Current world literature. Benign prostatic hyperplasia.
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Bibliography. Current world literature. Benign prostatic hyperplasia.
Explore the source record for details and available documents.
Humans↗
Bibliography. Current world literature. Benign prostatic hyperplasia.
Explore the source record for details and available documents.
Humans↗
Bibliography. Current world literature. Benign prostatic hyperplasia.
Explore the source record for details and available documents.
Humans↗
The natural history and course of untreated benign prostatic hyperplasia.
An understanding of the natural history or developmental growth and clinicopathologic evolution of benign prostatic hyperplasia (BPH) is important in assessing prognosis, providing adequate treatment, and evaluating the potential usefulness of newer therapeutic agents. Currently, the general view is that BPH is basically a progressive disease characterized by different growth rates in different individuals. However, the reason for possible fluctuations in growth rate, or even that of spontaneous regression in some individuals as the result of unknown endogenous factors in the host, remains to be determined.
Adult↗
Sonographic measurements of transition zone of prostate in men with and without benign prostatic hyperplasia.
Modern transrectal ultrasonography is a reliable means of visualizing the transition zone within the prostate gland. We measured the transverse, longitudinal, and anterior diameters and calculated the volume of the prostate and the transition zone in 400 patients. Ninety-seven patients with neither clinical nor sonographic evidence of benign prostatic hyperplasia (BPH) were compared with 108 patients with sonographically apparent BPH. The mean size of the transition zone was 6.14 +/- 3.2 g in the normal group and 24.81 +/- 14.4 g in the BPH group. The size of the transition zone increased significantly in relation to increased age of the patient. Ultrasonography allows accurate measurement of the transition zone and would be useful for documenting changes in the extent of BPH in response to therapy.
Adult↗
[Transition zone index in predicting therapeutic efficacy of benign prostatic hyperplasia].
PURPOSE: We studied how transition zone index (TZ index) influenced the therapeutic efficacy of benign prostatic hyperplasia (BPH). In addition, we retrospectively investigated the availability of TZ index in selection of the more effective therapeutic method for BPH. METHOD: One hundred twenty-five patients with symptomatic BPH whose prostate volume (PV) was more than 15 ml by transrectal ultrasonography were investigated. Sixty-nine men underwent transurethral resection of the prostate (TURP) whereas 56 were treated with alpha 1-blocker. Tamsulosin hydrochloride. These patients were evaluated based on TZ index as well as ordinary parameters of BPH; international prostatic symptom score, QOL score, peak flow rate and PV. RESULTS: The patients with TZ index > or = 0.5 showed good therapeutic results in the TURP group. On the other hand, the patients with TZ index < 0.5 showed favorable response in alpha 1-blocker group. Multivariate analysis revealed that TZ index affected the therapeutic efficacy more strongly than the other parameters. CONCLUSION: TZ index had strong influence on therapeutic efficacy of TURP or alpha 1-blocker and seemed to be a useful tool for the selection of BPH therapy.
Adrenergic alpha-Antagonists↗
A randomized controlled trial comparing transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia: analysis of subjective changes, morbidity and mortality.
PURPOSE: We analyze subjective changes, morbidity and mortality in men with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH) after transurethral resection of the prostate, contact laser prostatectomy and electrovaporization. MATERIALS AND METHODS: A prospective, randomized controlled trial was conducted on men with lower urinary tract symptoms, who met the criteria of the International Scientific Committee on BPH, had a prostate volume between 20 and 65 ml., and had Schäfer's obstruction grade 2 or greater. Objective morbidity was recorded for up to 12 months. Subjective morbidity was measured by a questionnaire completed by patients. Subjective changes were quantified using the International Prostate Symptom Score, Symptom Problem Index, Quality of Life question and BPH Impact Index. These indexes and the morbidity questionnaire were measured weekly for the first 6 weeks postoperatively and then at 3, 6 and 12 months. RESULTS: Transurethral prostatic resection was analyzed in 50 men, laser treatment in 45 and electrovaporization in 46. Baseline characteristics, and changes in the symptom scores up to 12 months postoperatively were similar. Perioperative blood loss and perforation were greatest in the resection group, and retention was greatest in the laser group. During the first 6 postoperative weeks there was less pain and less hematuria after resection, and less incontinence after laser prostatectomy. CONCLUSIONS: Subjective changes are similar for transurethral prostatic resection, contact laser and electrovaporization. In the first 6 weeks after treatment there are only slight differences in pain, hematuria and incontinence among the therapies.
Aged↗
Benign prostatic hyperplasia cell line viability and modulation of jm-27 by doxazosin and Ibuprofen.
PURPOSE: Benign prostatic hyperplasia (BPH) is among the most common diseases affecting quality of life in older men. Despise intense research efforts to our knowledge the genetic mechanisms underlying the BPH disease process and therapeutic markers needed to determine patient responsiveness to a particular form of pharmacological therapy are still not identified. This has slowed the development of new therapeutic agents for the treatment of BPH. MATERIALS AND METHODS: We investigated the cellular effects of certain drugs on BPH. Besides doxazosin, which is the prevailing drug to treat BPH, the effect of ibuprofen was examined as a new therapeutic approach due to strong evidence of a correlation between BPH and inflammation. RESULTS: This study showed that doxazosin as well as ibuprofen significantly decreases cell viability and induced apoptosis in 267 B1 cells as well as in BPH-1 cells. In addition, we observed that the administration of doxazosin and ibuprofen to BPH-1 cells decreased the expression of JM-27, a protein particularly expressed in prostate that is highly up-regulated in symptomatic BPH. CONCLUSIONS: Our findings suggest that ibuprofen may be a new therapeutic target for the treatment of BPH. Further research must be done to investigate the potential use of ibuprofen in patients with BPH and examine if JM-27 expression in patients with BPH may stratify individuals who may be most responsive to pharmacological treatment.
Adrenergic alpha-Antagonists↗
Serum proteins in patients with benign prostatic hyperplasia.
Studies of serum protein patterns done in a group of 42 patients with benign prostatic hyperplasia (PBH) revealed the following: (1) prior to the operation significant hypalbuminaemia and increase of alpha 2-, beta- and gamma-globulins, IgG, IgA, IgM and CRP levels; (2) 12 days after operation a marked decrease of albumin concentration, increase of alpha 2-globulin and a sharp rise of CRP; (3) after 1 year a decrease of hypalbuminaemia and increase of alpha 2- and beta-globulins and CRP; in contrast to that, there was further increase of gamma-globulin concentration expressed also in the IgG, IgA and IgM levels.
Aged↗
Impact of benign prostatic hyperplasia on general well-being of men.
Little is known about the impact of benign prostatic hyperplasia (BPH) on the general well-being of men with this condition. All men aged 40-79 years registered with a group general practice were enumerated. BPH was defined as enlargement of the prostate gland of equivalent weight > 20 g in the presence of symptoms of urinary dysfunction and/or a urinary peak flow rate < 15 ml/s, without evidence of malignancy. Four hundred and ten men (20% of those who participated) satisfied these criteria. The proportion of men with a negative feeling of well-being was higher in men with BPH than in men who did not have BPH. The difference was consistent for all aspects of well-being (anxiety, depression, self-control, vitality, being worried or being bothered by illness). Men with BPH had a higher level of bothersomeness attributed to urinary symptoms, and more interference in selected daily living activities caused by urinary dysfunction. These were related to worry or concern over urinary function and prostate cancer, together with a higher level of embarrassment caused by urinary dysfunction, compared with men who did not have BPH. Patients' feelings of well-being should be taken into account in the clinical management of BPH.
Adult↗
[Impact of hypertension on angiogenesis in the tissues of benign prostatic hyperplasia].
OBJECTIVE: To investigate the impact of primary hypertension on angiogenesis in the tissues of benign prostatic hyperplasia (BPH). METHODS: Immunohistochemistry was carried out to examine the expression of CD34, so as to calculate the microvassel density (MVD), and the expression of vascular endothelial growth factor (VEGF) in the tissues of prostatic gland, resected during operation, of 50 simple BPH patients, aged 68.3 (56 approximately 83), and 50 patients with BPH with hypertension, aged 69.0 (55 approximately 91) with a course of hypertension of 16.5 +/- 11.9 years (1 - 41 years). RESULTS: The MVD of the simple BPH group was 23.1 +/- 9.2, significantly lower than that of the BPH complicated with hypertension group (28.2 +/- 9.5, P < 0.01), especially the BPH complicated with hypertension group with a course >/= 15 years (31.3 +/- 8.5). The MVD of the BPH complicated with hypertension group with a course >/= 15 years was significantly higher than that of the BPH complicated with hypertension group with a course < 15 years (25.7 +/- 9.7, P < 0.05). The VEGF positive rate of the stroma of the simple BPH group was 46.0%, significantly lower than that of the BPH complicated with hypertension group (66.0%, P < 0.05), especially that of the BPH complicated with hypertension group with a course >/= 15 years (81.8%). The VEGF positive rate of the stroma of the BPH complicated with hypertension group with a course >/= 15 years was significantly higher than that of the BPH complicated with hypertension group with a course < 15 years (53.6%, P < 0.05). In the group of BPH with hypertension, MVD was positively correlated with the expression of VEGF in the stromal tissue (R = 0.11, P < 0.05). CONCLUSION: Hypertension may be closely related to the increased expression of VEGF in prostatic stroma. The increased expression of VEGF may induce angiogenesis and consequently lead to clinical progression of BPH in patients with hypertension.
Aged↗
[Treatment of benign prostatic hyperplasia with tamsulosin].
The past few decades mark a rejuvenation of the contingent of benign prostate hyperplasia (BPH) patients. The condition affects mainly the active age in men, with the substantial financial burden of treatment leading to a surge of interest in the disease. The hazards of postoperative complications development constrain modern urologists to seek for new, safer and more effective methods of conservative management. The task undertaken is to assay the effect of application and possible side phenomena of Tamsulosin treatment in BPH patients, administered at dose 0.4 mg a single time on a daily basis over 12 to 24 weeks. A nationwide multicenter, parallel, randomized study is conducted in seven urological clinical units throughout the country, covering a one year period. For the purpose a total of 310 men, aged 52 to 68 years, presenting moderately expressed BPH symptomatology are investigated. IPSS improvement is documented in 229 patients (74%), and a significant MUD improvement is observed in 115 patients (37%), with the residual urine quantity decreasing significantly in 108 patients (35%). In conclusion, it is believed that Tamsulosin administration as a superselective alpha-1-A adrenoblocker is one of major achievements in the conservative therapeutic approach to prostate adenoma.
Aged↗
A population based study of incidence and treatment of benign prostatic hyperplasia among residents of Olmsted County, Minnesota: 1987 to 1997.
PURPOSE: The treatment of benign prostatic hyperplasia (BPH), a common problem faced by aging men, has changed dramatically during the last decade. While BPH has long been considered a surgical condition, the advent of less invasive therapies makes the evaluation of the use of these various treatments important. Thus, this population based study was undertaken to describe the incidence and treatment for BPH from 1987 to 1997 among residents of Olmsted County, Minnesota. MATERIALS AND METHODS: We identified all Olmsted County men with a new diagnosis of BPH from 1987 to 1997 through the Medical and Surgical Indices made available through the Rochester Epidemiology Project. Overall year and age specific incidence rates were calculated for diagnosed BPH and by treatment type (surgical, minimally invasive, pharmacological, watchful waiting) assuming all men of the Olmsted County population to be at risk. Temporal changes in incidence were analyzed by Poisson regression. RESULTS: From 1987 to 1997, 2,330 cases of BPH were identified representing an age adjusted, corrected incidence for BPH among male residents of Olmsted County of 854.7 per 100,000 men. While the incidence of BPH increased from 1987 to 1992, coinciding with the introduction of serum prostate specific antigen testing, and subsequently decreased through 1997, the overall incidence of BPH decreased during the 10-year period for the entire cohort (p =0.002). Although the incidence of watchful waiting appeared to increase in the mid 1990s, significant decreases in age adjusted incidence were observed for the period overall (p <0.001). Significant decreases in surgical treatments were observed (p <0.0001). In contrast, there were significant increases in the age adjusted rates of pharmacological treatments during the 10 years (p <0.0001). No significant differences in incidence patterns of treatment type over time were observed by age group. CONCLUSIONS: The introduction of serum prostate specific antigen testing as a screening tool for prostate cancer along with the advent of less invasive alternatives, including pharmacological therapy, have had a significant impact on the incidence of diagnosed BPH in the last decade.
Adrenergic alpha-Antagonists↗
Benign prostatic hyperplasia: from A - Z.
The management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia over the last decade underwent many changes. The introduction of many medical options including alpha blockers and 5 alpha reductase inhibitors provided alternatives to what used to be surgery or "watchful waiting". Alpha blockers evolved over the years from non specific alpha 1, and 2 blockers to alpha 1 selective and then to alpha 1a selective with a wider acceptance due to lack of need to titrate and a better safety profile. 5 alpha reductase inhibitor (finasteride) passed through a lot of changes from being the first medication directed at treating the disease process to less acceptance because of time to response and early data supporting no added benefit when combined to alpha blockers for a short period. Longer studies now demonstrate a benefit to combination causing a reduction of progression parameters and an advantage over 4 years in reducing endpoints, namely acute urinary retention and surgery. Surgical options have also undergone many changes over the last decade with introduction of minimally invasive options as well as the introduction of new energy sources to reduce complications and allow for management of larger glands such as Holmium laser enucleation of the prostate or the use of bipolar loops. The journey has been long and exciting and we are sure Ernie Ramsey enjoyed being in the forefront of the evolution.
5-alpha Reductase Inhibitors↗
Benign prostatic hyperplasia, sexual function, and overall evaluation of the male patient.
Erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) are a significant problem for a large proportion of men in the United States. Lower urinary tract symptoms (LUTS), which are often caused by BPH, and ED are common in the aging male population. From numerous epidemiologic studies, it is well known that the prevalence of BPH and the loss of erectile function increase with advancing age. Men with LUTS have sexual dysfunction, including ejaculatory loss, painful ejaculation, and ED. Even though the pathogenic relationship between BPH and ED is not completely understood, a direct association between these two symptom complexes in aging men is now becoming evident. This presentation reviews the role of LUTS and ED in aging men and noninvasive and invasive treatment modalities for BPH.
Age Factors↗
[Etiology of nocturia and clinical efficacy of naftopidil on nocturia in patients with benign prostatic hyperplasia--analysis of frequency volume charts].
The etiology of nocturia in 70 patients with benign prostatic hyperplasia (BPH) who had nocturia of two or more times were examined based on frequency volume charts (FVC). Nocturia was classified into four groups: nocturnal polyuria, low capacity, combined nocturia, and no evidence of abnormality. Nearly half of the cases had nocturnal polyuria only. A little under 70% of patients had associated nocturnal polyuria (nocturnal polyuria+combined nocturia). Naftopidil was administered for three months to the patients with BPH who had nocturia with a urinary frequency of two or more times. Clinical efficacy was evaluated in 32 patients based on FVC and naftopidil was shown to improve nocturia. The improvement in nocturia was determined by the increment in voided volume.
Adrenergic alpha-Antagonists↗
[Clinical significance of prostatic-specific antigen levels in patients with benign prostatic hyperplasia complicated by low urinary tract syndrome].
OBJECTIVE: To evaluate the clinical significance of prostatic-specific antigen (PSA) levels in patients with benign prostatic hyperplasia (BPH) complicated by low urinary tract syndrome( LUTS). METHODS: The levels of tPSA, fPSA and fPSA/tPSA ratio were detected and compared in 520 cases of BPH with LUTS and 196 cases without LUTS. RESULTS: The mean levels of tPSA in the cases of BPH with LUTS and without LUTS were (5.13 +/- 2.49) microg/L and (1.73 +/- 1.26) microg/L respectively (P<0.01). The mean levels fPSA were (1.57 +/- 0.80) microg/L and (0.54 +/- 0.38) microg/L respectively (P < 0.01). The mean ratios of fPSA/tPSA were (0.31 +/- 0.09) and (0.30 +/- 0.11) respectively ( P > 0.05). CONCLUSION: The levels of tPSA, fPSA are significantly higher in the cases of BPH with LUTS than those in the cases without LUTS, but the ratio of fPSA/tPSA is stable in BPH.
Aged↗