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PubMedDate not supplied

[Changes in the levels of prostate-specific antigen and its molecular forms with alpha 1-antichymotrypsin in patients with benign prostatic hyperplasia].

Analysis of the changes in the levels of total prostatic specific antigen (t-PSA) in patients with benign prostatic hyperplasia (BPH) shows that the patient's age, size of the prostatic gland and chronic bacterial prostatitis influence the levels of t-PSA but have no effect on the levels of PSA-ACT. The relationship between the levels of t-PSA and age in BPH patients is explained by growing mass of benign hyperplasia causing mechanical load on the intact prostatic tissue. The maximal concentration of t-PSA of 8.7 +/- 1.22 ng/ml was observed in BPH patients at the age of 61-70 years. BPH stages, chronic pyelonephritis, chronic non-bacterial prostatitis, chronic renal failure are not essential for t-PSA and PSA-ACT and can be neglected in interpretation of t-PSA values in BPH patients.

Age Factors↗
PubMed2003

Prostate hyperplasia in a transgenic mouse with prostate-specific expression of prolactin.

Prolactin (PRL) is one of several polypeptide factors known to exert trophic effects on the prostate. We have previously reported a dramatic prostate enlargement with concurrent chronic hyperprolactinemia and elevated serum androgen levels in a PRL transgenic mouse (Mt-PRL) with ubiquitous expression of the transgene. To address the role of local PRL action in the prostate, a new transgenic mouse model (Pb-PRL) was generated using the prostate-specific rat probasin (Pb) minimal promoter to drive expression of the rat PRL gene. Pb-PRL transgenic males developed a significant enlargement of both the dorsolateral and ventral prostate lobes evident from 10 wk of age and increasing with age. Expression of the transgene was restricted to the prostate and detected from 4 wk of age. Low levels of transgenic rat PRL were detectable in the serum of adult Pb-PRL animals. Serum androgen levels were normal. The Pb-PRL prostate displayed significant stromal hyperplasia, ductal dilation, and focal areas of epithelial dysplasia. Quantitative analysis of prostatic tissue cellularity demonstrated a marked increase in the stromal to epithelial ratio in all lobes of Mt-PRL and Pb-PRL transgenic prostates compared with controls. Microdissections demonstrated an increased ductal morphogenesis in dorsolateral and ventral prostate lobes of Mt-PRL prostate vs. Pb-PRL and controls. In conclusion, this study indicates the ability of PRL to promote, directly or indirectly, ductal morphogenesis in the developing prostate and further to induce abnormal growth primarily of the stroma in the adult gland in a setting of normal androgen levels.

Animals↗
PubMed1995

[Therapy of benign prostatic hyperplasia with alpha receptor blockers].

The therapeutic efficacy of alpha-blockers in disorders of bladder emptying has been known for 20 years. Substantial side effects initially prevented their wide use in benign prostatic hyperplasia. The situation has changed with the development of the very much better tolerated selective alpha 1-adrenoceptor antagonists. In numerous countries, alpha 1-blockers are also licensed for use in the treatment of benign prostatic hyperplasia in addition to the main indication, vascular hypertension. Of those available in Germany, the slow-acting antihypertensive agents terazosin and doxazosin are the most suitable for use in this condition. The modern alpha 1-blockers have proved their effectiveness in large-scale placebo-controlled studies. However, the effects consist solely in improvement of the subjective symptoms and a moderate increase of urinary flow and are not comparable to those achieved with transurethral resection. alpha 1-Blockers are indicated in patients with moderate to fairly severe symptomatic benign prostatic hyperplasia (as an alternative, for example, to phytotherapeutic agents) and in patients who have severe symptoms but for whom surgical treatment is not desired, needs to be postponed or is contraindicated. Side effects arise from the concomitant vasodilatation, so that contraindications for alpha-blockers are cardiac and renal failure, a prior history of cerebrovascular incidents and a tendency to hypotension. Further attenuation of these side effects appears possible with the future development of "uroselective" alpha 1-blockers.

Adrenergic alpha-Antagonists↗
PubMed1995

Transurethral microwave thermotherapy for benign prostatic hyperplasia: clinical results after a 1-year follow-up.

Since September 1992, 63 patients with symptomatic benign prostatic hyperplasia (BPH) have been treated with transurethral microwave thermotherapy (TUMT) using the Prostatron device. The International Prostate Symptom Score (I-PSS) and quality of life (QOL) score were used to evaluate subjective symptoms. The mean I-PSS (total, irritative and obstructive scores) and QOL scores had decreased by 40, 38, 45 and 40%, respectively, at 12 months (p < 0.0001). While the mean peak flow rate had increased by 72% (p < 0.001). The clinical efficacy at 12 months was 42%, using a modification of the response criteria proposed at the 2nd International Consultation on Benign Prostatic Hyperplasia. There were no significant differences in the baseline and treatment parameters between those who responded favorably to TUMT and those who did not. The total thermal dose delivered to the prostate did not predict clinical response. However, there was a positive correlation between I-PSS or QOL at baseline and % reduction at 3, 6 and 12 months, and a negative correlation between peak flow rate at baseline and % increase at 3 and 6 months. There were no major complications associated with TUMT during the follow-up period. In summary, our 1-year clinical results are compatible with previous reports, suggesting that TUMT is a safe, effective and lasting non-surgical treatment for BPH. However, evaluation of efficacy should be based on uniform criteria to facilitate comparisons of different clinical trials. The most suitable patient profiles for TUMT could not be identified by retrospective analysis.

Aged↗
PubMed2002

Symptomatic and asymptomatic benign prostatic hyperplasia: molecular differentiation by using microarrays.

Benign prostatic hyperplasia (BPH) is a disease of unknown etiology that significantly affects the quality of life in aging men. Histologic BPH may present itself either as symptomatic or asymptomatic in nature. To elucidate the molecular differences underlying BPH, gene expression profiles from the prostate transition zone tissue have been analyzed by using microarrays. A set of 511 differentially expressed genes distinguished symptomatic and asymptomatic BPH. This genetic signature separates BPH from normal tissue but does not seem to change with age. These data could provide novel approaches for alleviating symptoms and hyperplasia in BPH.

Adolescent↗
PubMed1999

Benign prostatic hyperplasia. A review of diagnostic and treatment options.

Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland caused by histologic hyperplasia that produces an inward transmission of pressure on the urethra and an increased resistance to urine flow. The dominant risk factors for the disease are age and male gender. Weak urine stream and hesitancy are the cardinal obstructive features in BPH. Other signs and symptoms include inability to terminate micturition abruptly, sensation of incomplete emptying and occasionally, urinary retention. Many men with prostate enlargement can be successfully treated with lifestyle modification and medication. But if symptoms persist, with no significant improvement after 6 months of finasteride or 2 to 3 months of an alpha-1 blocker, consider a urology consultation. Several surgical options are available.

Aged↗
PubMed2003

Identification of a specifically expressed modified form of novel PSP-94 protein in the secretion of benign prostatic hyperplasia.

Using two-dimensional gel electrophoresis, we investigated the profile of prostatic secretory proteins in human expressed prostatic secretion (EPS) from benign prostate hyperplasia (BPH) patients and compared the patterns with normal controls. We identified three specifically expressed proteins, including prostate secretory protein 61 (PSP61), in EPS from benign BPH patients but absent in normal controls. In addition, we found that PSP61 was a modified isoform of the well-documented PSP-94, which had a perfect matching (100% homology) to the first 61 amino acids of the PSP-94 protein but with a deleted C-terminus. This shortened PSP61 was not due to alternative splicing of the PSP-94 gene at transcription level. Our results provide first evidence on the possibility of using PSP61 as a specific biological marker for diagnosis of BPH.

Aged↗
PubMed1996

The outcome of renal ultrasound in the assessment of 556 consecutive patients with benign prostatic hyperplasia.

PURPOSE: We determined the additional value of renal ultrasonography in the assessment of patients with benign prostatic hyperplasia. MATERIALS AND METHODS: Renal ultrasound was performed in 556 consecutive patients with benign prostatic hyperplasia and the results were correlated with other clinical parameters. RESULTS: Of the patients 14 (2.5%) had dilatation of the renal pelvis, 65 (11.7%) had renal cysts and 1 (0.18%) had renal cell carcinoma. The serum creatinine level appeared to be correlated with dilatation of the renal pelvis. To predict dilatation additional information can be obtained by including the results of the post-void residual measurements. CONCLUSIONS: Renal ultrasound is indicated only in patients with a specific serum creatinine level and/or post-void residual volume.

Carcinoma, Renal Cell↗
PubMed1996

[Treatment of benign prostatic hyperplasia with Proscar (finasteride). Results of a 10-year Scandinavian study].

707 patients with moderate prostatic hyperplasia were recruited to a two-year Scandinavian multicenter study. The study was randomized, prospective and double-blind. Half of the patients were treated with finasteride (5 mg daily) and the controls were given placebo. The patients were monitored with regard to symptoms, urinary flow rate and prostate volume. In addition, various laboratory examinations were performed. A statistically significant difference was found between the groups with regard to symptom improvement and increase in urinary flow rate in favour of finasteride. Finasteride reduced prostate volume and stopped further growth, leading to a difference of 30% in prostate volume between the two groups after two years of treatment. Thus, finasteride was able to stop the continuous growth of the prostate in the elderly male. The proportion of patients with adverse clinical experiences was similar in both treatment groups. However, the finasteride-treated group contained more patients with sexual dysfunction. We conclude that finasteride is an alternative to vigilant waiting for patients with moderate symptoms of benign prostatic hyperplasia.

Aged↗
PubMed2003

Simultaneous transurethral resection of bladder tumor and benign prostatic hyperplasia: hazardous or a safe timesaver?

PURPOSE: We evaluated the effect of simultaneous transurethral resection of bladder tumor (TURBT) and benign prostatic hyperplasia (TURP) on recurrences at the bladder neck and prostatic urethra. MATERIAL AND METHODS: During the 10-year study period 51 patients fulfilled the entry criteria of past simultaneous TURBT and TURP, histologically confirmed transitional cell carcinoma of the bladder and benign prostatic hyperplasia, a preserved bladder and a minimal followup of 12 months. Their records were analyzed retrospectively. Patients were divided into 28 with single (group 1) and 23 with multiple (group 2) bladder tumors. RESULTS: During the 12 to 120 months of followup (mean 37.3) the average tumor recurrence rate was 68.6%, that is 53.6% in group 1 and 86.9% in group 2. Recurrences appeared within an average of 14.9 months, that is within 18 (range 4 to 36) in group 1 and 13.5 (range 3 to 36) in group 2. Tumor recurrence was at the bladder neck and/or prostatic urethra in 11 of the 51 cases (21.5%). Average time to recurrence at the prostatic fossa was 23.8 months, that is 27 (range 13 to 46) in group 1 and 21.6 (range 4 to 60) in group 2. Only 1 patient had a single recurrence in the prostatic fossa, while the others also had synchronous and metachronous recurrences at other bladder sites. Tumor progression to invasiveness was diagnosed in 3 of the 51 patients (5.9%). CONCLUSIONS: Our data indicate that simultaneous TURBT and TURP do not negatively affect tumor recurrence at the bladder neck and prostatic urethra.

Aged↗
PubMed1984

Primary non-Hodgkin lymphoma of prostate presenting as benign prostatic hyperplasia.

A case of primary non-Hodgkin lymphoma of the prostatic gland is reported. The patient presented with a classic picture of benign prostatic hyperplasia. Review of the literature disclosed about 300 reported cases. Much controversy and confusion exists in the classification of non-Hodgkin lymphoma. The two current classifications are presented, and management of this condition is reviewed.

Diagnosis, Differential↗
PubMed1991

Local hyperthermia in the treatment of benign prostatic hyperplasia. Assessment of 100 patients.

This study includes our first 100 patients who received local prostatic hyperthermia treatment for benign prostatic hyperplasia. Subjective symptoms such as nycturia, stream, urgency, and objective facts like urine flow and postmicturition residue were monitored before treatment and 3 months after. The clinical (subjective) symptoms improved in 76 patients. Urinary flow increased in 63 patients, and the postmicturition urinary residue decreased in 32 patients. We were able to show that local prostatic hyperthermia is a valid option for the treatment of benign prostatic hyperplasia although it is still too early to assess the long-term results.

Aged↗
PubMed1985

[Clinical evaluation of Cernilton on benign prostatic hyperplasia].

Twenty-two patients whose average age was 67 years and who had benign prostatic hyperplasia of stage I and II were treated with Cernilton for more than 4 weeks. Subjective symptoms were excellently improved and the improvement rate was over 85% in all of the evaluated symptoms of dysuria. In the overall evaluation, 18 out of 22 patients were rated as moderately improved or better, 2 were slightly improved and 2 remained unaltered. Aggravation of the symptoms was found in none of the patients. Objective findings such as residual urine volume and urinary flow rate were improved in 3 patients, although the shrinkage of the prostate was not observed on rectal palpation, retrograde urethro cystography or transrectal ultrasonography. No adverse reaction was observed during Cernilton therapy. In conclusion, it is suggested that Cernilton may be effective and safe for the conservative treatment of patients with early stage prostatic hyperplasia of non-surgical indication.

Aged↗
PubMed2003

Insulin-like growth factor I, insulin-like growth factor binding protein 3, and urologic measures of benign prostatic hyperplasia.

Laboratory studies suggest that insulin-like growth factor I (IGF-I) promotes prostatic growth. The authors evaluated the association between benign prostatic hyperplasia and IGF-I and its binding protein IGFBP-3 in community-dwelling men to determine whether this laboratory finding is manifest at the population level. Participants (n = 471) were Olmsted County, Minnesota, Caucasian males aged 40-79 years in 1990. Urologic measures were assessed from the International Prostate Symptom Score, peak urinary flow rates, prostate volume, and serum prostate-specific antigen (PSA), and serum IGF-I and IGFBP-3 levels were measured. After adjustment for age, the relative odds (odds ratios) of an abnormal urologic measure in men with high versus low serum IGF-I levels were 0.98 (95% confidence interval (CI): 0.66, 1.45) for a symptom score of >7, 1.14 (95% CI: 0.72, 1.80) for a peak urinary flow rate of <12 ml/second, 1.11 (95% CI: 0.72, 1.72) for a prostate volume of >30 ml, and 0.71 (95% CI: 0.46, 1.09) for a PSA level of >1.4 ng/ml. A low IGFBP-3 level was associated with an enlarged prostate (odds ratio = 1.72, 95% CI: 1.05, 2.82), after simultaneous adjustment for IGF-I and age, but not with other urologic measures. These data do not provide evidence for an association between benign prostatic hyperplasia and serum IGF-I.

Adult↗
PubMed1984

Characterization of alpha1 adrenergic receptors in human benign prostatic hyperplasia.

Bladder outlet obstruction in men with benign prostatic hyperplasia is decreased following administration of prazosin, a selective alpha1 adrenergic antagonist. Prazosin presumably binds and antagonizes alpha1 adrenergic receptors on the smooth muscle cells of the prostatic adenoma. This study represents the first identification and characterization of alpha1 adrenergic receptors in the prostate using radioligand receptor binding methods. The binding of [3H] prazosin in homogenates obtained from human prostatic adenomas was saturable and a single high affinity prazosin binding site was identified (Kd = 0.29 +/- 0.09 nM). The alpha1 adrenergic receptor concentration in these homogenates ranged between 0.28 to 2.05 fmol./ mg. wet wt. prostate. The equilibrium dissociation constant and density of prazosin binding sites were similar in different regions of an enucleated prostate suggesting homogeneity of receptor density and receptor binding sites within an adenoma. The receptor density was not directly proportional to the weight of the surgically removed adenoma. The pharmacology of the prazosin binding sites was characterized by competitive binding experiments using [3H] prazosin and several unlabelled adrenergic analogs. The IC50's determined from competitive binding experiments using [3H] prazosin and alpha-methylnorepinephrine, rauwolscine and corynanthine were characteristic of alpha1 adrenergic receptor binding.

Binding Sites↗
PubMed1995

Pharmacotherapy in benign prostatic hyperplasia.

Symptomatic bladder outlet obstruction due to benign prostatic hyperplasia (BPH) has been conventionally treated by transurethral resection. In recent years, a better understanding of the natural history and pathophysiology of BPH coupled with significant morbidity of prostate surgery has led to renewed interest in the medical therapy of BPH. Both alpha 1 blockers and 5 alpha-reductase inhibitors have been shown to be effective in recent clinical trials in the treatment of BPH. Both these drugs are safe and their side effects reversible. Medical therapy has a bigger role to play now especially for those high risk patients with moderate to severe symptoms of BPH. Further development of more effective alpha blockers and anti-androgens with less side effects would make pharmacotherapy an even more attractive alternative than the more invasive procedures.

5-alpha Reductase Inhibitors↗
PubMed2002

[The clinical efficacy of Naftopidil tablet in the treatment of benign prostatic hyperplasia].

OBJECTIVES: To evaluate the clinical efficacy and safety of Naftopidil tablet in treating benign prostatic hyperplasia. METHODS: Eighty BPH patients were divided into two groups randomly by double-blind, double-simulated and active control parallel study trials. Forty patients in treatment group were given Naftopidil tablet 25 mg, p.o., qn for 42 days, while 40 patients in control group were given Tamsulosin 0.2 mg, p.o., qn for 42 days. Statistical analysis was given from 77 cases in the groups. Estimation of the efficacy was done by the change of major indexes include international prostate symptom score (IPSS), maximum flowrate (Qmax) and secondary indexes such as quality of life (QOL), residual urine (Ru) and volume of prostate (V). RESULTS: The changes of IPSS, Qmax, QOL had significant difference between two groups before and after treatment(P < 0.05). The change of Ru had no significant difference between two groups before and after treatment (P > 0.05) while there was significant difference between two groups after six-week treatment(P < 0.05). The change of V had no significant difference (P > 0.05). The adverse reactions in both groups were mild, and there was no significant difference between two groups(P > 0.05). CONCLUSIONS: Naftopidil tablet was safe and effective in treating benign prostatic hyperplasia.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed2003

Transurethral resection of prostrate and suprapubic ballistic vesicolithotrity for benign prostatic hyperplasia with vesical calculi.

Bladder calculi associated with benign prostatic hyperplasia are fairly common, and a popular treatment is transurethral resection of the prostate (TURP) with endoscopic lithotripsy as a combined procedure. We have been routinely using a Reuter's suprapubic trocar and cannula for continuous irrigation during TURP for medium-size and large glands. Rather than performing the vesicolithotripsy per urethra, we have found it easier and faster to use the suprapubic route, especially because the suprapubic tract was already partly made by the Reuter's trocar and half sheath. We describe the technique in detail and explain why we find it easier to extract the stone by the suprapubic rather than the urethral route.

Humans↗