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At least 163 records · Page 9Linked to original sources
PubMed1994

[Changes in the voiding condition with aging in elderly males--results of a field survey for prostatic diseases].

We investigated changes in the voiding condition with aging in 1476 males 50 years and older, who participated in a field survey for prostatic diseases conducted from 1982 to 1991 in Hokkaido. Voiding conditions were evaluated subjectively with a symptom index (weak stream, intermittency, nocturia, urge incontinence), and objectively with maximum flow rate. Digital rectal examination (DRE) revealed 10.3% (572 participants) of total evaluable participants to have moderate or marked enlargement of the prostate. The incidence of enlargement of the prostate apparently increased with aging. Subjective urinary symptoms, both obstructive and irritative, increased in the incidence and degree with aging. The maximum flow rate and maximum flow rate-nomogram also became worse with aging the incidences participants having urinary symptoms or decreased maximum flow rate increased in parallel with the size of the prostate on DRE. For each size of the prostate on DRE, the incidence of participants having urinary symptoms increased with aging. The maximum flow rate showed a similar tendency, decreasing with aging, irrespective of the size of the prostate. These results indicate that aging as well as the size of the prostate may affect the voiding condition in males aged 50 years and older.

Aged↗
PubMed2000

Endocrine patterns in patients with benign and malignant prostatic diseases.

BACKGROUND: The known importance of the endocrine system, particularly of steroid hormones, for development of the prostate gland and the fact that steroid hormones act as immunmodulators prompted us to compare hypophyseal, adrenal, and gonadal hormones, including cortisol, in patients with benign and malignant prostatic diseases. METHODS: Patients with newly diagnosed, untreated prostate cancer (PC) (n = 75) and, as a control population, those with untreated lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) (n = 159) entered this prospective study. In all patients, the following parameters were obtained by serum analysis: prostate-specific antigen (PSA), human luteinizing hormone (hLH), human follicle-stimulating hormone (hFSH), testosterone, estradiol (E2), cortisol, and dehydroepiandrosterone-sulphate (DHEA-S). Serum samples were collected of fasting patients between 7. 30-10.00 AM. RESULTS: Age was comparable in both groups (PC: 65.6 +/- 7.6 years (mean +/- standard deviation) vs. controls: 64.9 +/- 8. 1 years; P = 0.56). HFSH (PC: 6.6 +/- 3.9 mIU/ml; controls: 8.4 +/- 6.4 mIU/ml; P = 0.04), hLH (PC: 5.3 +/- 4.8mIU/ml; controls: 7.6 +/- 6.2 mIU/ml; P = 0.009), and estradiol (PC: 25.8 +/- 12.7 pg/ml; controls: 32.6 +/- 12.6 pg/ml; P = 0.0003) were significantly lower in PC patients than controls. Cortisol (PC: 16.7 +/- 4.2 microg/dl; controls: 13.5 +/- 4.3 microg/dl; P < 0.0001) was significantly higher in cases. The difference for cortisol and estradiol concentrations between PC patients and controls held true in all life-decades. Serum concentrations for DHEA-S and testosterone were comparable between PC and control patients. In PC patients, none of the endocrine parameters correlated to serum PSA or clinical/pathological stage. CONCLUSIONS: Patients with newly diagnosed, untreated PC yielded significantly higher cortisol and lower estradiol serum concentrations than controls. The known effect of cortisol on the immune status warrants further studies.

Aged↗
PubMed1994

[The effect of subjective urinary symptoms on quality of life (QOL)--results of a field survey for prostatic diseases].

We investigated the effect of subjective urinary symptoms on quality of life (QOL) in 536 males who participated in a field survey for prostatic diseases in Hokkaido from 1991 to 1993. To quantitatively estimate the subjective urinary symptoms, we used a questionnaire that included questions about irritative symptoms such as "diurnal frequency", "nocturia", "sensation of residual urine", "urgency" and "frequent urination within 2 hrs.", and obstructive symptoms such as "difficulty to start urination", "intermittency during urination", "strain or pushing", "weak stream" and "stopping or starting urination". The incidences of participants with poor QOL increased as irritative and obstructive symptoms became apparent (p < 0.001). However, some participants, who had only mild urinary symptoms, could not tolerate the situation and felt impairment of QOL. In contrast, others did not feel a decrease of QOL in daily life in spite of severe symptoms. Thus, subjective urinary symptoms did not always correlate with QOL in some individuals. These results indicated that we should keep in mind not only subjective urinary symptoms but their effect on QOL whenever we determine an indication for medical or surgical intervention for patients having urinary symptoms.

Humans↗
PubMed2002

Epidemiology of radical prostatectomy for localized prostate cancer in the era of prostate-specific antigen: an overview of the Department of Defense Center for Prostate Disease Research national database.

BACKGROUND: Because of public awareness and screening, the incidence of clinically localized prostate cancer has increased dramatically in the last 15 years. The Department of Defense Center for Prostate Disease Research (CPDR) was established by the US Congress in 1991 to study prostate cancer in the US military health care system. A key component of CPDR is a multicenter prospective and retrospective prostate research database that collects comprehensive standardized data on all consenting patients. To verify and document changes in the epidemiology of men electing radical prostatectomy (RP) as primary treatment for their localized prostate cancer, we undertook an analysis of such cases when the PSA screening test became widely available and used. METHODS: The CPDR database consists of standardized data collection forms for each episode of care completed prospectively, and in some cases, retrospectively, on men with prostate cancer and those undergoing a prostate biopsy for presumed cancer at participating medical centers. In July 2001, a query of all RPs performed between January 1, 1991, and December 31, 2000, was conducted, revealing 3681 cases for analysis from 9 hospital sites. These cases were analyzed over time (calendar year), and changes in the characteristics of the patients, disease severity, and surgical results were compared. RESULTS: There was a significant shift to younger men undergoing RP with the median age declining to 62.3 years old by 2000, and more than 40% of the men were less than 60 years old. There was an increase in African-Americans undergoing RP and a large increase in clinical stage T1 disease candidates of both races representing 56.5% of men by 2000. There was a large increase in patients having pretreatment PSA levels between 4 and 10 ng/mL (59.2% by 2000). Retropubic approach was predominant (over 80%) and was associated with a much lower blood loss by 2000 (approximately 800 mL). There was an increase in use of nerve-sparing procedures, and operative time declined significantly to a median of 3.5 hours by 2000. Finally, there was a marked surgical stage migration with a higher proportion of men with organ-confined disease and negative surgical margins; by 2000, 63.4% had pT2 disease. The early outcomes improved with a 1-year disease-free survival in excess of 93%. CONCLUSIONS: RP is being performed more commonly on younger men with earlier stage disease in the PSA era. The operation is now performed more rapidly with less blood loss, and the surgical pathology outcome end points and early disease-free survival are improved. These results portend well for improved long-term outcomes of surgical therapy.

Age Distribution↗
PubMed1993

[Simultaneous enucleo-resection of synchronous bilateral renal carcinoma, incidentally discovered during prostate disease screening].

Bilateral synchronous renal cell carcinoma is rare, incidental discovery is exceptional. We report a case of asymptomatic bilateral simultaneous renal tumor discovered during screening for prostatic disease. Two year previously the patient underwent sonography and IVP for right ureteral stone, spontaneously ejected, with no evidence of renal masses. Ultrasound, CT and selective digital angiography demonstrated two renal tumors < 3 cm in size. Bilateral simultaneous enucleoresection was the therapeutic choice, that we consider to be elective in such a case.

Carcinoma, Renal Cell↗
PubMed1987

[Clinical studies of gamma-seminoprotein in prostatic disease. I. Clinical evaluation of serum gamma-seminoprotein].

Serum gamma-seminoprotein (gamma-Sm) in patients with prostatic disease was determined by enzyme immunoassay. A total of 136 patients including 13 untreated and 40 treated patients with prostatic cancer, 45 patients with benign prostatic hyperplasia (BPH) and 38 patients with other urological diseases were analyzed. The mean +/- SD of serum gamma-Sm in the 13 patients with untreated prostatic cancer and the 45 patients with BPH was 31.7 +/- 46.1 and 3.7 +/- 6.6 ng/ml, respectively, there being a statistically significant difference between the two groups. All patients with untreated stage A or B prostatic cancer had a serum gamma-Sm of less than 4 ng/ml (cut off value). The mean level of serum gamma-Sm was 5.1 +/- 1.9 ng/ml for all patients with untreated stage C prostatic cancer; 66% of them had a value above the cut off value. However, it was 55.9 +/- 52.6 ng/ml in all patients with untreated stage D prostatic cancer; 87.5% of them had a value above the cut-off value. These results suggest that gamma-Sm may be a useful tumor marker in the management of patients with prostatic cancer.

Acid Phosphatase↗
PubMed2001

The contribution of inhibins and activins to malignant prostate disease.

The normal human prostate expresses inhibin and activin subunits. In prostate cancer, the inhibin alpha subunit gene is down regulated and this is associated with loss of heterozygosity (LOH) at the gene locus and methylation of the promoter. These data support the hypothesis that the inhibin alpha subunit is tumor suppressive in the prostate. The pluripotent effects of activins and the similarities to transforming growth factor beta (TFGbeta) suggest a role for activins in progression to malignancy, whereby, the normal growth inhibitory action of activin A observed on benign cells is lost with the acquisition of activin resistance in prostate cancer cells. The mechanisms of rendering tumor cells resistant to activin A may include: alteration in activin binding protein (follistatin) synthesis and/or dimerisation with activin beta(C) to form novel activin dimers. The contribution of the activin signalling cascade to malignancy requires further evaluation to identify the synergies and differences to other members of the TGFbeta superfamily.

Activins↗
PubMed2005

Measurement of the mechanical characteristics of benign prostatic tissue: a novel method for assessing benign prostatic disease.

OBJECTIVES: To investigate the relationship between the morphology and the mechanical properties of benign prostatic tissues measured in vitro. METHODS: Fresh tissue specimens were collected from 17 patients undergoing transurethral resection of the prostate for benign prostatic obstruction. Individual tissue specimens underwent immediate mechanical testing, by applying a dynamic compressive strain to the samples. The amplitude ratio (E*) and phase difference (tan delta), measures of tissue elastic and viscous components, were derived. Individual sections from the processed specimens underwent immunohistochemical staining and computerized image analysis to measure the morphologic characteristics of each transurethral resection of the prostate chipping. Correlations between the morphologic and mechanical measurements were assessed. RESULTS: A strong positive correlation was found between prostatic smooth muscle content and (E*) (R2 = 0.58, P = 0.009). CONCLUSIONS: The results of this study have demonstrated that strong correlations exist between prostatic tissue morphology and mechanical characteristics. We believe that the ability to quantify prostatic tissue mechanical characteristics in vivo may be of clinical benefit in the future assessment and treatment of benign prostatic disease.

Aged↗
PubMed1985

Vesicoureteral reflux in patients with obstructive prostatic disease.

We present our experience during a 22-year period with the management of 53 patients in whom vesicoureteral reflux was associated with obstructive prostatic disease. There were 45 cases of benign prostatic hyperplasia and 8 cases of carcinoma of the prostate. After prostatectomy medical management of reflux was successful in controlling urinary infection in 34 patients and an operation was performed in 19. Each patient was followed for at least 1 year.

Adolescent↗
PubMed2005

Measurement of tissue mechanical characteristics to distinguish between benign and malignant prostatic disease.

OBJECTIVES: To investigate the relationship between the morphology and mechanical properties of benign and malignant prostatic tissues measured in vitro. METHODS: Fresh tissue specimens were collected from patients undergoing transurethral resection of the prostate (TURP) for benign or malignant prostatic enlargement. Individual TURP chippings underwent immediate mechanical testing by applying a dynamic compressive strain to the samples. The amplitude ratio (E*) and phase difference (tan delta), measures of tissue elastic and viscous components respectively, were derived. Individual sections from the processed specimens underwent immunohistochemical staining and computerized image analysis was used to measure the morphologic characteristics of each TURP chipping. Linear regression analysis was used to assess correlations between morphologic and mechanical measurements, and the unpaired t test, assuming equal variances, was used to compare the mechanical and morphologic characteristics of benign and malignant prostates. RESULTS: Significant differences were noted between the morphology of the benign and malignant prostates. Tan delta was significantly smaller within the malignant prostates (P = 001). No difference was found between the benign and malignant prostates with respect to E*. Within the malignant prostates, a strong negative correlation was found between the epithelial tissue content and tan delta (R2 = 0.50, P = 0.031). CONCLUSIONS: The results of this study showed that measurable differences exist between the mechanical characteristics of benign and malignant prostatic tissue and provide further evidence that significant correlations exist between prostatic tissue morphology and mechanical characteristics. We believe that the ability to quantify prostatic tissue mechanical characteristics in vivo may be of clinical benefit in the future assessment of prostatic diseases, both benign and malignant.

Aged↗