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Sample records for benign prostatic enlargement

  1. Lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction: are these conditions related to vascular dysfunction?

    Science.gov (United States)

    Shimizu, Shogo; Tsounapi, Panagiota; Shimizu, Takahiro; Honda, Masashi; Inoue, Keiji; Dimitriadis, Fotios; Saito, Motoaki

    2014-09-01

    Although the pathogenesis of lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction is poorly understood and thought to be multifactorial, it has been traditionally recognized that these conditions increase with age. There is increasing evidence that there is an association between cardiovascular disease and lower urinary tract symptoms as well as benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction in elderly patients. Age might activate systemic vascular risk factors, resulting in disturbed blood flow. Hypertension, diabetes, hyperlipidemia and atherosclerosis are also linked to the etiology of lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction. In the present review, we discuss the relationship between decreased pelvic blood flow and lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction. Furthermore, we suggest possible common mechanisms underlining these urological conditions.

  2. Benign prostate hyperplasia (BPH) - resources

    Science.gov (United States)

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

  3. ROPE Registry Project to Determine the Safety and Efficacy of Prostate Artery Embolisation (PAE) for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Enlargement (LUTS BPE).

    Science.gov (United States)

    2016-08-03

    Lower Urinary Tract Symptoms Caused by Benign Prostatic Enlargement (LUTS BPE); Prostate Artery Embolisation (PAE); Transurethral Resection of the Prostate (TURP); Open Prostatectomy; Laser Enucleation or Ablation of the Prostate

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

  5. Enlarged prostate

    Science.gov (United States)

    ... prostate URL of this page: //medlineplus.gov/ency/article/000381.htm Enlarged prostate To use the sharing ... sperm during ejaculation. The prostate gland surrounds the urethra, the tube ... hyperplasia (BPH). It is not cancer, and it does not raise your risk for ...

  6. [Position statement for the diagnosis and treatment of men with benign prostate enlargement and lower urinary tract symptoms].

    Science.gov (United States)

    Greenstein, Alexander; Ferman, Zvi; Stav, Kobi; Gruenwald, Ilan; Matzkin, Haim; Ramon, Jacob

    2014-09-01

    Benign prostate enlargement causing lower urinary symptoms is a common progressive phenomenon in adult men. Lower urinary tract symptoms may emerge during the storage, voiding, and post micturition phases, harm quality of life and may be caused by a variety of factors. The purpose of evaluation is to identify benign prostate enlargement and factors other than enlarged prostate as the cause of symptoms, and recognize the risk factors for progression of the condition. The goal of treatment is to alleviate symptoms and improve quality of life, and to prevent deterioration of symptoms and development of complications. Medical therapy is the basic approach, whereas surgery and minimally invasive procedures are reserved for patients not interested in medical therapy or for those in whom symptoms were not alleviated by means of medical therapy. In the present position statement, we present the approach to the evaluation and treatment of lower urinary tract symptoms in men with benign prostate enlargement.

  7. Enlarged prostate - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about enlarged prostate; Benign prostatic hypertrophy - what to ask your doctor; BPH - what to ... nlm.nih.gov/pubmed/23234640 . Roehrborn CG. Benign prostatic hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In: Wein ...

  8. Benign Prostatic Hyperplasia

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    ... prostate gets bigger, it may press on the urethra and cause the flow of urine to be slower and less forceful. "Benign" means the enlargement isn't caused by cancer or infection. "Hyperplasia" means enlargement. SymptomsWhat are the ...

  9. Goserelin acetate before transurethral resection of moderately enlarged benign prostatic hyperplasia: Prospective randomised-controlled clinical trial

    Science.gov (United States)

    Abo El-Enen, Mohamed; Tawfik, Ahmed; El-Abd, Ahmed S.; Ragab, Maged; El-Abd, Sherin; Elrashidy, Mohamed; Elmashad, Nehal; Rasheed, Mohamed; El-Abd, Shawky

    2015-01-01

    Objective To evaluate the impact of a luteinising hormone-releasing hormone (LHRH) agonist, goserelin acetate (GA), on surgical blood loss during transurethral resection of the prostate (TURP), as well as its histopathological effect on prostatic microvessel density (MVD). Patients and methods Patients who underwent TURP due to benign prostatic enlargement (60–100 mL) were randomly subdivided into two equal groups according to whether they received preoperative GA administration (3.6 mg; group A) or not (group B). Evaluation parameters were operative time, weight of resected prostatic tissue, perioperative haematocrit (HCT) changes, estimation of intraoperative blood loss, and suburethral and stromal prostatic MVD. Effects of GA on prostate weight and any possible side-effects were also monitored. Results In all, 35 and 33 patients were included in groups A and B, respectively. Operative time and HCT values’ changes were significantly less in group A (P < 0.05). Also, operative blood loss (both total and adjusted per weight of resected tissue) was lower in group A, at a mean (SD) of 178.13 (77.71) mL and 3.74 (1.52) mL/g vs 371.75 (91.09) mL and 8.59 (2.42) mL/g (P < 0.001). The median MVD in both suburethral [8 vs 11 vessels/high-power field (HPF)] and stromal tissues (9 vs 17 vessels/HPF) were significantly lower in group A (P < 0.001). Side-effects were minimal. Conclusion A single dose of GA, a LHRH agonist, before TURP is safe and effective in reducing surgical blood loss. It significantly reduced MVD in both suburethral and stromal nodular prostatic tissues without regional discrepancy. PMID:26966595

  10. Enlarged prostate - after care

    Science.gov (United States)

    ... ncbi.nlm.nih.gov/pubmed/21420124 . NcNicholas TA, Kirby RS, Lepor H. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 10th ed. Philadelphia, ...

  11. Benign Prostatic Hyperplasia

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    Gil Ortega, Joan

    2015-01-01

    Benign prostatic hyperplasia (BPH) is a prevalent disease but its molecular mechanism remains unknown. Using human tissue samples from 16 patients diagnosed with BPH, we performed an ultrastructural study to clarify the mechanism and the role of glandular cells in this pathology. We have made a description of all the changes that suffers the prostatic epithelium. We have shown that the glandular architecture presents many non-physiological forms such as papillae and papillary fronds. Basal c...

  12. Cholesterol and benign prostate disease.

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    Freeman, Michael R; Solomon, Keith R

    2011-01-01

    The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly understood. Patients suffering from benign prostatic symptoms report a substantially reduced quality of life, and the relationship between benign prostate conditions and prostate cancer is uncertain. Epidemiologic data for BPH and CP/CPPS are limited, however an apparent association between BPH symptoms and cardiovascular disease (CVD) has been consistently reported. The prostate synthesizes and stores large amounts of cholesterol and prostate tissues may be particularly sensitive to perturbations in cholesterol metabolism. Hypercholesterolemia, a major risk factor for CVD, is also a risk factor for BPH. Animal model and clinical trial findings suggest that agents that inhibit cholesterol absorption from the intestine, such as the class of compounds known as polyene macrolides, can reduce prostate gland size and improve lower urinary tract symptoms (LUTS). Observational studies indicate that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer, while prostate cancer cell growth and survival pathways depend in part on cholesterol-sensitive biochemical mechanisms. Here we review the evidence that cholesterol metabolism plays a role in the incidence of benign prostate disease and we highlight possible therapeutic approaches based on this concept.

  13. [Benign prostatic hypertrophy and prostate cancer].

    Science.gov (United States)

    Mourey, Loïc; Doumerc, Nicolas; Gaudin, Clément; Gérard, Stéphane; Balardy, Laurent

    2014-01-01

    Prostatic diseases are extremely common, especially in older men. Amongst them, benign prostatic hypertrophy may affect significantly the quality of life of patients by the symptoms it causes. It requires appropriate care. Prostate cancer is the second most common cancer in men after lung cancer and the fifth leading cause of cancer deaths in the world. It affects preferentially older men. An oncogeriatric approach is required for personalised care.

  14. Prostate Enlargement: Benign Prostatic Hyperplasia (BPH)

    Science.gov (United States)

    ... not they have urinary problems. Digital rectal exam Medical Tests A health care provider may refer men to a urologist—a doctor ... the following side effects should contact a health care provider right away or get emergency medical care: hives rash itching shortness of breath rapid, ...

  15. Consideration of Drug Therapy in Benign Prostatic Hypertrophy

    Directory of Open Access Journals (Sweden)

    G. Diamantis

    2015-01-01

    Full Text Available Benign prostatic hypertrophy (BPH has become a major global health problem both in its frequency by which it determines the complications and the problems of diagnosis and treatment it requires. BPH is a heterogeneous disease. The symptoms attributed to BPH may have other coexisting causes and growth factors both androgen-dependent and independent, which promotes prostate enlargement. It is well known that prostate size correlates poorly with the symptoms so that reducing prostate using 5-alphareductase or alphablocants inhibitors may not always be sufficient. A better understanding of the pathophysiology of BPH and its interactions with other drugs will help the development of new substances with a better efficiency. This present work aims to be a modest contribution related to medical treatment in benign prostatic hyperplasia and the role that the generalist practitioner should play in managing of this urinary disease quite common in elderly men.

  16. Contact laser vaporization of the prostate for benign prostatic hypertrophy

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    Gomella, Leonard G.; Lotfi, M. A.; Milam, Douglas F.; Albala, David; Reagan, Gary

    1994-05-01

    The contact laser applications for the removal of the enlarged prostate are distinctly different than the majority of non-contact Nd:YAG lasers that rely on coagulation necrosis and delayed sloughing. Contact Nd:YAG laser allows cutting, coagulation and vaporization of tissue with minimal penetration beyond the contact surface. Using the contact laser prostatectomy technique, the contact laser probe directly touches and immediately vaporizes the prostatic tissue under the probe. The net result is the immediate removal of the obstructing tissue, in a manner similar to the standard electrosurgical TURP. This immediate removal of tissue offers the patient treated with the contact laser the potential for decreased catheter time and a more rapid resolution of symptoms. Our initial experience suggests that the contact technique may be better suited for the smaller prostate gland (i.e. less than 30 gm). The contact laser may also be used for a procedure termed the `laser assisted TURP': a standard electrosurgical TURP is performed and the contact laser is used for hemostasis. Several investigators have reported non-randomized results of the contact technique with good outcomes. A prospective randomized trial of the contact laser prostatectomy vrs the electrosurgical TURP is underway. The contact laser vaporization of the prostate holds great promise for the treatment of symptomatic benign prostatic hypertrophy: it is virtually bloodless and allows immediate visualization of the TUR defect.

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

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

    2014-01-01

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

  18. Acute respiratory failure in a rapidly enlarging benign cervical goitre.

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    Garingarao, Carlo Jan; Añonuevo-Cruz, Cecille; Gasacao, Ryan

    2013-07-22

    Benign goitres have the potential to reach massive sizes if neglected, but most have a protracted course that may or may not present with compressive symptoms. We report the case of a 57-year-old man who presented with a rapidly enlarging nodular goitre resulting in acute respiratory failure. Endotracheal intubation and emergency total thyroidectomy were performed, revealing massive thyroid nodules with minimal intrathoracic extension and tracheal erosion. Despite a course and clinical findings suggestive of malignant disease, histopathology was consistent with a benign multinodular goitre. Several cases of benign goitres necessitating endotracheal intubation have been reported. Airway compromise was attributed to a significant intrathoracic component, or inciting events such as thyroid haemorrhage, pregnancy, radioiodine uptake or major surgery. Obstructive symptoms may not correlate well with objective measures of upper airway obstruction such as radiographs or flow volume loops.

  19. Management of Benign Prostatic Hyperplasia in Older Adults.

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    Woodard, Todd J; Manigault, Kendra R; McBurrows, Niesha N; Wray, Tiffany L; Woodard, Laresa M

    Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a nonmalignant adenomatous overgrowth of the periurethral prostate gland commonly seen in aging men. Historically, it has been assumed that the pathophysiology of lower urinary tract symptoms in men is the result of bladder outlet obstruction associated with prostate enlargement. Symptoms such as urinary hesitancy, incomplete bladder emptying, dribbling or prolonged urination, nocturia, urinary urgency, and/or urge incontinence are common. Understanding the differential diagnosis and ordering appropriate laboratory tests are essential in accurately identifying a BPH diagnosis. Management can be broken down into medical or pharmacological and surgical therapies. This article aims to provide an overview of BPH and its management in older adults.

  20. Nocturia and benign prostatic hyperplasia

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    Laketić Darko

    2008-01-01

    Full Text Available Background/Aim. Nocturia often occurs in patients with benign prostate hyperplasia (BPH. The aim of the study was to investigate the frequency of nocturia in patients with BPH. Nocturia and other factors associated with it were also investigated. Methods. Forty patients with the confirmed diagnosis of BPH were studied. Transurethral and transvesical prostatectomy were performed in all the patients. Symptoms were evaluated with the International Prostate Symptom Score before, as well as three and six months after the surgery. All the results were compared with the control group. Results. There was no statistically significant difference between the patients before and after the surgery regarding nocturia. There was, however, a statistically significant difference between the operated patients and the control group regarding nocturia, as well as a statistically significant correlation between noctruia and the age of the patients in both the investigated and the control group. A correlation also existed between nocturia and the prostatic size. Conclusion. There was no statistically significant improvement in symptoms of nocturia after the surgery. It is necessary to be very careful in decision making in patients with nonabsolute indiction for surgery and isolated bothersome symptom of nocturia. Age of a patient should also be considered in the evaluation of favorable result of the surgery because of a significant correlation between noctura and the age of a patient.

  1. Convective Water Vapor Energy for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia.

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    DeLay, Kenneth Jackson; McVary, Kevin T

    2016-08-01

    Benign prostatic hyperplasia (BPH) refers to proliferation of smooth muscle and epithelial cells within the transition zone of the prostate. Half of men over 40 develop histologic BPH. About half of men with BPH develop an enlarged prostate gland, called benign prostatic enlargement; among these, about half develop some degree of bladder outlet obstruction. Bladder outlet obstruction and changes in smooth muscle tone and resistance may result in lower urinary tract symptoms, including storage disturbances (such as daytime urinary urgency, frequency, and nocturia) and voiding disturbances (such as urinary hesitancy, weak urinary stream, straining to void, and prolonged voiding).

  2. Oxidative stress in benign prostate hyperplasia.

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

    2016-02-01

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

  3. Phytotherapeutic Agents for Benign Prostatic Hyperplasia: An Overview.

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    Passi, Neelima Dhingra

    2016-06-20

    Benign prostatic hyperplasia (BPH) the most common condition in aging men is the non malignant enlargement of the prostate gland with increase in numbers of both epithelial and stromal cells within the periurethal transition zone of the prostate. Sources of symptoms in patient with BPH appear to be both static and dynamic component. Management of BPH has undergone a rapid evolution over the past decade to aid men with lower urinary tract symptoms attributed to bladder outlet obstruction. Treatment of clinical BPH aims to improve symptoms, prevent urinary tract infections, avoid renal insult, relief obstruction and improve bladder emptying.Prostate cancer patients and those with benign prostatic hyperplasia are increasingly exploring the use of plant derived non-nutritive compounds with protective or disease preventive properties, especially due to long term side effects of pharmacological treatment and risk of mortality associated with surgical procedures. Phytotherapeutic preparations are plant extracts with different components obtained by different extraction procedures. Numerous mechanisms of action have been postulated for mono and combination plant extracts. This article give a brief account of rationale and efficacy of various existing phytotherapeutic agents in the management of benign prostatic hyperplasia, including the herbs which hold the potential promise are also mentioned , although much research is still required.

  4. Alpha blocker prazosin for the treatment of benign prostatic hypertrophy (BPH.

    Directory of Open Access Journals (Sweden)

    Punekar S

    1995-10-01

    Full Text Available In this study medical treatment with alpha blocker-prazosin is compared with transurethral resection of prostate (TURP in 62 patients suffering from benign enlargement of prostate with a gland size of less than 20 gms. After thorough interrogation patients were offered either TURP or prazosin therapy. Symptom scoring, residual volume of urine and urinary flow rates were estimated in both the groups before and 3 months after the therapy. 23.5% patients in prazosin group while 90% of patients in TURP group had significant improvement. This distinctly brings out the superiority of TURP for benign enlargement of prostate.

  5. Urodynamic implications of benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Jensen, K M; Andersen, J T

    1990-01-01

    By the age of 60, about 70% of men have developed benign prostatic hyperplasia (BPH), and 85%-95% of these have symptomatic dysfunction of the lower urinary tract, 10%-20% undergoing prostatectomy. Although transurethral resection of the prostate is generally considered to be a safe and effective...

  6. Benign prostate hyperplasia and stem cells: a new therapeutic opportunity.

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    Notara, Maria; Ahmed, Aamir

    2012-12-01

    Most men over 50 experience some lower urinary tract symptoms of nocturia, poor stream, urgency and frequency for urination, due to hyperplastic enlargement of the prostate (benign prostate hyperplasia, BPH). BPH is thought to be a disease with multiple aetiologies including hormone signalling, disruption of proliferation and apoptosis dynamics and chronic inflammation with changes in the morphology and phenotype of the prostate stroma. It has been proposed, recently, that stromal stem cells in prostate may be caused by the development of BPH. This review focuses on this putative role of stromal stem or stem-like cells in the development of BPH and assesses the potential of targeting the stem cells for the treatment of BPH.

  7. Natural history of benign prostate hyperplasia

    Institute of Scientific and Technical Information of China (English)

    WU Shi-liang; LI Ning-chen; XIAO Yun-xiang; JIN Jie; QIU Shao-peng; YE Zhang-qun; KONG Chui-ze; SUN Guang; NA Yan-qun

    2006-01-01

    Background Benign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.Methods One hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.Results All patients were visited after 6 months, the mean volume of transitional zone was found to haveincreased by 1.6 ml (P<0.01), International Prostate Symptom Score was increased by 0.8 (P<0.01) and Quality of Life was increased by 0.2 (P<0.01), and there was no statistical change in other data. Among these patients,17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).Conclusions After one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

  8. Prostate Artery Embolization for Benign Prostatic Hyperplasia: Current Status.

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    Mirakhur, Anirudh; McWilliams, Justin P

    2017-02-01

    Prostate artery embolization has garnered much attention as a promising treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. We aim to provide an up-to-date review of this minimally invasive technique, including discussion of potential benefits and technical challenges. Current evidence suggests it is a safe and effective option for patients with medication-refractory urinary obstructive symptoms who are poor surgical candidates or refuse surgical therapy. Larger, randomized studies with long-term follow-up data are needed for this technique to be formally established in the treatment paradigm for benign prostatic hyperplasia.

  9. Benign prostatic hyperplasia: symptoms and objective interpretation

    DEFF Research Database (Denmark)

    Andersen, J T

    1991-01-01

    Considerable new knowledge about benign prostatic hyperplasia has been gained over the past two decades, particularly with regard to its natural history, hydrodynamic changes in the lower urinary tract, and the symptomatic and urodynamic results of treatment. A survey of the literature has been u...

  10. Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

    Energy Technology Data Exchange (ETDEWEB)

    Bilhim, Tiago, E-mail: tiagobilhim@hotmail.com [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal); Pisco, Joao; Rio Tinto, Hugo; Fernandes, Lucia [Interventional Radiology, Saint Louis Hospital (Portugal); Campos Pinheiro, Luis [Universidade Nova de Lisboa (UNL), Departamento Universitario de Urologia, Faculdade de Ciencias Medicas (FCM) (Portugal); Duarte, Marisa; Pereira, Jose A. [Interventional Radiology, Saint Louis Hospital (Portugal); Oliveira, Antonio G. [Universidade Nova de Lisboa (UNL), Biostatistics Department, Faculdade de Ciencias Medicas (FCM) (Portugal); O' Neill, Joao [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal)

    2013-04-15

    This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-{mu}m nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.

  11. [Drugs for the treatment of benign prostatic hypertrophy].

    Science.gov (United States)

    Caprino, L

    2000-06-01

    Benign Prostatic Hyperplasia (BPH) usually occurs in males 45-50 old and progressively involves 75% of the male population over 75 years of age. The clinical manifestations of BPH are related primarily to bladder outlet obstructions resulting from enlargement (mechanical component) of the prostate gland, and from extrinsic and intrinsic sympathetic activation of alpha-adrenoceptors (dynamic component) present in the prostatic muscle tissue, prostatic urethra, bladder base and neck. Several drugs have been employed in the last decades: LHRH analogs (Leuprorelin and Goserelin) which can reduce the testicular production of androgens with reduction in prostate size; Serenoa repens for its anti-androgenic and anti-estrogenic activities; Finasteride (5-alpha-reductase inhibitor) which blocks the conversion of testosterone into the more active dihydrotestosterone. Finally, the alpha 1 blocking agents (Terazosin, Doxazosin, Tamsulosin) that improve urinary symptoms by acting on dynamic component. Clinical improvements derive from their antagonist action on alpha 1 adrenergic receptors which mediate contraction of the prostate gland, proximal urethra, bladder base and neck, with the consequent reduction of urethral pressure, bladder outlet resistance, and increase of urinary flow. Due to its pharmacodynamic and pharmacokinetic properties, as well as the clinical results obtained, Terazosin, alpha 1 blocker, appears to be particularly useful in the treatment of patients with mild- to moderate symptomatic BPH.

  12. Transurethral resection of the prostate (TURP) - Series (image)

    Science.gov (United States)

    An enlarged prostate gland compresses the urethra, causing problems with urination. Prostate enlargement is caused by prostate gland overgrowth (benign prostatic hypertrophy or hyperplasia) or in some cases, prostate cancer.

  13. Giant Benign Prostatic Hyperplasia in a Pakistani Patient

    Directory of Open Access Journals (Sweden)

    Zafaruddin Khan

    2014-01-01

    Full Text Available “Giant hyperplasia” of the prostate is a rare pathology of the prostate gland. We report one such case, in which a successful retropubic prostatectomy was performed on an elderly male patient in Pakistan. The weight of the resected prostate was 700 g, which is the eighth largest prostate with benign prostatic hyperplasia reported.

  14. Benign prostatic hyperplasia: age-related tissue-remodeling.

    Science.gov (United States)

    Untergasser, Gerold; Madersbacher, Stephan; Berger, Peter

    2005-03-01

    Aging and androgens are the two established risk factors for the development of benign prostatic hyperplasia (BPH) and benign prostatic enlargement (BPE), which can lead to lower urinary tract symptoms (LUTS) in elderly men. BPH, consisting of a nodular overgrowth of the epithelium and fibromuscular tissue within transition zone and periurethral areas, is first detectable around the fourth decade of life and affects nearly all men by the ninth decade. The pathogenesis of BPH is still largely unresolved, but multiple partially overlapping and complementary theories have been proposed, all of which seem to be operative at least to some extent. In addition to nerve-, endocrine- and immune system, local para- and luminocrine pleiotrope mechanisms/factors are implicated in the prostatic tissue-remodeling process. Prostate tissue-remodeling in the transition zone is characterized by: (i) hypertrophic basal cells, (ii) altered secretions of luminal cells leading to calcification, clogged ducts and inflammation, (iii) lymphocytic infiltration with production of proinflammatory cytokines, (iv) increased radical oxygen species (ROS) production that damages epithelial and stromal cells, (v) increased basic fibroblast (bFGF) and transforming growth factor beta (TGF-beta 1) production leading to stromal proliferation, transdifferentiation and extracellular matrix production, (vi) altered autonomous innervation that decreases relaxation and leads to a high adrenergic tonus, (vii) and altered neuroendocine cell function and release of neuroendocrine peptides (NEP). This review summarizes the multifactorial nature of prostate tissue remodeling in elderly men with symptomatic BPH with a particular focus on changes of cell-cell interactions and cell functions in the human aging prostate.

  15. Testosterone and benign prostatic hyperplasia

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    Thomas R Jarvis

    2015-04-01

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

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

    OpenAIRE

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

    2015-01-01

    The prostate is an androgen-sensitive organ that needs proper androgen/androgen receptor (AR) signals for normal development. The progression of prostate diseases, including benign prostate hyperplasia (BPH) and prostate cancer (PCa), also needs proper androgen/AR signals. Tissue recombination studies report that stromal, but not epithelial, AR plays more critical roles via the mesenchymal-epithelial interactions to influence the early process of prostate development. However, in BPH and PCa,...

  17. A signaling network in phenylephrine-induced benign prostatic hyperplasia.

    Science.gov (United States)

    Kim, Jayoung; Yanagihara, Yutaka; Kikugawa, Tadahiko; Ji, Mihee; Tanji, Nozomu; Masayoshi, Yokoyama; Freeman, Michael R

    2009-08-01

    Benign prostatic hyperplasia (BPH) is an age-related disease of unknown etiology characterized by prostatic enlargement and coinciding with distinctive alterations in tissue histomorphology. To identify the molecular mechanisms underlying the development of BPH, we conducted a DNA microarray study using a previously described animal model in which chronic alpha(1)-adrenergic stimulation by repeated administration of phenylephrine evokes histomorphological changes in the rat prostate that resemble human BPH. Bioinformatic tools were applied to microarray data obtained from prostate tissue to construct a network model of potentially relevant signal transduction pathways. Significant involvement of inflammatory pathways was demonstrable, including evidence for activation of a TGF-beta signaling cascade. The heterodimeric protein clusterin (apolipoprotein J) was also identified as a prominent node in the network. Responsiveness of TGF-beta signaling and clusterin gene and protein expression were confirmed independently of the microarray data, verifying some components of the model. This is the first attempt to develop a comprehensive molecular network for histological BPH induced by adrenergic activation. The study also implicated clusterin as a novel biochemical target for therapy.

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

    Science.gov (United States)

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

    2015-10-01

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

  19. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 2, Insights into the Technical Rationale.

    Science.gov (United States)

    Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M

    2016-02-01

    Rationale of prostatic artery embolization (PAE) in the treatment of symptomatic benign prostatic hyperplasia is conventionally believed to include two parts: shrinkage of the enlarged prostate gland as a result of PAE-induced ischemic infarction and potential effects to relax the increased prostatic smooth muscle tone by reducing the number and density of α1-adrenergic receptor in the prostate stroma. This review describes new insights into the likely mechanisms behind PAE, such as ischemia-induced apoptosis, apoptosis enhanced by blockage of androgens circulation to the embolized prostate, secondary denervation following PAE, and potential effect of nitric oxide pathway immediately after embolization. Studies on therapeutic mechanisms in PAE may shed light on potentially new treatment strategies and development of novel techniques.

  20. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 2, Insights into the Technical Rationale

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Fei, E-mail: feisun@ccmijesususon.com; Crisóstomo, Verónica, E-mail: crisosto@ccmijesususon.com; Báez-Díaz, Claudia, E-mail: cbaez@ccmijesususon.com; Sánchez, Francisco M., E-mail: msanchez@ccmijesususon.com [Jesús Usón Minimally Invasive Surgery Centre (Spain)

    2016-02-15

    Rationale of prostatic artery embolization (PAE) in the treatment of symptomatic benign prostatic hyperplasia is conventionally believed to include two parts: shrinkage of the enlarged prostate gland as a result of PAE-induced ischemic infarction and potential effects to relax the increased prostatic smooth muscle tone by reducing the number and density of α{sub 1}-adrenergic receptor in the prostate stroma. This review describes new insights into the likely mechanisms behind PAE, such as ischemia-induced apoptosis, apoptosis enhanced by blockage of androgens circulation to the embolized prostate, secondary denervation following PAE, and potential effect of nitric oxide pathway immediately after embolization. Studies on therapeutic mechanisms in PAE may shed light on potentially new treatment strategies and development of novel techniques.

  1. Treating benign prostatic hyperplasia with botulinum neurotoxin.

    Science.gov (United States)

    Brisinda, G; Vanella, S; Marniga, G; Crocco, A; Maria, G

    2011-01-01

    Botulinum toxin (BoNT) has been increasingly used in the interventional treatment of several disorders; the use of this agent has extended to a plethora of conditions including focal dystonia, spasticity, inappropriate contraction in most gastrointestinal sphincters, eye movement disorders, hyperhidrosis, genitourinary disorders and aesthetically undesirable hyperfunctional facial lines. In addition, BoNT is being investigated for the control of pain, and for the management of tension or migraine headaches and myofascial pain syndrome. Benign prostatic hyperplasia (BPH) is a common condition in ageing men; the goal of therapy is to reduce the lower urinary tract symptoms (LUTS) associated with BPH and to improve the quality of life. However, medical treatment, including drugs that relax smooth muscle within the prostate and drugs that shrink the gland are not totally effective or without complications. The standard surgical treatment for BPH is progressively changing to minimally invasive therapies, but none of them has provided clear results. The use of BoNT-A to inhibit the autonomic efferent effects on prostate growth and contraction, and inhibit the abnormal afferent effects on prostate sensation, might be an alternative treatment for BPH. BoNT injections have several advantages over drugs and surgical therapies in the management of intractable or chronic disease; systemic pharmacologic effects are rare, permanent destruction of tissue does not occur, and graded degrees of relaxation may be achieved by varying the dose injected. In this paper, clinical experience over the last years with BoNT in BPH impaired patients will be illustrated.

  2. Transurethral microwave thermotherapy for benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Rubeinstein Jonathan N.

    2003-01-01

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

  3. Transurethral electrochemical treatment of benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    张民; 龚侃; 李宁; 曾荔; 那彦群

    2003-01-01

    Objective To study the mechanism and feasibility of transurethral electrochemical therapy for the treatment of benign prostatic hyperplasia (BPH). Methods Between March 1998 and March 2000, specifically designed devices and catheters for electrochemical therapy were applied to 6 prostate specimens obtained by suprapubic prostatectomy in order to treat BPH patients with urinary retention for whom surgery was contraindicated. Sixteen patients (with a mean age of 77.3 years old) underwent electrical treatment totaling 160-220 coulombs under topical urethral anesthesia for 68-132 min. The catheters remained inside the patient for 7-10 d. Results Irreversible destructive changes occurred within cathodal tissue, while carbonization occurred within anodic tissue. The radius of tissue change was 7-8 mm and 1-2 mm, respectively. In vivo trial: 11 (69%) patients could be weaned off the catheters with satisfactory urination. Three months after therapy, the mean international prostate symptom score (IPSS) was 14.5, mean peak flow rate was 10.5 ml/s, and mean residual urine was 39 ml. No serious complications were observed. Conclusion Transurethral electrochemical treatment is potentially a minimally invasive alternative for treatment of BPH, especially for elderly patients at high risk.

  4. Risk stratification for benign prostatic hyperplasia.

    Science.gov (United States)

    Zattoni, Fabio; Ficarra, Vincenzo; Novara, Giacomo

    2017-03-18

    Benign prostatic hyperplasia (BPH) represents an important public health problem in ageing men due to frequently associated lower urinary tract symptoms (LUTS), which may impair quality of life. BPH is also a progressive disease, mainly characterized by a worsening of LUTS over time, and in some patients by the occurrence of serious outcomes such as acute urinary retention and need for BPH-related surgery. The management of BPH and LUTS in men should move forward its focus on symptom control only. Indeed, the goals of therapy for BPH are not only to improve bothersome LUTS but also to identify those patients at risk of unfavourable outcomes in order to optimize their management and reduce complications. Risk stratification and tailored treatment should improve the reductions in both symptoms and the long-term consequences of BPH and BPH treatments. To do this, clinicians need to know possible factors that may support the develop of PBH and possible risks due to the BPH itself.

  5. Immunohistochemical Analysis of Omi/HtrA2 Expression in Prostate Cancer and Benign Prostatic Hyperplasia

    Institute of Scientific and Technical Information of China (English)

    HU Xiaoyong; CHEN Xiaochun; PING Hao; CHEN Zhaohui; ZENG Fuqing; LU Gongcheng

    2005-01-01

    To study the expression and significance of the serine protease Omi/HtrA2 in prostate cancer and benign prostatic hyperplasia. The expression of Omi/HtrA2 was assayed by means of immunohistochemical technique in 41 prostate cancer (Cap), 20 benign prostatic hyperplasia (BPH) and 10 normal prostate (NP) specimens. Omi/HtrA2 expression was positive in 30 (73.17%) prostate cancer specimens, and the positive rate of Omi/HtrA2 was lower in well differentiated than in poorly and moderately differentiated groups (P<0.05). By contrast, the cells in normal prostate and benign prostatic hyperplasia groups showed no or weak expression of Omi/HtrA2.Prostate cancer cells in vivo may need Omi/HtrA2 expression for apoptosis, and that Omi/HtrA2expression might be involved in prostate cancer development.

  6. Review of Prostate Anatomy and Embryology and the Etiology of Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Aaron, LaTayia; Franco, Omar E; Hayward, Simon W

    2016-08-01

    Prostate development follows a common pattern between species and depends on the actions of androgens to induce and support ductal branching morphogenesis of buds emerging from the urogenital sinus. The human prostate has a compact zonal anatomy immediately surrounding the urethra and below the urinary bladder. Rodents have a lobular prostate with lobes radiating away from the urethra. The human prostate is the site of benign hyperplasia, prostate cancer, and prostatitis. The rodent prostate has little naturally occurring disease. Rodents can be used to model aspects of human benign hyperplasia, but care should be taken in data interpretation and extrapolation to the human condition.

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

    Directory of Open Access Journals (Sweden)

    Haopeng Pang, MD, PhD

    2015-12-01

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

  8. Risks of Prostate Cancer Screening

    Science.gov (United States)

    ... prostate may be similar to symptoms of prostate cancer . Enlarge Normal prostate and benign prostatic hyperplasia (BPH). A normal prostate does not block the flow of urine from the bladder. An enlarged prostate presses on the bladder and urethra and blocks the flow of urine. See the ...

  9. Epidemiology and management of symptomatic benign prostatic hyperplasia

    NARCIS (Netherlands)

    K.M.C. Verhamme (Katia)

    2004-01-01

    textabstractBenign prostatic hyperplasia (BPH) is the most common non-cancerous form of cell growth in men and usually begins with the formation of microscopic nodules in younger men. As BPH progresses, overgrowth occurs in the central area of the prostate, called the transition zone, which wraps ar

  10. Minimally Invasive Surgical Treatments for Benign Prostatic Hyperplasia

    NARCIS (Netherlands)

    V. Tzortzis; S. Gravas; J.J.M.C.H. de la Rosette

    2009-01-01

    Although transurethral resection of the prostate (TURP) is considered to be the reference standard for minimally invasive surgical treatment (MIST) of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO), it is associated with a noteworthy rate of complication. Transurethral

  11. Benign Prostatic Hyperplasia: Health Seeking Behaviour of patients at a tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Aman Deep

    2010-03-01

    Full Text Available BackgroundBenign Prostatic Hyperplasia is a widely prevalent conditionaffecting elderly men throughout the world. With increasinglife expectancy, there has been a rise in the percentage ofelderly men and so for this disease across the globe. There islack of information about health seeking behaviour of patientswith Benign Prostatic Hyperplasia. Therefore the study wasdesigned with the objectives of assessing health-seekingbehaviour and the effect of literacy on it among adult andolder subjects suffering from Benign Prostatic Hyperplasiaattending a tertiary care hospital.MethodA series of 81 patients suffering from Benign ProstaticHyperplasia above the age of 50 years, attending surgical OutPatient Department of a tertiary care hospital in Delhi, wereassessed for their health seeking behaviour using a pre-testedand a modified questionnaire designed for assessing healthseeking behaviour.ResultsPositive health seeking behaviour of patients was observed in44%, who reported to a doctor within a month of noticingtheir problem. A greater proportion of the literates was awareabout the symptoms suggestive of enlarged prostate andconsulted a qualified health care practitioner as their firstaction. More literates approached the higher level of healthcare facility on being referred and had maximum faith inallopathic system of medicine. Also, lesser number of literateshad performed pooja (Hindi word for worship or othertraditional rituals for relief of their problems.ConclusionWe concluded that majority of subjects suffering fromBenign Prostatic Hypertrophy were not aware of theirdisease and their health-seeking behaviour was poor andcould be related to literacy. Our data highlights the needfor public awareness program targeting the younger malepopulation so that early detection and treatment can beoffered.

  12. Comparison of telomerase activity in prostate cancer, prostatic intraepithelial neoplasia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Soleiman Mahjoub

    2006-11-01

    Full Text Available BACKGROUND: Telomerase is a reverse transcriptase enzyme that synthesizes telomeric DNA on chromosome ends. The enzyme is important for the immortalization of cancer cells because it maintains the telomeres. METHODS: Telomerase activity (TA was measured by fluorescence-based telomeric repeat amplification protocol (FTRAP assay in prostate carcinoma and benign prostatic hyperplasia (BPH. RESULTS: TA was present in 91.4% of 70 prostate cancers, 68.8% of 16 prostatic intraepithelial neoplasia (PIN, 43.3% of 30 BPH*, 21.4% of 14 atrophy and 20% of 15 normal samples adjacent to tumor. There was not any significant correlation between TA, histopathological tumor stage or gleason score. In contrast to high TA in the BPH* tissue from the cancer-bearing gland, only 6.3% of 32 BPH specimens from patients only diagnosed with BPH were telomerase activity-positive. CONCLUSIONS: These results indicate that TA is present in most prostate cancers. The high rate of TA in tissue adjacent to tumor may be attributed either to early molecular alteration of cancer that was histologically unapparent, or to the presence of occult cancer cells. Our findings suggest that the re-expression of telomerase activity could be one step in the transformation of BPH to PIN. KEY WORDS: Telomerase activity, prostate cancer, prostatic intraepithelial neoplasia, benign prostatic hyperplasia.

  13. The frequency of benign prostate hypertrophy in Calabar.

    Science.gov (United States)

    Umezurike, B I; Ekanem, T B; Eluwa, M A; Etta, K K; Udo-Affah, G A; Aligwekwe, A U

    2006-09-01

    The present study was to find out through histopathological records the most frequently occurring disease of the prostate from suspected prostate diseases in Calabar, Cross River State, Nigeria. A total number of 324 cases of prostatic biopsies and autopsy materials recorded in the histopathology laboratory of the University of Calabar Teaching Hospital (UCTH), Calabar between 1986 and 1995 were used for this study. Benign prostatic hypertrophy was observed as the major pathology among all the diseases of the prostate gland recorded in UCTH in Calabar having accounted for 76.3% (261 out of 342) while prostatic carcinoma accounted for 19% (65 out of 324), rest 4.7% (16 out of 342) were inflammatory lesions. The result indicated that benign prostatic hypertrophy occurs in men from 40 years and above. The frequency increased with age, reaching a maximum of 34.5% (90 out of 261) in the age group (70-79) years old. The people in Cross River State should be informed of the high frequency of benign prostatic hypertrophy and should be advised to seek health care promptly in suspected prostate related illness.

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

    Science.gov (United States)

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

    2016-04-01

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

  15. TISSUE POLYPEPTIDE-SPECIFIC ANTIGEN - A DISCRIMINATIVE PARAMETER BETWEEN PROSTATE-CANCER AND BENIGN PROSTATIC HYPERTROPHY

    NARCIS (Netherlands)

    MARRINK, J; OOSTEROM, R; BONFRER, HMG; SCHRODER, FH; MENSINK, HJA

    1993-01-01

    The serum concentration of the cell proliferation marker TPS (tissue polypeptide-specific antigen) was compared with the tumour marker PSA (prostate specific antigen). PSA was found elevated in 50% of the benign prostatic hypertrophy (BPH) patients, in 88% of the patients with active prostate cancer

  16. The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    George Camara-Lopes

    2013-04-01

    Full Text Available Objective Prostatic artery embolization (PAE for the treatment of patients with symptomatic benign prostatic hyperplasia (BPH is believed to be a safe procedure with a low risk of adverse side effects. Artery embolization is a viable treatment option in patients who are refractory to the classic noninvasive treatments. Knowledge of the histological characteristics of prostate tissue following the procedure is still limited. In this study, we describe the microscopic aspects of the prostate following PAE for BPH. Materials and Methods Two patients underwent transurethral resections of the prostate (TURP after PAE. Embolizations were performed under local anesthesia with an initial pelvic angiography to evaluate the iliac vessels and the prostate arteries using a 2.8 French microcatheter. The prostate was embolized with 300-500µm Microspheres (Embosphere®, using complete blood stasis as the end point. The prostate tissues were analyzed histologically to characterize the effects of the embolization. Results The embolic material within the prostate tissue was easily identified as homogeneous, bright eosin-red spheroids filling the vessel lumens. Ischemic necrosis surrounded or not by chronic inflammatory reactions containing macrophages were considered as a result of the artery embolization. Also, some aspects related to the healing process were observed being fibrotic nodules surrounded by glands with squamous metaplasia of the epithelial lining the most important. In the remaining sections, due to the precocious surgical intervention, the classic findings of BPH were still present with the glandular and stromal hyperplasia associated with nonspecific chronic prostatitis. Conclusions This is the first description of prostate histology in BPH patients treated by PAE, a new procedure that is being used increasingly as a therapeutic intervention. The recognition of the changes caused by this new modality of treatment has become a very important

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

    Science.gov (United States)

    Lokant, M T; Naz, R K

    2015-04-01

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

  18. The medical management of lower urinary tract symptoms and benign prostatic hyperplasia.

    Science.gov (United States)

    Holtgrewe, H L

    1998-11-01

    Prostatism is a widely used term assigned to the symptom complex of older men with voiding dysfunction. The cause of the syndrome has routinely been ascribed to an enlarged prostate. More recent thinking recognizes that many men with such symptoms do not, in fact, have prostate enlargement or benign prostatic hyperplasia (BPH) and that such symptoms are not a surrogate for BPH. Such recognition is essential if cost effective medical management of lower urinary tract symptoms (LUTS) is to be achieved. Prostate volume has emerged as a key factor in the selection of medical therapy of LUTS and BPH not only regarding symptom relief but also to the newer concept of the prevention of disease progression and the avoidance of future adverse events in those men with true BPH. In the United States, medical management is now first line therapy for LUTS. The proper selection of therapy based on the patient's individual pathophysiologic characteristics is now made possible by many new recent studies within the medical literature.

  19. Role of Transition Zone Index in the Prediction of Clinical Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Muhammet Güzelsoy

    2016-12-01

    Full Text Available Objective The objective of this study was to determine the role of the transition zone (TZ index (TZI in the prediction of clinical benign prostatic hyperplasia (BPH in patients who underwent transurethral prostatectomy (TUR-P and to analyze the correlation between the amount of resected tissue and TZ volume (TZV. Materials and Methods Twenty-six male clinical BPH patients with obstructive complaints and 17 male benign prostate enlargement (BPE patients without any complaints were included in the study. Both the groups were over the age of 50. Clinical BPH patients underwent complete TUR-P. Statistical analysis was done with SPSS. Sensitivity, specificity, positive and negative predictive values of TZI-as a method of assessing clinical BPH-were measured. Results There was a statistically significant difference in prostate volume, uroflowmetry patterns, prostate-specific antigen (PSA, International prostate symptom score (IPSS, TZV and TZI between the two groups. There was a correlation between TZV and the amount of resected tissue (r=0.97; p0.40 has a high level of sensitivity and specificity in the prediction of clinical BPH among patients who undergo TUR-P due to obstructive symptoms and reported as BPH. There is a strong correlation between the amount of resected tissue and TZV. TZI is a valuable tool in diagnosis, and TZV gives valuable information about the patient to the surgeon.

  20. Smoking habits and benign prostatic hyperplasia

    Science.gov (United States)

    Xu, Huan; Fu, Shi; Chen, Yanbo; Chen, Qi; Gu, Meng; Wang, Zhong

    2016-01-01

    Abstract Previous studies have warned against the promoting effects of cigarette smoking on benign prostatic hyperplasia (BPH). In contrast, some have argued that smoking confers a protective effect regarding BPH, while others have observed an aggravated effect. Thus, we performed this meta-analysis to determine whether cigarette use is associated with BPH risk. To identify articles from observational studies of relevance, a search was performed concurrent to March 21, 2016, on PubMed, Web of Science, Cochrane, EBSCO, and EMBASE databases. Random-effect model, according to the heterogeneity, was calculated to reveal the relative risks (RRs) and corresponding 95% confidence intervals (CIs). Eight articles were included in this meta-analysis, representing data for 44,100 subjects, of which 5221 (11.8%) had BPH as defined according to the criteria. Seven reports are concerned with analysis between nonsmokers and ex-smokers, in which no significant difference was observed (RR = 0.99, 95% CI 0.94–1.05). Another meta-analysis of 7 studies indicated an observable trend, but without significant difference between groups of nonsmokers and current smokers (RR = 1.17, 95% CI 0.98–1.41). Between groups of heavy (6 articles; RR = 1.02, 95% CI 0.84–1.24) and light smokers (5 articles; RR = 0.90, 95% CI 0.71–1.15), again no significant difference appears. Finally, we combined individuals as never-smokers and ever-smokers and still found no significant difference between the 2 groups of patients (RR = 1.03, 95% CI 0.92–1.15). Sensitivity analysis was displayed and confirmed the stability of the present results. Combined evidence from observational studies shows no significant association between cigarette smoking and BPH risk, either for ex-smokers or for current smokers. The trend of elevated BPH risk from smoking was observed only in current smokers compared with nonsmokers, while marginal significance was observed in comparing ever-smokers with

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-07-01

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

  2. Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia

    NARCIS (Netherlands)

    Mochtar, CA; Kiemeney, LALM; van Riemsdijk, MM; Barnett, GS; Laguna, MP; Debruyne, FMJ; de la Rosette, JJMCH

    2003-01-01

    Objectives: To assess the ability of serum prostate specific antigen (PSA) to estimate prostate volume (PV) to aid in the management of patients with benign prostatic hyperplasia (BPH). Methods: From 1989 to 2002, data were collected from 2264 patients complaining of lower urinary tract symptoms (LU

  3. Developing appropriate criteria for Benign Prostatic Hyperplasia Surgery Using RAND Appropriateness Method (RAM

    Directory of Open Access Journals (Sweden)

    R Ostovar

    2009-07-01

    Full Text Available ABSTRACT: Introduction & Objective: Results of different studies show that a relatively large number of healthcare services offered are inappropriate or unnecessary. Benign prostatic hyperplasia is a benign enlargement of the prostate gland. Clinical features of this disease are one of the most common problems encountered by elderly males. The aim of this study was to assess the appropriateness of benign prostatic hyperplasia surgery. Materials & Methods: In this qualitative study which was conducted in 2008-9, in Tehran University of Medical Sciences, the RAN/UCLA method was used, which was designed in 1980 by the RAND institute and the University of California in Los Angeles. Regarding the stages of our method, scenarios and indications for benign prostatic hyperplasia surgery were chosen from the latest approved scientific resources and subsequently sent to urology specialists, who were chosen as members of the specialized panel. Panel members gave scores ranging from 1 to 9 to each indication and scenario based on scientific resources, clinical experiences and patient’s condition in two separate panel sessions. After compilation, the indications were finally grouped as appropriate, equivocal, and inappropriate so that they could be used to determine appropriateness of benign prostatic hyperplasia surgery in hospitals. In this study, the most suitable and most approved clinical guidelines related to benign prostatic hyperplasia, the Guidelines Evaluation and Research Appraisal (AGREE were used.The selected guidelines were used as scientific resources for choosing the indications of benign prostatic hyperplasia surgery. SPSS version 16 and kappa weighted value were used in analysis process of the study. Results: Out of 282 scenarios grouped as 9 conditions related to benign prostatic hyperplasia surgery, which were extracted from scientific sources, 73 cases (25.9% were considered as appropriate, 14 cases (5% as equivocal and 7 cases (2

  4. Expression of cyclooxygenase-2 in prostate adenocarcinoma and benign prostatic hyperplasia.

    Science.gov (United States)

    Lee, L M; Pan, C C; Cheng, C J; Chi, C W; Liu, T Y

    2001-01-01

    Elevated expression of cyclo-oxygenase (COX)-2 has been found in several human cancers, including prostate adenocarcinoma. To evaluate the potential prognostic role of COX-2 in prostate cancer, we assessed the expression of COX-2 in benign prostatic hyperplasia (BPH) and prostate cancer samples employing immunohistochemistry. COX-2 was over-expressed in 15 out of 18 (83%) prostate cancer samples whereas it was detected in only 22% (4 of 18) paired benign tissues. The intensity of immunostaining correlated with the tumor grading. In addition, COX-2 was expressed in 7 of the 22 (32%) BPH samples examined. The significance a COX-2 expression in the BPH samples is not known at present. This data suggest that COX-2 is over-expressed in prostate cancer and COX-2 inhibitors may be useful in combination chemotherapy or chemoprevention for prostate cancer.

  5. The link between benign prostatic hyperplasia and prostate cancer

    DEFF Research Database (Denmark)

    Ørsted, David Dynnes; Bojesen, Stig E

    2013-01-01

    studies have shown that men with BPH have an increased risk of prostate cancer and prostate-cancer-related mortality, it remains unclear whether this association reflects a causal link, shared risk factors or pathophysiological mechanisms, or detection bias upon statistical analysis. Establishing BPH...... as a causal factor for prostate cancer development could improve the accuracy of prognostication and expedite intervention, potentially reducing the number of men who die from prostate cancer....... therapy. Furthermore, risk factors such as prostate inflammation and metabolic disruption have key roles in the development of both diseases. Despite these commonalities, BPH and prostate cancer exhibit important differences in terms of histology and localization. Although large-scale epidemiological...

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  7. Expression of TRPC6 in benign and malignant human prostate tissues

    Institute of Scientific and Technical Information of China (English)

    Dan Yue; Yong Wang; Jian-Ying Xiao; Ping Wang; Chang-Shan Ren

    2009-01-01

    ancer cell lines. In summary, TRPC6 is detected in benign and malignant human prostate tissues and prostate cancer cell lines and is associated with the histological grade, Gleason score and extraprostatic extension of prostate cancer.

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

    Science.gov (United States)

    Nicholson, Tristan M; Ricke, William A

    2011-01-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  10. Malondialdehyde in benign prostate hypertrophy: a useful marker?

    Directory of Open Access Journals (Sweden)

    Rosaria Alba Merendino

    2003-01-01

    Full Text Available Benign prostate hypertrophy (BPH is the most common benign tumor in men due to obstruction of the urethra and, finally, uremia. Malondialdehyde (MDA is a product derived from peroxidation of polyunsaturated fatty acids and related esters. Evaluation of MDA in serum represents a non-invasive biomarker of oxidative stress. Prostate-specific antigen (PSA is a sensitive marker for prostatic hypertrophy and cancer. We analyzed MDA serum levels to evaluate the oxidative stress in BPH. To this end, 22 BPH patients and 22 healthy donors were enrolled. Data show an increase of MDA level in BPH patients and a positive correlation between PSA and MDA levels. In conclusion, we describe a previously unknown relationship between PSA and MDA as an index of inflammation and oxidative stress in BPH.

  11. [Sexual problems in patients with prostate cancer and those with benign prostatic hypertrophy].

    Science.gov (United States)

    Danilin, J E; Marilov, V V; Brukhin, A E

    2011-03-23

    We use the word "tumour" both for a benign prostatic hypertrophy and for a prostatic cancer. The psycho-emotional reactions from a man suffering from these illnesses could be different depending on the kind of tumour, but could be similar especially concerning sexual problems connected with the specific affliction. Hence the necessity also to consider beneficial a psychotherapeutic and sexotherapeutic intervention.

  12. Possible relations between oxidative damage and apoptosis in benign prostate hyperplasia and prostate cancer patients.

    Science.gov (United States)

    Kosova, Funda; Temeltaş, Gökhan; Arı, Zeki; Lekili, Murat

    2014-05-01

    Cancer has been described as the twentieth century plague, and is a very common health problem. It has been reported that ROS and ROS products play a key role in cancer and that oxidative damage is effective in apoptosis initiation. In this study we aimed to evaluate the relationship between MDA (malondialdehyde), DNA damage (8-hydroxyguanine, 8-OH-dG), and caspase-3 in BHP and prostate cancer patients. Twenty male patients with prostate cancer and 20 male patients with benign prostate hyperplasia were included into this study. The MDA (nanomole), DNA damage (nanograms per millilitre), and caspase-3 (nanograms per millilitre) levels were measured in prostate cancer and benign prostate hyperplasia using Elisa kits (Millipore Corporation, Billerica, MA, USA). In the prostate cancer group, serum MDA (30.96 ± 9.25) and DNA damage (4.42 ± 0.36) levels were significantly raised (p benign prostate hyperplasia group (24.05 ± 8.06, 3.99 ± 0.54). However, in the prostate cancer group, serum caspase-3 (2.36 ± 0.82) levels were statistically significantly lowered (p benign prostate hyperplasia group (3.15 ± 1.04). We observed that altered prooxidant, DNA damage levels may lead to an increase in oxidative damage and may consequently play an important role in prostate carcinogenesis. These findings indicate that, although the triggering of these changes is unknown, changes in the levels of MDA, DNA damage, and caspase-3 in the blood are related to prostatic carcinoma development. In addition, it would be appropriate to conduct new studies with a large number of patients at different stages.

  13. Enlarged vestibular aqueduct (EVA) related with recurrent benign paroxysmal positional vertigo (BPPV).

    Science.gov (United States)

    Manzari, Leonardo

    2008-01-01

    The vestibular aqueduct is a bony canal related to the bony labyrinth of the inner ear and represents the non-sensory components of the endolymph-filled, closed, membranous labyrinth. The association of congenital sensorineural hearing loss with a large or enlarged vestibular aqueduct is well known as the large vestibular aqueduct syndrome (LVAS). The enlarged VA (EVA) comprises abnormalities not only in the structure of the inner ear, but also in the physiology of the auditory and vestibular systems. The clinical picture of this clinical entity is variable [Yetiser S, Kertment M, Ozkaptan Y. Vestibular disturbance in patients with Large Vestibular Aqueduct Syndrome (LVAS). Acta Otolaryngol (StochK) 1999;119: 641-646]. Signs and symptoms of the auditory impairment are more commonly described in the literature: hearing loss ranges from mild to profound, arising from fluctuating to stepwise progressive or sudden. Vestibular disturbances, ranging from mild imbalance to episodic vertigo, are rarely described in the literature. Benign paroxysmal positional vertigo (BPPV) is a labyrinthine disorder with a typical behavior: intense crises of rotational vertigo induced by postural changes of the head, with short duration and usually good responsiveness to rehabilitative maneuvers. These maneuvers are effective in about 80% of patients with BPPV. BPPV often recurs. About 1/3 of patients have a recurrence in the first year after treatment, and by five years, about half of all patients have a recurrence. Vestibular aqueduct has been demonstrated by conventional tomography and computed tomography (CT), however, CT scans cannot show the membranous labyrinth itself. On MR images it is not the vestibular aqueduct that is visualized but its contents, the endolymphatic duct and sac, and can show the abnormalities of the fluid spaces related to the membranous labyrinth. It is proposed that recurrent benign paroxysmal positional vertigo (BPPV) is related with volumetric abnormalities

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

    Science.gov (United States)

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

    2012-10-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

  16. Pharmacological and nutritive support of patients with benign prostatic hyperplasia and chronic prostatitis

    Directory of Open Access Journals (Sweden)

    A. B. Bat'ko

    2015-01-01

    Full Text Available The articles presents a view of the pharmacological and nutritive therapy of the most frequent diseases of males, which are benign prostatic hyperplasia and chronic prostatitis. A modern man is in constant deficiency of various biologically active substances, with the lack of them in food and without generating of sufficient quantity of coenzymes and enzymes. In the author,s opinion, complex drugs that contain highquality biological extracts may provide the substances required for prevention and slowing down the progress of benign prostatic hyperplasia and chronic prostatitis to the male organism. Study of biological activity of food supplement Andro-PRO (Russia that contain the elements required for normalization of the functional state of the prostate was performed. Application of the drug favors positive dynamics of clinical symptoms of the studied nosological entities and has restorative effect on the function of the glandular tissue of the prostate. Analysis of modern references, primary results of clinical studies show the necessity of pharmacological and nutritive support of patients with asymptomatic progress of benign prostatic hyperplasia and chronic prostatitis with the drug. Application of drug studied is efficient and safe, which is confirmed with improvement of indicators and life quality assessment, positive clinical dynamics, and absence of side effects. 

  17. Pharmacological and nutritive support of patients with benign prostatic hyperplasia and chronic prostatitis

    Directory of Open Access Journals (Sweden)

    A. B. Bat ,ko

    2015-04-01

    Full Text Available The articles presents a view of the pharmacological and nutritive therapy of the most frequent diseases of males, which are benign prostatic hyperplasia and chronic prostatitis. A modern man is in constant deficiency of various biologically active substances, with the lack of them in food and without generating of sufficient quantity of coenzymes and enzymes. In the author,s opinion, complex drugs that contain highquality biological extracts may provide the substances required for prevention and slowing down the progress of benign prostatic hyperplasia and chronic prostatitis to the male organism. Study of biological activity of food supplement Andro-PRO (Russia that contain the elements required for normalization of the functional state of the prostate was performed. Application of the drug favors positive dynamics of clinical symptoms of the studied nosological entities and has restorative effect on the function of the glandular tissue of the prostate. Analysis of modern references, primary results of clinical studies show the necessity of pharmacological and nutritive support of patients with asymptomatic progress of benign prostatic hyperplasia and chronic prostatitis with the drug. Application of drug studied is efficient and safe, which is confirmed with improvement of indicators and life quality assessment, positive clinical dynamics, and absence of side effects. 

  18. Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia.

    Science.gov (United States)

    Holtgrewe, H L

    1998-04-01

    Management of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) has been central to urology for decades. The urologic community has increasingly come to realize that many men with LUTS do not have prostate enlargement and do not need their prostates debulked surgically. Of all the factors that have emerged to alter the trends associated with management of LUTS and BPH, none has had more impact than the advent of medical therapy. The selective, long-acting, alpha1-blocking agents terazosin, doxazosin, and tamsulosin have become most popular because of their specificity in the urinary tract, reduced side effects, and simplicity of dosage. In addition, finasteride, a 5-alpha-reductase inhibitor, was found to be effective in men with prostates of > or = 40 g. Furthermore, the larger the prostate at baseline, the greater the efficacy of finasteride on symptom relief and flow rate improvement. In addition to medical therapy, an array of device therapies has emerged in the management of LUTS and BPH. Laser prostatectomy is the oldest of the device therapies and includes transurethral vaporization of the prostate (VLAP), transurethral evaporation of the prostate (TUEP), and transurethral interstitial laser prostatectomy (TILP). Studies report beneficial outcomes approaching those achieved with transurethral resection of the prostate (TURP) with less morbidity and a shorter hospital stay. Common diseases contribute the most to national healthcare expenditures. The management of LUTS and BPH are such disorders and result in the expenditure of vast healthcare resources worldwide. The surgical strategies have an established record of outcomes documenting their potential for symptom relief and the avoidance of future complications. Medical and device therapies, although currently promising and attractive, therefore must prove comparable durability.

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

    OpenAIRE

    IZUMI, KOUJI; Mizokami, Atsushi; Lin, Wen-Jye; Lai, Kuo-Pao; Chang, Chawnshang

    2013-01-01

    Benign prostate hyperplasia (BPH) is a major cause of lower urinary tract symptoms, with an increased volume of transitional zone and associated with increased stromal cells. It is known that androgen/androgen receptor (AR) signaling plays a key role in development of BPH, and that blockade of this signaling decreases BPH volume and can relieve lower urinary tract symptoms, but the mechanisms of androgen/AR signaling in BPH development remain unclear, and the effectiveness of current drugs fo...

  20. Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction

    Directory of Open Access Journals (Sweden)

    Nikesh Thiruchelvam

    2014-01-01

    Full Text Available 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.

  1. Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction.

    Science.gov (United States)

    Thiruchelvam, Nikesh

    2014-04-01

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

  2. Inhibitory effect of diosgenin on experimentally induced benign prostatic hyperplasia in rats.

    Science.gov (United States)

    Chen, Jing; Zhang, Huai-Fen; Xiong, Chao-Mei; Ruan, Jin-Lan

    2016-12-01

    This study investigated the effect of diosgenin, a natural sapogenin possessing various pharmacological activities, on benign prostatic hyperplasia (BPH) in rats and the possible mechanisms. BPH was established in the castrated rats by subcutaneous injection of testosterone propionate. Animals were randomly divided into four groups (n=10 each): model group (0.5% sodium carboxymethyl cellulose); positive control group (3 mg/kg finasteride); two diosgenin groups (50 and 100 mg/kg). The drugs were intragastricaly given in each group for consecutive 3 weeks. Another 10 rats with no testicles cut off served as negative controls and they were subcutaneously injected with 0.1 mL olive oil per day and then treated with 0.5% sodium carboxymethylcellulose. After 3-week administration, the prostate index and serum PSA level were determined, and histopathological examination was carried out. The levels of MDA, SOD and GPx in prostates were also measured. Additionally, the expression of Bcl-2, Bax and p53 was examined using Western blotting. The results showed that the prostate index and serum PSA level were significantly decreased, and the pathological changes of the prostate gland were greatly improved in diosgenin groups as compared with the model group. Elevated activities of SOD and GPx, and reduced MDA level were also observed in diosgenin-treated rats. In addition, the expression of Bcl-2 in prostates was down-regulated, whereas that of Bax and p53 was up-regulated in diosgenin-treated rats. These results indicated that diosgenin was effective in inhibiting testosterone propionate-induced prostate enlargement and may be a candidate agent for the treatment of BPH.

  3. Bladder drainage and glandular epithelial morphometry of the prostate in benign prostatic hyperplasia with severe symptoms

    Directory of Open Access Journals (Sweden)

    Carlos A. Cury

    2006-04-01

    Full Text Available OBJECTIVE: Morphometrically analyze the cells nuclei of the basal layer of the prostatic glandular epithelium in 20 patients aged between 57 and 85 years presenting benign prostatic hyperplasia with severe symptoms, catheterized or not. MATERIALS AND METHODS: Patients with score of severe prostatic symptoms (with indication for transurethral resection of the prostate were distributed according to the presence or absence of bladder drainage previous to the surgery, in the treated group (n = 10, catheter during 3 months and in the control group (n = 10, without catheter. After obtaining prostate fragments through transurethral resection and the use of morphometric techniques, 100 nuclei of prostatic glands epithelium cells were studied (as to size and form, and compared to 500 nuclei from patients submitted to catheter drainage and 500 nuclei of non-catheterized patients. RESULTS: Significantly reduced values of the major, medium and minor nuclear diameters, volume, area and perimeter, contour index and nuclear volume-nuclear area ratio were observed in the treated group in relation to the control group. As to the form, eccentricity and coefficient of nuclear form, there were significant differences between treated and control groups. CONCLUSION: Long-term catheter bladder drainage in patients presenting benign prostatic hyperplasia with severe symptoms is associated to the reduction of morphometric parameters of the nuclei of prostatic glands’ epithelial cells, suggesting a likely decompressive duct effect.

  4. Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

    Directory of Open Access Journals (Sweden)

    Giovanni Corona

    2014-10-01

    Full Text Available Digito-rectal examination (DRE of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction (SD. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects (n = 1823; mean age 54.7 ± 11.4 selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome (HR = 1.346 (1.129-1.759; P = 0.030, type 2 diabetes mellitus (HR = 1.489 (1.120-1.980; P = 0.006, increased LDL cholesterol (>100 mg dl−1 ; HR = 1.354 (1.018-1.801; P = 0.037 and increased mean blood pressure (BP values (HR = 1.017 (1.007-1.027 for each mmHg increment; P = 0.001. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction (ED, as well as with other andrological conditions, such as varicocele and premature ejaculation (PE. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample (HR = 3.318 (2.304; 4.799 for each log unit increment in PSA levels; P < 0.0001. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical (DRE or biochemical (PSA inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular (CV background of the patient.

  5. Comparison between prostate volume and intravesical prostatic protrusion in detecting bladder outlet obstruction due to benign prostatic hyperplasia.

    Science.gov (United States)

    Hossain, A K M S; Alam, A K M K; Habib, A K M K; Rashid, M M; Rahman, H; Islam, A K M A; Jahan, M U

    2012-04-01

    The objectives of this study were to determine and compare the correlation of intravesical prostatic protrusion (IPP) and prostate volume (PV) with bladder outlet obstruction (BOO). This study was conducted in the department of urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2009 to September 2010. Fifty benign prostatic hyperplasia (BPH) patients were included in the study. Their evaluation consisted of history along with International Prostate Symptoms Score (IPSS), digital rectal examination (DRE), transabdominal ultrasonography to measure prostate volume, intravesical prostatic protrusion & post voidal residual (PVR) urine and pressure-flow studies to detect bladder outflow obstruction (BOO). Statistical analysis included Unpaired 't' test, Chi-square test and Spearman's Rank correlation test. Receiver Operator Characteristic (ROC) curves were used to compare the correlation of PV and IPP with BOO. Mean prostate volume was significantly larger in bladder outlet obstructed patients (PProstate volume & intravesical prostatic protrusion measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with bladder outlet obstruction in patients with benign prostatic hyperplasia and the correlation of IPP is much more stronger than that of prostate volume.

  6. Benign prostatic hyperplasia: An overview of existing treatment

    Directory of Open Access Journals (Sweden)

    Neelima Dhingra

    2011-01-01

    Full Text Available Benign prostatic hyperplasia (BPH is the most common condition in aging men, associated with lower urinary tract symptoms (LUTS. A better understanding of the prostate physiology, function, and pathogenesis has led to the development of promising agents, useful in the management of LUTS in men. The specific approach used to treat BPH depends upon number of factors like age, prostrate size, weight, prostate-specific antigen level, and severity of the symptoms. 5α-reductase inhibitors decrease the production of dihydrotestosterone within the prostate, which results in decreased prostate volume, increased peak urinary flow rate, improvement of symptoms, decreased risk of acute urinary retention, and need for surgical intervention. α1 -adrenergic receptor (α1 -AR antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Clinical efficacy of either 5α-reductase inhibitor or α1 -AR antagonist has been further improved by using combination therapy; however, long-term outcomes are still awaited. Many more potential new therapies are under development that may improve the treatment of BPH. This article gives a brief account of rationale and efficacy of different treatment options presently available in the management of BPH.

  7. Understanding Prostate Enlargement | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... tender, or has abnormalities that require more testing. Medical Tests. A health care provider may refer men to a urologist—a doctor ... more urine for longer periods Medications A health care provider or ... such as the Medical Therapy of Prostatic Symptoms (MTOPS) study, have shown ...

  8. Risk factors for prostatic inflammation extent and infection in benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Fa-Xian Yi; Qiang Wei; Hong Li; Xiang Li; Ming Shi; Qiang Dong; Yu-Ru Yang

    2006-01-01

    Aim: To investigate the risk factors for prostatic inflammation extent and infection in patients with benign prostatic hyperplasia (BPH) so as to manage prostatic inflammation more efficiently. Methods: Sixty patients with BPH undergoing TURP between September 2005 and December 2005 in West China Hospital of Sichuan University were studied. Prostate fluid (PF) was collected for the measurement of secretory IgA (SIgA) and complement 3 (C3).Prostate tissue were collected for testing bacterial 16S rDNA by real-time PCR, examining SIgA in the tissue and examining the inflammation. The possible clinical and immune risk factors for prostatic inflammation or infection were analyzed by using the logistic regression method. Results: Abnormal white blood cell count in urinalysis, prostatic infection and a high concentration of C3 in PF are the risk factors for prostatic inflammation extent (P = 0.025, 0.034 and 0.035, respectively and odds ratio [OR] = 18.269, 8.284 and 1.508, respectively). Risk factors for prostatic infection include the C3 concentration and the concentration of S IgA in PF (P = 0.003 and 0.013, respectively, and OR= 1.645 and 0.993, respectively). Conclusion: The present study suggests that prostatic inflammation is associated with urinary tract infection, prostatic infection and the activated complement and that prostatic infection is associated with the activated complement and downregulated mucosal immunity in prostates of the patients with BPH. It is also suggested that individual immune regulation should be considered in the treatment of prostatic inflammation and infection of patients with BPH.

  9. The value of imaging techniques in the diagnosis of benign prostate hyperplasia and prostate cancer; Wertigkeit der bildgebenden Diagnostik bei benigner Prostatahyperplasie und beim Prostatakarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Doersam, J. [Chirurgisches Zentrum, Abt. Urologie und Poliklinik, Univ. Heidelberg (Germany); Kaelble, T. [Chirurgisches Zentrum, Abt. Urologie und Poliklinik, Univ. Heidelberg (Germany); Riedasch, G. [Chirurgisches Zentrum, Abt. Urologie und Poliklinik, Univ. Heidelberg (Germany); Staehler, G. [Chirurgisches Zentrum, Abt. Urologie und Poliklinik, Univ. Heidelberg (Germany)

    1994-03-01

    Diseases of the prostate are of high socioeconomic importance owing to their high incidence and prevalence rates. Benign prostatic hyperplasia (BPH) can be detected in 80% of males over the age of 80. Clinical symptoms do not correlate with organ enlargement. Only 10% of patients with BPH need surgical treatment. The decision for surgical treatment is made as a result of objective findings and the symptoms reported by the patient. Preoperative evaluation of BPH must include digital rectal examination (DRE), measurement of peak flow rate, sonographic estimation of residual urine, transrectal ultrasound (TRUS), urethrocystography and the assessment of subjective complaints using symptom scores. Prostatic carcinoma is the most common malignancy in men. An abnormal DRE, increased PSA level and/or hypoechogenic lesions in TRUS are indications for prostate biopsy. The sensitivity of TRUS is superior to that of CT and MRI. New MRI techniques are promising with regard to local tumour extent. Whereas CT and MRI are not useful in screening of patients, these methods are valuable diagnostic tools in the follow-up of prostate cancer. (orig.) [Deutsch] Erkrankungen der Prostata haben aufgrund der hohen Inzidenz und Praevalenz eine hohe soziooekonomische Bedeutung. Die benigne Prostatahyperplasie kann histologisch bei 80% der 80jaehrigen Maenner nachgewiesen werden. Die klinische Symptomatik korreliert nicht mit der Organgroesse. Nur ca. 10% der Maenner mit BPH beduerfen einer chirurgischen Therapie. Die Indikation zum operativen Eingriff ergibt sich aus objektiven Befunden und den subjektiven Beschwerden. Die praeoperative Diagnostik besteht aus rektal-digitaler Untersuchung, Uroflowmetrie mit anschliessender sonographischer Bestimmung des Restharnvolumens, transrektaler Sonographie, Urethrozystographie und Evaluation der Beschwerden mittels Symptomscores. Das Prostatakarzinom ist inzwischen der haeufigste Tumor des Mannes. Bei suspektem Befund der rektal-digitalen Untersuchung

  10. MR imaging of post transurethral enucleation of the prostate for benign prostatic hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Tajima, Natsuki; Okada, Susumu [Nippon Medical School, Chiba (Japan). Chiba Hokusoh Hospital; Hiraoka, Yasunori; Tajima, Hiroyuki; Iida, Eiji; Kobayashi, Yuko; Sugizaki, Kenichi; Yamamoto, Kanae; Kumazaki, Tatsuo

    1995-11-01

    Magnetic resonance imaging of post transurethral enucleation of the prostate for benign prostatic hypertrophy was evaluated in 11 patients. Both pre- and post-enucleation images were evaluated in 6 patients. Decrease in maximum diameter of prostatic glands after this method had a good correlation with the resected volume, uroflowmetry analysis and clinical symptoms. Intensity decrease of peripheral zone on T2-weighted image was detected in 3 of 6 patients, while size increase of peripheral zone was seen in 1 of 6 patients. Low intensity band around the resected urethra was demonstrated in all patients after surgical intervention. (author).

  11. Relationship between lower urinary tract symptoms and objective measures of benign prostatic hyperplasia: a Chinese survey

    Institute of Scientific and Technical Information of China (English)

    WANG Jian-ye; PANG Jian; LIU Ming; ZHANG Yao-guang; ZENG Ping; DING Qiang; HUANG Jian; HE Da-lin; SONG Bo; KONG Chui-ze

    2008-01-01

    Background The enlarged prostate leads to obstruction and lower urinary tract symptoms (LUTS), which comprise frequency, urgency, weak stream, straining and nocturia. This study was conducted in a large series of patients to evaluate the relationship between LUTS as stipulated in the International Prostate Symptom Score (IPSS) and the objective parameters related to benign prostatic hyperplasia (BPH).Methods We enrolled 1295 BPH patients from seven centers. The patients were either at first diagnosis of BPH or had discontinued medical treatment for at least 3 months. Those with several other diseases that may be potential risk factors affecting urinary symptoms were excluded from the study. Age, IPSS, prostate volume, peak flow rate, urine volume and post-voiding residual urine volume were measured. The relationship between IPSS and objective parameters were quantified by means of Spearman correlation coefficients. The differences in these parameters between the groups with mild, moderate or severe symptoms were also evaluated.Results Statistically significant correlations were found between IPSS and objective parameters by means of Spearman correlation coefficients. When the patients were divided into three groups with different severities of symptoms,there were significant differences in peak flow rate, urine volume, prostate volume, residue urine volume and quality of life, whereas average age and prostate-specific antigen levels were similar. However, there was evident overlap of these parameters between the groups. The same results were found when the irritative or obstructive subscore of IPSS was considered.Conclusions The correlation between objective parameters of BPH and LUTS is significant. However, it is hard to predict the severity of symptoms by these parameters.

  12. Ursolic acid reduces prostate size and dihydrotestosterone level in a rat model of benign prostatic hyperplasia.

    Science.gov (United States)

    Shin, In-Sik; Lee, Mee-Young; Jung, Da-Young; Seo, Chang-Seob; Ha, Hye-Kyung; Shin, Hyeun-Kyoo

    2012-03-01

    Benign prostatic hyperplasia (BPH) is characterized by hyperplasia of prostatic stromal and epithelial cells, which can lead to lower urinary tract symptoms. The prevalence of BPH increases in an age-dependent manner. We investigated the protective effect of ursolic acid in BPH development using a testosterone-induced BPH rat model. BPH was induced in experimental groups by daily subcutaneous injections of testosterone propionate (TP), for a period of four weeks. Ursolic acid was administrated daily by oral gavage at a dose level of 5mg/kg during the four weeks of TP injections. Animals were sacrificed on the scheduled termination, before prostates were weighed and subjected to histopathological examination. TP and dihydrotestosterone (DHT) levels in the serum and prostate were also measured. BPH-induced animals displayed an increase in prostate weight with increased testosterone and DHT levels in both the serum and prostate. However, ursolic acid treatment resulted in significant reductions in prostate weight and testosterone and DHT levels in both the serum and prostate, compared with BPH-induced animals. Histopathological examination also showed that ursolic acid treatment suppressed TP-induced prostatic hyperplasia. These findings indicate that ursolic acid may effectively inhibit the development of BPH and it may be a useful agent in BPH treatment.

  13. Ectopic opening of cystic dilatation of the ejaculatory duct into enlarged prostatic utricle.

    Science.gov (United States)

    Lin, Jian-Zhong; Wu, Hong-Fei; Wang, Ji-Chen; Le, Mei-Zhao; Yu, Hong-Bo; Zhou, He-Tong

    2012-01-01

    A 28-year-old man was referred to our department for the management of recurrent hemospermia during the past 5 years. Genital examination and hormonal levels were normal. Semen analysis showed no change in volume and pH; however, hemospermia and asthenozoospermia were observed. Ultrasonography and computed tomography scan revealed the presence of a cystic lesion with calcification in the terminal part of seminal vesicles adjoining the prostate gland. The following vasography and endoscopic retrograde urethrography demonstrated 2 communicating cystic dilatations arising from the verumontanum. The diagnosis of cystic dilatation of the ejaculatory duct opening into an enlarged prostatic utricle was reached. Transurethral unroofing of the cyst was separately performed with a successful outcome. The characteristic of the 2 cystic dilatations was confirmed by pathologic examination. To the best of our knowledge, this is the first case of ectopic cystic dilatation of the ejaculatory duct opening into an enlarged prostatic utricle.

  14. Acute colonic obstruction due to benign prostatic hypertrophy.

    LENUS (Irish Health Repository)

    Mac Giobuin, S

    2012-02-01

    A seventy two year old man presented to the Emergency Department with clinical features of colonic obstruction. Subsequent radiological investigations confirmed this impression and revealed the aetiology to be compression of the sigmoid colon against the sacrum by a massively distended urinary bladder. Chronic urinary retention due to benign prostatic hypertrophy is an extremely unusual cause of large bowel obstruction. Little in this patient\\'s clinical findings suggested this aetiology. We reviewed the literature in this area and highlight the benefits of CT scanning over contrast studies.

  15. The early days of prostatectomy for benign prostatic hypertrophy.

    Science.gov (United States)

    Ellis, Harold

    2011-10-01

    The syndrome of bladder neck obstruction, often leading to retention of urine, in ageing men has been recognised since earliest times. Catheterisation for the relief of urinary retention was used by the ancient Chinese and Egyptians and is described in the writings of the Indian surgeon Susrata, who flourished in Benares sometime after Christ. Although many of these cases were the result of urethral stricture from trauma or gonorrhoea, we can assume that, in older men, the cause was often benign prostatic hypertrophy (BPH).

  16. Water-induced thermotherapy for benign prostatic hyperplasia.

    Science.gov (United States)

    Cioanta, I; Muschter, R

    2000-12-01

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

  17. Carbohydrate structure and differential binding of prostate specific antigen to Maackia amurensis lectin between prostate cancer and benign prostate hypertrophy.

    Science.gov (United States)

    Ohyama, Chikara; Hosono, Masahiro; Nitta, Kazuo; Oh-eda, Masayoshi; Yoshikawa, Kazuyuki; Habuchi, Tomonori; Arai, Yoichi; Fukuda, Minoru

    2004-08-01

    Serum prostate-specific antigen (PSA) assay is widely used for detection of prostate cancer. Because PSA is also synthesized from normal prostate, false positive diagnosis cannot be avoided by the conventional serum PSA test. To apply the cancer-associated carbohydrate alteration to the improvement of PSA assay, we first elucidated the structures of PSA purified from human seminal fluid. The predominant core structure of N-glycans of seminal fluid PSA was a complex type biantennary oligosaccharide and was consistent with the structure reported previously. However, we found the sialic acid alpha2-3 galactose linkage as an additional terminal carbohydrate structure on seminal fluid PSA. We then analyzed the carbohydrate moiety of serum PSA from the patients with prostate cancer and benign prostate hypertrophy using lectin affinity chromatography. Lectin binding was assessed by lectin affinity column chromatography followed by determining the amount of total and free PSA. Concanavalin A, Lens culinaris, Aleuria aurantia, Sambucus nigra, and Maackia amurensis lectins were tested for their binding to the carbohydrates on PSA. Among the lectins examined, the M. amurensis agglutinin-bound fraction of free serum PSA is increased in prostate cancer patients compared to benign prostate hypertrophy patients. The binding of PSA to M. amurensis agglutinin, which recognizes alpha2,3-linked sialic acid, was also confirmed by surface plasmon resonance analysis. These results suggest that the differential binding of free serum PSA to M. amurensis agglutinin lectin between prostate cancer and benign prostate hypertrophy could be a potential measure for diagnosis of prostate cancer.

  18. Evaluation of the resistive index of prostatic blood flow in benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Osama Abdelwahab

    2012-04-01

    Full Text Available OBJECTIVE: The aim of this work is to study the resistive index (RI of prostatic blood flow by transrectal power Doppler sonography in benign prostatic hyperplasia (BPH to determine its correlation with other parameters of BPH. MATERIALS AND METHODS: Eighty-two male patients aged 52-86 years with lower urinary tract symptoms (LUTS due to BPH were included in the study. Patients with prostate cancer, neurogenic bladder, or with other pathology (e.g. prostatitis, bladder stone were excluded from the study. All patients were evaluated by full history including Internatinoal Prostate Symptoms Score (IPSS, general and local examination (DRE, neurologic examination, uroflowmetry, laboratory investigations including urine analysis, routine laboratory tests and serum prostate specific antigen (PSA. Transrectal ultrasonography was used to calculate the total prostatic volume. Transrectal Power Doppler Ultrasound (PUD was used to identify the capsular and urethral arteries of the prostate and to measures the RI value. RESULTS: The mean prostate volume was 75.1 ± 44.7 g. The mean RI of the right and left capsular arteries were 0.76 ± 0.06 and 0.76 ± 0.07, respectively. The mean RI of the urethral arteries was 0.76 ± 0.08. There was a high significative correlation between the increase of the RI of the right and left capsular and urethral arteries and the degree of obstruction (P value < 0.001, severity of symptoms (P value < 0.001 and also the prostatic volume (P value < 0.001. CONCLUSION: Resistive index of the prostatic blood flow can be applied as an easy and non-invasive tool to evaluate the lower urinary tract obstruction due to BPH.

  19. Ultrasonographic Findings of the Prostatic Disease : Comparative Analysis of the Benign and Malignant Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Song, Yun Gyu; Kim, Ji Yang; Lee, Su Han; Kong, Su Jin; Sung, Young Soon; Kwon, Jae Soo [Masan Samsung General Hospital, Masan (Korea, Republic of)

    1996-06-15

    We evaluated the characteristics of the benign and malignant nodules on transrectal ultrasound in diagnosis of prostatic disease. Histologic examination of the trans perineal prostatic biopsy of the total 47 cases resulted in 19 cases of BPH, 8 cases of prostatic cancer, and 20 cases of normal prostatic tissue group. The hypoechoic mass in peripheral zone on TRUS had high possibility of prostatic carcinoma and the isoechoic or mixed echogenic mass in central gland had high possibility of benign lesion. Hypoechoic haloes around nodules and cysts were noted in BPH and normal prostatic tissue group, that were compatible with benign lesion. The mean value of PSA was 12.0 ng/ ml in BPH, 8.5 ng / ml in normal prostatic tissue group, and 65.6 ng / ml in prostatic cancer, which was very high in prostatic cancer. Between BPH and normal prostatic tissue group, there was no demonstrable difference in location of nodule, pattern of calcification, and echogenicity of the nodules on TRUS. The size of prostatic gland was relatively smaller and mean value of PSA was lower in normal prostatic tissue group, compared with in BPH. In conclusion, the location of the nodules and PSA value are considered to be important in differentiation of the benign and malignant prostatic nodules

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

    Science.gov (United States)

    Noor, Amir; Fischman, Aaron M

    2016-07-01

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

  1. THE CLINICAL SIGNIFICANCE OF PERCENT FREE PSA IN DIFFERENTIATING PROSTATE CANCER AND BENIGN PROSTATE HYPERPLASIA

    Institute of Scientific and Technical Information of China (English)

    王子明; 张鹏; 种铁; 赵丽华

    2004-01-01

    Objective To evaluate using prostate specific antigen (PSA) and percent free PSA(fPSA) for the diagnosis of prostate cancer(Pca) and benign prostate hyperplasia(BPH). Methods 315 men with BPH and 55 men with Pca were randomly chosen, serum fPSA and total PSA were determined by ELISA and then we compared the sensitivity and specificity of PSA and percent fPSA for the diagnosis of Pca. Results While using PSA and percent fPSA for the diagnosis of prostate cancer, the sensitivity was similar (89.8% vs. 94.5%, P>0.05), but the specificity was significanty different (52.7% vs. 89.8%, P<0.005). Conclusions Using percent fPSA might decrease false-positive and avoid 37.1% negative biopsies as compared with PSA, it is very valuable for the diagnosis of Pca.

  2. Accumulation of [{sup 11}C]acetate in normal prostate and benign prostatic hyperplasia: comparison with prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Takashi; Tsukamoto, Eriko; Takei, Toshiki; Shiga, Tohru; Nakada, Kunihiro; Tamaki, Nagara [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 6, Kita-ku, Sapporo 060-8638 (Japan); Kuge, Yuji; Katoh, Chietsugu [Department of Tracer Kinetics, Hokkaido University Graduate School of Medicine, Sapporo (Japan); Shinohara, Nobuo [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo (Japan)

    2002-11-01

    Carbon-11 acetate positron emission tomography (PET) has been reported to be of clinical value for the diagnosis of prostate cancer. However, no detailed analysis has yet been carried out on the physiological accumulation of [{sup 11}C]acetate in the prostate. The purpose of this study was to elucidate the physiological accumulation of [{sup 11}C]acetate in the prostate using dynamic PET. The study included 30 subjects without prostate cancer [21 with normal prostate and nine with benign prostatic hyperplasia (BPH)] and six patients with prostate cancer. A dynamic PET study was performed for 20 min after intravenous administration of 555 MBq of [{sup 11}C]acetate. The standardised uptake value (SUV) at 16-20 min post tracer administration and the early-to-late-activity ratio of the SUV (E/L ratio), which was determined by dividing the SUV{sub 6-10} {sub min} by the SUV {sub 16-20min}, were calculated to evaluate the accumulation of [ {sup 11}C]acetate. The prostate was clearly visualised and distinguished from adjacent organs in PET images in most of the cases. The SUV of the prostate (2.6 {+-}0.8) was significantly higher than that of the rectum (1.7 {+-}0.4) or bone marrow (1.3 {+-}0.3) (P <0.0001 in each case). The SUV of the normal prostate of subjects aged <50 years (3.4 {+-}0.7) was significantly higher than both the SUV for the normal prostate of subjects aged {>=}50 years (2.3 {+-}0.7) and that of subjects with BPH (2.1 {+-}0.6) (P <0.01 in each case). The primary prostate cancer in six cases was visualised by [ {sup 11}C]acetate PET. However, the difference in the SUV between subjects aged {>=}50 with normal prostate or with BPH and the patients with prostate cancer (1.9 {+-}0.6) was not statistically significant. There was also no significant difference in the E/L ratio between subjects aged {>=}50 with normal prostate (0.98 {+-}0.04) or BPH (0.96 {+-}0.08) and patients with prostate cancer (1.02 {+-}0.12). In conclusion, a normal prostate exhibits age

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

    Directory of Open Access Journals (Sweden)

    Chun-Jen Hsiao

    2016-01-01

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

  4. Suppression of benign prostate hyperplasia by Kaempferia parviflora rhizome

    Directory of Open Access Journals (Sweden)

    Kazuya Murata

    2013-01-01

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

  5. Visual laser coagulation for benign prostatic hyperplasia; Visuell laserkoagulasjon for benign prostatahyperplasi

    Energy Technology Data Exchange (ETDEWEB)

    Wold, T.; Karlsen, S.J.; Bull-Njaa, T.; Lund, M. [Aker Sykehus, Oslo (Norway)

    1996-04-01

    A total of 28 patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia were treated by visual laser coagulation (VLAP) performed with the Myriadlase side-firing neodymium: YAG laser fibre at 40 watts power. The treatment was performed as an outpatient procedure using intraurethral gel anaesthesia and light intravenous sedation and analgesia. Prostatic volume was 32 g and 650 joule per gram prostatic tissue was administered. The patients were evaluated at mean 9.2 weeks. The mean operative time was 34 minutes. The procedure was very gentle, all patients tolerated it well and there was no bleeding. Most patients experienced some dysuria for three to four weeks after the procedure, two had severe symptoms. Two patients remained in retention and required transurethral resection. The rest expressed subjective satisfaction with the results. Peak urinary flow increased from mean 9.0 ml/sec preoperatively to 15.4 ml/sec; a mean increase of 78%. One patients developed clinical urinary tract infection. There were no other complications of clinical significance. 19 refs., 1 fig.

  6. Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

    Institute of Scientific and Technical Information of China (English)

    Giovanni Corona; Mauro Gacci; Elisa Maseroli; Giulia Rastrelli; Linda Vignozzi; Alessandra Sforza; Gianni Forti; Edoardo Mannucci; Mario Maggi

    2014-01-01

    Digito‑rectal examination(DRE) of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of ifnding an enlarged prostate size at DRE in subjects with sexual dysfunction(SD). Aconsecutive series of 2379patients was retrospectively studied. The analysis was focused on a subset of subjects(n=1823; mean age 54.7±11.4) selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome(HR=1.346(1.129–1.759);P=0.030), type2 diabetes mellitus(HR=1.489(1.120–1.980);P=0.006), increased LDL cholesterol(>100mgdl−1; HR=1.354(1.018–1.801);P=0.037) and increased mean blood pressure(BP) values(HR=1.017(1.007–1.027) for each mmHg increment;P=0.001). Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction(ED), as well as with other andrological conditions, such as varicocele and premature ejaculation(PE). PSA levels were signiifcantly higher in subjects with enlarged prostate size when compared to the rest of the sample(HR=3.318(2.304; 4.799) for each log unit increment in PSA levels;P<0.0001). Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical(DRE) or biochemical(PSA) inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular(CV) background of the patient.

  7. Prostate adenocarcinoma presenting with supraclavicular node enlargement: report of a case.

    Science.gov (United States)

    Platania, Marco; Bajetta, Emilio; Guadalupi, Valentina; Buzzoni, Roberto; Colecchia, Maurizio

    2008-01-01

    This report describes a case of prostate adenocarcinoma presenting with supraclavicular adenopathy and deep venous thrombosis in the ipsilateral arm. Biopsy revealed the enlarged node to be an undifferentiated adenocarcinoma of unknown origin, while CT scan evidenced widespread adenopathies. Because of the increase in serum PSA, the immunohistochemical staining of the biopsy specimen was reviewed and strong positivity for PSA suggested a prostatic origin. We emphasize the importance of PSA immunohistochemistry and serum PSA level monitoring in men presenting with carcinoma of undetermined origin and generalized lymphadenopathies.

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

    Science.gov (United States)

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

    2011-09-01

    We evaluated the correlations between BMI, fasting glucose, insulin, testosterone level, insulin resistance, and prostate size in non-diabetic benign prostatic hyperplasia (BPH) patients with normal testosterone levels. Data from 212 non-diabetic BPH patients with normal testosterone levels, who underwent transurethral resection of the prostate (TURP) due to medical treatment failure, were evaluated retrospectively. Patients with prostate specific antigen (PSA) levels of ≥ 3 ng/mL underwent multicore transrectal prostate biopsy before TURP to rule out prostate cancer. Patients with diabetes mellitus (DM) or serum testosterone levels of Prostate size correlated positively with age (r = 0.227, P 0.05). Testosterone level inversely correlated with BMI (r = -0.327, P prostate size, PSA, or fasting glucose level (each P > 0.05). Upon multiple adjusted linear regression analysis, prostate size correlated with elevated PSA (P prostate hyperplasia.

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

    Science.gov (United States)

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

    2012-04-01

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

  10. Tamsulosin versus terazosin for benign prostatic hyperplasia: a systematic review.

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    Dong, ZhiLong; Wang, ZhiPing; Yang, KeHu; Liu, YaLi; Gao, WenHui; Chen, WenYuan

    2009-08-01

    The effectiveness and safety of tamsulosin and terazosin for patients with benign prostatic hyperplasia (BPH) was evaluated by literature review. PubMed, Embase, the Cochrane Library, Chinese biomedicine literature database (CBM), reference lists of reports, and reviews were searched for randomized controlled trials (RCTs), or quasi-RCTs of tamsulosin versus terazosin in BPH. Twelve studies involving 2,816 men were included. Outcomes included international prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Q(max)), average urinary flow rate (Q(ave)), residual volume, prostate volume, and adverse effect (dizziness, severe hypotension, dry mouth). Relative risk was calculated for dichotomous data. Sensitivity analyses assessed the influence of baseline symptom severity. We found that tamsulosin is better than terazosin when assessed by IPSS (weighted mean difference (WMD)=-1.24 95% CI [- 1.98, -0.51], there was no significant difference between the two groups in QOL (WMD=0.04 95% CI [-0.16, 0.24]), Qmax (WMD=-0.38 95% CI [-1.18, 0.41]), Q(ave) (WMD=-0.39 95% CI [- 0.84, 0.06]), residual volume (WMD=-4.32 95% CI [-10.96, 2.33]), and prostate volume (WMD=-0.28 95% CI [- 3.37, 2.81]). Fewer patients receiving tamsulosin experienced dizziness (relative risk (RR) -0.38 95% CI [0.30, 0.48]), severe hypotension (RR=0.16 95% CI [0.04, 0.68]), and dry mouth (RR=0.14 95% CI [0.03, 0.77]), compared with patients receiving terazosin. Many of the high quality RCTs showed beneficial effects of tamsulosin in terms of improving IPSS. However, whether tamsulosin proves more efficacious than terazosin in long term therapy requires confirmation by additional large sample, high quality trials.

  11. Outcome of Transurethral Plasmakinetic Vaporization for Benign Prostatic Hyperplasia

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    Magdy El-Tabey

    2015-04-01

    Full Text Available Purpose To assess the outcome of transurethral plasmakinetic vaporization (PKVP in the management of benign prostatic hyperplasia (BPH. Patients and methods From August 2010 to May 2012, 60 patients with obstructive LUTS due to BPH were included in the study. All patients were evaluated by International Prostate Symptom Score (IPSS, general examination, digital rectal examination, PSA, routine laboratory examinations, pelvi-abdominal ultrasound, trans-rectal ultrasound, and uroflowmetry. Patients with Qmax of 8 and a prostate volume of >40 mL underwent transurethral PKVP. Results Mean age of the patients was 66.8±4.5 years. The mean times of the operation, post-operative bladder irrigation, and post-operative catheterization were 63.8±13.9 minutes, 15.2±5.7 hours, and 23.9±5.2 hours, respectively. At 3 months of follow-up, there were significant reductions in the mean IPSS from 23.4±3.5 to 9.2±3.7 (P=0.4, mean PSA from 3.03±2.2 ng/mL to 1.2±1.04 ng/mL (P value=0.02, mean post voiding residual urine from 149.8±59.5 mL to 46.9±24.1 mL (P value <0.01, and mean prostate volume from 72.8±10.3 mL to 22.7±6.1 mL (P value <0.01. Also, there was a statistically significant increase in the mean Q max. from 8.7±2.4 mL/s to 19.5±3.5 mL/s (P value <0.01. Conclusion PKVP is an effective and safe treatment option in the management of symptomatic BPH.

  12. Depot medroxyprogesterone in the management of benign prostatic hyperplasia.

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    Onu, P E

    1995-01-01

    The effects of depot medroxyprogesterone (DMPA), a 5 alpha-reductase, luteinizing-hormone release and human androgen receptor adhesion inhibitor, were assessed in 80 patients with benign prostatic hyperplasia (BPH) in a double-blind, placebo-controlled study. Patients were randomized to DMPA 150 mg single-dose intramuscular injection or placebo in a similar fashion. The following changes were seen with DMPA after 3 months (duration of DMPA effect): (1) serum testosterone reached castration levels within 3 days as compared to no changes in the placebo group; (2) the prostate volume was reduced by 25% compared to a 3% decrease with placebo (p < 0.001); (3) maximum urinary-flow rates increased by 3.7 ml/s compared to placebo (p < 0.001); (4) total urinary symptom scores decreased by 4.9 points compared to a nonsignificant decrease with placebo (p < 0.005). There was a 2.5-point decrease in irritative symptoms (urinary frequency, nocturia and urgency) as compared to a nonsignificant decrease with placebo (p < 0.005). After 3 months, the urinary symptoms and urodynamic changes were reversed but significantly greater than the baseline values (p < 0.001). The prostates showed regrowth to the initial sizes within 18-36 weeks. DMPA was better tolerated, except for a higher incidence of impotence, decreased libido and ejaculatory disorders, than in the placebo group. The quality of life is improved with DMPA since it did not produce hot flashes. It was concluded that single-dose DMPA 150 mg is a safe and effective treatment for prostatic obstruction where potency is a secondary consideration.

  13. Experience of terahertz therapy in benign prostatic hyperplasia combined with chronic abacterial prostatitis

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    Popkov V.M.

    2014-12-01

    Full Text Available Objective: to improve the treatment results of patients with benign prostatic hyperplasia (stage l-ll accompanied with chronic abacterial prostatitis (category III A by the use of terahertz therapy at frequencies of molecular spectrum of emission and absorption of nitric oxide 150,176-150,664 GHz. Material and methods. Atotal number of 75 patients met the inclusion criteria and were available for analysis. They were divided into three groups: 1st core group — 25 patients with BPH (stage l-ll accompanied with chronic abacterial prostatitis (category III, which received standard medical therapy in combination with THZ-therapy; second group — 25 patients with BPH (stage l-ll accompanied with CAP, which received standard medical therapy; third control group — 25 healthy men. Results. The combination of THZ — therapy with standard medical treatment allowed us to achieve marked improvements in the IPSS and QoL system, rapid anesthetic effect, more significant volume reduction of the prostate tissue in the 1st core group. Also THZ-therapy in 1st core group revealed a statistically significant increase of the maximum speed of blood vessels in the prostate tissue, improved a prostate secretion and rheological properties of blood. Conclusion. THZ-therapy as a complementary treatment has a beneficial effect on the clinical course of BPH (stage l-ll accompanied with CAP (category III.

  14. Immunohistochemical analysis of estrogen receptors in prostate and clinical correlation in men with benign prostatic hyperplasia

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    Gangkak, Goto; Mittal, Alka; Yadav, Sher Singh; Tomar, Vinay; Yadav, Ajay; Mehta, Jayanti

    2017-01-01

    Purpose Estrogens act through interaction with 2 receptor subtypes, ER alpha (ERα) and ER beta (ERβ), in human prostate. The aim of the present study was to semiquantitatively assess the differential expression of ER subtypes in human benign prostatic hyperplasia (BPH) by use of immunocytochemistry (IHC) methods and to explore their relationship with various measures of BPH. Materials and Methods A total of 45 patients with BPH undergoing transurethral resection of the prostate and 22 patients with bladder cancer with normal prostate undergoing surveillance cystoscopy were studied as cases and controls, respectively. Quantitative immunolabeling of ER subtypes was scored by use of a semiquantitative scale. Also, correlations were assessed between ER levels in prostate and various measures of BPH. Results Overall, we found strong immunostaining for ERα in stroma and for ERβ in epithelium, respectively. The IHC score for ERα differed significantly between BPH patients and controls in both stroma (p≤0.001) and epithelium (p=0.008), respectively. The ERβ IHC score was also significantly higher in the epithelium of BPH patients (p=0.01). Also, we found a significant correlation between prostatic ER levels and various clinical measures of BPH. Conclusions ERs may play an important role in the pathogenesis of BPH.

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

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

    1982-02-01

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

  16. Transurethral enucleation of large benign prostatic hyperplasia in sodium chloride solution

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    I. N. Shvarev

    2016-01-01

    Full Text Available Background. Transurethral resection is a generally recognized treatment for small to medium-sized benign prostatic hyperplasia (BPH. Numerous original tools are proposed for surgery of large BPH. These include laser (holmium laser enucleation of the prostate and transurethral (transurethral enucleation with bipolar (TUEB enucleation in 0.9 % NaCl solution, which are accompanied by removal of the maximum adenoma tissue volume, short-term recovery, and a substantially fewer early and late complications.Objective: to evaluate the safety and efficiency of TUEB in patients with large BPH.Subjects and methods. TUEB was carried out in 58 patients with large BPH. Their mean age was 64 years. The gland size was ≥ 102 сm3. The residual urine volume in all the patients was more than 100 ml. One year later, the results of treatment were analyzed using the International Prostate Symptom Score (IPSS, Quality of Life (QoL Questionnaire, as well as from residual urine volume and remaining prostate tissue.Results. The mean time of surgery and enucleation was 90 and 55 min, respectively. The mean volume of removed adenoma tissue was 99 ml. By the end of month 2 following TUEB, there was a progressive reduction in the total IPSS and QoL scores from 35 to 7 and from 5 to 1, respectively, which preserved this trend by the end of a 1-year follow-up. study. The residual urine amount was less than 30 ml. The mean volume of the prostate tissue left was 8.5 сm3 and less than 11.0 сm3. The ultrasound anatomy of the prostatic urethra (transformation of thin-walled spherical TUR defect that is characteristic slit-like one resembles the inverted letter Y eventually formed by the end of the 1-year follow-up. Stricture of the urethra and contracture of the bladder neck were noted in none of the cases. Conclusion. TUEB is an alternative to open surgery in patients with the enlarged prostate. The use of isotonic NaCl solution as washing fluid allows one to plan

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

    Science.gov (United States)

    Holtgrewe, H L

    1995-09-01

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

  18. Current clinical management strategies for benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiang-hua

    2008-01-01

    @@ This article summarizes the major new findings on clinical management for benign prostatic hyperplasia (BPH) that were presented at the annual meeting of the American Urological Association (AUA) in May 2008.The management of symptomatic BPH has been changed significantly over the last decade in response to the availability of new treatment options.Prior to the 1980s,open prostatectomy was the only widely accepted intervention for BPH.Since then,the advent of new medical therapies for BPH and the introduction of a range of minimally invasive therapies have provided for men with lower urinary tract symptoms (LUTS) secondary to BPH.1 In this year's AUA meeting,several new findings were reported in the filed of BPH which involved epidemiology,clinical progression,drug therapy and new technologies in surgical therapy of BPH.

  19. Expression analysis of thrombospondin 2 in prostate cancer and benign prostatic hyperplasia.

    Science.gov (United States)

    Matos, A R; Coutinho-Camillo, C M; Thuler, L C S; Fonseca, F P; Soares, F A; Silva, E A; Gimba, E R

    2013-06-01

    Thrombospondin 2 (TSP2) is a protein with important roles in different tumor types, mainly related to tumor inhibition. However, there are limiting data regarding TSP2 in prostate cancer (PCa) and benign prostatic hyperplasia (BPH). We aimed to investigate TSP2 transcript and protein expression in tumoral and non-tumoral prostate tissues and cell lines, and its implications for PCa diagnosis and progression. TSP2 transcript expression was evaluated by real time PCR in PCa and BPH tissue samples and in tumoral and non-tumoral cell lines. TSP2 protein expression analysis was conducted by immunohistochemistry in a tissue microarray (TMA) containing PCa and BPH tissue samples. TSP2 transcript was down-regulated in PCa tissue samples and cell lines, when compared to BPH and non-tumoral samples (PBPH tissue samples (PBPH epithelial and stromal compartments. TSP2 stromal staining scores were significantly lower in PCa than in BPH tissues (PBPH diagnosis.

  20. The comparison between vitamin d concentration in upper silesia patients with prostate cancer and with benign prostatic hyperplasia.

    Science.gov (United States)

    Wieczorek, K; Braczkowski, R S; Skrzypek, M; Stryjewski, P J; Kuczaj, A; Al-Srory, G

    2015-01-01

    A number of studies have shown that vitamin D has a protective effect against the development of cancer, which may also be related to prostate cancer. Low serum vitamin D concentration has also been demonstrated in benign prostate hyperplasia. We compared serum vitamin D concentration in two groups of Polish men with prostate cancer and benign prostate hyperplasia. Each group comprised 30 patients. The concentration was determined by ELISA. To assess the difference between the study population, non-parametric Mann Whitney U test was used. The results revealed that patients with prostate cancer are deficient in vitamin D (median =25.3, quartiles q1 - q3: 13.4 -33.4). The concentration of vitamin D in the group of patients with prostate cancer was lower than in the group of benign prostatic hyperplasia with vitamin D deficiency (median =34.8, quartiles q1 - q3: 17.9 – 44.3). Vitamin D concentration in Polish men with prostate cancer is lower compared to patients with benign prostatic hyperplasia.

  1. Androgen receptor roles in the development of benign prostate hyperplasia.

    Science.gov (United States)

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

    2013-06-01

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

  2. Fibronectin Pattern in Benign Hyperplasia and Cancer of the Prostate

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    Miroslava M. Janković

    2008-01-01

    Full Text Available Fibronectin (FN is a multifunctional glycoprotein involved in cell-matrix interactions. It exhibits a complex pattern of forms differing in respect to aminoacid and oligosaccharide composition. In this study we examined glycobiochemical and functional properties of the FN in benign prostatic hyperplasia (BPH and prostatic cancer (PCa, attempting to resolve disease-related differences. Two BPH sera pools and three PCa sera pools were used as the FN source. The affinity-purified molecule was characterized by SDS-PAGE, immuno- and lectin blot, lectin-affinity chromatography and adhesion assay. BPH FN existed as intact molecule, giving the main immunoreactive band at 220 kDa. In contrast, PCa FN comprised three main immunoreactive fragments of 140, 110 and 90 kDa. As for glycosylation the ratio of altogether lectin-reactive PCa FN was different from that of BPH FN manifested as a decrease of Con A- and an increase of LCA-reactive moieties. Fibroblasts adhered to both FN preparations in a concentration dependent manner, but with a significantly lower efficiency to PCa FN. The results obtained showing distinct structural characteristics of PCa FN compared to BPH FN could be important for modulation of its ligand and recognition properties expressed as gain or loss of functions or as specific markers of its origin.

  3. Evaluation for Madigan's prostatectomy in patients with benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Li-Min LIAO; Bing-Yi SHI; Chun-Quan LIANG; Werner SCH(..)AFER

    2001-01-01

    To comparatively evaluate the efficacy and post-operative complications of the Madigan's prostatectomy (MPC) and suprapubic prostatectomy (SPPC). Methods: A total of 43 patients with benign prostatic hyperplasia were divided into two groups: 21 underwent MPC and 22, SPPC. In all the patients, the international prostate symptom score (IPSS) and urinary pressure-flow studies were assessed before and 6 months after operation. The International Continence Society (ICS) nomogram, Abrams-Griffiths (AG) number and linear passive urethral resistance relation analysis (L-PURR) were used to diagnose and grade bladder outlet obstruction (BOO). The IPSS and the urodynamic parameters before and after operation, as well as the advantages and post-operative complications were recorded and compared. Results: Patients of both the MPC and SPPC groups had a significant improvement in IPSS and urodynamic parameters. Obstruction was relieved in 81.0% of MPC and 86.4 % of SPPC patients. MPC has the advantages of the absence of postoperative hematuria and post-catheter stricture, a shorter period of hospitalization, and lower incidence of retrograde ejaculation and erectile dysfunction. Conclusion: Both MPC and SPPC can effectively relieve BOO. MPC has certain advantages and a lower incidence of complications as compared with SPPC.

  4. Immunohistochemical study of the expression of epidermal growth factor receptor in benign prostatic hypertrophy, prostatic intraepithelial neoplasia and prostatic carcinoma.

    Science.gov (United States)

    Rana, Shveta; Sen, Rajeev; Kalra, Rajnish; Arora, B; Sharma, Puja; Gahlawat, Sapna

    2006-10-01

    The present study provides an analysis of immunohistochemical expression and localization of epidermal growth factor receptor (EGFR) in formalin fixed paraffin embedded specimens of prostate. Thirty-five cases each of benign prostatic hypertrophy (BPH) and prostatic carcinoma and 30 cases of prostatic intraepithelial neoplasia (PIN) were taken up for study. Streptavidin biotin peroxidase method was employed for immunohistochemical staining. EGFR positivity was observed in all the cases (100%) of BPH and PIN and in only 10 cases (28.5%) of prostatic carcinoma. In both BPH and PIN the basal cells revealed significantly higher intensity and percentage cell positivity than the luminal cells. Intensity and percentage of positively stained basal cells in BPH was higher than PIN basal cells but the difference was not statistically significant. The intensity and percentage cell positivity of BPH basal cells and PIN basal and luminal cells were significantly greater than the epithelial cells of prostatic carcinoma. Presently, the significance of variable expression of EGFR in various types of prostatic lesions is unknown.

  5. Radiological Findings of Prostatic Arterial Anatomy for Prostatic Arterial Embolization: Preliminary Study in 55 Chinese Patients with Benign Prostatic Hyperplasia.

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    Guodong Zhang

    Full Text Available To describe the prostatic arterial supply using Cone-beam computed tomography (CT and digital subtraction angiography (DSA before prostatic arterial embolization (PAE for benign prostatic hyperplasia (BPH.In a retrospective study from January 2012 to January 2014, 55 male patients (110 hemipelves with BPH who underwent PAE were evaluated by Cone-beam CT in addition to pelvic DSA during embolization planning. Each hemipelvis was evaluated regarding the number of prostatic arteries (PA and their origins, diameters, territorial perfusion, and anastomoses with adjacent arteries.A total of 114 PAs were identified in 110 hemipelves. There was one PA in 96.4% of the hemipelves (n=106, and two independent PAs in the other 3.6% (n=4. The PA was found to originate from the anterior trunk of the internal iliac artery in 39.5% of cases (n=45 , from the superior vesical artery in 32.6% (n=37, and from the internal pudendal artery in 27.9% of cases (n=32. Extra-prostatic anastomoses between PA and adjacent arteries were found in 39.1% of hemipelves (n=43. Intra-prostatic anastomoses between PAs and contra-lateral prostatic branches were found in 61.8% of hemipelves (n=68. In 67.3% of our study population (n=37, the prostate was dominantly supplied via a unilateral PA.The prostatic vascularization is complex with frequent anatomic variations. Knowledge of the vascular anatomy of the prostate may provide indications for planning PAE and avoiding nontarget embolization.

  6. Occupational physical activity in relation with prostate cancer and benign prostatic hyperplasia.

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    Lagiou, Areti; Samoli, Evi; Georgila, Christina; Minaki, Ploumi; Barbouni, Anastasia; Tzonou, Anastasia; Trichopoulos, Dimitrios; Lagiou, Pagona

    2008-08-01

    Using data from two case-control studies undertaken in Athens, Greece from 1994 to 1997, we have examined the association of occupational physical activity with the risk of prostate cancer and benign prostatic hyperplasia (BPH). Cases consisted of 320 patients with histologically confirmed incident prostate cancer and 184 patients with surgically treated BPH. Controls were 246 patients hospitalized for minor conditions. Occupations before retirement were classified, independently and blindly as to case-control status, into high, medium, and low physical activity levels. After fine controlling for years of schooling, there was a suggestive inverse association of physical activity with prostate cancer (P for trend 0.12) and a significant one with BPH (P for trend 0.04). The odds ratio (95% confidence interval) for high versus low activity was 0.69 (0.40-1.22) for prostate cancer and 0.59 (0.31-1.11) for BPH. The association of physical activity with both conditions tended to be more pronounced among men 65 years old or younger. Given the high frequency of occurrence of the examined conditions in the male population and our limited knowledge about other modifiable risk factors, preventive measures may have to focus on increasing physical activity.

  7. Correlation of transrectal ultrasonographic findings of the prostate with the occurrence of detrusor instability in patients with benign prostatic hyperplasia.

    Science.gov (United States)

    Tong, Y C; Lin, Y M; Yang, W H; Tzai, T S; Lin, J S

    1995-01-01

    Forty patients with benign prostatic hyperplasia were evaluated with urodynamics and transrectal ultrasonography. Seventeen patients were found to have detrusor instability while the remaining 23 did not. No significant differences were noted during ultrasonography in the estimated prostatic volume, the presumed circle area ratio and the incidence of finding prostatic calcification between these two groups. However, the incidence of detecting intravesical protrusion of the prostate is significantly higher in patients with instability than in patients with stable bladder (53 vs. 13%, p prostate and alter the stability status of the urinary bladder.

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

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    Andrew Thomson

    2005-06-01

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

  9. Association of catechol-o-methyl transferase gene polymorphism with prostate cancer and benign prostatic hyperplasia

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    mir davood omrani

    2009-08-01

    Full Text Available

    • BACKGROUND: A single nucleotide variation within  atechol-o-methyl transferase (COMT gene may alter the COMT enzyme activity level. Polymorphism of Val158Met in the COMT gene has been related to malignancy. In this regard, a study was carried out to find a possible association between the COMT gene polymorphism in patients with sporadic prostate cancer (PCa and benign prostatic hyperplasia (BPH.
    • METHODS: All types of COMT158 Val/Met polymorphism were carried out using ASO-PCR method in 41 patients with prostate cancer, 193 patients with benign prostatic hyperplasia and 107 healthy male individuals.
    • RESULTS: The results of this study showed that the frequency of low producer allele A at codon 158 of the  OMT gene is significantly different in BPH group compared to normal male control group (OR, 95% CI, p value 1.95: 1.46, 2.44, 0.021, respectively. However no significant difference was noticed when the comparison was made between prostate cancer group and normal male control group and also between BPH and PCa groups.
    • CONCLUSIONS: Decreased level of catechol-o-methyl transferase gene

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

      Science.gov (United States)

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

      2015-01-01

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

    • Matrix metalloproteinase 9 expression in primary human prostatic adenocarcinoma and benign prostatic hyperplasia.

      Science.gov (United States)

      Hamdy, F. C.; Fadlon, E. J.; Cottam, D.; Lawry, J.; Thurrell, W.; Silcocks, P. B.; Anderson, J. B.; Williams, J. L.; Rees, R. C.

      1994-01-01

      Matrix metalloproteinase (MMP) expression was investigated in patients with prostatic adenocarcinoma and benign prostatic hyperplasia (BPH). Forty-one men were studied: 26 had histologically proven prostate cancer, with 14 (54%) showing metastatic disease; 15 patients had BPH. Prostatic tissue was obtained from transurethral resection and needle core biopsies; gelatinolytic activity was determined by zymography. Seven gelatinolytic bands were detected, with molecular weights ranging from > 100 kilodalton (kDa) to 29 kDa. Nine of 14 patients (64%) with skeletal metastases had 92 kDa activity, present in only two of 12 patients (17%) with a negative bone scan, and absent in BPH. The 92 kDa gelatinolytic activity was expressed in 73% of aneuploid tumours compared with 20% of diploid tumours. A 97 kDa gelatinase was expressed in 80% of BPH samples and 23% of carcinoma patients. Enzyme bands of 72, 66 and 45 kDa were equally expressed in malignant tissue, irrespective of metastatic status, but were expressed in fewer BPH patients. The 97, 92, 66 and 45 kDa enzymes were identified as being pro-MMP-9 sequences by Western blotting, using a specific antibody directed against the pro sequence of the mature protein. MMP activity appeared to be increased in malignant prostatic tissue compared with BPH. Pro-MMP-9, in its 92 kDa form, was shown to be exclusively expressed by malignant prostatic tissue, and in particular by tumours that exhibited the aggressive and metastatic phenotype. Images Figure 1 Figure 2 PMID:7506923

    • Benign Conditions That Mimic Prostate Carcinoma: MR Imaging Features with Histopathologic Correlation.

      Science.gov (United States)

      Kitzing, Yu Xuan; Prando, Adilson; Varol, Celi; Karczmar, Gregory S; Maclean, Fiona; Oto, Aytekin

      2016-01-01

      Multiparametric magnetic resonance (MR) imaging combines anatomic and functional imaging techniques for evaluating the prostate and is increasingly being used in diagnosis and management of prostate cancer. A wide spectrum of anatomic and pathologic processes in the prostate may masquerade as prostate cancer, complicating the imaging interpretation. The histopathologic and imaging findings of these potential mimics are reviewed. These entities include the anterior fibromuscular stroma, surgical capsule, central zone, periprostatic vein, periprostatic lymph nodes, benign prostatic hyperplasia (BPH), atrophy, necrosis, calcification, hemorrhage, and prostatitis. An understanding of the prostate zonal anatomy is helpful in distinguishing the anatomic entities from prostate cancer. The anterior fibromuscular stroma, surgical capsule, and central zone are characteristic anatomic features of the prostate with associated low T2 signal intensity due to dense fibromuscular tissue or complex crowded glandular tissue. BPH, atrophy, necrosis, calcification, and hemorrhage all have characteristic features with one or more individual multiparametric MR imaging modalities. Prostatitis constitutes a heterogeneous group of infective and inflammatory conditions including acute and chronic bacterial prostatitis, infective and noninfective granulomatous prostatitis, and malacoplakia. These entities are associated with variable clinical manifestations and are characterized by the histologic hallmark of marked inflammatory cellular infiltration. In some cases, these entities are indistinguishable from prostate cancer at multiparametric MR imaging and may even exhibit extraprostatic extension and lymphadenopathy, mimicking locally advanced prostate cancer. It is important for the radiologists interpreting prostate MR images to be aware of these pitfalls for accurate interpretation. Online supplemental material is available for this article.

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

      Directory of Open Access Journals (Sweden)

      Daniele Gianfrilli

      2014-01-01

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

    • Transurethral enucleation of prostate with button electrode plasmakinetic vaporization for the treatment of Benign Prostatic Hyperplasia

      Science.gov (United States)

      Peng, Bo; Huang, Jianhua; Wang, Guangchun; Zhang, Haimin; Liu, Min

      2016-01-01

      Benign prostatic hyperplasia (BPH) is a common disease in aged men. In this study, we investigated the efficacy and safety of transurethral enucleation of prostate with button electrode plasmakinetic vaporization for the treatment of BPH. 60 patients diagnosed with BPH who were treated in our hospital from August to December, 2014 by enucleation with button electrode were retrospectively reviewed, and operation time, urinary catheter indwelling time, continuous bladder irrigation time, operation related complications, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS), quality of life assessment (QOL), perioperative hemoglobin and electrolytes were recorded. All the operations were completed successfully. The operation time and urinary catheter indwelling time were 45.3 ± 16.2 min and 1.72 ± 0.32 d, respectively. During the follow-up, urethral stricture (n = 1), and urinary incontinence (n = 2) were found with recovery after 1-month training. Postoperative PVR at 1, 3 and 6 months significantly decreased compared with preoperative ones (P prostate with button electrode was efficient and safe, which was worth being recommended. PMID:28008957

    • Dynamic contrast-enhanced MRI of benign prostatic hyperplasia and prostatic carcinoma: correlation with angiogenesis

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      Ren, J. [Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi' an (China); Huan, Y. [Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi' an (China)], E-mail: huanyi3000@163.com; Wang, H. [Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi' an (China); Chang, Y.-J.; Zhao, H.-T.; Ge, Y.-L.; Liu, Y.; Yang, Y. [Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi' an (China)

      2008-02-15

      Aim: To investigate the diagnostic and differential diagnostic values of dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) in prostatic diseases, and to investigate the correlation between the parameters of SI-T curves and angiogenesis. Materials and methods: Twenty-one patients with proven prostatic carcinoma (Pca) and 29 patients with proven benign prostatic hyperplasia (BPH) were examined using DCE MRI. Diagnostic characteristics for differentiation were examined using threshold values for maximum peak time, enhancement degree, and enhancement rate. Then, the signal intensity-time curves (SI-T curves) were analysed, and the correlations between the parameters of SI-T curves and the expression levels of vascular endothelial growth factor (VEGF) and microvascular density (MVD) were investigated. All patients underwent prostatectomy. DCE MRI and histological findings were correlated. Results: Pca showed stronger enhancement with an earlier peak time, higher enhancement, and enhancement rate (p < 0.05). Regarding the type of SI-T curves, in the BPH group six were type A, 10 were type B, and 13 were type C, whereas in the Pca group, 14 were type A, six were type B, and only one was type C (Chi-square test, {chi}{sup 2} = 13.57, P < 0.005). The VEGF and MVD expression levels of Pca were higher than those of BPH. Peak time was negatively correlated with the expression levels of VEGF and MVD, whereas the enhancement degree and enhancement rate showed positive correlations (Pearson correlation, p < 0.05). Conclusion: Based on T2-weighted imaging, DCE MRI curves can help to differentiate benign from malignant prostate tissue. In the present study the type C curve was rarely seen with malignant disease, but these results need confirmation.

    • Management of benign prostatic hypertrophy-related urinary retention: current trends and perspectives.

      Science.gov (United States)

      Stamatiou, Konstantinos

      2009-01-01

      The failure of prostate-directed treatment modalities to help all men or all symptoms has questioned the longstanding assumption that the prostate is at the root of all male urinary symptoms, and a correlation between urinary bladder function and prostate pathology has been recognized. Now, it is widely recognized that bladder dysfunction plays a role in some, if not most, of the benign prostatic hyperplasia-related symptoms and signs, and recent studies have suggested that pharmacotherapies that target the bladder, such as antimuscarinics, may improve storage urinary symptoms. Indeed, the current mainstays of overactive bladder syndrome pharmacotherapy are antimuscarinic agents with mixed actions, including musculotropic (calcium antagonistic) activity. Moreover, the combination therapy with alpha blocker and antimuscarinic agents is now suggested when bladder outlet obstruction related to benign prostatic hyperplasia coexists with overactive bladder symptoms. Combinational treatment, targeting to both decrease resistance to urine outflow through the prostatic urethra and increase bladder smooth muscle, may improve the bladder outlet surgery success rate, and perhaps it might reinforce the need to offer an additional trial without catheter in patients with benign prostatic hyperplasia who are likely to suffer from detrusor hypocontractivity. Currently, no clinical trial supporting the use of parasympathomimetic drugs in those with poor voiding and longstanding symptomatic benign prostatic hyperplasia exists in the literature; however, experimental studies present promising results.

    • Correlation between benign prostate hyperplasia and the related indicators of atherosclerosis

      Institute of Scientific and Technical Information of China (English)

      张瑞华

      2012-01-01

      Objective To investigate the correlation between benign prostate hyperplasia (BPH) and atherosclerotic related indicators. Methods Totally 125 patients were divided into two groups based on prostate volume(PV):50 cases without BPH(PV≤30 ml) and 75 cases with BPH (PV>30ml)

    • Estimated costs of treatment of benign prostate hyperplasia in Brazil

      Directory of Open Access Journals (Sweden)

      Haylton J. Suaid

      2003-06-01

      Full Text Available INTRODUCTION: The treatment of benign prostate hyperplasia (BPH presents 2 options: medical or surgical, and there are doubts about what is the best treatment since 80% of patients who undergo surgery become asymptomatic and 10 to 40% of those under medical regimen undergo surgery within a 5 years period. It is difficult to assess the actual costs of treating BPH in Brazil due to several factors, among them regional particularities and the scarcity of current statistical data. PATIENTS AND METHODS: Recently, in the Ribeirão Preto area, São Paulo, Brazil, the IPSS (International Prostatic Symptoms Score and quality of life were verified in 934 volunteers. It was determined the percentage of individuals with ages ranging from 40 to 79 years with moderate symptoms (score 8-19 and with severe symptoms (score 20-35, values for which are indicated medical and surgical treatment, respectively, according to the Brazilian Society of Urology consensus on BPH. Data on Brazilian population in that age range were obtained from the Brazilian Institute of Geography and Statistics referent to the year of 2000. It was determined the number of patients, according to the criteria above, subjected to either one of the treatments mentioned. Surgical costs of prostate transurethral resection were researched according to Unified Health System - SUS tables (US$ 173 and of Brazilian Medical Society - AMB with a mean cost in 3 hospitals of US$ 933. Drug costs were calculated by the annual mean price (US$ 355 of 4 alpha-blockers (tamsulosin, alfuzosin, doxazosin and terazosin. RESULTS: The estimated population for medical treatment was 5,397,321 individuals, with a cost corresponding to US$ 1,916,489,055.00. The estimated population for surgical treatment was 2,040,299 men, what would represent a cost of US$ 353,291,204.00 based on the SUS table and of US$ 1,904,279,066.00 based on AMB with hospital expenses included. CONCLUSION: All theses facts induce us to predict

    • [Vaporizing resection - a new treatment of benign prostatic hyperplasia].

      Science.gov (United States)

      Martov, A G; Razumov, S V; Gushchin, B L; Sysoev, P A

      1999-01-01

      Though transurethral resection (TUR) remains a routine treatment for benign prostatic hyperplasia (BPH), its complications observed in up to 18% of patients necessitate active search for novel endoscopic methods. Vaporizing resection (VR) is among them. It makes use of two electrosurgical techniques of tissue removal--resection and vaporization--which provide adequate removal of the tissue and good coagulation. VR was made in 84 BPH patients aged 57-82 years. 19 of them had epicystostomy. 1-year follow up examination showed that complaints index by IPSS scale diminished from 21.9 to 4.6, life quality--from 3.9 to 1.1, urine residual volume--from 118 to 19 ml, maximal urination rate Qmax increased from 6.7 to 18.5 ml/s. Thus, the scheme of BPH patients' examination, the operative technique and indications in VR are the same as in TUR, while the course of the postoperative period, frequency and type of complications are typical for electrovaporization: minimum of hemorrhagic complications, low probability of TUR-syndrome, less severe postoperative period, etc.

    • Hi-tech of the prostate: interstitial laser coagulation of benign prostatic hypertrophy

      Science.gov (United States)

      Muschter, Rolf; Hofstetter, Alfons G.; Hessel, Stefan F. F.; Keiditsch, Ernst; Rothenberger, Karl-Heinz; Schneede, Peter; Frank, Klaus H.

      1992-06-01

      We report on the new technique of interstitial laser coagulation of the prostate (ILCP) in the treatment of benign prostatic hyperplasia (BPH). Basic experiments by use of a Nd:YAG laser in combination with a newly designed fiber tip homogeneously distributing the laser irradiation have been performed in potato, muscle, liver, and surgically removed human BPH-tissue to determine the volume of coagulation. The coagulation zone surrounding the probe was well defined and homogeneous. The size was dependent on laser power and irradiation time. Carbonization was never present except in darker tissues irradiated with high energy. Volume and time resolved measurements correlated well with the size of coagulation. 10 W and 5 minutes, for example, resulted in a coagulation zone of 17 X 15 mm. Comparable results have been seen in in-vivo experiments in surgically exposed canine prostates. Specimen for macroscopic and microscopic examination were taken immediately after treatment and after 5 and 35 days. The well demarked coagulation necrosis of the early stage resulted in cystic degeneration and fibrosis in the later stages. This was combined with shrinkage and reduction in volume. The urothelium of the urethra, the external sphincter and the rectum showed no damage. Until now, 15 patients suffering from obstructive symptoms due to BPH have been treated with interstitial laser coagulation. The probes were inserted from the perineum into the center of each lateral lobe of the prostate by transrectal ultrasound guidance, while the median lobe was treated by urethroscopic guidance, while the median lobe was treated by urethroscopic control. Dependent on the size of the prostate irradiation, time was 5 to 10 minutes per lobe at a power setting of 5 to 10 W.

  1. The study of mucin histochemistry in benign and malignant lesions of prostate

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    Durgaprasad N Agrawal

    2014-01-01

    Full Text Available Objective: To evaluate the usefulness of mucin stains in differentiating benign and malignant lesions of prostate. Materials and Methods: Sections were obtained from archival paraffin blocks which included randomly selected 70 cases of benign hyperplasia and 30 cases of carcinoma prostate. After confirming the diagnosis, sections were stained for Periodic Acid Schiff (PAS to study neutral mucins, Alcian blue (2.5 pH to study acidic mucins and combined Alcian blue - PAS to study the mucin character. Results: Benign hyperplasia of prostate showed positivity for neutral mucins (98.57% but not for acidic mucins, whereas prostatic carcinomas showed positivity for acidic mucins (46.66% in addition to the positivity for neutral mucins (56.66%. All the cases of low grade prostatic carcinomas showed positivity for acidic mucins but none of the high grade carcinomas showed positivity for the same. Conclusion: Positivity for acidic mucins with Alcian Blue (2.5 pH technique can be used to differentiate well differentiated adenocarcinomas of prostate from benign hyperplasia especially in those cases where prostatic lesion is a questionable malignancy either because it is so well differentiated histologically or have altered architecture so as to make it cytologically un diagnosable (P = 0.001.

  2. Interleukin-1α Is a Paracrine Inducer of FGF7, a Key Epithelial Growth Factor in Benign Prostatic Hyperplasia

    OpenAIRE

    Giri, Dipak; Ittmann, Michael

    2000-01-01

    Benign prostatic hyperplasia (BPH) is an extremely common disease of older men in which there is benign overgrowth of the prostatic transition zone, leading to obstruction of urine outflow. FGF7, a potent growth factor for prostatic epithelial cells, is increased by threefold in BPH and is correlated with increased epithelial proliferation in this condition. Immunohistochemistry of normal and hyperplastic prostate revealed that FGF7-expressing fibroblastic cells were present in higher numbers...

  3. Photoselective vaporization of the prostate in the treatment of benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    FU Wei-jun; HONG Bao-fa; YANG Yong; CAI Wei; GAO Jiang-ping; WANG Chun-yang; WANG Xiao-xiong

    2005-01-01

    Background The treatment of symptomatic benign prostatic hyperplasia (BPH) remains a challenge for most urologic surgeons. We studied a cumulative cohort of patients with symptomatic benign prostatic hyperplasia (BPH) who underwent photoselective vaporization of the prostate (PVP) and evaluated the efficacy and safety of this procedure.Methods A total of 196 patients with lower urinary tract obstruction symptoms secondary to BPH were treated using laser vaporization of the prostate under sacral canal anesthesia at our institutions. The therapeutic results were assessed using following variables: the safety and efficacy of sacral anesthesia, blood loss, operative time, indwelling catheterization. Preoperative and perioperative parameters were evaluated in the international prostate symptom score (IPSS), quality of life score (QoL), maximal urinary flow rate (Qmax), post-void residual urine volume (PVR) and the change of sexual function. Patients were also assessed for 3-month follow up. Results PVP was performed successfully for all patients. There were 195 patients under sacral anesthesia and 1 patient under epidural anesthesia. Mean operative time was (45.2±18.5) minutes. The mean IPSS decreased from (26.6±3.2) to (5.6±1.4) and the QoL score decreased from (5.7±0.4) to (1.6±0.5), respectively (P<0.05), while mean Qmax increased from (6.7±2.5) ml/s preoperatively to (19.6±2.4) ml/s, PVR decreased from 158.4 to 25.8 ml, respectively (P<0.05). Average catheterization time was (1.8±0.9) days. There was no significant blood loss or fluid absorption during the period of PVP. Complications consisted of transient dysuria in 3 patients (1.5%), delayed gross hematuria in 5 patients (2.5%), respectively. Significant improvement in clinical outcomes were noted as early as 3 months after PVP treatment.Conclusions PVP is considered as a high satisfaction rate by patient and a minimal postoperative complication. Hence, PVP is a novel, safe, effective and minimal invasive

  4. Characteristic gene expression profiles of benign prostatic hypertrophy and prostate cancer.

    Science.gov (United States)

    Endo, Takumi; Uzawa, Katsuhiro; Suzuki, Hiroyoshi; Tanzawa, Hideki; Ichikawa, Tomohiko

    2009-09-01

    The molecular mechanism playing a role in the development of benign prostate hypertrophy (BPH) and prostate cancer (PC) is not well defined. We performed microarray analysis to assess the gene expression change in BPH and PC, and performed network analysis. Normal prostate, BPH and PC tissues were obtained from patients who underwent an operation at Chiba University Hospital. Using Affymetrix Human Genome U133 Plus2.0 Array, we identified genes differentially expressed. The identified genes were analyzed using the Ingenuity Pathway Analysis (IPA) to investigate the functional network and gene ontology. The microarray analysis identified 402 genes in BPH and 141 genes in PC, which were up- or down-regulated at least 5.0-fold change in PC at all dose points. Analysis using IPA software revealed eight networks in BPH and five networks in PC. We narrowed these down to the top five genes, which were up- or down-regulated on the networks in their characteristic manner. From this new perspective, comparing BPH and PC in microarray studies, our data showing gene expression profiles provide candidate genes for better understanding of disease and new therapeutic targets.

  5. Radiological and clinical observation on benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jai Hee; Kim, Young Chul; Kim, Yeon; Han, Jung Suh [College of Medicine, Cho-Sun University, Seoul (Korea, Republic of)

    1980-12-15

    A radiological and clinical observation was made on 77 cases of benign prostatic hyperplasia admitted to the department of Urology, Cho-Sun University Hospital during the period from January 1972 to December 1979 and following results were obtained. 1. Incidence of PBH was 8.1% to 953 total inpatients, 11.3% to 679 male inpatients, and 34.5% to male inpatients of 50 years more. 2. Majority of cases was found in 7th and 8th decades (80.5%) with mean age of 69.4 years old. 3. A gradual tendency of annual increase of the cases was observed and the mean interval elapsed from initial symptoms to visit was 29.9 months. Common symptoms were dysuria in 72 cases (93.5%), hematuria in 53 cases (68.8%), frequency in 51 cases (66.2%) and 12 cases (15.6%) were acute urinary retention. 4. I. V. P. findings of BPH were elevation of the bladder base in 71 cases (92.2%), trabeculation of the bladder wall in 58 cases (75.3%), hypertrophy of the bladder in 24 cases (31.2%) and the complications-hydronephrosis and hydroureter 16 cases (20.8%), bladder diverticula 9 cases (11.7%) and bladder stone were 5 cases (6.5%). 5. Cystourethrographic findings of the posterior urethra with 33 cases of PBH were smooth, gentle sloping in 28 cases 84.8%), widening in sagittal plane in 23 cases (69.7%), elongation and narrowing of the urethra in 26 cases (78.8%)

  6. 5{alpha}-reductase expression by prostate cancer cell lines and benign prostatic hyperplasia in vitro

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-04-01

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

  7. Safety and efficiency of thulium laser prostate resection for the treatment of benign prostatic hyperplasia in large prostates.

    Science.gov (United States)

    Wei, Hai-bin; Zhuo, Jian; Sun, Xiao-wen; Pang, Kun; Shao, Yi; Liang, Sheng-jie; Cui, Di; Zhao, Fu-jun; Yu, Jun-jie; Xia, Shu-jie

    2014-05-01

    Thulium laser resection of the prostate-tangerine technique (TmLRP-TT) dissects whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. The present study aimed to evaluate the safety and efficacy of TmLRP-TT for older symptomatic benign prostatic hyperplasia patients with large prostates during 18 months of follow-up. A prospective analysis of 95 consecutive patients with large prostates (>80 ml) who underwent surgical treatment using TmLRP-TT was carried out. All patients were evaluated preoperatively and at 1, 6, 12, and 18 months postoperatively by the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Q max), postvoid residual urine volume (PVR), International Index of Erectile Function 5 (IIEF-5), urine analysis, and urine culture. Perioperative complications were recorded and graded by the modified Clavien classification system (CCS). Mean preoperative prostate volume was 106.81 ± 24.79 ml. TmLRP-TT was successfully completed in all patients. The mean operative duration, catheterization time, and hospital stay were 95.36 ± 27.06 min, 2.25 ± 0.9 days, and 5.39 ± 1.18 days, respectively. The decrease in mean hemoglobin level was 1.23 ± 0.72 g/dl, and that in mean serum sodium level was 0.71 ± 2.56 mmol/l. Within the observation period of 18 months, the patients showed an improvement in IPSS (20.01 ± 7.08 vs. 4.96 ± 3.68), QoL (4.10 ± 1.16 vs. 1.23 ± 1.30), Q max (8.14 ± 3.81 ml/s vs. 18.33 ± 2.56 ml/s) and PVR (102.70 ± 70.64 ml vs. 20.28 ± 30.02 ml), compared with baseline values (P prostates as assessed during an 18-month follow-up period. It is a promising technology, which may be considered as one of the alternatives to open simple prostatectomy (OP) for large prostates in the future.

  8. Relationship of blood pressure variability and heart rate variability with prostatic volume in patients with benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    金江丽

    2014-01-01

    Objective To investigate the relationship of blood pressure variability(BPV)and heart rate variability(HRV)with prostatic volume(PV)in patients with benign prostatic hyperplasia(BPH).Methods A total of133 patients admitted to our department between January2011 and April 2013 were analyzed retrospectively.The patients were divided into BPH group and non-BPH group according to the PV value.The ambulatory blood

  9. Circulating Prostate Cells Found in Men with Benign Prostate Disease Are P504S Negative: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Nigel P. Murray

    2013-01-01

    Full Text Available Introduction. Developments in immunological and quantitative real-time PCR-based analysis have enabled the detection, enumeration, and characterization of circulating tumor cells (CTCs. It is assumed that the detection of CTCs is associated with cancer, based on the finding that CTCs can be detected in all major cancer and not in healthy subjects or those with benign disease. Methods and Patients. Consecutive men, with suspicion of prostate cancer, had blood samples taken before prostate biopsy; mononuclear cells were obtained using differential gel centrifugation and CPCs detecting using anti-PSA immunocytochemistry. Positive samples underwent further classification with anti-P504S. Results. 329 men underwent prostate biopsy; of these men 83 underwent a second biopsy and 44 a third one. Of those with a biopsy negative for cancer, 19/226 (8.4% had CPCs PSA (+ P504S (− detected at first biopsy, 6/74 (8.1% at second biopsy, and 5/33 (15.2% at third biopsy. Men with cancer-positive biopsies did not have PSA (+ P504S (− CPCs detected. These benign cells were associated with chronic prostatitis. Conclusions. Patients with chronic prostatitis may have circulating prostate cells detected in blood, which do not express the enzyme P504S and should be thought of as benign in nature.

  10. The experience of Goldwater Tongzhi for treating benign prostatic hyperplasia%金水同治治疗前列腺增生体会

    Institute of Scientific and Technical Information of China (English)

    刘志勇

    2013-01-01

      Benign prostatic hyperplasia, also known as enlarged prostate is a common disease of the older men. Ancient Chinese physicians accumulated a wealth of experience in the treatment of benign prostatic hyperplasia. The author according to lung and kidney homologous Goldwater Aioi traditional Chinese medicine theory, dialectical theory of governance based on the use of the the Goldwater Tongzhi method of treatment of benign prostatic hyperplasia, and achieved satisfactory efficacy.%  前列腺增生又称前列腺肥大,是老年男性的一种常见病。中国古代医家积累了丰富的治疗经验。笔者根据肺肾同源、金水相生的中医理论,在辨证论治的基础上,运用金水同治的方法治疗前列腺增生,取得了满意的疗效。

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Elizabeth Singer

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

  13. A study of molecular signals deregulating mismatch repair genes in prostate cancer compared to benign prostatic hyperplasia.

    Science.gov (United States)

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

    2015-01-01

    Prostate cancer is one of the leading causes of mortality among aging males. There is an unmet requirement of clinically useful biomarkers for early detection of prostate cancer to reduce the liabilities of overtreatment and accompanying morbidity. The present population-based study investigates the factors disrupting expression of multiple functionally related genes of DNA mismatch repair pathway in prostate cancer patients to identify molecular attributes distinguishing adenocarcinoma from benign hyperplasia of prostate. Gene expression was compared between tissue samples from prostate cancer and benign prostatic hyperplasia using real-time-PCR, western blot and immunohistochemistry. Assessment of genotypes of seven single-nucleotide-polymorphisms of three MMR genes was conducted using PCR-coupled RFLP and sequencing. Promoter methylation was interrogated by methylation-specific-PCR and bisulfite-sequencing. Interaction between microRNAs and MMR genes was verified by 3'UTR-based dual luciferase assays. Concurrent reduction of three MMR genes namely hMLH1, hMSH6 and hMSH2 (34-85%, Pprostate cancer tissues. hMSH6 polymorphism rs1800932(Pro92Pro) conferred a borderline protection in cancer patients (OR = 0.33, 95% CI = 0.15-0.75). Relative transcript level of hMLH1 was inversely related (r = -0.59, Pprostate cancer. This comparative study reflects that microRNA expression level, particularly hsa-miR-155, exhibits predictive signature of prostate adenocarcinoma.

  14. Analysis of risk factors for benign prostatic hyperplasia and metabolic syndrome in the elderly undergoing health examination

    Institute of Scientific and Technical Information of China (English)

    王蕾蕾

    2013-01-01

    Objective To investigate the prevalences of benign prostatic hyperplasia (BPH) and metabolic syndrome (MS) and to analyze the risk factors for benign prostatic hyperplasia and metabolic syndrome in the elderly.Methods A total of 490 elderly men undergoing health examination in our hospital from January 2010 to

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

    Science.gov (United States)

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

    2009-06-24

    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.

  16. Nutritional status and nutritional habits of men with benign prostatic hyperplasia or prostate cancer - preliminary investigation

    Directory of Open Access Journals (Sweden)

    Zuzanna Goluch-Koniuszy

    2013-09-01

    Full Text Available Introduction. The ageing in men, the most frequent pathologic lesions affecting the prostatic gland in this period are benign prostatic hyperplasia (BPH and prostate cancer (PC, the course of which may be infl uenced by the improper nutritional status of patients and their nutritional habits. The aim of this study was, therefore, to evaluate the nutritional status and eating habits of men diagnosed and treated for one of the above diseases. Material and metods. The nutritional status of 30 male patients with clinically confi rmed and treated disease of the prostatic gland, including 15 men (aged 51-75 years with BPH and 15 men (aged 51-73 years with PC, was evaluated based on their BMI, WC, WHR, and WHtR parameters. In turn, the energy and nutritive value of 90 daily food rations (DFRs was evaluated. Finally, calculations were made for the Key’s index of diet atherogenicity, resultant Glycemic Index (GI and Glycemic Load (GL. Results. Higher values of the BMI, WC, WHR and WHtR parameters were noted in the men with PC, they were also characterized by a higher incidence of peripheral subcutaneous obesity and visceral obesity. The DFRs of the men were characterized by a low energy value and by a low intake of available carbohydrates, dietary fi ber, K, Ca, Mg, vitamins D and C, and fl uids at a simultaneously high intake of total and animal protein, cholesterol, Na, P, Fe, Cu as well as vitamins B2 and PP. The contribution of energy derived from the basic nutrients diverged from the recommended values. In addition, the DFRs were characterized by high values of Key’s index and 24-h GL. Differences in meeting the RDA for selected nutrients between the analysed groups of men were statistically signifi cant. Conclusions. The improper nutritional status of the men may result from their incorrect nutritional habits which fail to improve their health status, and even predispose them to the development of some diet-dependent diseases. In view of that

  17. Hormonal manipulation of lower urinary tract symptoms secondary to benign prostatic obstruction

    Directory of Open Access Journals (Sweden)

    Adita Raja

    2014-01-01

    Full Text Available Although the etiology of lower urinary tract symptoms (LUTS is often multifactorial, a significant proportion of men over the age of 50 suffer from benign prostatic obstruction (BPO secondary to benign prostatic hyperplasia. Prostate, being an androgen responsive organ is dependent on the male sex hormone, testosterone, for growth. Thus, treatment strategies that manipulate the levels of circulating hormones that influence the level of testosterone and/or prostatic growth represent an important potential option for patients suffering with troublesome LUTS due to BPO. Despite this, the only hormonal treatment that is currently used in daily clinical practice is the 5-alpha reductase inhibitor. In this article, we review the current evidence on the use of the 5-alpha reductase inhibitors finasteride and dutasteride. We also discuss new emerging hormonal manipulation strategies for patients with LUTS secondary to BPO.

  18. Optical coherence elastography (OCE) as a method for identifying benign and malignant prostate biopsies

    Science.gov (United States)

    Li, Chunhui; Guan, Guangying; Ling, Yuting; Lang, Stephen; Wang, Ruikang K.; Huang, Zhihong; Nabi, Ghulam

    2015-03-01

    Objectives. Prostate cancer is the most frequently diagnosed malignancy in men. Digital rectal examination (DRE) - a known clinical tool based on alteration in the mechanical properties of tissues due to cancer has traditionally been used for screening prostate cancer. Essentially, DRE estimates relative stiffness of cancerous and normal prostate tissue. Optical coherence elastography (OCE) are new optical imaging techniques capable of providing cross-sectional imaging of tissue microstructure as well as elastogram in vivo and in real time. In this preliminary study, OCE was used in the setting of the human prostate biopsies ex vivo, and the images acquired were compared with those obtained using standard histopathologic methods. Methods. 120 prostate biopsies were obtained by TRUS guided needle biopsy procedures from 9 patients with clinically suspected cancer of the prostate. The biopsies were approximately 0.8mm in diameter and 12mm in length, and prepared in Formalin solution. Quantitative assessment of biopsy samples using OCE was obtained in kilopascals (kPa) before histopathologic evaluation. The results obtained from OCE and standard histopathologic evaluation were compared provided the cross-validation. Sensitivity, specificity, and positive and negative predictive values were calculated for OCE (histopathology was a reference standard). Results. OCE could provide quantitative elasticity properties of prostate biopsies within benign prostate tissue, prostatic intraepithelial neoplasia, atypical hyperplasia and malignant prostate cancer. Data analysed showed that the sensitivity and specificity of OCE for PCa detection were 1 and 0.91, respectively. PCa had significantly higher stiffness values compared to benign tissues, with a trend of increasing in stiffness with increasing of malignancy. Conclusions. Using OCE, microscopic resolution elastogram is promising in diagnosis of human prostatic diseases. Further studies using this technique to improve the

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Is transition zone index useful in assessing bladder outflow obstruction due to benign prostatic hyperplasia?: A prospective study

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    S L Sailo

    2006-01-01

    Full Text Available BACKGROUND: Benign prostatic enlargement (BPE is the commonest cause of bladder outlet obstruction in men above 50 years of age. Though pressure-flow study is the gold standard in establishing outlet obstruction, it is associated with definite morbidity. Several noninvasive parameters are described to diagnose outlet obstruction due to BPE and evaluate treatment efficacy. AIM: We studied the role of transitional zone index (TZI in assessing bladder outlet obstruction (BOO due to BPE. SETTING AND DESIGN: Prospective hospital-based cross-sectional diagnostic study. MATERIALS AND METHODS: Thirty-five men aged between 50 and 77 years with untreated lower urinary tract symptoms due to BPE were studied. Patients with prostate cancer, prostatitis, active UTI urethral stricture, neurovesical dysfunction and diabetes mellitus were excluded. All patients underwent a standard assessment using the American Urological Association (AUA symptom score, uroflow, pressure-flow (PF study and transrectal ultrasound (TRUS estimation of TZI. Investigators undertaking PF studies and TRUS were blinded to the investigation of others. From the PF studies, Abrams Griffith (AG number was calculated. Based on this, patients were grouped into obstructed (AG>40 and unobstructed (AG< 40 groups. STATISTICAL ANALYSIS: TZI was calculated and compared with PF studies using Mann-Whitney U test, logistic regression analysis and receiver operator characteristic curve (ROC. RESULTS: The mean age was 63.2 years (SD. The mean AUA scores and peak flow rate were 16.7 and 7.5 ml/sec, respectively. Of the 35 men, 21 were obstructed and 14 were unobstructed. TZI was not significantly different between the two groups, while the differences in age, AUA symptom score, prostate volume and TZ volume were statistically significant. Logistic regression model did not show any independent effect of TZI in predicting obstruction. ROC curve showed a poor overall accuracy in diagnosing obstruction due

  1. Modification of sulpiride model of benign prostatic hyperplasia for evaluation of the effectiveness of drug therapy.

    Science.gov (United States)

    Borovskaja, T G; Sergeeva, S A; Udut, V V; Fomina, T I; Jurmazov, Z A; Pahomova, A V; Poluektova, M E; Chemerova, J A; Rumpel', O A

    2011-09-01

    Specific effects of ultra-low doses of antibodies to prostate-specific antigen obtained from laboratory rats of late reproductive age with sulpiride model of benign prostatic hyperplasia were compared with the results of clinical application of the preparation. Clinical reproducibility of experimental data was proven, which suggests that the developed model is adequate for pilot testing of the effects of pharmacotherapy of this disease.

  2. Intraprostatic ozone therapy: A minimally invasive approach in benign prostatic hyperplasia

    OpenAIRE

    Shabbir Hussain; Sharma, Deepti B.; Fanindra S Solanki; Ajay Pathak; Dhananjay Sharma

    2017-01-01

    Introduction: Transurethral resection of prostate (TURP) remains the golden standard therapy since decades. There are various minimally invasive therapies (MITs) for the treatment of benign prostatic hyperplasia (BPH). Still, there is a need for therapy with lesser side effects and better outcome. We had studied the effect of intraprostatic ozone injection (IPOI) as an MIT for patients with BPH who have failed trial without catheter (TWOC). Materials and Methods: Thirty elderly patients wi...

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

    Science.gov (United States)

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

    2014-01-01

    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 prostate cancer cases, PDCD10 staining was weak in 95 (59.4%) and strong in 65 (40.6%) (P prostatic hyperplasia cases (P prostate cancer (only 26.5% of these cases staining strongly; P prostate cancer and may play roles in prostate tumorigenesis. MST4 may be a helpful marker for identifying prostate cancer.

  4. Benign or Malignant? Two Case Reports of Gigantic Prostatic Cyst

    Directory of Open Access Journals (Sweden)

    Jiang Yu

    2016-09-01

    Full Text Available A 60-year-old male with a huge prostate cyst presented with obstruction symptom of urethra and intestinal tract. Complete excision of the cystic prostate failed as a result of the strong adherence and twice operations history, but we confirmed prostate adenocarcinoma and relieved his obstruction symptom. Case 2 was a 77-year-old male with an 8 cm cyst of which biopsy showed prostate cancer in local hospital. He was admitted 18 months later because of intestinal obstruction. Radical resection had a satisfied result of obstruction symptom and PSA. Here we summarized malignant characteristics of cystic lesions in prostate or surrounding structures and management.

  5. Inhibitory effects of Tripterygium wilfordii multiglycoside on benign prostatic hyperplasia in rats.

    Science.gov (United States)

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

    2015-06-01

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

  6. Effect of β Radiation on Bcl-2 and Bax Expressions in Benign Prostate Hyperplasia Tissues

    Institute of Scientific and Technical Information of China (English)

    MA Qing-jie; GAO Shi; ZHAO Jie; GU Xin-quan; CAI Shan-yu; ZHAO Guo-qing

    2008-01-01

    The authors chose specimens from nine normal prostate tissues(NP group),15 benign prostate hyperplasia(BPH) prostates(BPH group),and 35 BPH prostates that had been treated with 90Sr/90Y Prostatic Hyperplasia Applicator(exposure group),The expressions of bcl-2 and bax in stroma and epithelia of prostate tissues were demonstrated by means of immunohistochemical staining,and the staining positive rate was semiquantatively determined,so as to observe the expression of bcl-2 and bax genes in the prostate tissues of normal individuals and BPH patients,before and after β radiation,and to evaluate the influence of β radiation on bcl-2 and bax expressions,The expressions of gene bcl-2 in the prostate epithelia of NP and BPH are significantly higher than those in the prostate stroma(P<0.01),However,the expressions of bcl-2 in the prostate epithelia and stroma of the BPH group are obviously higher than those in the NP group(P<0.01),The expression of gene bax in the prostate epithelia of the NP group is higher than that in the BPH group(P<0.05),However,bcl-2 expressions in the prostate epithelia and stroma of the BPH group are significantly higher than the bax expressions(P<0.01),Compared with those of the NP group,the expressions of bcl-2 in the prostate epithelia and stroma of the exposure group decrease remarkably,even as the expressions of the bax notably increase(P<0.01),Thus,the administration of β radiation can remarkably affect bcl-2 and bax gene expressions,to regulate cell apoptosis,in the prostate tissues of BPH.

  7. Cellular distribution of Glut-1 and Glut-5 in benign and malignant human prostate tissue.

    Science.gov (United States)

    Reinicke, Karin; Sotomayor, Paula; Cisterna, Pedro; Delgado, Carolina; Nualart, Francisco; Godoy, Alejandro

    2012-02-01

    Over-expression of hexose transporters (Gluts), specifically Glut-1, is a common event in human malignancies. In prostate cancer (CaP), however, expression of Gluts has been characterized poorly. In this study, expression and distribution of Glut-1 and Glut-5 proteins were characterized using immunohistochemistry in 76 specimens of benign prostate, 10 specimens of high-grade intraepithelial neoplasia (HGPIN), and 28 specimens of CaP. In addition, mRNA expression of Glut-2, Glut-7, Glut-9, and Glut-11 was analyzed in a set of five specimens of benign prostate and CaP. In benign prostate, Glut-1 localized to the basal cells and to the basolateral membrane of secretory/luminal epithelial cells. Glut-5, however, localized to the apical membrane of secretory/luminal epithelial cells. In HGPIN, Glut-1 was immunohistochemically undetectable. Glut-5, however, localized to the apical membrane of the neoplastic epithelial cells. In CaP, Glut-1 and Glut-5, were immunohistochemically undetectable. However, over-expression of GLUT1 was observed in some specimens of highly proliferative intraductal CaP. Glut-7, Glut-9, and Glut-11 mRNAs were detected in benign prostate and CaP, however, only Glut-11 mRNA was consistently up-regulated in CaP compared to benign prostate. Low levels of expression of Glut-1 protein in the majority of CaP could explain, at least in part, the limited clinical applicability of positron emission tomography using 2-[18F]-fluoro-2-deoxy-D-glucose for imaging CaP. Moreover, expression of Glut-5 in HGPIN suggested that fructose could be utilized as potential metabolic substrate in HGPIN. Understanding the molecular mechanisms involved in regulation/dysregulation of Gluts in CaP could provide insight in the understanding of hexose metabolism in CaP.

  8. Benign Prostatic Hyperplasia: Cone-Beam CT in Conjunction with DSA for Identifying Prostatic Arterial Anatomy.

    Science.gov (United States)

    Wang, Mao Qiang; Duan, Feng; Yuan, Kai; Zhang, Guo Dong; Yan, Jieyu; Wang, Yan

    2017-01-01

    Purpose To describe findings in prostatic arteries (PAs) at digital subtraction angiography (DSA) and cone-beam computed tomography (CT) that allow identification of benign prostatic hyperplasia and to determine the value added with the use of cone-beam CT. Materials and Methods This retrospective single-institution study was approved by the institutional review board, and the requirement for written informed consent was waived. From February 2009 to December 2014, a total of 148 patients (mean age ± standard deviation, 70.5 years ± 14.5) underwent DSA of the internal iliac arteries and cone-beam CT with a flat-detector angiographic system before they underwent prostate artery embolization. Both the DSA and cone-beam CT images were evaluated by two interventional radiologists to determine the number of independent PAs and their origins and anastomoses with adjacent arteries. The exact McNemar test was used to compare the detection rate of the PAs and the anastomoses with DSA and with cone-beam CT. Results The PA anatomy was evaluated successfully by means of cone-beam CT in conjunction with DSA in all patients. Of the 296 pelvic sides, 274 (92.6%) had only one PA. The most frequent PA origin was the common gluteal-pudendal trunk with the superior vesicular artery in 118 (37.1%), followed by the anterior division of the internal iliac artery in 99 (31.1%), and the internal pudendal artery in 77 (24.2%) pelvic sides. In 67 (22.6%) pelvic sides, anastomoses to adjacent arteries were documented. The numbers of PA origins and anastomoses, respectively, that could be identified were significantly higher with cone-beam CT (301 of 318 [94.7%] and 65 of 67 [97.0%]) than with DSA (237 [74.5%] and 39 [58.2%], P Cone-beam CT provided essential information that was not available with DSA in 90 of 148 (60.8%) patients. Conclusion Cone-beam CT is a useful adjunctive technique to DSA for identification of the PA anatomy and provides information to help treatment planning during

  9. Alpha 1-blockers vs 5 alpha-reductase inhibitors in benign prostatic hyperplasia. A comparative review

    DEFF Research Database (Denmark)

    Andersen, J T

    1995-01-01

    During recent years, pharmacological treatment of symptomatic benign prostatic hyperplasia (BPH) has become the primary treatment choice for an increasing number of patients. The 2 principal drug classes employed are alpha 1-blockers and 5 alpha-reductase inhibitors. Current information from...... of patients who will respond well to alpha 1-blockers have yet to be identified, and data concerning the long term effects of these drugs are not yet available. 5 alpha-Reductase inhibitors have a slow onset of effect, but treatment leads to improvement in symptoms, reduction of the size of the prostate gland...... or unwilling to undergo surgical resection of the prostate will benefit from such therapy....

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

    Directory of Open Access Journals (Sweden)

    Petra Leidinger

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

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

    Science.gov (United States)

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

    2015-01-01

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

  12. Detection of benign prostatic hyperplasia nodules in T2W MR images using fuzzy decision forest

    Science.gov (United States)

    Lay, Nathan; Freeman, Sabrina; Turkbey, Baris; Summers, Ronald M.

    2016-03-01

    Prostate cancer is the second leading cause of cancer-related death in men MRI has proven useful for detecting prostate cancer, and CAD may further improve detection. One source of false positives in prostate computer-aided diagnosis (CAD) is the presence of benign prostatic hyperplasia (BPH) nodules. These nodules have a distinct appearance with a pseudo-capsule on T2 weighted MR images but can also resemble cancerous lesions in other sequences such as the ADC or high B-value images. Describing their appearance with hand-crafted heuristics (features) that also exclude the appearance of cancerous lesions is challenging. This work develops a method based on fuzzy decision forests to automatically learn discriminative features for the purpose of BPH nodule detection in T2 weighted images for the purpose of improving prostate CAD systems.

  13. Estrogen receptors in the human male prostatic urethra and prostate in prostatic cancer and benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Bødker, A; Bruun, J; Balslev, E

    1999-01-01

    stroma in eight cases and in the glandular epithelium in one. In four cases ERs were seen in the prostatic stroma and in the glandular epithelium. In the prostatic urethra, ERs were found in 19 cases located in the urothelium, lamina propria and/or periurethral glands. In the PC group, ERs were...... in the stroma, but in BPH specimens they can also be found in the glandular epithelium. Biochemically, the use of the DCC analysis is of limited value, since ER content in the human prostate and prostatic urethra is at the limit of detection with this method....

  14. The correlation between metabolic syndrome and benign prostatic hyperplasia and drug efficacy evaluation

    Institute of Scientific and Technical Information of China (English)

    李欣

    2014-01-01

    Objective To explore the correlation between metabolic syndrome(MS)and benign prostatic hyperplasia(BPH)and the drug treatment of BPH.Methods 300cases of BPH patients treated between May 2011 to June2012 in our hospital and Tonghai County hospitals of traditonal Chinese medicine were included.The patients were divided into observing group(n=100)and control

  15. Clinical effects of statins on benign prostatic hyperplasia complicating metabolic syndrome in elderly patients

    Institute of Scientific and Technical Information of China (English)

    曾小芳

    2014-01-01

    Objective To evaluate the effect of simvastatin and atorvastatin on clinical progression of benign prostatic hyperplasia(BPH)in elderly patients with metabolic syndrome(MS).Methods A total of 135 patients with BPH and MS aged 60 years and over were divided into three groups:simvastatin group(n=45,40 mg/d),atorvasta-

  16. Nonablative minimally invasive thermal therapies in the treatment of symptomatic benign prostatic hyperplasia.

    NARCIS (Netherlands)

    Ancona, F.C.H. d'

    2008-01-01

    PURPOSE OF REVIEW: As all new treatment modalities nonablative thermal therapy for minimal invasive treatment of benign prostatic hyperplasia should be critically analyzed. This review discusses the literature to identify the merits of these so-called minimally invasive treatments and the place they

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Androgen deficiency and lower urinary tract symptoms in patients with benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    S. P. Darenkov

    2014-11-01

    Full Text Available This article analyzes the existing literature on late onset hypogonadism deficiency and its relationship with lower urinary tract symptoms and benign prostatic hyperplasia. Aspects of modern therapy and its effectiveness were considered. The possibility testosterone drugs use for men with late onset hypogonadism and lower urinary tract symptoms was analyzed. Evaluated the safety and efficacy of hormone replacement therapy.

  19. Incidence of benign prostate hypertrophy in Danish men with and without HIV infection

    DEFF Research Database (Denmark)

    Ahlström, Magnus Glindvad; Kronborg, Gitte; Larsen, Carsten S

    2015-01-01

    BACKGROUND: Information on risk of benign prostate hypertrophy (BPH) in HIV-infected men is sparse. We aimed to estimate the incidence of being diagnosed with BPH among HIV-infected men compared with an age and sex-matched comparison cohort from the background population. To exclude that family...

  20. Efficacy observation on benign prostatic hyperplasia treated with acupuncture and moxibustion

    Institute of Scientific and Technical Information of China (English)

    徐泽杰

    2014-01-01

    Objective To compare the difference in the clinical efficacy on benign prostatic hyperplasia(BPH)between the acupuncture-moxibustion therapy and the medication of Qianliekang tablets.Methods One hundred and twenty eight patients were randomized into an acupuncturemoxibustion group and a Qianliekang,64 cases in each.In the acupuncture-moxibustion group,acupuncture was

  1. Increased Antioxidant Quality Versus Lower Quantity Of High Density Lipoprotein In Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Aydin Ozgur

    2015-10-01

    Full Text Available Background: Oxidative stress may be involved in the pathogenesis of every human disease. To understand its possible role in benign prostatic hyperplasia (BPH, we measured the overall oxidative status of patients with BPH and the serum activity of the high density lipoprotein (HDL-related antioxidant enzymes paraoxonase 1 (PON1 and arylesterase (ARE.

  2. TRANSURETHRAL RADIOFREQUENCY HEATING OR THERMOTHERAPY FOR BENIGN PROSTATIC HYPERTROPHY - A PROSPECTIVE TRIAL ON 65 CONSECUTIVE CASES

    NARCIS (Netherlands)

    MEIER, AHP; WEIL, EHJ; VANDOORN, ESCV; VERHAEGH, GTCM; JANKNEGT, RA

    1992-01-01

    65 consecutive cases with symptomatic benign prostate hypertrophy were treated with transurethral radiowave thermotherapy (TURF) using the Thermex-II at a temperature of 44.5-degrees-C. We report uroflowmetry and symptom scores after a follow-up of 6 months. The mean age was 63 years, the mean maxim

  3. Evaluation of benign prostatic hyperplasia treatments : How can we improve the outcome measures and success criteria?

    NARCIS (Netherlands)

    Mensink, H

    1997-01-01

    Treatment evaluation in benign prostatic hyperplasia (BPH) is complicated by a number of interdependent factors. The evaluation of the individual patient is influenced by the risk:benefit ratio and health related quality of life and this, in turn, is interrelated with the evaluation of therapeutic o

  4. Placebo effects in the pharmacological treatment of uncomplicated benign prostatic hyperplasia

    NARCIS (Netherlands)

    Hansen, BJ; Meyhoff, HH; Nordling, J; Mensink, HJA; Mogensen, P; Larsen, EH; Leenarts, JAF; Oosten, JK; vanSoest, FF; Dijkman, GA; Hoekstra, JW; vanBaasbank, NJW; Bijleveld, RT; Braam, PFCM; Schlatmann, TJM; Felderhof, J; Kapper, BJ; Dik, P; Schou, J; Poulsen, AL; Christoffersen, J; Geerdsen, JP; Hvidt, [No Value; Dahl, C; Luke, M; Lendorph, A; Jacobsen, B; Bilde, T; Mortensen, S; Walter, S

    1996-01-01

    In order to establish accurately the exact effect of any drug therapy for symptomatic benign prostatic hyperplasia (BPH) it is important to define the effect of placebo treatment. This effect was assessed by thoroughly analyzing the placebo arm, which included 101 patients, from a randomized, double

  5. Protective Effect of Naringin on Testosterone Induced Benign Prostatic Hyperplasia in Rats

    Directory of Open Access Journals (Sweden)

    Naresh KN

    2013-06-01

    Full Text Available Major components of plants being flavonoids containing polyphenolic derivatives which possesantioxidant property have shown to improve uncontrolled growth of the prostate gland and urinary tractsymptoms, which are associated with benign prostatic hyperplasia. Our study investigated whetherNaringin prevents testosterone induced prostatic hyperplasia in rats by virtue of its antioxidant property.In vitro studies were carried out to assess the protective effect of prostate tumor cell lines. BPH wasinduced in experimental groups by intramuscular injection of Testosterone Enanthate on day 1, 7 and 14.Naringin was administered daily by oral gavage for a period of 21 days. On 22nd day, rats weresacrificed, prostate tissue weighed and histopathological studies were carried out. Prostate zinc,oxidative parameters were measured. Treatment with Naringin showed significant inhibition of prostateenlargement and restored the histoarchitecture when compared with positive control group. Inconclusion, the present study showed that Naringin reduced the elevated levels of both prostate weightand prostate weight to body weight ratio, markers of testosterone induced prostatic hyperplasia in rats.

  6. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia.

    Science.gov (United States)

    Barry, M J; Cockett, A T; Holtgrewe, H L; McConnell, J D; Sihelnik, S A; Winfield, H N

    1993-08-01

    In previous studies the severity of symptoms of prostatism in men with benign prostatic hyperplasia have not correlated well with prostate size, degree of bladder trabeculation, uroflowmetry or post-void residual volume. As part of a prospective cohort study of benign prostatic hyperplasia treatment effectiveness in 4 university-based urology practices, we correlated symptom severity and these commonly used measures of disease severity. Symptom severity was quantified using the American Urological Association symptom index. Analyses were based on 198 outpatients completing a standardized evaluation (84 of these men have completed 6 months of followup after treatment with prostatectomy, balloon dilation, terazosin or watchful waiting). At baseline, symptom severity was not correlated with uroflowmetry, post-void residual, prostate size and degree of bladder trabeculation. However, symptom severity was much more strongly related to overall health status than the other measures. Reduction in symptoms with treatment did correlate with improvements in uroflowmetry. This poor baseline correlation with symptoms may reflect unreliability in measurement of the physiological/anatomical variables. Alternatively, these parameters may be measuring different pathophysiological phenomena.

  7. Comparison of MR imaging and urodynamic findings in benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Alam, A.M.; Ishida, Jun; Igawa, Mikio [Shimane Medical Univ., Izumo (Japan); Sugimura, Kazuro; Okizuka, Hiromi

    2000-04-01

    In benign prostatic hyperplasia (BPH), it is uncertain whether the size of the prostate is related to the degree of urodynamically demonstrated bladder outlet obstruction. We compared MR imaging findings and urodynamic data in patients with surgically confirmed BPH. We prospectively studied 43 benign prostatic hyperplasia (BPH) patients in whom transurethral resection of the prostate (TURP) was planned. We obtained T1- and T2-weighted images in the transverse and sagittal planes with a 1.5 Tesla superconducting unit. The predicted volume of the inner gland and the peripheral zone were obtained on T2-weighted transverse images. Prostatic protrusion into the urinary bladder (IB protrusion) and the inner gland ratio (IG ratio: inner gland volume/total prostatic volume) were determined. IB protrusion and inner IG ratio were significantly greater in patients with severe stenosis than in those without. A surgical capsule (SC) was seen in 20 of 25 patients (80%) with severe stenosis and 8 of 18 (44%) of those without it. The accuracy of IB protrusion + IG ratio, IB protrusion + surgical capsule, and IB protrusion + IG ratio + surgical capsule was 89%, and that of IG ratio + surgical capsule was 86%. The inner gland ratio, protrusion into the bladder, and presence of surgical capsule were the most important factors in bladder outlet obstruction. The probability of outlet stenosis increases in patients with more than two of these criteria. (author)

  8. Prostatic Urethral Lift Vs Prostate Arterial Embolization: Novel Nonablative Strategies in the Management of Lower Urinary Tract Symptoms Secondary to Benign Prostate Hyperplasia.

    Science.gov (United States)

    Jones, Patrick; Rai, Bhavan Prasad; Aboumarzouk, Omar M; Somani, Bhaskar K

    2016-01-01

    Prostate urethral lift and prostate arterial embolization represent two evolving techniques with contrasting mechanisms of action (mechanical decompression vs angiographic embolization). Both yield relief of lower urinary tract symptoms over a period of several weeks. They display similar safety profiles with self-limiting pelvic discomfort characterizing the commonest minor adverse event. Both procedures have the potential to be carried out under local anesthesia and in the outpatient setting with suitability for patients with cardiovascular comorbidities. Neither has been found to cause degradation of sexual function. Further randomized studies are needed to delineate the formal position of these techniques in the surgical management of benign prostate hyperplasia.

  9. Predictors of urinary retention in benign prostate hyperplasia

    Directory of Open Access Journals (Sweden)

    Chandrashekhar C. Mahakalkar

    2016-02-01

    Conclusions: Out of the four factors considered to be the independent risk factors, all of them have positive correlation with the symptom of acute urinary retention. None of these four factors i.e. age in years, symptom severity, prostate Volume on DRE and USG grade could establish significant correlation. [Int J Res Med Sci 2016; 4(2.000: 486-490

  10. Ablation of benign prostatic hyperplasia using microbubble-mediated ultrasound cavitation.

    Science.gov (United States)

    Li, Tao; Liu, Zheng

    2010-04-01

    Benign prostatic hyperplasia (BPH) is a world-wide common disease in elderly male patients. A number of invasive physiotherapies have been used to replace prostatectomy. In this article we report our hypothesis of using microbubbles-mediated ultrasound cavitation effects to ablate prostatic tissues. Microbubble ultrasound contrast agent is widely used contrast media in ultrasonography, yet it is also found to act as cavitation nuclei or enhancer. Once excited by a high peak pressure ultrasound pulse, the mechanical effects, like shock wave and microstream, released from cavitation could produce a series of bioeffects, contributing to sonoporation, microvascular rupture and hematoma. BPH is known to have hyperplastic neovasculature and this make it possible to be disrupted by the physical effects of cavitation under existing microbubbles in circulation. Mechanical ablation of prostatic capillary or small vessels could result in pathological alterations such as thrombosis, micro-circulation blockage, prostatic necrosis and atrophia. Thereupon it could effectively treat BPH by nontraumatic ways.

  11. Scandinavian clinical study of finasteride in the treatment of benign prostatic hyperplasia.

    Science.gov (United States)

    Beisland, H O; Binkowitz, B; Brekkan, E; Ekman, P; Kontturi, M; Lehtonen, T; Lundmo, P; Pappas, F; Round, E; Shapiro, D

    1992-01-01

    The effects of finasteride, a potent 5 alpha-reductase inhibitor, were assessed in patients with benign prostatic hyperplasia. Patients were treated with finasteride or placebo for 24 weeks in a double-blind multicenter study followed by a 12-month open-extension period. After 24 weeks, finasteride-treated patients, when compared to placebo-treated patients, showed a significant reduction in prostate volume (22.5% median decrease) and prostate significant antigen (32.4% median decrease), a significant increase in maximum urinary flow (1.6 ml/s mean increase from baseline) and a significant improvement in their obstructive symptom scores (two-point decrease from baseline). Finasteride was well tolerated, and the improvements in prostate volume, maximum urinary flow rate and obstructive symptom scores observed in the controlled study were maintained throughout the extension study.

  12. COMPARATIVE ANALYSIS OF THE BACTERIAL POPULATION OF THE PROSTATE IN ITS CANCER AND BENIGN HYPERPLASIA

    Directory of Open Access Journals (Sweden)

    M. I. Kogan

    2011-01-01

    Full Text Available A bacteriological study of prostate biopsy specimens was conducted in patients with prostate benign hyperplasia (PBH and in those with prostate cancer (PC. It revealed a wide range of aerobic (Corynebacterium sp., Enterococcus sp., E. coli, S. haemolyticus, S. hominis and nonclostridial anaerobic (Bacteroides sp., Bifidobacterium sp., Eubacterium sp., Propionibacterium sp., Рeptococcus niger, Peptostreptococcus sp., Prevotella sp., Veilonella sp., Fusobacterium sp., Capnocytophaga ochracea, Streptococcus parvulus bacteria. Differences were seen in the detection rate of these microorganisms and in the level of tissue infectivity in PBH and PC. The average seeding of the prostate biopsy specimens and the detection rate of different types of bacteria in PBH were greater than those in PC; moreover, some bacteria were undetectable in PC at all.

  13. COMPARATIVE ANALYSIS OF THE BACTERIAL POPULATION OF THE PROSTATE IN ITS CANCER AND BENIGN HYPERPLASIA

    Directory of Open Access Journals (Sweden)

    M. I. Kogan

    2014-08-01

    Full Text Available A bacteriological study of prostate biopsy specimens was conducted in patients with prostate benign hyperplasia (PBH and in those with prostate cancer (PC. It revealed a wide range of aerobic (Corynebacterium sp., Enterococcus sp., E. coli, S. haemolyticus, S. hominis and nonclostridial anaerobic (Bacteroides sp., Bifidobacterium sp., Eubacterium sp., Propionibacterium sp., Рeptococcus niger, Peptostreptococcus sp., Prevotella sp., Veilonella sp., Fusobacterium sp., Capnocytophaga ochracea, Streptococcus parvulus bacteria. Differences were seen in the detection rate of these microorganisms and in the level of tissue infectivity in PBH and PC. The average seeding of the prostate biopsy specimens and the detection rate of different types of bacteria in PBH were greater than those in PC; moreover, some bacteria were undetectable in PC at all.

  14. A CLINICAL STUDY ON THE EFFICACY OF PATALADI KASHAYA IN THE MANAGEMENT OF ‘VATASHTEELA’ VIS A VIS ‘BPH’ (BENIGN PROSTATIC HYPERTROPHY

    Directory of Open Access Journals (Sweden)

    Pradeep E K

    2013-12-01

    Full Text Available In the present clinical study the cases of disease ‘Vatashteela’, which is a type of Mutraghata in terms of Benign Prostate Hypertrophy (BPH, were considered. The objective of the study was to assess the efficacy of Pataladi kashaya in Vatashteela ‘vis a vis’ BPH. Total 30 patients having signs and symptoms of ‘Vatashteela’ ‘vis a vis’ BPH were included according to criteria of AUA-SI (American Urological Association – Symptom Index, and also after diagnosing BPH by Digital Rectal Examination, and Ultrasonography of Abdomen and pelvis. Patients were assigned into a single group consisting of 30 patients for whom Pataladi kashaya 30 ml thrice a day before food with sukhoshna jala for 30 days was administered. Incomplete emptying, Frequency, Urgency, Intermittency, Straining, Weak stream and Nocturia were the Subjective parameters, data of which were collected before (day 0, during (day 15, after (day 30 and follow up (day 60. The objective parameters were residual urine, volume and size of the prostate. These data were collected before (day 0 and after (day 30 of the clinical trial. The analysis was done statistically by using Repeated Measure ANOVA, student‘t’ test and contingency co-efficient table. The statistical values showed significant results in subjective and objective parameters. In lateral lobe enlargement, symptoms were relieved to a greater extent compared to median lobe enlargement. Residual urine, volume of the prostate, obstructive symptoms showed marked improvement in many of the patients, and there was also significant decrease in size of the prostate. Overall assessment showed marked and moderate improvement in many patients. Pataladi kashaya is useful in reducing the signs and symptoms of ‘Vatashteela’ ‘vis a vis’ ‘BPH’ and even residual urine, volume and size of the prostate. Pataladi kashaya is beneficial due to its properties in improving obstructive symptoms and reducing the size of the

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

    Science.gov (United States)

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

    2014-03-01

    Learning how to separate benign confounders from prostate cancer is important because the imaging characteristics of these confounders are poorly understood. Furthermore, the typical representations of the MRI parameters might not be enough to allow discrimination. The diagnostic uncertainty this causes leads to a lower diagnostic accuracy. In this paper a new cascaded classifier is introduced to separate prostate cancer and benign confounders on MRI in conjunction with specific computer-extracted features to distinguish each of the benign classes (benign prostatic hyperplasia (BPH), inflammation, atrophy or prostatic intra-epithelial neoplasia (PIN). In this study we tried to (1) calculate different mathematical representations of the MRI parameters which more clearly express subtle differences between different classes, (2) learn which of the MRI image features will allow to distinguish specific benign confounders from prostate cancer, and (2) find the combination of computer-extracted MRI features to best discriminate cancer from the confounding classes using a cascaded classifier. One of the most important requirements for identifying MRI signatures for adenocarcinoma, BPH, atrophy, inflammation, and PIN is accurate mapping of the location and spatial extent of the confounder and cancer categories from ex vivo histopathology to MRI. Towards this end we employed an annotated prostatectomy data set of 31 patients, all of whom underwent a multi-parametric 3 Tesla MRI prior to radical prostatectomy. The prostatectomy slides were carefully co-registered to the corresponding MRI slices using an elastic registration technique. We extracted texture features from the T2-weighted imaging, pharmacokinetic features from the dynamic contrast enhanced imaging and diffusion features from the diffusion-weighted imaging for each of the confounder classes and prostate cancer. These features were selected because they form the mainstay of clinical diagnosis. Relevant features for

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

    Directory of Open Access Journals (Sweden)

    Aoun F

    2015-08-01

    Full Text Available Fouad Aoun1, Quentin Marcelis,1,2 Thierry Roumeguère,2 1Department of Urology, Jules Bordet Institute, 2Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium Abstract: Benign prostatic hyperplasia (BPH represents a spectrum of related lower urinary tract symptoms (LUTS. The cost of currently recommended medications and the discontinuation rate due to side effects are significant drawbacks limiting their long-term use in clinical practice. Interventional procedures, considered as the definitive treatment for BPH, carry a significant risk of treatment-related complications in frail patients. These issues have contributed to the emergence of new approaches as alternative options to standard therapies. This paper reviews the recent literature regarding the experimental treatments under investigation and presents the currently available experimental devices and techniques used under local anesthesia for the treatment of LUTS/BPH in the vast majority of cases. Devices for delivery of thermal treatment (microwaves, radiofrequency, high-intensity focused ultrasound, and the Rezum system, mechanical devices (prostatic stent and urethral lift, fractionation of prostatic tissue (histotripsy and aquablation, prostate artery embolization, and intraprostatic drugs are discussed. Evidence for the safety, tolerability, and efficacy of these “minimally invasive procedures” is analyzed. Keywords: lower urinary tract symptoms (LUTS, benign prostatic hyperplasia (BPH, minimally invasive therapies, new approaches, experimental therapy

  17. Cratylia mollis lectin nanoelectrode for differential diagnostic of prostate cancer and benign prostatic hyperplasia based on label-free detection.

    Science.gov (United States)

    Silva, Priscila M S; Lima, Amanda L R; Silva, Bárbara V M; Coelho, Luana C B B; Dutra, Rosa F; Correia, Maria T S

    2016-11-15

    The research for new biomarkers of cancer has studied the role of fetuin glycoprotein on the metastatic disease diagnosis. Cratylia mollis is a lectin with high finity to fetuin, and used here to differentiate prostate cancer and benign prostatic hyperplasia. A label-free electrochemical nanosensor based on assembled carboxylated carbon nanotubes (COOH-CNTs) and poly-L-lysine (PLL) film was developed and applied to serum samples of prostate cancer positive for Gleason score. The electrode analytical response to fetuin in PBS samples, obtained by square wave voltammetry, exhibited a linear range from 0.5 to 25µgmL(-1), with a high correlation coefficient (r=0.994, pprostate cancer patients with known the Gleason score were tested showing a significant statistically correlation. Thus, the lectin nanoelectrode was able to distinguish the degree of staging prostate cancer, providing the diagnostic differentiation of benign and malign hyperplasia. To the best of our knowledge, it is the first biosensor for this application using a lectin.

  18. Role of Acoustic Radiation Force Impulse (ARFI) Elastography in Determination of Severity of Benign Prostate Hyperplasia

    Science.gov (United States)

    Alan, Bircan; Utangaç, Mazhar; Göya, Cemil; Dağgülli, Mansur

    2016-01-01

    Background The aim of this study was to investigate the potential contribution of acoustic radiation force impulse (ARFI) elastography to the determination of the severity of benign prostate hypertrophy (BPH) by performing shear wave velocity (SWV) measurements of the prostate using ARFI technology. Material/Methods Sixty BPH patients and 40 healthy volunteers were included in this study. SWV measurements of the prostate were performed by transabdominal ultrasonography (US), both in the BPH patients and control subjects. The BPH patients also underwent uroflowmetry measurements. Using the International Prostate Symptom Score (IPSS), the BPH patients were divided into two subgroups, a mild-to-moderate BPH group and a severe BPH group, to compare SWV values. Results The BPH patients had higher SWV values for the central area of the prostate compared to the control subjects (2.52±0.59 m/s and 1.47±0.42 m/s, pprostate were higher in the severe BPH group compared to the mild-to-moderate BPH group (2.62±0.58 and 2.25±0.55, p=0.02). Conclusions Our ARFI elastography results indicated that the central prostate SWV values of BPH patients were significantly higher relative to those of a healthy control group. The central prostate SWV values increased in proportion to the increased severity of BPH. Measurement of SWV by ARFI technology constitutes a non-invasive alternative to other methods for the determination of BPH severity. PMID:27876713

  19. Intraprostatic Botulinum Neurotoxin Type A Injection for Benign Prostatic Hyperplasia—A Spotlight in Reality

    Directory of Open Access Journals (Sweden)

    Yu-Chao Hsu

    2016-04-01

    Full Text Available Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum. It inhibits the release of acetylcholine and other neurotransmitters from the nerve terminal. Botulinum toxin, specifically toxin type A (BoNT-A has been used since the 1970s to reduce the muscular hypercontraction disorders. The application of BoNT-A in urology field started from intra-bladder injection for overactive bladder, which has been recognized as third line therapy in many countries. Since prostate gland as well as bladder is under the influence of autonomic innervation, theorectically, injection of BoNT-A into the prostate induces chemo-denervation and modulation of prostate function, and reduces lower urinary tract symptoms (LUTS. This article reviews the application of BoNT-A in patients with LUTS/ benign prostatic hyperplasia (BPH from mechanisms of action to clinical results. BoNT-A has been shown to induce prostate apoptosis, downregulation of alpha 1A receptors, and reduce contractile function of prostate in animal studies. Open studies of intraprostate BoNT-A injection have demonstrated promising results of reducing LUTS and improvement of voiding function in human LUTS/BPH, however, intraprostatic BoNT-A injection did not perform better than the placebo group in recent publications of placebo controlled studies. We suggested that BoNT-A prostate injection might benefit selected population of BPH/LUTS, but it is unlikely to be an effective therapy for general population of male LUTS/BPH.

  20. Role of Acoustic Radiation Force Impulse (ARFI) Elastography in Determination of Severity of Benign Prostate Hyperplasia.

    Science.gov (United States)

    Alan, Bircan; Utangaç, Mazhar; Göya, Cemil; Dağgülli, Mansur

    2016-11-23

    BACKGROUND The aim of this study was to investigate the potential contribution of acoustic radiation force impulse (ARFI) elastography to the determination of the severity of benign prostate hypertrophy (BPH) by performing shear wave velocity (SWV) measurements of the prostate using ARFI technology. MATERIAL AND METHODS Sixty BPH patients and 40 healthy volunteers were included in this study. SWV measurements of the prostate were performed by transabdominal ultrasonography (US), both in the BPH patients and control subjects. The BPH patients also underwent uroflowmetry measurements. Using the International Prostate Symptom Score (IPSS), the BPH patients were divided into two subgroups, a mild-to-moderate BPH group and a severe BPH group, to compare SWV values. RESULTS The BPH patients had higher SWV values for the central area of the prostate compared to the control subjects (2.52±0.59 m/s and 1.47±0.42 m/s, pprostate were higher in the severe BPH group compared to the mild-to-moderate BPH group (2.62±0.58 and 2.25±0.55, p=0.02). CONCLUSIONS Our ARFI elastography results indicated that the central prostate SWV values of BPH patients were significantly higher relative to those of a healthy control group. The central prostate SWV values increased in proportion to the increased severity of BPH. Measurement of SWV by ARFI technology constitutes a non-invasive alternative to other methods for the determination of BPH severity.

  1. The therapeutic potential of royal jelly in benign prostatic hyperplasia. Comparison with contemporary literature.

    Science.gov (United States)

    Pajovic, Bogdan; Radojevic, Nemanja; Dimitrovski, Antonio; Tomovic, Savo; Vukovic, Marko

    2016-09-01

    The aim of this study is to establish the scientific benefit of royal jelly (RJ) on prostatic-specific antigen (PSA), post-void residual (PVR) volume and International Prostate Symptom Score (IPSS) in benign prostatic hyperplasia. For the study, a group of 40 men were administered 38 mg of RJ over a period of three months, their PSA values, prostate volumes and the volumes of their transitory prostate zones, PVR and IPPS values were measured at the end of the first month, and at the end of the third month. The results of this study confirm the potential of RJ in reducing PSA scores and improving IPSS values. Since the use of RJ did not lead to any significant reduction in PVR, prostate volume, or to any involution of the transitory zone, it appears that it may only affect the blood marker of prostatic hyperplasia and to improve quality-of-life (QoL) in those patients. Overall, in comparison to phytotherapy and conventional therapy, RJ had similar positive effects on QoL in patients with BPH, however it exhibited markedly better effects on reducing PSA levels in blood. The therapeutical use of RJ exhibited no side effects.

  2. Extravasation of Urine Associated with Bilateral Complete Ureteral Duplication, Vesicoureteral Reflux and Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Suzuki, Issei; Kaga, Kanya; Takei, Kohei; Tokura, Yuumi; Sakamoto, Kazumasa; Nishihara, Daisaku; Mizuno, Tomoya; Yuki, Hideo; Betsunoh, Hironori; Abe, Hideyuki; Yashi, Masahiro; Fukabori, Yoshitatsu; Yamanishi, Tomonori; Kamai, Takao

    2017-02-01

    We report a rare case of extravasation of urine, which may be associated with bilateral complete ureteral duplication, vesicoureteral reflux (VUR), and benign prostatic hyperplasia (BPH). A 71-year-old male presented with a complaint of right abdominal pain. An extravasation of urine was noted, and was improved by indwelling urethral catheterization. Transurethral resection of the prostate and the endoscopic subureteral injection of dextanomer/hyaluronic acid were performed for the treatment of BPH and VUR, respectively. The post-surgery recovery was successful.

  3. Elevated mortality following transurethral resection of the prostate for benign hypertrophy! But why?

    DEFF Research Database (Denmark)

    Andersen, T F; Brønnum-Hansen, Henrik; Sejr, T;

    1990-01-01

    This paper reevaluates the recently reported excess mortality following transurethral resection of the prostate (TURP) for benign hypertrophy as compared with traditional open resection (OPEN). We studied survival through linkage of hospital discharge data with mortality data for the entire male...... the causes suggested on the basis of previously reported Canadian data. The current evidence is thus ambiguous with regard to hypothetical biologic mechanisms behind the excess mortality over TURP patients. Further investigations are needed to evaluate the safety and effectiveness of prostate surgery....

  4. The classification of benign and malignant human prostate tissue by multivariate analysis of {sup 1}H magnetic resonance spectra

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, P.; Smith, I.; Leboldus, L.; Littman, C.; Somorjai, L.; Bezabeh, T. [Institute for Biodiagnostic, National Research Council, Manitoba (Canada)

    1998-04-01

    {sup 1}H magnetic resonance spectroscopy studies (360 MHz) were performed on specimens of benign (n = 66) and malignant (n = 21) human prostate tissue from 50 patients and the spectral data were subjected to multivariate analysis, specifically linear-discriminant analysis. On the basis of histopathological assessments, an overall classification accuracy of 96.6 % was achieved, with a sensitivity of 100 % and a specificity of 95.5 % in classifying benign prostatic hyperplasia from prostatic cancer. Resonances due to citrate, glutamate, and taurine were among the six spectral subregions identified by our algorithm as having diagnostic potential. Significantly higher levels of citrate were observed in glandular than in stromal benign prostatic hyperplasia (P < 0.05). This method shows excellent promise for the possibility of in vivo assessment of prostate tissue by magnetic resonance. (author)

  5. The Role of Multiplex Polymerase Chain Reaction in Detecting Etiological Causes of Bacterial Prostatitis Associated Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Bramastha Rosadi

    2015-01-01

    Full Text Available Background: Benign Prostatic Hyperplasia (BPH has been correlated with chronic prostatitis according recent study. Chronic pelvic pain is the chief complain of BPH followed by prostatitis. The gold standard of the etiological diagnosis is urine culture, but the negativity rate is still high. Multiplex polymerase chain reaction (PCR as a diagnostic tool in search of etiological causes could identify microorganism on DNA level. This research aims to find out the role of multiplex polymerase chain reaction as diagnostic tools on prostatitis patients. Material and Method: A total of 12 samples collected during the TURP procedure in Sanglah General Hospital Denpasar – Bali from February until May 2015. All of the samples has been diagnosed prostatitis clinically and perform urine culture test. The prostate specimen taken was sent to the Pathological anatomy for histopathology diagnostic and underwent multiplex PCR for etiologic diagnostic. Result: 12 samples have been declared as prostatitis based on histopathology examination, and then were analyzed using multiplex PCR. 10 samples were positive (6 were E. coli, 2 were C. trachomatis, the rest were N. gonorrhea and P. aeruginosa. The urine culture revealed 9 positive, within the result 6 were E. coli, and the others were P. aeruginosa, M. morganii and A. haemolyticus. Conclusion: In prostatitis patient, the etiological diagnostic was important. Multiplex PCR as diagnostic tools could detect the microorganism on a negative urine culture. The combination of the urine culture test and multiplex PCR revealed a better result on etiologic diagnosis which leads to a better management of the disease. 

  6. Carvedilol for the treatment of benign prostatic hypertrophy in patients with heart failure?

    Science.gov (United States)

    Rohrer, Colleen K; Page, Robert Lee; Shakar, Simon F; Lindenfeld, Joann

    2011-10-01

    Heart failure (HF) and benign prostatic hypertrophy (BPH) are two conditions that commonly coexist in men 60 years and older. Carvedilol is the only β-adrenergic blocker approved for HF that also has additional α1-adrenergic blockade. As α1-adrenergic blockers are used in the treatment of BPH, it is intuitive that carvediolol could improve BPH symptoms. We present a case where carvedilol was replaced with bisoprolol resulting in acute urinary retention. When carvediolol was reinstituted, the patient's symptoms of BPH resolved. Benign prostatic hypertrophy was later diagnosed by digital rectal exam. Six month after reinstituting the carvediolol, the patient remains free of his BPH symptoms. This case suggests that carvedilol may be considered for the management of HF with systolic dysfunction in patients with concomitant BPH thus eliminating the need for an α1-adrenergic blockers.

  7. A study of molecular signals deregulating mismatch repair genes in prostate cancer compared to benign prostatic hyperplasia.

    Directory of Open Access Journals (Sweden)

    Sanmitra Basu

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

  8. Case Study: Transitional Care For a Patient with Benign Prostatic Hyperplasia and Recurrent Urinary Tract Infections

    OpenAIRE

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

    2013-01-01

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

  9. [Prostatilen effects on voiding disorders in patients with benign prostatic hyperplasia].

    Science.gov (United States)

    Al'-Shukri, S Kh; Gorbachev, A G; Borovets, S Iu; Belousov, V Ia; Kuz'min, I V

    2005-01-01

    The authors review the experience with prostatilen treatment gained in the urological clinic of the St-Petersburg State Medical University and analyze treatment outcomes for 96 patients with benign prostatic hyperplasia (BPH) aged from 51 to 89 years. Prostatilen proved its efficacy in relieving manifestations of infravesical obstruction in BPH, therefore, prostatilen administration in the treatment of patients with initial or moderate subjective and objective symptoms is justified. Dimexide suppositoria containing 30 mg of prostatilen are preferable.

  10. [Zinc, calcium and sodium values in secretions of patients with benign prostatic hyperplasia].

    Science.gov (United States)

    Romics, I; Bach, D

    1990-12-01

    In two randomized patients groups suffering from benign prostatic hyperplasia (BPH) two exprimate samples were drawn at a seven-day interval. In the untreated control group no changes in the values of Ca, Na and Zn were found. In the other group the patients have been treated with ERU capsules (Radicis urticae) for 7 days and thereafter a significant decrease of Zn values were found.

  11. Recent advances in treatment for Benign Prostatic Hyperplasia [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Simon van Rij

    2015-12-01

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

  12. Intraurethral Catheter: Alternative Management for Urinary Retention in Patients With Benign Prostatic Hypertrophy

    OpenAIRE

    Sulabha Punekar; Ramkrishnan, Prem A.; Anand R. Kelkar; Date, Jaydeep A.; Vasudeo R. Ridhorkar

    1995-01-01

    A polyurethane intraurethral catheter (IUC) was used in 27 patients with benign prostatic hypertrophy who were unfit for surgery, or were awaiting surgery. All of them had previously had a periurethral catheter inserted. The IUC was inserted with a cystoscope under fluoroscopic control. Spontaneous voiding through the IUC resumed in 25 patients (93%) in the immediate postprocedure period. At the end of 6 months follow-up, the peak flow rates and the residual volumes estimated in 22 patients w...

  13. Two micron continuous wave laser vaporesection for the treatment of benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Wei-Jun Fu; Bao-Fa Hong; Yong Yang; Jiang-Ping Gao; Lei Zhang; Wei Cai; Yao-Fu Chen; Xiao-Xiong Wang

    2008-01-01

    @@ Dear Editor. I'm Wei-Jun Fu, from Department of Urology, Chi-nese People's Liberation Army General Hospital, Military Postgraduate Medical College, Beijing, China. We write to you to present an observation on the safety and clini-cal effects of RevoLix 70 W 2 micron continuous wave laser vaporesection for the treatment of obstructive be-nign prostatic hyperplasia (BPH).

  14. Down-regulated CFTR During Aging Contributes to Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Xie, Chen; Sun, Xiao; Chen, Jing; Ng, Chi Fai; Lau, Kin Mang; Cai, Zhiming; Jiang, Xiaohua; Chan, Hsiao Chang

    2015-08-01

    Benign prostatic hyperplasia (BPH) is a hyper-proliferative disease of the aging prostate; however, the exact mechanism underlying the development of BPH remains incompletely understood. The present study investigated the possible involvement of the cystic fibrosis transmembrane conductance regulator (CFTR), which has been previously shown to negatively regulate nuclear factor-κB (NF-κB)/cyclooxygenase 2 (COX2)/prostaglandin E2 (PGE2) pathway, in the pathogenesis of BPH. Our results showed decreasing CFTR and increasing COX2 expression in rat prostate tissues with aging. Furthermore, suppression of CFTR led to increased expression of COX2 and over-production of PGE2 in a normal human prostate epithelial cell line (PNT1A) with elevated NF-κB activity. PGE2 stimulated the proliferation of primary rat prostate stromal cells but not epithelial cells, with increased PCNA expression. In addition, the condition medium from PNT1A cells after inhibition or knockdown of CFTR promoted cell proliferation of prostate stromal cells which could be reversed by COX2 or NF-κB inhibitor. More importantly, the involvement of CFTR in BPH was further demonstrated by the down-regulation of CFTR and up-regulation of COX2/NF-κB in human BPH samples. The present results suggest that CFTR may be involved in regulating PGE2 production through its negative regulation on NF-κB/COX2 pathway in prostate epithelial cells, which consequently stimulates cell growth of prostate stromal cells. The overstimulation of prostate stromal cell proliferation by down-regulation of CFTR-enhanced PGE2 production and release during aging may contribute to the development of BPH.

  15. Oral exposure to low-dose bisphenol A aggravates testosterone-induced benign hyperplasia prostate in rats.

    Science.gov (United States)

    Wu, Jian-Hui; Jiang, Xiu-Rong; Liu, Gui-Ming; Liu, Xiang-Yun; He, Gui-Lin; Sun, Zu-Yue

    2011-10-01

    The declining level of androgen during aging, associated with an inclining level of estrogen, has been hypothesized to be important in the development of benign prostatic hyperplasia (BPH). Within physiologic range, increasing estrogen levels can stimulate prostate to develop and permanently increase prostate size. As an estrogenic endocrine disruptor, bisphenol A (BPA) might be stimulatory to prostate development. We further hypothesized that low dose BPA could induce hyperplasia prostate to proliferate and aggravate the symptom of BPH in male SD rats. BPH was induced by testosterone and then treated with BPA (10, 30, or 90 μg/kg, i.g., daily), 17β-estradiol (E(2); 50.0 μg/kg, s.c., daily), or vehicle for 4 weeks. We found that weight and volume in rats treated with low dose BPA (10 μg/kg) was higher than that of model control, and BPA significantly increased the relative weight of prostate (p prostate lobes, BPA 10 μg/kg/day significantly increased relative weight of ventral prostate (VP), weight and relative weight of dorsolateral prostate (DLP) (p prostate-specific antigen level. E(2) treatment also showed an obvious effect on relative weight of VP and DLP, HEC, and hormone levels. We concluded that environment exposure to low dose of BPA may induce prostate to proliferate and aggravate testosterone-induced benign hyperplasia prostate in rats.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

  18. Intraprostatic ozone therapy: A minimally invasive approach in benign prostatic hyperplasia

    Science.gov (United States)

    Hussain, Shabbir; Sharma, Deepti B.; Solanki, Fanindra S.; Pathak, Ajay; Sharma, Dhananjay

    2017-01-01

    Introduction: Transurethral resection of prostate (TURP) remains the golden standard therapy since decades. There are various minimally invasive therapies (MITs) for the treatment of benign prostatic hyperplasia (BPH). Still, there is a need for therapy with lesser side effects and better outcome. We had studied the effect of intraprostatic ozone injection (IPOI) as an MIT for patients with BPH who have failed trial without catheter (TWOC). Materials and Methods: Thirty elderly patients with BPH with a prostate size of 30 g or more were enrolled for the study. Forty milliliters of ozone at a concentration of 30 μg/dl was injected in prostate (20 ml in each lateral lobe) per rectally. Prostate volume (PV) by ultrasonography was assessed after catheter removal on the 7th day and after 1 month. Observations and Results: Totally thirty patients (mean age - 67.8 years) with mean prostatic volume (MPV) of 46.10cc received IPOI. MPV came as 44.96cc on the 7th day of postozone therapy (P = 0.008). Successful voiders showed a significant reduction in PV (mean = 13.12cc) as compared to unsuccessful voiders (mean = 2.61cc) after 1 month. Conclusion: Intraprostatic ozone injection helps to reduce the PV to some extent and can be helpful in patients who have failed TWOC even on alpha blockers and are unfit for TURP. Larger studies are required to assess the efficacy and long-term results of this technique. PMID:28216927

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

    Directory of Open Access Journals (Sweden)

    Sarbishegi

    2016-01-01

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

  20. Morphogenetic aspects of biomineralization on the background of benign prostatic hyperplasia.

    Science.gov (United States)

    Moskalenko, R; Romanyuk, A; Danilchenko, S; Stanislavov, O; Piddubniy, A; Zakorko, I-М; Tkach, G

    2013-01-01

    Despite the considerable spread of pathological prostate inclusions their nature and significance in the development of gland pathology are not established exactly. The work includes histological research of 628 surgical biopsies of benign prostatic hyperplasia, the sections were stained with hematoxylin and eosin or Congo red, von Kossa methods. Mineral constituent of prostatoliths (5 cases) was studied by infrared spectroscopy (IRS); scanning electron microscopy with X-ray microanalysis (REMMA/EDX), transmission electron microscopy and electron diffraction (TEM/ED). The average age of the operated patients was 69,5±0,42 years old. In 88,22±1,67% of cases nodular prostatic hyperplasia was combined with diffuse or focal inflammation, engorgements of prostate gland secretion were observed in 81,76±2,97%. In the lumen of the prostate gland corpora amylacea were detected in 64,72±1,13% of cases, in 27,6±3,48% - concreations. There was a significant strong correlation between inflammation and calculi - r = 0.93 (pprostate secretions, but it's not a dystrophic calcification of the corpora amylacea. Mineral component of prostatic concrements is carbonate bioapatite with a minor inclusion of other chemical elements.

  1. Update on the use of dutasteride in the management of benign prostatic hypertrophy

    Directory of Open Access Journals (Sweden)

    Joe Miller

    2007-04-01

    Full Text Available Joe Miller, Thomas H TarterDivision of Urology, Southern Illinois University School of Medicine, Springfield, IL, USAAbstract: Benign prostatic hyperplasia (BPH is a frequent cause of lower urinary symptoms, with a prevalence of 50% by the sixth decade of life. Hyperplasia of stromal and epithelial prostatic elements that surround the urethra cause lower urinary tract symptoms (LUTS, urinary tract infection, and acute urinary retention. Medical treatments of symptomatic BPH include; 1 the 5α-reductase inhibitors, 2 the α1-adrenergic antagonists, and 3 the combination of a 5α-reductase inhibitor and a α1-adrenergic antagonist. Selective α1-adrenergic antagonists relax the smooth muscle of the prostate and bladder neck without affecting the detrussor muscle of the bladder wall, thus decreasing the resistance to urine flow without compromising bladder contractility. Clinical trials have shown that α1-adrenergic antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Inhibitors of 5α-reductase decrease production of dihydrotestosterone within the prostate resulting in decreased prostate volumes, increased peak urinary flow rates, improvement of symptoms, and decreased risk of acute urinary retention and need for surgical intervention. The combination of a 5α-reductase inhibitor and a α1-adrenergic antagonist reduces the clinical progression of BPH over either class of drug alone.Keywords: prostatic hyperplasia, 5α-reductase, dutasteride

  2. Symptoms, prostate volume, and urodynamic findings in elderly male volunteers without and with LUTS and in patients with LUTS suggestive of benign prostatic hyperplasia

    NARCIS (Netherlands)

    Eckhardt, MD; van Venrooij, GEPM; Boon, TA

    2001-01-01

    Objectives. To estimate the differences in symptoms, prostate volume, and urodynamic variables of symptom-free elderly volunteers, volunteers with lower urinary tract symptoms (LUTS), and urologic patients with LUTS suggestive of benign prostatic hyperplasia. Methods. The study included 14 male volu

  3. Association of Clinical Benign Prostate Hyperplasia with Prostate Cancer Incidence and Mortality Revisited: A Nationwide Cohort Study of 3 009 258 Men

    DEFF Research Database (Denmark)

    Ørsted, David Dynnes; Bojesen, Stig E; Nielsen, Sune F;

    2011-01-01

    BACKGROUND: Although benign prostate hyperplasia (BPH) and prostate cancer (PCa) share features such as hormone-dependent growth and response to treatment with antiandrogen therapy, BPH is generally not considered a premalignant lesion. OBJECTIVE: To determine whether clinical BPH is associated...

  4. Benign prostatic hyperplasia presenting with renal failure--what is the role for transurethral resection of the prostate (TURP)?

    LENUS (Irish Health Repository)

    Thomas, A Z

    2009-02-01

    The aim of the study was to determine the role of transurethralresection of prostate (TURP) in normalising renal function in men presenting with obstructive renal failure secondary to benign prostatic hyperplasia. We reviewed the cases of 14 men who presented in the last 5 years with renal impairment associated with symptoms of bladder outflow obstruction and radiological evidence of obstructive uropathy. The mean serum creatinine at presentation was 632 ng\\/mL (range 1299 - 225). The mean age at presentation was 68.2 years (range 50 - 83 years). Duration of symptoms prior to presentation ranged between 1 - 118 months (mean 21.5 months). Following catheter insertion, all patients underwent TURP. Six of the 14 patients required dialysis prior to surgery. Histology of the resected prostate confirmed benign prostatic hypertrophy and\\/or hyperplasia in all cases. Patients with carcinoma of the prostate were excluded from the study. Following TURP, 2 of the 14 men (14%) failed to void spontaneously following removal of catheter - one patient performs clean self intermittent catheterization (CSIC), the other man has an in-dwelling catheter in situ. One patient died 7 months following TURP due to a myocardial infarction. However, 8 patients, (57%) remained dialysis dependent following TURP. Two of these patients have since undergone successful renal transplantation. Of the remaining 6 patients, only 3 have normal renal function with the other 3 experiencing moderately elevated serum creatinine (range 236 - 344 ng\\/mL). In patients presenting with renal failure due to bladder outflow obstruction, TURP restores normal voiding pattern in many cases. However renal failure due to bladder outflow obstruction tends to be more refractory and only 3 of 14 patients experienced return to normal renal function post treatment.

  5. Benign prostatic hyperplasia presenting with renal failure--what is the role for transurethral resection of the prostate (TURP)?

    Science.gov (United States)

    Thomas, A Z; Thomas, A A; Conlon, P; Hickey, D; Little, D M

    2009-02-01

    The aim of the study was to determine the role of transurethralresection of prostate (TURP) in normalising renal function in men presenting with obstructive renal failure secondary to benign prostatic hyperplasia. We reviewed the cases of 14 men who presented in the last 5 years with renal impairment associated with symptoms of bladder outflow obstruction and radiological evidence of obstructive uropathy. The mean serum creatinine at presentation was 632 ng/mL (range 1299 - 225). The mean age at presentation was 68.2 years (range 50 - 83 years). Duration of symptoms prior to presentation ranged between 1 - 118 months (mean 21.5 months). Following catheter insertion, all patients underwent TURP. Six of the 14 patients required dialysis prior to surgery. Histology of the resected prostate confirmed benign prostatic hypertrophy and/or hyperplasia in all cases. Patients with carcinoma of the prostate were excluded from the study. Following TURP, 2 of the 14 men (14%) failed to void spontaneously following removal of catheter - one patient performs clean self intermittent catheterization (CSIC), the other man has an in-dwelling catheter in situ. One patient died 7 months following TURP due to a myocardial infarction. However, 8 patients, (57%) remained dialysis dependent following TURP. Two of these patients have since undergone successful renal transplantation. Of the remaining 6 patients, only 3 have normal renal function with the other 3 experiencing moderately elevated serum creatinine (range 236 - 344 ng/mL). In patients presenting with renal failure due to bladder outflow obstruction, TURP restores normal voiding pattern in many cases. However renal failure due to bladder outflow obstruction tends to be more refractory and only 3 of 14 patients experienced return to normal renal function post treatment.

  6. [Anatomoradiologic correlations in prostate benign hypertrophy. Report of a series of 220 cases].

    Science.gov (United States)

    Debbagh, A; Dahami, Z; Fekak, H; Joual, A; Bennani, S; Elmrini, M; Benjelloun, S

    2002-05-01

    In our daily practice, the reliability of ultrasonography (US) and digital rectal examination (DRE) is limited by many factors. The aim of our study is to correlate between the prostatic volume assessed by the DRE, the pre operative US results and the actual weight of the enucleated or endoscopic resection benign prostatic hyperplasia (BPH). We report a serie of 220 patients with BPH treated by endoscopic resection or by open surgery. The mean age is 65 years (40-90 years old). Ultrasonography was performed in 92% of the cases, and transrectal ultrasound only in 8%. All our patients either underwent endoscopic resection (49.6%) or adenomectomy (50.4%). We found a high correlation between the prostatic volume assessed by DRE and by ultrasonography (r = 0.79; P < 0.0001) and the weight of the piece of surgical adenomectomy (r = 0.701, P < 0.0001). However, the volume of benign prostatic hyperplasia assessed by US did not correlate with the piece of endoscopic resection (r = 0.214, P < 0.05). This study and a review of recent literature enabled us to notice the various anatomical and radiological factors implicated in this correlation.

  7. Exosomal lncRNAs may to Help Distinguish Prostate Cancer from Benign Disease

    Directory of Open Access Journals (Sweden)

    Mustafa eIsin

    2015-05-01

    Full Text Available Exosomes are membranous vesicles containing various biomolecules including lncRNAs which are involved in cellular communication and are secreted from many cells including cancer cells. In our study, investigated the exosomal GAS5 and lincRNA-p21 lncRNA levels in urine samples from 30 patients with prostate cancer (PCa and 49 patients with benign prostatic hyperplasia. Quantification of lncRNA molecules was performed by real-time PCR. We observed a significant difference in the exosomal lincRNA-p21 levels between PCa and BPH patients whereas the GAS5 levels did not reveal a difference. Our data suggest that the discriminative potential of exosomal lincRNA-p21 levels may help to improve the diagnostic prediction of the malignant state for patients with prostate cancer.

  8. Expression of hypoxia-inducible factor 1α in human normal, benign, and malignant prostate tissue

    Institute of Scientific and Technical Information of China (English)

    都镇先; 藤山千里; 陈永昕; 真崎善二郎

    2003-01-01

    Objective To investigate hypoxia-inducible factor 1α (HIF-1α) protein expression in normal prostates (NP), benign prostatic glandular hyperplasia (BPH), and prostate adenocarcinoma (Pca).Methods HIF-1α protein expression was determined by immunohistochemistry in formalin-fixed and paraffin-embedded specimens obtained from 13 cases of NP, 28 cases of BPH, and 34 cases of Pca. In cases of Pca, the relationship between HIF-1α protein expression and certain clinicopathological factors, such as clinicopathologic stage and Gleason score, was evaluated.Results NP manifested no immunoreactivity, whereas Pca and BPH showed significantly increased HIF-1α protein expression. A significantly higher expression was observed in Pca specimens compared with BPH samples. In Pca, no significant relationship between HIF-1α protein expression and clinicopathological factors was found.Conclusion Our findings of increased HIF-1α protein expression in BPH and Pca specimens suggests the potential role of this protein in BPH and Pca.

  9. Gambaran Histopatologi Penyakit Benign Prostatic Hyperplasia (BPH) dan Kanker Prostat di Laboratorium Patologi Anatomi Rumah Sakit Umum pusat Umum Pusat Haji Adam Malik Medan, periode 2008-2009

    OpenAIRE

    Hamawi, Mohd Lokman

    2010-01-01

    Background: Benign Prostatic Hyperplasia and prostate cancer are global heath problems, in either incidence occurrences or mortality. So, in order for early diagnosis and therapy, requires histopathologic features of BPH and prostate cancer. Location: Location of the study is at Rumah Sakit Umum Pusat Haji Adam Malik,Medan. It is choosen due to the number of cases available and to take account that this hospital is one of the centre of reference from parts of Sumatera Uta...

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

    Directory of Open Access Journals (Sweden)

    Naitao Wang

    2016-05-01

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

  11. KAI1/CD82 gene expression in benign prostatic hyperplasia and late-stage prostate cancer in Chinese

    Institute of Scientific and Technical Information of China (English)

    Wei-LieHU; Ying-QiuLI; Hui-XuHE; Qing-RongLI; YeTIAN; Ri-QuanLAI; HuaMEI

    2000-01-01

    Aim: To evaluate KAI1/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and latestage carcinoma of prostate (CAP). Methods: Thirty Chinese patients with benign prostatic hyperplasia and 34 with CaP (adenocarcinoma clinical stage C and D) were analyzed by means of immunohistochemical methods. Results: The KAI1/CD82 expression in BPH tissue was all positive, which was uniformly located on the glandular cell membrane at the cell-to-cell borders, but KAI1/CD82 expression in metastasis CaP tissues was either significantly lower than that of BPH or negative, and the immunostaining pattern was not continuous. In late-stage CaP KAI1/CD82 expression was correlated inversely to the pathological grade ( P 0.05). Conclusion: The authors believe that decreased and negative KAI1/CD82 expression in late-stage CAP may be related to tumor pro-gression and metastasis, and appears to be a prognostic marker.

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

    Science.gov (United States)

    Wang, Anxi

    2016-01-01

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

  13. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications.

    Science.gov (United States)

    Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M

    2016-01-01

    Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

  14. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Fei, E-mail: feisun@ccmijesususon.com; Crisóstomo, Verónica, E-mail: crisosto@ccmijesususon.com; Báez-Díaz, Claudia, E-mail: cbaez@ccmijesususon.com; Sánchez, Francisco M., E-mail: msanchez@ccmijesususon.com [Jesús Usón Minimally Invasive Surgery Centre (Spain)

    2016-01-15

    Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

  15. Possible factors influencing high serum Prostate-specific Antigen (PSA in Indonesian patients with Benign Prostatic Hyperplasia (BPH

    Directory of Open Access Journals (Sweden)

    Djoko Rahardjo

    2001-03-01

    Full Text Available Benign prostatic hyperplasia (BPH cases in Indonesia frequently associated with high serum prostate specific antigen (PSA. To explore possible factors that could increase serum PSA level, we performed a retrospective, cross-sectional study on 805 consecutive patients in Sumber Waras and Dr. Cipto Mangunkusumo Hospitals from 1994 to 1997. Clinical manifestations were evaluated and prostate biopsies were performed if indicated. Complete histopathological data were only available in 82 BPH patients with no urinary retention from 1998-1999 and a thin section of paraffin blocks of BPH patients which still could be found from 1994-1999 was analyzed using flow cytometer to obtain the S-phase fraction as a parameter of proliferative activity, From 805 patients, 461 (57% presented with urinary retention and need to be catheteized. Catheteization significantly increased PSA level if compared to noncatheterized patients (16.3 vs. 6,8 ng/mL, p= 0,000. Another data of 82 uncatheteized patients from 1998-1999 has revealed that 79 patients (96.3% had chronic prostatitis and 19 (23.2% showed the presence of prostatic-intraepithelial neoplasia (PIN with an increase of PSA level (5.4 ng/mL. The S-phase fraction of BPH without PIN cases was significantly higher in cases with PSA > 4 ng/ml than patients with PSA ≤ 4 ng/ml (I3.1% vs. 8.9%, p=0,008. As conclusion, the high serum PSA level was mostly due to urethral catheteization and increased prostate volume. There was a tendency of increasing PSA in subclinical inflammation and PIN. Cases with high PSA also showed high proliferative activities which is suggestive of mitogenic activity. (Med J Indones 2001; 10:22-8Keywords: BPH, high PSA, PIN, proliferative activity, s-phase fraction

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

    Science.gov (United States)

    Wang, Zongwei; Olumi, Aria F

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-03-01

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

  18. Update on the use of dutasteride in the management of benign prostatic hypertrophy.

    Science.gov (United States)

    Miller, Joe; Tarter, Thomas H

    2007-01-01

    Benign prostatic hyperplasia (BPH) is a frequent cause of lower urinary symptoms, with a prevalence of 50% by the sixth decade of life. Hyperplasia of stromal and epithelial prostatic elements that surround the urethra cause lower urinary tract symptoms (LUTS), urinary tract infection, and acute urinary retention. Medical treatments of symptomatic BPH include; 1) the 5alpha-reductase inhibitors, 2) the alpha1-adrenergic antagonists, and 3) the combination of a 5alpha-reductase inhibitor and a alpha1-adrenergic antagonist. Selective alpha1-adrenergic antagonists relax the smooth muscle of the prostate and bladder neck without affecting the detrussor muscle of the bladder wall, thus decreasing the resistance to urine flow without compromising bladder contractility. Clinical trials have shown that alpha1-adrenergic antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Inhibitors of 5alpha-reductase decrease production of dihydrotestosterone within the prostate resulting in decreased prostate volumes, increased peak urinary flow rates, improvement of symptoms, and decreased risk of acute urinary retention and need for surgical intervention. The combination of a 5alpha-reductase inhibitor and a alpha1-adrenergic antagonist reduces the clinical progression of BPH over either class of drug alone.

  19. Apoptosis and hormonal milieu in ductal system of normal prostate and benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Shu-Jie XIA; Chun-Xiao XU; Xiao-Da TANG; Wan-Zhong WANG; De-Li DU

    2001-01-01

    Aim: To study theapoptotic rate (AR) and the androgen and estrogen milieu in the proximal and distal ductal sys tems of prostate, in order to help exploring the effects of these factors on prostatic growth and the pathogenesis of be nign prostatic hypertrophy (BPH). Methods: The proximal and distal ends of the ductal system were incised from 20 normal prostate as well as the hypertrophic prostate tissue from 20 patients with BPH. The AR was determined by the DNA end-labeling method and dihydrotestosterone (DHT) and estrodiol (E2), by radioimmunoassay. Results:There was no significant difference in DHT and E2 density between the proximal and distal ends of the ductal systems in normal prostate. E2 appeared to be higher in BPH than in normal prostatic tissues, but the difference was statistically in significant. In normal prostatic tissue, the AR was significantly higher in the distal than in the proximal ends of the ductal system ( P < 0.05), while the AR of the proximal ends was significantly higher ( P < 0.01) than that in the BPH tissue. No significant correlation was noted between the DHT and E2 density and the AR both in the normal prostate and BPH tissues. Conclusion: The paper is the first time describing a difference in AR in different regions of the ductal system of normal prostate, while the hormonal milieu is similar, indicating a functional inhomogeneity of these regions. A low AR in the proximal duct, where BPH originates, and an even lower AR in the BPH tissue, sug gesting the participation of apoptosis in the BPH pathogenesis.

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    de Sousa VP

    2013-08-01

    Full Text Available Valeria Pereira de Sousa,1 Joanne Crean,2 Vinícius Raphael de Almeida Borges,1 Carlos Rangel Rodrigues,1 Lidia Tajber,2 Fabio Boylan,2 Lucio Mendes Cabral1 1Department of Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 2School of Pharmacy and Pharmaceutical Sciences and Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland Abstract: 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. Keywords: babassu oil, nanocomposite, poly(lactic-co-glycolic acid, nanoparticles, benign prostatic hyperplasia, treatment, nanotechnology

  3. Adiponectin deficiency contributes to the development and progression of benign prostatic hyperplasia in obesity

    Science.gov (United States)

    Fu, Shi; Xu, Huan; Gu, Meng; Liu, Chong; Wang, Qiong; Wan, Xiang; Chen, Yanbo; Chen, Qi; Peng, Yubing; Cai, Zhikang; Zhou, Juan; Wang, Zhong

    2017-01-01

    The incidence of benign prostatic hyperplasia (BPH) is increasing among obese individuals, but few studies have fully explained the underlying mechanisms. We aimed to elucidate the relationship between obesity and BPH. Herein, we show that in prostatic epithelial and stromal cells, adiponectin exerts multifunctional effects including anti-proliferation, blocking of G1/S-phase progression and the promotion of apoptosis via inhibiting the MEK-ERK-p90RSK axis. Furthermore, we found that a high-fat diet (HFD) led to adiponectin deficiency and microscopic BPH in a mouse model of obesity. And an adiponectin supplement protected the obese mice from microscopic BPH. The present study provides evidence that adiponectin is a protective regulator in the development and progression of BPH and that adiponectin deficiency causally links BPH with obesity. PMID:28256562

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-01-01

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

  5. Comparative evaluation of different methods of surgery in patients with benign prostatic hyperplasia large

    Directory of Open Access Journals (Sweden)

    Z. A. Kadyrov

    2014-11-01

    Full Text Available This paper presents the results of different removal methods of the prostate in 122 patients with benign prostatic hyperplasia in larger sizes (80 ml. The perioperations data of extraperitoneoscopic, traditional simple prostatectomy (EP, TTP and RP and TUR were analyzed. The results of blood loss, time of activation, the uses of analgesics, time of irrigation, Hb dinamic, duration of catheterization and hospital stay after the TP were worse compared to other methods. EP has long operation time however short time duration of catheterization and hospital stay, and the minimal use of analgesics make this method more feasible. TUR and RP demonstrate better results in many parameters. It was revealed that early and late postoperative complications were more common in patients after TUR – 93.2 % and traditional prostatectomy (TTP – 65 %, compared to the RP and EP – 20.5 % and 41.9 %, respectively.

  6. Comparative evaluation of different methods of surgery in patients with benign prostatic hyperplasia large

    Directory of Open Access Journals (Sweden)

    Z. A. Kadyrov

    2013-01-01

    Full Text Available This paper presents the results of different removal methods of the prostate in 122 patients with benign prostatic hyperplasia in larger sizes (80 ml. The perioperations data of extraperitoneoscopic, traditional simple prostatectomy (EP, TTP and RP and TUR were analyzed. The results of blood loss, time of activation, the uses of analgesics, time of irrigation, Hb dinamic, duration of catheterization and hospital stay after the TP were worse compared to other methods. EP has long operation time however short time duration of catheterization and hospital stay, and the minimal use of analgesics make this method more feasible. TUR and RP demonstrate better results in many parameters. It was revealed that early and late postoperative complications were more common in patients after TUR – 93.2 % and traditional prostatectomy (TTP – 65 %, compared to the RP and EP – 20.5 % and 41.9 %, respectively.

  7. The Association Between Metabolic Syndrome and Characteristics of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Wang, Jian-Ye; Fu, Yan-Yan; Kang, De-Ying

    2016-05-01

    The purpose of this systematic review was to examine the association of metabolic syndrome (MS) with measures of benign prostatic hyperplasia (BPH) including prostate growth rate, prostate volume, International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA) level, and maximal flow rate.Medline, Cochrane CENTRAL, EMBASE, CBM, and Google Scholar databases were searched until March 23, 2015 using combinations of the keywords benign prostate hyperplasia/BPH, metabolic syndrome, total prostate volume, prostate growth rate, prostate specific antigen, International Prostate Symptom Score/IPSS, maximal flow rate. Cohort or case-control studies of patients with BPH and MS that reported quantitative outcomes were included. The pooled mean differences of the outcome measures were compared between patients with and without MS.A total of 158 potentially relevant studies were identified, and 8 were included in the meta-analysis. The 8 studies included in the meta-analysis contained a total of 3093 BPH patients, wherein 1241 had MS and 1852 did not have MS. BPH patients with MS had a significantly higher prostate growth rate (pooled mean difference = 0.67 mL/y, P flow rate (pooled mean difference = -1.41 mL/s, P = .345) between BPH patients with and without MS. A borderline nonsignificant difference in PSA (pooled mean difference = 0.24 ng/mL, P = 0.056) was noted between BPH patients with and without MS.The results of this meta-analysis are consistent with literature indicating that BPH patients with MS have a higher prostate growth rate and larger prostate volume than those without MS; however, further study is necessary to determine the association of BPH and metabolic disorder elements and the potential risk of disease progression in BPH patients with MS.

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

    Directory of Open Access Journals (Sweden)

    Hae Jeong Park

    2013-01-01

    Full Text Available 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.

  9. Sonablate-500TM Transrectal High-intensity Focused Ultrasound (HIFU) for Benign Prostatic Hyperplasia Patients

    Institute of Scientific and Technical Information of China (English)

    L(U) Jun; HU Weilie; WANG Wei; ZHANG Yuanfeng; CHEN Zhaoyang; YE Zhangqun

    2007-01-01

    To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH), serial studies were conducted in 150 BPH pa- tients before and 30 min, 1, 2, 6 and 12 month(s) after Sonablate-500TM HIFU treatment. A sili- con-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score (IPSS), quality of life (QOL), uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month(s) (P<0.01). Maximum urine flow rate (6.0 to 17.2 mL/s, P<0.01), PVR (75.0 to 30.3,P<0.01) and prostatic volume (65.0 to 38.1 mL, P<0.05) were significantly improved 12 months after the operation. Recurrent urinary retention (n=2) and urethrorectal fistula (n=1) occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 rain. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.

  10. Safety and efficacy of silodosin for the treatment of benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Yoshida M

    2011-06-01

    Full Text Available Masaki Yoshida1, Junzo Kudoh2, Yukio Homma3, Kazuki Kawabe41Department of Medical Informatics, 2Department of Urology, Japan Labor Health and Welfare Organization, Kumamoto Rosai Hospital, Kumamoto, Japan; 3Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 4Tokyo Teishin Hospital, Tokyo, JapanAbstract: Lower urinary tract symptoms (LUTS associated with benign prostatic hyperplasia (BPH are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS associated with BPH. Mainstays in the treatment of male LUTS and clinical BPH are the α1-adrenergic receptor antagonists. Silodosin is a new α1-adrenergic receptor antagonist that is selective for the α1A-adrenergic receptor. By antagonizing α1A-adrenergic receptors in the prostate and urethra, silodosin causes smooth muscle relaxation in the lower urinary tract. Since silodosin has greater affinity for the α1A-adrenergic receptor than for the α1B-adrenergic receptor, it minimizes the propensity for blood pressure-related adverse effects caused by α1B-adrenergic receptor blockade. In the clinical studies, patients receiving silodosin at a total daily dose of 8 mg exhibited significant improvements in the International Prostate Symptom Score and maximum urinary flow rate compared with those receiving placebo. Silodosin showed early onset of efficacy for both voiding and storage symptoms. Furthermore, long-term safety of silodosin was also demonstrated. Retrograde or abnormal ejaculation was the most commonly reported adverse effect. The incidence of orthostatic hypotension was low. In conclusion, silodosin, a novel selective α1A-adrenergic receptor antagonist, was effective in general and without obtrusive side effects. This review provides clear evidence in support of the clinical usefulness of silodosin in the treatment of LUTS associated with BPH.Keywords: α1A-adrenoceptor antagonist, silodosin, selective, benign prostatic

  11. Effects of transurethral resection of prostate on the quality of life of patients with benign prostatic hyperplasia.

    LENUS (Irish Health Repository)

    O'Sullivan, MartinJ

    2012-02-03

    BACKGROUND: This article investigated the effects of transurethral resection of prostate on quality of life (QOL) and urinary symptoms in patients with benign prostatic hyperplasia (BPH). STUDY DESIGN: In a prospective study, 30 patients without significant comorbidities undergoing transurethral resection of prostate for BPH were studied. Patients completed four validated questionnaires: the International Prostate Symptom Score and the associated QOL index because urinary symptoms, the Montgomery and Asberg Depression Rating Scale, the McGill Pain Questionnaire, and the QOL questionnaire Short Form-36. These were completed preoperatively, on the first postoperative day, on discharge from hospital, and at 1 and 3 months postoperatively. RESULTS: The QOL of patients who undergo transurethral resection of prostate for BPH had significantly improved at 3 months after their operation. The International Prostate Symptom Score scores at 1 month (9.3+\\/-4.6) and 3 months (5.4+\\/-5.6) were less than they were preoperatively (19.9+\\/-7.1). The QOL index because urinary symptoms was less at 1 month (2.4+\\/-1.9) and at 3 months postoperatively (1.5+\\/-1.4) in comparison with the preoperative scores (4.5+\\/-1.2). The Montgomery and Asberg Depression Rating Scale scores at 1 month (5.4+\\/-6.8) and 3 months (4.9+\\/-6.5) were less than they were preoperatively (9.2+\\/-8.3). The McGill Pain Questionnaire sensory and pain rating index scores were less at 3 months than they were preoperatively (p=0.02 and p<0.02 respectively). The McGill Pain Questionnaire affective score was less at 1 month than it was preoperatively (p<0.03). The McGill Pain Questionnaire evaluative scores were less than the preoperative score at all times postoperatively. The role physical (p=0.007), bodily pain (p=0.006), social function (p=0.007), and physical component summary (p=0.007) subsections of the Short Form-36 were greater at 3 months postoperatively when compared with the preoperative scores

  12. Associations among benign prostate hypertrophy, atypical adenomatous hyperplasia and latent carcinoma of the prostate%良性前列腺肥大、非典型腺瘤性增生和潜伏性前列腺癌的关联

    Institute of Scientific and Technical Information of China (English)

    Konstantinos Stamatiou; Alevizos Alevizos; Mohamed Natzar; Constantinos Mihas; Anargiros Mariolis; Emmanouel Michalodimitrakis; Fragiskos Sofras

    2007-01-01

    Aim: To investigate the frequency of atypical adenomatous hyperplasia (AAH) and its associations with benign prostate hypertrophy (BPH) and latent histological carcinoma of the prostate (LPC) in autopsy material. Methods:Two hundred and twelve prostate specimens obtained from autopsy material were subjected to whole mount analysis in an attempt to investigate the associations among BPH, AAH and LPC. Results: Most histological carcinomas and AAH lesions were found in enlarged prostates with intense hypertrophy. No statistically significant relation was found between BPH and the main characteristics of LPC, such as tumor volume, histological differentiation and biological behavior. Our data regarding multi-focal tumors showed a tendency for multi-focal carcinomas to develop in larger prostates, and a tendency of AAH lesions to develop in larger prostates. No statistically significant relation was found between AAH and LPC. Conclusion: There seems not any causative aetiopathogenetical or topographical relation between AAH lesions and prostate adenocarcinoma. AAH lesion seems to be a well-defined mimicker of prostatic adenocarcinoma, and the reported association of AAH with prostatic carcinoma could probably be an epiphenomenon.

  13. Decline of seminal parameters in middle-aged males is associated with lower urinary tract symptoms, prostate enlargement and bladder outlet obstruction

    Directory of Open Access Journals (Sweden)

    Kristo Ausmees

    2013-09-01

    Full Text Available Purpose We aimed to compare the associations between semen quality, associated reproductive indicators and the main prostate-related parameters in middle-aged men. Materials and Methods: This is a prospective study on 422 middle-aged men who underwent the screening for prostate health. Their reproductive function, semen quality and prostate-related pathologies were investigated. Results Significant associations between semen quality and prostate-related parameters could be seen. Total sperm count and sperm density decreased along with the increase of the I-PSS score and total prostate volume. Also, the related lower urinary tract characteristics showed a negative correlation with main semen parameters for all investigated subjects. No significant differences in age, testicular size, and hormonal parameters were found between the subjects with or without lower urinary tract symptoms and prostate enlargement. Conclusions Our study suggests that altered seminal parameters in middle-aged men are associated with LUTS, prostate enlargement and/or bladder outlet obstruction. Although the assessments of prostate and lower urinary tract symptoms may not replace the semen parameters evaluating the male reproductive status, there is a need for further and more detailed investigations about the pathways behind these associations as well as possible related conditions.

  14. DIFFERENTIATION BETWEEN BENIGN PROSTATIC HYPERPLASIA AND PROSTATE CANCER IN THE TRANSITIONAL ZONE EVALUATED BY 1H MAGNETIC RESONANCE SPECTROSCOPIC IMAGING

    Institute of Scientific and Technical Information of China (English)

    Sa-ying Li; Min Chen; Rui Wang; Cheng Zhou

    2007-01-01

    To quantitatively evaluate the metabolic changes of benign prostatic hyperplasia (BPH) and prostate cancer in the transitional zone using magnetic resonance spectroscopic imaging ( MRSI), and to analyze the characteristics and differences of the spectra in this zonal area.Methods Eighteen patients with prostate cancer in the transitional zone underwent magnetic resonance imaging( MRI)/MRSI examinations. The ( Choline + Creatine)/Citrate (CC/Ci) ratio and the Choline/Creatine (Cho/Cr) ratio were evaluated in each voxel with cancer or BPH confirmed by pathological results. Discriminant analysis was used to determine the power of the two ratios in differentiation between cancer and BPH.Results The CC/Ci ratio and Cho/Cr ratio for cancer voxels were significantly higher than those in the voxels with BPH in the transitional zone ( CC/Ci: 2.36 ± 1.31 vs. 0.85 ± 0.29, P < 0.01; Cho/Cr: 4.14 ± 1.79 vs. 1.26 ±0.45, P < 0.01 ). As for the discriminant function with the CC/Ci ratio and the Cho/Cr ratio, the specificity, sensitivity, and accuracy were 98.6%, 85.7%, 92.9% respectively for the differentiation between cancer and BPH.Conclusions The prostate cancer is characterized by higher CC/Ci ratio and Cho/Cr ratio compared to BPH in the transitional zone. Both CC/Ci ratio and Cho/Cr ratio have high specificity, sensitivity, and accuracy in their discriminative power between cancer and BPH in this zonal area.

  15. Three-dimensional grayscale ultrasound: evaluation of prostate cancer compared with benign prostatic hyperplasia.

    NARCIS (Netherlands)

    Sedelaar, J.P.M.; Roermund, J.G. van; Leenders, G.L. van; Hulsbergen-van de Kaa, C.A.; Wijkstra, H.; Rosette, J.J.M.H.C. de la

    2001-01-01

    OBJECTIVES: To compare the accuracy of the detection, localization, and staging of prostate cancer using transrectal three-dimensional (3D) grayscale ultrasonography (3D-US) with conventional transrectal two-dimensional grayscale ultrasonography (2D-US). METHODS: Fifty patients with clinical localiz

  16. Telomerase activity in needle biopsies from prostate cancer and benign prostates

    NARCIS (Netherlands)

    Wymenga, LFA; Wisman, GBA; Ruiters, MHJ; Mensink, HJA; Veenstra, R.

    2000-01-01

    Background Telomerase activation is thought to be essential for the immortality of cancer cells. It may be a prognostic factor in small volume well differentiated prostate cancers and hence a guide for the aggressiveness of the approach. The length of the chromosome tips (telomeres) are maintained b

  17. Alpha-1 adrenergic antagonists in aircrew for the treatment of benign prostatic hypertrophy.

    Science.gov (United States)

    Matthies, Andrew K; Tachikawa, Nina J

    2013-01-01

    Benign prostatic hypertrophy (BPH) affects the majority of men later in life. Other than surgery, finasteride (Proscar) is currently the only pharmacologic option available for U.S. Air Force (USAF) aircrew. This article will evaluate the current literature regarding the treatment of benign prostatic hypertrophy with FDA approved tamsulosin (Flomax) and alfuzosin (Uroxatrol), third-generation alpha-1 adrenergic antagonists. Current literature supports the fact that some third-generation alpha blockers limit the side effects of hypotension when compared to other alpha blockers as a result of the specificity of subtype binding of the receptors and the sustained release formulation. Alpha blockers are currently used almost universally for the treatment of BPH; however, they are currently not approved for USAF aircrew. This article will review the aeromedical implications of the side effects of alpha-1 adrenergic antagonists (alfuzosin, tamsulosin), which affect aircrew while performing aeronautical duties, and examine whether alpha-1 adrenergic antagonists should be acceptable medications in certain situations depending on airframe and aeronautical duties.

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

    Directory of Open Access Journals (Sweden)

    Liya Liu

    2015-01-01

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

  19. Relationship between serum sex hormones levels and degree of benign prostate hyperplasia in Chinese aging men

    Institute of Scientific and Technical Information of China (English)

    Qin-Song Zeng; Zheng Li; Bo Wang; Ying-Hao Sun; Chuan-Liang Xu; Zhi-Yong Liu; Hui-Qing Wang; Bo Yang; Wei-Dong Xu; Tai-Le Jin; Cheng-Yao Wu; Gang Huang

    2012-01-01

    Benign prostatic hyperplasia (BPH) is one of the most common medical conditions in middle aged and older men.This study investigated the relationship between serum levels of sex hormones and measures of BPH in the aging male population of China.Prostate symptoms were assessed as part of a free health screening program for men ≥40 years of age.The examination included digital rectal examination,determination of serum prostate-specific antigen levels,International Prostate Symptom Scorn (IPSS) and transrectal ultrasonography.Serum levels of total testosterone (TT),sex hormone binding globulin (SHBG),free testosterone (FT),luteinizing hormone (LH),follicle-stimulating hormone (FSH),prolactin (PRL) and estradiol (E2) were evaluated.The men also completed a health and demographics questionnaire and received a detailed physical examination.The final study population consisted of 949 men with a mean age of 58.9 years.Pearson correlation analysis indicated that there were significant correlations between age and levels of all sex hormones except TT,and between age and prostate volume (PV; r=-0.243; P<0.01) or IPSS (r=0.263; P<0.01 ).Additional significant correlations were found between IPSS and serum levels of LH (r=0.112; P<0.01 ) and FSH (r=0.074; P<0.05),but there were no significant correlations between sex hormone levels and PV.Multivariate linear regression analysis showed significant correlations between age and body mass index (BMI) with PV (P<0.0001).In addition,there was a significant correlation between age and PV with IPSS (P<0.0001).Serum sex hormone levels did not correlate with PV or IPSS.The effects of endocrine changes on measures of BPH in aging men require further investigation in longitudinal and multicenter studies that include patients with all severities of BPH.

  20. Plasmakinetic enucleation of prostate versus 160-W laser photoselective vaporization for the treatment of benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Si-Jun Wang

    2017-01-01

    Full Text Available To evaluate the safety and efficacy of plasmakinetic enucleation of the prostate (PKEP for the treatment of symptomatic benign prostatic hyperplasia (BPH compared with 160-W lithium triboride laser photoselective vaporization of the prostate (PVP. From February 2011 to July 2012, a prospective nonrandomized study was performed. One-hundred one patients underwent PKEP, and 110 underwent PVP. No severe intraoperative complications were recorded, and none of the patients in either group required a blood transfusion. Shorter catheterization time (38.14 ± 23.64 h vs 72.54 ± 28.38 h, P< 0.001 and hospitalization (2.32 ± 1.25 days vs 4.07 ± 1.23 days, P< 0.001 were recorded in the PVP group. At 12-month postoperatively, the PKEP group had a maintained and statistically improvement in International Prostate Symptom Score (IPSS (4.07 ± 2.07 vs 5.00 ± 2.10; P< 0.001, quality of life (QoL (1.08 ± 0.72 vs 1.35 ± 0.72; P= 0.007, maximal urinary flow rate (Qmax (24.75 ± 5.87 ml s−1 vs 22.03 ± 5.04 ml s−1 ; P< 0.001, postvoid residual urine volume (PVR (14.29 ± 6.97 ml vs 17.00 ± 6.11 ml; P= 0.001, and prostate-specific antigen (PSA value (0.78 ± 0.57 ng ml−1 vs 1.27 ± 1.07 ng ml−1 ; P< 0.001. Both PKEP and PVP relieve low urinary tract symptoms (LUTS due to BPH with low complication rates. PKEP can completely remove prostatic adenoma while the total amount of tissue removed by PVP is less than that can be removed by PKEP. Based on our study of the follow-up, PKEP provides better postoperative outcomes than PVP.

  1. Transurethral dividing vaporesection for the treatment of large volume benign prostatic hyperplasia using 2 micron continuous wave laser

    Institute of Scientific and Technical Information of China (English)

    SUN Dong-chong; YANG Yong; WEI Zhi-tao; HONG Bao-fa; ZHANG Xu

    2010-01-01

    Background The safety and efficiency of transurethral laser resection of the prostate to treat benign prostatic hyperplasia have been verified. However, this method does still not manage large volume prostates efficiently. To tackle this problem, we have designed a method of "transurethral dividing vaporesection of prostate" using a 2 micron continuous wave laser. The aim of this study was to evaluate the safety and efficiency of this method in the management of large prostates (>80 ml).Methods In this study, 45 cases of benign prostatic hyperplasia with a median prostatic volume of (123.7±26.7) ml (range, 80.2-159.8 ml) were treated by the same surgeon under epidural anesthesia. During the surgery, superapubic catheters were needed, and saline solution was used for irrigation. First, the prostate was divided longitudinally into several parts from the bladder neck to the prostatic apex, and then gradually incised transversely chip by chip. Intraoperative blood transfusion rate, postoperative complications, maximum urinary flow rate, International Prostate Symptom Score and quality of life scores were recorded for statistical analysis using SPSS 16.0 software.Results Intraoperatively, no transurethral resection syndrome was observed, and no blood transfusions were needed.The resected prostatic chips were easily flushed out of the bladder through the resectoscope sheath without the use of a morcellator. Median vaporesection time was (95.0±13.2) minutes (range, 75-120 minutes), and the median retrieved and removed prostatic tissue were (25.2±5.1) g (range, 15.5-34.7 g) and (75.4±16.4) g (range, 43.8-106.1 g), respectively. Median catheter time and hospital stay were (3.3±0.9) days (range, 3-5 days) and (4.8±1.8) days (range, 3-9 days), respectively. After a follow-up of 6 to 12 months, two patients had stress urinary incontinence and three had anterior urethral strictures. Satisfactory improvement was seen in maximum urinary flow rate, International Prostate

  2. High milk consumption does not affect prostate tumor progression in two mouse models of benign and neoplastic lesions.

    Directory of Open Access Journals (Sweden)

    Sophie Bernichtein

    Full Text Available Epidemiological studies that have investigated whether dairy (mainly milk diets are associated with prostate cancer risk have led to controversial conclusions. In addition, no existing study clearly evaluated the effects of dairy/milk diets on prostate tumor progression, which is clinically highly relevant in view of the millions of men presenting with prostate pathologies worldwide, including benign prostate hyperplasia (BPH or high-grade prostatic intraepithelial neoplasia (HGPIN. We report here a unique interventional animal study to address this issue. We used two mouse models of fully penetrant genetically-induced prostate tumorigenesis that were investigated at the stages of benign hyperplasia (probasin-Prl mice, Pb-Prl or pre-cancerous PIN lesions (KIMAP mice. Mice were fed high milk diets (skim or whole for 15 to 27 weeks of time depending on the kinetics of prostate tumor development in each model. Prostate tumor progression was assessed by tissue histopathology examination, epithelial proliferation, stromal inflammation and fibrosis, tumor invasiveness potency and expression of various tumor markers relevant for each model (c-Fes, Gprc6a, activated Stat5 and p63. Our results show that high milk consumption (either skim or whole did not promote progression of existing prostate tumors when assessed at early stages of tumorigenesis (hyperplasia and neoplasia. For some parameters, and depending on milk type, milk regimen could even exhibit slight protective effects towards prostate tumor progression by decreasing the expression of tumor-related markers like Ki-67 and Gprc6a. In conclusion, our study suggests that regular milk consumption should not be considered detrimental for patients presenting with early-stage prostate tumors.

  3. Two-year results after convective radiofrequency water vapor thermal therapy of symptomatic benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Dixon CM

    2016-11-01

    Full Text Available Christopher M Dixon,1 Edwin Rijo Cedano,2 Dalibor Pacik,3 Vítězslav Vit,3 Gabriel Varga,3 Lennart Wagrell,4 Thayne R Larson,5 Lance A Mynderse6 1Department of Urology, Phelps Memorial Hospital, Sleepy Hollow, New York, NY, USA; 2Department of Urology, Clinical Canela, La Romana, Dominican Republic; 3Department of Urology, Brno University Hospital, Brno, Czech Republic; 4Urologcentrum, Stockholm, Sweden; 5Institute of Medical Research, Scottsdale, AZ, 6Department of Urology, Mayo Clinic, Rochester, MN, USA Objective: The objective of this study was to assess the effectiveness and safety of convective radiofrequency (RF water vapor thermal therapy in men with lower urinary tract symptoms (LUTS associated with benign prostatic hyperplasia (BPH; a pilot study design with 2-year follow-up evaluations.Patients and methods: Men aged ≥45 years with an International Prostate Symptom Score ≥13, a maximum urinary flow rate (Qmax ≤15 mL/s, and prostate volume 20–120 cc were enrolled in a prospective, open-label pilot study using convective RF water vapor energy with the Rezūm System. Patients were followed up for 2 years after transurethral thermal treatment at 3 international centers in the Dominican Republic, Czech Republic, and Sweden. The transurethral thermal therapy utilizes radiofrequency to generate wet thermal energy in the form of water vapor injected through a rigid endoscope into the lateral lobes and median lobe as needed. Urinary symptom relief, urinary flow, quality of life (QOL impact, sexual function, and adverse events (AEs were assessed at 1 week, 1, 3, 6, 12, and 24 months. Results: LUTS, flow rate, and QOL showed significant improvements from baseline; prostate volumes were appreciably reduced. Sexual function was maintained and no de novo erectile dysfunction occurred. The responses evident as early as 1 month after treatment remained consistent and durable over the 24 months of study. Early AEs were typically transient and

  4. The short-term effects of terazosin in Japanese men with benign prostatic hyperplasia.

    Science.gov (United States)

    Horiuchi, K; Tsuboi, N; Suzuki, Y; Yoshida, K; Akimoto, M

    2001-04-01

    We evaluated the short-term efficacy of terazosin for treating symptomatic benign prostatic hyperplasia (BPH). Thirty men, aged 52 to 83 years (mean: 69.2 years) complaining of obstructive urinary symptoms due to BPH who had not received any prior treatment for their symptoms were orally administered 2 mg/day of terazosin. Symptoms (the total IPSS and the obstructive and irritative symptom scores) and objective parameters (peak flow rate [Qmax] and prostatic volume) were evaluated before treatment and after 1, 2, and 4 weeks of treatment. The mean total IPSS and the mean symptom scores for weak stream and nocturia were significantly decreased after only 1 week of treatment, while the mean scores for emptying, frequency, and urgency were significantly decreased after 2 weeks of treatment. However, the mean scores for intermittency and hesitancy did not decrease significantly at any time during treatment. Regarding objective parameters, the mean Qmax was significantly improved after 1 week of treatment, but the mean prostatic volume remained almost unchanged after 4 weeks. In conclusion, short-term terazosin therapy not only improved Qmax but also alleviated symptoms including irritative symptoms.

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

    Science.gov (United States)

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

    2005-08-01

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

  6. Role of IAPs in prostate cancer progression: immunohistochemical study in normal and pathological (benign hyperplastic, prostatic intraepithelial neoplasia and cancer human prostate

    Directory of Open Access Journals (Sweden)

    Olmedilla Gabriel

    2010-01-01

    Full Text Available Abstract Background In this study was investigate IAPs in normal human prostate (NP, benign prostatic hyperplasia (BPH, prostatic intraepithelial neoplasia (PIN and prostatic carcinoma (PC, and their involvement in apoptosis/proliferation via NF-kB (TNF-α, IL-1 stimulation. Methods Immunohistochemical and Western blot analyses were performed in 10 samples of normal prostates, 35 samples of BPH, 27 samples diagnosis of PIN (with low-grade PIN or high-grade PIN and 95 samples of PC (with low, medium or high Gleason grades. Results In NP, cytoplasm of epithelial cells were positive to c-IAP1/2 (80% of samples, c-IAP-2 (60%, ILP (20%, XIAP (20%; negative to NAIP and survivin. In BPH, epithelial cells were immunostained to c-IAP1/2 (57.57%, c-IAP-2 (57.57%, ILP (66.6%, NAIP (60.6%, XIAP (27.27%, survivin (9.1%. Whereas low-grade PIN showed intermediate results between NP and BPH; results in high-grade PIN were similar to those found in PC. In PC, epithelial cells were immunostained to c-IAP1/2, c-IAP-2, ILP, NAIP, XIAP (no Gleason variation and survivin (increasing with Gleason. Conclusions IAPs could be involved in prostate disorder (BPH, PIN and PC development since might be provoke inhibition of apoptosis and subsequently cell proliferation. At the same time, different transduction pathway such as IL-1/NIK/NF-kB or TNF/NF-kB (NIK or p38 also promotes proliferation. Inhibitions of IAPs, IL-1α and TNFα might be a possible target for PC treatment since IAPs are the proteins that inhibited apoptosis (favour proliferation and IL-1α and TNFα would affect all the transduction pathway involucrate in the activation of transcription factors related to survival or proliferation (NF-kB, Elk-1 or ATF-2.

  7. Possible autocrine loop of the epidermal growth factor system in patients with benign prostatic hyperplasia treated with finasteride: a placebo-controlled randomized study

    DEFF Research Database (Denmark)

    Tørring, Niels; Jensen, Klaus Møller-Ernst; Lund, L;

    2002-01-01

    To analyse the expression of the epidermal growth factor (EGF) system in prostate tissue and secretions obtained from patients with benign prostatic hyperplasia (BPH) treated with or without finasteride (which primarily targets the androgen-sensitive secretory epithelial cells in the prostate...

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

    Science.gov (United States)

    Uchida, Toyoaki

    2011-09-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

  10. Influence of immune inflammation on androgen receptor expression in benign prostatic hyperplasia tissue

    Institute of Scientific and Technical Information of China (English)

    Zong-Lin Wu; Ya Yuan; He Geng; Shu-Jie Xia

    2012-01-01

    This study was designed to investigate the association between immune inflammation and androgen receptor (AR) expression in benign prostatic hyperplasia (BPH).We retrospectively analyzed 105 prostatectomy specimens.An immune inflammation score for each specimen was defined by combining three immunohistochemical markers (CD4,CD8 and CD20).The immunohistochemical markers were CD4 and CD8 for T lymphocytes,CD20 for B lymphocytes and AR antibody for the AR in BPH samples.Rates of CD4,CD8,CD20 and AR expression in BPH were 20 (19.0%),21 (20.0%),101 (96.2%) and 48 (45.7%),respectively.Total prostate volume (TPV) was higher in the immune inflammation group than in the non-immune inflammation group (62.7 ml vs.49.2 ml,t=2.482,P<0.05).Patients in the immune inflammation group had a higher serum prostate-specific antigen (PSA) than those in the non-inflammation group (7.5 ng ml-1 vs.5.4 ng ml-1,t=2.771,P<0.05).Specifically,the immune inflammation group showed a higher rate of AR expression than the non-inflammation group (56.1% vs.28.2%,x2=7.665,P<0.05).Our study revealed a strong association between immune inflammation and TPV,serum PSA and AR expression in BPH tissue.Prostate hyperplasia caused by an immune inflammatory process may contribute to BPH progression over time.Therefore,the inflammatory response involved in BPH may be a prime therapeutic target.

  11. A Review on Clinical Pharmacokinetics of Tamsulosin in Patients with Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Tolou Ghamari

    2016-08-01

    Full Text Available Context Benign prostatic hyperplasia (BPH that disturbs aged males is described as the abundant, chronic progressive disorder usually associated with lower urinary tract symptoms. The alpha 1A-adrenergic receptor antagonist, tamsulosin (Flomax®/Omnic®, seems to be an appropriate management from the view point of urological surgeons. The current review aimed to evaluate the clinical pharmacological properties of tamsulosin in prostate disorders. Evidence Acquisition United States national library of medicine (PubMed, NLM were searched from April 1991 to March 2016. The Mesh terms were: tamsulosin, tamsulosin pharmacokinetics in urology, tamsulosin in BPH and clinical pharmacokinetics of tamsulosin in BPH. Published clinical trials and review articles applicable to pharmacotherapy of tamsulosin in BPH were reviewed. Results In patients with mild international prostate symptom score (< 8 to moderate symptoms of BPH, initial treatment with an alpha 1-adrenergic antagonist monotherapy were useful. With a half-life of 9 - 13 hours, the oral bioavailability of drug was reported 100%. The drug is metabolized by liver. Excretion through renal was reported 76%. Initial dose of drug was 0.4 mg/day and the maximum dose was reported 0.8 mg/day. The drug could cause dizziness, sever drowsiness and problems in thinking, driving and many other complications. Other serious adverse reactions could be mentioned as hives, rash, itching, and difficulty in breathing, swelling of face, lips, tongue and throat. Tamsulosin therapy should be stopped in patients who experience hypotension. Conclusions To treat BPH therapeutically, it is necessary to stabilize severities of the patient’s symptoms with potential side effects of the treatment. Tamsulosin blocks alpha 1-receptors in smooth muscles both in the bladder neck and prostate, which leads to relaxation and subsequently less resistance to urinary flow. By advancement of tamsulosin, pharmacotherapy strategies could

  12. Can we identify men who will have complications from benign prostatic obstruction (BPO)? ICI-RS 2011.

    NARCIS (Netherlands)

    Oelke, M.; Kirschner-Hermanns, R.; Thiruchelvam, N.; Heesakkers, J.P.F.A.

    2012-01-01

    AIMS: This ICI-RS report aims to analyze morphological or functional complications of the lower or upper urinary tract in elderly men, clarify the association between complications and benign prostatic obstruction (BPO) and define men who will develop these complications. Research proposals to furth

  13. Chemical characterization, anti-benign prostatic hyperplasia effect and subchronic toxicity study of total flavonoid extract of Pteris multifida.

    Science.gov (United States)

    Dai, Guang-Cheng; Hu, Bin; Zhang, Wen-Fang; Peng, Fang; Wang, Rong; Liu, Zhi-Yuan; Xue, Bo-Xin; Liu, Jiang-Yun; Shan, Yu-Xi

    2016-11-12

    The decoction of Pteris multifida had been applied to attenuate symptoms of benign prostatic hyperplasia in Chinese folk medicine. In this study, the total flavonoid extract of Pteris multifida was processed at first. High performance liquor chromatography and tandem mass spectrometer assay revealed 10 flavonoids as key constituents of this extract. After 60-day administration, the total flavonoid extract (180 mg/kg, i. g.) decreased the prostate index in mice of benign prostatic hyperplasia apparently. Immunohistochemical assay revealed inhibition of vascular endothelial growth factor expression, together with activation of transforming growth factor-beta 1 expression in the prostatic samples after administration of the extract. A 90-day subchronic toxicity test was further undertaken in male Sprague-Dawley rats, and the no-observed-adverse-effect level for the extract was 200 mg/kg body weight/day. These results revealed that the total flavonoid extract of Pteris multifida exhibited positive effect with safety, which might be applied in treatment of benign prostatic hyperplasia.

  14. The treatment effects of flaxseed-derived secoisolariciresinol diglycoside and its metabolite enterolactone on benign prostatic hyperplasia involve the G protein-coupled estrogen receptor 1.

    Science.gov (United States)

    Ren, Guan-Yu; Chen, Chun-Yang; Chen, Wei-Guo; Huang, Ya; Qin, Li-Qiang; Chen, Li-Hua

    2016-12-01

    Secoisolariciresinol diglucoside (SDG), a lignan extracted from flaxseed, has been shown to suppress benign prostatic hyperplasia (BPH). However, little is known about the mechanistic basis for its anti-BPH activity. The present study showed that enterolactone (ENL), the mammalian metabolite of SDG, shared the similar binding site of G1 on a new type of membranous estrogen receptor, G-protein-coupled estrogen eceptor 1 (GPER), by docking simulations method. ENL and G1 (the specific agonist of GPER) inhibited the proliferation of human prostate stromal cell line WPMY-1 as shown by MTT assay and arrested cell cycle at the G0/G1 phase, which was displayed by propidium iodide staining following flow cytometer examination. Silencing GPER by short interfering RNA attenuated the inhibitory effect of ENL on WPMY-1 cells. The therapeutic potential of SDG in the treatment of BPH was confirmed in a testosterone propionate-induced BPH rat model. SDG significantly reduced the enlargement of the rat prostate and the number of papillary projections of prostatic alveolus and thickness of the pseudostratified epithelial and stromal cells when comparing with the model group. Mechanistic studies showed that SDG and ENL increased the expression of GPER both in vitro and in vivo. Furthermore, ENL-induced cell cycle arrest may be mediated by the activation of GPER/ERK pathway and subsequent upregulation of p53 and p21 and downregulation of cyclin D1. This work, in tandem with previous studies, will enhance our knowledge regarding the mechanism(s) of dietary phytochemicals on BPH prevention and ultimately expand the scope of adopting alternative approaches in BPH treatment.

  15. Prediction of alpha1-adrenoceptor occupancy in the human prostate from plasma concentrations of silodosin, tamsulosin and terazosin to treat urinary obstruction in benign prostatic hyperplasia.

    Science.gov (United States)

    Yamada, Shizuo; Kato, Yasuhiro; Okura, Takashi; Kagawa, Yoshiyuki; Kawabe, Kazuki

    2007-07-01

    Alpha1-adrenoceptor antagonists are clinically useful for the improvement of urinary obstruction due to benign prostatic hyperplasia (BPH), and their therapeutic effects are mediated through the blockade of prostatic alpha(1)-adrenoceptors. The present study was undertaken to predict the magnitude and duration of alpha(1)-adrenoceptor occupancy in the human prostate after oral alpha(1)-adrenoceptor antagonists. Prostatic alpha(1)-adrenoceptor-binding parameters of silodosin were estimated by measuring specific [(3)H]prazosin binding in rat prostate after oral administration of this drug. The plasma concentration of silodosin after oral administration in rats and healthy volunteers was measured using a high-performance liquid chromatographic method. The alpha(1)-adrenoceptor-binding affinities (K(i)) of silodosin, tamsulosin, and terazosin in the human prostate and plasma concentrations of tamsulosin and terazosin were obtained from the literature. Using the alpha(1)-adrenoceptor binding parameters of silodosin in rat prostate, alpha(1)-adrenoceptor occupancy in the human prostate was estimated to be around 60-70% at 1-6 h after oral administration of silodosin at doses of 3.0, 8.1, and 16.1 micromol. Thereafter, the receptor occupancy was periodically decreased, to 24% (8.1 micromol) and 54% (16.1 micromol) 24 h later. A similar magnitude and time course of alpha(1)-adrenoceptor occupancy by silodosin in the human prostate were estimated using alpha(1)-adrenoceptor-binding affinities (K(i)) in the human prostate. Despite about two orders of differences in the plasma unbound concentrations after clinically effective oral dosages of silodosin, tamsulosin, and terazosin, there was a comparable magnitude of prostatic alpha(1)-adrenoceptor occupancy by these drugs. In conclusion, the prediction of alpha(1)-adrenoceptor occupancy in the human prostate by alpha(1)-adrenoceptor antagonists may provide the rationale for the optimum dosage regimen of these drugs in the

  16. The efficacy and safety of 2-μm continuous laser in the treatment of high-risk patients with benign prostatic hyperplasia.

    Science.gov (United States)

    Tao, Wei; Sun, Chuanyang; Xue, Boxin; Yang, Dongrong; Wang, Mingchao; Cai, Chunjie; Shan, Yuxi

    2017-02-01

    Two-micrometer laser resection of prostate-tangerine technique dissects whole prostatic lobes off the surgical capsular, similar to peeling a tangerine. The present study aimed to evaluate the safety and efficacy of 2-μm continuous laser vaporization in the treatment of high-risk patients with benign prostatic hyperplasia (BPH) during the 24-month follow-up. The study included 248 patients with moderate to severe lower urinary tract symptoms who underwent 2-μm continuous laser vaporization of the prostate. All patients were accompanied with different degree comorbidities and 94 patients were taking oral anticoagulants. BPH was successfully treated with 2-μm continuous laser vaporization in all patients. Mean pre-operative prostate volume was 76 ± 25.3 ml and mean operative time was 49.8 ± 16.5 min. There were no major complications intra-operatively or postoperatively, and no blood transfusions were needed. About 20 patients (8.1%) needed bladder irrigation postoperatively. Average catheterization time was 2.0 ± 1.8 days (range 1-5 days). Four patients required reoperation due to enlarged prostates from residual adenoma. At 3-, 6-, 12-, and 24-month follow-ups, maximum urinary flow rates (Qmax) increased from 6.9 ± 1.7 to 19.1 ± 4.2, 19.5 ± 4.6, 19.4 ± 4.6, and 19.5 ± 4.1 ml/s, respectively. Mean International Prostate Symptom Scores (IPSS) decreased from 27.6 ± 5.1 (pre-operation) to 9.2 ± 2.6, 7.12 ± 1.42, 6.18 ± 1.32, and 6.25 ± 1.30 at 3-, 6-, 12-, and 24-month post-operation, respectively. Two-micrometer continuous laser vaporization is a safe and effective surgical endoscopic technique associated with low complication rate in BPH patients at high risk and those on anticoagulation therapy who have severe LUTS caused by BPH.

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

    Science.gov (United States)

    Skolarus, TA; Wei, JT

    2010-01-01

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

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

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    Nishant D Patel

    2014-01-01

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

  19. Androgen receptor CAG polymorphism and the risk of benign prostatic hyperplasia in a Brazilian population

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    Vanderlei Biolchi

    2012-06-01

    Full Text Available Benign prostatic hyperplasia (BPH is a very frequent age-related proliferative abnormality in men. Polymorphic CAG repeat in the androgen receptor (AR can alter transactivation of androgen-responsive genes and potentially influence BPH risk. We investigated the association between CAG repeat length and risk of BPH in a case-control study of a Brazilian population. We evaluated 214 patients; 126 with BPH and 88 healthy controls. DNA was extracted from peripheral leucocytes and the AR gene was analyzed using fragment analysis. Hazard ratio (HR and 95% confidence interval were estimated using logistic regression models. Mean CAG length was not different between patients with BPH and controls. The CAG repeat length was examined as a categorical variable (CAG 21 and CAG 22 and did not differ between the control vs. the BPH group. We found no evidence for an association between AR CAG repeat length in BPH risk in a population-based sample of Brazilians.

  20. Continuous finasteride therapy for benign prostate hypertrophy upgrades both neuroendorcine differentiation and aggressive prostate cancer.

    Science.gov (United States)

    Tarle, Marko; Spajic, Borivoj; Kraljic, Ivo; Kusic, Zvonko

    2009-05-01

    Finasteride has been recognized as a drug suitable for the chemoprevention of prostate cancer (PC) by reducing intracellular dihydrotestosterone (DHT) levels. The Prostate Cancer Prevention Trial (PCPT) database on continuous finasteride treatment of almost 19 thousands patients indicated the reduction in cancer prevalence by about 25% . However, in this same study more than a twofold increase in high grade aggressive prostate tumors was recorded when compared to controls thus arising serious doubts upon the real benefits of the protocol. Here, our investigation was performed three years on a continuous versus intermittent (six month treatment followed by 6 months resting period) finasteride treatment in 125 BPH patients (pts) each. The overall PC prevalence in both finasteride-treated groups was lower that in untreated controls and thus being in accordance with the PCPT data. However, continuous therapy gave significantly higher incidence in Gleason score (GS)>6 carcinomas compared to intermitted therapy and controls (44.5%, 25% and 18.2% of total acquired PC, respectively). In addition, the acquired elevated chromogranin A (CgA) values were also more than doubled in pts treated continuously compared to the other two groups (13.6%, 5.6% and 6.4%, respectively). Acquired PC GS>6 recorded in pts with a raise in CgA was higher in continuously treated pts (50%) than in the other two studied groups (20% and 25%, respectively). In pts with the retained normal CgA concentration highest PC incidence was found in controls (5.1%) and lower prevalence was recorded in continuously (2.8%) and intermittently treated pts (2.5%) while the respective PC GS>6 incidence was lower in controls than in treated pts. Seemingly, finasteride treatment reduces PC prevalence in pts free of NED but elevates the number of aggressive carcinomas in CgA-positive pts only if continuous treatment is applied. In conclusion, current chemoprevention protocols need to be carefully reconsidered prior to

  1. Interactions between medications employed in treating benign prostatic hyperplasia and food - A short review.

    Science.gov (United States)

    Paśko, Paweł; Rodacki, Tomasz; Domagała-Rodacka, Renata; Owczarek, Danuta

    2016-10-01

    Benign prostatic hyperplasia (BPH) is the most common disease in elderly men. BPH symptoms include frequent urination, urgent tenesmus and urination at night, a weak and interrupted urine flow and a sense of incomplete emptying of the bladder. Alpha- 1 adrenergic receptor antagonists and 5 α-reductase inhibitors form the most important groups of medications employed in BPH. Appropriately managed BPH patients shall be subject to counselling on interactions between agents belonging to these groups, and on particular components of the food they have. The present review has been aimed at assessing potential effects of consumed food, alcohol and fruit juices on the pharmacokinetics and pharmacodynamics of medications for benign prostatic hyperplasia. The authors reviewed the English PubMed database covering the years 1991-2015. Additionally, a digital version of Stockley Drugs Interaction and other electronic databases such as drugs.com and Medscape were also researched; characterisation charts for particular medical products were also analyzed. Pharmacokinetics of extended-release forms of alfuzosin, doxazosin, tamsulosin and silodosin is well known to be food-sensitive. Alfuzosin, tamsulosin and silodosin due to their likely interaction with grapefruit juice and citrus fruits, may intensify adverse effects of the drugs. Alpha-1 adrenergic receptor antagonists are known to interact with alcohol, leading to orthostatic hypotension. For 5 alpha-reductase inhibitors, such as finasteride, or dutasteride, the pharmacokinetic effect due to consumed food is of no clinical importance and thus they may be taken regardless of meals. As in general grapefruit juice and alcohol tend to significantly affect the efficacy and safety of the applied drug therapy, it is highly advisable to be knowledgeable on the subject in order to educate patients.

  2. ASSESSMENT OF INDIRECT HEMAGGLUTINATION AND ZYMOGRAPHY PROCEDURES IN EVALUATION OF GELATINASE A IN PATIENTS WITH BENIGN AND MALIGNANT PROSTATE HYPERPLASIA

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    Nastaran Aalizadeh

    2003-09-01

    Full Text Available There are increasing data on novel tumor markers such as gelatinase A, which play a key role in tissue invasion and metastasis. Since prostate cancer is one of the common malignancies, we designed a simple and applicable Indi¬rect Hemagglutination (IHA test for determination of total gelatinase A in se¬rum samples. In this study, we have analyzed the circulating form of gelatinase A (MMP-2 in patients suffering from either benign prostate hyperplasia (n= 54 or prostate cancer (n= 26 and normal individuals as control (n= 26. The gelatinolytic activity was determined by zymography followed by densitomet-ric analysis. PSA was quantified by using a standard ELISA technique. Corre¬lation of densitometric analysis of gelatinase A activity and IHA titer was sig¬nificant at 0.01 level (p< 0.01, r = 0.916. Correlation of PSA and IHA titer was significant at 0.01 level (p< 0.01, r = 0.746. Border line IHA titer in patients with prostate cancer was 512 ± 1 tube titer, in benign prostate hyper¬plasia patients was 128 ± 1 tube titer, and the titer in normal individuals was 8 ± 1 tube titer. These results demonstrate that IHA compared to zymography may be a better and simpler procedure in monitoring and screening patients with prostate cancer.

  3. Evaluation of discoidin domain receptor-2 (DDR2) expression level in normal, benign, and malignant human prostate tissues.

    Science.gov (United States)

    Azemikhah, Mitra; Ashtiani, Hamidreza Ahmadi; Aghaei, Mahmoud; Rastegar, Hosein

    2015-01-01

    Discoidin domain receptor (DDR) is a new member of the receptor tyrosine kinase family. There are two isoforms of discoidin domain receptor (DDR), DDR1 and DDR2. These receptors play a major role in the adhesion, motility and cell proliferation. Due to the important role of DDR2 in the development of tumor extension, this receptor is pivotal in the field of carcinogenesis. The aim of this study was to investigate the mRNA and protein expression of DDR2, in the malignant, benign prostatic hyperplasia (BPH) and normal tissues of patients with prostate cancer. In this study the gene and protein expression of DDR2 in adjacent normal (n=40), BPH (n=40), and malignant (n=40) prostate tissue were measured using real-time PCR and Western blotting. Then, the correlation of DDR2 gene and protein expression with prognostic factors such as age, tumor grade, tumor stage, lymph node involvement, and serum prostate-specific antigen (PSA) concentration were evaluated. The relative mRNA and protein expression level of DDR2 in malignant and benign prostate tissue was significantly higher than those of adjacent normal tissues (PDDR2 mRNA and protein expression with prognostic factors such as tumor grade, stage, lymph node involvement, and serum PSA concentration. However, significant correlation with age was not observed. These findings suggest that DDR2 is a cancer-related gene associated with the aggressive progression of prostate cancer patients.

  4. Biological effect of human serum collected before and after oral intake of Pygeum africanum on various benign prostate cell cultures

    Institute of Scientific and Technical Information of China (English)

    Stéphane Larré; Philippe Camparo; Eva Comperat; Delphine Boulbés; Mohammed Haddoum; Sylvain Baulande; Pascal Soularue; Pierre Costa; Olivier Cussenot

    2012-01-01

    Pygeum africanum (Tadenan) is a popular phytotherapeutic agent used in the treatment of symptomatic benign prostatic hyperplasia.The active compounds of the drug have not been identified,and determining the plasma concentration of the drug is,therefore,not possible.Because there are conflicting results on the efficacy of this drug,we aimed to investigate its effect on prostate cell growth in vitro using human serum collected before and after Pygeum africanum intake.We used primary and organotypic cultures of human prostatic stromal myofibroblast cell line WPMY and prostatic epithelial cell line PNT2.We also used fresh benign prostatic tissue.The serum of a treated man induced decreases in the proliferation of primary cells,organotypic cells and WPMY cells but not PNT2 cells.We also analysed the effect of treated serum on the gene expression profile of WPMY cells.The transcriptome analysis revealed an upregulation of genes involved in multiple tumour suppression pathways and a downregulation of genes involved in inflammation and oxidative-stress pathways.The oral intake of Pygeum africanum resulted in serum levels of active substances that were sufficient to inhibit the proliferation of cultured myofibroblasts prostatic cells.This inhibition was associated with changes in the transcriptome.

  5. Withania coagulans Extract Induces Cell Apoptosis and Inhibits COX-2 Expression in a Rat Model of Benign Prostatic Hyperplasia

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    Sarbishegi

    2016-08-01

    Full Text Available Background Phytotherapy is a popular treatment option in cases of benign prostatic hyperplasia (BPH, with many different herbal products being used for the treatment of this condition. Withania coagulans (WC is an herbal medicine that has shown anti-tumoral, anti-inflammatory, and antioxidant effects. Objectives This study examined the effect of Withania coagulans extract (WCE on prostatic cell apoptosis and cyclooxygenase-2 (COX-2 expression in cases of benign prostatic hyperplasia (BPH in rats. Methods Forty Wistar rats were equally divided into five groups: control, sham, BPH, BPH + WCE, and BPH + CLX (celecoxib as a positive control group. The induction of BPH was achieved via the subcutaneous injection of 3 mg/kg of testosterone propionate (TP daily for 28 days. The animals received WCE, celecoxib, or distilled water by oral gavage accompanied by the TP injection. After four weeks, the prostate glands of the rats were weighed to measure the prostatic index (PI. The ventral lobes of the prostates were dissected and processed with paraffin blocks in order to study the number of mast cells. A TUNEL analysis was performed to evaluate the cell apoptosis, while the expression of COX-2 was examined using immunohistochemistry. Results BPH was obvious in the ventral lobe of the prostate, and the administration of WCE markedly decreased the PI and the number of mast cells (P < 0.001 in the BPH rats. Additionally, the WCE treatment induced prostatic cell apoptosis when compared to the BPH group. Furthermore, following the WCE treatment, the expression of COX-2 in the prostatic tissues was significantly decreased when compared to the BPH groups. Conclusions According to the results of this study, WCE was effective in the treatment of BPH in rats. It may therefore have beneficial effects in the treatment of patients with BPH.

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

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    Smith Nadine

    2005-06-01

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

  7. Comparative study of serum zinc concentrations in benign and malignant prostate disease: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zhao, Jiang; Wu, Qingjiang; Hu, Xiaoyan; Dong, Xingyou; Wang, Liang; Liu, Qian; Long, Zhou; Li, Longkun

    2016-05-12

    Many studies have investigated the relationship between serum zinc concentration and prostatic disease, but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the correlation between serum zinc concentration and prostate disease. Systematic literature searches were conducted with PubMed, EMBASE, Science Direct/Elsevier, MEDLINE, CNKI and the Cochrane Library up to June 2015 for studies that involved the relationship between serum zinc concentration and prostate disease. Fourteen studies were identified from the databases. Our results illustrated that the serum zinc concentrations in prostate cancer patients were significantly lower than those in Benign prostatic hyperplasia (BPH) patients and normal controls (SMD (95% CI), -0.94 [-1.57, -0.32]; -1.18 [-1.90, -0.45]). However, the serum zinc concentrations in BPH patients were significantly higher than those in normal controls (SMD (95% CI) 1.77 [0.15, 3.39]). The present study showed that different levels of serum zinc concentrations are correlated with different prostatic disease. Serum zinc concentration may be used as a tool for the diagnosis and screening of prostate disease. But, further studies with well-designed larger sample studies are needed in this field to further clarify the correlation between serum zinc concentration and prostate disease.

  8. Intraprostatic injection of alcohol gel for the treatment of benign prostatic hyperplasia: preliminary clinical results.

    Science.gov (United States)

    Larson, Benjamin T; Netto, Nelson; Huidobro, Christian; de Lima, Marcelo Lopez; Matheus, Wagner; Acevedo, Cristian; Larson, Thayne R

    2006-09-06

    Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH. A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20-30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months. The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment. This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an

  9. Apoptotic Pathways Linked to Endocrine System as Potential Therapeutic Targets for Benign Prostatic Hyperplasia

    Science.gov (United States)

    Minutoli, Letteria; Rinaldi, Mariagrazia; Marini, Herbert; Irrera, Natasha; Crea, Giovanni; Lorenzini, Cesare; Puzzolo, Domenico; Valenti, Andrea; Pisani, Antonina; Adamo, Elena B.; Altavilla, Domenica; Squadrito, Francesco; Micali, Antonio

    2016-01-01

    Benign prostatic hyperplasia (BPH) is a chronic condition common in older men that can result in bothersome lower urinary tract symptoms. The molecular mechanisms and networks underlying the development and the progression of the disease are still far from being fully understood. BPH results from smooth muscle cell and epithelial cell proliferation, primarily within the transition zone of the prostate. Apoptosis and inflammation play important roles in the control of cell growth and in the maintenance of tissue homeostasis. Disturbances in molecular mechanisms of apoptosis machinery have been linked to BPH. Increased levels of the glycoprotein Dickkopf-related protein 3 in BPH cause an inhibition of the apoptosis machinery through a reduction in B cell lymphoma (Bcl)-2 associated X protein (Bax) expression. Inhibitors of apoptosis proteins influence cell death by direct inhibition of caspases and modulation of the transcription factor nuclear factor-κB. Current pharmacotherapy targets either the static component of BPH, including finasteride and dutasteride, or the dynamic component of BPH, including α-adrenoceptor antagonists such as tamsulosin and alfuzosin. Both these classes of drugs significantly interfere with the apoptosis machinery. Furthermore, phytotherapic supplements and new drugs may also modulate several molecular steps of apoptosis. PMID:27529214

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

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    Jielin Sun

    2013-04-01

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

  11. Does bladder outlet obstruction affect distance between the ureteric orifices in patients with benign prostate hyperplasia?

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    Cüneyt Özden

    2009-01-01

    Full Text Available Objectives: Many morphological changes occur in the bladder due to bladder outlet obstruction (BOO in pa-tients with benign prostate hyperplasia (BPH. In the present study we evaluated the relationship between in-terureteric distance (IUD of the orifices and BOO in BPH patients.Materials and methods: Thirty-seven consecutive pa-tients with lower urinary tract symptoms at the urology polyclinic included in the study. Patients divided into 2 groups according to maximal flow rate (Qmax. The first group constituted of 18 patients with Qmax 15ml/s. The IUD measurement was performed with Doppler ultrasonography.Results: There was no significant difference between the groups regarding mean age and prostate volume. Mean IUD in the first group was 32.7±5.4 mm and mean IUD in the second group was 31.5±5.1 mm. There was no statistically significant difference between the groups regarding the IUD.Conclusions: Data obtained from the study revealed that measurement of IUD with Doppler ultrasonography not significantly related to BOO.

  12. Impact of primary hypertension on hematuria of the patients with benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    GUO Li-jun; TANG Yuan; GUO Chao-ming; ZHANG Xiang-hua

    2010-01-01

    Background Both benign prostatic hyperplasia (BPH) and primary hypertension are common in the elderly men. The purpose of this study was to investigate the possible effect of primary hypertension on the hematuria in patients with BPH.Methods All patients who underwent transurethral resection of prostate or opening operation had confirmed diagnoses of BPH histologically. comparative analysis of packet was used to analyze the incidence of hematuria in 423 BPH patients with or without hypertension. Immunostaining of CD34 and vascular endothelial growth factor (VEGF) was carried out in tissues of 50 cases of simple BPH and 50 cases of BPH accompanied with hypertension. Results The incidence of hematuria in the BPH with hypertension was significantly higher than that in the simple BPH (P<0.01). Furthermore, the incidence of hematuria in patients who had hypertension for more than 10 years was clearly higher than that in the patients who had hypertension for less than 10 years (P <0.01). Both microvessel density (MVD) based on CD34 immunostaining and VEGF expression were significantly higher in the BPH tissues of patients with hypertension than that in the simple BPH (P<0.01, P<0.05).Conclusions Long-term hypertension may significantly increase the incidence of hematuria in patients with both BPH and hypertension. Increased MVD level and VEGF expression may account for the higher incidence of hematuria in these patients.

  13. Intraurethral Catheter: Alternative Management for Urinary Retention in Patients With Benign Prostatic Hypertrophy

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    Sulabha Punekar

    1995-01-01

    Full Text Available A polyurethane intraurethral catheter (IUC was used in 27 patients with benign prostatic hypertrophy who were unfit for surgery, or were awaiting surgery. All of them had previously had a periurethral catheter inserted. The IUC was inserted with a cystoscope under fluoroscopic control. Spontaneous voiding through the IUC resumed in 25 patients (93% in the immediate postprocedure period. At the end of 6 months follow-up, the peak flow rates and the residual volumes estimated in 22 patients were satisfactory. Immediate complications included incontinence due to distal displacement in 2 patients and hematuria in one patient; long-term complications included mild encrustation of the IUC in 2 patients and calculus formation on the IUC in 1 patient. None of the patients had clinically significant urinary tract infection. The presence of the IUC did not compromise the subsequent transurethral resection of the prostate gland. We recommend the use of an IUC for up to 6 months in patients with urinary retention who are awaiting surgery or are unfit for surgery as an alternative to an indwelling urethral catheter.

  14. Apoptotic Pathways Linked to Endocrine System as Potential Therapeutic Targets for Benign Prostatic Hyperplasia

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    Letteria Minutoli

    2016-08-01

    Full Text Available Benign prostatic hyperplasia (BPH is a chronic condition common in older men that can result in bothersome lower urinary tract symptoms. The molecular mechanisms and networks underlying the development and the progression of the disease are still far from being fully understood. BPH results from smooth muscle cell and epithelial cell proliferation, primarily within the transition zone of the prostate. Apoptosis and inflammation play important roles in the control of cell growth and in the maintenance of tissue homeostasis. Disturbances in molecular mechanisms of apoptosis machinery have been linked to BPH. Increased levels of the glycoprotein Dickkopf-related protein 3 in BPH cause an inhibition of the apoptosis machinery through a reduction in B cell lymphoma (Bcl-2 associated X protein (Bax expression. Inhibitors of apoptosis proteins influence cell death by direct inhibition of caspases and modulation of the transcription factor nuclear factor-κB. Current pharmacotherapy targets either the static component of BPH, including finasteride and dutasteride, or the dynamic component of BPH, including α-adrenoceptor antagonists such as tamsulosin and alfuzosin. Both these classes of drugs significantly interfere with the apoptosis machinery. Furthermore, phytotherapic supplements and new drugs may also modulate several molecular steps of apoptosis.

  15. Metabolic syndrome and lower urinary tract symptoms secondary to benign prostatic hyperplasia.

    Science.gov (United States)

    Kasturi, Sanjay; Russell, Shane; McVary, Kevin T

    2006-07-01

    Increasing evidence recently has pointed toward a relationship between lower urinary tract symptoms (LUTS) and the presence of metabolic syndrome. This relationship has been supported by recent epidemiologic findings. Possible pathophysiologic links also have been proposed to explain the relationship between these two syndromes. The increasing prevalence of obesity in the United States makes this an increasingly relevant problem. Animal studies support a link between autonomic nervous system (ANS) overactivity and the development of urinary symptoms, low bladder compliance, compensatory prostatic hyperplasia, and blockage of the same using alpha-blockade. There appears to be a significant link between ANS overactivity as part of the metabolic syndrome and LUTS secondary to benign prostatic hyperplasia (BPH). However, it is unlikely that ANS overactivity could be responsible for the development of LUTS. Rather, ANS overactivity plays a key role in increasing the severity of LUTS above an intrinsic basal intensity that is determined by the genitourinary anatomic/pathophysiologic characteristics of each BPH patient. This paper defines metabolic syndrome as a collection of abnormalities, including being overweight (visceral abdominal fat distribution), dyslipidemia, hypertension, impaired glucose metabolism, elevated C-reactive protein (chronic inflammation), and autonomic-sympathetic overactivity, with insulin resistance as the hypothesized underlying pathogenic mechanisms.

  16. Comparison of long-term results of transurethral incision of the prostate with transurethral resection of the prostate, in patients with benign prostatic hypertrophy.

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    Tkocz, Michal; Prajsner, Andrzej

    2002-01-01

    One hundred patients with benign prostatic hypertrophy (BPH) were randomized to transurethral incision (TUIP) or transurethral resection of the prostate (TURP). The average prostate weight before operation was not more than 30.0 g. Indications for the operations were based on the disease history, physical examination, digital rectal examination, laboratory values, and pressure-flow examination. All operations were performed with patients under spinal anesthesia. TUIP was performed with a Collins knife, and TURP was performed with a resectoscope. Follow-up was performed 24 months after the operations. After treatment there were statistically significant daytime and nocturnal reduction in voiding frequencies of 2.9 and 1.7, respectively, after TUIP, and 2.0 and 1.5 after TURP. In both groups, there occurred significantly better maximal flow rate from 7.6 mL/s to 16.9 mL/s in group I and from 6.9 mL/s to 17.6 mL/s in group II. The mean values of linearized passive urethral resistance relation in both groups significantly decreased from 3.6 +/- 0.6 to 1.0 +/- 0.5 after TUIP and from 3.9 +/- 04 to 1.4 +/- 0.5 after TURP. The TUIP procedure is effective and safe for patients with a small number of complications.

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

    Science.gov (United States)

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

    2014-06-01

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

  18. Lower urinary tract symptoms and benign prostatic hyperplasia and their impact on quality of life

    Directory of Open Access Journals (Sweden)

    Antonio Carbone

    2015-11-01

    Full Text Available LUTS is an acronym that refers to symptoms affecting the lower urinary tract, which are very common in elderly subjects (between 60 and 70%, and often associated with, but not always caused by, benign prostatic hypertrophy (BPH. BPH is a chronic condition characterized by an increase in the number of cells, particularly in the transition area of the prostate. BPH involves a compression of the surrounding tissues, consequently obstructing vescical voiding. Nycturia and urgency represent the most prevalent symptoms and those with the greatest impact on quality of life measured as urinary-specific health-related quality. The prevalence of BPH is directly proportional to age; therefore, the absolute number of subjects affected is growing throughout the world. BPH is one of the most common medical conditions affecting those over 50. The overall cost for the diagnosis and treatment of BPH-related LUTS, in the US, has been estimated at approximately 1.1 billion US$/year, compared to total annual expenditure for urological conditions of some 9 billion and this cost continues to increase. The quick prostate test, which was developed by the Italian Urology Society (SIU, is an easy to use instrument that can be utilized in first-level screening for evaluation of the male population with LUTS. This test can be used both in patients not on pharmacological treatment and as a therapy-monitoring instrument. A positive response to one of the questions is sufficient for requesting a more in-depth investigation, which may provide indications on the therapeutic strategy to be taken.

  19. [Additional effect of propiverine for naftopidil-resistant nocturia in the patient with benign prostate hypertrophy].

    Science.gov (United States)

    Kamimura, Noritaka; Hatakeyama, Shingo; Kudo, Shigemasa; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Yoshikawa, Kazuaki; Kawaguchi, Toshiaki; Takahashi, Shinya; Ohyama, Chikara

    2011-02-01

    The efficacy and safety of additional administration of propiverine were prospectively studied for naftopidil-resistant nocturia in patients with benign prostatic hypertrophy (BPH). Patients of 50 years and over with BPH who experienced nocturia twice a night or more and an overall International Prostate Symptom Score (IPSS) of 8 or more were first administered naftopidil (50 or 75 mg/day) for 4 weeks. Thirty subjects who did not show improvement in nocturia and requested further treatment were enrolled in the present study. Propiverine was then administered concomitantly 10 mg/day for 8 weeks. Significant improvement was observed with additional propiverine in the frequency of nocturia on voiding diary, total IPSS, voiding symptom, storage symptom and nocturnal voiding scores. No significant change was observed in the peak urinary flow rate (Qmax), mean urinary flow rate (Qave), voided urine volume, or residual urine volume. Adverse events were dysuria (2 cases), increased residual urine (6 cases), weak urine flow (1 case), thirsty (2 cases), angular cheilitis (1 case). Administration of propiverine was suspended in 7 subjects, 1 following dysuria and 6 following increased residual urine volume. The suspension of propiverine following increased residual urine volume was significantly more prevalent in subjects with pretreatment Qmax values of less than 10 ml/second or in subjects whose prostate specific antigen (PSA) levels were 2 ng/ml or more. In conclusion, the results indicate that additional administration of propiverine may be useful for the patients with BPH who have naftopidil-resistant nocturia. However, caution must be exercised regarding Qmax and PSA levels.

  20. Comparison of the response to treatment between Asian and Caucasian men with benign prostatic hyperplasia: long-term results from the combination of dutasteride and tamsulosin study.

    Science.gov (United States)

    Chung, Byung-Ha; Lee, Seung Hwan; Roehrborn, Claus G; Siami, Paul F; Major-Walker, Kim; Wilson, Timothy H; Montorsi, Francesco

    2012-11-01

    The Combination of Avodart and Tamsulosin study was a 4-year, randomized, double-blind study of the efficacy and safety of dutasteride and tamsulosin, alone or in combination, in men with moderate-to-severe benign prostatic hyperplasia. In this post-hoc investigation, we analyzed primary and secondary end-points from the Combination of Avodart and Tamsulosin study in Asian (n = 325) and Caucasian men (n = 4259). The incidence of acute urinary retention or benign prostatic hyperplasia-related surgery did not differ significantly between treatment groups in the Asian subpopulation. In Caucasian men, the incidence of acute urinary retention/benign prostatic hyperplasia-related surgery was significantly lower in the combination therapy group compared with the tamsulosin monotherapy group (P benign prostatic hyperplasia clinical progression and resulted in improved International Prostate Symptom Score, maximum urinary flow rate, quality of life, and reduced prostate volume in Asian and Caucasian men who received combination therapy compared with tamsulosin monotherapy. Combination therapy also significantly improved (P benign prostatic hyperplasia clinical progression, International Prostate Symptom Score, maximum urinary flow rate and quality of life versus dutasteride in the Caucasian subpopulation. The adverse-event profile was comparable between subpopulations. In conclusion, Asian and Caucasian men respond similarly to these treatments, despite apparent racial differences in 5α-reductase activity.

  1. THE ACTIVITY OF PROTEOLYTIC ENZYMES AND THEIR INHIBITORS IN THE SECRETION OF THE PROSTATE IN ITS BENIGN HYPERPLASIA AND CANCER

    Directory of Open Access Journals (Sweden)

    M. I. Kogan

    2011-01-01

    Full Text Available Background. Prostate-specific antigen is the most commonly used serum marker for the early detection of prostate cancer (PC. However, the specificity of the test is low and accounts for about 20%. The study of the regulatory functions of proteinases and their inhibitors in carcinogenesis is promising in terms of developing methods for the early cancer diagnosis.Objective: to analyze impaired proteolytic processes in the secretion of the prostate in its benign hyperplasia (BPH and PC, by determining the key indicators of the kallikrein-kinin and renin-angiotensin systems and the activity of leukocyte elastase in the prostatic secretion.Subjects and methods. Group 1 included 20 patients with PC (mean age 62.7±2.3 years. Group 2 comprised 20 men with BPH (mean age 62.2±1.4 years. A control group consisted of 20 healthy men (mean age 35.6±4.5 years. The prostatic secretions from the patients of all the groups were used to estimate the indicators of proteolytic systems: kallikrein activity, prekallikrein levels, the inhibitory activity of α1-proteinase inhibitor (α1-PI, and α2-macroglobulin (α2-MG, and the activity of angiotensin-converting enzyme (ACE and elastase and elastase-like activity.Results. Comparative analysis of the specific features of impaired proteolytic processes during benign and malignant prostate processes indicated that in PC the prostatic secretion showed a 39.2% increase in the activity of kallikrein (p < 0.001 and a 41.3% reduction in that of ACE (p < 0.001 as compared to those in BPH, which seems to reflect a decrease in prostatic secretion angiotensin II levels. PC is characterized by a drastic rise in the inhibitory potential of prostatic secretion; for the prostatic secretion activities of α1-PI and α2-MG are 56.9 (p < 0.001 and 96.8% (p < 0.001 respectively, higher than those in BPH. There are 2 statistically significant criteria for PC diagnosis: the activity of kallikrein and ACE with 75.0% specificity and 66

  2. Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Isen, K. [Karaelmas Univ., Zonguldak (Turkey). School of Medicine; Sinik, Z.; Alkibay, T.; Sezer, C.; Soezen, S.; Atilla, S.; Ataoglu, O.; Isik, S.

    2001-02-01

    The purpose of this study was to determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate unltrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. The mean stromal percentage was 60.5{+-}18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P<0.05). Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer. (author)

  3. 合并前列腺炎的良性前列腺增生症的临床分析%Clinical analysis of benign prostatic hyperplasia combined with prostatitis

    Institute of Scientific and Technical Information of China (English)

    崔博; 叶纯; 王健

    2016-01-01

    Objective To analyze the clinical characteristics of benign prostatic hyperplasia combined with prostatitis, and to provide guidance for the clinical treatment of benign prostatic hyperplasia. Methods 90 cases of benign prostatic hyperplasia patients admitted to our hospital from December 2015 to May 2011 were selected as the research subjects of this study, 76 cases among them with benign prostatic hyperplasia combined with prostatitis, 14 patients with simple benign prostatic hyperplasia. Clinical datas of 90 cases of benign prostatic hyperplasia patients were retrospective analysis. The course of disease, age, PSA, IPSS and prostate volume of benign prostatic hyperplasia patients combined with prostatitis and patients with benign prostatic hyperplasia were analyzed and compared. Results Through the comparison between simple benign prostatic hyperplasia patients and patients with benign prostatic hyperplasia ( BPH) and prostatitis, the differences of the course of disease, age, PSA and IPSS and the volume of the prostate between groups were statistically significant, P<0.05. PSA, IPSS score and prostatic volume of patients ( with benign prostatic hyperplasia combined with prostatitis ) in different classification were different, P<0. 05. Conclusions There is a strong positive correlation between prostatitis and benign prostatic hyperplasia, and the higher the prostatitis grade is, the serious the benign prostatic hyperplasia.%目的:分析合并前列腺炎的良性前列腺增生症的临床特点,为临床提供指导。方法抽取入住我院的90例良性前列腺增生症患者(2011年5月至2015年12月)作为本次实验的研究对象,其中有76例良性前列腺增生症患者合并前列腺炎,有14例患者为单纯良性前列腺增生症,对90例良性前列腺增生症患者的临床资料进行回顾性分析。分析比较单纯良性前列腺增生症患者和合并前列腺炎的良性前列腺增生症患者的病程、年龄、PSA、IPSS

  4. APPLICATION OF TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR PATIENTS WITH ACUTE URINARY RETENTION AND SEVERE COMBINED COMORBIDITY FROM BENIGN PROSTATIC HYPERPLASIA

    Directory of Open Access Journals (Sweden)

    A. Mysak

    2014-12-01

    Conclusions. Taking into consideration the minimally invasive nature, favourable tolerability and absence of adverse effects, TUMT can be considered a method of choice in patients with BPH-triggered AUR and contraindications to major surgical treatments and general anaesthesia. Remote outcomes of TUMT may be evaluated as satisfactory, with good effects in 71.62% patients. However in prostatic volumes exceeding 85 cm3 and pronounced intravesical pattern of BPH growth the efficcacy of TUMT is arguable. KEY WORDS: benign prostatic hyperplasia, acute urinary retention, transurethral microwave hermotherapy.

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

    Science.gov (United States)

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

    2014-01-01

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

  6. Contribution of Diagnostic Tests and Drug Therapy in Screening of Benign Prostatic Hyperplasia (BPH) in Western Algerian Hospital

    OpenAIRE

    Abdelkrim Berroukche; Abderahmane Labani; Mohamed Terras

    2014-01-01

    The incidence of benign prostatic hyperplasia (BPH) is known through the American and European continents whereas it remains much to make to know the epidemiologic profile of this pathology in Algeria. This study aims to show a contribution of diagnostic tests and drug therapy in screening of BPH in Western Algerian hospital. Our study was carried out on 385 men recruited in the Urology department of Saida hospital during the period 2010-2013, consulting for urologic problems whose 120 patien...

  7. Tamsulosin oral controlled absorption system (OCAS in the treatment of benign prostatic hypertrophy

    Directory of Open Access Journals (Sweden)

    Mischel G Neill

    2008-03-01

    Full Text Available Mischel G Neill, Rohan Shahani, Alexandre R ZlottaDivision of Urology, Department of Surgical Oncology, Princess Margaret and Mount Sinai Hospitals, University of Toronto, Toronto, CanadaAbstract: The efficacy of tamsulosin at the cost of a relatively benign side effect profile has been attributed to receptor selectivity directed at the α1a and α1d adrenergic receptor subtypes. The oral-controlled absorption system (OCAS® represents a drug delivery refinement that incorporates a matrix of gel-forming and gel-enhancing agents to promote a constant drug release independent of environmental food or fluid. There are clinical data to support the concept that drug peaks are lessened and that drug release continues throughout the alimentary tract due to the OCAS formulation. Furthermore this equates with less adverse effects on physiologic parameters. To date however improvements in cardiovascular symptoms such as dizziness, headache and syncope have not been demonstrated in healthy men. Ejaculatory dysfunction appears less problematic with the OCAS preparation. Tamsulosin OCAS may be of greatest benefit to men with cardiovascular co-morbidities taking anti-hypertensive medications that might predispose them to symptomatic hypotensive episodes. It will be necessary to evaluate this group of men more closely in further trials to determine what they stand to gain from changing medications, and then relate this to drug costs to draw a final conclusion as to the place of tamsulosin OCAS in contemporary urological practice.Keywords: lower urinary tract symptoms, benign prostatic hyperplasia, tamsulosin OCAS, safety, efficacy, tolerability

  8. Efficacy and safety of tamsulosin for the treatment of benign prostatic hyperplasia: a meta analysis

    Institute of Scientific and Technical Information of China (English)

    REN Rui-min; KOU Min; LAN Xiao-xu

    2010-01-01

    Background Pharmacological therapy has been considered as the first-line treatment for patients with uncomplicated benign prostatic hyperplasia (BPH). The aim of this study was to evaluate the efficacy and safety of tamsulosin compared with a placebo for treating BPH. Methods The randomized placebo-controlled trials (RCT) of tamsulosin for the treatment of BPH from all over the world were searched. PubMed, Ovid, ScienceDirect, EBSCO, CBM, and CNKI were searched, as well as a manual search of four Chinese journals: Chinese Journal of Andrology, National Journal of Andrology, Chinese Journal of Urology, and Journal of Clinical Urology was also performed. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Divergences of opinions were settled by discussion. Meta-analysis was processed by Rev Man 5.0 software, fail-safe number was performed by SAS8.0 software. Results Seven RCTs involving 2455 men met the inclusion criteria. The basic characteristics of patients were comparable in all the studies. Comparing three common criteria: international prostate symptom score (IPSS)/Boyarsky symptom score, maximum flow rate (MFR), quality of life (QOL), tamsulosin was better than placebo at improving IPSS and MFR, with no significant difference in the QOL. Adverse events of tamsulosin also showed no significant difference from the placebo group (Z=1.62, P=0.10, OR=1.22, 95% CI 0.96-1.54).Conclusions Tamsulosin is better than placebo at improving IPSS and MFR. Adverse events of tamsuloisn show no significant difference compared with placebo. More high quality trials with larger samples and longer follow-up are proposed.

  9. Holmium laser assisted ′anatomical′ enucleation of adenoma of benign hyperplasia of prostate

    Directory of Open Access Journals (Sweden)

    Shivadeo S Bapat

    2006-01-01

    Full Text Available Aims: To present our technique of Holmium Laser assisted "ANATOMICAL" enucleation of the benign prostatic adenoma (HoLEP in 219 patients. Procedure is based on the principle of digital enucleation of the adenoma from its surgical capsule, but performed entirely by perurethral endoscopic technique assisted by Holmium Laser. Materials and Methods: From March 2001 to November 2004, 219 patients under went HoLEP. After the initial cuts from bladder neck to verumontanum at 5 and 7 o′clock position, capsule is identified. The beak of the resectoscope sheath was inserted in the plane between the capsule and the adenoma and the adenoma was physically pushed away towards the urethra from the capsule. Laser was used to coagulate the bleeders, to cut the mucosal attachments and tough stromal tissue. Procedure was repeated for median and two lateral lobes. There was minimal bleeding and fluid absorption. Complications were few. Results: In 206 cases successful enucleation of the adenoma was carried out. First 13 cases formed part of the learning curve and were completed by standard transurethral resection of prostate (TURP. IPSS score dropped from average of 23 to 8 and peak flow improved from 20. No patient had postoperative urinary incontinence or stricture. Conclusions: HoLEP is an effective alternative to TURP. Ultimate end results replicate the end results of open enucleation of BPH without its morbidity and have all the advantages of endoscopic surgery. It offers distinct advantages over standard TURP as the incidence of blood transfusion and fluid absorption are greatly minimized.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  11. Dihydroquercetin effects on the morphology and antioxidant/prooxidant balance of the prostate in rats with sulpiride-induced benign hyperplasia.

    Science.gov (United States)

    Borovskaya, T G; Krivova, N A; Zaeva, O B; Fomina, T I; Kamalova, S I; Poluektova, M E; Vychuzhanina, A V; Shchemerova, Yu A; Grigor'eva, V A; Goldberg, V E; Plotnikov, M B

    2015-02-01

    A course of dihydroquercetin (antioxidant) injections to 5-month-old Wistar rats with sulpiride-induced benign prostatic hyperplasia led to reduction of proliferative activity in the glandular structures and to attenuation of the inflammatory reaction in the tissue. Prostatic antioxidant/prooxidant balance returned to normal after the treatment.

  12. A comparison of transrectal hyperthermia, transurethral thermotherapy, urolume wallstent, and prostatic spiral for benign prostatic hyperplasia patients at poor operative risk.

    Science.gov (United States)

    Montorsi, F; Guazzoni, G; Bergamaschi, F; Consonni, P; Galli, L; Rigatti, P

    1994-01-01

    Transrectal hyperthermia, transurethral thermotherapy, prostatic stent, and prostatic spiral were used to treat 120 poor operative risk patients with symptomatic benign prostatic hyperplasia. The preoperative subjective and objective conditions of the four groups (each of 30 patients) were comparable. None of the patients had an indwelling catheter, but according to flow nomograms, all were obstructed. The greatest increase in peak flow rate was observed after stent placement, while the greatest decrease of residual urine volume was seen after the insertion of the stent and transrectal hyperthermia. According to maximum flow nomograms, only the placement of the stent resolved bladder outlet obstruction. The greatest improvement in subjective symptoms was the result of stent insertion, but the heating procedures also caused a significant reduction of symptom scores. The spiral produced satisfactory results only in the short term.

  13. [A randomized comparative study assessing once versus twice a day treatment of benign prostatic hyperplasia with terazosin].

    Science.gov (United States)

    Suzuki, H; Ohnishi, T; Ikemoto, I; Ohishi, Y; Suzuki, Y; Yamazaki, H

    2001-02-01

    We compared the efficacy of once a day administration of terazosin hydrochloride with that of twice a day administration for benign prostatic hyperplasia (BPH) patients. Forty-two patients with BPH were randomly assigned to receive a maximum dose of 2 mg terazosin either once (n = 21) or twice (n = 21) a day. International prostate symptom score (IPSS), uroflowmetry and side effect profile were determined before and 4 weeks after randomization. Both groups were similar with respect to patient age, baseline IPSS and prostate volume. After 4 weeks of treatment with terazosin, significant improvement in IPSS, maximum flow rate and mean flow rate were observed in both groups. However, these improvements did not differ significantly between them. In addition, there were no differences in side effects between the groups. In conclusion, once a day administration of terazosin hydrochloride is as effective and safe as twice a day administration in patients with BPH.

  14. Comparative evaluation of Prostina and terazosin in the treatment of benign prostatic hyperplasia.

    Science.gov (United States)

    Dogra, Prem N; Biswas, Nihar R; Ravi, Alok K; Mani, Kalaivani; Kumar, Vinod

    2005-02-01

    The objective of the present study was to evaluate the efficacy and safety of Prostina, a multi-ingredient herbal formulation in benign prostatic hyperplasia (BPH) in comparison with terazosin. A randomised, open, parallel, controlled clinical trial was carried out in ambulatory men aged between 40-80 years suffering from BPH, with American Urological Association (AUA) symptom index score of at least 8 or more at recruitment. One group received 2 Prostina capsules twice daily for 12 weeks; the other received terazosin 2 mg at bedtime for 12 weeks. Urodynamic parameters, AUA score, biochemical and clinical adverse effects were assessed. Twenty subjects completed the study in Prostina group and 20 in terazosin group. The groups were comparable at baseline in age and assessment criteria. Majority of urodynamic parameters showed improving trends in both the groups. AUA symptom score declined significantly from 19.50 +/- 1.40 (mean +/- standard error) to 1.04 +/- 0.68 in Prostina group and from 16.95 +/- 1.23 to 4.14 +/- 0.88 in terazosin group. The AUA symptom score in 12 weeks follow-up was significantly lower in Prostina group than terazosin group (p = 0.005). Other laboratory-parameters remained unaltered in both the groups. Prostina is as effective as terazosin in providing symptomatic relief in BPH.

  15. Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected?

    Directory of Open Access Journals (Sweden)

    Alberto A. Antunes

    2009-12-01

    Full Text Available Objective: To assess the impact of the percent of resected tissue on the improvement of urinary symptoms. Materials and methods: The study included a prospective analysis of 88 men with benign prostatic hyperplasia. Patients were divided in three groups according to the percent of resected tissue: Group 1 50%. Each patient was re-evaluated 3 months after surgery. We assessed the international prostatic symptom score, nocturia and serum prostate specific antigen levels. Results: All patients presented a significant decrease on mean International Prostate System Score (IPSS (23 to 5.9, Quality of Life (QoL (4.9 to 1.0 and nocturia (3.2 to 1.9. Variation in the IPSS was 16.7, 16.6 and 18.4 for patients from Group 1, 2 and 3 respectively (P = 0.504. Although the three groups presented a significant decrease in QoL, patients in Group 3 presented a significantly greater decrease when compared to Group 1. Variation in QoL was 3.1, 3.9 and 4.2 for patients from Group 1, 2 and 3 respectively (p = 0.046. There was no significant difference in nocturia variation according to the percent of resected tissue (p = 0.504. Median pre and postoperative PSA value was 3.7 and 1.9 ng/mL respectively. Patients from Group 1 did not show a significant variation (p = 0.694. Blood transfusions were not required in any group. Conclusions:Resection of less than 30% of prostatic tissue seems to be sufficient to alleviate lower urinary tract symptoms related to benign prostate hyperplasia. However, these patients may not show a significant decrease in serum PSA level.

  16. Prostate Ultrasound

    Medline Plus

    Full Text Available ... as detailed as with the transrectal probe. An MRI of the pelvis may be obtained as an ... Benign Prostatic Hyperplasia (BPH) Prostate Cancer Ultrasound- and MRI-Guided Prostate Biopsy Images related to Ultrasound - Prostate ...

  17. 下尿路症候群与前列腺疾病%Lower urinary tract symptoms and benign prostatic diseases

    Institute of Scientific and Technical Information of China (English)

    高建平

    2005-01-01

    下尿路症候群(lower urinary tract symptoms,LUTS)是所有排尿障碍的总称。良性前列腺增生症(benign prostatich yperplasia,BPH),良性前列腺肥大症(benign prostatic enlargement,BPE)和良性前列腺梗阻(benign prostatic obstruction,BPO)是老年男性中能引起LUTS最常见的疾病,自然病程多为缓慢进行性发展,

  18. Examination of CK2α and NF-κB p65 expression in human benign prostatic hyperplasia and prostate cancer tissues.

    Science.gov (United States)

    Qaiser, Fatima; Trembley, Janeen H; Sadiq, Sarah; Muhammad, Iqbal; Younis, Rubina; Hashmi, Shoaib Naiyar; Murtaza, Badar; Rector, Thomas S; Naveed, Abdul Khaliq; Ahmed, Khalil

    2016-09-01

    Protein kinase CK2 plays a critical role in cell growth, proliferation, and suppression of cell death. CK2 is overexpressed, especially in the nuclear compartment, in the majority of cancers, including prostate cancer (PCa). CK2-mediated activation of transcription factor nuclear factor kappa B (NF-κB) p65 is a key step in cellular proliferation, resulting in translocation of NF-κB p65 from the cytoplasm to the nucleus. As CK2 expression and activity are also elevated in benign prostatic hyperplasia (BPH), we sought to increase the knowledge of CK2 function in benign and malignant prostate by examination of the relationships between nuclear CK2 and nuclear NF-κB p65 protein expression. The expression level and localization of CK2α and NF-κB p65 proteins in PCa and BPH tissue specimens was determined. Nuclear CK2α and NF-κB p65 protein levels are significantly higher in PCa compared with BPH, and these proteins are positively correlated with each other in both diseases. Nuclear NF-κB p65 levels correlated with Ki-67 or with cytoplasmic NF-κB p65 expression in BPH, but not in PCa. The findings provide information that combined analysis of CK2α and NF-κB p65 expression in prostate specimens relates to the disease status. Increased nuclear NF-κB p65 expression levels in PCa specifically related to nuclear CK2α levels, indicating a possible CK2-dependent relationship in malignancy. In contrast, nuclear NF-κB p65 protein levels related to both Ki-67 and cytoplasmic NF-κB p65 levels exclusively in BPH, suggesting a potential separate impact for NF-κB p65 function in proliferation for benign disease as opposed to malignant disease.

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

    Science.gov (United States)

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

    2015-01-01

    To evaluate the efficacy and safety of plasmakinetic resection of the prostate (PKRP) versus transurethral resection of the prostate (TURP) for the treatment of patients with benign prostate hyperplasia (BPH), a meta-analysis of randomized controlled trials was carried out. We searched PubMed, Embase, Web of Science and the Cochrane Library. The pooled estimates of maximum flow rate, International Prostate Symptom Score, operation time, catheterization time, irrigated volume, hospital stay, transurethral resection syndrome, transfusion, clot retention, urinary retention and urinary stricture were assessed. There was no notable difference in International Prostate Symptom Score between TURP and PKRP groups during the 1-month, 3 months, 6 months and 12 months follow-up period, while the pooled 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.

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

    Directory of Open Access Journals (Sweden)

    Kai Wang

    2015-02-01

    Full Text Available 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.

  1. Stereological evaluation of fibronectin in the periurethral region of the transitional zone from normal human prostates compared with benign prostatic hyperplasia.

    Science.gov (United States)

    Manaia, Jorge H M; Cardoso, Gilberto P; Babinski, Marcio A

    2015-01-01

    The aim of this study was to assess the volumetric density (Vv) of the fibronectin in the periurethral region of patients with benign prostatic hyperplasia (BPH) and compare with a control group. Prostatic periurethral tissue samples were obtained from ten patients (age range 65 to 79 years, mean 66) with clinical symptoms of bladder outlet obstruction who had undergone open prostatectomy. The control group samples (periurethral tissue samples from the transitional zone) were collected from prostates obtained during autopsy of accidental death adults of less than 25 years. The volumetric density (Vv) of the fibronectin was determined with stereological methods from 25 random fields per sample using the point-count method with an M-42 grid test system. The quantitative data were analyzed using the Kolmogorov-Smirnov and Mann-Whitney U tests. The Vv in the control and BPH groups was 21.9% ± 1.5% and 29.1% ± 1.2% in the fibronectin, respectively. BPH tissues presented a significant increase of fibronectin in prostatic periurethral region in the transitional zone that may cause lengthening of the prostatic urethra.

  2. Diagnostic and predictive value of voiding diary data versus prostate volume, maximal free urinary flow rate, and Abrams-Griffiths number in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

    NARCIS (Netherlands)

    van Venrooij, Ger E. P. M.; van Melick, Harm H. E.; Eckhardt, Mardy D.; Boon, Tom A.

    2008-01-01

    OBJECTIVES To investigate the information of voiding data in relation to symptoms and well-being in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and to compare this information with that of prostate volume (Vprostate), maximal free urinary flow rate (

  3. Multiple factors related to detrusor overactivity in Chinese patients with benign prostate hyperplasia

    Institute of Scientific and Technical Information of China (English)

    LIU Ning; MAN Li-bo; HE Feng; HUANG Guang-lin; WANG Hai; LI Gui-zhong; WANG Jian-wei; L(U) Yan-wei

    2012-01-01

    Background Detrusor overactivity (DO) is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia (BPH) patients.We sought to investigate the clinical and urodynamic factors that are associated with the presence of DO in Chinese BPH patients.Methods Two hundred and eighty-seven consecutive patients with clinical BPH were retrospectively evaluated in this study.Each patient underwent urodynamic evaluation and completed the International Prostate Symptom Score (IPSS)and Quality of Life (QoL) questionnaire.Patients with neurological symptoms or other diseases likely to affect detrusor functions were strictly excluded.The 184 BPH patients included in the study were divided into groups according to the presence of DO as shown in urodynamic tests.Univariate analysis of factors associated with the presence of DO were performed using Student's t-test and the Mann-Whitney test; multivariate analysis used stepwise Logistic regressions.The relationship between degree of bladder outlet obstruction (BOO) and DO was also investigated using a linear-by-linear association test.Results Of 184 BPH patients,DO was present in 76 (41.3%).On univariate analysis,patients with DO were older (P=0.000),and showed smaller maximal bladder capacity (MBC,P=0.000) and voided volume (P=0.000),higher maximal detrusor pressure (P=0.000) and projected isovolumetric pressure (PIP) (P=0.005),higher Abrams-Griffiths number (P=0.000) and degree of bladder outlet obstruction (P=0.000),higher IPSS (P=0.000) and irritative IPSS subscores (P=0.000).Stepwise Logistic regression analysis showed that PIP (OR=1.012,95% CI1.002-1.023,P=0.019),age (OR=1.030,95% CI 1.005-1.067,P=0.059),and MBC (OR=0.993,95% CI 0.990-0.996,P=0.000)were independent risk factors for DO in BPH patients.Linear-by-linear association tests indicated a positive linear association between DO and severity of BOO,with incidence of DO increasing with BOO grade (P=0.000).Conclusions In

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

    Science.gov (United States)

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

    2015-03-01

    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 β 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.

  5. Combination of signal intensity measurements of lesions in the peripheral zone of prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Engelhard, K.; Kreckel, M. [Department of Radiology, Martha-Maria Hospital Nuernberg (Germany); Hollenbach, H.P.; Deimling, M. [Siemens Medical Engineering Group, Erlangen (Germany); Riedl, C. [Dept. of Urology, University of Erlangen-Nuernberg, Erlangen (Germany)

    2000-12-01

    The aim of this study was to predict the benign or malignant nature of a prostatic lesion by defining a threshold value of signal intensity ratio and a limiting value of serum prostate-specific antigen (PSA) in patients with elevated PSA level. Twenty-six patients with elevated PSA level and no hypoechogenic lesions at endosonography underwent MR imaging using an endorectal body phased-array coil at 1.5 T (Siemens Magnetom Symphony). A T2-weighted turbo-spin-echo (TSE) pulse sequence was applied in a transverse orientation. Two radiologists evaluated the images. In the presence of a pathological finding they defined regions of interest (ROI) in the suspicious pathological area of the peripheral zone and in muscle for reference. The quotient of the two ROIs was calculated and then correlated with the actual PSA level. Diagnosis was confirmed by prostate biopsy. Ten of 12 patients with quotients smaller than 4 showed cancer at histology. Nine of 12 men with cancer proven by biopsy had PSA levels higher than 10 ng/ml. A significant difference (p < 0.001) was found between the quotients of cancer and quotients of chronic prostatitis, fibrosis, or glandular atrophy. The accuracy of tumor differentiation of the method was 77 %. Measurement of signal intensity quotients in the peripheral zone of the prostate in combination with knowledge of defined limits of PSA levels the technique could be helpful in detecting additional cancer areas for prostate biopsy. False-negative tumor results of standard sextant biopsy can be reduced. In men with high PSA values the method has a role in differentiating between patients who require prostate biopsy and those of clinical observation. (orig.)

  6. Correlation between molecular biomarkers and risk factors for the clinical progression of benign prostatic hyperplasia using tissue microarray immunostaining

    Institute of Scientific and Technical Information of China (English)

    Ma Ding; Yang Bing; Zhou Zhe; Pan Dongliang; Zhang Xianghua

    2014-01-01

    Background The pathogenesis of benign prostatic hyperplasia (BPH) has been widely studied,and several biomarkers are known to play roles in its development.This study aimed to investigate the possible role of cysteine-rich protein 61 (CYR61),vascular endothelial growth factor (VEGF),androgen receptor (AR),interleukin-6 (IL-6),cytochrome c,caspase-3,and proliferating cell nuclear antigen (PCNA) in the clinical progression of BPH.Methods Tissue specimens from 96 BPH cases who underwent transurethral resection of the prostate were processed and transferred to tissue microarrays.Patient age,prostate volume,serum prostate-specific antigen (PSA) level,and International Prostate Symptom Score (IPSS) of all BPH cases were collected before surgery.The expression of CYR61,VEGF,AR,IL-6,cytochrome c,caspase-3,and PCNA was examined by immunostaining in the BPH specimens,and any possible correlation between the different biomarkers and risk factors for BPH clinical progression was analyzed.Results The expression of CYR61,VEGF,AR,IL-6,cytochrome c,caspase-3,and PCNA in the BPH cases was 68.8% (66/96),77.1% (74/96),43.8% (42/96),31.3% (30/96),35.4% (34/96),56.3% (54/96),and 29.2% (28/96),respectively.The expression of both CYR61 and VEGF was positively correlated with patient age,prostate volume,and serum PSA level (P <0.05).Furthermore,cytochrome c and caspase-3 expression were inversely related to prostate volume (P <0.05),and AR expression was positively related to serum PSA level (P <0.05).Conclusion CYR61 and VEGF expression might serve as biomarkers for predicting the clinical progression of BPH due to effects on stromal cell proliferation and angiogenesis.

  7. Giant prostatic hyperplasia: report of a previously asymptomatic man presenting with gross hematuria and hypovolemic shock.

    Science.gov (United States)

    Wroclawski, Marcelo Langer; Carneiro, Ariê; Tristão, Rodrigo Alves; Sakuramoto, Paulo Kouiti; Youssef, Jorg Daoud Merched; Lopes Neto, Antonio Correa; Santiago, Lucila Heloísa Simardi; Pompeo, Antonio Carlos Lima

    2015-01-01

    Giant prostatic hyperplasia is a rare condition characterized by very high volume benign prostatic enlargement (>500g). Few cases have been reported so far and most of them are associated with severe lower urinary symptoms. We report the first case of asymptomatic giant prostatic hyperplasia in an elderly man who had a 720g prostate adenoma, sudden gross hematuria and hypovolemic shock. The patient was successfully treated with open transvesical prostatectomy and had an uneventful postoperative recovery.

  8. Lifetime occupational and recreational physical activity and risk of benign prostatic hyperplasia.

    Science.gov (United States)

    Dal Maso, Luigino; Zucchetto, Antonella; Tavani, Alessandra; Montella, Maurizio; Ramazzotti, Valerio; Polesel, Jerry; Bravi, Francesca; Talamini, Renato; La Vecchia, Carlo; Franceschi, Silvia

    2006-05-15

    To investigate the relation between occupational and recreational physical activity (PA) in different periods of life and the risk of benign prostatic hyperplasia (BPH), we conducted a hospital-based, case-control study in Italy. The study included 1,369 histologically confirmed BPH and 1,451 controls, admitted to the same hospitals for acute, nonneoplastic diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) of BPH, according to lifetime PA, were obtained by unconditional multiple logistic regression models, including terms for age, study center and education. Compared to the lowest level of occupational PA, the multivariate ORs for BPH for the heavy/strenuous level were 0.6 (95% CI, 0.4-0.8) at age 15-19, 0.6 (95% CI, 0.4-0.8) at age 30-39 and 0.7 (95% CI, 0.5-0.9) at age 50-59. Moreover, compared to or=5 hr/week) were 0.5 (95% CI, 0.4-0.7) at age 15-19, 0.6 (95% CI, 0.5-0.8) at age 30-39, and 0.7 (95% CI, 0.5-0.8) at age 50-59. All inverse trends in risk were significant, and no heterogeneity was found by reason of BPH-diagnosis, age at diagnosis, and body mass index (BMI). The inverse association between PA and BPH risk may be due to favorable hormonal correlates of PA, but residual confounding by socioeconomic covariates cannot be excluded. A moderate PA at any ages may help reducing a sizeable number of BPH.

  9. Preparation, characterization and stability study of dutasteride loaded nanoemulsion for treatment of benign prostatic hypertrophy.

    Science.gov (United States)

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

    2014-01-01

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

  10. Clinical outcome following a low-suspicion multiparametric prostate MRI or benign MRI-guided biopsy to detect prostate cancer

    DEFF Research Database (Denmark)

    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke;

    2017-01-01

    predictive values of MRI in ruling out any prostate cancer and significant prostate cancer defined as: a) any core with Gleason score (GS) > 6 or b) > 2 positive cores/cancerous core ≥ 50%. RESULTS: Prostate cancer was detected in 38/194 (20%) patients during the median study period of 47 months...... (interquartile range 43-52). The overall negative predictive value of MRI in ruling out any and significant prostate cancer was 80% (156/194) and 95% (184/194), respectively. No patient with a low-suspicion MRI had intermediate/high grade cancer (Gleason score > 6). The majority of patients with no cancer during...

  11. A comparison of the efficacy of naftopidil and tamsulosin hydrochloride in medical treatment of benign prostatic enlargement

    Directory of Open Access Journals (Sweden)

    Chenthil Perumal

    2015-01-01

    Conclusion: It was seen that during the period of follow-up of 30 days naftopidil had a better effect on UFM, PVR, IPSS compared with tamsulosin. In general, obstructive symptoms showed better improvement in tamsulosin and irritative symptoms showed better improvement in naftopidil.

  12. Efficacy and safety of bipolar plasma vaporization of the prostate with "button-type" electrode compared with transurethral resection of prostate for benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shi-ying; HU Hao; ZHANG Xiao-peng; WANG Dong; XU Ke-xin; NA Yan-qun; HUANG Xiao-bo; WANG Xiao-feng

    2012-01-01

    Background Transurethral resection of prostate (TURP) has been considered as the standard treatment for benign prostatic hyperplasia (BPH).However,issues that have not yet been overcome for TURP include bleeding and absorption of irrigation fluid.Thus,novel improvement of the surgery is necessary.This study aimed to evaluate the efficacy and safety of bipolar plasma vaporization of the prostate (BPVP) with "button-type" electrode against standard TURP for BPH.Methods From January 2009 to January 2012,30 patients who scheduled for surgical treatment of BPH surgical treatment were enrolled in the trial with provided consent for the study.Patients were prospectively randomized 1∶1 to undergo either BPVP or TURP.Participants were blinded to the randomization scheme.All cases were assessed preoperatively and followed at 1,3,and 6 months postoperatively by indwelling catheter time,blood loss,hospital stays,International Prostate Symptom Score (IPSS),quality of life (QOL),and Qmax.Results BPVP was significantly superior to TURP in terms of indwelling catheter time ((4.1±4.1) days vs.(6.8±6.8)days,P=0.000),blood loss ((64.7±103.8) ml vs.(254.7±325.4) ml,P=0.040),hospital stay ((8.7±1.0) days vs.(11.7±1.5)days,P=0.000),IPSS ((4.2±8.0) vs.(9.3±3.7),P=0.049),QOL ((1.5±0.8) vs.(2.6±1.4),P=0.027),Qmax ((16.3±5.7) ml/s vs.(12.5±3.1) ml/s,P=0.038),hemoglobin ((130.7±9.4) g/L vs.((122.1±11.9) g/L,P=0.047),Na+ level ((138.6±2.1)mmol/L vs.((137.2±2.0) mmol/L,P=0.046) and operation time ((39.0±15.5) minutes vs.((69.3±24.8) minutes,,P=0.004).And there were no statistical differences between BPVP group and TURP group in preoperatively assessment:patient's age ((70.9±7.1) years vs.(71.9±6.1) years,P=0.736),IPSS ((24.6±4.7) vs.(27.3±5.9),P=0.100),QOL ((5.1±0.8) vs.(5.1±1.0),P=0.940),Qmax ((4.4±2.7) ml/s vs.(5.3±2.6) ml/s,P=0.314),hemoglobin ((137.4±8.7) g/L vs.(139.2±10.4)g/L,P=0.623),Na+ level ((140.5±1.8) mmol/L vs.(141.3±1.4) mmol/L,P=0.192) and

  13. Impact of alpha 1-adrenergic antagonist use for benign prostatic hypertrophy on outcomes in patients with heart failure.

    Science.gov (United States)

    Dhaliwal, Amandeep S; Habib, Gabriel; Deswal, Anita; Verduzco, Melinda; Souchek, Julianne; Ramasubbu, Kumudha; Aguilar, David; Ma, Tony S; Jneid, Hani M; Bolos, Mariana; Bozkurt, Biykem

    2009-07-15

    Previous clinical trials have shown that alpha(1)-adrenergic antagonists are not effective in subjects with heart failure (HF) and might increase HF rates when used for hypertension. However, alpha(1)-adrenergic antagonists may be prescribed to subjects with HF who have symptomatic benign prostatic hyperplasia. We sought to determine any association between alpha(1)-adrenergic antagonist use, commonly prescribed for benign prostatic hyperplasia, and the clinical outcomes of subjects with HF receiving contemporary therapy. An existing database of 388 subjects with decompensated HF admissions from 2002 to 2004 at the Veterans Affairs Hospital was analyzed according to the use of alpha(1)-adrenergic antagonists at discharge. Covariate-adjusted Cox proportional hazard models were used to examine any association with future admissions for decompensated HF and total mortality. Alpha-1-adrenergic antagonist therapy was prescribed in 25% of our HF population, predominantly for benign prostatic hyperplasia, and was not associated with significant increases in the combined risk of all-cause mortality and rehospitalization for HF (hazard ratio 1.24, 95% confidence interval 0.93 to 1.65, p = 0.14), HF hospitalization (hazard ratio 1.20, 95% confidence interval 0.85 to 1.70, p = 0.31), or all-cause mortality (hazard ratio 1.10, 95% confidence interval 0.78 to 1.56, p = 0.57). In patients not receiving beta-blocker therapy, alpha(1)-adrenergic antagonist therapy was significantly associated with increased HF hospitalizations (hazard ratio 1.94, 95% confidence interval 1.14 to 3.32, p = 0.015). In conclusion, in patients with chronic HF, the use of alpha(1)-adrenergic antagonists was significantly associated with more HF hospitalizations when prescribed without concomitant beta blockade. Thus, background beta-blocker therapy appears to be protective against the potential harmful effects of alpha(1)-adrenergic antagonist therapy in patients with HF.

  14. The Role of Minimally Invasive Surgical Techniques in the Management of Large-gland Benign Prostatic Hypertrophy.

    Science.gov (United States)

    Sivarajan, Ganesh; Borofsky, Michael S; Shah, Ojas; Lingeman, James E; Lepor, Herbert

    2015-01-01

    Lower urinary tract symptoms (LUTS) secondary to benign prostatic hypertrophy (BPH) are among the most common medical issues for aging men. Population-based studies suggest that 13.8% of men in their 40s and more than 40% of men over age 60 have BPH. When LUTS are refractory to medical therapy and bothersome enough to warrant surgical intervention, transurethral resection of the prostate and open simple prostatectomy have been the historical reference-standard procedures for decades. Both procedures are highly effective and offer durable improvements in urinary functional outcomes. However, they also have the potential for considerable perioperative complications and morbidity. In an effort to limit surgical morbidity, a variety of minimally invasive surgical techniques to treat BPH have been introduced. Herein we present a comprehensive, evidence-based review of the efficacy and safety profile of modern minimally invasive treatments for large-gland BPH.

  15. Comparison of the clinical efficacy of medical treatment of symptomatic benign prostatic hyperplasia between normal and obese patients

    Institute of Scientific and Technical Information of China (English)

    Seung Hwan Lee; Cheol Young Oh; Kyung Kgi Park; Mun Su Chung; Se Jeong Yoo; Byung Ha Chung

    2011-01-01

    @@ We aimed to investigate the difference in efficacy of medical treatment of symptomatic benign prostatic hyperplasia (BPH) between normal and obese patients with BPH; obesity was determined by either body mass index (BMI) or waist circumference (WC).In this 12-week prospective observational study,a total of 175 patients aged >,40 years with International Prostate Symptom Scores (IPSS))12 points and prostate volume ≧20ml were prospectively enrolled.The patients were divided into two groups according to BMI orWC.Patients received the doxazosin gastrointestinal therapeutic system (GITS) at a dose of 4 mg once per day for 12 weeks.The changes from baseline in the IPSS,maximal urinary flow rate (Qmax),post-void residual volume,quality of life (QoL) scores and adverse events (AEs) were analysed.Of the 175 enrolled patients,132 completed the study.Sixty-seven patients had BMI >23kg m-2,and 43 had WC>90 cm.Obese patients represented by WC>90 cm or BMI≧23kg m-2 had a significantly greater prostate volume compared with non-obese patients at baseline.Total IPSS was significantly higher in the WC >90 cm group compared to the WC≦90 cm group.Total IPSS was positively correlated with prostate volume (P=0.031) and WC (P=0.045).All groups showed significant improvements in total I PSS and QoL at 12 weeks.However,the improvement of total IPSS was greater in the high-BMI and high-WC groups.The most frequent AE was dizziness (n=13),and it was significantly lower in the obese BPH patients.Obesity was associated with increased prostate volume and lower urinary tract symptoms.Alpha-blockers appear to be efficacious for controlling symptoms,especially in obese men.

  16. Effects of Kangquan Recipe(康泉方) on Sex Steroids and Cell Proliferation in Rats with Benign Prostatic Hyperplasia

    Institute of Scientific and Technical Information of China (English)

    黄源鹏; 杜建; 洪振丰; 陈治卿; 吴锦发; 赵锦燕

    2009-01-01

    Objective:To investigate the effects of Kangquan Recipe(康泉方,KQR)on sex steroids and cell proliferation in an experimental benign prostatic hyperplasia(BPH)model in rats.Methods:Seventy-two SD rats were randomly divided into six groups:the normal group,the model group,the finasteride group,and the low-, middle-,and high-dose KQR groups,12 in each group.Except those in the normal group,the rats were injected with testosterone after castration for the establishment of BPH model and then given respectively w...

  17. [Combined therapy of voiding irritative disorders after surgical treatment of benign prostatic hyperplasia with Andro-Gin].

    Science.gov (United States)

    Loran, O B; Luk'ianov, I V; Markov, A V

    2005-01-01

    The results of operative and rehabilitative treatment of benign prostatic hyperplasia (BPH) was analysed for 69 BPH patients with postoperative irritative disorders of voiding. The patients were divided into four groups by rehabilitative therapy: group 1 received antibacterial therapy; group 2--antibacterial therapy+alpha-adrenoblockers; group 3--antibacterial therapy+transrectal laser and magnetic physiotherapy; group 4--antibacterial therapy+alpha-adrenoblockers+transrectal laser and magnetic physiotherapy. The worst result was obtained in group 1, the best one in groups 3 and 4 (the response was compatible). Thus, the addition of physiotherapy to the complex of postoperative rehabilitation of patients operated for BPH is justified and provides treatment improvement.

  18. 17β-Hydroxyestra-4,9,11-trien-3-one (Trenbolone) preserves bone mineral density in skeletally mature orchiectomized rats without prostate enlargement.

    Science.gov (United States)

    McCoy, Sean C; Yarrow, Joshua F; Conover, Christine F; Borsa, Paul A; Tillman, Mark D; Conrad, Bryan P; Pingel, Jennifer E; Wronski, Thomas J; Johnson, Sally E; Kristinsson, Hordur G; Ye, Fan; Borst, Stephen E

    2012-10-01

    Testosterone enanthate (TE) administration attenuates bone loss in orchiectomized (ORX) rats. However, testosterone administration may increase risk for prostate/lower urinary tract related adverse events and polycythemia in humans. Trenbolone enanthate (TREN) is a synthetic testosterone analogue that preserves bone mineral density (BMD) and results in less prostate enlargement than testosterone in young ORX rodents. The purpose of this experiment was to determine if intramuscular TREN administration attenuates bone loss and maintains bone strength, without increasing prostate mass or hemoglobin concentrations in skeletally mature ORX rodents. Forty, 10 month old male F344/Brown Norway rats were randomized into SHAM, ORX, ORX+TE (7.0mg/week), and ORX+TREN (1.0mg/week) groups. Following surgery, animals recovered for 1 week and then received weekly: vehicle, TE, or TREN intramuscularly for 5 weeks. ORX reduced total and trabecular (t) BMD at the distal femoral metaphysis compared with SHAMs, while both TREN and TE completely prevented these reductions. TREN treatment also increased femoral neck strength by 28% compared with ORX animals (pTREN induced a non-significant 20% reduction in prostate mass compared with SHAMs, ultimately producing a prostate mass that was 64% below that found in ORX+TE animals (pTREN animals to a similar degree above both SHAM and ORX conditions (pTREN completely prevented the ORX-induced loss of tBMD at the distal femoral metaphysis and increased LABC mass. TREN also augmented femoral neck strength and maintained prostate mass at SHAM levels. These findings indicate that TREN may be an advantageous agent for future clinical trials evaluating agents capable of preventing bone loss resulting from androgen deficiency.

  19. Differential blood-based diagnosis between benign prostatic hyperplasia and prostate cancer: miRNA as source for biomarkers independent of PSA level, Gleason score, or TNM status.

    Science.gov (United States)

    Leidinger, Petra; Hart, Martin; Backes, Christina; Rheinheimer, Stefanie; Keck, Bastian; Wullich, Bernd; Keller, Andreas; Meese, Eckart

    2016-08-01

    Since the benefit of prostate-specific antigen (PSA) screening remains controversial, new non-invasive biomarkers for prostate carcinoma (PCa) are still required. There is evidence that microRNAs (miRNAs) in whole peripheral blood can separate patients with localized prostate cancer from healthy individuals. However, the potential of blood-based miRNAs for the differential diagnosis of PCa and benign prostatic hyperplasia (BPH) has not been tested. We compared the miRNome from blood of PCa and BPH patients and further investigated the influence of the tumor volume, tumor-node-metastasis (TNM) classification, Gleason score, pretreatment risk status, and the pretreatment PSA value on the miRNA pattern. By microarray approach, we identified seven miRNAs that were significantly deregulated in PCa patients compared to BPH patients. Using quantitative real time PCR (qRT-PCR), we confirmed downregulation of hsa-miR-221* (now hsa-miR-221-5p) and hsa-miR-708* (now hsa-miR-708-3p) in PCa compared to BPH. Clinical parameters like PSA level, Gleason score, or TNM status seem to have only limited impact on the overall abundance of miRNAs in patients' blood, suggesting a no influence of these factors on the expression of deregulated miRNAs.

  20. Safety of greenlight photoselective vaporisation of prostate in lower urinary tract symptoms due to benign prostatic hyperplasia in patients using anticoagulants due to cardiovascular comorbidities

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    Basri Cakiroglu

    2015-07-01

    Full Text Available Lasers have been used in the management of benign prostatic hyperplasia for the last two decades. To be comparable, they should reduce or avoid the immediate and long-term complications of transurethral resection of the prostate (TURP or open prostatectomy (OP, especially bleeding and need for blood transfusion. Although Holmium laser treatment of the prostate was compared frequently in terms of cardiovascular safety with TURP or OP, photoselective vaporisation of the prostate (PVP was not largely evaluated. In this article we analyzed the current literature to see if there is convincing data to support the observation of some authors that use of PVP is associated with increased safety in patients on anticoagulants with cardiovascular comorbidities. With this purpose a Medline search between January 2004 to March 2013 was performed using evidence obtained from randomised trials, well-designed controlled studies without randomisation, individual cohort studies, individual case control studies and case reports Results: In the last 10 years, several case-control and cohort studies have demonstrated the efficacy of PVP as well as its safety in patients with cardiovascular comorbidities using anticoagulants. The results confirmed the overall lower perioperative and postoperative morbidity of PVP, whereas the efficacy was comparable to TURP in the short term, despite a higher reoperation rate. Conclusion: Although it is still developing, PVP with KTP or LBO seems to be a promising alternative to both TURP and OP in terms of cardiovascular safety and in patients using anticoagulants.

  1. 17Beta-estradiol at low concentrations acts through distinct pathways in normal versus benign prostatic hyperplasia-derived prostate stromal cells.

    Science.gov (United States)

    Park, Irwin I; Zhang, Qiang; Liu, Victoria; Kozlowski, James M; Zhang, Ju; Lee, Chung

    2009-10-01

    The aim of this study was to identify differential responses to low concentrations of 17beta-estradiol (E2) in primary stromal cell cultures derived from either normal organ donors or benign prostatic hyperplasia or hypertrophy (BPH) specimens. Furthermore, we sought to identify the potential mechanism of E2 action in these cell types, through either a genomic or nongenomic mechanism. We initially treated stromal cells derived from five normal prostates or five BPH specimens with low concentrations of E2 (0.001-1.0 nM) and analyzed their growth response. To determine whether genomic or nongenomic pathways were involved, we performed studies using specific estrogen receptor antagonists to confirm transcriptional activity or MAPK inhibitors to confirm the involvement of rapid signaling. Results of these studies revealed a fundamental difference in the mechanism of the response to E2. In normal cells, we found that a nongenomic, rapid E2 signaling pathway is predominantly involved, mediated by G protein-coupled receptor-30 and the subsequent activation of ERK1/2. In BPH-derived prostate stromal cells, a genomic pathway is predominantly involved because the addition of ICI 182780 was sufficient to abrogate any estrogenic effects. In conclusion, prostate stromal cells respond to far lower concentrations of E2 than previously recognized or examined, and this response is mediated through two distinct mechanisms, depending on its origin. This may provide the basis for new insights into the causes of, and possible treatments for, BPH.

  2. [FEATURES OF CLINICAL COURSE AND MORPHOMETRIC PARAMETERS OF BENIGN PROSTATIC HYPERPLASIA IN MEN WITH METABOLIC SYNDROME AND ANDROGEN DEFICIENCY].

    Science.gov (United States)

    Tyuzikov, I A; Grekov, E A; Kalinchenko, S Yu

    2015-01-01

    The study was aimed to the evaluation of the effect of the components of the metabolic syndrome (obesity, insulin resistance (IR)) and androgen deficiency on the clinical course of lower urinary tract symptoms against the background of benign prostatic hyperplasia (LUTS/BPH) and nocturia, as well as on some of the parameters of BPH (prostate volume, residual urine volume, total prostate-specific antigen (PSA) blood level). The comprehensive survey of 160 men with LUTS/BPH (mean age 56.7 ± 3.3 years) was performed; based on the results of survey, three comparison groups were formed: Group 1 (n = 70)--patients with isolated obesity; Group 2 (n = 36)--patients with obesity and insulin resistance; and Group 3 (n = 54)--patients with obesity, insulin resistance and androgen deficiency. The control group consisted of 30 patients with LUTS/BPH without these metabolic and hormonal disorders. In patients with LUTS/BPH and obesity, higher frequency of nocturia compared with the control group was revealed (63.7% vs 23.3%; P resistance and androgen deficiency had the highest average prostate volume and residual urine volume compared with those of other groups (P resistance, androgen deficiency are associated pathological conditions, greatly aggravating the clinical course of LUTS/BPH due to adverse impact on the BPH parameters, acting both together and separately. The most severe LUTS/BPH were associated with the presence of all three of the above systemic disorders.

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

    Science.gov (United States)

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

    2015-11-01

    Lower urinary tract symptoms (LUTS) may develop more commonly in men with type 2 diabetes mellitus (T2DM). LUTS are often associated with benign prostate hyperplasia (BPH), in general population. An association between LUTS and hypovitaminosis D, and between hypovitaminosis D and type 2 diabetes (T2DM), has also been suggested. Thus, we aim to evaluate possible relationships between hypovitaminosis D, LUTS, and BPH in T2DM men. In this prospective observational study, 67 T2DM males (57.9 ± 9.28 years) underwent medical history collection, International Prostate Symptom Score (IPSS) questionnaire, that allows the identification and grading of LUTS, physical examination, biochemical/hormonal blood tests (fasting plasma glucose, glycated haemoglobin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, creatinine, LH, total testosterone, estradiol (E2 ), 25-OH-vitamin D, PTH, calcium, phosphate, and PSA) and ultrasound transrectal prostate examination. Subdividing patients into three groups, on the base of 25-OH-vitamin D concentration (sufficiency ≥50; insufficiency >25 hypovitaminosis D remained an independent predictor of both IPSS and prostate volume. In conclusion, we showed, for the first time, an association between 25-OH-vitamin D deficiency, LUTS, and BPH in T2DM men.

  4. CURRENT OPPORTUNITIES FOR COMBINATION TREATMENT OF LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA IN MEN

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    G. R. Kasyan

    2016-01-01

    Full Text Available Lower urinary tract symptoms (LUTS associated with benign prostatic hyperplasia (BPH are widely presented, particularly among elderly men. It was commonly accepted that LUTS are directly or indirectly connected with the prostate. Recent studies have shown that mild andsevere forms of LUTS may have a different etiology, such as, bladder related problems: overactive bladder (OAB/detrusor overactivity or, conversely, an underactive bladder due to compromised contractions of the detrusor. There are three main groups of LUTS: storage symptoms, voiding symptoms and post-micturition symptoms. Patients with LUTS/BPH who are not sufficiently respond to monotherapy with alpha-blockers should receive additional treatment with M‑anticholinergics in accordance with the European urological guidelines. Current studies show that up to 65% of patients with LUTS/BPH with symptoms of urgency and frequency do not have sufficient reduction of symptoms after 3 months of treatment with alphablocker as monotherapy. Until recently, alpha-blockers and M‑anticholinergic medications were prescribed in combination therapy as a two separate pills. Vesomni is a combination of antimuscarinic drug solifenacin 6 mg with α1‑blocker tamsulosin OCAS 0.4 mg in one tablet. It is developed to relieve storage (urgency and frequency and voiding symptoms in men with LUTS/BPH. Solifenacin suppresses the overactivity of the detrusor and reduces storage symptoms. Tamsulosin OCAS relaxes smooth muscle of the prostate, prostatic urethra and bladder neck, and eliminates most voiding symptoms and, to a lesser extent, storage symptoms.

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

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    Xin Gu

    2013-01-01

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

  6. Smoking habits and benign prostatic hyperplasia: A systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Xu, Huan; Fu, Shi; Chen, Yanbo; Chen, Qi; Gu, Meng; Wang, Zhong

    2016-08-01

    Previous studies have warned against the promoting effects of cigarette smoking on benign prostatic hyperplasia (BPH). In contrast, some have argued that smoking confers a protective effect regarding BPH, while others have observed an aggravated effect. Thus, we performed this meta-analysis to determine whether cigarette use is associated with BPH risk.To identify articles from observational studies of relevance, a search was performed concurrent to March 21, 2016, on PubMed, Web of Science, Cochrane, EBSCO, and EMBASE databases. Random-effect model, according to the heterogeneity, was calculated to reveal the relative risks (RRs) and corresponding 95% confidence intervals (CIs).Eight articles were included in this meta-analysis, representing data for 44,100 subjects, of which 5221 (11.8%) had BPH as defined according to the criteria. Seven reports are concerned with analysis between nonsmokers and ex-smokers, in which no significant difference was observed (RR = 0.99, 95% CI 0.94-1.05). Another meta-analysis of 7 studies indicated an observable trend, but without significant difference between groups of nonsmokers and current smokers (RR = 1.17, 95% CI 0.98-1.41). Between groups of heavy (6 articles; RR = 1.02, 95% CI 0.84-1.24) and light smokers (5 articles; RR = 0.90, 95% CI 0.71-1.15), again no significant difference appears. Finally, we combined individuals as never-smokers and ever-smokers and still found no significant difference between the 2 groups of patients (RR = 1.03, 95% CI 0.92-1.15). Sensitivity analysis was displayed and confirmed the stability of the present results.Combined evidence from observational studies shows no significant association between cigarette smoking and BPH risk, either for ex-smokers or for current smokers. The trend of elevated BPH risk from smoking was observed only in current smokers compared with nonsmokers, while marginal significance was observed in comparing ever-smokers with never-smokers in

  7. A Comparative Study between Cystoscopy and Cystography in Detecting Bladder Diverticulae in Patients with Benign Prostatic Hyperplasia

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    Manish Swarnkar

    2016-04-01

    Full Text Available Background: Bladder diverticulae are mucosal outpunching and majority are acquired and secondary to either benign prostatic hypertrophy or the upper motor type of neurogenic bladder. Aim & Objectives: This study was undertaken to increase knowledge and understanding the presumed role of Benign Prostatic Hyperplasia (BPH in the development of bladder diverticulae and to compare cystoscopy and cystography in detecting bladder diverticulae. Material and Methods: During a one year period, 74 patients with BPH, who were admitted in the hospital for surgery, were examined by cystoscopy and cystography to detect bladder diverticulae. Results: In this study, prevalence of bladder diverticulae was found to be 61%. There was a slight increase of bladder diverticulae with increasing age. We could not find any statistical difference between cystoscopy and cystography in detecting bladder diverticulae 2 (c =1.86, p value=.60, NS, p<0.05.Malignancy within diverticulae seen in 6.8% of cases. Conclusion: This study shows that the prevalence of bladder diverticulae is considerably high. Considering this high prevalence and potential complications, we suggest cystoscopy for the early diagnosis and possible treatment of bladder diverticulae in older patients with lower urinary tract symptoms

  8. Application of dual-energy spectral CT imaging in differential diagnosis of bladder cancer and benign prostate hyperplasia

    Science.gov (United States)

    Chen, Anliang; Liu, Ailian; Liu, Jinghong; Tian, Shifeng; Wang, Heqing; Liu, Yijun

    2016-01-01

    Abstract The aim of this study was to explore the clinical value of dual-energy spectral CT imaging in the differential diagnosis between bladder cancer and benign prostate hyperplasia (BPH). We retrospectively analyzed images of 118 patients who received pelvic dual-energy spectral CT imaging. These patients were later confirmed to have bladder cancer in 61 patients and BPH in 57 patients. CT values of the 2 lesion types from 40 to 140 keV were measured from the monochromatic spectral CT image to generate spectral HU curves. The slope of the spectral curve and the lesion effective atomic number were calculated. The measured parameters were analyzed with independent-sample Mann-Whitney U test. There was a statistically significant difference in CT value between the 2 groups from 40 to 90 keV, with the biggest difference at 40 keV (median and interquartile range: 83.3 HU and 22.9 HU vs 60.6 HU and 16.7 HU, Z = 5.932, P benign prostate hyperplasia. PMID:28033269

  9. Biomarkers of Prostatic Cancer: An Attempt to Categorize Patients into Prostatic Carcinoma, Benign Prostatic Hyperplasia, or Prostatitis Based on Serum Prostate Specific Antigen, Prostatic Acid Phosphatase, Calcium, and Phosphorus.

    Science.gov (United States)

    Sarwar, Shahana; Adil, Mohammed Abdul Majid; Nyamath, Parveen; Ishaq, Mohammed

    2017-01-01

    Prostatitis, BPH, and P.Ca are the most frequent pathologies of the prostate gland that are responsible for morbidity in men. Raised levels of PSA are seen in different pathological conditions involving the prostate. PAP levels are altered in inflammatory or infectious or abnormal growth of the prostate tissue. Serum calcium and phosphorus levels were also found to be altered in prostate cancer and BPH. The present study was carried out to study the levels of PSA, PAP, calcium, and phosphorus in serum of patients with Prostatitis, BPH, or P.Ca and also to evaluate the relationship between them. Males in the age group of 50-85 years with LUTS disease symptoms and with PSA levels more than 4 ng/mL were included. A total of 114 patients were analyzed including 30 controls. Prostatitis in 35.7% of cases, BPH in 35.7% of the cases, and P.Ca in 28.57% of the cases were observed. Thus, the nonmalignant cases constitute a majority. PSA, a marker specific for prostatic conditions, was significantly high in all the diseases compared to controls. A rise in serum PSA and PAP indicates prostatitis or, in combination with these two tests, decreased serum calcium shows advanced disease.

  10. Biomarkers of Prostatic Cancer: An Attempt to Categorize Patients into Prostatic Carcinoma, Benign Prostatic Hyperplasia, or Prostatitis Based on Serum Prostate Specific Antigen, Prostatic Acid Phosphatase, Calcium, and Phosphorus

    Science.gov (United States)

    Sarwar, Shahana; Nyamath, Parveen; Ishaq, Mohammed

    2017-01-01

    Prostatitis, BPH, and P.Ca are the most frequent pathologies of the prostate gland that are responsible for morbidity in men. Raised levels of PSA are seen in different pathological conditions involving the prostate. PAP levels are altered in inflammatory or infectious or abnormal growth of the prostate tissue. Serum calcium and phosphorus levels were also found to be altered in prostate cancer and BPH. The present study was carried out to study the levels of PSA, PAP, calcium, and phosphorus in serum of patients with Prostatitis, BPH, or P.Ca and also to evaluate the relationship between them. Males in the age group of 50–85 years with LUTS disease symptoms and with PSA levels more than 4 ng/mL were included. A total of 114 patients were analyzed including 30 controls. Prostatitis in 35.7% of cases, BPH in 35.7% of the cases, and P.Ca in 28.57% of the cases were observed. Thus, the nonmalignant cases constitute a majority. PSA, a marker specific for prostatic conditions, was significantly high in all the diseases compared to controls. A rise in serum PSA and PAP indicates prostatitis or, in combination with these two tests, decreased serum calcium shows advanced disease. PMID:28168057

  11. Biomarkers of Prostatic Cancer: An Attempt to Categorize Patients into Prostatic Carcinoma, Benign Prostatic Hyperplasia, or Prostatitis Based on Serum Prostate Specific Antigen, Prostatic Acid Phosphatase, Calcium, and Phosphorus

    Directory of Open Access Journals (Sweden)

    Shahana Sarwar

    2017-01-01

    Full Text Available Prostatitis, BPH, and P.Ca are the most frequent pathologies of the prostate gland that are responsible for morbidity in men. Raised levels of PSA are seen in different pathological conditions involving the prostate. PAP levels are altered in inflammatory or infectious or abnormal growth of the prostate tissue. Serum calcium and phosphorus levels were also found to be altered in prostate cancer and BPH. The present study was carried out to study the levels of PSA, PAP, calcium, and phosphorus in serum of patients with Prostatitis, BPH, or P.Ca and also to evaluate the relationship between them. Males in the age group of 50–85 years with LUTS disease symptoms and with PSA levels more than 4 ng/mL were included. A total of 114 patients were analyzed including 30 controls. Prostatitis in 35.7% of cases, BPH in 35.7% of the cases, and P.Ca in 28.57% of the cases were observed. Thus, the nonmalignant cases constitute a majority. PSA, a marker specific for prostatic conditions, was significantly high in all the diseases compared to controls. A rise in serum PSA and PAP indicates prostatitis or, in combination with these two tests, decreased serum calcium shows advanced disease.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

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    Giovanni Corona

    2014-01-01

    Full Text Available 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.

  14. The Effect of Seoritae Extract in Men with Mild to Moderate Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

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    Woong Jin Bae

    2016-01-01

    Full Text Available We evaluated the effects of Seoritae extract (SE on mild to moderate lower urinary tract symptoms (LUTS suggestive of benign prostatic hyperplasia (BPH. Seventy-six subjects with mild to moderate LUTS suggestive of BPH were prospectively recruited from the urology outpatient clinic and assigned to either SE (4200 mg or 6 tablets 3 times a day or matching placebo. The primary outcome variable, the International Prostatic Symptom Score (IPSS, was evaluated at baseline and at 4 and 12 weeks. Postvoid residual volume (PVR, maximum urine flow rate (Qmax, and prostate-specific antigen (PSA levels were evaluated. IPSSs decreased significantly from baseline to 12 weeks within the SE group. Significant improvements in IPSS voiding scores at 4 and 12 weeks were also observed in the SE group compared to the placebo group. IPSS storage and quality of life scores were also significantly decreased at 12 weeks in the SE group. There was no change in Qmax or PVR in both groups after 12 weeks. Administration of SE for 12 weeks led to significant improvements in LUTS, and it can be concerned as a reasonable and safe alternative for men with mild to moderate LUTS.

  15. Lack of ERG-antibody in Benign Mimickers of Prostate Cancer

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    Bachurska Svitlana Y.

    2016-03-01

    Full Text Available Introduction: Prostate carcinoma (PC is the second most diagnosed cancer in men worldwide. Prostate tissue in needle biopsy expresses a wide variety of architectural patterns some of which are difficult to interpret. Immunohistochemical markers, such as AMACR, p63 and 34βE12 that are currently used in diagnosing prostate cancer, are of great value, but often their interpretation is ambiguous. In 2005 Tomlins et al. identified an emerging marker, erythroblastosis E26 rearrangement gene (ERG, which is a member of the family of genes encoding erythroblast-transformation specific transcription factors (ETS with frequent expression in PC.

  16. High serum dihydrotestosterone examined by ultrasensitive LC-MS/MS as a predictor of benign prostatic hyperplasia or Gleason score 6 cancer in men with prostate-specific antigen levels of 3-10 ng/mL.

    Science.gov (United States)

    Miyoshi, Y; Uemura, H; Suzuki, K; Shibata, Y; Honma, S; Harada, M; Kubota, Y

    2016-11-03

    There has been no consensus on the role of serum androgen concentrations in prostate cancer detection in men with prostate-specific antigen levels of 3-10 ng/mL. In this study, testosterone and dihydrotestosterone concentrations in blood were examined by a newly developed method using ultrasensitive liquid chromatography with two serially linked mass spectrometers (LC-MS/MS). We investigated the correlation between serum androgen levels and Gleason scores at biopsy. We analyzed data of 157 men with a total prostate-specific antigen range of 3-10 ng/mL who underwent initial systematic prostate needle biopsy for suspected prostate cancer between April 2000 and July 2003. Peripheral blood testosterone and dihydrotestosterone concentrations were determined by LC-MS/MS. Blood levels of testosterone and dihydrotestosterone were compared with pathological findings by multivariate analyses. Median values of prostate-specific antigen and prostate volume measured by ultrasound were 5.7 ng/mL and 31.4 cm(3) , respectively. Benign prostatic hyperplasia was diagnosed in 97 patients (61.8%), and prostate cancer was diagnosed in 60 (38.2%) patients, including 31 (19.7%) patients with a Gleason score of 6 and 29 (18.5%) patients with a Gleason score of 7-10. Median values of testosterone and dihydrotestosterone in blood were 3798.7 and 371.7 pg/mL, respectively. There was a strong correlation between serum testosterone and dihydrotestosterone. In multivariate analysis, age, prostate volume, and serum dihydrotestosterone were significant predictors of benign prostatic hyperplasia or prostate cancer with a Gleason score of 6. The area under the receiver operating characteristics curve for age, prostate volume, and serum dihydrotestosterone were 0.67, 0.67, and 0.67, respectively . We confirmed that high dihydrotestosterone blood levels can predict benign prostatic hyperplasia or prostate cancer with a Gleason score of 6 in men with prostate-specific antigen levels of 3-10 ng/mL.

  17. Monopolar versus bipolar transurethral resection of prostate for benign prostatic hyperplasia: Operative outcomes and surgeon preferences, a real-world scenario

    Science.gov (United States)

    Madduri, Vijay Kumar Sarma; Bera, Malay Kumar; Pal, Dilip Kumar

    2016-01-01

    Context: Monopolar transurethral resection of prostate (M-TURP) is considered the gold standard for the management of bladder outlet obstruction due to benign prostatic hyperplasia. Its newly introduced modification, bipolar TURP (B-TURP), promises to overcome its most prominent shortcomings, namely bleeding and dilutional hyponatremia. Literature is conflicting regarding merits of B-TURP over M-TURP. Aims: To find a difference, if any, in perioperative outcomes between M-TURP and B-TURP in a real-wold setting. Settings and Design: Prospective nonrandomized study. Subjects and Methods: Operative outcomes of patients undergoing M-TURP and B-TURP from February 2014 to October 2015 were compared. Statistical Analysis Used: Categorical data were compared by Fischer exact test and numerical data were compared by independent samples Mann–Whitney U-test. P <0.05 was considered statistically significant. Results: The mean size of prostate operated by bipolar technology was significantly greater than those operated by monopolar technology (38.12 ± 9.59 cc vs. 66.49 ± 22.95 cc; P < 0.001). The mean fall in postoperative serum sodium concentration was 0.99 ± 0.76 mEq/L for the B-TURP group as compared to 3.60 ± 2.89 mEq/L for the M-TURP group (P < 0.001). The mean drop in postoperative hemoglobin concentration (P = 0.28) was statistically insignificant, even though larger glands were operated by B-TURP. There were three instances of the transurethral resection (TUR) syndrome in the M-TURP group whereas no TUR syndrome occurred in the B-TURP group. Conclusions: In spite of various contrary viewpoints in literature, surgeons prefer to operate on larger prostates using bipolar technology. B-TURP definitely reduces the incidence of bleeding and dilutional hyponatremia, making it a contender to replace M-TURP as the new gold standard. PMID:27453650

  18. 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

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

    2013-08-01

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

  19. A novel equation and nomogram including body weight for estimating prostate volumes in men with biopsy-proven benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Yasukazu Nakanishi; Iwao Fukui; Kazunori Kihara; Hitoshi Masuda; Satoru Kawakami; Mizuaki Sakura; Yasuhisa Fujii; Kazutaka Saito; Fumitaka Koga; Masaya Ito; Junji Yonese

    2012-01-01

    Anthropometric measurements,e.g.,body weight (BW),body mass index (BMI),as well as serum prostate-specific antigen (PSA) and percent-free PSA (%fPSA) have been shown to have positive correlations with total prostate volume (TPV).We developed an equation and nomegram for estimating TPV,incorporating these predictors in men with benign prostatic hyperplasia (BPH).A total of 1852 men,including 1113 at Tokyo Medical and Dental University (TMDU) Hospital as a training set and 739 at Cancer Institute Hospital (CIH) as a validation set,with PSA levels of up to 20 ng ml-1,who underwent extended prostate biopsy and were proved to have BPH,were enrolled in this study.We developed an equation for continuously coded TPV and a logistic regression-based nomngram for estimating a TPV greater than 40 ml.Predictive accuracy and performance characteristics were assessed using an area under the receiver operating characteristics curve (AUC) and calibration plots.The final linear regression model indicated age,PSA,%fPSA and BW as independent predictors of continuously coded TPV.For predictions in the training set,the multiple correlation coefficient was increased from 0.38 for PSA alone to 0.60 in the final model.We developed a novel nomogram incorporating age,PSA,%fPSA and BW for estimating TPV greater than 40 ml.External validation confirmed its predictive accuracy,with AUC value of 0.764.Calibration plots showed good agreement between predicted probability and observed proportion.In conclusion,TPV can be easily estimated using these four independent predictors.

  20. Clinical evaluation of patients with benign prostatic hyperplasia, treated with the natural product Calprost®: a randomized, controlled study

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    Magnelis Machado-Leiva

    2016-10-01

    Full Text Available Context: Benign Prostatic Hyperplasia (BPH is a common disease that course with Lower Urinary Tract Symptoms (LUTS, mainly in over 50 years-old men. Commonly indicated drugs such as alpha adrenergic-blockers are life-treatment with some adverse reactions. Center for Drug Research and Development produce a microencapsulated lipophilic extract of pumpkin seed oil (Calprost® with anti-androgenic, anti-inflammatory, antioxidant, antiproliferative and diuretic properties. Aims: To evaluate the effect and safety of Calprost® in patients with BPH and LUTS. Methods: A multicenter, randomized, controlled, open exploratory clinical trial was conducted. Two experimental groups, study group (Calprost®, 140 mg daily (n=81, and control group (terazosin, 2 mg daily (n=50 were conformed. All the patients were treated during three months. Efficacy was evaluated through International Prostate Symptoms Score (IPSS, residual bladder volume and prostate volume. Results: Most of the included patients (74.0% were white skin color and their mean age was 66 yrs. Fifteen patients, nine of them from terazosin group, withdraw the trial voluntarily. A significant reduction in the overall IPSS scale was obtained for both groups. Nevertheless, some obstructive (intermittency, straining and irritative (frequency, urgency urinary symptoms decreased more markedly in the Calprost® group being milder. Median residual and prostatic volumes decreased significantly (p=0.048 and p=0.002, respectively only into the Calprost® group. Most of the adverse events were recorded in the terazosin group (79.4%, where postural hypotension prevailed. Conclusions: The natural product Calprost® was probed as a successful treatment of patients with BPH/LUTS, being also well-tolerated.

  1. ALFUZOSIN IN THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA - EFFECTS ON SYMPTOM SCORES, URINARY FLOW-RATES AND RESIDUAL VOLUME - A MULTICENTER, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL

    NARCIS (Netherlands)

    HANSEN, BJ; NORDLING, J; MENSINK, HJA; WALTER, S; MEYHOFF, HH; LEENARTS, JAF; OOSTEN, JK; VANSOEST, FF; DIJKMAN, GA; HOEKSTRA, JW; VANBAASBANK, NJW; BIJLEVELD, RT; BRAAM, PFCM; SCHLATMANN, TJM; FELDERHOF, J; KHOE, GSS; DIK, P; MENSINK, HJA; SKOV, J; CHRISTOFFERSEN, J; GEERDSEN, JP; HVIDT, [No Value; DAHL, C; LUKE, M; LENDORPH, A; JACOBSEN, B; BILDE, T; MORTENSEN, S; LARSEN, EH

    1994-01-01

    In order to assess the efficacy and safety of alfuzosin, a selective alpha-1 receptor antagonist, 205 patients with Benign Prostatic Hyperplasia (BPH) were randomly assigned in a double-blind, placebo-controlled manner, to receive either alfuzosin 2,5 mg TID or placebo TID during 12 weeks. After 12

  2. Development of a decision aid for the treatment of benign prostatic hyperplasia : A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, Romy E D; Cuypers, Maarten; Garvelink, Mirjam M.; Bosch, J. L H Ruud; Kil, Paul J M

    2016-01-01

    Objective: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Methods: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2: Identify

  3. Analysis and reliability of data from 24-hour frequency-volume charts in men with lower urinary tract symptoms due to benign prostatic hyperplasia

    NARCIS (Netherlands)

    Gisolf, KWH; van Venrooij, GEPM; Eckhardt, MD; Boon, TA

    2000-01-01

    Objectives: The aims of this study were to analyse the data from frequency-volume charts and to study the reliability of these charts in men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), Methods: Males with LUTS due to BPH were consecutively included in the stud

  4. Transurethral Resection of the Prostate (TURP) Versus Original and PErFecTED Prostate Artery Embolization (PAE) Due to Benign Prostatic Hyperplasia (BPH): Preliminary Results of a Single Center, Prospective, Urodynamic-Controlled Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Iscaife, Alexandre, E-mail: iscaifeboni@yahoo.com.br; Yoshinaga, Eduardo M., E-mail: dumuracca@ig.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil); Moreira, Airton Mota, E-mail: motamoreira@gmail.com [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Antunes, Alberto A., E-mail: antunesuro@uol.com.br; Srougi, Miguel, E-mail: srougi@uol.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2016-01-15

    PurposeTo compare clinical and urodynamic results of transurethral resection of the prostate (TURP) to original and PErFecTED prostate artery embolization (PAE) methods for benign prostatic hyperplasia.MethodsWe prospectively randomized 30 patients to receive TURP or original PAE (oPAE) and compared them to a cohort of patients treated by PErFecTED PAE, with a minimum of 1-year follow-up. Patients were assessed for urodynamic parameters, prostate volume, international prostate symptom score (IPSS), and quality of life (QoL).ResultsAll groups were comparable for all pre-treatment parameters except bladder contractility and peak urine flow rate (Q{sub max}), both of which were significantly better in the TURP group, and IIEF score, which was significantly higher among PErFecTED PAE patients than TURP patients. All groups experienced significant improvement in IPSS, QoL, prostate volume, and Q{sub max}. TURP and PErFecTED PAE both resulted in significantly lower IPSS than oPAE but were not significantly different from one another. TURP resulted in significantly higher Q{sub max} and significantly smaller prostate volume than either original or PErFecTED PAE but required spinal anesthesia and hospitalization. Two patients in the oPAE group with hypocontractile bladders experienced recurrence of symptoms and were treated with TURP. In the TURP group, urinary incontinence occurred in 4/15 patients (26.7 %), rupture of the prostatic capsule in 1/15 (6.7 %), retrograde ejaculation in all patients (100 %), and one patient was readmitted for temporary bladder irrigation due to hematuria.ConclusionsTURP and PAE are both safe and effective treatments. TURP and PErFecTED PAE yield similar symptom improvement, but TURP is associated with both better urodynamic results and more adverse events.

  5. Characterization of fibrillar collagens and extracellular matrix of glandular benign prostatic hyperplasia nodules.

    Directory of Open Access Journals (Sweden)

    Tyler M Bauman

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

  6. Re: Cross-Sectional and Longitudinal Associations of Sexual Function with Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Fwu C-W

    2015-03-01

    Full Text Available In this study authors examine the cross-sectional associations between baseline characteristics and sexual function and the longitudinal associations between change in lower urinary tract symptoms and change in sexual function among men with benign prostatic hyperplasia. The cross-sectional cohort included 2.916 men who completed Brief Male Sexual Function Inventory (BMSFI at baseline. The longitudinal cohort included 672 men who were randomized to placebo. Increased age, less education, obesity and severe lower urinary tract symptoms were found significantly associated poorer sexual drive, erectile dysfunction, ejaculatory function, sexual problem assessment and overall satisfaction. However, none of these baseline characteristics predicted change in sexual function in the longitudinal cohort. The decline in sexual dysfunction associated with worsening of lower urinary tract symptoms in men assigned to placebo was small.

  7. Influence of bladder outlet obstruction and detrusor contractility on residual urine in patients with benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    张鹏; 武治津; 高居忠

    2003-01-01

    Objective To study the relationship between the degree of bladder outlet obstruction (BOO), detrusor contractility and residual urine in patients suffering from benign prostatic hyperplasia (BPH).Methods In 181 patients with BPH, degree of BOO, detrusor contractility, residual urine caculated from cathetering combined with the difference between the filling and the voiding were recorded and analysized statistically using urodynamic technique.Results Residual urine increased when the detusor contractility was weakened (F=12.134, P=0.001). In patients wih severe BOO, there was no significant difference in residual urine (F=2.386, P=0.071).Conclusions Increased residual urine is mainly resulted from decreased detrusor contractility. BOO has no significant influence on residual urine. Some patients with normal or weakened detrusor contractility may have more residual urine

  8. Histopathologic effects of hypofractionated robotic radiation therapy on malignant and benign prostate tissue.

    Science.gov (United States)

    Suy, Simeng; Oermann, Eric; Hanscom, Heather; Lei, Sue; Vahdat, Saloomeh; Yu, Xia; Park, Hyeon U; Chen, Viola; Collins, Brian T; McGeagh, Kevin; Dawson, Nancy; Jha, Reena; Azumi, Norio; Dritschilo, Anatoly; Lynch, John; Collins, Sean P

    2010-12-01

    We describe the first histopathologic analysis of prostatic tissue following hypofractionated robotic radiation therapy. A 66 year-old man presented with stage II, low risk adenocarcinoma of the prostate and underwent elective conformal hypofractionated radiation therapy. His pretreatment evaluation revealed T1c adenocarcinoma, Gleason's grade 3 + 3 = 6 and a prostate specific antigen (PSA) level of 4.87 ng/ml. Hypofractionated radiation therapy (37.5 Gy in five daily fractions of 7.5 Gy) was completed on an Internal Review Board approved protocol. One year later, he developed progressive urinary retention. Transurethral prostatic resection was performed to alleviate obstructive symptoms. Bilobar hypertrophy was observed without evidence of stricture. Histolopathologic analyses of resected prostate tissues revealed changes consistent with radiation treatment, including cellular changes, inflammation, glandular atrophy and hyperplasia. There was no evidence of residual cancer, fibrosis or necrosis. The patient's postoperative course was uneventful with post-treatment PSA of 0.5 ng/ml and residual grade 1 stress incontinence.

  9. Multi-sequential surface plasmon resonance analysis of haptoglobin-lectin complex in sera of patients with malignant and benign prostate diseases.

    Science.gov (United States)

    Kazuno, Saiko; Fujimura, Tsutomu; Arai, Takahiro; Ueno, Takashi; Nagao, Keiji; Fujime, Makoto; Murayama, Kimie

    2011-12-15

    Screening for prostate cancer remains unsatisfactory. Recent studies have examined the cancer diagnostic/prognostic values of various acute phase proteins, such as haptoglobin. We describe here a novel method of surface plasmon resonance (SPR) based on multi-sequential analysis with SNA-1, AAL, and PHA-L(4) lectin, to estimate the glycosylation status of haptoglobin in sera of patients with prostate cancer (n=15), benign prostate disease (BPD) including benign prostatic hypertrophy (n=20), and normal subjects (n=11). The SPR-based analysis involves the use of anti-haptoglobin as ligand and dilution of the analyte to 1400-fold and filtration, followed by detection of the sugar chain by lectin solution. The normalized RU of lectin to haptoglobin represents the binding amount of lectin divided by that of haptoglobin. The normalized RU by SNA-1 of the prostate cancer group was significantly higher than those of the control and BPD group. SNA-1 detected NeuAcα2,6 in a biantennary sugar chain, whose content was the highest among the major glycoproteins in serum. Serum samples diluted about 7000-fold were subjected to microanalysis at 10 ng/μl and 10 μl/min for 4 min. The combination of SNA-1 and haptoglobin by SPR multi-sequential analysis offered the most accurate diagnosis of prostate cancer without any modification of serum glycoproteins.

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

    Science.gov (United States)

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

    2008-10-01

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

  11. [Initial results of transurethral enucleation with bipolar system for benign prostate hypertrophy patients].

    Science.gov (United States)

    Nakao, Atsushi; Fukui, Koji; Togo, Yoshikazu; Kokura, Koji

    2010-07-01

    We have performed transurethral enucleation with bipolar system (TUEB) on 60 patients since April 2008. The patients were 61 to 81 years old (average 71.7 years old), and estimated prostate volumes were 25 cm3 to 80.43 cm3 (average 51.1 cm3). The weight of prostate removed was 8 g to 56 g (average 27.4 g) during the operations which lasted between 40 min to 200 min (average 117.5 min). The International Prostate Symptom Score (IPSS), quality of life index (QOL) maximum flow rate (Q max) and average flow rate (Qave) were recorded before operation, and at 1 and at 3 months after operation. The results indicated a high safety with TUEB compared to TUR-P even for beginners. In conclusion, TUEB may become the most common approach in the treatment of BPH.

  12. The anti-hyperplasia, anti-oxidative and anti-inflammatory properties of Qing Ye Dan and swertiamarin in testosterone-induced benign prostatic hyperplasia in rats.

    Science.gov (United States)

    Wu, Xinying; Gu, Ye; Li, Lun

    2017-01-04

    Qing Ye Dan (QYD) is the whole plant of Swertia mileensis and used in Chinese folk medicine for the treatment of prostatitis, benign prostatic hyperplasia (BPH) and so on. This study was to investigate the effects of QYD and its main component swertiamarin on BPH induced by testosterone in rats. The prostatic expressions of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor (βFGF) and proliferating cell nuclear antigen (PCNA) were detected by immunohistochemistry assay. Prostatic levels of oxidative stress and inflammatory-related factors were also analyzed. Additionally, the prostatic expressions of androgen receptor (AR), estrogen receptor (ER)-α, ER-β, hypoxia-inducible factor (HIF)-1α, B-cell CLL/lymphoma (Bcl)-2 and Bcl-2-associated X protein (Bax) were measured by western blot. The epithelial-mesenchymal transition (EMT) associated factors were evaluated by quantitative RT-PCR. It showed that QYD and swertiamarin ameliorated the testosterone-induced prostatic hyperplasia and collagen deposition, attenuated the over-expressions of HIF-1α, VEGF, EGF, βFGF, PCNA, AR and ER-α, reduced the ratio of Bcl-2/Bax, enhanced the expression of ER-β, inhibited the oxidative stress and local inflammation, as well as relieved prostatic EMT. It suggested that QYD and swertiamarin had prostatic protective potential against BPH.

  13. On Chip Immuno-Affinity Profiling of Cancer- and Benign Hyperplasia-Associated Free Prostate Specific Antigen

    Directory of Open Access Journals (Sweden)

    Maja M. Kosanovic

    2011-01-01

    Full Text Available Prostate specific antigen (PSA exhibits pronounced heterogeneity in both primary structure and glycan composition, resulting in the existence of different molecular forms. Investigation of PSA structure is a demanding task facing limitations due to inadequate sensitivity of analytical techniques and low concentrations of the different forms. This study aimed to profile free PSA (fPSA, especially lower molecular mass species lacking detailed classification, in normal seminal plasma and in sera from subjects with benign hyperplasia (BPH or cancer of the prostate (PCa as samples of known clinical relevance. fPSA forms were separated from complex proteomes on chips with immobilized anti-fPSA antibody followed by detection using surface-enhanced laser desorption/ionization time of flight mass spectrometry. At least 39 fPSA-immunoreactive species, ranging from 3–29 kDa were detected in seminal plasma. General fPSA profiles in seminal plasma and sera were similar, but differed in the abundance and presence of particular peaks/clusters of the lower molecular mass species. No striking difference in fPSA forms was observed between BPH and PCa samples, but some distinct peaks varied in intensity and frequency within or between groups. Obtained data verify fPSA heterogeneity that might be important for better exploration of all their molecular and marker potentials.

  14. Contribution of Diagnostic Tests and Drug Therapy in Screening of Benign Prostatic Hyperplasia (BPH in Western Algerian Hospital

    Directory of Open Access Journals (Sweden)

    Abdelkrim Berroukche

    2014-12-01

    Full Text Available The incidence of benign prostatic hyperplasia (BPH is known through the American and European continents whereas it remains much to make to know the epidemiologic profile of this pathology in Algeria. This study aims to show a contribution of diagnostic tests and drug therapy in screening of BPH in Western Algerian hospital. Our study was carried out on 385 men recruited in the Urology department of Saida hospital during the period 2010-2013, consulting for urologic problems whose 120 patients, aged between 45-84 years, have BPH. BPH frequency was 31.1 %. It was prevalent in the age – specific range of 65-74 years. The physical, biological and histological examinations revealed that 75 % of the patients were diagnosed by digital rectal examination (DRE, 70 % have serum-TPSA level lower than 4 ng/ml and 71.2 % have a histological type named "prostatic hyperplasia adeno-fibro-Leio myomatic (or PHAFLM". As for an assumption of responsibility concerning BPH patients 52.7 % have chosen a medical treatment. This work showed the proportion of the subjects carrying BPH in this area of Algeria. This study provides information on the incidence of BPH in this area of Algeria. But more work needs to come to reinforce the results to uncover the various risk factors (age, race, diet, hormones that are behind the development of this disease.

  15. Evaluation of short term outcomes of patients undergone transurethral resection with plasmakinetic energy for benign prostate hyperplasia

    Directory of Open Access Journals (Sweden)

    Suleyman Baris Kartal

    2013-08-01

    Full Text Available Aim: To evaluate short term outcomes of patients undergone transurethral resection with plasmakinetic energy for benign prostate hyperplasia and to present safety and efficacy of the procedure. Material and Method:86 patients applied to our clinic between March 2011 and February 2012 were enrolled into the study. PSS scores, uroflowmetry, post voiding residual urine, prostate volumes of the patients were recorded. Post operative urethral stricture, bladder neck stricture, incontinance rates were noted. Data assessed after six months were compared to peroperative data. After the operations, the surgeons evaluated their comfort of surgery with visual analog scale from 0 to 10. Results: 24 of 86 patients were hospitalized for acute urinary retention. One patient was hospitalized because of hematuria. Peroperative IPSS was 22.2. at post operative sixth month, mean IPSS was 6.8. VAS scores of surgeons was; to assess visual comfort was 7.41, to assess coagulation was 7.62. Conclusion:After evaluating the data and literature, we believe bipolar plasmakinetik TUR is a safe and comforting method to treat bladder outlet obstruction with goog hemodynamic stability. [Cukurova Med J 2013; 38(4.000: 696-675

  16. Nonspecific genitourinary pain improves after prostatectomy using holmium laser enucleation of prostate in patients with benign prostatic hyperplasia: a prospective study.

    Directory of Open Access Journals (Sweden)

    Sung Han Kim

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

  17. Uroflowmetry in males. Refrence values and clinical application in benign prostatic hypertrophy.

    NARCIS (Netherlands)

    Rollema, Harm Jan

    1981-01-01

    In this thesis the results are presented of a computerassisted study on uroflowmetry in males. Chapter I introduces the aim of the study and gives a short reviw. Urinary outflow obstruction due to begign prostatic hypertrophy (BPH) is a slowly progressive disease that initially gives rise to a few s

  18. Risk of gynecomastia and breast cancer associated with the use of 5-alpha reductase inhibitors for benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Hagberg KW

    2017-02-01

    Full Text Available Katrina Wilcox Hagberg,1 Hozefa A Divan,2 Shona C Fang,2 J Curtis Nickel,3 Susan S Jick1 1Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, 2New England Research Institutes, Inc., Watertown, MA, USA; 3Kingston General Hospital, Queen’s University, Kingston, ON, Canada Background: Clinical trial results suggest that 5-alpha reductase inhibitors (5ARIs for the treatment of benign prostatic hyperplasia (BPH may increase the risk of gynecomastia and male breast cancer, but epidemiological studies have been limited. Patients and methods: We conducted a cohort study with nested case–control analyses using the UK Clinical Practice Research Datalink. We identified men diagnosed with BPH who were free from Klinefelter syndrome, prostate, genital or urinary cancer, prostatectomy or orchiectomy, or evidence of gynecomastia or breast cancer. Patients entered the cohort at age ≥40 years and at least 3 years after the start of their electronic medical record. We classified exposure as 5ARIs (alone or in combination with alpha blockers [ABs], AB only, or unexposed to 5ARIs and ABs. Cases were men who had a first-time diagnosis of gynecomastia or breast cancer. Incidence rates and incidence rate ratios (IRRs with 95% confidence intervals (CIs in the gynecomastia analysis and crude and adjusted odds ratios (ORs with 95% CIs in both analyses were calculated. Results: Compared to no exposure, gynecomastia risk was elevated for users of 5ARIs (alone or in combination with ABs in both the cohort (IRR=3.55, 95% CI 3.05–4.14 and case–control analyses (OR=3.31, 95% CI 2.66–4.10, whereas the risk was null for users of AB only. The increased risk of gynecomastia with the use of 5ARIs persisted regardless of the number of prescriptions, exposure timing, and presence or absence of concomitant prescriptions for drugs known to be associated with gynecomastia. The risk was higher for dutasteride than for

  19. Can finasteride reverse the progress of benign prostatic hyperplasia? A two-year placebo-controlled study. The Scandinavian BPH Study Group

    DEFF Research Database (Denmark)

    Andersen, J T; Ekman, P; Wolf, H;

    1995-01-01

    OBJECTIVES. To 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. METHODS. This was a multicenter, double-blind, placebo...... rate, prostate volume, postvoiding residual urinary volume, and serum concentrations of prostate-specific antigen together with laboratory safety parameters were measured at entry and at months 12 and 24. Interim physical and laboratory examinations were performed when indicated clinically. RESULTS....... The maximum urinary flow rate decreased in the placebo group, but improved in the finasteride group, resulting in a between-group difference of 1.8 mL/s at 24 months (P prostate volume was +12% in the placebo group versus -19% in the finasteride-treated group (P

  20. 儿童扩张的前列腺囊影像学诊断%Imaging diagnosis of enlarged prostatic utricle in children

    Institute of Scientific and Technical Information of China (English)

    孙龙伟; 干芸根; 周洋洋; 张龚巍

    2016-01-01

    Objective To discuss the image characteristics of enlarged prostatic utricle in children.Methods 13 children with enlarged prostatic utricle were retrospectively analyzed,6 of whom checked by voiding cystic urethrography (VCUG),5 of whom by MRI,2 of whom by both VCUG and MRI.Results 8 cases with VCUG showed round-like or long circle utricle filled with contrast media located in the rear posterior urethra.Among them,3 cases showed the tubiform between utricle and posterior urethra.The other 5 cases displayed overlap between utricle and urethra,and there was no tubiform between utricle and posterior urethra.7 cases with MRI showed oblong cyst at the right rear middle of the bladder that showed low signal with T1 weighted image and high signal with T2 weighted image,crossing the center of prostate gland.Among them,5 cases showed the communication between oblong cyst and posterior urethra.Also,among them,5 cases were associated with the orchitis,epididymis phlogistic,scrotal phlogistic,and 1 case showed the right renal agenesis.Conclusion The VCUG and MRI are helpful to check enlarged prostatic utricle in children.They have different advantages in different aspect.%目的:探讨儿童扩张的前列腺囊影像学特点。方法回顾性分析13例儿童临床诊断为扩张的前列腺囊病例,其中6例行排泄性膀胱尿道造影(VCUG)检查,5例行 MRI 检查,2例行 VCUG 及 MRI 检查。结果8例 VCUG 均在排尿时后尿道后方膀胱后下方见类圆形或长圆形囊腔影,3例囊腔可见管状影与后尿道相通,另5例囊腔影与尿道影重叠,囊腔与后尿道相通管道显示不清。7例 MRI 检查,均在膀胱后方中线区见上下走行长圆形囊状长 T1长 T2信号,穿过前列腺中心。5例囊腔可见条形高信号与后尿道高信号相通,5例发现睾丸炎、附睾炎、阴囊炎,1例发现右肾缺如。结论VCUG 和 MRI 检查是儿童扩张的前列腺囊重要检查方法,两者各有优缺点。

  1. Characterization of time-enhancement curves of benign and malignant prostate tissue at dynamic MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, Olivier; Raudrant, Anne; Colin-Pangaud, Catherine; Lyonnet, Denis [Department of Genitourinary Radiology, Pavillon P, Hopital Edouard Herriot, 5 place d' Arsonval, 69437 Lyon Cedex 03 (France); Ecochard, Rene [Department of Biostatistics, 162 avenue Lacassagne, 69424 Lyon Cedex 03 (France); Pasquiou, Carole; Bouvier, Raymonde [Department of Pathology, Batiment 10, Hopital Edouard Herriot, 5 place d' Arsonval, 69437 Lyon Cedex 03 (France); Marechal, Jean Marie [Department of Urology, Pavillon V, Hopital Edouard Herriot, 5 place d' Arsonval, 69437 Lyon Cedex 03 (France)

    2003-05-01

    Our objectives were to determine time-enhancement curves of prostate cancer, peripheral zone, and adenoma at gadolinium-enhanced MR imaging, and to determine if a high-spatial/low-temporal dynamic imaging could be accurate in depicting prostate cancer, or if a higher temporal resolution (and a lower spatial resolution) should be favored. Thirty-nine patients with prostate cancer underwent MR imaging before radical prostatectomy by using T1- and T2-weighted axial images and a single-slice dynamic gadolinium-enhanced sequence (40 images; one image per 6 s; injection of 20 ml at 2 ml/s). After analysis of the pathologic specimens, four region-of-interest (ROI) cursors (cancer, peripheral zone, adenoma, and muscle) were retrospectively placed on dynamic images. Time-enhancement curves of the ROIs were obtained. The theoretical accuracy of a 30-s dynamic multislice MR sequence in depicting cancer within peripheral zone and adenoma (ROC curves) was calculated from these curves. On average, prostate cancer enhanced more and earlier than peripheral zone and adenoma, but there were great interindividual variations. For start delays ranging from 12 to 84 s, the areas under the ROC curves ranged from 0.602 to 0.698 for the depiction of cancer within adenoma and from 0.614 to 0.827 for the depiction of cancer within peripheral zone. The best results were obtained with a 36-s start delay. In conclusion, we found a 30-s scanning window which seems to allow a good depiction of cancer within peripheral zone. Because of largely overlapping enhancement patterns, cancer will probably not be depicted within adenoma by dynamic imaging, at least by using low temporal resolution. (orig.)

  2. Dural metastases from disseminated prostate cancer clinically mimicking a benign reactive condition of the dura: case report and review of the literature.

    Science.gov (United States)

    Gunia, S; Ecke, T; Wohlfarth, B; Koch, S; Erbersdobler, A

    2011-01-01

    Dural spread from prostate cancer (PC) is exceedingly uncommon. We report on a 62-year-old man suffering from disseminated PC with osseous metastases who presented with a parietal skull metastasis along with a circumscribed nodular thickening of the adjacent dura. Magnetic resonance imaging findings suggested a benign reactive condition of the dura which, however, histologically turned out to be a dural metastasis. Therefore, the present case report stresses the notion that very rarely, disseminated PC might present with clinically unsuspected dural metastases radiologically mimicking a benign condition.

  3. 前列腺增生58例临床观察与治疗%The clinical observation and treatment in 58 cases of benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    孟昭旭

    2014-01-01

    Objective:To investigate the clinical observation and treatment of benign prostatic hyperplasia.Methods:58 patients with benign prostatic hyperplasia were selected from May 2008 to May 2012.They were treated with transurethral resection of prostate, and we observed and compared the residual urine volume,maximum urine flow,prostate symptom score,prostate volume and other clinical symptoms before and after the treatment.Results:After the treatment,58 patients with benign prostatic hyperplasia had an obviously clinical effect,and the differences in clinical indexes were statistically significant before and after the treatment(P<0.05).Conclusion:Patients with benign prostatic hyperplasia can quickly recoved through the treatment of transurethral transurethral resection of prostate.This therapeutic method is simple,in addation,it has high safety and obviously curative effect,so it is worthy of clinical application and promotion.%目的:探讨前列腺增生的临床观察与治疗。方法:2008年5月-2012年5月收治前列腺增生患者58例,采用经尿道前列腺增生电切术治疗,并对患者的剩余尿量、最大尿流量、前列腺症状评分、前列腺体积等临床症状进行治疗前后的对比观察。结果:58例前列腺增生患者治疗后的临床效果明显,治疗前后的临床指标差异有统计学意义(P<0.05)。结论:经尿道前列腺增生电切术恢复快、安全性高、操作简单、疗效明显,值得临床应用和推广。

  4. Preliminary assessment of neck circumference in benign prostatic hyperplasia in patients with metabolic syndrome

    Science.gov (United States)

    Akin, Yigit; Gulmez, Hakan; Ates, Erhan; Gulum, Mehmet; Savas, Murat

    2017-01-01

    ABSTRACT Objectives To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients. Materials and Methods Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alpha-blockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p<0.05 . Results In total, 197 patients were enrolled with mean age of 60.5±8.1 years. Mean NC and WC were higher in MtS patients (p<0.001). Uroflowmetry parameters and QoL indexes were comparable between groups before treatment. International prostate symptom score, uroflowmetry parameters, and QoL significant improved in Group 2 than Group 1, at 1 st and 6 th months of treatment with alpha-blockers. Success rate of treatment was significant higher in Group 2 than Group 1 (p<0.001). Cut-off values were 42.5cm and 113.5cm for NC and WC respectively, for response to alpha-blockers in BPH patients with MtS. Conclusions MtS can be related with BPH and can negatively affect the response to alpha-blocker treatment. NC can be used for predicting response to alpha-blocker treatment in BPH patients with MtS.

  5. Cost effectiveness comparison of dutasteride and finasteride in patients with benign prostatic hyperplasia - the Markov model based on data from Montenegro

    OpenAIRE

    Dabanović Vera; Kostić Marina; Janković Slobodan

    2016-01-01

    Background/Aim. Benign prostatic hyperplasia (BPH) is one of the most common disease among males aging 50 years and more. The rise of the prevalence of BPH is related to aging, and since duration of life time period has the tendency of rising the prevalence of BPH will rise as costs of BPH treatment will and its influence on health economic budget. Dutasteride is a new drug similar to finasteride, inhibits enzyme testosterone 5-alpha reductase, diminish sym...

  6. Advances in the research of the relation between Livin and benign prostatic hyperplasia%Livin与良性列腺增生关系的研究进展

    Institute of Scientific and Technical Information of China (English)

    李鑫

    2011-01-01

    良性前列腺增生(benign prostatic hyperplasia,BPH)是老年男性的常见病和多发病,随着社会人口老龄化,BPH的发病率将会越来越高.凋亡抑制蛋白Livin通过改变组织细胞凋亡增殖的平衡,而在BPH的发生发展中发挥着重要作用.

  7. Prospective double-blind randomized controlled trial of terazosin, finasteride and allylestrenol in the management of benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Madhu S Agrawal

    2001-01-01

    Full Text Available Medical management is rapidly becoming a very im-portant part of the armamentarium of the urologist in-volved in the treatment of benign prostatic hyperplasia. The commonest options for medical management include alpha-blockers, 5-alpha reductase inhibitors, and pro-gestational anti-androgens. We present a double-blind randomized controlled trial evaluating the safety and efficacy of terazosin, finasteride and allylestrenol, the prototype drugs in each of these respective categories. A total of 140 patients who satisfied the inclusion and exclusion criteria were inducted into the trial after an informed consent. They were randomized into 4 groups, which received placebo, terazosin, finasteride and allylestrenol respectively for 6 months. Since 29 patients did not complete 6 months of therapy, there were 111 evaluable patients at the end of the study. We found that these 3 drugs produce comparable improvement in symp-tom score (-40%, flow rates (-60% and PVR (-50% which is significantly better than that in the placebo group. Both allylestrenol and finasteride bring about a comparable reduction in prostate volume (-23%, which is statistically significant as compared to the placebo and terazosin groups. Terazosin in doses of I and 2 mg/ day was, found to be effiective and well-tolerated in the vast majority of our cases. No adverse effects were seen in the placebo and finasteride groups, while 9.6% in the terazosin group had postural hypotension and 10.7% in the allylestrenol group had some loss of libido, prob-lems which were reversible upon cessation of therapy.

  8. Drug Treatment Application Value in Benign Prostatic Hyperplasia%药物治疗在良性前列腺增生中的应用价值

    Institute of Scientific and Technical Information of China (English)

    石岩

    2015-01-01

    Elderly patients with benign prostatic hyperplasia drug treatment is a more effective method.Current drug therapy in the clinical treatment of the mechanism and treatment progressed very quickly,using the drug to treat benign prostatic hyperplasia has become a very effective method of treatment,ongoing research work on drug dosage to improve and reduce adverse reactions and other aspects.In this paper,the progress of benign prostatic hyperplasia drug treatment abroad were discussed.%老年良性前列腺增生患者采用药物进行治疗是一种比较有效的方法。目前药物治疗在临床治疗机制与治疗上进展很快,采用药物治疗良性前列腺增生已成为非常有效的治疗方法,目前正在开展药物剂型改进和不良反应降低等方面的研究工作。本文针对国内外药物治疗良性前列腺增生的进展进行初步探讨。

  9. Non-interventional (observational study of application of the tamsulosin (Proflosin® in patients with benign prostatic hyperplasia in routine clinical practice

    Directory of Open Access Journals (Sweden)

    L. G. Spivak

    2015-02-01

    Full Text Available The problem of therapy of benign prostatic hyperplasia has not lost its relevance today due to the high prevalence rate of this pathologyamong the male population. The article provides the results of non-interventional (observational study of application of the tamsulosin(Proflosin® drug or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno of patients with benign prostatic hyperplasia in routine clinical practice. 1,000 practicing urology experts from 100 cities and towns of Russia took part in the study as well as 23 492 patients with the established diagnosis of benign prostatic hyperplasia, which were prescribed with tamsulosin (Proflosin® monotherapy or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno in conditions of outpatient clinical practice. As a result of the study, improvement of the life standard and subjective symptoms were stated with patients with the absence of significant side effects directly associated with intake of the drug studies.

  10. Non-interventional (observational study of application of the tamsulosin (Proflosin® in patients with benign prostatic hyperplasia in routine clinical practice

    Directory of Open Access Journals (Sweden)

    L. G. Spivak

    2014-01-01

    Full Text Available The problem of therapy of benign prostatic hyperplasia has not lost its relevance today due to the high prevalence rate of this pathologyamong the male population. The article provides the results of non-interventional (observational study of application of the tamsulosin(Proflosin® drug or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno of patients with benign prostatic hyperplasia in routine clinical practice. 1,000 practicing urology experts from 100 cities and towns of Russia took part in the study as well as 23 492 patients with the established diagnosis of benign prostatic hyperplasia, which were prescribed with tamsulosin (Proflosin® monotherapy or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno in conditions of outpatient clinical practice. As a result of the study, improvement of the life standard and subjective symptoms were stated with patients with the absence of significant side effects directly associated with intake of the drug studies.

  11. Biodistribution of [sup 125]I labeled monoclonal antibody against gamma seminoprotein in the nude mice bearing human benign prostatic hyperplasia xenografts

    Energy Technology Data Exchange (ETDEWEB)

    Fujino, Awato (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

    1993-07-01

    The biodistribution of [sup 125]I labeled monoclonal antibody against gamma seminoprotein ([gamma]-Sm) in the nude mice bearing human benign prostatic hyperplasia xenograft was evaluated by whole body autoradiography and by counting of radioactivity in organs. The monoclonal antibody (murine Ig G[sub 1], K) to [gamma]-Sm which was established in this institute and its F(ab')[sub 2] fragment were radioiodinated using Iodogen method. The autoradiograms demonstrated specific uptake of [sup 125]I-intact Ig G as well as [sup 125]I-F(ab')[sub 2] within the prostatic adenoma xenografts 4 days after intravenous administrations. Radioactivity in the xenograft was relatively higher than those in the liver, kidney or lung. These results suggest that radio-labeled monoclonal antibody against [gamma]-Sm might be applicable for radioimmunodetection of prostatic tumors which produce [gamma]-Sm. (author).

  12. A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up.

    Science.gov (United States)

    Wu, Gang; Hong, Zhe; Li, Chao; Bian, Cuidong; Huang, Shengsong; Wu, Denglong

    2016-05-01

    The objective of this study is to compare the efficacy and safety of diode laser enucleation of the prostate (DiLEP) with plasmakinetic enucleation of the prostate (PKEP) for symptomatic benign prostatic hyperplasia (BPH) patients with large prostate (volume > 80 ml). From January 2013 to June 2014, 80 consecutive patients were randomized treated with DiLEP (n = 40) or PKEP (n = 40). Perioperative and postoperative outcome data were assessed during a 1-year follow-up. There were no significant preoperative differences between the two surgical groups. The mean prostate volumes in the DiLEP and PKEP groups were 98.6 and 93.3 ml, respectively. DiLEP was equivalent to PKEP in improvement in International Prostate Symptom Score (IPSS), quality of life scores, and maximum flow rate. Compared with PKEP, patients treated with DiLEP showed a lower risk of blood loss (P prostates (volume > 80 ml). Compared with PKEP, DiLEP provides a decreased risk of hemorrhage, reduced bladder irrigation, and catheterization times, as well as shorter hospital stays.

  13. Impact of pharmacotherapy on the incidence of transurethral prostatectomy for benign prostatic hyperplasia and the implications for surgical training.

    LENUS (Irish Health Repository)

    Long, R

    2010-10-01

    Medical therapy has become first line treatment for Benign Prostatic Hypertrophy (BPH) and in many cases TURP may no longer be required. Proof and quantification of this evolution in practice has been somewhat elusive and provided the principle impetus for this study. This is a retrospective study of BPH management in Republic of Ireland from 1995 to 2008. National treatment databases were sourced for numbers undergoing TURP and pharmacotherapy prescribing data was obtained from individual pharmaceutical companies. A total of 28,240 TURP\\'s were performed nationally between 1995 and 2008. TURP\\'s performed annually, decreased by 1,494 (51%), alpha-blocker prescriptions increased from 8,710 to 302,159 units and the number of urology trainees increased by 10 (60%). Clear association between decreases in TURP\\'s and increases in pharmacotherapy for BPH is demonstrated. Implications on training likely exist and will require proper evaluation in order to maintain future standards in this surgical practice.

  14. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.

    Science.gov (United States)

    Barry, M J; Fowler, F J; O'Leary, M P; Bruskewitz, R C; Holtgrewe, H L; Mebust, W K; Cockett, A T

    1992-11-01

    A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach's alpha = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects' global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p < 0.001). The AUA symptom index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols.

  15. Impact of pharmacotherapy on the incidence of transurethral prostatectomy for benign prostatic hyperplasia and the implications for surgical training.

    LENUS (Irish Health Repository)

    Long, R

    2012-01-31

    Medical therapy has become first line treatment for Benign Prostatic Hypertrophy (BPH) and in many cases TURP may no longer be required. Proof and quantification of this evolution in practice has been somewhat elusive and provided the principle impetus for this study. This is a retrospective study of BPH management in Republic of Ireland from 1995 to 2008. National treatment databases were sourced for numbers undergoing TURP and pharmacotherapy prescribing data was obtained from individual pharmaceutical companies. A total of 28,240 TURP\\'s were performed nationally between 1995 and 2008. TURP\\'s performed annually, decreased by 1,494 (51%), alpha-blocker prescriptions increased from 8,710 to 302,159 units and the number of urology trainees increased by 10 (60%). Clear association between decreases in TURP\\'s and increases in pharmacotherapy for BPH is demonstrated. Implications on training likely exist and will require proper evaluation in order to maintain future standards in this surgical practice.

  16. Inhibitory Activities of Phenolic Compounds Isolated from Adina rubella Leaves Against 5α-Reductase Associated with Benign Prostatic Hypertrophy.

    Science.gov (United States)

    Yin, Jun; Heo, Jun Hyeok; Hwang, Yoon Jeong; Le, Thi Tam; Lee, Min Won

    2016-07-07

    Adina rubella Hance (AR), a plant native to Korea, has been used as traditional medicine for dysentery, eczema, intoxication, and external hemorrhages. Previous phytochemical studies of AR have reported several components, including terpenoids, phenolics, and alkaloids. The current study evaluated the anti-oxidative and anti-inflammatory activities and 5α-reductase inhibition of isolated compounds of AR leaves to find a potential therapeutic agent for benign prostatic hypertrophy (BPH). Repeated chromatographic isolation of an 80% acetone extract of AR leaves yielded seven phenolic compounds: caffeic acid (1), chlorogenic acid (2), methyl chlorogenate (3), quercetin-3-rutinoside (4), kaempferol-3-O-α-l-rhamnopyranosyl-(1→6)-β-d-glucopyranoside (5), hyperoside (6), and grandifloroside (7). Compound 7 is a novel compound in AR. Caffeoyl derivatives 1-3 and 7 showed good anti-oxidative activities. In particular, caffeic acid (1) and grandifloroside (7) showed potent anti-inflammatory activities, and 7 also exhibited potent inhibitory activity against TNF-α and 5α-reductase. Our results show that the extract and grandifloroside (7) from leaves of AR might be developed as a source of potent anti-oxidative and anti-inflammatory agents and therapeutic agent for BPH.

  17. Inhibitory Activities of Phenolic Compounds Isolated from Adina rubella Leaves Against 5α-Reductase Associated with Benign Prostatic Hypertrophy

    Directory of Open Access Journals (Sweden)

    Jun Yin

    2016-07-01

    Full Text Available Adina rubella Hance (AR, a plant native to Korea, has been used as traditional medicine for dysentery, eczema, intoxication, and external hemorrhages. Previous phytochemical studies of AR have reported several components, including terpenoids, phenolics, and alkaloids. The current study evaluated the anti-oxidative and anti-inflammatory activities and 5α-reductase inhibition of isolated compounds of AR leaves to find a potential therapeutic agent for benign prostatic hypertrophy (BPH. Repeated chromatographic isolation of an 80% acetone extract of AR leaves yielded seven phenolic compounds: caffeic acid (1, chlorogenic acid (2, methyl chlorogenate (3, quercetin-3-rutinoside (4, kaempferol-3-O-α-l-rhamnopyranosyl-(1→6-β-d-glucopyranoside (5, hyperoside (6, and grandifloroside (7. Compound 7 is a novel compound in AR. Caffeoyl derivatives 1–3 and 7 showed good anti-oxidative activities. In particular, caffeic acid (1 and grandifloroside (7 showed potent anti-inflammatory activities, and 7 also exhibited potent inhibitory activity against TNF-α and 5α-reductase. Our results show that the extract and grandifloroside (7 from leaves of AR might be developed as a source of potent anti-oxidative and anti-inflammatory agents and therapeutic agent for BPH.

  18. CLINICAL USE OF LOW DOSE TADALAFIL IN COMBINATION WITH ALPHA BLOCKER IN THE MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA

    Directory of Open Access Journals (Sweden)

    Manish

    2016-02-01

    Full Text Available Benign Prostatic Hyperplasia associated with lower urinary tract symptoms is a common geriatric condition in males, which considerably impairs the quality of life due to the irritable and obstructive symptoms, decreased urinary flow and progression to bladder outlet obstruction. Tadalafil is a selective, reversible inhibitor of cyclic guanosine monophosphate (cGMP – specific phosphodiesterase type 5 (PDE5. PDE5 receptor is identified in the lower urinary tract – prostate, ureter and bladder and also identified in visceral smooth muscles, skeletal muscles, platelets, kidney, lungs and cerebellum. It is well established as the first line treatment for erectile dysfunction and approved for treatment of BPH and LUTS with or without ED. OBJECTIVE To evaluate the efficacy of low-dose Tadalafil (5mg along with alpha blocker in the management of Benign Prostatic Hyperplasia (BPH and Lower Urinary Tract Symptoms (LUTS. PATIENTS AND DURATION The study was conducted by the Dept. of Urology, Mahatma Gandhi Medical College and Hospital, Jaipur. In this retrospective study, we reviewed the records of 60 patients in the outpatient clinic from August 2014 to August 2015 with prostatomegaly and LUTS, who were subject to a single daily dose of tamsulosin 0.4mg or alfuzosin 10mg and a daily dose of 5mg Tadalafil. METHOD Patients with LUTS and BPH who were previously managed with alpha blockers (Tamsulosin 0.4mg or Alfuzosin 10mg and who developed progressively bothersome symptoms with stable or increasing IPSS were included in our study by addition of 5mg phosphodiesterase type 5 inhibitor (Tadalafil, which has been reported by various well designed studies to be useful in the management of ED, BPH and LUTS. We analysed the International Prostate Symptom Score (IPSS, BPH Impact Index (BII and Quality of Life (QoL. Mean age of inclusion was 45 to 80 years. RESULTS Before the inclusion of tadalafil in patients, patients exclusively on alpha blockers had a mean

  19. The Effect of Combined Therapy with Tamsulosin Hydrochloride and Meloxicam in Patients with Benign Prostatic Hyperplasia Symptoms and Impact on Nocturia and Sleep Quality

    Directory of Open Access Journals (Sweden)

    Sacit Nuri Gorgel

    2013-09-01

    Full Text Available Purpose We aimed to compare the effect and feasibility of a combined therapy with tamsulosin hydrochloride plus meloxicam, and tamsulosin hydrochloride alone in patients with benign prostate hyperplasia symptoms and impact on nocturia and sleep quality. Materials and Methods Four hundred male patients were included in this study between 2008 and 2011. Patients were randomly divided into two groups: one received tamsulosin hydrochloride 0.4 mg (Group 1, 200 patients and the other tamsulosin hydrochloride 0.4 mg plus meloxicam 15 mg (Group 2, 200 patients prospectively. Patients were evaluated for benign prostate hyperplasia (BPH symptoms according to the American Urological Association clinical guidelines and sleep quality according to Pittsburgh Sleep Quality Index (PSQI. Patients were reevaluated after three months of treatment. The International Prostatic Symptom Score (IPSS, IPSS-Quality of Life (IPSS-QoL, maximal urinary flow rates (Qmax, average urinary flow rates (AFR, post void residual urine volumes (PVR, nocturia and Pittsburgh Sleep Quality Score (PSQS were recorded at baseline and after three months. Results Mean age was 63.3 ± 6.6 and 61.4 ± 7.5 years in groups 1 and 2, respectively (p = 0.245. There were no statistically significant differences between both groups. Also, baseline prostate specific antigen (PSA, prostate volume, creatinine, International Prostatic Symptom Score (IPSS, IPSS-Quality of Life (IPSS-QoL, maximal urinary flow rates (Qmax, average urinary flow rates (AFR, post void residual urine volumes (PVR, nocturia and Pittsburgh Sleep Quality Score (PSQS were similar in both groups. In addition, the total IPSS, IPSS-QoL, PVR, nocturia, and PSQS were significantly lower in Group 2 compared with Group 1 after treatment (p < 0.05. Qmax and AFR were higher significantly in Group 2 compared with Group 1 after treatment (p < 0.05. Conclusions Cyclooxygenase (COX-2 inhibitors in combination with an alpha blocker may

  20. Photoselective vaporization of the prostate with GreenLight 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zang, Ya-Chen; Deng, Xin-Xi; Yang, Dong-Rong; Xue, Bo-Xin; Xu, Li-Jun; Liu, Xiao-Long; Zhou, Yi-Bin; Shan, Yu-Xi

    2016-02-01

    The aim of this study is to assess the overall efficacy and safety of photoselective vaporization of the prostate (PVP) with GreenLight 120-W laser versus transurethral resection of the prostate (TURP) for treating patients of benign prostate hyperplasia (BPH) with lower urinary tract symptoms (LUTS). We performed a literature search of The Cochrane Library and the electronic databases, including Embase, Medline, and Web of Science. Manual searches were conducted of the conference proceedings, including European Association of Urology and American Urological Association (2007 to 2012). Outcomes reviewed included clinical baseline characteristics, perioperative data, complications, and postoperative functional results, such as postvoid residual (PVR), international prostate symptom score (IPSS), quality of life (QoL), and maximum flow rate (Qmax). Six randomized controlled trials (RCTs) were enrolled. Three hundred and forty-seven patients undergone 120-W PVP, and 350 patients were treated with TURP in the RCTs. There were no significant differences for clinical characteristics in these trials. In perioperative data, catheterization time and length of hospital stay were shorter in the PVP group. However, the operation time was shorter in the TURP group. Capsular perforation, blood transfusion, clot retention, and macroscopic hematuria were markedly less likely in PVP-treated subjects. The other complications between PVP and TURP did not demonstrate a statistic difference. There were no significant differences in QoL, PVR, IPSS, and Qmax in the 1, 3, 6, 12, and 24 months of postoperative follow-up. There was no significant difference at postoperation follow-up of functional outcomes including IPSS, PVR, Qmax, and QoL between the TURP-treated subjects and PVP-treated subjects. Owing to a shorter catheterization time, reduced hospital duration and less complication, PVP could be used as an alternative and a promising minimal invasive surgical procedure for the

  1. CLINICAL OBSERVATION ON 60 CASES OF BENIGN HYPERPLASIA OF PROSTATE TREATED BY INJECTION OF "CHUAN-SHEN-TONG" INJECTIO INTO HUIYIN (CV 1)

    Institute of Scientific and Technical Information of China (English)

    WANG Runs-heng; GUO Xiao-chuan

    2005-01-01

    Objective:To observe the therapeutic effect of injection of "Chuan-Shen-Tong" Injectio 川参通注射液 at Huiyin 会阴 CV 1 on benign hyperplasia of prostate. Methods: 60 cases of benign hyperplasia of prostate patients were evenly randomized into treatment group and control group. Those of treatment group were treated with injection of "Chuan-Shen-Tong" Injectio composed of Rhizoma Ligustici Chuanxiong, Radix Salviae Miltiorrhizae, etc. For relieving hyperplasis of prostate, 4 mL/acupoint into Huiyin CV 1 and the other 60 cases of control group were treated by oral administration of Hytrin 1 mg/d in the 1st week and increasing 1 mg/3 d, 4 mg at most. After 28 days' treatment, their therapeutic effects were compared. Results: After treatment, of each 60 cases in treatment and control groups, 11 18.3% and 11 11.7% were controlled in their symptoms, 25 41.7% and 16 26.7% had marked improvement, 18 30.0% and 17 28.3% had improvement, and 6 10.0% and 20 33.3% failed, with the effective rate and the markedly effective rate being 90.0% and 66.7% in the treatment group and 66.7% and 38.3% in the control group respectively. The therapeutic effect of treatment group was significantly superior to that of control group P<0.01 and P<0.05. Conclusion: The therapeutic effect of point-injection of "Chuan-Shen-Tong" for benign hyperplasia of prostate is better than that of oral administration of Hytrin.

  2. Therapeutic effect evaluation of TUPKEP combined with percutaneous cystotomy and nephroscopic EMS minimally invasive therapy for benign prostatic hyperplasia with multiple large bladder calculi

    Institute of Scientific and Technical Information of China (English)

    Zhi-Hu Zhu; Bing-Xun He; Hou-Bin Kang

    2016-01-01

    Objective:To study the therapeutic effect of TUPKEP combined with nephroscopic EMS pneumatic minimally invasive therapy for benign prostatic hyperplasia with multiple large bladder calculi.Methods: Benign prostatic hyperplasia patients with multiple (large) bladder calculi who received surgical treatment in our hospital from May 2012 to October 2015 were selected as the research subjects and randomly divided into TUPKEP group and TURP group, and then perioperative situation, serum PSA levels, liver and kidney function and the degree of inflammation were compared between two groups.Results: During operation, the amount of bleeding and the weight of removed prostate of TUPKEP group were significantly lower than those of TURP group; during postoperative recovery, the time of retention catheterization of TUPKEP group was shorter than that of TURP group; 1 d, 3 d and 7 d after operation, serum PSA levels of both groups were significantly higher than those before operation and serum PSA levels of TUPKEP group were significantly lower than those of TURP group; 3 days after operation, ALT, AST, BUN and Scr levels of TUPKEP group and TURP group were not different, and IL-1β and IL-18 levels in serum as well as mRNA levels of NLPR3, ACS, Caspase-1, IL-1β and IL-18 in peripheral blood mononuclear cells of TUPKEP group were significantly lower than those of TURP group.Conclusion: TUPKEP combined with nephroscopic EMS pneumatic minimally invasive therapy for benign prostatic hyperplasia with multiple large bladder calculi causes less damage, has better resection effect on the hyperplastic gland tissue than TURP, and has equivalent long-term curative effect to TURP.

  3. Risk of gynecomastia and breast cancer associated with the use of 5-alpha reductase inhibitors for benign prostatic hyperplasia

    Science.gov (United States)

    Hagberg, Katrina Wilcox; Divan, Hozefa A; Fang, Shona C; Nickel, J Curtis; Jick, Susan S

    2017-01-01

    Background Clinical trial results suggest that 5-alpha reductase inhibitors (5ARIs) for the treatment of benign prostatic hyperplasia (BPH) may increase the risk of gynecomastia and male breast cancer, but epidemiological studies have been limited. Patients and methods We conducted a cohort study with nested case–control analyses using the UK Clinical Practice Research Datalink. We identified men diagnosed with BPH who were free from Klinefelter syndrome, prostate, genital or urinary cancer, prostatectomy or orchiectomy, or evidence of gynecomastia or breast cancer. Patients entered the cohort at age ≥40 years and at least 3 years after the start of their electronic medical record. We classified exposure as 5ARIs (alone or in combination with alpha blockers [ABs]), AB only, or unexposed to 5ARIs and ABs. Cases were men who had a first-time diagnosis of gynecomastia or breast cancer. Incidence rates and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) in the gynecomastia analysis and crude and adjusted odds ratios (ORs) with 95% CIs in both analyses were calculated. Results Compared to no exposure, gynecomastia risk was elevated for users of 5ARIs (alone or in combination with ABs) in both the cohort (IRR=3.55, 95% CI 3.05–4.14) and case–control analyses (OR=3.31, 95% CI 2.66–4.10), whereas the risk was null for users of AB only. The increased risk of gynecomastia with the use of 5ARIs persisted regardless of the number of prescriptions, exposure timing, and presence or absence of concomitant prescriptions for drugs known to be associated with gynecomastia. The risk was higher for dutasteride than for finasteride. 5ARI users did not have an increased risk of breast cancer compared to unexposed men (OR=1.52, 95% CI 0.61–3.80). Conclusion In men with BPH, 5ARIs significantly increased the risk of gynecomastia, but not breast cancer, compared to AB use and no exposure. PMID:28228662

  4. 手术治疗慢性前列腺炎并前列腺增生症的临床效果观察%Clinical effect of surgical treatment of chronic prostatitis and benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    董向明; 周光辉

    2015-01-01

    OBJECTIVE: To: study the clinical effect of surgical treatment of chronic prostatitis and benign prostatic hyperplasia. Methods: 128 cases of chronic prostatitis and benign prostatic hyperplasia were selected as the research object in our hospital from January 2013 to January. randomly divided into observation group and control group, 64 cases in each group, aged 45~75 years, average age (53+9.6 years), the observation group of chronic prostatitis and prostatic hyperplasia patients for surgery, mainly is for suprapubic bladder and prostate removal surgery, control group prostatic hyperplasia patients with surgical treatment, and to observe the two groups of patients after complications. Results: the observation group of patients with chronic prostatitis and benign prostatic hyperplasia surgery, the effect is poor, the complications are more. Conclusion: Patients with chronic prostatitis in patients with benign prostatic hyperplasia, and between the two presented is is correlation. therefore, in surgery must strictly grasp the operation indication, operation to do a good job in the corresponding prevention and control measures, and thus avoid patients after complication.%目的:研究手术治疗慢性前列腺炎并前列腺增生症的临床效果。方法本研究选择我院自2013年1月~2015年1月收治的128例慢性前列腺炎并前列腺增生症患者作为研究对象。随机分为观察组和对照组,每组64例,年龄45~75岁,平均年龄(53±9.6)岁,其中观察组慢性前列腺炎并前列腺增生症患者进行手术治疗,主要是进行耻骨上膀胱前列腺摘除手术,对照组前列腺增生症患者进行手术治疗,并观察两组患者手术后的并发症发生情况。结果观察组慢性前列腺炎并前列腺增生症患者手术的疗效较差,并发症较多。结论慢性前列腺炎患者对合并前列腺增生,并且二者之间呈现的是正相关联系,因此,在进行手术治疗时就必须

  5. Men’s preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment

    Directory of Open Access Journals (Sweden)

    Mankowski C

    2016-11-01

    Full Text Available Colette Mankowski,1 Divine Ikenwilo,2,† Sebastian Heidenreich,2 Mandy Ryan,2 Jameel Nazir,1 Cathy Newman,1 Verity Watson2 1Health Economics and Outcomes Research, Astellas Pharma Europe Ltd., Chertsey, 2Health Economics Research Unit, University of Aberdeen, Aberdeen, UK †Dr Ikenwilo passed away on November 27, 2015 Objective: To explore and quantify men’s preferences and willingness to pay (WTP for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment. Subjects and methods: Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8 were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes. Results: In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level, but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency, and £6.65/month and £1.39/month for each unit reduction in night- and ­daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild

  6. Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications.

    Science.gov (United States)

    Seftel, A; Rosen, R; Kuritzky, L

    2007-01-01

    In a large-scale epidemiology study, 50% of aging men reported erectile dysfunction (ED) or ejaculatory dysfunction (EjD), with lower urinary tract symptoms (LUTS) an independent risk factor for each of these conditions. In light of the shift from urologists (UROs) to primary care/internal medicine physicians (PCPs) for the initial management of men with LUTS associated with benign prostatic hyperplasia (BPH), a survey was conducted to assess the perceptions of UROs and PCPs regarding sexual dysfunction (SD) in men with LUTS/BPH and the effects of BPH treatments (alpha(1)-adrenergic receptor antagonists (alpha-blockers) and 5alpha-reductase inhibitors (5ARIs)) on sexual function. The survey was mailed to 7500 UROs and 2500 PCPs, with 1275 (13%) surveys returned (1087 by UROs, 177 by PCPs and 11 by other specialty). Alpha-blocker monotherapy was the most common medication prescribed by both UROs (56%) and PCPs (47%). UROs estimated that 19% of their patients with LUTS/BPH experienced SD owing to their symptoms compared with the estimate of 27% by PCPs. UROs estimated that 19% of their patients experienced SD owing to their BPH medication compared with the PCP estimate of 24%. The incidence of EjD owing to BPH medications estimated by UROs (32%) was higher than that estimated by PCPs (22%); the rate of ED estimated by PCPs (34%) was higher than that estimated by UROs (23%). UROs were more aware than PCPs of the specific sexual side effects caused by alpha-blockers versus 5ARIs. These results suggest that physicians are underestimating the prevalence of SD in men with LUTS/BPH. As men with LUTS/BPH are at increased risk for SD, physicians should be especially cognizant of BPH treatment-related sexual side effects.

  7. Measuring disease-specific health status in men with benign prostatic hyperplasia. Measurement Committee of The American Urological Association.

    Science.gov (United States)

    Barry, M J; Fowler, F J; O'Leary, M P; Bruskewitz, R C; Holtgrewe, H L; Mebust, W K

    1995-04-01

    In preparation for an outcomes study of benign prostatic hyperplasia (BPH), two measures of disease-specific health status were developed to supplement a symptom score and overall health status measures. The symptom problem index (SPI) captures how troublesome patients find their urinary symptoms. The BPH impact index (BII) measures how much their urinary problems affect various domains of health. A prospective revalidation of the refined instruments (N = 108 BPH patients and 50 controls) documented that both indices had good internal consistency (Cronbach's alpha = 0.88 and 0.79, respectively) and test-retest (r = 0.88 for both) reliabilities, correlated strongly with symptom scores (r = 0.86 and 0.77), and discriminated between BPH and control subjects (receiver-operating characteristic areas = 0.87 and 0.85, respectively). These indices were nearly as responsive as symptom scores in 50 men actively treated for BPH, and much more responsive than a non-disease-specific General Health Index (GHI), a Mental Health Index (MHI), and an Activity Index (AI). Finally, these measures capture most of the health status significance of BPH symptoms. In linear regression models constructed to predict scores on the GHI, MHI, and AI, symptom scores added little explanatory power to the SPI and, particularly, to the BII. These measures help clarify how BPH affects overall health status and function. Such measures have an important role to play in studies of the outcomes of treatment for BPH, and probably for other conditions that interfere with health status and function.

  8. Association of Variants in Genes Related to the Immune Response and Obesity with Benign Prostatic Hyperplasia in CLUE II

    Science.gov (United States)

    Lopez, David S.; Peskoe, Sarah B.; Tsilidis, Konstantinos K.; Hoffman-Bolton, Judy; Helzlsouer, Kathy J.; Isaacs, William B.; Smith, Michael W.; Platz, Elizabeth A.

    2014-01-01

    BACKGROUND Chronic inflammation and obesity may contribute to the genesis or progression of benign prostatic hyperplasia (BPH) and BPH-associated lower urinary tract symptoms (LUTS). The influence of variants in genes related to these states on BPH has not been studied extensively. Thus, we evaluated the association of 17 single nucleotide polymorphisms (SNPs) in immune response genes (IL1B, IL6, IL8, IL10, TNF, CRP, TLR4, RNASEL) and genes involved in obesity, including insulin regulation (LEP, ADIPOQ, PPARG, TCF7L2), with BPH. METHODS BPH cases (N=568) and age-frequency matched controls (N=568) were selected from among adult male CLUE II cohort participants who responded in 2000 to a mailed questionnaire. BPH was defined as BPH surgery, use of BPH medications, or symptomatic BPH (American Urological Association Symptom Index Score ≥15). Controls were men who had not had BPH surgery, did not use BPH medications, and whose symptom score was ≤7. Age-adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. RESULTS None of the candidate SNPs was statistically significantly associated with BPH. However, we could not rule out possible weak associations for CRP rs1205 (1082C>T), ADIPOQ rs1501299 (276C>A), PPARG rs1801282 (-49C>G), and TCF7L2 rs7903146 (47833T>C). After summing risk alleles, men with ≥4 had an increased BPH risk compared with those with ≤1 (OR, 1.78; 95% CI, 1.10-2.89; Ptrend=0.006). CONCLUSION SNPs in genes related to immune response and obesity, especially in combination, may be associated with BPH. PMID:25224558

  9. ADME studies and preliminary safety pharmacology of LDT5, a lead compound for the treatment of benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    F. Noël

    Full Text Available This study aimed to estimate the absorption, distribution, metabolism and excretion (ADME properties and safety of LDT5, a lead compound for oral treatment of benign prostatic hyperplasia that has previously been characterized as a multi-target antagonist of α1A-, α1D-adrenoceptors and 5-HT1A receptors. The preclinical characterization of this compound comprised the evaluation of its in vitro properties, including plasma, microsomal and hepatocytes stability, cytochrome P450 metabolism and inhibition, plasma protein binding, and permeability using MDCK-MDR1 cells. De-risking and preliminary safety pharmacology assays were performed through screening of 44 off-target receptors and in vivo tests in mice (rota-rod and single dose toxicity. LDT5 is stable in rat and human plasma, human liver microsomes and hepatocytes, but unstable in rat liver microsomes and hepatocytes (half-life of 11 min. LDT5 is highly permeable across the MDCK-MDR1 monolayer (Papp ∼32×10-6 cm/s, indicating good intestinal absorption and putative brain penetration. LDT5 is not extensively protein-bound and is a substrate of human CYP2D6 and CYP2C19 but not of CYP3A4 (half-life >60 min, and did not significantly influence the activities of any of the human cytochrome P450 isoforms screened. LDT5 was considered safe albeit new studies are necessary to rule out putative central adverse effects through D2, 5-HT1A and 5-HT2B receptors, after chronic use. This work highlights the drug-likeness properties of LDT5 and supports its further preclinical development.

  10. Risk of prostate cancer diagnosis and mortality in men with a benign initial transrectal ultrasound-guided biopsy set

    DEFF Research Database (Denmark)

    Klemann, Nina; Røder, M Andreas; Helgstrand, J Thomas

    2017-01-01

    BACKGROUND: The risk of missing prostate cancer in the transrectal ultrasound-guided systematic biopsies of the prostate in men with suspected prostate cancer is a key problem in urological oncology. Repeat biopsy or MRI-guided biopsies have been suggested to increase sensitivity for diagnosis....... METHODS: Data were extracted from the Danish Prostate Cancer Registry-a population-based registry including all men undergoing histopathological assessment of prostate tissue. All men who were referred for transrectal ultrasound-guided biopsy for assessment of suspected prostate cancer between Jan 1, 1995......, and Dec 31, 2011, in Denmark were eligible for inclusion. Follow-up data were obtained on April 28, 2015. The primary endpoint was the cumulative incidence of prostate cancer-specific mortality, analysed in a competing risk setting, with death from other causes as the competing event. FINDINGS: Between...

  11. Medical and Surgical Treatment Modalities for Lower Urinary Tract Symptoms in the Male Patient Secondary to Benign Prostatic Hyperplasia: A Review.

    Science.gov (United States)

    Macey, Matthew Ryan; Raynor, Mathew C

    2016-09-01

    Benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) is one of the most common ailments affecting aging men. Symptoms typically associated with BPH include weak stream, hesitancy, urgency, frequency, and nocturia. More serious complications of BPH include urinary retention, gross hematuria, bladder calculi, recurrent urinary tract infection, obstructive uropathy, and renal failure. Evaluation of BPH includes a detailed history, objective assessment of urinary symptoms with validated questionnaires, and measurement of bladder function parameters, including uroflowmetry and postvoid residual. In general, treatment of LUTS associated with BPH is based on the effect of the symptoms on quality of life (QOL) and include medical therapy aimed at reducing outlet obstruction or decreasing the size of the prostate. If medical therapy fails or is contraindicated, various surgical options exist. As the elderly population continues to grow, the management of BPH will become more common and important in maintaining patient's QOL.

  12. Clinical Analysis of 28 cases with Benign Prostatic Hyperplasia%前列腺增生28例临床分析

    Institute of Scientific and Technical Information of China (English)

    喻德康

    2007-01-01

    目的 了解尿道前列腺汽化电切术(transurethral electrovaporization of the prostate, TUVP)对良性前列腺增生症(benign prostatic hyperplasia , BPH)的疗效.方法 回顾性分析2003年1月~2005年1月于我院就诊的28例BPH患者资料.28例患者均采用TUVP治疗.结果 ①术后共发生并发症2例.②患者术后6个月最大尿流率、国际前列腺症状评分、以及生活质量评分等指标与术前比较均有明显改善(P<0.05).

  13. Pharmaceutical evaluation of naftopidil enantiomers: Rat functional assays in vitro and estrogen/androgen induced rat benign prostatic hyperplasia model in vivo.

    Science.gov (United States)

    Huang, Jun-Jun; Cai, Yi; Huang, Min-Yi; Zhu, Liu; He, Fei; Liu, Xia-Wen; Huang, Bi-Yun; Yi, Yan-Zhen; Yuan, Mu

    2016-11-15

    Naftopidil (NAF) is a α1D/1A adrenoceptor selective drug used for the treatment of both benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS). However, NAF is used as a racemate in clinic. To compare the differences and similarities among two enantiomers and racemate, pharmacological activities were evaluated through rat functional assays in vitro and estrogen/androgen (E/T) induced rat BPH model in vivo. NAF and the two enantiomers showed similar blocking activity on α1 receptor. S-NAF exhibited more α1D/1A adrenoceptor subtype selectivity than R-NAF and the racemate. The selectivity ratios pA2 (α1D)/pA2 (α1B) and pA2 (α1A)/pA2 (α1B) were 40.7- and 16.2-fold, respectively. NAF and its enantiomers effectively prevented the development of rat prostatic hyperplasia via suppressing the increase of the prostatic wet weight, visually. The quantitative analysis of the relative acinus volume, relative stroma volume, relative epithelial volume, epithelial height and expression of proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) were carried out. S-NAF showed an advantage on the effect of inhibiting prostate wet weight and stroma volume over R-NAF and racemate NAF (P<0.05). Nevertheless, no other significant difference was observed between these two enantiomers. In conclusion, both R-NAF and S-NAF not only relax prostate muscle but also inhibit the prostate growth, thus relieve BPH.

  14. Three-year outcome analysis of alpha 1-blocker naftopidil for patients with benign prostatic hyperplasia in a prospective multicenter study in Japan

    Science.gov (United States)

    Masumori, Naoya; Tsukamoto, Taiji; Shibuya, Akihiko; Miyao, Noriomi; Kunishima, Yasuharu; Iwasawa, Akihiko

    2016-01-01

    Purpose Our aim was to prospectively analyze the 3-year outcomes of naftopidil treatment for patients with benign prostatic hyperplasia (BPH), including those who dropped out during follow-up and had retreatment for BPH after termination of the drug within 3 years. Patients and methods Naftopidil, 50 mg/d or 75 mg/d, was given to 117 patients having BPH aged 50 years and older who had international prostate symptom scores (IPSS) ≥8. They were prospectively followed for 3 years with periodic evaluation. If naftopidil was terminated, the reason was determined. For patients with termination, an outcome survey was done to evaluate the status of retreatment for BPH at 3 years. Results Twenty-five patients (21.4%) continued the same medication for 3 years. The total IPSS, quality of life index, BPH problem index, and maximum flow rate were significantly improved during 3 years. Treatment failure defined as symptomatic progression (an increase in the IPSS of ≥4 points compared to the baseline value), development of acute urinary retention, conversion to other α1-blockers, add-on of a 5α-reductase inhibitor, or conversion to surgery was observed in 41 patients (35.0%). In the univariate analysis, age, prostate volume, and serum prostate-specific antigen were predictors of treatment failure. Of the 50 patients who discontinued naftopidil during the follow-up, only 13 (26%) patients reported that they needed retreatment with α1-blockers and/or surgery within 3 years. Conclusion Long-term efficacy of naftopidil was observed, although older age, increased prostate volume, and elevated prostate-specific antigen at baseline were highly likely to result in treatment failure. Even after termination for various reasons, only a small portion of the patients needed retreatment for BPH within 3 years. PMID:27524886

  15. [Drug therapy of benign prostatic hyperplasia. Is combination therapy with 5 alpha-reductase inhibitors and alpha-receptor blockers effective?].

    Science.gov (United States)

    Horninger, W; Bartsch, G

    2002-09-01

    5 alpha-reductase inhibitors and alpha 1-receptor blockers are the two main drug therapies used in the management of symptomatic benign prostatic hyperplasia. As alpha-reductase inhibitors and alpha 1-receptor blockers act through different mechanisms, a combination of the two agents might be promising. The potential benefits of combination therapy with selective alpha 1-receptor blockers and finasteride, a 5 alpha-reductase inhibitor, are currently being evaluated in several placebo-controlled prospective multicenter studies (VA Study, ALFIN Study, PREDICT Study, and MTOPS Study). The data from these studies available so far demonstrate a statistically significant benefit for the study groups receiving alpha 1-receptor blockers and combination therapy vs placebo and finasteride monotherapy in terms of symptom scores and peak urine flow rates. However, none of the studies yielded a statistically significant advantage of combination therapy over treatment with alpha 1-receptor blockers. These results should be interpreted with reference to the prostatic volume, which in the studies mentioned above was relatively low. From the results of all these studies, it can be concluded that in symptomatic patients with prostate volumes of up to 40-45 ml a combination of 5 alpha-reductase inhibitors with alpha 1-receptor blockers does not appear to provide any benefit. Yet, it can be assumed that in symptomatic patients with prostate volumes of more than 60 ml combination therapy may indeed prove more effective.

  16. EU Enlargement

    DEFF Research Database (Denmark)

    Pedersen, Peder J.; Pytlikova, Mariola

    countries chose a transition period in relation to the "new" EU members. We employ a differences-in-differences estimator in our analysis. The results show that the estimated effect of the opening of Swedish labour market in 2004 on migration is insignificantly different from zero. Further, we......We look at migration flows from 8 Central and Eastern European Countries (CEECs) to 5 Nordic countries over the years 1985 - 2005 and we can exploit a natural experiment that arose from the fact that while Sweden opened its labour market from the day one of the 2004 EU enlargement, the other Nordic...

  17. Prostatitis

    OpenAIRE

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

    1998-01-01

    The laboratory diagnosis of acute bacterial prostatitis is straightforward and easily accomplished in clinical laboratories. Chronic bacterial prostatitis, and especially chronic idiopathic prostatitis (most often referred to as abacterial prostatitis), presents a real challenge to the clinician and clinical microbiologist. Clinically, the diagnosis of chronic idiopathic prostatitis is differentiated from that of acute prostatitis by a lack of prostatic inflammation and no “significant” (cont...

  18. Evaluation and validation of the core lower urinary tract symptom score as an outcome assessment tool for the treatment of benign prostatic hyperplasia: effects of the α1-adrenoreceptor antagonist silodosin.

    Science.gov (United States)

    Ito, Hiroki; Sano, Futoshi; Ogawa, Takehiko; Yao, Masahiro

    2014-01-01

    We investigated the Core Lower Urinary Tract Symptom Score as an outcome assessment tool for the treatment of lower urinary tract symptoms using silodosin. In addition, the ability of the Core Lower Urinary Tract Symptom Score to detect overactive bladder in male patients with lower urinary tract symptoms was examined. The present study included 241 males with benign prostatic hyperplasia treated at 31 medical facilities between June 2009 and December 2010. All patients were given silodosin, and the effects of silodosin intake were measured using four questionnaires: the Core Lower Urinary Tract Symptom Score, International Prostate Symptom Score, Overactive Bladder Symptom Score and Quality-of-Life index. The efficacy of silodosin for treating lower urinary tract symptoms was validated according to the total scores of all four questionnaires weighted equally (P benign prostatic hyperplasia (ρ = 0.314) and benign prostatic hyperplasia/overactive bladder (ρ = 0.244). Our findings showed the Core Lower Urinary Tract Symptom Score, both its total score and each subscore, is able to show the efficacy of silodosin, similar to other questionnaires. The Core Lower Urinary Tract Symptom Score is also useful for identifying overactive bladder symptoms in patients with benign prostatic hyperplasia. As the Core Lower Urinary Tract Symptom Score does not correlate well with the Quality-of-Life index, these two questionnaires might be better used in combination to assess treatment outcomes.

  19. Review of dutasteride/tamsulosin fixed-dose combination for the treatment of benign prostatic hyperplasia: efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Barkin J

    2011-10-01

    Full Text Available Jack BarkinHumber River Regional Hospital, Toronto, Canada and Department of Surgery, University of Toronto, Toronto, Ontario, CanadaAbstract: Lower urinary tract symptoms (LUTS caused by benign prostatic hyperplasia (BPH will usually affect older men, of whom 50% over the age 60 years and almost 90% in their nineties will be bothered enough by their symptoms that they request some type of treatment. However, symptomatic bother may also affect men in their forties with a prevalence rate of almost 18%. The International Prostate Symptom Score (IPSS has become the most widely used and best validated questionnaire to allow the patient to quantify the severity of his LUTS/BPH symptoms. This score has become the cornerstone in demonstrating the “rate of symptom response” for the patient who has been exposed to any type BPH management. Question 8 on the IPSS score is what is defined as the “Quality of Life” question or what is also termed the “Bothersome Index.” The score out of 6 as declared by the patient will reflect the degree of concern that the patient is feeling about his symptoms and the reduction of the score after treatment is a statement of their improved quality of life. There are 2 families of accepted medical therapy to treat the symptoms of BPH and potentially prevent the most worrisome long-term sequelae of progression of BPH: urinary retention or the need for surgery. When defining the impact of the main types of medical therapy, the alpha blockers have been termed the “openers” and the 5 alpha-reductase inhibitors are described as the “shrinkers.” Since they each offer a different mechanism of effect, the concept of combination therapy was raised and trialed many times over recent years. The final aspect of any medical therapy is the patient's satisfaction with the treatment and the side effects. In the CombAT (Combination of Avodart and Tamsulosin trial a new assessment was developed and tested called the Patient

  20. Influence of depression on benign prostate hyperplasia in rats%抑郁对大鼠前列腺增生影响的实验研究

    Institute of Scientific and Technical Information of China (English)

    黄小波; 李宗信; 李斌; 郭德育; 敖平; 李日庆

    2004-01-01

    BACKGROUND: There are few reports on the influence of depression on benign prostate hyperplasia in rats, although studies show that many factors can affect benign prostate hyperplasia in rats OBJECTIVE: To study the influence of depression on benign prostate hyperplasia in ratsDESIGN: A randomized controlled trial.SETTING and MATERIALS: The experiments were made in Animal Lab of Xuanwu Hospital of Capital University of Medical Sciences. Forty male Sprague-Dawley(SD) rats, mass 220 - 230 g, special pathogen free animal (SPF) without special pathogen, were selected.INTERVENTIONS: All the rats were randomly divided into 4 different groups: normal control group, depression group, testosterone propionaste (TP)group, and depression & TP group. In TP group and depression & TP group,each rat was given TP 1 mg/d subcutaneous injection(TP was solved into soy oil, 2 g/L), with the injection quantity of 0. 5 mL. Each rat of normal control group and depression group were injected equivalent solvent. The animal models were made in 3 weeks.MAIN OUTCOME MEASURES: Prostate quality, prostate index of rats were measured, and prostate tissues sections with HE dyeing were observed. PCNA multiplication index were calculated by immunohistochemistry method.RESULTS: The prostate index and prostate quality in depression group, TP group and depression & TP group were significantly higher than that in control group ( P<0.05 -0.01 ), and the prostate index and prostate quality in depression & TP group were also higher than that in simple depression group( P<0.01). The prostate index and PCNA index in simple depression group were significantly higher than that in control group( P<0.05) . The observation by histology showed that the prostate of rats in depression group was proliferated.CONCLUSION: The result shows that depression can accelerate benign hyperplasia prostate to a certain degree in rats.%背景:有多种因素对大鼠前列腺增生模型影响的实验研究,但抑郁对大

  1. Expression of COX-2 and VEGF in benign prostatic hyperplasia combined with prostatitis%合并前列腺炎的前列腺增生组织中COX-2、VEGF的表达

    Institute of Scientific and Technical Information of China (English)

    关胜; 曹林升

    2010-01-01

    Objectives To study the expressions of Vascular endothelial growth factor ( VEGF) and cyclooxygenase-2 in benign prostatic hyperplasia combined with Prostatitis,analyze their correlation and to investigate the effect and molecular mechanism of prostatitis on BPH.Methods 60 specimens were obtained from patients undergoing transurethral prostatic resection(TURP).The paraffin section of the specimens were stained with hematoxylin and eosin,and observed under light microscope to examine the inflammation pathological changes.Depending on whether the benign prostatic hyperplasia combined with prostatitis,those specimens were divided into group of simple benign prostatic hyperplasia ( A group) and group of benign prostatic hyperplasia combined with prostatitis ( B group),using inununohistochemistry and Real-time fluorescence quantitative PCR ( RT-PCR) to detect the expressions of COX-2 and VEGF in prostate tissues.Results (1) immunohistochemical staining: COX-2 and VEGF expressed in the A group and B group,but in the B group of tissues were significantly higher than A group of tissues( p <0.05); COX-2 and VEGF expression in the B group of organizations had a positive correlation ( R = 0.92,p <0.05) (2) COX-2 mRNA in the A group,the relative ratio; 0.141 ± 0.019,in the B group,the relative ratio: 0.161 ± 0.013;VEGF mRNA in the A group relative ratio: 0.2S4 ± 0.015,in the B group,the relative ratio; 0.341 ± 0.012,The expressions of COX-2mRNA and VEGF mRNA in the B group were significantly higher than the expressions of A group ( p <0.05) .Conclusions The inflammatory factor COX-2 and proliferative factor VEGF in the tissues of benign prostatic hyperplasia combined with prostatitis are significantly increased and the expression levels of both positive correlation,COX-2 by the way of up-regulating VEGF expression may be involved in the development process of benign prostatic hyperplasia.%目的 研究环氧化酶-2(COX-2)、血管内皮生长冈子(VEGF)在合并前列

  2. The inflammatory microenvironment of the aging prostate facilitates cellular proliferation and hypertrophy.

    Science.gov (United States)

    Begley, L A; Kasina, S; MacDonald, J; Macoska, J A

    2008-08-01

    Benign Prostatic Hypertrophy (BPH, also known as benign prostatic hyperplasia or benign prostatic enlargement), is one of the most common benign proliferative conditions associated with aging in men and is pathologically characterized by the proliferation of fibroblast/myofibroblast and epithelial cell types in the prostate. Previous studies from our laboratory have shown that the CXC-type chemokines, CXCL5 and CXCL12, are secreted by aging prostate stroma and promote both proliferative and transcriptional responses from prostate epithelial cells. Using array-based gene expression profiling and quantitative reverse-transcriptase polymerase chain reaction, we now show that the transcriptome of the aging prostate stroma is characterized by the up-regulation of several genes that encode secreted inflammatory mediators, including secreted CXC-type chemokines (CXCL1, CXCL2, CXCL5, CXCL6, CXCL12), interleukins (IL11, IL33), and transcripts with cytokine homology (CYTL1). At the protein level, ELISA experiments demonstrated that CXCL1, CXCL5, and CXCL6 were secreted by primary prostate stromal fibroblasts explanted from aging prostate stroma. Dose-response assays confirmed that, like CXCL5 and CXCL12, CXCL1 and CXCL6 promote low-level proliferative responses from both prostate stromal fibroblasts and epithelial cells. Taken together, these data suggest that inflammatory mediators are secreted by prostatic stroma consequent to aging, that the levels of these mediators are sufficient to promote low-level increases in the proliferative rate of both epithelial and stromal fibroblast cell types. Moreover, these processes may account for the low-level, but cumulative, proliferation of both epithelial and fibroblastic/myofibroblastic cell types that characterizes the aging-associated development of benign prostatic hypertophy.

  3. Xanthogranulomatous Prostatitis, a Rare Prostatic Entity

    Directory of Open Access Journals (Sweden)

    Alejandro Noyola

    2017-01-01

    Full Text Available There are several benign prostatic pathologies that can clinically mimic a prostate adenocarcinoma. Xanthogranulomatous prostatitis is a benign inflammatory condition of the prostate and a rare entity. A 47-year old male, with 3 years of lower urinary tract symptoms, with a palpable hypogastric tumor, digital rectal examination: solid prostate, of approximately 60 g. Initial PSA was 0.90 ng/mL. He underwent surgical excision of the lower abdominal nodule and prostatectomy. Histopathology showed xanthogranulomatous prostatitis, without malignancy. Xanthogranulomatous prostatitis is an extremely rare entity that can simulate prostate adenocarcinoma, therefore having a correct histopathological diagnosis is essential.

  4. Xanthogranulomatous Prostatitis, a Rare Prostatic Entity.

    Science.gov (United States)

    Noyola, Alejandro; Gil, José Fernando; Lujano, Heriberto; Piñon, Omar; Muñoz, Gabriel; Michel, José Manuel; Garcia, Jorge; Valdez, Jorge; Morales, Omar

    2017-01-01

    There are several benign prostatic pathologies that can clinically mimic a prostate adenocarcinoma. Xanthogranulomatous prostatitis is a benign inflammatory condition of the prostate and a rare entity. A 47-year old male, with 3 years of lower urinary tract symptoms, with a palpable hypogastric tumor, digital rectal examination: solid prostate, of approximately 60 g. Initial PSA was 0.90 ng/mL. He underwent surgical excision of the lower abdominal nodule and prostatectomy. Histopathology showed xanthogranulomatous prostatitis, without malignancy. Xanthogranulomatous prostatitis is an extremely rare entity that can simulate prostate adenocarcinoma, therefore having a correct histopathological diagnosis is essential.

  5. Benign Prostatic Hyperplasia (BPH)

    Science.gov (United States)

    ... of this procedure aren't available. Open or robot-assisted prostatectomy The surgeon makes an incision in ... transurethral microwave therapy. If you have open or robot-assisted prostatectomy, you might need to restrict activity ...

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

    Science.gov (United States)

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

    2015-08-04

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  8. High-energy transurethral microwave thermotherapy in patients with benign prostatic hyperplasia: comparative study between 30-and 60-minute single treatments.

    Directory of Open Access Journals (Sweden)

    Yokoyama T

    2004-06-01

    Full Text Available We retrospectively evaluated the subjective and objective treatment results of transurethral microwave thermotherapy (TUMT for benign prostatic hyperplasia (BPH and explored the difference in effectiveness between 30- and 60-min single treatments. From June 1997 through March 2003, 58 men with BPH underwent TUMT using the Targis device. Twenty-seven and 31 patients each received a single treatment of 60 or 30 min, respectively. Evaluations after treatment included a clinical determination of the International Prostate Symptom Score, urodynamic assessments by peak flow rate, and magnetic resonance imaging (MRI. In the 60-min treatment, the symptom score improved significantly, from 17.9 to 9.5 after 2 months. Similarly, there was a significant improvement in peak flow rate, from 6.7 to 11.2 ml/sec after 2 months. In the 30-min treatment, the symptom score also improved significantly, from 18.4 to 13.4 after 2 weeks. Similarly, there was a significant improvement in the peak flow rate, from 6.4 to 11.7 ml/sec after 1 month. MRI imaging showed necrosis of the prostate gland 2 weeks after either treatment. These results demonstrated that both the 60-min and the 30-min treatments were effective for patients with BPH. Moreover, the 30-min treatment led to quicker improvement than the 60-min treatment. Thus, a 30-min TUMT protocol is considered recommendable for this treatment.

  9. A rare benign genitourinary tumor in a Japanese male: urinary retention owing to aggressive angiomyxoma of the prostate

    Directory of Open Access Journals (Sweden)

    Hayakazu Nakazawa

    2010-03-01

    Full Text Available Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.

  10. Chrysophanic acid reduces testosterone-induced benign prostatic hyperplasia in rats by suppressing 5α-reductase and extracellular signal-regulated kinase.

    Science.gov (United States)

    Youn, Dong-Hyun; Park, Jinbong; Kim, Hye-Lin; Jung, Yunu; Kang, JongWook; Jeong, Mi-Young; Sethi, Gautam; Seok Ahn, Kwang; Um, Jae-Young

    2017-02-07

    Benign prostatic hyperplasia (BPH) is one of the most common chronic diseases in male population, of which incidence increases gradually with age. In this study, we investigated the effect of chrysophanic acid (CA) on BPH. BPH was induced by a 4-week injection of testosterone propionate (TP). Four weeks of further injection with vehicle, TP, TP + CA, TP + finasteride was carried on. In the CA treatment group, the prostate weight was reduced and the TP-induced histological changes were restored as the normal control group. CA treatment suppressed the TP-elevated prostate specific antigen (PSA) expression. In addition, 5α-reductase, a crucial factor in BPH development, was suppressed to the normal level close to the control group by CA treatment. The elevated expressions of androgen receptor (AR), estrogen receptor α and steroid receptor coactivator 1 by TP administration were also inhibited in the CA group when compared to the TP-induced BPH group. Then we evaluated the changes in three major factors of the mitogen-activated protein kinase chain during prostatic hyperplasia; extracellular signal-regulated kinase (ERK), c-Jun-N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (p38). While ERK was elevated in the process of BPH, JNK and p38 was not changed. This up-regulated ERK was also reduced as normal by CA treatment. Further in vitro studies with RWPE-1 cells confirmed TP-induced proliferation and elevated AR, PSA and p-ERK were all reduced by CA treatment. Overall, these results suggest a potential pharmaceutical feature of CA in the treatment of BPH.

  11. Survivin and NAIP in Human Benign Prostatic Hyperplasia: Protective Role of the Association of Serenoa repens, Lycopene and Selenium from the Randomized Clinical Study

    Science.gov (United States)

    Morgia, Giuseppe; Micali, Antonio; Rinaldi, Mariagrazia; Irrera, Natasha; Marini, Herbert; Puzzolo, Domenico; Pisani, Antonina; Privitera, Salvatore; Russo, Giorgio I.; Cimino, Sebastiano; Ieni, Antonio; Trichilo, Vincenzo; Altavilla, Domenica; Squadrito, Francesco; Minutoli, Letteria

    2017-01-01

    Benign prostatic hyperplasia (BPH) treatment includes the apoptosis machinery modulation through the direct inhibition of caspase cascade. We previously demonstrated that Serenoa repens (Ser) with lycopene (Ly) and selenium (Se) reawakened apoptosis by reducing survivin and neuronal apoptosis inhibitory protein (NAIP) levels in rats. The aim of this study was to evaluate the effectiveness of Ser-Se-Ly association on survivin and NAIP expression in BPH patients. Ninety patients with lower urinary tract symptoms (LUTS) due to clinical BPH were included in this randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to receive placebo (Group BPH + placebo, n = 45) or Ser-Se-Ly association (Group BPH + Ser-Se-Ly; n = 45) for 3 months. At time 0, all patients underwent prostatic biopsies. After 3 months of treatment, they underwent prostatic re-biopsy and specimens were collected for molecular, morphological, and immunohistochemical analysis. After 3 months, survivin and NAIP were significantly decreased, while caspase-3 was significantly increased in BPH patients treated with Ser-Se-Ly when compared with the other group. In BPH patients treated with Ser-Se-Ly for 3 months, the glandular epithelium was formed by a single layer of cuboidal cells. PSA showed high immunoexpression in all BPH patients and a focal positivity in Ser-Se-Ly treated patients after 3 months. Evident prostate specific membrane antigen (PSMA) immunoexpression was shown in all BPH patients, while no positivity was present after Ser-Se-Ly administration. Ser-Se-Ly proved to be effective in promoting apoptosis in BPH patients. PMID:28327526

  12. Survivin and NAIP in Human Benign Prostatic Hyperplasia: Protective Role of the Association of Serenoa repens, Lycopene and Selenium from the Randomized Clinical Study

    Directory of Open Access Journals (Sweden)

    Giuseppe Morgia

    2017-03-01

    Full Text Available Benign prostatic hyperplasia (BPH treatment includes the apoptosis machinery modulation through the direct inhibition of caspase cascade. We previously demonstrated that Serenoa repens (Ser with lycopene (Ly and selenium (Se reawakened apoptosis by reducing survivin and neuronal apoptosis inhibitory protein (NAIP levels in rats. The aim of this study was to evaluate the effectiveness of Ser-Se-Ly association on survivin and NAIP expression in BPH patients. Ninety patients with lower urinary tract symptoms (LUTS due to clinical BPH were included in this randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to receive placebo (Group BPH + placebo, n = 45 or Ser-Se-Ly association (Group BPH + Ser-Se-Ly; n = 45 for 3 months. At time 0, all patients underwent prostatic biopsies. After 3 months of treatment, they underwent prostatic re-biopsy and specimens were collected for molecular, morphological, and immunohistochemical analysis. After 3 months, survivin and NAIP were significantly decreased, while caspase-3 was significantly increased in BPH patients treated with Ser-Se-Ly when compared with the other group. In BPH patients treated with Ser-Se-Ly for 3 months, the glandular epithelium was formed by a single layer of cuboidal cells. PSA showed high immunoexpression in all BPH patients and a focal positivity in Ser-Se-Ly treated patients after 3 months. Evident prostate specific membrane antigen (PSMA immunoexpression was shown in all BPH patients, while no positivity was present after Ser-Se-Ly administration. Ser-Se-Ly proved to be effective in promoting apoptosis in BPH patients.

  13. 经导管动脉栓塞治疗良性前列腺增生症一例报道%Transcatheter Arterial Embolization for benign prostatic hyperplasia - case report

    Institute of Scientific and Technical Information of China (English)

    兰春虎

    2009-01-01

    经导管动脉栓塞治疗良性前列腺增生症(benign prostatic hyperplasi,BPH),文献报道较少,省内未见报道。兹报告我院栓塞治疗的良性前列腺增生症1例如下。

  14. Validation of the self-administered Danish Prostatic Symptom Score (DAN-PSS-1) system for use in benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Hansen, B J; Flyger, H; Brasso, K;

    1995-01-01

    To validate the Danish Prostatic Symptom Score (DAN-PSS-1), a self-administered quality-of-life questionnaire comprising 12 questions related to voiding problems and the perceived bother of each individual symptom.......To validate the Danish Prostatic Symptom Score (DAN-PSS-1), a self-administered quality-of-life questionnaire comprising 12 questions related to voiding problems and the perceived bother of each individual symptom....

  15. 血清C-反应蛋白水平升高与前列腺癌患者的相关性%Association between Serum C-Reactive Protein and Benign Prostatic and Patients with Prostatic Cancer Hyperplasia

    Institute of Scientific and Technical Information of China (English)

    林莎; 赵莹; 张杰

    2014-01-01

    目的:探讨血清 C-反应蛋白(CRP)水平与前列腺癌(prostatic cancer,PCa)和良性前列腺增生(benign prostatic hyperplasia,BPH)患者的相关性。方法回顾性纳入2010年1月~2012年8月浙江大学附属第一医院泌尿外科住院的总前列腺特异性抗原(total prostate specific antigen,TPSA)大于4 ng/ml的患者110例,经前列腺穿刺术后病理切片确诊为前列腺癌54例,良性前列腺增生56例。采用透射免疫比浊法检测54例 PCa和56例 BPH 患者血清 CRP水平和化学发光免疫法检测TPSA水平,根据 Gleason评分将PCa患者分为高危性和低危性PCa两组,用非参数 Mann-Whitney U方法分析高危性和低危性PCa患者与BPH患者血清CRP水平的差异。结果高危性PCa的CRP水平为4.20±2.12 mg/L,低危性PCa的CRP水平为1.90±0.91 mg/L,BNP患者CRP水平为1.49±0.87 mg/L,高危性 PCa和低危性 PCa的血清CRP水平明显高于BPH患者,差异均具有统计学意义(P<0.05)。结论 PCa患者血清CRP水平明显升高,尤其是高危性PCa患者。%Objective To explore the association between C reactive protein (CRP)with prostatic cancer (PCa)and benign prostatic hyperplasia (BPH).Methods Retrospective analysis the 110 patients of the First Affiliated Hospital of Zhejiang University In January 2010 to August 2012 whose TPSA>4 ng/ml,postoperative pathology confirmed the diagnosis of 54 cases of prostate cancer,5 6 cases of benign prostatic hyperplasia.Detected serum CRP levels by using transmission turbidim-etry and TPSA levels by using chemiluminescence immunoassay of 54 PCa and 56 BPH patients.According to the Gleason score,PCa patients were divided into high-risk and low-risk PCa two groups,the differences among high-risk PCa,low-risk PCa and BPH groups were analyzed by nonparametric statistics analysis.Results The CRP level of high-risk PCa was 4.20~2.12 mg/L,the CRP level of low-risk PCa was 1.90~0.91 mg/L and the CRP levels

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

    Directory of Open Access Journals (Sweden)

    Li Ruan

    2015-01-01

    Full Text Available 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.

  17. Tai Chi for Lower Urinary Tract Symptoms and Quality of Life in Elderly Patients with Benign Prostate Hypertrophy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Seil Jung

    2012-01-01

    Full Text Available Tai chi exercise has been recommended as suitable for the improvement of health in the elderly. The purpose of this study was to investigate the effects of tai chi on lower urinary tract symptoms (LUTSs, quality of life (QoL, and sex hormone levels in patients with benign prostate hypertrophy (BPH. The elderly patients with BPH were randomized to receive tai chi or usual care. Fifty-six participants were randomized into either the tai chi group (n=28 or the control group (n=28. After 12 weeks of treatment, the tai chi group showed significant improvement in LUTS and QoL. There was a significant effect of tai chi on testosterone but no significant effect on insulin or glucose. No serious adverse events were observed during the study period. In conclusion, our results suggest that 12 weeks of tai chi may improve LUTS and QoL in elderly patients with BPH.

  18. Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Arie Carneiro

    2016-04-01

    Full Text Available ABSTRACT Purpose: This study compared the suprapubic (SP versus retropubic (RP prostatectomy for the treatment of large prostates and evaluated perioperative surgical morbidity and improvement of urinary symptoms. Materials and Methods: In this single centre, prospective, randomised study, 65 consecutive patients with LUTS and surgical indication with prostate volume greater than 75g underwent open prostatectomy to compare the RP (32 patients versus SP (33 patients technique. Results: The SP group exhibited a higher incidence of complications (p=0.002. Regarding voiding pattern analysis (IPSS and flowmetry, both were significantly effective compared to pre-treatment baseline. The RP group parameters were significantly better, with higher peak urinary flow (SP: 16.77 versus RP: 23.03mL/s, p=0.008 and a trend of lower IPSS score (SP: 6.67 versus RP 4.14, p=0.06. In a subgroup evaluation of patients with prostate volumes larger than 100g, blood loss was lower in those undergoing SP prostatectomy (p=0.003. Patients with prostates smaller than 100g in the SP group exhibited a higher incidence of low grade late complications (p=0.004. Conclusions: The SP technique was related to a higher incidence of minor complications in the late postoperative period. High volume prostates were associated with increased bleeding when the RP technique was utilized. The RP prostatectomy was associated with higher peak urinary flow and a trend of a lower IPSS Score.

  19. Expression of urokinase plasminogen activator, its receptor and type-1 inhibitor in malignant and benign prostate tissue

    DEFF Research Database (Denmark)

    Usher, Pernille Autzen; Thomsen, Ole Frøkjær; Iversen, Peter

    2005-01-01

    RNAs was predominantly seen in cells identified as macrophages, which in most of the carcinomas (approximately 90%) were located in the interstitial tissue between the tumor cell islands, while in most of the benign hyperplasias they were located in the lumen of the glands and were in only a few cases (approximately 30......%) found in the interstitial tissue. uPAR immunoreactivity correlated with the mRNA expression and was, in addition, found in neutrophils. PAI-1 mRNA was detected in 13 of the 16 carcinomas and in 8 of the 9 benign hyperplasias, located in scattered fibroblast-like cells in both groups, in some vascular...... structures and in a few macrophages located in the interstitial tissue of both malignant and benign lesions. A similar expression pattern was found for PAI-1 immunoreactivity. In 8 of the 16 carcinomas, all 3 components were present, and in several areas colocalization was observed in stromal cells in close...

  20. Uroflowmetry, trans rectal ultra sonography and power doppler to develop a less invasive bladder outlet obstruction score in benign prostatic hyperplasia: A prospective analysis

    Directory of Open Access Journals (Sweden)

    Rajiv Goyal

    2006-01-01

    Full Text Available OBJECTIVE : To evaluate the ability of transrectal power doppler sonography (TRPDS in combination with conventional grey scale transrectal ultrasonography (TRUS, uroflowmetry and clinical parameters, to predict bladder outlet obstruction (BOO in benign prostatic hyperplasia (BPH. MATERIALS AND METHODS : Sixty-nine male patients with more than 50 years of age, presenting with lower urinary tract symptoms were evaluated prospectively for BOO secondary to BPH. TRUS was done to estimate prostate volume (PV, transition zone volume (TZV, median lobe projection in the bladder (ML and bladder wall thickness (BWT. TRPDS was done to measure resistive index (RI of transition zone vessels. All patients also underwent PFS and depending upon its results, the patients were divided into Group 1 [Abram-Griffiths (AG number 40. Mean values of TRUS and TRPDS parameters and uroflowmetry in the two groups were compared to identify predictive factors for BOO. RESULTS : Demographic profile of Group 1 (n= 42 was similar to that of Group 2 (n= 27. Significant independent factors for prediction of BOO were maximum flow rate, resistive index of transition zone, median lobe projection into the bladder and post void residue. BOO scoring system was developed based on these 4 factors, which showed a specificity of 77.8% and a sensitivity of 85.7%, with an overall predictive value of 82.6%. CONCLUSIONS : Transrectal power doppler ultrasonography (resistive index in combination with uroflowmetry, median lobe projection in bladder and post void residue measurement can predict BOO with a high specificity and sensitivity.

  1. Efficacy of electroacupuncture at Zhongliao point (BL33 for mild and moderate benign prostatic hyperplasia: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ding Yulong

    2011-09-01

    Full Text Available Abstract Background Acu-point specificity is a key issue in acupuncture. To date there has not been any satisfactory trial which can ratify the specific effect of acupuncture. This trial will evaluate the specific effect of BL33 for mild and moderate benign prostatic hyperplasia (BPH on the basis of its effectiveness. The non-specific effect will be excluded and the therapeutic effect will be evaluated. Method This is a double-blinded randomized controlled trial. 100 Patients will be randomly allocated into the treatment group (n = 50 and the control group (n = 50. The treatment group receives needling at BL33 and the control group receives needling at non-point. The needling depth, angle, direction, achievement of De Qi and parameters of electroacupuncture are exactly the same in both groups. The primary outcome measure is reduction of international prostate symptom score (IPSS at the 6th week and the secondary outcome measures are reduction of bladder residual urine, increase in maximum urinary flow rate at the 6th week and reduction of IPSS at the 18th week. Discussion This trial will assess the specific therapeutic effect of electroacupuncture at BL33 for mild and moderate BPH. Trial registration Protocol Registration System of Clinical Trials.gov NCT01218243

  2. Prostatic paracoccidioidomycosis: differential diagnosis of prostate cancer

    Directory of Open Access Journals (Sweden)

    Daniel Lima Lopes

    2009-02-01

    Full Text Available Symptomatic prostatic paracoccidioidomycosis (PCM is a very rare condition; however, it may express as a typical benign prostatic hyperplasia or a simulating prostatic adenocarcinoma. This case report presents PCM mimicking prostatic adenocarcinoma. The purpose of this paper is to call the general physician's attention to this important differential diagnosis.

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Variation characteristics of proinflammatory cytokines in patients with prostatitis and benign prostatic hyperplasia%前列腺增生症合并前列腺炎患者促炎性细胞因子的变化特点

    Institute of Scientific and Technical Information of China (English)

    李海宽; 王瑞; 周增祥

    2015-01-01

    Objective To observe the variation characteristics of proinflammatory cytokines in patients with prostatic hyperplasia and prostatitis.Methods From 2012 June to 2014 January, 70 cases of hospitalized patients with disease of pros-tate, prostatic hyperplasia and prostatitis patients of 35 cases as the observation group, patients only with hyperplasia of pros-tate in 35 cases as the control group.Immunohistochemistry and immuno fluorescence quantitative PCR detection method were used for detection of proinflammatory cytokines, including interleukin 8 (IL-8), fibroblast growth factor 2 (FGF-2) and ma-trix metalloproteinase 2 ( MMP-2 ) , transforming growth factor beta ( TGF-β1 ) .And then through the immunohistochemical method to detect the tumor necrosis factor alpha (TNF-α),interleukin 6 (IL-6) and cluster of differentiation 3 (CD3) con-tent;finally, the detection results were statistical analyzed.Results The observation group’s IL-8, FGF-2 and MMP-2 pro-tein and IL-8 mRNA, FGF-2 mRNA and MMP-2 mRNA were higher than those in control group ( t =2.540 1, t =2.859 9, t =12.755 1, t =19.124 5, t =12.294 4, t =8.532 3, P 0.05), IL-6, CD3 level were higher than that of the control group ( t =3.942 0, t =6.988 1, P <0.01); bFGF-2 protein with moderate expression in the control group was 37.1%, which was lower than those in the observation group’ s 80%, the TGF-β1 protein moderate and above expression in the control group was 20%, which was lower than that of the observation group’s 82.8%(χ2 =2.721 8,χ2 =2.6784, P <0.01).Con-clusion The expression of proinflammatory cytokines in patients with benign prostatic hyperplasia and prostatitis was higher than patients with benign prostatic hyperplasia, prostatitis may change benign prostatic hyperplasia.%目的:观察促炎性细胞因子在前列腺增生症合并前列腺炎患者中的变化特点。方法选取2012年6月—2014年1月住院的前列腺疾病患者70例,前列腺增

  5. 前列腺增生危险因素的病例对照研究%Case-control study of the risk factors on benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    冀楠; 李晋军; 漆咏梅

    2011-01-01

    目的 研究前列腺增生(BPH)的各种危险因素及其危害程度.方法 以132例病理确诊的前列腺增生患者为病例组,以年龄匹配的132例无前列腺增生患者为对照组进行1:1配对病例对照研究.采集人口学因素、高血压史、糖尿病史、实验检测等临床资料.资料分析采用单因素和多因素条件Logistic回归分析.结果 (1)单因素分析显示:在吸烟、饮酒、糖尿病史、高血压史、慢性支气管炎史、肾囊肿史和慢性前列腺炎史差异统计学意义(P<0.05).(2)多因素分析显示:吸烟(OR=0.530)、糖尿病史(OR=2.227)、高血压史(OR=1.862)、慢性前列腺炎(OR=2.414)是BPH的独立危险因素(P<0.05).结论 前列腺炎史、高血压史、糖尿病史是BPH发病的危险因素,吸烟为保护性因素.良好的血压和血糖控制是预防BPH的重要方法.%Objective To identify the risk factors and related degree associated to benign prostatic hyperplasia (BPH). Methods A 1:1 case-control study on 132 BPH patients were matched with 132 controls with non-BPH. Collection of demographic factors, history of hypertension, diabetes, laboratory indicators and other clinical data. Data were analyzed with conditional univariate and multivariate logistic regression analysis. Results ( 1 ) Single-factor analysis showed:the two groups were significantly different in smoking, drinking, history of hypertension , diabetes, chronic bronchits , renal cysts and chronic prostatitis. (2)Multi-factor analysis indicated: smoking, history of diabetes, history of hypertension chronic prostatitis were independent risk factors of BPH. The ratio of the four factors for BPH were 0.530、2.227、1. 862、2.414 respectively. Conclusions History of diabetes, hypertension, chronic prostatitis may be the risk factors of BPH. Smoking may be the preventive factors. The effective control of blood pressure and blood sugar are important ways to prevent benign prostatic hyperplasia.

  6. Prostate Ultrasound

    Medline Plus

    Full Text Available ... also known as benign prostatic hyperplasia (BPH) , with measurements acquired as needed for any treatment planning. detect ... Rarely, a small amount of blood may be present in the sperm or urine following the procedure. ...

  7. Prostate Ultrasound

    Medline Plus

    Full Text Available ... also known as benign prostatic hyperplasia (BPH) , with measurements acquired as needed for any treatment planning. detect ... accredited facilities database . This website does not provide cost information. The costs for specific medical imaging tests, ...

  8. The role of chronic prostatitis in the pathogenesis and progression of benign prostatic hyperplasia%慢性前列腺炎在前列腺增生症发病与进展中的作用探讨

    Institute of Scientific and Technical Information of China (English)

    张益明; 范武林; 林国太; 林永平; 陈如

    2016-01-01

    目的 探讨慢性前列腺炎在前列腺增生症发病与进展中的可能作用.方法 回顾性分析本院2011年5月至2014年12月期间因前列腺增生就诊患者356例,根据术后病理结果分为前列腺增生并慢性前列腺炎组及单纯性前列腺增生组,统计分析两组临床特征,包括:年龄(Age)、前列腺体积(PV)、PSA、IPSS评分、是否合并急性尿潴留(AUR).结果 前列腺增生并慢性前列腺炎121/356例(34.0%),发生急性尿潴留48/121例(39.7%);单纯前列腺增生235/356例(66.0%),发生尿潴留60/235例(25.5%).两组对比年龄差别无统计学意义(P>0.05);但前列腺增生合并慢性前列腺炎组较单纯前列腺增生组PV、PSA、IPSS评分、尿潴留发生率均高,差别具有统计学意义(P<0.05).结论 前列腺增生合并慢性前列腺炎通常具有更大的体积、更高的PSA及IPSS评分、更易发生尿潴留.因此,前列腺慢性炎症在前列腺增生的发病、进展中可能起作用.%Objectives To investigate the role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH).Methods We enrolled 356 patients with BPH from May 2011 to December 2014 in our hospital were analyzed retrospectively.According to the pathological results,all patients were divided into the BPH with prostatitis group and BPH group.Age,prostate volume (PV),PSA,IPSS,and acute urinary retention (AUR) of the two groups were analyzed.Results In the BPH with prostatitis group,121/356 (34.0%) patients were be confirmed as BPH with prostatitis,the other 48/121 (39.7%) patients were be confirmed as acute urinary retention (AUR).In the BPH group,235/356 (66.0%) patients were be comfirmed as simple BPH.and there were 60 (25.5%) patients with AUR.There was no significant difference in patient's age between the two groups (P > 0.05),but PV,PSA,IPSS and incidence of AUR in the BPH with prostatitis group were higher than BPH group (P

  9. Increased serum C-reactive protein level is associated with increased storage lower urinary tract symptoms in men with benign prostatic hyperplasia.

    Directory of Open Access Journals (Sweden)

    Shun-Fa Hung

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

  10. Efficacy and safety of combined therapy with terazosin and tolteradine for patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: a prospective study

    Institute of Scientific and Technical Information of China (English)

    YANG Yong; ZHAO Xiao-feng; LI Han-zhong; WANG Wei; ZHANG Yong; XIAO He; ZHANG Xin

    2007-01-01

    Background The primary objectives of the treatment for the lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are to produce rapid, sustained, and safe improvements in the symptoms that affect the quality of life in the majority of men over 50. In this study, we evaluated the efficacy and safety of the combined therapy with terazosin (α1-adrenergic receptor antagonist) and tolterodine (anticholinergic agent) for LUTS associated with BPH.Methods This combination study included 69 patients diagnosed with LUTS associated with BPH based on the International Prostate Symptom Scores (IPSS), urinary flow rate, prostate volume, urinary residual, and their serum prostate-specific antigen levels. Initially, 191 patients were treated with terazosin 2 mg once daily for one week. Those patients with continued LUTS after the initial treatment were allocated randomly into two groups: terazosin group (n=36)in which patients were treated with terazosin 2 mg once daily for six weeks, and combination group (n=33) in which patients were treated with both terazosin 2 mg once daily and tolterodine 2 mg twice daily for 6 weeks.Results The IPSS were significantly improved in both groups after treatment, and the reduction of IPSS in the combination group was significantly greater than that in the terazosin group (P<0.01). A decrease in urgency, frequency and nocturia were the main contributory factors causing the reduction of IPSS in the combination group. The differences about the peak urinary flow rate and the residual urine from the baseline values were noted in both groups after treatment,but were not significant between the two groups. The incidence of adverse effects in the combination group was higher than that in the terazosin group. As expected the most common adverse effect was mouth dryness which was associated with anticholinergic drugs such as tolterodine.Conclusions Patients with LUTS associated BPH appear the improved IPSS after

  11. Benign prostatic hyperplasia and new treatment options – a critical appraisal of the UroLift system

    Directory of Open Access Journals (Sweden)

    McNicholas TA

    2016-05-01

    Full Text Available Thomas Anthony McNicholas1–3 1Section of Urology, Royal Society of Medicine, London, UK; 2Urology Department, Lister Hospital, East and North Herts NHS Trust, Stevenage, UK; 3Faculty of Health and Human Sciences, University of Hertfordshire, Hatfield, Herts, UK Abstract: The prostatic urethral lift procedure, more commonly known as UroLift, has been designed to improve male lower urinary tract symptoms while avoiding the complications and disadvantages of existing drug and surgical therapies. In particular, UroLift does not damage ejaculatory function or affect orgasmic sensation. It appears an option for men who wish to avoid long-term drug therapy, the side effects of drugs or surgery and who do not need or will not accept traditional surgical treatments. UroLift was introduced following a series of planned studies that led to US Food and Drug Administration approval in September 2013. UroLift has recently been approved by the UK National Institute for Clinical and Health Excellence (September 2015 as effective and safe and cost-effective for use in the UK health system. This review describes the device and the procedure and the evidence base that has led to those approvals. Keywords: UroLift, prostatic urethral lift, LUTS prostatic hyperplasia, minimally invasive, BPH

  12. Pseudoangiomatous stromal hyperplasia causing massive breast enlargement.

    Science.gov (United States)

    Bourke, Anita Geraldine; Tiang, Stephen; Harvey, Nathan; McClure, Robert

    2015-10-16

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal proliferative process, initially described by Vuitch et al. We report an unusual case of a 46-year-old woman who presented with a 6-week history of bilateral massive, asymmetrical, painful enlargement of her breasts, without a history of trauma. On clinical examination, both breasts were markedly enlarged and oedematous, but there were no discrete palpable masses. Preoperative image-guided core biopsies and surgery showed PASH. PASH is increasingly recognised as an incidental finding on image-guided core biopsy performed for screen detected lesions. There are a few reported cases of PASH presenting as rapid breast enlargement. In our case, the patient presented with painful, asymmetrical, massive breast enlargement. Awareness needs to be raised of this entity as a differential diagnosis in massive, painful breast enlargement.

  13. Diagnosis and treatment of benign prostate hypertrophy and chronic prostatitis%良性前列腺增生和慢性前列腺炎的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    周占松

    2011-01-01

    @@ 前列腺是男性重要的性腺器官,学术界将前列腺的功能、病理变化与形态学联系起来,划分为中央区、周边区和移行区.目前的观点认为移行区是良性前列腺增生症发生的唯一部位,而前列腺癌则常发生于周边区[1].在临床工作中,良性前列腺增生(benign prostate hypertrophy,BPH)与慢性前列腺炎(chronic prostatitis,CP)是男性泌尿系统最常见的疾病之一.现将我所良性前列腺增生和慢性前列腺炎的诊断和治疗经验介绍如下,以供临床同行参考.

  14. 女性"前列腺增生症"的临床诊治分析%Female Benign Prostatic Hyperplasia:Analysis of Clinical Diagnoses and Treatments

    Institute of Scientific and Technical Information of China (English)

    林峰; 陈军; 王鸿康

    2013-01-01

    Objective To analyze the clinical diagnosis and treatments of female benign prostatic heperplasia to strengthen physicians'awareness to improve their diagnoses and treatments. Methods The clinical data of 46 cases of female benign prostatic hyperplasia admitted between June 2009 and August 2012 were analyzed retrospectively, to summarize its clinical manifestations, misdiagnoses, laboratory tests, therapeutic methods and effects, prognosis. Results Twenty - one patients were misdiagnosed ( 6 as urinary tract infection, 15 as urethral syndrome ). The main symptom was urinary tract infection in 28 patients and urinary obstruction in 18. By routine urine examination, 40 had negative results, 41 had negative mid - stream u-rine culture. Ultrasound and cystoscopy showed varying - degree proliferation and hypertrophy at neck of bladder. Urodynamics showed decreased maximum urinary flow rate ( average 9. 8 ml/s ). Four patients had conservative treatment. The symptoms of 42 patients disappeared after bladder neck transuretinal resection without surgical complications. Conclusion Female benign prostatic hyperplasia is easy to be misdiagnosed. Its diagnosis should depend on cystoscopy and urodynamic tests besides case histories, clinical manifestations, physical check -ups, uronoscopy and B ultrasonography. Transurethral resection of bladder neck can obtain better clinical efficacy without surgical complications.%目的 通过对女性"前列腺增生症"患者的临床诊治资料进行分析,加强对本病的认识,提高临床诊治水平.方法 对我院2009年6月-2012年8月收治的46例女性前列腺增生症患者的临床资料进行回顾性分析,总结该病的误诊情况、临床表现、实验室检查、治疗方法、疗效及预后情况.结果 46例患者中有21例被误诊(6例被误诊为尿路感染,15例被误诊为尿道综合征).28例患者临床表现以尿路刺激症状为主,18例患者以排尿梗阻症状为主.尿常规检查40例

  15. Vitamin K: the missing link to prostate health.

    Science.gov (United States)

    Donaldson, Michael S

    2015-03-01

    Though age-related prostate enlargement is very common in Western societies, and the causes of benign prostate hyperplasia, BPH, have been diligently sought after, there is no biological, mechanistic explanation dealing with the root causes and progression of this very common disorder among men. All treatments to date are based on symptomatic relief, not a fundamental understanding of the cause of the disease. However, recent advances have shown that even subclinical varicoceles, which are more common than generally realized, cause retrograde blood flow from the testes past the prostate gland causing over a 130-fold increase in free testosterone in the veins near the prostate. By treating the varicoceles via embolization of the internal spermatic vein and its communicating and connected vessels the prostate enlargement can be reversed with corresponding symptomatic relief. So, varicose veins in the pampiniform venous plexus, varicoceles, are the direct cause of BPH. But what causes varicoceles? Recent research has uncovered the role of vitamin K in the calcification of varicose veins as well as a role in the proliferation of smooth muscle cells in the media layer of the vein wall. Vitamin K is intimately involved in the formation of varicose veins. The hypothesis is that poor prostate health is essentially a vitamin K insufficiency disorder. By providing vitamin K in the right form and quantity, along with other supporting nutrients and phytochemicals, it is likely that excellent prostate health can be extended much longer, and perhaps poor prostate health can be reversed. A protective role for vitamin K with respect to advanced prostate cancer was already found in the Heidelberg cohort of the EPIC study. This hypothesis can be further evaluated in studies examining the connection between vitamin K and varicoceles, and also by examining the connection between varicoceles and benign prostate hyperplasia. If this hypothesis is found to be true, management of prostate

  16. Abnormality of growth regulatory factors in benign prostatic hyperplasia%生长调控因子异常与前列腺增生的关系

    Institute of Scientific and Technical Information of China (English)

    艾力·艾尼; 史永华; 辛钟成

    2011-01-01

    目的 探讨多种生长调控因子在前列腺增生过程中的作用.方法 采用免疫组织化学Max vision二步法检测61例前列腺增生(BPH)和15例正常前列腺组织中TGF-β1、b-FGF、EGFR和TGF-α的表达.结果 TGF-β1主要定位于前列腺上皮细胞浆、间质细胞浆内,呈棕黄色颗粒,BPH及正常前列腺组织中上皮细胞阳性率分别为45.90%、13.33%;间质细胞阳性率分别为24.59%、6.67%,BPH中前腺上皮细胞和间质细胞总阳性率为52.46%,正常前列腺组织中上皮细胞和间质细胞总阳性率为20.00%,两组比较差异有统计学意义P0.05).结论 TGF-β1、b-FGF、EGFR和TGF-α是促进BPH的重要因素,TGF-β1、b-FGF和TGF-α主要与前列腺间质增生有关,EGFR主要与前列腺上皮增生有关.%Objective To investigate the role of 4 growth regulatory factors in the pathogenesis of benign prostatic hyperplasia (BPH). Methods The expressions of 4 growth regulatory factors were detected in 61 BPH tissues and 15 normal prostate tissues by Immunohistochemical Max vision staining. Results The expression rate of TGF β1 in the gland epithelium cell plasma and stroma cell plasma in BPH was 45.90% and 24.59% respectively, expressed in the BPH gland epithelium and stroma cell together 52.46%, and was 20.00% in normal prostatic tissue. The expression rate of b-FGF in in epithelium cell and the stroma cell plasma plasma in BPH was 26.23% and 75.41% respectively,expressed in the BPH gland epithelium and stroma cell together 75.41%, and was 13.33% in normal prostatic tissue.Expression of TGF β 1 and b-FGF in BPH was significantly higher than that in normal prostate tissue. EGFR was expressed mainly in the gland epithelium cell membrane in BPH, and TGF- α was expressed mainly in the stroma cell in BPH. Expressions of EGFR and TGF- α in BPH were significantly higher than those in normal prostate. Conclusion Abnormality of multiple growth regulatory factors might be involved in

  17. Transurethral electrovaporization of the prostate in the treatment of benign prostatic hypertrophy%经尿道前列腺电汽化术治疗前列腺增生症138例报告

    Institute of Scientific and Technical Information of China (English)

    梁庆祖; 黄勇平; 黄键; 黄群

    2001-01-01

    为探讨治疗前列腺增生(Benign Prostatic Hyertroph,BPH)的新方法,经尿道前列腺电汽化术(TVRP)治疗BPH138例。结果显示:术后排尿梗阻症状消失,随访1~18个月,残余尿由术前138.2±45.7ml降至16.0±2.6ml,IPSS由术前26.6±1.4分降至9.7±1.5分,QOL由术前5.4±0.5分降至2.0±0.4分,最大尿流率由术前10.8±2.1ml/s增至20.5±2.4ml/s。认为TVRP是治疗BPH的有效、安全且并发症少的新方法。如术前作膀胱造瘘、缩短手术时间、避免包膜穿孔等可使全身情况较差者手术成功。%In order to investigate new methods for the treatment of benign prostatic hypertrophy (BPH), 138 patients with BPH received transurethral electrovaporization of the prostate. Results showed that the emiction obstruction disappeared. In the follow-up from 1 to 18 months it was noted that the residual urine decreased from 138.2±45.7ml to 16.0±2.6ml, IPSS decreased from 26.6±1.4 by 9.7±1.5, QOL decreased from 5.4±0.5 to 2.0±0.4, and the maximal uroflow ratio increased from 10.8±2.1ml/s to 20.5±2.4ml/s. This report suggests that TVRP is an effective and safe new therapy with less complication for the treatment of BPH. A fistulation for bladder before operation, the shortened operative time and the avoidance of capsular perforation can result in a successful operation for patients in poor condition.

  18. 良性前列腺增生症并发前列腺结核%Benign Prostatic Hyperplasia with tuberculosis

    Institute of Scientific and Technical Information of China (English)

    姜睿; 陈明; 李洪位; 陈同良

    2001-01-01

    Purpose:To explore the clinical features of benign prostate hypertrophy (BPH) with tuberculosis.Method:Retrospective analysis of 8 cases BPH with tuberculosis has been made.Results:6 cases underwent open surgery and 1 case was treated with antituberculosis therapy,and 1 cases was treated by TURP.6 cases were followed up for an average of 10.8 months.The therapeutic results were satisfactory.Conclusions:Clinically, BPH with tuberculosis was often mistaken for BPH or prostatic carcinoma, so attention should be paid to the differential diagnosis. The final diagnosis should rely on pathological examination.%目的:提高对良性前列腺增生症(BPH)并发前列腺结核的认识。方法:回顾性分析8例BPH并发前列腺结核患者临床资料。结果:8例BPH并发前列腺结核均依靠病理检查确立诊断。1例接受抗结核治疗,1例接受TURP,6例接受开放手术。1例发生切口延迟愈合和尿瘘,另6例平均随访10.8个月,疗效满意。结论:BPH并发前列腺结核极易与 BPH或前列腺癌混淆, 确诊依靠病理检查,一经确诊,应及时应用抗结核药物,防止并发症。

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

    Directory of Open Access Journals (Sweden)

    Ferdinando Fusco

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

  20. 经尿道2μm激光前列腺剜除术治疗良性前列腺增生的疗效分析%Transurethral prostate enucleation with 2 μm laser in the treatment of benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    郭和清; 洪泉; 周高标; 刘红明; 孙斌; 潘广新; 穆大为; 严景民; 邢继章; 李迪

    2011-01-01

    Objective To investigate the feasibility and efficacy of transurethral prostate enucleation with 2 μm laser in the treatment of benign prostatic hyperplasia (BPH). Methods One hundred and seven patients with BPH were treated by transurethral prostate enucleation with 2 μm laser under continuous epidural anesthesia or laryngeal mask anesthesia. The patient′s, average age was 67±9 yrs (52 to 85 yrs). Of whom, 10 patients had a history of urinary retention. The mean prostate volume was 72.5±17.6 ml (45 to 158 ml). Two deep trenches were cut at the 5 and 7 o, clock position from the bladder neck to the verumontanum. The incision continued to the urethral mucosa and submucosa along with the verumontanum bilaterally in an arc-shape and ended at the internal arc of urethral sphincter. Then the urethral mucosa at the level of the verumontanum was cut and the surgical capsule plane was identified. A retrograde blunt dissection was made along the surgical capsule plane with the resectoscope sheath front-end, and the sheath was swung from side to side to extend the capsule plane. The significantly enlarged middle lobe was treated with laser vaporization resection. In the same way, a trench was made at the 12 o, clock position, and the lateral lobe were removed by the sheath from the verumontanum level, finally only two cord-like pedicles were kept at the 1 and 11 o, clock position at the bladder neck, so that the removed gland tissue was fixed and hung in the gland fossa. For prostate volume less than 60 ml, the laser vaporization resection was carried out directly. If the prostate volume was greater than 60ml, transurethral resection would be performed instead of laser vaporization resection. With 4% mannitol irrigation, the enucleated prostate tissue was then cut into small pieces and washed out by a Braun plastic bottle through the resectoscope sheath. Intraoperative bleeding, operative time, catheterization time, postoperative voiding status, maximum urinary flow

  1. Diagnostic Value of 64-slice CT Perfusion Imaging in Prostate Cancer and Benign Prostatic Hyperplasia%64排CT灌注成像对前列腺癌与良性前列腺增生的诊断价值

    Institute of Scientific and Technical Information of China (English)

    常泰; 戴娜

    2011-01-01

    [目的]探讨前列腺64排CT灌注成像的可行性及对前列腺癌与良性前列腺增生(BPH)的诊断价值.[方法]选择经手术或穿刺病理证实的前列腺癌患者28例(A组)和BPH患者35例(B组),所有患者均行前列腺64排CT灌注扫描,比较两组灌注参数:血流量 (BF)、血容量(BV)、峰值(PE)、达峰时间(TTP)、表面通透性(PS).[结果]A组BF、BV、PE分别为(0.492±0.115) mL/(100 g·min),(0.146±0.019) mL/100 g,(33.4±5.1) HU均显著小于BPH组(1.712±0.095) mL/(100 g·min),(0.276±0.031) mL/100 g,(56.7±6.7) HU(P<0.05),TTP、PS分别为(54.2±5.6)S和(54.8±6.9)mL/(100 g·min)均显著大于BPH组(26.4±4.6)S和(20.1±4.8)mL/(100 g·min) (P<0.05).[结论]前列腺64排CT灌注成像方法可行,灌注数据获得简单快捷,能够在一定程度上反映出前列腺血流灌注变化;前列腺64排CT灌注成像能定量地提供前列腺血流信息,可无创性地辅助诊断前列腺癌和BPH.%[Objective] To explore the feasibility and diagnostic value of 64-clice CT perfusion imaging in prostate cancer(PC) and benign prostatic hyperplasia(BPH). [Methods] Twenty-eight PC patients (group A) and thirty-five BPH patients (group B) confirmed by surgery or pathology were selected. All patients were performed by 64-slice CT perfusion of prostate. The perfusion parameters such as blood flow(BF) , blood volume (BV) , peak enhancement (PE) , time to peak (TTP) and permeability surface(PS) were compared between two groups. [Results] BF, BV and PE in group A were 0. 492 ± 0. 115 mL/(100g · min),(0. 146 ± 0. 019) mL/100g and (33. 4 ± 5. 1)HU respectively, which were significantly lower than those in group B[(1. 712 ± 0.095) mL/(100 g · min),(0. 276 ± 0. 031) mL/100 g and (56. 7 ± 6. 7) HU] ( P <0. 05). TTP and PS in group A were 54. 2 ± 5. 6S and 54. 8 ± 6. 9ml/(100g · min) respectively, which were significantly higher than those in group B[(26. 4 ± 4. 6)s and (20. 1 ± 4. 8) mL/(100g · min)]( P <0. 05

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

    Science.gov (United States)

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

    2016-04-01

    To assess the efficacy and the safety of Greenlight(TM) high-performance system (HPS) 120-W laser photoselective vaporization of the prostate (PVP) compared with transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia (BPH). The related original studies only including randomized controlled trials were searched by databases MEDLINE, EMBASE, Google Scholar, and the Cochrane Controlled Trial Register. The databases were updated till July 2014. The risk ratio, mean difference, and their corresponding 95% confidence intervals were calculated. Risk of bias of the enrolled trials were assessed according to Cochrane Handbook. A total of four trials involving 559 patients were enrolled. Statistical analysis was performed by software Review Manager (V5.3.3). There was no significant difference in International Prostate