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PubMed1992

Phenotypic characterization of infiltrating leukocytes in benign prostatic hyperplasia.

This study for the first time elaborates on cells of the immune system present in benign prostatic hyperplasia (BPH). Compared with normal prostate, all BPH-derived specimens revealed a marked increase of CD45+ leukocytes, characterization of which demonstrated three major cell types, i.e., CD3+ T lymphocytes, CD11c+ macrophages and CD20+ B lymphocytes. Frequencies of CD3+ cells/mm2 of cryocut sections were increased at least 10 times in BPH specimens, and the CD8+:CD4+ T suppressor/cytotoxic:T helper cell ratio was reversed. The infiltrating leukocytes predominantly populate the interstitium and accumulate around epithelial ducts which, however, were found to be invaded and/or destroyed only in a number of cases. Phenotypic alterations of surface antigen expression on prostate epithelial cells in BPH that might be due to the presence of lymphocytes were examined by using monoclonal antibodies (mAb) directed against human leukocyte antigens (HLA). Whereas anti-HLA-DR reactivity in normal prostate is restricted to small numbers of macrophages and includes neither prostate epithelial cells nor prostate T cells, it was found to be dramatically increased in BPH, comprising CD45+ cells and prostate epithelial cells as demonstrated by double-staining with anti-cytokeratin or anti-prostate-specific antigen. A mean of 40% of analyzed epithelial glands in BPH reacted with anti-HLA-DR, but not with anti-DQ or -DP monoclonal antibodies. A new method for the enrichment of prostate-derived lymphocytes was established to facilitate phenotypic analysis by flow cytometry, demonstrating 70 to 80% of enriched CD45+ cells to stain for CD3, approximately 60% thereof for CD4, 30% for CD8, and the remaining 10% with anti-CD20, a pan-B-cell marker. Flow cytometry showed that, in contrast to peripheral T cells, both CD4+ and CD8+ prostatic T cells were positive for the T cell activation markers HLA-DR and interleukin-2-receptor.

Antibodies, Monoclonal↗
PubMed2005

Expression of survivin and apoptotic biomarkers in benign prostatic hyperplasia.

PURPOSE: We assessed the differential expression of survivin and other apoptotic markers in stromal and epithelial compartments of benign prostatic hyperplasia (BPH) and normal prostate tissue. MATERIALS AND METHODS: Immunohistochemical staining for survivin, and transforming growth factor-beta1 and its receptors was done in normal prostate and BPH areas from 114 consecutive patients who underwent radical prostatectomy. Moreover, staining for survivin, Bcl-2, Bax, caspase-3 and Ki-67 was performed in prostate specimens from 23 consecutive patients who underwent open prostatectomy and 4 young patients who underwent cystoprostatectomy and had a normal prostate. RESULTS: Survivin and Bcl-2 expression increased incrementally from normal prostate to epithelial BPH to stromal BPH. Caspase-3 expression was higher in BPH epithelium than in BPH stroma, which in turn was higher than that in normal prostate. Ki-67 was significantly over expressed in BPH stroma and epithelium. Survivin expression in BPH tissue correlated with International Prostate Symptom Score, quality of life, post-void residual urine volume, maximum urine flow rate and transforming growth factor-beta1 expression. CONCLUSIONS: Survivin is over expressed in BPH and it correlates with BPH parameters. Increases in proliferation and inhibition of apoptosis have a role in BPH.

Adult↗
PubMed2006

[Identification of low-molecular weight prostate-specific antigen(PSA) and lactoferrin in the prostatic secretion of benign prostatic hyperplasia].

OBJECTIVE: To investigate the expression of low-molecular-weight PSA(lw-PSA) and lactoferrin in the expressed prostatic secretion (EPS) from both benign prostatic hyperplasia (BPH) and normal prostate. METHODS: Forty human EPS samples obtained from 20 BPH patients and 20 normal males were subjected to two-dimensional gel electrophoresis (2-DE). Mass spectrometry was performed to confirm the nature of the secreted proteins in EPS. RESULTS: One uniquely expressed protein in BPH was detected and mass spectrometry determined its nature as lw-PSA (molecular weight 10x10(3), pI 8.5-9.3). More importantly, Western blotting analysis also revealed that lw-PSA detected in BPH-EPS, but was undetectable in BPH-free EPS. In addition, up-regulation of Lactoferrin (molecular weight 35x10(3), pI 7-7.5) in BPH-EPS, as compared with BPH-free EPS, was also observed. More interestingly, lactoferrin was absent in prostate cancer tissues. CONCLUSION: Our results indicate lw-PSA may be produced specifically by BPH epithelium and it has a potential to be used as a specific biological marker for the diagnosis of BPH. In addition, benign prostatic epithelium can produce more lactoferrin while prostate cancer tissues go without its lactoferrin secretion.

Aged↗
PubMed1997

Bladder compliance in patients with benign prostatic hyperplasia.

Factors influencing bladder compliance were examined in 116 patients with benign prostatic hyperplasia (BPH), by evaluating patients' histories, response of isolated bladder strips to acetylcholine, and the effect of prostatic urethral anesthesia. Patients' age, frequency of micturition, and duration of voiding difficulty were not correlated with bladder compliance. Bladder compliance was significantly low in patients within 30 days after urinary retention, as compared with bladder compliance in patients without an episode of retention. More than 30 days after retention, however, there was a tendency toward increased bladder compliance. Restricted to patients without an episode of retention, bladder compliance in the overactive detrusor group was found to be significantly lower than in the normal group. The responses to acetylcholine of bladder strips were compared between patients with low and normal-compliance bladders. The dose-response curve of patients with low-compliance bladders did not differ from that of those with normal compliance bladders, even when patients with an episode of retention were excluded. After prostatic urethral anesthesia, a significant increase of bladder compliance was observed in patients with an overactive detrusor, while the increase was not significant in patients with a normal detrusor. Our results strongly suggest that easy irritability of the anatomically altered prostatic urethra, as well as bladder over-distension caused by urinary retention, are important factors affecting bladder compliance in BPH patients.

Acetylcholine↗
PubMed1994

[Clinical and experimental study of benign prostatic hyperplasia with intraglandular injection of chuan shen tong].

1038 cases of benign prostatic hyperplasia (BPH) were treated by injection of Chuan Shen Tong (CST), a Chinese herbal medicine, into the prostate gland. At the end of treatment the effective rate was 96%. After the treatment the BPH with urodynamic measurement was studied and it was found that the peak flow rate and mean flow rate increased 18% and 41.8% respectively. Transabdominal and transrectal ultrasonographies were used to measure the shrinkage of prostate's size after the injection treatment to be 0.51 and 0.4 cm (mean diameter) respectively. Animal model of BPH was established by the testosterone propionate. The prostatic weight and prostatic index was measured in mice after the injection of CST, it significantly decreased compared with that of the control (P < 0.01). The pathological findings: The hyperplastic papillae disappeared and the body of prostate markedly shrank in size. Experiment dogs has been carried out for the prostate quantitative analysis. The result revealed that the prostate parenchyma and intercellular substance shrank to 26.8% and 4.5% respectively.

Aged↗
PubMed1996

Citral and testosterone interactions in inducing benign and atypical prostatic hyperplasia in rats.

Citral is a monoterpene in wide use as an aromatic supplement in the cosmetics and food industries. Previous studies in our laboratory have shown that cutaneous application of citral on adolescent rats may induce benign prostatic hyperplasia (BPH)-like and even atypical hyperplastic changes in the ventral lobes. In the present study we investigate the possible interactions between citral and serum testosterone levels on the induction of hyperplastic changes in the ventral prostate of adolescent rats. In addition, the study includes a comparative analysis of normal intact rats showing circadian variations of serum testosterone levels and rats in whom this rhythmic pattern was abolished either by excessive supplementation of exogenous androgen or by castration. Our results demonstrate an induction of benign as well as atypical prostatic hyperplasia following citral application. The most severe atypical changes were noted in the citral-treated rats with high serum testosterone levels. Although the mechanism of action of citral is yet unknown, the present results suggest a synergism between citral and testosterone resulting in hyperplastic changes in the rat ventral prostate. In addition, the results reconfirm that serum testosterone levels fluctuate according to a circadian rhythm in intact young and adolescent male rats. The application of citral tends to lower the morning circadian peaks, and the circadian pattern was abolished in orchiectomized rats and in those treated with testosterone implants.

Acyclic Monoterpenes↗
PubMed2004

Association of prostatic inflammation with down-regulation of macrophage inhibitory cytokine-1 gene in symptomatic benign prostatic hyperplasia.

PURPOSE: Our previous DNA microarray analyses revealed that the macrophage inhibitory cytokine-1 (MIC-1) gene was significantly down-regulated in symptomatic benign prostatic hyperplasia (BPH) samples. We compared the histopathological features of inflammatory changes in prostate adenoma tissues from individuals with symptomatic and asymptomatic (histological only) BPH using MIC-1 mRNA levels. MATERIALS AND METHODS: Prostate adenoma tissues were obtained from 25 patients who underwent transurethral prostatectomy to relieve lower urinary tract symptoms due to BPH and 6 patients with bladder cancer who underwent cystoprostatectomy due to bladder cancer. Inflammatory changes in the prostate were examined histopathologically and immunohistochemically, and classified according to the consensus classification system of the Chronic Prostatitis Collaborative Research Network and International Prostatitis Collaborative Network advocated in 2001 with some modification. MIC-1 mRNA was assessed quantitatively by real-time reverse transcriptase-polymerase chain reaction. RESULTS: MIC-1 gene down-regulation was observed in 16 of 25 symptomatic BPH samples (64.0%), whereas MIC-1 mRNA was high in 6 of 6 prostate adenoma samples from patients with bladder cancer (p = 0.0006). MIC-1 gene down-regulation correlated with the grade of glandular/ periglandular inflammatory changes with statistical significance (p = 0.0387). MIC-1 gene down-regulation was found in only 1 of 7 BPH samples with a glandular predominant pattern, whereas it was found in 15 of 24 BPH samples with a mixed type or stromal predominant pattern (p = 0.0373). CONCLUSIONS: Gland destruction by inflammatory infiltrates, followed by replacement of the stromal component in symptomatic BPH may be induced by the down-regulation of the MIC-1 gene.

Aged↗
PubMed1998

Transforming growth factor-beta1 serum concentration in patients with prostatic cancer and benign prostatic hyperplasia.

OBJECTIVE: To assess serum levels of transforming growth factor-beta1 (TGF-beta1), normally markedly elevated in prostate cancer tissue, in patients with cancer of the prostate, and to correlate these levels with tumour stage and serum prostate specific antigen (PSA) levels. PATIENTS AND METHODS: Serum TFG-beta1 and PSA levels were determined in 32 patients with untreated prostate cancer. Patients were divided into: group 1, 14 patients with pT1-3pN0M0; group 2, four with T1-3pN+M0); and group 3, 14 with T1-4NxM+. Ten patients with histologically confirmed benign prostatic hyperplasia (BPH) served as controls. RESULTS: The median TGF-beta1 levels were no different between patients with cancer or BPH (30.7 ng/mL and 26.9 ng/mL, respectively; P > 0.05). Furthermore, there was no increase in TGF-beta1 concentrations with advancing tumour stage (group 1, 34.1 ng/mL; group 2, 33.0 ng/mL; group 3, 28.3 ng/mL; P > 0.05). There was no correlation with PSA levels (group 1, r= -0.42: group 2, r= -0.43; group 3, r= -0.23; BPH, r=0.38). CONCLUSION: TGF-beta1 levels did not discriminate between patients with BPH and prostate cancer, and there was no increase in TGF-beta1 levels with advancing tumour stage.

Aged↗
PubMed2003

Sexual function in patients treated for benign prostatic hyperplasia.

CONTEXT: What is the effect of different treatment options for benign prostatic hyperplasia (BPH) on sexual function or dysfunction? With increasing age, sexual dysfunction and BPH become more prevalent. Some treatments for BPH can affect sexual function. Different surgical treatments have different effects on sexual function depending on how much the internal involuntary sphincter is affected. The same is true for medical therapies, each class of drug having a unique affect on sexual function. STARTING POINT: In the past, many articles suggested a causal relation between BPH and sexual dysfunction. But a recent report by H Leliefeld and colleagues (BJU International 2002; 89: 208-13) confirms the idea that the relation is coincidental. Prospectively, these investigators examined patients at baseline and 9 months after various treatments for BPH with questionnaires on voiding symptoms, related complications, and sexual function. 84% of patients reported no change in sexual function. All treatments showed both improvement and deterioration in 3-14% and 0-16% of patients, respectively. As expected, age was the most important determinant of sexual function. In addition, the effect of severe irritative symptoms or the presence of urological comorbidity, such as bladder stones, increased the rate of sexual dysfunction. In this study, most patients underwent surgical therapy or watchful waiting while fewer had medical therapy. Too few patients had minimally invasive procedures to comment on their effect on sexual function. WHRE NEXT? Thus the relation between treatment of BPH (or watchful waiting) and sexual dysfunction is usually coincidental, unless symptoms become severe or complications (such as bladder stones or urinary retention) develop. More prospective studies are needed to assess the effect of BPH and its treatment on sexual function. Medical therapy is now more common than surgery in developed countries and treatment of BPH is commonly advocated for improvement in quality of life. Therefore any effects on sexual function become even more important. As minimally invasive surgical operations become more common, more data will be required for such interventions. The difficulty will be in keeping up with the rapidly evolving techniques of minimally invasive therapies.

Adult↗
PubMed2006

[Simultaneous treatment for benign prostate hyperplasia and its concomitant diseases].

OBJECTIVE: To investigate the surgical treatment of benign prostate hyperplasia (BPH) and its concomitant diseases at the same time. METHODS: One hundred and fourteen operations were performed for BPH patients, including transurethral resection/vapor of the prostate (TURP/TUVP), inguinal herniorrhaphy, internal urethrotomy, transurethral resection of bladder tumor (TURBt) or vesical litholapaxy, and the data were reviewed. RESULTS: The procedures were successful in all cases. A follow-up of 3 to 60 months found a good outcome of TURP. There was no recurrence in 30 cases of inguinal hernia and 39 cases of vesical calculus. Of the 25 cases of urethral stricture, 1 had an obvious hypotension during the operation and 4 needed urethral dilatation after operation. Six of the 20 cases of bladder tumor underwent a second TURBt due to the recurring tumor which was far from prostatic urethra. CONCLUSION: Inguinal hernia, urethral stricture, bladder tumor or vesical calculus can be treated simultaneously during TURP.

Aged↗
PubMed1993

Effect of transurethral resection of prostate on plasma hormone levels in benign prostatic hyperplasia.

Circulating levels of pituitary and adrenal hormones were measured in patients with benign prostatic hyperplasia before and after transurethral resection of the prostate (TURP). TURP caused a significant increase in plasma LH levels 2 weeks and 3 weeks after surgery. The plasma prolactin level decreased significantly 3 weeks after prostatectomy but plasma concentrations of FSH and ACTH were unchanged. TURP did not alter circulating levels of aldosterone, cortisol, DHEA-S and testosterone. These data suggest that the human prostate has a role in regulating the pituitary secretion of LH and prolactin.

Adrenal Cortex Hormones↗
PubMed1997

Clinical and biological characteristics of familial benign prostatic hyperplasia.

PURPOSE: We attempted to determine the clinical and biological characteristics of familial benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Urinary flow rate, prostate size, symptom score, serum prostate specific antigen, testosterone and dihydrotestosterone were measured in subjects who participated in the nationwide Merck phase III finasteride clinical trial. Findings in the 69 men with familial BPH (3 or more family members with BPH, including the proband) were compared to those in the 345 with no family history of BPH. Logistic regression was used to detect relationships between familial BPH, and these variables before and after 5 alpha-reductase inhibition with finasteride. RESULTS: Familial BPH was characterized by large prostate size. Mean prostate volume in men with familial and sporadic BPH was 82.7 and 55.5 ml., respectively (p < 0.001). Other clinical findings, including serum androgen levels and response to finasteride, were similar in familial and sporadic BPH. The frequency of familial BPH in patients with prostate size in the largest and smallest deciles was 46 and 13%, respectively. CONCLUSIONS: Familial BPH in this group of patients was associated with large prostate size, normal serum androgen levels and normal response to 5 alpha-reductase inhibition. A genetic factor responsible for familial BPH may exert its influence through androgen independent control of prostatic growth.

5-alpha Reductase Inhibitors↗
PubMed2026

A transition zone enriched WIF1+ basal cell subtype is associated with benign prostatic hyperplasia.

The cellular composition and disease susceptibilities of the distinct zones of the human prostate remain incompletely understood. Benign prostatic hyperplasia (BPH) is a common condition that causes widespread morbidity and is nearly exclusively localized to the transition zone (TZ). Through extensive single-cell RNA sequencing (scRNA-seq) of benign regions from prostatectomy specimens, we identified a basal cell population expressing WIF1, VCAN, and NRG1, among other genes, that was significantly enriched in the TZ. Analysis of previously published scRNA-seq datasets further confirmed that WIF1+ basal cells were significantly enriched in BPH compared with normal prostate. Pathway and cell-cell communication analyses revealed that this basal subtype is associated with programs related to cell proliferation, epithelial-mesenchymal transition, immune regulation, angiogenesis, and hormone response. Together, the molecular signature, zonal distribution, and pathway enrichment suggest that TZ-enriched WIF1+ basal cells may contribute to BPH pathogenesis by promoting epithelial and stromal remodeling. &#xa9; 2026 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

NRG1↗
PubMed1999

[Long-term efficacy of transurethral electrovaporization of the prostate for symptomatic benign prostatic hyperplasia].

OBJECTIVE: To observe long-term efficacy of transurethral electrovaporization of the prostate for symptomatic benign prostatic hyperplasia. METHODS: Two types of electrode of transurethral electrovaporization of the prostate (TVP) were performed on 150 patients of symptomatic BPH (mean age 74.8 years). The patients were assessed at baseline for both efficacy and followup at 36 months. Efficacy parameters evaluated included operation time (minutes), I-PSS and quality of life score, digital rectal examination, transrectal ultrasound, urodynamics and postvoid residual urine. RESULTS: 36 months after operation, I-PSS was decreased from 24.8 to 5.4 and the quality of life score also was decreased from 4.9 to 2.1. The mean peak uroflow was increased from 9.8 to 18.5 ml/s and postvoid residual urine was decreased from 108 ml to 22 ml (P < 0.05). The mean operation time was 44.7 min. Urodynamic results of 139 cases (92.7%) showed no bladder outlet obstruction, the remaining 11 cases showed severe bladder outlet obstruction to mild obstruction after 36 months. Hematuria was the only complication of our procedure. CONCLUSIONS: Significant clinical improvement is maintained with minimal morbidity. The long-term efficacy and safety of TVP is satisfactory. TVP is a potential useful procedure for transurethral resection of the prostate.

Aged↗
PubMed2004

Detection of telomerase activity in prostate massage samples improves differentiating prostate cancer from benign prostatic hyperplasia.

PURPOSE: We performed a case-control study in which we tested the ability of a non-invasive assay to detect telomerase activity and to distinguish between prostatic cancer (Pca) and benign prostatic hyperplasia (BPH) on samples of epithelial cells obtained after prostatic massage. METHODS: Telomerase activity was determined by a telomeric repeat amplification protocol (TRAP) assay. We selected 60 patients with histologically proven Pca (30 cases) or BPH (30 cases). Specimens included in this study were from patients who had no suspicious findings on digital rectal examination for cancer, had clinical evidence of lower urinary tract symptoms, had no sonographic signs of Pca at the transrectal ultrasound evaluation, had total PSA values moderately elevated (2.6-15 ng/ml), and had no evidence of other urological cancers. The whole procedure was conducted in double blind between pathologists and molecular biology operators. RESULTS: Telomerase activity was detected in 90% of Pca cases and in 13% of BPH cases. The sensitivity (90%) and specificity (76%) of this method were calculated. The positive predictive value, negative predictive value, and diagnostic efficiency were 87%, 90%, and 88% respectively. CONCLUSION: Our data indicate that telomerase activity detected by TRAP assay on prostate epithelial cells collected by prostate massage can substantially improve the distinction between Pca and BPH conditions. One of the clinical benefits resulting from the use of this new assay would be to refine the biopsy indication and to avoid for several patients without Pca the unnecessary cost and the complications of prostate biopsy.

Aged↗
PubMed1999

[Clinical study of transurethral electrovaporization of the prostate for benign prostatic hyperplasia].

We report our clinical experience of transurethral electrovaporization of the prostate (TUVP) for benign prostatic hyperplasia (BPH) using VaporTrode developed by Circon ACMI. From April to November 1995, we treated 22 patients with symptomatic BPH with TUVP. The mean I-PSS decreased significantly, from 21.8 at baseline to 8.1, 4.5, 4.3 and 5.4 at 1, 3, 6 and 12 months after operation, respectively. The mean QOL index also decreased significantly, from 5.2 to 1.5, 1.0, 1.3 and 1.3. The mean peak flow rate increased significantly, from 9.0 preoperatively to 17.4, 17.7, 20.8 and 16.5 ml/sec at 1, 3, 6 and 12 months after TUVP, respectively. The mean prostate volume decreased significantly, from 41.5 to 22.9, 18.6, 18.8 and 19.9 ml. The mean residual urine decreased significantly, from 90.0 to 17.6, 20.6, 24.1 and 9.4 ml. As for overall efficacy, the rate of excellent and good cases at 1, 3, 6 and 12 months was 77.3, 95.5, 95.0 and 84.2%, respectively. No serious complications were observed. Our clinical results suggest that TUVP using VaporTrode has several potential advantages including good efficacy, minimal morbidity and lower cost compared with other less invasive procedures, and may become the useful way of surgical treatment for BPH.

Aged↗
PubMed1996

Soluble CD44 molecules in serum of patients with prostate cancer and benign prostatic hyperplasia.

Recent studies suggest that expression of CD44 splice variants are of prognostic significance for a variety of neoplasias. It was the aim of this study to investigate whether any correlation exists between the concentration of soluble CD44 molecules in serum (CD44 standard form and CD44 splice variants v5 and v6) and the prostate cancer stage. Serum levels of these soluble CD44 isoforms were measured by ELISA tests specific for these proteins in controls (n = 30), patients with benign prostatic hyperplasia (BPH; n = 30), with prostate cancer without metastasis (T1,2,3pN0M0; n = 30) and with locally advanced prostate cancer and/or metastatic disease (T3,4pN1,2M1; n = 19). sCD44std and sCD44v6 concentrations were not significantly different among the four groups studied, with few patients' levels outside the central 95% reference intervals. The mean sCD44v5 concentrations of both prostate cancer and BPH patients were significantly lower than those of the controls. There was no significant difference between the soluble CD44 concentrations of the two groups of prostate cancer patients studied. In contrast to results observed in other carcinomas, the determination of soluble CD44 proteins in serum is not suitable for providing additional prognostic information on patients with prostate cancer.

Adult↗
PubMed1995

Cystoscopy in the evaluation of benign prostatic hyperplasia.

Cystoscopy has a limited role in the evaluation of benign prostatic hyperplasia (BPH). The examination is recommended in the evaluation of BPH patients with hematuria or a history of risk factors for urethral stricture. Available data suggest that bladder trabeculation in BPH is a predictor of the treatment outcome. Cystoscopy might be performed prior to invasive therapy to guide the urologist in choosing an operative approach.

Cystoscopy↗