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1

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

2

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

3

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

MedlinePLUS

... BPH uses high-frequency radio waves to cause thermal injury to the prostate. Transurethral needle ablation is a relatively new procedure that uses needles to deliver interstitial low-level radio frequency energy to produce a temperature above 100oC and subsequently ...

4

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

PubMed Central

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

Cambio, Angelo J; Evans, Christopher P

2007-01-01

5

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

6

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

7

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

8

Assessing the Influence of Benign Prostatic Hyperplasia (BPH) on Erectile Dysfunction (ED) among patients in Poland  

PubMed Central

Introduction Erectile dysfunction (ED) and the lower urinary tract symptoms caused by benign prostatic hyperplasia (LUTS/BPH) are highly prevalent among aging men. More data are needed from studies evaluating the impact of LUTS/BPH on ED. This study aimed to assess ED in patients with LUTS/BPH independent of comorbidities. Material and methods During 2007 and 2008, we examined 10,932 patients aged 50 to 69 years with LUTS/BPH (IPSS = 8-19 points) using questionnaires: Sex-Score and International Index of Erectile Function 5 (IIEF-5). Patients who used alcohol and/or cigarettes and those with hypertension, diabetes, or hyperlipidemia and cholesterolemia were excluded from meta analyses, which left 4,354 patients with LUTS/BPH without any comorbidity for the analyses. The main survey instruments used were the Sex-Score and IIEF-5. Results Regarding sexual coexistence, 1,497 (34.4%) and 2,638 (60.6%) patients considered it very important or important respectively; however, 219(5%) patients reported no sexual activity. After excluding sexually inactive patients, only 1,088 (25%) patients had the ability to obtain an erection during sexual activity always or nearly always. However, that erection was only strong enough to penetrate their partner almost always or most of the time in 218 (5%) and 826 (19%) patients respectively and only 610 (14%) patients were always able to maintain their erection during sexual intercourse. While only 87 (2%) patients had no difficulty maintaining their erection until the completion of intercourse, 174 (4%) and 914 (21%) patients stated that sexual intercourse gave satisfaction nearly always or most of the time respectively. Conclusions The impact of ED on patients with LUTS/BPH is evident across domains. PMID:24578949

Skawi?ski, Dariusz; Duda, Wies?aw; Duda, Magdalena

2012-01-01

9

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

PubMed Central

Objective To estimate the effectiveness and harms of Serenoa repens monotherapy in the treatment of lower urinary tract symptoms (LUTS) consistent with benign prostatic hyperplasia (BPH). Materials and methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and other sources through to January 2012 to identify randomised trials. Trials were eligible if they randomised men with symptomatic BPH to receive Serenoa repens extract monotherapy for at least 4 weeks in comparison with placebo, and assessed clinical outcomes and urodynamic measurements. Our primary outcome was improvement in LUTS, based on change in urological symptom-scale scores. Results In all, 17 randomised controlled trials (N = 2008) assessing Serenoa repens monotherapy (typically 320 mg/day) vs placebo met inclusion criteria, although only five reported American Urological Association Symptom Index (AUASI) or International Prostate Symptom Scores (IPSS). Trial lengths ranged from 4 to 72 weeks. The mean age of all enrolees was 64.3 years and most participants were of White race. The mean baseline total score was 14 points, indicating moderately severe symptoms. In all, 16 trials were double blinded and adequate treatment allocation concealment was reported in six trials. In a meta-analysis of three high quality long-to-moderate term trials (n = 661), Serenoa repens therapy was no better than placebo in reducing LUTS based on the AUASI/IPSS (weighted mean difference [WMD] ?0.16 points, 95% confidence interval [CI] ?1.45 to 1.14) or maximum urinary flow rate (Qmax; WMD 0.40 mL/s, 95% CI ?0.30 to 1.09). Based on mostly short-term studies, Qmax measured at study endpoint were also not significantly different between treatment groups (WMD 1.15 mL/s, 95% CI ?0.23 to 2.53) with evidence of substantial heterogeneity (I2 58%). One long-term dose escalation trial (72 weeks) found double and triple doses of Serenoa repens extract did not improve AUASI compared with placebo and the proportions of clinical responders (? 3 point decrease in the AUASI) were nearly identical (43% vs 44% for Serenoa repens and placebo, respectively) with a corresponding risk ratio of 0.96 (95% CI 0.76–1.22). Long-term, Serenoa repens therapy was no better than placebo in improving nocturia in one high-quality study (P = 0.19). Pooled analysis of nine short-term Permixon® trials showed a reduction in the frequency of nocturia (WMD ?0.79 times/night, 95% CI?1.28 to ?0.29), although there was evidence of heterogeneity (I2 76%) Adverse events of Serenoa repens extracts were few and mild, and incidences were not statistically significantly different vs placebo. Study withdrawals occurred in ?10% and did not differ between Serenoa repens and placebo. Conclusions Serenoa repens therapy does not improve LUTS or Qmax compared with placebo in men with BPH, even at double and triple the usual dose. Adverse events were generally mild and comparable to placebo. PMID:22551330

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

2012-01-01

10

The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy.  

PubMed

A chronic prostatic inflammation seems to play a crucial role in benign prostatic hyperplasia (BPH) pathogenesis and progression. Therefore, inflammation could represent a new potential target for medical therapy of lower urinary tract symptoms (LUTS) due to BPH (LUTS/BPH). This review article analyzes the evidence supporting the role of inflammation in the onset and progression of BPH, and it assesses the potential impact of previous mechanisms on medical therapy of LUTS/BPH. Literature data support the role of inflammation as a relevant factor in the pathogenesis of BPH. Indeed, several data favour the role of infiltrating lymphocytes in the development and progression of prostate adenoma as an effect of a self-maintaining remodeling process. Although available drugs commonly used in the treatment of LUTS/BPH do not exhibit an anti-inflammatory activity, it seems to be obvious considering the inflammation as a new target in the treatment of LUTS/BPH. Drugs currently investigated for the treatment of prostatic inflammation include the hexanic lipidosterolic extract of Serenoa repens, nonsteroidal anti-inflammatory drugs, and vitamin D receptor agonists. PMID:25312251

Ficarra, Vincenzo; Rossanese, Marta; Zazzara, Michele; Giannarini, Gianluca; Abbinante, Maria; Bartoletti, Riccardo; Mirone, Vincenzo; Scaglione, Francesco

2014-12-01

11

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

E-print Network

), including 282 patients treated by surgery for a complicated and/or symptomatic BPH. Inflammation score Analysis ; Middle Aged ; Prostatic Hyperplasia ; complications ; pathology ; Prostatitis ; complications

Boyer, Edmond

12

Prostate: Benign Prostatic Hyperplasia (BPH)  

MedlinePLUS

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

13

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

PubMed

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

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

2008-01-01

14

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

Microsoft Academic Search

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

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

1997-01-01

15

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

Microsoft Academic Search

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

G. Bartsch; R. Rittmaster; H. Klocker

2002-01-01

16

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

17

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

18

Estrogenic action of commonly used fragrant agent citral induces prostatic hyperplasia  

Microsoft Academic Search

A rat model for benign prostatic hyperplasia in man (BPH) was investigated. Citral treatment of male Copenhagen rats for 4 months via the transdermal route resulted in a marked hyperplasia of glandular epithelium and interglandular stroma in the ventral prostate. Despite the cellular hyperplasia there was not a significant increase in prostate weight. Investigations of the mechanism of action of

A. A. Geldof; C. Engel; B. R. Rao

1992-01-01

19

Consumption of aqueous garlic extract leads to significant improvement in patients with benign prostate hyperplasia and prostate cancer  

Microsoft Academic Search

AimInvestigation of possible effects of garlic extract supplementation on disease parameters of patients with benign prostate hyperplasia (BPH) and prostate cancer (PC). Materials and methods: Twenty seven patients with BPH and 9 patients with prostate cancer participated in the study. Patients consumed aqueous garlic extract at the daily amount of 1 ml\\/kg weight for a month and then, pre- and

lker Durak; Erdal Y?lmaz; Erdinç Devrim; Hakk? Perk; Murat Kaçmaz

2003-01-01

20

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

21

The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men  

Microsoft Academic Search

The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men.BackgroundBenign prostatic hyperplasia (BPH) and chronic kidney disease are important public health problems in older men. Previous referral-based studies disagree on whether BPH is associated with chronic kidney disease. The objective of this study was to determine the community-based association between clinical measures of BPH and chronic kidney

Andrew D. Rule; Debra J. Jacobson; Rosebud O. Roberts; Cynthia J. Girman; Michaela E. McGree; Michael M. Lieber; Steven J. Jacobsen

2005-01-01

22

Evaluating Men with Benign Prostatic Hyperplasia  

PubMed Central

The clinical manifestations of benign prostatic hyperplasia (BPH) include lower urinary tract symptoms (LUTS), poor bladder emptying, urinary retention, detrusor instability, urinary tract infection, hematuria, and renal insufficiency. However, the majority of men with BPH present with LUTS only. Because LUTS can indicate a variety of conditions, evaluation of symptomatic men must first aim to identify or exclude BPH and, if present, assess its severity. It is important to assess symptom severity at baseline and during follow-up, using the American Urological Association Symptom Index or the International Prostate Symptom Score. Further testing can then be tailored to narrow the diagnosis and guide treatment decisions. Factors such as patient age and concomitant malignancy will also affect management, but the main goal of treatment remains the improvement of quality of life for the patient. PMID:16985855

Lepor, Herbert

2004-01-01

23

The connective tissue framework in the normal prostate, B.P.H and prostate cancer: analysis by scanning electron microscopy after cellular digestion  

Microsoft Academic Search

The objective of this study was twofold: (1) to determine if a cellular digestion process can facilitate examination of the\\u000a morphology of the connective tissue framework of the prostate, and (2) to examine the connective tissue framework in normal\\u000a prostate tissue, benign prostatic hyperplasia (BPH) and prostate cancer. Ten prostate glands were examined. Using the Ohtani\\u000a method of digestion, the

Colin Morrison; John Thornhill; Eoin Gaffney

2000-01-01

24

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

25

Oxidative stress in benign prostate hyperplasia.  

PubMed

Benign Prostate Hyperplasia (BPH) is the common health problem in ageing male. Free radicals and reactive oxygen species (ROS) are produced more with advancement of age leads to oxidative stress. This study aims to assess Malondialdehyde (MDA), the marker of lipid peroxidation and vitaminic antioxidants e.g. alpha-Tocopherol (Toc) and Ascorbate (Asc) status in plasma of BPH patients. This is a case control study conducted in Department of Biochemistry in collaboration with Dept of Surgery, BPKIHS. Forty eight (n = 48) confirmed patients of BPH and forty six (n = 46) healthy age matched controls were enrolled. Plasma MDA, Asc and alpha-Toc were estimated. Plasma MDA level showed 4.81 +/- 1.87 nmol/ml in BPH patients compared to 3.69 +/- 1.56 nmol/ml in healthy controls (p < 0.001). There were significant decrease in plasma alpha-Toc and Asc level which were 0.85 +/- 0.12 mg/dl and 0.93 +/- 0.13 mg/dl in BPH patients compared to 1.37 +/- 0.31 mg/dl and 1.44 +/- 0.38 mg/dl in healthy controls respectively. Inverse correlation of plasma MDA with a- Toc (r = -0.09) and Asc (r = -0.51) was found in BPH patients. There was mild elevation of PSA in BPH patients compared with control but was not statistically significant. Thus, our study showed the evidence of association of oxidative stress in BPH patients. PMID:18298008

Aryal, M; Pandeya, A; Gautam, N; Baral, N; Lamsal, M; Majhi, S; Chandra, L; Pandit, R; Das, B K L

2007-12-01

26

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

27

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

28

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

Microsoft Academic Search

The authors conducted a nested case-control study of serum steroid concentrations and risk of benign prostatic hyperplasia (BPH), using data from the placebo arm of the Prostate Cancer Prevention Trial (1993-2003). Incident BPH over 7 years (n ¼ 708) was defined as receipt of treatment, a report of 2 International Prostate Symptom Score (IPSS) values greater than 14, or 2

Alan R. Kristal; Jeannette M. Schenk; YoonJu Song; Kathryn B. Arnold; Marian L. Neuhouser; Phyllis J. Goodman; Daniel W. Lin; Frank Z. Stanczyk; Ian M. Thompson

29

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

30

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

Microsoft Academic Search

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

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

1995-01-01

31

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

32

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

33

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

34

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

Microsoft Academic Search

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

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

1995-01-01

35

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

PubMed

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

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

2015-01-15

36

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

Microsoft Academic Search

It has long been appreciated that a healthy lifestyle plays a critical role in cardiovascular health. It is now apparent that\\u000a the same is true in the development of benign prostatic hyperplasia (BPH). Prospective cohort data originating from recently\\u000a published randomized trials on the medical treatment of BPH and prevention of prostate cancer have been invaluable. A growing\\u000a body of

Kenneth S. Poon; Kevin T. McVary

2009-01-01

37

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

PubMed Central

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

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

2012-01-01

38

Oxidative stress in patients with benign prostate hyperplasia.  

PubMed

Benign Prostate Hyperplasia (BPH) is a common health problem in aging male. Free radicals and Reactive Oxygen Species (ROS) are produced in overwhelming quantity with advancement of age. When in oxidative stress, these reactive species cause extensive damage to various organ in the body, may be associated with pathogenesis of BPH also. This study aimed at assessing Malondialdehyde (MDA), the marker of lipid peroxidation and anti-oxidants e.g. alpha-Tocopherol and Ascorbate status in plasma in BPH patients. Forty eight (n=48) cases of BPH and forty six (n = 46) healthy age matched controls were enrolled. Plasma MDA level showed 4.81+/-1.87 nmol/ml in cases compared to 3.69+/-1.56 nmol/ml in healthy controls (p<0.001). There were significant decrease in plasma alpha-Tocopherol and ascorbate level which were 0.85+/-0.12 mg/dl and 0.93 +/- 0.13 mg/dl in cases compared to 1.37+/-0.31 mg/dl and 1.44+/-0.38 mg/dl in healthy controls respectively. Inverse correlation of plasma MDA with alpha-Tocopherol (r = -0.09, p>0.05) and Ascorbate (r =-0.51, p=0.008) was found in BPH patients. There was mild elevation of PSA in BPH patients compared with control but was not statistically significant. Thus, our study showed the evidence of association of oxidative stress in BPH patients. PMID:18274564

Aryal, M; Pandeya, A; Bas, B K; Lamsal, M; Majhi, S; Pandit, R; Agrawal, C S; Gautam, N; Baral, N

2007-01-01

39

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

40

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

PubMed Central

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

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

2014-01-01

41

Silodosin in the treatment of benign prostatic hyperplasia  

PubMed Central

Benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS due to BPH. Alpha-adrenergic receptor blockers remain one of the mainstays in the treatment of male LUTS and clinical BPH. They exhibit early onset of efficacy with regard to both symptoms and flow rate improvement, and this is clearly demonstrated in placebo-controlled trials with extensions out to five years. These agents have been shown to prevent symptomatic progression of the disease. The aim of this article is to offer a critical review of the current literature on silodosin, formerly known as KMD-3213, a novel alpha-blocker with unprecedented selectivity for ?1A-adrenergic receptors, as compared with both ?1B- and ?1D -adrenoceptors, exceeding the selectivity of all currently used ?1-blockers, and with clinically promising effects. PMID:21116335

Rossi, Maxime; Roumeguère, Thierry

2010-01-01

42

Diagnosis and management of benign prostatic hyperplasia in primary care  

PubMed Central

Benign prostatic hyperplasia (BPH), and its clinical manifestation as lower urinary tract symptoms (LUTS), is a major health concern for aging men. There have been significant advances in the diagnosis and treatment of BPH in recent years. There has been a renewed interest in medical therapies and less invasive surgical techniques. As a consequence, the treatment needs of men with mild to moderate LUTS without evidence of prostate cancer can now be accomplished in a primary care setting. There are differences in the way urologists and primary care physicians approach the evaluation and management of LUTS due to BPH, which is not reflected in Canadian Urological Association (CUA) and American Urological Association (AUA) guidelines. A “shared care” approach involving urologists and primary care physicians represents a reasonable and viable model for the care of men suffering from LUTS. The essence of the model centres around educating and communicating effectively with the patient on BPH. This article provides primary care physicians with an overview of the diagnostic and management strategies outlined in recent CUA and AUA guidelines so that they may be better positioned to effectively deal with this patient population. It is now apparent that we must move away from the urologist as the first-line physician, and allow primary care physicians to accept a new role in the diagnosis and management of BPH. PMID:19543429

Tanguay, Simon; Awde, Murray; Brock, Gerald; Casey, Richard; Kozak, Joseph; Lee, Jay; Nickel, J. Curtis; Saad, Fred

2009-01-01

43

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

PubMed Central

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

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

2013-01-01

44

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

Microsoft Academic Search

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

Mark I. Miller; Peter J. Puchner

1998-01-01

45

PPAR?: A Molecular Link between systemic metabolic disease and benign prostate hyperplasia  

PubMed Central

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

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

2011-01-01

46

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

47

[The transurethral microwave thermotherapy of benign prostatic hyperplasia].  

PubMed

The authors have treated benign prostatic hyperplasia (BPH) in 50 patients aged 54-89 years (mean age 67.5 years) including 10 patients with cystostoma. The patients were exposed to transurethral microwave thermotherapy (TUMT) performed on the prostcare unit. Only 1 session (60 min at 45 degrees C) was conducted. Inflammatory complications of TUMT occurred in 4(8%) patients. A 1.5-year follow-up covered 45 patients. A subjective response was obtained in 86% of patients. An objective response by urination rate and prostatic size 3 months after TUMT was reached in 80 and 90% of patients, respectively; 1.5 years after in 48, 34 and 47%, respectively. TUMT is recommended in uncomplicated BPH as an alternative to chemotherapy or surgical treatment (in patients with cystostoma and serious intercurrent diseases). PMID:9381615

Prokhorov, A V; Karpov, V K; Sivkov, A V; Apolikhin, O I; Ignashin, N S; Churakov, B I

1997-01-01

48

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

PubMed

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

Carnevale, Francisco C; Antunes, Alberto A

2013-12-01

49

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

50

Treatment of Benign Prostatic Hyperplasia Using Transurethral Split of the Prostate with a Columnar Balloon Catheter.  

PubMed

Abstract 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

2014-10-01

51

Correlations between urethral elastance and histological architecture in patients with benign prostatic hyperplasia.  

PubMed

To investigate whether the properties of the flow-controlling zone (FCZ) in obstructive benign prostatic hyperplasia (BPH) would be affected by differences in the histological architecture of the prostate, we evaluated relationships between morphometric and urodynamic data. BPH specimens from 14 patients undergoing transurethral surgery were analysed by quantitative morphometry. The cross-sectional area and mean elastance of FCZ, together with other parameters, were calculated on a preoperative pressure-flow study. Correlations between these parameters and tissue composition were determined. Our study group comprised men with clinical and urodynamic evidence of infravesical obstruction secondary to BPH. No correlations were found between the area density or total volume of each histological element and the cross-sectional area of FCZ at peak flow rate. Neither area density nor total volume of each element correlated with the mean urethral elastance. Our results indicate that the histological architecture of the prostate in patients with obstructive BPH cannot predict the urethral elastance. PMID:9689702

Ichiyanagi, O; Sasagawa, I; Aoyama, N; Ishigooka, M; Kubota, Y; Nakada, T

1998-05-01

52

Estrogen and androgen signaling in the pathogenesis of BPH  

Microsoft Academic Search

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

Clement K. M. Ho; Fouad K. Habib

2011-01-01

53

Sulforaphane inhibits histone deacetylase activity in BPH-1, LnCaP and PC-3 prostate epithelial cells  

PubMed Central

Sulforaphane (SFN), an isothiocyanate first isolated from broccoli, exhibits chemopreventive properties in prostate cancer cells through mechanisms that are poorly understood. We recently reported on a novel mechanism of chemoprotection by SFN in human colon cancer cells, namely the inhibition of histone deacetylase (HDAC). Here, we show that addition of 15 ?M SFN also inhibited HDAC activity by 40, 30 and 40% in BPH-1, LnCaP and PC-3 prostate epithelial cells, respectively. The inhibition of HDAC was accompanied by a 50–100% increase in acetylated histones in all three prostate cell lines, and in BPH-1 cells treated with SFN there was enhanced interaction of acetylated histone H4 with the promoter region of the P21 gene and the bax gene. A corresponding 1.5- to 2-fold increase was seen for p21Cip1/Waf1 and Bax protein expression, consistent with previous studies using HDAC inhibitors, such as trichostatin A. The downstream events included cell cycle arrest and activation of apoptosis, as evidenced by changes in cell cycle kinetics and induction of multi-caspase activity. These findings provide new insight into the mechanisms of SFN action in benign prostate hyperplasia, androgen-dependent prostate cancer and androgen-independent prostate cancer cells, and they suggest a novel approach to chemoprotection and chemotherapy of prostate cancer through the inhibition of HDAC. PMID:16280330

Myzak, Melinda C.; Hardin, Karin; Wang, Rong; Dashwood, Roderick H.; Ho, Emily

2008-01-01

54

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

PubMed Central

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

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

2014-01-01

55

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

PubMed

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

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

1998-01-01

56

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

57

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

58

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

PubMed Central

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

2012-01-01

59

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

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... desired. Commonly it is an undesirable effect (e.g., nausea, headache, insomnia, acute toxic reaction or drug ...

60

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

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... desired. Commonly it is an undesirable effect (e.g., nausea, headache, insomnia, acute toxic reaction or drug ...

61

BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). DRE: ...

62

Energy Delivery Systems for Treatment of Benign Prostatic Hyperplasia  

PubMed Central

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

2006-01-01

63

Differential expression of MST4, STK25 and PDCD10 between benign prostatic hyperplasia and prostate cancer  

PubMed Central

Both benign prostatic hyperplasia (BPH) and prostate cancer (PC) are common diseases for men around the world. Both serine/threonine protein kinase MST4 (MST4) and serine/threonine kinase 25 (STK25) belong to the Ste20-like kinases and interact with programmed cell death 10 (PDCD10) which is closely linked to cancer diseases. To clarify the roles of MST4, STK25 and PDCD10 in prostate carcinogenesis, we examined MST4, STK25 and PDCD10 expression in tissue microarray blocks containing 110 cores of BPH and 160 cores of PC immunohistochemically and evaluated their correlation with clinicopathological findings. MST4 was not expressed in all the BPH cases and expressed in 38.7% of PC cases (P < 0.0001). STK25 expression was found in 77.3% of BPH cases and 93.1% of PC cases (P < 0.0001). PDCD10 staining was considered weak in 82 (74.5%) and strong in 28 (25.5%) of BPH cases. However, in prostate cancer cases, PDCD10 staining was weak in 95 (59.4%) and strong in 65 (40.6%) (P < 0.05). PDCD10 and STK25 immunostaining were associated with age in prostatic hyperplasia cases (P < 0.05). The staining intensity for STK25 was significantly greater in Gleason grades 3-5 (47.1% of such cases staining strongly) compared with other grades of prostate cancer (only 26.5% of these cases staining strongly; P < 0.05). Our results suggest that MST4, STK25 and PDCD10 are unregulated in prostate cancer and may play roles in prostate tumorigenesis. MST4 may be a helpful marker for identifying prostate cancer.

Zhang, Heyu; Ma, Xi; Peng, Saihui; Nan, Xu; Zhao, Hongshan

2014-01-01

64

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

PubMed

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

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

2013-01-01

65

Clinical application of contrast enhanced ultrasound to diagnose benign prostatic hyperplasia  

PubMed Central

Abstract Background This study aimed to investigate the clinical significance of contrast enhanced ultrasound (CEUS) in diagnosis of benign prostatic hyperplasia (BPH) through comparing CEUS parameters between BPH and normal person. Methods A retrospective study of sixty BPH patients (aged 73.5?±?20.5 years old) and thirty normal controls without prostate diseases (aged 75.3?±?19.7 years old) who had accepted CEUS detection were performed. Time-intensity curves were obtained for all tests in regions of interest. Images were processed using ACQ software and the following parameters were obtained: arrival time (AT), peak intensity (P), time to peak (TP), area under the curve (AUC), mean transit time (MTT) and extinction time (ET). Differences in inner and outer gland of prostate between BPH and the normal tissue were evaluated. Results There was a clear boundary between the inner and outer gland of BPH prostate. AT, TP, MTT, ET and P in BPH outer gland were significantly higher than the control group. In inner gland, MTT, ET, AUC and P were also significantly higher than the controls. The accurate rate to diagnose BPH using CEUS was 95.6%, and the sensitivity and specificity were 95.0% and 96.7%, respectively. Conclusions Among these significantly changed parameters, the increases of MTT, ET and AUC in inner gland and AT, TP in outer gland were most likely related to BPH. These parameters provide an objective visual assessment to diagnosis of BPH. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4852383312229155 PMID:24986664

2014-01-01

66

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

PubMed

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

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

2010-04-01

67

Community-based research on the benign prostatic hyperplasia prevalence rate in Korean rural area  

PubMed Central

Purpose We investigated the prevalence rate of benign prostatic hyperplasia (BPH) among Korean males in a rural area through a cross-sectional, community-based epidemiologic survey and analyzed the correlation with epidemiologic factors. Materials and Methods A total of 779 males who lived in Yangpyeong County participated in a prostate examination campaign. Targeting these men, we collected the International Prostate Symptom Score (IPSS), medical history, demographic information, serum prostate-specific antigen, and prostate volume as measured by transrectal ultrasonography. The data for 599 participants were analyzed, excluding 180 men who had a possibility of prostate cancer. BPH was defined as an IPSS of 8 points or higher and a prostate volume of 25 mL or more. Results The prevalence rate of BPH was 20.0%. The prevalence rate increased with age. There were 2 subjects (4.4%) in the age group of 40-49 years, 18 subjects (10.9%) in the age group of 50-59 years, 44 subjects (22%) in the age group of 60-69 years, and 56 subjects (26.6%) in the age group of over 70 years; this increase with age was statistically significant (p<0.001). In the BPH group, the average IPSS was 14.67±5.95, the average prostate volume was 37.04±11.71 g, and the average prostate-specific antigen value was 1.56±0.88 ng/mL. In the analysis of correlations between the epidemiologic factors and the risk of BPH, smoking was the only statistically significant factor. Conclusions The total prevalence rate of BPH in this study was 20.0%, which was a little lower than the rate reported in other cities or rural areas.

Goh, Hyeok Jun; Kim, Shin Ah; Nam, Ji Won; Choi, Bo Youl

2015-01-01

68

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

PubMed Central

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

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

2014-01-01

69

Role of Inflammation in Benign Prostatic Hyperplasia  

PubMed Central

Inflammation of the prostate may represent a mechanism for hyperplastic changes to occur in the prostate. There are a variety of growth factors and cytokines that may lead to a proinflammatory process within the prostate. There are several proposed mechanisms that lead to both the intrinsic and extrinsic basis of inflammation. Prostatic inflammation may represent an important factor in influencing prostatic growth and progression of symptoms. This article reviews the recent literature on inflammation leading to chronic prostatic diseases, such as benign prostatic hyperplasia. PMID:22110398

Chughtai, Bilal; Lee, Richard; Te, Alexis; Kaplan, Steven

2011-01-01

70

Finasteride in the treatment of patients with moderate symptoms of benign prostatic hyperplasia.  

PubMed

This was a prospective study involving 27 patients with moderate symptoms of benign prostatic hyperplasia (BPH) treated continuously with 5 mg of finasteride daily for one year. There was improvement in clinical BPH symptoms in 22 patients (81.48%), increase in urinary flow rates by a mean of 2.2 mls/sec in 20 patients (74.07%) and a mean decrease in prostate volume of 20.9% in 25 patients (92.59%) comparable to the findings of the other investigators. No patient on finasteride therapy developed acute urinary retention suggesting reduced risk. The reversal in BPH progression stems from the ability of finasteride to reduce prostate volume thus relieving urinary obstruction and to decrease BPH symptoms and increase urinary flow rates. Finasteride therapy was well tolerated in this study. No adverse effect was observed except impotence in one patient (3.7%) and loss of libido in another patient (3.7%). For symptomatic relief in men with moderate obstructive symptoms of BPH, finasteride should be considered an effective alternative to watchful waiting. These findings warrant further investigations and may signal a positive change in the role of medical therapy in the future long term management of BPH. PMID:9746993

Magoha, G A

1998-05-01

71

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

72

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

Microsoft Academic Search

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

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

73

Evaluation of symptoms and quality of life in men with benign prostatic hyperplasia.  

PubMed

Benign prostatic hyperplasia (BPH) is a common histologic condition among older men, which conveys its morbidity through lower urinary tract symptoms and complications, such as acute urinary retention, obstructive uropathy, and urinary tract infections. The mechanisms linking the histologic process and lower urinary tract symptoms remain uncertain; prostatic enlargement and bladder outlet obstruction are involved. However, measurements of prostate size and the severity of bladder outlet obstruction correlate poorly with the severity of lower urinary tract symptoms. The severity of lower urinary tract symptoms associated with BPH can be measured reliably, from the patient's perspective, with a number of validated questionnaires, including the International Prostate Symptom Score, the Danish Prostate Symptom Score, and the International Continence Society (ICS)male questionnaire. In the clinical setting, these questionnaires can be used (1) to assess the severity of symptoms in men with lower urinary tract symptoms that may be attributable to BPH, based on their age and clinical characteristics; and (2) to follow changes in symptoms over time and with treatment. None of these questionnaires can accurately determine whether a symptomatic patient has underlying bladder outlet obstruction. Additional questionnaires are available to measure the impact of lower urinary tract symptoms on men's lives, as well as associated phenomena, such as continence and sexual function, which may be affected by BPH and its treatments. Men with a severe burden of lower urinary tract symptoms often have measurable decrements in overall health-related quality of life, which can be ameliorated by treatment. PMID:11750246

Barry, M J

2001-12-01

74

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

PubMed Central

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

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

2014-01-01

75

Acute urinary retention in benign prostatic hyperplasia: Risk factors and current management  

PubMed Central

Acute urinary retention (AUR) is one of the most significant, uncomfortable and inconvenient event in the natural history of benign prostatic hyperplasia (BPH). The immediate treatment is bladder decompression using urethral or suprapubic catheterization. Several factors have been identified that are associated with or precipitate AUR. It is useful to classify AUR as BPH-related or not, than spontaneous or precipitated when the initial management is considered. Use of prophylactic 5 a-reductase inhibitors can prevent AUR in men with BPH having moderate to severe lower urinary tract symptoms and large prostate size. Alpha blockers can prevent AUR in symptomatic BPH patients and also facilitate catheter removal following episodes of spontaneous AUR. Anticholinergics can be safely combined with alpha blockers in symptomatic BPH patients without increasing the risk of AUR. Surgical treatment carries a higher rate of morbidity and mortality in men presenting with AUR compared to those presenting with symptoms alone. Urgent prostatic surgery after AUR is associated with greater morbidity and mortality than delayed prostatectomy. Alpha blockers mainly help to delay the surgery and may avoid surgery altogether in a subgroup of patients. TURP remains the “gold standard” if a trial without catheter fails. Alternative minimally invasive procedures can be considered in poor-risk patients, but its value is yet to be established. PMID:19718286

Muruganandham, K.; Dubey, Deepak; Kapoor, Rakesh

2007-01-01

76

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

77

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

78

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

79

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

80

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

81

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

PubMed

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

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

2012-11-01

82

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

PubMed Central

Purpose To investigate any associations between lower urinary tract symptoms (LUTS)/benign prostate hyperplasia (BPH) and metabolic syndrome (MetS). Materials and Methods In all, 1,224 male police officers in their 50s who had participated in health examinations were included. LUTS/BPH was assessed by serum prostate-specific antigen, International Prostate Symptom Score (IPSS), transrectal ultrasonography, maximum urinary flow rate (Q max), and postvoid residual urine volume (PVR). In addition, testosterone was also examined. The MetS was defined using NCEP-ATP III guidelines. We used the multiple linear regression test and logistic regression analyses to examine the relationships. Results MetS was diagnosed in 29.0% of participants. There was no significant difference in the percentage of cases of BPH (IPSS >7, Q max <15 ml/sec, and prostate gland volume ? 20 ml) (14.2% in the non-MetS group vs. 17.2 in the MetS group; p value=0.178). The total IPSS score and the Q max were not significantly different. The prostate volume and PVR were significantly greater in the subjects with MetS. After adjusting for age and testosterone, the presence of MetS was not associated with BPH (multivariate odds ratio, 1.122; 95% confidence interval, 0.593~2.120). Additionally, MetS was not related to IPSS (Beta, -0.189; p value=0.819), prostate volume (Beta, 0.815; p value=0.285), Q max (Beta, -0.827; p value=0.393), or PVR (Beta, 0.506; p value=0.837). Conclusions According to our results, the MetS was not clearly correlated with LUTS/BPH in Korean men in their 50s. PMID:23596610

Park, Yeon Won; Min, Seung Ki

2012-01-01

83

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

84

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

PubMed

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

2014-07-01

85

[The value of self-assessment in management of patients with benign prostatic hyperplasia].  

PubMed

Since benign prostatic hyperplasia (BPH) is a very common and slowly progressive disease which requires surgical treatment in only one-third of those affected, surveillance of the condition on the basis of subjective symptoms is of considerable importance. For this reason, the WHO developed a prostate symptom score (WHO-PSS or I-PSS), which includes both irritative and obstructive symptoms, and which has become accepted all over the world. This score can be used both in investigative studies as a means of monitoring the efficacy of therapy, and as a very good instrument for patient management in the doctor's office. PMID:7543430

Schneider, H J

1995-06-10

86

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

87

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

88

Managing benign prostatic hyperplasia in primary care. Patient-centred approach.  

PubMed Central

PROBLEM ADDRESSED: Management of benign prostatic hyperplasia (BPH) is changing from a surgical approach to a medical approach, and the role of primary care physicians is expanding. OBJECTIVE OF PROGRAM: To introduce a patient-centred approach to managing BPH in primary care through a continuing medical education (CME) program. MAIN COMPONENTS OF PROGRAM: A practice-based, small group, peer-led CME program focused on application of the International Prostate Symptom Score and Quality of Life Assessment in four case studies on prostatism, including BPH. At 86 workshops held across Canada, 658 physicians participated in discussions with case materials that included videos and a handbook. A before-after practice behaviour questionnaire was administered at each workshop to evaluate "intent to change." CONCLUSIONS: Participating physicians showed willingness to learn new skills for patient-centred management of BPH. These results suggest that peer-led, small group CME can successfully encourage use of new practice guidelines in primary are and teach physicians practical steps for developing therapeutic alliances with their patients. PMID:10690495

McSherry, J.; Weiss, R.

2000-01-01

89

Turbulent urinary flow in the urethra could be a causal factor for benign prostatic hyperplasia.  

PubMed

Benign prostatic hyperplasia (BPH) is the most common form of prostate disease in middle-aged and elderly men, and leads to severe impairment later in life. Despite its significant impact on public health, the underlying cause of BPH is yet to be determined. This hypothesis proposes a new causal factor for BPH. Applying concepts of dynamics of fluids to the process of urination it could be stated that a turbulent urinary flow through the passage of the urethra. The turbulent urinary flow in the urethra applies pressure and stretch forces to the surrounding tissue. This stimulus repeated over time and coupled with age-related changes of the urethral tissue could contribute to the development of BPH. In support of this hypothesis, several mechanotransduction studies have shown that vibration and pressure forces applied to different cell tissues can provoke cellular and molecular changes. Another supportive data is the presence of the hyperplasic reaction surrounding the urethra specifically located in the transition zone, the only zone where BPH develops. It is crucial to identify causal factors to understanding the disease and to determine effective primary prevention strategies. Future studies of the dynamics of fluids in the urethra are warranted. The finding of significant forces transmitted to the periurethral tissue from a turbulent urinary flow could give us the clue to the underlying cause of BPH. If this hypothesis proves to be valid there are several primary prevention measures that could be implemented to impede the development of BPH. Educational intervention measures in younger populations to avoid frequent urinary retention and active urination (process of forcing the urine through the urethra at a high velocity) could be considered. Studies of the impact of turbulence in the standing vs. sitting position during urination in men should also be considered. PMID:16764996

Martinez-Borges, Anibal R

2006-01-01

90

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

91

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

92

Silodosin: a review of its use in the treatment of the signs and symptoms of benign prostatic hyperplasia.  

PubMed

Silodosin is a highly selective ?1A-adrenoceptor antagonist indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH). Oral silodosin had a rapid onset of effect in men with lower urinary tract symptoms (LUTS) associated with BPH, with improvements seen in voiding and storage symptoms, maximum urinary flow rate and health-related quality of life in well-designed, 12-week trials. Silodosin was noninferior to tamsulosin in terms of improving LUTS associated with BPH. The efficacy of silodosin was maintained in 9-month extension studies and was also seen in a phase IV study conducted in a real-world setting. Silodosin was generally well tolerated and was associated with a low risk of orthostatic hypotension. Abnormal ejaculation was the most commonly reported adverse event, although few patients discontinued treatment with silodosin because of this adverse event. In conclusion, silodosin is a useful option for the treatment of LUTS associated with BPH. PMID:25575983

Keating, Gillian M

2015-02-01

93

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

PubMed Central

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

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

2014-01-01

94

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

PubMed Central

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

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

2014-01-01

95

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

PubMed Central

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

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

2011-01-01

96

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

97

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

Microsoft Academic Search

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

Michael J Marberger

1998-01-01

98

[Long-term efficacy of naftopidil for treatment of lower urinary tract symptoms with benign prostatic hyperplasia].  

PubMed

Naftopidil was administered to 67 patients with benign prostatic hyperplasia (BPH) for 12 months. Changes in total/each International Prostate Symptom Score (IPSS) for irritative and obstructive symptoms, nocturia, and residual urine volume were compared before and after its administration. As a result, a significant decrease of score was found in total-IPSS, obstructive and irritative symptoms, which also showed a tendency to decrease at the end of the first month. Nocturia and residual urine volume also significantly decreased after its administration. Naftopidil is considered to be effective in the treatment of BPH, especially irritative symptoms including nocturia in treatments for BPH, because both irritative and obstructive symptoms (IPSS subjective endpoints) and residual urine volume (objective endpoint) were improved after its long-term administration. PMID:12784711

Akasaka, Toshiyuki; Funaki, Hiroyoshi; Hirano, Shigeru; Ohinata, Mitsuru; Fujishima, Mikihiko; Kudou, Takuji; Suzuki, Akira; Iinuma, Masahiro

2003-04-01

99

The Impact of Diabetes Type 2 in the Pathogenesis of Benign Prostatic Hyperplasia: A Review  

PubMed Central

Introduction. Clinical observation of larger prostate glands in men with diabetes mellitus type 2 led some investigators to hypothesize that an association between these two conditions exists. In fact, both diseases are very common in men as they age and seem to be sharing similar epidemiologic features. Several studies examining the above hypothesis were yielded. Aim. The purpose of this paper is to summarize the existing literature focusing on the coexistence of BPH and diabetes mellitus type 2 and to elucidate whether or not an association among these conditions exists. Methods. We identified studies published from 1990 onwards by searching the MEDLINE database of the National Library of Medicine. Initial search terms were benign prostatic hyperplasia, epidemiology, and risk factor, combined with diet hyperinsulinemia, and diabetes mellitus type 2. Results. Diabetes mellitus type 2 and hyperinsulinemia are quite common conditions and often coexist with BPH. There are several studies (observational, epidemiological, and experimental) examining the association between them in literature. Conclusion. Evidence suggests that an association between BPH and diabetes through a common pathogenic mechanism is possible. The specific pathway interfering in the development of both conditions is still poorly investigated; thus, the exact relationship of BPH to diabetes remains unclear. PMID:19902013

Stamatiou, K.; Lardas, M.; Kostakos, E.; Koutsonasios, V.; Michail, E.

2009-01-01

100

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

101

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

102

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

103

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

Microsoft Academic Search

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

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

1997-01-01

104

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

PubMed Central

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

Dobruch, Jakub; Nyk, ?ukasz; Szostek, Przemys?aw; Szempli?ski, Stanis?aw; Borówka, Andrzej

2014-01-01

105

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.

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

2015-01-01

106

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

107

DIABETES TREATMENT AND PROGRESSION OF BENIGN PROSTATIC HYPERPLASIA IN COMMUNITY DWELLING BLACK AND WHITE MEN  

PubMed Central

Objectives Diabetes has been associated with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) in aging men. We conducted a study to determine if diabetes treatment was associated with BPH/LUTS and progression in black and white men. Methods Using the Olmsted County Study of Urinary Symptoms and Health Status among Men (OCS) and the Flint Men’s Health Study (FMHS), we examined how use of medical therapy (e.g., insulin regimens, oral hypoglycemics, etc.) related to changes in LUTS severity, maximum urinary flow rate measured by uroflowmetry, prostate volume determined by transrectal ultrasound, and serum PSA concentrations. Results Of the 2,226 men participating in the OCS and the FMHS, 186 men reported a history of diabetes, 76.9% of which were treated with medical therapy. Overall, men with diabetes had significantly greater odds of moderate/severe LUTS (age- and race-adjusted OR=1.37, 95% CI=1.00, 1.87) compared to non-diabetics. However, among diabetic men, those not taking medications had higher odds of moderate/LUTS than those taking medications. This association among men not taking medications was seen for five of the seven individual symptoms. Prostate volume and PSA were not significantly associated with diabetes treatment. No significant differences were observed for annual change in BPH characteristics by diabetes treatment status. Conclusions These findings suggest that the presence of diabetes and subsequent poor glycemic control may be less related to prostate growth and more to the dynamic components of lower urinary tract function. Further evaluations of the associations between glycemic control and BPH progression are warranted. PMID:22112286

Sarma, Aruna V.; St. Sauver, Jennifer L.; Hollingsworth, John M.; Jacobson, Debra J.; McGree, Michaela E.; Dunn, Rodney L.; Lieber, Michael M.; Jacobsen, Steven J.

2012-01-01

108

Morphological Changes of Benign Prostatic Hyperplasia in Culture  

PubMed Central

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

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

1973-01-01

109

[Is there a rational therapy for symptomatic treatment of benign prostatic hyperplasia with phytogenic drugs? Illustrated with the example of the prostate agent from Serenoa repens (Sabal fructus)].  

PubMed

In summary, even when the scientific findings are subjected to a stringently critical evaluation, it must be concluded that the denigration of herbal prostate drugs to mere placebos, as occasionally occurs, is not scientifically tenable. This is especially true of the lipophilic extract of Saw Palmetto (Serenoa repens fruits) in a daily dose of 320 mg extract. All in all, far more experimental and clinical studies have been conducted with herbal prostate drugs than with "fashionable" drugs, such as alpha 1-receptor antagonists and finasteride, since with the latter only studies of recent design are available. A dogmatic evaluation of one drug group or another is certainly not in the patients' best interest. As the overview shows, both groups of substances are useful for individualized treatment of benign prostatic hyperplasia (BPH), provided that conservative pharmacological treatment of BPH is basically accepted and that the patients' quality of life is also considered. Phytomedicines have less side effects and lower costs. PMID:10483690

Schilcher, H

1999-01-01

110

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

PubMed

The aim of this study was to determine the improvement in symptoms and quality of life in men with Benign Prostatic Hyperplasia (BPH) after transurethral resection of prostate (TURP). Fifty consecutive patients fit for undergoing TURP for BPH were included in this study. All patients were assessed prior to definitive surgical treatment using standardized questionnaires of international prostate symptom score (IPSS) which includes single disease-specific quality of life (QOL) score. Follow up of these patients was done at three months with same questionnaires. Data was analyzed using the statistical package for social sciences (SPSS) for Windows. The mean age and duration of symptom was 68.3 years and 26.7 months respectively. The average volume of prostate was 46.1 cm3. Preoperative IPSS and QOL score were 23.4 and 5.2 respectively; 56.6% of the score was contributed by obstructive symptoms. At three months follow up, the mean IPSS reduced down to 7.9 and QOL score improved to 1.5. The average change in IPSS and QOL score were 15.6 and 3.6; these changes were statistically significant and correlated with preoperative symptom severity. Most of the patients presented with severe symptom associated with decreased QOL. After TURP, there was significant improvement in IPSS and QOL scores. The improvement was graded as good out come and strongly related to preoperative symptom severity. PMID:18298015

Chalise, P R; Agrawal, C S

2007-12-01

111

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

PubMed

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

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

2014-08-01

112

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

PubMed

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

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

2014-11-25

113

A novel nonsecosteroidal VDR agonist (CH5036249) exhibits efficacy in a spontaneous benign prostatic hyperplasia beagle model.  

PubMed

To date, there have been no reports showing the efficacy of nonsecosteroidal vitamin D receptor (VDR) agonists in a benign prostatic hyperplasia (BPH) animal model. To examine the efficacy of CH5036249, a novel nonsecosteroidal VDR agonist, we orally administered the compound at 0.03 microg/kg to a beagle model with spontaneous BPH. Prostate volume was checked by rectal ultrasonic probe periodically during 11 months of administration and the prostate tissues histologically examined. CH5036249 inhibited prostate growth in two out of three dogs compared with vehicle-treated dogs. In the prostate specimens, substantial atrophy of the epithelium was observed in all dogs administered CH5036249. At the dose given, serum calcium levels slightly increased in the CH5036249-treated dogs but stayed within a normal range. We next examined the cell growth inhibition of CH5036249 using human prostate stromal cells and found the cell growth inhibitory activity of CH5036249 to be comparable to that of 1alpha,25(OH)2D3. The bioavailability from oral administration in rats was 95.1% with a t1/2 of 17.6 h. Both micro-AMES and micronucleus tests were negative. Although the results are still preliminary, we consider the novel nonsecosteroidal VDR agonist CH5036249 to be a possible new drug candidate for the treatment of BPH in humans. PMID:20304062

Taniguchi, K; Katagiri, K; Kashiwagi, H; Harada, S; Sugimoto, Y; Shimizu, Y; Arakawa, H; Ito, T; Yamazaki, M; Watanabe, T; Kato, A; Hoshino, E; Takahashi, T; Esaki, T; Suzuki, M; Takeda, S; Ichikawa, F; Harada, A; Sekiguchi, N; Ishigai, M; Kawata, H; Yoneya, T; Onuma, E; Sudoh, M; Aoki, Y

2010-07-01

114

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

Microsoft Academic Search

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

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

1996-01-01

115

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

116

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

PubMed Central

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are common in aging men and can significantly affect quality of life. Men with bothersome LUTS/BPH often present with various other age-related conditions, including sexual dysfunction, heart disease, hypertension, diabetes, and the metabolic syndrome, which can complicate management decisions. Therefore, healthcare providers should be familiar with first-line treatment options for LUTS/BPH and their differing safety profiles, particularly with respect to cardiovascular and sexual function side effects. This article presents a review of first-line medical therapy options for managing aging men with LUTS/BPH and patient considerations when evaluating and selecting these therapies, with a focus on the clinical efficacy and cardiovascular and sexual function safety profiles of the uroselective ?1-adrenergic receptor antagonist alfuzosin 10 mg once daily. Alfuzosin improves LUTS, peak urinary flow rates, and disease-specific quality of life, reduces the long-term risk of overall BPH progression, and is well tolerated in aging men, with minimal vasodilatory and sexual function side effects, even in those with comorbidities. Alfuzosin is well tolerated when used in combination with antihypertensive medications and phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction. The long-term clinical efficacy and good cardiovascular and sexual function safety profile of alfuzosin can contribute to an improved quality of life for aging men with LUTS/BPH. PMID:18982921

Roehrborn, Claus G; Rosen, Raymond C

2008-01-01

117

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

PubMed

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

Squadrito, Francesco; Morgia, Giuseppe

2011-01-01

118

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

119

Is There a Relationship between Androgenic Alopecia and Benign Prostatic Hyperplasia?  

PubMed

Androgenic alopecia as a physiologic process and benign prostatic hyperplasia (BPH) as a pathologic process in the older population are androgen-dependent processes influenced by 5-alpha reductase enzyme which converts testosterone to dihydrotestosterone. This cross sectional study was done to evaluate the relationship between androgenic alopecia and BPH. 150 men older than 50 years old, who presented to the free prostate screening clinic, were included. They were asked about urinary symptoms. PSA level, prostate volume with sonography and alopecia grading using Hamilton-Norwood classification (grade I to VII) were evaluated. Analysis was done by SPSS statistical method. 59.6% of men had mild alopecia (grade I, II, III), 34.1% had moderate alopecia (grade IV, V) and 6.3% had severe alopecia (grade VI, VII).The mean PSA level was 1.37 ± 1.48 ng/ml. The minimum PSA level was 0.1 ng/ml, and the maximum level was 6.8 ng/ml. The mean prostate volume was 37.85 ± 21.85cc. The minimum prostate size was 10 ml, and the maximum volume was 173 ml. The mean international prostate symptom score (IPSS) was 7.6 ± 6.11 with the minimum score 0 and the maximum score 27. However, no relationship between these parameters and androgenic alopecia was detected. This study showed that there is no relationship between androgenic alopecia, PSA level, IPSS, and prostate volume. Occurrence of alopecia in younger age and a positive family history correlated with a higher grade of alopecia. PMID:25597602

Dastgheib, Ladan; Shirazi, Mehdi; Moezzi, Iman; Dehghan, Saber; Sadati, Maryam-Sadat

2015-01-01

120

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

121

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

PubMed Central

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

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

2013-01-01

122

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

123

Doxazosin in the treatment of benign prostatic hyperplasia in normotensive patients: a multicenter study.  

PubMed

A 16-week, double-blind, placebo controlled, dose titration study was done on 100 normotensive patients age 45 years or older to determine the efficacy and safety of doxazosin, a selective alpha 1-adrenoceptor antagonist, in the treatment of benign prostatic hyperplasia (BPH). Of the 41 efficacy evaluable patients 88% underwent dose titration to a maximum of 8 mg. doxazosin once daily. Maximum and average urinary flow rates increased significantly above baseline with doxazosin (2.9 ml. per second and 1.4 ml. per second, respectively) compared with placebo (0.7 ml. per second and 0.3 ml. per second, respectively). A significant effect on maximum flow rate was noted as early as week 2 of double-blind treatment at the initial efficacy evaluation. Doxazosin was superior to placebo in patient and investigator assessments of total, obstructive and irritative BPH symptoms. The onset of efficacy for total patient-assessed symptoms was significant for doxazosin compared to placebo 4 weeks after the start of the treatment regimen. Statistically significant decreases in mean blood pressure of 4 to 6 mm. Hg were noted with doxazosin compared with placebo. Adverse events, primarily mild to moderate in severity, were reported in 44% of patients given doxazosin and 30% of those given placebo. Our results strongly demonstrate that doxazosin is significantly superior to placebo in the treatment of BPH in normotensive patients, with the patient experiencing significant relief early after initiation of therapy. PMID:7539853

Fawzy, A; Braun, K; Lewis, G P; Gaffney, M; Ice, K; Dias, N

1995-07-01

124

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

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. PMID:25120327

Yang, Yong June; Koh, Jun Sung; Ko, Hyo Jung; Cho, Kang Joon; Kim, Joon Chul; Lee, Soo-Jung; Pae, Chi-Un

2014-08-01

125

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

126

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

127

Benign prostatic hyperplasia is a significant risk factor for bladder cancer in diabetic patients: a population-based cohort study using the National Health Insurance in Taiwan  

PubMed Central

Background Diabetic patients have a higher risk of bladder cancer and benign prostatic hyperplasia (BPH). Theoretically, BPH patients may have an increased risk of bladder cancer because residual urine in the bladder surely increases the contact time between urinary excreted carcinogens and the urothelium. However, whether BPH increases bladder cancer risk in patients with type 2 diabetes has not been studied. Methods The reimbursement databases of all Taiwanese diabetic patients under oral anti-diabetic agents or insulin from 1996 to 2009 were retrieved from the National Health Insurance. An entry date was set at 1 January 2006 and a total of 547584 men with type 2 diabetes were followed up for bladder cancer incidence until the end of 2009. Incidences of bladder cancer for BPH by status and by duration were calculated and adjusted hazard ratios (95% confidence intervals) were estimated by Cox regression. The effects of diabetes duration and medications used for diabetic control in relation with bladder cancer risk were also evaluated by Cox regression in BPH men. Results The incidences were 258.77 and 69.34 per 100,000 person-years for patients with and without BPH, respectively, adjusted hazard ratio 1.794 (1.572, 2.047). For BPH patients, those who underwent surgical procedures for BPH had a higher incidence than those who did not (355.45 vs. 250.09 per 100,000 person-years), respective adjusted hazard ratios: 2.459 (1.946, 3.109) and 1.709 (1.492, 1.958). The significantly higher risk could be demonstrated for BPH of any duration: respective adjusted hazard ratios 1.750 (1.430, 1.605), 1.844 (1.543, 2.203), 2.011 (1.680, 2.406) and 1.605 (1.341, 1.921) for BPH <1, 1–3, 3–5 and ?5?years versus patients without BPH. Sensitivity analyses for patients aged ?60?years and after excluding BPH patients with surgical procedures or without surgical procedures, respectively, yielded similar results. In BPH men, diabetes duration was not significantly related with bladder cancer; but metformin was consistently associated with a significantly lower risk, with adjusted hazard ratio of 0.719 (0.590, 0.875) for all ages and 0.742 (0.604, 0.912) for age ?60?years. Conclusions BPH is a significant risk factor for bladder cancer in men with type 2 diabetes. Metformin may protect against bladder cancer in BPH men. PMID:23286275

2013-01-01

128

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

129

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

130

Long-term treatment of benign prostatic hyperplasia with alfuzosin: a 12-18 month assessment. BPHALF Group.  

PubMed

In order to assess the efficacy and safety of alfuzosin, an alpha-1 blocker, in symptomatic patients with benign prostatic hyperplasia (BPH), 131 patients who had completed a 6-month placebo-controlled trial conducted on parallel groups entered a 12-month open study; 122 patients were treated with alfuzosin for 12 months and 56 patients for 18 months. After 12 months, all obstructive and irritative symptoms assessed according to the Boyarsky scale were significantly improved, as were peak flow rates in obstructed patients and mean flow rates and residual urine in the whole population. Voiding symptoms showed sustained improvement after treatment for 12 to 18 months. Only 5.3% of patients experienced vasodilatory side effects, none of which led to withdrawal from the study. No side effect related to long-term administration was reported. Alfuzosin has a beneficial effect on voiding symptoms in patients with BPH and can be safely used in long-term administration. PMID:10071548

Jardin, A; Bensadoun, H; Delauche-Cavallier, M C; Attali, P

1993-11-01

131

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

PubMed

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

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

2015-01-01

132

Detection of human papillomavirus (HPV) DNA in archival specimens of benign prostatic hyperplasia and prostatic cancer using a highly sensitive nested PCR method.  

PubMed

Human papillomavirus is thought to be an etiological factor for urological tumors such as penile cancer. However, there is much conflicting data surrounding prostatic cancer. We recently established a highly sensitive nested PCR method with consensus human papillomavirus (HPV) primers for the detection of many high-risk HPV types. HPV DNA from the long-control region (LCR) to E7 open reading frame was amplified with first primer pairs and subsequently amplified with second internal E6-E7 primers. Our nested PCR method could detect HPV16, 18, 31, 33, 35, 52, 58 and some undetermined HPV DNAs. Using this method, we investigated the existence of HPV DNA in formalin-fixed paraffin-embedded tissue of the prostate. We found HPV DNA in three of 71 specimens of benign prostatic hyperplasia (BPH) and in none of 38 prostatic carcinomas. These three samples were infected with HPV 16. These results suggest that HPV is not a causal factor for prostatic cancer and BPH. PMID:9694597

Noda, T; Sasagawa, T; Dong, Y; Fuse, H; Namiki, M; Inoue, M

1998-01-01

133

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

PubMed Central

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

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

2015-01-01

134

A New Prostatic Stent for the Treatment of Benign Prostatic Hyperplasia in High–Risk Patients  

Microsoft Academic Search

Objectives: The objective of this study was to evaluate the efficacy and safety of a new prostatic stent (Trestle®, Boston Scientific Microvasive) for the treatment of BPH in patients with complete urinary retention and considered to be inoperable.Methods: The efficacy of the stent was evaluated in terms of return of micturition, level of patient satisfaction, uroflowmetry and residual urine. Any

Olivier Traxer; Maurice Anidjar; François Gaudez; François Saporta; Michel Daudon; Ariane Cortesse; François Desgrandchamps; Olivier Cussenot; Pierre Teillac; Alain Le Duc

2000-01-01

135

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

136

Outcome of Surgery for Benign Prostatic Hyperplasia-Is It Predictable?  

PubMed Central

Aim: The study was done to evaluate the pre-operative and intra operative factors which influence the post-operative outcome in patients undergoing surgery for Benign Prostatic Hyperplasia (BPH). Setting and Design: It was carried out prospectively at a university college hospital in northern India. Material & Methods: The study was carried out prospectively in 31 patients who underwent surgery for BPH (TURP – 50, Open Prostatectomy – 10). Various pre-operative and intra-operative parameters were studied by means of a detailed history and examination, IPS score, urodynamic evaluation & cystoscopic examination. Their effect on post-operative outcome was evaluated by measuring changes in IPSS, maximum and average flow rates, and fall in PSA values. Statistical Analysis: Repeated measure ANNOVA was applied to calculate the significance of preoperative factors on post operative outcome (IPSS, Q max and Q av). Results: All parameters studied in the patients improved significantly following surgery. Patients who had pre-operative urinary retention and catheter at the time of surgery had significant improvement in both subjective (IPSS ,p=.oo4) and objective (maximum & average flow rates p=.04) parameters studied. Patients with larger prostrate had a significantly better maximum flow rate (p=.03) and IPSS at 3 months post-operatively. Similarly, patients with larger bladder capacity (more than 150 ml), better compliance (more than 6 ml per cm of water) and lower post-voidal residue (less than 60ml) had better post-operative outcome. Conclusion: Patients with pre-operative urinary retention, shorter duration of bladder catheterization, lower post voidal residue, high IPSS score, larger prostrate, larger bladder capacity and compliance had a significantly better outcome following surgery for BPH as assessed by various parameters studied. PMID:24551658

Suhani; Gupta, Sanjay; Gupta, Arun; Saha, Sudipta; Mahapatra, Lalatendu; Srivastava, UK

2013-01-01

137

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

138

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

139

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

140

A new patient weighted symptom score system (DAN-PSS-1). Clinical assessment of indications and outcomes of transurethral prostatectomy for uncomplicated benign prostatic hyperplasia.  

PubMed

A patient weighted symptom score system, the Danish Prostatic Symptom Score (DAN-PSS-1), including a disease specific self administered quality of life questionnaire, is presented. The model was evaluated pre- and postoperatively in 29 patients apparently suffering from uncomplicated benign prostatic hyperplasia. The score system is based on the severity of 12 symptoms related to bladder storage and voiding function, and three questions related to sexual function (symptom score). For each of these parameters the patient must also evaluate its influence on his daily life (bother score). In the 29 patients with uncomplicated benign prostatic hyperplasia (BPH) bother scores exceeded symptom scores for the irritative symptoms but not for the obstructive symptoms, and surprisingly the symptom score was less improved than the bother score 6 months after transurethral resection of the prostate (TUR-P). Furthermore the postvoiding dribble was worsened after the operation. We find that this model, DAN-PSS-1, assists in creating a solid base for the indication for and the evaluation of treatment of uncomplicated BPH. PMID:7512748

Meyhoff, H H; Hald, T; Nordling, J; Andersen, J T; Bilde, T; Walter, S

1993-01-01

141

Applicators for MR-Guided Ultrasonic Ablation of BPH  

PubMed Central

Objectives To evaluate in a canine model, applicators designed for ablation of human benign prostatic hyperplasia (BPH) in vivo under MRI guidance, including magnetic resonance thermal imaging (MRTI). To determine the ability of MRI techniques to visualize ablative changes in prostate, and to evaluate the acute and longer term histologic appearances of prostate tissue ablated during these studies. Materials and Methods A MRI-compatible transurethral device incorporating a tubular transducer array with dual 120 sectors was employed to ablate canine prostate tissue in vivo, in zones similar to regions of human BPH (enlarged transition zones (TZ)). MRTI was used for monitoring of ablation in a 3T environment, and post-ablation MRI's were performed to determine visibility of ablated regions. Three canine prostates were ablated in acute studies, and 2 animals were rescanned prior to sacrifice at 31 days post ablation. Acute and chronic appearances of ablated prostate tissue were evaluated histologically, and correlated with the MRTI and post ablation MRI scans. Results It was possible to ablate regions similar in size to enlarged TZ in human BPH in 5 to 15 minutes. Regions of acute ablation showed a central “heat fixed” region surrounded by a region of more obvious necrosis with complete disruption of tissue architecture. After 31 days, ablated regions demonstrated complete apparent resorption of ablated tissue with formation of cystic regions containing fluid. The inherent cooling of the urethra using the technique resulted in complete urethral preservation in all cases. Conclusions Prostatic ablation of zones of size and shape corresponding to human BPH is possible using appropriate transurethral applicators using MRTI, and ablated tissue may be depicted clearly in contrast-enhanced MR images. The ability accurately to monitor prostate tissue heating, the apparent resorption of ablated regions over one month, and the inherent urethral preservation suggest the MR guided technques described are highly promising for the in vivo ablation of symptomatic human BPH. PMID:23462673

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

2014-01-01

142

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

143

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

PubMed Central

Prostate cancer (PCa) is common in Western populations and the second leading cause of cancer-related mortality among males in North America, with an increasing morbidity in China and other Asian countries. The aim of this study was to evaluate the protein expression of autophagy-related genes Beclin-1 and LC3 in patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) and elucidate their association with p53 and Bcl-2. The total protein of 34 PCa and 50 BPH samples was extracted and the expression of Beclin-1 and LC3 was analyzed by western blotting assay. Subsequently, a total of 96 paraffin-embedded BPH tissue samples was subdivided into 2 groups, one group in which patients had received 5?-reductase inhibitor, due to its effect of androgen ablation, and the control group, in which patients had not received the 5?-reductase inhibitor. The samples were randomly collected and examined using immunohistochemical (IHC) analysis. The western blot analysis demonstrated that Beclin-l and LC3 expression was higher in BPH tissues compared to PCa tissues (P<0.001). There was no statistically significant difference between PCas of different Gleason scores (P>0.05). The result of IHC revealed that Beclin-l and LC3 expression in the group of patients who had received the 5?-reductase inhibitor was significantly higher compared to that in the control group; however, the expression of Bcl-2 and p53 was lower (P<0.05). Beclin-1 expression exhibited a negative correlation with Bcl-2 (r=?0.402, P<0.001), whereas LC3 expression exhibited a positive correlation with Beclin-1 (r=0.345, P=0.001) and a negative correlation with Bcl-2 (r=?0.216, P=0.035). It was suggested that autophagy-related genes Beclin-l and LC3 may be involved in the development and progression of PCa. In addition, the expression of these genes was higher in patients with BPH who had received a 5?-reductase inhibitor, due to androgen reduction. As a result, the induced autophagy may reduce the risk of PCa. PMID:24649042

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

2013-01-01

144

Transurethral microwave thermotherapy for uncomplicated benign prostatic hyperplasia. A prospective study with emphasis on symptomatic improvement and complications.  

PubMed

A single session of transurethral microwave thermotherapy (TUMT) was used in 115 patients with symptomatic uncomplicated benign prostatic hyperplasia (BPH). Subjective symptoms and urodynamic parameters were assessed before treatment, at 6 weeks, 3, 6 and 12 months after treatment and complications recorded. There was significant improvement in obstructive, irritative and total symptom scores at all time intervals. The maximum and corrected flow rate improved significantly at all time intervals as well as the decrease in residual urine. Complications occurred in 45.2% patients with no mortality. The most frequent complications were urinary tract infection (32.1%) and urinary retention (28.6%). Two patients experienced retrograde ejaculation. No patient was hospitalized due to complication. Four (3.5%) patients required transurethral resection of the prostate during the follow-up period due to persistent symptoms; 96.5% have remained satisfied. In conclusion, TUMT is a promising treatment option in selected patients with BPH, is well tolerated and complications are easy to treat. Its main advantage is the fact that it can be administered on an outpatient basis, thus reducing patient inconvenience and costs. PMID:7516577

Marteinsson, V T; Due, J

1994-03-01

145

Factors in Predicting Failure with Medical Therapy for BPH  

PubMed Central

Perhaps more than other common disorders, the management of benign prostatic hyperplasia (BPH) has been subject to the “reatment du jour” approach. Although pharmacotherapy has largely replaced surgery in the treatment of BPH, recommendations for optimal therapy seem to change every time a new study is published. ?-Blockers, 5?-reductase inhibitors, and combination therapy with the 2 have all proved highly effective, in both trials and clinical practice. Nevertheless, medical therapy does not work for everyone, and identification of baseline factors that can help predict failure with a particular therapy is needed. Currently, the evidence supports the use of single-agent ?-blocker therapy for patients with low prostate volumes at baseline, and combination therapy for patients with larger prostates. Symptom severity at baseline also seems predictive of success or failure. PMID:16986060

Kaplan, Steven A

2005-01-01

146

Lack of association between the UDP-glucuronosyltransferase 1A1 (UGT1A1) gene polymorphism and the risk of benign prostatic hyperplasia in Caucasian men.  

PubMed

Glucuronidation, mediated by the UDP-glucuronosyltransferase 1A1 (UGT1A1) enzyme, is an important metabolic process during which steroids are converted to more easily excreted compounds in steroid target tissues, such as the prostate. The aim of our study was to investigate the possible correlation between UGT1A1 promoter gene polymorphism and benign prostatic hyperplasia. 421 blood samples were obtained from 138 consecutive patients diagnosed with benign prostatic hypeplasia (BPH group) and 283 healthy volunteers (control group). A(TA)6TAA promoter polymorphism of UGT1A1 gene was studied using the Fragment Analysis Software of an automated DNA sequencer and three genotypes (homozygous 7/7, heterozygous 6/7 and normal homozygous 6/6) were identified. No significant differences were observed between the BPH group and controls regarding the genotyping distribution of the three UGT1A1 promoter genotypes (P = 0.39). Also, no association was found between overall disease risk and the presence of the polymorphic homozygous genotype (TA(7)/TA)7) vs. TA(6)/TA(7) + TA(6)/TA(6)) (P = 0.31). Our data suggest that the TA repeat polymorphism of UGT1A1 is not associated with increased BPH risk susceptibility in Caucasian men. PMID:24057187

Karatzas, Anastasios; Tzortzis, Vassilios; Giannatou, Eirini; Gravas, Stavros; Zachos, Ioannis; Oeconomou, Athanassios; Melekos, Michael; Tsezou, Aspasia

2013-12-01

147

Correlation of the AUA symptom index with urodynamics in patients with suspected benign prostatic hyperplasia.  

PubMed

The AUA symptom index is widely used to access patients with suspected benign prostatic hyperplasia (BPH). In order to determine how well symptoms as assessed by this index correlate with urodynamic findings, we evaluated 83 patients referred to our urology clinics with symptoms of BPH. All patients completed the AUA symptom index and then underwent a multichannel urodynamic evaluation. Patients were classified as obstructed, unobstructed, or equivocal according to the Abrams Griffiths nomogram. The AUA symptom index was recorded as the total score and, for purposes of symptom classification, further subdivided into an obstructive score (questions 3, 5, and 6) and an irritative score (questions 1, 2, 4, and 7). The mean age of the 83 patients was 67 (45-84). The mean total AUA symptom score was 16.6 (6-34), mean obstructive score was 6.1 (0-15), and the mean irritative score 10.4 (3-20). Pressure flow analysis using the Abrams-Griffiths nomogram classified 28 patients (34%) as obstructed, 17 (20%) as unobstructed, and 38 (46%) as equivocal. Using the analysis of variance procedure (ANOVA) there was no statistically significant difference in the mean total (P = 0.446), obstructive (P = 0.979), or irritative (P = 0.136) scores. Detrusor instability was present in 45 patients (54%). While total and obstructive scores were not significantly different in patients with detrusor instability vs. those with stable bladders, irritative scores were higher in patients with instability (P = 0.028) using the T-test procedure. Using ANOVA, the difference in post void residual (PVR) between the groups was not quite statistically significant (P = 0.057).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7530554

Nitti, V W; Kim, Y; Combs, A J

1994-01-01

148

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

149

The development and preliminary evaluation of a decision aid based on decision analysis for two treatment conditions: benign prostatic hyperplasia and hypertension.  

PubMed

This paper discusses the development and evaluation of a computerised decision aid that provides individualised information about Benign Prostatic Hyperplasia (BPH) and Hypertension to patients. The program is based on decision analysis, using decision trees as a way of providing users with information regarding the probability of different outcomes occurring, obtaining an individual evaluation of the different outcomes, before providing guidance on what might be the 'best' option for that patient. It is intended that the program can be used as the basis for helping patients to become more involved in decisions about their medical treatment. Eight health care professionals and 19 patients (9 with BPH and 10 with Hypertension) evaluated the program. Overall it was assessed positively by both health care professionals and patients. However, before it can be integrated into health care practice, the program is to be evaluated further in a randomised trial. PMID:15132527

Dowding, Dawn; Swanson, Vivien; Bland, Richard; Thomson, Pat; Mair, Chris; Morrison, Audrey; Taylor, Anne; Beechey, Claire; Simpson, Richard; Niven, Kate

2004-02-01

150

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

PubMed Central

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

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

2014-01-01

151

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

152

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.  

PubMed

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 average flow rate (8 mg. and 12 mg.) compared with placebo. The increase in maximum flow rate was significant with doxazosin versus placebo within 1 week of initiating double-blind therapy. Doxazosin compared to placebo significantly decreased patient-assessed total, obstructive and irritative BPH symptoms. Blood pressure was significantly lower with all doxazosin doses compared with placebo. Adverse events, primarily mild to moderate in severity, were reported in 48% of patients on doxazosin and 35% on placebo. Our results strongly support the use of doxazosin as a nonoperative therapeutic alternative in the management of uncomplicated BPH. Doxazosin would also be particularly useful in the management of patients who have BPH and hypertension. PMID:7539854

Gillenwater, J Y; Conn, R L; Chrysant, S G; Roy, J; Gaffney, M; Ice, K; Dias, N

1995-07-01

153

Localized hyperthermia versus the sham procedure in obstructive benign hyperplasia of the prostate: a prospective randomized study.  

PubMed

Hyperthermia was shown to cause improvement in 50 to 60% of the patients with benign prostatic hyperplasia (BPH) without considering placebo effects. We studied 68 patients randomly assigned to a treatment group (38) and a sham group (30) who underwent the same manipulation but without applying radio frequency power. The Biodan Prostathermer was used. Criteria for inclusion were based on objective and subjective symptoms. Treatment was performed 6 times at 43 +/- 0.5C for the treatment group. Followup evaluation was performed at 3 months, and the same objective and subjective symptoms were recorded. We observed a statistically significant subjective improvement in the sham group (33%) that was not accompanied by any significant objective improvement. In the treatment group the subjective response was significantly better regarding number of patients (68%) and response rate, and was substantiated by a significant improvement in all objective symptoms (53% of the patients) except voided volume. Therefore, hyperthermia treatment had a definite therapeutic effect on BPH in excess of placebo. PMID:1372660

Zerbib, M; Steg, A; Conquy, S; Martinache, P R; Flam, T A; Debre, B

1992-04-01

154

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

155

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

156

Serenoa repens extract in the treatment of benign prostatic hyperplasia.  

PubMed

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

Geavlete, Petrisor; Multescu, Razvan; Geavlete, Bogdan

2011-08-01

157

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

PubMed Central

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

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

2014-01-01

158

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

159

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

160

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

PubMed Central

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

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

2010-01-01

161

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

PubMed Central

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

Sankhwar, Satyanarayan

2013-01-01

162

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

163

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

164

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

PubMed

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

Ne?mark, A I; Nozdrachev, N A

2013-01-01

165

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

PubMed

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

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

2013-01-01

166

Investigation of granulomatous prostatitis incidence following intravesical BCG therapy  

PubMed Central

In the present manuscript, we studied the incidence of granulomatous prostatitis in the prostatectomy specimen of the patients who underwent transurethral resection of the prostate (TURP) after superficial bladder cancer treatment with intravesical Bacillus Calmette-Guerin (BCG) and were diagnosed with benign prostate hyperplasia (BPH). The clinical data and histopathological specimen records of 472 patients who underwent TUR-P due to BPH diagnosis, obtained over a period of 6 years in the urology department of Private Konya Hospital, Konya, Turkey, were studied retrospectively. The cases were divided into two groups as (Group I) who did not undergo any treatment and as (Group II) who underwent BCG treatment. The frequency and the clinical course of the cases with granulomatous prostatitis were studied histopathologically. There were in total 472 patients who underwent TUR-P. Out of the 459 patients who did not undergo BCG treatment (Group I), the histopathological specimen records of 262 (57%) was BPH, of 197 (43%) BPH + chronic prostatitis. Of the second group, 13 cases underwent intravesical BCG treatment before surgical intervention due to superficial bladder CA diagnosis. In this group 4 of the cases were diagnosed as (30%) BPH, 9 as (70%) chronic prostatitis + BPH. 6 out of the 9 chronic prostatitis cases were chronic prostatitis, 2 caseous granulomatous prostatitis, 1 non-caseous granulomatous prostatitis. Granulomatous prostatitis cases should require no specific therapy. Conclusion: In patients with obstruction complaints following intravesical BCG treatment, granulomatous prostatitis should also be considered and treatment plans should be made accordingly. PMID:25035779

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

2014-01-01

167

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

NASA Astrophysics Data System (ADS)

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

Muschter, Rolf

1994-12-01

168

Comparison of 7 ?(1)-adrenoceptor antagonists in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia:a short-term crossover study.  

PubMed

A crossover study was conducted to identify the best ?1-adrenoceptor (?1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). One hundred thirteen patients (mean age 70.8 years) were enrolled. All patients met BPH clinical study guidelines. Seven agents were utilized:tamsulosin 0.2mg, silodosin 8mg, urapidil 60mg, naftopidil 50mg, prazosin 1mg, terazosin 2mg, and doxazosin 1mg. Patients were initially prescribed tamsulosin or silodosin for a week and then urapidil for a week. Two weeks later, they were prescribed the better of the 2 agents for a week and a new agent for the next week. This cycle was repeated until all 7 agents were tested. Efficacy was evaluated with the International Prostate Symptom Score. The agent rankings were doxazosin (25 [22%]), silodosin (22 [19%]), urapidil (19 [17%]), naftopidil (17 [15%]), terazosin (12 [11%]), tamsulosin (11 [10%]), prazosin (7 [6%]). Only 12 patients (11%) changed agents after the crossover study was completed. The major reason was adverse events (83%). We found that each of the 7 ?1AR antagonists has its own supporters. Further, the one-week crossover study was useful in identifying the best agent for the treatment of each individual with LUTS. PMID:23970323

Araki, Tohru; Monden, Koichi; Araki, Motoo

2013-01-01

169

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

PubMed

We examined whether the effects (efficacy on the urethra and hypotension) of silodosin (alpha(1A)-adrenoceptor antagonist) and tamsulosin (alpha(1A+1D)-adrenoceptor antagonist) in dogs with benign prostatic hyperplasia altered with age. We used young and old dogs, diagnosed as having benign prostatic hyperplasia by veterinarian's palpation. Under anesthesia, the increase in intraurethral pressure evoked by hypogastric nerve stimulation was measured, together with the level of systemic mean blood pressure. Each drug was administered intravenously in progressively increasing doses. At the end of the experiment, the prostate was isolated from each dog, then weighed and investigated pathologically to confirm benign prostatic hyperplasia. The wet weight of the prostate was greater in old dogs with benign prostatic hyperplasia than in young dogs with benign prostatic hyperplasia. By light microscopy, hyperplasia in the prostatic epithelium was confirmed in both groups. Silodosin (0.3-300 microg/kg) dose-dependently inhibited the hypogastric nerve stimulation-induced increase in intraurethral pressure (without significant hypotensive effects) in both young and old dogs with benign prostatic hyperplasia. Tamsulosin (0.3-300 microg/kg) also dose-dependently inhibited the intraurethral pressure increase in both groups, but it had a hypotensive effect that was significantly greater in old than in young dogs with benign prostatic hyperplasia. In conclusion, as regards the effect of silodosin on intraurethral pressure, potency was similar between young and old dogs with benign prostatic hyperplasia, and it was without significant hypotensive effects. We therefore suggest that silodosin might be a good medication for lower urinary tract symptoms in patients with benign prostatic hyperplasia in all age groups. PMID:19389393

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

2009-06-24

170

29-week doxazosin treatment in patients with symptomatic benign prostatic hyperplasia. A double-blind placebo-controlled study.  

PubMed

In a placebo-controlled study, the safety and efficacy of the selective alpha 1-adrenoceptor-blocking agent doxazosin 4 mg once daily in the symptomatic treatment of benign prostatic hyperplasia (BPH) were evaluated. One hundred patients were primarily included in a 9-weeks study, and after this 75 patients accepted to continue in the present 20 weeks extension. Of the patients in the doxazosin-group (DG) 61% reported overall improvement against 53% in the placebo-group (PG)--(p = 0.56). In the DG, 49% of obstructive symptoms were improved compared to 27% in the PG (p < 0.01), and a reduction of 60% of irritative symptoms was found in the DG against 36% in the PG (p < 0.01). Daytime frequency was reduced by median 1.5 in the DG and remained unchanged in the PG (p < 0.01). Nocturia was reduced by median 1 and 0.5 respectively (p = 0.06). Maximum urinary flow rate (MFR) was improved by median 1.5 ml/s in the DG, while it deteriorated by median 0.5 ml/s in the PG (p < 0.05), Considering postvoid residual urine volume, cystometry variables (first sensation and bladder capacity), changes in sexual function and adverse events there was no difference between the two groups. In conclusion, doxazosin 4 mg once daily in long-term treatment of patients with BPH reduces both obstructive and irritative symptoms, daytime voiding frequency and although only slightly, significantly augments MFR without interference with sexual function and without other serious adverse effects. PMID:7516576

Bendix Holme, J; Christensen, M M; Rasmussen, P C; Jacobsen, F; Nielsen, J; Nørgaard, J P; Olesen, S; Noer, I; Wolf, H; Elkjaer Husted, S

1994-03-01

171

How reliable is a single measurement of urinary flow in the diagnosis of obstruction in benign prostatic hyperplasia?  

PubMed

Twenty-six elderly patients with obstructive symptomatology and an initial low peak urinary flow rate (< 15 ml/s) were observed for 6 to 12 months. Repeated assessments were made of flow rates and residual volumes. Within patients variation of the maximal urinary flow was significant; the standard deviation (SD) varied from 0.8 to 5.5 ml/s. The SD varied with the mean peak flow rates and this suggests that the precision of a single determination of a patient's peak flow is inversely related to the peak flow itself. In all, 333 determinations of peak flow were obtained. Only 80% were below 2 SD of the mean Siroky nomogram. Multiple determinations were used to estimate the sensitivity rate for each patient, i.e. the proportion of peak flows that were less than 2 SD below the mean of Siroky's nomogram. The average sensitivity for all of the flow values was 0.813 when applied to voided volumes and increased only slightly to 0.838 when applied to total bladder volume. Given a prevalence of 0.70 of obstruction ascribed to benign prostatic hyperplasia (BPH) among elderly men, the positive predictive value of an abnormally low peak flow was 0.97. A single low peak flow based on assessment of voided volume may serve as an almost sure indication of obstruction. If a patient has a single normal peak flow rate, he still has a 0.31 probability of having evidence of obstruction in his following uroflow determinations. Using total bladder volume does not make a difference in most patients and is not worth the effort and discomfort. The only patients who require accurate residual measurements are those with a normal uroflow but clear-cut obstructive symptomatology or with borderline peak flow. The results of this study are relevant to everyday clinical practice and to the evaluation of studies on alternatives to surgery in BPH. PMID:7691369

Matzkin, H; van der Zwaag, R; Chen, Y; Patterson, L A; Braf, Z; Soloway, M S

1993-08-01

172

Transrectal ultrasound in local hyperthermia to the benign prostate  

Microsoft Academic Search

A total of 95 patients suffering from prostatic symptoms due to benign hyperplasia (BPH) and scheduled for surgery elected to participate in a clinical trial of local hyperthermia therapy to the prostate. Transrectal ultrasound (TRUS) was performed before and following completion of the treatment. Changes in volume and in the configuration of the gland were observed. Such changes showed no

Z. Leib; A. Lev; C. Servadio

1991-01-01

173

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

174

Sexually transmitted diseases and other urogenital conditions as risk factors for prostate cancer: a case–control study in Wayne County, Michigan  

Microsoft Academic Search

Objective To investigate associations between prostate cancer and sexually transmitted diseases (STDs), prostatitis, benign prostatic hyperplasia (BPH), and vasectomy in a population-based case–control study in Wayne County, Michigan, among African American and white men aged 50–74 years.

Divya A. Patel; Cathryn H. Bock; Kendra Schwartz; Angela S. Wenzlaff; Raymond Y. Demers; Richard K. Severson

2005-01-01

175

Inflammatory mechanisms associated with prostatic inflammation and lower urinary tract symptoms  

Microsoft Academic Search

Inflammation is a common finding in histologic prostate specimens obtained from aging men. Accumulating data suggest that\\u000a inflammation may play an important role in the development of benign prostatic hyperplasia (BPH), and the development and\\u000a progression of lower urinary tract symptoms (LUTS). Inflammatory processes may contribute to prostatic enlargement directly\\u000a through stimulation of prostate growth, or, alternatively, through decreasing prostatic

Jennifer L. St. Sauver; Steven J. Jacobsen

2008-01-01

176

Factors Influencing Nonabsolute Indications for Surgery in Patients With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: Analysis Using Causal Bayesian Networks  

PubMed Central

Purpose To identify the factors affecting the surgical decisions of experienced physicians when treating patients with lower urinary tract symptoms that are suggestive of benign prostatic hyperplasia (LUTS/BPH). Methods Patients with LUTS/BPH treated by two physicians between October 2004 and August 2013 were included in this study. The causal Bayesian network (CBN) model was used to analyze factors influencing the surgical decisions of physicians and the actual performance of surgery. The accuracies of the established CBN models were verified using linear regression (LR) analysis. Results A total of 1,108 patients with LUTS/BPH were analyzed. The mean age and total prostate volume (TPV) were 66.2 (±7.3, standard deviation) years and 47.3 (±25.4) mL, respectively. Of the total 1,108 patients, 603 (54.4%) were treated by physician A and 505 (45.6%) were treated by physician B. Although surgery was recommended to 699 patients (63.1%), 589 (53.2%) actually underwent surgery. Our CBN model showed that the TPV (R=0.432), treating physician (R=0.370), bladder outlet obstruction (BOO) on urodynamic study (UDS) (R=0.324), and International Prostate Symptom Score (IPSS) question 3 (intermittency; R=0.141) were the factors directly influencing the surgical decision. The transition zone volume (R=0.396), treating physician (R=0.340), and BOO (R=0.300) directly affected the performance of surgery. Compared to the LR model, the area under the receiver operating characteristic curve of the CBN surgical decision model was slightly compromised (0.803 vs. 0.847, P<0.001), whereas that of the actual performance of surgery model was similar (0.801 vs. 0.820, P=0.063) to the LR model. Conclusions The TPV, treating physician, BOO on UDS, and the IPSS item of intermittency were factors that directly influenced decision-making in physicians treating patients with LUTS/BPH. PMID:25558417

Kim, Myong; Ramirez, Luis; Yoo, Changwon; Choo, Minsoo; Paick, Jae-Seung

2014-01-01

177

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

178

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

Microsoft Academic Search

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

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

1999-01-01

179

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

180

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

181

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

PubMed

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

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

2009-08-01

182

Inhibition of Spontaneous Canine Benign Prostatic Hyperplasia by an Urtica fissa Polysaccharide Fraction.  

PubMed

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

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

2015-01-01

183

Combined Low-Frequency Ultrasound and Microbubble Contrast Agent for the Treatment of Benign Prostatic Hyperplasia  

PubMed Central

Abstract Background and Purpose Benign prostatic hyperplasia is one of the most common conditions in middle-aged and elderly men. The aim of the study was to investigate the treatment effects of low-frequency ultrasound combined with a microbubbles agent on benign prostatic hyperplasia. Methods Eighteen 7-year-old male beagles with prostatic hyperplasia were randomly divided into six groups (n=3): Control group, 21?kHz ultrasound group, 21?kHz ultrasound and microbubble contrast agent group, 1?MHz ultrasound group, 1?MHz ultrasound and microbubble contrast agent group, and microbubble contrast agent group. The histopathologic damage to prostate cells was assessed via transmission electron microscopy and optical microscopy. The protein expressions of prostate-specific antigen (PSA), inducible nitric oxide synthase (iNOS), and super oxidase dimutase (SOD) were detected by enzyme-linked immunosorbent assay. Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine (Cr) were detected by the Biochemistry Automatic Analyzer. Results Significant tissue injury, mitochondria injury, and cell apoptosis were observed in 21?kHz ultrasound and the microbubble contrast agent group. Compared with the control and microbubbles contrast agent groups, the decrease in levels of PSA or increase in levels of iNOs and SOD in the other four groups were statistically significant (P<0.05). The lowest level of PSA and the highest levels of iNOs and SOD were observed in the 21?kHz ultrasound and microbubbles contrast agent group. No significant changes in levels of AST, ALT, BUN, and Cr were observed between the six groups. Conclusions Our results suggest that lower frequency ultrasound may have a better effect on benign prostatic hyperplasia, and microbubble contrast agent application further strengthens this biological effect. PMID:23607285

Yang, Shao-ling; Tang, Ke-qiang; Bai, Wen-kun; Zhao, Yi-Wen; Shen, E; Tao, Jun-jia

2013-01-01

184

Atypical adenomatous hyperplasia of prostate lacks TMPRSS2-ERG gene fusion.  

PubMed

Atypical adenomatous hyperplasia (AAH) is a distinct entity in prostate pathology, defined as a well-circumscribed lobule of closely packed crowded small glands or acini. Although it has been proposed as a precursor lesion to prostate cancer, the biological nature of AAH is currently uncertain. The TMPRSS2-ERG fusion gene is a common recurrent chromosomal rearrangement in prostate cancer and in its precursor lesion, prostatic intraepithelial neoplasia. The prevalence of TMPRSS2-ERG alteration in AAH is unknown. Fifty-five separate prostate specimens containing AAH were investigated by fluorescence in situ hybridization and immunohistochemistry for TMPRSS2-ERG rearrangement. TMPRSS2-ERG rearrangements were not identified in AAH either by fluorescence in situ hybridization or by immunohistochemistry. PMID:23887154

Cheng, Liang; Davidson, Darrell D; Maclennan, Gregory T; Lopez-Beltran, Antonio; Montironi, Rodolfo; Wang, Mingsheng; Tan, Puay-Hoon; Baldridge, Lee Ann; Zhang, Shaobo

2013-10-01

185

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

NASA Astrophysics Data System (ADS)

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

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

1995-05-01

186

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

187

180-W XPS GreenLight laser vaporization for benign prostate hyperplasia: 12-month safety and efficacy results for glands larger than 80 mL.  

PubMed

The purpose of the current study was to evaluate the efficacy and safety of laser prostatectomy by using the latest 180-W XPS GreenLight laser with the new MoXy fiber in the surgical treatment of glands larger than 80 mL in a prospective study. From December 2011 to May 2013, 68 consecutive patients with a mean age of 71.1?±?9.8 years (range 49 to 85) underwent 180-W XPS laser prostatectomy at our institution. The baseline characteristics, perioperative data, and complications were recorded. Evaluation of outcomes was assessed at 3, 6, and 12 months postoperatively comparing subjective (International Prostate Symptom Score [IPSS], International Index of Erectile Function-5 [IIEF-5]) and objective (Maximal flow rate [Qmax], postvoid residual urine [PVR], transrectal ultrasound [TRUS] volume) parameters to the preoperative data. Mean preoperative prostate volume was 104.3?±?29.7 mL (range 81 to 185). Mean operation time was 65.5?±?29.6 min (range 38 to 124), with a mean energy delivery of 398?±?169 kJ (range 39 to 523). The catheterization time was 20.8?±?1.9 h (range 6 to 92) and the hospital stay was 27.3?±?8.7 h (range 12 to 80). No major intraoperative complications were observed. Improvement in IPSS, Qmax, and PVR was statistically significant (p?prostate (PVP) using the new 180-W XPS GreenLight laser system seems to be a safe and effective procedure and could play an important role in the surgical treatment of symptomatic benign prostatic hyperplasia (BPH) patients with larger prostate volumes. PMID:25274195

Altay, Bulent; Erkurt, Bulent; Kiremit, Murat Can; Guzelburc, Vahit; Boz, Mustafa Yucel; Albayrak, Selami

2015-01-01

188

Correlations between parameters in uroflowmetry and histological compositions in patients with benign prostatic hyperplasia.  

PubMed

The objective of this study was to determine whether area densities of histological elements within prostatic adenoma affect objective and subjective parameters of patients with prostatic hyperplasia. Modified uroflowmetry parameters including Qmax/T100, TQmax/T100 and voiding efficiency were also measured. The area densities of histological elements did not affect uroflowmetry parameters. In addition, subjective symptom score was not correlated with morphometric findings. Our findings suggest that the degree of infravesical obstruction as measured by uroflowmetry parameters and symptom scores cannot be explained by the tissue compositions of adenomas alone. PMID:8840491

Ishigooka, M; Hayami, S; Hashimoto, T; Suzuki, Y; Sasagawa, I; Nakada, T

1996-01-01

189

Simultaneous open preperitoneal repair of inguinal hernia with open prostatectomy for benign prostate hyperplasia.  

PubMed

Where surgical resources are slim, patients may suffer the obstructive symptoms of benign prostate hyperplasia until they present with frank urinary retention and they may have unattended inguinal hernia. The best strategy to take care of patients who have both problems at once has remained elusive. We report a small case series of 10 patients in whom open preperitoneal inguinal hernia repair was done together with suprapubic prostatectomy over a 10-year period in the district hospital. PMID:25406258

Johnson, O Kenneth

2015-01-01

190

Comparative evaluation of the efficiency of prostatotropic agents of natural origin in experimental benign prostatic hyperplasia.  

PubMed

Comparative evaluation of the efficiency of prostatotropic agents was carried out in rat experiments. Serenoa repens plant preparation and polypeptides isolated from the cattle prostate were used for the treatment of benign hyperplasia. Drugs in parallel with sulpiride similarly led to shrinkage of the acinar epithelial area and to emergence of a trend to an increase of the stromal/epithelial proportion, more so after Serenoa repens treatment. PMID:23667874

Borovskaya, T G; Fomina, T I; Ermolaeva, L A; Vychuzhanina, A V; Pakhomova, A V; Poluektova, M E; Shchemerova, Yu A

2013-05-01

191

Preliminary immunohistochemical characterization of a monoclonal antibody (pro:4-216) prepared from human prostate cancer nuclear matrix proteins  

Microsoft Academic Search

ObjectivesA nuclear matrix protein (PC-1) was previously identified and reported to be present only in human prostate cancer but absent in tissue from the same prostate containing either benign prostatic hyperplasia (BPH) or normal prostate tissue. The PC-1 protein was identified by high resolution two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and exhibited a molecular mass of 56 kDa and an isoelectric

Alan W. Partin; Joseph V. Briggman; Eric N. P. Subong; Robert Szaro; Ana Oreper; Sarah Wiesbrock; Jane Meyer; Donald S. Coffey; Jonathan I. Epstein

1997-01-01

192

Clinicopathological Study of Prostatic Biopsies  

PubMed Central

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

2014-01-01

193

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

194

Multiple immunoperoxidase markers in benign hyperplasia and adenocarcinoma of the prostate.  

PubMed

A series of 60 cases of prostatic adenocarcinoma and 34 cases of benign prostatic hyperplasia were examined quantitatively after immunoperoxidase staining for prostate-specific antigen (PSA), prostate-specific acid phosphatase (PSAP), carcino-embryonic antigen (CEA), epithelial membrane antigen (EMA), alpha fetoprotein (AFP), and human chorionic gonadotrophin (HCG). The tumors were graded I to IV according to the MDAH grading system recently proposed. Fifty-nine of the 60 tumors were positive for PSA and 58 were positive for PSAP. The one PSA and PSAP negative case was CEA negative and weakly EMA positive. Grade I to III tumors stained more tumor cells and more diffusely for PSA and PSAP than grade IV tumors. There was no significant difference in the intensity or extent of staining between grade I and grade II-III tumors for PSA and PSAP. A comparison of PSA and PSAP showed that PSA stained more intensely and more extensively than PSAP. Benign prostatic tissue and low-grade prostatic tumors did not stain for CEA but three of the 20 grade IV tumors and one of the 23 grade II-III tumors did. Staining for EMA was focal and showed no relation to tumor grade. Benign and malignant lesions failed to stain for AFP and HCG. PMID:6199966

Ellis, D W; Leffers, S; Davies, J S; Ng, A B

1984-03-01

195

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

196

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

197

Flavonoid and botanical approaches to prostate health.  

PubMed

Benign prostatic hyperplasia (BPH) is a common problem among aging men that produces significant morbidity and health care costs. Contention exists as to whether currently available surgical and pharmacologic options for BPH are appropriate for men in the watchful-waiting stage. Recently, the possible benefits of phytotherapies (plant-derived preparations) in treating BPH and prostate cancer are being considered. Several phytotherapies, including saw palmetto, Pygeum africanum, curbicin, and isoflavone-containing supplements (red clover [Trifoleum pratense] and soy), are widely used in patients with BPH. Evidence suggests that the consumption of isoflavones found in legumes is related to lower rates of BPH and prostate cancer among Asian men. When evaluating natural therapies, the physician should look for a product that relieves symptoms and is safe, contains a health-conferring ingredient with a defined mechanism of action, and is standardized for that ingredient. Phytotherapies, particularly isoflavone-containing supplements, are likely to have an important role in the management of patients in the watchful-waiting stage of BPH. PMID:12614534

Katz, Aaron E

2002-12-01

198

Long-term effects of finasteride on prostate tissue composition  

Microsoft Academic Search

Objectives. To determine the long-term effects of finasteride treatment on prostate tissue composition; to relate these effects to clinical outcomes; and to test the hypothesis that finasteride exerts a selective or preferential action on the transition zone.Methods. Nineteen men with symptomatic benign prostatic hyperplasia (BPH) who completed a 6-month double-blind trial of finasteride were enrolled in a 24-month open-label extension

Leonard S. Marks; Alan W. Partin; Frederick J. Dorey; Glenn J. Gormley; Jonathan I. Epstein; Joel B. Garris; Maria Luz Macairan; Erlinda D. Shery; Paul Bryan Santos; Elizabeth Stoner; Jean B. deKernion

1999-01-01

199

Effect of finasteride on bother and other health-related quality of life aspects associated with benign prostatic hyperplasia  

Microsoft Academic Search

Objectives. To investigate the long-term effects of finasteride on bother and health-related quality of life (HRQOL) in men with symptomatic benign prostatic hyperplasia.Methods. A large prospective 4-year placebo-controlled trial (PLESS) of 3040 men with moderate to severe lower urinary tract symptoms and an enlarged prostate was performed that included self-administered questionnaires assessing HRQOL.Results. Significantly greater reductions in bother score were

Reginald Bruskewitz; Cynthia J. Girman; Jackson Fowler; Odell F. Rigby; Michael Sullivan; R. Bruce Bracken; Harold A. Fusilier; Douglas Kozlowski; Scott D. Kantor; Edward Lee Johnson; Daniel Z. Wang; Joanne Waldstreicher

1999-01-01

200

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

201

A PROSPECTIVE STUDY OF THE NATURAL HISTORY OF HEMATURIA ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA AND THE EFFECT OF FINASTERIDE  

Microsoft Academic Search

Purpose: We prospectively studied the effect of finasteride on chronic hematuria associated with benign prostatic hyperplasia. Materials and Methods: We prospectively evaluated 57 patients with chronic intermittent hematuria who were randomized to a finasteride treated or a control arm. Results: In the untreated control group hematuria recurred in 17 patients (63%) within a year but in only 4 (14%) in

STEPHEN J. FOLEY; LEMKIE Z. SOLOMAN; ANDREW W. WEDDERBURN; KASHIF M. KASHIF; DUNCAN SUMMERTON; VANESSA BASKETTER; SIMON A. V. HOLMES

2000-01-01

202

Vascular Endothelial Growth Factor (VEGF) Expression in Prostate Cancer and Benign Prostatic Hyperplasia  

Microsoft Academic Search

PurposeVascular endothelial growth factor (VEGF) is a potent inducer of endothelial cell growth and is expressed at elevated levels in several tumor types. In this study immunohistochemical localization and distribution of isoforms of VEGF were examined in malignant and non-malignant human prostatic tissues.

Michael W. Jackson; Jacqueline M. Bentel; Wayne D. Tilley

1997-01-01

203

Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial  

Microsoft Academic Search

ObjectivesTo evaluate the efficacy and tolerability of the selective alpha1-adrenergic antagonist doxazosin and the 5-alpha-reductase inhibitor finasteride, alone and in combination, for the symptomatic treatment of benign prostatic hyperplasia.

Roger S Kirby; Claus Roehrborn; Peter Boyle; Georg Bartsch; Alain Jardin; Margaret M Cary; Michael Sweeney; Eric B Grossman

2003-01-01

204

Efficacy and Safety of the Selective ?1A-Adrenoceptor Blocker Silodosin for Severe Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Prospective, Single-Open-Label, Multicenter Study in Korea  

PubMed Central

Purpose To evaluate the efficacy and safety of silodosin 8 mg once daily in a 12-week treatment of subjects with severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Materials and Methods A total of 100 subjects from 10 urology centers in Korea were included in this study. The inclusion criteria were as follows: age ?50 years, International Prostate Symptom Score (IPSS) ?20, quality of life (QoL) score ?3, urine volume ?120 mL and maximal urinary flow rate (Qmax) <15 mL/s, and postvoid residual volume (PVR) <100 mL. We assessed the improvement of LUTS with change in IPSS, QoL score, Qmax, PVR, and adverse events at baseline and 4 and 12 weeks after treatment with silodosin 8 mg once daily. Results The IPSS values were 23.27±3.34, 15.89±6.26, and 13.80±6.31 at baseline, 4, and 12 weeks, respectively, with significant improvements (p<0.0001, p=0.0214, respectively). QoL scores were 4.44±0.85, 3.38±1.20, and 3.04±1.20 at baseline, 4, and 12 weeks, respectively, and the differences were statistically significant (p<0.0001). There was a significant difference in Qmax between baseline and 12 weeks (p<0.0001) but not in PVR (p=0.9404) during the clinical trial. The most frequent adverse event in this study was ejaculation failure with 13 cases. However, no subject dropped out because of ejaculation failure, and in 12 of the 13 cases it was fully resolved without further treatment. Conclusions Silodosin 8 mg once daily may be effective and safe in Korean patients with severe LUTS associated with BPH. PMID:24868338

Moon, Ki Hak; Song, Phil Hyun; Yang, Dae Yul; Park, Nam Cheol; Kim, Soo Woong; Lee, Sung Won; Kim, Sae Woong; Moon, Du Geon; Park, Jong Kwan; Ahn, Tai Young

2014-01-01

205

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

206

Inflammatory Mechanisms Associated with Prostatic Inflammation and Lower Urinary Tract Symptoms  

PubMed Central

Inflammation is a common finding in histologic prostate specimens obtained from aging men, and accumulating data suggest that inflammation may play an important role in the development of benign prostatic hyperplasia (BPH), and the development and progression of lower urinary tract symptoms (LUTS). Inflammatory processes may contribute to prostatic enlargement directly through stimulation of prostate growth, or, alternatively, through decreasing prostatic apoptosis. Additionally, inflammatory processes may impact other components of the urogenital tract, such as the bladder, and contribute to the LUTS that may be experienced both in the presence and in the absence of prostate enlargement. Current research therefore offers clues about converging inflammatory pathways which may be targeted to improve treatment of BPH and/or LUTS as well as identifying potential targets for prevention of these syndromes. PMID:19809538

St. Sauver, Jennifer L.; Jacobsen, Steven J.

2009-01-01

207

Urethral resistance factor (URA) versus Schäfer's obstruction grade and Abrams-Griffiths (AG) number in the diagnosis of obstructive benign prostatic hyperplasia.  

PubMed

Different methods of analyzing pressure/flow plots to quantify bladder outlet resistance in men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) were developed in the past. The aims of this study were to quantify the degree of agreement between the diagnosis of obstruction by the different methods, and to compare the applicability of the different methods in the evaluation of bladder outflow conditions, in a large group of these men. In consecutive men with LUTS basic initial evaluations, recommended diagnostic tests, and urodynamic investigations were performed. From pressure/flow studies, the group-specific resistance factor (URA), Schäfer's obstruction grade, and Abrams-Griffiths (AG) number were estimated. Men with 21 cm H(2)O < or = URA < or = 29 cm H(2)O and men with Schäfer's grade equal 2 were classified as equivocal. In conformity with the provisional ICS definition, men with 20 < or = AG number < or = 40 were classified as equivocal. In 78% of the 565 included men Schäfer's classification agreed with URA classification. In 82% ICS classification agreed with URA classification. Most agreement (94%) existed between Schäfer's classification and ICS classification. All differences were near the points of intersection of the different boundaries, and a decision whether to perform surgery on a patient is not likely to be influenced by this disagreement. Males with relatively low detrusor pressure at maximum flow and relatively low maximum flow had a high prevalence among those in whom URA and Schäfer's classifications and among those in whom URA and ICS classifications differed. PMID:11170192

Eckhardt, M D; van Venrooij, G E; Boon, T A

2001-01-01

208

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

PubMed

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

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

2014-01-01

209

Sustained-Release Alfuzosin, Finasteride and the Combination of Both in the Treatment of Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objectives: To assess the additive benefit of combining an ?1-blocker and a 5?-reductase inhibitor. Methods: This European, randomized, double-blind, multicenter trial involved 1.051 patients with lower urinary tract symptoms related to benign prostatic hyperplasia. Patients received sustained release (SR) alfuzosin (n = 358), a selective ?1-blocker given at a dose of 5 mg twice daily without dose titration; finasteride (n

F. M. J. Debruyne; A. Jardin; D. Colloi; L. Resel; W. P. J. Witjes; M. C. Delauche-Cavallier; C. McCarthy; C. Geffriaud-Ricouard

1998-01-01

210

Nutraceuticals in Prostate Disease: The Urologist’s Role  

PubMed Central

Interest in and use of complementary and alternative therapies, especially nutraceuticals, is high in prostate disease. These therapies have shown potential in benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer. Some have produced results equal to or better than pharmaceuticals currently prescribed for BPH. In category III prostatitis, some nutraceuticals may offer relief to patients who get little from standard therapy. Because it is becoming apparent that inflammation may play a role in the progression of BPH and development of prostate cancer, nutraceuticals, which commonly have anti-inflammatory properties, may play a role. These therapies have also shown potential in prostate cancer treatment and prevention, especially those that also reduce cardiovascular events or risk. Nevertheless, uses of some nutraceuticals in prostate disease have had less desirable consequences, showing lack of efficacy, adulteration, and/or severe side effects or drug interactions. By ensuring that these therapies undergo careful study for effectiveness, quality, and safety, urologists can look forward to adding them to their evidence-based armamentarium for prostate disease. PMID:18836556

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

2008-01-01

211

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

212

Association of Diet With Prostate Specific Antigen and Prostate Volume  

PubMed Central

Background: Prostate is an important male reproductive system gland and its disorders can affect men's quality of life and health. Prostatitis, benign prostatic hyperplasia (BPH), and prostate adenocarcinoma are major disorders that can be found in all men in different ages. Objectives: The aim of this study was to investigate the association of diet with serum prostate specific antigen (PSA) level as well as prostate volume. Patients and Methods: In this cross-sectional study, 950 men older than 40 years of age who had attended our clinic for a screening program for prostate cancer were enrolled. Data was extracted from the program database. The eligible cases included all noncancerous subjects with available data concerning serum PSA level and prostate volume; the patients had completed a 50-item self-administered food frequency questionnaire about their diet during the preceding two year. Results: No overall association was found between the consumption of foods and prostate volume as well as serum PSA level. There was a significant correlations between age and serum PSA level (r = 0.24) as well as with prostate volume (r = 0.22) (P < 0.001). In addition, there was a significant correlation between serum PSA level and prostate volume (r = 0.41 and P < 0.001). Conclusions: The results of this study confirmed the previous reports regarding the serum PSA level correlation with prostate volume. There was no evidence that dietary patterns might have any important effect on prostate volume and serum PSA in this Iranian population.

Shirazi, Mehdi; Ariafar, Ali; Zeyghami, Shahryar; Hosseini, Mohammad Mehdi; Khezri, Abdol Aziz

2014-01-01

213

Multicenter, prospective, comparative cohort study evaluating the efficacy and safety of alfuzosin 10 mg with regard to blood pressure in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia with or without antihypertensive medications  

PubMed Central

Background The objective of this study was to assess the efficacy and safety of alfuzosin 10 mg monotherapy or combined antihypertensive medication on blood pressure (BP) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH/LUTS) with or without antihypertensive medication. Methods This was a 3-month, multicenter, randomized, open-label study in 335 patients aged ?45 years with a clinical diagnosis of BPH/LUTS by medical history and clinical examination, a total International Prostatic Symptom Score (IPSS) ?8 points, a maximum flow rate >5 mL/sec and ?15 mL/sec, and a voided volume ?120 mL. Eligible subjects were randomized to receive alfuzosin 10 mg as monotherapy (group 1) or alfuzosin 10 mg + antihypertensive combination therapy (group 2). Based on baseline BP and hypertensive history with or without antihypertensive medications at first medical examination, group 1 was divided into two subgroups of normotensive and untreated hypertensive patients, and group 2 into two subgroups of controlled hypertensive and uncontrolled hypertensive patients. The primary study outcomes were change in IPSS, BP, and heart rate from baseline. Secondary outcomes were change in IPSS-quality of life score, maximum flow rate, average flow rate, voided volume, and post-voided volume. Results The overall BP change was not significantly different between groups 1 and 2 (systolic BP, P=0.825; diastolic BP, P>0.999). In patients with uncontrolled or untreated hypertension, alfuzosin 10 mg alone or combined with antihypertensive therapy significantly decreased systolic and diastolic BP. The mean difference in total IPSS and IPSS-quality of life scores from baseline between groups 1 and 2 was 0.45 (95% CI: ?1.26, 2.16) and 0.12 (95% CI: ?0.21, 0.45), respectively (both P>0.05). Maximum flow rate, average flow rate, voided volume, and post-voided volume at endpoint were numerically, but not significantly, changed from baseline (all P>0.05). Conclusion This study shows that alfuzosin 10 mg is effective and well tolerated in patients with BPH/LUTS with or without antihypertensive medications. However, in patients with uncontrolled or untreated hypertension, alfuzosin 10 mg alone or in combination with antihypertensive medication appears to decrease systolic and diastolic BP, and these patients should be warned about a decrease in BP on initiation of therapy. PMID:25653511

Zhang, Li Tao; Lee, Sung Won; Park, Kwangsung; Chung, Woo Sik; Kim, Sae Woong; Hyun, Jae Seog; Moon, Doo Geon; Yang, Sang-Kuk; Ryu, Ji Kan; Yang, Dae Yul; Moon, Ki Hak; Min, Kweon Sik; Park, Jong Kwan

2015-01-01

214

The relevance of preoperative cystometrography in patients with benign prostatic hyperplasia: correlating the findings with clinical features and outcome after prostatectomy.  

PubMed

Preoperative water cystometrograms in 437 patients with benign prostatic hyperplasia (BPH) were examined in a retrospective study. The cystometrographic results were analyzed regarding the preoperative clinical features: patient age, presence or absence of urinary incontinence, history of urinary retention and rate of residual urine. The prognostic value in improvement in voiding difficulty and postoperative urinary incontinence was also analyzed at 1 and 6 months after elective prostatectomy. Subjective symptoms of the patients were the primary reasons for prostatectomy, the majority of which were performed by a single competent resectionist (K. T.) who evaluated the outcome but was blinded to the cystometric findings. Of these patients 263 (60.2%) had detrusor instability (group 1), while 174 did not (group 2). Vesical denervation supersensitivity to bethanechol chloride was noted in 47 of 375 patients (12.5%). The difference in clinical features was significant between the 2 groups, with group 1 showing older patient age (p < 0.01), and a greater incidence of urinary incontinence (p < 0.001) and retention (p < 0.001). The difference between groups 1 and 2 in mean bladder capacity (p < 0.01), compliance (p < 0.01) and a greater positive rate of vesical denervation supersensitivity (p < 0.001) was also significant. The clinical and cystometrographic parameters studied worsened with advancing patient age. Although the majority of the patients (94.7%) were relieved of obstructive symptoms after transurethral prostatectomy (6 months later), 113 (25.9%) were not at 1 month. Compared to 324 patients with early improvement (74.1%), those without improvement at 1 month were characterized by older age (p < 0.01), greater prevalence of preoperative incontinence (p < 0.05), retention (p < 0.01), greater residual rate (p < 0.05), a less compliant bladder (p < 0.01) and a higher positive rate of vesical denervation supersensitivity (p < 0.05). Cystometrographic findings, however, had no relevance to late (6 months) outcome of voiding difficulty. On the other hand, postoperative incontinence was noted in 100 patients (22.9%) at 1 month after transurethral prostatectomy, with the majority having episodes similar to those experienced preoperatively (70.0%) as well as detrusor instability (87.0%). They also were older (p < 0.01), and had a less compliant bladder (p < 0.01) and a higher positive rate of vesical denervation supersensitivity (p < 0.01) than did continent patients. Only 18 elderly patients (4.1%) remained incontinent 6 months later, all with a less compliant (p < 0.01) and more unstable (p < 0.01) bladder initially. The genesis of this detrusor dysfunction was believed to be aging in male patients, in whom BPH evolves and progresses. In conclusion, preoperative cystometrography in patients with BPH is valuable in that it correlated well with the clinical features and it can predict to some extent the outcome of obstructive symptoms and urinary incontinence after transurethral prostatectomy. PMID:7516977

Ameda, K; Koyanagi, T; Nantani, M; Taniguchi, K; Matsuno, T

1994-08-01

215

Transurethral laser coagulation of the prostate  

NASA Astrophysics Data System (ADS)

We describe the laser coagulation of the prostate using a conventional bare fiber inserted in a modified Albarran bridge which presents at the distal tip, a newly designed gold-plated reflector, connected by a deflecting mechanism. This allows delivery of laser energy (40 - 80 W) by direct reflection of the Nd:YAG laser light, an angularity more accentuated compared with other systems. Transurethral laser coagulation was performed on 25 patients for prostatic obstruction benign prostatic hyperplasia (BPH) and 6 selected patients for carcinoma of the prostate (December 91 - January 93). Patient selection (BPH) was limited to median lobe (range 50 - 55 years), small prostates, older and high-risk patients. Successful results were noted in 20 of the 25 cases of BPH group (80%). A significant reduction of obstructive symptoms was associated with an increase of maximal a medium flow rates. In the early prostate cancer group, the method has resulted in 3 patients with no evidence of disease, despite repeated biopsy, biochemical, and clinical investigations (PSA range level > 20 ng/ml to < 0.5 ng/ml at one year). The results are encouraging at this stage.

Mattioli, Stefano; Cremona, M.

1994-02-01

216

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

PubMed Central

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

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

2014-01-01

217

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

PubMed Central

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

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

2013-01-01

218

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

PubMed

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

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

2013-01-01

219

Arylpiperazines for management of benign prostatic hyperplasia: design, synthesis, quantitative structure-activity relationships, and pharmacokinetic studies.  

PubMed

A series of 27 aryl/heteroaryl/aralkyl/aroyl piperazines were synthesized, and most of these compounds reduced prostate weight of mature rats by 15-47%. Three compounds, 10, 12, and 18, had better activity profile (reduced prostate weight by 47%, 43%, and 39%, respectively) than the standard drug flutamide (24% reduction). QSAR suggested structures with more cyclic and branched moieties, increased topological separation of O and N therein, and reduced solvation connectivity index for better activity. Pharmacokinetic study with compound 10 at an oral dose of 10.0 mg/kg indicated good absorption, negligible extrahepatic elimination, and rapid distribution to the target organ (prostate) but restricted entry through the blood-brain barrier. A 10-fold decrease in PSA and 15-fold increase in ER-? gene expressions of human prostate cancer cells (LNCaP) by compound 10 in vitro indicated AR and ER-? mediated actions. The findings may stimulate further explorations of identified lead for the management of benign prostatic hyperplasia. PMID:21128595

Sarswat, Amit; Kumar, Rajeev; Kumar, Lalit; Lal, Nand; Sharma, Smriti; Prabhakar, Yenamandra S; Pandey, Shailendra K; Lal, Jawahar; Verma, Vikas; Jain, Ashish; Maikhuri, Jagdamba P; Dalela, Diwakar; Kirti; Gupta, Gopal; Sharma, Vishnu L

2011-01-13

220

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

221

Nerve growth factor signaling following unilateral pelvic ganglionectomy in the rat ventral prostate is age dependent  

PubMed Central

Benign prostatic hyperplasia (BPH) is a serious health concern and is an underlying cause of lower urinary tract symptoms (LUTS) in many men. In affected men, LUTS/BPH is believed to result from benign proliferation of the prostate resulting in bladder outlet obstruction. Postnatal growth of the prostate is controlled via growth factor and endocrine mechanisms. However, little attention had been given to the function of the autonomic nervous system in prostate growth and differentiation. Nerve growth factor (NGF) is a prostatic mitogen that has a trophic role in autonomic sensory end organ interaction. In this study, we examine how the autonomic nervous system influences prostate growth as a function of age by quantifying NGF in the rat ventral prostate (VP) after pelvic ganglionectomy. Unilateral pelvic ganglionectomy was performed on postnatal days 30 (P30), 60 and 120 Sprague–Dawley rats in comparison to sham controls (n=39). Semiquantitative RT-PCR, Western blotting and immunohistochemical analysis for NGF were performed on denervated, intact (contralateral side) and sham control VP 7 days after surgery. Ngf RNA expression was significantly increased in the denervated and intact hyperplastic VP. Western blotting showed age-dependent increases in NGF protein at P60 in the contralateral intact VP. NGF was localized in the nerves, basal cells and columnar epithelium of the prostatic ducts. Denervation causes age-dependent increases in NGF in the VP, which is a potential mechanism by which the autonomic nervous system may regulate prostate growth and lead to BPH/LUTS. PMID:23872662

Podlasek, Carol A; Ghosh, Rudrani; Onur Cakir, Omer; Bond, Christopher; McKenna, Kevin E; McVary, Kevin T

2013-01-01

222

[Benign hypertrophy of the prostate: which treatment, for whom?].  

PubMed

Approximately 25% of men over 40 or 50 suffer from lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). The bothersomeness of the symptoms varies considerably from one individual to the other and can fluctuate with time. Symptoms tend to gradually worsen as time goes on through. Surprisingly, there appears to be no particular relationship between symptoms and the overall prostate size and weight. Symptoms of BPH are divided in obstructive (voiding) and irritative (storage) symptoms, of which the irritative are the most bothersome. Until recently, surgery (open or transurethral resection) was the only treatment option. Nowadays, a range of less invasive treatments and pharmacological therapies are available to relieve BPH symptoms. Finasteride, for instance, reduces the prostate size by blocking 5-alpha-reductase, the enzyme which plays a role in the growth of the prostate. It takes however a long time before a clinically significant effect is noticed: +/- 6 to 12 months. Then, there are alpha 1-blockers. These agents result in relaxation of prostatic and bladder neck smooth muscle. alpha 1-blockers act relatively fast. Most alpha 1-blockers used in the treatment of symptomatic BPH were originally developed to treat hypertension. The adverse events most commonly associated with alpha 1-blockers, such as dizziness, headache, asthenia, tachycardia/palpitation, postural hypotension and syncope are possibly related to the blood pressure lowering effect. This stimulated the search for more selective alpha-blockers which act predominantly on the prostate and have less effect on the blood levels (afluzosin: Xatral and tamsulosin: Omic). Presently, alpha-blockers have become the first-line drugs in the medical treatment of symptomatic BPH. Surgery (open or TURP) is limited to patients with recurrent infections, large residue (> 200 ml), recurrent hematuria, bladder stones. New alternative and minimally invasive treatment such as TUNA generate necrotic lesions within the prostate through needle introduced endoscopically. This leads also to marked improvement in patients symptomatology. PMID:10523895

Schulman, C

1999-09-01

223

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.

Feil, Katharina; Bardins, Stanislavs; Waidelich, Raphaela

2014-01-01

224

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

225

Management of the complications of BPH/BOO  

PubMed Central

Most men will develop histological BPH if they live long enough. Approximately, half will develop benign prostatic enlargement (BPE) and about half of these will get BOO with high bladder pressures and low flow, this in turn leads to detrusor wall hypertrophy. Many of these men will only have lower urinary tract symptoms (LUTS) but a significant number will also suffer the other complications of BPH. These include urinary retention (acute and chronic), haematuria, urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Recognition of the complications of BPH/BOO early allows more effective management of these complications. This is particularly important for the more serious urinary infections and also for high-pressure chronic retention (HPCR). Complications of LUTS/BPH are very rare in clinical trials because of their strict inclusion and exclusion criteria but are more common in real life practice. PMID:24744522

Speakman, Mark J.; Cheng, Xi

2014-01-01

226

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

PubMed

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

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

2014-01-01

227

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

228

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

229

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

230

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

231

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

232

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

PubMed Central

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

2014-01-01

233

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

PubMed

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

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

1995-03-01

234

Beneficial Effect of Increasing the Dose of Tamsulosin to 0.4 mg in Japanese Patients with Benign Prostatic Hyperplasia  

PubMed Central

Objective: Tamsulosin is often administered at a dose of 0.2 mg in Japan, Korea, and elsewhere in Asia, while a dose of 0.4 mg is more common in the West. In order to determine the higher dose might also be appropriate in the North-East Asian setting, we studied whether the effect of increasing the dose to 0.4 mg in Japanese patients who had dysuria associated with benign prostatic hyperplasia. Patients and Methods: Twenty-two cases with a voiding volume ? 100 ml assessed by uroflowmetry out of 31 patients with benign prostatic hyperplasia and an IPSS (International Prostate Symptom Score) ? 8 whose symptoms were controlled with 0.2 mg of tamsulosin were entered into this study. We evaluated IPSS and QOL (quality of life) score, urinary flow parameters and residual urine volume before and 4 weeks after increasing the dose of tamsulosin. Results: Statistical analyses performed using the Wilcoxon test showed no significant alteration in IPSS total score or QOL score with the increased dose, but Qmax (maximum urinary flow rate) improved from 10.1 ± 5.5 ml/s to 12.1 ± 6.5 ml/s (p = 0.013), and residual urine volume improved from 37.6 ± 26.4 ml to 22.2 ± 24.3 ml (p = 0.012). Two of the 31 patients complained of new symptoms; 1 complained of breast pain and the other complained of dizziness. Conclusions: From the lack of side effects of more than moderate grade in the present study, increasing the dose of tamsulosin might be recommended before switching patients to other drugs.

Hirose, Yasuhiko; Ando, Ryosuke; Nakane, Akihiro; Akita, Hidetoshi; Okamura, Takehiko

2011-01-01

235

Computer-assisted interstitial laser coagulation for BPH  

NASA Astrophysics Data System (ADS)

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

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

2001-06-01

236

Is prostatic adenocarcinoma in a relationship with Human Papilloma Virus in Isfahan -Iran  

PubMed Central

Background: Prostatic adenocarcinoma is the most prevalent cancer and the second cause of cancer-related death among men. Human Papilloma Virus (HPV) considered as a preventable risk factor for prostatic adenocarcinoma. In this study, we detected the frequency of HPV infection in prostatic adenocarcinoma and benign prostatic hyperplasia (BPH) in Isfahan. Materials and Methods: In this study, 120 paraffin-embedded blocks (90 and 30 cases with definite diagnosis of BPH and adenocarcinoma, respectively) were selected. Immunohistochemical (IHC) staining was performed for all selected blocks to detect HPV infection. The rate of infection was compared in the two studied groups. Results: Totally, HPV was detected in four blocks. HPV infection was positive in 10% (3/30) of cases with adenocarcinoma and 1.1% (1/90) of cases with BPH (P = 0.04, OR = 9.88, CI 95%). Mean age of patients with positive and negative HPV infection was 61.75 ± 8.3 and 68.51 ± 11.7 years, respectively. Conclusion: Considering the higher prevalence of HPV infection in prostatic adenocarcinoma, it is suggested that HPV could be probable risk factor for prostatic adenocarcinoma. It is recommended to investigate the prevalence of HPV infection in Iranian men and the outcome of prevention and treatment of HPV infection on prostatic adenocarcinoma. PMID:24379849

Mokhtari, Mojgan; Taghizadeh, Faegheh; Hani, Mohsen

2013-01-01

237

[The results of the 10-year study of efficacy and safety of Serenoa repens extract in patients at risk of progression of benign prostatic hyperplasia].  

PubMed

The article presents the results of an open, noncomparative, observational study of the efficacy and safety of continued use of the Serenoa repens (prostamol uno) plant extract at a dose of 320 mg 1 time a day for 10 years in 38 patients with early manifestations of BPH and the risk of its progression. The results of study showed the absence of progression, both on subjective criteria (IPSS, and QoL scores), and objective criteria (prostate volume, the rate of urination, residual urine volume). Furthermore, patients had no undesirable effects directly related to the use of this drug. PMID:24159762

Aliaev, Iu G; Vinarov, A Z; Demidko, Iu L; Spivak, L G

2013-01-01

238

[Transurethral laser ablation of the prostate in high risk patients with obstructive benign prostatic hyperplasia. Perioperative morbidity and 6 month outcome in 72 patients].  

PubMed

Between November 1993 and September 1995, we carried out visual laser ablation of the prostate (VLAP) in 72 high-risk patients (ASA 3-4; severe cardiovascular and/or pulmonary diseases) aged 60-88 years (mean 76.7 years); the prostate volume was 22-136 ml (mean 56 ml). The urinary peak flow rates (Qmax.) ranged from 2 to 15 ml/s (mean 4.4 ml/s) preoperatively; 42 patients (58.3%) suffered from acute urinary retention for up to 2 weeks and had an indwelling catheter. The residual urinary volume (RUV) was 0-320 ml (mean 142.3 ml) in those 30 patients with spontaneous micturition. The International Prostate Symptom Score (IPSS) ranged from 10 to 33 (mean 21.8). In the first 37 patients, pressure-flow studies were carried out only in cases of doubt to verify obstruction. In the last 35 patients, pressure-flow studies were carried out in every case. Perioperatively, there was no appearance of blood loss of absorption of irrigation fluid. None of our patients needed transfusions or intensive care perioperatively. Further complications were not severe and could be handled without problems. In two patients with large benign prostate hypertrophy (BPH) a second operation (VLAP, no conventional transurethral prostatectomy) was necessary. After 6 weeks, 29.4% of the patients suffered from symptomatic urinary tract infections (UTI). After 6 months, only 7.1% of the patients had symptomatic UTI. After 6 weeks (n = 61), Qmax. was 6-34 ml/s (mean 15.3 ml/s), RUV was 0-230 ml (mean 51.5 ml), and the IPSS was 12.3 (8-28). After 3 months (n = 54), Qmax. was 9-45 ml/s (mean 19.8 ml/s), RUV was 0-96 ml (mean 31.6 ml), and the IPSS was 1-23 (mean 7.4). After 6 months (n = 52) Qmax. was 12-33 ml/s (mean 20.4 ml), RUV was 0-53 ml (mean 26.4 ml), and the IPSS was 1-12 (mean 4.1). VLAP provided no further risks for our high-risk patients, while Qmax., RUV, and IPSS were improved noticeably (improvement of more than 75%). It represents a step forward in the treatment of obstructive BPH in high-risk patients. Particularly in high-risk patients with cardiac diseases, this procedure lessens the perioperative risk. Despite the minimal appearance of UTI after 6 months, UTI seemed to be the most important complication during the first few weeks after VLAP by virtue of the bothersome symptoms. PMID:9199046

Miller, J; Erkens, U; Fischer, C; Klötzer, J P; Weidner, W

1997-03-01

239

Correlation of transrectal and transabodominal ultrasound measurement of transition zone volume with post-operative enucleated adenoma volume in benign prostatic hypertrophy  

PubMed Central

Introduction Benign prostatic hyperplasia is a common disease of ageing men worldwide. Though transrectal ultrasonography (TRUS) is the standard in most parts of the world in evaluation of benign prostatic hyperplasia (BPH), it is rarely done in some less developed countries because of non availability of appropriate probes and or specialists. Transabdominal ultrasonography (TAUS) remains the mainstay in these areas. Some controversies still exist in literature about the accuracy of TAUS evaluation of prostatic volume in patients with BPH. This study aimed at comparing the transition zone volume estimation of the prostate on transrectal and transabdominal ultrasound with post-operative enucleated adenoma volume in Nigeria patients with BPH and to suggest better predictor of prostate volume in evaluation of BPH. Methods Forty-six (46) patients with lower urinary tract symptoms due to BPH attending the urologic clinic were evaluated ultrasonographically and eventually managed with open surgery (prostatectomy) after due counselling. The post operative samples were weighted using a sensitive top loading weighing balance and converted to volume. Since the specific gravity of the prostate is equivalent to that of water,the weight is the same as volume. Results Patients’ ages ranged between 59 and 90 years with a peak age incidence at seventh decade. Transition Zone (TZ) volume estimation on both transrectal and transabdominal ultrasound showed positive correlation with the post operative enucleated adenoma(r = 0.594, p < 0.001) but the transrectal method was more accurate. There was no significant relationship between the TZ volume and patients’ symptoms(r = 0.491, p = 0.007). Conclusion Both TRUS and TAUS are comparable at TZ volume estimation and therefore TAUS can be utilized in regions where intracavitary probes and or the expertise is/are not available. PMID:24876907

Ajayi, Idowu; Aremu, Ademola; Olajide, Abimbola; Bello, Tope; Olajide, Folake; Adetiloye, Victor

2013-01-01

240

Expression of kallikrein-related peptidase 7 is decreased in prostate cancer  

PubMed Central

Recent evidence suggests that the human kallikrein 7 (KLK7) is differentially regulated in a variety of tumors. The aim of this study was to determine the expression of kallikrein-related peptidase 7 and KLK7 in our large collection of prostate samples. Between August 2000 and December 2012, 116 patients with histologically confirmed prostate cancer (PCa) and 92 with benign prostate hyperplasia (BPH) were recruited into the study. Using immunohistochemistry, quantitative reverse transcription polymerase chain reaction (RT-PCR) and western blot, kallikrein-related peptidase 7 expression in BPH and PCa tissues was determined at the mRNA and protein levels. The relationships between kallikrein-related peptidase 7 mRNA expression and clinicopathological features were analyzed. A total of 64 of 92 (69.57%) benign cases showed positive staining for KLK7 and 23 of 116 (19.83%) malignant cases showed positive, the difference of KLK7 expression between PCa and BPH was statistically significant (P < 0.001). The expression level of kallikrein-related peptidase 7 mRNA was significantly decreased in PCa tissues compared with that in BPH tissues and normal prostate tissue. Kallikrein-related peptidase 7 mRNA exhibited different expression patterns in terms of localization depending on pathological category of PCa. Similarly, our western immunoblot analyses demonstrated that the protein expression levels of KLK7 was lower in PCa than in BPH tissues and normal prostate tissue. Kallikrein-related peptidase 7 and KLK7 expression are down-regulated in PCa and lower expression of kallikrein-related peptidase 7 closely correlates with higher Gleason score and higher prostate-specific antigen level. PMID:25219913

Zhang, Chong-Yu; Zhu, Yu; Rui, Wen-Bin; Dai, Jun; Shen, Zhou-Jun

2015-01-01

241

Enlarged prostate gland  

MedlinePLUS Videos and Cool Tools

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

242

Evaluation of glycophenotype in prostatic neoplasm by chemiluminescent assay.  

PubMed

This work aimed to evaluate the glycophenotype in normal prostate, bening prostatic hyperplasia (BPH) and prostatic adenocarcinoma (PCa) tissues by a chemiluminescent method. Concanavalin A (Con A), Ulex europaeus agglutinin (UEA-I) and Peanut agglutinin (PNA) lectins were conjugated to acridinium ester (lectins-AE). These conjugates remained capable to recognize their specific carbohydrates. Tissue samples were incubated with lectins-AE. The chemiluminescence of the tissue-lectin-AE complex was expressed in relative light units (RLU). Transformed tissues (0.25 cm(2) by 8 µm of thickness) showed statistical significant lower ?-D-glucose/mannose (BPH: 226,931 ± 17,436; PCa: 239,520 ± 12,398) and Gal-?(1-3)-GalNAc (BPH: 28,754 ± 2,157; PCa: 16,728 ± 1,204) expression than normal tissues (367,566 ± 48,550 and 409,289 ± 22,336, respectively). However, higher ?-L-fucose expression was observed in PCa (251,118 ± 14,193) in relation to normal (200,979 ± 21,318) and BHP (169,758 ± 10,264) tissues. It was observed an expressive decreasing of the values of RLU by inhibition of the interaction between tissues and lectins-AE using their specific carbohydrates. The relationship between RLU and tissue area showed a linear correlation for all lectin-AE in both transformed tissues. These results indicated that the used method is an efficient tool for specific, sensitive and quantitative analyses of prostatic glycophenotype. PMID:25120756

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

2014-01-01

243

Evaluation of glycophenotype in prostatic neoplasm by chemiluminescent assay  

PubMed Central

This work aimed to evaluate the glycophenotype in normal prostate, bening prostatic hyperplasia (BPH) and prostatic adenocarcinoma (PCa) tissues by a chemiluminescent method. Concanavalin A (Con A), Ulex europaeus agglutinin (UEA-I) and Peanut agglutinin (PNA) lectins were conjugated to acridinium ester (lectins-AE). These conjugates remained capable to recognize their specific carbohydrates. Tissue samples were incubated with lectins-AE. The chemiluminescence of the tissue-lectin-AE complex was expressed in relative light units (RLU). Transformed tissues (0.25 cm2 by 8 µm of thickness) showed statistical significant lower ?-D-glucose/mannose (BPH: 226,931 ± 17,436; PCa: 239,520 ± 12,398) and Gal-?(1-3)-GalNAc (BPH: 28,754 ± 2,157; PCa: 16,728 ± 1,204) expression than normal tissues (367,566 ± 48,550 and 409,289 ± 22,336, respectively). However, higher ?-L-fucose expression was observed in PCa (251,118 ± 14,193) in relation to normal (200,979 ± 21,318) and BHP (169,758 ± 10,264) tissues. It was observed an expressive decreasing of the values of RLU by inhibition of the interaction between tissues and lectins-AE using their specific carbohydrates. The relationship between RLU and tissue area showed a linear correlation for all lectin-AE in both transformed tissues. These results indicated that the used method is an efficient tool for specific, sensitive and quantitative analyses of prostatic glycophenotype. PMID:25120756

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

2014-01-01

244

Testosterone and 17?-Estradiol Induce Glandular Prostatic Growth, Bladder Outlet Obstruction, and Voiding Dysfunction in Male Mice  

PubMed Central

Benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO) are common in older men and can contribute to lower urinary tract symptoms that significantly impact quality of life. Few existing models of BOO and BPH use physiological levels of hormones associated with disease progression in humans in a genetically manipulable organism. We present a model of BPH and BOO induced in mice with testosterone (T) and 17?-estradiol (E2). Male mice were surgically implanted with slow-releasing sc pellets containing 25 mg T and 2.5 mg E2 (T+E2). After 2 and 4 months of hormone treatment, we evaluated voiding patterns and examined the gross morphology and histology of the bladder, urethra, and prostate. Mice treated with T+E2 developed significantly larger bladders than untreated mice, consistent with BOO. Some mice treated with T+E2 had complications in the form of bladder hypertrophy, diverticula, calculi, and eventual decompensation with hydronephrosis. Hormone treatment caused a significant decrease in the size of the urethral lumen, increased prostate mass, and increased number of prostatic ducts associated with the prostatic urethra, compared with untreated mice. Voiding dysfunction was observed in mice treated with T+E2, who exhibited droplet voiding pattern with significantly decreased void mass, shorter void duration, and fewer sustained voids. The constellation of lower urinary tract abnormalities, including BOO, enlarged prostates, and voiding dysfunction seen in male mice treated with T+E2 is consistent with BPH in men. This model is suitable for better understanding molecular mechanisms and for developing novel strategies to address BPH and BOO. PMID:22948219

Nicholson, Tristan M.; Ricke, Emily A.; Marker, Paul C.; Miano, Joseph M.; Mayer, Robert D.; Timms, Barry G.; vom Saal, Frederick S.; Wood, Ronald W.

2012-01-01

245

Testosterone and 17?-estradiol induce glandular prostatic growth, bladder outlet obstruction, and voiding dysfunction in male mice.  

PubMed

Benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO) are common in older men and can contribute to lower urinary tract symptoms that significantly impact quality of life. Few existing models of BOO and BPH use physiological levels of hormones associated with disease progression in humans in a genetically manipulable organism. We present a model of BPH and BOO induced in mice with testosterone (T) and 17?-estradiol (E(2)). Male mice were surgically implanted with slow-releasing sc pellets containing 25 mg T and 2.5 mg E(2) (T+E(2)). After 2 and 4 months of hormone treatment, we evaluated voiding patterns and examined the gross morphology and histology of the bladder, urethra, and prostate. Mice treated with T+E(2) developed significantly larger bladders than untreated mice, consistent with BOO. Some mice treated with T+E(2) had complications in the form of bladder hypertrophy, diverticula, calculi, and eventual decompensation with hydronephrosis. Hormone treatment caused a significant decrease in the size of the urethral lumen, increased prostate mass, and increased number of prostatic ducts associated with the prostatic urethra, compared with untreated mice. Voiding dysfunction was observed in mice treated with T+E(2), who exhibited droplet voiding pattern with significantly decreased void mass, shorter void duration, and fewer sustained voids. The constellation of lower urinary tract abnormalities, including BOO, enlarged prostates, and voiding dysfunction seen in male mice treated with T+E(2) is consistent with BPH in men. This model is suitable for better understanding molecular mechanisms and for developing novel strategies to address BPH and BOO. PMID:22948219

Nicholson, Tristan M; Ricke, Emily A; Marker, Paul C; Miano, Joseph M; Mayer, Robert D; Timms, Barry G; vom Saal, Frederick S; Wood, Ronald W; Ricke, William A

2012-11-01

246

Prostate Cancer Jonathan Hagopian  

E-print Network

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

Gleeson, Joseph G.

247

Prostatic hyperplasia is highly associated with nocturia and excessive sleepiness: a cross-sectional study  

PubMed Central

Objectives The objective of this study is to assess the impact of nocturia on sleep in patients with lower urinary tract symptoms (LUTS)/benign prostatic enlargement (BPE) (nocturia?2). Design Cross-sectional survey. Setting 798 urologists and general practitioners randomly selected from the overall population of urologists and general practitioners of every French region. Participants A total of 2179 LUTS/BPE men (aged 67.5±7.5?years old) were recruited. Primary and secondary outcome measures Validated patients' self-administered questionnaires were used to assess the severity of LUTS/BPE (the International Prostate Symptom Score), sleep characteristics (sleep log) and sleep disorders (the International Classification of Sleep Disorders (ICSD-2) and the DSM-IV). Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). The volume of 24?h diuresis (1500?ml) was measured. Results Participants had on average 2.9±0.9 nocturia episodes (three or more episodes in 67%) and the International Prostate Symptom Score of 15.8±5.7; 60.9% complained of insomnia according to the ICSD-2, 7.9% of restless leg syndrome and 6.4% of obstructive sleep apnoea. 32.3% had excessive sleepiness (ESS >10) and 3.1% severe excessive sleepiness (ESS >16). Insomnia was mainly nocturnal awakenings with an average wake after sleep onset of 89±47?min. The number of episodes of nocturia per night correlated significantly with wake after sleep onset and ESS but not with total sleep time and sleep latency. Conclusion Nocturia is significantly associated with sleep maintenance insomnia and sleepiness in men with BPE. PMID:22649170

Chartier-Kastler, Emmanuel; Leger, Damien; Comet, Denis; Haab, François

2012-01-01

248

Farming, Reported Pesticide Use, and Prostate Cancer  

PubMed Central

Prostate cancer is the leading cancer type diagnosed in American men and is the second leading cancer diagnosed in men worldwide. Although studies have been conducted to investigate the association between prostate cancer and exposure to pesticides and/or farming, the results have been inconsistent. We performed a meta-analysis to summarize the association of farming and prostate cancer. The PubMed database was searched to identify all published case–control studies that evaluated farming as an occupational exposure by questionnaire or interview and prostate cancer. Ten published and two unpublished studies were included in this analysis, yielding 3,978 cases and 7,393 controls. Prostate cancer cases were almost four times more likely to be farmers compared with controls with benign prostate hyperplasia (BPH; meta odds ratio [OR], crude = 3.83, 95% confidence interval [CI] = 1.96–7.48, Q-test p value = .352; two studies); similar results were obtained when non-BPH controls were considered, but with moderate heterogeneity between studies (meta OR crude = 1.38, 95% CI = 1.16–1.64, Q-test p value = .216, I2 = 31% [95% CI = 0–73]; five studies). Reported pesticide exposure was inversely associated with prostate cancer (meta OR crude = 0.68, 95% CI = 0.49–0.96, Q-test p value = .331; four studies), whereas no association with exposure to fertilizers was observed. Our findings confirm that farming is a risk factor for prostate cancer, but this increased risk may not be due to exposure to pesticides. PMID:22948300

Ragin, Camille; Davis-Reyes, Brionna; Tadesse, Helina; Daniels, Dennis; Bunker, Clareann H.; Jackson, Maria; Ferguson, Trevor S.; Patrick, Alan L.; Tulloch-Reid, Marshall K.; Taioli, Emanuela

2013-01-01

249

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

PubMed Central

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

Szopinski, Tomasz; Chlosta, Piotr; Borówka, Andrzej

2014-01-01

250

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

PubMed Central

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

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

2012-01-01

251

[Transurethral laser ablation of the prostate (TULAP). Initial results with 188 patients].  

PubMed

Laser therapy for benign prostatic hyperplasia (BPH) is now the most impressive alternative to transurethral resection of the prostate (TUR-P). Transurethral laser ablation of the prostate (TULAP) is a new technique that combines non-contact and contact laser treatment of BPH. From November 1992 to August 1994, 188 patients were treated by the TULAP technique. Their median age was 70.3 (58-87) years. The mean prostatic volume determined by transrectal ultrasound, was 49.2 ml. A 6-month follow up was possible for 102 patients. The AUA 7-Symptom Score decreased from 29 points preoperatively to 6 points after 6 months. Residual urine volume decreased from 205 ml to 27 ml after 6 months. Maximum flow rate increased from 7.2 ml/s to 19.3 ml/s after 6 months. No severe complications were observed, and in particular no major bleeding or TUR syndrome. We regard the TULAP procedure as an effective treatment alternative for obstructive symptoms caused by BPH. PMID:7538711

Gottfried, H W; Krautschick, A; Hefty, R; Weber, H M; Frohneberg, D; Hautmann, R E

1995-03-01

252

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

PubMed Central

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

2014-01-01

253

Prostate stem cell antigen (PSCA) expression in human prostate cancer tissues and its potential role in prostate carcinogenesis and progression of prostate cancer  

PubMed Central

Background Prostate stem cell antigen (PSCA) is a recently defined homologue of the Thy-1/Ly-6 family of glycosylphosphatidylinositol (GPI)-anchored cell surface antigens. The purpose of the present study was to examine the expression status of PSCA protein and mRNA in clinical specimens of human prostate cancer (Pca) and to validate it as a potential molecular target for diagnosis and treatment of Pca. Materials and Methods Immunohistochemical (IHC) and in situ hybridization (ISH) analyses of PSCA expression were simultaneously performed on paraffin-embedded sections from 20 benign prostatic hyperplasia (BPH), 20 prostatic intraepithelial neoplasm (PIN) and 48 prostate cancer (Pca) tissues, including 9 androgen-independent prostate cancers. The level of PSCA expression was semiquantitatively scored by assessing both the percentage and intensity of PSCA-positive staining cells in the specimens. Then compared PSCA expression between BPH, PIN and Pca tissues and analysed the correlations of PSCA expression level with pathological grade, clinical stage and progression to androgen-independence in Pca. Results In BPH and low grade PIN, PSCA protein and mRNA staining were weak or negative and less intense and uniform than that seen in HGPIN and Pca. There were moderate to strong PSCA protein and mRNA expression in 8 of 11 (72.7%) HGPIN and in 40 of 48 (83.4%) Pca specimens examined by IHC and ISH analyses, with statistical significance compared with BPH (20%) and low grade PIN (22.2%) samples (p < 0.05, respectively). The expression level of PSCA increased with high Gleason grade, advanced stage and progression to androgen-independence (p < 0.05, respectively). In addition, IHC and ISH staining showed a high degree of correlation between PSCA protein and mRNA overexpression. Conclusions Our data demonstrate that PSCA as a new cell surface marker is overexpressed by a majority of human Pca. PSCA expression correlates positively with adverse tumor characteristics, such as increasing pathological grade (poor cell differentiation), worsening clinical stage and androgen-independence, and speculatively with prostate carcinogenesis. PSCA protein overexpression results from upregulated transcription of PSCA mRNA. PSCA may have prognostic utility and may be a promising molecular target for diagnosis and treatment of Pca. PMID:15132743

Zhigang, Zhao; Wenlv, Shen

2004-01-01

254

The Efficacy and Safety of Combined Therapy with ?-Blockers and Anticholinergics for Men with Benign Prostatic Hyperplasia: A Meta-Analysis  

PubMed Central

Purpose We performed a meta-analysis to compare treatment with ?-blockers and anticholinergics (ie combination therapy) to ?-blocker monotherapy to clarify the efficacy and safety of this treatment approach among men with storage urinary symptoms related to benign prostatic hyperplasia. Materials and Methods We searched for trials of men with benign prostatic hyperplasia/lower urinary tract symptoms that were randomized to combination treatment or ?-blockers alone. We pooled data from 7 placebo controlled trials meeting inclusion criteria. Primary outcomes of interest included changes in International Prostate Symptom Score (storage subscores) and urinary frequency. We also assessed post-void residual volume, maximal flow rate and the incidence of urinary retention. Data were pooled using random effects models for continuous outcomes and the Peto method to generate odds ratios for acute urinary retention. Results Combination therapy had a significantly greater reduction in International Prostate Symptom Score storage subscores (? ?0.73, 95% CI ?1.09 – ?0.37) and voiding frequency (? ?0.69 voids, 95% CI ?0.97 – ?0.41). There was also a greater reduction in maximal urinary flow rate (? ?0.59 ml per second, 95% CI ?1.04 – ?0.14) and increase in post-void residual urine volume (? 11.60 ml, 95% CI 8.50–14.70) with combination therapy. The number needed to treat with combination therapy to cause 1 acute urinary retention episode was 101 (95% CI 60–267). Conclusions Combination treatment with ?-blockers and anticholinergics significantly improved storage voiding parameters compared to men treated with ?-blocker therapy alone. This treatment approach is safe with a minimal risk of increased post-void residual urine volume, decreased maximal urinary flow rate or acute urinary retention. PMID:23727412

Filson, Christopher P.; Hollingsworth, John M.; Clemens, J. Quentin; Wei, John T.

2013-01-01

255

Can Mean Platelet Volume Serve as a Marker for Prostatitis?  

PubMed Central

Aim: The aim of the study was to compare the yield of mean platelet volume (MPV), total prostate specific antigen (tPSA), free prostate specific antigen (fPSA), f/t PSA ratio and complex prostate specific antigen (cPSA) in patients with prostatitis. Material and method: The study was designed in the Kayseri Education and Research Hospital. Ninety-six patients with prostatitis were enrolled retrospectively into the study. Laboratory data were obtained from the computerized patient database. We evaluated the correlation between tPSA, fPSa, f/t PSA ratio, cPSA, MPV and extent and aggressiveness of inflammation in the surgical specimens of patients who underwent surgery for benign prostatic hyperplasia (BPH). Inflammation in the prostatic tissues was scored for extent and aggressivity of inflammation using the grading system designed by Irani et al. Results: The total PSA, fPSa, f/t PSA ratio, cPSA and pre- and post-treatment MPV values of each group did not differ (p>0.05) (Table 1). Also there was no correlation between the histopathological grades and the MPV, tPSA, fPSA, f/t PSA ratio and cPSA of patients. However, MPV values significantly decreased after treatment in all grades of prostatitis (p<0.001). Conclusion: MPV values may be used as an inflammation marker in patients with prostatitis. PMID:23983600

Karaman, Hatice; Karakukcu, Cigdem; Kocer, Derya

2013-01-01

256

TUIP for infravesically obstructed BPH patients: a review of 300 cases.  

PubMed

Our experience is described in the treatment of BPH by prostatic incision. Three hundred patients were treated from 1989 to 1993; 285 had obstructive BPH (48 in complete urine retention) and 15 had prostatic carcinoma. One hundred eighty-nine patients were controlled and in 93% the results were satisfactory for disappearance of symptoms. Insignificant complications were recorded and only 9% had retrograde ejaculation. Ninety-six urodynamic controls (flowmetry) were performed which showed a considerable improvement in maximum urinary flow rate. The operation was successful even in patients with large adenomas, with a considerable reduction of the Boyarsky score (mean from 17.8 to 3.8) six months postoperatively. In conclusion TUIP is a good procedure in BPH. It is an easy technique without important complications. PMID:7530948

Cerruti, G; Tani, F

1994-11-01

257

A novel robotic platform for laser-assisted transurethral surgery of the prostate.  

PubMed

Benign prostatic hyperplasia (BPH) is the most common pathology afflicting ageing men. The gold standard for the surgical treatment of BPH is transurethral resection of the prostate. The laser-assisted transurethral surgical treatment of BPH is recently emerging as a valid clinical alternative. Despite this, there are still some issues that hinder the outcome of laser surgery, e.g., distal dexterity is strongly reduced by the current endoscopic instrumentation and contact between laser and prostatic tissue cannot be monitored and optimized. This paper presents a novel robotic platform for laser-assisted transurethral surgery of BPH. The system, designed to be compatible with the traditional endoscopic instrumentation, is composed of a catheter-like robot provided with a fiber optic-based sensing system and a cable-driven actuation mechanism. The sensing system allows contact monitoring between the laser and the hypertrophic tissue. The actuation mechanism allows steering of the laser fiber inside the prostatic urethra of the patient, when contact must be reached. The design of the proposed robotic platform along with its preliminary testing and evaluation is presented in this paper. The actuation mechanism is tested in in vitro experiments to prove laser steering performances according to the clinical requirements. The sensing system is calibrated in experiments aimed to evaluate the capability of discriminating the contact forces, between the laser tip and the prostatic tissue, from the pulling forces exerted on the cables, during laser steering. These results have been validated demonstrating the robot's capability of detecting sub-Newton contact forces even in combination with actuation. PMID:25248176

Russo, S; Dario, P; Menciassi, A

2015-02-01

258

Androgen-independent effects of Serenoa repens extract (Prostasan®) on prostatic epithelial cell proliferation and inflammation.  

PubMed

Extracts from Serenoa repens are widely used for the treatment of benign prostatic hyperplasia (BPH) and traditionally for prostatitis. In the present study we evaluated the biological effects of Serenoa repens extract (Prostasan®) on prostate cells beyond its known antiandrogenic actions. Prostasan® inhibited epidermal growth factor (EGF) and lipopolysaccharide (LPS) induced proliferation of the prostatic epithelial, androgen independent cell line PC-3. At effective concentrations of 50?µg/mL, Prostasan® partly displaced EGF from EGF receptor (EGFR) but fully blocked EGF-induced cell proliferation of PC-3 cells. Similarly, Prostasan® inhibited LPS-induced proliferation of PC-3 cells without affecting LPS activation of the NF?B pathway via toll-like receptor-4 (TLR-4). Additionally, Prostasan® reduced the constitutive secretion of monocyte chemotactic protein-1 (MCP-1), the LPS-induced secretion of IL-12 and inhibited MCP-1 and granulocyte-macrophage colony-stimulating factor (GM-CSF) production in the presence of LPS on PC-3 cells. Taken together, our results suggest that S. repens extracts, in addition to other reported effects on BPH development and prostatitis, inhibits EGF-dependent growth and proinflammatory responses of the prostate epithelial cells. PMID:21656602

Iglesias-Gato, Diego; Carsten, Tober; Vesterlund, Mattias; Pousette, Ake; Schoop, Roland; Norstedt, Gunnar

2012-02-01

259

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

PubMed Central

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

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

2013-01-01

260

Transurethral convective water vapor as a treatment for lower urinary tract symptomatology due to benign prostatic hyperplasia using the Rez?m® system: evaluation of acute ablative capabilities in the human prostate  

PubMed Central

Background The purpose of this study was to assess the acute ablative characteristics of transurethral convective water vapor (steam) using the Rez?m® system in men with benign prostatic hyperplasia through histologic and radiographic studies. Methods Seven patients were treated with transurethral intraprostatic injections of sterile steam under endoscopic visualization followed by previously scheduled adenectomies. The extirpated adenomas were grossly examined followed by whole mount sectioning and staining with triphenyl-tetrazolium chloride (TTC) to evaluate thermal ablation. Histology was performed after hematoxylin and eosin staining on one prostate. After review of results from the first patient cohort, an additional 15 patients with clinical benign prostatic hyperplasia were treated followed by gadolinium-enhanced magnetic resonance imaging (MRI) at one week. Results In the first patient cohort, gross examination of TTC-stained tissue showed thermal ablation in the transition zone. In addition, there was a distinct interface between viable and necrotic prostatic parenchyma. Histopathologic examination revealed TTC staining-outlined necrotic versus viable tissue. Gadolinium-enhanced MRIs in the cohort of 15 patients demonstrated lesion defects in all patients at 1 week post-procedure. Coalesced lesions were noted with a mean (± standard deviation) lesion volume of 9.6±8.5 cm3. The largest lesion volume was 35.1 cm3. Ablation using vapor was rapid and remained confined to the transition zone, consistent with the thermodynamic principles of convective thermal energy transfer. Conclusion Thermal ablation was observed in all specimens. The resulting coalescing ablative lesions, as seen on MRI, were confined to the transition zone. These studies confirm the ablative capabilities of vapor, validate the thermodynamic principles of convective heating, and allow for further clinical studies.

Dixon, Christopher M; Rijo Cedano, Edwin; Mynderse, Lance A; Larson, Thayne R

2015-01-01

261

Role of cyclin D1 immunoreactivity and AgNOR staining in the evaluation of benign and malignant lesions of the prostate  

PubMed Central

Purpose: Prostatic carcinoma is a common and growing public health problem. Histological evaluation is fairly adequate for assessing tumor differentiation, but tumor proliferative activity is difficult to measure. Increasing evidence suggests that the factors controlling cell cycle progression also modulate the rate of ribosome biogenesis. Despite the influence of cyclin D1 and argyrophilic nuclear organizer region (AgNOR) on prostate cancer proliferation, few studies have evaluated the diagnostic importance of these markers. Therefore, the present study was carried out to analyze the diagnostic value of the proliferative markers cyclin D1 and AgNOR in various prostatic lesions and to determine whether any association or relation between these markers and different Gleason grades exists. Methods: A total 50 cases of various prostatic lesions were studied. Tumor grade, AgNOR staining, and cyclin D1 expression were evaluated in all cases. Correlations between the intensity and differential localization of these markers and Gleason grades were evaluated. Results: The mean AgNOR count in cases of prostatic intraepithelial neoplasia was high compared with cases of benign prostatic hyperplasia (BPH) but lower than that of carcinoma cases. The intensity of cyclin D1 expression was high in carcinoma. A total of 14 cases (46.67%) showed strong positivity. No significant correlation was found between the intensity of cyclin D1 expression, AgNOR count, and histologic grades of prostatic carcinoma, whereas a significant correlation was observed between intensity and percentage expression of cyclin D1 in BPH and carcinoma (P<0.01). Nuclear as well as cytoplasmic positivity was seen among various grades of carcinoma. Conclusions: AgNOR count and cyclin D1 may be helpful in distinguishing between BPH and carcinoma of the prostate but may not be used as reliable indicators of the grade of prostatic adenocarcinoma because of overlapping values in various grades. However, further studies on larger samples are required to elucidate the role of these markers in identification of premalignant lesions. PMID:25032195

Gupta, Veena; Garg, Monika; Chaudhry, Manish; Singh, Sunita; Sen, Rajeev; Gill, Meenu; Sangwaiya, Ashok

2014-01-01

262

The dark side of 5?-reductase inhibitors' therapy: sexual dysfunction, high Gleason grade prostate cancer and depression.  

PubMed

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

Traish, Abdulmaged M; Mulgaonkar, Ashwini; Giordano, Nicholas

2014-06-01

263

Transition zone volume and transition zone ratio: predictor of uroflow response to finasteride therapy in benign prostatic hyperplasia patients  

Microsoft Academic Search

Objectives. The aim of this study was to: (1) determine effects of finasteride on transition zone (TZ) volume, TZ ratio (TZ volume\\/total prostate volume), and total prostate volume; (2) analyze differences in TZ and total volume reduction among patients who improve peak urinary flow rates following finasteride therapy with those who do not; (3) investigate which parameters correlate with improvement

Ashutosh Tewari; Katsuto Shinohara; Perinchery Narayan

1995-01-01

264

Assessment of BPH/BOO  

PubMed Central

The assessment of men with bladder outflow obstruction relies on an adequate history and examination. Uroflowmetry and post-void residue estimation are very revealing and may be sufficient in the majority of men. The prostate-specific antigen test may be used to select men who are at a high risk of progression. In specific situations, cystometry may be required. We discuss the use of cystometry and the newer less-invasive methods of assessment that have emerged over the last few years, including ultrasound estimation of intravesical prostatic protrusion, prostatic urethra angle, detrusor wall thickness, ultrasound-estimated bladder weight, near-infrared spectroscopy and the condom catheter and penile cuff tests. Although these techniques show promise, they still require further modifications, standardization and testing in larger populations. In addition, they should be used in men where only specific questions need to be answered. PMID:24744517

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

2014-01-01

265

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

Microsoft Academic Search

The prostate-specific antigen test has been a major factor in increasing awareness and better patient management of prostate cancer (PCA), but its lack of specificity limits its use in diagnosis and makes for poor early detection of PCA. The objective of our studies is to identify better bio- markers for early detection of PCA using protein profiling technologies that can

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

2002-01-01

266

The role of transurethral resection of the prostate for patients with an elevated prostate-specific antigen  

PubMed Central

Purpose The aim of this study was to define the clinical significance of transurethral resection of the prostate (TURP) in patients with benign prostate hyperplasia (BPH) and an elevated prostate-specific antigen (PSA) level. Methods We retrospectively evaluated patients with BPH, lower urinary tract symptoms (LUTS; International Prostate Symptom Score [IPSS]?8), an elevated serum PSA level (?4 ng/mL), and previous negative transrectal ultrasonography (TRUS) guided prostate biopsy. The PSA level after TURP was monitored by long-term follow-up. The tumor detection rate on resected prostate tissue, IPSS, maximal urinary flow rate (Qmax), and postvoid residual urine (PVR) were analyzed. Results One-hundred and eighty-six patients were enrolled. Histological examination of resected tissue by TURP revealed prostate cancer in 12 of these patients (6.5%). Among 174 patients without prostate cancer, the mean PSA level and the PSA normalization rate in 112 patients followed up at postoperative day (POD) 3 months were 1.26±0.13 ng/mL and 94.6%, respectively. The mean PSA level and the PSA normalization rate were 1.28±1.01 ng/mL and 95.7% in 47 patients at 1st year, 1.17±0.82 ng/mL and 97.1% in 34 patients at second years, and 1.34±1.44 ng/mL and 97.2% in 36 patients at third years of TURP. One patient showed a dramatic increase in the PSA level was diagnosed with prostate cancer at 7 years after TURP. IPSS, quality of life, Qmax, and PVR were improved significantly at POD 3 months compared to baseline (P<0.05), respectively. Conclusions TURP significantly reduced the serum PSA level, which was maintained for at least 3 years. This could be helpful to screen the prostate cancer using PSA value in the patient with previous negative biopsy and elevated PSA. In addition, TURP improves IPSS, Qmax, and PVR in patients with BPH, moderate LUTS, and an elevated PSA level. PMID:25599076

Cho, Hee Ju; Shin, Soon Cheol; Cho, Jeong Man; Kang, Jung Yoon; Yoo, Tag Keun

2014-01-01

267

Silodosin and tadalafil have synergistic inhibitory effects on nerve-mediated contractions of human and rat isolated prostates.  

PubMed

Lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH) are associated with erectile dysfunction. Alpha-1-adrenoceptor antagonists are effective drugs for treating symptomatic BPH. Clinical data show improvements in LUTS by phosphodiesterase 5 inhibitors. This study aimed to evaluate effects of silodosin, a highly selective ?1A-adrenoceptor antagonist, alone or in combination with the phosphodiesterase 5 inhibitor tadalafil on contractions of isolated human and rat prostates. In organbath studies, effects of increasing concentrations of silodosin (1nM-1µM) and tadalafil (100nM-100µM) on contractions by electrical field stimulation or phenylephrine of human and rat prostate strip preparations were investigated. The combination silodosin and tadalafil reduced electrically-induced contractions of human prostate preparations better than single drugs alone. At any frequencies (1-32Hz), inhibitory effects of combined therapy (P-values vs single drug) in human tissue were 26-42% (1nM silodosin+100nM tadalafil; P<0.05), 40-58% (10nM silodosin+1µM tadalafil; P<0.001-0.05), 56-67% (100nM silodosin+10µM tadalafil; P<0.01-0.05), and 33-55% (1µM silodosin+100µM tadalafil P<0.01-0.05). Similar findings were obtained in rat prostate preparations. In human and rat prostate tissue, the drug combination exerted similar inhibitory effect on phenylephrine contractions as silodosin alone. Silodosin plus tadalafil had greater potency than each drug alone to inhibit prostate contractions to electrical field stimulation but not to phenylephrine. This study supports the clinical application of a combination of an ?1A-adrenoceptor antagonist and a phosphodiesterase 5 inhibitor for symptomatic BPH and suggests that the drug combination requires endogenous nerve-activity for optimal effect. PMID:25261033

Buono, Roberta; Briganti, Alberto; Freschi, Massimo; Villa, Luca; La Croce, Giovanni; Moschini, Marco; Benigni, Fabio; Castiglione, Fabio; Montorsi, Francesco; Hedlund, Petter

2014-12-01

268

Common variants at 8q24 are associated with prostate cancer risk in Serbian population.  

PubMed

Previous studies have shown correlation between single nucleotide polymorphisms (SNPs) at 8q24 and prostate cancer (PCa) risk. This study aimed to evaluate possible association between genotypes and alleles of 8q24 polymorphisms (rs1447295, rs4242382, rs6983267, rs7017300, and rs7837688) and PCa risk and progression. 150 patients with PCa, 150 patients with benign prostatic hyperplasia (BPH), and 100 healthy controls selected from the general population were recruited for this study. SNPs were genotyped by using PCR-RFLP analysis. There was a significant positive association between the A allele of the SNP rs4242382 and PCa risk [PCa vs. BPH comparison, P?=?0.014 for the best-fitting dominant model; odds ratio (OR) =1.98; 95 % confidence interval (95%CI) 1.14-3.43]. We found evidence (P?=?0.0064) of association between PCa risk and rs7017300 (heterozygote OR?=?1.60; 95%CI 0.95-2.69) when comparing genotype distributions in PCa and BPH patients. The association between T allele rs7837688 and PCa risk was determined in PCa vs. BPH comparison with the best-fitting model of inheritance being log-additive (P?=?0.0033; OR?=?2.14, 95%CI 1.27-3.61). Odds ratio for carriers of rs6983267 TT genotype under recessive model of association with PCa was found to be 0.36 (PCa vs. control comparison, P?=?0.0029; 95%CI 0.19-0.71). For rs1447295, deviation from Hardy-Weinberg equilibrium was observed in BPH patients and controls. We found no association between parameters of PCa progression and five 8q24 SNPs. Locus 8q24 harbors genetic variants associated with PCa risk in Serbian population. PMID:23532531

Brankovi?, Ana S; Brajuškovi?, Goran N; Mir?eti?, Jovan D; Nikoli?, Zorana Z; Kalaba, Predrag B; Vukoti?, Vinka D; Tomovi?, Saša M; Cerovi?, Snežana J; Radoji?i?, Zoran A; Savi?-Pavi?evi?, Dušanka L J; Romac, Stanka P

2013-07-01

269

Testosterone protects from metabolic syndrome-associated prostate inflammation: an experimental study in rabbit.  

PubMed

Metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) are often associated. One of their common denominators is hypogonadism. However, testosterone supplementation is limited by concerns for potential prostatic side effects. The objective was to determine whether MetS-associated prostate alterations are prevented by testosterone supplementation. We used a previously described animal model of MetS, obtained by feeding male rabbits a high-fat diet (HFD) for 12 weeks. Subsets of HFD rabbits were treated with testosterone or with the farnesoid X receptor agonist INT-747. Rabbits fed a standard diet were used as controls. HFD-animals develop hypogonadism and all the MetS features: hyperglycemia, glucose intolerance, dyslipidemia, hypertension, and visceral obesity. In addition, HFD-animals show a prostate inflammation. Immunohistochemical analysis demonstrated that HFD-induced prostate fibrosis, hypoxia, and inflammation. The mRNA expression of several proinflammatory (IL8, IL6, IL1?, and TNF?), T lymphocyte (CD4, CD8, Tbet, Gata3, and ROR ?t), macrophage (TLR2, TLR4, and STAMP2), neutrophil (lactoferrin), inflammation (COX2 and RAGE), and fibrosis/myofibroblast activation (TGF?, SM22?, ?SMA, RhoA, and ROCK1/ROCK2) markers was significantly increased in HFD prostate. Testosterone, as well as INT-747, treatment prevented some MetS features, although only testosterone normalized all the HFD-induced prostate alterations. Interestingly, the ratio between testosterone and estradiol plasma level retains a significant, negative, association with all the fibrosis and the majority of inflammatory markers analyzed. These data highlight that testosterone protects rabbit prostate from MetS-induced prostatic hypoxia, fibrosis, and inflammation, which can play a role toward the development/progression of BPH/LUTS. PMID:22010203

Vignozzi, Linda; Morelli, Annamaria; Sarchielli, Erica; Comeglio, Paolo; Filippi, Sandra; Cellai, Ilaria; Maneschi, Elena; Serni, Sergio; Gacci, Mauro; Carini, Marco; Piccinni, Marie-Pierre; Saad, Farid; Adorini, Luciano; Vannelli, Gabriella B; Maggi, Mario

2012-01-01

270

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

PubMed Central

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

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

2014-01-01

271

Endometrial Hyperplasia  

MedlinePLUS

... is endometrial hyperplasia? Endometrial hyperplasia occurs when the endometrium , the lining of the uterus , becomes too thick. ... to cancer of the uterus. How does the endometrium normally change throughout the menstrual cycle? The endometrium ...

272

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

NASA Astrophysics Data System (ADS)

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

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

2005-01-01

273

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

NASA Astrophysics Data System (ADS)

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

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

2014-02-01

274

Safety and Tolerability of the Dual 5?-Reductase Inhibitor Dutasteride in the Treatment of Benign Prostatic Hyperplasia  

Microsoft Academic Search

Objective: The objective of this paper is to examine safety and tolerability data from a number of recently completed clinical trials with the novel, dual 5?-reductase inhibitor, dutasteride.Methods: Intent-to-treat analyses were conducted on data for dutasteride 0.5mg\\/day for drug-related adverse events, clinical laboratory test results, and prostate-specific antigen (PSA) levels derived from four large, randomised, double-blind clinical trials (n=5655). Further

Gerald L Andriole; Roger Kirby

2003-01-01

275

The effect of 5alpha-reductase inhibition with finasteride and dutasteride on bone mineral density in older men with benign prostatic hyperplasia.  

PubMed

Testosterone is converted to dihyrotestosterone by two isoenzymes of 5alpha-reductase. Finasteride and dutasteride are 5alpha-reductase inhibitors commonly used in the treatment of benign prostatic hyperplasia. We compared indices of bone mineral density in 50 men treated with finasteride, 50 men treated with dutasteride and 50 men as control. Bone mineral density of spine and hip were measured using dual energy X-ray absorptiometry. Bone formation was assessed by measuring serum osteocalcin and bone resorptionby measuring serum C-terminal telopeptide of collagen type 1. In addition serum total testosteron and estradiol were determined. The dutasteride group had significantly higher mean bone min- eral density, mean bone mineral content, mean T score, mean Z score at femoral neck and mean total hip Z score than control. Mean total testosterone and estradiol levels were higher in the dutasteride group. There were no significant dif- ferences between the groups in lumbar spine bone density parameters or bone turnover markers. Our results provide evidence that long-term 5alpha-reductase suppression does not adversely affect bone mineral density. Dutasteride therapy could have beneficial effect on bone density. PMID:25420363

Ma?ukat, Indira Radin; Spanjol, Josip; Orli?, Zeljka Crncevi?; Butorac, Marta Zuvi?; Marinovi?, Marin; ?upi?, Dora Fu?kar

2014-09-01

276

The effect of 5alpha-reductase inhibition with finasteride and dutasteride on bone mineral density in older men with benign prostatic hyperplasia.  

PubMed

Testosterone is converted to dihyrotestosterone by two isoenzymes of 5alpha-reductase. Finasteride and dutasteride are 5alpha-reductase inhibitors commonly used in the treatment of benign prostatic hyperplasia. We compared indices of bone mineral density in 50 men treated with finasteride, 50 men treated with dutasteride and 50 men as control. Bone mineral density of spine and hip were measured using dual energy X-ray absorptiometry. Bone formation was assessed by measuring serum osteocalcin and bone resorptionby measuring serum C-terminal telopeptide of collagen type 1. In addition serum total testosteron and estradiol were determined. The dutasteride group had significantly higher mean bone min- eral density, mean bone mineral content, mean T score, mean Z score at femoral neck and mean total hip Z score than control. Mean total testosterone and estradiol levels were higher in the dutasteride group. There were no significant dif- ferences between the groups in lumbar spine bone density parameters or bone turnover markers. Our results provide evidence that long-term 5alpha-reductase suppression does not adversely affect bone mineral density. Dutasteride therapy could have beneficial effect on bone density. PMID:25507347

Ma?ukat, Indira Radin; Spanjol, Josip; Orli?, Zeljka Crncevi?; Butorac, Marta Zuvi?; Marinovi?, Marin; ?upi?, Dora Fu?kar

2014-09-01

277

High-Sensitivity Immunoassay with Surface Plasmon Field-Enhanced Fluorescence Spectroscopy Using a Plastic Sensor Chip: Application to Quantitative Analysis of Total Prostate-Specific Antigen and GalNAc?1-4GlcNAc-Linked Prostate-Specific Antigen for Prostate Cancer Diagnosis.  

PubMed

A high-sensitivity immunoassay system with surface plasmon field-enhanced fluorescence spectrometry (SPFS) was constructed using a plastic sensor chip and then applied to the detection of total prostate-specific antigen (total PSA) and GalNAc?1-4GlcNAc-linked prostate-specific antigen (LacdiNAc-PSA) in serum, to discriminate between prostate cancer (PC) and benign prostate hyperplasia (BPH). By using this automated SPFS immunoassay, the detection limit for total PSA in serum was as low as 0.04 pg/mL, and the dynamic range was estimated to be at least five digits. A two-step sandwich SPFS immunoassay for LacdiNAc-PSA was constructed using both the anti-PSA IgG antibody to capture PSA and Wisteria floribunda agglutinin (WFA) for the detection of LacdiNAc. The results of the LacdiNAc-PSA immunoassay with SPFS showed that the assay had a sensitivity of 20.0 pg/mL and permitted the specific distinction between PC and BPH within the PSA gray zone. These results suggested that high-sensitivity automated SPFS immunoassay systems might become a powerful tool for the diagnosis of PC and other diseases. PMID:25546230

Kaya, Takatoshi; Kaneko, Tomonori; Kojima, Shun; Nakamura, Yukito; Ide, Youichi; Ishida, Kenji; Suda, Yoshihiko; Yamashita, Katsuko

2015-02-01

278

Magnetic resonance imaging following microwave thermotherapy, laser ablation and transurethral resection in patients with BPH.  

PubMed

Morphologic changes in hyperplastic prostate tissue following three different treatments were analysed by MRI using an endorectal surface coil. In cases treated by TUMT, the MRI findings of the prostate showed hemorrhagic necrosis, which was absorbed in 12 weeks, and a widened prostatic urethra. In cases treated by laser ablation, the thermal effect went deep, causing necrotic changes, and it took more than 8 weeks for the tissue to be shed and re-epithelization completed. In TURP, degenerative changes were seen only near the surface following mass reduction of the hyperplastic tissue, and the capsule shrinkage resulted in normalization of the prostatic urethra. It is suggested that improvement of the other parameters, such as IPSS and peak flow, in patients with obstructive BPH basically depends on these morphologic changes shown by MRI. PMID:7538707

Tazaki, H; Deguchi, N; Baba, S; Imai, Y; Nakashima, J

1995-03-01

279

Aberrant Methylation of PCDH10 Predicts Worse Biochemical Recurrence-Free Survival in Patients with Prostate Cancer After Radical Prostatectomy  

PubMed Central

Background Prostate cancer is a common malignancy in men, and inevitably some patients experience biochemical recurrence after radical prostatectomy. To date, there are no reliable predictors for prostate cancer recurrence, and novel predictors are urgently needed. PCDH10 (protocadherin-10) is a novel tumor suppressor gene, which is down-regulated by promoter methylation in prostate cancer. The aim of this study was to evaluate the feasibility of using PCDH10 methylation to predict the biochemical recurrence (BCR) of prostate cancer after radical prostatectomy. Material/Methods Fresh tissue samples were obtained from 151 patients with primary prostate cancer, and from 34 patients with benign prostatic hyperplasia (BPH) as control. The methylation status of PCDH10 in prostate cancer tissues and controls were examined using methylation-specific PCR (MSP), and then associated with clinicopathological features and BCR-free survival of patients with prostate cancer. Results We found that PCDH10 methylation was detected in 79 (52.3%) patients with prostate cancer, but no methylation was found in controls (P<0.0001). Moreover, PCDH10 methylation was significantly associated with higher preoperative prostate-specific antigen (PSA) level (P <0.0001), higher Gleason Score (P<0.0001), advanced clinical stage (P=0.0002), lymph node metastasis (P=0.0389), angiolymphatic invasion (P=0.0303), and biochemical recurrence (P=0.0068). Moreover, PCDH10 methylation was associated with poor BCR-free survival (P<0.0001), and may be used as an independent predictor of BCR-free survival (P=0.0046). Conclusions Our results indicate that PCDH10 methylation in prostate cancer tissue is an independent prognostic biomarker of worse BCR-free survival of patients with prostate cancer after radical prostatectomy. PMID:25086586

Wang, Li; Xie, Pei-Gen; Lin, Ying-Li; Ma, Jian-Guo; Li, Wen-Ping

2014-01-01

280

[Treatment of prostatic pathology with local hyperthermia. Analysis of the results of a study on 60 patients].  

PubMed

The authors report the results of the hyperthermic treatment employed from January 1989 to April 1991 in 60 patients with BPH, PR and NP. Analysis of the results shows a determinant role for prostatitis (RC: 73.91%); the results for BPH are equally valid (RC: 56.25%). The authors used the same treatment for BPH with initially obstructive urinary symptomatology. PMID:1283468

Marino, G; Pugno, E; Griffa, D; Cocimano, V; Marten Perolino, R

1992-01-01

281

Nicotinamide N-methyltransferase is overexpressed in prostate cancer and correlates with prolonged progression-free and overall survival times.  

PubMed

Nicotinamide N -methyltransferase (NNMT) has been identified to be associated with tumorigenesis and the malignant transformation of numerous types of cancer. The aim of the present study was to explore the expression and prognostic significance of NNMT in prostate cancer (PCa). Immunohistochemical NNMT expression was examined in 26 cases of benign prostate hyperplasia (BPH), 18 cases of high-grade prostatic intraepithelial neoplasia (HGPIN) and 120 cases of PCa. While rarely expressed in BPH (8/26 cases; 30.8%), NNMT was found to be significantly upregulated in HGPIN (15/18 cases; 83.3%) and PCa (77/120 cases; 64.2%). Clinicopathological analysis revealed that NNMT expression was negatively correlated with Gleason score (P<0.001). Furthermore, Kaplan-Meier survival curves revealed that high NNMT expression was associated with prolonged progression-free survival (PFS) and overall survival (OS) times in patients with advanced PCa. Multivariate analysis showed that NNMT was an independent prognostic marker of PFS and OS in patients with advanced PCa. The results of the present study suggested that NNMT may contribute to the development of PCa and may potentially be a favorable prognostic marker for the survival of patients with advanced PCa. PMID:25120681

Zhou, Weimin; Gui, Ming; Zhu, Min; Long, Zhi; Huang, Lihua; Zhou, Jun; He, Leye; Zhong, Kuangbiao

2014-09-01

282

Nicotinamide N-methyltransferase is overexpressed in prostate cancer and correlates with prolonged progression-free and overall survival times  

PubMed Central

Nicotinamide N-methyltransferase (NNMT) has been identified to be associated with tumorigenesis and the malignant transformation of numerous types of cancer. The aim of the present study was to explore the expression and prognostic significance of NNMT in prostate cancer (PCa). Immunohistochemical NNMT expression was examined in 26 cases of benign prostate hyperplasia (BPH), 18 cases of high-grade prostatic intraepithelial neoplasia (HGPIN) and 120 cases of PCa. While rarely expressed in BPH (8/26 cases; 30.8%), NNMT was found to be significantly upregulated in HGPIN (15/18 cases; 83.3%) and PCa (77/120 cases; 64.2%). Clinicopathological analysis revealed that NNMT expression was negatively correlated with Gleason score (P<0.001). Furthermore, Kaplan-Meier survival curves revealed that high NNMT expression was associated with prolonged progression-free survival (PFS) and overall survival (OS) times in patients with advanced PCa. Multivariate analysis showed that NNMT was an independent prognostic marker of PFS and OS in patients with advanced PCa. The results of the present study suggested that NNMT may contribute to the development of PCa and may potentially be a favorable prognostic marker for the survival of patients with advanced PCa. PMID:25120681

ZHOU, WEIMIN; GUI, MING; ZHU, MIN; LONG, ZHI; HUANG, LIHUA; ZHOU, JUN; HE, LEYE; ZHONG, KUANGBIAO

2014-01-01

283

[Transurethral resection of the prostate with the Holmium contact laser. Progress in treatment of benign prostatic hypertrophy?].  

PubMed

After the initial enthusiasm subsided lasercoagulation of the prostate has been criticized because the extent of tissue destruction cannot be controlled and many patients may be expected to have significant postoperative obstructive as well as irritative voiding symptoms which may last for weeks. Thanks to new laservaporization techniques these disadvantages have been largely eliminated. With the Holmium laser a real resection of prostatic tissue is possible allowing the surgeon to see the prostatectomy defect immediately and to assess tissue destruction during the operation ("what you see is what you get"). The postoperative voiding disturbances are diminished and comparable to those after TUR-P. At the Department of Urology of the University of Berne 116 patients were treated with the Holmium laser for benign prostatic hyperplasia (BPH). During the initial learning period 12 patients required a secondary TUR-P due to persistent obstruction and in 12 patients a combined laser/conventional resection was performed due to underestimated prostate size. 5 patients were lost to follow-up. In the remaining 87 patients the median duration of catheterization was 2 days. 10/87 patients required postoperative treatment for urinary tract infection. There were no significant perioperative decreases in hemoglobin and no cases of TUR syndrome. 66 patients have been followed for 6 months and 30 patients have been followed for 12 months. The maximum urinary flow improved from 7 ml/s preoperatively to 15 ml/s at 6 months and 14 ml/s at 12 months. The volume of residual urine decreased from a median of 120 ml preoperatively to 24 ml at 6 and 12 months. The IPSS decreased from a median of 20 preoperatively to 3 at 6 and 12 months. In 50 patients followed with pressure-flow study pre- and 6 months postoperatively detrusor pressure at maximum flow decreased from 90 cm H2O to 55 cm H2O and linear PURR sank from 2.06 to 0.6. Taking into account the initial learning curve, transurethral Holmium laser resection of the prostate is a promising method of treatment for BPH as shown by the increase in urinary flow and decrease in detrusor pressure. Although it does not yet rank equally with TUR-P, it is a less invasive alternative providing efficient, safe and almost bloodless' treatment of BPH. PMID:10231937

Hochreiter, W; Hugonnet, C; Studer, U E

1999-03-01

284

Urine of patients with early prostate cancer contains lower levels of light chain fragments of inter-alpha-trypsin inhibitor and saposin B but increased expression of an inter-alpha-trypsin inhibitor heavy chain 4 fragment.  

PubMed

The present study was aimed at the identification of proteins that are differentially expressed in the urine of patients with prostate cancer (PCa), those with benign prostatic hyperplasia (BPH) and age-matched healthy male control subjects. Using a combination of 2DE and MS/MS, significantly lower expression of urinary saposin B and two different fragments of inter-alpha-trypsin inhibitor light chain (ITIL) was demonstrated in the PCa patients compared to the controls. However, only one of the ITIL fragments was significantly different between the PCa and BPH patients. When image analysis was performed on urinary proteins that were transferred onto NC membranes and detected using a lectin that binds to O-glycans, a truncated fragment of inter-alpha-trypsin inhibitor heavy chain 4 was the sole protein found to be significantly enhanced in the PCa patients compared to the controls. Together, these urinary peptide fragments might be useful complementary biomarkers to indicate PCa as well as to distinguish it from BPH, although further epidemiological evidence on the specificity and sensitivity of the protein candidates is required. PMID:23417432

Jayapalan, Jaime J; Ng, Keng L; Shuib, Adawiyah S; Razack, Azad H A; Hashim, Onn H

2013-06-01

285

New steroidal 17?-carboxy derivatives present anti-5?-reductase activity and anti-proliferative effects in a human androgen-responsive prostate cancer cell line.  

PubMed

The androgens testosterone (T) and dihydrotestosterone (DHT), besides playing an important role in prostate development and growth, are also responsible for the development and progression of benign prostate hyperplasia (BPH) and prostate cancer. Therefore, the actions of these hormones can be antagonized by preventing the irreversible conversion of T into DHT by inhibiting 5?-reductase (5?-R). This has been a useful therapeutic approach for the referred diseases and can be achieved by using 5?-reductase inhibitors (RIs). Steroidal RIs, finasteride and dutasteride, are used in clinic for BPH treatment and were also proposed for chemoprevention of prostate cancer. Nevertheless, due to the increase in bone and muscle loss, impotency and occurrence of high-grade prostate tumours, it is important to seek for other potent and specific molecules with lower side effects. In the present work, we designed and synthesized steroids with the 3-keto-?(4) moiety in the A-ring, as in the 5?-R substrate T, and with carboxamide, carboxyester or carboxylic acid functions at the C-17? position. The inhibitory 5?-R activity, in human prostate microsomes, as well as the anti-proliferative effects of the most potent compounds, in a human androgen-responsive prostate cancer cell line (LNCaP cells), were investigated. Our results showed that steroids 3, 4 and 5 are good RIs, which suggest that C-17? lipophylic amides favour 5?-R inhibition. Moreover, these steroids induce a decrease in cell viability of stimulated LNCaP cells, in a 5?-R dependent-manner, similarly to finasteride. PMID:23933094

Amaral, Cristina; Varela, Carla; Correia-da-Silva, Georgina; Tavares da Silva, Elisiário; Carvalho, Rui A; Costa, Saul C P; Cunha, Sara C; Fernandes, José O; Teixeira, Natércia; Roleira, Fernanda M F

2013-11-01

286

Immunohistochemical expression of matrix metalloproteinase-9 and inhibitor of matrix metalloproteinase-1 in prostate adenocarcinoma  

PubMed Central

An immunohistochemical study on the cells proliferative activity by Ki-67 protein and localization of the matrix metalloproteinase-9 and the inhibitor of matrix metalloproteinase-1 was carried out at the benign prostatic hyperplasia (BPH) and the adenocarcinoma (AC) of different Gleason’s grades. A significant decrease of the MMP-9 and TIMP-1 level in the AC of different gradations was observed. A moderate positive correlation between the Gleason score and cell proliferation Ki-67 index (rs = 0.674) and a moderate negative correlation with the level of such a score and expression of MMP-9 (rs = -0.660) was detected. A weak negative correlation exists also between the level of proliferative activity of secretory cells and the expression of MMP-9 by tumor cells (rs = -0.369). The invasive properties of AC cells that promote a degradation of the basal membrane and connective tissue in prostate may be explained by the imbalance between the MMP-9 and TIMP-1, which expression is significantly reduced in AC, in comparison with BPH.

Babichenko, Igor I; Andriukhin, Mikhail I; Pulbere, Sergey; Loktev, Artem

2014-01-01

287

High intensity focused ultrasound (HIFU) treatment of BPH: results of a multi-center phase III study  

NASA Astrophysics Data System (ADS)

The five centers phase III trial was to show that HIFU can treat prostate tissue thermally for symptomatic relief of BPH and improve flow rates. At five sites, 68 BPH patients were treated with the Sonablate device (Focus Surgery, Inc. Indianapolis, IN). A urethral Foley catheter was inserted into the urethra to aid in positioning and was kept in-situ during the treatment. A cooling device was used to cool the rectal wall. The patients returned home within a few hours after the procedure. The Foley catheter was kept electively to avoid any incidence of acute urinary retention following the therapy. The catheter was removed after 4-5 days. The average treatment time was 38 minutes. The patients were treated without pain, blood loss or complications. At 90 days post treatment, average Qmax and AUA Symptom Scores improved from 8.7 ml/s to 12.66 ml/s (48%) and 23.06 to 11.62 (52%), respectively. Significant prostate tissue changes took place before and after the treatment. 80% of the patients had cavity formation at the site of treatment at the bladder neck and prostate. Nonsurgical HIFU therapy is safe and effective for providing symptomatic relief of BPH symptoms and the treatment can be performed as an outpatient procedure.

Sanghvi, N.; Gardner, T.; Koch, M.; Bihrle, R.; Foster, R.; Resnick, M.; Seftel, A.; Grunberger, I.; Stiedle, C.; Corchan, J.

2003-04-01

288

Day care monopolar transurethral resection of prostate: Is it feasible?  

PubMed Central

Introduction: Benign prostatic hyperplasia is a common disease accounting for 30% of our OPD cases and about 25% of our surgery cases. Various treatment options are now available for more efficient care and early return to work. We wanted to determine the safety and feasibility of day care monopolar transurethral resection of prostate (m-TURP), by admitting the patients on the day of surgery and discharging the patient without catheter on the same day. We also compared the morbidity associated with conventional TURP where in the catheter is removed after 24-48 h of surgery and day care TURP where in the catheter is removed on the day of surgery. Materials and Methods: A total of 120 patients who fulfilled the criteria were included in the study which was conducted between November 2008 and December 2010. A total of 60 patients were assigned for day care and 60 for conventional monopolar TURP. There was no significant difference in age, prostatic volume or IPSS score. Day care patients were admitted on day of surgery and discharged the same day after the removal of catheter. Results: Both the groups were comparable in outcome. Stricture rate was less with day care TURP. Mean catheterization time was similar to laser TURP. Conclusion: Monopolar TURP is still the gold standard of care for BPH. If cases are selected properly and surgery performed diligently it remains the option of choice for small and medium sized glands and patients can be back to routine work early. PMID:25371612

Khan, Altaf

2014-01-01

289

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

PubMed

Patients with presumed non-obstructive BPH (Q (max )>or= 15 ml/s) treated with tolterodine ER 4 mg/day for OAB symptoms, alone or added to unsuccessful alpha-blocker treatment of >or=6 weeks duration, were observed for 12 weeks in a non-interventional study to generate real-life efficacy and safety data. Patients completed the IPSS, the OAB-q and a 2-day micturition diary at baseline and 12 weeks. PVR was determined sonographically. Seven hundred and forty one patients were analysed. Mean PVR did not increase (25.4 +/- 26.5 vs. 29.3 +/- 30.9 ml at baseline). AUR requiring catheterization occurred in two patients, acute UTI in four patients. Median IPSS total scores decreased from 17 to 10, IPSS QoL scores from 4 to 2, OAB-q symptom bother scores from 50.0 to 22.5 and OAB-q HRQL scores increased from 59.2 to 81.6. In men with OAB symptoms and presumed non-obstructive BPH, tolterodine ER provided considerable symptomatic and QoL improvements with a low risk of AUR, acute UTI, or increased PVR. PMID:17906864

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

2007-12-01

290

Curvilinear transurethral ultrasound applicator for selective prostate thermal therapy.  

PubMed

Thermal therapy offers a minimally invasive option for treating benign prostatic hyperplasia (BPH) and localized prostate cancer. In this study we investigated a transurethral ultrasound applicator design utilizing curvilinear, or slightly focused, transducers to heat prostatic tissue rapidly and controllably. The applicator was constructed with two independently powered transducer segments operating at 6.5 MHz and measuring 3.5 mm x 10 mm with a 15 mm radius of curvature across the short axis. The curvilinear applicator was characterized by acoustic efficiency measurements, acoustic beam plots, biothermal simulations of human prostate, ex vivo heating trials in bovine liver, and in vivo heating trials in canine prostate (n=3). Each transducer segment was found to emit a narrow acoustic beam (max width <3 mm), which extended the length of the transducer, with deeper penetration than previously developed planar or sectored tubular transurethral ultrasound applicators. Acoustic and biothermal simulations of human prostate demonstrated three treatment schemes for the curvilinear applicator: single shot (10 W, 60 s) schemes to generate narrow ablation zones (13 x 4 mm, 52 degrees C at the lesion boundary), incremental rotation (10 W, 10 degrees/45 s) to generate larger sector-shaped ablation zones (16 mm x 180 degrees sector), and rotation with variable sonication times (10 W, 10 degrees/15-90 s) to conform the ablation zone to a predefined boundary (9-17 mm x 180 degrees sector, 13 min total treatment time). During in vivo canine prostate experiments, guided by MR temperature imaging, single shot sonications (6 W/transducer, 2-3 min) with the curvilinear applicator ablated 20 degree sections of tissue to the prostate boundary (9-15 mm). Multiple adjacent sonications ("sweeping") ablated large sections of the prostate (180 degrees) by using the MR temperature imaging to adjust the power (4-6.4 W/transducer) and sonication time (30-180 s) at each 10 degrees rotation such that the periphery of the prostate reached 52 degrees C before the next rotation. The conclusion of this study was that the curvilinear applicator produces a narrow and penetrating ultrasound beam that, when combined with image guidance, can provide a precise technique for ablating target regions with a contoured outer boundary, such as the prostate capsule, by rotating in small steps while dynamically adjusting the net applied electrical power and sonication time at each position. PMID:16013714

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

2005-06-01

291

ORIGINAL ARTICLE Upregulation of RASGRP3 expression in prostate cancer  

E-print Network

OPEN ORIGINAL ARTICLE Upregulation of RASGRP3 expression in prostate cancer correlates and tissues in BPH and prostate cancer (PCa), as well as its associations with cancer invasion and prognosis in prostate carcinomas. METHODS: Expression analysis of RasGRP3 was accomplished using immunohistochemical

Cai, Long

292

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

SciTech Connect

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

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

2009-02-13

293

Preoperative cystometrography in patients with clinical benign prostatic hypertrophy.  

PubMed

Preoperative water cystometrograms obtained from 437 patients with benign prostatic hyperplasia (BPH) were examined in a retrospective study. The cystometrographic results were analyzed regarding the preoperative clinical features: the patients' age, presence or absence of urinary incontinence, history of urinary retention, and rate of residual urine. Their prognostic value in terms of improvement in voiding difficulty and postoperative urinary incontinence was also analyzed at 1 and 6 months after elective transurethral resection of the prostate (TURP). Of these patients, 263 (60.2%) had detrusor instability (group I), whereas 174 did not (group II). Vesical denervation supersensitivity (Vds) to bethanecol chloride was noted in 47 (12.5%) of 375 patients. The observed difference in clinical features was significant between the two groups, with group I being older (P < 0.01) and showing a greater incidence of urinary incontinence (P < 0.001) and retention (P < 0.001). The difference seen between groups I and II in terms of mean bladder capacity (P < 0.01), compliance (P < 0.01), and a greater positive rate of Vds (P < 0.001) was also significant. The clinical and cystometrographic parameters studied worsened with advancing age of the patients. Although the majority of the patients (94.7%) were relieved of obstructive symptoms after TURP (6 months later), 113 (25.9%) showed no relief at 1 month.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7539677

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

1995-01-01

294

Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology  

PubMed Central

Objective To characterize risk of hypotension requiring admission to hospital in middle aged and older men treated with tamsulosin for benign prostatic hyperplasia. Design Population based retrospective cohort study (between patient methodology) and self controlled case series (within patient methodology). Setting Healthcare claims data from the IMS Lifelink database in the United States. Participants Men aged 40-85 years with private US healthcare insurance entering the cohort at their first dispensing for tamsulosin or for a 5? reductase inhibitor (5ARI) between January 2001 and June 2011after a minimum of six months’ enrolment. Main outcomes measures Hypotension requiring admission to hospital. Cox proportional hazards models estimated rate ratios at time varying intervals during follow-up: weeks 1-4, 5-8, and 9-12 after tamsulosin initiation; weeks 1-4, 5-8, and 9-12 after restarting tamsulosin (after a four week gap); and maintenance tamsulosin treatment (remaining exposed person time). Covariates included age, calendar year, demographics, antihypertensive use, healthcare use, and a Charlson comorbidity score. A self controlled case series, having implicit control for time invariant covariates, was additionally conducted. Results Among 383?567 new users of study drugs (tamsulosin 297?596; 5ARI 85?971), 2562 admissions to hospital for severe hypotension were identified. The incidence for hypotension was higher for tamsulosin (42.4 events per 10?000 person years) than for 5ARIs (31.3 events per 10?000 person years) or all accrued person time (29.1 events per 10?000 person years). After tamsulosin initiation, the cohort analysis identified an increased rate of hypotension during weeks 1-4 (rate ratio 2.12 (95% confidence interval 1.29 to 3.04)) and 5-8 (1.51 (1.04 to 2.18)), and no significant increase at weeks 9-12. The rate ratio for hypotension also increased at weeks 1-4 (1.84 (1.46 to 2.33)) and 5-8 (1.85 (1.45 to 2.36)) after restarting tamsulosin, as did maintenance tamsulosin treatment (1.19 (1.07 to 1.32)). The self controlled case series gave similar results as the cohort analysis. Conclusions We observed a temporal association between tamsulosin use for benign prostatic hyperplasia and severe hypotension during the first eight weeks after initiating treatment and the first eight weeks after restarting treatment. This association suggests that physicians should focus on improving counseling strategies to warn patients regarding the “first dose phenomenon” with tamsulosin. PMID:24192967

2013-01-01

295

Transurethral incision of the prostate using the holmium:YAG laser.  

PubMed

Transurethral incisions of the prostate were made endoscopically in 5 dogs under a fluid medium using a holmium:YAG (Ho:YAG) laser operating at a wavelength of 2.1 microns and with delivery of 1.0 J/pulse in 15 Hz (15 W). Histopathologic examination of tissues collected immediately after surgery revealed irregular crevices outlined by a narrow zone of coagulative necrosis. Ulcerated fissures persisted at 5 and 7 days with the initial stages of epithelial regeneration partially re-epithelializing the ulcerated surfaces. A modest inflammatory response characterized by edema, hemorrhage, and a mixed inflammatory cell infiltrate was also associated with the laser incision sites at 5 and 7 days. Three weeks postlasing, the ulcerated surfaces of the fissures were completely re-epithelialized. At 5 weeks only a slight indentation persisted at the incision sites with minimal changes in the subjacent submucosa and prostatic glandular architecture. Although the results of these investigations are preliminary, we believe that the Ho:YAG laser warrants further clinical evaluation for treating patients with benign prostatic hyperplasia (BPH), urethral strictures, bladder neck contractures, and constrictions of the upper urinary tracts. PMID:1495363

Johnson, D E; Cromeens, D M; Price, R E

1992-01-01

296

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

PubMed Central

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

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

2014-01-01

297

Preparation, Characterization and Stability Study of Dutasteride Loaded Nanoemulsion for Treatment of Benign Prostatic Hypertrophy  

PubMed Central

Benign prostatic hyperplasia (BPH)is the most common condition in aging men, associated with lower urinary tract symptoms. It is caused due to the augmented levels of the androgen dihydrotestosterone. Dutasteride, a 5?-Reductase inhibitor has been recommended for the treatment of BPH upon oral administration. However, long term oral administration of dutasteride may cause sexual problem in man. Therefore the main objective of this study was to develop transdermal patch having nanoemulsion gel of dutasteride in order to enhance physical and chemical stability and eliminate adverse effect of dutasteride. Optimized nanoemulsion was prepared by aqueous phase-titration method and characterized by droplet size, viscosity and refractive index. In-vitro skin permeation of dutasteride through rat abdominal skin was determined by the Franz diffusion cell.Significant increase in the steady state flux (Jss), permeability coefficient (Kp) and enhancement ratio (Er) was observed in optimized nanoemulsion formulation A1 (p < 0.05). The Er of optimized nanoemulsion A1 was found to be 1.52 times with respect to control which indicates transdermal delivery may be better approach for BPH. Stability studies were performed for the period of 3 months. It was found that droplet size, viscosity and refractive index were slightly increased at refrigerator and room temperature in 3 months period. However, the changes in these parameters were not statistically significant (p ? 0.05). The shelf-life of optimized nanoemulsion A1 was found to be 2.18 years at room temperature. These results indicated that both physical as well as chemical stability of dutasteride in nanoemulsion formulation.

Ali, Mohammad Sajid; Alam, Mohammad Sarfaraz; Alam, Nawazish; Siddiqui, Masoom Raza

2014-01-01

298

Prostatic Leiomyoma: A Case Report  

PubMed Central

Prostatic enlargement due to benign adenomatous hyperplasia is very common in elderly males. However, benign mesenchymal tumors especially true leiomyoma of the prostate are rare. We describe a 68-year-old male presenting a urinary obstruction lasting more than two years. The patient was referred for an acute urinary retention. The clinical examination was normal. The perrectal examination revealed an enlarged prostate without abnormalities. An endoscopic resection was performed. The histopathological examination revealed a benign smooth muscle tumor with absence of glandular hyperplasia; the result was confirmed by immunohistochemistry. Accordingly, the diagnosis of true leiomyoma of the prostate was made. PMID:23198266

Mellas, Soufiane; Bouchikhi, Ahmed Amine; Tazi, Mohammed-Fadl; Khallouk, Abdelhak; Elammari, Jalal-Eddin; El Fassi, Mohammed-Jamal; Farih, Moulay Hassan

2012-01-01

299

[a-blockers in benign prostatic hyperplasia: the problem of "floppy iris syndrome". Results of a case-control study to evaluate the surgical risk through the meausurement of pupil diameter.  

PubMed

OBJECTIVES. ?-blockers are a group of ?-adrenoceptor antagonists used by urologists to treat lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Recent studies have suggested that these drugs - tamsulosin in particular - are involved in the development of iris complications during phacoemulsification. The objective of this study is to investigate the effects of ?-blockers - especially tamsulosin - on pupil diameter. MATERIALS AND METHODS. We measured the photopic, mesopic and post-dilatation pupil diameters in both eyes of 24 patients (46 eyes in total), 16 of them treated with ?-blockers and 8 of them (16 eyes in total) not treated with any drugs (controls). RESULTS. All patients treated with tamsulosin showed minor photopic, mesopic and post-dilatation diameters compared to controls. Patients treated with other ?-blockers did not show any difference compared to controls. CONCLUSIONS. Even if a small number of eyes was evaluated, our study shows that tamsulosin - through its selective effect on ?1A receptors - is the most involved drug in the Intraoperative Floppy Iris Syndrome. PMID:21086326

Pavone, C; Abbadessa, D; Serretta, V; Maggioni, A; Abed El Rahman, D

300

Epigenetic regulation of MDR1 gene through post-translational histone modifications in prostate cancer  

PubMed Central

Background Multidrug resistance 1 (MDR1) gene encodes for an ATP binding cassette transporter - P-glycoprotein (P-gp) - involved in chemoresistance to taxanes. MDR1 promoter methylation is frequent in prostate carcinoma (PCa), suggesting an epigenetic regulation but no functional correlation has been established. We aimed to elucidate the epigenetic mechanisms involved in MDR1 deregulation in PCa. Results MDR1 promoter methylation and P-gp expression were assessed in 121 PCa, 39 high-grade prostatic intraepithelial neoplasia (HGPIN), 28 benign prostatic hyperplasia (BPH) and 10 morphologically normal prostate tissue (NPT) samples, using quantitative methylation specific PCR and immunohistochemistry, respectively. PCa cell lines were exposed to a DNA methyltransferases inhibitor 5-aza-2?deoxycytidine (DAC) and histone deacetylases inhibitor trichostatin A (TSA). Methylation and histone posttranscriptional modifications status were characterized and correlated with mRNA and protein expression. MDR1 promoter methylation levels and frequency significantly increased from NPTs, to HGPIN and to PCa. Conversely, decreased or absent P-gp immunoexpression was observed in HGPIN and PCa, inversely correlating with methylation levels. Exposure to DAC alone did not alter significantly methylation levels, although increased expression was apparent. However, P-gp mRNA and protein re-expression were higher in cell lines exposed to TSA alone or combined with DAC. Accordingly, histone active marks H3Ac, H3K4me2, H3K4me3, H3K9Ac, and H4Ac were increased at the MDR1 promoter after exposure to TSA alone or combined with DAC. Conclusion Our data suggests that, in prostate carcinogenesis, MDR1 downregulation is mainly due to histone post-translational modifications. This occurs concomitantly with aberrant promoter methylation, substantiating the association with P-gp decreased expression. PMID:24344919

2013-01-01

301

Identification and characterization of Bph14, a gene conferring resistance to brown planthopper in rice  

PubMed Central

Planthoppers are highly destructive pests in crop production worldwide. Brown planthopper (BPH) causes the most serious damage of the rice crop globally among all rice pests. Growing resistant varieties is the most effective and environment-friendly strategy for protecting the crop from BPH. More than 19 BPH-resistance genes have been reported and used to various extents in rice breeding and production. In this study, we cloned Bph14, a gene conferring resistance to BPH at seedling and maturity stages of the rice plant, using a map-base cloning approach. We show that Bph14 encodes a coiled-coil, nucleotide-binding, and leucine-rich repeat (CC-NB-LRR) protein. Sequence comparison indicates that Bph14 carries a unique LRR domain that might function in recognition of the BPH insect invasion and activating the defense response. Bph14 is predominantly expressed in vascular bundles, the site of BPH feeding. Expression of Bph14 activates the salicylic acid signaling pathway and induces callose deposition in phloem cells and trypsin inhibitor production after planthopper infestation, thus reducing the feeding, growth rate, and longevity of the BPH insects. Our work provides insights into the molecular mechanisms of rice defense against insects and facilitates the development of resistant varieties to control this devastating insect. PMID:20018701

Du, Bo; Zhang, Weilin; Liu, Bingfang; Hu, Jing; Wei, Zhe; Shi, Zhenying; He, Ruifeng; Zhu, Lili; Chen, Rongzhi; Han, Bin; He, Guangcun

2009-01-01

302

De novo large cell neuroendocrine carcinoma of the prostate gland with pelvic lymph node metastasis: a case report with review of literature  

PubMed Central

Neuroendocrine (NE) differentiation in prostate carcinomas can be seen in two settings: as a focal finding in conventional acinar adenocarcinoma, identifiable by immunohistochemical staining, or as a primary NE tumor of the prostate gland, such as carcinoid, small cell carcinoma, or large cell NE carcinoma. Of particular interest is the large cell NE carcinoma, which had been previously reported in isolated cases or in limited case series. In this report, we describe a case of a large cell NE carcinoma diagnosed in a 48-year-old man who presented with difficulty in voiding and urine retention. A cystoscopy revealed an enlarged, elongated prostate with an intra-urethral obstructing mass in the prostatic urethra. Subsequently, a transurethral resection of prostate (TURP) was performed at an outside hospital under the clinical diagnosis of benign prostatic hyperplasia (BPH). Microscopic examination of the TURP specimen revealed several foci of low-grade transitional-zone-type adenocarcinoma corresponding to Gleason score 5 (3 + 2), and a focus of high-grade large cell NE carcinoma. Concurrent x-ray computed tomography scans of the chest, abdomen, and pelvis demonstrated an enlarged left pelvic lymph node, which was biopsied and the patient was diagnosed with metastatic large cell NE carcinoma. He subsequently underwent 8 cycles of neoadjuvant chemotherapy with Lupron, a laparoscopic robotic-assisted radical retropubic prostatectomy, and pelvic lymphadenectomy. He died of widely metastatic prostatic carcinoma with leptomeningeal metastases 13 months after radical prostatectomy. Here, we present a rare case of large cell NE carcinoma with a review of the published literature.

Okoye, Ekene; Choi, Eunice K; Divatia, Mukul; Miles, Brian J; Ayala, Alberto G; Ro, Jae Y

2014-01-01

303

Adrenal medullary hyperplasia. Hyperplasia-pheochromocytoma sequence.  

PubMed

We present a case of unilateral adrenal medullary hyperplasia in a 63-year-old woman with clinical signs and symptoms of pheochromocytoma unassociated with multiple endocrine neoplasia. The surgically removed adrenal gland revealed diffuse medullary hyperplasia with multiple micronodules measuring up to 2 mm. The micronodules were composed of enlarged chromaffin cells with atypia, histologically similar to those of pheochromocytoma, forming small solid alveolar patterns separated by a fibrovascular stroma. Removal of the hyperplastic adrenal gland resulted in disappearance of paroxysmal nocturnal hypertension and palpitation. These results suggest that diffuse and nodular medullary hyperplasia is the precursor of pheochromocytoma. PMID:2260475

Kurihara, K; Mizuseki, K; Kondo, T; Ohoka, H; Mannami, M; Kawai, K

1990-09-01

304

A pilot study on the use of serum glyoxalase as a supplemental biomarker to predict malignant cases of the prostate in the PSA range of 4-20 ng/ml  

PubMed Central

Background & objectives: Serum prostate specific antigen (PSA) though most commonly used for diagnosis of prostate cancer lacks specificity. This study was aimed at exploring the use of serum glyoxalase as a supplemental biomarker to differentiate between malignant vs non-malignant diseases of the prostate in patients with PSA in the range of 4-20 ng/ml. Methods: Serum glyoxalase and PSA were measured in 92 men (30 control, 31 cases of benign prostate hyperplasia (BPH) and 31 cases of adenocarcinoma of prostate). Of the latter group, 11 cases of prostate cancer in the PSA range of 4-20 ng/ml were included for studying the diagnostic utility of combination of both serum PSA and glyoxalase. Results: In prostate cancer cases with PSA in the range of 4-20 ng/ml, the glyoxalase was found to be 233.3 ± 98.6 ?mol/min while for the non-malignant group it was 103.1 ± 19.7 ?mol/min. A cut-off of 19.2 ng/ml PSA showed sensitivity of 9 per cent, specificity of 96.7 per cent, positive predictive value (PPV) of 50 per cent and negative predictive value (NPV) of 75 per cent. A serum glyoxalase cut-off of 141 ?mol/min showed sensitivity of 81.8 per cent, specificity of 100 per cent, PPV of 100 per cent and NPV of 93.9 per cent. Further, ROC analysis showed a significant difference in the area under curve (AUC) for glyoxalase as compared to serum PSA (0.92 vs 0.57; P<0.001). Interpretation & conclusions: Serum glyoxalase appears to be predictive of prostate cancer in the PSA range of 4-20 ng/ml. Studies with larger number of participants would be required to confirm this finding. PMID:22089607

Chavan, Sushant V.; Chavan, Niraj R.; Balaji, Anusha; Trivedi, Vatsala D.; Chavan, Padma R.

2011-01-01

305

Prostate cancer detection using combined auto-fluorescence and light reflectance spectroscopy: ex vivo study of human prostates  

PubMed Central

This study was conducted to evaluate the capability of detecting prostate cancer (PCa) using auto-fluorescence lifetime spectroscopy (AFLS) and light reflectance spectroscopy (LRS). AFLS used excitation at 447 nm with four emission wavelengths (532, 562, 632, and 684 nm), where their lifetimes and weights were analyzed using a double exponent model. LRS was measured between 500 and 840 nm and analyzed by a quantitative model to determine hemoglobin concentrations and light scattering. Both AFLS and LRS were taken on n = 724 distinct locations from both prostate capsular (nc = 185) and parenchymal (np = 539) tissues, including PCa tissue, benign peripheral zone tissue and benign prostatic hyperplasia (BPH), of fresh ex vivo radical prostatectomy specimens from 37 patients with high volume, intermediate-to-high-grade PCa (Gleason score, GS ?7). AFLS and LRS parameters from parenchymal tissues were analyzed for statistical testing and classification. A feature selection algorithm based on multinomial logistic regression was implemented to identify critical parameters in order to classify high-grade PCa tissue. The regression model was in turn used to classify PCa tissue at the individual aggressive level of GS = 7,8,9. Receiver operating characteristic curves were generated and used to determine classification accuracy for each tissue type. We show that our dual-modal technique resulted in accuracies of 87.9%, 90.1%, and 85.1% for PCa classification at GS = 7, 8, 9 within parenchymal tissues, and up to 91.1%, 91.9%, and 94.3% if capsular tissues were included for detection. Possible biochemical and physiological mechanisms causing signal differences in AFLS and LRS between PCa and benign tissues were also discussed. PMID:24877012

Sharma, Vikrant; Olweny, Ephrem O.; Kapur, Payal; Cadeddu, Jeffrey A.; Roehrborn, Claus G.; Liu, Hanli

2014-01-01

306

Preliminary results on diode-laser assisted vaporization of prostate tissue  

NASA Astrophysics Data System (ADS)

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

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

2007-07-01

307

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

E-print Network

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

Paxton, Anthony T.

308

[Use of alpha1-adrenergic blockaders in treating voiding disorders after transurethral resection of the prostate].  

PubMed

Removal of infravesicular obstruction by transurethral resection (TUR) of the prostate rapidly eradicates obstructive symptoms but irritative symptoms persist. We studied the effect of alpha 1-adrenoblockers (A1AB) in respect of optimization of TUR effects. The trial was performed in 1998-2002 and included 197 patients treated surgically (TUR) for benign prostatic hyperplasia (BPH). 96 patients received no A1AB in the postoperative period (group 1). 52 patients took terazosine (group 2) and 49 patients were given tansulosine (group 3). IPSS symptoms and QoL estimation were registered monthly, the patients recorded the urination. After 3 and 6 months after TUR, maximal urination rate (MUR) and residual urine were assessed. It was found that MUR and QoL did not differ significantly between the groups but in groups 2 and 3 a fall in the overall score by IPSS was greater. The positive symptomatic improvement was achieved due to relief of the symptoms of urinary bladder filling corresponding to an increase in physiological capacity of the organ, the difference being significant (p < 0.05). PMID:12518670

Martov, A G; Gushchin, B L; Oshchepkov, V N; Ergakov, D V

2002-01-01

309

Cross-talk between Paracrine-Acting Cytokine and Chemokine Pathways Promotes Malignancy in Benign Human Prostatic Epithelium  

Microsoft Academic Search

The present study explores the mechanisms by which human prostatic carcinoma-associated fibroblasts (CAF) induce tu- morigenesis in initiated but nonmalignant human prostatic epithelial cells (BPH-1). CAF express elevated levels of both transforming growth factor-B1(TGF- B1) and stromal cell- derived factor-1 (SDF-1\\/CXCL12). TGF-B inhibits the growth of BPH-1cells in vitro, but was found to be necessary for the tumorigenic response to

Mingfang Ao; Omar E. Franco; Dayanidhi Raman; Karin Williams; Simon W. Hayward

310

No Detection of XMRV in Blood Samples and Tissue Sections from Prostate Cancer Patients in Northern Europe  

PubMed Central

Background We recently published the rare detection of xenotropic murine leukemia virus-related virus (XMRV) (1/105) in prostate cancer (PCA) tissue of patients in Northern Europe by PCR. The controversial discussion about the virus being detected in PCA tissue, blood samples from patients suffering from chronic fatigue syndrome (CFS), as well as from a significant number of healthy controls prompted us to deepen our studies about detection of XMRV infection applying different detection methods (PCR, cocultivation and immunohistochemistry [IHC]). Methodology/Principal Findings Peripheral blood mononuclear cells (PBMCs) from 92 PCA and 7 healthy controls were isolated, PHA activated and cocultivated with LNCaP cells for up to 8 weeks. Supernatant of these cells was applied to a reporter cell line, DERSE-iGFP. Furthermore, the PBMCs and cocultivated LNCaP cells were tested for the presence of XMRV by PCR as well as Western Blot analysis. While all PCR amplifications and Western Blot analyses were negative for signs of XMRV infection, DERSE-iGFP cells displayed isolated GFP positive cells in three cases. In all three cases XMRV presence could not be confirmed by PCR technology. In addition, we performed XMRV specific IHC on PCA tissue sections. Whole tissue sections (n?=?20), as well as tissue microarrays (TMA) including 50 benign prostate hyperplasia (BPH), 50 low grade and 50 high grade PCA sections and TMAs including breast cancer, colon cancer and normal tissues were stained with two XMRV specific antisera. XMRV protein expression was not detected in any cancer sections included. One BPH tissue displayed XMRV specific protein expression in random isolated basal cells. Conclusion We were unable to conclusively detect XMRV in the blood from PCA patients or from healthy controls and there is no conclusive evidence of XMRV protein expression in PCA, breast cancer and colon cancer tissue sections tested by IHC staining. PMID:22022417

Stieler, Kristin; Schindler, Sarah; Schlomm, Thorsten; Hohn, Oliver; Bannert, Norbert; Simon, Ronald; Minner, Sarah; Schindler, Michael; Fischer, Nicole

2011-01-01

311

p27Kip1 deficiency promotes prostate carcinogenesis but does not affect the efficacy of retinoids in suppressing the neoplastic process  

PubMed Central

Background p27 is a cell cycle suppressor gene, whose protein is a negative regulator of cyclin/cdk complexes. p27 is also a potential target of retinoids in cancer prevention studies. In benign prostate hyperplasia (BPH), and in most carcinomas, p27Kip1 is down-regulated, suggesting its potential resistance to retinoids. To test this hypothesis, we examined the efficacy of 9-cis retinoic acid (9cRA) to suppress prostate cell proliferation (PECP) and carcinogenesis in p27Kip1 deficient mice. Methods p27Kip1 deficient (-/-), heterozygous (+/-) and homozygous (+/+) mice were treated for 7 days with testosterone, 9cRA, or with both, and cell proliferation in dorsolateral prostate (DLP) was determined by BrdU labeling. Prostate carcinogenesis was induced by N-Methyl-N-Nitrosourea (MNU) and hormone stimulation. Results PECP in DLP of two-month-old mice of all genotypes was similar but significantly increased in old p27-/- mice only. Testosterone treatment increased PECP in all three p27 genotypes with the highest values in p27-/- mice. p27Kip1 deficiency did not affect the response of PEC to 9cRA and to 9cRA+testosterone. The decrease of p27Kip1 in p27+/- and p27-/- mice progressively increased the incidence and frequency of PIN and tumors. 9cRA suppressed PIN in all three p27 genotypes and this was associated with decreased PECP and increased cellular senescence. Conclusions This data indicates that p27Kip1 deficiency promotes prostate cell proliferation and carcinogenesis but does not affect 9cRA's potential to suppress prostate carcinogenesis, suggesting that patients with PIN and carcinomas lacking or having a low level of p27Kip1 expression may also benefit from clinical trials with retinoids. PMID:20932324

2010-01-01

312

iTRAQ Identification of Candidate Serum Biomarkers Associated with Metastatic Progression of Human Prostate Cancer  

PubMed Central

A major challenge in the management of patients with prostate cancer is identifying those individuals at risk of developing metastatic disease, as in most cases the disease will remain indolent. We analyzed pooled serum samples from 4 groups of patients (n?=?5 samples/group), collected prospectively and actively monitored for a minimum of 5 yrs. Patients groups were (i) histological diagnosis of benign prostatic hyperplasia with no evidence of cancer ‘BPH’, (ii) localised cancer with no evidence of progression, ‘non-progressing’ (iii) localised cancer with evidence of biochemical progression, ‘progressing’, and (iv) bone metastasis at presentation ‘metastatic’. Pooled samples were immuno-depleted of the 14 most highly abundant proteins and analysed using a 4-plex iTRAQ approach. Overall 122 proteins were identified and relatively quantified. Comparisons of progressing versus non-progressing groups identified the significant differential expression of 25 proteins (p<0.001). Comparisons of metastatic versus progressing groups identified the significant differential expression of 23 proteins. Mapping the differentially expressed proteins onto the prostate cancer progression pathway revealed the dysregulated expression of individual proteins, pairs of proteins and ‘panels’ of proteins to be associated with particular stages of disease development and progression. The median immunostaining intensity of eukaryotic translation elongation factor 1 alpha 1 (eEF1A1), one of the candidates identified, was significantly higher in osteoblasts in close proximity to metastatic tumour cells compared with osteoblasts in control bone (p?=?0.0353, Mann Whitney U). Our proteomic approach has identified leads for potentially useful serum biomarkers associated with the metastatic progression of prostate cancer. The panels identified, including eEF1A1 warrant further investigation and validation. PMID:22355332

Glen, Adam; Cross, Simon S.; Eaton, Colby L.; Down, Jenny; Pesce, Giancarlo; Phillips, Joshua T.; Yen, Ow Saw; Thalmann, George N.; Wright, Phillip C.; Hamdy, Freddie C.

2012-01-01

313

Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction  

PubMed Central

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

Thiruchelvam, Nikesh

2014-01-01

314

A head-mounted display-based personal integrated-image monitoring system for transurethral resection of the prostate  

PubMed Central

The head-mounted display (HMD) is a new image monitoring system. We developed the Personal Integrated-image Monitoring System (PIM System) using the HMD (HMZ-T2, Sony Corporation, Tokyo, Japan) in combination with video splitters and multiplexers as a surgical guide system for transurethral resection of the prostate (TURP). The imaging information obtained from the cystoscope, the transurethral ultrasonography (TRUS), the video camera attached to the HMD, and the patient's vital signs monitor were split and integrated by the PIM System and a composite image was displayed by the HMD using a four-split screen technique. Wearing the HMD, the lead surgeon and the assistant could simultaneously and continuously monitor the same information displayed by the HMD in an ergonomically efficient posture. Each participant could independently rearrange the images comprising the composite image depending on the engaging step. Two benign prostatic hyperplasia (BPH) patients underwent TURP performed by surgeons guided with this system. In both cases, the TURP procedure was successfully performed, and their postoperative clinical courses had no remarkable unfavorable events. During the procedure, none of the participants experienced any HMD-wear related adverse effects or reported any discomfort.

Yoshida, Soichiro; Takeshita, Hideki; Fujii, Yasuhisa

2014-01-01

315

A head-mounted display-based personal integrated-image monitoring system for transurethral resection of the prostate.  

PubMed

The head-mounted display (HMD) is a new image monitoring system. We developed the Personal Integrated-image Monitoring System (PIM System) using the HMD (HMZ-T2, Sony Corporation, Tokyo, Japan) in combination with video splitters and multiplexers as a surgical guide system for transurethral resection of the prostate (TURP). The imaging information obtained from the cystoscope, the transurethral ultrasonography (TRUS), the video camera attached to the HMD, and the patient's vital signs monitor were split and integrated by the PIM System and a composite image was displayed by the HMD using a four-split screen technique. Wearing the HMD, the lead surgeon and the assistant could simultaneously and continuously monitor the same information displayed by the HMD in an ergonomically efficient posture. Each participant could independently rearrange the images comprising the composite image depending on the engaging step. Two benign prostatic hyperplasia (BPH) patients underwent TURP performed by surgeons guided with this system. In both cases, the TURP procedure was successfully performed, and their postoperative clinical courses had no remarkable unfavorable events. During the procedure, none of the participants experienced any HMD-wear related adverse effects or reported any discomfort. PMID:25562008

Yoshida, Soichiro; Kihara, Kazunori; Takeshita, Hideki; Fujii, Yasuhisa

2014-12-01

316

Prostatic intraepithelial neoplasia and prostate cancer.  

PubMed

Prostatic intraepithelial neoplasia (PIN) is composed of dysplastic cells with a luminal cell phenotype, expressing the androgen receptor as well as prostate specific antigen. PIN is characterized by progressive abnormalities of phenotype which are intermediate between normal prostatic epithelium (NP) and cancer, indicating impairment of cell differentiation and regulatory control with advancing stages of carcinogenesis. High-grade PIN is considered the most likely precursor of prostatic carcinoma (PCa), according to virtually all available evidence. Androgen deprivation decreases the prevalence and extent of PIN and the degree of capillary vascularization (e.g., angiogenesis) in the surrounding stroma via the suppression of vascular endothelial growth factor (VEGF) production. It is likely that PCa might also arise from precursor lesions other than high-grade PIN (low-grade PIN, atypical adenomatous hyperplasia, malignancy-associated foci, and atrophy). PMID:12094135

Montironi, R; Santinelli, A; Mazzucchelli, R

2002-09-01

317

Treating prostate cancer: a rationale for targeting local oestrogens  

Microsoft Academic Search

Prostate cancer is the most commonly diagnosed cancer and the second most common cause of cancer-related death in men, and benign prostatic hyperplasia is the most common benign condition known to occur in ageing men. Oestrogen has been implicated in the development of prostate cancer, and offers a promising new avenue for treatment. Despite this, the role of oestrogens in

Stuart J. Ellem; Gail P. Risbridger

2007-01-01

318

COMMENTARY Androgen Deprivation as a Strategy for Prostate Cancer Chemoprevention  

Microsoft Academic Search

Androgens are required for the normal development and function of the prostate gland. Prostate cancer and benign pros- tatic hyperplasia are common in men and develop in an envi- ronment of continuous androgen exposure. The utility of andro- gen deprivation as a treatment for advanced prostate cancer was first demonstrated in 1941 (1), and many new classes of drugs that

Joseph W. Aquilina; James J. Lipsky; David G. Bostwick

319

A prospective trial of GreenLight PVP (HPS120) versus transurethral resection of the prostate in the treatment of lower urinary tract symptoms in Ontario, Canada  

PubMed Central

Background: Photoselective vaporization of the prostate (PVP) is a bloodless, relatively painless alternative to transurethral resection of the prostate (TURP) for relief of lower urinary tract symptoms (LUTS) in benign prostatic hyperplasia (BPH). Objective: We compare the effectiveness, safety and cost-effectiveness of Greenlight Laser PVP (HPS-120) and TURP. Methods: We conducted a prospective, non-randomized trial in 3 Ontario centres from March 2008 to February 2011. Assessments were completed at baseline, 1 and 6 months following surgery at the physicians’ offices and at 12 and 24 months by phone. The primary outcome was the change in International Prostate Symptoms Score (IPSS) score at 6 months versus baseline. Secondary outcomes were changes in flow rate, postvoid residual (PVR), prostate-specific antigen (PSA) and sexual health inventory for men (SHIM) scores. Adverse events, health-related quality of life (HRQoL), resource utilization and productivity losses were collected. Results: Although the IPSS decreased in both arms (n = 140 for PVP and n = 24 for TURP) between baseline and 6 months, the difference in change over time between the groups was not statistically significant (p = 0.718). Other outcomes improved equally from baseline and 6 months (Qmax, SHIM, PSA and HRQoL), with only changes in PVR favouring PVP (p = 0.018). There were no statistical differences in serious adverse events. In total, 130 of 140 PVP patients were outpatients, all TURP subjects were inpatients. PVP was less costly than TURP ($3891 vs. $4863; p < 0.001) with similar quality-adjusted life years (0.448 vs. 0.441; p = 0.658). Conclusion: Greenlight Laser PVP (HPS-120) is a safe and cost-effective alternative to TURP for outpatient treatment of LUTS and can be completed as an outpatient with minimal blood loss. PMID:24319513

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

2013-01-01

320

Immunolocalization of 3?-hydroxysteroid dehydrogenase in normal and hyperplastic ram prostates  

Microsoft Academic Search

The enzyme 3?-hydroxysteroid dehydrogenase (3?-HSD) is essential in the synthesis of all steroids by cleaving dehydroepiandrosterone to androstenedione. In the present study, 3?-HSD immunoreactivity was investigated in the prostate of Akkaraman breed rams aged older than 3 years. Five normal and five hyperplastic ram prostates were processed for immunohistochemistry. Prostate hyperplasia was determined by histopathological evaluation of 375 ram prostate

Murat Yarim; Siyami Karahan; Nalan Kabakci; Tar?k Atmaca

2006-01-01

321

Quantitative analysis of prostate specific antigen isoforms using immunoprecipitation and stable isotope labeling mass spectrometry.  

PubMed

Prostate specific antigen (PSA) is a widely used serum marker for prostate cancer (PCa), but has limited specificity for distinguishing early PCa from benign prostatic hyperplasia (BPH). Recently, proPSAs, comprised of native proPSA, as well as truncated proPSA forms, [-2] proPSA, [-5] proPSA, and [-7] proPSA, have been shown to be better diagnostic targets than PSA for PCa. Stable isotope labeling-multiple reaction monitoring mass spectrometry (SIL/MRM-MS) has been frequently used to measure low-abundance biomarkers in tissues and biofluids, owing to its high sensitivity and specificity, simplicity, and multiplexing capability. In this study, we have developed and optimized a strategy using immunoprecipitation in conjunction with SIL/MRM-MS assay which is capable of sensitive and accurate quantification of proPSA in serum. Since serum and plasma are by far the most complex biological fluids, the immunoprecipitation workflow was optimized to achieve sufficient sensitivity, efficiencies of protein purification with immunoaffinity depletion were determined. The developed strategy can detect proPSA and PSA with a limit of detection (LOD) and limit of quantitation (LOQ) at nanogram per milliliter levels, corresponding to a concentration 6 orders-of-magnitude lower than the most abundant serum proteins. Furthermore, the simultaneous measurement of multiple biomarkers, including the mature and precursor forms of PSA, can be achieved in a single multiplexed analysis using LC/MRM-MS. The strategy demonstrated here provides an attractive alternative to ELISAs or RIAs for the reliably measurement of proPSA to improve the specificity of PCa diagnosis. PMID:25427836

Chen, Yi-Ting; Tuan, Li-Ping; Chen, Hsiao-Wei; Wei, I-An; Chou, Min-Yuan; Chen, Han-Min; Tyan, Yu-Chang; Chen, Sung-Fang

2015-01-01

322

Protective effect of tadalafil on the functional and structural changes of the rat ventral prostate caused by chronic pelvic ischemia  

PubMed Central

Background The etiology of Benign Prostatic Hyperplasia (BPH), a common among aged men, is not fully understood, however, in addition to androgens and aging, chronic ischemia has been proposed to contribute. Using an established rat model, we investigated whether chronic ischemia alters the structural and functional properties of the ventral rat prostate, and whether phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) may have a protective action. Methods Adult male Sprague-Dawley rats were divided into control, arterial endothelial injury (AI), and AI with tadalafil treatment (AI-tadalafil) groups. AI and AI-tadalafil groups underwent endothelial injury of the iliac arteries and received a 2% cholesterol diet following AI. AI-tadalafil rats were treated with tadalafil (2?mg/kg/day) orally for 8 weeks after AI. The control group received a regular diet. After 8 weeks, animals were sacrificed, and pharmacological and morphological studies on prostate tissues were performed. Results Iliac arteries from AI rats displayed neo-intimal formation and luminal occlusion, an effect that was not prevented by tadalafil treatment. In the AI group, there was an obvious epithelial atrophy and a statistically significant increase in collagen fibers compared with the controls. Immunohistochemically, there was an up-regulation of smooth muscle ?-actin (SMA). Contractile responses of prostate strips to KCl, electrical field stimulation (EFS), and phenylephrine (PE) were significantly higher after AI than in controls. Chronic treatment with tadalafil prevented the increase in contractile responses in ischemic tissue, and decreased the collagen deposition compared with the AI group. Conclusions In this rat model, chronic pelvic ischemia caused distinct functional and morphological changes in the prostate. Prostatic tissue from ischemic animals showed an increased contractile response to electrical and pharmacological stimulation, an increase in SMA, and an increased deposition of collagen. All these changes could be prevented by treatment with the PDE5 inhibitor, tadalafil, suggesting an involvement of cyclic guanosine monophosphate (cGMP). Prostate 75:233–241, 2015. © 2014 The Authors. The Prostate Published by Wiley Periodicals, Inc. PMID:25327615

Zarifpour, Mona; Nomiya, Masanori; Sawada, Norifumi; Andersson, Karl-Erik

2015-01-01

323

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

NASA Astrophysics Data System (ADS)

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

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

2013-02-01

324

Doxazosin treatment in patients with prostatic obstruction. A double-blind placebo-controlled study.  

PubMed

The safety and efficacy of the selective alpha 1-blocking agent doxazosin 4 mg once daily in the symptomatic treatment of benign prostatic hyperplasia were evaluated in a randomized, double-blind and placebo-controlled 9-week study of 100 patients. By patients' overall assessment of voiding difficulties, 79% in the doxazosin group (DG) and 44% in the placebo group (PG) reported improvement (p = 0.001). In the DG, improvement was noted in 63% of obstructive symptoms compared to 32% in the PG (p = 0.015), whereas improvement was noted in 76% and 45%, respectively, of irritative symptoms (p = 0.12). Daytime frequency was reduced by 1.5 in the DG and increased by 0.3 in the PG (p = 0.001), and nocturia was reduced by 1.1 and 1.0, respectively (p = 0.12). Maximum urinary flow rate was improved by 1.5 ml/s in the DG, while it deteriorated by 0.3 ml/s in the PG (p = 0.11). Considering postvoid residual urine volume, cystometry variables (first sensation and bladder capacity) and adverse events there was no difference between the two groups. In conclusion, doxazosin 4 mg once daily is safe and effective in relieving symptoms in patients with BPH. PMID:7684157

Christensen, M M; Bendix Holme, J; Rasmussen, P C; Jacobsen, F; Nielsen, J; Nørgaard, J P; Olesen, S; Noer, I; Wolf, H; Husted, S E

1993-01-01

325

Prostate Adenocarcinoma  

Cancer.gov

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

326

Engrailed-2 protein as a potential urinary prostate cancer biomarker: a comparison study before and after digital rectal examination.  

PubMed

This study was designed to compare and evaluate the presence of engrailed-2 (EN2) protein in urine collected before and after prostate massage as a diagnostic marker for prostate cancer (PCa). We analysed and compared 76 urine samples (38 before and 38 after prostate massage) from the benign group (BPH) and 66 urine samples (33 before and 33 after prostate massage) from patients with PCa confirmed by prostate biopsy. EN2 levels from the PCa and men with BPH (age range 50-82) were related to the tumour stage, Gleason score and prostate-specific antigen. EN2 levels were determined by enzyme-linked immunosorbent assay in urine. The median EN2 levels in urine after prostate massage were significantly different from those determined in urine before prostate massage (1.25 ng/ml in the PCa group and 0.34 ng/ml in the BPH). The mean EN2 levels in PCa patients were 3.76-fold higher than those in non-PCa patients after prostate massage. The distinct influence of prostate massage on EN2 levels was found to be related to the Gleason score and tumour stage. EN2 may be considered a marker of PCa with certain limitations, such as those related to tumour staging. The specificity and sensitivity of the protocol are highly dependent on prostate massage. PMID:25003607

Marsza??, Micha? Piotr; Sroka, Wiktor; Adamowski, Marek; S?upski, Piotr; Jarzemski, Piotr; Siódmiak, Joanna; Odrow??-Sypniewska, Gra?yna

2015-01-01

327

Unusual histopathological diagnosis of prostatic blue nevus: a case report  

PubMed Central

Introduction Prostatic blue nevus was first described as a benign lesion of uncertain and controversial histogenesis by Nogogosyan in 1963. Currently, 30 cases have been reported in the world literature. Case presentation A 63-year-old Hispanic man presented with prostatism of several months’ evolution. Histopathological examination revealed a blue nevus associated with nodular hyperplasia and acute inflammation. Conclusion Prostatic blue nevus is a rare and unusual, histologically benign prostatic lesion with limited clinical significance and a favorable prognosis. PMID:24377954

2013-01-01

328

Racial Differences in Longitudinal Changes in Serum Prostate-Specific Antigen Levels: The Olmsted County Study and The Flint Men’s Health Study  

PubMed Central

Objective To determine the distribution of and racial differences in changes in PSA from a population-based sample of men. Materials and Methods Data from two prospective cohort studies of a random sample of Caucasian men, ages 40–79 in 1990, followed biennially through 2007 and African-American men, ages 40–79 in 1996, followed through 2000 were examined to assess longitudinal changes in PSA concentrations. Serum PSA levels were determined at each examination for both cohorts and observations after a diagnosis of prostate cancer or treatment for benign prostatic hyperplasia (BPH) were censored. Observed and estimated annual percentage change in serum PSA levels were examined by race. Results At baseline, the median PSA level in Caucasian men did not differ from the median level observed in African-American men (Caucasian men: 0.9 ng/mL; African-American men: 0.9 ng/mL; P value=0.48). However, African-American men had a much more rapid increase in PSA level over time compared to Caucasian men (median annual percent change in PSA Caucasian men: 3.6%/year; African-American men: 7.9%/year; P value<0.001). Conclusion These data suggest that African-American men have more rapid rates of change in PSA levels over time. If the difference in rate of changes between African-American and Caucasian men is an early indicator of future prostate cancer diagnosis, earlier detection in African-American men could help to alleviate the racial disparities in prostate cancer diagnosis and mortality. PMID:24139354

Sarma, Aruna V.; St. Sauver, Jennifer L.; Jacobson, Debra J.; McGree, Michaela E.; Klee, George G.; Lieber, Michael M.; Girman, Cynthia J.; Hollingsworth, John M.; Jacobsen, Steven J.

2013-01-01

329

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

PubMed

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

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

1996-01-01

330

Congenital adrenal hyperplasia  

MedlinePLUS

... or inappropriately). Congenital adrenal hyperplasia can affect both boys and girls. About 1 in 10,000 to 18,000 ... penis but normal testes Well-developed muscles Both boys and girls will be tall as children but much shorter ...

331

Crinum Latifolium Leave Extracts Suppress Immune Activation Cascades in Peripheral Blood Mononuclear Cells and Proliferation of Prostate Tumor Cells  

PubMed Central

Plants of the genus Crinum (Amaryllidaceae) are widely used in folk medicine in different tropical and subtropical regions around the world. The Indian species Crinum latifolium (L.) was traditionally used to treat rheumatism, fistula, tumors, earaches, rubefacient, tubercle and whitlow. In Vietnamese and Chinese traditional medicine Crinum latifolium preparations are used until nowadays because of their antiviral and antitumor properties. In this study, we demonstrate potent in vitro antioxidant activity of an aqueous Crinum latifolium extract by an oxygen radical absorbance capacity (ORAC) value of 1610 ± 150 ?mol Trolox equivalents/g. Furthermore, significant anti-inflammatory effects of this extract were shown by its potential to suppress indoleamine 2,3-dioxygenase (IDO) mediated tryptophan degradation in unstimulated- and mitogen-stimulated PBMC at IC50 doses of 241 ± 57 ?g/ml and 92 ± 20 ?g/ml, respectively. Concentrations of the immune activation marker neopterin were slightly diminished in unstimulated PBMC, whereas a dose-dependent inhibition of neopterin formation was observed in mitogen-stimulated PBMC (IC50 = 453 ± 86 ?g/ml). Additionally, we measured also dose-dependent inhibitory effects of this aqueous Crinum latifolium extract on cell proliferation of highly metastatic human prostate carcinoma PC3 cells (IC50 = 4.5 ± 0.8 mg/ml), androgen-sensitive prostate adenocarcinoma LNCaP cells (IC50 =2.3 ± 0.1 mg/ml), and benign prostate hyperplasia BPH-1 cells (IC50 = 2.1 ± 0.04 mg/ml). We conclude that both effects, inhibition of tumor cell growth and recovery of immune functions, are important for the antitumor properties of Crinum latifolium. PMID:21773069

Jenny, Marcel; Wondrak, Angela; Zvetkova, Elissaveta; Tram, Nguyen Thi Ngoc; Phi, Phan Thi Phi; Schennach, Harald; Culig, Zoran; Ueberall, Florian; Fuchs, Dietmar

2011-01-01

332

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

PubMed Central

Objective. Inflammation is an important hallmark of all cancers and net inflammatory response is determined by a delicate balance between pro- and anti-inflammatory cytokines, which may be affected by tobacco exposure, so the present study was designed to explore the effect of various modes of tobacco exposure on interleukin-12 (IL-12) and interleukin-10 (IL-10) inflammatory cytokine levels and survival in prostate carcinoma (PCa) patients. Methods. 285 cancer patients and equal controls with 94 BPH (benign prostatic hyperplasia) were recruited; baseline levels of serum IL-12 and IL-10 were measured and analyzed in various tobacco exposed groups by appropriate statistical tool. Five-year survivals of patients were analyzed by Log-rank (Mantel-Cox) test (graph pad version 5). Results. The expression of serum proinflammatory (IL-12) and anti-inflammatory (IL-10) cytokines was correlated with tobacco exposed group as smokers, chewers, and alcohol users have shown significantly higher levels (P < 0.001) with significantly lower median survivals (27.1 months, standard error = 2.86, and 95% CI: 21.4–32.62); than nonusers. Stages III and IV of tobacco addicted patients have also shown significantly increased levels of IL-12 and IL-10. Conclusions. IL-12 and IL-10 seem to be affected by various modes of tobacco exposure and inflammation also affects median survival of cancer patients. PMID:25177683

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

2014-01-01

333

Bladder consequences of prostatic obstruction.  

PubMed

The development of new imaging techniques has improved our knowledge of the cross-sectional anatomy of the pelvis and thereby our understanding of the bladder's response to prostatic obstruction. It is now known that changes in the bladder are intimately linked to the development of irritative and obstructive symptoms of BPH. This paper illustrates the anatomical changes within the pelvic region that can develop as a consequence of prostatic enlargement. The anatomical position of the prostate is such that its enlargement inevitably affects neighbouring organs. Enlargement of the median lobe can cause irritation of the trigone and the physical trapping of urine behind the lobe. The urethra may also become mechanically obstructed leading to an increase in the detrusor muscle mass as it struggles to overcome the restriction of the bladder outlet. In time, a change in the collagen to muscle ration in favour of collagen may develop, with the consequence that bladder compliance is reduced and the ability to increase volume without increasing pressure is diminished. Thereafter one of two scenarios may develop: the 'high pressure conflict' bladder or the 'distended low pressure' bladder. Urinary disturbance in BPH therefore results from an inadequate balance between bladder contractility and urethral resistance. PMID:9218936

Mauroy, B

1997-01-01

334

Further observations on the effect of local hyperthermia on benign enlargement of the prostate  

Microsoft Academic Search

Previous studies have indicated that local hyperthermia applied to the prostate may be of considerable help in the relief of obstructive signs and clinical symptoms in patients with cancer of the prostate as well as in cases with benign hyperplasia and chronic abacterial prostatitis. The purpose of the present study was to conduct a prospective, randomized multicenter trial to evaluate

C. Servadio; A. Lindner; A. Lev; Z. Leib; Y. Siegel; Z. Braf

1989-01-01

335

[Interstitial laser coagulation of the prostate in patients with prostatic hypertrophy: preliminary results with medium-term follow-up].  

PubMed

Although transurethral resection of the prostate (TURP) is the gold standard for treatment of BPH, a new, minimally invasive technique, called Interstitial Laser Coagulation (ILC), introduced by Muschter and Hofstetter, has been developed to treat BPH. ILC is base on the coagulation of prostatic tissue by means of diffused laser light using a diode laser system with a temperature feed-back (Indigo Medical 830e TM). We report our results in treating 20 patients with BPH and Bladder Outlet Obstruction (BOO), after a mean follow-up of 7 months. To define the indication for treatment and to monitor the success, urinary flow-rate (Omax), I-PSS symptoms score, residual urinary volume and prostate volume determined by ultrasound were recorded before treatment and after 3, 6, 12 months. Transurethrally, under spinal or regional anaesthesia, 2 or 3 insertions of the laser fibre in each prostatic lobe were performed beginning at the apex directly proximal to the bladder neck, made at 1 cm intervals, using a modified model Olympus cystoscope. After 6 months, Qmax increased from 6, 7 ml/sec to 11, 3 ml/sec; I-PSS score decreased from 18 to 8; residual urinary volume from 130 ml to 40 ml, prostate volume decreased from 60 to 48 ml. In selected cases, urodynamic evaluation was performed before and after treatment. Urodynamic findings were classified according Shafer diagram to grade B.O.O.: the score was 4 before treatment and 2 after 6 months. We observed UTI in 3 cases, retrograde ejaculation and acute urinary retention in 1 case, transitory irritative and obstructive syndrome in 8 cases after treatment. ILC is a simple, safe and effective treatment for BPH with significant improvements in both objective and subjective parameters. It is cheaper than others mini-invasive therapies and is able to treat any prostate volume, saving urethra and sexual function. PMID:9707768

Baldassari, M; Galosi, A B; Cristalli, A F; Servi, L; Polito, M

1998-06-01

336

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

Microsoft Academic Search

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

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

2004-01-01

337

Fibroblast growth factor 8 isoform B overexpression in prostate epithelium: a new mouse model for prostatic intraepithelial neoplasia.  

PubMed

Fibroblast growth factor 8 isoform b (FGF8b), a mitogenic and transforming polypeptide, was demonstrated to be naturally up-regulated in prostatic premalignant and malignant lesions in men. We generated four independent lines of transgenic mice with targeted overexpression of FGF8b in the prostatic epithelium using an improved rat probasin promoter, ARR(2)PB. Transgene expression in the prostate tissue was readily demonstrated by reverse transcription-PCR and localized to the prostatic epithelium by in situ hybridization. The histopathology of the prostate tissues was followed in different age groups of the various lines but most extensively in one line (line 3), starting from 1 month of age up to 24 months. Prostatic hyperplasia appeared in the lateral and ventral prostates in some animals as early as 2-3 months and in other lobes between 6 and 16 months. Beginning at 5-7 months, dysplasia, akin to what may be considered low-grade prostatic intraepithelial neoplasia (LGPIN) in humans, was detected. During the first 14 months, 100% of animals exhibited multifocal epithelial hyperplasia; 35% also had areas of LGPIN. This profile changed in subsequent months (15-24 months) to a higher incidence of LGPIN (66%) along with high-grade PIN (HGPIN) lesions (51%). Similar to HGPIN, stromal proliferation and appearance of papillary hyperplasia with atypia displayed a delayed pattern. The affected stroma consisted primarily of the smooth muscle cell component. The incidence of chronic inflammation, mostly involving T cells, was higher in the prostate of the transgenic mice relative to controls; however, the presence of a direct correlation between inflammation and hyperplasia or preneoplastic lesions was not identified. These transgenic mice represent a "natural" animal model for investigating the mechanism of development and progression of prostatic diseases, such as prostatic hyperplasia and preneoplastic lesions. PMID:12208767

Song, Zhigang; Wu, Xiantuo; Powell, William C; Cardiff, Robert D; Cohen, Michael B; Tin, Robert T; Matusik, Robert J; Miller, Gary J; Roy-Burman, Pradip

2002-09-01

338

Successful minimally-invasive management of a case of giant prostatic hypertrophy associated with recurrent nephrogenic adenoma of the prostate  

PubMed Central

Background Benign Prostatic Hypertrophy (BPH) is said to affect at least a third of men over 60. However, the literature contains fewer than 200 reports of prostates over 200g in mass - Giant Prostatic Hypertrophy (GPH). Nephrogenic adenomas are benign lesions of the urinary tract that are believed to represent the local proliferation of shed renal tubular cells implanting at sites of urothelial injury. Case presentation We present the first case in the literature of these two rare pathologies co-existing in the same patient and the successful management and 36-month follow-up of the patient’s symptoms with minimally invasive therapy, including the still-uncommon selective prostatic artery embolisation. We also briefly discuss the role of PAX2 in injured renal tissues and nephrogenic adenomas. Conclusions Symptomatic Giant Prostatic Hypertrophy (GPH) can be successfully managed with a combination of serial TURPs, 5 ?-reductase inhibition and selective prostatic artery embolisation (SPAE). PMID:23565707

2013-01-01

339

Symptomatic and urodynamic responses in patients with reduced or no seminal emission during silodosin treatment for LUTS and BPH  

PubMed Central

Data from phase 3 studies (NCT00224107, NCT00224120) of silodosin for treatment of BPH symptoms were analyzed to examine the relationship between treatment efficacy and occurrence of abnormal ejaculation. Men aged ?50 years with International Prostate Symptom Scores (IPSS) ?13 and peak urinary flow rates (Qmax) of 4–15?ml?s?1 received placebo or silodosin 8?mg once daily for 12 weeks. Silodosin-treated patients were stratified by absence or presence of ‘retrograde ejaculation' (RE). Groups were compared using analysis of covariance (for change from baseline) and responder analyses. Of the 466 patients receiving silodosin, 131 (28%) reported RE and 335 (72%) did not; 4 of the 457 patients receiving placebo (0.9%) reported RE. Most RE events in silodosin-treated patients (110/134; 82%) were reported as ‘orgasm with absence of seminal emission.' Silodosin-treated patients with (+) and without (?) RE showed significant improvement in IPSS, Qmax and quality of life versus placebo (P<0.02). RE+ patients versus RE? patients experienced numerically greater improvement, but differences were not statistically significant (P>0.05). For RE+ patients, the odds of achieving improvement of ?3 points in IPSS and ?3?ml?s?1 in Qmax by study end were 1.75 times those for RE? patients (P=0.0127). Absence of seminal emission may predict superior treatment efficacy of silodosin in individual patients. PMID:21135869

Roehrborn, C G; Kaplan, S A; Lepor, H; Volinn, W

2011-01-01

340

Effect of the androgen receptor CAG repeat polymorphism on transcriptional activity: specificity in prostate and non-prostate cell lines  

Microsoft Academic Search

The action of androgens is essential for the development of benign prostatic hyperplasia and carcinoma of the prostate. The androgen receptor is a ligand-dependent nuclear transcription factor. The transcriptional activation domain of the androgen receptor gene contains a polymorphic CAG repeat sequence. A shorter CAG repeat sequence within the normal range has been reported to be associated with increased risk

J Beilin; EMA Balll; J M Favaloro; J D Zajac

2000-01-01

341

Hypertrichosis with hereditary gingival hyperplasia  

PubMed Central

Two cases of infantile hypertrichosis who subsequently developed oral abnormalities are described. In one case generalized gingival hyperplasia was associated with retarded eruption of deciduous and permanent teeth and macrodontia. In the second case the mucosal hyperplasia was limited to the palatal surface. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7 PMID:4834021

Winter, G. B.; Simpkiss, M. J.

1974-01-01

342

Treatment with finasteride preserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebo-controlled clinical trial  

Microsoft Academic Search

Objectives. To evaluate prostate cancer detection and prostate-specific antigen (PSA) among men with benign prostatic hyperplasia treated with finasteride.Methods. Three thousand forty men 45 to 78 years of age with PSA less than 10 ng\\/mL and no history of prostate cancer were randomized in a double-blind, placebo-controlled trial to finasteride (n = 1524) or placebo (n = 1516) for up

G. L. Andriole; H. A. Guess; J. I. Epstein; H. Wise; D. Kadmon; E. D. Crawford; P. Hudson; C. L. Jackson; N. A. Romas; L. Patterson; T. J. Cook; J. Waldstreicher

1998-01-01

343

Enhanced radiofrequency ablation of canine prostate utilizing a liquid conductor: the virtual electrode.  

PubMed

Conventional radiofrequency (RF) ablative techniques have shown promise for the treatment of symptomatic benign prostatic hyperplasia (BPH); however, present RF technology is limited by the small lesion size, necessitating several probe placements and heating cycles to achieve sizable lesions. This limitation is attributable primarily to a rapid increase in electrical impedance secondary to tissue desiccation and charring at the electrode tip. We devised a hollow screw-tip needle electrode that permits fixation to tissue, recording of temperature and impedance, infusion of fluid, and delivery of RF energy. Infusion of electrolyte solution (i.e., saline) into tissue prevents impedance rise by conducting RF energy away from the metal electrode and permits the creation of large lesions. By varying the conductivity of the perfusate (concentration and temperature), lesions of large diameter can be created in a controlled manner. To determine the long-term tissue effects, we applied this new modified RF technique to the prostates of five mongrel dogs in a chronic (0.5 to 8-week) study. The screw-tip electrode was serially embedded into each lobe of the perineally exposed glands with 1-minute infusion of 0.9% saline (2 mL/min) followed by application of RF energy (500 KHz, 50 W, 2-18 minutes) along with continuous saline infusion. Thermocouples were embedded 5 mm below and at the gland capsule, and RF application was discontinued when the temperature reached 50 degrees C at the periphery. Postoperatively, the animals were examined daily for clinical status and weekly for glandular changes using transrectal ultrasonography. At predetermined intervals, the animals were sacrificed and the prostates excised, measured, sectioned, and examined for histologic changes. Ablative tissue temperatures of 50 to 100 degrees C were produced while impedance remained stable. Four animals required a single catheterization for relief of urinary retention between days 2 and 3; otherwise, all animals demonstrated a quick and uneventful recovery with no edema detectable on day 7 ultrasound examination. The outside dimensions of the gland remained relatively constant throughout the study (+ or - 0.39 cm L + W + H). Histologic examination revealed coagulation necrosis (ablation) in both lobes of all prostates (69.94% + or - 16.62% of the gland) with tissueless cavities forming from the ablation area (28.71% + or - 8.24% of the gland) contained within the capsule surrounded by healthy tissue at the periphery. Intraprostatic lesions were obtained without any gross damage to surrounding tissue, including the bladder and rectal wall. Utilizing a liquid conductor in prostate tissue allows a single electrode-placement heating cycle for controlled ablation for the potential treatment of BPH. This new technique produces more extensive and uniform lesions than conventional RF procedures, and lesion size is limited only by the duration of RF energy application. PMID:8833722

Leveillee, R J; Hoey, M F; Hulbert, J C; Mulier, P; Lee, D; Jesserun, J

1996-02-01

344

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

SciTech Connect

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

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

2013-02-15

345

Assessment of Bacterial bph Gene in Amazonian Dark Earth and Their Adjacent Soils  

PubMed Central

Amazonian Anthrosols are known to harbour distinct and highly diverse microbial communities. As most of the current assessments of these communities are based on taxonomic profiles, the functional gene structure of these communities, such as those responsible for key steps in the carbon cycle, mostly remain elusive. To gain insights into the diversity of catabolic genes involved in the degradation of hydrocarbons in anthropogenic horizons, we analysed the bacterial bph gene community structure, composition and abundance using T-RFLP, 454-pyrosequencing and quantitative PCR essays, respectively. Soil samples were collected in two Brazilian Amazon Dark Earth (ADE) sites and at their corresponding non-anthropogenic adjacent soils (ADJ), under two different land use systems, secondary forest (SF) and manioc cultivation (M). Redundancy analysis of T-RFLP data revealed differences in bph gene structure according to both soil type and land use. Chemical properties of ADE soils, such as high organic carbon and organic matter, as well as effective cation exchange capacity and pH, were significantly correlated with the structure of bph communities. Also, the taxonomic affiliation of bph gene sequences revealed the segregation of community composition according to the soil type. Sequences at ADE sites were mostly affiliated to aromatic hydrocarbon degraders belonging to the genera Streptomyces, Sphingomonas, Rhodococcus, Mycobacterium, Conexibacter and Burkholderia. In both land use sites, shannon's diversity indices based on the bph gene data were higher in ADE than ADJ soils. Collectively, our findings provide evidence that specific properties in ADE soils shape the structure and composition of bph communities. These results provide a basis for further investigations focusing on the bio-exploration of novel enzymes with potential use in the biotechnology/biodegradation industry. PMID:24927167

Brossi, Maria Julia de Lima; Mendes, Lucas William; Germano, Mariana Gomes; Lima, Amanda Barbosa; Tsai, Siu Mui

2014-01-01

346

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

PubMed Central

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

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

2013-01-01

347

Ascribing novel functions to the sarcomeric protein, myosin binding protein H (MyBPH) in cardiac sarcomere contraction.  

PubMed

Myosin binding protein H (MyBPH) is a protein of unknown function, which shares sequence and structural similarities with myosin binding protein C (cMyBPC), a protein frequently implicated in hypertrophic cardiomyopathy (HCM). Given the similarity between cMyBPC and MyBPH, we proposed that MyBPH, like cMyBPC, could be involved in HCM pathogenesis and we therefore sought to determine its function. We identified MyBPH-interacting proteins by using yeast two-hybrid (Y2H) analysis. The role of MyBPH and cMyBPC in cardiac cell contractility was analysed by measuring the planar cell surface area of differentiated H9c2 rat cardiomyocytes in response to ?-adrenergic stress after siRNA knockdown of MyBPH and cMyBPC. Individual knockdown of either protein had no effect on cardiac contractility, while concurrent knockdowns reduced cardiac contractility. These proteins therefore functionally compensate for one another and are critical for cardiac contractility. We further show that both proteins co-localise with the autophagosomal membrane protein LC3, suggesting that both proteins are involved in autophagosomal membrane maturation processes. The results of this study ascribe novel functions to MyBPH, which may contribute to our understanding of its role in the sarcomere. This study provides evidence for a potential role of MyBPH in HCM, which warrants further investigation. PMID:25449695

Mouton, Jomien; Loos, Ben; Moolman-Smook, Johanna C; Kinnear, Craig J

2015-02-15

348

Prolactin-induced prostate tumorigenesis.  

PubMed

The physiological role of prolactin (PRL) in the prostate gland is not clearly understood. Genetically-modified mouse models that have invalidated actors of the PRL signaling axis failed to identify an essential regulatory function on this tissue. However, a large body of evidence suggests an important role for PRL in prostate tumorigenesis. Mainly through the activation of its downstream target STAT5, PRL can induce growth and survival of prostate cancer cells and tissues in several experimental settings. In the clinic, PRL expression and STAT5 activation in human prostate tumors correlate with disease severity. Available data point to a role of local (autocrine/paracrine) rather than circulating (endocrine) PRL in the induction of disease progression. In mice, transgenic expression of PRL in the prostate leads to enhanced epithelial hyperplasia and dysplasia, with amplification of basal/stem cells which have been recently identified as prostate cancer-initiating cells. Thus, targeting PRL receptor (PRLR)/STAT5 signaling may provide an alternative therapy for the treatment of prostate cancer. Corresponding targeted therapies currently in preclinical development include antagonists or blocking antibodies for the PRLR and small molecule inhibitors directed against the tyrosine kinase JAK2 upstream of STAT5. Present efforts are aimed at validating these therapies for the treatment of prostate cancer, while understanding the mechanisms of disease progression induced by PRL/STAT5. PMID:25472541

Sackmann-Sala, Lucila; Goffin, Vincent

2015-01-01

349

Extra-adrenal paraganglioma of the prostate  

PubMed Central

Extra-adrenal pheochromocytomas, or paragangliomas, are rare tumours that may develop from extra-adrenal chromaffin cells, and most occur in the organ of Zuckerkandl. Extra-adrenal paraganglioma of the prostate is extremely rare. We report a 53-year-old man with hypertension and lower urinary tract symptoms, who was initially diagnosed with benign prostate hyperplasia. Computed tomography (CT) showed a large heterogenously enhancing mass in the prostate, imprinting the right distal ureter and urinary bladder. Before surgical intervention, CT-guided biopsy of the prostatic mass was performed and the result of histologic examination confirmed extra-adrenal paraganglioma. He underwent radical prostatectomy, partial cystectomy and right ureteroneocystostomy. The patient recovered and his blood pressure returned within normal range after surgical removal of the prostate tumour. In this article, we stress that the rarity of prostatic paraganglioma, preoperative localization and imaging-guided biopsy were useful in determining the surgical strategy. PMID:23766843

Wang, Hong-Hau; Chen, Yen-Lin; Kao, Hao-Lun; Lin, Shih-Chung; Lee, Chiao-Hua; Huang, Guo-Shu; Chang, Wei-Chou

2013-01-01

350

Pseudohyperplastic prostatic adenocarcinoma in transurethral resections of the prostate.  

PubMed

Pseudohyperplastic prostatic adenocarcinoma is a recently described variety of adenocarcinoma that has been studied in core-needle biopsies and prostatectomy specimens. It is characterized by malignant glands that simulate benign hyperplastic glands with complex, medium to large-sized glands with papillary infoldings, luminal undulations, branching or cystic dilatations, and columnar cells with macronucleoli and nuclear enlargement. Our aim was to define frequency, tumor volume, and histologic features of pseudohyperplastic prostatic adenocarcinoma in transurethral resections of prostate. We studied 250 specimens from transurethral resections; 150 specimens were originally diagnosed as benign glandular hyperplasia, and 100 as conventional prostate adenocarcinomas. Of the 150 biopsies originally diagnosed as benign glandular hyperplasia, two (1.3%) had areas of pseudohyperplastic carcinoma. In both cases the neoplasm was limited to two chips and measured 3 and 4 mm in diameter, respectively. Both patients were asymptomatic 2 and 4 years after diagnosis. Of the 100 biopsies with adenocarcinoma, areas of pseudohyperplastic carcinoma were found in three cases. In the first two these areas were found in two fragments, and in the other case they were found in three chips, and measured 3, 4, and 6 mm, respectively. The clinical course in these cases was unfavorable, and two patients had metastasis. Main histologic findings included crowded glands (5/5), papillary projections (5/5), nuclear enlargement (5/5) macronucleoli (4/5) cystic glandular dilatation (4/5) straight luminal borders (4/5), pink amorphous secretions (4/5) nuclear hyperchromasia (3/5) and transition to small acinar pattern of adenocarcinoma (3/5). In conclusion, pseudohyperplastic prostate carcinoma is rare in transurethral resection specimens and is found in scarce chips. Frequency of false negative results in biopsies originally diagnosed as benign glandular hyperplasia was 1.3%. In biopsies diagnosed as carcinoma, this frequency was 3%. These patients had an adverse clinical course, apparently due to association with areas of conventional adenocarcinoma. PMID:14688829

Arista-Nasr, Julián; Martinez-Benitez, Braulio; Valdes, Samuel; Hernández, Mercedes; Bornstein-Quevedo, Leticia

2003-01-01

351

Congenital lipoid adrenal hyperplasia  

PubMed Central

Congenital lipoid adrenal hyperplasia (lipoid CAH) is the most fatal form of CAH, as it disrupts adrenal and gonadal steroidogenesis. Most cases of lipoid CAH are caused by recessive mutations in the gene encoding steroidogenic acute regulatory protein (StAR). Affected patients typically present with signs of severe adrenal failure in early infancy and 46,XY genetic males are phenotypic females due to disrupted testicular androgen secretion. The StAR p.Q258X mutation accounts for about 70% of affected alleles in most patients of Japanese and Korean ancestry. However, it is more prevalent (92.3%) in the Korean population. Recently, some patients have been showed that they had late and mild clinical findings. These cases and studies constitute a new entity of 'nonclassic lipoid CAH'. The cholesterol side-chain cleavage enzyme, P450scc (CYP11A1), plays an essential role converting cholesterol to pregnenolone. Although progesterone production from the fetally derived placenta is necessary to maintain a pregnancy to term, some patients with P450scc mutations have recently been reported. P450scc mutations can also cause lipoid CAH and establish a recently recognized human endocrine disorder. PMID:25654062

2014-01-01

352

Focal nodular hyperplasia (FNH).  

PubMed

Focal nodular hyperplasia (FNH) is a benign tumour of the liver (hepatic tumour), which is the second most prevalent tumour of the liver (the first is hepatic hemangioma). It has a higher incidence in females, 20-40 years old, but also occurs in men and even in children. It is usually asymptomatic, rarely grows or bleeds, and has no malignant potential. This tumour was once often resected because it was difficult to distinguish from hepatic adenoma, but with modem multiphase imaging it is now diagnosed strictly by imaging criteria, and not resected. We present the case of a 78 years old man who presented to emergency room (ER) with a history of dry cough, chest pain and mild dyspnea. Chest X-ray showed ascension of the right hemidiaphragm, and a homogeneous round opacity of 6/6.2 cm in the right cardiophrenic angle. The first suspicion was of pulmonary tumor, but the final diagnosis was FNH, confirmed by CT scan. We discuss the differential diagnosis and prognosis of this entity. The particularities of the case are the presentation with respiratory symptoms and pulmonary mass, and the age of the patient. PMID:25000678

Nat, Laura; Poant?, Laura Irina

2014-01-01

353

Amphiregulin and Epidermal Hyperplasia  

PubMed Central

Overexpression of amphiregulin has been shown to induce psoriasiform changes in the skin of transgenic mice shortly after birth. Therefore, amphiregulin has been suggested as a target for anti-psoriatic therapy. To test this theory, a humanized monoclonal antibody capable of neutralizing human amphiregulin was examined for anti-proliferative effects in the human skin-severe combined immunodeficient (SCID) mouse transplant model. The anti-amphiregulin antibody reduced epidermal thickness of transplanted psoriatic skin and also inhibited the hyperplastic response that developed in nonpsoriatic skin after transplantation. The same antibody also suppressed keratinocyte proliferation in monolayer culture in a dose-dependent manner. Under the same conditions in which keratinocyte proliferation was inhibited, the antibody had little effect on proliferation of human dermal fibroblasts and no effect on type I procollagen production by these cells. Taken together, these data indicate an important role for amphiregulin in psoriatic hyperplasia and suggest that inhibition of amphiregulin activity could be an efficacious therapeutic strategy for psoriasis. These data also suggest that the hyperplastic response occurring in nonpsoriatic human skin on transplantation to the SCID mouse is mediated, in large part, by amphiregulin. PMID:15793282

Bhagavathula, Narasimharao; Nerusu, Kamalakar C.; Fisher, Gary J.; Liu, Gao; Thakur, Archana B.; Gemmell, Lorraine; Kumar, Shankar; Xu, Zenghai H.; Hinton, Paul; Tsurushita, Naoya; Landolfi, Nicholas F.; Voorhees, John J.; Varani, James

2005-01-01

354

Metabolic syndrome and diabetes for the urologist  

PubMed Central

Type 2 diabetes has a number of know urological consequences. Epidemiologic and clinical data suggest a link between metabolic syndrome and prostatic diseases, such as benign prostatic hyperplasia (BPH) and prostate cancer. Recent studies have identified metformin as a viable treatment for patients with type 2 diabetes and prostate cancer. PMID:25243043

Fleshner, Neil E.; Bhindi, Bimal

2014-01-01

355

Implication of high risk Human papillomavirus HR-HPV infection in prostate cancer in Indian population- A pioneering case-control analysis  

PubMed Central

Prostate cancer is the second most common cancer with sexual history as a consistent risk factor. This is the pioneering study that evaluates the frequency of HPV infection in prostate cancer in India. Ninety five (95) histopathologically confirmed cancer and fifty five (55) BPH from Indian population were analyzed for HPV infection using a pair of consensus sequence primer followed by type specific PCRs for both high-risk and low-risk HPV types. The data demonstrate HPV infection in 41% of prostate tumor biopsies and 20% in BPH. Subsequent PCR- based HPV typing using type - specific primers revealed 32% were infected with HPV type 16 whereas 6% were found to be positive for HPV type 18, while in BPH controls only 5% of the BPH controls were infected with HPV 16 and this difference was highly significant (p = 0.0004). Significant proportion of HPV infected (74%) cases belonged to stage III and IV (p < 0.001) with a high Gleason score ?8 (p = 0.003). The study represents for the first time the incidence of HPV infection in prostate cancer in Indian population and strengthens the hypothesis that HPV infection could be one of the co factor associated with progression of prostate cancer. PMID:25592643

Singh, Neha; Hussain, Showket; Kakkar, Nandita; Singh, Shrawan K.; Sobti, Ranbir C.; Bharadwaj, Mausumi

2015-01-01

356

Implication of high risk Human papillomavirus HR-HPV infection in prostate cancer in Indian population- A pioneering case-control analysis.  

PubMed

Prostate cancer is the second most common cancer with sexual history as a consistent risk factor. This is the pioneering study that evaluates the frequency of HPV infection in prostate cancer in India. Ninety five (95) histopathologically confirmed cancer and fifty five (55) BPH from Indian population were analyzed for HPV infection using a pair of consensus sequence primer followed by type specific PCRs for both high-risk and low-risk HPV types. The data demonstrate HPV infection in 41% of prostate tumor biopsies and 20% in BPH. Subsequent PCR- based HPV typing using type - specific primers revealed 32% were infected with HPV type 16 whereas 6% were found to be positive for HPV type 18, while in BPH controls only 5% of the BPH controls were infected with HPV 16 and this difference was highly significant (p = 0.0004). Significant proportion of HPV infected (74%) cases belonged to stage III and IV (p < 0.001) with a high Gleason score ?8 (p = 0.003). The study represents for the first time the incidence of HPV infection in prostate cancer in Indian population and strengthens the hypothesis that HPV infection could be one of the co factor associated with progression of prostate cancer. PMID:25592643

Singh, Neha; Hussain, Showket; Kakkar, Nandita; Singh, Shrawan K; Sobti, Ranbir C; Bharadwaj, Mausumi

2015-01-01

357

Development and validation of a PCR-based functional marker system for the brown planthopper resistance gene Bph14 in rice  

PubMed Central

Brown planthopper (BPH) is the most damaging rice pest globally. Resistant varieties are the most effective and environmental strategy for protecting the rice crop from BPH. Functional markers (FMs) designed from polymorphic sites within gene sequences affecting phenotypic variation are highly efficient when used for marker assisted selection (MAS). Bph14 is the first and only cloned insect resistance gene so far in rice. Compared to the sequences of its non-effective alleles there are a number SNP differences. In this study, the method of allele-specific amplification (ASA) was adopted to design a simple, co-dominant, functional marker Bph14P/N for Bph14. Bph14P/N was combined with two specific dominant markers: one, named Bph14P, targets the promoter region of Bph14 and amplifies 566 bp fragments; and the other, Bph14N, targets the LRR region of bph14 and amplifies 345 bp fragments. Specificity and applicability of the functional marker system were verified in two breeding populations and a Chinese mini core collection of Oryza sativa. We recommend the use of this simple, low-cost marker system in routine genotyping for Bph14 in breeding populations. PMID:24273431

Zhou, Lei; Chen, Zhijun; Lang, Xuyong; Du, Bo; Liu, Kai; Yang, Guocai; Hu, Gang; Li, Sanhe; He, Guangcun; You, Aiqing

2013-01-01

358

Development and validation of a PCR-based functional marker system for the brown planthopper resistance gene Bph14 in rice.  

PubMed

Brown planthopper (BPH) is the most damaging rice pest globally. Resistant varieties are the most effective and environmental strategy for protecting the rice crop from BPH. Functional markers (FMs) designed from polymorphic sites within gene sequences affecting phenotypic variation are highly efficient when used for marker assisted selection (MAS). Bph14 is the first and only cloned insect resistance gene so far in rice. Compared to the sequences of its non-effective alleles there are a number SNP differences. In this study, the method of allele-specific amplification (ASA) was adopted to design a simple, co-dominant, functional marker Bph14P/N for Bph14. Bph14P/N was combined with two specific dominant markers: one, named Bph14P, targets the promoter region of Bph14 and amplifies 566 bp fragments; and the other, Bph14N, targets the LRR region of bph14 and amplifies 345 bp fragments. Specificity and applicability of the functional marker system were verified in two breeding populations and a Chinese mini core collection of Oryza sativa. We recommend the use of this simple, low-cost marker system in routine genotyping for Bph14 in breeding populations. PMID:24273431

Zhou, Lei; Chen, Zhijun; Lang, Xuyong; Du, Bo; Liu, Kai; Yang, Guocai; Hu, Gang; Li, Sanhe; He, Guangcun; You, Aiqing

2013-09-01

359

Prostatitis - bacterial  

MedlinePLUS

Prostatitis is most often caused by a bacterial infection of the prostate gland. Any bacteria that can cause a urinary tract infection can cause acute bacterial prostatitis. Some sexually transmitted diseases (STDs) ...

360

Florid reactive lymphoid hyperplasia of terminal ileum  

PubMed Central

Florid lymphoid hyperplasia in the terminal ileum can present to surgeons as an acute abdominal pain. Only few cases were reported in the literature. Our case illustrates that a rare case of florid lymphoid hyperplasia can present to surgeons as acute appendicitis. During the operation the gross appearance may mimic Crohn’s disease. A limited resection is sufficient to clinch the diagnosis of florid lymphoid hyperplasia / Crohn’s disease. In florid lymphoid hyperplasia limited resection may be curative. PMID:22242075

Kanakala, Venkatesh; Birch, Peter; Kasaraneni, Ramesh

2010-01-01

361

The Effect of Finasteride on the Expression of Vascular Endothelial Growth Factor and Microvessel Density: A Possible Mechanism for Decreased Prostatic Bleeding in Treated Patients  

Microsoft Academic Search

PurposeSeveral studies have confirmed the benefit of finasteride in limiting hematuria from benign prostatic hyperplasia. Vascular endothelial growth factor (VEGF), a potent stimulator of angiogenesis, and microvessel density have been independently evaluated in the mechanism of decreased bleeding observed in patients treated with finasteride. We evaluated the expression of VEGF and suburethral prostatic microvessel density in patients with benign prostatic

GYAN PAREEK; MARIA SHEVCHUK; NOEL A. ARMENAKAS; LJILJANA VASJOVIC; DAVID A. HOCHBERG; JAY B. BASILLOTE; JOHN A. FRACCHIA

2003-01-01

362

Adenomatoid hyperplasia of lower lip  

PubMed Central

Adenomatoid hyperplasia (AH) is an uncommon, non-neoplastic swelling on the palate caused due to hyperplasia of the mucinous acini. The lesion clinically presents as a sessile tumor-like nodule resembling pleomorphic adenoma. Histopathologic findings include lobules of enlarged mucinous acini which are filled with secretory granules. The nuclei are squeezed to the basal portions, associated with focal inflammation and ductal dilatation, and a history of trauma is often elicited. Here, we report a rare case of AH of the lower lip in a 20-year-old male patient, which mimics a mucous retention cyst or mucocele. PMID:22135695

Sharma, Gaganjot Kaur; Sharma, Manish; Vanaki, Srinivas S.

2011-01-01

363

Thymic hyperplasia in Graves’ disease  

PubMed Central

Graves’ disease is an autoimmune thyroid condition characterized by the production of autoantibodies against the thyrotropin receptor. It is known to be associated with autoimmune conditions such as myasthenia gravis, Addison's disease, type 1 diabetes mellitus, and vitiligo. We present a case of rare autoimmune association of Graves’ disease with thymic hyperplasia which regressed after treatment with antithyroid drugs. Exact pathophysiology of thymic hyperplasia in Graves’ is not well understood; it is likely to be the result of rather than the cause of Graves’ disease. PMID:23869315

Kotwal, Narendra; Singh, Yashpal; Menon, Anil; Behera, Vineet

2013-01-01

364

Pretreatment with finasteride decreases perioperative bleeding associated with transurethral resection of the prostate  

Microsoft Academic Search

Objectives. The efficacy of finasteride in the treatment of gross hematuria associated with benign prostatic hyperplasia is well established. We evaluated a regimen of pretreatment with finasteride in decreasing perioperative bleeding associated with transurethral resection of the prostate (TURP).Methods. A prospective analysis compared 25 patients pretreated with finasteride for 2 to 4 months before TURP with 50 patients without pretreatment.

Jennifer A Hagerty; Phillip C Ginsberg; Justin D Harmon; Richard C Harkaway

2000-01-01

365

Dissociation of epithelial and neuroendocrine carcinoma lineages in the transgenic adenocarcinoma of mouse prostate model of prostate cancer.  

PubMed

The transgenic adenocarcinoma of mouse prostate (TRAMP) model is widely used in prostate cancer research because of rapid tumor onset and progression. The transgenic mouse is on a C57BL/6 (B6) background and expresses SV40 T-antigen under the probasin promoter. The strong genetic component of susceptibility to prostate cancer in humans prompted us to investigate the effect of mouse strain background (FVB and B6) on incidence, progression, and pathology of prostate cancer in this model. Because TRAMP lesions are unique but differ from conventional prostatic intraepithelial neoplasia because the epithelium and stroma are affected diffusely, we designated them as "atypical hyperplasia of Tag." Although the incidence and severity of atypical hyperplasia of Tag is similar, FVB-TRAMP mice live significantly shorter lives than B6-TRAMP mice because of the rapid development and progression of neuroendocrine carcinomas. This is associated with an increased frequency of neuroendocrine precursor lesions in young TRAMP mice, detectable at 4 weeks after birth. These lesions show properties of bipotential stem cells and co-express markers of epithelial (E-cadherin) and neuroendocrine (synaptophysin) lineages, as well as the transcription factors Foxa1 and Foxa2. Transplantation studies using TRAMP prostatic ducts suggested that neuroendocrine carcinomas arise independently from atypical hyperplasias or other epithelial lesions. Adenocarcinomas were not seen in our cohort. Thus, neuroendocrine carcinomas are the principal malignancy in this model and may develop from bipotential progenitor cells at an early stage of prostate tumorigenesis. PMID:18156212

Chiaverotti, Teresa; Couto, Suzana S; Donjacour, Annemarie; Mao, Jian-Hua; Nagase, Hiroki; Cardiff, Robert D; Cunha, Gerald R; Balmain, Allan

2008-01-01

366

Initial Choices and Final Outcomes in Lower Urinary Tract Symptoms  

Microsoft Academic Search

Management of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) requires careful thought so that the most appropriate treatment can be targeted to each individual patient. Initial choices in the management of LUTS\\/BPH include watchful waiting, medical therapies and surgical interventions. A decision on treatment choice should be taken together with the patient. It should be based

Mark J. Speakman

2001-01-01

367

Somatic Single-hits Inactivate the X-linked Tumor Suppressor FOXP3 in the Prostate  

PubMed Central

Despite clear epidemiological and genetic evidence for X-linked prostate cancer risk, all prostate cancer genes identified are autosomal. Here we report somatic inactivating mutations and deletion of the X-linked FOXP3 gene residing at Xp11.23 in human prostate cancer. Lineage-specific ablation of FoxP3 in the mouse prostate epithelial cells leads to prostate hyperplasia and prostate intraepithelial neoplasia. In both normal and malignant prostate tissues, FOXP3 is both necessary and sufficient to transcriptionally repress cMYC, the most commonly over-expressed oncogene in prostate cancer as well as among the aggregates of other cancers. FOXP3 is an X-linked prostate tumor suppressor in the male. Since the male has only one X chromosome, our data represents a paradigm of “single-genetic-hit” inactivation-mediated carcinogenesis. PMID:19800578

Wang, Lizhong; Liu, Runhua; Li, Weiquan; Chen, Chong; Katoh, Hiroto; Chen, Guo-Yun; McNally, Beth; Lin, Lin; Zhou, Penghui; Zuo, Tao; Cooney, Kathleen A.; Liu, Yang; Zheng, Pan

2009-01-01

368

GreenLight 180W XPS photovaporization of the prostate: how I do it.  

PubMed

Transurethral resection of the prostate (TURP) is the most common surgical intervention for benign prostatic hyperplasia (BPH), largely due to lower urinary tract symptoms refractory to medical therapy. TURP remains the gold standard for men with prostates sized 30g-80g, while open prostatectomy has been the preferred option for men with glands larger than 80g-100 g and those with other lower urinary tract anomalies such as large bladder stones or bladder diverticula. Unfortunately, these procedures have complications including bleeding (often requiring transfusion in 7%-13% of cases), electrolyte abnormalities (2% TURP syndrome), erectile dysfunction (6%-10%), and retrograde ejaculation (50%-75%). The overall incidence of a second intervention (repeat TURP, urethrotomy and bladder neck incision) has been reported in 12% and 15% of men at 5 and 10 years following TURP. Alternative therapies have been developed with the aim of reducing the level of complications while maintaining efficacy. These include microwave therapy, transurethral needle ablation, and a range of laser procedures (Holmium, Diode, Thulium and 532nm-Greenlight). Photoselective vaporization of the prostate (PVP), initially launched as a 60W prototype, was ultimately introduced to the urology community as a 80W system (American Medical Systems, Minnetonka, Minnesota, USA), has been the predominant device used in clinical trials. This 1st generation used an Nd:YAG laser beam passed through a potassium-titanyl-phosphate (KTP) crystal, halving the wavelength (to 532nm), doubling the laser's frequency, and resulting in a green light. Outcomes have demonstrated a reduced frequency and severity of clinical complications, however it was limited to smaller prostate sizes. In 2006, the 120W lithium triborate laser (LBO), also known as the GreenLight HPS (High Performance System) laser was introduced. This laser utilizes a diode pumped Nd:YAG laser light that is emitted through an LBO instead of a KTP crystal, resulting in a higher-powered 532 nm wavelength green light laser while still using the same 70-degree deflecting, side firing, silica fiber delivery system. The HPS offered an 88% more collimated beam and smaller spot size, resulting in much higher irradiance or power density in its 2 predecessors (60W and 80W) with a beam divergence of 8 versus 15 degrees. The primary aim for this upgrade was to reduce lasing time and improve clinical outcomes while demonstrating the same degree of safety for patients. Limitations of the 120W system included treatment of large prostates greater than 80g-100g and increased cost related to fiber devitrification and fracture. In 2011, the 180W-Greenlight XPS system was introduced, not only with increased power setting to vaporize tissue quicker but significant fiber-design changes. Internal cooling, metal-tip cap protection and FiberLife (temperature sensing feedback), better preserve the integrity of the fiber generally producing a 1-fiber per case expectation. Initial personal experience with XPS has provided comparable outcomes related to morbidity, but with the opportunity to perform a more complete and rapid procedure. Published clinical data with the XPS is unfortunately lacking. The objective of this report is to detail our approach and technique for GreenLight XPS drawing on personal experience with both enucleation and vaporization techniques with various laser technologies along with having performed over 500 GreenLight HPS and 100 XPS procedures. In this regard, recommendations for training are also made, which relate to existing users of the 80W and 120W GreenLight laser as well as to new laser users. PMID:22018158

Zorn, Kevin C; Liberman, Daniel

2011-10-01

369

Atypical lymphoid hyperplasia mimicking lymphoma.  

PubMed

The distinction between reactive and neoplastic lymphoid infiltrates is a common problem in clinical practice and can be problematic. The clinical implications for both the patient and the treating clinician are profound. In this article, we discuss six of the common entities that can present as atypical lymphoid hyperplasia and thus can mimic malignant lymphomas, with emphasis on morphologic features, immunophenotypic findings, and molecular correlates that help distinguish these disorders from neoplastic conditions. The six conditions to be discussed in detail include reactive follicular hyperplasia versus follicular lymphoma; progressive transformation of germinal centers versus nodular lymphocyte predominant Hodgkin lymphoma; immunoblastic proliferations versus diffuse large B-cell lymphomas; variant forms of Castleman disease that may mimic a number of lymphoid cancers; Kikuchi's disease versus large cell lymphomas; and finally, dermatopathic lymphadenopathy and its distinction from lymph nodes showing early involvement by cutaneous T-cell lymphoma (Mycosis fungoides). PMID:19577167

Good, David J; Gascoyne, Randy D

2009-08-01

370

Hypoglycaemia in congenital adrenal hyperplasia.  

PubMed Central

Two young children with salt-losing congenital adrenal hyperplasia developed profound hypoglycaemia. In one child hypoglycaemia occurred after a prolonged fast and in the other it was precipitated by infection. This complication may be more common than the literature suggests, and emergency treatment with glucose or hydrocortisone, given by injection, should be given to any child with the disorder who suddenly or unexpectedly collapses. PMID:879852

Mackinnon, J; Grant, D B

1977-01-01

371

Characterization of transgenic tobacco plants containing bacterial bphC gene and study of their phytoremediation ability.  

PubMed

Genetically modified plants can serve as an efficient tool for remediation of diverse dangerous pollutants of the environment such as pesticides, heavy metals, explosives and persistent organic compounds. Transgenic lines of Nicotiana tabacum containing bacterial bphC gene from the degradation pathway of polychlorinated biphenyls (PCBs) were tested. The product of the bphC gene - enzyme 2,3-dihydroxybiphenyl-1,2-dioxygenase is responsible for cleaving of the biphenyl ring. The presence of bphC gene in transgenic plants was detected on DNA, RNA and protein level. The expression of the bphC/His gene was verified afterpurification of the enzyme from plants by affinity chromatography followed by a Western blot and immunochemical assay. The enzyme activity of isolated protein was detected. Efficient transformation of 2,3-DHB by transgenic plants was achieved and the lines also exhibited high production of biomass. The transgenic plants were more tolerant to the commercial PCBs mixture Delor 103 than non-transgenic tobacco. And finally, the higher decrease of total PCB content and especially congener 28 in real contaminated soil from a dumpsite was determined after cultivation of transgenic plant in comparison with nontransgenic tobacco. The substrate specificity of transgenic plants was the same as substrate specificity of BphC enzyme. PMID:24933894

Viktorovtá, Jitka; Novakova, Martina; Trbolova, Ladislava; Vrchotova, Blanka; Lovecka, Petra; Mackova, Martina; Macek, Tomas

2014-01-01

372

Balloon dilatation of prostate: keys to sustained favorable results.  

PubMed

Seventy-seven patients with small prostates (less than 40 g) and significant obstructive symptomatology were treated using balloon dilatation of the prostate (BDP) with a sized-to-fit intra-prostatic balloon. Eighty-seven percent of the patients experienced a 50 percent or greater decrease in symptom score at longest follow-up (12.0 months, average: 3-24 months, range). Forty-nine percent of the patients had a 50 percent or greater improvement in peak uroflow. An anterior commissurotomy through the fibromuscular stroma was consistently found and is the hallmark of a technical and therapeutic success. No cases of incontinence, retrograde ejaculation, or impotence developed. When properly performed, BDP has a place in the spectrum of BPH treatment alternatives. PMID:1373013

Moseley, W G

1992-04-01

373

Crystal structure of the chromophore binding domain of an unusual bacteriophytochrome, RpBphP3, reveals residues that modulate photoconversion  

PubMed Central

Bacteriophytochromes RpBphP2 and RpBphP3 from the photosynthetic bacterium Rhodopseudomonas palustris work in tandem to modulate synthesis of the light-harvesting complex LH4 in response to light. Although RpBphP2 and RpBphP3 share the same domain structure with 52% sequence identity, they demonstrate distinct photoconversion behaviors. RpBphP2 exhibits the “classical” phytochrome behavior of reversible photoconversion between red (Pr) and far-red (Pfr) light-absorbing states, whereas RpBphP3 exhibits novel photoconversion between Pr and a near-red (Pnr) light-absorbing states. We have determined the crystal structure at 2.2-? resolution of the chromophore binding domains of RpBphP3, covalently bound with chromophore biliverdin IX?. By combining structural and sequence analyses with site-directed mutagenesis, we identify key residues that directly modulate the photochemical properties of RpBphP3 and RpBphP2. Remarkably, we identify a region spanning residues 207–212 in RpBphP3, in which a single mutation, L207Y, causes this unusual bacteriophytochrome to revert to the classical phenotype that undergoes reversible photoconversion between the Pr and Pfr states. The revers