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PubMedDate not supplied

[The transurethral microwave thermotherapy of benign prostatic hyperplasia].

Treatment outcomes are available for 502 patients with benign prostatic hyperplasia exposed to transurethral microwaves (TUMW) on Prostatron unit. Of the patients whose age ranged from 55 to 84, 328 had stage I disease, the rest stage II. 32 patients had previously undergone cystostomy. Acute urine retention was registered in 67 patients on day 1-4 after microwave therapy because of edema of the tumor. To remove the urine, cystostoma and catheter were placed in 18 and 49 patients, respectively. In half a year a positive effect occurred in 80% of cases. As microwave therapy relieves symptoms, increases the quality of life, improves urine flow and reduces the tumor size it can be recommended for the treatment of benign hyperplasia of the prostate.

Aged↗
PubMed1997

The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign prostate hyperplasia.

BACKGROUND: Determining the ratio of free to total prostate specific antigen (f-PSA to t-PSA, calculated as the percentage of f-PSA [f-PSA%]) in serum allow for a clearer distinction between patients with prostate carcinoma (PCa) and patients with benign prostate hyperplasia (BPH) than determining the level of t-PSA alone. To find influencing factors on f-PSA%, the authors investigated prostate volume, TNM classification, and tumor stage. METHODS: The authors measured f-PSA and t-PSA in 36 men with untreated PCa (tumor classification: T1, 2, 3pNO, MO), 44 patients with BPH, and 54 healthy controls. Prostate volume was determined by transrectal ultrasound. RESULTS: The median values of t-PSA and f-PSA% were 7.8 micrograms/L and 10.5% in PCa patients, 4.3 micrograms/L and 20.8% in patients with BPH, and 1.4 micrograms/L and 23.6% in the control group. Patients with PCa had a significantly lower proportion of f-PSA than BPH patients and healthy men. There was no correlation of f-PSA% to TNM stage or tumor grade. In PCa patients a significant positive correlation (correlation coefficient [r] = 0.51, P < 0.001) was found between f-PSA% and prostate volume, whereas there was no significant correlation in BPH patients (r = -0.27, P > 0.05). There was a significant difference in f-PSA% between PCa and BPH patients with prostate volumes smaller than 40 cm3 (9.0% vs. 21.6%, P < 0.01) but not between patients in these 2 groups with prostate volumes exceeding 40 cm3 (15.1% vs. 18.2%, P = 0.11). CONCLUSIONS: Determining the ratio of f-PSA to t-PSA to discriminate between PCa and BPH patients yields significant results only in men with a prostate volume of less than 40 cm3.

Aged↗
PubMed1993

Inhibition of steroid-induced prostatic hyperplasia in rats by treatment with anti-androgen (TZP-4238).

The effect of a synthetic steroidal anti-androgen, TZP-4238, on steroid-induced rat prostatic hyperplasia was investigated. Male Wistar rats were divided into four experimental groups. Group 1 consisted of intact controls. The other animals were castrated. The castrated animals were treated for 7 weeks with 1) testosterone 1 mg/head plus 17 beta-estradiol (E2) 0.01 mg/head (Group 2), 2) testosterone plus E2 + TZP-4238 8 mg/kg (Group 3) and 3) testosterone plus E2 + chlormadinone acetate (CMA) 20 mg/kg (Group 4). TZP-4238 and CMA were administered orally for 4 weeks after 3 weeks treatment with testosterone plus E2. In group 2, glandular hyperplasia of the prostate was clearly observed, and the number of bromo-deoxyuridine (BrdU)-positive cells showed a significant increase. In contrast, combined treatment with TZP-4238 (Group 3) or CMA (Group 4) produced marked atrophy of the glandular epithelium, and the number of BrdU-positive cells were remarkably decreased compared with Group 2. In addition, the localization of glutathione-peroxidase (GSH-PO) which effectively reduces the lipid peroxides in the glandular epithelial cells was markedly decreased. Furthermore, nuclear immunostaining of androgen receptor was remarkably decreased after combined treatment with TZP-4238 or CMA. Our data indicate that TZP-4238 is a potent steroidal androgen receptor antagonist for the prevention of rat prostatic growth in the steroid-induced prostatic hyperplasia model.

Androgen Antagonists↗
PubMed2006

[Influence of antioxidants on the development of benign prostatic hyperplasia].

The main objectives of the study was the evaluation of concentration of endogenous antioxidants (Vitamins E, A, C and Beta-carotene) in the blood plasma of elderly men and to determine their roles in the development of benign prostatic hyperplasia. There were carried out investigations in 110 men during 2003-2006 in the Urological Clinic of the Tbilisi State Medical Academy. 71 patient entered into the main group (65-81 years old), who were diagnosed for benign prostate hyperplasia. The control group included 30 men (60-80 years old) who did not suffer from the typical signs of benign prostatic hyperplasia. Besides, to evaluate normal levels of endogenous antioxidants (Vitamins E, A, C and Beta-carotene) concentration in the blood plasma additionally were studied young practically healthy 10 persons (20-35 years old), they compiled the second control group. Our study showed that endogenous antioxidants concentration reduces in the blood plasma with the age, this reduction becomes more obvious with the clinical detection of prostate benign hyperplasia. It is recommended for elderly patients to control periodically the endogenous antioxidants level (Vitamins A, C, E and Beta-carotene) in the blood plasma and in the case of changes to get food enriched with vitamins or combined vitamins preparations. This will be accomplice factor for the prophylactic of benign prostatic hyperplasia. This will be prophylactic activity during the conservative treatment process (by alpha-adrenoceptor blocking drugs, phytotherapy medicines, 5 alpha-reductase inhibitors and others). Inclusion of vitamins complexes which contains antioxidants is necessary. Prescription of antioxidants complex after the operative treatment will accelerate the healing process and reduce the rehabilitation period.

Adult↗
PubMed1994

Results of an epidemiological survey using a modified American Urological Association symptom index for benign prostatic hyperplasia in France.

The prevalence of urinary symptoms associated with benign prostatic hyperplasia was studied in a community-based, nationwide, representative sample of 2,011 French men 50 to 80 years old. Symptoms were assessed by the American Urological Association symptom index. After exclusion of patients with prostate cancer, 6.9% of the subjects reported having undergone prostate surgery. Among the surgery-free subjects, nocturia and repeat voiding within 2 hours were the most prevalent symptoms. Based on the American Urological Association symptom index, 18.8% of the men were considered free of urinary symptoms, and 67%, 13% and 1.2%, respectively, ranked between 1 and 7, 8 and 19, and 20 or more. The proportion of men scoring greater than 7 approximately doubled with each decade of age. Our estimation indicated that in 1992 approximately 1.14 million French men had moderate to severe urinary symptoms that were likely to be associated with benign prostatic hyperplasia. Previous studies had yielded higher prevalence estimates, probably due to differences in sampling design and diagnostic criteria.

Aged↗
PubMed2006

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

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 SIgA 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.

Bacteria↗
PubMed1987

The effects of interferons on the activity of alpha-glycerolphosphate dehydrogenase in benign prostatic hyperplasia cells in primary culture.

Human benign prostatic hyperplasia (BPH) tissues were obtained from patients undergoing transurethral resection of the prostate and viable cells from these were successfully maintained in primary cultures grown on collagen gel. The prostatic origin of the cells was confirmed by the measurement of prostate specific acid phosphatase and by scanning and transmission electron microscopy before and after immunostaining with human prostate specific antigen-antibody. The cell cultures were treated with various interferons (IFNs), both in the presence and absence of testosterone propionate (TP), for 72 hours and the activities of seven enzymes of carbohydrate metabolism were estimated in the cytosolic fraction of the cells. Treatment with TP induced a significant decrease in the activity of alpha-glycerolphosphate dehydrogenase (alpha-GPDH). Using this enzyme activity as a marker, the effects of various types of IFNs were investigated. IFN-alpha (wellferon) increased the activity of the enzyme both in the presence of one microgram./ml. of TP and in its absence whereas IFN-gamma inhibited the activity under similar conditions. The effect of treatment with IFN-beta in the presence of TP was biphasic in that there was an increase in the activity of the enzyme at the lowest concentration while at higher concentrations an inhibition of enzymic activity was observed. In the absence of TP IFN-beta inhibited the activity. The significance of these findings in terms of the clinical usefulness of IFNs is discussed and it is postulated that IFN-alpha (wellferon) might be effective in the treatment of metastatic carcinoma of the prostate in selected patients.

Cells, Cultured↗
PubMed1995

Regulation of prostatic smooth muscle contractility by intracellular second messengers: implications for the conservative treatment of benign prostatic hyperplasia.

The increased sympathetic neurotransmission in benign prostatic hyperplasia (BPH) results in a alpha 1C-adrenoceptor-mediated increase in prostatic smooth muscle tone which seems to be responsible for the dynamic infravesical obstruction occurring in BPH. The prostatic smooth muscle contractions evoked by norepinephrine can be efficiently blocked by alpha 1-adrenoceptor blockers. Moreover, an impressive number of clinical trials illustrated the beneficial results of alpha 1-adrenoceptor blockers in the treatment of BPH. However, despite knowledge of alpha 1-adrenergic neurotransmission and the clinical application of its blockade by selective alpha 1-adrenoceptor antagonists, very little is known about the intracellular pathways involved in the regulation of prostatic smooth muscle contractility. To study the intracellular mechanism of the alpha 1C-adrenoceptor-induced prostatic smooth muscle contraction, the patch-clamp technique in the whole-cell configuration mode combined with the Fura-II fluorescence technique was used in human, enzymatically isolated smooth muscle cells obtained from patients undergoing transurethral resection of the prostate because of symptomatic BPH. Furthermore changes in prostatic smooth muscle contractility were registered in organ bath experiments. Application of the selective alpha 1-adrenoceptor agonist phenylephrine (PE) increased the L-type Ca(2+)-channel current (ICa) dose dependently from 8 up to 18.5 microA/cm2, simultaneously elevating the free cytoplasmic Ca2+ concentration ([Ca2+]i) up to 1.9 microM. Pretreating the myocytes with pertussis toxin, an exotoxin of Bordetella pertussis which inactivates GTP-binding proteins (G proteins) of the Gi and G(o) family by ADP ribosylation, reduced the PE-induced ICa stimulation by 71.5 +/- 5.6% (n = 21). Dialysis of the cytosol with the second messenger inositol-1,4,5-trisphosphate (IP3), which releases Ca2+ from intracellular non-mitochondrial, IP3-sensitive Ca2+ pools, imitated the PE-evoked responses. Pretreating the myocytes with the Ca(2+)-release blockers ryanodine (10-100 microM, n = 8), thapsigargin (0.1 microM, n = 11) or low-molecular weight heparin (n = 14) largely attenuated the PE-evoked responses. The experimental results suggest a coupling of alpha 1-adrenoceptors to phospholipase C-converting phosphoinositol-4,5-bisphosphate into diacylglycerol, an endogenous activator of the protein kinase C and IP3 which releases Ca2+ from intracellular stores stimulating ICa via Ca(2+)-calmodulin-dependent protein kinase induced phosphorylation of voltage-dependent Ca2+ channels. This knowledge could be of interest for conservative treatment in symptomatic BPH.

Calcium Channel Blockers↗
PubMed1986

Expression of the c-myc protooncogene in human prostatic carcinoma and benign prostatic hyperplasia.

We have examined the level of c-myc transcripts in prostate tissue obtained from patients with both benign prostatic hyperplasia and adenocarcinoma of the prostate. A significantly higher level of c-myc transcripts is observed in patients with adenocarcinoma (P less than 0.05). In addition, a subset of patients with adenocarcinoma had levels of c-myc transcripts 2-fold higher than the mean level for this group. These preliminary results indicate that the investigation of c-myc levels as a prognostic indicator in prostatic carcinoma is warranted.

Acid Phosphatase↗
PubMed1993

Efficacy of transurethral hyperthermia in benign prostatic hyperplasia.

From February 1990 through May 1991, 37 patients with benign prostatic hyperplasia were treated by transurethral hyperthermia according to two different protocols. In group I, 10 patients with an indwelling catheter underwent six one-hour sessions twice a week for three weeks, at a temperature of 43 degrees C. The 27 patients from group II (11 with indwelling catheter) had two sessions of two hours each for one week, at a temperature of 44.5 degrees C. Prostatic volume, Madsen symptom score, two estimates of peak flow, average flow, and residual urine measurements were recorded before treatment and one week, one month, six months, and one year after completing the sessions. Hyperthermia was applied through a metal ring, which was used both for heating and temperature control, mounted on a 16-F Foley-Tieman-like catheter. The follow-up period was five to fifteen months. From those who had an indwelling catheter, 5 of 10 patients (50%) from group I and 8 of 11 patients (72.7%) from group II regained spontaneous micturition and continued to void satisfactorily throughout the follow-up period. Nine of 16 patients without catheter (56.3%), showed objective and subjective improvement. Transurethral hyperthermia is a new, simple, noninvasive, and well-tolerated method for the treatment of benign prostatic hyperplasia.

Aged↗
PubMed1994

Clinical experience of the detection of prostate cancer in patients with benign prostate hyperplasia treated with finasteride. The Finasteride Study Group.

The clinical experience relating to the detection of prostate cancer in patients participating in 2 large multicenter clinical trials of finasteride in the treatment of benign prostatic hyperplasia is reviewed. A total of 1,645 patients 40 to 83 years old with benign prostatic hyperplasia was randomized to receive 1 or 5 mg finasteride or placebo once a day for 12 months in a double-blind fashion followed by an open extension study in which all patients were treated with 5 mg finasteride daily. At entry, all patients were to have a maximum urinary flow rate of 15 ml per second or less with a voided volume of 150 ml or more, an enlarged prostate and symptoms of urinary obstruction. Patients with a prostate specific antigen level of 40 ng/ml or more, or any finding suggestive of prostate cancer were excluded. During the study period 32 cases of prostate cancer were diagnosed: 12 were detected during the 12 months of the controlled study and were evenly distributed among the treatment groups (4 on placebo, and 3 on 1 mg and 5 on 5 mg finasteride) and 20 cases were detected in the extension study. From these results we conclude that finasteride-treated patients should be evaluated periodically by digital rectal examination, careful monitoring of prostate specific antigen levels and appropriate investigation of any suspicious findings.

Aged↗
PubMed2002

[Transurethral microwave thermotherapy for benign prostatic hyperplasia: preliminary clinical results].

We evaluated the efficacy of high energy transurethral microwave thermotherapy for treating benign prosthetic hyperplasia. During two years 42 patients with benign prostatic hyperplasia were treated with high energy transurethral microwave thermotherapy. It makes 18% of all the patients been treated. Initial evaluation consisted of a history, clinical examination, transrectal prostate ultrasonography, biopsy, PSA and urodynamic investigation with a pressure flow study. At baseline median patient age was 73 years and median prostate size was 68 g. Median 85 W were administered and treatment time 49 min. After the treatment we subjectively noticed that the patients were feeling better. The complaints according IPSS decreased to 42%, the prostate weight - 22%, removed cistostoms 75% patient, after 6 months been operated 7% of the patient. We noticed the following complications: 3 patients macrohematuria, 1 - orchoepidydymitis, 1 - acute retention of the urination. TUMT has some advantages comparing with other. It is the minimal invasion, the procedure is less painful, less hemorrhage, less complicated numbers. This method is not often used, because there are some contraindication. For patients, who need operation, the age is longer, because of the advance of good medicinal therapy. Transurethral hyperthermia represents a safe and promising method to treat benign prostatic hyperplasia, particularly for patient who candidates for conventional surgical approaches because of medical or personal reasons.

Age Factors↗
PubMedDate not supplied

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

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.

Adenocarcinoma↗
PubMed1995

[Transurethral radiofrequency thermotherapy for benign prostatic hyperplasia].

Transurethral radiofrequency thermotherapy was performed in 38 patients with benign prostatic hyperplasia using Thermex II (Direx) between December 1992 and June 1993, and its clinical efficacy was evaluated by analysing the subjective and objective responses following the treatment. Each patient was treated with an indwelling 16 Fr balloon catheter with electrode, in a single session of 90 minutes at 47-47.5 degrees C. The clinical efficiency was evaluated by total of AUA symptom score and objective findings in terms of maximum flow rate 12 weeks after treatment. The symptom score improved from 15.4 +/- 4.9 (mean +/- SD) to 7.3 +/- 5.2 25% or more improvement was found in 80% (20/25) of patients. No significant change was found in average of maximum flow rate before and after treatment, which were 8.9 +/- 4.1 (ml/sec) and 9.2 +/- 3.3, respectively. During the treatment no severe adverse effect except sense of heat and urgency was detected. Posttreatment urinary retension was found in 9 patients and catheters were indwelled in eight of them for a few days and prostatectomy was performed in one patients after 8 weeks of treatment. In four patients prostatectomy was performed between one day and 8 weeks after thermotherapy and histrogical effect on the resected specimen was examined. In the prostatic urethra, hemorrhage and inflammatory change were observed. However, in the prostatic tissue there was no necrotic region. Transurethral radiofrequency thermotherapy is safe and easy and it may be one of the useful treatments for benign prostatic hyperplasia.

Aged↗
PubMed1996

[Diagnosis and treatment of benign prostatic hyperplasia in general practice. Norwegian Medical Society].

The prevalence of benign prostatic hyperplasia increases with increasing age. The growing number of elderly men in the population will cause a marked increase in the number of men suffering from this condition. The magnitude of the problem necessitates close cooperation between urologists and general practitioners in future in order to take care of patients with benign prostatic hyperplasia. The purpose of the present survey is to present guidelines for general practitioners to enable them to diagnose this condition and to present the various alternative treatments currently available. Patients with mild and modest symptoms do not need to be referred to an urologist and can be taken care of by the general practitioners themselves.

Diagnosis, Differential↗
PubMed1986

A high risk factor score in the management of benign prostatic hyperplasia.

To evaluate high risk factors in the management of benign prostatic hyperplasia, a scoring system has been devised which includes associated medical diseases and such complications as retention, infection and uraemia. A score of 1 to 3 was given for each high risk factor. Patients with a total score of 1 to 3 were regarded as grade 1, 4 to 6 as grade II and more than 7 as grade III. Three hundred and fifty cases of benign prostatic hyperplasia were evaluated and the patients' hospital stay, complications and mortality compared.

Aged↗
PubMed1989

Management of urinary retention due to benign prostatic hyperplasia using luteinizing hormone-releasing hormone agonist.

A common affliction of older men is bladder outlet obstruction secondary to benign prostatic hyperplasia for which the standard treatment is surgical prostatectomy. We report on six men with urinary retention from benign prostatic hyperplasia who were not medically able to undergo surgical prostatectomy but were successfully treated with the luteinizing hormone-releasing hormone (LH-RH) agonist, leuprolide acetate. This therapy is exemplified by the case of a sixty-six-year-old man with hemophilia B and urinary retention. The patient was treated with daily subcutaneous injections of 1 mg of leuprolide acetate, and prostatic size decreased from 132 g to 42 g, with initiation of spontaneous micturition while on treatment. For patients with symptomatic benign prostatic hyperplasia who are not candidates for surgery, treatment with an LH-RH agonist, such as leuprolide acetate, should be considered as a possible alternative.

Aged↗
PubMed2003

Changes in health-related quality of life of men with prostate cancer 3 months after diagnosis: the role of psychosocial factors and comparisment with benign prostate hyperplasia patients.

The objective of the pilot study is to measure the changes in health-related quality of life (HRQOL, general and prostate specific) 3 months after the disease has been diagnosed in men with prostate cancer. The results are compared with benign prostate hyperplasia (BPH) patients. Also the influence of psychosocial factors (distress, coping and social support) on the experienced changes in health-related quality of life is studied for both patient groups. The sample consists of 61 patients who filled in the questionnaire before the diagnosis was know to them and after 3 months (38 benign prostate hyperplasia and 23 prostate cancer patients). The measures consist of: quality of life, micturation symptoms, sexual functioning, coping style, psychological distress, life events, social support, social desirability, and health behavior. The results show a decrease in quality of life for prostate cancer patient after three moments, while the quality of life measure for BPH patients are stable over time. For both patient groups, the psychosocial factors do not change after 3 months. The psychosocial factors contribute only marginal to the changes in quality of life. Conclusions are drawn concerning the need and the content of psychosocial support and education for prostate cancer patients.

Adaptation, Psychological↗