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PubMed1993

Expression of transforming growth factor-alpha, epidermal growth factor and the epidermal growth factor receptor in adenocarcinoma of the prostate and benign prostatic hyperplasia.

The present immunohistochemical study examines the expression of TGF alpha, EGF, and the EGF receptor in prostatic tissues obtained from patients with either benign prostatic hyperplasia (BPH) or adenocarcinoma of the prostate. Frozen sections were cut at 5 microns and were incubated with monoclonal antibodies directed against TGF alpha, EGF, or the EGF receptor. The remainder of the staining procedure was performed with an avidin-biotin-complex peroxidase procedure. Strong TGF alpha expression was not detected in any of the 15 BPH specimens examined or in the normal/hyperplastic tissue intermixed within the adenocarcinomas. In contrast, malignant cells in 9 of 11 adenocarcinomas strongly expressed TGF alpha. EGF reactivity was observed in both hyperplastic and malignant epithelial tissues. EGF receptor expression was strongest along the basal aspects of cells of normal or hyperplastic glands. Although most malignant cells also were positive for the EGF receptor the level of staining was less than that observed in cells forming normal or hyperplastic glands. These results suggest that EGF and the EGF receptor may be components of an autocrine/paracrine regulatory pathway involved in hyperplastic and/or malignant disease of the prostate. The finding that TGF alpha is expressed only in malignant cells suggests that TGF alpha may represent a locally active autocrine regulator of malignant prostate cells.

Adenocarcinoma↗

PubMed2004

Alcohol and the risk of prostate cancer and benign prostatic hyperplasia.

OBJECTIVES: To examine the association between alcohol and the risk of prostate cancer/benign prostatic hyperplasia (BPH) in a population with a wide range of alcohol consumption, using a hospital-based, case-control study. Data from several epidemiologic studies have allowed us to exclude a strong association between alcohol drinking and prostate cancer risk. However, limited information is available for BPH. Also, it is unclear whether various types of alcoholic beverages may have a different impact on risk. METHODS: We conducted this hospital-based case-control study in Italy between 1991 and 2002. A total of 2663 men younger than 75 years had incident, histologically confirmed prostate carcinoma (1294 cases) or symptomatic obstructive BPH (1369 cases) (maximal flow rate less than 15 mL/s) refractory to medical treatment. A total of 1451 patients younger than 75 years were used as controls. Odds ratios and corresponding 95% confidence intervals were estimated using unconditional multiple logistic regression models including terms for age, center, education, body mass index, physical activity, and family history of prostate cancer. RESULTS: Alcohol consumption showed no consistent association with prostate cancer risk, but a statistically significant inverse trend in risk for BPH. Compared with abstainers, the odds ratio was 0.88 for fewer than three drinks, 0.71 for three to four drinks, 0.79 for five to six drinks, and 0.65 for seven or more drinks per day. The patterns of risk were similar with reference to different alcoholic beverages. The inverse relation between elevated alcohol consumption and BPH was apparently stronger in subjects with a lower body mass index. CONCLUSIONS: Alcohol drinking is unrelated to prostate cancer risk. The inverse relationship with BPH may be related to the hormonal correlates (ie, lower androgen levels) of heavy alcohol drinkers.

Adenocarcinoma↗

PubMedDate not supplied

Benign prostatic hyperplasia: an approach for the internist.

In benign prostatic hyperplasia, urodynamic testing and the many available drugs and surgical procedures have complicated the issue of what to do for whom. Although the severity of a patient's symptoms and his informed preferences should be the driving forces, specialized tests can help tailor treatment to the individual patient.

Adrenergic alpha-Antagonists↗

PubMed1998

Minimally invasive therapies for the treatment of symptomatic benign prostatic hyperplasia: the University of Florida experience.

OBJECTIVE: To describe the University of Florida experience with minimally invasive therapies in the surgical treatment of benign prostatic hyperplasia (BPH). BACKGROUND DATA: Typically, the standard surgical treatment for symptomatic benign prostatic hyperplasia (BPH) has been transurethral resection of the prostate (TURP). Due to the morbidity associated with TURP, several minimally invasive therapies, such as laser, microwaves, high intensity focused ultrasound, and radiofrequency needle ablation, have been utilized to treat BPH. METHODS: The authors review their experience, along with that of others, with various forms of heat therapy in the treatment of BPH. RESULTS AND CONCLUSIONS: Although high intensity focused ultrasound (HIFU), interstitial laser, and microwaves procedures have been shown to be effective in the treatment of BPH, our experience has been with laser, VaporTrode, and TUNA. We found that VaporTrode and TUNA currently offer several advantages over many of the other modalities.

Electrosurgery↗

PubMed2004

Serum insulin-like growth factor-I and insulin-like growth factor-binding protein-3 in localized, metastasized prostate cancer and benign prostatic hyperplasia.

OBJECTIVE: Insulin-like growth factors (IGF-I and IGF-II) are important mitogenic peptides and are thought to be significant factors involved in normal and malignant cellular proliferation including benign prostatic hyperplasia (BPH) and prostate cancer (PC). In particular, the association between IGF-I and PC has received much attention. Insulin-like growth factor binding protein-3 (IGFBP-3) is the major carrier protein in serum for the IGF-I, thus is an important functional modulator of it. On the other hand, one of the functions of prostate-specific antigen (PSA) is to cleave IGFBP-3. Epidemiological studies have shown that decreased levels of serum IGFBP-3 are associated with increased PC risk. Controversial results have also been reported on the value of serum IGF-I and/or IGFBP-3 in the detection of PC, especially of metastatic PC; as increased, decreased or unchanged when compared to BPH. The aim of the present study was to investigate whether serum IGF-I and IGFBP-3 levels change in localized and metastasized PC cases compared with BPH as the control cases. METHOD: The study included 45 BPH, 24 localized PC and 19 metastasized PC cases. Serum IGF-I and IGFBP-3 levels were measured by two-site immunoradiometric assay kits, and serum total and free PSA levels were assayed by chemiluminescence method. RESULTS: Serum IGF-I levels in both localized and metastasized PC cases were similar to BPH cases (138.3 +/- 58.2, 137.7 +/- 39.0 and 147.7 +/- 44.2 ng/ml, respectively), whereas serum IGFBP-3 levels were lower in metastasized PC group than in BPH group (1,795.6 +/- 305.6 and 2,196.0 +/- 505.7 ng/ml; p = 0.005). In localized PC, serum IGFBP-3 levels (1,911.00 +/- 349.58 ng/ml) were similar to metastasized PC. There were significant correlations between serum IGFBP-3 and serum free PSA in three groups (r = -0.46, p = 0.02 for localized PC; r = -0.56, p = 0.01 for metastasized PC, and r = -0.31, p = 0.03 for BPH). CONCLUSION: These data reveal that serum IGF-I levels may not change either in localized or metastasized PC, and that decreased serum IGFBP-3 levels may be attributed to its proteolysis by PSA which is increased in PC.

Aged↗

PubMed1998

Association of benign prostatic hyperplasia with male pattern baldness.

OBJECTIVES: Both benign prostatic hyperplasia (BPH) and male pattern baldness (androgenic alopecia) share the pathogenesis of an androgen-dependent disorder and afflict a large population of elderly men with chronobiologic progress. However, it is unclear whether these diseases are related epidemiologically. We evaluated the association of frequency and severity of male pattern baldness between patients with BPH and a control group. METHODS: A total of 225 patients with BPH (mean age 69.3 +/- 6.5 years) and 1 60 controls (mean age 68.5 +/- 6.4 years), all over 60 years of age, were included in this study. The estimation of baldness severity was based on Norwood's classification (grade I to VII). The International Prostate Symptom Score (IPSS) and genetic tendency for baldness were also evaluated. The difference between IPSS and grade of baldness between the two groups was analyzed by the Mann-Whitney test and the frequency of inherited baldness was compared by the chi-square test. Correlation between severity of baldness and IPSS in each group was estimated by Spearman's rank correlation method. RESULTS: The patients with BPH had an apparently higher grade of male pattern baldness in comparison with that of controls (median value of grade IV versus III, P <0.001). The proportion of men with male pattern baldness of grade IV or higher in the BPH group was significantly larger than that of controls (53.8% versus 36.9%, P <0.01). There was a greater frequency of inherited baldness in the BPH group than in the controls (31.6% versus 12.5%, P <0.001). No significant correlation was noted between baldness severity and IPSS in either group. CONCLUSIONS: This study demonstrates a strong association of BPH with male pattern baldness.

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

PubMed2005

[Development of the quality of life scale specific for patients with benign prostatic hyperplasia].

OBJECTIVE: To develop a specific quality of life (QOL) scale for Chinese patients with benign prostatic hyperplasia (BPH). METHODS: The scale was developed with the programmed decision methods. The item pool was certified by experts. Five methods were used in item selection after a pilot study for which 256 BPH patients had been recruited. The scale was evaluated by its reliability and validity. RESULTS: We formed a 27-item quality of life scale specific for patients with benign prostatic hyperplasia prior test version (BPHSQL). The test-retest correlation coefficient and Cronbach's alpha coefficient of BPHSQL were 0. 774 and 0. 945. The structure of the scale was similar to the theory construction. The scale's correlation coefficients with criteria ranged from 0.531 to 0.700. BPHSQL could well discriminate the quality of life between BPH and non-BPH patients as well as patients with different degrees of symptoms, different sources and patients with or without urethral catheters. CONCLUSION: BPHSQL is reliable, valid and sensitive, and will be a convenient tool in clinical research to provide advice on different treatments for different patients.

Adult↗

PubMed1992

Immunoreactive EGF in human benign prostatic hyperplasia: relationships with androgen and estrogen receptors.

Benign prostatic hyperplasia (BPH) is a sex steroid dependent disease. Estrogens and androgens can modulate in different mammalian tissues epidermal growth factor (EGF) production and/or secretion. In order to clarify the relationships between estrogen and androgen receptor concentrations and those of immunoreactive EGF (irEGF), we have evaluated these parameters in 14 human BPH samples, by means of a dextran-coated charcoal method and radioimmunoassay, respectively. Cytosolic steroid receptors did not seem to correlate with irEGF. A linear significative relationship was evident between nuclear androgen receptor (ARn) levels and endogenous irEGF but not between nuclear estrogen receptors and irEGF: in ARn negative BPH samples, irEGF levels were lower than in ARn positive ones. Therefore, it is possible that androgens act at prostatic tissue level, through their own receptors, by modulating EGF production and/or secretion.

Aged↗

PubMed1994

Effect of naftopidil on urethral obstruction in benign prostatic hyperplasia: assessment by urodynamic studies.

Thirty-two patients with voiding dysfunction attributable to symptomatic benign prostatic hyperplasia were treated with naftopidil, an alpha 1-blocker, at doses of 25-75 mg/day for 4-6 weeks. The efficacy of the drug was assessed from the changes in urinary symptoms and urodynamic data. Total symptom scores were significantly reduced after treatment (P < 0.001). Average flow rate and maximum flow rate were significantly increased (P < 0.001 and P < 0.001, respectively), and residual urine volume, residual urine rate (ratio of residual urine volume/sum of voided volume and residual urine volume), and maximum urethral closure pressure were significantly (P < 0.05, P < 0.01, and P < 0.05, respectively) reduced, and at bladder capacity, the first desire to void was significantly (P < 0.05) increased. The pressure/flow study demonstrated no changes in intravesical pressure at maximum flow, but a significant (P < 0.05) reduction in minimum urethral resistance. A mild side effect (dizziness) was noted in one patient (3.3%), which soon disappeared after the dose was decreased. The efficacy was good or excellent in 21 of 30 patients (70.0%). The drug was evaluated to be promising in the treatment of bladder outlet obstruction due to benign prostatic hyperplasia.

Adrenergic alpha-Antagonists↗

PubMed1983

Human benign prostatic hyperplasia in organ culture: studies on iododeoxyuridine uptake.

Prostate tissue architecture and function may be retained in vitro using organ culture. However, the application of the technique is limited due to the lack of simple means for measuring tissue response, for instance to factors controlling cell growth. It is confirmed in this study that measuring the uptake of the radioactive precursor of DNA, 5-[125I]-iodo-2'-deoxyuridine, is simple, rapid, and reproducible provided the heterogeneity of benign prostatic hyperplasia (BPH) is taken into account. Factors affecting the reproducibility (numbers of replicate explants and dishes), specificity (removal of unbound radioactivity and uptake into killed tissue), and sensitivity (radioactive concentration and exposure period) of this technique were investigated. A particular advantage of this approach is that histological assessments are made on the same tissue used for biochemical measurements. Furthermore, the method is sufficiently simple to permit serial investigations chronologically concerning factors, such as hormones, controlling BPH cell growth.

DNA↗

PubMed1991

[Occult cancer in patients with symptomatic benign prostatic hyperplasia].

The results of a prospective study undertaken in 29 patients with symptomatic benign prostatic hyperplasia (BPH) are presented. Transrectal ultrasound, ultrasound-guided biopsy and prostate specific antigen (PSA) were utilized in the search for hidden cancer of the prostate. However, no cancer was detected in any patient. Very high values of PSA were found, particularly in patients with an indwelling catheter. Transrectal ultrasound yielded no false negatives and no complications were observed.

Adenocarcinoma↗

PubMed1998

Ultrastructural study in canine prostatic hyperplasia--effect of antiandrogen.

Ultrastructural changes in canine prostates after treatment with chlormadinone acetate (CMA) were investigated. Old male beagle dogs (5-8 years old ) were divided into two experimental groups; group 1 consisted of benign prostatic hyperplasia (BPH) controls, and group 2 received 0.3 mg/kg/day CMA orally for 6 months. In group 1 animals, the most striking ultrastructural changes were detected in the rough endoplasmic reticulum (rER) and Golgi complexes. The secretory granules were lined up along the apical plasma membrane, and exocytosis was frequently seen. In group 2 animals, the cytoplasm was electron-lucent and contained relatively few, poorly developed organelles. The rER was sparse and consisted of a few scattered, short profiles studded with ribosomes. The Golgi complexes were inconspicuous. The secretory granules were markedly decreased in both number and size. Furthermore, mitochondrial degeneration such as swollen or disappeared mitochondrial cristae or decreased electron density of the matrix were frequently seen in the smooth muscle cells. Based on our data, atrophy after treatment with CMA may be due to shrinkage of both glandular and stromal compartments in the prostate tissue.

Animals↗

PubMed1999

[The use of desmopressin as an alternative in the treatment of nycturia in patients with benign prostatic hyperplasia (BPH)].

OBJECTIVE: Evaluating in patients with benign prostatic hyperplasia (BPH), the effects of a synthetic analog of vasopressin (Desmopressin) in the nycturia. METHODS: 20 patients with BPH, with a mean age of 68 years that they referred marked nycturia of 4 to 10 voiding episodes in the night, they were subject treatment with Desmopressin 20 mcg given intranasally before bedtime. RESULTS: The nycturia diminishes in the patient, the volume of evacuated urine diminishes but in the night that in the day. They were not observed side effects. CONCLUSIONS: The desmopressin is an alternative but in the aid to the patient with BPH that they presented a marked nycturia.

Aged↗

PubMedDate not supplied

Insulin-like growth factor-I and -II in human benign prostatic hyperplasia: relationship with binding proteins 2 and 3 and androgens.

In prostatic tissue, androgen action may be mediated by growth factors such as insulin-like growth factor-I (IGF-I) and II (IGF-II), which are mitogenic for prostatic cells and modulate the stroma-epithelium interaction. IGF-binding proteins (IGFBPs) have an autocrine and/or paracrine role in regulating the local actions of the IGFs. In this study, testosterone, dihydrotestosterone (DHT), 3 alpha androstanediol (3 alpha diol), IGF-I, IGF-II, IGFBP2, and IGFBP3 concentrations were evaluated in human benign prostatic hyperplasia (BPH) tissue. Samples of prostate tissue were removed by suprapubic prostatectomy from twelve BPH patients. Androgen tissue levels were determined by radioimmunoassay after purification on celite microcolumns. IGF-I, IGFBP2, and IGFBP3 were measured by radioimmunoassay, and IGF-II by immunoradio metric assay, after acidification and chromatography on Sep-pak C18 Cartridges for IGF-I and IGF-II. Androgen concentrations, expressed in ng/g tissue (mean +/- SE), were 0.51 +/- 0.05 for testosterone, 5.3 +/- 0.16 for DHT, and 1.1 +/- 0.07 for 3 alpha diol. IGF-I, IGF-II, IGFBP2, and IGFBP3 levels were 24 +/- 3.7, 121 +/- 14 ng/g tissue and 0.44 +/- 0.05 and 1.2 +/- 0.17 micrograms/g tissue, respectively. No correlation between IGF-I, androgens, and IGFBPs was found. IGF-II was positively correlated with DHT (r = 0.78; p = 0.003) and 3 alpha diol (r = 0.66; p = 0.021) but not with IGFBPs. These data suggest that in BPH, DHT modulates the IGF system by increasing IGF-II without modifying IGFBPs. Therefore, the stroma-epithelium interaction, which plays an important role in prostatic growth, may be regulated by DHT through IGF-II.

Aged↗

PubMed1993

[Alternative therapy of benign prostatic hyperplasia--the Porges Urospiral].

In patients with benign prostate hyperplasia (BPH) who could not be subjected to surgery because of an associated internal disease the authors ensured by a physical method-insertion of a urospiral-derivation of urine. In 15 patients they recorded favourable results (eradication of urinary infection, a satisfactory stream of urine, continence, complete evacuation of the urinary bladder). All patients improved greatly from the psychic aspect. Personal hygiene was also favourably influenced. Irritation caused by insertion of the urospiral disappeared within several days. Only in one patient the authors removed the urospiral after 6 days because of dysuria and partial incontinence. The authors' initial experience, extending over almost one year, in encouraging and the authors assume that this physical therapeutic method will be more widely applied in the risk patients, in particular patients in advanced age groups.

Aged↗

PubMed1994

Stent of shape-memory alloy for urethral obstruction caused by benign prostatic hyperplasia.

Dilation and positioning a stent in the prostatic urethra have become important alternatives for the management of benign prostatic hyperplasia (BPH), but both have significant drawbacks, namely the need to repeat the treatment in the former case and the conflict between the introducing means and the generation of sufficient expansile force in the latter case. A spiral of a Chinese titanium-nickel alloy with shape memory was implanted in 25 patients with BPH using a self-made coaxial sheath. With a follow-up of 3 to 20 months, the success rate is 92%. There has been no encrustation or migration of the spirals. We deem the spiral of this shape-memory alloy to be a good alternative in patients with BPH who are unfit for surgery.

Aged↗

PubMed1999

Alpha-adrenergic blocking drugs in the management of benign prostatic hyperplasia: interactions with antihypertensive therapy.

Management of benign prostatic hyperplasia (BPH) is often complicated by concomitant hypertension, a life-threatening condition that must be managed optimally. Many of the alpha blockers used to treat BPH also decrease blood pressure, and terazosin and doxazosin have been shown to have significant cardiovascular side effects, such as asthenia/fatigue, postural hypotension, and dizziness when used to treat BPH patients. Furthermore, these drugs are not first-line therapies for hypertension, and the majority of hypertensive BPH patients will be receiving other antihypertensive agents. Therefore, it is possible that the introduction of these drugs will affect blood pressure control, at least temporarily, with possible adverse effects. In contrast, the selective alpha1A blocker tamsulosin does not appear to have significant cardiovascular side effects and produces minimal blood pressure reductions. Therefore, urologists can choose either to use alpha blockers to treat both hypertension and BPH or to treat BPH using alpha blockers that do not interact with antihypertensive therapy. This review focuses on the alpha blockers currently being used to treat BPH, their effects on the cardiovascular system, and their interaction with antihypertensive drugs.

Adrenergic alpha-Antagonists↗

PubMed2001

Extracts from fruits of saw palmetto (Sabal serrulata) and roots of stinging nettle (Urtica dioica): viable alternatives in the medical treatment of benign prostatic hyperplasia and associated lower urinary tracts symptoms.

Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are very common disorders in aging men. Despite the great clinical importance, many aspects of their aetiology remain uncertain although it is generally accepted that advanced age and testicular androgens are important requirements for the development of these complaints. The currently available therapeutic options include watchful waiting, changes of life style, medical treatments and invasive therapies. In many European countries the use of phytopharmaceuticals for the management of BPH and related LUTS is common and these products represent up to 80 % of all drugs prescribed for this disorder. In particularly, extracts from the fruits of saw palmetto (Sabal serrulata, syn. Serenoa repens) and the roots of stinging nettle (Urtica dioica) are popular. During the last years numerous papers have been published which elaborated on the pharmacological activities and the clinical assessment of these herbal remedies. These investigations have not only broadened the scientific basis for the rational use of phytotherapeutics but have also provided evidence for their therapeutic efficacy and favourable safety profile.

Androgen Antagonists↗