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Jung SJ, Park EO, Chae SW, Lee SO, Kwon JW, You JH, Kim YG. Effects of Unripe Black Raspberry Extract Supplementation on Male Climacteric Syndrome and Voiding Dysfunction: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2023; 15:3313. [PMID: 37571251 PMCID: PMC10421075 DOI: 10.3390/nu15153313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Male climacteric syndrome (MCS) is a medical condition that can affect middle-aged men whose testosterone levels begin to decline considerably. These symptoms may include fatigue, decreased libido, mood swings, and disturbed sleep. MCS can be managed with lifestyle modifications and testosterone replacement. However, testosterone therapy may cause number of side effects, including an increased risk of cardiovascular issues. This study aims to evaluate the efficacy and safety of unripe black raspberry extract (BRE) against MCS and voiding dysfunction in men with andropause symptoms. A total of 30 subjects were enrolled and randomly assigned to the BRE group (n = 15) or the placebo group (n = 15). Participants were supplemented with 4800 mg BRE or placebo twice daily for 12 weeks. The impact of BRE was assessed using the Aging Male's Symptoms (AMS scale), International Prostate Symptom Score (IPSS) and the IPSS quality of life index (IPSS-QoL). Additionally, male sex hormones, lipid profiles, and anthropometric indices were assessed 6 and 12 weeks after treatment. The AMS scores did not differ significantly between the two groups. In the BRE group, the total IPSS and IPSS-QoL scores decreased significantly after 12 weeks compared to baseline (p < 0.05), but there was no significant difference compared to the placebo group. However, a significant difference was observed in the IPSS voiding symptoms sub-score compared to the placebo group. Furthermore, LDL-C and TC levels were also significantly lower in the BRE group than in the placebo group (p < 0.05). Collectively, the study provides strong evidence supporting the safety of BRE as a functional food and its supplementation potentially enhances lipid metabolism and alleviates MCS and dysuria symptoms, limiting the development of BPH.
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Affiliation(s)
- Su-Jin Jung
- Clinical Trial Center for Functional Foods, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea; (S.-J.J.); (E.-O.P.); (S.-W.C.); (S.-O.L.)
- Clinical Trial Center for K-FOOD Microbiome, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
- Research Institute of Clinical Medicine, Medical School, Jeonbuk National University, Jeonju 54907, Republic of Korea
| | - Eun-Ock Park
- Clinical Trial Center for Functional Foods, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea; (S.-J.J.); (E.-O.P.); (S.-W.C.); (S.-O.L.)
- Clinical Trial Center for K-FOOD Microbiome, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Soo-Wan Chae
- Clinical Trial Center for Functional Foods, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea; (S.-J.J.); (E.-O.P.); (S.-W.C.); (S.-O.L.)
- Clinical Trial Center for K-FOOD Microbiome, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
- Research Institute of Clinical Medicine, Medical School, Jeonbuk National University, Jeonju 54907, Republic of Korea
| | - Seung-Ok Lee
- Clinical Trial Center for Functional Foods, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea; (S.-J.J.); (E.-O.P.); (S.-W.C.); (S.-O.L.)
- Clinical Trial Center for K-FOOD Microbiome, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
- Research Institute of Clinical Medicine, Medical School, Jeonbuk National University, Jeonju 54907, Republic of Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical School, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Ji-Wung Kwon
- Berry & Bio Food Research Institute, Gochang, Jeonbuk 56417, Republic of Korea;
| | - Jae-Hyung You
- Department of Urology, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Young-Gon Kim
- Clinical Trial Center for Functional Foods, Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea; (S.-J.J.); (E.-O.P.); (S.-W.C.); (S.-O.L.)
- Research Institute of Clinical Medicine, Medical School, Jeonbuk National University, Jeonju 54907, Republic of Korea
- Department of Urology, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
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Liang QF, Zhang SC, Yu XH, Li JH, Zheng JB, Zhao J, Liang GQ, Shi HJ, Zhou WJ, Zhu QX. Longitudinal changes in prostate volume in a community-based cohort study of middle-aged and elderly men in rural China. Andrology 2019; 8:358-363. [PMID: 31539457 DOI: 10.1111/andr.12711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 08/31/2019] [Accepted: 09/16/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Prostate volume (PV) and its change rate are important for the progression of prostate disease, but studies on their estimates are inconsistent. OBJECTIVES To investigate whether age, prostate-specific antigen (PSA), and other specific characteristics are associated with PV and its change rate. MATERIALS AND METHODS A community-based cohort study was conducted in a rural area of China among male residents aged 40-80 years. PV was estimated at baseline and at 4 years of follow-up by trans-abdominal ultrasound. Annual PV change rate (PVCR) was calculated as change in volume divided by time interval. Baseline characteristics, including age, serum PSA, and hormones, were evaluated. And their relationships with PV or PVCR were assessed with Pearson correlation and multivariate linear regression analyses. RESULTS Totally, 462 participants completed the follow-up with baseline PV (PV0 ) of 15.6 ± 5.5 ml. PV0 was highly correlated with age and PSA in pairwise correlations (Pearson r = 0.35 and 0.34, respectively, p < 0.01). Multivariate linear regression showed similar associations that PV0 tended to increase with age and PSA. The average PVCR was 0.7 ± 1.8 ml/year. In pairwise correlations, PVCR was inversely correlated with PV0 and positively correlated with PSA, while it was not significantly related to baseline age. Linear regression of PVCR on age and PSA in groups classified by PV0 quartile showed that age was not a significant estimator of PVCR, whereas PSA was. In each PV0 group, PVCR tended to increase with PSA. DISCUSSION AND CONCLUSION PV was positively associated with age and PSA, and it tended to grow faster in men with smaller baseline PV and higher PSA. PSA can be a valuable parameter for estimating both the size and the growth speed of prostate. Although age is associated with prostate enlargement, it does not appear to be related to the longitudinal change rate of PV.
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Affiliation(s)
- Q-F Liang
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - S-C Zhang
- Department of Cell Biology, National Research Institute for Family Planning, Beijing, China
| | - X-H Yu
- Department of Urology, The First People's Hospital of Jiashan, Zhejiang, China
| | - J-H Li
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - J-B Zheng
- Department of Urology, The First People's Hospital of Jiashan, Zhejiang, China
| | - J Zhao
- Department of Cardiology, the Key Laboratory of Cardiovascular Disease, The First Hospital of Lanzhou University, Lanzhou, China
| | - G-Q Liang
- Department of Urology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - H-J Shi
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - W-J Zhou
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Q-X Zhu
- Department of Reproductive Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
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Accurate Estimation of Prostate Size in the Evaluation of Nocturia. CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0420-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Stone BV, Shoag J, Halpern JA, Mittal S, Lewicki P, Golombos DM, Bedretdinova D, Chughtai B, Barbieri CE, Lee RK. Prostate size, nocturia and the digital rectal examination: a cohort study of 30 500 men. BJU Int 2016; 119:298-304. [DOI: 10.1111/bju.13613] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Benjamin V. Stone
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Jonathan Shoag
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Joshua A. Halpern
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Sameer Mittal
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Patrick Lewicki
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - David M. Golombos
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Dina Bedretdinova
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Bilal Chughtai
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Christopher E. Barbieri
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
| | - Richard K. Lee
- Department of Urology; Weill Cornell Medical College/NewYork Presbyterian Hospital; New York NY USA
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Putra IBO, Hamid AR, Mochtar CA, Umbas R. Relationship of age, prostate-specific antigen, and prostate volume in Indonesian men with benign prostatic hyperplasia. Prostate Int 2016; 4:43-8. [PMID: 27358842 PMCID: PMC4916066 DOI: 10.1016/j.prnil.2016.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To investigate the relationship between age, prostate specific antigen (PSA), and prostate volume (PV) in Indonesian men with histologically proven benign prostatic hyperplasia. METHODS Data were generated from our BPH database from June 1994 until December 2013. Subjects were men with a minimum age of 40 years with chief complaint of LUTS or urinary retention, diagnosed with BPH. All patients underwent TRUS-guided prostate biopsy. Patients with PSA level >10 ng/mL were excluded from the study to exclude the possibility of occult prostate cancer. PV was measured with TRUS. Appropriate statistical tests were employed for data analysis. RESULTS In all, 1638 patients were enrolled in our study. There was a statistically significant difference in PSA (P = 0.03) and PV (P < 0.0001) between age groups. Overall correlation between age, PSA, and PV were: i). Age and PV (r = 0.12, P < 0.0001); ii). Age and PSA (r = 0.07, P = 0.008); iii). PSA and PV (r = 0.26, P < 0.0001). Subgroup analysis in terms of indwelling catheter use versus without: i). Age 66.09 ± 8 years versus 65.38 ± 7.66 years (P = 0.158); ii). PSA 4.93 ± 2.62 ng/mL versus 4.68 ± 2.82 ng/mL (P = 0.038); iii). PV 47.58 ± 21.33 mL versus 41.43 ± 20.55 mL (P < 0.0001). Correlation between age, PSA, and PV in patients were similar in patients with and without indwelling catheter. CONCLUSION In Indonesian men with biopsy-proven BPH, both PV and PSA increased with ageing. Prostate volume was significantly correlated with PSA. Even though the results were weaker, these results are consistent with results in other sets of population. The results vary between different countries and thus, ethnicities. Indonesia is a populous a sociocultural and ethnically diverse country. Therefore, aside from PSA, age, and PV, when investigating men with BPH, ethnicity may also need to be taken into account.
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Affiliation(s)
| | | | | | - Rainy Umbas
- Department of Urology, Faculty of Medicine University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Shirazi M, Ariafar A, Zeyghami S, Hosseini MM, Khezri AA. Association of diet with prostate specific antigen and prostate volume. Nephrourol Mon 2014; 6:e19411. [PMID: 25695023 PMCID: PMC4317717 DOI: 10.5812/numonthly.19411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 05/12/2014] [Indexed: 11/16/2022] Open
Abstract
Background: Prostate is an important male reproductive system gland and its disorders can affect men's quality of life and health. Prostatitis, benign prostatic hyperplasia (BPH), and prostate adenocarcinoma are major disorders that can be found in all men in different ages. Objectives: The aim of this study was to investigate the association of diet with serum prostate specific antigen (PSA) level as well as prostate volume. Patients and Methods: In this cross-sectional study, 950 men older than 40 years of age who had attended our clinic for a screening program for prostate cancer were enrolled. Data was extracted from the program database. The eligible cases included all noncancerous subjects with available data concerning serum PSA level and prostate volume; the patients had completed a 50-item self-administered food frequency questionnaire about their diet during the preceding two year. Results: No overall association was found between the consumption of foods and prostate volume as well as serum PSA level. There was a significant correlations between age and serum PSA level (r = 0.24) as well as with prostate volume (r = 0.22) (P < 0.001). In addition, there was a significant correlation between serum PSA level and prostate volume (r = 0.41 and P < 0.001). Conclusions: The results of this study confirmed the previous reports regarding the serum PSA level correlation with prostate volume. There was no evidence that dietary patterns might have any important effect on prostate volume and serum PSA in this Iranian population.
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Affiliation(s)
- Mehdi Shirazi
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Ali Ariafar
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Urology Oncology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Ali Ariafar, Urology Oncology Research Center and Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7112330724, E-mail:
| | - Shahryar Zeyghami
- Urology Oncology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Mohammad Mehdi Hosseini
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Abdol Aziz Khezri
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Park DS, Hong JY, Hong YK, Lee SR, Hwang JH, Kang MH, Kwon SW, Oh JJ. Correlation Between Serum Prostate Specific Antigen Level and Prostate Volume in a Community-based Cohort: Large-scale Screening of 35,223 Korean Men. Urology 2013; 82:1394-9. [DOI: 10.1016/j.urology.2013.07.071] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/18/2013] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
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Park DS, Oh JJ, Hong JY, Hong YK, Choi DK, Gong IH, Hwang JH, Kwon SW. Serum prostate-specific antigen as a predictor of prostate volume and lower urinary tract symptoms in a community-based cohort: a large-scale Korean screening study. Asian J Androl 2013; 15:249-53. [PMID: 23353717 DOI: 10.1038/aja.2012.132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim of this study is to assess the ability of serum prostate-specific antigen (PSA) to predict prostate volume (PV) and lower urinary tract symptoms (LUTS) represented by the international prostate symptom score (IPSS). From January 2001 to December 2011, data were collected from men who first enrolled in the Korean Prostate Health Council Screening Program. Patients with a serum PSA level of >10 ng ml(-1) or age <40 years were excluded. Accordingly, a total of 34 857 men were included in our study, and serum PSA, PV and the IPSS were estimated in all patients. Linear and age-adjusted multivariate logistic analyses were used to assess the potential association between PSA and PV or IPSS. The predictive value of PSA for estimating PV and IPSS was assessed based on the receiver operating characteristics-derived area under the curve (AUC). The mean PV was 29.9 ml, mean PSA level was 1.49 ng ml(-1) and mean IPSS was 15.4. A significant relationship was shown between PSA and PV, and the IPSS and PSA were also significantly correlated after adjusting by age. The AUCs of PSA for predicting PV >20 ml, >25 ml and >35 ml were 0.722, 0.728 and 0.779, respectively. The AUCs of PSA for predicting IPSS >7, >13 and >19 were 0.548, 0.536 and 0.537, respectively. Serum PSA was a strong predictor of PV in a community-based cohort in a large-scale screening study. Although PSA was also significantly correlated with IPSS, predictive values of PSA for IPSS above the cutoff levels were not excellent. Further investigations are required to elucidate the exact interactions between PSA and LUTS and between PSA and PV in prospective controlled studies. Such studies may suggest how PSA can be used to clinically predict PV and the IPSS.
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Affiliation(s)
- Dong Soo Park
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Nakanishi Y, Masuda H, Kawakami S, Sakura M, Fujii Y, Saito K, Koga F, Ito M, Yonese J, Fukui I, Kihara K. A novel equation and nomogram including body weight for estimating prostate volumes in men with biopsy-proven benign prostatic hyperplasia. Asian J Androl 2012; 14:703-7. [PMID: 22773012 DOI: 10.1038/aja.2012.31] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Anthropometric measurements, e.g., body weight (BW), body mass index (BMI), as well as serum prostate-specific antigen (PSA) and percent-free PSA (%fPSA) have been shown to have positive correlations with total prostate volume (TPV). We developed an equation and nomogram for estimating TPV, incorporating these predictors in men with benign prostatic hyperplasia (BPH). A total of 1852 men, including 1113 at Tokyo Medical and Dental University (TMDU) Hospital as a training set and 739 at Cancer Institute Hospital (CIH) as a validation set, with PSA levels of up to 20 ng ml(-1), who underwent extended prostate biopsy and were proved to have BPH, were enrolled in this study. We developed an equation for continuously coded TPV and a logistic regression-based nomogram for estimating a TPV greater than 40 ml. Predictive accuracy and performance characteristics were assessed using an area under the receiver operating characteristics curve (AUC) and calibration plots. The final linear regression model indicated age, PSA, %fPSA and BW as independent predictors of continuously coded TPV. For predictions in the training set, the multiple correlation coefficient was increased from 0.38 for PSA alone to 0.60 in the final model. We developed a novel nomogram incorporating age, PSA, %fPSA and BW for estimating TPV greater than 40 ml. External validation confirmed its predictive accuracy, with AUC value of 0.764. Calibration plots showed good agreement between predicted probability and observed proportion. In conclusion, TPV can be easily estimated using these four independent predictors.
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Affiliation(s)
- Yasukazu Nakanishi
- Department of Urology, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
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Masuda H, Kawakami S, Sakura M, Fujii Y, Koga F, Saito K, Numao N, Yonese J, Fukui I, Kihara K. Performance of prostate-specific antigen mass in estimation of prostate volume in Japanese men with benign prostate hyperplasia. Int J Urol 2012; 19:929-35. [PMID: 22694207 DOI: 10.1111/j.1442-2042.2012.03069.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Obese men with benign prostate hyperplasia might have lower serum prostate-specific antigen because of hemodilution, resulting in underestimation of total prostate volume by serum prostate-specific antigen. The aim of this study was to compare the performance of prostate-specific antigen mass as the absolute amount of prostate-specific antigen protein secreted into circulation with that of serum prostate-specific antigen in the prediction of total prostate volume. METHODS A total of 1517 men with serum prostate-specific antigen up to 10 ng/mL, including 1425 with biopsy-proven benign prostate hyperplasia, were enrolled in this study. Height and weight were used to estimate body mass index, body surface area and plasma volume. Prostate-specific antigen mass was calculated as serum prostate-specific antigen multiplied by plasma volume. The association between serum prostate-specific antigen or prostate-specific antigen mass and transrectal ultrasound-measured total prostate volume were evaluated by Pearson's correlation coefficient (Υ), linear regression analyses and receiver operating characteristic curves. RESULTS Serum prostate-specific antigen had an inverse relationship with plasma volume, decreasing as plasma volume increased, after adjustment of total prostate volume. Larger total prostate volume per serum prostate-specific antigen was found in men with higher body mass index or plasma volume. Among all participants, the correlation (Υ = 0.456) between prostate-specific antigen mass and total prostate volume was apparently stronger than that (Υ = 0.442) between serum prostate-specific antigen and total prostate volume. Prostate-specific antigen mass outperformed serum prostate-specific antigen at estimating total prostate volume cut-off values of 30 and 40 mL. These findings were more significant in men aged ≥60 years. CONCLUSIONS Prostate-specific antigen mass performs better than serum prostate-specific antigen in estimating TPV, especially in men aged ≥60 years.
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Affiliation(s)
- Hitoshi Masuda
- Department of Urology, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan.
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Marschall J, Zhang L, Foxman B, Warren DK, Henderson JP. Both host and pathogen factors predispose to Escherichia coli urinary-source bacteremia in hospitalized patients. Clin Infect Dis 2012; 54:1692-8. [PMID: 22431806 DOI: 10.1093/cid/cis252] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The urinary tract is the most common source for Escherichia coli bacteremia. Mortality from E. coli urinary-source bacteremia is higher than that from urinary tract infection. Predisposing factors for urinary-source E. coli bacteremia are poorly characterized. METHODS In order to identify urinary-source bacteremia risk factors, we conducted a 12-month prospective cohort study of adult inpatients with E. coli bacteriuria that were tested for bacteremia within ±1 day of the bacteriuria. Patients with bacteremia were compared with those without bacteremia. Bacterial isolates from urine were screened for 16 putative virulence genes using high-throughput dot-blot hybridization. RESULTS Twenty-four of 156 subjects (15%) had E. coli bacteremia. Bacteremic patients were more likely to have benign prostatic hyperplasia (56% vs 19%; P = .04), a history of urogenital surgery (63% vs 28%; P = .001), and presentation with hesitancy/retention (21% vs 4%; P = .002), fever (63% vs 38%; P = .02), and pyelonephritis (67% vs 41%; P = .02). The genes kpsMT (group II capsule) (17 [71%] vs 62 [47%]; P = .03) and prf (P-fimbriae family) (13 [54%] vs 40 [30%]; P = .02) were more frequent in the urinary strains from bacteremic patients. Symptoms of hesitancy/retention (odds ratio [OR], 7.8; 95% confidence interval [CI], 1.6-37), history of a urogenital procedure (OR, 5.4; 95% CI, 2-14.7), and presence of kpsMT (OR, 2.9; 95% CI, 1-8.2) independently predicted bacteremia. CONCLUSIONS Bacteremia secondary to E. coli bacteriuria was frequent (15%) in those tested for it. Urinary stasis, surgical disruption of urogenital tissues, and a bacterial capsule characteristic contribute to systemic invasion by uropathogenic E. coli.
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Affiliation(s)
- Jonas Marschall
- Division of Infectious Diseases, Washington University School of Medicine, St Louis, Missouri, USA
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Age-stratified normal values for prostate volume, PSA, maximum urinary flow rate, IPSS, and other LUTS/BPH indicators in the German male community-dwelling population aged 50 years or older. World J Urol 2011; 29:171-8. [DOI: 10.1007/s00345-010-0638-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 12/16/2010] [Indexed: 10/18/2022] Open
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Abstract
Male lower urinary tract symptoms, benign prostatic hyperplasia, enlargement of the prostate, and bladder outlet obstruction are common among aging men and will increase in socioeconomic and medical importance at a time of increased life expectancy and aging of the baby boomer generation. This article reviews the epidemiology, management, and therapeutic options for these conditions. In patients bothered by moderate to severe symptoms, providers can make educated and differential choices between several classes of drugs, alone or in combination, to treat effectively and improve the symptoms in most men. Despite the efficacy of medical therapy, there will be patients who require referral to a urologist either early, to rule out prostate cancer and other conditions, or later, after initial medical therapy and lifestyle management has failed. Perhaps as many as 30% of patients fail to achieve sufficient symptom improvement with medication, lifestyle adjustment, and fluid management, and may require more invasive or surgical treatment options.
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Affiliation(s)
- Claus G Roehrborn
- Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, J8 142, Dallas, TX 75390-9110, USA.
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Mosli HA, Abdel-Meguid TAA. The relationship between prostate volume, prostate-specific antigen and age in Saudi men with benign prostatic conditions. AFRICAN JOURNAL OF UROLOGY 2010. [DOI: 10.1007/s12301-010-0025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Auffenberg GB, Helfand BT, McVary KT. Established Medical Therapy for Benign Prostatic Hyperplasia. Urol Clin North Am 2009; 36:443-59, v-vi. [DOI: 10.1016/j.ucl.2009.07.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tsukamoto T, Masumori N, Nakagawa H, Arai Y, Komiya A, Ichikawa T, Takei M, Yamaguchi A, Liu Y, Crane MM. Changes in prostate volume in Japanese patients with benign prostatic hyperplasia: Association with other urological measures and risk of surgical intervention. Int J Urol 2009; 16:622-7. [DOI: 10.1111/j.1442-2042.2009.02323.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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González-Díaz H, González-Díaz Y, Santana L, Ubeira FM, Uriarte E. Proteomics, networks and connectivity indices. Proteomics 2008; 8:750-78. [DOI: 10.1002/pmic.200700638] [Citation(s) in RCA: 170] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Bohnen AM, Groeneveld FP, Bosch JLHR. Serum Prostate-Specific Antigen as a Predictor of Prostate Volume in the Community: The Krimpen Study. Eur Urol 2007; 51:1645-52; discussion 1652-3. [PMID: 17320271 DOI: 10.1016/j.eururo.2007.01.084] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2005] [Accepted: 01/23/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Serum prostate-specific antigen (PSA) is considered a proxy for prostate volume (PV). This study investigates which range of PSA values has the best utility in the determination of PV (<30 cc, at 30, 40, and 50 cc), and whether PSA performs better than digital rectal examination (DRE) when estimating PV. METHODS In a population-based follow-up study of 1688 men in Krimpen aan den IJssel, The Netherlands, at baseline we estimated PV by DRE and by transrectal planimetric ultrasound (TRUS), in addition to measuring PSA. Men who tested positive for prostate cancer (PCa) at baseline and at 2 and 4 yr of follow-up were excluded from the analyses (n=142). Of the men without PCa, PSA and PV data were available in 1524 participants. RESULTS Of all 1524 men analysed, 76.7% had a PSA of 0-2.0, 15.0% had a PSA of 2.1-4.0, and 8.3% a PSA>4. Low PSA ranges (0-2 and 2.1-4.0) discriminate better for a PV of 30 cc (eg, in men with a PSA range of 2.1-2.5 ng/ml there was a 72% chance of having a PV>30 cc). Higher ranges of PSA (>4.0) discriminate better for a PV>40 or 50 cc. (eg, in men with a PSA in the range of 4.1-7.0 ng/ml there was a 69% chance of having a PV>40 cc and in men with a PSA>10 ng/ml there was a 75% chance of a PV>50 cc). The receiver operating curve (ROC) for the performance of PSA in estimating a PV>30 cc shows an area under the curve (AUC) of 0.79, denoting reasonable discrimination, and AUCs of 0.86 and 0.92, denoting good discrimination of PVs>40 cc and >50 cc, respectively. PSA performed significantly better than DRE at estimating PV. Multiple regression analysis shows that both DRE and an interaction term for age and PSA provided minimal additional information beyond PSA in the prediction of PV; however, their contribution is numerically minimal/not clinically meaningful. CONCLUSIONS In men for whom a diagnosis of PCa has been ruled out, PSA can be used to detect an enlarged prostate (>30 cc and with more accuracy PV>40 or 50 cc). More precision in estimating PV can be obtained when using a formula that contains PSA, age, DRE, and an interaction term between age and PSA; however, the clinical advantage of the formula over PSA alone is only modest as shown by the ROC curves. Thus, for clinicians looking for an easy and fast way to identify patients with an enlarged prostate, PSA is a good approximation for men without PCa.
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Affiliation(s)
- Arthur M Bohnen
- Erasmus MC, Department of General Practice, Rotterdam, The Netherlands.
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St Sauver JL, Jacobson DJ, McGree ME, Lieber MM, Jacobsen SJ. Protective association between nonsteroidal antiinflammatory drug use and measures of benign prostatic hyperplasia. Am J Epidemiol 2006; 164:760-8. [PMID: 16905643 DOI: 10.1093/aje/kwj258] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In 1990-2002, the authors conducted a population-based cohort study of 2,447 Caucasian men in Olmsted County, Minnesota, to determine whether daily users of nonsteroidal antiinflammatory drugs (NSAIDs) were at lower risk than nondaily NSAID users of developing benign prostatic hyperplasia. Participants completed validated questionnaires during a home visit, including information about daily NSAID use. A random subset of 634 men also participated in a clinical evaluation including transrectal ultrasonography and assessment of serum prostate-specific antigen levels. Examinations and questionnaires were repeated biennially through 2002. Benign prostatic hyperplasia measures included development of moderate/severe urinary symptoms (American Urological Association Symptom Index score >7), low maximum urinary flow rate (<12 ml/second), prostate volume >30 ml, or prostate-specific antigen level >1.4 ng/ml. After adjustment for age, daily NSAID use was inversely associated with onset of moderate/severe urinary symptoms (hazard ratio (HR) = 0.73, 95% confidence interval (CI): 0.64, 0.82), low maximum flow rate (HR = 0.51, 95% CI: 0.43, 0.61), increased prostate volume (HR = 0.53, 95% CI: 0.41, 0.68), and elevated prostate-specific antigen level (HR = 0.52, 95% CI: 0.40, 0.68). In age-specific analyses, inverse associations between NSAID use and urinary measures tended to be stronger in the oldest age groups, although this interaction was statistically significant for only obstructive symptoms and treatment. Results suggest that NSAID use may prevent or delay development of benign prostatic hyperplasia.
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Affiliation(s)
- Jennifer L St Sauver
- Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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Gittelman M, Ramsdell J, Young J, McNicholas T. Dutasteride Improves Objective and Subjective Disease Measures in Men With Benign Prostatic Hyperplasia and Modest or Severe Prostate Enlargement. J Urol 2006; 176:1045-50; discussion 1050. [PMID: 16890688 DOI: 10.1016/j.juro.2006.04.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE We determined whether the effect of dutasteride for benign prostatic hyperplasia is influenced by baseline prostate volume using data from 3 phase III clinical trials. MATERIALS AND METHODS Patients randomized to dutasteride or placebo in the double-blind portion of the phase III studies were eligible to receive 0.5 mg dutasteride daily in a 2-year open label extension in dutasteride/dutasteride and placebo/dutasteride groups. Patients were prospectively stratified according to baseline prostate volume 30 to less than 40 and 40 cc or greater. RESULTS In patients treated with dutasteride throughout the study (dutasteride/dutasteride group) the mean reduction in prostate volume from baseline to month 48 was 30.3% in those with a baseline prostate volume of 30 to less than 40 cc and 26.2% in those with a prostate volume of 40 cc or greater. Mean improvements in peak urinary flow from baseline to month 48 were 2.7 ml per second regardless of baseline prostate volume. Improvements in the American Urological Association symptom index score were 6.3 in men with a prostate volume of 30 to less than 40 cc and 6.5 in those with a prostate volume of 40 cc or greater. No significant relationships between treatment effect and baseline prostate volume were observed for these parameters. In dutasteride/dutasteride treated patients the risk of acute urinary retention was decreased by 60% in those with a prostate volume of 30 to less than 40 cc and 55% in those with a prostate volume of 40 cc or greater vs values in placebo/dutasteride treated patients (p = 0.036 and <0.001, respectively). The corresponding values for benign prostatic hyperplasia related surgery were 27% and 48% (p = 0.35 and <0.001, respectively). CONCLUSIONS This analysis demonstrates that dutasteride significantly improves objective (prostate volume and peak urinary flow) and subjective (symptom scores) measures even in patients with only a slightly enlarged prostate (30 to less than 40 cc). The risks of acute urinary retention and benign prostatic hyperplasia related surgery were decreased regardless of baseline prostate volume.
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Affiliation(s)
- Marc Gittelman
- South Florida Medical Research, 21150 Biscayne Boulevard, Aventura, FL 33180, USA
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Sosna J, Rofsky NM, Gaston SM, DeWolf WC, Lenkinski RE. Determinations of prostate volume at 3-Tesla using an external phased array coil: comparison to pathologic specimens. Acad Radiol 2003; 10:846-53. [PMID: 12945918 DOI: 10.1016/s1076-6332(03)00015-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
RATIONALE AND OBJECTIVES To compare techniques for measuring in vivo prostate volumes using torso phased-array imaging at 3-Tesla. METHODS Eleven patients imaged at 3-Tesla with a torso-phased array coil using multiplanar fast spin echo (FSE) T2-weighted imaging who underwent radical prostatectomy comprised the study population. Surgical specimens were imaged. The pathologic specimen volume was compared with varieties of magnetic resonance volume determinations, the latter using ellipsoid and planimetric assessments. Three-dimensional images of the excised prostate were generated. Linear correlation coefficients were calculated comparing volume determinations from image data and pathologic data. RESULTS Correlation coefficient (r2) values from the ellipsoid formula among six different data sets ranging between 0.325 to 0.751; the highest in vivo r2 value was obtained by multiplying the anterior-posterior and the superior-inferior dimensions from the sagittal image by the right-left dimension from the axial image. The r2 values of the planimetric volume and specimen 3-dimensional volume rendering were 0.652 and 0.86, respectively. CONCLUSIONS Surface coil prostate imaging at 3-Tesla provides undistorted images for volume assessment and in vivo volume determinations very close to ex vivo imaging volume determinations.
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Affiliation(s)
- Jacob Sosna
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
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