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PubMed1999

Mortality and prostate cancer risk in 19,598 men after surgery for benign prostatic hyperplasia.

OBJECTIVES: To examine postoperative mortality and prostate cancer risk after the first prostatectomy for benign prostatic hypertrophy over a 17-year period in a population-based cohort of men in Western Australia, using improved methods to adjust for comorbidity. PATIENTS AND METHODS: The relative survival from death and prostate cancer incidence was calculated against the background population rates. The outcomes of transurethral resection of the prostate (TURP) and open prostatectomy (OP) were compared adjusting for calendar year, age, admission type and comorbidity using Cox regression. Fractional polynomials were used to take account of nonlinearity in confounder effects. RESULTS: At 10 years, the relative survival was 116.5% in TURP patients and 123.5% after OP. Adjusting only for confounding by age, calendar year and admission type, TURP had a higher mortality rate than OP (rate ratio, RR, 1. 20; 95% confidence interval 1.08-1.34). The RR fell to 1.10 (0.99-1. 23) after adjustment for comorbidity and to 1.07 (0.95-1.19) when accounting for nonlinearity. The relative survival from the incidence of prostate cancer at 10 years was 103.7% after TURP and 104.5% after OP. The RR adjusted for age and calendar year was 1.44 (0.94-2.21) for incidence and 1.37 (0.81-2.29) for prostate cancer mortality. CONCLUSION: There is at most a small and clinically unimportant excess mortality risk from TURP; any difference could be due to a protective effect of OP on the long-term risk of prostate cancer and a lower rate of repeat prostatectomy.

Humans↗
PubMed1997

Value of prostatic cancer screening in patients treated for benign prostatic hyperplasia with medical or minimally invasive modalities.

OBJECTIVE: To assess the likelihood of overlooking the diagnosis of prostate cancer (PCA), using current screening methods, in patients treated for benign prostatic hyperplasia (BPH) with medical or minimally invasive treatment modalities, which do not produce tissue specimens for histologic review. To appraise this, we examined the impact of the preoperative use of prostatic specific antigen (PSA) in combination with transrectal ultrasound (TRUS) and systematic sextant prostate needle biopsy (PNbx) on the subsequent incidence of stage A PCA in patients undergoing transurethral resection of the prostate (TURP). METHODS/RESULTS: After excluding all patients found to have PCA during pretreatment screening, 485 patients who underwent TURP for presumed BPH from 1976 to 1994, were reviewed. From 1976 to 1989, PSA was not used for pretreatment screening, and stage A PCA was diagnosed in 11.4% of 317 patients. In 1990 and 1991, pretreatment screening included PNbx obtained under ultrasound guidance for PSA > or = 15.0 ng/ml. Stage A PCA was diagnosed in 14.2% of 63 patients. From 1992 to 1994, pretreatment screening included systematic sextant PNbx performed for PSA > 4.0 ng/ml, and stage A PCA was diagnosed in 2.8% of 105 patients. The difference in incidence of stage A PCA between the first two groups and group three was significant (p = 0.021); so is the difference in incidence of stage A2 (p = 0.037). For stage A1, the difference did not reach statistical significance (p = 0.089). CONCLUSION: Our findings suggest that systematic sextant PNbx for PSA > 4.0 ng/ml significantly reduces the risk of overlooking prostate cancer in patients undergoing treatment of BPH with modalities that do not provide tissue specimens.

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PubMed2002

A randomized controlled trial comparing transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia: urodynamic effects.

PURPOSE: We compared urodynamic and uroflowmetry improvements in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH) after transurethral prostate resection, contact laser prostatectomy and electrovaporization. MATERIALS AND METHODS: A prospective randomized controlled trial was performed in men with lower urinary tract symptoms suggestive of BPH who met the criteria of the International Scientific Committee on BPH, had a prostate volume of between 20 and 65 ml., and a Schäfer obstruction grade of 2 or greater. Before and 6 months after treatment urodynamics and free uroflowmetry were performed. RESULTS: A total of 50, 45 and 46 men were randomized to transurethral prostate resection, laser treatment and electrovaporization, respectively. Baseline characteristics were similar in the 3 groups. Detrusor contractility did not change in any of the treatment groups. The average maximum free flow rate increased by a factor of 2.4 after transurethral prostate resection, 2.5 after laser prostatectomy and 2.4 after electrovaporization. The Schäfer obstruction grade decreased by a factor of 0.3 in all groups. Obstruction (Schäfer grade greater than 2) was not noted after transurethral prostate resection or electrovaporization but it was evident in 2 patients after laser prostatectomy. Effective capacity increased by a factor of 1.5 or more. The incidence of detrusor instability was decreased by half in all groups. The incidence of significant post-void residual urine volume decreased in all groups. CONCLUSIONS: There were no significant differences in the improvement in urodynamic and uroflowmetry parameters 6 months after treatment when comparing transurethral prostate resection, contact laser prostatectomy and electrovaporization in men with lower urinary tract symptoms suggestive of BPH.

Aged↗
PubMedDate not supplied

[Doksazozin "Cardura" in acute urinary retention caused by benign prostatic hyperplasia].

Drug treatment of acute ischuria (AI) caused by benign prostatic hyperplasia (BPH) is discussed. Catheterization of the urinary bladder is the main treatment for AI. AI is caused by anatomical obstruction, hypertone of smooth myocytes, and energy imbalance of detrusor. Use of alpha 1-adrenoblockers in AI is pathogenetically justified, as the development of stable spasm of smooth-muscle structures of the prostate, vesical cervix, and prostatic compartment of the urethra resultant from increased functional activity of alpha 1-adrenoreceptors underlies the dynamic component of obstruction. alpha 1-Adrenoblocker doxazosin (cardura) was used for arresting AI caused by BPH after 12-h randomization and catheterization of the bladder. A prospective randomized placebo-controlled study was carried out on 36 patients. Spontaneous urination was restored in 55.5% patients, in 63.3% of these after doxazosin and in 16.6% after placebo. 37.9% of patients from the doxazosin group were discharged from hospital for outpatient therapy with alpha-blockers and the rest were operated on. Hence, doxazosin increases the chance of recovery of spontaneous urination for patients with AI caused by BPH and allows time and conditions for preparation of patients to surgery. Therapy with alpha 1-adrenoblockers after resolution of AI in patients with BPH can be effective and should be further investigated.

Acute Disease↗
PubMed1995

Current assessment and proposed staging of patients with benign prostatic hyperplasia.

With better understanding of the natural history of benign prostatic hyperplasia (BPH), and recent advances in ultrasound and the many new modalities of treatment, the assessment of BPH has undergone rapid changes in the past few years. A system of staging of patients with BPH, to assist in the tailoring of treatment to the severity of the disease is proposed. The initial assessment consists of the International Prostatic Symptoms Score (IPSS) and the Quality of Life Index, digital rectal examination (DRE), urinalysis, prostate specific antigen (PSA) estimation, and subsequently, assessment with ultrasound of the urinary system and estimation of residual urine and uroflow done at the same sitting. Patients with no bothersome symptoms and no significant obstruction are classified as stage one, and they can generally be watched. Stage 2 patients are those with bothersome symptoms but no significant obstruction and they can be treated with pharmacotherapy in the first instance, failing which other less invasive therapies such as thermotherapy are advised before considering transurethral resection of the prostate (TURP). Stage 3 patients are those with significant obstruction and defined as patients with significant residual urine of more than 100 ml, generally with a maximum flow rate of less than 10 ml. This group of patients would be advised TURP first, then thermotherapy, or pharmacotherapy in descending order, taking into account the age of the patients, their co-morbidity and preferences. Stage 4 patients are those with complications resulting from significant obstruction by BPH such as retention of urine, bladder stone and recurrent urinary infection; they would be strongly advised to have TURP. With proper assessment and staging, it is hoped that patients with BPH will not be over or undertreated, and treatment outcome will be improved.

Humans↗
PubMed2006

Relationship between serum prostate-specific antigen and prostate volume in Korean men with benign prostatic hyperplasia: a multicentre study.

OBJECTIVES: To evaluate the relationship between prostate specific antigen (PSA) and prostate volume (PV) in Korean men, as PV is a key predictor of both disease progression and response to medical therapy in patients with benign prostatic hyperplasia (BPH), and PSA has been suggested as a proxy marker to estimate the total PV, mainly in Caucasians. PATIENTS AND METHODS: From 1999 to 2004, men aged 50-79 years with lower urinary tract symptoms (LUTS) and BPH were enrolled into this multicentre study. The analyses included 5716 patients presenting to 11 medical centres with LUTS (International Prostate Symptom Score >8, peak urinary flow rate <15 mL/s); they had a mean age of 64.3 years, mean baseline PV of 36.9 mL, and mean baseline PSA level of 2.2 ng/mL. Men with a baseline PSA of >10 ng/mL were excluded, to reduce the likelihood of including occult prostate cancer. A biopsy was taken in those with suspicious findings on a digital rectal examination or serum PSA level of >4 ng/mL, to exclude prostate cancer. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of serum PSA to predict threshold PV in men with BPH. RESULTS: The PV and serum PSA level had an age-dependent log-linear relationship, the strength of which increased with age. The ROC curve analysis showed that PSA had good predictive value for various prostate volume thresholds (30, 40 and 50 mL). CONCLUSIONS: The PSA-PV relationship in Korean men is similar to that in Caucasians, but Korean men have a slightly lower PSA level and a smaller PV than Caucasians. The approximate age-specific criteria for detecting Korean men with a PV of >40 mL were a PSA level of >1.3 ng/mL, >1.7 ng/mL and >2.0 ng/mL for men with BPH in their sixth, seventh and eighth decade, respectively.

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PubMed2002

[The correlation between urodynamics and morphology in men with benign prostatic hyperplasia].

OBJECTIVE: We have the impression that the degree of obstruction was stronger in the patients with a middle lobe of hyperplastic nodule than in those without such a lobe in patients with benign prostatic hyperplasia. In the present study, we compared the data from a pressure-flow study (PFS) and a presence of a middle lobe. MATERIALS AND METHODS: A transurethral resection for benign prostatic hyperplasia was performed in 2,439 patients, 798 underwent PFS. The PFS findings and the presence of a middle lobe were compared with the following parameters, namely, the bladder detrusor function, the degree of obstruction, the post-voided residual volume, the maximum flow rate, the prostate volume and the resected volume. RESULTS: In the pressure-flow study, the rate of the normal bladder detrusor function was higher in the patients with a middle lobe than in those without such a lobe (71.9 versus 53.3%). The degree of obstruction was also stronger in the patients with a middle lobe than in those without in the patients with a normal bladder detrusor function (89.0 versus 79.4%). Then in the patients with a middle lobe, the quantity of the post-voided residual volume was greater, however, the maximum flow rate was lower. CONCLUSION: Most patients with a middle lobe demonstrate an improved voiding ability after underwent a transurethral resection.

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PubMed2006

Laser treatment of symptomatic benign prostatic hyperplasia.

The treatment of lower urinary symptoms secondary to benign prostatic hyperplasia (BPH) after failure of medical therapies remains controversial for most urologic surgeons. The complications of traditional surgery are the driving force behind the development of several minimally invasive treatments of symptomatic BPH. Laser prostatectomy is one of the most investigated such modalities. In this article we reviewed the results of the most common types of lasers used in prostatic surgery.

Humans↗
PubMedDate not supplied

Bladder catheterization and a plasma prostate-specific antigen in patients with benign prostatic hyperplasia and complete urine retention.

Nineteen men with BPH (benign prostatic hyperplasia) were studied who had up to 6 months prior to complete urine retention PSA levels measured (PSA I). Subsequent PSA levels were obtained at 2 weeks post catheterization upon catheter removal (PSA II) and at 4 (PSA III) and 6 weeks post catheterization (PSA IV). Analysed were 18 mean PSA values [ng/ml] (as one patient was found to have prostatic cancer and his data were discarded): PSA I - 6.46, PSA II - 14.26, PSA III - 9.83 and PSA IV - 7.47. Initial data suggest that the irritation of the adenoma by the catheter may cause PSA levels to rise.

Aged↗
PubMed2001

Postvoid residual urine in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: pooled analysis of eleven controlled studies with alfuzosin.

OBJECTIVES: A pooled analysis was conducted in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia to examine the relationship between the postvoid residual urine (PVR) volume and various clinical characteristics and to assess the effect of alfuzosin, a clinically uroselective alpha(1)-blocker, on PVR volume and any other associated outcome. METHODS: Nine hundred fifty-three patients, 42 to 89 years old, with a baseline PVR volume between 50 and 350 mL (mean 106 mL) were enrolled in 11 double-blind controlled studies and received either alfuzosin (n = 607) or placebo (n = 346) for 1 to 6 months. The relationships between the baseline PVR volume measured by transabdominal ultrasound and age, symptoms, maximum flow rate (Qmax), estimated bladder capacity, and prostate-specific antigen level were assessed. The changes in the PVR volume with treatment were evaluated in all available patients at three endpoints (1, 3, and 6 months). RESULTS: At baseline, a PVR volume of 100 mL or greater was observed in 60%, 47%, and 39% of patients with a Qmax less than 8, 8 to 11, and greater than 11 mL/s, respectively (P = 0.001). The bladder capacity was also significantly related to the Qmax (P = 0.0001). No relationship was found between PVR volume and age, symptoms, or prostate-specific antigen level. The changes in the PVR volume with treatment were related to the baseline PVR volume. However, at all endpoints and whatever the baseline PVR volume, the decreases in the PVR volume were significantly (P <0.01) greater with alfuzosin than with placebo. Acute urinary retention occurred in 7 patients (2 [0.3%] of 607 patients taking alfuzosin and 5 [1.4%] of 346 patients taking placebo); 6 of these 7 patients had a baseline PVR volume greater than 100 mL. CONCLUSIONS: In this population of men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia, the PVR olume and bladder capacity were related to the baseline Qmax. Alfuzosin significantly reduced the PVR volume compared with placebo, and this effect was more marked in patients with a high PVR volume at baseline. Acute urinary retention occurred mainly in patients with a PVR volume greater than 100 mL and was less frequent in patients taking alfuzosin than in those taking placebo.

Adrenergic alpha-Antagonists↗
PubMed1990

Clinical manifestations of benign prostatic hyperplasia and indications for therapeutic intervention.

The symptomatology of benign prostatic hyperplasia is a complex issue, and the clear-cut indications for therapeutic intervention are few. Overflow incontinence is a clear indication for treatment, and it seems prudent to recommend surgical intervention for patients with large postvoiding residual volumes. Acute urinary retention, recurrent infection, azotemia, and severe hematuria are other strong indications. When the indications are less clear, the patient's perspective on the impact of prostate disease on his life is important.

Humans↗
PubMed1997

Treatment of benign prostatic hyperplasia. A pharmacoeconomic perspective.

Men with moderate symptoms of benign prostatic hyperplasia (BPH) are the best candidates for medical treatment, while surgery is usually indicated for patients with severe symptoms. Men with mild symptoms do not usually need treatment, but they might be re-evaluated annually if desirable. Finasteride, which produces selective hormonal deprivation, is now established as a well tolerated drug for the long term medical therapy of BPH. Recent studies suggest that finasteride is most effective in men with large prostates (> 40 ml), and the drug should probably be reserved for these patients. alpha-Blockers work in men with small or large prostates, and their rapid onset of action facilitates the identification of responders. alpha-Blockers are more effective than finasteride during the first year of treatment, but only finasteride induces regression of the prostate and offers increased efficacy over time. Even if drug therapy reduces the need for prostate surgery, the total economic cost of BPH treatment is likely to rise because of the increasing application of medical treatment. The magnitude of this increase depends largely on what percentage of the male population embark on long term therapy, at what age treatment is started, and how successful it is. At present, the answers to these questions are largely unknown. The personal economic expenses for men who begin long term medical therapy will probably be an important factor in deciding how common drug treatment for BPH will become in the future. For many men, the main benefit of drug treatment will be the relief of urinary symptoms, but whether this improvement is substantial enough to improve their overall quality of life has not yet been clearly demonstrated in controlled studies.

Adrenergic alpha-Antagonists↗
PubMed1975

The effect of steroid hormones on the growth pattern and RNA synthesis in human benign prostatic hyperplasia in organ culture.

The effect of testosterone, dihydrotestosterone, 3 beta-androstanediol and oestradiol-17 beta on the morphology and RNA synthesis in human benign prostatic hyperplasia (BPH) in organ culture has been investigated. In hormone treated and untreated explants alike, the epithelium multiplied to form several layers. This effect was most marked after exposure to dihydrotestosterone. In explants grown in non-supplemented medium the epithelium showed some squamous changes; testosterone or dihydrotestosterone preserved the secretory character of the epithelium while oestradiol-17 beta caused cellular degeneration. The incorporation of 3H-uridine into RNA was studied by autoradiography. In the epithelium, testosterone or dihydrotestosterone raised the uptake significantly over that measured in the control explants, oestradiol-17 beta reduced it while 3 beta-androstanediol produced similar values to those found in the control explants. The incorporation of 3H-uridine in the smooth muscle cells was increased by testosterone and decreased by oestradiol-17 beta. A comparison with normal rat prostatic epithelium in organ culture showed that in the absence of androgens the incorporation of 3H-uridine was lower than in BPH and the effect of testosterone correspondingly greater. The results suggest that although the growth of human BPH in organ culture appears to be androgen dependent, it still remains hormone sensitive and can be influenced by steroid hormones in a similar manner to that in rat prostatic gland. They further show that the smooth muscle of the stroma is also hormone sensitive, a point which should be considered in the hormonal management of benign prostatic hyperplasia.

Aged↗
PubMed1997

A pharmacoeconomic analysis of patients with symptoms of benign prostatic hyperplasia.

A pharmacoeconomic analysis of therapies for patients with benign prostatic hyperplasia (BPH) was conducted. The therapies compared were androgenic hormone inhibition (finasteride) and alpha-blockade (doxazosin, prazosin and terazosin). This was a cost-effectiveness analysis from the perspective of the US military. The 36-month decision-tree model considered the aforementioned drugs as initial therapy for BPH following an unsuccessful period of watchful waiting. Therapy was continued toward a successful response. All patients who did not respond to therapy received secondary interventions, including transurethral resection of the prostate (TURP). The main outcome measures were clinical effectiveness and incurred costs. A Monte Carlo sensitivity analysis was performed on all cost-effectiveness ratios. The model and sensitivity analysis supported prazosin as the most cost effective alpha-blocker over finasteride: the mean difference was $US381.65 (1994 values) per successfully treated patient, with a range of $US57.83 to $US675.53, in favour of prazosin. If prazosin was used as initial drug therapy after watchful waiting for a man over 50 years of age with classical symptoms of prostatism and no other severe or confounding comorbid conditions, a cost of $US578.15 per treatment could be expected, with clinical effectiveness of 70.3%. Patients who cannot tolerate prazosin should be considered for terazosin therapy before moving on from alpha-blockers. Subsequent treatment with finasteride would cost $US1426.53, with an additional clinical effectiveness of 9.9%. For the small number of patients who fail both therapies, the cost effectiveness of a first TURP as 'third-line' intervention [$US4321.36 for an additional effectiveness of 8.62% and a repeat TURP as 'fourth-line' ($US7650.54 for 0.59%) interventional] was calculated in a similar manner. Costs were cumulative, and effectiveness was derived from the total number of patients who started prazosin therapy. Pharmacological therapy was more cost effective than surgical intervention, and alpha-blockers were more cost effective than finasteride. Among the alpha-blockers, prazosin was by far the most cost effective followed by terazosin, then doxazosin.

Cost-Benefit Analysis↗
PubMed1998

Recent developments in the surgical management of benign prostatic hyperplasia.

A new era in the surgical management of benign prostatic hyperplasia (BPH) has emerged in the past decade. A variety of less invasive treatment modalities have been introduced and well-established surgical treatments are being reassessed. Although progress has been made in the management of BPH, the substantial economic burden to the healthcare system caused by BPH emphasizes the importance of cost-effective treatment. Open prostatectomy is the most efficient BPH treatment for relieving symptoms and improving uroflow, but it is also the most invasive and morbid. Transurethral resection of the prostate (TURP) is still the "gold standard" for treatment of BPH, but open prostatectomy has been reported to have a lower perioperative mortality than TURP, and low retreatment rates reduce the long-term cost. The morbidity associated with TURP, such as impotence or urinary incontinence, has been reduced in recent years while new features, such as performing TURP under local anesthesia and bipolar electrosurgical techniques, have been introduced. Transurethral electrovaporization of the prostate (TVP) is a recent modification of TURP that has rapidly gained popularity. TVP greatly reduces TURP syndrome, provides good hemostasis, and may reduce catheterization and hospitalization times. Transurethral incision of the prostate (TUIP) is another safe and inexpensive procedure that is well-documented and comparable to TURP in long-term efficacy. TUIP is an underused procedure with which the newer, less invasive treatments should be compared. Whereas the well-established surgical treatments primarily relieve obstruction by tissue ablation, some of the newer treatment modalities may ameliorate lower urinary tract symptoms (LUTS) with minimal urodynamic change. In some of the newer nonresection treatments, no major significant postoperative reduction in prostate volume can be demonstrated. Laser treatments are based on a broad variety of techniques, generators, and fibers, of which most have initially demonstrated promising results. Well-known techniques include visually laser-assisted prostatectomy (VLAP) and interstitial laser coagulation (ILC). The laser techniques are generally not as effective as TURP, but are safe under local anesthesia on an outpatient basis with low complication rates. Transurethral microwave thermotherapy of the prostate (TUMT) and radiofrequency transurethral needle ablation (TUNA) are minimally invasive, safe new therapies. There is some evidence that the procedures create long-term, alpha-adrenoceptor-like blockade. Complications, except for transient catheterization in up to 40% of patients, may be practically nonexistent. The cost is difficult to estimate and the long-term outcome is still to be assessed. If the newer, less invasive treatment modalities provide stable long-term results and competitive costs, they will be tempting alternatives to prostate resections and may also challenge medical therapy.

Catheter Ablation↗
PubMed1991

Benign prostatic hyperplasia: symptoms and objective interpretation.

Considerable new knowledge about benign prostatic hyperplasia has been gained over the past two decades, particularly with regard to its natural history, hydrodynamic changes in the lower urinary tract, and the symptomatic and urodynamic results of treatment. A survey of the literature has been undertaken with special attention to the results of interventional studies and suggestions for future research.

Aged↗
PubMed2006

Prostate-specific antigen changes as a result of chlormadinone acetate administration to patients with benign prostatic hyperplasia: a retrospective multi-institutional study.

BACKGROUND: Antiandrogens used to treat benign prostatic hyperplasia (BPH) may affect the diagnosis of prostate cancer by decreasing serum prostate-specific antigen (PSA) values. We conducted a retrospective survey of BPH patients treated with chlormadinone acetate (CMA) and analysed the effect of CMA on their PSA values. METHODS: A chart-based, retrospective, multi-institutional survey of clinically diagnosed patients with BPH who had been treated with CMA (Prostal; 50 mg/day) was conducted. The patients were divided into three groups according to their baseline PSA values: <4 ng/mL, Group I; >or=4 ng/mL and <10 ng/mL, Group II; and >or=10 ng/mL, Group III. The changes in the PSA values from baseline after 16, 26, and 52 weeks of CMA therapy were predicted using a nonlinear regression model analysis. RESULTS: Data from 192 of the 303 enrolled patients were analysed. The predicted percent changes from baseline among all patients after 16, 26, and 52 weeks of treatment were -49.6%, -49.8%, and -49.9%, respectively. The corresponding values were -42.4%, -43.7% and -43.8% in Group I; -57.4%, -58.4% and -58.5% in Group II; and -50.6%, -50.6% and -50.6% in Group III, respectively. CONCLUSION: The PSA values reached a nadir, approximately -50% of the baseline, after 16 weeks of CMA administration and remained at the same level thereafter. When CMA is used to treat BPH patients, the possibility of abnormal increases in PSA associated with prostate cancer must be considered; if prostate cancer is suspected, prompt testing, including a biopsy, should be performed.

Aged↗
PubMed2000

Polymorphisms in the vitamin D receptor gene and the androgen receptor gene and the risk of benign prostatic hyperplasia.

OBJECTIVE: Little is known about risk factors for the development of benign prostatic hyperplasia (BPH). Recently, associations were observed between prostate cancer (CaP) risk and polymorphisms in the vitamin D receptor (VDR) gene and the androgen receptor (AR) gene. Since both receptors are relevant for prostate growth, the VDR and AR are also expected to be involved in the development of BPH. The objective of this study is to establish the relationship between the risk of BPH and a polymorphism in the number of CAG repeats in the AR gene and a TaqI restriction enzyme polymorphism in the VDR gene. METHODS: For this study, 98 patients who had been treated for BPH-related complaints and 61 convenience controls (predominantly bladder cancer patients) were recruited from the outpatient clinic. DNA was isolated from peripheral blood, and genotyping was performed with PCR-based methods. Means as well as odds ratios (ORs) with 95% confidence intervals (CI) were calculated using SPSS software. RESULTS: The mean number of CAG repeats in the AR gene in patients and controls was found to be similar: 21.8 (SD = 2.8) and 21.9 (SD = 2.9), respectively. In the subgroup of patients with a prostate volume of at least 50 cm(3), the mean number of repeats was 21.5 (SD = 2.6). The OR for BPH for individuals with homozygous presence of the VDR TaqI restriction fragment length polymorphism (RFLP) (tt) versus individuals with homozygous absence (TT) or heterozygotes (Tt) was found to be 1.0 (95% CI 0.4-2.4). For individuals with a prostate volume of at least 50 cm(3), the OR was 1.2 (95% CI 0.5-3. 2). CONCLUSION: Unlike earlier observations in prostate cancer, we did not find an association between the CAG repeat polymorphism in the AR gene and the TaqI RFLP polymorphism in the VDR gene and the risk of BPH.

Aged↗