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1

Benign prostate hyperplasia (BPH) - resources  

MedlinePLUS

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

2

Is Benign Prostatic Hyperplasia (BPH) an Immune Inflammatory Disease?  

Microsoft Academic Search

ObjectivesChronic inflammation has been documented for years in benign prostatic hyperplasia (BPH), but only now has it become evident as a major factor in disease progression. This review highlights the immunologic key features of chronic inflammation in BPH and the present interpretation of these changes in the development and progression of BPH.

Gero Kramer; Dieter Mitteregger; Michael Marberger

2007-01-01

3

EAU Guidelines on Benign Prostatic Hyperplasia (BPH)  

Microsoft Academic Search

Objective: To establish guidelines for the diagnosis, treatment, and follow–up of BPH.Methods: A search of published work was conducted using Medline. In combination with expert opinions recommendations were made on the usefulness of tests for assessment and follow–up: mandatory, recommended, or optional. In addition, indications and outcomes for the different therapeutic options were reviewed.Results: A digital rectal examination is mandatory

Jean J. M. C. H. de la Rosette; Gerasimos Alivizatos; Stephan Madersbacher; Massimo Perachino; David Thomas; François Desgrandchamps; Michel de Wildt

2001-01-01

4

Role of laser therapy in benign prostate hyperplasia (BPH)  

NASA Astrophysics Data System (ADS)

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

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

2001-05-01

5

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

MedlinePLUS

... Enlarged Prostate) C Cancer of the Ureter and Renal Pelvis Circumcision Cloacal Exstrophy Complete Blood Count (CBC) Conn's Syndrome Continent Urinary Diversion Contrast and Radionuclide Cystography Cryptorchidism CT Scan Cushing's Syndrome Cystocele/Fallen Bladder Cystometry Cystoscopy ...

6

BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... prostate cancer urinary cytology - a urine test to screen for bladder cancer a measurement of post-void residual volume (PVR) - the amount of urine left in the bladder after urinating uroflowmetry, or urine flow study - a measure of how fast urine flows ...

7

Critical review of lasers in benign prostatic hyperplasia (BPH).  

PubMed

• Laser treatment of benign prostatic hyperplasia has challenged transurethral resection of the prostate (TURP) due to advances in laser technology, better understanding of tissue-laser interactions and growing clinical experience. • Various lasers have been introduced including neodymium: yttrium aluminium garnet (YAG), holmium (Ho):YAG, potassium titanyl phosphate:YAG, thulium(Tm) and diode laser. Based on the different wave-length dependent laser-prostatic tissue interactions, the main techniques are coagulation, vaporization, resection and enucleation. • The present review aims to help urologists to distinguish and to critically evaluate the role of different laser methods in the treatment by using an evidence-based approach. It also details further evidence for use in specific patient groups (in retention, on anticoagulation) and addresses the issues of cost and learning curve. • Coagulation-based techniques have been abandoned; holmium ablation/resection of the prostate has been superseded by the enucleation technique Ho-laser enucleation of the prostate (HoLEP). The short-term efficacy of the emerging laser treatments such as diode and Tm prostatectomy has been suggested by low quality studies. HoLEP and photoselective vaporization of the prostate (PVP) represent valid clinical alternatives to TURP. HoLEP is the most rigorously analysed laser technique with durable efficacy for any prostate size and low early and late morbidity. PVP has grown in acceptance and popularity but long-term results from high quality studies are pending. PMID:21438974

Gravas, Stavros; Bachmann, Alexander; Reich, Oliver; Roehrborn, Claus G; Gilling, Peter J; De La Rosette, Jean

2011-04-01

8

Treatment preference patterns during a videotape decision aid for benign prostatic hyperplasia (BPH)  

Microsoft Academic Search

ObjectiveAs part of a study of men's responses to a videotape decision aid [Rovner DR, Wills CE, Bonham V, Williams G, Lillie J, Kelly-Blake K, Williams MV, Holmes-Rovner M. Decision aids for benign prostatic hyperplasia: applicability across race and education. Med Decis Making 2004;24:359–66], preferences for BPH treatment options were assessed.

Celia E. Wills; Margaret Holmes-Rovner; David Rovner; Janet Lillie; Karen Kelly-Blake; Vence Bonham; Gilbert Williams

2006-01-01

9

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

PubMed Central

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

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

2013-01-01

10

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

Microsoft Academic Search

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

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

2005-01-01

11

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

NASA Astrophysics Data System (ADS)

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

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

2003-06-01

12

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

PubMed Central

Benign prostatic hyperplasia (BPH) is the major cause of lower urinary tract symptoms in men aged 50 or older. Symptoms are not normally life threatening, but often drastically affect the quality of life. The number of men seeking treatment for BPH is expected to grow in the next few years as a result of the ageing male population. Estimates of annual pharmaceutical sales of BPH therapies range from $US 3 to 10 billion, yet this market is dominated by two drug classes. Current drugs are only effective in treating mild to moderate symptoms, yet despite this, no emerging contenders appear to be on the horizon. This is remarkable given the increasing number of patients with severe symptoms who are required to undergo invasive and unpleasant surgery. This review provides a brief background on prostate function and the pathophysiology of BPH, followed by a brief description of BPH epidemiology, the burden it places on society, and the current surgical and pharmaceutical therapies. The recent literature on emerging contenders to current therapies and novel drug targets is then reviewed, focusing on drug targets which are able to relax prostatic smooth muscle in a similar way to the ?1-adrenoceptor antagonists, as this appears to be the most effective mechanism of action. Other mechanisms which may be of benefit are also discussed. It is concluded that recent basic research has revealed a number of novel drug targets such as muscarinic receptor or P2X-purinoceptor antagonists, which have the potential to produce more effective and safer drug treatments. PMID:21410684

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

2011-01-01

13

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

PubMed Central

This review assesses lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with or without erectile dysfunction (ED) and related therapies focusing on tadalafil. A literature search was obtained and reviewed for the epidemiology, treatment therapies, pathophysiology, and efficacy and safety of phosphodiesterase type 5 inhibitor (PDE5i) tadalafil in patients with LUTS/BPH. Approximately 42% of men aged 51 to 60 years have BPH. Approximately 90% of men aged 45 to 80 years have LUTS. Occurrence of LUTS increases with age for almost all racial/ethnic groups (range, 32% to 56%) with prevalence of LUTS highest among Hispanic men, then Blacks, Caucasians, and Asians. There is an independent relationship with LUTS/BPH and ED, with approximately 70% of men with LUTS/BPH having ED with severity of one disease often correlating with the other. The European Urological Association guidelines include the use of the PDE5i tadalafil. Tadalafil is the only therapy recommended for treatment of co-existing BPH and ED, while other therapies have unwanted ED side effects. The mode of action of tadalafil may involve different areas of the lower urinary tract such as smooth muscle cell relaxation in the bladder neck, prostate, and urethra, but there may also be resulting modulation of the afferent nerve activity. Tadalafil (5 mg) in Asian men with LUTS/BPH, similar to global studies, is efficacious and safe. Tadalafil (5 mg) improves co-existing LUTS/BPH and ED, independently. Men with LUTS/BPH likely also have ED. Asian men with LUTS/BPH have similar incidence rates, co-existing ED, comorbid diseases, and risks as non-Asian men. Tadalafil can improve co-existing LUTS/BPH and ED. PMID:24459652

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

2013-01-01

14

Early Experience with Laparoscopic Retropubic Simple Prostatectomy in Patients with Voluminous Benign Prostatic Hyperplasia (BPH)  

PubMed Central

Purpose Laparoscopic simple prostatectomy was recently developed to treat voluminous benign prostatic hyperplasia (BPH). We describe the surgical technique and assess the feasibility of laparoscopic simple prostatectomy through our early experience. Materials and Methods The medical records of 11 patients who underwent laparoscopic simple prostatectomy between March 2008 and January 2010 were retrospectively analyzed. The subjects were limited to the patients who satisfied the following conditions: prostate volume was at least 75 g, acute urinary retention repeatedly occurred or maximal flow rate (Qmax) was at most 10 ml/s, and International Prostate Symptom Score (IPSS) was at least 12. The surgery was performed by the laparoscopic extraperitoneal approach with a transcapsular route. Feasibility was assessed by objective operative parameters (reconversion, operating time, and blood loss) and perioperative complications. Data on short-term follow-up were also available. Results The mean age of the patients was 70.6 years. Mean preoperative prostate-specific antigen and prostate volume were 6.1 ng/ml and 109.3 cc, respectively. Mean operation time was 191.9 minutes and estimated blood loss was 390.9 cc. The resected adenoma weighed on average 72.4 g. No conversion to open surgery was required. Mean preoperative IPSS and quality of life (QoL) scores were 26.86 and 4.86. Mean Qmax, measured before the surgery, was 4.5 ml/s and residual urine was 106 ml. Mean postoperative IPSS and QoL scores were 4.2 and 1.5. After the surgery, mean Qmax was 15.5 ml/s and residual urine was 24.1 ml. Conclusions In the case of voluminous BPH, laparoscopic retropubic simple prostatectomy is expected to be a useful treatment on the condition that the learning curve can be overcome with clinical experience. PMID:20495695

Yun, Han Ki; Kwon, Joon Beom; Cho, Sung Ryong

2010-01-01

15

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

PubMed Central

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

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

2014-01-01

16

Drug Treatment of Benign Prostatic Hyperplasia and Hospital Admission for BPH-Related Surgery  

Microsoft Academic Search

Objective: To investigate whether there is a difference in the risk of progressing to BPH-related prostatic surgery between patients using alpha-blockers and patients using the 5-alpha-reductase inhibitors (5-ARIs).Methods: A population-based cohort study was conducted, using data from the PHARMO Record Linkage System. We identified 5671 patients (?50 years old, no history of using both alpha-blockers and 5-ARIs, more than one

P. C. Souverein; J. A. Erkens; J. J. M. C. H. de la Rosette; H. G. M. Leufkens; R. M. C. Herings

2003-01-01

17

BPH and prostate cancer risk  

PubMed Central

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

Miah, Saiful; Catto, James

2014-01-01

18

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

Microsoft Academic Search

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

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

2001-01-01

19

? 1-Adenoceptor Antagonists for the Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia (LUTS\\/BPH): State of the Art  

Microsoft Academic Search

An update of an analysis of placebo-controlled and direct-comparative studies with ?1-AR antagonists in LUTS\\/BPH was performed to assess whether the ?1-adrenoceptor (AR) antagonists currently available for the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS\\/BPH) (alfuzosin, terazosin, doxazosin and tamsulosin) can be differentiated with regard to efficacy and\\/or tolerability. It appears that all ?1-AR antagonists

Bob Djavan

2004-01-01

20

Risk factors for disease progression in patients with lower urinary tract symptoms\\/benign prostatic hyperplasia (LUTS\\/BPH): a systematic analysis of expert opinion  

Microsoft Academic Search

Disease progression has become an important issue for the management of lower urinary tract symptoms\\/benign prostatic hyperplasia (LUTS\\/BPH). Although several risk factors have been identified, no specific patient risk profiles have been established that can be useful in the day-to-day management of LUTS\\/BPH. In this study, an international panel of urologists developed a risk classification based on the attribution of

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

2005-01-01

21

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

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,

Robert M. Guthrie; Richard L. Siegel

1999-01-01

22

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

E-print Network

: +33149812568 E-mail address: adelataille@hotmail.com Running Head Title: BPH and inflammation Word Count: Abstract: 220 Manuscript: 2320 Figure: 1 Tables: 4 Key Words: Benign prostatic hyperplasia; BPH inflammation could be a key component in prostate enlargement and benign prostatic hyperplasia (BPH

Paris-Sud XI, Université de

23

Phytotherapy for benign prostatic hyperplasia  

Microsoft Academic Search

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

Glenn S. Gerber

2002-01-01

24

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

E-print Network

Diagn Mol Pathol . Author manuscript Page /1 9 BPH gene expression profile associated to prostate-Regulation Introduction Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting aging men. Clinicians commonly use the term BPH to describe a clinical syndrome consisting of three components: lower

Boyer, Edmond

25

Combination Therapy with Rofecoxib and Finasteride in the Treatment of Men with Lower Urinary Tract Symptoms (LUTS) and Benign Prostatic Hyperplasia (BPH)  

Microsoft Academic Search

Purpose:Cyclooxygenase-2 (COX-2) is expressed in human BPH tissue and displays either a pro-inflammatory effect or a proliferative effect on prostate cells. The aim of this study is to analyze whether combination therapy with rofecoxib, a COX-2 inhibitor, and finasteride offers an advantage compared to finasteride monotherapy in patients with BPH.

Franco Di Silverio; Cesare Bosman; Monti Salvatori; Luca Albanesi; Laura Proietti Pannunzi; Mauro Ciccariello; Antonio Cardi; Gianfilippo Salvatori; Alessandro Sciarra

2005-01-01

26

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 ...

27

[Treatment of benign prostatic hyperplasia].  

PubMed

Due to innovative pharmacological and endoscopic/interventional concepts of therapy, the strategies of facing the benign prostatic hyperplasia have undergone a significant diversification within the last ten years. In addition to phytotherapeutic drugs, which have been in clinical use for decades, alpha receptor blockers and blockers of DHT-synthesis have gained increasing importance. More or less convincing instrumental competing methods have been developed as an alternative to the transurethral resection of the prostate or the transvesical prostatectomy. Regarding the altered age pyramid structure and decreasing financial means, guidelines for the diagnosis and therapy of the BPH-syndrome are consequently being developed in order to support the establishment of an individual therapy of BPH, to increase the efficacy of therapy and to be able to get along with the existing financial barriers. The development of the International Prostate Symptoms Score (IPSS) is regarded essential for this effort. PMID:9702820

Harzmann, R; Weckermann, D; Wawroschek, F

1998-06-01

28

Benign Prostatic Hyperplasia: from Bench to Clinic  

PubMed Central

Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options. PMID:22468207

Cho, Hee Ju

2012-01-01

29

Should We Investigate Prostatic Inflammation for the Management of Benign Prostatic Hyperplasia?  

Microsoft Academic Search

ContextAlthough benign prostatic hyperplasia (BPH) is the most frequent disease in elderly men, only a few predictive factors have been identified. Recently, prostatic inflammation has emerged as one of them.

Grégoire Robert; Aurélien Descazeaud; Yves Allory; Francis Vacherot; Alexandre de la Taille

2009-01-01

30

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

PubMed Central

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

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

2013-01-01

31

Development of Interpretable Predictive Models for BPH and Prostate Cancer  

PubMed Central

BACKGROUND Traditional methods for deciding whether to recommend a patient for a prostate biopsy are based on cut-off levels of stand-alone markers such as prostate-specific antigen (PSA) or any of its derivatives. However, in the last decade we have seen the increasing use of predictive models that combine, in a non-linear manner, several predictives that are better able to predict prostate cancer (PC), but these fail to help the clinician to distinguish between PC and benign prostate hyperplasia (BPH) patients. We construct two new models that are capable of predicting both PC and BPH. METHODS An observational study was performed on 150 patients with PSA ?3 ng/mL and age >50 years. We built a decision tree and a logistic regression model, validated with the leave-one-out methodology, in order to predict PC or BPH, or reject both. RESULTS Statistical dependence with PC and BPH was found for prostate volume (P-value < 0.001), PSA (P-value < 0.001), international prostate symptom score (IPSS; P-value < 0.001), digital rectal examination (DRE; P-value < 0.001), age (P-value < 0.002), antecedents (P-value < 0.006), and meat consumption (P-value < 0.08). The two predictive models that were constructed selected a subset of these, namely, volume, PSA, DRE, and IPSS, obtaining an area under the ROC curve (AUC) between 72% and 80% for both PC and BPH prediction. CONCLUSION PSA and volume together help to build predictive models that accurately distinguish among PC, BPH, and patients without any of these pathologies. Our decision tree and logistic regression models outperform the AUC obtained in the compared studies. Using these models as decision support, the number of unnecessary biopsies might be significantly reduced. PMID:25780348

Bermejo, Pablo; Vivo, Alicia; Tárraga, Pedro J; Rodríguez-Montes, JA

2015-01-01

32

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

Microsoft Academic Search

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

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

1998-01-01

33

Use of 5?-reductase inhibitors to prevent benign prostatic hyperplasia disease  

Microsoft Academic Search

A histologic change in the prostate, benign prostatic hyperplasia (BPH), is a normal part of aging. However, BPH disease,\\u000a defined here as a life-altering urinary condition caused by BPH requiring prompt medical intervention, is a serious medical\\u000a disorder associated with major complications, surgical intervention, and severe lifestyle interference. BPH disease is preventable.\\u000a The rationale for BPH disease prevention rests on

Leonard S. Marks

2006-01-01

34

Association of Benign Prostatic Hyperplasia with Male Pattern Baldness  

Microsoft Academic Search

Objectives. Both benign prostatic hyperplasia (BPH) and male pattern baldness (androgenic alopecia) share the pathogenesis of an androgen-dependent disorder and afflict a large population of elderly men with chronobiologic progress. However, it is unclear whether these diseases are related epidemiologically. We evaluated the association of frequency and severity of male pattern baldness between patients with BPH and a control group.Methods.

Bong Ryoul Oh; Seong Jin Kim; Jai Dong Moon; Hyeung Nam Kim; Dong Duek Kwon; Young Ho Won; Soo Bang Ryu; Yang Il Park

1998-01-01

35

Optimizing the management of benign prostatic hyperplasia  

PubMed Central

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

Elterman, Dean S.; Kaplan, Steven A.

2012-01-01

36

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

Microsoft Academic Search

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

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

1999-01-01

37

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

NASA Astrophysics Data System (ADS)

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

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

2002-05-01

38

Phytotherapy of benign prostatic hyperplasia. A minireview.  

PubMed

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

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

2014-07-01

39

Benign prostatic hyperplasia: pathogenesis and medical therapy.  

PubMed

Epidemiologic studies in castrates strongly support the key role of the testis in the pathogenesis of benign prostatic hyperplasia (BPH). Since the testis secretes androgen and estrogen, both of these hormones have been implicated in BPH. Much information supports the important role of dihydrotestosterone (DHT) in BPH, including intraprostatic activities of enzymes that regulate DHT. Although controversy still exists, DHT levels in BPH may be higher than in normal prostate tissue. Based upon these findings and the ability to quantitate prostate size and function with reliable new techniques, suppression of androgen-mediated action has been tested to assess the validity of the DHT theory. A variety of drugs has been demonstrated to decrease prostate size by approximately 30% by either blocking secretion of circulating testosterone and adrenal androgen, inhibiting 5 alpha-reductase to prevent DHT formation, or blocking DHT binding to androgen receptors. Accompanying these changes in size was significant improvement in clinical symptoms of prostatism in about 50% of patients, when double-blind, large multicenter studies were conducted with one of these drugs. Although these results suggest a very important role for androgen, particularly DHT, in the pathogenesis of BPH, other abnormalities may coexist since significant numbers of patients do not show a total reversal of disease. There is strong indirect evidence for a possible role for estrogen in the pathogenesis of BPH, and studies are under way to test the effects of estrogen withdrawal on prostate size and symptoms. Similarly, dynamic aspects of prostatic obstruction, which are under alpha-adrenergic regulation, may also be a component of this disease and amenable to therapy with alpha-adrenergic blockers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1720438

Geller, J

1991-12-01

40

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

PubMed Central

Benign prostatic hyperplasia (BPH) and prostate carcinoma (CaP) are linked to aging and the presence of androgens, suggesting that androgen regulated genes play a major role in these common diseases. Androgen regulation of prostate growth and development depends on the presence of intact epithelial-stromal interactions. Further, the prostatic stroma is implicated in BPH. This suggests that epithelial cell lines are inadequate to identify androgen regulated genes that could contribute to BPH and CaP and which could serve as potential clinical biomarkers. In this study, we used a human prostate xenograft model to define a profile of genes regulated in vivo by androgens, with an emphasis on identifying candidate biomarkers. Benign transition zone (TZ) human prostate tissue from radical prostatectomies was grafted to the sub-renal capsule site of intact or castrated male immunodeficient mice, followed by the removal or addition of androgens, respectively. Microarray analysis of RNA from these tissues was used to identify genes that were; 1) highly expressed in prostate, 2) had significant expression changes in response to androgens, and, 3) encode extracellular proteins. A total of 95 genes meeting these criteria were selected for analysis and validation of expression in patient prostate tissues using quantitative real-time PCR. Expression levels of these genes were measured in pooled RNAs from human prostate tissues with varying severity of BPH pathologic changes and CaP of varying Gleason score. A number of androgen regulated genes were identified. Additionally, a subset of these genes were over-expressed in RNA from clinical BPH tissues, and the levels of many were found to correlate with disease status. Our results demonstrate the feasibility, and some of the problems, of using a mouse xenograft model to characterize the androgen regulated expression profiles of intact human prostate tissues. PMID:20027305

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

2009-01-01

41

Hyperinsulinaemia as a Risk Factor for Developing Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objective: To determine the validity coefficient of the total prostate gland volume as an expression of the transition zone (TZ) volume. To test the hypothesis of hyperinsulinaemia as a causal factor for the development of benign prostatic hyperplasia (BPH).Patients and Methods: Three hundred and seven consecutive patients with lower urinary tract symptoms were studied. A subgroup of 114 patients were

Jan Hammarsten; Benkt Högstedt

2001-01-01

42

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

NASA Astrophysics Data System (ADS)

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

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

2003-06-01

43

Presence of PSA auto-antibodies in men with prostate abnormalities (prostate cancer/benign prostatic hyperplasia/prostatitis).  

PubMed

Prostate-specific antigen (PSA), produced by the prostate, liquefies post-ejaculate semen. PSA is detected in semen and blood. Increased circulating PSA levels indicate prostate abnormality [prostate cancer (PC), benign prostatic hyperplasia (BPH), prostatitis (PTIS)], with variance among individuals. As the prostate has been proposed as an immune organ, we hypothesise that variation in PSA levels among men may be due to presence of auto-antibodies against PSA. Sera from healthy men (n = 28) and men having prostatitis (n = 25), BPH (n = 30) or PC (n = 29) were tested for PSA antibody presence using enzyme-linked immunosorbent assay (ELISA) values converted to standard deviation (SD) units, and Western blotting. Taking ?2 SD units as cut-off for positive immunoreactivity, 0% of normal men, 0% with prostatitis, 33% with BPH and 3.45% with PC demonstrated PSA antibodies. One-way analysis of variance (anova) performed on the mean absorbance values and SD units of each group showed BPH as significantly different (P < 0.01) compared with PC and prostatitis. All others were nonsignificant (P < 0.05). Men (33%) with BPH had PSA antibodies by ELISA and Western blot. These discoveries may find clinical application in differential diagnosis among prostate abnormalities, especially differentiating BPH from prostate cancer and prostatitis. PMID:24620795

Lokant, M T; Naz, R K

2015-04-01

44

Transforming growth factor -receptor II protein expression in benign prostatic hyperplasia is associated  

E-print Network

prostatic hyperplasia (BPH) using immunohistochemistry analysis, and to compare the analysis with phenotypic surgery for BPH. · The were also assessed, including CD3, CD4, CD8, CD20, and CD163. · surgical procedure: · TGFBRII protein expression was found in BPH epithelium cells for both basal and secretory cells, as well

Paris-Sud XI, Université de

45

[Pharmacologic treatment of benign prostatic hypertrophy (BPH): a combination of mepartricin and simvastatin. Analysis and results].  

PubMed

The Authors propose a medical treatment for Benign Prostatic Hyperplasia (BPH) using mepartricina-simvastatina, two drugs with a hypocholesterolemizing action. We have treated fifty patients with BPH (twelve with permanent catheters) obtaining a complete clinical results in 40% of the total and a partial clinical result in 38%. This therapy, in association with a correct diet and adequate physical activity, significantly improved not only the cervicurethral obstruction but also general hematochemical and, above all, lipidemic parameters. PMID:1725937

Marino, G; Pugno, E; Cevoli, R; Griffa, D; Pastorini, S; Cocimano, V

1991-01-01

46

Androgen Receptor Roles in the Development of Benign Prostate Hyperplasia  

PubMed Central

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

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

2014-01-01

47

Photoselective vaporization of the prostate for treating benign prostatic hyperplasia.  

PubMed

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

Chughtai, Bilal; Te, Alexis

2011-09-01

48

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

Microsoft Academic Search

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

Michael Marberger

2006-01-01

49

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

PubMed

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

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

2014-06-01

50

Microwave Treatment of Prostate Cancer and Hyperplasia  

NASA Technical Reports Server (NTRS)

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

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

2005-01-01

51

Therapeutic options in the treatment of benign prostatic hyperplasia  

PubMed Central

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

Sandhu, Jaspreet S

2009-01-01

52

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 ...

53

Overview of interventional treatment options for benign prostatic hyperplasia  

PubMed Central

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

Elhilali, Mostafa M.

2012-01-01

54

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

PubMed Central

Lasers have been given much hype as regards their use in surgical management of benign prostatic hyperplasia (BPH). Transurethral resection of prostate (TURP), especially with its modifications still remains the gold standard treatment for BPH, owing to its efficacy and proven advantages over laser prostatectomy. Cost, unproven long-term durability, steep learning curve, and no advantages of laser prostatectomy over TURP and its modifications, make lasers superfluous in the surgical management of BPH in developing countries. PMID:19881145

Gupta, Narmada P.; Anand, Ajay

2009-01-01

55

BPH and Sexuality  

Microsoft Academic Search

Quality of life has become a very important parameter in benign prostatic hyperplasia (BPH) and one of the major concepts identified by the patients to be important is related to sexuality after BPH therapy. The impact on sexuality resulting from the various treatment modalities of BPH, either medical, surgical or instrumental has been too often neglected in the past and

Alexandre R. Zlotta; Claude C. Schulman

1999-01-01

56

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

PubMed Central

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

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

2013-01-01

57

Current Laser Treatments for Benign Prostatic Hyperplasia  

PubMed Central

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

Son, Hwancheol; Song, Sang Hoon

2010-01-01

58

Pharmacotherapy for benign prostatic hyperplasia.  

PubMed Central

Benign prostatic hyperplasia is a benign neoplasm of the prostate seen in men of advancing age. Microscopic evidence of the disorder is seen in about 70% of men by 70 years of age, whereas symptoms requiring some form of surgical intervention occur in 30% of men during their lifetime. Although the exact cause of benign prostatic hyperplasia is not clear, it is well recognized that high levels of intraprostatic androgens are required for the maintenance of prostatic growth. In recent years, extensive surveys of patients undergoing transurethral resection of the prostate reveal an 18% incidence of morbidity that has essentially not changed in the past 30 years. This procedure is also the second highest reimbursed surgical therapy under Medicare. These findings have resulted in an intensive search for alternative therapies for prostatic hyperplasia. An alternative that has now been well defined is the use of alpha-adrenergic blockers to relax the prostatic urethra. This is based on findings that a major component of benign prostatic hyperplasia symptoms is spasm of the prostatic urethra and bladder neck, which is mediated by the alpha-adrenergic nerves. A second approach is to block androgens involved in maintaining prostate growth. Several such drugs are now available for clinical use, and we discuss their side effects and use. We also include the newer recommendations on evaluating benign prostatic hyperplasia that are cost-effective yet comprehensive. Images PMID:7528957

Narayan, P; Indudhara, R

1994-01-01

59

The Senescence-Associated Secretory Phenotype Promotes Benign Prostatic Hyperplasia  

PubMed Central

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

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

2015-01-01

60

Various treatment options for benign prostatic hyperplasia: A current update  

PubMed Central

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

Shrivastava, Alankar; Gupta, Vipin B.

2012-01-01

61

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

PubMed

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

Shrivastava, Alankar; Gupta, Vipin B

2012-01-01

62

Finasteride Reduces the Risk of Incident Clinical Benign Prostatic Hyperplasia  

PubMed Central

Background Despite the high prevalence of clinical benign prostatic hyperplasia (BPH) among older men, there remains a notable absence of studies focused on BPH prevention. Objective To determine if finasteride prevents incident clinical BPH in healthy older men. Design, setting, and participants Data for this study are from the Prostate Cancer Prevention Trial. After excluding those with a history of BPH diagnosis or treatment, or an International Prostate Symptom Score (IPSS) ?8 at study entry, 9253 men were available for analysis. Outcome measurements and statistical analysis The primary outcome was incident clinical BPH, defined as the initiation of medical treatment, surgery, or sustained, clinically significant urinary symptoms (IPSS >14). Finasteride efficacy was estimated using Cox proportional regression models to generate hazards ratios (HRs). Results and limitations Mean length of follow-up was 5.3 yr. The rate of clinical BPH was 19 per 1000 person-years in the placebo arm and 11 per 1000 person-years in the finasteride arm (p < 0.001). In a covariate-adjusted model, finasteride reduced the risk of incident clinical BPH by 40% (HR: 0.60; 95% confidence interval, 0.51–0.69; p < 0.001). The effect of finasteride on incident clinical BPH was attenuated in men with a body mass index ?30 kg/m2 (pinteraction = 0.04) but otherwise did not differ significantly by physical activity, age, race, current diabetes, or current smoking. The post hoc nature of the analysis is a potential study limitation. Conclusions Finasteride substantially reduces the risk of incident clinical BPH in healthy older men. These results should be considered in formulating recommendations for the use of finasteride to prevent prostate diseases in asymptomatic older men. PMID:22459892

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

2014-01-01

63

Treatment of benign prostatic hyperplasia with 5-alpha-reductase inhibitor: morphological changes in patients who fail to respond  

Microsoft Academic Search

AIMS: To describe the prostatic adenectomy specimens of six patients with symptomatic benign prostatic hyperplasia (BPH) who failed to respond to long term treatment with a 5-alpha-reductase inhibitor, finasteride. METHODS: Histological sections from six cases of BPH who had been treated with finasteride were investigated. Five patients were prescribed 5 mg finasteride daily for six months and one patient 5

R Montironi; M Valli; G Fabris

1996-01-01

64

Benign prostatic hyperplasia: An overview of existing treatment  

PubMed Central

Benign prostatic hyperplasia (BPH) is the most common condition in aging men, associated with lower urinary tract symptoms (LUTS). A better understanding of the prostate physiology, function, and pathogenesis has led to the development of promising agents, useful in the management of LUTS in men. The specific approach used to treat BPH depends upon number of factors like age, prostrate size, weight, prostate-specific antigen level, and severity of the symptoms. 5?-reductase inhibitors decrease the production of dihydrotestosterone within the prostate, which results in decreased prostate volume, increased peak urinary flow rate, improvement of symptoms, decreased risk of acute urinary retention, and need for surgical intervention. ?1-adrenergic receptor (?1-AR) antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Clinical efficacy of either 5?-reductase inhibitor or ?1-AR antagonist has been further improved by using combination therapy; however, long-term outcomes are still awaited. Many more potential new therapies are under development that may improve the treatment of BPH. This article gives a brief account of rationale and efficacy of different treatment options presently available in the management of BPH. PMID:21455413

Dhingra, Neelima; Bhagwat, Deepak

2011-01-01

65

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

Microsoft Academic Search

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,

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

2009-01-01

66

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

PubMed Central

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

Nicholson, Tristan M.; Ricke, William A.

2011-01-01

67

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

Microsoft Academic Search

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

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

2002-01-01

68

TREATMENT FOR BENIGN PROSTATIC HYPERPLASIA AMONG COMMUNITY DWELLING MEN: THE OLMSTED COUNTY STUDY OF URINARY SYMPTOMS AND HEALTH STATUS  

Microsoft Academic Search

PurposeWe describe treatments for benign prostatic hyperplasia (BPH) among men participating in the Olmsted County study of urinary symptoms and health status among men during 10,000 person-years of followup.

STEVEN J. JACOBSEN; DEBRA J. JACOBSON; CYNTHIA J. GIRMAN; ROSEBUD O. ROBERTS; THOMAS RHODES; HARRY A. GUESS; MICHAEL M. LIEBER

1999-01-01

69

The Functional Role of Reactive Stroma in Benign Prostatic Hyperplasia  

PubMed Central

The human prostate gland is one of the only internal organs that continue to enlarge throughout adulthood. The specific mechanisms that regulate this growth, as well as the pathological changes leading to the phenotype observed in the disease benign prostatic hyperplasia (BPH), are essentially unknown. Recent studies and their associated findings have made clear that many complex alterations occur, involving persistent and chronic inflammation, circulating hormonal level deregulation, and aberrant wound repair processes. BPH has been etiologically characterized as a progressive, albeit discontinuous, hyperplasia of both the glandular epithelial and stromal cell compartments coordinately yielding an expansion of the prostate gland and clinical symptoms. Interestingly, the inflammatory and repair responses observed in BPH are also key components of general wound repair in post-natal tissues. These responses include altered expression of chemokines, cytokines, matrix remodeling factors, chronic inflammatory processes, altered immune surveillance and recognition, as well as the formation of a prototypical ‘reactive’ stroma which is similar to that observed across various fibroplasias and malignancies of a variety of tissue sites. Stromal tissue, both embryonic mesenchyme, and adult reactive stroma myofibroblasts, has been shown to exert potent and functional regulatory control over epithelial proliferation and differentiation as well as immunoresponsive modulation. Thus, the functional biology of a reactive stroma, within the context of an adult disease typified by epithelial and stromal aberrant hyperplasia, is critical to understand within the context of prostate disease and beyond. The mechanisms that regulate reactive stroma biology in BPH represent targets of opportunity for new therapeutic approaches that may extend to other tissue contexts. Accordingly, this review seeks to address the dissection of important factors, signaling pathways, genes, and other regulatory components that mediate the interplay between epithelium and stromal responses in BPH. PMID:21664759

Schauer, Isaiah G.; Rowley, David R.

2011-01-01

70

Conservative non-instrumental treatment of benign prostatic hyperplasia  

Microsoft Academic Search

This paper critically reviews the clinical effects in benign prostatic hyperplasia (BPH) patients that can be achieved with the presently available medical treatment options. The classes of drugs that are reviewed include: 5-a-reductase inhibitors,a-blockers, cholesterol-lowering agents and phytotherapeutic drugs. Only double-blind placebo-controlled studies with a duration of at least 3 months that have reported symptomatic changes and changes in flow

J. L. H. Ruud Bosch

1997-01-01

71

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

Microsoft Academic Search

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

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

2000-01-01

72

DNA base modifications and antioxidant enzyme activities in human benign prostatic hyperplasia  

Microsoft Academic Search

The authors have studied DNA base damage and activities of antioxidant enzymes in human benign prostatic hyperplasia (BPH) tissues and surrounding disease-free tissues removed from prostate glands of 15 patients. In these tissues, endogenous levels of various typical hydroxyl radical-induced products of DNA bases and activities of catalase and superoxide dismutase were measured. The majority of patients had higher levels

Ryszard Olinski; Tomasz H. Zastawny; Marek Foksinski; Anrzej Barecki; Miral Dizdaroglu

1995-01-01

73

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

PubMed Central

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

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

2014-01-01

74

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

PubMed Central

Background. Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Among 242 consecutive unselected patients who underwent prostate biopsy, after excluding those with history of prostate biopsy/surgery or using medications not for BPH, we studied 190 patients. On the 15th day after procedure patients were questioned about symptoms lasting over a week and classified according to pharmacological BPH treatment. Results. Thirty-three patients (17%) were using alpha-blocker exclusively, five (3%) 5-alpha-reductase inhibitor exclusively, twelve (6%) patients used both medications, and 140 (74%) patients used none. There was no difference in regard to age among groups (P = 0.5). Postbiopsy adverse effects occurred as follows: hematuria 96 (50%), hematospermia 53 (28%), hematochezia 22 (12%), urethrorrhagia 19 (10%), fever 5 (3%), and pain 20 (10%). There was a significant negative correlation between postbiopsy hematuria and BPH pharmacological treatment with stronger correlation for combined use of 5-alpha-reductase inhibitor and alpha-blocker over 6 months (P = 0.0027). Conclusion. BPH pharmacological treatment, mainly combined for at least 6 months seems to protect against prostate biopsy adverse effects. Future studies are necessary to confirm our novel results. PMID:24876834

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

2014-01-01

75

Incidence and Prevalence of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in Primary Care—The Triumph Project  

Microsoft Academic Search

Objective: Benign prostatic hyperplasia (BPH) is one of the most common conditions associated with ageing in men. BPH often presents as lower urinary tract symptoms (LUTS) due to difficulties in voiding and irritability of the bladder. We conducted a retrospective cohort study within the Integrated Primary Care Information (IPCI) database, a general practitioners database in The Netherlands, to assess the

K. M. C Verhamme; J. P Dieleman; G. S Bleumink; J van der Lei; M. C. J. M Sturkenboom

2002-01-01

76

Cytokine Expression Pattern in Benign Prostatic Hyperplasia Infiltrating T Cells and Impact of Lymphocytic Infiltration on Cytokine mRNA Profile in Prostatic Tissue  

Microsoft Academic Search

The aim of the study is to characterize the type of immune response in benign prostatic hyperplasia (BPH) tissue. BPH tissue–derived T cells (n = 10) were isolated, activated (PMA + ionomycin), and analyzed for intracellular reactivity with anti–IFN-? and IL-2, -4, -5, -6, -10, and -13, as well as TNF-? and -? by four-color flow cytometry. Lymphokine release was

Georg E Steiner; Ursula Stix; Alessandra Handisurya; Martin Willheim; Andrea Haitel; Franz Reithmayr; Doris Paikl; Rupert C Ecker; Kristian Hrachowitz; Gero Kramer; Chung Lee; Michael Marberger

2003-01-01

77

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

PubMed Central

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

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

2014-01-01

78

Effect of a Vitamin D3 Analogue on Keratinocyte Growth Factor-Induced Cell Proliferation in Benign Prostate Hyperplasia  

Microsoft Academic Search

Prostate enlargement and function is under the dual control of androgens and intraprostatic growth factors. They regulate, in con- cert, prostate cell proliferation and apoptosis. An increased signaling of both growth factors and androgens are supposed to underlie benign prostate hyperplasia (BPH), one of the more common disorders of the aging male. Since, in clinical practice, androgen ablation resulted in

CLARA CRESCIOLI; MARIO MAGGI; GABRIELLA BARBARA VANNELLI; MICHAELA LUCONI; ROBERTO SALERNO; TULLIO BARNI; MASSIMO GULISANO; GIANNI FORTI; MARIO SERIO

2010-01-01

79

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

PubMed Central

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

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

2012-01-01

80

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

SciTech Connect

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

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

1982-02-01

81

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

Microsoft Academic Search

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

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

2003-01-01

82

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

SciTech Connect

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

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

2013-12-15

83

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

PubMed Central

Seoritae is a type of black soybean that is known to have health-promoting effects due to its high isoflavone and anthocyanin contents. We evaluated whether Seoritae extract (SE) had beneficial effects on the reduction of prostate weight in a rat model of benign prostatic hyperplasia (BPH). BPH was induced by intramuscular injections of testosterone enanthate once a week for 5 weeks in Sprague-Dawley rats, and rats were treated with or without daily oral doses of SE during BPH induction. After 5 weeks, the oxidative stress (superoxide dismutase and 8-hydroxy-2-deoxyguanosine), apoptosis (caspase-3), and activity of 5-alpha reductase were evaluated in the serum and prostate. The SE treatment group showed a significant decrease in prostate weight, oxidative stress, apoptosis, and 5-alpha reductase activity compared to the nontreated BPH group. These results show that SE is effective in decreasing the weight and proliferation of the prostate, and suggest that SE may be an effective treatment for BPH. PMID:24701239

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

2014-01-01

84

Pharmacotherapy of benign prostatic hyperplasia: Inhibitor of 5 alpha-reductase  

Microsoft Academic Search

We studied the effects of 5 alpha-reductase inhibitor (finasteride) in the treatment of benign prostatic hyperplasia (BPH).\\u000a This study is a randomized controlled trial. Sixty-two patients were treated with 5 alpha-reductase (finasteride 5 mg\\/day)\\u000a and 61 patients (control group) with placebo for one year. Prostatic volume, maximal urine flow rate, AUA symptom scoring,\\u000a residual urine volume and prostate-specific antigen (PSA)

Ö. Polat; I. Özbey; O. Gül; A. Demirel; Y. Bayraktar

1997-01-01

85

Laser Treatment of Benign Prostatic Hyperplasia: Dosimetric and Thermodynamic Considerations  

NASA Astrophysics Data System (ADS)

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

Anvari, Bahman

1993-01-01

86

Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction  

PubMed Central

Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors – including age, genetics and geography – play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies. PMID:24744516

Patel, Nishant D.; Parsons, J. Kellogg

2014-01-01

87

Personalized Medicine for Management of Benign Prostatic Hyperplasia  

PubMed Central

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

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

2014-01-01

88

Treatment of benign prostatic hyperplasia using transurethral split of the prostate with a columnar balloon catheter.  

PubMed

Transurethral dilation of the prostate (TUDP) with a spherical balloon catheter is a traditional treatment for patients with benign prostatic hyperplasia (BPH). TUDP, however, has been abandoned in clinical application because of its unsatisfying treatment benefit and severe complications. In this study, we redesigned an improved TUDP surgical procedure-transurethral split of the prostate (TUSP)-by replacing the spherical balloon with a columnar balloon. To evaluate the clinical therapeutic effect, we compared the lower urinary tract symptoms (LUTS) of patients with BPH after TUSP treatment and analyzed the urethra through CT films. Animal experiments were performed on aged dogs to investigate the urine function and electromyography (EMG) changes. Histopathology was used to evaluate the inflammation and injury. In addition, collagen content was detected by Trichrome Masson. TUSP attenuated LUTS and reconstructed the urethra in patients with BPH. The attenuation of LUTS was reflected in terms of LUTS parameters such as peak urine flow rate, postvoid residual urine volume, quality of life score, and International Prostate Symptom Score. TUSP expanded the urethra in experimental dogs by splitting the prostate tissues and decreasing the collagen content, with maintenance of normal urinary function and EMG characteristics. The successful clinical application of TUSP with significant therapeutic effect and limited complications made TUSP an ideal choice for the patients with BPH. PMID:25285775

Huang, Weiguo; Guo, Yinglu; Xiao, Guofeng; Qin, Xiang

2015-03-01

89

Acupuncture for benign prostatic hyperplasia: a systematic review protocol  

PubMed Central

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

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

2015-01-01

90

Medical management of benign prostatic hyperplasia  

Microsoft Academic Search

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.

Andrew Chacon; Manoj Monga

1999-01-01

91

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

Microsoft Academic Search

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

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

2001-01-01

92

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

Microsoft Academic Search

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

Kurt Dreikorn

2002-01-01

93

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

PubMed Central

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

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

2014-01-01

94

Zinc and cadmium concentration in prostatic carcinoma of different histological grading in comparison to normal prostate tissue and adenofibromyomatosis (BPH)  

Microsoft Academic Search

Zn and Cd concentrations in tissue of normal prostate gland, BPH and prostatic carcinoma of different histological grades have been determined by atomic absorption spectrometry before therapy. We found a distinct biological anatagonistic effect between Zn and Cd in the human prostate gland. We have seen an increasing amount of Zn in BPH, but a decrease in prostatic cancer. In

A. Feustel; R. Wennrich; D. Steiniger; P. Klauss

1982-01-01

95

Prostate histotripsy for BPH: initial canine results  

NASA Astrophysics Data System (ADS)

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.

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

2009-02-01

96

Suppression of benign prostate hyperplasia by Kaempferia parviflora rhizome  

PubMed Central

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

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

2013-01-01

97

Benign prostatic hyperplasia and urinary symptoms: Evaluation and treatment.  

PubMed

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

Mobley, David; Feibus, Allison; Baum, Neil

2015-04-01

98

Economic issues and the management of benign prostatic hyperplasia.  

PubMed

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

Holtgrewe, H L

1995-09-01

99

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

PubMed Central

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

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

2013-01-01

100

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

PubMed Central

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

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

2013-01-01

101

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

Microsoft Academic Search

In 68 men with benign prostatic hyperplasia, we evaluated the association between obesity and prostatic enlargement, as well\\u000a as changes in serum levels of oestradiol, testosterone, dihydroepiandrosterone and dihydroepiandrosterone sulphate. Despite\\u000a the larger adenomas, no increase in the symptom score for BPH was observed with increasing obesity. Average specimen weights\\u000a increased with increasing obesity and increasing host age from 46

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

1996-01-01

102

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

NASA Astrophysics Data System (ADS)

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

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

2003-06-01

103

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

PubMed Central

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

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

2011-01-01

104

Physical Activity and Benign Prostatic Hyperplasia-Related Outcomes and Nocturia  

PubMed Central

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

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

2015-01-01

105

LILRA3 Is Associated with Benign Prostatic Hyperplasia Risk in a Chinese Population  

PubMed Central

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

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

2013-01-01

106

Micro and bulk analysis of prostate tissues classified as hyperplasia  

NASA Astrophysics Data System (ADS)

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

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

2007-07-01

107

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

Microsoft Academic Search

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

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

2007-01-01

108

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

PubMed Central

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

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

2013-01-01

109

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

SciTech Connect

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

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

2010-04-15

110

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

PubMed

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

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

2012-05-01

111

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

Microsoft Academic Search

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

Louis Kuritzky

2005-01-01

112

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. ...

113

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

Microsoft Academic Search

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

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

1995-01-01

114

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

PubMed Central

Recent studies reported that rs2252004 at 10q26 was significantly associated with prostate cancer (PCa) risk in a Japanese population and was subsequently confirmed in a Chinese population. We aimed to assess the relationship between this locus and risk/aggressiveness of benign prostatic hyperplasia (BPH). The current study included 426 BPH cases and 1,008 controls from Xinhua Hospital in Shanghai, China. All BPH patients were treated with ?-adrenergic blockers and 5?-reductase inhibitors for at least 9 months. Associations between rs2252004 and BPH risk/aggressiveness were tested using logistic regression. Associations between rs2252004 and clinical parameters including International Prostate Symptom Score (IPSS), total prostate volume (TPV), total PSA (tPSA), and free PSA (fPSA) were evaluated by linear regression. Allele “A” in rs2252004 was significantly associated with increased risk for aggressiveness of BPH in a Chinese population (OR?=?1.42, 95% CI: 1.04–1.96, P = 0.03). Patients with the genotype “A/A” (homozygous minor allele) had an increase of IPSS and TPV after treatment (P = 0.045 and 0.024, resp.). No association was observed between rs2252004, BPH risk, and baseline clinicopathological traits (All P > 0.05). Our study is the first to show that rs2252004 at 10q26 was associated with BPH aggressiveness and efficacy of BPH treatment. PMID:23984071

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

2013-01-01

115

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

MedlinePLUS

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

116

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

MedlinePLUS

Urology Care Foundation The Official Foundation of the American Urological Association Increase Text Size Decrease Text Size Text Size Urology Care Foundation on Twitter Urology Care Foundation on ...

117

Prostate Diseases  

MedlinePLUS

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

118

Exendin-4 shows no effects on the prostatic index in high-fat-diet-fed rat with benign prostatic hyperplasia by improving insulin resistance.  

PubMed

Benign prostatic hyperplasia (BPH) is a prevalent disease globally, and accumulating evidence has indicated an association between BPH, insulin resistance (IR) and diabetes. Exendin-4 is widely used in clinics, which could enhance the proliferation of pancreatic ? cells. The ability of exendin-4 to promote tumorigenesis has been of concern, and whether exendin-4 would enhance the propagation of BPH is not fully understood. We aimed to determine whether glucagon-like peptide-1 receptors (GLP-1Rs) were expressed in rat prostate and to determine the effect of exendin-4 on prostate of BPH. Male Wistar rats were used and assigned to six groups: normal diet (ND), high-fat diet (HFD), HFD + exendin-4, HFD + BPH, HFD + BPH + exendin-4 and HFD + BPH + rosiglitazone group. After castration, steroids were injected subcutaneously for 4 weeks to induce BPH. Rats were kept on high-fat diet to induce IR. Treatment groups were treated with exendin-4 and rosiglitazone. Prostatic index and HOMA-IR index were used to evaluate the prostatic hyperplasia status and the degree of IR respectively. The expression of GLP-1R was indicated not only by immunohistochemistry, but also by Western blot analysis. The expression of GLP-1R was significantly higher, and HOMA-IR index and body weight significantly decreased after administration of exendin-4. However, no significant differences in the prostatic index were observed between exendin-4 treatment groups and non-exendin-4 treatment groups. Prostatic index was not influenced by exendin-4 maybe by improving IR and weight loss. PMID:24605934

Zheng, J-X; Xiao, Y-C; Hu, Y-R; Hao, M; Kuang, H-Y

2015-03-01

119

Antagonism of estrogen-mediated cell proliferation by raloxifene in prevention of ageing-related prostatic hyperplasia  

PubMed Central

Estrogen has important roles in the initiation and development of benign prostatic hyperplasia (BPH). Regulators of the estrogen receptor (ER) are tissue- and cell-specific. We evaluated the effect of estrogen antagonist, raloxifene (Ral), on the prevention and treatment of BPH by investigating its effect on the proliferation of two different prostate cell lines: a stromal cell line, WPMY-1, and a benign prostatic hyperplasia epithelial cell line, BPH-1. We additionally evaluated its effect on prostatic hyperplasia induced by estrogen and androgen in a rat model. The effect of Ral on the prevention of prostatic hyperplasia was analyzed by haematoxylin and eosin staining and quantitative immunohistochemistry (IHC) for proliferating cell nuclear antigen and ?-smooth muscle actin. In vitro and in vivo, tamoxifen (Tam), another anti-estrogen drug, and finasteride (Fin), a drug for the clinical treatment of BPH, served as efficacy controls. The in vitro data showed that neither Ral nor Tam alone affected the proliferation of WPMY-1 and BPH-1, but both antagonized the effect of oestradiol in promoting the proliferation of the two cells. Results from the IHC staining of the rat prostates indicated that, similar to Tam and Fin, Ral inhibited the proliferation of stromal cells in vivo. Interestingly, in contrast to Tam, both Ral and Fin inhibited the proliferation of epithelial cells. Furthemore, Ral treatment much strongly decreased the number of prostatic acini and the surrounding layers of smooth muscle cells than Fin (P < 0.05). Our data showed for the first time that Ral may have a role in the response of the rat prostate to selective ER modulators. PMID:20473319

Yang, Rui; Ma, Yu-Xia; Chen, Lin-Feng; Zhou, Ying; Yang, Zhan-Po; Zhu, Yan; Du, Xiao-Ling; Shi, Jian-Dang; Ma, Hong-Shun; Zhang, Ju

2010-01-01

120

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

PubMed

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

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

2011-08-01

121

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

SciTech Connect

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

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

1996-04-01

122

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

PubMed Central

Introduction Lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) and bladder outlet obstruction may affect up to 30% of men in their early 70s. Symptoms can improve without treatment, but the usual course is a slow progression of symptoms, with acute urinary retention occurring in 1% to 2% of men with BPH per year. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical, herbal, and surgical treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 63 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: 5 alpha-reductase inhibitors, alpha-blockers, beta-sitosterol plant extract, Pygeum africanum, rye grass pollen extract, saw palmetto plant extracts, transurethral electrovaporisation, transurethral Holmium laser enucleation of the prostate, transurethral microwave thermotherapy, transurethral needle ablation, and transurethral resection (including transurethral resection versus transurethral incision, and transurethral resection versus visual laser ablation/laser vaporisation). PMID:21871136

2011-01-01

123

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

PubMed

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

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

124

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

PubMed

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

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

2013-01-01

125

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

PubMed

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

Pearson, Ryan; Williams, Pamela M

2014-12-01

126

Water-induced thermotherapy for benign prostatic hyperplasia.  

PubMed

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

Cioanta, I; Muschter, R

2000-12-01

127

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

PubMed Central

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

2014-01-01

128

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

PubMed Central

BACKGROUND AND PURPOSE Inflammation plays a key role in the development of benign prostatic hyperplasia (BPH). Eicosanoids derived from the COX and 5-lipoxygenase (5-LOX) pathways are elevated in the enlarging prostate. Flavocoxid is a novel flavonoid–based ‘dual inhibitor’ of the COX and 5-LOX enzymes. This study evaluated the effects of flavocoxid in experimental BPH. EXPERIMENTAL APPROACH Rats were treated daily with testosterone propionate (3 mg·kg?1 s.c.) or its vehicle for 14 days to induce BPH. Animals receiving testosterone were randomized to receive vehicle (1 mL·kg?1, i.p.) or flavocoxid (20 mg·kg?1, i.p.) for 14 days. Histological changes, eicosanoid content and mRNA and protein levels for apoptosis-related proteins and growth factors were assayed in prostate tissue. The effects of flavocoxid were also tested on human prostate carcinoma PC3 cells. KEY RESULTS Flavocoxid reduced prostate weight and hyperplasia, blunted inducible expression of COX-2 and 5-LOX as well as the increased production of PGE2 and leukotriene B4 (LTB4), enhanced pro-apoptotic Bax and caspase-9 and decreased the anti-apoptotic Bcl-2 mRNA. Flavocoxid also reduced EGF and VEGF expression. In PC3 cells, flavocoxid stimulated apoptosis and inhibited growth factor expression. Flavocoxid-mediated induction of apoptosis was inhibited by the pan-caspase inhibitor, Z-VAD-FMK, in PC3 cells, suggesting an essential role of caspases in flavocoxid-mediated apoptosis during prostatic growth. CONCLUSION AND IMPLICATIONS Our results show that a ‘dual inhibitor’ of the COX and 5-LOX enzymes, such as flavocoxid, might represent a rational approach to reduce BPH through modulation of eicosanoid production and a caspase-induced apoptotic mechanism. PMID:22471974

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

2012-01-01

129

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

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

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

2014-01-01

130

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

PubMed

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

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

2014-03-01

131

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

PubMed Central

Purpose The objective of this study was to report the experience acquired at the Seoul National University Hospital with Holmium Laser Enucleation of Prostate (HoLEP), combined with mechanical morcellation for symptomatic benign prostatic hyperplasia (BPH). Methods A retrospective review was performed on the clinical data of 309 consecutive patients who underwent HoLEP at our institution between July 2008 and June 2010. All patients were evaluated preoperatively for prostate volume by transrectal ultrasound, maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS) and quality of life (QoL) score. Peri- and postoperative parameters were evaluated and patients were followed-up at 1-, 3-, 6-, and 12- months with the aforementioned investigations. Results The patients' mean age was 68.3 (±6.5) years and mean prostate volume was 55.6 (±23.6) mL. Mean enucleation time was 56.2 (±25.1) minutes, mean morcellation time was 11.3 (±9.5) minutes, and the mean resected weight of the prostate was 20.8 (±16.9) g. The mean catheter indwelling period was 1.9 (±1.7) days and mean hospital stay was 2.9 (±1.5) days. Significant improvement was noted in Qmax, IPSS, and QoL at the 1-year follow-up compared with baseline (P<0.01). At 1 month 17.2% of patients complained of irritative urinary symptoms, which were typically self-limiting within 3 months. Transient stress incontinence was reported in 15.2% of patients. No patient experienced persistent obstructive symptoms that required reoperation. Conclusions Our study showed that HoLEP is a safe and effective therapeutic modality for BPH. PMID:21468284

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

2011-01-01

132

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

PubMed Central

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

Park, Ju Hyun; Paick, Jae-Seung

2010-01-01

133

Microwave applicators for BPH thermotherapy  

NASA Astrophysics Data System (ADS)

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

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

2004-04-01

134

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

SciTech Connect

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

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

1996-03-01

135

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

PubMed Central

Benign prostatic hyperplasia (BPH) can lead to lower urinary tract symptoms. Rape pollen is an apicultural product that is composed of nutritionally valuable and biologically active substances. The aim of the present study was to investigate the protective effect of rape pollen supercritical CO2 fluid extract (SFE-CO2) in BPH development using a testosterone-induced BPH rat model. BPH was induced in the experimental groups by daily subcutaneous injections of testosterone for a period of 30 days. Rape pollen SFE-CO2 was administered daily by oral gavage concurrently with the testosterone injections. Animals were sacrificed at the scheduled termination and the prostates were weighed and subjected to histopathological examination. Testosterone, dihydrotestosterone (DHT), 5?-reductase and cyclooxygenase-2 (COX-2) levels were also measured. BPH-induced animals exhibited an increase in prostate weight with increased testosterone, DHT, 5?-reductase and COX-2 expression levels. However, rape pollen SFE-CO2 treatment resulted in significant reductions in the prostate index and testosterone, DHT, 5?-reductase and COX-2 levels compared with those in BPH-induced animals. Histopathological examination also demonstrated that rape pollen SFE-CO2 treatment suppressed testosterone-induced BPH. These observations indicate that rape pollen SFE-CO2 inhibits the development of BPH in rats and these effects are closely associated with reductions in DHT, 5?-reductase and COX-2 levels. Therefore, the results of the present study clearly indicate that rape pollen SFE-CO2 extract may be a useful agent in BPH treatment. PMID:24944593

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

2014-01-01

136

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

PubMed Central

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

Zhang, Li Tao; Park, Jong Kwan

2015-01-01

137

Saw Palmetto for Benign Prostatic Hyperplasia  

Microsoft Academic Search

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

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

2006-01-01

138

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

SciTech Connect

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.

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

1983-01-01

139

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

PubMed Central

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

Issa, Muta M

2005-01-01

140

Managing the progression of lower urinary tract symptoms/benign prostatic hyperplasia: therapeutic options for the man at risk.  

PubMed

There are two fairly divergent reviews in this month's issue. The first is a paper which concentrates on the progression of LUTS and BPH. Previous papers on LUTS and BPH were focused on changes in urinary flow rates and symptom scores, a rather static view of things. The first author in this review introduced the concept of dynamic variables in LUTS and BPH, and this, along with the idea of progression of the disease which the MTOPS study brought to our notice, has lead to a major change to our approach to trials of therapy in LUTS and BPH. The second review is really statement of a theory, an expression of a concept being proposed by the author, which hopefully will be of interest to the reader. In benign prostatic hyperplasia (BPH), increased prostate volume has been shown to be associated with future symptom deterioration and progression to acute urinary retention (AUR) or BPH-related surgery. Dihydrotestosterone (DHT) is the primary androgen responsible for prostate growth. Inhibition by 5alpha-reductase inhibitors (5-ARIs) of the enzyme responsible for the production of DHT decreases prostate volume. This translates to an overall improvement in symptoms and a reduction in the risk of AUR and/or BPH-related surgery. Selective blockage of alpha(1)-adrenoceptors, principally in the region of the prostate, results in rapid symptom relief for the patient but this does not translate into a long-term reduction in the risk of AUR or BPH-related surgery. Given their different modes of action the rationale has always existed for using 5ARIs and alpha-blockers together in men deemed to be both symptomatic and at risk of progression. The factors that predict this progression and the methods available to reduce the risk of it occurring are the subjects of this review. PMID:17617135

Emberton, Mark; Zinner, Norman; Michel, Martin C; Gittelman, Marc; Chung, Moon-Kee; Madersbacher, Stephan

2007-08-01

141

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

PubMed Central

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 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

Xia, Shu-Jie

2009-01-01

142

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

NASA Astrophysics Data System (ADS)

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

Uchida, Toyoaki

2011-09-01

143

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

PubMed Central

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

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

2013-01-01

144

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

PubMed

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

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

2014-06-01

145

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

PubMed Central

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

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

2014-01-01

146

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

NASA Astrophysics Data System (ADS)

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

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

2009-04-01

147

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

SciTech Connect

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

Hall, Timothy L.; Hempel, Chris R.; Lake, Alison M.; Kieran, Kathy [University of Michigan Department of Urology, Ann Arbor, MI (United States); Ives, Kim; Cain, Charles A. [University of Michigan Department of Biomedical Engineering, Ann Arbor, MI (United States); Fowlkes, J. Brian [University of Michigan Department of Radiology, Ann Arbor, MI (United States); University of Michigan Department of Biomedical Engineering, Ann Arbor, MI (United States); Roberts, William W. [University of Michigan Department of Urology, Ann Arbor, MI (United States); University of Michigan Department of Biomedical Engineering, Ann Arbor, MI (United States)

2009-04-14

148

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

PubMed

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

Nahata, A; Dixit, V K

2012-05-01

149

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

PubMed Central

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

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

2014-01-01

150

Testosterone and benign prostatic hyperplasia.  

PubMed

The use of testosterone to treat the symptoms of late-onset hypogonadal men has increased recently due to patient and physician awareness. However, concerns regarding the effect of testosterone on the prostate, in particular any possible effect on the risk of prostate cancer have prompted further research in this regard. Surprisingly, numerous retrospective or small, randomized trials have pointed to a possible improvement in male lower urinary tract symptoms (LUTS) in patients treated with testosterone. The exact mechanism of this improvement is still debated but may have a close relationship to metabolic syndrome. For the clinician, the results of these studies are promising but do not constitute high levels of evidence. A thorough clinical examination (including history, examination and laboratory testing of testosterone) should be undertaken before considering the diagnosis of late-onset hypogonadism or instigating treatment for it. Warnings still remain on the testosterone supplement product labels regarding the risk of urinary retention and worsening LUTS, and these should be explained to patients. PMID:25337845

Jarvis, Thomas R; Chughtai, Bilal; Kaplan, Steven A

2015-01-01

151

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

PubMed

Benign Prostatic Hyperplasia (BPH) is a burning senile problem of elderly men and no definitive conservative cure is available. The present available surgical and minimal invasive methods have their own limitations. Hence, to find out a suitable Ayurvedic approach, an effort has been made towards the management of BPH, In this study, 32 selected patients of Mootraghata at par to BPH were divided into three groups randomly and treated accordingly. In group A, Gokshuradi compound (GC) Vati (GV) 500 mg was given three times a day with luke-warm water after food; while in group B, Dhanyaka-Gokshura Ghrita (DGG) as Matra Basti (MB) of 60 ml, once in a day, just after lunch and combined therapy of both formulations in group C was administered. Out of 32 patients, total 30 patients (10 in each group) were completed the treatment course of 21 days. In results, 54.09% improvement was seen in group C, 45.67% in group A and 47.99% in group B. The size of prostate gland was found reduced highly significant in group C. Hence, it is concluded that combined therapy of GV and DGG MB is beneficial without developing any adverse drug reactions and can be prescribed safely for Mootraghata (BPH). PMID:23723674

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

2012-10-01

152

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

PubMed Central

Benign Prostatic Hyperplasia (BPH) is a burning senile problem of elderly men and no definitive conservative cure is available. The present available surgical and minimal invasive methods have their own limitations. Hence, to find out a suitable Ayurvedic approach, an effort has been made towards the management of BPH, In this study, 32 selected patients of Mootraghata at par to BPH were divided into three groups randomly and treated accordingly. In group A, Gokshuradi compound (GC) Vati (GV) 500 mg was given three times a day with luke-warm water after food; while in group B, Dhanyaka-Gokshura Ghrita (DGG) as Matra Basti (MB) of 60 ml, once in a day, just after lunch and combined therapy of both formulations in group C was administered. Out of 32 patients, total 30 patients (10 in each group) were completed the treatment course of 21 days. In results, 54.09% improvement was seen in group C, 45.67% in group A and 47.99% in group B. The size of prostate gland was found reduced highly significant in group C. Hence, it is concluded that combined therapy of GV and DGG MB is beneficial without developing any adverse drug reactions and can be prescribed safely for Mootraghata (BPH). PMID:23723674

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

2012-01-01

153

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

PubMed Central

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

Cho, Hee Ju; Yoo, Tag Keun

2014-01-01

154

Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction  

PubMed Central

Introduction: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) are clinical entities very prevalent in men aged over 50 years. There is evidence that both may have a common pathophysiology. Objective: The objective of this study was to conduct a literature review aiming to show theories and hypotheses that justify a single pathophysiology for ED and LUTS/BPH. Methods: A search in Medline using the keywords of the Medical Subject Headings (MESH) ‘erectile dysfunction’ and ‘lower urinary tract symptoms’ in all fields of the database up to 15 December 2012. This search found 198 relevant articles that were analyzed. Results: The data and articles were divided according to the type of evidence found. There are strong epidemiological data showing that LUTS/BPH is a risk factor for developing ED. Several experimental models demonstrated partial obstruction of the bladder in animals causes voiding disorders as well as a negative impact on erectile function of the operated animals. The increased adrenergic tonus in animals leads to prostate growth and urodynamic conditions similar to those found in men with LUTS and ED. Arteriosclerosis may lead to loss of vesical complacency, urinary tract obstruction and fibrosis of the cavernous bodies. The use of phosphodiesterase type 5 inhibitors (PDE-5i) and/or alpha-adrenergic blockers to treat ED and LUTS/BPH reinforces the hypothesis that, at least in some patients, both clinical pictures may have the same pathophysiology. PMID:23904860

Glina, Felipe Placco Araujo

2013-01-01

155

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

PubMed

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

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

2014-05-01

156

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

Microsoft Academic Search

Objective: To review the contemporary management of symptomatic benign prostatic hyperplasia (BPH) in the United Kingdom (UK). Methods: Information was obtained from published scientific articles, IMS market analysis data and surveys among primary care practitioners and urologists. Results: A survey in Stirling (Scotland) identified the number of men aged 40–79 years with symptomatic BPH defined as a prostate size >20

Tom A. McNicholas

1999-01-01

157

A Prospective, Randomized, Controlled, Multicenter Study of Naftopidil for Treatment of Male Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia: 75 mg Once Daily in the Evening Compared to 25 mg Thrice Daily  

Microsoft Academic Search

Introduction: We examined the tolerability of dosage methods of naftopidil in the treatment of male lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH\\/male LUTS). Patients and Methods: A total of 80 patients with BPH\\/male LUTS who had an International Prostate Symptom Score (IPSS) ?8 and IPSS quality of life (QoL) ?2 were enrolled and randomly administered naftopidil for

Shinji Tsuritani; Tetsuo Nozaki; Akiou Okumura; Hitomi Kimura; Taizo Kazama

2010-01-01

158

Role of the impairment of oxidative metabolism in pathogenesis of lower urinary tract symptoms with benign prostatic hyperplasia and their treatment by ? 1-adrenoblocker alfuzosin  

Microsoft Academic Search

The role of impairment of general oxidative and energy metabolism in pathogenesis of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) and their correction by (1-adrenoblocker alfuzosin was studied. One group of patients (N=126) was examined by standard methods for determination of the severity of LUTS by IPSS and mean effective volume of urinary bladder (MEVUB).

E. L Vishnevsky; M. N Kondrashova; D. Y Pushkar; A. A Demidov; T. V Sirota; A. V Temnov; N. V Khunderyakova; M. V Zakharchenko; N. I Kosyakova

2003-01-01

159

Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH  

PubMed Central

Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA???S-2 Introduction???S-2 Benign Prostatic Hyperplasia (BPH)???S-3 •?Overview???S-3•?Current BPH Treatment Paradigm???S-4•?BPH Continuum of Care: Bladder Health???S-5 New Treatment Option for BPH???S-5 •?The UroLift® System???S-6•?Positioning of UroLift® in BPH Treatment Paradigm???S-7 New Value Proposition???S-8 •?Addressing Bladder Health: Breaking the Cycle???S-8•?Cost Benefit Analysis: The Big Picture???S-8 Patient and Family Engagement???S-10 Summary???S-11 PMID:24070242

2013-01-01

160

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

Microsoft Academic Search

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

S. Gravas; M. Oelke

2010-01-01

161

Chinese Urologists' Views of Practice Patterns in the Diagnosis and Treatment of Benign Prostatic Hyperplasia: A Nationwide Survey  

PubMed Central

Purpose To assess the compliance of Chinese urologists with China's benign prostatic hyperplasia (BPH) clinical practice guideline and to explore the diagnosis and therapy modalities for geriatric patients with BPH. Methods A cross-sectional survey study was carried out in 33 medical centers in 11 different cities in China. A total of 190 urologists participated in a survey to record their preferences for diagnostic tests and treatment options for BPH outpatients. Diagnostic test results as well as health care demands were collected by surveying 2,027 outpatients aged 60 years and older. Results The survey response rate was 97.4%. The respondents generally used the diagnostic tests recommended in China's BPH clinical practice guideline at varying rates. The used rates for medical history, ultrasonography, and urinalysis were above 90.0%; that for uroflowmetry was 31.2%. In addition, the rate of use of recommended tests was higher among doctors in the north than among those in the south. Combination therapy with ?-adrenoceptor antagonists and 5?-reductase inhibitors was the preferred treatment option for BPH, and was increasingly used with worsening lower urinary tract symptoms. Finasteride was the most prescribed medication (48.0%), followed by tamsulosin (22.7%). Conclusions This study assessed the preferences of urologists in the diagnosis and treatment of BPH, which will serve as an important reference for updating and improving China's current BPH clinical practice guideline. PMID:23346486

Sun, Jian; Yu, Pulin; Sun, Zhenqiu

2012-01-01

162

Elevated red blood cell distribution width in benign prostatic hyperplasia patients with metabolic syndrome  

PubMed Central

Red blood distribution width (RDW) is a novel prognostic marker that reflects oxidative stress and inflammation in patients. Chronic inflammation has been proposed as a candidate mechanism between benign prostatic hyperplasia (BPH) and metabolic syndrome (MetS). However, the relationship between RDW and MetS in BPH patients is unclear. Men aged 50 year-old or older with BPH were recruited into the study. The BPH patients were classified as MetS group and non-MetS group. 69 patients without BPH and MetS were as the control group. The clinical information and RDW were measured to identify their relationship. MetS was diagnosed in 34% of the patients. The RDW values were found to be higher in the BPH group than in the control group [(13.3 ± 0.8) vs. (12.6 ± 0.8), P < 0.001]. The total prostate volume (TPV) and post void residual (PVR) urine volume were significantly higher in subject with MetS than in non-MetS and related with the number of metabolic abnormalities. High serum triglyceride and low serum high- density lipoprotein cholesterol (HDL-C) levels were significantly associated with TPV even adjusting for age (adjusted r = 0.373, P < 0.001, and adjusted r = -0.425, P < 0.001, respectively).There was a significant correlation between RDW and TPV (r = 0.370, P < 0.001), Body mass index (BMI) (r = 0.367, P < 0.001) and MetS (r = 0.276, P < 0.001). The data indicated that RDW was independently correlated with the presence of MetS (odd ratio 1.226, 95% confidence intervals 0.89-1.87, P < 0.001). MetS is associated with BPH development in men. The RDW level is significantly higher in patients with BPH than that in control. RDW is an independent predictor of MetS in BPH patients. PMID:25785115

Dong, Xingmo; Liao, Ying; Chen, Kaihong; Fang, Yong; Li, Weiguo; Chen, Jiande; You, Lixia; Li, Shuiping

2015-01-01

163

The Impact of Benign Prostatic Hyperplasia Surgical Treatment with Turp Method on the Quality of Life  

PubMed Central

Introduction/Objective Transurethral resection of the prostate (TURP) is a gold treatment method in older men who develop lower urinary tract symptoms (LUTS) which are caused by benign prostatic hyperplasia (BPH) and benign prostatic obstruction (BPO). The objective of the study was to assess the impact of BPH surgical treatment with TURP method on the quality of life, as a consequence of urinary symptoms. Material and methods The research material was based on 40 patients who, due to BPH, were treated with the method of transurethral resection. International Prostate Symptom Score (IPSS) was used in the research i.e. question Nº 8 that relates to the quality of life, as a consequence of the urinary symptoms. The criteria for the patients to be selected for this type of BPH surgical treatment were good general status of the patient, age under 80, the weight of benign prostatic gland hyperplasia tissue 30–80 grams, postvoid residual urine (PVR) higher than 150 ml, IPSS value >19 points, and Index of Quality of Life (IQL) values > 3 points. All patients, first preoperatively, and then postoperatively, gave answers to IPSS IQL in time intervals of 4, 8 and 12 weeks. Results Difference testing of IQL arithmetic means (AM) between results before the operation, then during the first, second and third checkup was performed with the t-test and Wilcoxon test of equivalent pairs, and has shown that there is a highly statistically significant difference between preoperative values and the values during all the postoperative checkups. Taking into consideration the age subgroups (20 patients between 59 and 69 years and 20 patients between 70 and 80 years), difference testing of arithmetic means between results before the operation and first, second and third checkup, isolated, for each age subgroup, was carried out. It has demonstrated that there is a statistically significant difference between preoperative values and values during all postoperative checkups. Difference testing of arithmetic means between the stated age groups has also been conducted. The t-test and Mann-Whitney test have been used for this purpose and have shown that there is no statistically significant difference between preoperative test results and the results during all postoperative checkups. Conclusion The quality of life, as a consequence of urinary symptoms, has significantly improved after the BPH treatment with TURP method. The impact of TURP on the quality of life is not related to age i.e. TURP is equally efficient regardless of patient’s age. PMID:23407383

Milicevic, Snjezana

2011-01-01

164

The Evolution of Alpha-Blockers for the Treatment of Benign Prostatic Hyperplasia  

PubMed Central

Alpha-blockers have been evaluated for the treatment of benign prostatic hyperplasia (BPH) for 30 years, from early trials with the nonselective ?-inhibitor phenoxybenzamine to short-acting (prazosin) then long-acting (terazosin, doxazosin, tamsulosin, alfuzosin) selective ?1-antagonists. All of the ?-blockers evaluated have demonstrated comparable effectiveness, and the evolution of ?-blocker therapy for BPH has therefore focused primarily on improving convenience and tolerability. Although all of the long-acting ?1-blockers are well tolerated, only tamsulosin and alfuzosin SR are administered without the requirement for dose titration. Alfuzosin has the additional advantage over tamsulosin of a lower incidence of ejaculatory dysfunction. Studies of subtype-selective ?1-antagonists have not demonstrated superior efficacy or improved tolerability over the existing long-acting ?1-blockers. PMID:17215999

Lepor, Herbert

2006-01-01

165

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

NASA Astrophysics Data System (ADS)

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

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

1999-06-01

166

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

PubMed Central

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

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

2014-01-01

167

Population-based Comparative Effectiveness of Transurethral Resection of the Prostate and Laser Therapies for Benign Prostatic Hyperplasia  

PubMed Central

Introduction As the American population ages, benign prostatic hyperplasia (BPH) and its associated lower urinary tract symptoms (LUTS) have become increasingly important causes of chronic morbidity. We assessed the comparative effectiveness of two common forms of surgical therapy, transurethral resection of the prostate (TURP) and laser therapies for BPH. Methods Using patient level discharge data and revisit files from the Agency for Healthcare Research and Quality, we evaluated a cohort of patients who underwent TURP or laser therapy for BPH in 2005 in California. Short-term outcomes (in-hospital complications, length of stay, 30-day readmission, 30-day repeat surgery, 30-day emergency room visits) were compared between the therapies through regression analysis. Long-term retreatment (defined as absence of secondary procedures for BPH or complications of therapy) was assessed with survival analysis. Analyses were adjusted for medical comorbidity, race, age, and insurance status. Results From 11,645 discharges, mean length of stay was shorter for laser patients versus TURP [0.70 versus 2.03 days respectively, (p <0.0001)]. 30-day revisits occurred in 16% of laser patients and 17.7% of TURP patients (p = 0.0338). Retreatment rates at 4 years were 8.3% for TURP and 12.8% for laser (p < 0.0001). After adjustment, TURP patients were 37% less likely to require repeat therapy than laser patients (HR 0.64; p< 0.0001). Conclusions Laser procedures and TURP both provide effective management of BPH/LUTS. Laser procedures are associated with less need for hospitalization then TURP, but appear to involve a tradeoff in long term efficacy. PMID:22341267

Strope, Seth A.; Yang, Liu; Nepple, Kenneth G.; Andriole, Gerald L.; Owens, Pamela L.

2012-01-01

168

Association between Single Nucleotide Polymorphism of Vitamin D Receptor Gene FokI Polymorphism and Clinical Progress of Benign Prostatic Hyperplasia  

PubMed Central

Background. The aim of the study was to investigate the association between single nucleotide polymorphism (SNP) of vitamin D receptor (VDR) gene and clinical progress of benign prostatic hyperplasia (BPH) in Chinese men. Methods. The DNA was extracted from blood of 200 BPH patients with operation (progression group) and 200 patients without operation (control group), respectively. The genotypes of VDR gene FokI SNP represented by “F/f” were identified by PCR-restriction fragment length polymorphism. The odds ratio (OR) of having progression of BPH for having the genotype were calculated. Results. Our date indicated that the f alleles of the VDR gene FokI SNP associated with the progression of BPH (P = 0.009). Conclusion. For the first time, our study demonstrated that VDR gene FokI SNP may be associated with the risk of BPH progress. PMID:25685834

Ruan, Li; Zhu, Jian-guo; Pan, Cong; Hua, Xing; Yuan, Dong-bo; Li, Zheng-ming; Zhong, Wei-de

2015-01-01

169

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

PubMed

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

Plosker, G L; Goa, K L

1997-02-01

170

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

Microsoft Academic Search

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

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

2000-01-01

171

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

Microsoft Academic Search

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

Mark Greenberger; Mitchell S. Steiner

1998-01-01

172

Introduction of laser technology and procedure use for benign prostatic hyperplasia: data from Florida  

PubMed Central

Objective To examine the association of laser technology adoption in a market with surgery rates for benign prostatic hyperplasia (BPH). Methods Using the Florida files from the State Ambulatory and Inpatient Surgery Databases (2001 to 2009), we identified all patients who underwent transurethral surgery for BPH. We calculated rates of BPH surgery for all markets within the state (defined by Hospital Service Area) over time. Markets were split into 3 categories: 1) always offering, 2) never offering, or 3) initially not offering but adopting laser prostatectomy after 2001. We used multivariable regression models to estimate surgery rates, adjusted for other market characteristics. Interaction terms were included in the models to examine differences in time trends between market categories. Results After adjusting for market characteristics, time trends differed by market category (p<0.001). Surgery rates decreased from 318 to 248 procedures per 100,000 men in markets always offering laser prostatectomy (p<0.001). Markets never offering laser surgery had much lower rates that remained stable (180 to 187 procedures per 100,000 men, p=0.805). In markets adopting laser technology, rates increased from 268 to 296 procedures per 100,000 men after adoption (p=0.044), such that four years after adoption these markets had the highest rates among the three categories. Conclusions Adoption of laser technology is associated with rising rates of surgical intervention for BPH. This trend appears to be induced by the introduction of laser surgery. PMID:22840735

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

2012-01-01

173

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

PubMed Central

Introduction: The Holmium laser enucleation of the prostate (HoLEP) technique to remove residual adenoma has not been reported. Salvage HoLEP enables anatomical enucleation of residual adenoma in patients who have previously undergone surgical treatment. We describe not only anatomical insights into the frequent location of adenoma recurrence, but also the feasibility of the salvage HoLEP technique. Methods: We retrospectively reviewed a database containing HoLEP video records for 35 patients out of a total of 535 individuals on whom HoLEP was performed by 2 surgeons (SJO & JSP) between July 2008 and June 2011. Group 1 consisted of patients who underwent salvage HoLEP due to recurring adenoma and Group 2 of patients who underwent HoLEP as an initially surgical management to treat benign prostate hyperplasia (BPH). We compared the dataset of pre-, intra- and postoperative parameters between Groups 1 and 2. Results: In the analysis of the video records of Group 1 (n = 35), there was significant remnant tissue around the verumontanum and the lateral lobes were also incompletely removed by previous conventional procedures. When we compared pre-, intra- and postoperative parameters between the 2 groups, there were no significant differences, including operation time, duration of hospital stay. However, the duration of the catheterization of Group 1 was shorter than that of Group 2 (1.38 ± 0.55 vs. 1.90 ± 1.81 days, p < 0.001). Conclusions: Even for cases of residual BPH, salvage HoLEP is a feasible and effective procedure for treating residual adenoma along the anatomical plane. PMID:24839489

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

2014-01-01

174

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

PubMed Central

Purpose To assess changes in lower urinary tract symptoms (LUTS), prostate volume, and serum prostate-specific antigen (PSA) after discontinuation of 5-alpha reductase inhibitor (5ARI) combination therapy in patients with benign prostatic hyperplasia (BPH). Materials and Methods From December 2003 to December 2012, data were collected retrospectively from 81 men more than 40 years of age with moderate to severe BPH symptoms (International Prostate Symptom Score [IPSS]?8). The men were classified into group 1 (n=42) and group 2 (n=39) according to the use of 5ARI therapy. A combination of dutasteride 0.5 mg with tamsulosin 0.2 mg was given daily to all patients for 1 year. For the next 1 year, group 1 (n=42) received the combination therapy and group 2 (n=39) received tamsulosin 0.2 mg monotherapy only. The IPSS, prostate volume, and PSA level were measured at baseline and at 12 and 24 months according to the use of dutasteride. Results Discontinuation of dutasteride led to significant deterioration of LUTS, increased prostate volume, and increased PSA level. The repeated-measures analysis of variance showed that the changes in IPSS, prostate volume, and PSA level over time also differed significantly between groups 1 and 2 (p<0.001). Conclusions Withdrawal of 5ARI during combination therapy resulted in prostate regrowth and deterioration of LUTS. The PSA level is also affected by the use of 5ARI. Therefore, regular check-up of the IPSS and PSA level may be helpful for all patients who either continue or discontinue the use of 5ARI. PMID:24466398

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

2014-01-01

175

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

PubMed Central

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

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

2013-01-01

176

HIGH-INTENSITY FOCUSED ULTRASOUND IN THE TREATMENT OF PROSTATIC TISSUE*  

E-print Network

- nign prostatic hyperplasia (BPH). Despite the relative success and safety of transurethral resec- tion `beam. Dif- ferent from other forms of thermal energy being used to treat BPH, ultrasound has the unique

Illinois at Urbana-Champaign, University of

177

Vitamin D receptor as a therapeutic target for benign prostatic hyperplasia  

PubMed Central

The bioactive form of vitamin D, 1?, 25-dihydroxyvitamin D3 (1?, 25(OH)2D3), is a secosteroid hormone that binds to the vitamin D receptor (VDR), a member of the nuclear receptor super-family expressed in many cell types, and modulates a variety of biological functions. 1?, 25(OH)2D3 is essential for bone and mineral homeostasis, but also regulates growth and differentiation of multiple cell types, and displays immunoregulatory and anti-inflammatory activities. The antiproliferative, prodifferentiative, antibacterial, immunomodulatory and anti-inflammatory properties of synthetic VDR agonists could be exploited to treat a variety of chronic inflammatory and autoimmune diseases, including benign prostatic hyperplasia (BPH). It has been hypothesized that VDR may influence both the risk of a variety of diseases and their occurrence and prognosis. However, earlier studies investigating the associations between specific VDR polymorphisms and various diseases often show controversial results. We performed a systematic review of the current literature on vitamin D and BPH using the PubMed and Web of Knowledge databases. The aim of this review is to summarize the current knowledge on the utility of the VDR gene regarding prostate growth as well as the pathogenesis and treatment of BPH, a complex syndrome characterized by a static component related to prostate overgrowth, a dynamic component responsible for urinary storage symptoms, and an inflammatory component. Despite the massive advances in recent decades, further research is needed to fully characterize the exact underlying mechanisms of VDR action on BPH and to comprehend how these cellular changes translate into clinical development in physical concert. PMID:23450267

Manchanda, Parmeet Kaur; Kibler, Aaron J; Zhang, Mei; Ravi, Janani; Bid, Hemant K.

2012-01-01

178

Effect of Photoselective Vaporization Prostatectomy on Lower Urinary Tract Symptoms in Benign Prostatic Hyperplasia With or Without Intravesical Prostatic Protrusion  

PubMed Central

Purpose Intravesical protrusion of the prostate (IPP) can affect voiding. We evaluated the improvement in lower urinary tract symptoms and patient satisfaction after laser prostate photovaporization in benign prostatic hyperplasia (BPH) patients with or without IPP. Materials and Methods This prospective study included 134 patients who underwent GreenLight HPS laser photoselective vaporization prostatectomy (PVP) between January 2010 and July 2011 patient. Preoperative IPP was evaluated by using the retroflexed view from flexible cystoscopy. evaluation included complete medical history, International Prostate Symptom Scores (IPSS), maximum flow rate (Qmax), postvoid residual (PVR), serum prostate-specific antigen (PSA), and transrectal ultrasonogram. Changes from baseline in Qmax, PVR, total IPSS, and IPSS subscores (voiding and storage) were analyzed at postoperative months 1, 3, and 6. Results The patients' mean age was 66.6±7.8 years. Mean serum PSA and prostate volume were 1.7±1.5 ng/mL and 42.9±16.7 g, respectively. No significant differences existed between the IPP and no IPP groups in preoperative prostate volume, total IPSS, PSA, or lasing time and energy. The mean follow-up duration was 6.2±1.9 months. IPP patients showed significant improvements in total IPSS and voiding subscores at months 1 and 3. Improvements in the quality of life score and storage subscore were not significantly different between the groups. Qmax was significantly improved at 6 months postoperatively in the IPP group versus the no IPP group. Conclusions Among patients who underwent PVP for BPH, the IPP group showed more symptom improvement, especially in voiding symptoms, than did the no IPP group. Preoperative cystoscopy is helpful for evaluating IPP and for anticipating postoperative outcome. PMID:23362446

Kim, Myung Soo; Park, Kyung Kgi; Chung, Byung Ha

2013-01-01

179

Impact of treatment of BPH on sexuality  

Microsoft Academic Search

Benign prostatic hyperplasia (BPH) can have a profound affect on a patient's quality of life and sexual function and is considered by patients to be one of the most important aspects affected by the disease. Different treatments can produce a variable response in terms of the patient's quality of life, including sexual activity and satisfaction. Varying rates of erectile dysfunction

C Schulman

2001-01-01

180

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

PubMed Central

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

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

2014-01-01

181

Non-steroidal anti-inflammatory drug use and the risk of benign prostatic hyperplasia-related outcomes and nocturia in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial  

PubMed Central

Objectives To investigate the relationship between non-steroidal anti-inflammatory drug (NSAID) use and the incidence of benign prostatic hyperplasia (BPH)-related outcomes and nocturia, a lower urinary tract symptom (LUTS) of BPH, in light of accumulating evidence suggesting a role for inflammation in BPH/LUTS development. Patients and methods At baseline, participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial completed questions on recent, regular aspirin and ibuprofen use, BPH surgery, diagnosis of an enlarged prostate/BPH, and nocturia. Participants in the intervention arm also underwent a digital rectal examination (DRE), from which prostate dimensions were estimated, as well as a prostate-specific antigen (PSA) test. Only participants in the intervention arm without BPH/LUTS at baseline were included in the analysis (n = 4771). During follow-up, participants underwent annual DREs and PSA tests, provided annual information on finasteride use, and completed a supplemental questionnaire in 2006–2008 that included additional questions on diagnosis of an enlarged prostate/BPH and nocturia. Information collected was used to investigate regular aspirin or ibuprofen use in relation to the incidence of six BPH/LUTS definitions: diagnosis of an enlarged prostate/BPH, nocturia (waking two or more times per night to urinate), finasteride use, any self-reported BPH/LUTS, prostate enlargement (estimated prostate volume ? 30 mL on any follow-up DRE) and elevation in PSA level (> 1.4 ng/mL on any follow-up PSA test). Results Generally, null results were observed for any recent, regular aspirin or ibuprofen use (risk ratio = 0.92–1.21, P = 0.043–0.91) and frequency of use (risk ratio for one category increase in NSAID use = 0.98–1.11, P-trends = 0.10–0.99) with incident BPH/LUTS. Conclusions The findings obtained in the present study do not support a protective role for recent NSAID use in BPH/LUTS development. PMID:22429766

Sutcliffe, Siobhan; Grubb, Robert L.; Platz, Elizabeth A.; Ragard, Lawrence R.; Riley, Thomas L.; Kazin, Sally S.; Hayes, Richard B.; Hsing, Ann W.; Andriole, Gerald L.

2011-01-01

182

Comparison of Effectiveness of Monopolar and Bipolar Transurethral Resection of the Prostate and Open Prostatectomy in Large Benign Prostatic Hyperplasia  

PubMed Central

Purpose Transurethral resection of the prostate (TURP) is still considered the gold standard in the treatment of benign prostatic hyperplasia (BPH). However, open prostatectomy is indicated for prostate glands over 75 ml. There have been few reports concerning the use of TURP for large prostate glands over 100 ml. Herein we compared the effectiveness of monopolar TURP, bipolar TURP, and open prostatectomy in prostate glands larger than 100 ml. Materials and Methods We reviewed the data of 48 patients with prostate glands larger than 100 ml. A total of 19, 17, and 12 patients underwent monopolar TURP (group A), bipolar TURP (group B), or open prostatectomy (group C), respectively. Preoperative International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), prostate volume, resected tissue volume, resection velocity, and operative time were documented. Postoperative hemoglobin, serum sodium change, hospital stay, and postoperative 6-month IPSS and Qmax were evaluated. Results The prostate volumes did not differ significantly among the three groups. Operative time was similar in the two TURP groups, but open prostatectomy required a longer operative time. There was no significant difference in the resected prostate tissue or resection velocity between the two TURP groups. There was a marked decrease in postoperative serum sodium in the monopolar group compared with the other two groups. Among the groups, bipolar TURP required a shorter hospitalization. Postoperative IPSS, quality of life (QoL), and Qmax improved significantly in all groups. Conclusions Even for large prostate glands, the results of this study suggest that bipolar TURP is an effective and safe operation owing to the significant improvements in voiding symptoms, shorter hospitalization, and fewer complications such as transurethral resection syndrome. PMID:21556214

Kwon, Joon Seok; Lee, Jung Woo; Lee, Seung Wook; Choi, Hong Yong

2011-01-01

183

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

Microsoft Academic Search

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

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

2000-01-01

184

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

PubMed

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

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

2011-01-01

185

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

PubMed Central

Purpose Although transurethral resection of the prostate (TURP) is considered the standard surgical treatment for benign prostatic hyperplasia (BPH), Holmium laser enucleation of the prostate (HoLEP) is replacing TURP. We compared TURP with HoLEP with matching for prostate size. Materials and Methods We retrospectively reviewed the medical charts of patients who underwent TURP and HoLEP performed by one surgeon at our institute. All patients were categorized into 3 groups on the basis of prostate size (group 1, <40 g; group 2, 40-79 g; and group 3, >80 g), and 45 patients were selected for each method. Results No major intraoperative complications were encountered. The mean resected tissue weight was 6.3, 18.3, and 28.0 g for groups 1, 2, and 3, respectively, for TURP and 8.7, 25.0, and 39.8 g, respectively, for HoLEP. The mean operation time was 51.8, 89.3, and 101.9 minutes for TURP and 83.6, 122.8, and 131.2 minutes for HoLEP in groups 1, 2, and 3, respectively. HoLEP had better resection efficacy than TURP for any size prostate, but there was no statistical difference between the methods. Both methods resulted in an immediate and significant improvement of International Prostate Symptom Score, peak urinary flow rates, and postvoid residual urine volume. Conclusions HoLEP is effective for BPH treatment, regardless of prostate size, even in a small prostate. The perioperative morbidity of HoLEP is also comparable to that of TURP. PMID:25405016

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

2014-01-01

186

Efficacy of terazosin and finasteride in symptomatic benign prostatic hyperplasia: A comparative study.  

PubMed

Medical treatment for symptomatic Benign Prostatic Hyperplasia (BPH) has become popular for the last few years. This study was designed to find out and compare the efficacy of terazosin, a alpha1 adrenoceptor blocker and finasteride, a 5alpha-reductase inhibitor in symptomatic BPH. A total of 60 patients (30 in terazosin group and 30 finasteride group) of symptomatic BPH were selected. Terazosin group received 1 mg daily at bedtime for 3 days, 2 mg at bedtime for 7 days, thereafter 5 mg at bedtime daily for 6 months. Finasteride group received 5 mg once daily. In terazosin treated patients, improvement after 3 months were as follows, IPSS 3.93 +/- .74 points reduction, Qmax 2.13 +/- .68 ml/s increase, post-voided residual urine volume (PVR) 20.67 +/- 10.56 ml reduction (significant, p<0.001) and prostate volume 0.57 +/- 1.54 ml reduction (not significant). Similar statistical differences were observed at 6 months follow up. In finasteride treated patients, improvements after 3 months were as follows, International Prostate Symptom Score (IPSS) 1.38 +/- .63 points reduction, Qmax 0.55 +/- 0.78 ml/s increase, PVR 5.93 +/- 7.64 ml reduction (significant, p<0.001) and prostate volume 0.17 +/- 5.6 ml reduction (non-significant). At 6 month follow up statistical differences were significant in all parameters including prostate volume 4.57 +/- 5.30 ml reduction (p<0.001). In comparison, statistically significant superiority of terazosin over finasteride was found in improving IPSS, Qmax and PVR in both follow up visits. But terazosin had nonsignificant effect in reducing prostate volume; in contrast, finasteride had significant effect in second visit. It can be concluded from this study that terazosin 5mg once daily is effective in mild to moderate cases of symptomatic BPH. On the other hand, finasteride 5mg once daily may be useful in large prostate and to be given for at least 6 months. PMID:16967810

Anwarul Islam, A K M; Kashem, M A; Shameem, I A; Kibria, S A M G

2005-08-01

187

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

PubMed Central

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

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

2012-01-01

188

Factors related to delayed treatment and posttreatment symptom severity in Taiwanese patients with benign prostatic hyperplasia.  

PubMed

We evaluated the sociodemographic and clinical factors of delayed treatment and posttreatment symptom severity in outpatients with benign prostatic hyperplasia (BPH). The study included 146 BPH patients treated at the National Taiwan University Hospital in early 1997. All patients were treated with alpha-adrenergic antagonists or finasteride for at least 2 weeks. A questionnaire based on Andersen's Health Behavior Model was used to assess various sociodemographic features, while the pre- and posttreatment symptoms severity was rated according to the International Prostate Symptom Score (IPSS). Multiple logistic regression was used to assess the associations of these factors with delayed treatment and posttreatment symptom severity. Subjects who had recently quit smoking or were blue-collar workers tended to delay treatment, while those who chose a medical center as the care provider for chronic diseases tended to be less likely to delay treatment. However, none of these associations were statistically significant. No enabling factors (income, insurance) or need factors (symptom scores) evaluated were associated with delayed treatment. Predisposing factors associated with higher posttreatment symptom severity were delayed treatment (over 12 months) (adjusted odds ratio [OR]: 2.67, 95% confidence interval [CI]: 1.16-6.16), quitting smoking (adjusted OR: 4.47, 95% CI: 1.34-14.94), and having never smoked (adjusted OR: 3.73, 95% CI: 1.15-12.11). Subjects with severe pretreatment symptoms were far more likely than subjects with mild pretreatment symptoms to have severe symptoms after treatment (adjusted OR: 52.69, 95% CI: 54.46-621.90). Our findings, though based on a limited number of subjects, suggest sociodemographic factors rather than objective clinical attributes (prostate specific antigen level, prostate volume, and urodynamic results) are associated with delayed treatment in Taiwanese men with BPH. Both pretreatment symptom severity and sociodemographic factors are related to posttreatment symptom severity. PMID:9872032

Chang, C K; Yu, H J; Chan, K W; Chie, W C; Chen, J; Chen, Y T; Lai, M K

1998-11-01

189

120 W Greenlight HPS Laser Photoselective Vaporization of the Prostate for Treatment of Benign Prostatic Hyperplasia in Men with Detrusor Underactivity  

PubMed Central

Purpose Most men with benign prostatic hyperplasia (BPH) have bothersome lower urinary tract symptoms (LUTS). This study aimed to investigate the safety and efficacy of high-performance system (HPS) laser photoselective vaporization of the prostate (PVP) for the treatment of BPH in men with detrusor underactivity (DU). Materials and Methods From March 2009, 371 patients with BPH were divided into 2 groups according to the findings of preoperative urodynamic study: 239 (64.4%) patients with bladder outlet obstruction (BOO) and 132 (35.6%) patients with bladder outlet obstruction with detrusor underactivity (BOO+DU). 120 W HPS laser PVP was performed to resolve the BOO. The perioperative data and postoperative results at 1 month and 12 months, including the International Prostate Symptom Score (IPSS), maximum urinary flow (Qmax), and postvoid residual urine (PVR) values, were evaluated. Results Compared with the preoperative parameters, significant improvements in IPSS, Qmax, and PVR were observed in each group at 1 and 12 months after the operation. In addition, IPSS, Qmax, and PVR were not significantly different between the BOO and BOO+DU groups at 1 and 12 months after the operation. Conclusions Surgery to relieve BOO in the patients with BPH seems to be an appropriate treatment modality regardless of the existence of DU. PMID:22216394

Choi, Sae Woong; Choi, Yong Sun; Bae, Woong Jin; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung Hoo; Lee, Ji Youl; Hwang, Tae Kon

2011-01-01

190

National Trends in Surgical Therapy for Benign Prostatic Hyperplasia in the United States (2000-2008)  

PubMed Central

Introduction The rate of utilization of thermotherapy and laser therapy in the surgical treatment of benign prostatic hyperplasia (BPH) has been changing over the past decade in conjunction with a steady decrease of TURP. We now report an update of the change in utilization trends for different surgical treatments of BPH among the United States Medicare population data 2000-2008. Methods Using the 100% Medicare carrier file for the years 2000-2008 we calculated counts and population-adjusted rates of BPH surgery. Rates of TURP, thermotherapy and laser-utilizing modalities were calculated and compared in relation to age, race, clinical setting, and reimbursement. Results After years of a steady rise, the total rate of all BPH procedures peaked in 2005 at 1,078/100,000 then declined by 15.4% to 912/100,000 in 2008. TURP rates continued to decline from 670 in 2000 to 351/100,000 in 2008. Rates of TUMT peaked in 2006 at 266/100,000 then declined 26% in 2008. Laser vaporization almost completely replaced laser coagulation and in 2008, was the most commonly performed procedure second to TURP with the majority performed as outpatient procedures (70%) and an increasing percentage in the office (12%). Men between ages 70-75 had the highest rate of procedures. Reimbursement rates correlate with the use of some but not all procedures. Racial disparities reported previously appear to have resolved. Conclusions Surgical treatment of BPH continues to change rapidly. TURP continues to decline and laser vaporization is the fastest growing modality. There is a big shift towards outpatient/office procedures. Reimbursement rates do not appear to have a consistent effect on utilization. PMID:22546389

Malaeb, Bahaa S; Yu, Xinhua; McBean, A. Marshall; Elliott, Sean P

2012-01-01

191

Promising Molecular Targets and Biomarkers for Male BPH and LUTS  

PubMed Central

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

Gharaee-Kermani, Mehrnaz; Macoska, Jill A.

2013-01-01

192

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

Microsoft Academic Search

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

Mark J. Speakman

1999-01-01

193

The Urologist View of BPH Progression: Results of an International Survey  

Microsoft Academic Search

Objectives: To assess the opinion amongst the international urological community on whether benign prostatic hyperplasia (BPH) is a progressive disease.Methods: A 15-item questionnaire was distributed to the mailing list of the publication European Urology Today as well as being accessed through the website of the European Association of Urology (EAU). The survey included questions on: whether BPH was a progressive

B. Djavan; J. C. Nickel; J. de la Rosette; P. Abrams

2002-01-01

194

GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia: a prospective randomized trial.  

PubMed

The most recent advance in laser treatment of benign prostatic hyperplasia (BPH) is the introduction of a high-performance system (HPS) 120-W laser. The HPS laser beam at a wavelength of 532~nm is highly absorbed by oxyhemoglobin in the tissue and maintains focus with negligible divergence up to 3 mm from the fiber and with limited divergence at 5 mm. This study is designed to evaluate the three-year clinical efficacy and safety of photoselective vaporization of the prostate (PVP, n=100 cases) with GreenLight HPS laser compared with transurethral resection of the prostate (TURP, n=100 cases) for treatment of BPH. The results showed that the mean operating time, catheterization time and admission time were significantly shorter in the PVP group, respectively. There were dramatic improvements in International Prostate Symptom Score (IPSS), quality of life (Qol), maximum flow rate (Qmax) and postvoid residual (PVR) compared with preoperative values and the degree of improvements was comparable in both groups. The intraoperative complications were lower in PVP group. In summary, PVP is an effective technique in patients with BPH, when compared to TURP, producing equivalent improvements in IPSS, Qmax, Qol and PVR with the advantages of markedly reduced catheterization time, admission time and adverse events. PMID:23507858

Xue, Boxin; Zang, Yachen; Zhang, Yuanyuan; Yang, Dongrong; Gao, Jie; Sun, Chuanyang; Cui, Yong; Zhu, Jin; Liu, Xiaolong; Shan, Yuxi

2013-01-01

195

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

PubMed Central

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

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

2011-01-01

196

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

PubMed

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

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

2015-04-01

197

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

PubMed

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

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

2005-01-01

198

Immunohistochemical expression of heat shock proteins, p63 and androgen receptor in benign prostatic hyperplasia and prostatic carcinoma in the dog.  

PubMed

This study compared heat shock proteins Hsp60, Hsp72 and Hsp73, along with p63 and androgen receptor (AR) immunoexpression between 16 cases of benign prostatic hyperplasia (BPH) and 11 prostatic carcinomas (PCa) in dogs. The proportion of Hsp60-positive cells was higher in PCa compared with BPH (P?=?0.033), whereas the frequency and intensity of Hsp73 immunostaining did not differ significantly between the two groups. Hsp72-immunostained nuclei formed a discontinuous layer along the basement membrane in BPH, whereas cells in this layer in PCa were negative or weakly positive. Hsp72 nuclear score showed significant positive associations with both p63 (P?=?0.016) and AR (P?=?0.009) scores. Double immunofluorescence revealed Hsp72-p63 and Hsp72-AR co-expressions in basal cell nuclei. Aberrant cytoplasmic p63 immunolabelling was observed in 3 of 11 PCa cases. These results suggest a role of the combined expression of Hsp72, p63 and AR in basal epithelial cells in canine BPH and PCa. PMID:25059752

Romanucci, M; Frattone, L; Ciccarelli, A; Bongiovanni, L; Malatesta, D; Benazzi, C; Brachelente, C; Della Salda, L

2014-07-25

199

Differential adoption of laser prostatectomy for treatment of benign prostatic hyperplasia  

PubMed Central

OBJECTIVE To evaluate whether socioeconomic environment affects the adoption of new laser technology for treatment of benign prostatic hyperplasia (BPH). METHODS Using all payer data, we identified all discharges for laser prostatectomy or transurethral resection of the prostate (TURP) performed in Florida (2001–2009). We determined whether or not each of 114 healthcare markets (Hospital Service Areas) offered laser prostatectomy or TURP and assessed the market-level socioeconomic environment using a previously described ZIP code based summary score. We used generalized estimating equations to examine the association of socioeconomic environment with offering laser prostatectomy or TURP, adjusting for additional market characteristics. RESULTS Better socioeconomic environment was associated with offering laser prostatectomy (odds ratio 1.21 for each 1 point increase in summary score, 95% confidence interval 1.08–1.35, P <.001). Adoption of laser prostatectomy over time was more rapid in markets with superior socioeconomic environment (P <.001 for interaction of socioeconomic summary score with year), such that by study midpoint, 82% of advantaged vs 54% of disadvantaged markets had adopted this new technology. In contrast, socioeconomic environment had only minimal effects on whether or not a market offered TURP. CONCLUSION We found delayed access to new laser technology in more disadvantaged socioeconomic environments, which may translate into disparities in certain outcomes after transurethral surgery for BPH. PMID:23522295

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

2013-01-01

200

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

Microsoft Academic Search

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

Stavros Gravas; Matthias Oelke

2010-01-01

201

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

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

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

1995-01-01

202

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

PubMed Central

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

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

2014-01-01

203

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

PubMed Central

Purpose There is little data evaluating the changes of severity of bladder outlet obstruction after 80 W-potassium-titanyl-phosphate (KTP) photoselective laser vaporization prostatectomy (PVP) by pressure-flow study. We evaluated the efficacy of PVP to relieve the obstruction in benign prostate hyperplasia (BPH) compared with transurethral resection of the prostate (TURP). Materials and Methods This is a prospective, non-randomized single center study. The inclusion criteria were as follows: Men suffering from lower urinary tract symptoms (LUTS) secondary to BPH, age ?50 years, International Prostatic Symptom Score (IPSS) ?13, maximum flow rate (Qmax) ?15 ml/s, and ability to give fully informed consent. Patients with neurogenic cause or detrusor underactivity were excluded. The IPSS, bother score, Qmax, postvoid residual volume (PVR), detrusor pressure at maximum flow rate (PdetQmax), bladder outlet obstruction index (BOOI), and prostate volume were measured before and 6 months after surgery and compared between PVP and TURP. Results Sixty-seven patients (53 in PVP, 14 in TURP) were evaluable. In both groups, the IPSS, bother score, Qmax, and PVR had significantly improved (p<0.05), and there were no differences between the changes in those parameters. PVP could effectively reduce the PdetQmax, prostate volume, and BOOI from baseline (from 68.7±23.3 to 40.6±11.2 cmH2O, 49.5±16.3 to 31.3±12.1 ml, 49.8±25.6 to 9.8±20.7), similar to TURP. There were no differences in postoperative PdetQmax, prostate volume, or BOOI between the two groups. The percentage of patients with BOOI ?40 was decreased from 64% to 4% in the PVP group and from 86% to 14% in the TURP group. Conclusions PVP could reduce the prostate volume effectively and relieve bladder outlet obstruction similar to TURP by the 6-month follow up in men with BPH. PMID:23596606

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

2012-01-01

204

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

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

2014-01-01

205

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

PubMed Central

Chinese herbal medicine is commonly used as a treatment for benign prostatic hyperplasia (BPH), but its efficacy and safety remain to be examined. To compare the efficacy and adverse events of Chinese herbal medicine alone or used adjuvantly with Western medications for BPH. Two independent reviewers searched the major electronic databases for randomized controlled trials comparing Chinese herbal medicine, either in single or adjuvant use with Western medication, with placebo or Western medication. Relevant journals and grey literature were also hand-searched. The outcome measures included changes in urological symptoms, urodynamic measures, prostate volume and adverse events. The frequency of commonly used herbs was also identified. Out of 13 922 identified citations of publications, 31 studies were included. Eleven studies with a Jadad score ?3 were selected for meta-analysis. Chinese herbal medicine was superior to Western medication in improving quality of life and reducing prostate volume. The frequency of adverse events in Chinese herbal medicine was similar to that of placebo and less than that of Western medication. The evidence is too weak to support the efficacy of Chinese herbal medicine for BPH due to the poor methodological quality and small number of trials included. The commonly used herbs identified here should provide insights for future clinical practice and research. Larger randomized controlled trials of better quality are needed to truly evaluate the efficacy of Chinese herbal medicine. PMID:23728585

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

2013-01-01

206

A possible role of decreased relaxation mediated by beta-adrenoceptors in bladder outlet obstruction by benign prostatic hyperplasia.  

PubMed Central

1. To explore mechanisms of urinary obstruction in benign prostatic hyperplasia (BPH), the features of contraction and relaxation in human hyperplastic and non-hyperplastic (control) prostatic tissues were investigated for beta- and alpha 1-adrenoceptors by radioligand binding and in vitro isometric tension experiments. 2. Hyperplastic and control prostatic tissues had a similar number (per mg protein) of prazosin binding sites with similar affinities. Noradrenaline (NA) induced dose-dependent contraction in both tissues. Contraction induced by either exogenous NA or transmural stimulation was inhibited by prazosin in both tissues, indicating that the same contractile mechanisms mediated by alpha 1-adrenoceptors exist in hyperplastic and control tissues. 3. The number of dihydroalprenolol (DHA) binding sites (per mg protein) was less in hyperplastic tissues than in controls, whereas the affinity to the ligand was identical in both tissues. Isoprenaline caused a marked relaxation of the tonic contraction induced by KCl in control tissues, but not in hyperplastic tissues. Propranolol enhanced exogenous NA- or transmural stimulation-induced contraction more in control tissues than in hyperplastic tissues. Both tissues, however, similarly responded to forskolin by relaxation. 4. These results indicate that decreased beta-adrenoceptor-mediated relaxation in hyperplastic prostatic tissues, which is attributable at least in part to the decreased number of beta-adrenoceptors, may play a role in the urinary obstruction of BPH in addition to mechanical compression of the urethra by the enlarged prostate. PMID:1282075

Tsujii, T.; Azuma, H.; Yamaguchi, T.; Oshima, H.

1992-01-01

207

The use of alpha1-adrenoceptor antagonists in lower urinary tract symptoms: beyond benign prostatic hyperplasia.  

PubMed

The first empirical use of alpha(1)-adrenoceptor antagonists in urology occurred about 25 years ago in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), or LUTS/BPH. Today, many randomized, controlled trials have provided evidence for the efficacy and tolerability of alpha(1)-adrenoceptor antagonists in LUTS/BPH, and they are the most frequently used initial treatment option for this cause of LUTS. For many years, alpha(1)-adrenoceptor antagonists have also been used empirically in other types of lower urinary tract dysfunction (LUTD), such as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and neurogenic LUTD (NLUTD). Several investigators have shown that alpha(1)-adrenoceptor antagonists may be useful in patients with CP/CPPS. This was recently confirmed by a 6-week, double-blind, placebo-controlled pilot study evaluating the efficacy and safety of tamsulosin in 58 CP/CPPS patients. Further well-designed and -powered research into the use of alpha(1)-adrenoceptor antagonists in patients with CP/CPPS is currently ongoing. Several small-scale predominantly open-label studies have suggested that alpha(1)-adrenoceptor antagonists may be of benefit in patients with NLUTD. Data from 2 recent large-scale studies with tamsulosin in patients with NLUTD caused by suprasacral spinal cord injury suggest that long-term tamsulosin treatment improves bladder storage and emptying and also reduces symptoms of autonomic dysreflexia. Tamsulosin has also shown promise in ameliorating (early) storage symptoms and urinary retention associated with transurethral microwave thermotherapy, external-beam radiotherapy, and brachytherapy. In BPH patients presenting with the ultimate form of LUTS-acute urinary retention-treatment with tamsulosin before catheter removal results in a higher success rate of catheter-free voiding. Finally, it seems that alpha(1)-adrenoceptor antagonists may reduce the occurrence of urinary retention after (general) surgery. We can therefore conclude that alpha(1)-adrenoceptor antagonists, such as tamsulosin, may be useful for treating men with LUTS beyond BPH. PMID:12957198

Nickel, J Curtis

2003-09-01

208

[Significance of 5-alpha-reductase inhibitors in therapy of benign prostatic hyperplasia with mild to modern symptoms].  

PubMed

Medical therapy in the treatment of symptomatic benign prostatic hyperplasia has changed very much during the last few years. Finasteride is a 5-alpha-reductase inhibitor, which inhibits the predominant intraprostatic isoenzyme II of 5-alpha-reductase and therefore DHT, which is-among other factors-essential for the physiological growth of the prostate. However, it also has an important influence on developing BPH. It was shown in several studies that finasteride can increase urinary flow rates, decrease the prostate volume, and improve the symptom score and PSA value. The objective improvement in urinary flow rates was only moderate, but better results were obtained in the improvement of patient symptoms. Large multicenter studies will be conducted to see if the efficacy of treatment can be improved by combination therapy with alpha-1-blockers. PMID:9123679

Wirth, M P; Helke, C; Froschermaier, S E

1997-01-01

209

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

PubMed Central

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

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

2014-01-01

210

Prevalent Decrease of the EGF Content in the Periurethral Zone of BPH Tissue Induced by Treatment With Finasteride or Flutamide  

Microsoft Academic Search

The aim of the present investigation is to verify wheth- er treatment with Finasteride or Flutamide influences the regional distribution of testosterone (T), dihydrotestosterone (DHT), and epi- dermal growth factor (EGF) in benign prostatic hyperplasia (BPH) tissue. Thirty seven BPH patients were studied: 15 untreated, 9 treated with Flutamide (750 mg\\/day for 2 months), and 13 treated with Finasteride (5

SALVATORE MONTI; FRANCESCO SCIARRA; M. VITTORIA ADAMO; VINCENZO TOSCANO; M. CRISTINA TROTFA; CHIARA MARTINI; STEFANIA LANZARA; FRANCO D. SILVERIOt; W. Demark-Wahnefried; S. M. Lesko; M. R. Conaway; C. N. Robertson; R. V. Clark; B. Lobaugh; B. J. Mathias; T S. Strigo; D. E Paulson

211

Recent advances in the surgical treatment of benign prostatic hyperplasia.  

PubMed

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

Rocco, Bernardo; Albo, Giancarlo; Ferreira, Rafael Coelho; Spinelli, Matteo; Cozzi, Gabriele; Dell'orto, Paolo; Patel, Vipul; Rocco, Francesco

2011-12-01

212

Recent advances in the surgical treatment of benign prostatic hyperplasia  

PubMed Central

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

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

2011-01-01

213

[Influence of antioxidants on the development of benign prostatic hyperplasia].  

PubMed

The main objectives of the study was the evaluation of concentration of endogenous antioxidants (Vitamins E, A, C and Beta-carotene) in the blood plasma of elderly men and to determine their roles in the development of benign prostatic hyperplasia. There were carried out investigations in 110 men during 2003-2006 in the Urological Clinic of the Tbilisi State Medical Academy. 71 patient entered into the main group (65-81 years old), who were diagnosed for benign prostate hyperplasia. The control group included 30 men (60-80 years old) who did not suffer from the typical signs of benign prostatic hyperplasia. Besides, to evaluate normal levels of endogenous antioxidants (Vitamins E, A, C and Beta-carotene) concentration in the blood plasma additionally were studied young practically healthy 10 persons (20-35 years old), they compiled the second control group. Our study showed that endogenous antioxidants concentration reduces in the blood plasma with the age, this reduction becomes more obvious with the clinical detection of prostate benign hyperplasia. It is recommended for elderly patients to control periodically the endogenous antioxidants level (Vitamins A, C, E and Beta-carotene) in the blood plasma and in the case of changes to get food enriched with vitamins or combined vitamins preparations. This will be accomplice factor for the prophylactic of benign prostatic hyperplasia. This will be prophylactic activity during the conservative treatment process (by alpha-adrenoceptor blocking drugs, phytotherapy medicines, 5 alpha-reductase inhibitors and others). Inclusion of vitamins complexes which contains antioxidants is necessary. Prescription of antioxidants complex after the operative treatment will accelerate the healing process and reduce the rehabilitation period. PMID:17179581

Mchedlidze M G, M G; Shioshvili, T I

2006-11-01

214

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

PubMed Central

Purpose: This study was performed to describe and evaluate the management of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) by general practitioners (GPs) in Jakarta. Methods: This observational cross-sectional study was peformed between January 2013 and August 2013 in Jakarta. We developed a questionnaire consisting of 10 questions describing the management of male LUTS suggestive of BPH by GPs in their daily practice in the previous month. We collected questionnaires from 200 GPs participating in 4 urology symposiums held in Cipto Mangunkusumo Hospital, Jakarta. Results: Most GPs were aged between 25 and 35 years (71.5%) and had worked for more than 1 year (87.5%). One to 5 cases of male LUTS suggestive of BPH were treated by 81% of GPs each month. At diagnosis, the most common symptoms found were urinary retention (55.5%), frequency (48%), and nocturia (45%). The usual diagnostic workup included digital rectal examination (65%), scoring system (44%), measurement of prostate-specific antigen (PSA) level (23.5%), and renal function assessment (20%). Most GPs referred their male patients with LUTS suggestive of BPH to a urologist (59.5%) and 46.5% of GPs prescribed drugs as an initial therapy. Alpha-adrenergic antagonist monotherapy (71.5%) was the most common drug prescribed. Combination therapy with ?-adrenergic antagonists and 5?-reductase inhibitors was not routinely prescribed (13%). Thirty-eight percent of GPs referred their patients when recurrent urinary retention was present and 33% when complications were present. Conclusions: Our study provides evidence that the management of male LUTS suggestive of BPH by GPs in Jakarta suggests referral in part to available guidelines in terms of diagnostic methods and initial therapy. However, several aspects of the guidelines, such as PSA level measurement, renal function assessment, urinalysis, ultrasound examination, and prescription of combination therapies, are still infrequently performed. PMID:25032196

Matondang, Faisal Abdi; Rahardjo, Harrina Erlianti

2014-01-01

215

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

PubMed Central

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

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

2015-01-01

216

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

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

Takada, Junya; Honda, Norihiro; Hazama, Hisanao

2014-01-01

217

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

PubMed Central

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

Hueber, Pierre-Alain; Zorn, Kevin C.

2013-01-01

218

What patients take without telling you: holistic approach for BPH  

Microsoft Academic Search

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

Jillian L. Capodice; Aaron E. Katz

2006-01-01

219

Dose-response effect of Red Maca (Lepidium meyenii) on benign prostatic hyperplasia induced by testosterone enanthate.  

PubMed

The main goal of this study was to determine the effect of a freeze-dried aqueous extract of the red variety of Lepidium meyenii (Red Maca) on testosterone-induced benign prostatic hyperplasia (BPH) in adult rats of the Holtzman strain. Rats were treated with freeze-dried aqueous extract of Red Maca at doses of 0, 0.01, 0.05, 0.1, and 0.5 g/kg body wt. A positive control group received Finasteride (0.6 mg/kg body wt.). After treatment, the animals were sacrificed, and the ventral prostate was extracted, and weighed. HPLC was used to determine the presence of glucosinolates in Red Maca. The prostate weight diminished in a dose-dependent fashion in rats treated with Red Maca. The effect of Red Maca was better than that observed with Finasteride. Finasteride, but not Red Maca, reduced seminal vesicles weight. Analysis of the HPLC indicated the presence of benzyl glucosinolate (Glucotropaeolin) with a content of 0.639%. Serum testosterone levels were not affected by Red Maca. Moreover, serum testosterone levels were not related to prostate or seminal vesicles weight in rats treated with vehicle and Red Maca. In conclusion, Red Maca administered orally in rats seems to exert an inhibitory effect at a level post DHT conversion, on the BPH-induced experimentally, although a direct measure of reductase action would still be required. PMID:17289361

Gasco, M; Villegas, L; Yucra, S; Rubio, J; Gonzales, G F

2007-08-01

220

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

PubMed Central

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.

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

2015-01-01

221

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

PubMed

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

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

2015-01-01

222

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

PubMed Central

Naftopidil, approved only in Japan, is an ?1-adrenergic receptor antagonist (?1-blocker) used to treat lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Different from tamsulosin hydrochloride and silodosin, in that it has higher and extremely higher affinity respectively, for the ?1A-adrenergic receptor subtype than for the ?1D type, naftopidil has distinct characteristics because it has a three times greater affinity for the ?1D-adrenergic receptor subtype than for the ?1A subtype. Although well-designed large-scale randomized controlled studies are lacking and the optimal dosage of naftopidil is not always completely determined, previous reports from Japan have shown that naftopidil has superior efficacy to a placebo and comparable efficacy to other ?1-blockers such as tamsulosin. On the other hand, the incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may be lower than for tamsulosin and silodosin having high affinity for the ?1A-adrenergic receptor subtype. However, it remains unknown if the efficacy and safety of naftopidil in Japanese is applicable to white, black and Hispanic men having LUTS/BPH in western countries. PMID:21753885

Masumori, Naoya

2011-01-01

223

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

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

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

2014-01-01

224

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

Microsoft Academic Search

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

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

2004-01-01

225

Feedback microwave thermotherapy versus TURP for clinical BPH—a randomized controlled multicenter study  

Microsoft Academic Search

Objectives. To compare the outcome of a microwave thermotherapy feedback system that is based on intraprostatic temperature measurement during treatment (ProstaLund Feedback Treatment or PLFT) with transurethral resection of the prostate (TURP) for clinical benign prostatic hyperplasia (BPH) in a randomized controlled multicenter study. The safety of the two methods was also investigated.Methods. The study was performed at 10 centers

Lennart Wagrell; Sonny Schelin; Jorgen Nordling; Jonas Richthoff; Bo Magnusson; Moddy Schain; Thayne Larson; Emmett Boyle; Jens Duelund; Kurt Kroyer; Håkan Ageheim; Anders Mattiasson

2002-01-01

226

Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia.  

PubMed

We evaluated the relationship between prostatic resistive index (RI) and cardiovascular system (CVS) risk factors in patients with benign prostatic hyperplasia. The study included 120 patients who were attending our outpatient clinic with lower urinary tract symptoms related to benign prostatic hyperplasia. The clinical, laboratory, anthropometric data, and CVS risk factors (hypertension, diabetes mellitus, metabolic syndrome, history of CVS events, and smoking) of the patients were evaluated regarding the association between prostate RI level by regression analyses. The prostatic RI levels of the patients were measured using power Doppler imaging. In univariate regression analysis, there were statistically significant relationships between prostatic RI levels and the patients' age, International Prostate Symptom Score, hip circumference, fasting blood glucose, prostate specific antigen, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total prostate volume, uroflowmetric maximal flow rate, and all investigated CVS risk factors (p < 0.05). The prostatic RI levels were found to be associated with fasting blood glucose and total prostate volume, and also with CVS risk factors including only metabolic syndrome and cigarette smoking in the multivariate regression analysis. Our results showed that prostatic RI level is significantly related to metabolic syndrome and smoking among the investigated CVS risk factors. PMID:25835275

Baykam, Mehmet Murat; Aktas, Binhan Kagan; Bulut, Suleyman; Ozden, Cuneyt; Deren, Tagmac; Tagci, Suleyman; Gokkaya, Cevdet Serkan; Memis, Ali

2015-04-01

227

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

PubMed

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

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

2014-05-01

228

Rapid and Simple Determination of Plasma and Erythrocyte MDA Levels in Prostate Cancer Patients by a Validated HPLC Method  

Microsoft Academic Search

We undertook the present study to develop a validated HPLC method for the determination of malondialdehyde (MDA) levels and to use this method for determination of MDA levels in patients with prostate cancer and benign prostatic hyperplasia.MDA levels were estimated in the erythrocyte and plasma sample of the 25 non?metastatic prostate cancer patients, 36 benign prostatic hyperplasia (BPH) patients and

Ahmet Aydin; Ahmet Sayal; Ay?e Eken; Onur Erdem; Ayhan Sava?er; Koray Erten; Ya?ar Özgök; Aleksandar Dimovski

2007-01-01

229

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

Microsoft Academic Search

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

J Hammarsten; B Högstedt; N Holthuis; D Mellström

1998-01-01

230

The Canadian Benign Prostatic Hyperplasia Audit Study (CanBas) ORIGINAL RESEARCH  

Microsoft Academic Search

Objective: To determine the prevalence, diagnostic patterns and management of lower urinary tract symptoms (LUTS) associated with benign prostatic hyper- plasia (BPH) in Canadian urology outpatient practice. Methods: Representative urologists were randomly selected from lists provided by the Canadian and Quebec Urological Associations. Each patient identified with a BPH diagnosis during a typical 2-consecutive-week period during April, May or June

J. Curtis Nickel; Joe Downey; Francois Bénard; Michael Chetner; John Grantmyre; Alan So; Paul Whelan

231

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

PubMed Central

Purpose To identify potential predictive factors of incidental prostate cancer (IPca) in patients considering tissue-ablation treatment for benign prostatic hyperplasia (BPH). Materials and Methods From the 11 centers, 1,613 men who underwent transurethral resection of the prostate (TURP) or open prostatectomy were included. Before surgery, prostate biopsy was performed in all patients with prostate-specific antigen (PSA) ?4.0 ng/ml or with abnormal digital rectal examination (DRE) findings. The patients with prostate cancer preoperatively or with PSA >20 ng/ml were excluded. As predictive factors of IPca, age, body mass index, PSA, DRE, and transrectal ultrasonography (TRUS) findings, including total prostate volume (TPV), transition zone volume (TZV), and the presence of hypoechoic lesions, were reviewed. PSA density (PSAD) and PSAD in the transition zone (PSAD-TZV) were calculated. Results IPca was diagnosed in 78 patients (4.8%). DRE findings, PSA, and TZV were independent predictive factors in the multivariate analysis. In the receiver operating characteristic curve analysis of PSA, PSAD, and PSAD-TZV, the area under the curve (AUC) was the largest for PSAD-TZV (AUC, 0.685). Conclusions IPca was detected in 4.8% of the population studied. In addition to DRE findings, the combination of TZV and PSA can be useful predictive factors of IPca in patients considering tissue-ablation treatment as well as TURP. PMID:22741046

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

2012-01-01

232

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

PubMed Central

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

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

2014-01-01

233

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

PubMed Central

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

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

2012-01-01

234

The prevention and treatment effects of tanshinone IIA on oestrogen/androgen-induced benign prostatic hyperplasia in rats.  

PubMed

Benign prostatic hyperplasia (BPH) is one of the major diseases of the urinary system in elderly men. Tanshinone IIA (Tan IIA) is the active ingredient extracted from the traditional Chinese medicine Salvia, and it has effects of anti-oxidation, anti-inflammation, vascular smooth muscle relaxation and tumour growth inhibition. The present study aimed to investigate the therapeutic potential of Tan IIA in the prevention and treatment of BPH. In a rat model of oestradiol/testosterone-induced BPH, Tan IIA inhibited the increase in the thickness of the peri-glandular smooth muscle layer, suppressed the expression of proliferating cell nuclear antigen (PCNA) in both prostate epithelial cells and stromal cells, downregulated the expression of androgen receptor (AR), oestrogen receptor ? (ER?), cyclin B1 (CCNB1) and cyclin D1 (CCND1), and effectively prevented the development of the disorder. In vitro, Tan IIA inhibited the proliferation of human prostate stromal cell line WPMY-1 and epithelial cell line RWPE-1 in a dose- and time-dependent manner. In WPMY-1 cells, Tan IIA treatment arrested the cell cycle at the G2/M phase and downregulated the expression of CCNB1. However, in RWPE-1 cells, Tan IIA treatment arrested cell cycle at the G0/G1 phase and reduced the expression of CCND1. Tan IIA also reduced the expression of ER? and AR in WPMY-1 and RWPE-1 cells. These results suggest that Tan IIA can inhibit the growth of prostate stromal and epithelial cells both in vivo and in vitro by a mechanism that may involve arresting the cell cycle and downregulating ER? and AR expression. PMID:25290459

Wang, Chao; Du, Xiaoling; Yang, Rui; Liu, Jie; Xu, Da; Shi, Jiandang; Chen, Linfeng; Shao, Rui; Fan, Guanwei; Gao, Xiumei; Tian, Guo; Zhu, Yan; Zhang, Ju

2015-01-01

235

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

NASA Astrophysics Data System (ADS)

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

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

2001-07-01

236

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

PubMed Central

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

Dimitropoulos, Konstantinos; Gravas, Stavros

2015-01-01

237

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

PubMed Central

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

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

2014-01-01

238

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

SciTech Connect

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

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

2013-08-01

239

Estrogen receptor-alpha is a key mediator and therapeutic target for bladder complications of benign prostatic hyperplasia  

PubMed Central

Purpose While estrogens are important in prostate growth and play a role in benign prostatic hyperplasia (BPH), no current therapies directly target estrogen action. Estrogens act primarily via estrogen receptor alpha (ER?) and estrogen receptor beta (ER?). Using a mouse model, we evaluated the relative contribution of these receptors to bladder complications of BPH. We also evaluated prevention of these bladder complications by selective estrogen receptor modulators (SERMs), raloxifene and tamoxifen (ER? selective antagonists) and (R,R)-5,11-Diethyl-5,6,11,12-tetrahydro-2,8-chrysenediol (R,R-THC, ER? selective antagonist). Materials and Methods Adult male C57bl/6 mice received implants of 25 mg testosterone (T) and 2.5 mg 17?-estradiol (E2) slow release pellets and untreated controls underwent sham surgery. We used ER? and ER? knockout (KO) mice compared to their respective wild type (WT) littermates to probe contributions of ER subtypes. WT mice treated with T+E2 were compared to mice treated with T+E2 and 25 mg SERM to evaluate prevention of BPH complications with SERMs. Results While ER?WT and ER?WT littermates treated with T+E2 developed large bladders with urinary retention, ER?KO mice treated with T+E2 did not. ER?KO mice treated with T+E2 developed large bladders with urinary retention and increased bladder mass. Co-treatment with the ER? antagonist raloxifene resulted in decreased bladder mass compared to WT mice treated with T+E2, while bladders from mice treated with the ER? antagonist R,R-THC were similar to T+E2-treated mice. Conclusions ER?, but not ER?, is a key mediator of bladder complications of BPH, and is a potential target for future therapies. PMID:25167991

Nicholson, Tristan M.; Moses, Michael A.; Uchtmann, Kristen S.; Keil, Kimberly P.; Bjorling, Dale E.; Vezina, Chad M.; Wood, Ronald W.; Ricke, William A.

2014-01-01

240

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

PubMed

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

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

2004-01-01

241

Long-Term Aspects of Medical Treatment of BPH  

Microsoft Academic Search

Acute urinary retention (AUR) is an important complication of benign prostatic hyperplasia (BPH) and can affect 0.4–25% of men seen in urological practice each year. AUR is also one of the main indications for surgery, being the presenting features of 25–30% of transurethral resection of the prostate (TURP). However, TURP conducted under these conditions is associated with higher morbidity. A

Claude C. Schulman

2001-01-01

242

New advances in benign prostatic hyperplasia: laser therapy.  

PubMed

Throughout the past decade, numerous techniques for the treatment of benign prostatic hyperplasia have emerged. Laser therapy, in particular, has gained widespread popularity among urologists. Since its inception in 1996, holmium laser enucleation of the prostate (HoLEP) has been evaluated rigorously in the treatment of glands of all sizes. HoLEP has produced superior relief of bladder outlet obstruction as compared to transurethral resection of the prostate based on urodynamics, and has proved equally as effective as open prostatectomy, for the management of very large glands (>100 cc), with lower morbidity. In addition to HoLEP, several newer but less well-studied laser techniques currently are available. These include photoselective laser vaporization utilizing the potassium-titanyl-phosphate (KTP or "green light") laser, thulium laser enucleation, and high-power diode laser vaporization. This report reviews the most current literature on laser therapies utilized in the treatment of benign prostatic hyperplasia with regards to safety, outcome, efficiency, and long-term durability. PMID:21088938

Mandeville, Jessica; Gnessin, Ehud; Lingeman, James E

2011-02-01

243

Laser prostatectomy: holmium laser enucleation and photoselective laser vaporization of the prostate.  

PubMed

Historically, transurethral resection of the prostate has been the gold standard for the treatment of benign prostatic hyperplasia (BPH). Laser technology has been used to treat BPH for > 15 years. Over the past decade, it has gained wide acceptance by experienced urologists. This review provides an evidence-based update on laser surgery for BPH with a focus on photoselective laser vaporization and holmium laser enucleation of the prostate surgeries and assesses the safety, efficacy, and durability of these techniques. PMID:23671400

Bostanci, Yakup; Kazzazi, Amir; Djavan, Bob

2013-01-01

244

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

PubMed Central

Historically, transurethral resection of the prostate has been the gold standard for the treatment of benign prostatic hyperplasia (BPH). Laser technology has been used to treat BPH for > 15 years. Over the past decade, it has gained wide acceptance by experienced urologists. This review provides an evidence-based update on laser surgery for BPH with a focus on photoselective laser vaporization and holmium laser enucleation of the prostate surgeries and assesses the safety, efficacy, and durability of these techniques. PMID:23671400

Bostanci, Yakup; Kazzazi, Amir; Djavan, Bob

2013-01-01

245

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

NASA Astrophysics Data System (ADS)

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

Saleh, Khaldon Y.; Smith, Nadine B.

2003-10-01

246

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

Microsoft Academic Search

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

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

2011-01-01

247

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

PubMed

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

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

2008-06-01

248

Effectiveness and Safety of Photoselective Vaporization of the Prostate with the 120 W HPS Greenlight Laser in Benign Prostatic Hyperplasia Patients Taking Oral Anticoagulants  

PubMed Central

Purpose To examine the effectiveness and safety of photoselective vaporization of the prostate (PVP) with the 120 W high-performance system (HPS) Greenlight laser procedure in benign prostatic hyperplasia (BPH) patients taking oral anticoagulant medications. Materials and Methods This study was conducted on BPH patients taking oral anticoagulant medications form March 2009 to December 2010. Group I consisted of patients who stopped oral anticoagulant medications before surgery (n=30), and group II consisted of patients who continued oral anticoagulant medications before surgery (n=30). PVP applying the 120 W HPS Greenlight laser was done, and followed up for 12 weeks. Follow-up variables were International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and hemoglobin level change. Results At 12 weeks after surgery, we confirmed the improvement in the IPSS score of Group I compared with preoperative scores. The quality of life (QoL) score, Qmax and PVR were also improved. respectively, both of which were significantly improved. In Group II, similarly, the total IPSS score, the voiding symptom score, and the storage symptom score were improved in comparison with the preoperative scores. The QoL score, Qmax and the PVR were improved in comparison with the preoperative scores. During the 12-week follow-up period, no major postsurgical complications requiring transfusion, rehospitalization, etc. were observed. Conclusions The 120 W HPS Greenlight laser PVP procedure can be performed effectively and safely in BPH patients, even those who cannot stop oral anticoagulant medications despite requiring surgery. PMID:21461281

Sohn, Jun Ho; Choi, Yong Sun; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung Hoo; Lee, Ji Youl; Hwang, Tae-Kon

2011-01-01

249

Cardiovascular Effects of Alpha-Blockers Used for the Treatment of Symptomatic BPH: Impact on Safety and Well-Being  

Microsoft Academic Search

Alpha-adrenoceptor antagonists (?-blockers) are efficacious in treating lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO), also termed symptomatic benign prostatic hyperplasia (BPH), causing bladder outlet obstruction (BOO). There is little difference among the various ?-blockers in terms of efficacy in treating LUTS. However, conventional quinazoline derivatives such as terazosin, doxazosin and alfuzosin, originally developed for hypertension, have

Christian de Mey

1998-01-01

250

Interstitial laser coagulation therapy for benign prostatic hyperplasia  

NASA Astrophysics Data System (ADS)

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

McNicholas, Thomas A.; Alsudani, Mohammed

1996-05-01

251

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

PubMed

Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure and a size-independent treatment for benign prostatic hyperplasia with excellent long-term surgical outcome. HoLEP has become an alternative to conventional transurethral resection of the prostate or open prostatectomy owing to its efficacy and safety. Although HoLEP is known to have a steep learning curve, very few articles have addressed the technical aspects of HoLEP. Herein, we described detailed techniques and tips for HoLEP as performed at Seoul National University Hospital in a step-by-step manner with extensive review of the literature. PMID:24044089

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

2013-09-01

252

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

PubMed Central

Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure and a size-independent treatment for benign prostatic hyperplasia with excellent long-term surgical outcome. HoLEP has become an alternative to conventional transurethral resection of the prostate or open prostatectomy owing to its efficacy and safety. Although HoLEP is known to have a steep learning curve, very few articles have addressed the technical aspects of HoLEP. Herein, we described detailed techniques and tips for HoLEP as performed at Seoul National University Hospital in a step-by-step manner with extensive review of the literature. PMID:24044089

Kim, Myong; Lee, Hahn-Ey

2013-01-01

253

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

Microsoft Academic Search

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

Bertrand Lukacs

1999-01-01

254

Characteristics of Patients Presenting with LUTS\\/BPH in Six European Countries  

Microsoft Academic Search

ObjectivesKnowledge of the clinical profile of the population with lower urinary tract symptoms\\/benign prostatic hyperplasia (LUTS\\/BPH) is important for health care management, impacting on manpower requirements, pharmacologic demands and health service costs. Data collected by the TransEuropean Research Into the Use of Management Policies for LUTS suggestive of BPH in Primary Health care project were used to profile 4979 patients

Annie Hutchison; Richard Farmer; Christopher Chapple; Richard Berges; Ludger Pientka; Pierre Teillac; Andrzej Borkowski; Piotr Dobronski

2006-01-01

255

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

PubMed

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

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

2010-07-01

256

[Enzyme inhibition in the drug therapy of benign prostatic hyperplasia].  

PubMed

Enzyme inhibition belongs to common mechanisms of drug action and enzymes of hormone metabolism belong to targets in the treatment of benign prostatic hyperplasia. Transformation of testosterone to 5 alpha-dihydrotestosterone is catalyzed by cholestenone-5 alpha-reductase (EC 1.3.1.22, 5 alpha-reductase). Different effects of dihydrotestosterone and testosterone represent a rational basis for pharmacotherapy by 5 alpha-reductase inhibition. The enzyme is active in the prostate and other organs and tissues, with different distribution of at least two 5 alpha-reductase isoenzymes. Beside this, progesterone-5 alpha-reductase (EC 1.3.1.30) as another enzyme with 5 alpha-reductase activity is present in human tissues including the prostate. The existence of several 5 alpha-reductase activities gives bright possibilities of 5 alpha-reductase inhibition. Basic 5 alpha-reductase inhibitors are synthetic steroid (e.g. finasteride--Proscar). Various mechanisms of their effect (classical reversible competitive inhibition, mechanism-based "suicide" inhibitors, tightly bound irreversible inhibitors...) represent different pharmacokinetic patterns, too. Non-steroidal 5 alpha-reductase inhibitors (e.g. polyunsaturated fatty acids) are effective components of several phytopharmaceuticals. They receive attention due to their complexity and low hazards. Extracts of Serenoa repens seeds (Permixon, Capistan in the Czech Republic), of Pygeum africanum, of Urtica radicis roots (Urtica, Urtiron) or catequine structures from the green tea belong to this group. Beside androgens, participation of estrogens in the origin and development of benign prostatic hyperplasia is probable. Inhibition of the "aromatase" complex, which catalyzes transformation of androgens to estrogens, may contribute to the complexity of phytotherapeutic effects. PMID:12515038

Drsata, J

2002-10-11

257

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

PubMed

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

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

2011-04-01

258

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

PubMed Central

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

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

2013-01-01

259

Biochemical evaluation of obstructive bladder dysfunction in men secondary to BPH: a preliminary report  

Microsoft Academic Search

Objectives. In the rabbit, two of the major cellular alterations that mediate bladder dysfunction secondary to partial outlet obstruction are a decreased ability of the sarcoplasmic reticulum (SR) to store and release Ca2+, and mitochondrial dysfunction. The objective of the current study was to determine whether SR and mitochondrial dysfunctions are associated with symptomatic benign prostatic hyperplasia (BPH) in men.Methods.

Robert M Levin; Niels Haugaard; Laura Mogavero; Robert E Leggett; Anurag K Das

1999-01-01

260

Management of the BPH Syndrome in Germany: Who Is Treated and How?  

Microsoft Academic Search

Objectives: To review the available data on contemporary management of symptomatic benign prostatic hyperplasia (BPH) within the German healthcare system. Methods: Information was obtained from articles published in scientific journals retrieved through searches in Medline and Embase. In addition, preliminary data from the first representative German survey on lower urinary tract symptoms (LUTS) were obtained (‘Herner LUTS-Study’, a community-based survey

Richard R. Berges; Ludger Pientka

1999-01-01

261

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

Microsoft Academic Search

Objective: To investigate the management of symptomatic benign prostatic hyperplasia (BPH) in Italy. Methods: Information on diagnosis, medical and surgical treatment was obtained from two different questionnaires independently mailed to urological centers in Italy. Data on drug treatments were obtained from a national database. General practitioner (GP) clinical practice patterns were obtained from a panel discussion between general practitioners and

Andrea Tubaro; Emanuele Montanari

1999-01-01

262

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

Microsoft Academic Search

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

Reginald Bruskewitz

1999-01-01

263

Population based trends in the surgical treatment of benign prostatic hyperplasia  

PubMed Central

Purpose Laser prostatectomy has increased in popularity over the last decade. However, traditional transurethral resection of the prostate (TURP) remains common. In an effort to understand decisions surrounding use of laser prostatectomy versus TURP, we evaluated trends in transurethral surgery for benign prostatic hyperplasia (BPH) in an all payer dataset, focusing on patient and provider factors that are associated with receipt of laser prostatectomy. Methods Using the State Inpatient and Ambulatory Surgery Databases for Florida, we identified subjects undergoing laser prostatectomy or TURP (2001 to 2009). We calculated rates of surgery over time, stratified by procedure type. We used multilevel regression to examine patient (age, race, level of comorbidity) and provider (surgeon volume) factors associated with receipt of laser prostatectomy versus TURP. Results While the overall rates of transurethral surgery remained stable (p=0.227) over the study period, use of laser prostatectomy rose 400% (from 25 to 114 procedures per 100,000 men, p<0.001), replacing about half of all TURPs. Patients were less likely to undergo laser prostatectomy if they were older (OR 0.65, 95% CI 0.61–0.70) and less healthy (OR 0.48, 95% CI 0.45–0.51). While these factors were predictive of surgery type, the majority of the variation in laser prostatectomy use (69%) was explained by the urologist a patient saw. Conclusions Laser prostatectomy utilization has increased over the last decade at the expense of TURP, driven largely by provider effects. However, the elderly and more infirm patients are the least likely to receive it, raising concerns about underuse in this population. PMID:22999698

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

2014-01-01

264

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

PubMed Central

Background Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to ?1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study. Methods Subjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received ?1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the ?1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon. Results The mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P?=?0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P?=?0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P?=?0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events. Conclusions Ramelteon in combination with an ?1-blocker could be a treatment option for reducing nocturia in men with BPH. PMID:23758651

2013-01-01

265

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

PubMed Central

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

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

2010-01-01

266

Photoselective Vaporization for the Treatment of Benign Prostatic Hyperplasia  

PubMed Central

Background As an alternative to transurethral resection of the prostate (TURP), photoselective vaporization of the prostate (PVP) provides a bloodless, relatively painless relief of lower urinary tract symptoms for men with benign prostatic hyperplasia. Following a review of the evidence in 2006, the Ontario Health Technology Advisory Committee recommended that a study be conducted to evaluate PVP in Ontario. Objectives To compare the clinical effectiveness, safety, cost-effectiveness, and budget impact of PVP compared to conventional TURP for the treatment of benign prostatic hyperplasia in Ontario. Methods A prospective, nonrandomized trial was conducted in 3 Ontario centres. Consenting subjects were assessed at baseline and 1, 3, and 6 months following surgery. Outcome measures included International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), post-void residual (PVR) volume, prostate-specific antigen (PSA), health-related quality of life (HRQOL) using the EuroQol 5 Domain questionnaire, and the Sexual Health Inventory for Men (SHIM) score. Adverse events, resource utilization, and productivity losses were also assessed. Cost-effectiveness and budget impact analyses were completed using data from the study. Results Between February 2008 and August 2010, 164 subjects were enrolled in the study (n = 140 for PVP and n = 24 for TURP). Treatment outcomes were similar between the 2 groups at 6 months, with the IPSS decreasing similarly over time (P = 0.718). For other treatment outcomes (Qmax, PSA, HRQOL, SHIM) both treatments provided similar benefit over time; only changes in PVR volume favoured PVP (P = 0.018). The majority of PVP patients were managed on an outpatient basis, with only 7.1% requiring admission (all TURP subjects were inpatients). At 6 months, PVP was less costly than TURP ($3,891 versus $4,863; P = 0.001), with similar quality-adjusted life-years (0.448 versus 0.441; P = 0.658). PVP remained the most cost-effective treatment across all decision-making thresholds, with the technology costing less and providing similar clinical outcomes. Extrapolating the results to a provincial level indicated (based on an estimated case volume of 12,335 TURPs) that there is an opportunity to reallocate just over $14 million (Cdn), primarily related to the reduced need for hospital admission. Limitations This study was nonrandomized, and the results should be interpreted with some caution, despite generally similar baseline characteristics between the 2 groups. Recruiting individuals to the TURP arm was a challenge, resulting in a size imbalance between treatment arms. Conclusions Based on this analysis, PVP appears to be a cost-effective alternative to TURP, providing similar clinical benefit at a lower cost to the health system. Plain Language Summary For men with lower urinary tract symptoms due to an enlarged prostate, a laser treatment called photoselective vaporization of the prostate (or PVP) is just as effective as surgery. PVP does not require an overnight stay in the hospital for most men, and it costs almost $1,000 less. This report describes the results of a study that collected information about treatment outcomes, quality of life, and health care use related to PVP and surgery in Ontario. PMID:24019857

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

2013-01-01

267

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

PubMed Central

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

Dobrowolski, Dariusz; Wylegala, Edward

2011-01-01

268

Effects of Pumpkin Seed in Men with Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia in the One-Year, Randomized, Placebo-Controlled GRANU Study.  

PubMed

Introduction: The German Research Activities on Natural Urologicals (GRANU) study was a randomized, partially blinded, placebo-controlled, parallel-group trial that investigated the efficacy of pumpkin seed in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH/LUTS). Subjects and Methods: A total of 1,431 men (50-80 years) with BPH/LUTS were randomly assigned to either pumpkin seed (5 g b.i.d.), capsules with pumpkin seed extract (500 mg b.i.d.) or matching placebo. The primary response criterion was a decrease in International Prostate Symptom Score (IPSS) of ?5 points from baseline after 12 months. Secondary outcome measures included IPSS-related quality of life, IPSS single items and diary-recorded nocturia. Results: After 12 months, the response rate (intention-to-treat/last-observation-carried-forward approach) did not differ between pumpkin seed extract and placebo. In the case of pumpkin seed (responders: 58.5%), the difference compared with placebo (responders: 47.3%) was descriptively significant. The study products were well tolerated. Overall, in men with BPH, 12 months of treatment with pumpkin seed led to a clinically relevant reduction in IPSS compared with placebo. Conclusion: In order to fully justify a recommendation for the use of pumpkin seed to treat moderate LUTS, these findings need to be substantiated in a confirmatory study or systematic review. © 2014 S. Karger AG, Basel. PMID:25196580

Vahlensieck, Winfried; Theurer, Christoph; Pfitzer, Edith; Patz, Brigitte; Banik, Norbert; Engelmann, Udo

2014-09-01

269

Monocyte chemoattractant protein-1 gene expression in prostatic hyperplasia and prostate adenocarcinoma.  

PubMed Central

Human monocyte chemoattractant protein-1 (MCP-1) has been shown to act as a chemokine in the recruitment of monocyte/macrophages during inflammation states. Furthermore, there is increasing evidence that MCP-1 is involved in the recruitment of tumor-associated macrophages. In vivo, one of the major cellular sources of MCP-1 are the smooth muscle cells. As MCP-1 gene expression and/or protein production in these cells is not necessarily correlated with the accumulation of inflammatory cells, there might possibly be additional functions of this cytokine. In the present study, we investigated by use of 35S-labeled antisense RNA probes whether the MCP-1 gene is expressed in tissue specimens of benign prostatic hyperplasia (n = 13) and specimens of prostate carcinoma (n = 8), both of which are characterized by a prominent fibromuscular stroma and inconspicuous inflammatory infiltrates. MCP-1 transcripts were located in stromal smooth muscle cells and, additionally, in basal cells of benign prostatic glands. In prostate carcinoma, the number of MCP-1 mRNA-expressing cells was significantly less than in benign prostatic hyperplasia. MCP-1 transcripts were located in preserved fibromuscular stroma and in basal cells of entrapped non-neoplastic glands but not in carcinomatous cells. Immunohistochemical staining with polyclonal antibodies raised against MCP-1 revealed strong reactivity in the fibromuscular stroma surrounding both benign and malignant glands. MCP-1 gene expression or immunoreactivity for anti-MCP-1 antibodies was not related to the rare, lymphocytic interstitial infiltrates. The results show that 1) in the absence of significant leukocyte accumulation, it is unlikely that MCP-1 exerts chemotactic functions in the prostate and 2) that MCP-1, in contrast to previous findings in a wide variety of other human neoplasms, is not expressed in carcinomatous cells of the prostate. Images Figure 2 Figure 3 Figure 4 PMID:8701989

Mazzucchelli, L.; Loetscher, P.; Kappeler, A.; Uguccioni, M.; Baggiolini, M.; Laissue, J. A.; Mueller, C.

1996-01-01

270

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

PubMed Central

Lasers have arrived in a big way for the management of benign prostatic hyperplasia. The most common ones in use are holmium, potassium titanyl phosphate (KTP) and thulium. They remove the prostatic adenoma either by way of enucleation or ablation. Backed by numerous studies that prove their safety, efficacy and durability, lasers score over TURP in several ways. Their use is associated with less blood loss, shorter catheter time and decreased hospital stay. The fluid absorption during laser prostatectomy is negligible and thus makes it safer for use in cardiac patients. Also there is no chance of a transurethral resection syndrome, the incidence of which is approximately 2% with TURP. Due to superior hemostatic capabilities and non interference lasers can be used in patients on anti coagulants, cardiac pacemaker. Another advantage of laser over TURP is its ability to deal with prostates that are larger in size especially holmium laser which has been used to enucleate glands more than 300 g in size thus completely avoiding the need for open prostatectomy. The amount of tissue removed with enucleation is more thus retreatment rates are less than that of TURP. The initial cost of laser is higher but its capability to treat stones, its use in high risk situations, less morbidity, short hospital stay, and durable results make it an attractive option to treat BPH even in the developing world. PMID:19881144

Varshney, Anil; Agarwal, Anshuman

2009-01-01

271

Direct Visualization of Propionibacterium acnes in Prostate Tissue by Multicolor Fluorescent In Situ Hybridization Assay  

Microsoft Academic Search

Prostate tissues from patients with prostate cancer and benign prostatic hyperplasia (BPH) frequently contain histological inflammation, and a proportion of these patients show evidence of Propionibacterium acnes infection in the prostate gland. We developed a multicolor fluorescent in situ hybridization (FISH) assay targeting P. acnes 23S rRNA along with a 14-kb region of the P. acnes genome. This assay was

Oleg A. Alexeyev; Ingrid Marklund; Beverley Shannon; Irina Golovleva; Jan Olsson; Charlotte Andersson; Irene Eriksson; Ronald Cohen; Fredrik Elgh

2007-01-01

272

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

Microsoft Academic Search

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

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

2003-01-01

273

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

PubMed Central

Objective: We evaluated the safety and efficacy of photoselective vaporization of the prostate (PVP) using GreenLight 120-W lithium triborate (LBO) laser to treat symptomatic small-to-medium sized benign prostatic hyperplasia (BPH). Methods: This prospective non-controlled observational study included symptomatic BPH men ?50 years with international prostate symptom score (IPSS) ?14, prostate volume (PV) ?80 cc and maximum flow rate (Q-max) ?15 mL/s. PVP was performed using the GreenLight 120-W LBO laser machine. Patients were assessed at baseline and postoperatively at discharge, 2 weeks, and 3, 6 and 12 months. We measured changes in IPSS, PV, PSA, Q-max, post-void residual (PVR), hemoglobin (Hb), serum sodium (Na+) and reported complications. Statistical significance was p < 0.05. Results: The study included 103 men with mean age of 67 (±standard deviation)±9.7 years. Thirty patients were on indwelling urethral catheters for refractory urinary retention and 12 on ongoing anticoagulants. The mean baseline IPSS, PV, PSA, Q-max and PVR parameters significantly improved at follow-up (p < 0.001; each). Mean measurements at baseline versus at six months were: IPSS 25.6 ± 4.2 vs. 7.4±2.3; PV 44.6 ± 9.2 vs. 21.6 ± 6.3 cc (51.6% reduction); Q-max 5.8 ± 3.4 vs. 20.4 ± 4.8 mL/s; PVR 110 ± 40 vs. 35 ± 9 cc. Mean baseline Hb and serum Na+ declined non-significantly (p > 0.05) at discharge and at 2 weeks. No patient needed a blood transfusion. Secondary procedures were needed in 2 patients for urethral and bladder neck strictures. The re-treatment rate for residual adenoma was 0.97%. Conclusion: PVP using the GreenLight 120-W LBO laser to treat small-to-medium sized symptomatic BPH demonstrated significant improvements in efficacy parameters and high safety profile within 12 months of follow-up. The procedure entails good hemostasis with minimal blood loss even in patients receiving ongoing anticoagulants. PMID:22630338

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

2013-01-01

274

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

PubMed

OBJECTIVE: We evaluated the safety and efficacy of photoselective vaporization of the prostate (PVP) using GreenLight 120-W lithium triborate (LBO) laser to treat symptomatic small-to-medium sized benign prostatic hyperplasia (BPH). METHODS: This prospective non-controlled observational study included symptomatic BPH men ?50 years with international prostate symptom score (IPSS) ?14, prostate volume (PV) ?80 cc and maximum flow rate (Q-max) ?15 mL/s. PVP was performed using the GreenLight 120-W LBO laser machine. Patients were assessed at baseline and postoperatively at discharge, 2 weeks, and 3, 6 and 12 months. We measured changes in IPSS, PV, PSA, Q-max, post-void residual (PVR), hemoglobin (Hb), serum sodium (Na+) and reported complications. Statistical significance was p < 0.05. RESULTS: The study included 103 men with mean age of 67 (±standard deviation)±9.7 years. Thirty patients were on indwelling urethral catheters for refractory urinary retention and 12 on ongoing anticoagulants. The mean baseline IPSS, PV, PSA, Q-max and PVR parameters significantly improved at follow-up (p < 0.001; each). Mean measurements at baseline versus at six months were: IPSS 25.6 ± 4.2 vs. 7.4±2.3; PV 44.6 ± 9.2 vs. 21.6 ± 6.3 cc (51.6% reduction); Q-max 5.8 ± 3.4 vs. 20.4 ± 4.8 mL/s; PVR 110 ± 40 vs. 35 ± 9 cc. Mean baseline Hb and serum Na+ declined non-significantly (p > 0.05) at discharge and at 2 weeks. No patient needed a blood transfusion. Secondary procedures were needed in 2 patients for urethral and bladder neck strictures. The re-treatment rate for residual adenoma was 0.97%. CONCLUSION: PVP using the GreenLight 120-W LBO laser to treat small-to-medium sized symptomatic BPH demonstrated significant improvements in efficacy parameters and high safety profile within 12 months of follow-up. The procedure entails good hemostasis with minimal blood loss even in patients receiving ongoing anticoagulants. PMID:22630338

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

2012-05-15

275

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

PubMed

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

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

2013-01-01

276

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

PubMed Central

Purpose This study was conducted with the use of 12 months of follow-up data to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 980-nm diode laser for the treatment of symptomatic benign prostatic hyperplasia (BPH). Materials and Methods The clinical data of 84 men with symptomatic BPH who underwent PVP with the 980-nm K2 diode laser between March 2010 and October 2011 were retrospectively analyzed. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR), were assessed and compared with preoperative baseline values. Results Mean patient age was 72.4±6.5 years, and mean preoperative prostate volume was 47.2±16.3 g. Mean operative time was 23.3±19.1 minutes, and total amount of energy was 128±85 kJ. Mean catheterization time was 23.7±5.9 hours. At 1 month, significant improvements were noted in IPSS (11.5±6.8), QoL score (2.2±1.3), Qmax (12.9±6.5 mL/s), and PVR (41.2±31.3 mL). Three months after surgery, all postoperative follow-up parameters showed significant improvements, and the 6- and 12-month data showed sustained improvement of postoperative follow-up parameters. Bladder neck strictures were observed in 10.7% of the patients and urge incontinence in 16.6%. Conclusions PVP using a K2 diode laser is an effective procedure for the treatment of lower urinary tract symptoms secondary to BPH. PVP leads to an immediate and sustained improvement of subjective and objective voiding parameters. Surgeons should be vigilant for postoperative bladder neck stricture and urge incontinence. PMID:24175041

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

2013-01-01

277

Efficacy and safety of dutasteride, tamsulosin and their combination in a subpopulation of the CombAT study: 2-year results in Asian men with moderate-to-severe BPH  

Microsoft Academic Search

Although ethnicity-based differences in prostate size and physiology have been reported, results of benign prostatic hyperplasia (BPH) treatment trials in predominantly Caucasian patients are assumed to be applicable to non-Caucasian populations. This post hoc analysis investigated whether an Asian subpopulation of men with moderate-to-severe BPH in the CombAT study achieves treatment responses in line with those of the overall study

B-H Chung; C G Roehrborn; P Siami; K Major-Walker; B B Morrill; T H Wilson; F Montorsi

2009-01-01

278

Effect of D-004, a lipid extract from Cuban royal palm fruit, on histological changes of prostate hyperplasia induced with testosterone in rats.  

PubMed

Benign prostatic hyperplasia (BPH) is the nonmalignant, uncontrolled growth of prostate gland cells and stroma leading to difficulty in urinating. Lipid extracts from Saw palmetto (Arecaceae) fruits are used to treat BPH. The Cuban royal palm (Roystonea regia) is a member of this family and D-004, a lipid extract from its fruits, prevents prostate hyperplasia (PH) induced with testosterone, as opposed to dihydrotestosterone, in rodents. This study investigated whether D-004 could prevent the histological features of testosterone-induced PH in rats. Rats were distributed into six groups (10 rats per group): A negative control group receiving subcutaneous injections of soy oil and treated with vehicle, and five groups injected subcutaneously with testosterone and treated with the vehicle (positive control), D-004 (100, 200 and 400 mg/kg) or Saw palmetto (400 mg/kg). Treatments were given orally for 14 days. At sacrifice, prostates were removed and processed for light microscopy. The histopathological findings of PH were assessed according to a score-chart protocol. D-004 200 and 400 mg/kg, but not 100 mg/kg, significantly and moderately in a dose-dependent manner prevented prostate enlargement and the testosterone-induced histological changes. Compared with positive controls, D-004 200 and 400 mg/kg inhibited prostate size increases and the histological score up to 56.1% and 60.7%, respectively, while Saw palmetto 400 mg/kg reduced such variables by 45.8% and 49.0%, respectively. The effects of D-004 400 mg/kg on the histological changes, not on prostate size, were greater (p < 0.05) than those of Saw palmetto. D-004 and Saw palmetto did not affect body weight values. In conclusion, D-004 200 and 400 mg/kg administered orally for 14 days prevented the increase of prostate size and the testosterone-induced histological changes in rats, its effects being comparable or mildly better than those of Saw palmetto. These results extend previous data showing preventive effects of D-004 on testosterone-induced prostate enlargement with in rodents, and further studies are required to explore the mechanisms underlying such effects. PMID:16440586

Noa, M; Arruzazabala, M L; Carbajal, D; Más, R; Molina, V

2005-01-01

279

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

PubMed

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

Aho, Tevita F

2013-10-01

280

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

PubMed Central

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

2013-01-01

281

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

Microsoft Academic Search

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

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

2004-01-01

282

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

PubMed

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

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

2008-06-01

283

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

PubMed

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

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

2013-10-01

284

International registry results for an interstitial laser BPH treatment device  

NASA Astrophysics Data System (ADS)

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

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

1996-05-01

285

Transurethral needle ablation (TUNA) of the prostate: a clinical and urodynamic evaluation  

Microsoft Academic Search

Objectives. This prospective study evaluated the clinical and urodynamic changes in patients with obstruction due to benign prostatic hyperplasia (BPH) treated with transurethral needle ablation (TUNA)Methods. One hundred twenty patients with obstructive uropathy due to BPH were treated with the TUNA procedure between January 1994 and December 1995. All patients were selected according to the criteria established by the guidelines

Biagio Campo; Franco Bergamaschi; Piero Corrada; Giorgio Ordesi

1997-01-01

286

Prostate stem cell antigen (PSCA) mRNA expression in peripheral blood in patients with benign prostatic hyperplasia and/or prostate cancer.  

PubMed

The aim of this study was to determine whether detection of prostate stem cell antigen (PSCA) expression in BPH might be associated with the subsequent presence of Prostate cancer (PCa) and also to determine whether detection of PSCA expression has potential for prognosis in PCa. This study was comprised of 112 PCa patients, 111 BPH patients and 120 control subjects. We employed reverse-transcriptase polymerase chain reaction (RT-PCR) to detect PSCA mRNA-bearing cells in peripheral blood. PSCA mRNA was detected in the peripheral blood of 71.4% PCa patients and in 13.5% of patients with BPH by RT-PCR. PSCA was positive in 80% of high-grade diseases compared with 20% of low-grade diseases (P = 0.01). Whereas only 38.8% of prostate-confined diseases were PSCA positive, 61.2% of extraprostatic diseases were PSCA positive (P < 0.001). Patients with a lymphovascular invasion of tumor emboli tended to be PSCA positive (P = 0.02). BPH patients with RT-PCR PSCA positive were significantly more likely to develop prostate cancer (OR = 16, 95% CI = 8.1-31.6, P < 0.001). In conclusion, RT-PCR PSCA positivity is significantly associated with the Gleason score, LV tumor emboli and whether or not the tumor was organ confined. In this study, RT-PCR PSCA detection may be a promising tumor marker of diagnostic and metastasis detection for patients with prostate cancer. Also, it may be an important test for predicting BPH patients who are at high risk of subsequent cancer development. PMID:25698533

Fawzy, Mohamed S; Mohamed, Randa H; Elfayoumi, Abdel-Rahman R

2015-03-01

287

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

Microsoft Academic Search

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

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

2009-01-01

288

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

Microsoft Academic Search

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

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

1995-01-01

289

[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

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

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

2013-01-01

290

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

PubMed

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

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

2013-02-01

291

[Additional administration of dutasteride in patients with benign prostatic hyperplasia who did not respond sufficiently to ?1-adrenoceptor antagonist : investigation of clinical factors affecting the therapeutic effect of dutasteride].  

PubMed

We performed additional administration of dutasteride in patients who did not respond sufficiently to ?1-adrenoceptor antagonist treatment for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) (LUTS/BPH). Among 76 registered patients, efficacy was analyzed in 58 patients. International Prostate Symptom Score (IPSS), subscores for voiding and storage symptoms and quality of life (QOL) on the IPSS, and Overactive Bladder Symptom Score (OABSS) were all significantly improved from the third month of administration compared to the time of initiating additional administration of dutasteride. Additional administration of dutasteride also significantly reduced prostate volume, and residual urine with the exception of the sixth month after administration. Age at initiation of administration and voiding symptom subscore on the IPSS were clinical factors affecting the therapeutic effects of dutasteride. The rate of improvement with treatment decreased with increasing age at initiation of dutasteride administration, and increased as voiding symptom subscore on the IPSS increased. Therefore, additional administration of dutasteride appears useful for cases of LUTS/BPH in which a sufficient response is not achieved with ?1-adrenoceptor antagonist treatment. Because patients who have severe voiding symptoms or begin dutasteride at an early age may be expected to respond particularly well to dutasteride in terms of clinical efficacy, they were considered to be suitable targets for additional administration. PMID:24755815

Masuda, Mitsunobu; Murai, Tetsuo; Osada, Yutaka; Kawai, Masaki; Kasuga, Jun; Yokomizo, Yumiko; Kuroda, Shinnosuke; Nakamura, Mami; Noguchi, Go

2014-02-01

292

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

NASA Astrophysics Data System (ADS)

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

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

2003-06-01

293

Current treatment of BPH.  

PubMed

Benign prostatic hypertrophy (BPH) is one of the most common diseases of adult males which increases with age. Effective therapeutic agents are an attractive option for patients for whom surgery is not a necessity, improving quality of life when compared with watchful waiting. Epidemiological studies show that 88% of patients over 80 years of age present anatomical BPH. This prevalence is similar in male populations throughout the world. Surgical treatment (transurethral resection of the prostate: TURP) has been the gold standard for over 50 years in patients with an enlarged prostate and obstructive symptoms but 20% of patients remain unsatisfied with surgery. Various medicinal preparations have been used since biblical times, in particular plant extracts which are still prescribed in Europe. Some claim to have an enzymatic inhibitory effect, but currently have not demonstrated objective efficacy. Alpha-blockers act on bladder and prostate smooth muscle, the contraction of which is mediated through alpha 1-receptors. Treatment has shown increased uroflow, decreased residual volume and a decrease in symptoms of BPH. Alpha-blockers; however, have shown no effect on prostate volume nor a reduction in the need for surgery for these patients. Finasteride, currently the only 5 alpha-reductase inhibitor approved for treatment of symptomatic BPH, has been widely investigated. The drug has been shown to decrease prostate volume, improve symptoms, uroflow and invasive urodynamic parameters in the majority of patients. Dihydrotestosterone (DHT) is decreased but the level of serum testosterone is maintained. Prostatic specific antigen is decreased by 50% as an effect of the drug on epithelial cells. Overall, the drug is well tolerated but some patients have shown decreased libido and/or impotency; however, two-thirds of these patients improved when the treatment was continued. Two effective medical therapies are currently available for treating symptomatic BPH: finasteride and alpha antagonists. Studies are now in progress to determine whether a combination of these therapies would be an effective alternative to surgery or watchful waiting. PMID:8562858

Roylance, P; Gibelin, B; Espié, J

1995-01-01

294

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

PubMed Central

Objective To investigate changes in nonspecific genitourinary discomfort or pain (GUDP) before and after holmium laser enucleation of prostate (HoLEP). GUDP associated with lower urinary tract symptoms (LUTS) is a common complaint among benign prostatic hyperplasia (BPH) patients, but very little is known about this clinical entity. Methods From February 2010 to August 2011, 100 HoLEP patients with complete clinical data at a single institution were enrolled in the study to analyze the degree of GUDP with a visual analog scale (VAS) from 0 to 10 points at baseline and at 3 and 6 months postoperatively, and to investigate any relationships between GUDP and urodynamics, uroflowmetry, and scores from the International Prostate Symptom Score (IPSS) questionnaire. Results Fifty-six patients had LUTS only, while the remaining 44 had both LUTS and GUDP. Pain was located in the suprapubic (42.0%), perineal/penile (33.0%), back (17.0%), and perianal (8.0%) regions. During the post-operative period, at six months, the VAS, IPSS, peak flow rate and post-void residual volume had improved significantly in 44 GUDP patients (p<0.010). GUDP had completely resolved in 40 (90.9%) patients and had decreased in four (9.1%) patients, while seven (12.5%) patients developed GUDP with voiding in the urethral and perineal areas by the third month postoperatively. When compared to patients with complete resolution, those with persistent GUDP were found to have a significantly higher preoperative presence of bladder outlet obstruction (BOO) as an independent risk factor (OR 6.173, 95% CI 1.132–1.323). Conclusion Both GUDP and LUTS improved significantly after HoLEP. Patients with significant preoperative BOO tended to have persistent GUDP after surgery. PMID:24901224

Kim, Sung Han; Oh, Seung-June

2014-01-01

295

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

PubMed Central

Purpose This post hoc integrated analysis assessed the efficacy and safety of tadalafil 5 mg once daily in a large Korean population with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH-LUTS). Materials and Methods Individual Korean participant data were integrated from three 12-week, randomized, double-blind, placebo-controlled studies in Asian men with BPH-LUTS, wherein 177 Korean men received placebo and 177 received tadalafil 5 mg once daily. The primary objective was to compare the change from baseline to week 12 in total International Prostate Symptom Score (IPSS) after treatment with tadalafil versus placebo. Results A significantly greater improvement (p<0.001) in total IPSS from baseline to week 12 was observed for tadalafil compared to placebo (least squares mean: tadalafil=-5.97; placebo=-3.94 ). Total IPSS at weeks 4 and 12, IPSS voiding and storage subscores at weeks 4, 8, and 12, and IPSS quality of life index at weeks 8 and 12 were also significantly improved (p<0.05) for tadalafil compared to placebo. There was significant improvement (p<0.001) in the patient global Impression of improvement responses and numerical improvement in the clinician global impression of improvement responses with tadalafil compared to placebo. There were no significant treatment differences for peak urine flow rate or postvoid residual volume. Few participants had treatment-emergent adverse events and there were no unexpected safety findings. Conclusions This integrated analysis of three randomized, placebo-controlled Asian studies confirmed tadalafil 5 mg once daily as an efficacious and well-tolerated treatment for Korean men with BPH-LUTS. PMID:24872949

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

2014-01-01

296

A Precursor Form of Prostate-specific Antigen Is More Highly Elevated in Prostate Cancer Compared with Benign Transition Zone Prostate Tissue  

Microsoft Academic Search

Prostate-specific antigen (PSA) is a widely used serum marker for prostate cancer (PCa), but in the critical diagnostic range of 4 -10 ng\\/ml it has limited specificity for distinguishing early PCa from benign pros- tatic hyperplasia (BPH). PSA in serum is comprised of a variety of both \\

Stephen D. Mikolajczyk; Lisa S. Millar; Tang J. Wang; Harry G. Rittenhouse; Leonard S. Marks; Weitao Song; Thomas M. Wheeler; Kevin M. Slawin

297

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

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

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

2014-01-01

298

Decision Aids for Benign Prostatic Hyperplasia: Applicability across Race and Education  

Microsoft Academic Search

Background\\/Method. Decision aids have not been widely tested in diverse audiences. The authors conducted inter- views in a 2 2 race by education design with participants who were 50 years old (n = 188). The decision aid was a be- nign prostatic hyperplasia videotape. Results. There was an increase in knowledge equal in all groups, with baseline knowledge higher in

David R. Rovner; Celia E. Wills; Vence Bonham; Gilbert Williams; Janet Lillie; Karen Kelly-Blake; Mark V. Williams; Margaret Holmes-Rovner

2004-01-01

299

Hyperglycemia and insulin resistance and the risk of BPH/LUTS: an update of recent literature.  

PubMed

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

Breyer, Benjamin N; Sarma, Aruna V

2014-12-01

300

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

PubMed

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

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

301

Non-Hormonal treatment of BPH/BOO  

PubMed Central

Objectives: To review the use of non-hormonal pharmacotherapies in the treatment of lower urinary tract symptoms (LUTS) due to presumed benign prostatic hyperplasia (BPH). Materials and Methods: A search of the PUBMED database was conducted for the terms BPH, LUTS, bladder outlet obstruction, alpha-adrenoceptor blockers, anti-muscarinics, and phosphodiesterase-5-inhibitors. Results: Medical therapy has long been established as the accepted standard of care in the treatment of male LUTS. The aim of treatment is improvement in symptoms and quality of life whilst minimizing adverse effects. The agents most widely used as 1st line therapy are alpha-blockers (AB), as a standalone or in combination with 2 other classes of drug; 5-? reductase inhibitors and anti-muscarinics. AB have rapid efficacy, improving symptoms and flow rate in a matter of days, these effects are then maintained over time. AB do not impact on prostate size and do not prevent acute urinary retention or the need for surgery. Anti-mucarinics, alone or in combination with an AB are safe and efficacious in the treatment of bothersome storage symptoms associated with LUTS/BPH. Phosphodiesterase-5 inhibitors are an emerging treatment option that improve LUTS without improving flow rates. Conclusions: AB are the most well-established pharmacotherapy in the management of men with LUTS/BPH. The emergence of different classes of agent offers the opportunity to target underlying pathophysiologies driving symptoms and better individualize treatment. PMID:24744520

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

2014-01-01

302

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

PubMed Central

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

Szewczyk, Mariusz; Jesionek–Kupnicka, Dorota; Lipinski, Piotr; Ró?a?ski, Waldemar

2014-01-01

303

Inhibition of testosterone-induced hyperplasia of the prostate of sprague-dawley rats by pumpkin seed oil.  

PubMed

The oil from the pumpkin (Cucurbita pepo) seed is claimed to be useful in the management of benign prostatic hyperplasia. This investigation seeks to examine the effect of pumpkin seed oil on testosterone-induced hyperplasia of the prostate of rats. Hyperplasia was induced by subcutaneous administration of testosterone (0.3 mg/100 g of body weight) for 20 days. Simultaneous oral administration of either pumpkin seed oil (2.0 and 4.0 mg/100 g of body weight) or corn oil (vehicle) was also given for 20 days. The weights of the rats were recorded weekly, and the influence of testosterone and pumpkin seed oil on the weight gain of the rats was examined. On day 21, rats were sacrificed, and the prostate was removed, cleaned, and weighed. The prostate size ratio (prostate weight/rat body weight) was then calculated. Neither testosterone nor pumpkin seed oil had any significant influence on the weight gain of the rats. Testosterone significantly increased prostate size ratio (P < .05), and this induced increase was inhibited in rats fed with pumpkin seed oil at 2.0 mg/100 g of body weight. The protective effect of pumpkin seed oil was significant at the higher pumpkin seed oil dose (P < .02). We conclude pumpkin seed oil can inhibit testosterone-induced hyperplasia of the prostate and therefore may be beneficial in the management of benign prostatic hyperplasia. PMID:16822218

Gossell-Williams, M; Davis, A; O'Connor, N

2006-01-01

304

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

PubMed Central

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

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

2015-01-01

305

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

PubMed

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

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

2007-08-01

306

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

PubMed

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

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

2014-01-01

307

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

PubMed Central

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

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

2014-01-01

308

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

E-print Network

; metabolism ; pathology ; Receptors, Cell Surface ; metabolism ; Risk Assessment ; T-Lymphocytes ; immunology was to characterize inflammatory cells infiltrate within BPH tissue and to correlate inflammation and clinical data parameters were lymphocytes, macrophages and polynuclears leukocytes infiltrates, and three glandular aspect

Boyer, Edmond

309

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

PubMed Central

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

2013-01-01

310

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

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

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

2015-01-01

311

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

PubMed Central

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

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

2012-01-01

312

Efficacy and Safety of Tamsulosin for Treating Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia: A Multicenter, Randomized, Controlled, Open-Label Non-Inferiority Study  

PubMed Central

Purpose To compare the efficacy and safety of Sulosin D (PACIFICPHARMA, Korea) and Harnal D (ASTELLAS PHARMA KOREA, Korea) in treating patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). Materials and Methods This randomized, controlled, open-label, multicenter non-inferiority study was conducted at four sites in Korea. We randomly assigned 123 patients with an International Prostate Symptom Score (IPSS) ?12 to receive either Sulosin D or Harnal D treatment for 8 weeks. The primary outcome was the mean change in IPSS from baseline to endpoint. Secondary outcomes were the mean change from baseline to endpoint in IPSS quality of life subscores, maximum uroflowmetry (Qmax), and post-voiding residuals (PVR). Results In all, 123 patients were randomly assigned (60 Sulosin D and 63 Harnal D). The changes in the total IPSS from baseline in the Sulosin D- and Harnal D-treated groups were -4.97 and -4.03, respectively. There were significant decreases compared with baseline in both groups. The mean difference (Sulosin D - Harnal D) was -0.91 (with a two-sided 90% confidence interval), inferring that Sulosin D was not inferior to Harnal D. The mean changes in the IPSS subscore, Qmax, and PVR from baseline were comparable between the groups (both p>0.05). During the treatment periods, the incidence of adverse events was 23.33% and 34.92% in the Sulosin D and Harnal D groups, respectively (p=0.1580). Conclusions We demonstrate the non-inferiority of Sulosin D to Harnal D in patients with lower urinary tract symptoms associated with BPH. PMID:22468213

Lee, Hyo Serk; Kim, Sae Woong; Oh, Seung-June; Choo, Myung-Soo

2012-01-01

313

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

PubMed Central

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

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

2009-01-01

314

Symptom deterioration during treatment and history of AUR are the strongest predictors for AUR and BPH-related surgery in men with LUTS treated with alfuzosin 10 mg once daily  

Microsoft Academic Search

ObjectivesTo assess the predictors of acute urinary retention (AUR) and\\/or surgery related to benign prostatic hyperplasia (BPH) in 3514 men complaining of lower urinary tract symptoms and treated for 6 months with the selective alpha1-blocker alfuzosin at 10 mg once daily.

Mark Emberton; Mostafa Elhilali; Haim Matzkin; Niels Harving; Jeroen van Moorselaar; Rudolf Hartung; Antonio Alcaraz; Guy Vallancien

2005-01-01

315

The safety and efficacy of aspirin intake in photoselective vaporization laser treatment of benign prostate hyperplasia  

PubMed Central

Endoscopic surgical treatment has become an option to treat benign prostate hyperplasia. We evaluated the safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients. We evaluated preoperative and perioperative parameters, functional outcomes, and adverse events up to 12 months postoperatively of patients on oral anticoagulation therapy undergoing PVP, and compared the results with patients who did not take anticoagulation therapy. A total of 89 patients who received photoselective vaporization laser for benign prostate hyperplasia from May 2006 to February 2011 in our hospital were enrolled in our study. The patients were divided into two groups based on whether or not they were taking oral aspirin; 23 (25.8%) patients were taking aspirin derivatives (aspirin group), and 66 (74.2%) were not taking aspirin derivatives (control group). The mean prostate volume (58.8 mL vs 51 mL; P = 0.16) and mean energy consumption (235,268 J vs 289,793 J; P = 0.097) were comparable between the aspirin group and control group. The average postoperative results of hemoglobin were 13.4 mg/ dL for the aspirin group versus 13.9 mg/dL for the control group (P = 0.327). A significantly higher maximum flow rates and 80% improved post-void residual urine were noted during the followup. Postoperatively all variable showed significant improvement starting at month 1 of followup and remained improved for the 12 month followup. Postoperative complications were low and comparable between groups. PVP was characterized by excellent hemostatic properties and a very low intraoperative complication rate, even in the patients who were taking aspirin. On the basis of our perioperative results, we recommend PVP as a safe and effective procedure for patients with symptomatic benign prostate hyperplasia when taking an aspirin derivative. PMID:23662050

Shao, I-Hung; Hou, Chen-Pang; Chen, Shao-Ming; Chen, Chien-Lun; Lin, Yu-Hsiang; Chang, Phei-Lang; Tsui, Ke-Hung

2013-01-01

316

The "PErFecTED technique": proximal embolization first, then embolize distal for benign prostatic hyperplasia.  

PubMed

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

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

2014-12-01

317

Efficacy of a vaporization-resection of the prostate median lobe enlargement and vaporization of the prostate lateral lobe for benign prostatic hyperplasia using a 120-W GreenLight high-performance system laser: the effect on storage symptoms.  

PubMed

GreenLight laser photoselective vaporization of the prostate (PVP) was established as a minimally invasive procedure to treat patients with benign prostatic hyperplasia (BPH). However, it may be difficult to achieve adequate tissue removal from a large prostate, particularly those with an enlarged median lobe. The purpose of this study was to investigate the feasibility and clinical effect of a 120-W GreenLight high-performance system laser vaporization-resection for an enlarged prostate median lobe compared with those of only vaporization. A total of 126 patients from January 2010 to January 2014 had an enlarged prostate median lobe and were included in this study. Ninety-six patients underwent vaporization only (VP group), and 30 patients underwent vaporization-resection for an enlarged median lobe (VR group). The clinical outcomes were International Prostate Symptoms Score (IPSS), quality of life (QOL), maximum flow rate (Q max), and post-void residual urine volume (PVR) assessed at 1, 3, 6, and 12 months postoperatively between the two groups. The parameters were not significantly different preoperatively between the two groups, except for PVR. Operative time and laser time were shorter in the VR group than those in the VP group. (74.1 vs. 61.9 min and 46.7 vs. 37.8 min; P?=?0.020 and 0.013, respectively) and used less energy (218.2 vs. 171.8 kJ, P?=?0.025). Improved IPSS values, increased Q max, and a reduced PVR were seen in the two groups. In particular, improved storage IPSS values were higher at 1 and 3 months in the VR group than those in the VP group (P?=?0.030 and 0.022, respectively). No significant complications were detected in either group. Median lobe tissue vaporization-resection was complete, and good voiding results were achieved. Although changes in urinary symptoms were similar between patients who received the two techniques, shorter operating time and lower energy were superior with the vaporization-resection technique. In addition, vaporization-resection may have a beneficial effect on storage symptoms. PMID:25833318

Kim, Kang Sup; Choi, Sae Woong; Bae, Woong Jin; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl; Hwang, Tae-Kon; Kim, Sae Woong

2015-05-01

318

A Dual 5?-Reductase Inhibitor Dutasteride Caused Reductions in Vascular Density and Area in Benign Prostatic Hyperplasia  

PubMed Central

Objectives. Dutasteride, a dual 5?-reductase inhibitor, is used to treat benign prostatic hyperplasia. Nevertheless, its histopathological effects on the morphometrics of blood vessels and glands are still controversial. The aim here was to assess the histopathological effects of dutasteride in cases of benign prostatic hyperplasia in a retrospective study. Methods. Patients with benign prostatic hyperplasia more than 40?cm3 in prostatic volume were administered 0.5?mg of dutasteride daily or left untreated prior to receiving a transurethral resection of the prostate. Images of sections stained with hematoxylin/eosin and with anti-CD31 antibody were analyzed. Results. In the dutasteride-treated group, the duration of administration was 16.3 ± 8.1 weeks. Artery/arteriole density and vein/venule density in benign prostatic tissue were both lower in the dutasteride-treated group than in the control group. The vein/venule area as a percentage of the whole area was also lower in the dutasteride-treated group, while the artery/arteriole area did not show a significant difference. Glandular/CD31-expressing vessel densities as well as glandular/CD31-expressing vessel areas were comparable between the two groups. Conclusions. Dutasteride reduced the artery/arteriole and vein/venule densities and the proportion of vein/venule area in the tissue of patients with benign prostatic hyperplasia. PMID:23401800

Zaitsu, Masayoshi; Tonooka, Akiko; Mikami, Koji; Hattori, Mami; Takeshima, Yuta; Uekusa, Toshimasa; Takeuchi, Takumi

2013-01-01

319

Evaluation of the clinical benefit of permixon and tamsulosin in severe BPH patients-PERMAL study subset analysis  

Microsoft Academic Search

OBJECTIVE: To compare the efficacy of the lipido-sterolic extract of Serenoa repens, Permixon, to that of the a-blocker, tamsulosin, in the treatment of severe low urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH). METHODS: In a 12-month, double-blind, randomized study that showed equivalent efficacy of Permixon 320 mg\\/day and tamsulosin 0.4 mg\\/day (\\

F. M. J. Debruyne; P. Boyle; F. Calais Da Silva; J. G. Gillenwater; F. C. Hamdy; P. Perrin; P. Teillac; R. Vela-Navarrete; J. P. Raynaud; C. C. Schulman

2004-01-01

320

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

NASA Astrophysics Data System (ADS)

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

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

1991-07-01

321

[Up-to-date on the treatment of benign prostatic hyperplasia. Which adenoma to treat and how to do it?].  

PubMed

Benign prostatic hyperplasia is a state of the nature rather than a disease. It affects mainly men over 50 years and represents a public health problem. A literature review on the therapeutic management of benign prostatic hyperplasia was carried out from a selection of publications with the highest level of evidence. Medical treatment is based on herbal medicine, alpha-blockers and 5-alpha-reductase inhibitors. Surgical treatment is used in case of complications or failure of medical management. Surgical options are numerous. Transurethral prostate resection and prostate adenomectomy are the most usual procedures. Due to their significant morbidity, other less invasive procedures have recently been developed. The choice of treatment will depend on prostate volume and anatomy and patient's comorbidities. PMID:24262410

Lahlaidi, K; Ariane, M M; Fontaine, E

2014-03-01

322

Prostate cancer, benign prostatic hyperplasia and physical activity in Shanghai, China  

Microsoft Academic Search

Background Studies suggest that increased levels of physical activity might decrease the risk of prostate cancer. We ascertained lifetime measures of activity in a population-based case-control study of prostate cancer in Shanghai, China to investigate physical activity in a population where the incidence of prostate cancer is low but rising. Methods In all, 238 men with prostate cancer, diagnosed 1993-1995,

James V Lacey Jr; Jie Deng

2001-01-01

323

Hypermethylation of Cyclin D2 is associated with loss of mRNA expression and tumor development in prostate cancer  

Microsoft Academic Search

D-type cyclins play a pivotal role in cell cycle regulation and their abnormal expression was associated with several human malignancies. To assess Cyclin D2 promoter methylation status and expression levels in prostate tissues, quantitative methylation-specific PCR and quantitative reverse transcription PCR assays were performed in a large series of prostate carcinomas, high-grade prostatic intraepithelial neoplasias (HGPIN), benign prostate hyperplasias (BPH),

Rui Henrique; Vera Lúcia Costa; Nuno Cerveira; André Lopes Carvalho; Mohammad Obaidul Hoque; Franclim Ricardo Ribeiro; Jorge Oliveira; Manuel Rodrigues Teixeira; David Sidransky; Carmen Jerónimo

2006-01-01

324

The role of prostatic inflammation biomarkers in the diagnosis of prostate diseases.  

PubMed

Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are chronic conditions, which are hormone-dependent and epidemiologically associated with prostate inflammation. As a large number of studies have demonstrated, the stimulation of T-cells at the level of prostatic chronic inflammatory infiltrates is followed by stromal and epithelial cell proliferation. The aim of this review is to present the actual level of knowledge in the field of prostatic immune response and chronic inflammation, and to analyze the relationships between chronic inflammation and BPH/PCa. The most studied prostatic inflammation biomarkers detected in biological fluids are also presented, together with their potential roles in the diagnosis and prognosis of prostatic disease. PMID:24560954

Bardan, Razvan; Dumache, Raluca; Dema, Alis; Cumpanas, Alin; Bucuras, Viorel

2014-07-01

325

Qianliening capsules influence the apoptosis of benign prostatic hyperplasia epithelial-1 cells by regulating the extracellular matrix.  

PubMed

The present study investigated whether Qianliening capsules (QC) affected the apoptosis of benign prostatic hyperplastia epithelial (BPH?1) cells by regulating the extracellular matrix (ECM). The levels of fibronectin (FN) and collagen IV were determined in the culture medium of BPH?1 cells maintained in normal medium and of BPH?1 cells maintained in an environment rich in FN and collagen IV using an enzyme?linked immunosorbent assay. Reverse transcription quantitative polymerase chain reaction and western blot analysis were performed to determine the mRNA and protein expression levels of FN, collagen IV, B?cell lymphoma 2 (Bcl?2), Bcl?2?associated X protein (Bax) and cyclin D1, respectively. The cell morphology and viability were determined using light microscopy and an MTT assay and cell apoptosis was detected by annexin V staining. The results demonstrated that FN and collagen IV affected the apoptotic response of the BPH?1 cells, QC treatment significantly reduced the levels of FN and collagen IV secreted by the cells into the culture medium (P<0.01), inhibited the mRNA and protein expression levels of FN, collagen IV, Bcl?2 and cyclin D1 and promoted the mRNA and protein expression of Bax. Therefore, one of the mechanisms underlying the anti?BPH action of QC involves promoting apoptosis by regulating the expression of the extracellular matrix. PMID:25592406

Zhou, Jianheng; Lin, Jiumao; Liu, Liya; Zheng, Yuqing; Hong, Zhenfeng

2015-05-01

326

Transurethral microwave thermotherapy for the treatment of BPH: still a challenger?  

PubMed

Minimally invasive therapies for treatment of benign prostatic hyperplasia (BPH) compete with the gold standard transurethral resection of the prostate (TURP). Comparisons of efficacy and safety have broadened the knowledge of different treatment modalities. Concerns of quality of life such as unaltered sexual function as well as cost considerations drive the market to develop techniques of lower level invasiveness. Among the competitors the office based transurethral microwave thermotherapy (TUMT) provides the broadest scale of scientific data. Numerous manufacturers sell various modifications of this technology. According to different clinical studies TUMT proved to be an effective, safe, and durable therapy for the treatment of lower urinary tract symptoms (LUTS) secondary to BPH. However, TURP still holds the steadier long-term results and is more effective to reduce obstruction as well as other LUTS. PMID:16752156

Herrmann, T R W; Gross, A J; Schultheiss, D; Kaufmann, P M; Jonas, U; Burchardt, M

2006-09-01

327

Green light laser efficacy in patients with prostatic hyperplasia on long-term treatment with 5-alpha reductase inhibitors  

Microsoft Academic Search

Introduction: High prevalence of BPH and gradual ageing of the population, combined with the existence of effective medical treatments for this condition, have led to an increasing use of surgery in patients on long-term treatment with 5-alpha reductase inhibitors (5-ARIs). Initially, patients treated with 5-ARIs were not considered good candidates for photoselective vaporization of the prostate with green laser. Objective:

Joaquín Ulises; Juan Escudero; Emilio López Alcina; Macarena Ramos de Campos; Francisco Ramada Benlloch; Francisco Sánchez Ballester; Emilio Marqués Vidal

2010-01-01

328

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

PubMed Central

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

Lepor, Herbert

2006-01-01

329

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

PubMed Central

The gold standard for symptomatic relief of bladder outlet obstruction secondary to benign prostatic hyperplasia has traditionally been a transurethral resection of the prostate (TURP). Over the past decade, however, novel laser technologies that rival the conventional TURP have multiplied. As part of the ongoing quest to minimize complications, shorten hospitalization, improve resection time, and most importantly reduce mortality, laser prostatectomy has continually evolved. Today, there are more variations of laser prostatectomy, each with several differing surgical techniques. Although abundant data are available confirming the safety and feasibility of the various laser systems, future randomized-controlled trials will be necessary to verify which technique is superior. In this review, we describe the most common modalities used to perform a laser prostatectomy, mainly, the holmium laser and the potassium-titanyl-phosphate lasers. We also highlight the physical and clinical characteristics of each technology with a review of the most current and highest-quality literature. PMID:23789041

Choi, Benjamin B.

2013-01-01

330

Holmium laser enucleation of the prostate technique for benign prostatic hyperplasia.  

PubMed

Holmium laser resection of the prostate (HoLRP) was first described by Gilling et al in 1995. HoLRP has now evolved into holmium laser enucleation of the prostate (HoLEP) with the advent of the intravesical soft-tissue morcellator. The procedure involves anatomical dissection of the prostatic tissue off the surgical capsule in a retrograde fashion using a high-powered holmium laser followed by intravesical morcellation of the prostatic tissue. Some groups believe that the HoLEP procedure is the endoscopic equivalent to a simple open prostatectomy and may be superior to transurethral resection of the prostate (TURP) or even open prostatectomy. The objective of this article is to explain the techniques for holmium laser enucleation of the prostate (HoLEP). PMID:22316518

Kelly, Douglas C; Das, Akhil

2012-02-01

331

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

SciTech Connect

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.

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

1985-12-01

332

Holmium Laser Resection of the Prostate Versus Neodymium:Yttrium-Aluminum-Garnet Visual Laser Ablation of the Prostate: A Randomized Prospective Comparison of Two Techniques for Laser Prostatectomy  

Microsoft Academic Search

Objectives. To directly compare holmium laser resection of the prostate (HoLRP) with neodymium:yttrium-aluminum-garnet visual laser ablation of the prostate (VLAP), which represent two fundamentally different methods of laser prostatectomy.Methods. In a randomized, prospective comparison, a total of 44 men with symptomatic benign prostatic hyperplasia (BPH) were treated with either HoLRP or VLAP. Standard preoperative assessment included American Urological Association (AUA)

Peter J Gilling; Carol B Cass; Andrew Malcolm; Michael Cresswell; Mark R Fraundorfer; John N Kabalin

1998-01-01

333

Comparison of Transurethral Resection and Plasmakinetic Transurethral Resection Applications with Regard to Fluid Absorption Amounts in Benign Prostate Hyperplasia  

Microsoft Academic Search

Introduction: We compare the absorption of irrigant fluid during gyrus plasmakinetic transurethral prostatectomy (PK-TURP) and transurethral resection of the prostate (TURP). Patients and Methods: 42 patients with clinical benign prostatic hyperplasia were randomly assigned to undergo PK-TURP or TURP. In the PK-TURP group 0.9% NaCl was used as an irrigation fluid and 1.5% glycine in the TURP group. By adding

Murat Akçayöz; Özgür Akdemir; Fazil T. Aki; Mesut Çetinkaya

2006-01-01

334

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

PubMed Central

The oil of babassu tree nuts (Orbignya speciosa) is a potential alternative for treatment and prophylaxis of benign prostatic hyperplasia. Improved results can be obtained by drug vectorization to the hyperplastic tissue. The main objective of this work was the preparation and characterization of poly(lactic-co-glycolic acid) (PLGA) nanoparticle and clay nanosystems containing babassu oil (BBS). BBS was extracted from the kernels of babassu tree nuts and characterized by gas chromatography-mass spectrometry as well as 1H and 13C nuclear magnetic resonance. BBS-clay nanosystems were obtained by adding polyvinylpyrrolidone, Viscogel B8®, and BBS at a 2:1:1 mass ratio and characterized by X-ray diffraction, thermogravimetric analysis, infrared spectroscopy, and laser diffraction. The PLGA-BBS nanoparticles were prepared by the precipitation-solvent evaporation method. Mean diameter, polydispersity, zeta potential, and scanning electron microscopic images of the nanosystems were analyzed. Thermogravimetric analysis showed successful formation of the nanocomposite. PLGA nanoparticles containing BBS were obtained, with a suitable size that was confirmed by scanning electron microscopy. Both nanostructured systems showed active incorporation yields exceeding 90%. The two systems obtained represent a new and potentially efficient therapy for benign prostatic hyperplasia. PMID:23990721

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

2013-01-01

335

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

PubMed

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

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

2009-01-01

336

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

PubMed Central

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

Hwang, Jin Chul; Park, Sang Myung

2010-01-01

337

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

Microsoft Academic Search

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

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

2001-01-01

338

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

Microsoft Academic Search

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

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

2005-01-01

339

Autoradiographic Localisation and Contractile Properties of Prostatic Endothelin Receptors in Patients with Bladder Outlet Obstruction  

Microsoft Academic Search

Objectives: Previous studies have used endothelin (ET) receptor agonists and antagonists to localise ET receptor subtypes in prostatic tissue. We have utilised high affinity ETA ([125I]PD151242) and ETB ([125I]BQ3020) receptor–specific radioligands to determine the density and distribution of ET receptor subtypes in prostatic tissues obtained from patients with symptomatic benign prostatic hyperplasia (BPH). The contractile properties of the ET receptor

F. H. Mumtaz; M. R. Dashwood; C. S. Thompson; M. A. Khan; A. M. Naylor; D. P. Mikhailidis; R. J. Morgan; D. P. Mikhailidis

2001-01-01

340

The Evolution of KTP Laser Vaporization of the Prostate  

PubMed Central

The search for a minimally invasive approach to the treatment of Lower Urinary Tract Symptoms (LUTS) suggestive of Benign Prostatic Hyperplasia (BPH) is probably as old as Transurethral Resection of the Prostate (TURP). In an effort to overcome the limitations and morbidities of TURP, and in light of evidence suggesting that medical treatment for BPH has a limited life-span, laser-based treatments have emerged during the last decade. Photoselective Vaporization of the Prostate (PVP) by the "GreenLight" KTP laser is considered one of the most promising options, one that is constantly evolving new technologies in prostate surgery. In this overview of KTP laser usage in BPH treatment, we will briefly discuss the evolution of this modality since it was first introduced and focus on the available evidence regarding safety, efficacy and cost parameters of its application. PMID:18452253

Tsakiris, Peter

2008-01-01

341

The evolution of KTP laser vaporization of the prostate.  

PubMed

The search for a minimally invasive approach to the treatment of Lower Urinary Tract Symptoms (LUTS) suggestive of Benign Prostatic Hyperplasia (BPH) is probably as old as Transurethral Resection of the Prostate (TURP). In an effort to overcome the limitations and morbidities of TURP, and in light of evidence suggesting that medical treatment for BPH has a limited life-span, laser-based treatments have emerged during the last decade. Photoselective Vaporization of the Prostate (PVP) by the "GreenLight" KTP laser is considered one of the most promising options, one that is constantly evolving new technologies in prostate surgery. In this overview of KTP laser usage in BPH treatment, we will briefly discuss the evolution of this modality since it was first introduced and focus on the available evidence regarding safety, efficacy and cost parameters of its application. PMID:18452253

Sountoulides, Petros; Tsakiris, Peter

2008-04-30

342

A case-based evaluation of SRD5A1, SRD5A2, AR, and ADRA1A as candidate genes for severity of BPH  

Microsoft Academic Search

In men with a clinical diagnosis of benign prostatic hyperplasia (BPH), polytomous logistic regression analysis was conducted to evaluate associations between two silent polymorphisms in SRD5A1 (codon positions 30 and 116), two polymorphisms in SRD5A2 (Val89Leu substitution and C to T transition in intron 1), a trinucleotide (CAG)n repeat in androgen receptor (AR), and an Arg492Cys substitution in ADRA1A and

M Klotsman; C R Weinberg; K Davis; C G Binnie; K E Hartmann

2004-01-01

343

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

PubMed Central

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

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

2013-01-01

344

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

PubMed Central

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

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

2015-01-01

345

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

PubMed Central

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

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

2015-01-01

346

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

PubMed

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

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

2014-01-01

347

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

Microsoft Academic Search

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

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

2003-01-01

348

Combined Sabal and Urtica extract vs finasteride in BPH (Alken stage I–II)  

Microsoft Academic Search

Summary  \\u000a Therapeutic equivalence should be demonstrated in a randomised, reference-controlled multicentric double blind clinical trial\\u000a with PRO 160\\/120, a combination of Sabal- and Urtica-Extract, and Finasteride, respectively, in patients suffering from benign\\u000a prostatic hyperplasia (BPH, Stage I to II according to Alken). The study involved 543 patients, who were treated for 48 weeks\\u000a with two capsules of PRO 160\\/120 or

Jürgen Sökeland; J. Albrecht

1997-01-01

349

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

Microsoft Academic Search

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

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

2003-01-01

350

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

Microsoft Academic Search

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.

Roger S. Kirby; Timothy Christmas

1991-01-01

351

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

PubMed Central

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

Saleh, Khaldon Y; Smith, Nadine Barrie

2005-01-01

352

Use of 5-Alpha-Reductase Inhibitors Did Not Increase the Risk of Cardiovascular Diseases in Patients with Benign Prostate Hyperplasia: A Five-Year Follow-Up Study  

PubMed Central

Background This nationwide population-based study investigated the risk of cardiovascular diseases after 5-alpha-reductase inhibitor therapy for benign prostate hyperplasia (BPH) using the National Health Insurance Research Database (NHIRD) in Taiwan. Methods In total, 1,486 adult patients newly diagnosed with BPH and who used 5-alpha-reductase inhibitors were recruited as the study cohort, along with 9,995 subjects who did not use 5-alpha-reductase inhibitors as a comparison cohort from 2003 to 2008. Each patient was monitored for 5 years, and those who subsequently had cardiovascular diseases were identified. A Cox proportional hazards model was used to compare the risk of cardiovascular diseases between the study and comparison cohorts after adjusting for possible confounding risk factors. Results The patients who received 5-alpha-reductase inhibitor therapy had a lower cumulative rate of cardiovascular diseases than those who did not receive 5-alpha-reductase inhibitor therapy during the 5-year follow-up period (8.4% vs. 11.2%, P=0.003). In subgroup analysis, the 5-year cardiovascular event hazard ratio (HR) was lower among the patients older than 65 years with 91 to 365 cumulative defined daily dose (cDDD) 5-alpha-reductase inhibitor use (HR=0.63, 95% confidence interval (CI) 0.42 to 0.92; P=0.018), however there was no difference among the patients with 28 to 90 and more than 365 cDDD 5-alpha-reductase inhibitor use (HR=1.14, 95% CI 0.77 to 1.68; P=0.518 and HR=0.83, 95% CI 0.57 to 1.20; P=0.310, respectively). Conclusions 5-alpha-reductase inhibitor therapy did not increase the risk of cardiovascular events in the BPH patients in 5 years of follow-up. Further mechanistic research is needed. PMID:25803433

Lee, Shang-Sen; Lin, Tien-Huang; Liu, Hsin-Ho; Tsai, Tsung-Hsun; Chen, Chi-Cheng; Huang, Yung-Sung; Lee, Ching-Chih

2015-01-01

353

Sonographic assessment of postvoid residual urine volumes in patients with benign prostatic hyperplasia.  

PubMed Central

OBJECTIVE: To derive a formula that defines the postvoid residual (PVR) urine volume more accurately in patients with prostatic gland enlargement. DESIGN: Prospective. SETTING: Department of Radiology, University of Ilorin Teaching Hospital, Ilorin. SUBJECT: Fifty-two consecutive patients with benign prostatic hyperplasia. The mean age was 64.98+/-9.57 years. METHOD: PVR urine was evaluated by ultrasonography. Each patient had two examinations, the first of which was with a full bladder and the second of which was immediately after voiding. Two orthogonal diameters were measured on each bladder section (longitudinal and transverse) in the supine position. Fifty-two paired sets of ultrasonic measurements were thus obtained. Catheterized postvoid urine residue was regarded as the gold standard. RESULTS: Using these measurements, an equation--[PVR(CUBIC)=374.057+(-196.94+V1)+(32.5539+V1(2))+(-1.1480+V1(3)) where V1=average of the length (L), width (T), and the anteroposterior distance on transverse section (Dt) of the postvoid urinary bladder]--more accurate than previously existing ones was obtained by cubic regression analysis. Mean ultrasound estimated volume was 220.51 ml as against 220.76 ml after catheterization. The mean difference was 0.25 ml (not significant, p<0.01) with 95% confidence interval of +/-10 ml. With this equation, the ultrasonographic residual urine volume showed a higher correlation coefficient with the catheterized volume at p<0.01 (Pearson r=0.982, r2=0.96) than previously defined formulas. The standard error of the mean was 5.11 ml (mean=220.5+/-190.4 ml). CONCLUSION: With the above equation, we consider conventional transabdominal ultrasonography a reliable method for assessing the residual urine volume in patients with benign prostatic hyperplasia. This equation, though complex when compared to some of the pre-existing formulas, can be integrated into the memory of modern ultrasound machines for easy and faster computation. Images Figure 1 PMID:14977284

Amole, Adewumi O.; Kuranga, Sulyman A.; Oyejola, Benjamin A.

2004-01-01

354

Treatment response with transurethral radiofrequency thermotherapy for symptomatic benign prostatic hyperplasia.  

PubMed

One hundred and two patients with benign prostatic hyperplasia were treated by transurethral radio-frequency thermotherapy (TURT) device (Thermex-II, Direx, Israel) with 47.5 degrees C in single session for 2 hours and 30 minutes from November 1992 to October 1993. Among them, 83 patients, who were followed up for more than 3 months were included in this study. Twenty-seven (32.5%) patients had a history of acute retention. Pretreated values of the mean Madsen-Iversen symptom score, maximum urine flow rate, postvoiding residual urine volume, prostate volume and prostate specific antigen (PSA) were 15.4, 6.5 ml/sec, 61.3ml, 43.2ml and 0.77 ng/ml respectively. Madsen-Iversen symptom score, maximum urine flow rate were measured at 2 weeks, 1, 3 and 6 months after TURT. The residual urine volume, prostate volume and PSA level were measured at 3 and 6 months after TURT. During the follow up, the symptom score started to decrease significantly at 1 month (9.9, p < 0.01) after TURT, and gradually decreased up to 6.9 at 3 months. The maximum flow rate showed initial significant improvement at 2 weeks (8.1 ml/sec., p < 0.01), but no significant interval change was observed thereafter. The residual volume decreased significantly at 3 months (41.3 ml, p < 0.01) and no decrement was noted until 6 months. Neither the prostate volume nor PSA value changed significantly at 3 or 6 months after TURT. The improvement, which was defined as a change of 50% or more in at least one of subjective or objective symptoms showed in 63.9% (53/83) at 3 months and 57.1% (32/56) at 6 months. Both subjective and objective improvements at 3 and 6 months after treatment showed in 24.1% and 19.6%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7526562

Hong, S J; Choi, H R; Lee, T; Kang, Y S

1994-09-01

355

Effects of Tamsulosin on Premature Ejaculation in Men with Benign Prostatic Hyperplasia  

PubMed Central

Purpose Previous studies have revealed that tamsulosin is effective in improving lower urinary tract symptoms (LUTS) and erectile functioning but has some inhibitory effects on ejaculation, including decreased ejaculatory volume. However, these inhibitory effects on ejaculation can be beneficial to patients with premature ejaculation (PE). Therefore, this study was conducted to understand the effect of tamsulosin on PE in men with benign prostatic hyperplasia. Materials and Methods Twenty-nine patients who visited with LUTS were categorized into 2 groups of LUTS-only patients (n=12) and LUTS combined with PE (LUTS+PE) patients (n=17), and 0.4 mg of tamsulosin was administered to the patients of both groups for 12 weeks. Comparative analyses of before and after the treatment were conducted for calculating the International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), intravaginal ejaculatory latency time (IELT), premature ejaculation diagnostic tool (PEDT), and premature ejaculation profile (PEP). The patients with an IPSS score of 8 or higher were determined as LUTS patients, and the patients with IELT of less than 2 minutess and a PEDT score of 9 or higher were determined as PE patients. Results After treatment, the IPSS score significantly decreased in both groups. There was no statistically significant change in the PEDT for the LUTS group, but there was a significant decrease in PEDT (p=0.012; from 12.1±3.31 to 8.4±4.49) in the LUTS+PE group. Conclusions Tamsulosin not only has a treatment effect for LUTS but also improves the PE of LUTS+PE patients. Therefore, further studies are needed to confirm the effects of tamsulosin on PE. PMID:25237660

Choi, Jae Hwi; Hwa, Jung Seog; Kam, Sung Chul; Jeh, Seong Uk

2014-01-01

356

Patients with a large prostate show a higher prevalence of androgenetic alopecia  

Microsoft Academic Search

Androgenetic alopecia (AGA) and benign prostatic hyperplasia (BPH) are both androgen-dependent disorders, displaying in situ high levels of dihydrotestosterone with a good therapeutic response to finasteride. Embryological development of both the hair follicle and the prostate depends on mesenchymal-epithelial interaction, which is influenced by the expression of type 2 5?-reductase. The aim of this study was to elucidate the association

WenChieh Chen; Chao-Chun Yang; Guan-Yu Chen; Meng-Chie Wu; Hamm-Ming Sheu; Tzong-Shin Tzai

2004-01-01

357

GEOPHYSICS, ASTRONOMY AND ASTROPHYSICS: Second-harmonic generation as a DNA malignancy indicator of prostate glandular epithelial cells  

NASA Astrophysics Data System (ADS)

This paper first demonstrates second-harmonic generation (SHG) in the intact cell nucleus, which acts as an optical indicator of DNA malignancy in prostate glandular epithelial cells. Within a scanning region of 2.7 ?m×2.7 ?m in cell nuclei, SHG signals produced from benign prostatic hyperplasia (BPH) and prostate carcinoma (PC) tissues (mouse model C57BL/6) have been investigated. Statistical analyses (t test) of a total of 405 measurements (204 nuclei from BPH and 201 nuclei from PC) show that SHG signals from BPH and PC have a distinct difference (p < 0.05), suggesting a potential optical method of revealing very early malignancy in prostate glandular epithelial cells based upon induced biochemical and/or biophysical modifications in DNA.

Zhuang, Zheng-Fei; Liu, Han-Ping; Guo, Zhou-Yi; Zhuo, Shuang-Mu; Yu, Bi-Ying; Deng, Xiao-Yuan

2010-04-01

358

Holmium Laser Enucleation versus Transurethral Resection in Patients with Benign Prostate Hyperplasia: An Updated Systematic Review with Meta-Analysis and Trial Sequential Analysis  

PubMed Central

Background Holmium laser enucleation (HoLEP) in surgical treatment of benign prostate hyperplasia (BPH) potentially offers advantages over transurethral resection of the prostate (TURP). Methods Published randomized controlled trials (RCTs) were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Library up to October 10, 2013 (updated on February 5, 2014). After methodological quality assessment and data extraction, meta-analysis was performed using STATA 12.0 and Trial Sequential Analysis (TSA) 0.9 software. Results Fifteen studies including 8 RCTs involving 855 patients met the criteria. The results of meta-analysis showed that: a) efficacy indicators: there was no significant difference in quality of life between the two groups (P>0.05), but compared with the TURP group, Qmax was better at 3 months and 12 months, PVR was less at 6, 12 months, and IPSS was lower at 12 months in the HoLEP, b) safety indicators: compared with the TURP, HoLEP had less blood transfusion (RR 0.17, 95% CI 0.06 to 0.47), but there was no significant difference in early and late postoperative complications (P>0.05), and c) perioperative indicators: HoLEP was associated with longer operation time (WMD 14.19 min, 95% CI 6.30 to 22.08 min), shorter catheterization time (WMD ?19.97 h, 95% CI ?24.24 to ?15.70 h) and hospital stay (WMD ?25.25 h, 95% CI ?29.81 to ?20.68 h). Conclusions In conventional meta-analyses, there is no clinically relevant difference in early and late postoperative complications between the two techniques, but HoLEP is preferable due to advantage in the curative effect, less blood transfusion rate, shorter catheterization duration time and hospital stay. However, trial sequential analysis does not allow us to draw any solid conclusion in overall clinical benefit comparison between the two approaches. Further large, well-designed, multicentre/international RCTs with long-term data and the comparison between the two approaches remain open. PMID:25003963

Ruan, Xiao-Lan; Weng, Hong; Liu, Tong-Zu; Wang, Xiao; Zhang, Chao; Meng, Zhe; Wang, Xing-Huan

2014-01-01

359

LHRH antagonist Cetrorelix reduces prostate size and gene expression of proinflammatory cytokines and growth factors in a rat model of benign prostatic hyperplasia  

Microsoft Academic Search

BACKGROUND: Recent findings suggest that BPH has an inflammatory component. Clinical trials have documented that therapy with LHRH antagonist Cetrorelix causes a marked and prolonged improvement in LUTS in men with symptomatic BPH. We investigated the mechanism of action and effect of Cetrorelix in a rat model of BPH. METHODS: Adult male Wistar rats were used. BPH was induced in

F. G. Rick; A. V. Schally; N. L. Block; G. Halmos; R. Perez; J. B. Fernandez; I. Vidaurre; L. Szalontay

2011-01-01

360

SELECTIVITY OF FINASTERIDE AS AN IN VIVO INHIBITOR OF 5 alpha-REDUCTASE ISOZYME ENZYMATIC ACTIVITY IN THE HUMAN PROSTATE  

Microsoft Academic Search

The type II 5 alpha-reductase inhibitor finasteride is used in the treatment of benign prostatic hyperplasia (BPH), reducing local production of the growth promoting androgen dihydrotestosterone (DHT). The effect of prolonged treatment with this time-dependent irreversible inhibitor on the recently described prostatic type I 5 alpha-reductase, however, is not clear. Therefore, we assessed the effects of 5 mg. finasteride per

PAUL N. SPAN; MAUREEN C. W. VOLLER; ANTHONY G. H. SMALS; FRED G. J. SWEEP; JACK A. SCHALKEN; MARK R. FENELEY; ROGER S. KIRBY

1999-01-01

361

Application of the Modified Clavien Classification System to 402 Cases of Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia  

PubMed Central

Purpose We attempted to evaluate the perioperative complications of holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia by using the modified Clavien classification system (MCCS). Materials and Methods Targeting 402 patients who underwent HoLEP for benign prostatic hyperplasia performed by a single surgeon between July 2008 and January 2011, we investigated complications that occurred during and within 1 month after surgery and classified them into grade I to grade V on the basis of the MCCS. If two or more complications occurred in one patient, each complication was graded and counted. Results The mean age, prostate volume, operation time, hospital stay, and average follow-up period of 402 patients who underwent HoLEP were 68.8 years (range, 52-84 years), 53.2 g (range, 23-228 g), 58.2 minutes (range, 20-230 minutes), 4.5 days (range, 2-7 days), and 9 months (range, 4-27 months), respectively; 78 complications occurred in 71 of the patients (morbidity rate, 17.6%). In MCCS grade I, complications occurred in 54 cases (69.2%); in grade II, complications occurred in 19 cases (24.3%); in grade III, complications occurred in 4 cases (5.1%); and in grade IV, 1 patient required intensive care unit care because of cerebral infarction (1.2%). There were no grade V complications. Conclusions The HoLEP-based MCCS complications classification was performed very quickly. However, MCCS, when compared with other measures of endoscopic prostate surgery experiences, including HoLEP, exposed the lack of accuracy in low grade classification and the inability to include late complications. PMID:24648872

Choi, Jong In; Moon, Kyung Young; Yoon, Jong Hyun; Na, Woong

2014-01-01

362

Prostatic fluid electrolyte composition for the screening of prostate cancer: a potential solution to a major problem  

PubMed Central

Early detection is the key to effective treatment of prostate cancer, and to the prevention of deaths due to progression to untreatable advanced stage cancer. Because of mitigating factors, especially benign prostatic hyperplasia (BPH), that result in a low accuracy (about 60%) of prostate-specific antigen (PSA) testing, there is an urgent need for a more reliable biomarker for the identification of early stage through advanced stage prostate cancer and ‘at-risk’ individuals. To address this issue we propose that changes in prostatic fluid composition could provide accurate and reliable biomarkers for the screening of prostate cancer. Most notable is the consistent and significant decrease in citrate and zinc that is associated with the development and progression of prostate cancer. In this review we provide the clinical and physiological basis and the evidence in support of the utility of prostatic fluid analysis as an effective approach for screening/detection of prostate cancer, especially early stage and ‘at-risk’ subjects. The problem of BPH interference that plagues PSA testing is eliminated in the potential prostatic fluid biomarkers. The potential development of rapid, simple, direct, accurate clinical tests provides additional advantageous conditions. Further exploration and development of citrate, zinc and other electrolytes as prostatic fluid biomarkers are urgently needed to address this critical prostate cancer issue. PMID:18591961

Costello, LC; Franklin, RB

2013-01-01

363

4-aminopyridine improves lower urinary tract symptoms in a patient with benign prostatic hyperplasia and downbeat nystagmus syndrome.  

PubMed

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

Strupp, Michael; Feil, Katharina; Bardins, Stanislavs; Waidelich, Raphaela

2014-12-01

364

4-Aminopyridine Improves Lower Urinary Tract Symptoms in a Patient With Benign Prostatic Hyperplasia and Downbeat Nystagmus Syndrome  

PubMed Central

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

Feil, Katharina; Bardins, Stanislavs; Waidelich, Raphaela

2014-01-01

365

Contemporary Practice Patterns of Endoscopic Surgical Management for Benign Prostatic Hyperplasia Among Urologists in the United States  

PubMed Central

Purpose We describe contemporary trends in endoscopic surgical management for benign prostatic hyperplasia. We examined case logs submitted by urologists for American Board of Urology certification or recertification. We compared electrosurgical transurethral resection of the prostate vs laser vaporization or laser enucleation and determined the impact of surgeon age on practice patterns. Materials and Methods We analyzed case logs from 2004 to 2010 for trends and used logistic regression models to assess the impact of surgeon age on endoscopic surgery use. Results A total of 3,955 urologists included at least 1 endoscopic surgical management in the case logs, while 2,334 (59%) exclusively performed electrosurgical transurethral resection of the prostate and 309 (8%) exclusively performed laser vaporization or laser enucleation. We observed a large increase in the number and proportion of laser procedures from 11% in 2004 to 44% in 2010. Although there was no difference in median age between urologists who performed exclusively electrosurgical transurethral resection and those who performed laser procedures, the latter had a substantially higher case volume. Older urologists were significantly less likely to perform laser vaporization or enucleation when undergoing the second recertification (OR 0.56/10 years of age, 95% CI 0.36–0.87, p = 0.009), but not the initial certification. Conclusions There was a substantial increase in laser vaporization or laser enucleation procedures performed by urologists who underwent board certification or recertification in 2004 to 2010. However, of those undergoing the second recertification older age was significantly associated with a lower likelihood of performing laser procedures. These data provide estimates of current practice patterns and further our understanding of evolving surgical treatment for benign prostatic hyperplasia. PMID:23219542

Lowrance, William T.; Southwick, Andrew; Maschino, Alexandra C.; Sandhu, Jaspreet S.

2014-01-01

366

Java Web Start based software for automated quantitative nuclear analysis of prostate cancer and benign prostate hyperplasia  

Microsoft Academic Search

BACKGROUND: Androgen acts via androgen receptor (AR) and accurate measurement of the levels of AR protein expression is critical for prostate research. The expression of AR in paired specimens of benign prostate and prostate cancer from 20 African and 20 Caucasian Americans was compared to demonstrate an application of this system. METHODS: A set of 200 immunopositive and 200 immunonegative

Swaroop S Singh; Desok Kim; James L Mohler

2005-01-01

367

Mitochondria-dependent apoptogenic activity of the aqueous root extract of Croton membranaceus against human BPH-1 cells.  

PubMed

Croton membranaceus aqueous root extract (CMARE) is among the widely used phytotherapeutics in Ghana for the management of benign prostatic hyperplasia (BPH) and prostate cancer. However, the mechanism of action of CMARE remains to be elucidated. This study aimed to establish whether apoptosis is involved in the antiproliferative effect of CMARE on human BPH-1 cells. We determined the effect of treatment with 0, 1, 3, and 5 mg/mL CMARE for 24, 48, and 72 h on the viability and morphology of BPH-1 cells using the MMT assay and phase-contrast microscopy, respectively. We examined the apoptosis-inducing effects of CMARE after 48 h at the cellular level using Hoescht 33258 and JC-1 dye staining and flow cytometry analysis. We performed reverse transcription polymerase chain reaction and Western blotting to confirm the apoptotic effects of CMARE at the molecular level. CMARE induced a significant dose-dependent inhibition in the proliferation of BPH-1 cells (P < 0.05) and an alteration in their morphology and a reduction their density. Furthermore, CMARE induced dose-dependent staining of the nuclear chromatin, significant DNA fragmentation with G0/G1 sub-diploid cells (P < 0.01), and loss of the mitochondrial membrane potential in the treated cells compared to the controls after 48 h (P < 0.01). Additionally, while CMARE induced a significant upregulation of the mRNA and protein levels of Bax, those of Bcl2 did not change significantly. Therefore, induction of mitochondria-dependent apoptosis of BPH-1 cells may be a possible mechanism of action of CMARE. PMID:25729946

Afriyie, D K; Asare, G A; Bugyei, K; Lin, J; Peng, J; Hong, Z

2015-01-01

368

Standard surgical treatment for benign prostatic hyperplasia is safe for patients over 75 years: Analysis of 100 cases from a high-volume urologic center  

PubMed Central

OBJECTIVES: In this study, we aimed to determine the complications of standard surgical treatments among patients over 75 years in a high-volume urologic center. METHODS: We analyzed 100 consecutive patients older than 75 years who had undergone transurethral prostatic resection of the prostate or open prostatectomy for treatment of benign prostatic hyperplasia from January 2008 to March 2010. We analyzed patient age, prostate volume, prostate-specific antigen level, international prostatic symptom score, quality of life score, urinary retention, co-morbidities, surgical technique and satisfaction with treatment. RESULTS: Median age was 79 years. Forty-eight patients had undergone transurethral prostatic resection of the prostate, and 52 had undergone open prostatectomy. The median International Prostatic Symptom Score was 20, the median prostate volume was 83 g, 51% were using an indwelling bladder catheter, and the median prostate-specific antigen level was 5.0 ng/ml. The most common comorbidities were hypertension, diabetes and coronary disease. After a median follow-up period of 17 months, most patients were satisfied. Complications were present in 20% of cases. The most common urological complication was urethral stenosis, followed by bladder neck sclerosis, urinary fistula, late macroscopic hematuria and persistent urinary incontinence. The most common clinical complication was myocardial infarction, followed by acute renal failure requiring dialysis. Incidental carcinoma of the prostate was present in 6% of cases. One case had urothelial bladder cancer. CONCLUSIONS: Standard surgical treatments for benign prostatic hyperplasia are safe and satisfactory among the elderly. Complications are infrequent, and urethral stenosis is the most common. No clinical variable is associated with the occurrence of complications. PMID:23295595

Marmiroli, Rafael; Antunes, Alberto A.; Reis, Sabrina T.; Nakano, Elcio; Srougi, Miguel

2012-01-01

369

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

PubMed

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

Elberry, Ahmed A; Mufti, Shagufta; Al-Maghrabi, Jaudah; Abdel Sattar, Essam; Ghareib, Salah A; Mosli, Hisham A; Gabr, Salah A

2014-01-01

370

Immunomodulatory Effect of Red Onion (Allium cepa Linn) Scale Extract on Experimentally Induced Atypical Prostatic Hyperplasia in Wistar Rats  

PubMed Central

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

Elberry, Ahmed A.; Al-Maghrabi, Jaudah; Abdel Sattar, Essam; Ghareib, Salah A.; Mosli, Hisham A.; Gabr, Salah A.

2014-01-01

371

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

PubMed Central

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

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

2014-01-01

372

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

PubMed Central

Purpose With the use of 12 months of follow-up data, this study was conducted to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 120 W Greenlight high performance system (HPS) laser for the treatment of symptomatic benign prostatic hyperplasia. Materials and Methods Data were collected from 104 patients who were diagnosed with benign prostatic hyperplasia and who underwent PVP with the 120 W Greenlight HPS Laser. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR), were assessed and compared with preoperative baseline values. Results The mean age of the patients was 71.1±7.7. The baseline mean prostate-specific antigen level was 3.8±2.7 ng/ml, the mean prostate size was 43.9±20.6 g, the mean preoperative IPSS was 18.4±8.5, the mean QoL score was 4.1±1.0, the mean Qmax was 9.9±5.5 ml/sec, and the mean PVR was 89.6±207.1 ml. During surgery, the mean operation time was 21.8±11.3 minutes, the mean lasing time was 16.9±10.5 minutes, and the mean total applied energy was 170,068±63,181 J. At 1 month, significant improvements were observed in total IPSS (11.5±6.7, p<0.05), voiding symptom score (6.1±5.4, p<0.05), and QoL score (2.2±1.5, p<0.05); however, there were no significant improvements in storage symptom score (4.8±3.8, p=0.06), Qmax (12.6±10.2, p=0.06), and PVR (40.1±30.5, p=0.41). However, 3 months after surgery, all postoperative follow-up parameters showed significant improvements, and the 6- and 12-month data showed sustained improvement of postoperative follow-up parameters. Conclusions Significant improvements were observed in subjective and objective voiding parameters, which were evident at 3 months after PVP and were sustained throughout a period of 12 months after PVP. PMID:21556212

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

2011-01-01

373

Prostatic growth effects of rat urogenital sinus and human prostatic tissue in the rat.  

PubMed

It is known that fetal urogenital sinus (UGS) implanted into one ventral lobe of an adult mouse prostate produces a significantly increased DNA content in that lobe. In our study, we attempted to determine whether that growth was of host or of graft tissue. UGS from fetal rats and ventral prostate from adult rats were implanted in various sites in syngeneic Fischer rats, alone or as a recombinant tissue complex. Human benign prostatic hyperplasia (BPH) tissue was implanted into the ventral prostate of adult, male, hooded nude rats to determine whether it stimulated prostatic growth. All UGS-implanted in situ ventral lobes enlarged. Mean DNA content of UGS and ventral prostate implanted together in the flank was not different from the mean DNA content of UGS and ventral prostate implanted separately in the flank (P = 0.69). Mean DNA content of in situ control ventral lobe and of UGS grown singly in the flank was less than that of a UGS-implanted in situ ventral lobe (P less than 0.01). Thus overgrowth in the UGS-implanted in situ ventral prostate was location-dependent, but which tissue(s) enlarged remains unclear. Implanted human BPH tissue did not stimulate rat prostatic growth. PMID:2473458

Jarow, J P; Isaacs, J T

1989-01-01

374

Long-Term Evaluation of Transurethral Needle Ablation of the Prostate (TUNA) for Treatment of Symptomatic Benign Prostatic Hyperplasia: Clinical Outcome up to Five Years from Three Centers  

Microsoft Academic Search

Objective: TUNA has been demonstrated to be a safe and effective therapy for BPH. However the major criticism, as with all alternative treatments for BPH, was the lack of long-term data. We present the clinical outcome of patients treated by TUNA and followed for 5 years.Methods: 188 consecutive patients with symptomatic BPH treated with TUNA were followed for five years

Alexandre R. Zlotta; Xenofon Giannakopoulos; Odd Maehlum; Tonnes Ostrem; Claude C. Schulman

2003-01-01

375

Prostate gland development and adrenal tumor in a female with congenital adrenal hyperplasia: A case report and review from radiology perspective  

PubMed Central

We describe a case of a female with simple virilizing congenital adrenal hyperplasia (CAH) reared as a male diagnosed at the late age of 64. Computed Tomography (CT) demonstrated a large adrenal mass, bilateral diffuse adrenal enlargement, female pelvic organs as well as a clearly visualized prostate gland. This is to the best of our knowledge the first case of such a sizable prostate gland in a female CAH patient documented on CT. We review the literature regarding aspects where radiologists may encounter CAH and the finding of presence of a prostate gland in female CAH patients.

Fang, Benjamin; Cho, Francis; Lam, Wendy

2013-01-01

376

Identification of microRNAs differentially expressed in prostatic secretions of patients with prostate cancer.  

PubMed

Prostate cancer (PCa) is one of the leading causes of cancer deaths in men. Since there are limited treatment options available for the advanced tumors, there is an urgent need for novel diagnostic tools for PCa. Prostate secretion samples (PSS) from 23 PCa and 25 benign prostate hyperplasia (BPH) patients were obtained from Urology Department of Bagcilar Educational and Research Hospital (Istanbul). MicroRNA (miRNA) profiling of eight PSS (four from BPH, four from PCa patients) was performed using microarray. Four of significantly deregulated miRNAs were further confirmed using quantitative reverse-transcription PCR (qRT-PCR). Statistical analysis was performed using Student's t-test. ROC curves were plotted with SPSS-15.0. In this study, we aimed to identify a miRNA expression signature that could be used to distinguish PCa from BPH. MiRNA profiling of four PCa and four BPH patients with microarray revealed that miR-361-3p, miR-133b and miR-221 were significantly downregulated and miR-203 was upregulated in PSS of PCa patients. Further qRT-PCR analysis confirmed the altered expressions of these four miRNAs in PSS of 23 PCa and 25 BPH patients. Four miRNAs, together and individually have much power (AUC; 0.950) than PSA has (AUC; 0.463) to discriminate PCa from BPH patients. We have shown for the first time in the literature the presence of miRNAs in the PSS. We suggest PSS as a powerful non-invasive source for evaluation of prognosis in PCa, since prostate massages can be easily applied during routine examination. Our results showed that certain differentially expressed miRNAs in PSS could be used as diagnostics markers. PMID:24976077

Guzel, Esra; Karatas, Omer F; Semercioz, Atilla; Ekici, Sinan; Aykan, Serdar; Yentur, Serhat; Creighton, Chad J; Ittmann, Michael; Ozen, Mustafa

2015-02-15

377

5-ALA-assisted photodynamic therapy in canine prostates  

NASA Astrophysics Data System (ADS)

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

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

1996-05-01

378

Michael J. Barry, MD Founda5on President  

E-print Network

knowledge · Natural history of untreated disease · Benign prostatic hyperplasia (BPH Index · International Prostate Symptom Score · BPH Impact Index 5 Afrikaans Practice Guidelines · Benign prostatic hyperplasia (BPH) · Prostate cancer treatment

Myers, Lawrence C.

379

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

NASA Technical Reports Server (NTRS)

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

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

2006-01-01

380

[History of laser in BPH therapy.  

PubMed

Laser technology has been used in the treatment of BPH for more than 15-20 years in order to challenge transurethral resection of the prostate. The aim of this review article is to analyze the evolution of laser in BPH therapy, from early coagulative techniques - progressively abandoned for their elevated postoperative morbidity and unfavorable outcomes - to the newer techniques of vaporization, resection and enucleation of the prostate. A better comprehension of tissue-laser interactions, the improvement of laser technology and a growing clinical experience have lead to the development of different laser systems (Holmium, KTP, Thulium laser) that challenge TURP. Today, HoLEP and, secondarily, PVP are the laser techniques supported by more clinical evidences and represent valid alternatives to TURP. PMID:24665033

Grande, Marco; Facchini, Francesco; Moretti, Matteo; Larosa, Michelangelo; Leone, Marco; Ziglioli, Francesco; Pozzoli, Gian Luigi; Frattini, Antonio

2014-03-01

381

Cleveland Clinic experience with interstitial laser coagulation of the prostate  

NASA Astrophysics Data System (ADS)

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

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

2000-05-01

382

The Prostate 66:344 ^357 (2006) APreliminary Analysis and Modelof  

E-print Network

injections for benign prostate hypertrophy (BPH) and prostate cancer [5]. Recently, such approaches have been is beginning to see use as a possible imaging method for prostatic injections [6]. In the case of BPH, ethanol

Whitcomb, Louis L.

383

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

PubMed Central

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

Alsaikhan, Bader; Alrabeeah, Khalid; Carrier, Serge

2014-01-01

384

Epidemiologic characteristics of patients with prostatic neoplasms.  

PubMed

A case-control study was conducted between 1957 and 1965 on 128 patients with benign prostatic hyperplasia (BPH), 256 age-matched controls, 290 prostate cancer patients and 290 age-matched controls for the prostate cancer patients, all of whom had completed the Roswell Park Memorial Institute epidemiology questionnaire and were interviewed on admission to the Institute. Compared to the control groups a higher proportion of both case groups were Protestants and residents of smaller towns. The major finding in this case-control study was a significantly higher risk for prostate cancer in fertile males compared to both married and non-married, but infertile males. This finding was confirmed when fertility was used as a variable for the classification of study groups in an earlier prospective study reporting the follow-up of patients with BPH and non-neoplastic controls. In this study, patients with children were found to have a relative risk of 2.69 for prostate cancer compared to the married patients with no children. Fertility may be a manifestation of constitutional-hormonal factors that increase the risk of prostate cancer. PMID:50734

Armenian, H K; Lilienfeld, A M; Diamond, E L; Bross, I D

1975-07-01

385

Nuclear casein kinase 2 (CK-2) activity in human normal, benign hyperplastic, and cancerous prostate.  

PubMed

In previous work, we had observed that chromatin-associated nonhistone protein phosphorylation, catalyzed by intrinsic protein kinase reaction in ch