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PubMed2005

BPSA: A Novel Serum Marker for Benign Prostatic Hyperplasia.

Free prostate-specific antigen (fPSA) testing was developed and approved for widespread use despite the lack of knowledge regarding the underlying biologic basis for its ability to discriminate between benign prostatic hyperplasia (BPH) and prostate cancer. We hypothesized that the relationship of total PSA to prostate volume was due primarily to the fPSA component of serum PSA, and we studied the molecular forms of PSA found in prostate tissue. Later, more sophisticated studies resulted in the discovery of BPSA (benign PSA), a novel form of fPSA associated with nodular hyperplasia of the transition zone (TZ). We found that the serum BPSA level is highly correlated with TZ and total prostate volume. In our most recent studies, we found that BPSA correlates better with TZ volume than does PSA and can predict clinically significant prostate enlargement better than PSA or fPSA. Furthermore, the relation of BPSA and fPSA to total prostate and TZ volumes is independent of age.

Journal Article↗
PubMed1980

Comparison of the R-3327H rat prostatic adenocarcinoma to human benign prostatic hyperplasia and metastatic carcinoma of the prostate with regard to steroid hormone receptors.

Quantitative analyses of cytosolic steroid hormone receptors were performed on nine tumors from the transplantable rat prostatic adenocarcinoma R-3327H. Androgen receptors and estrogen receptors were found in eight of nine and five of six tumors, respectively. None of the tumours analyzed contained detectable progestin or glucocorticoid receptors (four and seven tumors, respectively). The apparent equilibrium dissociation constants for the androgen and estrogen receptors were 0.7-4.3 nM and 0.6-1.8 nM, respectively. The apparent equilibrium Bmax values (maximum number of binding sites) were 1,500-25,000 fmoles/gm tissue for the androgen receptor and 640 to 5,800 fmoles/gm tissue for the estrogen receptor. A comparison between the receptor contents of the R-3327H rat tumor and human benign prostatic hyperplasia and metastatic carcinoma of the prostate showed that the rat tumor was different from the human tissues in several respects. Hence, the search for an optimal animal model for prostatic carcinoma in man must be continued.

Adenocarcinoma↗
PubMed2004

Is extended 11-core biopsy valuable in benign prostatic hyperplasia patients with intermediate serum prostate-specific antigen (4.1-10 ng/ml) and prior negative sextant biopsy?

OBJECTIVE: To evaluate the importance of extended 11-core biopsy in benign prostatic hyperplasia (BPH) patients with intermediate prostate-specific antigen (PSA; 4.1-10 ng/ml) and prior negative sextant biopsy. MATERIAL AND METHODS: A total of 381 BPH patients with intermediate PSA (4.1-10 ng/ml) and prior negative sextant biopsy underwent extended 11-core biopsy, which included conventional sextant biopsy in addition to five cores from three alternative sites. Two cores were taken from the right and left anterior horns of the peripheral zone (PZ), two from the right and left anterior transition zones (TZs) and one from the midline of the PZ. Overall, 315 patients were subjected to transurethral resection of the prostate (n = 272) or open prostatectomy (n = 43). RESULTS: Repeat 11-core biopsy revealed prostate cancer in 66/381 cases (17.3%). The distribution of positive cores on repeat 11-core biopsy was as follows: sextant biopsy sites only in 50% of cases (33/66); alternative sites only in 31.8% (21/66); and sextant plus alternative biopsy sites in 18.2% (12/66). The anterior horn of the PZ was the most frequently positive alternative site (25/33; 75.8%), followed by the TZ (5/33; 15.2%), while the midline site was involved in 9% of cases (3/33). Eleven-core biopsy had a significantly better cancer detection rate compared to sextant biopsy when digital rectal examination was normal (p = 0.009), prostate volume was in the range 30-50 cm (p = 0.033) and PSA density was > or =0.15 (p = 0.024). Six cancer cases out of 315 (1.9%) were diagnosed as a result of the definitive pathology. The sensitivity of 11-core biopsy was 91.6%, compared to 62.5% for sextant biopsy (p < 0.001). CONCLUSION: An extended 11-core biopsy protocol is valuable in BPH patients with intermediate PSA (4.1-10 ng/ml) and prior negative sextant biopsy as it significantly improved the overall detection rate in our study by 32% (p = 0.019).

Age Distribution↗
PubMed1994

Consultation patterns in a community survey of men with benign prostatic hyperplasia.

BACKGROUND: The Stirling benign prostatic hyperplasia natural history group have previously reported a prevalence of this condition of 255 per 1000 in a community study of 1610 men aged 40-79 years. AIM: It was decided to examine the consultation patterns of men with benign prostatic hyperplasia in greater detail. METHOD: All participating men were invited to complete a previously validated lifestyle questionnaire including questions on consultations with their general practitioner during the previous year and previous history of prostatic problems. The men who had a urinary symptom score greater than 11, or who had a urinary flow rate of less than 15 ml per second were examined by transurethral ultrasonography for prostate size. RESULTS: Of 364 men with benign prostatic hyperplasia, 89% had not consulted their doctor about urinary symptoms in the year prior to the study. Men with moderate to severe urinary symptoms were six times more likely to have consulted their doctor than those with mild symptoms. Moderate to severe symptoms and greater interference with daily living activities were both associated with a greater likelihood of consultation, independent of age. Of all the men in the study referred to the specialist clinic for assessment of prostate size by transurethral ultrasonography, two thirds were referred because of low urinary flow rate and one third because of high urinary symptom scores. The reported consultation data showed a reverse ratio of one third of those consulting having a low urinary flow rate and approximately two thirds having urinary symptoms. CONCLUSION: While mass screening is unjustified, there is a need for patient education about benign prostatic hyperplasia in general and the recognition of declining strength of urinary flow as a symptom of benign prostatic hyperplasia and not of ageing alone. Furthermore, evaluation of primary care use of urinary flowmeters and the development of local protocols are suggested as elements of a case finding strategy for benign prostatic hyperplasia based on patient led consultation.

Adult↗
PubMed1989

Treatment of benign prostatic hyperplasia by androgen deprivation: effects on prostate size and urodynamic parameters.

The possible effect of medical androgen deprivation in the treatment of benign prostatic hyperplasia has been studied in 12 patients. Six patients received the luteinizing hormone-releasing hormone agonist buserelin and 6 others received the antiandrogen cyproterone acetate. The treatment resulted in an average decrease in prostatic size of 29 per cent after 12 weeks as measured by ultrasonography. This decrease led to an increase in peak urinary flow rate, a reduction in residual urine volume and a decrease in daytime voiding frequency. However, it caused no decrease in urethral resistance but only an increase in the bladder contraction strength. After discontinuation of the treatment the prostates showed regrowth to the initial sizes within 6 to 36 weeks. The urodynamic changes were reversed as well. Although statistically significant, the urodynamic changes were minimal from a clinical viewpoint and did not lead to an unobstructed state after 12 weeks of treatment. For this reason the clinical indication for use of medical androgen deprivation in benign prostatic hyperplasia patients will remain limited for the time being.

Androgen Antagonists↗
PubMed2001

Inducible nitric oxide synthase expression in benign prostatic hyperplasia, low- and high-grade prostatic intraepithelial neoplasia and prostatic carcinoma.

OBJECTIVE: To elucidate the incidence of inducible nitric oxide synthase (iNOS) expression in benign prostatic hyperplasia (BPH), low- and high-grade prostatic intraepithelial neoplasia (PIN) and prostatic carcinoma lesions, and to explore the role of iNOS in prostate tumorigenesis. MATERIALS AND METHODS: Immunoreactivity for iNOS was examined in 20 samples each of BPH, high-grade PIN, low-grade PIN and prostatic carcinoma. RESULTS: Positive iNOS immunostaining was detected in all samples from all patients; iNOS was detected in both basal epithelial cells and secretory cells of the glandular epithelium. High-grade PIN and prostatic carcinoma samples had more intense iNOS immunostaining than low-grade PIN and BPH samples. In all samples, smooth muscle cells showed weak or moderate iNOS immunoreactivity and endothelial cells showed moderate immunostaining. CONCLUSIONS: Nitric oxide generated by iNOS may be involved in prostate tumorigenesis and further studies with immunohistochemical and molecular biology are needed to determine the exact role of iNOS in the pathogenesis of prostatic carcinoma.

Adenocarcinoma↗
PubMed2003

Tamsulosin for benign prostatic hyperplasia.

BACKGROUND: Benign prostatic hyperplasia (BPH) is a nonmalignant enlargement of the prostate which can result in bothersome lower urinary tract symptoms. The treatment goal for men with BPH is to relieve these bothersome symptoms. OBJECTIVES: This systematic review assessed the effects of tamsulosin in the treatment of lower urinary tract symptoms (LUTS) compatible with BPH. SEARCH STRATEGY: Trials were searched in computerized general and specialized databases (MEDLINE, EMBASE, Cochrane Library), by checking bibliographies, and by contacting manufacturers and researchers. SELECTION CRITERIA: Trials were eligible if they (1) randomized men with BPH to receive tamsulosin in comparison with placebo, other BPH medications or surgical interventions and (2) included clinical outcomes such as urologic symptom scales, symptoms, or urodynamic measurements, and (3) had a treatment duration of 30 days or longer. 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 tamsulosin with placebo, medical or surgical interventions was the change in urologic symptom scale scores. Secondary outcomes included changes in urinary flow measures (peak urine flow rate). The main outcome measure for adverse effects was the number of men reporting adverse effects. MAIN RESULTS: Fourteen studies involving 4,122 subjects met inclusion criteria. Study duration ranged from 4-26 weeks, and no placebo-controlled study lasted longer than 13 weeks. The mean age of subjects was 64 years. Baseline symptom scores and urine flow rates demonstrated that men had moderate LUTS. Tamsulosin improved symptoms and peak urine flow relative to placebo. The weighted mean differences (WMD) for mean change from baseline for the Boyarsky symptom score for 0.4 mg and 0.8 mg doses of tamsulosin relative to placebo were -1.1 points (95% CI = -1.49, -0.72; 12% improvement) and -1.6 points (95% CI = -2.3, -1.0; 16% improvement), respectively. The WMD for mean change from baseline in peak urine flow were 1.1 mL/sec (95% CI = 0.59, 1.51) and 1.1 mL/sec (95% CI= 0.65, 1.48) for 0.4 mg and 0.8 mg, respectively. Tamsulosin (0.2 mg-0.4 mg) was as effective as other alpha antagonists and the phytotherapeutic agent Permixon in improving symptoms and flow rates though the doses of all alpha-antagonists studied may not have been optimal. Discontinuations from treatment for any reason and discontinuations "due to adverse events" were similar in the low dose tamsulosin (0.2 mg) and placebo groups but increased to 16% in trials utilizing a 0.8 mg dose of tamsulosin. Low dose tamsulosin was generally well tolerated although not all the trials reported specific adverse events. The most frequently reported adverse events that were significantly greater than placebo included dizziness, rhinitis and abnormal ejaculation. Adverse effects increased markedly as tamsulosin dosing increased, and were reported in 75% of men receiving the 0.8 mg dose. Men receiving a 0.2 mg dose tamsulosin were less likely to discontinue treatment compared to men receiving terazosin. REVIEWER'S CONCLUSIONS: Tamsulosin provided a small to moderate improvement in urinary symptoms and flow compared to men receiving placebo in men with BPH. Effectiveness was similar to other alpha antagonists and increased only slightly with higher doses. Long term effectiveness and ability to reduce complications due to BPH progression could not be determined. Adverse effects were generally mild but their frequency, including withdrawals, increased substantially with the higher doses that are generally available for treatment.

Adrenergic alpha-Antagonists↗
PubMed2003

Long-term results of contact laser versus transurethral resection of the prostate in the treatment of benign prostatic hyperplasia with small or moderately enlarged prostates.

OBJECTIVE: To evaluate the long-term results of contact laser vaporization (CLV) of the prostate and transurethral resection of the prostate (TURP) in patients with symptomatic bladder outflow obstruction (BOO) caused by benign prostatic hyperplasia (BPH) with prostates smaller than 40 ml. MATERIAL AND METHODS: A total of 52 patients with lower urinary tract symptoms (LUTS) and urodynamically confirmed BOO caused by BPH with glands smaller than 40 ml were treated by means of CLV or TURP in a randomized trial. Changes in symptom score, urodynamics and prostate volume were evaluated during a 4-year follow-up period. RESULTS: A total of 42 (81%) of the patients were available for review at 4 years. The re-operation rate was 1/26 for each treatment. A sustained improvement in median Danish Prostate Symptom Score was seen in the laser group from 18 (range 5-54) to 5 (0-34) and in the TURP group from 18 (4-46) to 4 (0-18) (p<0.001 for both). A sustained improvement in maximum urinary flow rate was also seen in the laser group from 8.3 (4.8-19.6) ml/s to 14.3 (10.1-33.6) ml/s (p<0.001) and in the TURP group from 8.6 (5.0-15.9) ml/s to 16.1 (7.7-39.6) ml/s (p<0.01), without differences between the study groups. Median detrusor pressure at maximum urinary flow rate decreased significantly after both treatments, in the CLV group from 64 (32-112) cmH2O to 38 (18-65) cmH2O and in the TURP group from 57 (40-137) cmH2O to 28 (9-44) cmH2O (p<0.001 for both), and at 48 months was significantly higher in the laser group (p<0.01). At 4 years, 7/22 (32%) of the laser patients and 2/20 (10%) of the TURP patients were urodynamically obstructed. Post-void residual at 48 months was significantly lower in the TURP group than in the CLV group. Median prostate volume was smaller after TURP at 6 and 48 months (p<0.05). CONCLUSIONS: Long-term data of CLV and TURP treatments for BPH with small or moderately enlarged prostates indicate no significant difference in the relief of symptoms or in the rate of re-operations. However, the number of patients in this study was small and consequently the power to detect differences between the study groups was low. Regarding most objective outcome parameters, long-term follow-up revealed a slight advantage of TURP over CLV.

Aged↗
PubMed1994

[Clinical study on comparison of tonifying kidney replenishing vitality and removing blood stasis and resolving mass in the treatment of prostatic hyperplasia].

70 patients with prostatic hyperplasia were observed. Among them 34 cases were treated with the regime of tonifying Kidney-replenishing Vitality (TKRV) and the other 36 cases were treated with removing blood stasis and resolving mass (Xiao Jin Dan). The dysuria of the patients in both groups was improved after treatment. The results of the transrectal ultrasonotomography showed as follows: (1) The effect on the volume of residual urine: the average values of the TKRV group were 43.29 +/- 14.03 ml before treatment and 17.24 +/- 5.13 ml after treatment (P < 0.05), that of Xiao Jin Dan were 21.17 +/- 5.57 ml and 7.37 +/- 2.87 ml respectively (P < 0.01). (2) The effect on the size of the prostate gland: only 10 cases in the TKRV group were measured both before and after treatment, the average size of the prostate gland were 46.30 +/- 8.23 ml and 43.60 +/- 4.52 ml respectively (P < 0.05), and 4 cases were decreased in the size after treatment. 35 cases in Xiao Jin Dan group were measured before and after treatment and their size of prostate gland were 47.83 +/- 2.50 ml and 43.45 +/- 2.24 ml (P < 0.01) respectively. 27 out of the 35 cases were decreased in their size of prostate gland. The results showed that the therapeutic effect of Xiao Jin Dan was slightly better than that of the TKRV, which suggested that the prostatic hyperplasia was closely related to the syndrome of Kidney-Deficiency as well as to the syndrome of Blood Stasis. So it is important that we combined the reinforcement and elimination in the treatment of prostatic hyperplasia.

Aged↗
PubMed1981

Changes in dihydrotestosterone metabolism associated with the development of canine benign prostatic hyperplasia.

Canine benign prostatic hyperplasia (BPH) is associated with, if not actually induced by, an increased prostatic ability for the net formation of dihydrotestosterone (DHT). This conclusion is based upon the observation in this study that: 1) when spontaneous BPH develops in the beagle there is a concomitant increase in the potential capacity for prostatic tissue to metabolize steroids favoring the net formation of DHT; 2) there is a similar change in steroid metabolism in the prostate when BPH is experimentally induced in young beagles by the combined administration of exogenous androgens and estrogens; 3) various hormonal treatments of young intact or castrate dogs which did not increase the prostate tissue's ability to produce DHT also did not induce a high incidence of experimental BPH; and 4) a highly significant linear correlation (r = 0.95) was observed between the size of the prostate gland and an increased prostatic ability for the net formation of DHT, as estimated by relative prostatic index values which quantitatively reflect such increased metabolic activities. These overall alterations in prostatic steroid metabolism favor an increase in the net formation of DHT and may account for the well documented increase in DHT concentration associated with BPH in both dog and man. The enhancement of these events by estrogens could play a major role in the etiology of BPH. (Endocrinology 108: 445, 1981)

Aging↗
PubMed1997

Transforming growth factor-beta 3 is expressed in nondividing basal epithelial cells in normal human prostate and benign prostatic hyperplasia, and is no longer detectable in prostate carcinoma.

BACKGROUND: We investigated the role of the transforming growth factor beta (TGF-beta) family in the neoplastic progression of the human prostate. METHODS: Expression of TGF-beta mRNA was measured by Northern blot analysis of tissue extracts, and TGF-beta protein by immunohistochemical analysis of tissue sections. Proliferating cells were detected by their expression of Ki-67 antigen. RESULTS: The level of TGF-beta 1 mRNA was equal among normal prostate, benign prostatic hyperplasia (BPH), and prostate carcinoma. TGF-beta 2 mRNA was not detectable, and TGF-beta 3 mRNA was expressed 20-fold lesion in carcinoma compared to BPH and normal prostate. TGF-beta 1 protein was expressed in the stromal cells in all three tissues and TGF-beta 3 protein in the basal layer of epithelial cells, but not in carcinoma. Proliferating epithelial cells fail to express TGF-beta 3. CONCLUSIONS: TGF-beta 1 and TGF-beta 3 are independently regulated, and carcinoma of the prostate is characterized by the loss of basal epithelial cells expressing TGF-beta 3.

Adult↗
PubMedDate not supplied

Androgen concentrations and their receptors in the periurethral region are higher than those of the subcapsular zone in benign prostatic hyperplasia (BPH).

Benign prostatic hyperplasia (BPH) is an androgen-dependent disease that initially develops in the inner prostate, where the highest concentrations of testosterone (T) and dihydrotestosterone (DHT) are found. In this study, we have evaluated the cytosolic androgen receptors (ARc), the nuclear androgen receptors (ARn), and the concentrations of T, DHT, and 3alpha-androstanediol (3alphaDiol) in BPH tissue to verify the existence of a possible correlation between androgens and their receptor concentrations. Prostatic samples, removed by suprapubic prostatectomy in 15 untreated patients, were sectioned in periurethral, intermediate, and subcapsular zones. Testosterone, DHT, and 3alphaDiol were evaluated by radioimmunoassay after extraction and purification on celite microcolumns, and ARc and ARn were evaluated by means of dextran-coated charcoal method. In total tissue, mean levels of DHT, T, and 3alphaDiol were 2,531+/-308, 260+/-36, and 403+/-35 pg/mg of DNA (mean+/-SE), respectively. Cytosolic androgen receptors, detectable in all cases, were 16+/-2.8 fmol/mg of protein (mean+/-SE), and ARn, detectable in 12 cases, were 108+/-15 fmol/mg of DNA (mean+/-SE). A linear correlation between DHT and 3alphaDiol, T and DHT, and 3alphaDiol and ARn was found. If the different regions are considered, the periurethral zone, site of the primitive BPH nodule, presents the highest levels of androgens and ARn with respect to the other regions. This relative hyperandrogenism may be responsible for the growth-promoting processes of this area, leading to urinary obstruction.

Aged↗
PubMed2004

Interleukin-8 expression is increased in senescent prostatic epithelial cells and promotes the development of benign prostatic hyperplasia.

BACKGROUND: Benign prostatic hyperplasia (BPH) is an extremely common disease of older men characterized by increased growth of prostatic epithelial and stromal cells. Previously we showed that senescent epithelial cells accumulate in the prostate of aging men and secrete interleukin-1 alpha (IL-1 alpha). IL-8 is also present at increased levels in BPH tissues and induces expression of FGF2, a potent stromal growth factor. Therefore, we sought to determine if IL-8 is also expressed at increased levels by senescent epithelial cells and if this secreted IL-8 plays a role in the pathogenesis of BPH. METHODS: Expression of IL-8 in human BPH tissue and primary cultures of prostatic epithelial cells was analyzed using an enzyme-linked immunoabsorption assay (ELISA). Tissue senescence was assessed by a quantitative assay for senescence-associated beta galactosidase (SA-beta gal). Proliferation of primary and immortalized prostatic epithelial cells in response to IL-8 was determined by counting of cells at intervals after addition of IL-8. RESULTS: Expression of IL-8 is significantly increased in vitro when cultured prostatic epithelial cells undergo senescence. Quantitative assay of BPH tissue extracts revealed that tissue IL-8 levels are correlated with both SA-beta gal activity and prostate weight. IL-8 promotes proliferation of primary and immortalized prostatic epithelial cells in culture. CONCLUSIONS: Senescence of prostatic epithelial cells results in increased expression of IL-8, which can promote proliferation of non-senescent epithelial and stromal cells by direct and indirect mechanisms, and in this manner contributes to the increased tissue growth seen in BPH.

Cellular Senescence↗
PubMed2005

Urologic diseases in America project: benign prostatic hyperplasia.

PURPOSE: Benign prostatic hyperplasia (BPH), the most common benign neoplasm in American men, is a chronic condition that is associated with progressive lower urinary tract symptoms and affects almost 3 of 4 men during the seventh decade of life. Approximately 6.5 million of the 27 million white men who are 50 to 79 years old in the United States in 2000 were estimated to meet the criteria for discussing treatment. MATERIALS AND METHODS: The analytical methods used to generate these results have been described previously. RESULTS: In 2000 approximately 4.5 million visits were made to physician offices to for a primary diagnosis of BPH and almost 8 million visits were made with a primary or secondary diagnosis of BPH. In the same year approximately 87,400 prostatectomies for BPH were performed in inpatients in nonfederal hospitals in the United States. While the number of outpatient visits for BPH increased consistently during the 1990s, there was a dramatic decrease in the use of transurethral prostatectomy, inpatient hospitalization and length of hospital stay for this condition. These trends reflect the changing face of medical management for BPH, ie increasing use of pharmacological agents and minimally invasive therapies. In 2000 the direct cost of BPH treatment was estimated to be $1.1 billion exclusive of outpatient pharmaceuticals. CONCLUSIONS: Given the impact that BPH has on quality of life and health care cost in millions of American men, additional research into risk factors, diagnostic and therapeutic resource use, and effectiveness and cost benefit of therapies are warranted.

5-alpha Reductase Inhibitors↗
PubMed2002

Rationale and assessment of minimally invasive approaches to benign prostatic hyperplasia therapy.

Benign prostatic hyperplasia affects quality of life, with most patients complaining of symptoms related to urination. For this reason, successful treatments can be defined by (1) their effect on lower urinary tract symptoms, (2) their impact on quality of life, and (3) their ability to unobstruct the flow of urine through the prostate. Minimally invasive therapy (MIT), which includes transurethral microwave thermotherapy, water-induced thermotherapy, interstitial devices (eg, transurethral needle ablation), and interstitial laser treatments, offers physicians and their patients cost-effective alternatives for achieving a substantially improved quality of life at an acceptable level of risk. Evidence-based medicine indicates that MIT is safe and achieves significant symptomatic improvement. Compared with long-term medical management, minimally invasive procedures offer effective, well-tolerated 1-time intervention with lasting effects that can be achieved on an outpatient basis. This article reviews the options for MIT.

Aged↗
PubMedDate not supplied

[The joint use of hyperbaric oxygenation and EHF therapy in benign prostatic hyperplasia and its combination with chronic prostatitis].

33 patients with benign prostatic hyperplasia (BPH) were exposed to hyperbaric oxygenation (HBO) and SHF waves. Group 1 patients had no prostatic inflammation, group 2 patients had combination of BPH with chronic prostatitis. Both these modalities are considered as to mechanism of action at different periods of the development of urination disturbances. The combined therapy imposed a positive trend in urination parameters, especially evident in group 2 patients. In them mean urination frequency reduced from 14.8-8.5 times to 6.3, mean urine volume increased from 83.6 to 199 ml. Index I-PSS fell in group 1 by 2 and group 2 by 6.4 scores. L index of quality of life declined by 1.2 and 1.6 scores in groups 1 and 2, respectively. It is inferred that combined use of HBO and SHF therapy is highly effective in urination disorders in patients with BPH suffering from or without chronic prostatitis.

Aged↗
PubMed2003

[Pharmacologic treatment of benign prostatic hyperplasia].

Medical treatment for benign prostatic hyperplasia is reviewed by the author. Experiences with herbal extracts have been known for more than 2 decades. Treating benign prostatic hyperplasia with these extracts are recommended in initial phase. Effectiveness of these drugs are approved by some placebo controlled double blind studies. However effectiveness of these are not as good as medical drugs'. It is well known that they have no side effects and are cheaper than medicines. Prostate volume is decreased and mechanical component of dysuria is improved by treating for long time (months, years) with 5 alfa reductase finasterid which contain hormone. This drug is indicated when volume of the prostate is over 40 g. Dynamical component of benign prostatic hyperplasia is treated with a receptor blockers which act on the bladder neck. These medicines effect earlier and are recommended for all benign prostatic hyperplasia patients independently of prostate volume. These might have some side effect like hypotension.

5-alpha Reductase Inhibitors↗
PubMed2000

Identification of a superimmunoglobulin gene family member overexpressed in benign prostatic hyperplasia .

BACKGROUND: Benign prostate hyperplasia (BPH), a nonmalignant disease with an increasing rate of occurrence associated with advancing age, requires auxiliary markers to help identify its presence and distinguish its progression from prostate cancer. METHODS: Hybridoma technology was used to generate an antibody against a BPH antigen, which was subsequently characterized by Western blot analysis, sequence homology, and RT-PCR. RESULTS: A BPH-associated protein, designated P25/26, was identified that showed a strong sequence similarity with superimmunoglobulin family members, overexpressed in BPH, with lower expression observed in both normal and prostate cancer tissues. CONCLUSIONS: Further studies appear warranted to assess the role that this and other superimmunoglobulin family members may have in the pathogenesis of BPH, and to determine if these glycoproteins have any clinical utility in the differential diagnosis or therapeutic monitoring of BPH.

Adult↗