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PubMed1995

[How does thermotherapy effectively work on benign prostatic hyperplasia--an experimental study].

Isometric contractile force of rabbit prostatic tissue in response to electric field stimulation (EFS), KCl, and phenylephrine were measured at incubation temperature of 37 degrees C, before and after thermal exposure to 42 degrees C, 45 degrees C, 48 degrees C and 50 degrees C for 30 minutes. The contractile force in response to EFS decreased after thermal exposure above 45 degrees C, and the contractile force in response to KCL or phenylephrine decreased after thermal exposure above 48 degrees C. All the contractile response abolished after thermal exposure to 50 degrees C. The results indicate that the nerve is more hear-sensitive than the smooth muscle in the prostate. Histological examination revealed shrinkage of cell body and dark staining of nuclear chromatin of the smooth muscle cells after thermal exposure above 48 degrees C. The same histological change of the smooth muscle as well as degenerative change of the nerve cells was observed on the prostate 3-7 months after clinical thermotherapy. From these results, it is suggested that clinical effect of thermotherapy is brought about from both neural and muscular damage of the prostate. Since the least temperature to cause an irreversible tissue damage ranges from 48 degrees C through 50 degrees C, we believe it is ideal to heat the prostate around 50 degrees C to obtain a good clinical effect of thermotherapy on benign prostatic hyperplasia as a minimum invasive treatment.

Aged↗
PubMed1980

Comparative light and electron microscopic study of the human, dog and rat prostate. An approach to an experimental model for human benign prostatic hyperplasia (light and electron microscopic analysis)--a review.

Stereology was shown in several studies to be a relevant method to study the quantitative amount of tissue and cell compartments of normal and pathological altered prostatic tissue. A morphological comparison of the rat (ventral lobe), dog and human prostate was performed by quantitative morphology. In comparing the light microscopic analysis of the rat ventral prostatic lobe with that of the dog prostate, the volumetric amount of the glandular cells in the dog prostate is two times greater than in the rat (ventral prostatic lobe). In the normal human prostate the volumetric amount of the glandular part was calculated to be 55% of the outer part, respectively 45% in the inner part of the prostate. Regarding the stromal tissue, there is no difference between the dog and the normal human prostate, but a striking difference compared to the rat ventral prostatic lobe, where stromal development seems to be sparse (25%). The quantitative measurements of spontaneous dog and human prostate hyperplasia show that the dog hyperplasia is primarily a glandular disease whereas human benign prostatic hyperplasia reflects more stromal activation. As shown by the electron microscopic measurements in the normal human and dog prostate, there is a similar great volumetric amount of secretory granules. In comparing the data of the rough endoplasmic reticulum, in the rat there is a higher amount than in the normal human and dog prostate. Conversely, the amount of secretory granules is higher in the dog and human prostate than in the rat (ventral prostatic lobe).

Animals↗
PubMed1995

Impact of prostate size on the outcome of transurethral laser evaporation of the prostate for benign prostatic hyperplasia.

OBJECTIVES: The aim of this study was to evaluate efficacy and safety of transurethral evaporation of the prostate (TUEP) using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in prostate glands of various sizes. METHODS: One hundred consecutive patients with benign prostatic hyperplasia (BPH) and prostate volumes less than 40 cc (group I, n = 41), 41 to 80 cc (group II, n = 39), and more than 80 cc (group III, n = 20), who had preoperative prostate volume estimation by transrectal ultrasound and had completed a minimum of 3 months' follow-up, underwent TUEP. At baseline, and at 3 and 6 months, American Urological Association (AUA) score, peak flow rate (PFR), postvoid residual urine (PVR), and complications, if any, were documented. RESULTS: There were no significant differences in failure rates, complications, or ability to improve symptom score, PFR, and PVR between patients with prostate glands of various sizes. The mean improvement in PFR at 6 months was: group I, 9.9 cc/s (116%); group II, 7.4 cc/s (81%); and group III, 9.2 cc/s (107%). Reduction in AUA score was: group I, 14.6 (63%); group II, 17.7 (71%); and group III, 16.2 (70%). PVR was: group I, 62.5 cc (51%); group II, 31.4 cc (16%), and group III, 71 cc (83%) (differences not significant). The patients in urinary retention were separately analyzed (group I, 9, group II, 12, and group III, 5) and mean PFR at 6 months was: group I, 18.5 cc/s, group II, 15 cc/s, and group III, 17.1 cc/s. Mean AUA score at 6 months was: group I, 25.8; group II, 21; and group III, 23.6. Mean PVR score was: group I, 370 cc, group II, 439 cc; and group III, 400 cc (differences not significant). Mean postoperative catheterization time was higher in patients with glands larger than 80 cc (2.2 versus 2.9 versus 4.7 days in groups I, II, and III, respectively, P < 0.009 between groups II and III). Incidence of urinary tract infection (10 versus 0%) was greater in patients receiving only 48-hour as opposed to 10-day postoperative antibiotics. CONCLUSIONS: TUEP appears to be a safe and effective treatment for relief of symptoms of BPH and improvement of PFR in patients with all sizes of prostate glands.

Aged↗
PubMed1988

[Benign prostatic hyperplasia as a frequent senile disease of the male].

An adenofibromyomatous proliferation starting from the region of the periurethral glands is referred to as benign prostatic hyperplasia. It is the result of a senile endocrinopathy, which leads to a disbalance of the peripheral hormonal milieu, and of an intraglandular disturbance of the utilization of the hormone. It becomes a disease when it is followed by an increase of the vesical outlet resistance and thus by an obstructive disturbance of the voiding of the urinary bladder. The indication for operation is determined by the degree of the obstruction and its pathophysiological sequelae as well as the complaints of the patients. The conservative therapy is above all symptomatic and indicated only at the initial stage of the disease. The transurethral resection is the operative therapy of choice. In very large hyperplasias the open surgical intervention may be necessary. In inoperable patients a urethral catheter should be renounced for a suprapubic puncture cystostomy. Also after operative ectomy of a benign prostatic hyperplasia the patients may fall ill with a carcinoma of the prostatic gland. Therefore, the duty for undergoing an annual preventive medical examination remains.

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PubMed2004

Long-term treatment with doxazosin in men with benign prostatic hyperplasia: 10-year follow-up.

INTRODUCTION AND OBJECTIVES: Benign prostatic hyperplasia (BPH) is a progressive condition that is characterized by an increased risk of acute urinary retention and BPH-related surgery. This study evaluates the safety and efficacy of doxazosin over 10 years in men with BPH. MATERIAL AND METHODS: The trial enrolled men (aged 49-83 years--mean 64.0) with symptomatic BPH (clinical stage II according to Alken) and no evidence of prostate cancer. The trial involved a 1.5 year controlled efficacy study with doxazosin (4 mg/day) 64 ambulatory patients with BPH, followed by a 5-year extension. During the study after 1 year 11 pts discontinued it (expense given as reason) and 6 pts underwent surgery. Then 47 pts (100%) receiving doxazosin continued therapy. After 5 years 32 pts (60%) aged 54-92 years--mean 69.4 years continued to be followed for further 5 years, giving a total follow-up of 10 years (next 8 pts underwent surgery; total 14 (26%) pts; and 14 (26%) pts died. RESULTS: Twenty (38%) of the 47 pts (100%) enrolled into doxazosin were judged as being successfully treated during the 10-year follow-up. In further 5 years only 2 pts underwent surgery and 7 pts (13%) died for reasons unrelated to doxazosin treatment. Three pts after 6 years therapy left study. Excluding 14 pts who died plus 14 pts who left the trial it means that after 10 years 20 pts remained successfully treated and 16 pts who had to be surgically treated. Assuming that all group make 36 pts (100%) than long term follow-up showed effective results in doxazosin treated 20 pts (56%) and thus can obviate surgery. Adverse events associated with doxazosin therapy were insignificant. 10 years therapy proved effective in increasing urina flow rates and decreasing residual urine volume--respectively 14.6 ml/s and 57.0 ml (mean value). CONCLUSIONS: 1. Long-term 10 years doxazosin (4 mg/daily) therapy has demonstrated that appropriately selected BPH patients are likely to have an excellent response. 2. The a/m trial indicates that surgery can be obviated in up to half of BPH treated patients. 3. The results of the trial demonstrate that doxazosin is safe, efficacious and well-tolerated.

Adrenergic alpha-Antagonists↗
PubMed2002

Herbs for benign prostatic hyperplasia.

OBJECTIVE: To review and evaluate the literature relative to the use of herbal therapies in the treatment of benign prostatic hyperplasia. DATA SOURCES: Literature was identified by MEDLINE, Embase, International Pharmaceutical Abstracts, and the International Bibliographic Information on Dietary Supplements searches and through cross-referencing of selected articles. STUDY SELECTION/DATA EXTRACTION: All articles identified from the data sources were evaluated and all information deemed relevant was included in this review. DATA SYNTHESIS: A large percentage of men >50 years old begin to experience signs and symptoms of benign prostatic hyperplasia (BPH). Herbs hold promise in the treatment of BPH. Serenoa repens, Pygeum africanum, Urtica dioica radix, and Cucurbita peponis semen are some of the botanical therapies used in the treatment of BPH. CONCLUSIONS: There are many European studies examining efficacy, dose, and adverse effects of these plants in the treatment of BPH. However, numerous questions remain. These include issues concerning long-term beneficial and adverse effects of herbal therapy, prevention of complications, standardization of extracts, and concomitant use with "mainstream" medications. Based on the information available today, these botanical therapies can be used for treatment of a number of objective and subjective symptoms in patients with BPH, stages I and II.

Cucurbita↗
PubMed1993

Transurethral grooving of the prostate in the treatment of patients with benign prostatic hyperplasia. An alternative to transurethral incision.

Various alternatives exist for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Incision of the bladder neck and prostate has proved its efficacy in many studies, especially in small prostates. The major drawback of the procedure is inability to obtain tissue specimens to exclude malignancy. We introduced a method to overcome this drawback by incising grooves at 5 and 7 o'clock with standard resection loops which created not only the incisions but also provided enough tissue for pathological examination. Twenty-five patients with BPH underwent transurethral grooving. Pre- and post-operative urodynamic studies revealed significant improvement in both maximum and average flow rates. The re-operation rate in the entire group was 12%. Transitional cell carcinoma of the prostatic urethra was detected in 1 patient, which proved its superiority to standard incision procedures.

Aged↗
PubMed2006

Uroselectivity in male dogs of silodosin (KMD-3213), a novel drug for the obstructive component of benign prostatic hyperplasia.

AIMS: Our main aim was to compare the prostatic selectivity of silodosin with that of other alpha(1)-adrenoceptor (AR) antagonists. METHODS: We examined uroselectivities in two sets of experiments namely, in vitro and in vivo functional studies using male dogs. In the in vitro study, after evaluating the inhibitory effects of silodosin on noradrenaline (NA)-induced contractions in the isolated prostate and isolated carotid artery using the Magnus method, we calculated prostatic selectivity. In the in vivo study, we examined the effects of drugs on the hypogastric nerve stimulation (HNS)-induced increase in intraurethral pressure (IUP) and on blood pressure. The uroselectivity of silodosin was compared with those of tamsulosin and naftopidil. RESULTS: In vitro, all drugs antagonized NA-induced contraction in both prostate and carotid artery. The prostatic selectivity of silodosin (79.4) was much higher than those of tamsulosin (1.78), naftopidil (0.55), BMY 7378 (0.115), and prazosin (0.01). In vivo, intravenously (i.v.) administered silodosin dose-dependently inhibited the HNS-induced increase in IUP with much less hypotensive effect than either tamsulosin or naftopidil, the uroselectivity (ED(15)/ID(50)) of silodosin (237) being significantly higher than those of tamsulosin (1.21) and naftopidil (2.65). CONCLUSIONS: Our results clearly demonstrate that silodosin is a potent and highly selective alpha(1A)-AR antagonist. A selective alpha(1A)-AR antagonist such as silodosin may have good potential as a less-hypotensive drug for the treatment of urinary dysfunction in benign prostatic hyperplasia patients.

Adrenergic alpha-1 Receptor Agonists↗
PubMed1999

The chimpanzee as a model of human benign prostatic hyperplasia.

PURPOSE: The etiology and natural history of benign prostatic hyperplasia (BPH), the most common benign disease in aging men, remain obscure. The canine BPH model has serious limitations but other animal BPH models have not been identified. We evaluated whether the chimpanzee, man's closest primate relative, developed spontaneous BPH. MATERIALS AND METHODS: A cross-sectional analysis of a colony (White Sands Research Center) that contained 700 chimpanzees was undertaken by sampling 63 male and female (controls) chimpanzees 8 to 35 years old. The presence of spontaneous BPH was evaluated by assessing pathological and clinical variables, including prostate volume, serum prostate specific antigen, presence of histological BPH, serum androgens and estradiol, and urodynamics studies. RESULTS: The chimpanzee had evidence of spontaneous histological BPH, and incidence and grade increased with age. Spontaneous BPH was manifested by increased prostate volume, higher serum prostate specific antigen, higher stromal/epithelial ratio and decreased urinary flow rates. As in man, serum androgens did not correlate with BPH in the chimpanzee. CONCLUSIONS: Male chimpanzees developed spontaneous histological BPH at the same relative point in their life cycle as humans which resulted clinically in larger prostates and decreased urinary flow rates. Serum hormone levels did not appear to correlate with BPH. A better understanding of the chimpanzee BPH model may lead to new therapeutic strategies for BPH in man.

Age Factors↗
PubMed1990

A dose titration study evaluating terazosin, a selective, once-a-day alpha 1-blocker for the treatment of symptomatic benign prostatic hyperplasia.

The efficacy and safety of terazosin, a selective long-acting alpha-1-adrenergic blocker, were evaluated in 45 normotensive patients with symptomatic benign prostatic hyperplasia ranging from 50 to 76 years old. All patients underwent a complete urodynamic evaluation and transrectal prostatic ultrasonography before enrollment into the study. The dose of terazosin was titrated to 5 mg. per day for a 1-month interval, provided adverse drug reactions were not observed. Of the patients 39 (87%) completed the dose titration study. The parameters used to assess the effectiveness of terazosin included peak and mean urinary flow rates, micturition symptom scores and the global assessment by the patient of symptomatic improvement. Over-all, the mean systolic and diastolic blood pressures changed by less than 1%. The peak and mean urinary flow rates increased by 42 and 48%, respectively. The obstructive and irritative symptom scores improved by 63 and 35%, respectively. Over-all, 30 of the 45 participants (67%) indicated that the voiding symptoms were markedly improved while on terazosin. Five patients did not complete the dose titration study due to development of adverse drug reactions, including erectile dysfunction (7%), tiredness (7%), light-headedness (4%), palpitations (4%), nasal congestion (2%) and asymptomatic hypotension (2%). There were 25 patients (55%) followed on terazosin for 4 to 10 months (mean 6.5 months). The improvements in urinary flow rates and symptom scores were maintained for this interval. Although this preliminary experience with terazosin is encouraging, the ultimate role of terazosin for the long-term treatment of benign prostatic hyperplasia needs further evaluation.

Adrenergic alpha-Antagonists↗
PubMed1995

alpha-blockade in the treatment of symptomatic benign prostatic hyperplasia.

PURPOSE: The clinical and urodynamic effects of oral alpha 1-selective adrenoceptor blockers in the treatment of symptomatic benign prostatic hyperplasia were quantified, and side effects and patient tolerance were assessed. MATERIALS AND METHODS: A total of 29 original reports of placebo controlled clinical trials of alpha-blockers in which results were adequately presented was identified and reviewed, along with additional pertinent literature. We assumed that the efficacy of the different alpha-blockers was basically the same and the weighted average treatment effect was calculated in comparison with placebo. RESULTS: The average improvement in maximum urine flow rate was 1.5 ml. per second but this rate would probably approach 1.8 to 1.9 ml. per second if all dosages had been titrated up to the highest level tolerated. Overall symptom score decreased by 14% and residual urine volume decreased by 29%. A slight decrease in detrusor pressure during voiding was suggested. CONCLUSIONS: alpha-Blockers were beneficial in the treatment of benign prostatic hyperplasia. Tolerance to treatment appeared to develop in a large proportion of patients after 6 months of therapy. However, for patients who benefit from long-term use of alpha-blockers effective treatment might be maintained for years.

Adrenergic alpha-Antagonists↗
PubMed1990

[Zinc, calcium and sodium values in secretions of patients with benign prostatic hyperplasia].

In two randomized patients groups suffering from benign prostatic hyperplasia (BPH) two exprimate samples were drawn at a seven-day interval. In the untreated control group no changes in the values of Ca, Na and Zn were found. In the other group the patients have been treated with ERU capsules (Radicis urticae) for 7 days and thereafter a significant decrease of Zn values were found.

Calcium↗
PubMed1997

Insulin-like growth factor-binding protein-2 in patients with prostate carcinoma and benign prostatic hyperplasia.

OBJECTIVE: Insulin-like growth factor-binding protein (IGFBP)-2 is a major prostatic IGFBP and may be involved in regulating prostate growth. Patients with prostate carcinoma (PC) have elevated serum IGFBP-2 levels which correlate with the specific PC marker, prostate-specific antigen (PSA). The aims of this study were to investigate whether elevated serum IGFBP-2 is unique to PC or also occurs in benign prostatic hyperplasia (BPH), to examine the relations among age, PSA and IGFBP-2 levels, and to examine longitudinal changes in serum IGFBP-2 with PSA in prostate carcinoma. DESIGN AND PATIENTS: Sixteen patients (61-83 years) with inoperable PC attending the oncology unit at a tertiary referral hospital were studied. Some serum samples were obtained retrospectively while the majority were collected prospectively over 13 months of treatment. The patients with PC were compared to 8 patients (66-73 years) with histologically proven BPH and 7 male control subjects (61-82 years) with no known prostate abnormality. MEASUREMENTS: A new IGFBP-2 RIA was developed. Serum PSA (by EIA), and IGFBP-2, IGFBP-3, IGF-I and IGF-II (by RIA) were measured in all subjects, and serially in patients with PC. RESULTS: Serum IGFBP-2 was significantly higher in PC with high PSA (560 +/- 66 micrograms/l, n = 12) than PC with normal PSA (292 +/- 65 micrograms/l, n = 4, P = 0.02), BPH (364 +/- 61 micrograms/l, P = 0.03) and controls (367 +/- 44 micrograms/l, P = 0.04). Mean IGFBP-2 in BPH was not different from controls. IGFBP-2 and PSA were significantly correlated with age (r = 0.543 and r = 0.433 respectively) and with each other even when the age effect was removed. Serum IGFBP-2 and PSA levels changed concordantly in all 7 PC patients who had serial sampling. Serum IGF-II but not IGF-I or IGFBP-3 was higher in PC and BPH than in controls (PC 332 +/- 23 micrograms/l), BPH 359 +/- 26 micrograms/l vs controls 241 +/- 37 micrograms/l; P = 0.03 and 0.02 respectively). CONCLUSIONS: Serum IGFBP-2 levels are uniquely elevated in active prostate carcinoma but not in benign prostatic hypertrophy. In PC, serum IGFBP-2 levels closely parallel those of PSA and probably reflect tumour burden. The relation between PSA and IGFBP-2 is partially independent of their individual relations with age. Although serum IGFBP-2 is less sensitive than PSA in PC, it may have adjunctive value in the management of prostate carcinoma.

Age Factors↗
PubMed2005

Efficacy of terazosin and finasteride in symptomatic benign prostatic hyperplasia: A comparative study.

Medical treatment for symptomatic Benign Prostatic Hyperplasia (BPH) has become popular for the last few years. This study was designed to find out and compare the efficacy of terazosin, a alpha1 adrenoceptor blocker and finasteride, a 5alpha-reductase inhibitor in symptomatic BPH. A total of 60 patients (30 in terazosin group and 30 finasteride group) of symptomatic BPH were selected. Terazosin group received 1 mg daily at bedtime for 3 days, 2 mg at bedtime for 7 days, thereafter 5 mg at bedtime daily for 6 months. Finasteride group received 5 mg once daily. In terazosin treated patients, improvement after 3 months were as follows, IPSS 3.93 +/- .74 points reduction, Qmax 2.13 +/- .68 ml/s increase, post-voided residual urine volume (PVR) 20.67 +/- 10.56 ml reduction (significant, p<0.001) and prostate volume 0.57 +/- 1.54 ml reduction (not significant). Similar statistical differences were observed at 6 months follow up. In finasteride treated patients, improvements after 3 months were as follows, International Prostate Symptom Score (IPSS) 1.38 +/- .63 points reduction, Qmax 0.55 +/- 0.78 ml/s increase, PVR 5.93 +/- 7.64 ml reduction (significant, p<0.001) and prostate volume 0.17 +/- 5.6 ml reduction (non-significant). At 6 month follow up statistical differences were significant in all parameters including prostate volume 4.57 +/- 5.30 ml reduction (p<0.001). In comparison, statistically significant superiority of terazosin over finasteride was found in improving IPSS, Qmax and PVR in both follow up visits. But terazosin had nonsignificant effect in reducing prostate volume; in contrast, finasteride had significant effect in second visit. It can be concluded from this study that terazosin 5mg once daily is effective in mild to moderate cases of symptomatic BPH. On the other hand, finasteride 5mg once daily may be useful in large prostate and to be given for at least 6 months.

Adrenergic alpha-Antagonists↗
PubMed2000

Relationship of prostate-specific antigen and prostate volume in patients with biopsy proven benign prostatic hyperplasia.

BACKGROUND: Emerging data suggest a direct correlation between prostate-specific antigen (PSA) and prostate volume in patients with lower urinary tract symptoms (LUTS) and clinical evidence of benign prostatic hyperplasia (BPH). We attempt to confirm that a similar correlation exists between PSA and prostate volume in patients with biopsy-proven BPH. METHODS: Over a 5 year period, 2,270 patients were confirmed to have BPH as the only histological diagnosis after evaluation with serum PSA, trans-rectal ultrasound (TRUS) biopsy, and prostate volume measurement. PSA and prostate volume were statistically analyzed by age-stratified cohorts, including multiple regression analysis and assessment of correlation using the Pearson correlation coefficient (r). RESULTS: Mean PSA and prostate volume increased with each advancing cohort of age, and the correlation of PSA and prostate volume was determined to be statistically significant (P < 0.001) in each cohort with a correlation coefficient ranging from 0.33 to 0.41. CONCLUSIONS: We confirm that the relationship between PSA and prostate volume in a large series of patients with biopsy-proven BPH provides a comparable correlation to data for patients with LUTS and clinical BPH. As such, PSA represents a valuable approximation of prostate volume, and may prove to be clinically useful in the management of patients with BPH.

Adult↗
PubMed1990

Cumulative prevalence of prostatism matches the autopsy prevalence of benign prostatic hyperplasia.

The age-specific cumulative prevalence of clinically diagnosed prostatism among 1,057 generally healthy men followed for up to 30 years in the Baltimore Longitudinal Study of Aging was compared with the age-specific autopsy prevalence of pathologically defined benign prostatic hyperplasia (BPH) from a published compilation of five independent autopsy studies involving 1,075 prostates. Clinical prevalences based on medical histories and digital rectal examinations showed excellent agreement with autopsy prevalences at all ages. Despite the well-known lack of correspondence between prostatism and objective urologic evidence of BPH in individual patients, these results suggest that the proportion of the male population with clinically recognizable prostatism by a given age is about the same as the proportion with pathological evidence of BPH.

Adult↗
PubMed1997

Prostate specific antigen in benign prostatic hyperplasia: purification and characterization.

PURPOSE: The ratio of free-to-total prostate specific antigen (PSA) in serum is greater in patients with benign prostatic hyperplasia (BPH) than in those with prostate cancer, and it provides a means of partially discriminating these 2 diseases. To understand the molecular mechanism of why the free-to-total PSA ratio is greater in BPH than in prostate cancer we analyzed PSA obtained directly from nodules of BPH tissue. MATERIALS AND METHODS: PSA from BPH nodule fluids was first purified by gel filtration and ion exchange chromatography. Purified BPH PSA was characterized by gel electrophoresis, enzyme assay and N-terminal sequence analysis of the amino acids. RESULTS: A single band at 30 kDa. on sodium dodecyl sulfate polyacrylamide gel electrophoresis under nonreducing conditions was identical to that of seminal fluid PSA. Under reducing conditions most BPH PSA was degraded, whereas most seminal fluid PSA existed as an intact molecule. BPH PSA had multiple internal cleavages in addition to the common cleavage site between lysines 145 and 146 of seminal fluid PSA. Cleavage sites at C-terminals of histidine 54 and phenylalanine 57 were also detected. Enzymatic activity studies with different substrates showed that PSA from seminal fluid and BPH nodules had similar specific trypsin-like activity. However, BPH PSA had much lower specific chymotrypsin-like activity than seminal fluid PSA. N-terminal sequence analysis showed that BPH PSA was neither in the pre-proenzyme form (261 amino acids) nor the zymogen proenzyme form (244 amino acids) of PSA, both of which are known precursors of mature PSA (237 amino acids). CONCLUSIONS: Most PSA in BPH nodules is in the nicked form with low chymotrypsin-like activity. When it leaks into the circulation it will form fewer PSA-antichymotrypsin complexes and more will remain in the free form. We predict that a protease with trypsin-like activity in BPH nodule fluid is probably responsible for the nicked form of BPH PSA. These findings suggest that antibodies produced against PSA in BPH nodules may be useful in discriminating prostate cancer from BPH.

Humans↗
PubMed2005

Prevalence of nocturnal polyuria in patients with benign prostatic hyperplasia.

Nocturia is a common symptom associated with benign prostatic hyperplasia which can persist even after effective treatment of BPH. Other causes may be responsible. We investigated a group of patients who were treated for BPH and continue to have nocturia. Our study has found a high prevalence (85.4%) of nocturnal polyuria in this group of patients. It has important clinical implication since the condition can be effectively treated with oral desmopressin. Empirical treatment without a routine frequency volume chart may be appropriate due to its high prevalence.

Aged↗