Search PubMed⌕ Search

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.

At least 739 records · Page 41Linked to original sources
PubMed1996

A non-randomized comparative study of visual laser ablation and transurethral resection of the prostate in benign prostatic hyperplasia.

BACKGROUND: Transurethral resection of the prostate (TURP) has been the preferred surgical treatment for benign prostatic hyperplasia (BPH) for the past 50 years. Alternative methods for treating BPH such as visual laser ablation (VLAP) have been established during the past decade. In order to assess the safety and efficacy of VLAP, this alternative method was performed using a Urolase fiber and neodymium: yttrium-aluminum-garnet laser, and compared to results obtained in patients treated with TURP for BPH. METHODS: In this non-randomized comparative study, 100 BPH patients were equally split between treatment with VLAP or TURP, and their cases compared. The efficacy was assessed using an International Prostate Symptom Score, urinary flow rates, post-void residual urinary volume and an estimated prostate volume. RESULTS: There was a clinically significant improvement in all parameters in both groups. In the VLAP and TURP groups, 92.0% and 81.6%, 90.2% and 86.2 and 93.1% and 100.0% were categorized as effectively-treated cases at 3, 6 and 12 months post-operatively, respectively. No severe side effect was seen in VLAP group. The total and post-operative lengths of hospitalization in the VLAP group were shorter, but the duration of post-operative bladder irrigation was longer in these patients. CONCLUSIONS: Although TURP remains the standard surgical treatment for BPH, VLAP is associated with less morbidity and the clinical outcome is similar compared to patients treated with TURP. VLAP in conjunction with TURP may result in less risk of postoperative urinary retention and vesical irritability.

Aged↗
PubMed1996

[Benign prostatic hyperplasia--its treatment with Proscar].

Benign prostate hyperplasia is a potentially serious condition affecting men in advanced age. The treatment is conservative and operative. Proskar of Msd is one of the drugs yielding encouraging results. It is a synthetic 4-azosteroid compound, and represents a new class of specific inhibitors of 5-alpha reductase, promoting stabilization of testosterone and the more active androgen dihydrotestosterone (DHT). A total of 35 patients undergo treatment with Proskar at 5 mg daily dose (one tablet) over a 6-month period. The study includes six patients with complete urinary retention. The results are assayed by the change in prostate gland volume, residual urine and maximal urinary flow, 6 PsA. Completely responsive to treatment are 71.44 per cent of patients, partial effect is recorded in 22.85 per cent, and no effect whatsoever--in 5.71 per cent.

Adult↗
PubMed1994

The influence of prostatic urethral anesthesia in overactive detrusor in patients with benign prostatic hyperplasia.

We examined the effects of prostatic urethral anesthesia on cystometrography in benign prostatic hyperplasia (BPH) patients with or without neurological disorders. Although cystometrography after anesthesia showed no disappearance of involuntary detrusor contraction, it did demonstrate significant increases in first sensation volume and maximum cystometric capacity in BPH patients without neurological diseases, as well as BPH patients with a history but no physical evidence of neurological disease. Furthermore, the bladder might be augmented more efficaciously in patients with involuntary detrusor contractions. No significant differences were found in first sensation volume or maximum cystometric capacity before and after anesthesia in patients without infravesical obstruction who had documented neurological disease with physical evidence. Our results demonstrated that prostatic urethral anesthesia can be used preoperatively in patients with infravesical obstruction to discriminate whether involuntary detrusor contractions are due to infravesical obstruction or to neurological disease.

Aged↗
PubMed1998

Prostatic infarction/infection in acute urinary retention secondary to benign prostatic hyperplasia.

PURPOSE: We assess the role of acute prostatic infarction and prostatic inflammation in causing acute urinary retention in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A prospective controlled clinicopathological study was undertaken comparing 35 patients who presented with acute urinary retention secondary to BPH with another 35 patients with symptomatic BPH. All 70 patients were treated with transurethral resection. The prostatic chips in each group were examined by 1 histopathologist, who was unaware of the clinical presentation of the patient, for changes of infarction, acute and chronic inflammation, and predominant histological pattern. RESULTS: There was a higher incidence of glandular pattern in the retention group compared to a stromal pattern in the control group, which was statistically significantly different (p < 0.001). A 5-fold higher incidence of prostatic carcinoma was noted in the acute retention group, which was also statistically significant (p < 0.05). CONCLUSIONS: Prostatic infarction and inflammation had no role in the etiology of acute urinary retention due to BPH.

Acute Disease↗
PubMed1994

Etiology of benign prostatic hyperplasia.

The natural history of benign prostatic hyperplasia (BPH) involves two phases. The first, or pathologic phase, is composed of two stages, microscopic and macroscopic, neither of which produces symptomatic clinical dysuria. Nearly all men throughout the world eventually develop microscopic BPH if they live long enough. In only about 50% of men, however, does microscopic BPH grow to produce a macroscopic enlargement of the gland, suggesting that additional factors are required for BPH progression. The second, or clinical, phase of BPH involves the progression of pathologic BPH to its clinical form, in which the patient develops symptomatic dysuria. Again, only about one half of the men with macroscopic BPH progress to clinical BPH. Although macroscopic enlargement of the prostate is necessary for the development of clinical BPH, it is usually not sufficient by itself for the progression to clinical BPH. Additional factors are required (e.g., prostatitis, vascular infarct, tensile strength of the glandular capsule). Successful treatment does not, therefore, require the prevention of pathologic BPH; instead, what is needed is a therapy to prevent or reverse the progression to clinical disease.

Aging↗
PubMed1989

Etiology and disease process of benign prostatic hyperplasia.

The natural history of benign prostatic hyperplasia (BPH) involves two phases. The first, or pathological phase of BPH, involves two stages, termed microscopic and macroscopic BPH, neither of which produces symptomatic clinical dysuria. Nearly all men throughout the world will eventually develop microscopic BPH if they live long enough. In only about one-half of the men with microscopic BPH, however, will microscopic BPH grow to produce a macroscopic enlargement of the gland (i.e., macroscopic BPH), suggesting that additional factors are required for the progression of microscopic to macroscopic BPH. Several theories have been proposed to explain the etiology of the pathological phase of BPH. The major theories include the hypotheses that pathological BPH is due to 1) a shift in prostatic androgen metabolism that occurs with aging, which leads to an abnormal accumulation of dihydrotestosterone, thus producing the enlarged prostate (i.e., DHT hypothesis), 2) a change in the prostatic stromal-epithelial interact that occurs with aging, which leads to an inductive effect on prostatic growth (i.e., embryonic reawakening theory), or 3) an increase in the total prostatic stem cell number and/or an increase in the clonal expanding of the stem cells into amplifying and transit cells that occurs with aging (i.e., stem cell theory). The second, or clinical phase of BPH, involves the progression of pathologic BPH to clinical BPH in which the patient develops symptomatic dysuria. Only about one-half the men with macroscopic BPH progress to clinical BPH. Although the macroscopic enlargement of the prostate is a necessary condition for the development of clinical BPH, this enlargement is usually not sufficient by itself for the progression of pathologic BPH to clinical BPH. The etiology of the progression of pathological BPH to clinical BPH requires additional factors (e.g., prostatitis, vascular infarct, tensile strength of the glandular capsule, etc.). A successful treatment for clinical BPH, therefore, does not necessarily require either the prevention or elimination of all degrees of pathologic BPH. Instead, what is needed is a therapy to prevent or reverse the progression of pathologic BPH to the clinical disease.

Adult↗
PubMed1991

The ability of systematic transrectal ultrasound guided biopsy to detect prostate cancer in men with the clinical diagnosis of benign prostatic hyperplasia.

Multiple directed and systematic ultrasound guided biopsies of the prostate were performed in 73 men with the clinical diagnosis of benign prostatic hyperplasia (BPH). Seven men (10%) had prostate cancer. Of the 67 patients with benign biopsies 40 underwent subsequent transurethral prostatectomy and 2 (5%) had prostate cancer. Multiple directed and systematic biopsies of the prostate detected 78% of the nonpalpable prostate cancers diagnosed in the study population. Radical prostatectomy was performed in all 9 men with prostate cancer: there were 3 small organ-confined tumors, 5 large organ-confined tumors and 1 stage C tumor with 1 focus of microscopic capsular penetration. Our results suggest that multiple directed and systematic ultrasound guided biopsies are capable of detecting low volume nonpalpable prostate cancer in men with BPH. However, the exact indication for pre-treatment ultrasound guided biopsy of the prostate in men with symptomatic BPH remains unclear. It may be that use of this modality is most appropriate for patients undergoing pharmacological therapy or balloon dilation of BPH rather than for those undergoing transurethral prostatectomy.

Aged↗
PubMed2000

Changes in serum prostate-specific antigen following prostatectomy in patients with benign prostate hyperplasia.

PURPOSE: To investigate how prostatectomy for patients with benign prostate hyperplasia (BPH) affected the serum prostate-specific antigen (PSA) levels. METHODS: In 193 patients who underwent prostatectomy for BPH, serum PSA levels were measured before and three months after the operation. The total prostate weight measured by transrectal ultrasonography (TRUS) and the weight of the surgical specimen were examined in relation to the pretreatment PSA value and the changes in PSA levels after the operation. RESULTS: The transition zone volume measured by TRUS could well estimate the weight of the surgical specimen in patients who underwent subcapsular prostatectomy and transurethral resection of the prostate. The concentration of preoperative serum PSA showed a significant correlation with the prostatic volume and with the transition zone volume. Removal of 1 g of BPH tissue reduced serum PSA levels by an average of 0.18 ng/mL. The change in serum PSA levels after the prostatectomy correlated with the total prostatic gland volume and with the transition zone volume. CONCLUSIONS: The elevated PSA levels in patients with BPH were caused by the enlargement of the transition zone. After the resection of the adenoma, PSA levels should be expected to decrease to the normal range.

Adenoma↗
PubMed2002

[Comparative study of transurethral electrovaporization of prostate versus transurethral resection of prostate on benign prostatic hyperplasia].

OBJECTIVES: To compare the efficacy of transurethral electrovaporization of prostate (TUVP) with transurethral resection of prostate (TURP). METHODS: 206 patients with symptomatic benign prostatic hyperplasia (BPH) whose prostatic sizes were all less than 60 grams were randomly divided into two groups. 97 cases were treated by TUVP while the other 109 cases were treated by TURP. The patients who underwent either TUVP or TURP were followed up for 12-34 months with an average of 20 months postoperatively. RESULTS: Both groups showed the significant decline in the mean IPSS (international prostatic symptom score) (P < 0.01), the mean PVR (Postovoiding Residual Volume) (P < 0.01), while increase in mean Qmax (Peak uroflow rate) (P < 0.01) in 12 months, 24 months after the operation. There were significant differences in the mean duration of operation or catheterization postoperatively (P < 0.05). The main complications of post-operation in the two groups were stress incontinence, TUR syndrome, urethral stricture, secondary bleeding. CONCLUSIONS: Both TUVP and TURP are effective treatment for the patient with BPH whose prostatic size is less than 60 grams. TUVP spends shorter time of the operation and postoperative catheterization than that of TURP.

Aged↗
PubMed1992

[The anti-androgen flutamide in the treatment of prostatic hyperplasia].

The authors treated 23 benign prostatic hyperplasia (BPH) patients with antiandrogen flutamide. Half of the patients were treated with 500 mg, the another part with 750 mg flutamide for three months, and after 3 months brake again for 3 months. The decrease of the residual urine and an increase of the flow were observed. The subjective parameters were improved, too. In some patients side effects (gynecomastia, loss of appetite and potency) were observed. There was no different in the effect of the two doses.

Androgen Antagonists↗
PubMed1995

Histopathological evaluation of laser thermocoagulation in the human prostate: optimization of laser irradiation for benign prostatic hyperplasia.

We have previously shown in a canine prostate model that a noncontact low power neodymium:YAG laser regimen of 15 watts for 180 seconds yields a larger volume of coagulation necrosis than the currently recommended high power regimen of 50 watts for 60 seconds. These 2 regimens have not yet been compared in humans. The objective of this study was to evaluate histopathologically the thermocoagulation effect of these 2 laser regimens in the human prostate and the effect of the spatial distribution of the laser lesions on the extent of coagulation necrosis. The study was conducted in 10 patients undergoing radical prostatectomy or cystoprostatectomy. The laser treatment was given transurethrally 1 hour before removal of the specimen. There were no fractures of the prostate. The coagulation necrosis did not reach the peripheral zone and it was minimal in areas rich in fibromuscular tissue, such as the bladder neck. At times, nodular benign prostatic hyperplasia was unaffected. A 4-quadrant treatment in the same plane often yielded small nonconfluent lesions. Confluent lesions in the same plane yielded approximately 30% greater depth of coagulation necrosis, which was achieved when 3 or 4 lesions were created on each side of the prostate (per single transverse plane). Likewise, coagulation necrosis observed with 15 watts for 180 seconds was approximately 40% greater than that noted with the 50 watts for 60 seconds regimen. Our findings suggest that noncontact laser prostatectomy is a safe procedure that can be improved by modifying the laser regimen and the spatial distribution of lesions.

Aged↗
PubMed1994

Obesity and benign prostatic hyperplasia.

Abdominal obesity increases the estrogen-to-androgen ratio and may increase sympathetic nervous activity, both hypothesized to influence the development of benign prostatic hyperplasia and the severity of urinary obstructive symptoms. In 1986 and 1987, men aged 40-75 years who were participants in the Health Professionals Follow-up Study and who were without prior diagnosis of cancer or prostatectomy provided data on weight, height, and waist and hip circumferences. The men were followed for incidence of prostatectomy for benign prostatic hyperplasia up to January 1992. In addition, the frequency and severity of symptoms of urinary obstruction were assessed among respondents to a questionnaire in 1992. Among 25,892 men who provided complete information for both surgery and symptoms, 837 men had surgery for benign prostatic hyperplasia, and 2,581 of those without surgery reported frequent urinary symptoms. After adjustment for age, smoking, and body mass index, abdominal obesity was related to prostatectomy (odds ratio (OR) = 2.38, 95% confidence interval (CI) 1.42-3.99, for those with a waist circumference > or = 43 inches (109 cm) relative to those with a waist circumference < 35 inches (89 cm); p trend < 0.0001) and with frequent urinary symptoms among those without prostatectomy (OR = 2.00, 95% CI 1.47-2.72; p < 0.0001). Body mass index, hip circumference, and waist-to-hip ratio were not associated with benign prostatic hyperplasia independently of waist circumference. These results suggest that abdominal obesity in men may increase the frequency and severity of urinary obstructive symptoms and may increase the likelihood that such obese men will undergo a prostatectomy.

Anthropometry↗
PubMed1994

Pathophysiology of benign prostatic hyperplasia.

The exact morphogenesis of benign prostatic hyperplasia (BPH) is unknown, but morphologic observations and different etiologic theories, such as the stem cell, dihydrotestosterone, and stromal-epithelial interaction hypotheses, help to explain some of the findings. For example, the initial changes in the development of BPH may result from an activation of mesenchymal clones with embryonal functions that stimulate development of the glandular component. This, in turn, induces the development and maturation of the stromal component. In areas that lack epithelial elements, such as those in the periurethral zone, the interaction stops and only embryonal small stromal nodules remain. On the other hand, the decrease in endocrine-paracrine cells may alter the normal local hormonal equilibrium of the periurethral area and may be an inducing factor in the development of BPH.

Humans↗
PubMed1992

[Clinical manifestations and indications for therapy of benign prostatic hyperplasia].

The high incidence of benign prostatic hyperplasia (BPH), together with the wide variability in its clinical manifestations and in the natural course of disease, requires a careful evaluation of the patient. Technical progress and continuing development of established methods mean that a wide range of diagnostic procedures is available and an "objective" correlate of infravesical obstruction can be obtained. In addition to these objective criteria, the patient's subjective perception of the impact of the symptoms on his quality of life also affects the decision as to whether therapeutic intervention should be attempted and the degree of success that can be attained, as is becoming increasingly evident. The diagnostic methods available for the routine assessment of patients with BPH is reviewed, and their relative value as a basis for deciding on therapeutic intervention is analysed.

Diagnostic Imaging↗
PubMed1995

Validation of the self-administered Danish Prostatic Symptom Score (DAN-PSS-1) system for use in benign prostatic hyperplasia.

OBJECTIVE: 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. METHODS: Using published results from several comparisons of other symptom scoring systems with DAN-PSS-1, the test-retest reliability, internal consistency, construct and content validity, and responsiveness of the DAN-PSS-1 system were assessed. RESULTS: The system was internally consistent (Cronbach's alpha = 0.73), the median test-retest reliability of answers to each question was 83.5% (range 0-99.7%) and the questionnaire was well understood by the patients. The DAN-PSS-1 system demonstrated a high degree of construct validity, correlating with the extensively used Madsen-Iversen score system (Spearman's correlation coefficient, rs = 0.51) and with the patients' answers to questions about how bothersome their symptoms were (rs = 0.71). The DAN-PSS-1 system discriminated clearly between patients with benign prostatic hyperplasia (BPH) and control subjects (an area under the receiver operating characteristic curve of 0.94). Finally, the DAN-PSS-1 was sensitive to changes following intervention, with scores decreasing from a median of 20 to zero 4 months after patients underwent transurethral prostatectomy and from a median of 11.5 to 7.5 (65%) after patients had received 4 months treatment with an alpha-blocker. CONCLUSIONS: The DAN-PSS-1 system is reliable, valid and responsive, and therefore can be recommended for assessing the severity of symptoms among patients presenting with lower urinary tract complaints suggestive of BPH and in the follow-up after intervention.

Adrenergic alpha-Antagonists↗
PubMed1986

Etiological considerations for the growth of stroma in benign prostatic hyperplasia.

The finding that human benign prostatic hyperplasia (BPH) consisted primarily of fibromuscular tissue has led to basic research into the hormonal control of the growth of male accessory sex organ smooth muscle. By using the separated epithelium and muscle layers of the guinea pig seminal vesicle, it was determined that the epithelium exhibited only reversible androgen-induced growths, whereas the muscle proved to be a target tissue for both androgen and estrogen, and exhibited irreversible growth responses. It was of particular interest that the normal androgen-dependent pubertal development of the muscle involved an approximate twofold increase in DNA, followed by the development of a complete and relatively selective androgenic insensitivity in this parameter. An understanding of the factors leading to this apparently normal androgen-dependent loss of the proliferative response in muscle may allow for the development of specific hypotheses for the reawakened stromal growth in BPH. Research on other organ systems focusing on the various factors and mechanisms involved in muscle growth regulation is briefly discussed.

Aging↗
PubMed1992

Comparative study between the use of a treatment with hyperthermia through the rectal approach versus the urethral approach for benign prostatic hyperplasia.

200 patients suffering from benign prostatic hyperplasia were treated with hyperthermia: 100 cases through the rectal approach and 100 through the urethral approach. Subjective symptoms were assessed as well as nycturia and objective data, urinary flow and postmicturition residue before treatment and 6 months after treatment. In the group of 100 patients treated rectally, the subjective symptoms and nycturia improved in 76; urine flow improved in 63, postmicturition residue decreased in 32 and the vesical catheter could be removed in 5 out of 8 patients. With the urethral approach, 77 patients out of 100 presented an improvement in their symptoms, nycturia improved in 53; urine flow improved in 28; the urine residue was decreased in 40 and the vesical catheter could be removed in 10 out of 16 patients who required it previously. Although slightly better results seem to be achieved with the use of rectal hyperthermia, as concerns nycturia and micturition flow, we prefer the urethral approach for its higher degree of convenience, easier handling, shorter time of treatment and reasonable effectiveness.

Aged↗
PubMed2002

Managing benign prostatic hyperplasia.

Medical and surgical options for the treatment of benign prostatic hyperplasia have expanded in recent years. Saw palmetto, the most widely used complementary medication, is less effective than standard medical therapy but has fewer side effects. Although non-selective alpha blockers provide rapid relief of symptoms and are relatively inexpensive, they can cause dizziness and orthostatic hypotension. These effects occur less often with tamsulosin, a more selective alpha blocker. Finasteride, a 5alpha-reductase inhibitor, slowly reduces prostatic volume but is not as effective as alpha blockers, especially in men with a smaller prostate. Dutasteride, a new 5alpha-reductase inhibitor, has recently been labeled for the treatment of benign prostatic hyperplasia. Surgery may be appropriate initial treatment in patients with severe symptoms who are not at high risk for complications. Surgery may also be indicated in patients who have failed medical therapy or have recurrent infection, hematuria, or renal insufficiency. Transurethral resection of the prostate is effective in most patients, but it carries some risk of sexual dysfunction, incontinence, and bleeding. Surgical procedures that use thermal microwave or laser energy to reduce hyperplastic prostate tissue have recently become available. In general, the newer procedures are less expensive than transurethral resection of the prostate and have fewer complications; however, the need for retreatment is somewhat greater with these less invasive techniques.

Complementary Therapies↗