative therapy. Group 3 consisted of BPH patients without ED, who received only conservative therapy. The effectiveness of treatment was assessed using patient self-assessment questionnaire. I-PSS score was used for the assessment of symptoms of the disease, for assessment of sexual function--AMS questionnaire for the age-related symptoms in men (specific section), short BSFI questionnaire, and International Index of Erectile Function (IIEF-5). Questionnaire survey was performed before treatment and 3, 6 and 9 months after therapy. Analysis of the results showed that there were significant impairments of sexual function in BPH. The use of phosphodiesterase inhibitor against the background of conservative therapy improves erectile function, and reduces the intensity of urination disorders. PMID:23789365

  6. Transrectal Ablation Of Prostate Tissue Using Focused Ultrasound N.T. Sanghvil.2, R.S. Foster3, R. Bihrle3, F.J. Fry', M. Phillips' and

    E-print Network

    Illinois at Urbana-Champaign, University of

    not rise more than 5' C over the baseline. In 15 patients with benign prostatic hyperplasia (BPH), no majorTransrectal Ablation Of Prostate Tissue Using Focused Ultrasound N.T. Sanghvil.2, R.S. Foster3, RFocal Surgery Inc., Milpitas, CA ABSTRACT Canine and human prostates were treated with high intensity

  7. Volumetric modeling in laser BPH therapy simulation.

    PubMed

    Zhang, Nan; Zhou, Xiangmin; Shen, Yunhe; Sweet, Robert

    2010-01-01

    In this paper, we introduce a novel application of volume modeling techniques on laser Benign Prostatic Hyperplasia (BPH) therapy simulation. The core technique in our system is an algorithm for simulating the tissue vaporization process by laser heating. Different from classical volume CSG operations, our technique takes experimental data as the guidance to determine the vaporization amount so that only a specified amount of tissue is vaporized in each time. Our algorithm uses a predictor-corrector strategy. First, we apply the classical CSG algorithm on a tetrahedral grid based distance field to estimate the vaporized tissue amount. Then, a volume-correction phase is applied on the distance field. To improve the performance, we further propose optimization approaches for efficient implementation. PMID:20975181

  8. Minimally Invasive Surgical Treatments for Benign Prostatic Hyperplasia

    Microsoft Academic Search

    Vassilios Tzortzis; Stavros Gravas; Jean J. M. C. H. de la Rosette

    2009-01-01

    Although transurethral resection of the prostate (TURP) is considered to be the reference standard for minimally invasive surgical treatment (MIST) of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO), it is associated with a noteworthy rate of complication. Transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), and laser prostatectomy (including holmium laser enucleation of the prostate [HoLEP

  9. Effect of the consumption of tomato paste on plasma prostate-specific antigen levels in patients with benign prostate hyperplasia.

    PubMed

    Edinger, M S; Koff, W J

    2006-08-01

    The consumption of tomatoes and tomato products has been associated with a reduced risk of prostate cancer. We observed a decrease of 10.77% in prostate-specific antigen (PSA) levels in patients with benign prostate hyperplasia who were submitted to daily ingestion of tomato paste. This was an experimental rather than a controlled study with a sample of 43 men ranging in age from 45 to 75 years, all with histological diagnoses of benign prostate hyperplasia and plasma PSA levels of 4-10 ng/mL. All patients received 50 g of tomato paste once a day for 10 consecutive weeks and PSA levels were analyzed before, during and after the consumption of tomato paste. ANOVA for repeated measures was used to compare PSA levels before, during and after the consumption of tomato paste. The mean +/- SD PSA level was 6.51 +/- 1.48 ng/mL at baseline and 5.81 +/- 1.58 ng/mL (P = 0.005) after 10 weeks. Acceptance was good in 88.3, regular in 9.3, and poor in 2.3% of the patients. Dietary ingestion of 50 g of tomato paste per day for 10 weeks significantly reduced mean plasma PSA levels in patients with benign prostate hyperplasia, probably as a result of the high amount of lycopene in tomato paste. This was not a prostate cancer prevention study, but showed some action of tomato paste in prostate biology. The development of prostate cancer is typically accompanied by an increase in plasma PSA levels, thus any intervention that affects plasma PSA levels can suggest an impact in the progression of disease. PMID:16906286

  10. Experience with the Peponen ® capsule in the management of benign prostatic hyperplasia

    Microsoft Academic Search

    A. Hamvas; Gy. Corradi; M. Hegedüs; D. Frang

    1991-01-01

    Sixty patients in Stages I and II of benign prostatic hyperplasia were treated with Peponen capsule. Out of them 26 took the drug for 10 months, 22 for at least 7, and 12 for at least 4 months. The daily dosage was\\u000a 32 capsules in the first month and 31 capsule for the rest of the time. On the ground

  11. 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 Central

    Leidinger, Petra; Keller, Andreas; Milchram, Lisa; Harz, Christian; Hart, Martin; Werth, Angelika; Lenhof, Hans-Peter; Weinhäusel, Andreas; Keck, Bastian; Wullich, Bernd

    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

  12. Efficacy and tolerability of drugs for treatment of benign prostatic hyperplasia.

    PubMed

    Dutkiewics, S

    2001-01-01

    It has long been recognised that neural factors are of considerable importance in lower urinary tract function. Whilst reduction in the bulk of the human prostate is feasible, experience on this therapeutic approach proved to be disappointing. Existing trial data with the agent finasteride are reviewed. A number of formulations derived from plant extracts have been advocated but their mechanism of action remain largely obscure and there is a dearth of placebo controlled information to support their efficacy. Experience over the last 10 years has demonstrated efficacy with the use of alpha adrenoceptor blockade in the management of BPH. Alpha adrenoceptor antagonists relax the prostatic smooth muscle by interrupting the sympathetic pathway at the receptor level. Recent developments in this field include the recognition that there are alpha I adrenoceptor subtypes. The functional adrenoceptor in the human prostate is predominantly the alpha IA - subtype. Of the alpha 1-adrenoceptor antagonists only tamsulosin discriminates between the alpha 1-adrenoceptor subtypes. Alpha 1-blockers should be used in first-line medical therapy for BPH and 5-alpha-reductase inhibitors reserved for those patients in whom alpha-blocker therapy fails. Alpha I-blockers such as doxazosin, tamsulosin, terazosin, alfuzosin are effective in the treatment of BPH both in younger and in older men. The drugs are well tolerated. The majority of side effects were classified as minor and mild. The most common complaints, as with other alpha-blockers, are dizziness, fatigue and headache, and these are often transient. In contrast, finasteride can lead to impotence, reduced libido. gynaecomastia or ejaculatory disorders. Men with small prostates may not be suitable candidates for finasteride therapy. PMID:11583366

  13. Antioxidant effects of lycopene in African American men with prostate cancer or benign prostate hyperplasia: a randomized, controlled trial.

    PubMed

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

    2011-05-01

    Consumption of tomato products is associated with a decreased risk of developing prostate cancer, and lycopene, the red carotenoid in the tomato, is a potent antioxidant that might contribute to this chemoprevention activity. A double-blind, randomized, placebo-controlled trial of 105 African American men veterans, recommended for prostate biopsy to detect cancer, was carried out to investigate whether oral administration of lycopene increases lycopene levels in blood and prostate tissue and lowers markers of oxidative stress. Urology patients were randomly assigned to receive 30 mg/d of lycopene as a tomato oleoresin or placebo for 21 days prior to prostate biopsy for possible diagnosis of prostate cancer. A total of 47 men had a diagnosis of prostate cancer, and 58 men had a diagnosis of benign prostate hyperplasia. Diet, smoking, and drinking habits were assessed. For the men receiving lycopene, the mean lycopene concentration increased from 0.74 ± 0.39 to 1.43 ± 0.61 ?mol/L in plasma (P < 0.0001) and from 0.45 ± 0.53 to 0.59 ± 0.47 pmol/mg in prostate tissue (P = 0.005). No significant changes in the DNA oxidation product 8-oxo-deoxyguanosine and the lipid peroxidation product malondialdehyde were observed in prostate tissue and plasma, respectively, as a result of lycopene administration. PMID:21430075

  14. Sexuality and the management of BPH with alfuzosin (SAMBA) trial.

    PubMed

    Chung, B-H; Lee, J-Y; Kim, C-I; Kim, C-S; Oh, C-Y; Lee, S-W; Lee, J-S; Yoo, S-J

    2009-01-01

    The sexuality and the management of benign prostatic hyperplasia (BPH) with alfuzosin (SAMBA) trial evaluated the effect of alfuzosin on sexual function in men treated for BPH using two sexual function scales: male sexual health questionnaire (MSHQ) and international index of erectile function (IIEF-15). A total of 148 patients with BPH were treated with alfuzosin for 24 weeks. The patients were followed at baseline, 4, 12 and 24 weeks after medication with alfuzosin. MSHQ was collected at every visit, whereas Q(max), IPSS and IIEF-15 were checked at baseline and end point. At the end point, Q(max) (+4.7 ml s(-1), P<0.01) and IPSS (-5.3, P<0.01) had improved significantly. Alfuzosin also significantly improved the total MSHQ (19.2%, 79.1-94.3, P<0.01) and the MSHQ ejaculatory scores (26.0%, 22.3-28.1, P=<0.01) versus baseline. Alfuzosin for the treatment of patients with BPH is effective in improving sexual function, as well as lower urinary tract symptoms (LUTSs) and quality of life, and is well tolerated. PMID:19078970

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

    PubMed

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

    2007-08-01

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

  16. Holmium Laser Enucleation of the Prostate (HoLEP): A Technical Update

    Microsoft Academic Search

    Ramsay L Kuo; Ryan F Paterson; Samuel C Kim; Tibério M Siqueira Jr; Mostafa M Elhilali; James E Lingeman

    2003-01-01

    INTRODUCTION: Holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation represents the latest refinement of holmium:YAG surgical treatment for benign prostatic hyperplasia (BPH). Utilizing this technique, even the largest of glands can be effectively treated with minimal morbidity. The learning curve remains an obstacle, preventing more widespread adoption of this procedure. This paper provides an outline of the

  17. Effects of silodosin and tamsulosin on the urethra and cardiovascular system in young and old dogs with benign prostatic hyperplasia

    Microsoft Academic Search

    Shinya Kobayashi; Yoshitaka Tomiyama; Satoshi Tatemichi; Yuji Hoyano; Mamoru Kobayashi; Yoshinobu Yamazaki

    2009-01-01

    We examined whether the effects (efficacy on the urethra and hypotension) of silodosin (?1A-adrenoceptor antagonist) and tamsulosin (?1A+1D-adrenoceptor antagonist) in dogs with benign prostatic hyperplasia altered with age. We used young and old dogs, diagnosed as having benign prostatic hyperplasia by veterinarian's palpation. Under anesthesia, the increase in intraurethral pressure evoked by hypogastric nerve stimulation was measured, together with the

  18. Safety, efficacy and outcomes of the new GreenLight XPS 180W laser system compared to the GreenLight HPS 120W system for the treatment of benign prostatic hyperplasia in a prospective nonrandomized single-centre study

    PubMed Central

    Eken, Alper; Soyupak, Bulent; Acil, Meltem; Arpaci, Taner; Akbas, Tugana

    2015-01-01

    Introduction: We compare and evaluate the safety, efficacy, and short-term outcomes of the new GreenLight XPS 180W (GL-XPS) laser system with the former generation GreenLight HPS 120W (GL-HPS) system for the treatment of benign prostatic hyperplasia (BPH) in a prospective nonrandomized single-centre study. Methods: From May 2012 to June 2013, 161 consecutive patients with lower urinary tract symptoms secondary to BPH were included: 88 patients were treated with the GL-HPS system and 73 were treated with the GL-XPS system. The perioperative variables International Prostate Symptom Score (IPSS), quality of life (QOL), and maximum flow rate (Qmax) were recorded at baseline, at one month and 6 months. Serum prostate-specific antigen (PSA) was assessed at baseline. Results: The mean age was 70.2 years in the GL-HPS group and 68.6 years in the GL-XPS group. Prostate volumes were 62.3 mL and 61.3 mL, respectively. Both groups showed significant postoperative improvement in the IPSS, QOL, Qmax variables compared to baseline levels. There were no significant differences in improvement in IPSS and QOL between groups. However, both operating and catheterization times were shorter in patients in the GL-XPS group. The overall postoperative complication rate was similar in both groups. Conclusion: Both GreenLight systems provide safe, effective tissue vaporization with significant clinical relief of BPH obstruction. The GL-XPS system appears more favourable with regard to reduced operating and hospitalization time, suggesting more cost-effective and efficient tissue removal. PMID:25737762

  19. Experience of treating high risk prostate hyperplasia patients with a HPS120 laser

    PubMed Central

    2013-01-01

    Background The aim of this study was to investigate the effects and safety of 120 watt PVP surgery for the high risk prostate hyperplasia patients. Methods 120 watt PVP surgery was performed on 120 cases of high risk prostate hyperplasia patients. The assessment included the operation time, energy consumed, hemoglobin changes, and serum salt concentration, whether to keep urinary catheter, hospitalization time, and complications after the operation. International Prostate Symptom Scoring (IPSS), the maximum urine flow rate (Qmax) and residual urine volume (RUV) were conducted preoperatively and postoperatively for the patients. Results There were 30% of patients taking oral anti-coagulant drug (n?=?36), 88 cases with abnormal ECGs. All the patient’s internal diseases, include the cardiovascular disease (42/120), the hypertension (56/120), the respiratory system diseases (51/120), the cerebrovascular diseases (39/120), anemia (24/120), liver or kidney dysfunction (16/120), diabetes (18/120), hypoproteinemia (15/120) were under controlled. The average age, prostate volume and energy consumed was 82.8?±?8.6 (70–96) years, 66.1?±?25.3 (30–160) ml, and 224?±?85 (31–596) kJ respectively. The average follow-up time was 20.8?±?3.2 (18–24) months. The incidence of bladder neck contracture and urethral stricture were 1.7% and 0.8% respectively, no prostate cancer occurred during the subsequent follow-up period. Conclusions 120 watt PVP surgery can safely and effectively alleviate the urination parameters of high risk prostate hyperplasia patients. The surgical process is safe and effective, and is not affected by the various internal diseases or the use of oral anti-coagulant drugs. PMID:24286544

  20. 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 5?-reductase inhibitor plus ? blocker is now the recommended option for the treatment of patients at risk of BPH progression. Other differences include the warning of potential worsening of cognitive disturbances with use of anticholinergics in older patients, the distinction between Serenoa repens preparations (according to the method of extraction), and the clearly defined threshold of prostate size for performing open surgery (>80 g). While the recommendations included in these guidelines are evidence based, clinical decisions should also be informed by patients’ clinical and physical circumstances, as well as patients’ preferences and actions. Conclusions: These guidelines are intended to assist physicians and patients in the decision-making process regarding the management of LUTS/BPH, and support the process of continuous improvement of the quality of care and services to patients. PMID:23205056

  1. Case study: Transitional care for a patient with benign prostatic hyperplasia and recurrent urinary tract infections.

    PubMed

    Bradway, Christine; Bixby, M Brian; Hirschman, Karen B; McCauley, Kathleen; Naylor, Mary D

    2013-01-01

    Chronic urologic conditions, including benign prostatic hyperplasia, recurrent urinary tract infections, and urinary incontinence, are common in older adults. This article highlights the urologic and transitional care needs of an elderly, cognitively impaired male during and after an acute hospitalization. Collaboration between the patient, his family, the advanced practice nurse, primary care providers, and outpatient urology office are described. The importance of mutual goal setting and a focused plan for transitional care are discussed. PMID:24079115

  2. Antidepression medication improves quality of life in elderly patients with benign prostatic hyperplasia and depression

    PubMed Central

    Ma, Lina; Zhao, Xiaoling; Liu, Huizhen; Zhu, Hong; Yang, Wei; Qian, Yuying; Wang, Jieyu; Feng, Ming; Li, Yun

    2015-01-01

    We aim to explore the influence of an antidepression medication on symptom scores and quality of life in elderly patients with benign prostatic hyperplasia accompanied by depression. We conducted a randomized controlled clinical trial which included 94 elderly patients with benign prostatic hyperplasia accompanied by depression in Xuan Wu Hospital and Beijing Boai Hospital during August 2008 to May 2012. The study was designed to compare outcomes related to patient quality of life (QoL). The patients were randomly assigned to one of two groups, consisting of a control group (n = 47) and a therapy group (n = 47), and were followed up for 3 months. The pre-treatment and post-treatment changes among patients in the two groups were compared using their respective IPSS symptom scores, HAM-D scores, and scores on the Short Form 36 Health Survey. Following treatment, the patient IPSS symptom scores in the therapy group were significantly lower than those in the control group (10.74 ± 4.72 vs. 16.42 ± 8.09, respectively; t = 4.157, P < 0.05). Additionally, each measured dimension of QoL was significantly higher in the therapy group [total score (69.12 ± 3.92) vs. (61.30 ± 3.51), P < 0.05]. The results show antidepression medication can improve the symptoms and quality of life among elderly patients with benign prostatic hyperplasia accompanied by depression. Our findings suggest that an antidepression medication should be included when treating elderly patients with benign prostatic hyperplasia.

  3. Cooled transurethral microwave thermotherapy for intractable chronic prostatitis—results of a pilot study after 1 year

    Microsoft Academic Search

    Christof Kastner; Werner Hochreiter; Christian Huidobro; Juan Cabezas; Paul Miller

    2004-01-01

    ObjectivesTo evaluate the side effects, tolerability, and efficacy of transurethral microwave thermotherapy with urethral cooling (cooled TUMT) for chronic prostatitis\\/chronic pelvic pain syndrome in a prospective feasibility trial. Cooled TUMT, using the Targis system from Urologix, is an established treatment option for benign prostatic hyperplasia (BPH) with minimal side effects.

  4. Transgenic expression of 15-lipoxygenase 2 (15-LOX2) in mouse prostate leads to hyperplasia and cell senescence.

    PubMed

    Suraneni, M V; Schneider-Broussard, R; Moore, J R; Davis, T C; Maldonado, C J; Li, H; Newman, R A; Kusewitt, D; Hu, J; Yang, P; Tang, D G

    2010-07-29

    15-Lipoxygenase 2 (15-LOX2), a lipid-peroxidizing enzyme, is mainly expressed in the luminal compartment of the normal human prostate, and is often decreased or lost in prostate cancer. Previous studies from our lab implicate 15-LOX2 as a functional tumor suppressor. To better understand the biological role of 15-LOX2 in vivo, we generated prostate-specific 15-LOX2 transgenic mice using the ARR2PB promoter. Unexpectedly, transgenic expression of 15-LOX2 or 15-LOX2sv-b, a splice variant that lacks arachidonic acid-metabolizing activity, resulted in age-dependent prostatic hyperplasia and enlargement of the prostate. Prostatic hyperplasia induced by both 15-LOX2 and 15-LOX2sv-b was associated with an increase in luminal and Ki-67(+) cells; however, 15-LOX2-transgenic prostates also showed a prominent increase in basal cells. Microarray analysis revealed distinct gene expression profiles that could help explain the prostate phenotypes. Strikingly, 15-LOX2, but not 15-LOX2sv-b, transgenic prostate showed upregulation of several well-known stem or progenitor cell molecules including Sca-1, Trop2, p63, Nkx3.1 and Psca. Prostatic hyperplasia caused by both 15-LOX2 and 15-LOX2sv-b did not progress to prostatic intraprostate neoplasia or carcinoma and, mechanistically, prostate lobes (especially those of 15-LOX2 mice) showed a dramatic increase in senescent cells as revealed by increased SA-betagal, p27(Kip1) and heterochromatin protein 1gamma staining. Collectively, our results suggest that 15-LOX2 expression in mouse prostate leads to hyperplasia and also induces cell senescence, which may, in turn, function as a barrier to tumor development. PMID:20514017

  5. 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.

  6. Ischemia in pelvic organs as an independent pathogenic factor in the development of benign prostatic hyperplasia and urinary bladder dysfunction.

    PubMed

    Kirpatovskii, V I; Mudraya, I S; Mkrtchyan, K G; Revenko, S V; Efremov, G D; Nadtochii, O N; Kabanova, I V

    2015-04-01

    Blood supply to the pelvic organs of outbred male rats was diminished by graduated constriction of the distal part of the inferior vena cava. Deficiency of intramural blood supply in prostate and urinary bladder was revealed by bioimpedance harmonic analysis according to the magnitude of first cardiac peak in the bioimpedance spectrogram. In 1-1.5 months, the histological examination revealed the glandular-stromal form of progressive benign prostatic hyperplasia in all ischemic rats. The development of hyperplasia was not accompanied by the changes in testosterone, dihydrotestosterone, or estradiol in blood and prostatic tissue. Assessment of vesical functional status by recording the intravesical pressure during infusion cystometry revealed an increase in the amplitude of spontaneous fluctuations of detrusor tone and intravesical pressure during bladder filling, which can be considered as indicator of detrusor hyperactivity. The data conclude that chronic ischemia of pelvic organs is an individual pathogenic factor in the development of benign prostatic hyperplasia and associated urinary disorders. PMID:25896589

  7. Prostate-specific antigen—comparative clinical appreciation of a serodiagnostic measure after 8 years of experience

    Microsoft Academic Search

    E. Allhoff; W. de Riese; M. Eifinger; J. Pethke; U. Jonas

    1989-01-01

    Summary In a prospective study, prostate-specific acid phosphatase\\/prostate-specific antigen (PSAP\\/PSA) serum levels were simultaneously determined in 696 patients with benign prostatic hyperplasia (BPH), 202 patients with newly diagnosed, untreated prostate cancer (p-Ca), and 414 patients with previously treated p-Ca; in 165 of the 202 patients with newly diagnosed p-Ca, sampling was continued at 3-month intervals after the onset of various

  8. Efficacy and Safety of Low-Dose Propiverine in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia with Storage Symptoms: A Prospective, Randomized, Single-Blinded and Multicenter Clinical Trial

    PubMed Central

    Bae, Jae Hyun; Kim, Sun Ouck; Yoo, Eun Sang; Moon, Kyung Hyun; Kyung, Yoon Soo

    2011-01-01

    Purpose The aim of this study was to evaluate whether low-dose anticholinergics combined with an ?1-receptor antagonist would continue the effect of an alpha-blocker, decrease the side effects of anticholinergics, and improve the symptoms of lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). Materials and Methods Two hundred nine men with LUTS/BPH with storage symptoms (International Prostate Symptom Score [IPSS] ?12; storage symptoms ?4) were randomly assigned in a prospective, multicentered, and single-blind fashion to either the control group (alfuzosin 10 mg, once daily) or the combined group (alfuzosin 10 mg, once daily, and propiverine 10 mg, once daily) for 2 months. IPSS, maximal urinary flow rate (Qmax), and postvoid residual volume (PVR) were used to grade symptoms, side effects, and the impact on quality of life (QoL) at the start of the study and after 1 and 2 months. Results There were no significant differences in patient background, including age, prostate size, Qmax, and PVR, between the control group and the combined group. In the combined group, the IPSS total score and the IPSS storage symptom score were significantly improved compared with the control group. The IPSS voiding symptom score, QoL, Qmax, and PVR did not differ significantly. There were no serious side effects in either group. Conclusions Management with an ?1-receptor antagonist combined with a low-dose anticholinergic improved the total score and storage symptom score of the IPSS compared with ?1-receptor antagonist only group without causing serious side effects. This initial combination medication can be considered an effective and safe treatment modality for LUTS/BPH patients with storage symptoms. PMID:21556215

  9. Comparison of Patients Undergoing PVP Versus TURP for LUTS/BPH.

    PubMed

    Anderson, Blake B; Pariser, Joseph J; Helfand, Brian T

    2015-08-01

    Transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) are currently the two most commonly performed procedures for the treatment of benign prostatic hyperplasia (BPH). While each procedure has been shown to be efficacious, TURP or PVP may be preferred in certain clinical scenarios. A number of factors may influence the choice of which patients undergo PVP or TURP. This decision may take into account patient characteristics, such as age, co-morbidities, predominance of irritative symptoms, and/or ongoing anticoagulation. Additionally, balancing desired outcomes with possible risks is critical. Considerations should include possible effects on sexual function, rates of reoperation, cost, and need for tissue specimen in those at risk for prostate cancer. The primary objective of this article is to summarize the comparative research of PVP and TURP and the implications on differences between patients who undergo either procedure. PMID:26077354

  10. Preoperative cystometrography in patients with clinical benign prostatic hypertrophy

    Microsoft Academic Search

    T. Koyanagi; K. Ameda; M. Nantani; K. Taniguchi; T. Matsuno; Y. Shinno

    1995-01-01

    Preoperative water cystometrograms obtained from 437 patients with benign prostatic hyperplasia (BPH) were examined in a retrospective study. The cystometrographic results were analyzed regarding the preoperative clinical features: the patients' age, presence or absence of urinary incontinence, history of urinary retention, and rate of residual urine. Their prognostic value in terms of improvement in voiding difficulty and postoperative urinary incontinence

  11. Silodosin versus naftopidil for the treatment of benign prostatic hyperplasia: a multicenter randomized trial.

    PubMed

    Yamaguchi, Kenya; Aoki, Yutaka; Yoshikawa, Tetsuo; Hachiya, Takahiko; Saito, Tadanori; Takahashi, Satoru

    2013-12-01

    This was a multicenter randomized trial to investigate the clinical efficacy and the impact on sexual function of alpha-1A selective silodosin and alpha-1D selective naftopidil for treatment of benign prostatic hyperplasia. A total of 97 patients with lower urinary tract symptoms/benign prostatic hyperplasia who had an International Prostate Symptom Score of 8 or more were randomly assigned to receive silodosin (8?mg/day, n?=?53) or naftopidil (75?mg/day, n?=?44). Before and 4, 8 and 12?weeks after treatment, International Prostate Symptom Score and its quality of life score were used to assess lower urinary tract symptoms. Also, International Index of Erectile Function-5, and an original questionnaire were used to evaluate erectile function and ejaculation for sexually active patients, respectively. The silodosin group showed advantages in terms of voiding symptoms and quality of life of International Prostate Symptom Score when compared with the naftopidil group. Both silodosin and naftopidil showed no significant effect on International Index of Erectile Function-5. A total of 23 sexually active patients in the silodosin group experienced more ejaculatory impairment than 21 patients in the naftopidil group, with a decrease of ejaculation volume (87% vs 40%, P?=?0.003), prolonged time to ejaculation (56% vs 33%, P?=?0.027) and decrease of orgasm (50% vs 39%, P?=?0.027). These results suggest that alpha-1A selective blockers are more effective for voiding symptoms, whereas alpha-1D selective blockers offer a minor degree of ejaculatory dysfunction. PMID:23731168

  12. Selection of the surgical procedure for management of benign prostatic hyperplasia.

    PubMed

    Mebust, W K

    1994-01-01

    The standard method of surgically treating obstructing benign prostatic hyperplasia is transurethral resection of the prostate. It is the gold standard by which other therapeutic modalities, medical and surgical, should be measured. In those patients with larger prostate, open prostatectomy is the procedure of choice. Transurethral incision of the prostate has been under-utilized and would be useful in the majority of patients. The procedure is best used in patients who have glands under 30 grams and preferably around 20 grams in size. Therefore, in a given patient, the surgical procedure will be dependent upon the patient's general condition, the anatomy and size of his prostate, and the surgeon's skill and experience. Newer less invasive procedures are currently under evaluation and must be compared to transurethral prostatectomy, so that we can determine their possible role in the armamentarium of the urologist. Prospective randomized studies, comparing these new modalities to TUR-P, are needed, particularly with long-term outcome data. PMID:7528405

  13. Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment

    Microsoft Academic Search

    Shu-Jie Xia

    2009-01-01

    Two-micron (thulium) laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. We recently reported the primary results. Here we introduce this procedure in detail. A 70-W, 2-?m (thulium) laser was used in continuous-wave mode. We joined the incision

  14. SAW PALMETTO BERRY EXTRACT INHIBITS CELL GROWTH AND COX2 EXPRESSION IN PROSTATIC CANCER CELLS

    Microsoft Academic Search

    Wolfgang H. Goldmann; Amita L. Sharma; Steve J. Currier; Paul D. Johnston; Ajay Rana; C. Pal Sharma

    2001-01-01

    The cytotoxicity of a commonly used material to alleviate the symptoms of benign prostatic hyperplasia (BPH), Saw Palmetto Berry Extract (SPBE), was examined as neat oil using a set of prostatic cell lines; 267B-1, BRFF-41T and LNCaP. Proliferation of these prostatic derived cell lines is inhibited to different degrees when dosed for 3 days with SPBE. The amount of SPBE

  15. Measurement of the Complex between Prostate-specific Antigen and a1Protease Inhibitor in Serum

    Microsoft Academic Search

    Wan-Ming Zhang; Patrik Finne; Jari Leinonen; Satu Vesalainen; Stig Nordling; Ulf-HAkan Stenman

    1999-01-01

    Background: Prostate-specific antigen (PSA) occurs in serum both free and in complex with protease inhibi- tors. The complex with a1-antichymotrypsin (ACT) is the major form in serum, and the proportion of PSA-ACT is higher in prostate cancer (PCa) than in benign prostatic hyperplasia (BPH). PSA also forms a complex with a1-protease inhibitor (API) in vitro, and the PSA-ACT complex has

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

    Microsoft Academic Search

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

    2005-01-01

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

  17. The Role of Gonadotropin-Releasing Hormone Antagonists for the Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Lepor, Herbert

    2006-01-01

    Medical therapy is the preferred first-line approach in the management of lower urinary tract symptoms in men with benign prostatic hyperplasia. The magnitude of the improvement in lower urinary tract symptoms observed in response to combination therapy (?-blocker plus 5-? reductase inhibitors) does not approach that achieved with prostatectomy. Various drugs have been under consideration, including BXL628, lonidamine, and phosphodiesterase inhibitors, all of which have had unacceptable side effects. The gonadotropin-releasing hormone antagonist cetrorelix is associated with dose-dependent symptom improvement and reduction of prostate volume. Elucidating the mechanism for cetrorelix-mediated improvement in lower urinary tract symptoms will likely contribute to unraveling the pathophysiology of lower urinary tract symptoms in men. PMID:17192797

  18. Effects of pumpkin seed oil and saw palmetto oil in Korean men with symptomatic benign prostatic hyperplasia.

    PubMed

    Hong, Heeok; Kim, Chun-Soo; Maeng, Sungho

    2009-01-01

    This study was to investigate the role of complementary and alternative medicine in the prevention and treatment of benign prostatic hyperplasia. For this purpose, a randomized, double-blind, placebo-controlled trial was performed over 12 months on 47 benign prostatic hyperplasia patients with average age of 53.3 years and international prostate symptom score over 8. Subjects received either sweet potato starch (group A, placebo, 320 mg/day), pumpkin seed oil (group B, 320 mg/day), saw palmetto oil (group C, 320 mg/day) or pumpkin seed oil plus saw palmetto oil (group D, each 320 mg/day). International prostate symptom score, quality of life, serum prostate specific antigen, prostate volume and maximal urinary flow rate were measured. In groups B, C and D, the international prostate symptom score were reduced by 3 months. Quality of life score was improved after 6 months in group D, while those of groups B and C were improved after 3 months, compared to the baseline value. Serum prostate specific antigen was reduced only in group D after 3 months, but no difference was observed in prostate volume in all treatment groups. Maximal urinary flow rate were gradually improved in groups B and C, with statistical significance after 6 months in group B and after 12 months in group C. None of the parameters were significantly improved by combined treatment with pumpkin seed oil and saw palmetto oil. From these results, it is suggested that administrations of pumpkin seed oil and saw palmetto oil are clinically safe and may be effective as complementary and alternative medicine treatments for benign prostatic hyperplasia. PMID:20098586

  19. The value of prostatic acid phosphatase and prostate specific antigen as serum markers in carcinoma of the prostate.

    PubMed

    Akda?, A; Sim?ek, F; Ilker, Y; Türkeri, L; Ercan, H

    1993-01-01

    The value of prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) as serum markers in carcinoma of the prostate (CaP) was investigated in this study. A group of 75 patients entered this trial, 25 with CaP, 25 with benign prostatic hyperplasia (BPH) and 25 with urologic disorders other than prostatic diseases. In the CaP group, PAP was above normal levels in 48% of the patients and PSA in 92%. In the BPH group these rates were 20% and 72%, respectively. No elevation was detected in the third group. In CaP patients with capsular invasion, PAP and PSA levels were above normal in 25 and 87.5%. In metastatic carcinoma, PAP was high in 75% and PSA in 100%. Our study reveals that neither of these markers is useful in the initial diagnosis of CaP. Though PSA seems to be more sensitive, it is not more specific than PAP. PMID:7693607

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

    PubMed

    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

  1. Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia: Effectiveness, Safety, and Overcoming of the Learning Curve

    PubMed Central

    Hwang, Jin Chul; Park, Sang Myung

    2010-01-01

    Purpose To examine the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for the surgical treatment of benign prostatic hyperplasia and to estimate the time to overcome the learning curve. Materials and Methods From May 2008 to October 2009, 164 consecutive patients treated with HoLEP were enrolled in this study. International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), and postvoid residual urine (PVR) were documented preoperatively and at 6 weeks and 3, 6, 12, and 18 months postoperatively. The 164 study subjects were divided into 3 groups (group 1 the first 50 patients treated, group 2 the second 50, and group 3 the third 64), and perioperative data and complications were analyzed in these groups to determine the learning curve. In addition, the inverse and upward techniques were compared in terms of the effects and the stability of morcellation. Results The mean patient age was 69 years, and the average operation time was 62 minutes (range, 20-208 minutes). Mean prostate volume was 54.2 ml and mean resected tissue weight was 18.6 g. Postoperatively, IPSS and PVR decreased and Qmax increased significantly. Postoperative complications were transient incontinence (8.5%), urinary retention (4.3%), hematuria (3.0%), urinary tract infection (1.2%), and urethral stricture (0.6%), and intraoperative complications were minor capsular perforation (4%) and bladder injury (8%). Conclusions HoLEP was found to be effective and safe regardless of prostate size. We recommend that a systematic educational program be established to reduce the learning curve. PMID:20856646

  2. PSMA/PSA ratio evaluated by immunohistochemistry may improve diagnosis of prostate cancer.

    PubMed

    Jemaa, Awatef Ben; Bouraoui, Yosra; Sallami, Sataa; Banasr, Ahmed; Nouira, Yassine; Oueslati, Ridha

    2014-01-01

    Prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) measured in serum are not fully satisfactory as biomarkers of prostate cancer (PC). Results obtained in this article indicated that PSMA/PSA ratio evaluated by immunohistochemistry in normal prostate (NP), benign prostatic hyperplasia (BPH), and PC at the individual level could be a useful tool for diagnosis and prognosis of PC. PSMA and PSA were equally expressed in NP and the PSMA/PSA ratio was 1.22 ± 0.15. Data also indicated that PSMA/PSA ratio fluctuates in BPH and PC compared to NP. In BPH, the PSMA/PSA ratio was around 0.47 ± 0.02, whereas it's significantly increased in PC, about 4.95 ± 0.83. In parallel, the highest PSMA/PSA ratio was associated with high intratumoral angiogenesis in PC patients with (PSMA+,PSA+) profile. PMID:24063616

  3. 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

  4. Transurethral ultrasound array for prostate thermal therapy: initial studies

    Microsoft Academic Search

    Chris J. Diederich; Everette C. Burdette

    1996-01-01

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

  5. 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.

  6. [Shared care in BPH. First national experience].

    PubMed

    Padilla León, M; Marchal Escalona, C; Caballero Alcántara, J; Padilla León, F; Lucas de Vega, I M

    1998-06-01

    The high prevalence of Benign Prostate Hyperplasia and the increased demand for care of this condition, should compel us to plan for shared care models in parallel to Primary Care, in the way it has happened with entities such as HBP and Diabetes. The set of measurements to be adopted when sharing services with primary care is known as "shared care". This paper presents the first national experience of "shared care" with primary care in BPH. The project has consisted in a series of steps to increase awareness, train and make available for family physicians, a clinical practice guide defining the criteria for initial evaluation, medical treatment and referral of patients to Urology surgeries, including with the referral document the appropriate diagnostic tests. A Quality Commission has been created to study the level of compliance of the documentation used for referral to the specialist and the clinical histories of patients treated in primary care. The results obtained are significant and most studies carried out fulfill the requirements in 60% cases, which has allowed to reduce overcrowding in the Urology outpatient offices (4200 surgery visits saved/year in our environment), has provided easy access of patients to adequate diagnosis and treatment, as well as significant financial savings (30 million pesetas/year). In short "shared care" is a reality in our environment that allows a more effective, fast medical assistance and improved access to specialist care by reducing the demand of specialized surgery hours. PMID:9734123

  7. Comparison of Saw Palmetto (extract and whole berry) and Cernitin on prostate growth in rats

    Microsoft Academic Search

    Nadeem Talpur; Bobby Echard; Debasis Bagchi; Manashi Bagchi; Harry G. Preuss

    2003-01-01

    Pharmaceuticals such as finasteride and alpha blockers are used to treat symptoms of benign prostatic hyperplasia (BPH) and are known to cause severe adverse reactions. Accordingly, a search for safer, natural products has been undertaken. Two natural agents (nutraceuticals) have come under recent scrutiny; because natural products, in general, often have evidence of long-term safety. The present study compares the

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

    PubMed Central

    Kunit, Thomas; Lusuardi, Lukas

    2014-01-01

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

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

    Microsoft Academic Search

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

    2003-01-01

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

  10. The potential value of 5-alpha-reductase inhibition in the treatment of bladder outflow obstruction due to benign prostatic hyperplasia

    Microsoft Academic Search

    Roger S. Kirby; Timothy Christmas

    1991-01-01

    The development of treatment forms for bladder outflow obstruction resulting from benign prostatic hyperplasia is traced from the early surgical techniques to the present. The positive effects and the drawbacks of modern pharmacological treatment are weighed against each other.

  11. Testosterone Replacement Therapy on the Natural History of Prostate Disease.

    PubMed

    Moore, Aaron; Butcher, Michael J; Köhler, Tobias S

    2015-08-01

    The physiology of testosterone production and action are closely related to prostatic disease. An understanding of the natural history of testosterone and prostate growth and development is needed in order to understand this complex relationship. Lower urinary tract symptoms (LUTS), benign prostatic hyperplasia (BPH), prostate cancer, and sexual function are common disorders for which testosterone is thought to play a role. Proposed in this review are some theories as to how testosterone interacts to potentially ameliorate these conditions. Further research is needed, but we feel our proposed points are valid given the review of the literature. PMID:26077355

  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. Prostate Diseases

    MedlinePLUS

    ... year in the United States to correct BPH. Prostate cancer is a frequent cancer diagnosis in American men. Although it is rare in ... Although prostatitis is less common than BPH or prostate cancer, about 8% of the male population will suffer from it at some point ... May 2012 Posted: May 2012

  14. Trends in alpha-blocker treatment of patients with benign prostatic hyperplasia and hypertension: dosing regimens and cost comparisons

    Microsoft Academic Search

    Joanne L. Raymond; Carl S. Smith

    1997-01-01

    Dosing regimen is an important determinant of both drug cost and patient compliance. This retrospective analysis evaluated dosing regimens and drug acquisition costs for 101 patients identified from medical records in a large metropolitan hospital as having hypertension and\\/or benign prostatic hyperplasia and receiving alpha-blocker therapy with either doxazosin or terazosin. Although once-daily administration is generally recommended for both drugs,

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

    Microsoft Academic Search

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

    1995-01-01

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

  16. 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

  17. Capillary electrophoresis of urinary prostate glycoproteins assists in the diagnosis of prostate cancer.

    PubMed

    Vermassen, Tijl; Van Praet, Charles; Vanderschaeghe, Dieter; Maenhout, Thomas; Lumen, Nicolaas; Callewaert, Nico; Hoebeke, Piet; Van Belle, Simon; Rottey, Sylvie; Delanghe, Joris

    2014-04-01

    Prostate marker assays are widely used for detection of prostate cancer (PCa) but are associated with considerable sensitivity and specificity problems. Therefore, we investigated prostatic protein glycosylation profiles as a potential biomarker. We determined the urinary asparagine-linked glycan (N-glycan) profile of prostatic proteins of healthy volunteers (n = 25), patients with benign prostate hyperplasia (BPH; n = 62) and newly diagnosed PCa patients (n = 42) using DNA-sequencer-assisted fluorophore-assisted carbohydrate electrophoresis. Through squeezing of the prostate, a sufficient amount of prostatic proteins was obtained for direct structural analyses of N-glycan structures. N-glycans of PCa compared to BPH were characterized by a significant decrease in triantennary structures (p = 0.047) and overall fucosylation (p = 0.026). Prostate-specific antigen (PSA) and the urinary glycoprofile marker showed comparable overall receiver operating characteristic curve analysis as well as in the diagnostic gray zone with serum PSA values between 4 and 10 ?g/L. However, when combining PSA and the urinary glycoprofile marker, the latter gave an additive diagnostic value to serum PSA (p ? 0.001). In conclusion, N-glycosylation profiling demonstrated differences between BPH and PCa. These changes could lead to the discovery of a new biomarker for PCa. PMID:24254641

  18. 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.

  19. Avaliação do valor da relação do antígeno prostático específico livre e total no diagnóstico do câncer de próstata Evaluation of the value of the relation between free and total prostate-specific antigen in the diagnosis of prostate cancer

    Microsoft Academic Search

    Ernani Luis Rhoden

    Introduction: The aim of this study was to evaluate the value of the relation of free PSA \\/ to total PSA (PSA) in the differentiation of prostate cancer from benign prostatic hyperplasia (BPH) in men with PSA levels between 4.1 and 10 ng\\/ml. Material and Methods: Between 1999 and 2000, 140 consecutive men with PSA le- vels between 4.1 and

  20. 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

  1. 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

  2. The Economic Impact of Delaying 5-Alpha Reductase Inhibitor Therapy in Men Receiving Treatment for Symptomatic Benign Prostatic Hyperplasia

    PubMed Central

    Naslund, Michael; Eaddy, Michael T.; Hogue, Susan L.; Kruep, Eric J.; Shah, Manan B.

    2011-01-01

    Background Pharmacologic treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia often includes alpha-blockers and 5-alpha reductase inhibitors. Many clinicians use alpha-blockers for rapid symptom control, later adding 5-alpha reductase inhibitors to modify long-term disease progression. Delaying the addition of these medications has been shown to result in reduced clinical outcomes. The economic impact of this practice has not been widely studied or reported to date. Objective The objective of this study was to assess the economic impact of delaying initiation of concomitant 5-alpha reductase inhibitor therapy (?30 days) in patients receiving alpha-blockers for lower urinary tract symptoms. Methods Using 2 nationally representative databases (Integrated Health Care Information Solutions and PharMetrics), 2 retrospective analyses were conducted involving 2636 and 4260 men, respectively, aged ?50 years treated for benign prostatic hyperplasia between 2000 and 2007. Economic outcomes (ie, the cost of therapy and the use of healthcare resources) were compared for adding 5-alpha reductase inhibitor therapy early (within <30 days of initiating an alpha-blocker) versus delaying these medications (?30 days after initiating an alpha-blocker). Results In the Integrated Health Care Information Solutions analysis, patients in the early add-on therapy group (n = 1572) had lower benign prostatic hyperplasia–related medical costs in the posttreatment period than those in the delayed-therapy group (n = 1064), $349 versus $618 (P <.0001). Similar trends were seen in the PharMetrics analysis—the medical costs in the early add-on therapy group (n = 2604) and delayed group (n = 1656) were $344 versus $449, respectively (P <.001). Pharmacy costs were $1068 for the early-treatment cohort and $989 for the delayed-treatment cohort for the Integrated Health Care Information Solutions database, yielding total costs of $1417 and $1606, respectively, for a $189 savings per patient over the initial year of treatment (P <.0001). In the PharMetrics analysis, pharmacy costs were $1391 for the early-treatment cohort and $1237 for the delayed-treatment cohort, resulting in total cost of $1735 and $1686, respectively, yielding $59 in additional costs per patient annually for those treated early (P = .8645). Conclusion These results suggest that patients receiving 5-alpha reductase inhibitor therapy within 30 days after initiating alpha-blocker treatment have lower benign prostatic hyperplasia–related medical costs than those who start combination treatment later. The increase in pharmacy costs associated with early initiation of 5-alpha reductase inhibitor therapy resulted in total costs that were similar or significantly lower than those of delayed combination users. PMID:25126348

  3. Investigation of pro- and antioxidative systems' changes in blood of patients with prostate tumours.

    PubMed

    Zibzibadze, M; Bochorishvili, I; Ramishvili, L; Managadze, L; Kotrikadze, N

    2009-04-01

    Great number of pathogenic processes, including cancer, are followed by disbalance between pro- and antioxidative systems. This is reflected on lipid peroxidation (LP). As a result diene conjugates - the primary products of peroxidation, cetodienes, trienes (secondary products), malondialdehyde (MDA) and Schiff's bases (the final products) are synthesized. Significant changes are expectable in functioning of antioxidant system on the background of tumour growth. The aim of the study was to investigate changes in the content of primary, secondary and final LP products and quantitative changes of main antioxidant of plasma - Ceruloplsmin (Cp) in blood of patients with prostate tumors (benign prostate hyperplasia (BPH), benign prostate hyperplasia with PING(3-4) regions and metastatic prostate adenocarcinoma (PCa). The tendency of diene conjugates reducing has been revealed compared with norm: The control group-->BPH-->benign prostate hyperplasia with PING(3-4)regions-->metastatic PCa. Level of cetodienes and trienes was sharply decreased in case of PCa. MDA content was increased in all cases we had studied, but it was significantly increased in benign prostate hyperplasia with PING(3-4) regions and PCa. Amount of Schiff's bases raised in lipid extracts in all cases of prostate cancer, especially in patients with benign prostate hyperplasia with PING(3-4) regions. Concentration of Cp was sharply increased in blood plasma of patients with malignant tumour. Strong intensification of LP in prostate cancer patients and accumulation of its final products occurs on the background of changes of the antioxidant system. This fact was revealed by sharp increase of Cp content in blood plasma of the patients. Both facts express disbalances of the anti- and prooxidative systems of organism in case of prostate gland malignant transformation. PMID:19430038

  4. 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

  5. Lipidosterolic Extract of Serenoa Repens Modulates the Expression of Inflammation Related-Genes in Benign Prostatic Hyperplasia Epithelial and Stromal Cells

    PubMed Central

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

    2013-01-01

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

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

    Microsoft Academic Search

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

    2002-01-01

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

  7. Expression of some selected cytokeratins and Ki67 protein in prostatic tumor: can these be used as tumor markers

    PubMed Central

    Adisa, James Olayiwola; Egbujo, Ejike Chukwudi; Ibrahim, Babangida; Musa, Bukar; Madukwe, Jonathan

    2015-01-01

    Introduction Diagnosis of prostatic diseases with Immunohistochemistry still faces challenges because of the peculiar histology of the prostate and difference(s) in reactivity of Monoclonal antibodies (MoAb) to benign and malignant changes. Methods Thirty (30) archived paraffin embedded tissue samples from primary prostate tumors (15 Benign Prostatic Hyperplasia (BPH) and 15 Cancer of the prostate (CaP)) were sectioned at thickness of 5µm and confirmed as BPH or CaP. Sections from each sample were stained by Immunohistochemistry using the Streptavidin-biotin method and using CK5/6, CK7, CK8,CK20 and Ki67 antibodies (Zymed Antibody products). Appropriate positive and negative controls for each antibody were setup alongside the test slides. Results BPH samples were reactive to Ck5/6 (93.3%), Ck7 (80%) and Ck8 (100%). Only 13.3% of BPH samples were reactive to Ki67. The reactivity of Ck5/6, 7, 8 in CaP is a contrast with only 3(20%) of samples positive with Ck5/6, 2(13.3%) positive with Ck7 and 14(93.3%) with Ck8. While reactivity of Ck 8 is similar in BPH and CaP, no reaction was recorded in Ck 20 in both BPH and CaP. Ki67 was only reactive in 2(13.3) of BPH samples and 15(100%) of CaP. Only Ck 8 was expressed in both BPH and CaP. There was co-expression of Ck5/6, 7,8 and Ki67 in13.3%; Ck7and Ki67 in 13.3% in both BPH and CaP. Conclusion The various cytokeratins are individually expressed in both BPH and CaP. Ck5/6 and Ck7 are co-expressed and may be used in the diagnosis of BPH, Ck5/6,7,8 and Ki67 are co-expressed in Prostatic adenocarcinoma and squamous cell carcinoma of the prostate while Ck8 and Ki67 are co-expressed and may be used for diagnosis of Prostatic adenocarcinoma alone.

  8. Trends in Medical Management of Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

    PubMed Central

    Filson, Christopher P.; Wei, John T.; Hollingsworth, John M.

    2014-01-01

    Objective To examine trends in medical management of men with BPH/LUTS in relation to sentinel events specific to particular medication regimens. Methods Using the National Ambulatory Medical Care Survey (1993–2010), we identified outpatient visits by men with BPH/LUTS. We ascertained prescriptions for medical therapy and distinguished between treatment with ?-blocker (AB) monotherapy, 5-? reductase inhibitor monotherapy, combination therapy, and anticholinergic therapy. We evaluated temporal trends in prescription patterns, and assessed for changes after sentinel events related to each regimen (e.g., FDA approval for tamsulosin and AB monotherapy). Finally, we used multivariable logistic regression to determine factors associated with each treatment strategy. Results From 1993–2010, there were over 101 million outpatient visits for men with a diagnosis of BPH/LUTS. Among these visits, use of BPH medication increased from 14% of visits in 1993–1995 to over 40% of visits in 2008–2010 (p<0.001). After tamsulosin was FDA approved, providers were twice as likely to prescribe ABs (OR 2.35, 95% CI 1.60 – 3.43). Providers were five times as likely to prescribe combination therapy after level 1 evidence supported its use (OR 5.13, 95% CI 3.35 – 7.86). Conclusions Over the past 15 years, there has been a steady increase in use of medications to manage men with BPH. Providers seem to have readily adopted novel medications and treatment regimens in response to FDA approval and supportive level 1 evidence. PMID:24269224

  9. Immunomodulatory effect of red onion (Allium cepa Linn) scale extract on experimentally induced atypical prostatic hyperplasia in Wistar rats.

    PubMed

    Elberry, Ahmed A; Mufti, Shagufta; 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'-?-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-?, IGF-1, and clusterin, while TGF-?1 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

  10. 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?-?-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-?, IGF-1, and clusterin, while TGF-?1 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

  11. Distribution of Inflammation, PreMalignant Lesions, Incidental Carcinoma in Histologically Confirmed Benign Prostatic Hyperplasia: A Retrospective Analysis

    Microsoft Academic Search

    Franco Di Silverio; Vincenzo Gentile; Anna De Matteis; Gianna Mariotti; Voria Giuseppe; Pastore Antonio Luigi; Alessandro Sciarra

    2003-01-01

    Objectives: We analyze our experience on BPH through 20 years of histopathological examinations performed by the same pathologist.Methods: We retrospectively reviewed all histopathological examinations performed from January 1979 to December 1998 in patients undergoing surgery in our urological clinic who were diagnosed with BPH. We limited our evaluation to the following variables in each BPH case analyzed: inflammatory aspects associated

  12. 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.

  13. LONG-TERM POOLED ANALYSIS OF MULTICENTER STUDIES OF COOLED THERMOTHERAPY FOR BENIGN PROSTATIC HYPERPLASIA: RESULTS AT THREE MONTHS THROUGH FOUR YEARS

    Microsoft Academic Search

    BRUCE J. TROCK; MICHELLE BROTZMAN; WILLIAM J. UTZ; ROLAND R. UGARTE; STEVEN A. KAPLAN; THAYNE R. LARSON; MICHAEL L. BLUTE; CLAUS G. ROEHRBORN; ALAN W. PARTIN

    Objectives. To determine the long-term efficacy of cooled thermotherapy in the treatment of lower urinary tract symptoms of clinical benign prostatic hyperplasia. Methods. A total of 541 men underwent cooled thermotherapy treatment in six multicenter studies in the United States, England, and Canada. Both fixed and random effects models were used to pool the data across the six studies. The

  14. Dutasteride: a review of its use in the management of prostate disorders.

    PubMed

    Keam, Susan J; Scott, Lesley J

    2008-01-01

    Dutasteride (Avodart), an oral synthetic 4-azasteroid, is a potent, selective, irreversible inhibitor of type 1 and type 2 5alpha-reductase (5AR), the enzyme that converts testosterone to dihydrotestosterone (DHT) intracellularly. Although type 2 5AR predominates, both isoenzymes are overexpressed in prostate tissue in benign prostatic hyperplasia (BPH) and at all stages in some prostate cancers. Oral dutasteride 0.5 mg once daily is approved for the treatment of moderate to severe symptomatic BPH in men with an enlarged prostate to improve symptoms, and to reduce the risk of acute urinary retention (AUR) and the need for BPH-related surgery.In pivotal 2-year phase III trials, oral dutasteride 0.5 mg once daily improved urinary symptoms, decreased total prostate volume (TPV), and reduced the risk of AUR and BPH-related surgery in men with moderate to severe symptoms of BPH and prostate enlargement. The good efficacy and tolerability of dutasteride was maintained for up to 4 years in open-label extension studies. Results of the pre-planned, 2-year interim analysis of the CombAT trial showed that the combination of dutasteride and tamsulosin was superior to either drug as monotherapy in improving BPH-related symptoms, peak urinary flow and BPH-related health status. The overall adverse event profile for combination therapy was consistent with those reported for both monotherapies. Although drug-related adverse events were more frequent with combination therapy versus both monotherapies, most did not result in treatment cessation. Dutasteride is being investigated for its efficacy in reducing the risk of prostate cancer in at-risk men in the 4-year REDUCE study and as treatment to extend the time to progression in men with low-risk localized prostate cancer who would otherwise undergo watchful waiting in the 3-year REDEEM study. Thus, dutasteride is an effective treatment option in patients with moderate to severe symptomatic BPH and demonstrable prostatic enlargement, and may have potential to reduce the risk of developing biopsy-detectable prostate cancer in at-risk individuals or extending the time to progression in low-risk localized prostate cancer. PMID:18318566

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

    SciTech Connect

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

    1987-01-01

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

  16. 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.

  17. Somatostatin receptors in prostate tissues and derived cell cultures, and the in vitro growth inhibitory effect of BIM-23014 analog.

    PubMed

    Tatoud, R; Degeorges, A; Prévost, G; Hoepffner, J L; Gauvillé, C; Millot, G; Thomas, F; Calvo, F

    1995-09-22

    We investigated somatostatin receptors (SSTRs) in surgical specimens of prostate cancer and benign prostate hyperplasia (BPH), a normal immortalized epithelial cell line (PNT1), epithelial cancer cell lines, and stromal cells in short-term culture derived from normal and BPH biopsies. Cross-linking studies with 125I-Tyr11-SRIF-14 (125I-SRIF) and the SRIF analog 125I-BIM-23104 identified one major 57-kDa band both in surgical specimens and in epithelial and stromal cells cultures. In membrane-enriched fractions and whole stromal cells from a normal prostate and from one BPH, a single type of SSTR was characterized (Kd = 6.10(-9) and 10(-8) M, respectively, Bmax = 1.6 pmol per mg of proteins). mRNA for SSTR1 was detected in all epithelial and stromal cells tested except for PNT1, while SSTR2 mRNA was detected in one BPH stromal cell culture. BIM-23104 had no effect on the in vitro growth of the epithelial cells tested. Conversely, 10(-10) M BIM-23104 induced >50% growth inhibition of stromal cells after 6 days in culture. These results may have implications for therapeutic strategies using SRIF analogs in BPH and prostate cancer. PMID:8674827

  18. 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

  19. Prostate hyperplasia caused by long-term obesity is characterized by high deposition of extracellular matrix and increased content of MMP-9 and VEGF.

    PubMed

    Silva, Silas Amâncio; Gobbo, Marina Guimarães; Pinto-Fochi, Maria Etelvina; Rafacho, Alex; Taboga, Sebastião Roberto; Almeida, Eduardo Alves; Góes, Rejane Maira; Ribeiro, Daniele Lisboa

    2015-02-01

    Recent studies have shown a positive association of cancer and obesity, but the morphological and molecular mechanisms involved in this relationship are still unknown. This study analysed the impact of long-term obesity on rat prostate, focusing on stromal changes. Male adult Wistar rats were treated with high-fat diet to induce obesity, while the control group received a balanced diet. After 30 weeks of feeding, the ventral prostate was analysed by immunohistochemistry for cell proliferation, smooth muscle ?-actin, vimentin, chondroitin sulphate and metalloproteinases (MMP-2 and 9). The content of androgen receptor (AR), oestrogen receptors (ERs) and vascular endothelial growth factor (VEGF) was measured by Western blotting, and activity of catalase and Glutathione-S-Transferase (GST) were quantified by enzymatic assay. Long-term obesity decreased testosterone plasma levels by 70% and resulted in stromal prostate hyperplasia, as evidenced by increased collagen fibres. Such stromal hyperplasia was associated with increased number of blood vessels and raised VEGF content, and increased expression of chondroitin sulphate, vimentin, ?-actin and MMP-9. In spite of the high cell density in prostate, the proliferative activity was lower in the prostates of obese rats, indicating that hyperplasia was established during the early phases in this obesity model. AR levels increased significantly, whereas the ER? decreased in this group. Moreover, the levels of catalase and GST were changed considerably. These findings indicate that long-term obesity, besides disturbing the antioxidant control, causes intense stromal remodelling and release of factors that create an environment that can promote proliferative disorders in the gland, culminating with diffuse hyperplasia. PMID:25529509

  20. O-GlcNAcylation is increased in prostate cancer tissues and enhances malignancy of prostate cancer cells.

    PubMed

    Gu, Yuchao; Gao, Jiangang; Han, Cuifang; Zhang, Xinling; Liu, Haiyan; Ma, Leina; Sun, Xiaoqing; Yu, Wengong

    2014-08-01

    O-GlcNAc is an O-linked ?-N-acetylglucosamine moiety attached to the side-chain hydroxyl of a serine or threonine residue in numerous cytoplasmic and nuclear proteins. In this study, we detected the level of O-GlcNAc in prostate, liver and pancreatic cancer tissues, and found that the global O-GlcNAc modification also known as O-GlcNAcylation, is specifically increased in prostate cancer tissues compared to corresponding adjacent tissues. In addition, we found that global O-GlcNAcylation is increased in prostate cancer cells and not in benign prostatic hyperplasia (BPH) epithelial cells. O-GlcNAc enhanced the anchorage-independent growth and the migratory/invasive ability of prostate cancer cells. More importantly, we provide here, for the first time to the best of our knowledge, direct evidence that increased O-GlcNAcylation induces malignant transformation of nontumorigenic (BPH) cells. Furthermore, our study suggested that inhibiting the formation of the E-cadherin/catenin/cytoskeleton complex may underly the O-GlcNAc-induced prostate cancer progression. Overall, these findings indicated that O-GlcNAcylation is increased in prostate, but not in liver and pancreatic cancer tissues, and that O-GlcNAc can enhance the malignancy of prostate cancer cells. PMID:24865644

  1. Tissue remodeling in Guinea pig lateral prostate at different ages after estradiol treatment.

    PubMed

    Scarano, Wellerson Rodrigo; Cordeiro, Renato Simões; Góes, Rejane Maira; Carvalho, Hernandes F; Taboga, Sebastião Roberto

    2005-09-01

    Estrogen seems to have an essential role in the fibromuscular growth characteristic of benign prostatic hyperplasia (BPH). This paper describes the effects of chronic estradiol treatment on Guinea pig prostatic stroma at different ages. Tissues from experimental animals were studied by histological and histochemical procedures, morphometric-stereological analysis and transmission electron microscopy (TEM). Marked fibromuscular hypertrophy was observed after estradiol treatment in animals of pre-pubertal and adult ages. Increases in the density and thickness of the collagen and elastic fibers were observed by histochemistry. TEM revealed wide distributions of collagen fibrils and large elastic fibers adjacent to the epithelial basal lamina and between the stromal cells, establishing contacts between them. These results indicate that the Guinea pig prostate simulates the stromal modifications observed in BPH in some aged animals after estrogen treatment at different ages, making it a good model for this disease. PMID:16095928

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

    Microsoft Academic Search

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

    1995-01-01

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

  3. High fat-induced obesity associated with insulin-resistance increases FGF-2 content and causes stromal hyperplasia in rat ventral prostate.

    PubMed

    Ribeiro, Daniele Lisboa; Pinto, Maria Etelvina; Maeda, Samantha Yuri; Taboga, Sebastião Roberto; Góes, Rejane Maira

    2012-08-01

    Obesity affects sex hormone secretion, which can negatively influence prostatic structure, homeostasis, and disease. This investigation aimed to evaluate the repercussions of obesity induced by a high-fat diet on the rat prostate, with or without treatment with the aromatase inhibitor, Letrozole. Adult Wistar rats were fed a high-fat diet (20% saturated fat, O) for 15 weeks to induce obesity or received a balanced diet (4% fat, C). Then, a group of C and O rats were daily treated with Letrozole (1 mg/kg b.w. per day) for 2 weeks (CL and OL, respectively). Subsequently, ventral prostate was processed for analysis by transmission electron microscopy, immunohistochemistry, and Western blotting. Obesity decreased 70% of the testosterone plasma level. The prostate showed epithelial atrophy and dilated acini in the intermediate portion and epithelial wrinkling in the distal tips. The relative frequency of smooth muscle ?-actin in the O group increased by 67%. Ultrastructurally, epithelial cells in obese animals presented altered secretory organelles, lipid droplets, and thicker subjacent fibromuscular layer. Letrozole treatment caused a partial restoration of the prostatic changes caused by obesity. Obesity increased the prostatic content of fibroblast growth factor-2 (FGF-2) by 150%, and Letrozole treatment increased this protein even more in the control and obese groups. This investigation shows that obesity provokes structural and ultrastructural changes in the epithelium of rat prostate; these changes might affect gland homeostasis and physiology. The epithelial and smooth muscle cell hyperplasia and increased FGF-2 expression observed in this experimental model of obesity/insulin-resistance might explain the high frequency of benign prostatic hyperplasia in insulin-resistant men. PMID:22661309

  4. 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

  5. Enlarged prostate gland

    MedlinePLUS Videos and Cool Tools

    ... is encased within the prostate gland. As a man ages, the prostate typically enlarges in size in ... urinate, and incontinence. Less than half of all men with BPH have symptoms of the disease, or ...

  6. Evaluation of glycophenotype in prostatic neoplasm by chemiluminescent assay.

    PubMed

    da Silva, Lúcia Patrícia Bezerra Gomes; de Almeida, Sinara Mônica Vitalino; de Lima, Luiza Rayanna Amorim; Cavalcanti, Carmelita de Lima Bezerra; de Melo Lira, Mariana Montenegro; da Silva, Maria da Paz Carvalho; Beltrão, Eduardo Isidoro Carneiro; de Carvalho Júnior, Luiz Bezerra

    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 cm(2) by 8 µm of thickness) showed statistical significant lower ?-D-glucose/mannose (BPH: 226,931 ± 17,436; PCa: 239,520 ± 12,398) and Gal-?(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 ?-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

  7. 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 ?-D-glucose/mannose (BPH: 226,931 ± 17,436; PCa: 239,520 ± 12,398) and Gal-?(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 ?-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

  8. Efficacy and tolerability of drugs for treatment of benign prostatic hyperplasia

    Microsoft Academic Search

    S. Dutkiewics

    2001-01-01

    It has long been recognised that neural factors are of considerable importance in lower urinary tract function. Whilst reduction\\u000a in the bulk of the human prostate is feasible, experience on this therapeutic approach proved to be disappointing. Existing\\u000a trial data with the agent finasteride are reviewed. A number of formulations derived from plant extracts have been advocated\\u000a but their mechanism

  9. 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

  10. Prostate Cancer Jonathan Hagopian

    E-print Network

    Gleeson, Joseph G.

    Prostate Cancer Jonathan Hagopian Histology Self-Study Presentation HHMI Med-Into-Grad Program Fall 2007 #12;Overview · The Prostate Gland · Non-Malignant Hyperplasia · Adenocarcinoma · Grading and Staging · Metastasis #12;The Prostate Gland #12;Non-Malignant Hyperplasia #12;Non-Malignant Hyperplasia

  11. Understanding Prostate Changes: A Health Guide for Men

    Cancer.gov

    You may be having prostate problems and want to learn more about prostate cancer symptoms and risk factors, the PSA screening test, and conditions that are not cancer such as an enlarged prostate (BPH) and prostatitis.

  12. Preoperative risk factors of postoperative delirium after transurethral prostatectomy for benign prostatic hyperplasia.

    PubMed

    Tai, Sheng; Xu, Lingfan; Zhang, Li; Fan, Song; Liang, Chaozhao

    2015-01-01

    The aim of this observational study was to investigate the occurrence of post operation delirium in the elderly patients undergoing the transurethral prostatectomy and to identify these factors associated with the delirium. 485 patients, undergoing the transurethral prostatectomy, were selected. Demographics, medical, cognitive and functional data, IPSS and NIH-CPSI score were collected as predictors for delirium. After surgery, the patients were divided on the basis of delirium onset within one week observation period, and the delirium was diagnosed by the Confusion Assessment Method. Totally, 21.23% (103) subjects were identified as the delirium and it lasted 2.9 ± 0.8 days. Patients with post operation delirium were significantly older and single, widowed and divorced, had a previous history of prehospitalization, were with the poor International Prostate Symptom Score (IPSS) and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, were more impaired in the instrumental activities of daily living (IADL), and had poor clock drawing test (CDT) and geriatric depression scale (GDS) score. Age, marital status, IPSS and NIH-CPIS score, cognitive and functional status and previous history of hospitalization are the predictors of post operation delirium. Our study has implications in preventing delirium via an early and targeted evaluation. PMID:26064386

  13. Transurethral microwave thermotherapy in the armamentarium of therapeutic modalities for benign prostatic hyperplasia.

    PubMed

    Floratos, D L; Alivizatos, G J; Debruyne, F M; de la Rosette, J J

    2000-12-01

    Transurethral microwave thermotherapy (TUMT) has gained a firm place in the spectrum of therapeutic modalities for management of patients with lower urinary tract symptoms suggestive of bladder outflow obstruction. To achieve optimum results following TUMT, intense research focuses on appropriate patient selection, heat-tissue interactions, and modification of technical specifications. Results of TUMT are good to excellent for the majority of patients, but there is a non-negligible number of patients who respond poorly. The selection of favorable candidates for TUMT aims to improve the therapeutic results, and both clinical baseline parameters and intrinsic characteristics of the prostate (histologic composition and vasculature) may influence treatment outcome. TUMT achieves therapeutic response through coagulative necrosis of the hyperplastic tissue, but additional theories have been proposed recently, suggesting that TUMT may cause neural destruction and induce apoptosis. Individualization of the treatment is expected to offer the best results, and because the temperature achieved inside the prostate determines the actual parenchymal necrosis, thermal monitoring during treatment will permit application of microwave energy in a feedback mode. Various microwave devices differ in technical specifications (operating frequency, design of antenna, cooling system), and recently introduced software programs (high-energy protocols, heat-shock strategy, short-duration protocols) aim at better efficacy, providing a more patient-friendly procedure. TUMT has survived the "test of time" that other, initially promising, modalities have failed. What remains to be determined is the maximum benefit that patients and health systems can gain from such a technique. PMID:11108561

  14. Preoperative risk factors of postoperative delirium after transurethral prostatectomy for benign prostatic hyperplasia

    PubMed Central

    Tai, Sheng; Xu, Lingfan; Zhang, Li; Fan, Song; Liang, Chaozhao

    2015-01-01

    The aim of this observational study was to investigate the occurrence of post operation delirium in the elderly patients undergoing the transurethral prostatectomy and to identify these factors associated with the delirium. 485 patients, undergoing the transurethral prostatectomy, were selected. Demographics, medical, cognitive and functional data, IPSS and NIH-CPSI score were collected as predictors for delirium. After surgery, the patients were divided on the basis of delirium onset within one week observation period, and the delirium was diagnosed by the Confusion Assessment Method. Totally, 21.23% (103) subjects were identified as the delirium and it lasted 2.9 ± 0.8 days. Patients with post operation delirium were significantly older and single, widowed and divorced, had a previous history of prehospitalization, were with the poor International Prostate Symptom Score (IPSS) and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, were more impaired in the instrumental activities of daily living (IADL), and had poor clock drawing test (CDT) and geriatric depression scale (GDS) score. Age, marital status, IPSS and NIH-CPIS score, cognitive and functional status and previous history of hospitalization are the predictors of post operation delirium. Our study has implications in preventing delirium via an early and targeted evaluation.

  15. Dietary patterns and prostatic diseases.

    PubMed

    Sebastiano, Cimino; Vincenzo, Favilla; Tommaso, Castelli; Giuseppe, Sortino; Marco, Russo; Ivana, Caldarella; Giorgio, Russo; Massimo, Madonia; Giuseppe, Morgia

    2012-01-01

    Dietary patterns play a role on prostatic diseases in association with genetic, behavioral, occupational and environmental ones. Data from reviewed literature provide evidences of a possible relationship between dietary habits and the incidence of prostate disorders, even if it is not enough to justify a widespread adoption of new dietary habits. In this review the role of dietary patterns, including the use of supplements, in the prevention and treatment of the most frequent and known prostatic diseases, benign prostatic hyperplasia (BPH) and prostate cancer (PC) was analyzed. A limited number of well designed trials were identified in which diet and dietary supplement intervention appeared to slow disease progression. Although conclusive evidences are limited, the current data suggest that a diet low in total calories and fat, high in vegetables and fruits and that body weight control could be possibly effective in preventing prostatic diseases. On the other hand care must be taken to ensure that over-consumption of dietary supplements does not occur because it may be harmful. PMID:22201864

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

    SciTech Connect

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

    1987-01-01

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

  17. Gene expression and epigenetic discovery screen reveal methylation of SFRP2 in prostate cancer.

    PubMed

    Perry, Antoinette S; O'Hurley, Gillian; Raheem, Omer A; Brennan, Kevin; Wong, Simon; O'Grady, Anthony; Kennedy, Anne-Marie; Marignol, Laure; Murphy, Therese M; Sullivan, Linda; Barrett, Ciara; Loftus, Barbara; Thornhill, John; Hewitt, Stephen M; Lawler, Mark; Kay, Elaine; Lynch, Thomas; Hollywood, Donal

    2013-04-15

    Aberrant activation of Wnts is common in human cancers, including prostate. Hypermethylation associated transcriptional silencing of Wnt antagonist genes SFRPs (Secreted Frizzled-Related Proteins) is a frequent oncogenic event. The significance of this is not known in prostate cancer. The objectives of our study were to (i) profile Wnt signaling related gene expression and (ii) investigate methylation of Wnt antagonist genes in prostate cancer. Using TaqMan Low Density Arrays, we identified 15 Wnt signaling related genes with significantly altered expression in prostate cancer; the majority of which were upregulated in tumors. Notably, histologically benign tissue from men with prostate cancer appeared more similar to tumor (r = 0.76) than to benign prostatic hyperplasia (BPH; r = 0.57, p < 0.001). Overall, the expression profile was highly similar between tumors of high (? 7) and low (? 6) Gleason scores. Pharmacological demethylation of PC-3 cells with 5-Aza-CdR reactivated 39 genes (? 2-fold); 40% of which inhibit Wnt signaling. Methylation frequencies in prostate cancer were 10% (2/20) (SFRP1), 64.86% (48/74) (SFRP2), 0% (0/20) (SFRP4) and 60% (12/20) (SFRP5). SFRP2 methylation was detected at significantly lower frequencies in high-grade prostatic intraepithelial neoplasia (HGPIN; 30%, (6/20), p = 0.0096), tumor adjacent benign areas (8.82%, (7/69), p < 0.0001) and BPH (11.43% (4/35), p < 0.0001). The quantitative level of SFRP2 methylation (normalized index of methylation) was also significantly higher in tumors (116) than in the other samples (HGPIN = 7.45, HB = 0.47, and BPH = 0.12). We show that SFRP2 hypermethylation is a common event in prostate cancer. SFRP2 methylation in combination with other epigenetic markers may be a useful biomarker of prostate cancer. PMID:22915211

  18. Immunohistochemical staining of radixin and moesin in prostatic adenocarcinoma

    PubMed Central

    2011-01-01

    Background Some members of the Protein 4.1 superfamily are believed to be involved in cell proliferation and growth, or in the regulation of these processes. While the expression levels of two members of this family, radixin and moesin, have been studied in many tumor types, to our knowledge they have not been investigated in prostate cancer. Methods Tissue microarrays were immunohistochemically stained for either radixin or moesin, with the staining intensities subsequently quantified and statistically analyzed using One-Way ANOVA or nonparametric equivalent with subsequent Student-Newman-Keuls tests for multiple comparisons. There were 11 cases of normal donor prostates (NDP), 14 cases of benign prostatic hyperplasia (BPH), 23 cases of high-grade prostatic intraepithelial neoplasia (HGPIN), 88 cases of prostatic adenocarcinoma (PCa), and 25 cases of normal tissue adjacent to adenocarcinoma (NAC) analyzed in the microarrays. Results NDP, BPH, and HGPIN had higher absolute staining scores for radixin than PCa and NAC, but with a significant difference observed between only HGPIN and PCa (p = < 0.001) and HGPIN and NAC (p = 0.001). In the moesin-stained specimens, PCa, NAC, HGPIN, and BPH all received absolute higher staining scores than NDP, but the differences were not significant. Stage 4 moesin-stained PCa had a significantly reduced staining intensity compared to Stage 2 (p = 0.003). Conclusions To our knowledge, these studies represent the first reports on the expression profiles of radixin and moesin in prostatic adenocarcinoma. The current study has shown that there were statistically significant differences observed between HGPIN and PCa and HGPIN and NAC in terms of radixin expression. The differences in the moesin profiles by tissue type were not statistically significant. Additional larger studies with these markers may further elucidate their potential roles in prostatic neoplasia progression. PMID:21235778

  19. The Efficacy and Safety of Combined Therapy with ?-Blockers and Anticholinergics for Men with Benign Prostatic Hyperplasia: A Meta-Analysis

    PubMed Central

    Filson, Christopher P.; Hollingsworth, John M.; Clemens, J. Quentin; Wei, John T.

    2013-01-01

    Purpose We performed a meta-analysis to compare treatment with ?-blockers and anticholinergics (ie combination therapy) to ?-blocker monotherapy to clarify the efficacy and safety of this treatment approach among men with storage urinary symptoms related to benign prostatic hyperplasia. Materials and Methods We searched for trials of men with benign prostatic hyperplasia/lower urinary tract symptoms that were randomized to combination treatment or ?-blockers alone. We pooled data from 7 placebo controlled trials meeting inclusion criteria. Primary outcomes of interest included changes in International Prostate Symptom Score (storage subscores) and urinary frequency. We also assessed post-void residual volume, maximal flow rate and the incidence of urinary retention. Data were pooled using random effects models for continuous outcomes and the Peto method to generate odds ratios for acute urinary retention. Results Combination therapy had a significantly greater reduction in International Prostate Symptom Score storage subscores (? ?0.73, 95% CI ?1.09 – ?0.37) and voiding frequency (? ?0.69 voids, 95% CI ?0.97 – ?0.41). There was also a greater reduction in maximal urinary flow rate (? ?0.59 ml per second, 95% CI ?1.04 – ?0.14) and increase in post-void residual urine volume (? 11.60 ml, 95% CI 8.50–14.70) with combination therapy. The number needed to treat with combination therapy to cause 1 acute urinary retention episode was 101 (95% CI 60–267). Conclusions Combination treatment with ?-blockers and anticholinergics significantly improved storage voiding parameters compared to men treated with ?-blocker therapy alone. This treatment approach is safe with a minimal risk of increased post-void residual urine volume, decreased maximal urinary flow rate or acute urinary retention. PMID:23727412

  20. Michael J. Barry, MD Founda5on President

    E-print Network

    Myers, Lawrence C.

    knowledge · Natural history of untreated disease · Benign prostatic hyperplasia (BPH Practice Guidelines · Benign prostatic hyperplasia (BPH) · Prostate cancer treatment) · Prostate cancer · Outcomes of treatment from the patient's perspective · Symptom

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

    PubMed

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

    2012-05-01

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

  2. Efficacy and safety of the simultaneous administration of mirodenafil and an ?-blocker in men with BPH-LUTS: a multicenter open-label prospective study.

    PubMed

    Bang, W J; Oh, C Y; Yoo, C; Cho, J S; Yang, D Y; Lee, D H; Lee, S H; Chung, B H

    2013-01-01

    We evaluated the clinical efficacy and safety of the coadministration of a PDE5 inhibitor and an ?-adrenergic blocker in patients with both benign prostatic hyperplasia/lower urinary tract symptoms (BPH-LUTS) and ED using mirodenafil 50?mg (Mvixx) once daily (OD) in patients already receiving stable ?-blocker therapy. This study was a prospective, multicenter, open-label trial. We selected 147 patients undergoing stable (longer than 4 weeks) ?-blocker therapy for BPH-LUTS as recipients of the additive mirodenafil 50?mg OD for 8 weeks. The coprimary measures were the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF-5). The key secondary measures were peak flow rate (Qmax) and postvoiding residual (PVR) volume. Safety was assessed by evaluating cardiovascular parameters and the participant-reported treatment-emergent adverse events (TEAEs). The additional administration of mirodenafil 50?mg OD significantly improved IPSS results (18.70-14.30 at 4 weeks and 18.70-13.72 at 8 weeks; P<0.001). The IIEF-5 score was improved at 8 weeks (10.94-16.16; P<0.001). There was no significant change in systolic blood pressure/diastolic blood pressure (124.8?mm?Hg/78.6?mm?Hg-122.0?mm?Hg/79.6?mm?Hg; P=0.638) and heart rates (78.8 per min to 80.2 per min; P=0.452). The most common TEAEs were hot flashes (10.9%) and headache (8.1%). The combination of mirodenafil with an ?-blocker did not significantly improve PVR; however, Qmax was improved at 8 weeks (14.51-16.80?ml?s(-1); P=0.026). Mirodenafil 50?mg OD in combination with an ?-blocker appeared to have few adverse effects, to improve BPH-LUTS and restore sexual function. PMID:23303333

  3. 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.

  4. Urodynamic Effects of Once-Daily Tadalafil in Men with LUTS Secondary to Clinical BPH

    Microsoft Academic Search

    Alex Gomelsky; Roger R. Dmochowski

    2010-01-01

    Lower urinary tract symptoms (LUTS) are common and increase with age in men with benign prostatic hypertrophy (BPH). Erectile\\u000a dysfunction (ED) also increases with age and is often a comorbid condition with BPH. Treatment with phosphodiesterase type\\u000a 5 (PDE5) inhibitors aimed at decreasing breakdown of nitric oxide (NO) is a mainstay of treatment for ED. Because NO has been\\u000a found

  5. Semiquantitative RT-PCR method coupled to capillary electrophoresis to study 5alpha-reductase mRNA isozymes in rat ventral prostate in different androgen status.

    PubMed

    Torres, Jesus M; Gómez-Capilla, José A; Ruiz, Estrella; Ortega, Esperanza

    2003-08-01

    The development and growth of the prostate gland depends on androgen stimulation. Dihydrotestosterone (DHT) is the primary androgen responsible for prostate development and also for the pathogenesis of benign prostatic hyperplasia (BPH). The incidence of prostate cancer (PCa) and benign prostatic hypertrophy (BPH) continues to rise in the Western world. DHT is synthesized in prostate from circulating testosterone (T) through the action of 5alpha-Reductase (5alpha-R) (EC 1.3.99.5), which occurs as two isozymes, type 1 and type 2. Type-1 5alpha-R is widely distributed in the body, and type-2 5alpha-R is confined to androgen-dependent structures. Both types are expressed in the prostate: type-2 isozyme is implicated in BPH and PCa; type-1 isozyme is also increased in some prostatic adenocarcinomas. In recent years, various inhibitors of type-2 isozyme or of both type-1 and type-2 isozyme have been used in prostatic diseases. In this work we present measurements of mRNA levels of steroid 5alpha-R isozymes in the ventral prostate of rats of different androgen status. We used a novel method that combines the high specificity of semiquantitive PCR with the sensitivity of laser-induced fluorescence capillary electrophoresis (LIF-CE). We demonstrated that T control the expression of 5alpha-R2 isozyme in rat prostrate. This approach could be of great value for the study of prostate diseases in humans and would allow study at the transcriptional level the effects of drugs that inhibit either or both of these isozymes. PMID:12962150

  6. 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.

  7. Incidental Prostate Cancer in Transurethral Resection of the Prostate Specimens in the Modern Era

    PubMed Central

    Barbieri, Christopher; Te, Alexis E.; Kaplan, Steven A.

    2014-01-01

    Objectives. To identify rates of incidentally detected prostate cancer in patients undergoing surgical management of benign prostatic hyperplasia (BPH). Materials and Methods. A retrospective review was performed on all transurethral resections of the prostate (TURP) regardless of technique from 2006 to 2011 at a single tertiary care institution. 793 men (ages 45–90) were identified by pathology specimen. Those with a known diagnosis of prostate cancer prior to TURP were excluded (n = 22) from the analysis. Results. 760 patients had benign pathology; eleven (1.4%) patients were found to have prostate cancer. Grade of disease ranged from Gleason 3 + 3 = 6 to Gleason 3 + 4 = 7. Nine patients had cT1a disease and two had cT1b disease. Seven patients were managed by active surveillance with no further events, one patient underwent radiation, and three patients underwent radical prostatectomy. Conclusions. Our series demonstrates that 1.4% of patients were found to have prostate cancer, of these 0.5% required treatment. Given the low incidental prostate cancer detection rate, the value of pathologic review of TURP specimens may be limited depending on the patient population. PMID:24876835

  8. A novel multidimensional protein identification technology approach combining protein size exclusion prefractionation, peptide zwitterion-ion hydrophilic interaction chromatography, and nano-ultraperformance RP chromatography/nESI-MS2 for the in-depth analysis of the serum proteome and phosphoproteome: application to clinical sera derived from humans with benign prostate hyperplasia.

    PubMed

    Garbis, Spiros D; Roumeliotis, Theodoros I; Tyritzis, Stavros I; Zorpas, Kostas M; Pavlakis, Kitty; Constantinides, Constantinos A

    2011-02-01

    The current proof-of-principle study was aimed toward development of a novel multidimensional protein identification technology (MudPIT) approach for the in-depth proteome analysis of human serum derived from patients with benign prostate hyperplasia (BPH) using rational chromatographic design principles. This study constituted an extension of our published work relating to the identification and relative quantification of potential clinical biomarkers in BPH and prostate cancer (PCa) tissue specimens. The proposed MudPIT approach encompassed the use of three distinct yet complementary liquid chromatographic chemistries. High-pressure size-exclusion chromatography (SEC) was used for the prefractionation of serum proteins followed by their dialysis exchange and solution phase trypsin proteolysis. The tryptic peptides were then subjected to offline zwitterion-ion hydrophilic interaction chromatography (ZIC-HILIC) fractionation followed by their online analysis with reversed-phase nano-ultraperformance chromatography (RP-nUPLC) hyphenated to nanoelectrospray ionization-tandem mass spectrometry using an ion trap mass analyzer. For the spectral processing, the sequential use of the SpectrumMill, Scaffold, and InsPecT software tools was applied for the tryptic peptide product ion MS(2) spectral processing, false discovery rate (FDR) assessment, validation, and protein identification. This milestone serum analysis study allowed the confident identification of over 1955 proteins (p ? 0.05; FDR ? 5%) with a broad spectrum of biological and physicochemical properties including secreted, tissue-specific proteins spanning approximately 12 orders of magnitude as they occur in their native abundance levels in the serum matrix. Also encompassed in this proteome was the confident identification of 375 phosphoproteins (p ? 0.05; FDR ? 5%) with potential importance to cancer biology. To demonstrate the performance characteristics of this novel MudPIT approach, a comparison was made with the proteomes resulting from the immunodepletion of the high abundant albumin and IgG proteins with offline first dimensional tryptic peptide separation with both ZIC-HILIC and strong cation exchange (SCX) chromatography and their subsequent online RP-nUPLC-nESI-MS(2) analysis. PMID:21174401

  9. Transurethral convective water vapor as a treatment for lower urinary tract symptomatology due to benign prostatic hyperplasia using the Rez?m® system: evaluation of acute ablative capabilities in the human prostate

    PubMed Central

    Dixon, Christopher M; Rijo Cedano, Edwin; Mynderse, Lance A; Larson, Thayne R

    2015-01-01

    Background The purpose of this study was to assess the acute ablative characteristics of transurethral convective water vapor (steam) using the Rez?m® system in men with benign prostatic hyperplasia through histologic and radiographic studies. Methods Seven patients were treated with transurethral intraprostatic injections of sterile steam under endoscopic visualization followed by previously scheduled adenectomies. The extirpated adenomas were grossly examined followed by whole mount sectioning and staining with triphenyl-tetrazolium chloride (TTC) to evaluate thermal ablation. Histology was performed after hematoxylin and eosin staining on one prostate. After review of results from the first patient cohort, an additional 15 patients with clinical benign prostatic hyperplasia were treated followed by gadolinium-enhanced magnetic resonance imaging (MRI) at one week. Results In the first patient cohort, gross examination of TTC-stained tissue showed thermal ablation in the transition zone. In addition, there was a distinct interface between viable and necrotic prostatic parenchyma. Histopathologic examination revealed TTC staining-outlined necrotic versus viable tissue. Gadolinium-enhanced MRIs in the cohort of 15 patients demonstrated lesion defects in all patients at 1 week post-procedure. Coalesced lesions were noted with a mean (± standard deviation) lesion volume of 9.6±8.5 cm3. The largest lesion volume was 35.1 cm3. Ablation using vapor was rapid and remained confined to the transition zone, consistent with the thermodynamic principles of convective thermal energy transfer. Conclusion Thermal ablation was observed in all specimens. The resulting coalescing ablative lesions, as seen on MRI, were confined to the transition zone. These studies confirm the ablative capabilities of vapor, validate the thermodynamic principles of convective heating, and allow for further clinical studies. PMID:25674555

  10. CAG Repeat Number in the Androgen Receptor Gene and Prostate Cancer.

    PubMed

    Madjunkova, S; Eftimov, A; Georgiev, V; Petrovski, D; Dimovski, Aj; Plaseska-Karanfilska, D

    2012-06-01

    Prostate cancer (PC) is the second leading cause of cancer deaths in men. The effects of androgens on prostatic tissue are mediated by the androgen receptor (AR) gene. The 5' end of exon 1 of the AR gene includes a polymorphic CAG triplet repeat that numbers between 10 to 36 in the normal population. The length of the CAG repeats is inversely related to the transactivation function of the AR gene. There is controversy over association between short CAG repeat numbers in the AR gene and PC. This retrospective case-control study evaluates the possible effect of short CAG repeats on the AR gene in prostate cancer risk in Macedonian males. A total of 392 male subjects, 134 PC patients, 106 patients with benign prostatic hyperplasia (BPH) and 152 males from the general Macedonian population were enrolled in this study. The CAG repeat length was determined by fluorescent polymerase chain reaction (PCR) amplification of exon1 of the AR gene followed by capillary electrophoresis (CE) on a genetic analyzer. The mean repeat length in PC patients was 21.5 ± 2.65, in controls 22.28 ± 2.86 (p = 0.009) and in BPH patients 22.1 ± 2.52 (p = 0.038). Short CAG repeats (<19) were found in 21.64% of PC patients vs. 9.43% in BPH patients (p = 0.0154). We also found an association of low Gleason score (<7) with short CAG repeat (<19) in PC patients (p = 0.0306), and no association between the age at diagnosis of PC and BPH and CAG repeat length. These results suggest that reduced CAG repeat length may be associated with increased prostate cancer risk in Macedonian men. PMID:24052720

  11. Differences between chemical element contents in hyperplastic and nonhyperplastic prostate glands investigated by neutron activation analysis.

    PubMed

    Zaichick, Vladimir; Zaichick, Sofia; Davydov, German

    2015-03-01

    In order to clarify the differences between Ag, Br, Ca, Co, Cr, Fe, Hg, K, Mg, Mn, Na, Rb, Sb, Sc, Se, and Zn contents in hyperplastic (patients with benign prostate hyperplasia (BPH), n = 32) and nonhyperplastic (control group of healthy male inhabitants, n = 32) prostates, an instrumental neutron activation analysis was performed. Mean values (M ± S??) for mass fraction (mg/kg, dry mass basis) of chemical elements in glands of patients with BPH were the following: Ag, 0.0346 ± 0.0060; Br, 30.4 ± 3.6; Ca, 2030 ± 165; Co, 0.0716 ± 0.0097; Cr, 1.073 ± 0.119; Fe, 130.0 ± 7.9; Hg, 0.232 ± 0.030; K, 14,470 ± 740; Mg, 1200 ± 80; Mn, 1.19 ± 0.09; Na, 11,610 ± 870; Rb, 14.7 ± 0.8; Sb, 0.163 ± 0.025; Sc, 0.0257 ± 0.0040; Se, 1.243 ± 0.079; and Zn, 1235 ± 92. It was observed that in BPH tissue, the mass fraction of Co (p < 0.015), Cr (p < 0.0002), Hg (p < 0.000007), K (p < 0.001), Rb (p < 0.048), Sb (p < 0.0001), and Se (p < 0.000001) were significantly higher than in controls. In the sixth to eighth decades, the mass fractions of almost all chemical elements in hyperplastic prostates did not depend from age. Our finding of correlation between pairs of prostatic chemical element mass fractions indicates that there is a great disturbance of prostatic chemical element relationships with a benign hyperplastic transformation. The results apparently confirm the disturbed homeostasis of Zn and Se and some other chemical elements in the etiology of BPH. PMID:25519178

  12. Evidence for steroidogenic potential in human prostate cell lines and tissues.

    PubMed

    Bennett, Nigel C; Hooper, John D; Lambie, Duncan; Lee, Cheok S; Yang, Tao; Vesey, David A; Samaratunga, Hemamali; Johnson, David W; Gobe, Glenda C

    2012-09-01

    Malignant prostate cancer (PCa) is usually treated with androgen deprivation therapies (ADTs). Recurrent PCa is resistant to ADT. This research investigated whether PCa can potentially produce androgens de novo, making them androgen self-sufficient. Steroidogenic enzymes required for androgen synthesis from cholesterol (CYP11A1, CYP17A1, HSD3?, HSD17?3) were investigated in human primary PCa (n = 90), lymph node metastases (LNMs; n = 8), and benign prostatic hyperplasia (BPH; n = 6) with the use of IHC. Six prostate cell lines were investigated for mRNA and protein for steroidogenic enzymes and for endogenous synthesis of testosterone and 5?-dihydrotestosterone. All enzymes were identified in PCa, LNMs, BPH, and cell lines. CYP11A1 (rate-limiting enzyme) was expressed in cancerous and noncancerous prostate glands. CYP11A1, CYP17A1, HSD3?, and HSD17?3 were identified, respectively, in 78%, 52%, 16%, and 82% of human BPH and PCa samples. Approximately 10% of primary PCa, LNMs, and BPH expressed all four enzymes simultaneously. CYP11A1 expression was stable, CYP17A1 increased, and HSD3? and HSD17?3 decreased with disease progression. CYP17A1 expression was significantly correlated with CYP11A1 (P = 0.0009), HSD3? (P = 0.0297), and HSD17?3 (P = 0.0090) in vivo, suggesting CYP17A1 has a key role in prostatic steroidogenesis similar to testis and adrenal roles. In vitro, all cell lines expressed mRNA for all enzymes. Protein was not always detectable; however, all cell lines synthesized androgen from cholesterol. The results indicate that monitoring steroidogenic metabolites in patients with PCa may provide useful information for therapy intervention. PMID:22796438

  13. Efficacy and safety of 120-W GreenLight High-Performance System laser photo vaporization of the prostate: 3-year results with specific considerations

    PubMed Central

    Choi, Yong Sun; Bae, Woong Jin; Kim, Su Jin; Kim, Kang Sup; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl; Hwang, Tae-Kon; Kim, Sae Woong

    2013-01-01

    Purpose: High-Performance System (HPS) laser photo vaporization of the prostate (PVP) is a widely used procedure nowadays. The safety and efficacy of the procedure has been affirmed in general patients with benign prostatic hyperplasia (BPH), but data on the safety and efficacy in specific situations, such as in patients with a large prostate, patients taking anticoagulant or 5-alpha reductase inhibitor (5-ARI) medication, and patients with a history of acute urinary retention (AUR) or previous transurethral resection of the prostate (TURP), is lacking. We investigated the safety and efficacy of HPS laser PVP in these unique patient groups. Methods: The study was conducted from March 2009 to February 2012 among patients for lower urinary tract symptoms. Patients in whom BPH was diagnosed and who were treated with 120-W HPS GreenLight PVP were selected. Patients were divided into groups of prostate size above and below 80, anticoagulant medication, 5-ARI medication, AUR history, and TURP history on the basis of the preoperative history and physical examination. Results: A total of 533 patients observable for a follow-up period of more than 6 months were enrolled as the study population. The patients’ mean preoperative prostate size was 51.0±32.7 mL and their mean prostate-specific antigen was 4.5±27.9 ng/mL. The average operating time was 24.5±12.2 minutes and the average applied energy during surgery was 152,184±89,495 J. Postoperative objective and subjective parameters in all groups were significantly improved compared with preoperative values. Conclusions: Laser resection of the prostate is safe and effective. The results of HPS laser PVP were not influenced by prostate size, the use of anticoagulants, the intake of 5-ARI for BPH management, a history of AUR, a history of TURP, or other factors. Thus, this study was able to reconfirm the efficacy and safety of laser resection of the prostate. PMID:24392442

  14. TURP for BPH. How Large is Too Large?

    PubMed Central

    Georgescu, D; Arabagiu, I; Cauni, V; Moldoveanu, C; Geavlete, P

    2010-01-01

    BPH remains one of the most common disease that the urologist has to manage. The last decade brought numerous new techniques, aiming to improve the minimally invasive approach to BPH, but none had, for the moment, changed the place of TURP as the gold standard treatment for medium sized prostates. Based on a large personal experience, the authors present a study in which TURP is used for prostates over 80ml, the cutoff point set by the guidelines of the European Association of Urology. The rationale for this study is that many situations require minimally invasive treatment, based on the express request of the patient, other conditions that makes open surgery very difficult or impossible, or the need for a quick discharge in an overcrowded service. The aim of the study was to prove that TURP is safe and effective even in larger prostates. The technique used is basically the classic one, with minor tactical alterations in some cases. Some cases required a two-stage approach, but offered good functional results after the first stage. The results proved that, with a good technique, a skilled urologist might achieve the same results by using TURP or open surgery for large sized prostates. PMID:21254734

  15. Silodosin is effective for treatment of LUTS in men with BPH: a systematic review

    PubMed Central

    Ding, Hui; Du, Wan; Hou, Zi-Zhen; Wang, Han-Zhang; Wang, Zhi-Ping

    2013-01-01

    The aim of this study was to systematically review the evidence on the efficacy and safety of silodosin treatments on lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH) from randomized controlled trials. We searched PubMed (1966–December 2011), Embase (1974–December 2011) and the Cochrane Library Database (2011, Issue 12). The assessed outcome measures were the change from baseline for the International Prostate Symptom Score (IPSS), quality of life (QoL) score, peak urine maximum flow rate (Qmax), QoL related to urinary symptoms and adverse effects. Two authors independently assessed the study quality and extracted data. All data were analysed using RevMan 5.1. The meta-analysis included four randomized controlled trials with a total of 2504 patients. The study durations were each 12 weeks. At the follow-up end points, the pooled results showed that the change from baseline for the silodosin group was significantly higher than the placebo group for the IPSS, QoL score and Qmax(mean difference (MD)=?2.78, P<0.00001; MD=?0.42, P=0.004; MD=1.17, P<0.00001,respectively) and patients felt more satisfied with QoL related to urinary symptoms in the silodosin group than the placebo group. Ejaculation disorder was the most commonly reported adverse effect. The pooled results also showed that the silodosin group was superior to the 0.2 mg tamsulosin group with respect to the IPSS and QoL score (IPSS: MD=?1.14, P=0.02; QoL score: MD=?0.26, P=0.02) and inferior to the 0.2 mg tamsulosin group with respect to Qmax (MD=?0.85, P=0.01). In contrast, there was no significant difference in the incidence of ejaculation disorder and dizziness between the silodosin and 0.2 mg tamsulosin groups. The current meta-analysis suggested that silodosin is an effective therapy for LUTS in men with BPH and is not inferior to 0.2 mg tamsulosin. PMID:23223034

  16. 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

  17. Chronic inflammatory mediators enhance prostate cancer development and progression.

    PubMed

    Thapa, Dinesh; Ghosh, Rita

    2015-03-15

    Chronic inflammation is postulated to influence prostate cancer progression. Preclinical studies have claimed that inflammatory mediators are involved in prostate cancer development and therefore suggested these as attractive targets for intervention. However, among the many pro-inflammatory mediators, there is no consensus regarding the identity of the primary one(s). In clinical studies, chronic inflammation has been found in prostate tumor specimens, and tissues resected for treatment of benign prostatic hyperplasia (BPH). Although collective evidence from molecular, experimental and clinical data suggests that inflammation can contribute or promote prostate carcinogenesis, an etiologic link has not yet been established. Moreover, the role of chronic inflammation in the onset of castration resistant and metastatic disease is unclear. Therefore it is important to open a dialog regarding recent findings on how chronic inflammatory mediators contribute to prostate cancer progression, and their usefulness to prevent disease progression. In this commentary, we assess the current literature with respect to chronic inflammation as a potential initiator and promoter of prostate carcinogenesis and discuss the prospects for its potential clinical applications. PMID:25593038

  18. The dark side of 5?-reductase inhibitors' therapy: sexual dysfunction, high Gleason grade prostate cancer and depression.

    PubMed

    Traish, Abdulmaged M; Mulgaonkar, Ashwini; Giordano, Nicholas

    2014-06-01

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

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

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

    Microsoft Academic Search

    Mahmood A. Hai; Reza S. Malek

    2003-01-01

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

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

    PubMed

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

    2006-01-01

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

  2. Evaluation of the effect of sildenafil and/or doxazosin on Benign prostatic hyperplasia–related lower urinary tract symptoms and erectile dysfunction

    PubMed Central

    Abolyosr, Ahmed; ElSagheer, Gamal A.; Abdel-Kader, Mohammad S.; Hassan, Ahmed M.; Abou-Zeid, Abdel-Monem M.

    2013-01-01

    Purpose: To verify the association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) and evaluate the influence of sildenafil and doxazosin either as single agents or combined on both symptoms. Material and Methods: A prospective randomized study including 150 patients presented with LUTS caused by BPH in association with clinically diagnosed ED, with age equal or more than 45 years from April 2010 to April 20011. They were categorized into three comparative groups each one containing 50 patients. These groups were comparable regarding pretreatment international prostate symptoms score (IPSS) and international index of erectile function (IIEF). The patients of the first group were given sildenafil 50 mg as monotherapy, those of the second group were given doxazosin 2 mg and those of the third group were given combination of both drugs for 4 months for each group. The main post-treatment parameters for assessment and comparison include assessment of patient's symptoms by repeated IPS Sand IIEF, uroflowmetry and assessment of PVR. The statistics was done by use of the Qui--square test. Results: Pre-treatment parameters were assessed and compared between the three groups. After 4 months of treatment, the comparative parameters were applied to all groups and the differences were measured post-treatment regarding IPSS, erectile function score, uroflowmetry, and post-void residual (PVR) urine. Sildenafil alone caused mild improvement in IPSS, more improvement in IIEF score, and little effect on flow rate and PVR urine. Doxazosin alone caused more improvement in IPSS, flow rate and PVR urine and less improvement in IIEF score. A combination of both sildenafil and doxazosin caused more improvement in all of the comparative parameters than when each drug was given alone. Conclusions: There is a strong relationship between LUTS and ED. Doxazosin or sidenafil as a single drug could be used in treating mild or mild to moderate symptoms but more severe symptoms may usually need a combination of both drugs. PMID:24311901

  3. EDB Fibronectin Specific Peptide for Prostate Cancer Targeting.

    PubMed

    Han, Zheng; Zhou, Zhuxian; Shi, Xiaoyue; Wang, Junpeng; Wu, Xiaohui; Sun, Da; Chen, Yinghua; Zhu, Hui; Magi-Galluzzi, Cristina; Lu, Zheng-Rong

    2015-05-20

    Extradomain-B fibronectin (EDB-FN), one of the oncofetal fibronectin (onfFN) isoforms, is a high-molecular-weight glycoprotein that mediates cell adhesion and migration. The expression of EDB-FN is associated with a number of cancer-related biological processes such as tumorigenesis, angiogenesis, and epithelial-to-mesenchymal transition (EMT). Here, we report the development of a small peptide specific to EDB-FN for targeting prostate cancer. A cyclic nonapeptide, CTVRTSADC (ZD2), was identified using peptide phage display. A ZD2-Cy5 conjugate was synthesized to accomplish molecular imaging of prostate cancer in vitro and in vivo. ZD2-Cy5 demonstrated effective binding to up-regulated EDB-FN secreted by TGF-?-induced PC3 cancer cells following EMT. Following intravenous injections, the targeted fluorescent probe specifically bound to and delineated PC3-GFP prostate tumors in nude mice bearing the tumor xenografts. ZD2-Cy5 also showed stronger binding to human prostate tumor specimens with a higher Gleason score (GS9) compared to those with a lower score (GS 7), with no binding in benign prostatic hyperplasia (BPH). Thus, the ZD2 peptide is a promising strategy for molecular imaging and targeted therapy of prostate cancer. PMID:25848940

  4. 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.

  5. 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 (?=0.05) between the groups studied.

  6. Comparative study between the use of a treatment with hyperthermia through the rectal approach versus the urethral approach for benign prostatic hyperplasia.

    PubMed

    Serrate, R G; Rius, G; Regué, R; Prats, J; Franco, A

    1992-01-01

    200 patients suffering from benign prostatic hyperplasia were treated with hyperthermia: 100 cases through the rectal approach and 100 through the urethral approach. Subjective symptoms were assessed as well as nycturia and objective data, urinary flow and postmicturition residue before treatment and 6 months after treatment. In the group of 100 patients treated rectally, the subjective symptoms and nycturia improved in 76; urine flow improved in 63, postmicturition residue decreased in 32 and the vesical catheter could be removed in 5 out of 8 patients. With the urethral approach, 77 patients out of 100 presented an improvement in their symptoms, nycturia improved in 53; urine flow improved in 28; the urine residue was decreased in 40 and the vesical catheter could be removed in 10 out of 16 patients who required it previously. Although slightly better results seem to be achieved with the use of rectal hyperthermia, as concerns nycturia and micturition flow, we prefer the urethral approach for its higher degree of convenience, easier handling, shorter time of treatment and reasonable effectiveness. PMID:1376691

  7. 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

  8. Application of Purified Botulinum Type A Neurotoxin to Treat Experimental Trigeminal Neuropathy in Rats and Patients with Urinary Incontinence and Prostatic Hyperplasia

    PubMed Central

    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 ?30°C 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

  9. Modified madigan prostatectomy: a procedure preserved prostatic urethra intact.

    PubMed

    Lu, Jun; Ye, Zhangqun; Hu, Weilie

    2005-01-01

    A total of 92 patients with benign prostatic hyperplasia (BPH) were subjected to modified Madigan prostatectomy (MPC) for a much satisfactory effect in open prostatectomy surgery. Exposing anterior prostatic urethra near the bladder neck and conjunct cystotomy modified the MPC procedure. This modified procedure preserved prostatic urethra intact and could also deal with intracystic lesions at the same time. The intact of prostatic urethra was kept completely or largely in 86 cases. The amount of blood loss during modified procedure was less. The mean operative time was 105 min. Seventy patients had been followed up for 3-24 months. The postoperative average Qmax was 19. 2 ml/s. The cystourethrography revealed that the urethra and bladder neck were intact in 10 patients postoperatively. Furthermore, the prostatic urethra was obviously wider after modified MPC. The modified MPC can reduce the occurrence of urethra injury and enlarge the MPC indications. The modified technique is easy to perform with less complications and much satisfactory clinical result. PMID:16201285

  10. Heterogeneity of DNA methylation in multifocal prostate cancer.

    PubMed

    Serenaite, Inga; Daniunaite, Kristina; Jankevicius, Feliksas; Laurinavicius, Arvydas; Petroska, Donatas; Lazutka, Juozas R; Jarmalaite, Sonata

    2015-01-01

    Most prostate cancer (PCa) cases are multifocal, and separate foci display histological and molecular heterogeneity. DNA hypermethylation is a frequent alteration in PCa, but interfocal heterogeneity of these changes has not been extensively investigated. Ten pairs of foci from multifocal PCa and 15 benign prostatic hyperplasia (BPH) samples were obtained from prostatectomy specimens, resulting altogether in 35 samples. Methylation-specific PCR (MSP) was used to evaluate methylation status of nine tumor suppressor genes (TSGs), and a set of selected TSGs was quantitatively analyzed for methylation intensity by pyrosequencing. Promoter sequences of the RASSF1 and ESR1 genes were methylated in all paired PCa foci, and frequent (?75 %) DNA methylation was detected in RARB, GSTP1, and ABCB1 genes. MSP revealed different methylation status of at least one gene in separate foci in 8 out of 10 multifocal tumors. The mean methylation level of ESR1, GSTP1, RASSF1, and RARB differed between the paired foci of all PCa cases. The intensity of DNA methylation in these TSGs was significantly higher in PCa cases than in BPH (p < 0.001). Hierarchical cluster analysis revealed a divergent methylation profile of paired PCa foci, while the foci from separate cases with biochemical recurrence showed similar methylation profile and the highest mean levels of DNA methylation. Our findings suggest that PCa tissue is heterogeneous, as between paired foci differences in DNA methylation status were found. Common epigenetic profile of recurrent tumors can be inferred from our data. PMID:25369892

  11. Exosomal lncRNA-p21 levels may help to distinguish prostate cancer from benign disease

    PubMed Central

    I??n, Mustafa; Uysaler, Ege; Özgür, Emre; Köseo?lu, Hikmet; ?anl?, Öner; Yücel, Ömer B.; Gezer, U?ur; Dalay, Nejat

    2015-01-01

    Exosomes are membranous vesicles containing various biomolecules including lncRNAs which are involved in cellular communication and are secreted from many cells including cancer cells. In our study, investigated the exosomal GAS5 and lincRNA-p21 lncRNA levels in urine samples from 30 patients with prostate cancer (PCa) and 49 patients with benign prostatic hyperplasia. Quantification of lncRNA molecules was performed by real-time PCR. We observed a significant difference in the exosomal lincRNA-p21 levels between PCa and BPH patients whereas the GAS5 levels did not reveal a difference. Our data suggest that the discriminative potential of exosomal lincRNA-p21 levels may help to improve the diagnostic prediction of the malignant state for patients with PCa. PMID:25999983

  12. In The News Monday, May 21, 2012

    E-print Network

    Arizona, University of

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

  13. Symptoms of acute posttraumatic stress disorder in prostate cancer patients following radical prostatectomy.

    PubMed

    Anastasiou, Ioannis; Yiannopoulou, Konstantina G; Mihalakis, Anastasios; Hatziandonakis, Nikolaos; Constantinides, Constantinos; Papageorgiou, Charalambos; Mitropoulos, Dionisios

    2011-01-01

    Psychological morbidity is increasingly reported in cancer survivors. The authors' objective was to determine the presence of acute posttraumatic stress disorder (PTSD) symptoms in prostate cancer (PC) patients following radical prostatectomy. Fifteen patients who underwent radical prostatectomy for localized prostate cancer were assessed for the presence of PTSD-related symptoms by completing the Davidson Trauma Scale (DTS), a month following the procedure. A group of 20 patients who underwent surgery for benign prostate hyperplasia (BPH) served as the control group. PTSD total scores were significantly higher in PC patients when compared with BPH patients, whose PTSD scores did not differ from those reported in the general population (32.6 ± 18.5 vs. 11.3 ± 9.7, p = .001). PTSD did not vary among PC patients when adjusted for educational status. PTSD symptoms are common among patients undergoing radical prostatectomy and independent of their educational level. Research investigating these aspects of posttreatment psychological adjustment is needed for developing well-targeted psychological interventions. PMID:20483867

  14. Although modern biotechnology has provided us with a greater understanding of

    E-print Network

    Cai, Long

    implicated in prostatic disease, both benign prostatic hyperplasia (BPH) and prostate cancer continue for normal prostate growth, and also have a permissive role in the genesis of both BPH and prostate cancer1 for treating prostate cancer was first demonstrated by Huggins and Hodges in the 1940s3 . BPH and prostate

  15. Saw Palmetto Extract Suppresses Insulin-Like Growth Factor-I Signaling and Induces Stress-Activated Protein Kinase\\/c-Jun N-Terminal Kinase Phosphorylation in Human Prostate Epithelial Cells

    Microsoft Academic Search

    TERI L. WADSWORTH; JULIE M. CARROLL; REBECCA A. MALLINSON; CHARLES T. ROBERTS

    2004-01-01

    A common alternative therapy for benign prostatic hyperpla- sia (BPH) is the extract from the fruit of saw palmetto (SPE). BPH is caused by nonmalignant growth of epithelial and stro- mal elements of the prostate. IGF action is important for pros- tate growth and development, and changes in the IGF system have been documented in BPH tissues. The main signaling

  16. Urinary MicroRNAs of Prostate Cancer: Virus-Encoded hsv1-miRH18 and hsv2-miR-H9-5p Could Be Valuable Diagnostic Markers

    PubMed Central

    Yun, Seok Joong; Jeong, Pildu; Kang, Ho Won; Kim, Ye-Hwan; Kim, Eun-Ah; Yan, Chunri; Choi, Young-Ki; Kim, Dongho; Kim, Jung Min; Kim, Seon-Kyu; Kim, Seon-Young; Kim, Sang Tae; Kim, Won Tae; Lee, Ok-Jun; Koh, Gou-Young; Moon, Sung-Kwon; Kim, Isaac Yi; Kim, Jayoung; Choi, Yung-Hyun; Kim, Wun-Jae

    2015-01-01

    Purpose: MicroRNAs (miRNAs) in biological fluids are potential biomarkers for the diagnosis and assessment of urological diseases such as benign prostatic hyperplasia (BPH) and prostate cancer (PCa). The aim of the study was to identify and validate urinary cell-free miRNAs that can segregate patients with PCa from those with BPH. Methods: In total, 1,052 urine, 150 serum, and 150 prostate tissue samples from patients with PCa or BPH were used in the study. A urine-based miRNA microarray analysis suggested the presence of differentially expressed urinary miRNAs in patients with PCa, and these were further validated in three independent PCa cohorts, using a quantitative reverse transcriptionpolymerase chain reaction analysis. Results: The expression levels of hsa-miR-615-3p, hsv1-miR-H18, hsv2-miR-H9-5p, and hsa-miR-4316 were significantly higher in urine samples of patients with PCa than in those of BPH controls. In particular, herpes simplex virus (hsv)-derived hsv1-miR-H18 and hsv2-miR-H9-5p showed better diagnostic performance than did the serum prostate-specific antigen (PSA) test for patients in the PSA gray zone. Furthermore, a combination of urinary hsv2-miR-H9-5p with serum PSA showed high sensitivity and specificity, providing a potential clinical benefit by reducing unnecessary biopsies. Conclusions: Our findings showed that hsv-encoded hsv1-miR-H18 and hsv2-miR-H9-5p are significantly associated with PCa and can facilitate early diagnosis of PCa for patients within the serum PSA gray zone. PMID:26126436

  17. Current usefulness of free/total PSA ratio in the diagnosis of prostate cancer at an early stage.

    PubMed

    Pfister, Christian; Basuyau, Jean-Pierre

    2005-09-01

    The aim of our study was to evaluate five different free/total PSA (f/t PSA) kits for the diagnosis of early stage prostate cancer. We compared the PSA density and the f/t PSA ratio to differentiate between benign prostatic hyperplasia (BPH) and prostate cancer. This prospective study included a total of 120 patients with suspected prostate cancer (PSA between 4 and 15 ng/ml) observed over a period of 30 months. All patients had a blood test as well as a prostate biopsy prior to inclusion. Serum immunoassay total-PSA (t PSA) and free-PSA (f PSA) were carried out using five different assay kits: IMX Abbott (A), Kryptor Brahms (B), Immulite DPC (D), IRMA Immunotech (I) and IRMA DiaSorin (S). The results were compared to determine sensitivity, specificity, threshold values, and to differentiate between BPH and cancer. No difference was found between assay reproducibility and variation in the assays, however, only a slight variation was observed in the mean t PSA values, whereas a significant difference was found with f/t PSA. Receiver operating curves were generated for t-PSA and f/t PSA. The area under the curves did not show any significant differences for either t PSA or f/t PSA. A low comparative variability between the five kits tested for tPSA was observed, which suggest that the f/t PSA ratio has no current usefulness in the initial diagnosis of prostate cancer, particularly in patients with larger prostates. Furthermore, no prognostic value was found for surgically positive margins in radical prostatectomy. PMID:16096832

  18. Clinical and Pathological Characteristics of Hard Nodules Resistant to Morcellation During Holmium Laser Enucleation of the Prostate

    PubMed Central

    Piao, Songzhe; Choo, Min Soo; Wang, Yue; Lee, Young Ju; Bae, Jungbum; Oh, Seung-June

    2015-01-01

    Purpose: To identify the clinical and pathological characteristics of hard nodules resistant to morcellation (HNRM) during holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH). Methods: Between July 2008 and October 2011, 246 patients underwent HoLEP for symptomatic BPH. The first 30 patients were excluded from the analysis due to the learning curve of the procedure. The remaining patients were divided into HNRM (n=29) and non-HNRM groups (n=187), and comparative analysis of the clinical parameters of the two groups was performed. International prostate symptom score analysis and urodynamic studies were performed preoperatively. Histological analysis was performed after hematoxylin and eosin staining and Masson trichrome staining of the HNRM specimens. Results: Twenty-nine patients (13.4%) had HNRM. The patients in the HNRM group had significantly higher proportions of advanced age (?65 years, P=0.029), total prostate volume ?65 mL (P<0.001), transition zone volume ?35 mL (P<0.001), serum prostate-specific antigen levels ?10 ng/mL (P=0.007), and functional urethral length ?70 mm (P=0.009); larger enucleation weight (P<0.001); longer operation (P=0.001), enucleation (P=0.042), and morcellation times (P<0.001); and higher enucleation ratio (P=0.028) and enucleation efficacy (P=0.001). After adjusting for confounding factors, multivariate logistic regression analysis revealed that age ?65 years and total prostate volume ?65 mL were independent risk factors for HNRM. Pathological examination did not reveal any malignant cells, with mainly dense fibrous tissue found in the HNRM. Conclusions: HNRM can make morcellation cumbersome and time-consuming, and older patients with larger prostates have a higher incidence of HNRM. However, the histopathology of HNRM revealed mainly fibrotic tissue. PMID:26126438

  19. Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

    SciTech Connect

    Bilhim, Tiago, E-mail: tiagobilhim@hotmail.com [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal)] [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal); Pisco, Joao; Rio Tinto, Hugo; Fernandes, Lucia [Interventional Radiology, Saint Louis Hospital (Portugal)] [Interventional Radiology, Saint Louis Hospital (Portugal); Campos Pinheiro, Luis [Universidade Nova de Lisboa (UNL), Departamento Universitario de Urologia, Faculdade de Ciencias Medicas (FCM) (Portugal)] [Universidade Nova de Lisboa (UNL), Departamento Universitario de Urologia, Faculdade de Ciencias Medicas (FCM) (Portugal); Duarte, Marisa; Pereira, Jose A. [Interventional Radiology, Saint Louis Hospital (Portugal)] [Interventional Radiology, Saint Louis Hospital (Portugal); Oliveira, Antonio G. [Universidade Nova de Lisboa (UNL), Biostatistics Department, Faculdade de Ciencias Medicas (FCM) (Portugal)] [Universidade Nova de Lisboa (UNL), Biostatistics Department, Faculdade de Ciencias Medicas (FCM) (Portugal); O'Neill, Joao [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal)] [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal)

    2013-04-15

    This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-{mu}m nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.

  20. The Impact of Increased Bladder Blood Flow on Storage Symptoms after Holmium Laser Enucleation of the Prostate

    PubMed Central

    Ide, Hisamitsu; Aoki, Hiroaki; Muto, Satoru; Yamaguchi, Raizo; Tsujimura, Akira; Horie, Shigeo

    2015-01-01

    In order to investigate how holmium laser enucleation of the prostate (HoLEP) improves urinary storage symptoms, we assessed blood flow in the urinary bladder mucosa of patients with benign prostatic hyperplasia (BPH) before and after laser surgery. Seventy-four consecutive patients with BPH (median age 69 years, range; 53–88) underwent HoLEP at our institution and are included in this study. We prospectively assessed the International Prostate Symptom Score (IPSS), IPSS-QOL Score, the Overactive Bladder Symptom Score (OABSS), uroflowmetry, and blood flow in the urinary bladder, before and after surgery. Blood flow in the bladder mucosa was measured using the OMEGA FLOW (OMEGAWAVE, Tokyo, Japan) laser Doppler flowmeter. The median volume of the enucleated adenomas was 45.0 g (range: 25.0 to 83.2). The median IPSS improved significantly from 20 (range: 6–35) to 3 (0–22) (p<0.001; Wilcoxon signed-rank test), as did the storage symptoms score, which decreased from 13 (2–20) to 3 (1–8) (p<0.001). Median bladder blood flow increased at the trigone from 9.57±0.83 ml/sec to 17.60±1.08 ml/sec. Multiple regression analysis for the improved storage symptom score eliminated all explanatory variables except increased bladder perfusion. The data suggest that HoLEP improves blood flow in the bladder mucosa, which independently leads to the improvement of storage symptoms. PMID:26090819

  1. Icaritin induces growth inhibition and apoptosis of human prostatic smooth muscle cells in an estrogen receptor-independent manner.

    PubMed

    Chen, Min-Feng; Qi, Lin; Li, Yuan; Zu, Xiong-Bing; Dai, Yuan-Qin; Zhang, Peng

    2010-05-01

    Icaritin has selective estrogen receptor (ER) modulating activity. ERs are expressed in the prostate stroma, and estrogens have an important role in the pathology of benign prostatic hyperplasia (BPH). However, the impact of icaritin on BPH was not studied. Human prostatic smooth muscle cells (PSMCs) were treated with 0-100 microM icaritin, also using 10 microM ICI182780 as a specific ER antagonist. The effects on cell growth and apoptosis were determined by cell counting and sandwich-enzyme-immunoassay. Western blotting was employed to illustrate the possible mechanisms. Cell growth was strongly inhibited by icaritin, and this was accompanied by an augmented apoptosis. Few changes in icaritin-induced growth inhibition and apoptosis were observed after pretreatment in the presence of ICI182780. Consistent with growth inhibition and apoptosis induction, icaritin decreased cyclin D1 and CDK4 expression and increased Bax/Bcl-2 ratio in human PSMCs. Furthermore, icaritin induced sustained phosphorylation of extracellular signal-regulated kinase (ERK) in human PSMCs. PD98059, a specific ERK inhibitor, blocked the activation of ERK by icaritin and abolished the icaritin-induced growth inhibition and apoptosis. The results indicate that icaritin reduces growth and induces apoptosis in human PSMCs via ERK signaling pathway without involvement of ERs. PMID:19876716

  2. The Impact of Increased Bladder Blood Flow on Storage Symptoms after Holmium Laser Enucleation of the Prostate.

    PubMed

    Saito, Keisuke; Hisasue, Shin-Ichi; Ide, Hisamitsu; Aoki, Hiroaki; Muto, Satoru; Yamaguchi, Raizo; Tsujimura, Akira; Horie, Shigeo

    2015-01-01

    In order to investigate how holmium laser enucleation of the prostate (HoLEP) improves urinary storage symptoms, we assessed blood flow in the urinary bladder mucosa of patients with benign prostatic hyperplasia (BPH) before and after laser surgery. Seventy-four consecutive patients with BPH (median age 69 years, range; 53-88) underwent HoLEP at our institution and are included in this study. We prospectively assessed the International Prostate Symptom Score (IPSS), IPSS-QOL Score, the Overactive Bladder Symptom Score (OABSS), uroflowmetry, and blood flow in the urinary bladder, before and after surgery. Blood flow in the bladder mucosa was measured using the OMEGA FLOW (OMEGAWAVE, Tokyo, Japan) laser Doppler flowmeter. The median volume of the enucleated adenomas was 45.0 g (range: 25.0 to 83.2). The median IPSS improved significantly from 20 (range: 6-35) to 3 (0-22) (p<0.001; Wilcoxon signed-rank test), as did the storage symptoms score, which decreased from 13 (2-20) to 3 (1-8) (p<0.001). Median bladder blood flow increased at the trigone from 9.57±0.83 ml/sec to 17.60±1.08 ml/sec. Multiple regression analysis for the improved storage symptom score eliminated all explanatory variables except increased bladder perfusion. The data suggest that HoLEP improves blood flow in the bladder mucosa, which independently leads to the improvement of storage symptoms. PMID:26090819

  3. Saw palmetto alters nuclear measurements reflecting DNA content in men with symptomatic BPH: evidence for a possible molecular mechanism

    Microsoft Academic Search

    Robert W. Veltri; Leonard S. Marks; M. Craig Miller; Wes D. Bales; John Fan; Maria Luz Macairan; Jonathan I. Epstein; Alan W. Partin

    2002-01-01

    ObjectivesTo examine the nuclear chromatin characteristics of epithelial cells, looking for an SPHB-mediated effect on nuclear DNA structure and organization. Saw palmetto herbal blend (SPHB) causes contraction of prostate epithelial cells and suppression of tissue dihydrotestosterone levels in men with symptomatic benign prostatic hyperplasia, but a fundamental mechanism remains unknown.

  4. Localized Prostate Cancer Detection with 18F FACBC PET/CT: Comparison with MR Imaging and Histopathologic Analysis

    PubMed Central

    Mena, Esther; Shih, Joanna; Pinto, Peter A.; Merino, Maria J.; Lindenberg, Maria L.; Bernardo, Marcelino; McKinney, Yolanda L.; Adler, Stephen; Owenius, Rikard; Choyke, Peter L.; Kurdziel, Karen A.

    2014-01-01

    Purpose To characterize uptake of 1-amino-3-fluorine 18-fluorocyclobutane-1-carboxylic acid (18F FACBC) in patients with localized prostate cancer, benign prostatic hyperplasia (BPH), and normal prostate tissue and to evaluate its potential utility in delineation of intraprostatic cancers in histopathologically confirmed localized prostate cancer in comparison with magnetic resonance (MR) imaging. Materials and Methods Institutional review board approval and written informed consent were obtained for this HIPAA-compliant prospective study. Twenty-one men underwent dynamic and static abdominopelvic 18F FACBC combined positron emission tomography (PET) and computed tomography (CT) and multiparametric (MP) 3-T endorectal MR imaging before robotic-assisted prostatectomy. PET/CT and MR images were coregistered by using pelvic bones as fiducial markers; this was followed by manual adjustments. Whole-mount histopathologic specimens were sliced with an MR-based patient-specific mold. 18F FACBC PET standardized uptake values (SUVs) were compared with those at MR imaging and histopathologic analysis for lesion- and sector-based (20 sectors per patient) analysis. Positive and negative predictive values for each modality were estimated by using generalized estimating equations with logit link function and working independence correlation structure. Results 18F FACBC tumor uptake was rapid but reversible. It peaked 3.6 minutes after injection and reached a relative plateau at 15–20 minutes (SUVmax[15–20min]). Mean prostate tumor SUVmax(15–20min) was significantly higher than that of the normal prostate (4.5 ± 0.5 vs 2.7 ± 0.5) (P < .001); however, it was not significantly different from that of BPH (4.3 ± 0.6) (P = .27). Sector-based comparison with histopathologic analysis, including all tumors, revealed sensitivity and specificity of 67% and 66%, respectively, for 18F FACBC PET/CT and 73% and 79%, respectively, for T2-weighted MR imaging. 18F FACBC PET/CT and MP MR imaging were used to localize dominant tumors (sensitivity of 90% for both). Combined 18F FACBC and MR imaging yielded positive predictive value of 82% for tumor localization, which was higher than that with either modality alone (P < .001). Conclusion 18F FACBC PET/CT shows higher uptake in intraprostatic tumor foci than in normal prostate tissue; however, 18F FACBC uptake in tumors is similar to that in BPH nodules. Thus, it is not specific for prostate cancer. Nevertheless, combined 18F FACBC PET/CT and T2-weighted MR imaging enable more accurate localization of prostate cancer lesions than either modality alone. © RSNA, 2013 Online supplemental material is available for this article. PMID:24475804

  5. A comparison of the efficacy and tolerability of tamsulosin and finasteride in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

    Microsoft Academic Search

    P Rigatti; M Brausi; R M Scarpa; D Porru; H Schumacher; C A Rizzi

    2003-01-01

    In this multicentre, double-blind study, patients with LUTS\\/BPH were randomised to 26 weeks with finasteride 5 mg once daily (n=204) or tamsulosin 0.4 mg once daily (n=199). Double-blind treatment was continued for another 26 weeks (total treatment duration: 1 y). The primary efficacy parameter was the difference in mean change in total Symptom Problem Index (SPI) from baseline to end

  6. [Laser thermocoagulation of adenoma of the prostate using an interstitial approach].

    PubMed

    Muschter, R; Hofstetter, A

    1997-01-01

    Interstitial laser coagulation (ILC) is a minimally invasive treatment for benign prostatic hyperplasia (BPH). The objective of ILC is to induce shrinking of the prostate while preserving all surrounding tissues. To achieve thermal coagulation well inside the adenoma, not at its urethral surface, laser radiation of a Nd:YAG laser or a diode laser is transmitted by specially designed laser fibers repeatedly placed in the prostate tissue. This results in secondary atrophy and regression of the prostate lobes, not sloughing of necrotic tissue. Since, July 1991, more than 800 patients have been treated in several studies. Based on initial experiences, many technical and procedural improvements of ILC have been introduced for clinical use, such as advanced radiation programs and new application devices including optical feedback systems. Imaging studies demonstrated treatment effects and allowed further treatment optimization. Clinical studies have demonstrated the safety and efficacy of ILC. This review summarizes several articles published on ILC and reports initial results of ongoing studies comparing ILC and transurethral resection of the prostate (TURP). PMID:9157819

  7. Production and Characterization of Monoclonal Antibodies against Human Prostate Specific Antigen

    PubMed Central

    Bayat, Ali Ahmad; Ghods, Roya; Shabani, Mahdi; Mahmoudi, Ahmad Reza; Yeganeh, Omid; Hassannia, Hadi; Sadeghitabar, Ali; Balay-Goli, Leila; Noutash-Haghighat, Farzaneh; Sarrafzadeh, Ali reza; Jeddi-Tehrani, Mahmood

    2015-01-01

    Background Prostate Specific Antigen (PSA) is an important laboratory marker for diagnosis of prostatic cancer. Thus, development of diagnostic tools specific for PSA plays an important role in screening, monitoring and early diagnosis of prostate cancer. In this paper, the production and characterization of a panel of murine monoclonal antibodies (mAbs) against PSA have been presented. Methods Balb/c mice were immunized with PSA, which was purified from seminal plasma. Splenocytes of hyperimmunized mice were extracted and fused with Sp2/0 cells. By adding selective HAT medium, hybridoma cells were established and positive clones were selected by ELISA after four times of cloning. The isotypes of produced mAbs were determined by ELISA and then purified from ascitic fluids using Hi-Trap protein G column. The reactivities of the mAbs were examined with the purified PSA and seminal plasma by ELISA and western blot techniques. Furthermore, the reactivities of the mAbs were assessed in Prostate Cancer (PCa), Benign Prostatic Hyperplasia (BPH) and brain cancer tissues by Immunohistochemistry (IHC). Results Five anti-PSA mAbs (clones: 2G2-B2, 2F9-F4, 2D6-E8, IgG1/?) and clones (2C8-E9, 2G3-E2, IgG2a/?) were produced and characterized. All mAbs, except 2F9-F4 detected the expression of PSA in PCa and BPH tissues and none of them reacted with PSA in brain cancer tissue in IHC. Besides, all mAbs could detect a protein band around 33 kDa in human seminal plasma in western blot. Conclusion These mAbs can specifically recognize PSA and may serve as a component of PSA diagnostic kit in various biological fluids. PMID:25926946

  8. A Prostate-Specific Antigen–Activated Channel-Forming Toxin as Therapy for Prostatic Disease

    PubMed Central

    Williams, Simon A.; Merchant, Rosemina F.; Garrett-Mayer, Elizabeth; Isaacs, John T.; Buckley, J. Thomas; Denmeade, Samuel R.

    2014-01-01

    Background Most men will develop prostatic abnormalities, such as benign prostatic hyperplasia (BPH) or prostate cancer, as they age. Prostate-specific antigen (PSA) is a serine protease that is secreted at high levels by the normal and diseased prostate. Therapies that are activated by PSA may prove effective in treating prostatic malignancies. Methods We modified proaerolysin (PA), the inactive precursor of a bacterial cytolytic pore-forming protein, to produce a PSA-activated protoxin (PRX302). The viability of the prostate adenocarcinoma cell lines LNCaP, PC-3, CWR22H, and DU145 and the bladder cancer cell line TSU after treatment with PA or PRX302 in the presence or absence of purified PSA was assayed. Mice carrying xenograft tumors derived from LNCaP, CWR22H, or TSU cells were treated with intratumoral injection of PA or PRX302, and tumor size was monitored. To test the safety of PRX302, we administered it into the PSA-secreting prostate glands of cynomolgus monkeys. All statistical tests were two-sided. Results Native PA was highly toxic in vitro but had no tumor-specific effects in vitro or in vivo. Picomolar concentrations of PRX302 led to PSA-dependent decreases in cell viability in vitro (PRX302 versus PRX302 + PSA: DU145 cells, mean viability = 78.7% versus mean = 1.6%, difference = 77.1%, 95% confidence interval [CI] = 70.6% to 86.1%; P<.001; TSU cells, mean = 100.2% versus mean = 1.4%, difference = 98.8%, 95% CI = 96.4% to 104.0%; P<.001). Single intratumoral injections of PRX302 produced substantial and often complete regression of PSA-secreting human prostate cancer xenografts (5 µg dose, complete regression in 6 of 26 mice bearing LNCaP or CWR22H xenografts [23%]; 10 µg dose, complete regression in 10 of 26 mice [38.5%]) but not PSA-null bladder cancer xenografts. The prostates of cynomolgus monkeys injected with a single dose of PRX302 displayed extensive but organ-confined damage, with no toxicity to neighboring organs or general morbidity. Conclusions Our observations demonstrate the potential safe and effective intraprostatic application of this engineered protoxin. PMID:17341729

  9. 11C-Acetate PET/CT Imaging in Localized Prostate Cancer: A study with MRI and Histopathologic Correlation

    PubMed Central

    Mena, Esther; Turkbey, Baris; Mani, Haresh; Adler, Stephen; Valera, Vladimir A.; Bernardo, Marcelino; Shah, Vijay; Pohida, Thomas; McKinney, Yolanda; Kwarteng, Gideon; Daar, Dagane; Lindenberg, Maria L.; Eclarinal, Philip; Wade, Revia; Linehan, W. Marston; Merino, Maria J.; Pinto, Peter A.; Choyke, Peter L.; Kurdziel, Karen A.

    2012-01-01

    This work characterizes the uptake of 11C-Acetate in prostate cancer (PCa), benign prostate hyperplasia (BPH) and normal prostate tissue in comparison with multi-parametric MRI, whole mount histopathology and clinical markers, to evaluate its potential utility for delineating intra-prostatic tumors in a population of patients with localized PCa. METHODS 39 men with presumed localized PCa underwent dynamic/static abdomen-pelvic 11C-Acetate PET/CT for 30-minutes and 3T multi-parametric (MP) MRI prior to prostatectomy. PET/CT images were registered to MRI using pelvic bones for initial rotation-translation, followed by manual adjustments to account for prostate motion and deformation from the MRI endorectal coil. Whole-mount pathology specimens were sectioned using an MRI-based patient specific mold resulting in improved registration between the MRI, PET and pathology. 11C-Acetate PET standardized uptake values were compared with MP-MRI and pathology. RESULTS 11C-Acetate uptake was rapid but reversible, peaking at 3–5 minutes post-injection and reaching a relative plateau at ~10 minutes. The average SUVmax(10–12min) of tumors was significantly higher than that of normal prostate tissue (4.4±2.05, range 1.8–9.2 vs. 2.1±0.94, range 0.7–3.4; p<0.001); however it was not significantly different from benign prostatic hyperplasia (4.8±2.01; range 1.8–8.8). A sector-based comparison with histopathology, including all tumors > 0.5 cm, revealed a sensitivity and specificity of 61.6 % and 80.0 % for 11C-Acetate PET/CT, and 82.3% and 95.1% for MRI, respectively. Considering only tumors >0.9 cm the 11C-Acetate accuracy was comparable to that of MRI. In a small cohort (n=9), 11C-Acetate uptake was independent of fatty acid synthase expression based on immunohistochemistry. CONCLUSION 11C-Acetate PET/CT demonstrates higher uptake in tumor foci than normal prostate tissue; however 11C-Acetate uptake in tumors is similar to BPH nodules. While 11C-Acetate PET/CT is not likely to have utility as an independent modality for evaluation of localized PCa, the high uptake in tumors may make it useful for monitoring focal therapy, where tissue damage after therapy may limit anatomic imaging methods. PMID:22343504

  10. Injection therapy for prostatic disease: A renaissance concept

    PubMed Central

    Saemi, Arash M.; Folsom, Jeffrey B.; Plante, Mark K.

    2008-01-01

    Purpose: Initially conceived as an intervention for prostatic infection, injection therapy has been used to alleviate urinary retention, and is now primarily investigated for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). For over a century, intraprostatic injection has been used as a minimally invasive surgical therapy (MIST), and is on the verge of a rebirth. This review will familiarize the reader with the origins and history of intraprostatic injection, and its evolution using transperineal, transrectal and transurethral routes with multiple injectants. Materials and Methods: A MEDLINE review of the literature on intraprostatic injections published between 1966 and 2007 was performed, augmented with articles and documents dating back to 1832. Results: Transperineal and transurethral injections have the most systematic evaluation in patients. There are advantages and disadvantages associated with each route. Most injectants consistently produce localized coagulative necrosis and gland volume reduction with varying degrees of LUTS relief. Anhydrous ethanol (AE) is the most extensively studied injected agent to date. Conclusions: Injection therapy is a promising minimally invasive treatment option for various prostatic conditions and has been examined for over 100 years. Further experience in systematic laboratory research and completion of currently ongoing clinical trials is necessary before widespread clinical application. PMID:19468462

  11. Giant prostatic calculi.

    PubMed

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

    2013-01-01

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

  12. Human prostate supports more efficient replication of HIV1 R5 than X4 strains ex vivo

    Microsoft Academic Search

    Anna Le Tortorec; Anne-Pascale Satie; Hélène Denis; Nathalie Rioux-Leclercq; Laurence Havard; Annick Ruffault; Bernard Jégou; Nathalie Dejucq-Rainsford

    2008-01-01

    BACKGROUND: In order to determine whether human prostate can be productively infected by HIV-1 strains with different tropism, and thus represent a potential source of HIV in semen, an organotypic culture of prostate from men undergoing prostatic adenomectomy for benign prostate hypertrophy (BPH) was developed. The presence of potential HIV target cells in prostate tissues was investigated using immunohistochemistry. The

  13. Testosterone and Prolactin Regulation of Metabolic Genes and Citrate Metabolism of Prostate Epithelial Cells

    PubMed Central

    Costello, L. C.; Franklin, R. B

    2015-01-01

    The control and alteration of key regulatory enzymes is a determinant of the reactions and pathways of intermediary metabolism in mammalian cells. An important mechanism in the metabolic control is the hormonal regulation of the genes associated with the transcription and the biosynthesis of these key enzymes. The secretory epithelial cells of the prostate gland of humans and other animals posses a unique citrate-related metabolic pathway regulated by testosterone and prolactin. This specialized hormone-regulated metabolic activity is responsible for the major prostate function of the production and secretion of extraordinarily high levels of citrate. The key regulatory enzymes directly associated with citrate production in the prostate cells are mitochondrial aspartate aminotransferase, pyruvate dehydogenase, and mitochondrial aconitase. Testosterone and prolactin are involved in the regulation of the corresponding genes associated with these enzymes (which we refer to as “metabolic genes”). The regulatory regions of these genes contain the necessary response elements that confer the ability of both hormones to control gene transcription. In this report, we describe the role of protein kinase c (PKC) as the signaling pathway for the prolactin regulation of the metabolic genes in prostate cells. Testosterone and prolactin regulation of these metabolic genes (which are constitutively expressed in all mammalian cells) is specific for these citrate-producing cells. We hope that this review will provide a strong basis for future studies regarding the hormonal regulation of citrate-related intermediary metabolism. Most importantly, altered citrate metabolism is a persistent distinguishing characteristic (decreased citrate production) of prostate cancer (PCa) and also (increased citrate production) of benign prostatic hyperplasia (BPH). An understanding of the role of hormonal regulation of metabolism is essential to understanding the pathogenesis of prostate disease. The relationships described for the regulation of prostate cell metabolism provides insight into the mechanisms of hormonal regulation of mammalian cells in general. PMID:12198595

  14. Lack of Liver X Receptors Leads to Cell Proliferation in a Model of Mouse Dorsal Prostate Epithelial Cell

    PubMed Central

    Dufour, Julie; Pommier, Aurélien; Alves, Georges; De Boussac, Hugues; Lours-Calet, Corinne; Volle, David H.; Lobaccaro, Jean-Marc A.; Baron, Silvère

    2013-01-01

    Recent studies underline the implication of Liver X Receptors (LXRs) in several prostate diseases such as benign prostatic hyperplasia (BPH) and prostate cancer. In order to understand the molecular mechanisms involved, we derived epithelial cells from dorsal prostate (MPECs) of wild type (WT) or Lxr???/? mice. In the WT MPECs, our results show that LXR activation reduces proliferation and correlates with the modification of the AKT-survival pathway. Moreover, LXRs regulate lipid homeostasis with the regulation of Abca1, Abcg1 and Idol, and, in a lesser extent, Srebp1, Fas and Acc. Conversely cells derived from Lxr???/? mice show a higher basal phosphorylation and consequently activation of the survival/proliferation transduction pathways AKT and MAPK. Altogether, our data point out that the cell model we developed allows deciphering the molecular mechanisms inducing the cell cycle arrest. Besides, we show that activated LXRs regulate AKT and MAPK transduction pathways and demonstrate that LXRs could be good pharmacological targets in prostate disease such as cancer. PMID:23554947

  15. Androgen receptor in the Mongolian gerbil ventral prostate: evaluation during different phases of postnatal development and following androgen blockage.

    PubMed

    Cordeiro, Renato S; Scarano, Wellerson R; Campos, Silvana G P; Santos, Fernanda C A; Vilamaior, Patricia S L; Góes, Rejane M; Taboga, Sebastião R

    2008-12-01

    The normal growth, differentiation and maintenance of the morphofunctional integrity of the prostate gland are dependent on the interaction of constant levels of androgens with their receptors. The need to study the responses to hormones under several conditions and the effect of their blockage is due to the fact that the human prostate is the site of a great number of age-related diseases, and the ones with a major medical importance are prostate cancer (CaP) and benign prostatic hyperplasia (BPH), which can both be treated with androgen suppression. Seventy-five male gerbils were divided, randomly, into 3 groups of 25 animals each, where each group corresponded to one phase of postnatal development. In each phase, it was possible to morphologically and stereologically analyze the compartments of prostatic ventral lobe, as well as to immunohistochemically analyze the degree of expression of androgen receptors (ARs) after the androgen blockage therapies. In addition, it was possible to establish the hormonal dosage of serum testosterone levels given the comparative approach of the expression of androgen receptors. There is a pattern of AR distribution in the prostatic ventral lobe throughout postnatal development, in which the younger the animal is the higher, the interaction of circulating androgens that stimulate the AR expression in both the epithelial and stromal compartments. The androgen blockage therapies decreased AR expression in the prostatic compartments, but the androgen reposition after these blockages was not sufficient to recover the glandular structure or stimulate the AR expression up to normal physiological conditions. Both the regulation and distribution of androgen receptors along the gerbil prostatic tissues are complex mechanisms that are likely to be genetically regulated by androgens prenatally or by other factors that are still unknown. This rodent species seems to be a valuable model in the attempt to improve the understanding of the morphophysiological and pathological behavior of this important gland in humans throughout aging and to stimulate new therapeutic ideas to fight prostate cancer. PMID:18394909

  16. Transurethral Resection of the Prostate

    Microsoft Academic Search

    Martin Marszalek; Anton Ponholzer; Marlies Pusman; Ingrid Berger; Stephan Madersbacher

    2009-01-01

    For decades, transurethral resection of the prostate (TURP) has been the gold-standard therapy for severe benign prostatic obstruction (BPO). Diagnostic work-up and indications for TURP should follow the European Association of Urology benign prostatic hyperplasia guidelines. Pressure flow studies are not indicated as a routine diagnostic procedure but are highly recommended under certain conditions (eg, unsuccessful TURP, young age, previous

  17. Numerical simulations of a diode laser BPH treatment system

    SciTech Connect

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

    1999-02-23

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

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

    PubMed

    Scholtysek, Carina; Krukiewicz, Aleksandra A; Alonso, José-Luis; Sharma, Karan P; Sharma, Pal C; Goldmann, Wolfgang H

    2009-02-13

    Saw Palmetto Berry Extract (SPBE) is applied for prostate health and treatment of urinary tract infections, nonbacterial prostitis and Benign Prostatic Hyperplasia (BPH) in man. An assumption is that SPBE affects tumor cell progression and migration in breast and prostate tissue. In this work, DU-145 cells were used to demonstrate that SPBE and its sterol components, beta-sitosterol and stigmasterol, inhibit prostate cancer growth by increasing p53 protein expression and also inhibit carcinoma development by decreasing p21 and p27 protein expression. In the presence of cholesterol, these features are not only reversed but increased significantly. The results show for the first time the potential of SPBE, beta-sitosterol and stigmasterol as potential anti-tumor agents. Since the protein p53 is also regarded as nuclear matrix protein facilitating actin cytoskeletal binding, 2D tractions were measured. The cell adhesion strength in the presence of SPBE, beta-sitosterol and cholesterol and the observation was that the increase in p53 expression triggered an increase in the intracellular force generation. The results suggest a dual function of p53 in cells. PMID:19059205

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

    SciTech Connect

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

    2009-02-13

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

  20. Transurethral microwave thermotherapy effectiveness in small prostates

    Microsoft Academic Search

    Benjamin T. Larson; Lance Mynderse; James Ulchaker; Chris Pulling; Thayne R. Larson

    2006-01-01

    ObjectivesTo dispel the misconceptions that patients with small prostates react differently than patients with larger prostates to cooled transurethral microwave thermotherapy. Cooled transurethral microwave thermotherapy has developed into a valid alternative to treat men with lower urinary tract symptoms due to benign prostatic hyperplasia. However, doubts still remain regarding the ability of this office-based technique to treat smaller prostates.

  1. Discontinuation of alpha-blockade after initial treatment with finasteride and doxazosin in men with lower urinary tract symptoms and clinical evidence of benign prostatic hyperplasia

    Microsoft Academic Search

    Kelly C Baldwin; Phillip C Ginsberg; Claus G Roehrborn; Richard C Harkaway

    2001-01-01

    Objectives. To determine the effect of discontinuation of alpha-blockade and continuation of finasteride in men with lower urinary tract symptoms and enlarged prostates receiving combination treatment and to determine whether the alpha-blocker dose influences the ability to discontinue it.Methods. We treated 272 consecutive men with a prostate size greater than 40 g and American Urological Association symptom score greater than

  2. Upregulation of Androgen-Responsive Genes and Transforming Growth Factor-?1 Cascade Genes in a Rat Model of Non-bacterial Prostatic Inflammation

    PubMed Central

    Funahashi, Yasuhito; O’Malley, Katherine J.; Kawamorita, Naoki; Tyagi, Pradeep; DeFranco, Donald B.; Takahashi, Ryosuke; Gotoh, Momokazu; Wang, Zhou; Yoshimura, Naoki

    2013-01-01

    Background Prostatic inflammation is associated with the development of prostatic hyperplasia. We investigated the effects of prostatic inflammation on expression levels of androgen-responsive genes and growth factors in the prostate. Methods Prostatic inflammation was induced by formalin injection into bilateral ventral lobes of the prostate of male SD rats. After 28 days, the prostate was harvested for analyses of proinflammatory cytokines, androgen-responsive genes in the epithelium and TGF-?1 cascade genes in the stroma. Some rats were given a COX-2 inhibitor (celecoxib; 10 mg/kg/day) by oral gavage for 28 days. Results The formalin-injected prostate exhibited widespread low-grade inflammation (< 50 leukocytes/10,000 ?m2) along with focal high-grade inflammation (> 100 leukocytes/10,000 ?m2) in limited areas. Compared to control, formalin-injected prostate exhibited a 2.5–6 fold increased protein expression of IL-1?, IL-1?, and IL-6. In the low-grade inflammatory regions, 3–9 fold and 2–3 fold upregulations of mRNA levels of androgen receptors/androgen-responsive genes and TGF-?1 cascade genes were respectively observed in the epithelium and stroma obtained by laser-capture microdissection. Positive staining for androgen receptors in the epithelial nuclei, and TGF-?1, IL-6 and COX-2 in the stroma was increased in the low-grade inflammation area. COX-2 inhibitor treatment suppressed these upregulations of cytokines, androgen-responsive and TGF-?1 cascade genes. Conclusions Prostatic inflammation induced increased expression of androgen-responsive genes in the epithelium and TGF-?1 cascade genes in the stroma, which were suppressed by COX-2 inhibitors, suggesting that activation of these genes in the low-grade inflammatory region might be involved in the development of symptomatic BPH. PMID:24446128

  3. ORIGINAL ARTICLE Upregulation of RASGRP3 expression in prostate cancer

    E-print Network

    Cai, Long

    OPEN ORIGINAL ARTICLE Upregulation of RASGRP3 expression in prostate cancer correlates and tissues in BPH and prostate cancer (PCa), as well as its associations with cancer invasion and prognosis Cancer and Prostatic Disease (2014) 17, 119­125; doi:10.1038/pcan.2013.51; published online 14 January

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

    PubMed

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

    2004-01-21

    Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either 90 degrees sectored tubular (3.5 mm OD x 10 mm) or planar transducers (3.5 mm x 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n = 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the 90 degrees tubular applicator (9-15 W, 12 min, 8 MHz) produced coagulated zones covering an 80 degrees wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, approximately 8 MHz) generated thermal lesions of approximately 30 degrees extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30 degrees each) demonstrated controllable coagulation of a 270 degrees contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study. PMID:15083666

  5. Effects of local prostatic hyperthermia on human NK and T cell function.

    PubMed

    Szmigielski, S; Sobczynski, J; Sokolska, G; Stawarz, B; Zielinski, H; Petrovich, Z

    1991-01-01

    Studies on lymphocyte subsets, mitogen transformation and NK cytotoxicity of blood mononuclear cells (BMNC) were performed in 30 patients who received transrectal microwave hyperthermia (TRHT) of the prostate. Of the 30 patients, 15 had advanced adenocarcinoma of the prostate (CAP) and 15 had severely symptomatic benign prostatic hyperplasia (BPH). Local TRHT was given twice a week for a total of six sessions. The treatments were administered at 2450 MHz or 434 MHz using a water-cooled rectal applicator. Each TRHT session lasted for 30 min at steady-state temperature controlled on the rectal mucosa at 45 degrees C. Studies of immune reactions were performed before TRHT, at the completion of six TRHT sessions, and at 1, 2, 4, and 6 months from therapy. Identical studies at the same time-interval were performed in 30 healthy male volunteers. In the 15 CAP patients the results of the immune studies obtained before TRHT, including CD4+/CD8+ ratio, PHA and Con-A transformation indices were significantly lower (p less than 0.01) than in the 15 BPH patients and in the 30 normal volunteers. The 15 BPH patients and the 30 normal volunteers all had immune parameters within the normal limits. Following the administration of TRHT in the 15 CAP patients, a transient significant (p less than 0.01) stimulation of the tested cell-mediated immune parameters was observed when compared with the pretreatment values. The peak effect of this stimulation was noted at 2 months with a subsequent decrease. In the 15 BPH patients a lesser degree of immune stimulation was noted. As expected there was no substantial change in the measured cell-mediated immune parameters in the 30 normal volunteers. A significant increase of NK cytotoxic activity was noted following TRHT in CAP patients when compared with the pretreatment results. This activity reached 120-130% of the individual initial values, being significant at p less than 0.01. The finding of transient stimulation of cell-mediated immune reaction, following local hyperthermia in patients with CAP, may be of some clinical relevance and of clinical importance. Additional studies are being formulated to confirm these interesting findings. PMID:1725293

  6. Molecular diagnosis of prostate cancer

    Microsoft Academic Search

    Eduardo I. Canto; Shahrokh F. Shariat; Kevin M. Slawin

    2004-01-01

    The diagnosis, staging, and management of prostate cancer as we know it today is greatly dependent on our ability to measure\\u000a serum prostate-specific antigen (PSA) concentration. Nevertheless, because serum PSA concentration, particularly when less\\u000a than 10 ng\\/mL, reflects the presence of benign prostatic hyperplasia more often than cancer, there is a clear need for more\\u000a specific prostate cancer markers. The

  7. Comparative analysis of prostatic acid phosphatase and prostate-specific antigen mRNA levels in hyperplastic prostate stimulated with steroid hormones and growth factors.

    PubMed

    Duli?ska, Joanna; Laidler, Piotr; Labed?, Maria

    2002-01-01

    Prostatic acid phosphatase (PAP) and prostate-specific antigen (PSA) are the markers of human prostatic gland. However, it is still not completely understood if and how, steroid hormones and growth factors affect their expression and metabolism in the respect to the major pathologies of the gland. Appropriate studies were carried out on histopathologically diagnosed benign prostatic hyperplasia--BPH (n = 42) using tissue slices and cells derived from them. They were incubated with steroid hormones: 5-alpha-dihydrotestosterone (DHT), estradiol (E) and growth factors: epidermal growth factor (EGF), basic fibroblastic growth factor (bFGF) under culture conditions for up to 24 hours. P-labelled specific oligonucleotide probes were used to analyze total RNA isolated from each sample for the presence of PAP and PSA mRNAs. DHT, E, bFGF, EGF or both DHT + bFGF and DHT + EGF increased PAP and PSA mRNA levels in a time- and dose-dependent manner. The highest and statistically significant increase (P < 0.001) for PAP mRNA was observed when DHT + bFGF were present in the medium while for PSA mRNA if DHT + EGF were added to the medium. Slow but constant decrease of PAP and PSA mRNA levels was observed in the absence of each of these factors in the incubation medium. The results suggest that early expression of PSA and PAP genes and/or their mRNA stability strongly depend on DHT while differ in their response to EGF and bFGF. PMID:12362977

  8. Impact of 120-W 2-?m continuous wave laser vapoenucleation of the prostate on sexual function.

    PubMed

    Wang, Yubin; Shao, Jinkai; Lu, Yongning; Lü, Yongan; Li, Xiaodong

    2014-03-01

    The objective of this work is to evaluate the impact of 120-W 2-?m continuous wave (cw) laser vapoenucleation of the prostate in patients with benign prostatic hyperplasia (BPH) on sexual function. One hundred twenty-two consecutive patients with BPH were retrospectively collected in this study and were classified into two groups for surgical treatment with 2-?m cw laser vapoenucleation or transurethral resection of the prostate (TURP). International Index of Erectile Function (IIEF) and general assessment questions were completed before and 12 months after treatment to determine the impact on sexual function. A total of 33 patients (52.4%) in group 1 and 31 (52.5%) in group 2 reported various degrees of erectile dysfunction before surgery. Interestingly, an increase in IIEF-EF score by 2 points was reported by 16 (25.4%) and 14 (23.7%) patients, respectively, and mean EF score did show a marginal but not significant increase postoperatively in both group. Differences about orgasmic intercourse satisfaction, sexual desire domain, and overall satisfaction scores in each group were not significant between preoperative and postoperative, but there was a significant decrease in the orgasmic function domain score at 12 months postoperation in both groups (p?

  9. Golgi phosphoprotein 3 expression predicts poor prognosis in patients with prostate cancer undergoing radical prostatectomy.

    PubMed

    Zhang, Longyang; Guo, Feng; Gao, Xinghua; Wu, Yanlin

    2015-07-01

    Golgi phosphoprotein 3 (GOLPH3) has recently been implicated as an oncogene involved in the development of carcinoma in a number of organs. The expression of GOLPH3 in prostate cancer (PCa) tissues was investigated in the present study. Human PC-3 and LNCaP PCa cell lines were analyzed in order to assess whether silencing of GOLPH3 expression affects cell vitality, migration and invasion, in vitro. An immunohistochemistry analysis was performed in order to measure the expression of GOLPH3 in samples from 117 patients with PCa and from 50 patients with benign prostatic hyperplasia (BPH). Associations between GOLPH3 expression and clinicopathological parameters, such as overall survival, were assessed. GOLPH3 expression was shown to be significantly greater in PCa tissues than in BPH tissues. GOLPH3 expression was positively correlated with Gleason score (P=0.031), tumor stage (T stage; P=0.020) and lymph node status (P=0.013), in patients with PCa. Biochemical recurrence-free survival (serum prostate-specific antigen-based) and overall survival, were reduced in patients with GOLPH3-positive PCa. A multivariate analysis indicated that GOLPH3 expression was an independent predictor of biochemical recurrence-free survival [hazard ratio (HR), 2.943; 95% confidence interval (CI), 1.190-5.521; P=0.028], and of overall survival (HR, 4.371; 95% CI, 2.045-7.109; P=0.014). Transfection with GOLPH3?targeted small interfering RNA reduced the capability of PC-3 and LNCaP cell lines to proliferate, migrate and invade in vitro, compared with the controls. The level of GOLPH3 expression in radical prostatectomy samples may be useful for predicting biochemical recurrence-free survival and overall survival in patients with PCa. PMID:25760033

  10. Holmium Laser Enucleation of the Prostate Versus Open Prostatectomy for Prostates >70 g: 24Month Follow-up

    Microsoft Academic Search

    Richard Naspro; Nazareno Suardi; Andrea Salonia; Vincenzo Scattoni; Giorgio Guazzoni; Renzo Colombo; Andrea Cestari; Alberto Briganti; Bruno Mazzoccoli; Patrizio Rigatti; Francesco Montorsi

    2006-01-01

    ObjectiveProspectively evaluate perioperative outcomes and 2-yr follow-up after holmium laser enucleation (HoLEP) and standard open prostatectomy (OP) for treating benign prostatic hyperplasia-related obstructed voiding symptoms, with prostates >70g.

  11. Prostate-specific RNA aptamer: promising nucleic acid antibody-like cancer detection

    PubMed Central

    Marangoni, Karina; Neves, Adriana F.; Rocha, Rafael M.; Faria, Paulo R.; Alves, Patrícia T.; Souza, Aline G.; Fujimura, Patrícia T.; Santos, Fabiana A. A.; Araújo, Thaise G.; Ward, Laura S.; Goulart, Luiz R.

    2015-01-01

    We described the selection of a novel nucleic acid antibody-like prostate cancer (PCa) that specifically binds to the single-stranded DNA molecule from a 277-nt fragment that may have been partially paired and bound to the PCA3 RNA conformational structure. PCA3-277 aptamer ligands were obtained, and the best binding molecule, named CG3, was synthesized for validation. Aiming to prove its diagnostic utility, we used an apta-qPCR assay with CG3-aptamer conjugated to magnetic beads to capture PCA3 transcripts, which were amplified 97-fold and 7-fold higher than conventional qPCR in blood and tissue, respectively. Histopathologic analysis of 161 prostate biopsies arranged in a TMA and marked with biotin-labeled CG3-aptamer showed moderate staining in both cytoplasm and nucleus of PCa samples; in contrast, benign prostatic hyperplasia (BPH) samples presented strong nuclear staining (78% of the cases). No staining was observed in stromal cells. In addition, using an apta-qPCR, we demonstrated that CG3-aptamer specifically recognizes the conformational PCA3-277 molecule and at least three other transcript variants, indicating that long non-coding RNA (lncRNA) is processed after transcription. We suggest that CG3-aptamer may be a useful PCa diagnostic tool. In addition, this molecule may be used in drug design and drug delivery for PCa therapy. PMID:26174796

  12. Prostate-specific RNA aptamer: promising nucleic acid antibody-like cancer detection.

    PubMed

    Marangoni, Karina; Neves, Adriana F; Rocha, Rafael M; Faria, Paulo R; Alves, Patrícia T; Souza, Aline G; Fujimura, Patrícia T; Santos, Fabiana A A; Araújo, Thaise G; Ward, Laura S; Goulart, Luiz R

    2015-01-01

    We described the selection of a novel nucleic acid antibody-like prostate cancer (PCa) that specifically binds to the single-stranded DNA molecule from a 277-nt fragment that may have been partially paired and bound to the PCA3 RNA conformational structure. PCA3-277 aptamer ligands were obtained, and the best binding molecule, named CG3, was synthesized for validation. Aiming to prove its diagnostic utility, we used an apta-qPCR assay with CG3-aptamer conjugated to magnetic beads to capture PCA3 transcripts, which were amplified 97-fold and 7-fold higher than conventional qPCR in blood and tissue, respectively. Histopathologic analysis of 161 prostate biopsies arranged in a TMA and marked with biotin-labeled CG3-aptamer showed moderate staining in both cytoplasm and nucleus of PCa samples; in contrast, benign prostatic hyperplasia (BPH) samples presented strong nuclear staining (78% of the cases). No staining was observed in stromal cells. In addition, using an apta-qPCR, we demonstrated that CG3-aptamer specifically recognizes the conformational PCA3-277 molecule and at least three other transcript variants, indicating that long non-coding RNA (lncRNA) is processed after transcription. We suggest that CG3-aptamer may be a useful PCa diagnostic tool. In addition, this molecule may be used in drug design and drug delivery for PCa therapy. PMID:26174796

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

    PubMed Central

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

    2014-01-01

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

  14. Expansion of prostate epithelial progenitor cells after inflammation of the mouse prostate.

    PubMed

    Wang, Liang; Zoetemelk, Marloes; Chitteti, Brahmananda R; Ratliff, Timothy L; Myers, Jason D; Srour, Edward F; Broxmeyer, Hal; Jerde, Travis J

    2015-06-15

    Prostatic inflammation is a nearly ubiquitous pathological feature observed in specimens from benign prostate hyperplasia and prostate cancer patients. The microenvironment of the inflamed prostate is highly reactive, and epithelial hyperplasia is a hallmark feature of inflamed prostates. How inflammation orchestrates epithelial proliferation as part of its repair and recovery action is not well understood. Here, we report that a novel epithelial progenitor cell population is induced to expand during inflammation. We used sphere culture assays, immunofluorescence, and flow cytometry to show that this population is increased in bacterially induced inflamed mouse prostates relative to naïve control prostates. We confirmed from previous reports that this population exclusively possesses the ability to regrow entire prostatic structures from single cell culture using renal grafts. In addition, putative progenitor cells harvested from inflamed animals have greater aggregation capacity than those isolated from naïve control prostates. Expansion of this critical cell population requires IL-1 signaling, as IL-1 receptor 1-null mice exhibit inflammation similar to wild-type inflamed animals but exhibit significantly reduced progenitor cell proliferation and hyperplasia. These data demonstrate that inflammation promotes hyperplasia in the mouse prostatic epithelium by inducing the expansion of a selected epithelial progenitor cell population in an IL-1 receptor-dependent manner. These findings may have significant impact on our understanding of how inflammation promotes proliferative diseases such as benign prostatic hyperplasia and prostate cancer, both of which depend on expansion of cells that exhibit a progenitor-like nature. PMID:25925259

  15. Acoustic Radiation Force Impulse Imaging of Human Prostates: Initial in vivo Demonstration

    PubMed Central

    Zhai, Liang; Polascik, Thomas J.; Foo, Wen-Chi; Rosenzweig, Stephen; Palmeri, Mark L.; Madden, John; Nightingale, Kathryn R.

    2011-01-01

    Reliably detecting prostate cancer (PCa) has been a challenge for current imaging modalities. Acoustic radiation force impulse (ARFI) imaging is an elasticity imaging method that uses remotely generated, focused acoustic beams to probe tissue stiffness. A previous study on excised human prostates demonstrated ARFI images portray various prostatic structures and has the potential to guide prostate needle biopsy with improved sampling accuracy. The goal of this study is to demonstrate the feasibility of ARFI imaging to portray internal structures and PCa in the human prostate in vivo. Custom ARFI imaging sequences were designed and implemented using a modified Siemens AntaresTM scanner with a 3D wobbler, end-firing, trans-cavity transducer, EV9F4. 19 patients were consented and imaged immediately preceding surgical prostatectomy. Pathologies and anatomic structures were identified in histological slides by a pathologist blinded to ARFI data, and were then registered with structures found in ARFI images. The results demonstrated that when PCa is visible, it is generally apparent as bilaterally asymmetric stiff structures; benign prostatic hyperplasia (BPH) appears heterogeneous with a nodular texture; the verumontanum and ejaculatory ducts appears softer compared to surrounding tissue, which form a unique 'V' shape; and the boundary of the transitional zone (TZ) forms a stiff rim separating the TZ from the peripheral zone (PZ). These characteristic appearances of prostatic structures are consistent with those found in our previous study of prostate ARFI imaging on excised human prostates. Compared to the matched B-mode images, ARFI images, in general, portray prostate structures with higher contrast. With the end-firing transducer used for this study, ARFI depth penetration was limited to 22mm, and image contrast and resolution were decreased as compared to the previous ex vivo study due to the small transducer aperture size. Even with these limitations, this study suggests ARFI imaging holds promise for guidance of targeted prostate needle biopsy and focal therapy, as well as aiding assessment of changes during watchful waiting/active surveillance. PMID:22104533

  16. Preparation, characterization and stability study of dutasteride loaded nanoemulsion for treatment of benign prostatic hypertrophy.

    PubMed

    Ali, Mohammad Sajid; Alam, Mohammad Sarfaraz; Alam, Nawazish; Siddiqui, Masoom Raza

    2014-01-01

    Benign prostatic hyperplasia (BPH)is the most common condition in aging men, associated with lower urinary tract symptoms. It is caused due to the augmented levels of the androgen dihydrotestosterone. Dutasteride, a 5?-Reductase inhibitor has been recommended for the treatment of BPH upon oral administration. However, long term oral administration of dutasteride may cause sexual problem in man. Therefore the main objective of this study was to develop transdermal patch having nanoemulsion gel of dutasteride in order to enhance physical and chemical stability and eliminate adverse effect of dutasteride. Optimized nanoemulsion was prepared by aqueous phase-titration method and characterized by droplet size, viscosity and refractive index. In-vitro skin permeation of dutasteride through rat abdominal skin was determined by the Franz diffusion cell.Significant increase in the steady state flux (J ss), permeability coefficient (K p) and enhancement ratio (E r) was observed in optimized nanoemulsion formulation A1 (p < 0.05). The Er of optimized nanoemulsion A1 was found to be 1.52 times with respect to control which indicates transdermal delivery may be better approach for BPH. Stability studies were performed for the period of 3 months. It was found that droplet size, viscosity and refractive index were slightly increased at refrigerator and room temperature in 3 months period. However, the changes in these parameters were not statistically significant (p ? 0.05). The shelf-life of optimized nanoemulsion A1 was found to be 2.18 years at room temperature. These results indicated that both physical as well as chemical stability of dutasteride in nanoemulsion formulation. PMID:25587300

  17. Preparation, Characterization and Stability Study of Dutasteride Loaded Nanoemulsion for Treatment of Benign Prostatic Hypertrophy

    PubMed Central

    Ali, Mohammad Sajid; Alam, Mohammad Sarfaraz; Alam, Nawazish; Siddiqui, Masoom Raza

    2014-01-01

    Benign prostatic hyperplasia (BPH)is the most common condition in aging men, associated with lower urinary tract symptoms. It is caused due to the augmented levels of the androgen dihydrotestosterone. Dutasteride, a 5?-Reductase inhibitor has been recommended for the treatment of BPH upon oral administration. However, long term oral administration of dutasteride may cause sexual problem in man. Therefore the main objective of this study was to develop transdermal patch having nanoemulsion gel of dutasteride in order to enhance physical and chemical stability and eliminate adverse effect of dutasteride. Optimized nanoemulsion was prepared by aqueous phase-titration method and characterized by droplet size, viscosity and refractive index. In-vitro skin permeation of dutasteride through rat abdominal skin was determined by the Franz diffusion cell.Significant increase in the steady state flux (Jss), permeability coefficient (Kp) and enhancement ratio (Er) was observed in optimized nanoemulsion formulation A1 (p < 0.05). The Er of optimized nanoemulsion A1 was found to be 1.52 times with respect to control which indicates transdermal delivery may be better approach for BPH. Stability studies were performed for the period of 3 months. It was found that droplet size, viscosity and refractive index were slightly increased at refrigerator and room temperature in 3 months period. However, the changes in these parameters were not statistically significant (p ? 0.05). The shelf-life of optimized nanoemulsion A1 was found to be 2.18 years at room temperature. These results indicated that both physical as well as chemical stability of dutasteride in nanoemulsion formulation. PMID:25587300

  18. Effects of ?-blocker ‘add on' treatment on blood pressure in symptomatic BPH with or without concomitant hypertension

    PubMed Central

    Lee, S H; Park, K K; Mah, S Y; Chung, B H

    2010-01-01

    We investigated the effects of ‘add on' treatment of ?-blocker (AB) on blood pressure (BP) and the safety of ABs in men with symptomatic BPH with or without hypertension. We retrospectively reviewed 2,924 BPH outpatients who took ABs at our institution between 2005 and 2009. BPH symptom severity, prostate volume and BP were determined for 953 patients with their baseline data. BP level and International Prostate Symptom Score were measured within 2 months after AB treatment. Patients were assigned to four groups: group 1 had 272 normotensive patients on concomitant hypertensive medication; group 2 had 293 normotensive patients not on the medication; group 3 had 216 hypertensive patients on concomitant medication; and group 4 had 172 hypertensive patients not on the medication. The addition of AB lowered the mean systolic BP by 16.6?mm?Hg for group 3 and by 8.6?mm?Hg for group 4, and diastolic BP by 18.0?mm?Hg for group 3 (P<0.05). However, normotensive groups on entry, irrespective of antihypertensive medication, showed no significant BP changes from baseline after AB medication. In the hypertensive groups on entry, the doxazosin gastrointestinal therapeutic system (GITS) resulted in significant reductions in systolic BP from 142.2 to 134.9?mm?Hg and in diastolic BP from 97.6 to 84.6?mm?Hg. When analyzed by AB regimen, the incidence of BP-related adverse events was comparable. AB therapy for BPH can have an appropriate and beneficial effect on BP, especially in baseline hypertensive patients. Doxazosin GITS treatment resulted in optimal management of BP within the normal range, especially in pharmacologically or physiologically hypertensive patients. PMID:20567256

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  20. Lower Levels of Human MOB3B Are Associated with Prostate Cancer Susceptibility and Aggressive Clinicopathological Characteristics.

    PubMed

    Kim, Eun-Ah; Kim, Ye-Hwan; Kang, Ho Won; Yoon, Hyung-Yoon; Kim, Won Tae; Kim, Yong-June; Yun, Seok-Joong; Moon, Sung-Kwon; Choi, Yung Hyun; Kim, Isaac Yi; Lee, Sang-Cheol; Kim, Wun-Jae

    2015-07-01

    Mps one binder (MOB) proteins are integral components of signaling pathways that control important cellular processes, such as mitotic exit, centrosome duplication, apoptosis, and cell proliferation. However, the biochemical and cellular functions of the human MOB (hMOB) protein family remain largely unknown. The present study investigated the association between hMOB3B expression and clinicopathological characteristics of prostate cancer (PCa).Study subjects included 137 PCa patients and 137 age-matched benign prostatic hyperplasia (BPH) patients. hMOB3B expression was estimated using real-time PCR and compared with clinicopathological parameters of PCa. hMOB3B mRNA expression was significantly lower in PCa tissues than in BPH control tissues (P<0.001). According to receiver operating characteristics curve analysis, the sensitivity of hMOB3B expression for PCa diagnosis was 84.7%, with a specificity of 86% (AUC=0.910; 95% CI=0.869-0.941; P<0.001). hMOB3B expression was significantly lower in patients with elevated prostate specific antigen (PSA) levels (?10 ng/mL), a Gleason score?8, and metastatic disease (any T, N+/M+) than in those with low PSA levels, a low Gleason score, and non-metastatic disease (each P<0.05). In conclusion, low levels of hMOB3B are closely associated with aggressive clinicopathologic features in patients with PCa. Our results suggest that hMOB3B may act as a tumor suppressor in human PCa. PMID:26130958

  1. Pyramiding and evaluation of the brown planthopper resistance genes Bph14 and Bph15 in hybrid rice

    Microsoft Academic Search

    Jie Hu; Xin Li; Changjun Wu; Changju Yang; Hongxia Hua; Guanjun Gao; Jinghua Xiao; Yuqing He

    The brown planthopper (BPH) is the most devastating insect pest in rice-producing areas. Shanyou 63 has become a widely cultivated\\u000a hybrid in China over the last two decades; however, this line has become increasingly susceptible to bacterial blight (BB),\\u000a blast, and BPH, resulting in a rapid decline in its use in rice production. In this study, a molecular marker-assisted selection

  2. Simultaneous transurethral resection of bladder cancer and prostate may reduce recurrence rates: A systematic review and meta-analysis

    PubMed Central

    LI, SHENG; ZENG, XIAN-TAO; RUAN, XIAO-LAN; WANG, XING-HUAN; GUO, YI; YANG, ZHONG-HUA

    2012-01-01

    The aim of this study was to evaluate the recurrence rate of simultaneous transurethral resection of bladder cancer and prostate (TURBT+TURP) in the treatment of non-muscle invasive bladder cancer (NMIBC) with benign prostatic hyperplasia (BPH). We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and the ISI Web of Knowledge databases from their establishment until March 2012, to collect all the original studies on TURBT+TURP vs. TURBT alone in the treatment of NMIBC with BPH. After screening the literature, methodological quality assessment and data extraction was conducted independently by two reviewers and meta-analysis was performed using the RevMan 5.1 software. The quality of data was assessed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Eight studies, including seven non-randomized concurrent controlled trials (NRCCTs) and one randomized controlled trial (RCT), involving a total of 1,372 patients met the criteria. Meta-analyses of NRCCTs showed that in the TURBT+TURP group, overall recurrence rates were lower [odds ratio (OR), 0.76; 95% confidence interval (CI), 0.60–0.96; P=0.02] and the difference was statistically significant. The postoperative recurrence rate in the prostatic fossa/bladder neck (OR, 0.96; 95% CI, 0.64–1.45; P=0.86) and bladder tumor progression rates (OR, 0.96; 95% CI, 0.49–1.87; P=0.91) were similar between the TURBT+TURP and TURBT groups, but the difference was not significant. According to the GRADE approach, the level of evidence was moderate or low. Only one RCT demonstrated that overall postoperative tumor recurrence rates, recurrence rates at prostate fossa/bladder neck and bladder tumor progression rates between simultaneous groups and control groups were almost equal. There was no significant difference (P>0.05), and the level of evidence was moderate. For patients with NMIBC and BPH, simultaneous resection did not increase the overall recurrence rate of bladder tumors, it also did not cause metastasis and tumor progression, but it may reduce the recurrence rate. However, due to the low quality of investigations included in the present study, careful selection was necessary, and more large-scale and high-quality randomized controlled trials are also required for further confirmation. PMID:23170127

  3. Simultaneous transurethral resection of bladder cancer and prostate may reduce recurrence rates: A systematic review and meta-analysis.

    PubMed

    Li, Sheng; Zeng, Xian-Tao; Ruan, Xiao-Lan; Wang, Xing-Huan; Guo, Yi; Yang, Zhong-Hua

    2012-10-01

    The aim of this study was to evaluate the recurrence rate of simultaneous transurethral resection of bladder cancer and prostate (TURBT+TURP) in the treatment of non-muscle invasive bladder cancer (NMIBC) with benign prostatic hyperplasia (BPH). We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and the ISI Web of Knowledge databases from their establishment until March 2012, to collect all the original studies on TURBT+TURP vs. TURBT alone in the treatment of NMIBC with BPH. After screening the literature, methodological quality assessment and data extraction was conducted independently by two reviewers and meta-analysis was performed using the RevMan 5.1 software. The quality of data was assessed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Eight studies, including seven non-randomized concurrent controlled trials (NRCCTs) and one randomized controlled trial (RCT), involving a total of 1,372 patients met the criteria. Meta-analyses of NRCCTs showed that in the TURBT+TURP group, overall recurrence rates were lower [odds ratio (OR), 0.76; 95% confidence interval (CI), 0.60-0.96; P=0.02] and the difference was statistically significant. The postoperative recurrence rate in the prostatic fossa/bladder neck (OR, 0.96; 95% CI, 0.64-1.45; P=0.86) and bladder tumor progression rates (OR, 0.96; 95% CI, 0.49-1.87; P=0.91) were similar between the TURBT+TURP and TURBT groups, but the difference was not significant. According to the GRADE approach, the level of evidence was moderate or low. Only one RCT demonstrated that overall postoperative tumor recurrence rates, recurrence rates at prostate fossa/bladder neck and bladder tumor progression rates between simultaneous groups and control groups were almost equal. There was no significant difference (P>0.05), and the level of evidence was moderate. For patients with NMIBC and BPH, simultaneous resection did not increase the overall recurrence rate of bladder tumors, it also did not cause metastasis and tumor progression, but it may reduce the recurrence rate. However, due to the low quality of investigations included in the present study, careful selection was necessary, and more large-scale and high-quality randomized controlled trials are also required for further confirmation. PMID:23170127

  4. De novo large cell neuroendocrine carcinoma of the prostate gland with pelvic lymph node metastasis: a case report with review of literature

    PubMed Central

    Okoye, Ekene; Choi, Eunice K; Divatia, Mukul; Miles, Brian J; Ayala, Alberto G; Ro, Jae Y

    2014-01-01

    Neuroendocrine (NE) differentiation in prostate carcinomas can be seen in two settings: as a focal finding in conventional acinar adenocarcinoma, identifiable by immunohistochemical staining, or as a primary NE tumor of the prostate gland, such as carcinoid, small cell carcinoma, or large cell NE carcinoma. Of particular interest is the large cell NE carcinoma, which had been previously reported in isolated cases or in limited case series. In this report, we describe a case of a large cell NE carcinoma diagnosed in a 48-year-old man who presented with difficulty in voiding and urine retention. A cystoscopy revealed an enlarged, elongated prostate with an intra-urethral obstructing mass in the prostatic urethra. Subsequently, a transurethral resection of prostate (TURP) was performed at an outside hospital under the clinical diagnosis of benign prostatic hyperplasia (BPH). Microscopic examination of the TURP specimen revealed several foci of low-grade transitional-zone-type adenocarcinoma corresponding to Gleason score 5 (3 + 2), and a focus of high-grade large cell NE carcinoma. Concurrent x-ray computed tomography scans of the chest, abdomen, and pelvis demonstrated an enlarged left pelvic lymph node, which was biopsied and the patient was diagnosed with metastatic large cell NE carcinoma. He subsequently underwent 8 cycles of neoadjuvant chemotherapy with Lupron, a laparoscopic robotic-assisted radical retropubic prostatectomy, and pelvic lymphadenectomy. He died of widely metastatic prostatic carcinoma with leptomeningeal metastases 13 months after radical prostatectomy. Here, we present a rare case of large cell NE carcinoma with a review of the published literature. PMID:25674288

  5. Preliminary results on diode-laser assisted vaporization of prostate tissue

    NASA Astrophysics Data System (ADS)

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

    2007-07-01

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

  6. Holmium laser enucleation of the prostate: morbidity in a series of 206 patients

    Microsoft Academic Search

    Ramsay L Kuo; Ryan F Paterson; Tibério M Siqueira; Stephanie L Watkins; Garrick R Simmons; Ronald E Steele; James E Lingeman

    2003-01-01

    ObjectivesTo review the complications associated with 206 holmium laser enucleation of the prostate (HoLEP) procedures. HoLEP is a minimally invasive surgical treatment for benign prostatic hyperplasia.

  7. Performance assessment of automated tissue characterization for prostate H and E stained histopathology

    NASA Astrophysics Data System (ADS)

    DiFranco, Matthew D.; Reynolds, Hayley M.; Mitchell, Catherine; Williams, Scott; Allan, Prue; Haworth, Annette

    2015-03-01

    Reliable automated prostate tumor detection and characterization in whole-mount histology images is sought in many applications, including post-resection tumor staging and as ground-truth data for multi-parametric MRI interpretation. In this study, an ensemble-based supervised classification algorithm for high-resolution histology images was trained on tile-based image features including histogram and gray-level co-occurrence statistics. The algorithm was assessed using different combinations of H and E prostate slides from two separate medical centers and at two different magnifications (400x and 200x), with the aim of applying tumor classification models to new data. Slides from both datasets were annotated by expert pathologists in order to identify homogeneous cancerous and non-cancerous tissue regions of interest, which were then categorized as (1) low-grade tumor (LG-PCa), including Gleason 3 and high-grade prostatic intraepithelial neoplasia (HG-PIN), (2) high-grade tumor (HG-PCa), including various Gleason 4 and 5 patterns, or (3) non-cancerous, including benign stroma and benign prostatic hyperplasia (BPH). Classification models for both LG-PCa and HG-PCa were separately trained using a support vector machine (SVM) approach, and per-tile tumor prediction maps were generated from the resulting ensembles. Results showed high sensitivity for predicting HG-PCa with an AUC up to 0.822 using training data from both medical centres, while LG-PCa showed a lower sensitivity of 0.763 with the same training data. Visual inspection of cancer probability heatmaps from 9 patients showed that 17/19 tumors were detected, and HG-PCa generally reported less false positives than LG-PCa.

  8. Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction

    PubMed Central

    Thiruchelvam, Nikesh

    2014-01-01

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

  9. The combined serum levels of miR-375 and urokinase plasminogen activator receptor are suggested as diagnostic and prognostic biomarkers in prostate cancer.

    PubMed

    Wach, Sven; Al-Janabi, Omar; Weigelt, Katrin; Fischer, Kersten; Greither, Thomas; Marcou, Marios; Theil, Ge