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 865 records · Page 48Linked to original sources
PubMed2004

Dutasteride: a potent dual inhibitor of 5-alpha-reductase for benign prostatic hyperplasia.

Dutasteride is a 5alpha-reductase inhibitor that inhibits both types 1 and 2 isozymes of 5alpha-reductase, the enzyme responsible for converting testosterone to dihydrotestosterone in the prostate and other tissues. Dihydrotestosterone is the primary cause of prostate growth and has been proven to play a key role in the development and progression of benign prostatic hyperplasia. Dutasteride has been investigated in three multicenter studies involving 4325 men aged 50 years and above with benign prostatic hyperplasia. Data from these two-year, placebo-controlled studies demonstrated that dutasteride 0.5 mg once daily reduced the risk of both acute urinary retention and the need for benign prostatic hyperplasia-related surgical intervention, improved benign prostatic hyperplasia-related symptoms, decreased prostate volume and increased maximum urinary flow rates with a low incidence of generally mild to moderate adverse events.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1995

The changing therapy of benign prostatic hyperplasia.

The diagnosis and treatment of benign prostatic hyperplasia (BPH) is increasingly under review and discussion. The diagnosis of BPH can be based on microscopic, clinical, or urodynamic criteria, and has important implications for treatment. Recommendations for treatment regimens are regularly updated, as new therapies enter the market and the cost effectiveness of new and established regimens are reviewed. Surgery, the mainstay of treatment for BPH, is declining, and medical therapy is assuming a greater role. Pharmacological regimens, for example alpha adrenoceptor blockers and 5-alpha reductase inhibitors, are becoming established for the treatment of mild and moderate symptoms of BPH. This paper will review the spectrum of BPH treatment modalities facing the urologist, and the factors that influence individual treatment choice.

5-alpha Reductase Inhibitors↗
PubMed1996

Estimate criteria for efficacy of treatment in benign prostatic hyperplasia.

BACKGROUND: Various treatment modalities for benign prostatic hyperplasia (BPH) have emerged and are now in use or await evaluation of clinical usefulness. It is difficult, however, to compare their efficacies on a single scale, because standardized criteria for therapeutic efficacy of BPH treatments have not been established. PATIENTS AND METHODS: A total of 692 BPH patients from 8 institutions in Japan received various treatments, and were judged by specialized physicians for overall efficacy, and for efficacy in 4 domains: symptom, function, anatomy, and quality of life (QOL). Efficacy of treatment was graded as excellent, good, fair or poor, and assessed using items based on conventional clinical measurements. These items included 1) the difference (post-pretreatment value), 2) relative ratio (post/pre) and, 3) the individual values of pre- or posttreatment measurements. The cut off levels for each grade were heuristically selected by Spearman's rank correlation and multiple regression analysis so that the results accurately predicted physicians' judgement, while the feasibility was maintained. RESULTS: The results for each efficacy grade (range of excellent, range of good, range of fair, range of poor) were summarized as follows: Symptom: (post/pre treatment ratio of I-PSS) < or = 0.25, < or = 0.5, < or = 0.75, > 0.75. Function: (post-pre of Qmax) > or = 10 mL/s, > or = 5 mL/s, > or = 0.25 mL/s, < 0.25 mL/s. Anatomy: (post/pre ratio of prostate volume) < or = 0.5, < or = 0.75, < or = 0.9, > 0.9. QOL: (pre-post of QOL index) > or = 4, 3, 2 and 1, < or = 0. The overall efficacy grade was defined as the median of efficacy grades of 3 domains: symptom, function and QOL. The agreement rates between the criteria and physicians' judgement on the dichotomous efficacy (either excellent plus good, or fair plus poor) were approximately 80% in individual domains and overall estimate, and consistent among various treatments. CONCLUSION: The proposed criteria are fairly accurate, simple, and practical, and thus may be useful as a standard method for assessing the clinical efficacy of BPH treatments.

Evaluation Studies as Topic↗
PubMed2002

The effect of doxazosin on sexual function in patients with benign prostatic hyperplasia, hypertension, or both.

The prevalence of both benign prostatic hyperplasia (BPH) and hypertension increases with advancing age. These conditions coexist in almost 25% of men aged 60 years and older. The use of transurethral prostatectomy, a common surgical therapy for BPH, alleviates symptoms but results in erectile dysfunction (ED) in up to 35% of patients. Pharmacological intervention for BPH, including androgen-suppressing agents, has resulted in an increased incidence of sexual adverse experiences compared with the incidence observed in patients receiving placebo. Patients with hypertension also frequently experience problems with sexual function; in addition, antihypertensive medications used to treat this disease may increase problems with sexual function. ED is an age-related phenomenon, with estimated prevalence rates of 39% among men 40 years old and 67% among those 70 years old. Doxazosin, an alpha1-adrenoceptor antagonist indicated for the treatment of patients with BPH and/or hypertension, is not associated with the occurrence of ED compared with other antihypertensive treatments.

Adrenergic alpha-Antagonists↗
PubMed1997

[Clinical significance of residual urine volume in bladder outlet obstruction with benign prostatic hyperplasia].

Bladder outlet obstruction (BOO) with benign prostatic hyperplasia (BPH) was determined by pressure-flow studies. Residual urine volume was measured by urethral catheterization. Fifty-one patients with or without BOO were investigated for residual urine. The mean residual urine volume was 32.8 +/- 35.9 ml and 25.2 +/- 22.7 ml in BOO group (31 patients) and no BOO group (20) respectively. The range of residual urine volume was from 6 to 210 ml and from 3 to 88 ml in the two groups respectively. Residual urine volume was not statistically different between the BOO group and no BOO group (P > 0.05). The results of pressure-flow studies were significantly different between the BOO group and no BOO group (P < 0.01). Residual urine determination was not a reliable criterion for selection of patients for surgery. The cause of residual urine is not only BOO. The patients with BOO may present insignificant residual urine. It is evident that the absence of post-void residual urine does not rule out BOO.

Aged↗
PubMed1981

Cell separation and characterization of epithelial cells from human benign prostatic hyperplasia.

Epithelial cells were isolated from human prostatic hyperplasia (BPH) after mechanical disruption of the tissue. The tissue was cut into small pieces, then mechanical pressure was applied. Stroma and epithelium were separated by a sequence of sedimentation steps. The recovery rate of epithelial cells was around 20 million cells per gram of tissue and more than 95% of the cells did exclude trypan blue. Epithelial cells can be identified by phase contrast microscopy and by the acid phosphatase content of the cells. In more than 95% of the cells the presence of acid phosphatase could be shown cytochemically with phosphorylcholine as a substrate. This finding indicates that the contamination with other cell types is very small. Histological study of the remaining stroma indicates that most of the epithelial cells are removed. Also, the acid phosphatase content of this fraction was found to be very low. The problem of obtaining large quantities of stromal cells in suspension has not yet been resolved. However, the technique described may be more suitable than others for the separate study of stroma and epithelium from BPH.

Acid Phosphatase↗
PubMed1995

The epidemiology of benign prostatic hyperplasia and observations on concomitant hypertension.

Benign prostatic hyperplasia (BPH) and hypertension are highly prevalent, age-related disorders in men which place a considerable burden on healthcare resources worldwide. Evidence of pathological BPH can be found in over 80% of autopsies conducted in men over 70 years of age; around 40% of men aged 50-64 years have symptoms compatible with the disease. Population studies suggest that over 50% of people aged 65-74 years may be hypertensive, and that cardiovascular disease is a major cause of death worldwide. The continued ageing of the population means that more people are living to older ages; life expectancy for men is likely to exceed 80 years by the end of this century in some developed countries. While BPH and hypertension are apparently diverse disease processes, they have some features in common (e.g. underlying aetiology of the sympathetic nervous system). However, little else is known about any associations between the two or the frequency of concomitant disease. There are clearly opportunities for further epidemiologic studies and the development of preventive strategies aimed at the early detection and treatment of concomitant BPH and hypertension.

Adult↗
PubMed2001

Microwave thermotherapy for benign prostatic hyperplasia with the Dornier Urowave: response durability and variables potentially predicting response.

OBJECTIVES: To evaluate the clinical efficacy and durability of transurethral microwave thermotherapy (TUMT) in the treatment of benign prostatic hyperplasia. The clinical variables useful in predicting outcome were identified. METHODS: From October 1996 to March 2000, 58 patients with symptomatic benign prostatic hyperplasia were treated with TUMT using the Urowave device. Treatment outcome was evaluated by the International Prostate Symptom Score (IPSS), quality-of-life assessment score, and urodynamic investigation. The patients were divided into those having a good and poor response on the basis of the degree of IPSS decrease at 3 months. RESULTS: The mean IPSS significantly decreased from 19.2 at baseline to 13.3 at 3 months (P <0.0001). The mean quality-of-life score changed from 4.6 at baseline to 2.9 at 3 months (P <0.0001). No statistically significant differences in peak flow rate, postvoid residual volume, Schäfer's obstruction scale, or detrusor pressure at peak flow were noted before or after TUMT. The pretreatment IPSS of the good response group was significantly higher than that of the poor response group (P=0.017). A more significant difference was obtained for the obstructive score (P = 0.002), and no difference was observed in the irritative score (P = 0.631). The Schäfer grading scale score of the good response group was significantly smaller than that of the poor response group (P = 0.047). CONCLUSIONS: TUMT with the Urowave was effective in eliminating symptoms associated with benign prostatic hyperplasia, but did not markedly improve the objective voiding parameters. Patients with urodynamically less obstructive symptoms but subjectively more obstructive symptoms are therefore probably good candidates for TUMT.

Aged↗
PubMed1975

Benign prostatic hyperplasia. Early recognition and management.

At the present time the medical management of prostatic hyperplasia remains primarily in the investigative stage. Various prostatic inhibitory substances, primarily hormonal in nature, have been studied in animals and humans. The work of Scott with cyproterone acetate in a group of 13 patients with nodular hyperplasia demonstrated improvement of the obstructive symptoms in 11 patients, an increased flow rate in 9, reduction of residual urine in 8, decrease in prostatic size in 7, and epithelial histologic changes in 8. Nevertheless in spite of these and other encouraging preliminry results, the principal therapy for genign prostatic hyperplasia is surgical relief of bladder neck obstruction by prostatectomy which has a mortality rate of less than one per cent. The effects of medical therapy remain uncertain and are employed primarily in patients who are poor surgical risks.

Chronic Disease↗
PubMed1990

[Diclofenac sodium therapy in irritating micturition syndrome following TUR for benign prostatic hyperplasia].

The irritative micturition syndrome is commonly observed following endoscopic surgery for benign prostatic hyperplasia. This condition almost consistently presents following removal of the bladder catheter and may last from 15 to 45 days. The present study was undertaken to determine the efficacy of treatment with diclofenac sodium. Fifty patients submitted to endoscopic resection for benign prostatic hyperplasia received the agent IM a few hours prior to catheter removal and posteriorly via the rectal route for a total treatment period of 13 days. Good results were achieved in 95.5% of the cases. Mild side effects were observed in 14% of the patients.

Diclofenac↗
PubMed2005

[Value of preoperative urodynamics to the prognosis of transurethral prostate resection for benign prostatic hyperplasia].

OBJECTIVE: To establish the value of preoperative urodynamics to the outcome prediction of transurethral prostate resection (TURP) for benign prostatic hyperplasia (BPH). METHODS: One hundred and sixty patients with BPH underwent urodynamic tests. Preoperative IPSS (International Prostate Symptom Score) and QOL (Quality of Life) were compared with those 8 to approximately 11 months after operation. RESULTS: The parameters of urodynamic tests (max. free flow, detrusor pressure at max. flow, Schafer grade, Abrams-Griffiths No, urethral resistance factor, cystometric capacity, effective capacity). IPSS and QOL were improved after operation (P < 0.001). And all the relative coefficients of linear dependence analysis, IPSS, QOL and max. free flow, detrusor pressure at max. flow, Schafer grade, Abrams-Griffiths value, urethral resistance factor, cystometric capacity, and effective capacity conducted postoperatively, were statistically significant. CONCLUSION: Preoperative urodynamics of transurethral prostate resection for benign prostatic hyperplasia may provide indication for operation and predict postoperative improvement of symptoms. Preoperative urodynamics should be considered as a routine examination.

Aged↗
PubMedDate not supplied

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

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

Aged↗
PubMed2002

Recruitment for a clinical trial of drug treatment for benign prostatic hyperplasia.

OBJECTIVES: To evaluate the effectiveness of various recruitment strategies for a 6-year multicenter clinical trial of medical therapy for benign prostatic hyperplasia, the Medical Therapy of Prostatic Symptoms Trial. METHODS: How participants learned about the trial was obtained during initial contact with clinical centers and at the first screening visit. The yield of randomized participants from the initial contact and first screening visit was calculated for each of the recruitment techniques. RESULTS: During a period of 28 months, 16,723 potential trial participants made an initial contact with the 17 clinical centers, and 2931 men were randomized. An average of four initial contacts were required for each first screen visit and six per randomized participant. Newspaper (29.9%) and mail (26.7%) were the two leading sources of randomized participants. Medical sources (9.6%), radio (8.8%), and newsletters (8.4%) were also important sources. All clinical centers achieved or exceeded their recruitment goals. CONCLUSIONS: Mass mail and newspaper were the most effective recruitment techniques to enlist the interest of men with urinary symptoms for a long-term trial of drug therapy for benign prostatic hyperplasia.

Humans↗
PubMed2003

[Clinical effects of naftopidil on nocturia associated with benign prostatic hyperplasia].

We studied the efficacy of naftopidil (50 mg/day) on nocturia associated with benign prostatic hyperplasia in 35 patients (62-80 years old). The patients had BPH > 20 ml, nocturia, more than 3 times, international prostate symptom score (IPSS) > 7, quality of life score (QOL) < 1, and maximum flow rate (Qmax) < 15 ml/sec. They received naftopidil for more than 6 weeks. IPSS, QOL, Qmax, micturition volume, and side effects were analyzed. Naftopidil was effective for nocturia associated with benign prostatic hyperplasia, especially when taken at night.

Adrenergic alpha-Antagonists↗
PubMed1994

Natural course of human benign prostatic hyperplasia with relation to urinary disturbance.

To examine the natural course of human benign prostatic hyperplasia (BPH), cases in health care examination with or without slight urinary symptoms were examined by echography. In comparison with these cases, the size of the prostate was examined in patients who received prostatectomy. Prostatic sizes of health care cases varied widely along with increasing age, but could be divided into two groups: increasing or no-change. According to serial determinations of prostatic sizes in the increasing group, the annual growth rate of the prostate was calculated as 1.65 +/- 1.13 and 0.85 +/- 0.44 g in men < 65 years old and in men > or = 65 years old, respectively. Distribution of prostatic sizes as a function of age in health care cases was similar to that in operated patients, showing that the size was not correlated with urinary symptoms or surgical indication. Since uroflow rates decreased along with increasing age in the no-change group of operated patients, aging was a factor in deterioration of uroflow. Between the increasing and the no-change groups in health care cases, differences were found in total cholesterol and neutral fat in serum, in addition to gamma-seminoprotein; the latter may be due to differences in the size of the prostate. In conclusion, natural course of the prostatic hyperplasia is separated into two groups, increasing and no-change. Occurrence of urinary symptoms does not simply relate to an increase in prostatic weight but, at least in part, to the aging process.

Adult↗
PubMed1996

Benign prostatic hyperplasia: a review of its histogenesis and natural history.

Although the exact etiology of benign prostatic hyperplasia (BPH) is not well-defined, it is thought to occur as a result of epithelial-stromal interactions in the appropriate hormonal milieu. Benign prostatic hyperplasia originates in the periurethral and transition zones of the prostate in a microscopic (histologically identifiable) state as early as the third decade of life. With advancing age and the presence of androgens, approximately 50% of microscopic BPH will develop into macroscopic (palpably enlarged prostate) BPH. However, clinically significant BPH, necessitating treatment, will develop in only 50% of men with an enlarged prostate gland. In the United States, the estimated risk of a 50-year old man undergoing therapeutic intervention in his lifetime is approximately 40%. If left untreated, a significant number of symptomatic patients will remain stable or improve without adverse sequelae.

Adult↗
PubMed1992

Transrectal hyperthermia-induced histological and ultrastructural changes of human benign prostatic hyperplasia tissue.

This prospective study evaluated the tissutal, cellular and intracellular effects of transrectal microwave hyperthermia on human benign prostatic hyperplasia. Forty-eight patients with benign prostatic hyperplasia underwent ten 60-min-long sessions of transrectal hyperthermia with an intraprostatic calculated temperature of 42 +/- 0.5 degrees C. Ultrasound-guided transperineal biopsies of the prostate were taken before and 1 month after completion of treatment. Postoperatively, morphometric analysis of bioptic specimens showed a statistically significant (p < 0.01) increase in the number of intraprostatic arterioles and capillary-like vessels. Diffused inflammatory infiltrates were also noted. Postoperative integrity of intracellular organelles and cellular membranes was evidenced by transmission electron microscopy. Our regimen of transrectal prostatic hyperthermia did not cause any irreversible histological or ultrastructural damage to the prostatic tissue. Hyperthermia-induced increase in blood flow could enhance drug delivery to the prostate gland.

Humans↗
PubMed1994

A modified prostatic UroLume Wallstent for healthy patients with symptomatic benign prostatic hyperplasia: a European Multicenter Study.

OBJECTIVES: This European multicenter study was aimed to assess the clinical reliability of a modified prostatic UroLume Wallstent (American Medical System, Minnetonka, MN) in the treatment of 135 healthy patients with symptomatic benign prostatic hyperplasia. METHODS: Ninety-one patients who were obstructed but still voiding spontaneously and 44 patients who had an indwelling catheter were treated by placement of a modified stent. RESULTS: A significant improvement in mean peak flow rates and residual urine volumes was maintained throughout follow-up. Both obstructive and irritative voiding symptoms were significantly improved after placement of the stent, although a greater amelioration was seen in obstructive symptoms. The rate of patients reporting erections increased after stent insertion. Eighty percent of sexually active patients reported the maintenance of antegrade ejaculation postoperatively. A greater than 80% epithelialization of the stent was seen in 28 patients (100%) examined at the 18-month follow-up. Long-term complications were seen in 51 patients (38%). Twenty-one of these patients had the stent removed due to intractable detrusor instability, stent encrustation, stent migration, or persistence of obstruction due to prominent median lobe, understenting, or severe hyperplasia of the epithelium of the prostatic urethra. In 6 of them another stent was reimplanted while the others were treated surgically. CONCLUSIONS: Although this modified stent was abandoned due to an unacceptable rate of complications, this study demonstrates that bladder outlet obstruction in healthy patients with benign prostatic hyperplasia can be successfully relieved by the placement of a UroLume Wallstent.

Aged↗