SEARCH · Search PubMed

Results for “Prostatic Hyperplasia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,675 records · Page 93Linked to original sources

PubMed2003

Transurethral electrovaporization for giant prostatic hyperplasia: report of a case.

Although open simple prostatectomy remains the reference standard for the treatment of excessively large or giant prostatic hyperplasia, advances in technology and techniques have facilitated safe transurethral management of select cases. We report a case undergoing removal over 200 g of prostatic adenoma by three transurethral electrovaporization (TVP) sessions and discuss its feasibility in clinical use.

Aged↗

PubMed2006

The economics of medical therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia.

Medical therapy is currently the most popular treatment choice for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Because medical therapy of BPH-related LUTS is considered a life-long strategy, short- and long-term cost considerations should play a major role in therapeutic decision-making. The effectiveness in terms of long and short amelioration of symptoms, flow rate, and quality of life are well documented for 5alpha-blockers and 5alpha-reductase inhibitors as well as for the gold standard treatment for BPH, transurethral resection of the prostate and minimally invasive therapies. Short- and long-term safety concerns also are well documented for these various treatment options. On the contrary, short- and long-term costs have been less well studied and comparisons depend on the model or analyses undertaken in the few studies available. However, the economic studies based on prospective clinical trial data that have become available throughout the past several decades allow us to rationalize our use of alpha- blockers, 5alpha-reductase inhibitors, and combination therapy, taking into consideration age, severity of symptoms, prostate volume, prostate-specific antigen, and the differential response of the various medications (and combination) in selected patients. Based on current studies, 5alpha-blockers generally provide cost-effective therapy for most patients, whereas 5alpha-reductase therapy and combination therapy provide cost-effective treatment for patients with larger prostate glands or higher baseline prostate-specific antigen levels.

Cost of Illness↗

PubMed1986

A double-blind trial of the effect of beta-sitosteryl glucoside (WA184) in the treatment of benign prostatic hyperplasia.

Cholesterol-lowering agents are still used in some countries for the treatment of benign prostatic hyperplasia (BPH). A randomized, double-blind, placebo-controlled urodynamic study, carried out on 53 patients with proven outflow obstruction, has failed to prove that the drug, beta-sitosteryl beta-D-glucoside (WA184), is superior to placebo in the treatment of outflow obstruction due to BPH when administered at a dose of 0.3 mg/day. Possible reasons for this include an insufficient dose and duration of treatment (this drug is known to have a potent effect on cholesterol metabolism in the prostate) and the predominantly stromal pathological changes which characterize BPH and which may be unaffected by such agents.

Aged↗

PubMed2003

5-alpha-Reductase Inhibitors Prevent the Progression of Benign Prostatic Hyperplasia.

Lower urinary tract symptoms (LUTS) associated with clinical benign prostatic hyperplasia (BPH) are a common occurrence in aging men, causing bother and interference with daily activities and affecting disease-specific quality of life. There is increasing evidence to suggest that, in many patients, the signs and symptoms of BPH are progressive. Progression can be measured as continued growth of the prostate gland; worsening of symptoms, bother, or quality of life; deterioration of urinary flow rate; episodes of acute urinary retention (AUR); and need for prostate-related surgery. Furthermore, it has become clear that the risk of disease progression increases with age as well as with increasing prostate volume and serum prostate-specific antigen (PSA) level. The 5-alpha-reductase inhibitor finasteride has been shown not only to improve symptoms, bother, and quality of life but also to prevent progression to AUR and surgery, with a relative risk reduction of over 50%. As the risk for such progression is higher in patients with larger glands or higher serum PSA values at baseline, it is in those patients that finasteride induces an even greater risk reduction, making it a cost-effective treatment choice for patients with LUTS associated with prostatic enlargement.

Journal Article↗

PubMed2003

5-alpha-Reductase Inhibitors Prevent the Progression of Benign Prostatic Hyperplasia.

Journal Article↗

PubMed1978

Subnormal tissue 3 alpha-androstanediol and androsterone in prostatic hyperplasia.

We investigated the role of 3 alpha-androstanediol (3 alpha-diol) in the development of benign prostatic hyperplasia (BPH) and the apparent equilibrium of enzymes which metabolize it in normal and hyperplastic prostatic tissue of humans. We determined the endogenous concentrations of 3 alpha-diol, androsterone, its 3 alpha-17-keto metabolite or precursor, and 5 alpha-dihydrotestosterone (DHT), its 3-keto,17 beta-hydroxy product of precursor, by RIA after extraction and paper chromatography of the androgens from normal and hyperplastic prostate glands. The mean concentrations of 3 alpha-diol and androsterone were about one-third of normal in BPH. The mean ratio of the concentration of DHT to 3 alpha-diol was significantly higher (P less than 0.005) than normal in BPH, whereas no statistical difference was observed for the mean ratio of the tissue levels of 3 alpha-diol to androsterone in the two groups. Our data do not support the postulate that 3 alpha-diol is causally related to the development of BPH. However, they indicate that the apparent equilibrium of the 3 alpha-hydroxysteroid oxidoreductase favors the formation of the 3-keto-oxidized product, DHT, which may have relevance to the occurrence of the renewed growth of the prostate of aging men.

Androgens↗

PubMedDate not supplied

[Automated complex diagnosis and choice of treatment method in benign prostatic hyperplasia].

The paper deals with rational choice of conservative and surgical treatment of patients with benign prostatic hyperplasia (BPH), based on an automatic diagnostic approach and realization of four stages of a logistic model of choice of BPH treatment policy with individual features of the status of urological patients being borne in mind. The procedure was tested in 72 patients from a Voronezh regional clinical hospital of the South-Western Railway, in 92 patients from a Voronezh regional clinical treatment-and-diagnosis center. The values of informative parameters were obtained on the basis of computer-aided patients' self-testing, results of baseline examinations, up-to-date non-invasive studies of the prostate: urofluometry, ultrasound bilocation, MR tomography, etc. The findings lead to the conclusion that integration of computer technologies and up-to-date medical equipment is promising for enhancing the quality of diagnosis and treatment of BPH.

Diagnosis, Computer-Assisted↗

PubMed2001

Interactions between prostate volume, filling cystometric estimated parameters, and data from pressure-flow studies in 565 men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.

The aim of this study was to establish the characteristics and to investigate the interactions between prostate volume, degree of obstruction, bladder contractility, the prevalence of residual volume, bladder compliance, bladder capacities, and the prevalence of instability in a large, well-defined group of men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). The 565 consecutive men included in this study met the criteria of the International Consensus Committee on BPH and voided more than 150 mL during uroflowmetry. Their residual urine volume and prostate size were estimated, and filling cystometry and pressure-flow studies were performed. Fifty-three percent of the men appeared to have obstruction. We found a positive correlation between prostate volume and Schäfer's obstruction grade, except that mean prostate volume decreased at Schäfer's grades 5 and 6. Significant negative correlations existed between Schäfer's grade and cystometric bladder capacity and effective capacity. Bladder outlet obstruction results in incomplete emptying. Of all men, 26% had a significant residual volume ( > 20% of cystometric capacity). Thirty-nine percent did not have residual volume. Of the 565 men, 46% had an unstable bladder. In particular, patients with an unstable bladder in the sitting and lying positions have a significantly higher Schäfer's grade and contractility grade and a significantly lower cystometric and effective bladder capacity compared with patients without instability. Patients with a residual volume or instability were significantly older. We conclude that in men with LUTS suggestive of BPH, abnormalities of bladder and bladder outlet function vary greatly and have complex mutual interactions.

Aged↗

PubMed1999

Nitric oxide based influence of nitrates on micturition in patients with benign prostatic hyperplasia.

BACKGROUND: Nitric oxide (NO) is involved in the physiologic regulation of smooth muscle relaxation in the prostate. Organic nitrates act as NO donors. In this prospective open study we prove the influence of orally given nitrates on micturition. METHODS: Thirty-two patients underwent a urological medical check-up prior to starting nitrate medication for cardiovascular disease. We examined peak flow rates, residual urine, IPS-score, PSA level and prostate volume. Exact inclusion and exclusion criteria were defined. Fifteen patients suffered from obstructive symptoms, 17 patients reported no subjective micturition problems. Urological re-evaluation was performed two weeks and three months after nitrate medication. RESULTS: A significant improvement of peak urinary flow rates (+3.1 ml/s; p<0.05), IPS score and significant decrease of residual urine volume (-22 ml; p<0.05) were found in the symptomatic patients. No significant changes of micturition parameters were found in asymptomatic patients. PSA levels and prostate volumes did not change in either groups. CONCLUSIONS: Organic nitrates influence micturition parameters in patients with obstructive benign prostatic hyperplasia. This might be explained by the known mechanism of NO donation (smooth muscle relaxation) of nitrates. More functional controlled studies are necessary to describe the grade of influence of nitrates on the prostate. Concomitant oral medication with nitrates must be considered as a relevant bias factor on BPH in future clinical studies.

Aged↗

PubMed1991

Benign prostatic hyperplasia: surgical versus nonsurgical treatment. A critical review.

With the advent of new treatments for benign prostatic hyperplasia (BPH), the urologist must objectively assess the results of new and traditional therapeutic options. This requires three sets of data-not all of which may be readily available-including a precise knowledge of the natural history of BPH; an objective assessment of the results of surgery, both open and transurethral; and an accurate estimate of objective and subjective results of medical treatment based on randomized studies with a placebo arm. The two types of medical treatment available are hormonal and neuropharmacologic manipulation. Hormonal treatment, using agents such as luteinizing hormone-releasing hormone agonists or antiandrogens, reduces the volume of the epithelial component of the prostate, but urodynamic improvement does not always parallel volumetric reduction. Neuropharmacologic treatment using alpha-blockers alone or in combination with anticholinergic agents has no effect on prostatic volume, but reduces the tone of the muscular component.

Androgen Antagonists↗

PubMed1997

[Phytotherapy of benign prostatic hyperplasia].

Phytopharmaceutical agents have been used for a long time in the treatment of symptomatic benign prostatic hyperplasia (BPH). However, until recently, it has been questioned whether phytotherapy is superior to a placebo treatment. In this article, the most widely used phytopharmaceutical agents, such as saw palmetto berry extracts, Radix urticae extracts, pumpkin seeds, pollen extracts and different phytosterols, are described. In addition, both in vitro and in vivo studies are discussed in an attempt to explain a possible mechanism of action. There are several new clinical studies which demonstrate a significant benefit compared with placebo treatment. Based on these results, the use of phytopharmaceutical agents for the treatment of mild to moderate symptomatic BPH seems to be well justified. So far, no significant inhibition of further prostate growth has been demonstrated. For this, a careful follow-up of the patients is necessary so as not to miss a deterioration and perhaps the need for an operation.

Aged↗

PubMed1996

Correlations between parameters in uroflowmetry and histological compositions in patients with benign prostatic hyperplasia.

The objective of this study was to determine whether area densities of histological elements within prostatic adenoma affect objective and subjective parameters of patients with prostatic hyperplasia. Modified uroflowmetry parameters including Qmax/T100, TQmax/T100 and voiding efficiency were also measured. The area densities of histological elements did not affect uroflowmetry parameters. In addition, subjective symptom score was not correlated with morphometric findings. Our findings suggest that the degree of infravesical obstruction as measured by uroflowmetry parameters and symptom scores cannot be explained by the tissue compositions of adenomas alone.

Humans↗

PubMed1989

Dose-dependent hormonal induction of benign prostatic hyperplasia (BPH) in castrated dogs.

A model for the dose-dependent hormonal induction of benign prostatic hyperplasia (BPH) in castrated dogs has been established using subcutaneously implanted Silastic capsules containing 5 alpha-androstane-3 alpha, 17 beta-diol (3 alpha-diol) and estradiol-17 beta. In vivo release rates per capsule approximated 122.0 +/- 4.2 micrograms 3 alpha-diol and 22.7 +/- 0.8 micrograms estradiol per day based on in vitro studies and resulted in dose-dependent increases in serum 3 alpha-diol and dihydrotestosterone concentrations. The implantation of castrated dogs with either 10 or 20 Silastic capsules containing 3 alpha-diol and one capsule containing estradiol or the intramuscular injection of 3 alpha-diol (75 mg/week) and estradiol (0.75 mg/week) for 99 days significantly increased (P less than .01) prostatic weights and total prostatic DNA over intact controls. These treatments also resulted in a histomorphological pattern similar to that observed in dogs with the glandular form of spontaneous BPH. In addition, normal prostatic secretory function as determined by semen volume was maintained in these dogs. Although subcutaneous implantation of five Silastic capsules containing 3 alpha-diol and one capsule containing estradiol into castrated dogs resulted in prostatic weights and total prostatic DNA that were similar (P less than .10) to intact controls, these prostates were characterized histomorphologically by glandular atrophy and squamous metaplasia. Furthermore, prostatic secretory function was decreased (P less than .05) in these animals compared with intact controls at 3 months of treatment. This study has led to the development of a model of steroid-induced BPH that will facilitate the evaluation of competitive androgen-receptor antagonists in the dog.

Androstane-3,17-diol↗

PubMed1992

Finasteride in the treatment of benign prostatic hyperplasia. A urodynamic evaluation.

A group of 69 men with bladder outflow obstruction due to benign prostatic hyperplasia (BPH) were treated in a double-blind, placebo-controlled study with finasteride (Proscar, MK-906), a 5-alpha reductase inhibitor, 5 mg or 10 mg/day or placebo for 3 months; subsequently, 20 patients received finasteride 5 mg/day for a further 9 months in an open extension study. In treated patients dihydrotestosterone declined by over 60%, remaining unchanged with placebo. Symptom scores fell significantly in all 3 groups. Mean maximum flow rates fell slightly in placebo-treated patients but improved by 1.5 ml/s in the 10 mg group and by 3.3 ml/s in the 5 mg group. After 1 year's treatment, the reduction in symptom score and increase in flow rate were well maintained; the mean prostate volume was reduced by 14% and prostatic specific antigen declined by 28%. It was concluded that finasteride shows some efficacy in the treatment of BPH, with minimal toxicity, but 12 months of therapy or longer may be necessary to achieve maximal effect.

Aged↗

PubMed1993

Effects of estrogen deprivation on human benign prostatic hyperplasia.

Sex steroids are thought to play an essential role in the pathogenesis of human benign prostatic hyperplasia (BPH). Since recent studies in animal models and in men have shown that estrogens might be causally linked to the onset and maintenance of BPH, we examined the effect of 1-methyl-androsta-1,4-diene-3,17-dione (Atamestane), a newly developed aromatase inhibitor, in men with BPH. In an open multicenter study 49 men (mean age 70.1 years, range 55 to 84) with obstructive BPH were treated with atamestane (3 x 200 mg/day) for 3 months. Of the 49 patients 44 completed the treatment period; the other patients discontinued the study for reasons unrelated to treatment. With treatment BPH-related symptoms such as daytime voiding frequency, nycturia, peak flow and residual urine improved considerably; however, these parameters did not reach statistical significance. The mean prostatic volume decreased significantly from 74.2 +/- 31.7 to 64.0 +/- 31 ml (mean +/- SD). Serum estrogen levels decreased markedly during treatment. In addition intraprostatic estrogen concentration decreased with treatment as compared to estrogen levels in hyperplastic prostates from untreated patients. The following conclusions can be drawn from this study: first, estrogens appear to have an important supportive role in established BPH, and second, estrogen deprivation improved BPH-related symptoms and reduced significantly prostatic volume.

Aged↗

PubMed2001

High plasma estradiol-17beta levels in dogs with benign prostatic hyperplasia and azoospermia.

The semen quality of 22 dogs (4 to 7 years old) with benign prostatic hyperplasia (BPH) was examined at the hospital of our university, and 4 of the 22 BPH dogs were diagnosed as azoospermic. The mean peripheral plasma estradiol-17beta (E2) level (17.3 pg/ml) of the 18 BPH dogs with spermatogenic function was higher than that of 5 normal male dogs and their mean T level (1.7 ng/ml) was lower. The mean E2 level (27.3 pg/ml) of the 4 BPH dogs with azoospermia was significantly higher than the value in the BPH dogs with spermatogenic function (P<0.01), and the mean T level (1.1 ng/ml) was significantly lower (P<0.05). Five normal male dogs were given 10 intramuscular injections of estradiol benzoate (E2B) 5 microg/kg, at 3-day intervals to investigate the relationship between high plasma E2 levels and the cause of the BPH and azoospermia. Their testes and prostates were measured and biopsied both before and 30 days after the start of E2B injections. At 30 days after the start of the E2B injections, the mean peripheral plasma T levels had decreased by half, and the mean testicular volume had decreased to 88% of original volume. The numbers of spermatocytes, spermatids, and spermatozoa in the seminiferous tubules of all of the dogs were significantly lower (P<0.05, 0.01). In addition, the mean prostatic volume increased to 130%, the mean height of the glandular epithelium decreased, and the glandular lumen became increased in diameter. These findings indicate that both BPH and serious spermatogenic dysfunction may be simultaneously induced by protracted high plasma E2 levels in dogs.

Animals↗

PubMed1993

Long-term urodynamic effects of finasteride in benign prostatic hyperplasia: a pilot study.

A group of 69 men with bladder outflow obstruction due to benign prostatic hyperplasia (BPH) were treated in a double-blind placebo-controlled study with finasteride (Proscar), a 5 alpha-reductase inhibitor, 5 mg or 10 mg/day, or an identical placebo for 3 months; subsequently, 20 patients received finasteride 5 mg/day in an open extension study. Ten of these patients have now completed 3 years of therapy and have been reevaluated with pressure/flow urodynamics. In finasteride-treated patients dihydrotestosterone (DHT) declined by over 60%, remaining unchanged with placebo. Symptom scores fell in both groups of patients, maximum flow rate values decreased on placebo but improved by a mean of 1.5 ml/s in the 10-mg group and 3.3 ml/s in the 5-mg group. After 1 year of therapy, the reduction in symptom score was well maintained and the flow rate had increased by a mean of 2.7 ml/s; the mean prostate volume was reduced by 14% and prostate-specific antigen (PSA) had declined by 28%. In the 10 patients treated for 3 years who consented to further urodynamic study, the maximum urinary flow rate had improved from a mean baseline value of 8.7 ml/s to a mean of 13.8 ml/s, while maximum subtracted voiding pressure had decreased from a mean baseline value of 72 cm H2O to an unobstructed mean value of 44 cm H2O. Side effects were minimal and reversible on stopping the medication.(ABSTRACT TRUNCATED AT 250 WORDS)

5-alpha Reductase Inhibitors↗

PubMed2005

[Evaluation of sexual function in men with symptomatic benign prostatic hyperplasia].

OBJECTIVE: To evaluate the degree of sexual dysfunction in an unselected population of men with benign prostatic hyperplasia (BPH) accompanied by lower urinary tract symptoms (LUTS), and to assess the correlation between sexual dysfunction and urinary symptoms and age. METHODS: A total of 88 men with symptomatic BPH were investigated using the International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), Brief Sexual Function Inventory (BSFI), and the measurement of urinary flow rate, the total prostatic volume and serum testosterone. Regression analysis was used to determine the correlation among the variables. RESULTS: The mean age of the patients was (67.90 +/- 7.59) years, the mean IPSS score was (18.4 +/- 7. 79), and the mean IIEF-5 was (8.50 +/- 8.98). There were 76 cases of erectile dysfunction (86.36%). Among the BSFI scores, the mean sexual drive score was (1.92 +/- 2.21), the mean erectile function score was (4.18 +/- 4.96), the mean ejaculation score was (2.55 +/- 3.57), the mean problem assessment score was (10.44 +/- 3.57), and the mean overall satisfaction score was (1.90 +/- 1.37). Among the 88 cases, 65 (72.86%) had poor sexual drive, 70 (79.55%) erectile dysfunction, and 60 (68.18%) poor ejaculation. There was statistically significant correlation between age and sexual symptom scores for erection (gamma = -0.552, P = 0.000), IIEF-5 scores (gamma = - 0.567, P = 0.000), and IPSS (gamma = 0.213, P = 0.047) as well as between IPSS and sexual symptom scores for erection and overall satisfaction (gamma = -0.332, P = 0.002 and gamma = -0.302, P = 0.005). IIEF-5 scores were significantly correlated with sexual symptom scores for each of the three categories (sexual drive, erection and ejaculation) (P < 0.05). Serum testosterone did not correlate to age, IIEF-5 scores and sexual function (P > 0.05), nor did peak urinary flow rate and total prostatic volume to IPSS, IIEF-5 scores and sexual function (P > 0.05). CONCLUSION: Results of this study suggest that age and LUTS are risk factors of sexual function, and sexual dysfunction is closely related to the severity of LUTS.

Adult↗