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PubMed1990

Transurethral hyperthermia for benign prostatic hyperplasia: preliminary clinical results.

A total of 21 patients with biopsy proved benign prostatic hyperplasia underwent treatment on a pilot protocol involving intracavitary transurethral radiating microwave (630 or 915 MHz.) antenna hyperthermia. Acute and subacute toxicity was mild and consisted primarily of bladder spasm (26% of the patients), hematuria (23%) and dysuria (9%), none of which significantly limited the achievement of desired temperatures during the treatment sessions. No chronic treatment-related morbidity or mortality was observed. Detailed thermal mapping, performed along the course of the prostatic urethra, recorded temperatures of 43C or more at greater than 75% of the loci. Highly significant increases in urine flow rate, decrease in post-void residual urine capacity and decrease in frequency of nocturia were observed. A marginally significant decrease in prostate volume was noted and, with a median followup of 12.5 months, only 3 patients have required subsequent prostatic resection. Transurethral hyperthermia represents a safe and promising outpatient approach to treatment of benign prostatic hyperplasia, particularly for patients who are not candidates for conventional surgical approaches because of medical or personal reasons. Further studies with the goal of optimizing the technique appear to be warranted, although long-term results would be best evaluated with prospective phase 3 trials.

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PubMed1994

Three-year safety and efficacy data on the use of finasteride in the treatment of benign prostatic hyperplasia.

OBJECTIVE: To assess the long-term safety and efficacy of finasteride in the treatment of symptomatic benign prostatic hyperplasia in patients treated with finasteride 5 mg for thirty-six months. METHODS: Two large multicenter studies were used. Patients were randomly assigned to treatment with finasteride, 1 or 5 mg, or placebo for twelve months. After completing twelve months of therapy, patients were invited to enter an open extension to the study in which all patients received finasteride 5 mg. Urinary symptoms, urinary flow rate, prostate volume, and serum concentrations of prostate-specific antigen and dihydrotestosterone were measured periodically during the study. RESULTS: After thirty-six months of treatment with finasteride 5 mg, prostate volume was reduced from baseline by approximately 27 percent, maximum urinary flow rate improved by approximately 2.3 mL/second, and symptom scores improved by 3.6 points. Forty-two percent of patients had a 30 percent or greater decrease in prostate volume, 40 percent of patients showed an increase of 3 mL/second or more in maximum urinary flow rate, and 48 percent of patients experienced a 50 percent or greater improvement in symptom scores. Finasteride was well tolerated and there was no evidence of increased adverse experiences with increased duration of treatment. CONCLUSIONS: The excellent safety profile and sustained clinical efficacy, over thirty-six months, of daily treatment with finasteride 5 mg recommend finasteride as a low-risk medical option for the treatment of symptomatic benign prostatic hyperplasia.

Adult↗
PubMed2001

Perioperative prediction by MRI of prostate volume six to twelve months after laser-induced thermotherapy of benign prostatic hyperplasia.

The purpose of this study was to predict prostate volume outcome 6-12 months after interstitial, laser-induced thermotherapy (LITT) for benign prostatic hyperplasia (BPH) on the basis of prostate magnetic resonance (MR) images obtained within 48 hours before and after LITT. Twenty patients (age, 64.2 +/- 7.4 years) with symptomatic BPH had LITT of the transitional zone of the prostate. MRI was performed within 48 hours before and after LITT, and 6-12 months after LITT (late follow-up). MRI included axial and sagittal T2-weighted fast spin-echo (FSE) images and contrast-enhanced, axial T1-weighted images. Volumes of different prostatic compartments (total prostate, transitional zone, peripheral zone, LITT lesions) were measured by planimetry. Subtraction of LITT lesion volume less than 48 hours after LITT from total and transitional zone volume before LITT, respectively, predicted respective prostatic volumes at late follow-up. Pearson correlations of predicted and measured total prostate and transitional zone volumes were 0.972 and 0.975, respectively. Total prostate volume at late follow-up was accurately predicted (difference, -0.5 +/- 5.7 cc; P = 0.6981, two-tailed paired t-test). Transitional zone volume was underestimated (difference, -3.1 +/- 4.7 cc; P = 0.0075). Peripheral zone volume was overestimated (difference, 2.6 +/- 3.5 cc; P = 0.0034). Perioperative MRI allows accurate prediction of prostate volume 6-12 months after LITT for BPH. Underestimation of transitional zone volume may be due to ongoing growth of BPH. LITT appears to affect peripheral zone tissue outside the target region. J. Magn. Reson. Imaging 2001;13:64-68.

Follow-Up Studies↗
PubMed1994

Selection of the surgical procedure for management of benign prostatic hyperplasia.

The standard method of surgically treating obstructing benign prostatic hyperplasia is transurethral resection of the prostate. It is the gold standard by which other therapeutic modalities, medical and surgical, should be measured. In those patients with larger prostate, open prostatectomy is the procedure of choice. Transurethral incision of the prostate has been under-utilized and would be useful in the majority of patients. The procedure is best used in patients who have glands under 30 grams and preferably around 20 grams in size. Therefore, in a given patient, the surgical procedure will be dependent upon the patient's general condition, the anatomy and size of his prostate, and the surgeon's skill and experience. Newer less invasive procedures are currently under evaluation and must be compared to transurethral prostatectomy, so that we can determine their possible role in the armamentarium of the urologist. Prospective randomized studies, comparing these new modalities to TUR-P, are needed, particularly with long-term outcome data.

Catheterization↗
PubMedDate not supplied

[Ultrastructural studies of the detrusor in patients with benign prostatic hyperplasia].

Unstable bladder was diagnosed in 15.9% of patients with post-operative problems with urination. It is suggested that the mechanism of urination defects in patients with benign prostatic hyperplasia may imply not only mechanical compression, stretching of the posterior urethra, changes in the urethrovesical angle, but also detrusor abnormalities. Ultrastructure of bladder muscles was studied in 6 patients with benign prostatic hyperplasia. In all cases bladder tissue underwent dystrophic, hypertrophic or atrophic changes. Lesions of the contractile apparatus of the bladder were associated with microcirculatory vessels sclerosis. The above ultrastructural alterations should be considered in combined therapy of patients with benign prostatic hyperplasia.

Adult↗
PubMed1997

The role of sex steroids in the pathogenesis and maintenance of benign prostatic hyperplasia.

BACKGROUND: It has long been suspected that sex steroids play a key role in the pathogenesis of benign prostatic hyperplasia (BPH). Prostatic diseases do not occur in males castrated before puberty or in males with heritable disorders of androgen production or action. Both estrogens and androgens have been shown to induce BPH in experimental animals. METHODS: Clinical studies utilizing hormonal therapies to treat BPH were reviewed. Studies that used total medical castration therapy via the use of a long-acting gonadotropin-releasing hormone (GnRH agonist), partial androgen blockade via the use of the 5 alpha-reductase inhibitor finasteride, and estrogen blockade (via the use of aromatase inhibitors) were analyzed. RESULTS AND CONCLUSIONS: Both the GnRH agonists and finasteride result in prostatic size reduction and alleviate symptoms in some patients. Both therapies are more effective in men with larger prostates (> 40 cc). Finasteride is less efficacious in terms of size reduction than the GnRH agonists but also has fewer side effects. To date, clinical trials with aromatase inhibitors have not yielded dramatic positive results in the treatment of BPH.

Antineoplastic Agents, Hormonal↗
PubMed2004

[Endoscopic resection of benign prostatic hyperplasia in men over 80 years of age: a retrospective study of 184 cases].

OBJECTIVE: The aim of the present study was to evaluate the outcome of transurethral resection of the prostate for benign prostatic hyperplasia in men over 80 years. MATERIAL AND METHOD: 184 men over 80 years underwent transurethral resection of the prostate for benign prostatic hyperplasia. Serious concomitant disease was found in 48.92% of cases. RESULTS: The mean operating time was 49 min ( 20 - 160mn). Others conditions found at surgery were treated during the same operation in 33.68% of cases. Peroperative complications were reported in 15 patients (8.15%) and immediate post operative complications were reported in 14 patients (7.60%), with died of 3 patients. The complications at 6 month after surgery in 172 available for followup were reported in 11 patients (6.39%). CONCLUSION: Transurethral resection of the prostate for benign prostatic hyperplasia in men over 80 years has a good outcome with an acceptable morbidity and mortality.

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PubMed2006

[Transurethral holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia].

OBJECTIVE: To evaluate the efficacy and safety of transurethral holmium laser enucleation of the prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH). METHODS: A retrospective review was conducted of transurethral (HoLEP) performed on 68 patients, aged 65.7 (50 - 91) with benign prostatic hyperplasia. The efficacy and complications were all assessed. RESULTS: The mean procedure time was 87 mins (45 - 158 mins). The mean specimen weight was 61 g (31 - 128 g). The procedure allows a precise, bloodless field with no need for transfusion. No TUR syndrome and other major complications were encountered during the operation. The mean catheter time and hospital stay were 2.8 d (1 - 4 d) and 3.6 d (2 - 5 d), respectively. Follow-up of 7.6 months (1 - 13 months) revealed that the urination symptoms were markedly improved in all patients, and that the IPSS decreased from 25.7 +/- 6.9 to 7.7 +/- 4.3 (P < 0.01) and the maximum urine flow rate increased from 8.1 +/- 4.2 ml/s to 18.8 +/- 4.6 ml/s (P < 0.01). Postoperative complications occurred in 3 patients. 2 with transient incontinence were recovered within 3 months postoperatively. The other one with mild posterior urethral stricture was treated effectively with urethral sounding. CONCLUSIONS: Was associated with high effectiveness, safety, short hospital stay and less complications, HoLEP is a new minimally invasive surgical procedure for BPH.

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PubMed2006

Furosemide use and hospitalization for benign prostatic hyperplasia.

OBJECTIVE: Recent studies have shown that furosemide may have anti-inflammatory properties. We explored whether exposure to furosemide would reduce the risk of being hospitalized with prostatism, a marker of benign prostatic hyperplasia. METHODS: Using record linkage and the computerized health insurance databases of the province of Québec, Canada, we identified a cohort of men 65 years of age and older within which we conducted a case-control study. Cases were individuals hospitalized with prostatism (ICD-9 code 600) between January 1991 and June 1993, with the index date taken as the date of hospitalisation. Controls were those not having experienced the event during the study period, with an index date selected randomly during their follow-up. Cases and controls were required to have at least 2 (1/2) years of health coverage prior to index date in order to identify risk factors for benign prostatic hyperplasia and establish baseline medical history. We assessed the subjects' exposure to furosemide and various other diuretics in the period 180 to 900 days preceding the index date. Logistic regression was used to evaluate the association between the use of furosemide and hospitalization for prostatism, adjusting for potential confounders. RESULTS: The cohort included 8,814 subjects, of which 231 were cases and 8,583 controls. The rate of hospitalization for prostatism was lower for users of furosemide compared to non-users (adjusted rate ratio 0.49; 95% CI: 0.25-0.95). There was no association with the use of thiazide or potassium sparing diuretics (adjusted rate ratio 0.95; 95% CI: 0.65-1.37). Results suggestive of a protective effect associated with corticosteroid use were observed (adjusted rate ratio 0.64; 95% CI: 0.44-0.93). CONCLUSIONS: This study supports the hypothesis that furosemide can reduce the risk of hospitalization for prostatism, a marker of benign prostatic hyperplasia.

Case-Control Studies↗
PubMed2003

Laser therapy for benign prostatic hyperplasia: a review of recent developments.

PURPOSE OF REVIEW: Over the past 10-15 years a variety of endoscopic laser techniques have evolved for the treatment of benign prostatic hyperplasia. The laser is merely an energy source with the ability to coagulate, incise, vaporize, resect and dissect (enucleate), all fundamentally different procedures. Generalization regarding "laser prostatectomy" is therefore inappropriate. The potential for shorter hospital stays and decreased morbidity while maintaining the efficacy and durability of transurethral resection of the prostate has been the driving force behind the laser techniques that acutely remove tissue, whereas the ideal minimally invasive non-tissue removing laser technique is a well-tolerated office procedure, performed under local anaesthesia. We define the various laser techniques currently available for the treatment of benign prostatic hyperplasia, and review developments reported during the period July 2001 to July 2002. RECENT FINDINGS: Although there are few long-term data available on laser techniques, more medium-term data is emerging. Issues such as cost-effectiveness and applicability to certain sub-groups of patients are being investigated as each laser technique aims to find its own niche in the ever-expanding treatment armamentarium for benign prostatic hyperplasia. SUMMARY: Satisfactory moderate term results are now available for several minimally invasive laser techniques including interstitial laser coagulation and visual laser ablation of the prostate. There are promising early results for holmium laser enucleation of the prostate and potassium titanyl-phosphate, which have the potential to rival transurethral resection if proved durable in the long-term. Holmium laser enucleation is currently a serious contender for the "gold standard" for large prostates.

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PubMed1995

New diagnostic and treatment guidelines for benign prostatic hyperplasia. Potential impact in the United States.

BACKGROUND: The Agency for Health Care Policy and Research (AHCPR) recently released the clinical practice guidelines for the diagnosis and treatment of benign prostatic hyperplasia. Prevalence estimates from a population-based cross-sectional study, the baseline component of a cohort study of the natural history of prostatism, were used to assess their potential impact in the United States. METHODS: The study group comprised a population-based sample of white men aged 50 to 79 years who were randomly selected within age- and residence-specific strata from the Olmsted County, Minnesota, population (1990 census, 105,720). These 1317 men completed symptom assessments and diagnostic evaluations that paralleled the AHCPR guidelines, including the measurement of urinary flow rates and, for a subset (n = 303), ultrasonic determination of postvoiding residual urine volume. RESULTS: The application of the AHCPR benign prostatic hyperplasia diagnostic guidelines to the study cohort (American Urologic Association Symptom Index > 7 and peak urinary flow rate < 15 mL/s) suggests that 17% of men aged 50 to 59 years, 27% of men aged 60 to 69 years, and 35% of men aged 70 to 9 years are eligible to discuss treatment options. Application of these percentages to the 1990 US white population suggests that approximately 5.6 million men aged 50 to 79 years are eligible to discuss treatment options. This number will double by the year 2020 owing to the aging of the population. CONCLUSION: The projected number of men potentially meeting AHCPR guidelines to discuss treatment options for benign prostatic hyperplasia could have a substantial impact on the health care system; this will be compounded by the aging of the population.

Adult↗
PubMed1997

Transurethral prostatectomy: a prospective randomized study of conventional resection and electrovaporization in benign prostatic hyperplasia.

OBJECTIVE: To compare transurethral electrovaporization of the prostate (TUVP) with conventional transurethral resection of the prostate (TURP) in the treatment of men with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Seventy consecutive patients with symptomatic BPH and a prostate size of < 60 g were prospectively randomized between equal treatment groups; one group underwent standard TURP and the other TUVP. Patients were assessed at baseline and 1, 3, 6 and 12 months after treatment, giving a mean (SD) duration of follow-up of 14.4 (1.9) months (range 12-17). Variables evaluated included the duration of operation, catheterization and hospital stay, and changes in blood levels of haemoglobin, haematocrit and sodium 1 h after the operation. The American Urologic Association (AUA)-7 symptom score, peak urinary flow rate (Qmax), post-voiding residual urine volume (PVR) and sexual function were also evaluated during the follow-up. RESULTS: Patients of both groups were balanced for the different baseline variables. The mean (SD) operative duration of TUVP was 52 (12.5) min, significantly longer than that of TURP, at 39.7 (8.8) min (P < 0.001). One hour after TURP, patients had significantly lower levels of haemoglobin, haematocrit and Na. The mean (SD) duration of catheterization after TURP was 2 (0.8) days, significantly more than after TUVP, at 1.1 (0.4) days (P < 0.001). The mean (SD) hospital stay was 2.5 (1) days after TURP and 1.5 (0.7) after TUVP (P < 0.001). Compared with baseline values, the AUA-7 symptom score, Qmax and PVR improved significantly in both groups at all intervals of follow-up and there were no significant differences between the groups during the follow-up. None of 15 potent men undergoing TURP and two of 18 potent men undergoing TUVP complained of impotence during the follow-up. CONCLUSIONS: TUVP is as effective as TURP in the treatment of BPH in men with a prostate size of < 60 g. TUVP has the advantages of less blood loss, less absorption of irrigant and a shorter hospital stay, but it had a significantly longer operative duration.

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PubMed2001

[Transurethral resection of the prostate in the treatment of benign prostatic hyperplasia].

BACKGROUND AND OBJECTIVES: Transurethral resection of the prostate (TURP) represents a method of choice in surgical treatment of benign prostatic hyperplasia (BPH). The objective of this prospective study was to evaluate TURP mortality and morbidity rates. PATIENTS AND METHODS: In 1998 184 patients with lower urinary tract symptoms (LUTS) indicating the presence of BPH underwent one of the following surgeries: TURP 149 (81%), transurethral incision of the prostate 19 (10.3%), and open surgery (suprapubic transvesical prostatectomy) 16 (8.7%). From the group of 149 patients treated by TURP the following patients were withdrawn from the study: 7 (4.7%) patients with a finding of incidental carcinoma of the prostate and 14 (9.4%) patients who did not attend the postoperative follow-ups. RESULTS: 64 (50%) patients were treated for LUTS syndrome before TURP. TURP was applied in 69 (53.9%) cases for absolute indications. During the surgery and within one year after it, no mortality was recorded. Complications during the surgery were present in 13 (10.2%) patients, and within 24 h after the surgery in 38 (29.7%) patients. Early postoperative complications (up to 4 postoperative weeks) were recorded in 49 (38.3%) patients. Late postoperative complications within 3 month after the surgery occurred in 16 (12.5%) patients, within 6 months in 17 (13.3%) patients, and after 12 months in 17 (13.3%) patients. CONCLUSIONS: Although complications occur almost in 58% of patients, TURP still represents the standard treatment of LUTS indicating the presence of BPH. (Tab. 5, Fig. 2, Ref. 15.).

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PubMed1991

Influence of age and endocrine factors on the volume of benign prostatic hyperplasia.

To determine whether endocrine factors influence the volume of benign prostatic hyperplasia (BPH), 23 hormonal factors were measured in the serum of 64 men ages 42 to 71 years with low volume prostatic cancer and these levels were correlated with the volume of benign hyperplastic tissue in their radical prostatectomy specimens. With age there was a significant increase in the volume of BPH. Also with age there was a significant decrease in the serum levels of free testosterone, androstenedione, dehydroepiandronsterone (DHA), dehydroepiandronsterone sulphate (DHA-S), delta 5-androstenediol, and 17-hydroxypregnenolone, and a significant increase in sex hormone-binding globulin (SHBG), LH, and FSH. When BPH volume and hormone levels were corrected for age, BPH volume correlated positively with free testosterone, estradiol, and estriol. These data indicate that with age patients with larger volumes of BPH have higher serum androgen and estrogen levels suggesting that serum androgen and estrogen levels may be factors in the persistent stimulation of BPH with age. If so, therapeutic attempts at lowering plasma testosterone levels, reducing estrogen levels, or blocking androgenic stimulation through other mechanisms may interfere with the progression of BPH with age. Conversely, the fact that androgen production declines gradually with age may explain the observation that only 20 to 30% of men who live to age 80 require surgical treatment for urinary obstruction from BPH.

Adenocarcinoma↗
PubMed1998

An open study on the efficacy and safety of transurethral needle ablation of the prostate in treating symptomatic benign prostatic hyperplasia: the University of Florida experience.

PURPOSE: We determine the safety and efficacy of transurethral needle ablation of the prostate in patients with moderate to severe symptoms of benign prostatic hyperplasia. MATERIALS AND METHODS: Transurethral needle ablation of the prostate was performed on 45 consecutive patients. For an average prostate of 2.5 to 3 cm. long treatments were performed in 2 separate planes at 4 quadrants (2, 4, 8 and 10 o'clock positions) each. The 2 planes were 1 cm. below the bladder neck and 1 cm. proximal to the verumontanum. For prostatic urethral lengths longer than 3 cm. a treatment plane was added for each additional centimeter of prostatic urethra. The procedure was performed in 26 patients under local anesthesia using 20 cc 2% intraurethral lidocaine gel (11) or supplemented with intravenous 1.25 to 5 mg. midozolam (15). Of these patients 2 had a supplemental perineal block using a mixture of equal amounts of 15 cc 2% lidocaine without epinephrine and 0.25% bripivacaine, 10 underwent the procedure under general anesthesia, 2 had epidural and 4 had spinal anesthesia, and 3 had managed anesthesia care. Mean length of each procedure was 79 minutes (range 50 to 240). All procedures were done on an outpatient basis and patients were released on the same operative day. RESULTS: Mean prostatic volume on transrectal ultrasound was estimated at 48.1 cc (range 20 to 185). Following treatment the International Prostate Symptom Score decreased from a mean of 20.9 at baseline to 15.4 at 1 month, 16.1 at 3 months, 10.7 at 6 months and 9.9 at 1 year. The peak flow rate improved from a baseline mean of 8.3 to 13.4 at 3 months, 13.1 at 6 months and 14.9 at 1 year. The quality of life score improved from a baseline of 4.8 to 3.5, 2.2, 2.5 and 1.03 at 1, 3, 6 and 12 months, respectively. Of the 2 patients in whom the procedure failed; 1 required a bladder neck incision at 3 months and the other transurethral resection of the prostate. Foley catheters were left in place in all patients for an average of 4.85 days. CONCLUSIONS: After a followup of up to 12 months we conclude that transurethral needle ablation of the prostate is an effective treatment for symptomatic benign prostatic hyperplasia. This procedure has minimal morbidity, is less costly than conventional transurethral resection of the prostate and can be performed as an outpatient office procedure under local anesthesia in a significant number of patients.

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PubMed1986

Early stages of the pathogenesis of rat ventral prostate hyperplasia induced by citral.

Typical lesions of benign prostatic hyperplasia (BPH) were induced experimentally in the ventral prostate of adolescent (6 week old) male rats by citral, a nonsteroidal compound. Incipient BPH changes were already observed in the acinar glands 10 days after citral administration. A longer period of treatment (1 month) significantly enhanced epithelial hyperplasia, whereas the stromal elements were less reactive. Characteristic BPH lesions involving both prostatic compartments were found after 3 months of treatment. Castration prior to citral administration prevented such BPH changes; however, citral did not prevent the involutive lesions of castration. The mechanism of action of citral is yet unknown, various possibilities concerning the induction of BPH in rats are presented and discussed. The potential advantage of this model, especially as BPH is not necessarily linked to age or exogenous hormones, may offer new alternative pathways for understanding the complexity of BPH pathogenesis in animals and perhaps even in man.

Acyclic Monoterpenes↗
PubMed2001

Comparison of histological compositions and apoptosis in canine spontaneous benign prostatic hyperplasia treated with androgen suppressive agents chlormadinone acetate and finasteride.

PURPOSE: Chlormadinone acetate and finasteride are androgen suppressive agents clinically used for benign prostatic hyperplasia but their mechanism for inducing prostatic atrophy differs. We investigated the effect of these androgen suppressive agents on prostatic histology and apoptosis using the spontaneous canine benign prostatic hyperplasia model. MATERIALS AND METHODS: Animals were treated with oral chlormadinone acetate or finasteride for 25 weeks. The prostatic volumes were analyzed every 5 weeks. Prostatic androgen and estrogen concentrations, histological composition and apoptosis were determined at the end of treatment. Apoptosis was measured by in situ labeling of 3' hydroxy ends of the DNA breaks using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling method. RESULTS: There was a similar volume reduction effect with 0.3 mg./kg. chlormadinone acetate daily and 1 mg./kg. finasteride daily. Chlormadinone acetate decreased testosterone and dihydrotestosterone but finasteride decreased only dihydrotestosterone in the prostate gland. The concentration ratio of estradiol-to-total androgen in the prostate was significantly increased in finasteride treated canines. Chlormadinone acetate and finasteride decreased the epithelial and stromal components. The extent of apoptosis observed in the prostate was significantly higher in the chlormadinone acetate group compared to that of the control and finasteride groups. CONCLUSIONS: Although a similar effect of chlormadinone acetate and finasteride was observed in the induction of prostatic regression and composition of the histological components, the sustained increase in apoptosis was observed only in chlormadinone acetate treated canines. We suggest that different intraprostatic endocrine environments created by chlormadinone acetate or finasteride, which have different intraprostatic testosterone levels and estradiol-to-androgen ratios, may be responsible for the different outcomes in the extent of apoptosis.

Androgen Antagonists↗
PubMed2006

Oxidative stress and antioxidant status in non-metastatic prostate cancer and benign prostatic hyperplasia.

OBJECTIVES: We undertook the present study to investigate the possible alteration of oxidant/antioxidant status in the circulation of patients with prostate cancer and benign prostatic hyperplasia. DESIGN AND METHODS: Thiobarbituric acid reactive substances (TBARS), the enzyme activities of superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT) and copper (Cu) and zinc (Zn) levels were estimated in the erythrocytes of 25 non-metastatic prostate cancer patients, 36 benign prostatic hyperplasia (BPH) patients and 24 age- and sex-matched healthy subjects (controls). RESULTS: TBARS concentrations were significantly increased, while erythrocyte GPX and SOD activities were significantly decreased in the prostate cancer group versus controls (P < 0.001) and BPH group (P < 0.05). Zn levels were lowered in prostate cancer patients versus controls (P < 0.01) with no significant changes between BPH and cancer groups. Similarly, lipid peroxidation was increased (P < 0.05) with decreased SOD activity and Zn level (P < 0.05) in BPH versus controls. CONCLUSION: These results reveal an alteration in the lipid peroxidation index, with concomitant changes in the antioxidant defense system in prostate cancer patients compared to BPH patients. We hypothesize that an altered prooxidant-antioxidant balance may lead to an increase in oxidative damage and consequently may play an important role in prostate carcinogenesis.

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