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PubMed2004

[Differentially expressed genes in prostate cancer and benign prostatic hyperplasia].

OBJECTIVE: To detect and analyze the differentially expressed genes in prostate cancer (PCa) and benign prostatic hyperplasia (BPH). METHODS: Oligonucleotide microarray containing 465 genes was used to investigate the differentially expressed genes in PCa and BPH. RESULTS: There were 35 differentially expressed genes between PCa and BPH, of which 17 were up-regulated and 18 down-regulated in PCa. CONCLUSION: The study of the differentially expressed genes in PCa and BPH should help to understand the molecular mechanism of PCa and identify the markers for diagnostic and therapeutic use.

Down-Regulation↗
PubMed1979

Role of preoperative urography in benign prostatic hyperplasia.

The excretory urograms of 184 consecutive patients admitted to hospital with a diagnosis of benign prostatic hyperplasia who subsequently underwent prostatectomy were reviewed to determine the usefulness of preoperative urography. Of 184 urograms reviewed, 10 were normal, 136 showed changes consistent with benign prostatic hyperplasia, and 38 revealed other abnormalities. Twenty-seven of 184 urograms (14.7 per cent) revealed significant pathologic conditions requiring further consideration, investigation, or treatment, of which 23 would not have been suspected without this radiologic examination.

Humans↗
PubMedDate not supplied

Transurethral hyperthermia for benign prostatic hyperplasia: long term results.

Transurethral resection of the prostate (TURP) is the only recognized treatment in patients with benign prostatic hyperplasia (BPH). Transurethral hyperthermia (TUHT) was used as an alternative treatment in patient who refused TURP. From 1987 to 1988, 21 BPH patients with moderate to severe symptoms and signs of prostatism were treated with TUHT in a phase I trial. Mean pre-treatment subjective and objective values were: total symptom score (TSS) 13.5, obstructive symptom score (OSS) 6.5, irritative symptom score (TSS) 7.0, peak flow rate (PFR) 11.6 cc/sec, post-voiding residual volume (PRV) 187 cc, and prostate volume (PV) 93 cc. TUHT was given for a total of 177 sessions (mean 8.4), each of 60 min duration at a steady state. Temperature was recorded continuously on the urethral surface, in all treatments. It ranged from Tmin 40.3 degrees C to Tmax = 49.2 degrees C and Tmean = 44.1 degrees C. The mean minimum temperature of > or = 42 degrees C was obtained in 98% of the TUHT sessions. Treatments were given on an outpatient basis without sedation or anaesthesia. Treatment tolerance was excellent with minor acute toxicity common (71% of patients), of no clinical importance and with no late complications. Of the 21 patients treated, 17 (81%) had an objective and 15 (71%) a subjective improvement recorded at 6 months post-treatment. This statistically highly significant improvement included: 61% decrease in TSS; 66% decrease in OSS; 55% decrease in ISS; 42% increase in PFR; 55% decrease in PRV; and 21% decrease in PV. Of the 17 patients with objective improvement, nine have maintained their response to TUHT for a minimum period of over six years, two relapsed at 11 and 40 months, respectively, and six patients died of cardiovascular causes maintaining their response to death. This study has demonstrated TUHT treatment efficacy with no major or clinically important toxicity in BPH patients. A relative weakness of this report is a lack of verification of objective study parameters in the patients at seven years post-treatment. Prospective randomized trials are needed to define the role of TUHT in the management of BPH patients.

Aged↗
PubMed2003

[Long-term efficacy of naftopidil for treatment of lower urinary tract symptoms with benign prostatic hyperplasia].

Naftopidil was administered to 67 patients with benign prostatic hyperplasia (BPH) for 12 months. Changes in total/each International Prostate Symptom Score (IPSS) for irritative and obstructive symptoms, nocturia, and residual urine volume were compared before and after its administration. As a result, a significant decrease of score was found in total-IPSS, obstructive and irritative symptoms, which also showed a tendency to decrease at the end of the first month. Nocturia and residual urine volume also significantly decreased after its administration. Naftopidil is considered to be effective in the treatment of BPH, especially irritative symptoms including nocturia in treatments for BPH, because both irritative and obstructive symptoms (IPSS subjective endpoints) and residual urine volume (objective endpoint) were improved after its long-term administration.

Adrenergic alpha-Antagonists↗
PubMed2002

Cytopathological changes in early stages of benign prostatic hyperplasia upon exposure to sustained delivery of androgens.

The objective of this study was to assess the possible morphological changes that occur in the columnar epithelial cells of the prostate peripheral zone during early development of benign prostatic hyperplasia. In this study benign prostatic hyperplasia (BPH) was encouraged by the continuous delivery of androgens using TCPL drug delivery devices. A total of 16 adult male rats were randomly divided into four groups (n = 4). Group 1 served as an intact control and Groups 2-4 were implanted with tricalcium phosphate lysine (TCPL) capsules designed to deliver continuous physiologic (40 mg) doses of specific androgens as follows: Group 2, testosterone (Test); Group 3, dihydrotestosterone (DHT); Group 4, androstenedione (AED), respectively. Upon completion of the study, the columnar epithelial cells were targeted for morphometric analysis. The means number of cells per high power field, cell length, cell area, nuclear area and nuclear to cytoplasmic ratio were measured using image analysis techniques. The results of this study showed that (1) the number of cells per high power field were not changed with treatment, (2) the cell length was decreased with treatment of all androgens, (3) the cell area was decreased with treatment, (4) the nuclear area was increased with treatment of Test and DHT, and (5) the N/C ratio was increased with all three androgens. These results suggest that very early in the development of BPH, remarkable changes occur in the nucleus of the columnar epithelial cells. These changes may indicate a specific physiological response to irritation arising from the continuous delivery of androgens.

Androgens↗
PubMed1996

Free-to-total prostate-specific antigen serum concentrations in patients with prostate cancer and benign prostatic hyperplasia.

OBJECTIVE: To determine whether the proportion of total serum prostate-specific antigen (tPSA) which is unbound or free (free PSA) offers a better discriminant for the detection of patients with prostate cancer (CaP) and those with benign prostatic hyperplasia (BPH) than does serum tPSA alone. PATIENTS AND METHODS: In a retrospective analysis, the proportion of free PSA was determined in the sera of 60 patients with histologically confirmed localized (n = 39; pT1-3NoMo) and metastatic (n = 21; T2-4NxM+) CaP and 45 patients with BPH. Forty patients with urolithiasis served as a control group. Serum levels of free and total PSA were determined using a chemiluminescent enzyme immunoassay. RESULTS: Patients with CaP had a lower percentage of free PSA (localized CaP median 8.8%; metastatic CaP median 7.1%) than patients with BPH (median 19.5%) and those with urolithiasis (median 18.8%: P < 0.001). The percentage of free PSA did not differ significantly between patients with clinically localized and metastatic disease. CONCLUSION: The determination of the proportion of free PSA enhanced the discrimination between BPH and CaP and may reduce the number of unnecessary biopsies in patients with an elevated PSA. The results warrant further investigations in a broader population to improve the clinical use of serum PSA as a tumour marker for discriminating patients with an early, potentially curable CaP from men with BPH.

Aged↗
PubMed2004

Evaluating men with benign prostatic hyperplasia.

The clinical manifestations of benign prostatic hyperplasia (BPH) include lower urinary tract symptoms (LUTS), poor bladder emptying, urinary retention, detrusor instability, urinary tract infection, hematuria, and renal insufficiency. However, the majority of men with BPH present with LUTS only. Because LUTS can indicate a variety of conditions, evaluation of symptomatic men must first aim to identify or exclude BPH and, if present, assess its severity. It is important to assess symptom severity at baseline and during follow-up, using the American Urological Association Symptom Index or the International Prostate Symptom Score. Further testing can then be tailored to narrow the diagnosis and guide treatment decisions. Factors such as patient age and concomitant malignancy will also affect management, but the main goal of treatment remains the improvement of quality of life for the patient.

Journal Article↗
PubMed1986

Prostatic carcinoma and benign prostatic hyperplasia: inability of MR imaging to distinguish between the two diseases.

Forty patients with prostatic carcinoma or benign prostatic hyperplasia (BPH) underwent magnetic resonance (MR) imaging of the prostate. In vitro MR images of six prostate specimens were also obtained. The prostatic parenchyma was best evaluated by a T2-weighted spin-echo pulse sequence. The prostate both in patients with prostatic carcinoma and patients with BPH often had an inhomogeneous and nodular appearance on T2-weighted images. While most of the prostatic carcinomas appeared hyperintense relative to muscle and adjacent prostatic parenchyma, some of the hyperplastic nodules had a signal intensity similar to carcinoma. With current imaging techniques, MR imaging cannot differentiate prostatic carcinoma from BPH with certainty.

Adult↗
PubMed2001

The effects of chlormadinone acetate (CMA), antiandrogen, on the pituitary, testis, prostate and adrenal gland of the dog with spontaneous benign prostatic hyperplasia.

The effect of chlormadinone acetate (CMA), a synthetic steroidal antiandrogen, on spontaneous benign prostatic hyperplasia (BPH) in dogs was investigated. Male beagle dogs (5-8 years old) were divided into four experimental group. Group 1 consisted of untreated controls. Groups 2 and 3 received CMA 0.03 and 0.1 mg/kg/day, p.o., respectively, for 6 months. In group 1, glandular hyperplasia of the prostate was clearly detected. The glandular epithelial cells showed uniformly intense nuclear staining for androgen receptor (AR). AR was also localized in the nuclei of the fibro-muscular stromal cells. In groups 2 and 3, CMA produced marked atrophy of the glandular epithelium. The interacinar fibro-muscular stroma was prominent. The nuclear staining for AR in both epithelial and stromal cells was remarkably decreased. In addition, a histopathological study showed that CMA medication for 6 months exerted no effect on the testes and adrenal glands or on immunoreactive positive cells to LH- and ACTH-antibody (pituitary LH- and ACTH-cells). Therefore, it is concluded that CMA (0.03 and 0.1 mg/kg) causes regression of spontaneous canine BPH without any histopathological effects on the testes, adrenal glands or pituitary LH- and ACTH-cells.

Adrenal Glands↗
PubMed2000

Effect of antiandrogen, chlormadinone acetate (CMA), in canine spontaneous benign prostatic hyperplasia (BPH).

The effect of synthetic steroidal antiandrogen, chlormadinone acetate (CMA), on spontaneous benign prostatic hyperplasia (BPH) in dogs was investigated. Male beagle dogs (5-8 years old) were divided into three experimental groups. Group 1 consisted of untreated controls. Groups 2 and 3 received CMA 0.03, and 0.1 mg/kg/day, p.o., respectively, for 6 months. In group 1, glandular hyperplasia of the prostate was clearly detected. In groups 2 and 3, CMA produced marked atrophy of the glandular epithelium. In addition, a histopathological study showed that CMA medication for 6 months exerted no effect on the testes and adrenals or on immunoreactive LH- and ACTH- cells of the anterior pituitary glands. Therefore, it is suggested that CMA (0.03 and 0.1 mg/kg) causes regression of spontaneous canine BPH without any histopathological effects on the testes, adrenals or anterior pituitary LH- and ACTH-cells.

Adrenal Glands↗
PubMedDate not supplied

[Late results of local transrectal hyperthermia in patients with benign prostatic hyperplasia and its complications].

LTH on Yakhta-4M unit was used in benign prostatic hyperplasia (BPH). The prostate was heated transrectally by directional radiation. The course of treatment comprised 5 sessions for 60 min twice a week. The efficacy of the treatment was assessed 3 years later in 78 patients which were divided into 4 groups: 31 patients with BPH, 30 patients with BPH in combination with chronic prostatitis, 9 patients with acute urine retention and 8 patients with cystostomy fistula. 5 patients underwent surgery. LTH is safe in relation to side effects, may be used both at early stage of the disease and in risk of operative intervention.

Aged↗
PubMed2002

Reducing the risk of benign prostatic hyperplasia progression.

The incidence of benign prostatic hyperplasia increases with age; the probability of progression rises with age at diagnosis and with baseline symptom severity. Although it is not life-threatening, the condition and its complications have a serious impact on quality of life. Acute urinary retention (AUR), though no longer thought an indication for immediate surgery, still requires treatment, often including surgery. Drug therapy with alpha-adrenergic receptor blockers or 5-alpha-reductase inhibitors, such as finasteride, reduces the risk for AUR and the need for surgery, as well as symptoms and bother. Finasteride therapy also results in long-term reduction in prostate volume.

Journal Article↗
PubMed2000

Transurethral hot-water balloon thermoablation for benign prostatic hyperplasia: patient tolerance and pathologic findings.

OBJECTIVES: To determine the patient tolerance and thermal ablation pattern in human prostatic tissue after treatment with a hot water, catheter-based system. METHODS: Twenty-seven men scheduled for surgery for symptomatic benign prostatic hyperplasia or adenocarcinoma of the prostate underwent water-induced thermotherapy. The patients were randomly assigned to one of four treatment groups. Lidocaine gel was the sole means of pain control. The patients and an observer recorded patient discomfort during therapy. A Foley catheter was left in place until surgery (n = 13) or successful voiding (n = 14). Prostates were subsequently enucleated or removed, whole mounted, and examined. RESULTS: Patients reported mild treatment discomfort, the level of which did not correlate with the extent of necrosis, balloon diameter, or water temperature (all P >0. 05). Distal penile burning was the most commonly reported discomfort. All 14 patients successfully voided within 12 days of treatment. Prostates were enucleated (n = 24) or removed (n = 3) at a mean of 27 days (range 4 to 120) after thermotherapy, except for a single adenectomy 17 months after therapy. Pathologic findings included periurethral hemorrhagic necrosis, with focal or extensive urothelial denudation and mild inflammation. The mean maximal depth of necrosis from the urethral lumen was 7, 9, 10.33, and 11 mm in groups 1, 2, 3, and 4, respectively. The extent of necrosis was similar in all groups (P = 0.11), regardless of the water temperature; conversely, the balloon diameter correlated with the depth of necrosis (P = 0.024). CONCLUSIONS: This system of tissue ablation appears to be well tolerated, and it produced consistent pathologic results.

Adenocarcinoma↗
PubMed1999

[Evaluation of serum lipid levels in clinical benign prostatic hyperplasia patients with terazosin monotherapy].

Nine clinical benign prostatic hyperplasia (BPH) patients were treated with oral terazoin monotherapy (2 mg daily) for 12 weeks. Serum lipid levels (total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, apoproteins) were estimated prior to and every 4 weeks during treatment in 5 patients. International Prostate Symptom Score (IPSS) and pressure-flow study were evaluated before and 12 weeks after treatment in 4 patients. The total cholesterol level decreased from a baseline of 210 +/- 36.6 mg/dl by 6.6% at the 12th week. This result was not significant but suggested a favorable effect of terazosin on diminishing the risk of coronary heart disease. This effect was marked especially in patients with a total cholesterol level over 200 mg/dl. On the other hand, IPSS improved in all cases. The mean change ranged from 19.5 to 10.0 and the mean peak flow rate from 9.0 to 15.7 ml/s. On Shäffer's nomogram, 1 patient showed improvement of obstruction and the other 3 patients were diagnosed as having week detrusor without obstruction. Clinical BPH patients with hyperlipidemia may markedly benefit from terazosin, which is a safe and useful initial treatment for BPH.

Aged↗
PubMed1993

Effect of finasteride on serum PSA concentration in men with benign prostatic hyperplasia. Results from the North American phase III clinical trial.

Finasteride, a 5-alpha reductase inhibitor recently introduced for the treatment of symptomatic benign prostatic hyperplasia, reduces prostate size and decreases serum PSA concentration. To interpret PSA in men treated with finasteride, it is necessary to take the reduction into account. This article describes the effect of finasteride on the serum PSA concentration in the North American Phase III clinical trial and discusses implications of these findings for the interpretation of serum PSA in men treated with finasteride.

Adult↗
PubMed2006

Protective association between nonsteroidal antiinflammatory drug use and measures of benign prostatic hyperplasia.

In 1990-2002, the authors conducted a population-based cohort study of 2,447 Caucasian men in Olmsted County, Minnesota, to determine whether daily users of nonsteroidal antiinflammatory drugs (NSAIDs) were at lower risk than nondaily NSAID users of developing benign prostatic hyperplasia. Participants completed validated questionnaires during a home visit, including information about daily NSAID use. A random subset of 634 men also participated in a clinical evaluation including transrectal ultrasonography and assessment of serum prostate-specific antigen levels. Examinations and questionnaires were repeated biennially through 2002. Benign prostatic hyperplasia measures included development of moderate/severe urinary symptoms (American Urological Association Symptom Index score >7), low maximum urinary flow rate (<12 ml/second), prostate volume >30 ml, or prostate-specific antigen level >1.4 ng/ml. After adjustment for age, daily NSAID use was inversely associated with onset of moderate/severe urinary symptoms (hazard ratio (HR) = 0.73, 95% confidence interval (CI): 0.64, 0.82), low maximum flow rate (HR = 0.51, 95% CI: 0.43, 0.61), increased prostate volume (HR = 0.53, 95% CI: 0.41, 0.68), and elevated prostate-specific antigen level (HR = 0.52, 95% CI: 0.40, 0.68). In age-specific analyses, inverse associations between NSAID use and urinary measures tended to be stronger in the oldest age groups, although this interaction was statistically significant for only obstructive symptoms and treatment. Results suggest that NSAID use may prevent or delay development of benign prostatic hyperplasia.

Adult↗
PubMed1992

[Endocrine environment of benign prostatic hyperplasia--relationships of sex steroid hormone levels with age and the size of the prostate].

To determine the influence of endocrine factors on benign prostatic hyperplasia (BHP), the levels of three sex steroid hormones i.e., total testosterone (Total-T), free testosterone (Free-T) and estradiol (E2), were measured in serum of healthy 154 men. Their ages ranged from 18 to 91 years old. In 59 men, prostatic size was estimated by digital examination and was subdivided into three groups: smaller than or equal to walnut size, small hen's egg size and equal to or larger than hen's egg size. Firstly, relationships of sex hormone levels with age were studied. There was a slight decrease in Total-T over 60 years old, a significant decrease in Free-T, and no change in E2 with age. Thus, E2/Total-T and E2/Free-T ratio increased significantly after middle-age. Secondly, relationships of hormone levels with prostatic size were studied. In the larger prostate group, a significantly lower level of Total-T and significantly higher level of E2 were detected. But there was no difference in Free-T. Thus, the prostatic size was correlated positively with E2 level, E2/Total-T and E2/Free-T ratio. These suggest that the endocrine environment tended to be estrogens-dominant with age, in particular, after middle-age, and that patients with large prostates have more estrogens-dominant environments. We conclude that estrogens are key hormones for the induction and the development of BPH.

Adolescent↗
PubMed1995

Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group.

Medical treatments have become available for benign hypertrophy of the prostate, including alpha-receptor blocking agents and 5-alpha-reductase inhibitors. Drugs derived from plants, for which no precise mechanism of action has been described, are widely used for this purpose in Europe. In a randomised, double-blind, placebo-controlled multicentre study, 200 patients (recruited between April and October 1993) with symptomatic benign prostatic hyperplasia were treated with either 20 mg beta-sitosterol (which contains a mixture of phytosterols) three times per day or placebo. Primary end-point was a difference of modified Boyarsky score between treatment groups after 6 months; secondary end-points were changes in International Prostate Symptom Score (IPSS), urine flow, and prostate volume. Modified Boyarsky score decreased significantly with a mean of -6.7 (SD 4.0) points in the beta-sitosterol-treated group versus -2.1 (3.2) points in the placebo group p < 0.01. There was a decrease in IPSS (-7.4 [3.8] points in the beta-sitosterol-treated group vs -2.1 [3.8] points in the placebo group) and changes in urine flow parameters: beta-sitosterol treatment resulted in increasing peak flow (15.2 [5.7] mL/s from 9.9 [2.5] mL/s), and decrease of mean residual urinary volume (30.4 [39.9] mL from 65.8 [20.8] mL). These parameters did not change in the placebo group (p < 0.01). No relevant reduction of prostatic volume was observed in either group. Significant improvement in symptoms and urinary flow parameters show the effectiveness of beta-sitosterol in the treatment of benign prostatic hyperplasia.

Aged↗