[Studies of the endocrine dependence of the diffuse prostate hyperplasia and the prostate adenoma].
Explore the source record for details and available documents.
Adenoma↗
SEARCH · Search PubMed
Results for “Prostatic Hyperplasia”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A comparison of quality of life with patient reported symptoms and objective findings in men with benign prostatic hyperplasia. The Department of Veterans Affairs Cooperative Study of transurethral resection for benign prostatic hyperplasia.
As part of a randomized, controlled, trial conducted by the Department of Veterans Affairs Cooperative Studies Program comparing the effectiveness of transurethral resection of the prostate to watchful waiting, we evaluated 707 men with mild to severe symptoms of benign prostatic hyperplasia (BPH). We examine the relationships among patient reported symptoms, quality of life responses, peak urine flow rates and post-void residual urine estimates. Correlations among responses to symptom and quality of life interviews, urine flow results and residual urine volume were low (less than 0.20). However, multivariate correlation analysis showed that patient reported irritative symptoms, such as urgency, frequency and nocturia, were associated with quality of life responses, while patient reported obstructive symptoms, peak urinary flow rates and post-void urine estimates were unrelated to diminished quality of life. Since the extent to which BPH interferes with the life-style is likely to influence the decision of the patient to seek medical evaluation, the lack of association between quality of life and obstructive symptoms may result in misdirected diagnostic evaluations. This may have a large role in the controversies regarding assessments of symptomatic BPH, guidelines for surgical intervention and outcomes of treatment. Further study is required to determine the influence of diminished quality of life and irritative symptoms on the outcomes of treatments for BPH.
Aged↗
Monotherapy versus combination drug therapy for the treatment of benign prostatic hyperplasia.
BACKGROUND: Benign prostatic hyperplasia (BPH) is a medical condition occurring in older men (ie, those aged >60 years) resulting from enlargement of the prostate gland. Consequently, affected men may experience bother-some urinary tract symptoms and diminished quality of life. The risk of lower urinary tract symptoms and complications such as acute urinary retention (AUR) may increase if BPH is untreated. Currently, 2 classes of drugs-alpha-adrenergic blockers (alpha-blockers) and 5alpha-reductase inhibitors-are indicated for the treatment of BPH. Although the 2 classes are commonly used in combination, the evidence has frequently not been supportive of this practice. Results from the Medical Therapy of Prostatic Symptoms (MTOPS) trial, the largest and longest clinical trial on this topic to date, revisited the role of combination therapy in the treatment of BPH. OBJECTIVE: This review presents published trials evaluating alpha-blockers or 5alpha-reductase inhibitors used alone or in combination for the treatment of BPH. METHODS: A MEDLINE search was conducted (December 1974 to November 2004) using the MeSH term prostatic hyperplasia limited to the subheading of drug therapy. These results were cross-referenced with the MeSH term combination drug therapy. An additional search was conducted using the MeSH terms finasteride and adrenergic alpha-antagonists limited to adverse effects and therapeutic uses. These results were cross-referenced with prostatic hyperplasia and combination drug therapy. Review articles and meta-analyses were also used. RESULTS: The Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group and the Prospective European Doxazosin and Combination Therapy studies were well-designed trials that failed to support the theory that combination therapy is preferred over alpha-blockers alone. Finasteride was also shown to be no better than placebo for the outcomes of symptom score and peak urinary flow rates. Other trials suggested that combination therapy (which included finasteride) was more effective at reducing symptom scores in men with enlarged prostates at 1 year and that alpha-blockers may be successfully discontinued once patients are stabilized on finasteride. Although it was a prespecified secondary end point, the incidence of surgery or AUR was reduced by 51% using finasteride over placebo. The additive benefit finasteride provides in reducing symptoms, risk of AUR, and invasive surgery was observed within the first year of treatment and correlated with larger prostate sizes (mean [SD], approximately 55 [26] mL). The MTOPS trial further demonstrated a relative risk reduction of 66% in clinical progression rates for the combination-therapy group versus 39% for the doxazosin group compared with placebo (P < 0.001); the doxazosin group was not statistically different from the finasteride monotherapy group. Improvements in symptom scores were greater in the combination-therapy group versus the doxazosin (P = 0.006) and finasteride monotherapy (P < 0.001) groups. CONCLUSION: Based on the literature, combination therapy has been proven to relieve symptoms and delay progression of BPH in men with moderate to severe symptoms and moderately enlarged prostate glands.
5-alpha Reductase Inhibitors↗
Models for studying benign prostatic hyperplasia.
Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting aging man. Attempts have been made to clarify the etiology and pathogenesis and, to that end, experimental models have been developed. To date, in vitro and in vivo models have been used, depending on the concept of the study. Spontaneous animal models are limited to the chimpanzee and the dog. Ethical and financial factors restrict the applicability of these models. The hormonal-induced canine BPH model is a good alternative that closely resembles human BPH in many aspects. The experimental models currently used for studying BPH are reviewed. Prostate Cancer and Prostatic Diseases (2000) 3, 28-33
Journal Article↗
High-power potassium-titanyl-phosphate photoselective laser vaporization of prostate for treatment of benign prostatic hyperplasia in men with large prostates.
OBJECTIVES: To study the safety and efficacy of high-power potassium-titanyl-phosphate photoselective laser vaporization of the prostate in men with prostate volumes greater than 60 cm3. METHODS: A total of 64 men with symptomatic benign prostatic hyperplasia and large-volume prostates underwent photoselective laser vaporization of the prostate between May 2002 and September 2003. Medical therapy had failed in all men, and 18 presented with urinary retention. The preoperative evaluation included the maximal flow rate, postvoid residual urine volume, prostate volume, serum sodium, creatinine, and hematocrit, and International Prostate Symptom Score. Transurethral prostatectomy was performed with an 80 W potassium-titanyl-phosphate (KTP) side-firing laser system through a 23F continuous-flow cystoscope with normal saline as the irrigant. The operative time, anesthesia type, length of stay, and postoperative serum sodium, creatinine, and hematocrit were recorded. The International Prostate Symptom Score, maximal flow rate, and postvoid residual urine volume were measured at each follow-up visit. RESULTS: The mean preoperative prostate volume was 101 +/- 40 cm3. The mean operative time was 123 +/- 70 minutes. No transfusions were required. Of the 64 patients, 62 were discharged within 23 hours. The serum sodium level did not change significantly. The International Prostate Symptom Score decreased from 18.4 preoperatively to 9.9, 8.6, 7.2, and 6.7 at 1, 3, 6, and 12 months postoperatively, and the maximal flow rate increased from 7.9 mL/s preoperatively to 16.4, 16.2, 20.0, and 18.9 mL/s at 1, 3, 6, and 12 months postoperatively. The postvoid residual urine volume also decreased from 189 mL preoperatively to 78, 78, 67, and 109 mL at 1, 3, 6, and 12 months postoperatively. CONCLUSIONS: Photoselective laser vaporization of the prostate is safe and efficacious, with durable results for men with symptomatic benign prostatic hyperplasia and large-volume prostates.
Adult↗
An appraisal of telomerase activity in benign prostatic hyperplasia.
BACKGROUND: Prostate cancer is one of the commonest neoplasms in elderly males in developed countries. It is not clear which individuals are at high risk of developing aggressive adenocarcinoma of the prostate. Biomarkers are therefore urgently needed to identify such individuals. It had been suggested both by ourselves and others that prostatic telomerase activity may represent a valuable marker in this respect, particularly if applied to BPH, as tissue is readily available from both transurethral resection of prostates and transrectal ultrasound biopsy. METHODS: Tissue was collected prospectively from 46 patients with BPH who underwent TURP for clinically benign prostatic disease, and who were examined using the telomeric repeat amplification protocol (TRAP assay). RESULTS: Telomerase activity was not detected in any of 46 BPH samples, using TRAP assay conditions of 0.12, 1.2, and 12.0 microg protein. CONCLUSIONS: The study confirms that telomerase is not detectable in BPH samples. This would suggest that absence of telomerase activity may be a strong indicator of a lack of cancer. However further studies are necessary to confirm this.
Adenocarcinoma↗
Validity of the "bother score" in the evaluation and treatment of symptomatic benign prostatic hyperplasia.
Benign prostatic hyperplasia (BPH) is a condition that is common among older men. It causes a variety of clinically significant lower urinary tract signs and symptoms. BPH is rarely life-threatening; the decision to seek treatment is frequently based on the degree to which patients find the symptoms bothersome and disruptive of daily activities. Recently developed reliable and valid outcome measures to evaluate treatments for BPH are clinical tools that urologists can use to determine the extent of bother and make treatment decisions. A single question used to determine the "bother score" provides a widely used and statistically valid measure of the need for treatment of BPH. Validation data support the argument that the bother score is a statistically reliable measure of treatment outcome in patients with BPH who view their symptoms as bothersome.
Journal Article↗
Clinical evaluation of benign prostatic hyperplasia.
Benign prostatic hyperplasia (BPH) is the most common neoplastic condition afflicting men and constitutes a major factor impacting male health. Clinical evaluation to assess the presence and degree of voiding dysfunction and/or the role of BPH in its presence has an increasingly broad spectrum of treatment goals. The goals of the evaluation of such men are to identify the patient's voiding or, more appropriately, urinary tract problems, both symptomatic and physiologic; to establish the etiologic role of BPH in these problems; to evaluate the necessity for and probability of success and risks of various therapeutic approaches; and to present the results of these assessments to the patient so he can make an informed decision about management recommendations and available alternatives.
Journal Article↗
Clinical evaluation of benign prostatic hyperplasia.
Benign prostatic hyperplasia (BPH) is the most common neoplastic condition afflicting men and constitutes a major factor impacting male health. Clinical evaluation to assess the presence and degree of voiding dysfunction and/or the role of BPH in its presence has an increasingly broad spectrum of treatment goals. The goals of the evaluation of such men are to identify the patient's voiding or, more appropriately, urinary tract problems, both symptomatic and physiologic; to establish the etiologic role of BPH in these problems; to evaluate the necessity for and probability of success and risks of various therapeutic approaches; and to present the results of these assessments to the patient so he can make an informed decision about management recommendations and available alternatives.
Journal Article↗
Pygeum africanum for benign prostatic hyperplasia.
BACKGROUND: Benign prostatic hyperplasia (BPH), nonmalignant enlargement of the prostate, can lead to obstructive and irritative lower urinary tract symptoms (LUTS). The pharmacologic use of plants and herbs (phytotherapy) for the treatment of LUTS associated with BPH has been growing steadily. The extract of the African prune tree, Pygeum africanum, is one of the several phytotherapeutic agents available for the treatment of BPH. OBJECTIVES: To investigate the evidence whether extracts of Pygeum africanum (1) are more effective than placebo in the treatment of Benign Prostatic Hyperplasia (BPH), (2) are as effective as standard pharmacologic BPH treatments, and (3) have less side effects compared to standard BPH drugs. SEARCH STRATEGY: Trials were searched in computerized general and specialized databases (MEDLINE (1966-2000), EMBASE, Cochrane Library, Phytodok), by checking bibliographies, and by contacting relevant manufacturers and researchers. SELECTION CRITERIA: Trials were eligible if they (1) were randomized (2) included men with BPH (3) compared preparations of Pygeum africanum (alone or in combination) with placebo or other BPH medications (4) included clinical outcomes such as urologic symptom scales, symptoms, or urodynamic measurements. Eligibility was assessed by at least two independent observers. DATA COLLECTION AND ANALYSIS: Information on patients, interventions, and outcomes were extracted by at least two independent reviewers using a standard form. The main outcome measure for comparing the effectiveness of Pygeum africanum with placebo and standard BPH medications was the change in urologic symptoms scale scores. Secondary outcomes included change in urologic symptoms including nocturia and urodynamic measures (peak and mean urine flow, prostate size). The main outcome measure for adverse effects was the number of men reporting adverse effects. MAIN RESULTS: A total of 18 randomized controlled trials involving 1562 men met inclusion criteria and were analyzed. Only one of the studies reported a method of treatment allocation concealment, though 17 were double-blinded. There were no studies comparing Pygeum africanum to standard pharmacologic interventions such as alpha-adrenergic blockers or 5-alpha reductase inhibitors. The mean study duration was 64 days (range, 30-122 days). Many studies did not report results in a method that permitted meta-analysis. Compared to men receiving placebo, Pygeum africanum provided a moderately large improvement in the combined outcome of urologic symptoms and flow measures as assessed by an effect size defined by the difference of the mean change for each outcome divided by the pooled standard deviation for each outcome (-0.8 SD [95% confidence interval (CI), -1.4, -0.3 (n=6 studies)]). Men using Pygeum africanum were more than twice as likely to report an improvement in overall symptoms (RR=2.1, 95% CI = 1.4, 3.1). Nocturia was reduced by 19%, residual urine volume by 24% and peak urine flow was increased by 23%. Adverse effects due to Pygeum Africanum were mild and comparable to placebo. The overall dropout rate was 12% and was similar between Pygeum Africanum (13%), placebo (11%) and other controls (8%). REVIEWER'S CONCLUSIONS: A standardized preparation of Pygeum africanum may be a useful treatment option for men with lower urinary symptoms consistent with benign prostatic hyperplasia. However, the reviewed studies were small in size, were of short duration, used varied doses and preparations and rarely reported outcomes using standardized validated measures of efficacy. Additional placebo-controlled trials are needed as well as studies that compare Pygeum africanum to active controls that have been convincingly demonstrated to have beneficial effects on lower urinary tract symptoms related to BPH. These trials should be of sufficient size and duration to detect important differences in clinically relevant endpoints and use standardized urologic symptom scale scores.
Humans↗
Pharmacological characteristics of smooth muscle in benign prostatic hyperplasia and normal prostatic tissue.
Strips of prostatic hyperplastic adenoma and normal prostate were studied by observing the mechanical response to application of certain drugs. The sensitivity of BPH tissue to potassium chloride, phenylephrine and prostaglandins was about double that of normal prostate. The small hyperplastic adenoma showed a higher sensitivity to phenylephrine than the large. However, sensitivity to phenylephrine was almost the same among the various histological types of BPH.
Adrenergic alpha-Agonists↗
Benign prostatic hyperplasia (the aging prostate).
BPH is a common phenomenon of the aging process. Clinical manifestations may range from minimally bothersome symptoms to urinary retention and renal failure. Tailoring of treatment based on the individual patient is required for successful management. For mild symptoms, watchful waiting is a valid option. For severe symptoms, surgical therapy is most appropriate. For men complaining of moderate symptoms, medical therapy has become front-line therapy, with other less invasive treatment modalities being available or in development.
Aged↗
Clinical impact of tamsulosin on generic and symptom-specific quality of life for benign prostatic hyperplasia patients: using international prostate symptom score and Rand Medical Outcomes Study 36-item Health Survey.
AIM: To examine the efficiency of alpha1-blocker treatment on disease-specific and generic quality of life (QOL) in men with clinically diagnosed benign prostatic hyperplasia (BPH), the improvement of QOL scores with International prostate symptom score (I-PSS) and Rand Medical Outcomes Study 36-item Health Survey (SF-36) was prospectively analyzed. METHODS: A total of 68 newly diagnosed patients with symptomatic BPH that satisfied all inclusion and none of the exclusion criteria were prospectively recruited. All patients received 0.2 mg/day of tamsulosin for 12 weeks. All patients underwent pretreatment documentation of lower urinary tract symptoms (LUTS) and assessment of symptom-specific QOL. Symptoms and general health-related QOL (HRQOL) were assessed using the I-PSS and SF-36, respectively. Also, other objective variables, such as prostate volume, maximal urinary flow and postvoid residual urine volume, were evaluated. RESULTS: After 12 weeks, decrease in I-PSS was 27% compared with baseline (from 16.4 +/- 7.18 to 11.9 +/- 7.56). All questionnaires in the I-PSS showed improvement after tamsulosin treatment and the I-PSS QOL score was improved from 4.51 +/- 1.14 to 3.17 +/- 1.38 (P < 0.0001) at 12 weeks after tamsulosin administration. In intragroup comparisons of HRQOL scores with age-gender adjusted SF-36 Japanese national norms, three SF-36 subscales (bodily pain, BP; social function, SF; and mental health, MH) were worse in the BPH group aged over 70 years, while younger BPH groups aged <70 had better mean SF-36 physical function (PF) scores compared with age-gender adjusted Japanese national norms. In the BPH group with a prostatic volume > or =20 mL, three mean SF-36 scales (BP, SF and MH) were significantly improved after tamsulosin treatment. It is noteworthy that these SF-36 subscales were identical to those observed to worsen in the older BPH group compared to Japanese national norms. CONCLUSIONS: Treatment with tamsulosin for symptomatic BPH patients is associated with significant improvement in the generic HRQOL, in addition to disease-specific QOL and symptoms, at 3 months after drug administration. In particularly, for generic HRQOL with SF-36, tamsulosin treatment can efficiently improve three mean SF-36 subscales (BP, SF and MH) that are decreased in older BPH patients.
Aged↗
[Basic study in the natural history of benign prostatic hyperplasia: biology of prostatic growth].
Explore the source record for details and available documents.
Aging↗
[Clinical effect of the drug "Prostamol-Uno" in patients with benign prostatic hyperplasia and chronic prostatitis].
Explore the source record for details and available documents.
Aged↗
KAI1/CD82 gene expression in benign prostatic hyperplasia and late-stage prostate cancer in Chinese.
AIM: To evaluate KAI1/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and late-stage 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), but not to clinical stage ( P > 0.05). CONCLUSION: The authors believe that decreased and negative KAI1/CD82 expression in late-stage CaP may be related to tumor progression and metastasis, and appears to be a prognostic marker.
Adenocarcinoma↗
Volume determinations by transrectal ultrasonography in patients with benign prostatic hyperplasia: correlation with removed prostate weight.
Estimation of prostate gland volume with transrectal ultrasonography (TRUS) provides important information in the evaluation of benign and malignant prostate disease. We evaluated 119 patients with clinically benign prostatic hyperplasia (BPH) by TRUS. Sixty-eight of these underwent transurethral resection of the prostate (TUR-P), and 51 patients underwent open prostatectomy. In both groups the estimated weight correlated well with the removed prostatic weight (r = 0.643, p < 0.0001 in TUR-P and r = 0.729, p < 0.0001 in open prostatectomy). We found that TRUS is a valuable method for estimation of prostatic volume in patients with BPH.
Aged↗
Transurethral enzyme injection--future management of benign prostatic hyperplasia.
Although benign prostatic hyperplasia, a common condition among elderly men, has been effectively treated with transurethral resection of the prostate, this surgical procedure is associated with many well-recognized risks and complications. Because of this potential morbidity and mortality, various alternative treatment strategies for benign prostatic hyperplasia have been proposed. The use of enzyme solubilization and ablation of prostatic tissue to alleviate urinary outlet obstruction has proved effective in dogs and warrants investigation in human trials. Transurethral enzyme injection of the prostate has the potential for being a treatment modality with minimal invasiveness, limited requirements for anesthesia, and minimal associated toxicity for the management of benign prostatic hyperplasia.
Anti-Bacterial Agents↗