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Pak SW, Shin YS, Park HJ. The Relationship between Gut Microbiota and Prostate Health. World J Mens Health 2024; 42:42.e47. [PMID: 38772532 DOI: 10.5534/wjmh.240024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 05/23/2024] Open
Affiliation(s)
- Shang Weon Pak
- Department of Urology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Yu Seob Shin
- Department of Urology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea.
| | - Hyun Jun Park
- Department of Urology, Medical Research Institute of Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
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Abuelnaga M, Elawady H, Mahmoud MA, Mostafa D, Samir M. Does the duration of catheterization have an impact on the outcome of trial without catheter in patients with acute urine retention (AUR) due to benign prostatic hyperplasia (BPH)? A prospective randomized study. Urologia 2024; 91:107-111. [PMID: 38044812 DOI: 10.1177/03915603231215936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
BACKGROUND To study the impact of early in comparison to late catheter removal following acute urine retention (AUR) secondary to benign prostatic hyperplasia (BPH) using silodosin therapy on the outcome of trial without catheter (TWOC). METHODS Two hundred sixty patients with AUR 2ry to BPH were catheterized then were randomly divided to receive silodosin 8 mg either for three or 7 days followed by catheter removal and successful voiding unaided was assessed. RESULTS Out of the 260 men (mean age 64.8 ± 6.5 years) treated, 74 men who were receiving 3 days of silodosin and 88 patients who were receiving 7 days of silodosin didn't require re-catheterization on the day of TWOC (57% and 68% respectively, p = 0.096). Complications like urinary leakage, acute urinary tract infection, hematuria, or catheter blockage recorded in 21 men (16.2%) who received 3 days of silodosin, and in 63 men (48.5%) who received 7 days of silodosin (p ⩽ 0.001). CONCLUSION Patients catheterized after AUR 2ry to BPH can spontaneously void following catheter removal if treated by silodosin, independent of the catheterization duration, while side effects have increased with prolonged catheterization.
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Affiliation(s)
- Mohamed Abuelnaga
- Faculty of Medicine, Department of Urology, Ain Shams University Hospitals, Cairo, Egypt
| | - Hossam Elawady
- Faculty of Medicine, Department of Urology, Ain Shams University Hospitals, Cairo, Egypt
| | - Mahmoud A Mahmoud
- Faculty of Medicine, Department of Urology, Ain Shams University Hospitals, Cairo, Egypt
| | - Diaa Mostafa
- Faculty of Medicine, Department of Urology, Ain Shams University Hospitals, Cairo, Egypt
| | - Mohamed Samir
- Faculty of Medicine, Department of Urology, Ain Shams University Hospitals, Cairo, Egypt
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Marghani BH, Ezz MA, Ateya AI, Fehaid A, Saleh RM, Rezk S. Comparative effects of finasteride and laser-irradiated silver nanoparticles on testicular function and histology in testosterone induced benign prostatic hyperplasia in rats. Life Sci 2023; 324:121747. [PMID: 37137466 DOI: 10.1016/j.lfs.2023.121747] [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: 12/23/2022] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
AIMS The objective of this study was to compare the effects of finasteride, a medication used to treat benign prostatic hyperplasia (BPH), and laser irradiated silver nanoparticles (AgNPs), a potential candidate for BPH therapy (Sanchez-Salas, 2017; Marghani et al., 2022) [1,2], on the sex hormone profiles, sperm quality, steroidogenesis, testicular oxidative stress, and histomorphology changes in BPH rats. MATERIALS AND METHODS BPH was induced in male Sprague-Dawley (SD) rats via intramuscular (i.m.) injection of 5 mg/kg BW testosterone propionate (TP) for 14 days. Once the BPH model was induced, rats were divided into four groups (n = 6) as follows: the control group; the BPH group; the BPH/Fina group, which received 5 mg/kg BW finasteride by oral gavage daily for 14 days; and the BPH/AgNPs group, which received a daily intraperitoneal (i.p.) injection of 50 mg/kg BW AgNPs, followed by 5 min of exposure to a 532 nm NIR laser in the prostatic area for the constitutive 14 days. KEY FINDINGS On day 14, the BPH rats had a significant increase in prostate specific antigen (PSA), dihydrotestosterone, and prostate weights, while testicular weights and sperm quality were significantly lower than in the control rats. On day 28, laser irradiated AgNps treated BPH rats showed improved sex hormone balance, testicular weights, sperm quality, steroidogenesis, and an ameliorative effect on testicular histopathology compared to finasteride. SIGNIFICANCE Surprisingly, these findings suggest that laser irradiated AgNPs can be used as an alternative therapy to finasteride for the treatment of BPH without causing negative effects on the testes.
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Affiliation(s)
- Basma H Marghani
- Department of Physiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; Department of Biochemistry, Physiology, and Pharmacology, Faculty of Veterinary Medicine, King Salman International University, South of Sinaa 46612, Egypt.
| | - Mohamed Aboul Ezz
- Department of Theriogenology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Ahmed I Ateya
- Department of Husbandry & Development of Animal Wealth, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Alaa Fehaid
- Department of Forensic Medicine and Toxicology, Faulty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Rasha M Saleh
- Department of Physiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Shaymaa Rezk
- Department of Cytology and Histology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
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Al-Bakri A, Al-Jaser A, Al-Gamdi K, Al-Reshaid R, Al-Enizi A, Al-Kharji AA, Al-Zahrani I, Al-Modahi N, Al-Harbi M, Al-Mani A. Safety of transurethral resection of large prostate. Urol Ann 2023; 15:162-165. [PMID: 37304516 PMCID: PMC10252772 DOI: 10.4103/ua.ua_192_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 06/18/2022] [Accepted: 06/02/2022] [Indexed: 06/13/2023] Open
Abstract
Background Benign prostatic hyperplasia is a common benign disease occurs in older men. Some patients can be treated medically but eventually, most of them will need a surgical intervention, and the most commonly applied procedure is transurethral resection of the prostate (TURP). Objectives The objective of this study is to assess the feasibility and safety of performing transurethral resection of large prostate (80 g and more). Methodology Out of 153 patients reviewed 48 cases included in this study. The main data collected from patients' files and patient interview. The criteria of exclusion were prostate size <80 g and previous history of TURP. The collected data were analyzed by the Statistical Package for the Social Sciences (SPSS). Results The main results showed that 93.7% of patients did not experience major bleeding postoperatively, neither major drop in hemoglobin level. Moreover, the patient's distribution according to the presence of TUR syndrome was only 2.1% with mild symptoms. No patient had an episode of retention during the hospital stay or in the follow-up. Conclusion Surgeon experience, systematic resection approach, and strict time of resection are important factors to assure the safety of TURP in large prostate. In cases of huge prostate size >100 g, staged TURP can be offered safely or if patients' obstructive symptoms do not resolve after the first procedure.
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Affiliation(s)
- Ayman Al-Bakri
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Abdullah Al-Jaser
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Khalid Al-Gamdi
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Reshaid Al-Reshaid
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Abdullah Al-Enizi
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Ali Ali Al-Kharji
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Ibrahim Al-Zahrani
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Nawaf Al-Modahi
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Moath Al-Harbi
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
| | - Abdullah Al-Mani
- Department of Surgery, Division of Urology, Security Forces Hospital, Riyadh Region, Kingdom of Saudi Arabia
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Awedew AF, Han H, Abbasi B, Abbasi-Kangevari M, Ahmed MB, Almidani O, Amini E, Arabloo J, Argaw AM, Athari SS, Atlaw D, Banach M, Barrow A, Bhagavathula AS, Bhojaraja VS, Bikbov B, Bodicha BBA, Butt NS, Caetano dos Santos FL, Dadras O, Dai X, Doan LP, Eftekharzadeh S, Fatehizadeh A, Garg T, Gebremeskel TG, Getachew ME, Ghamari SH, Gilani SA, Golechha M, Gupta VB, Gupta VK, Hay SI, Hosseini MS, Hosseinzadeh M, Humayun A, Ilic IM, Ilic MD, Ismail NE, Jakovljevic M, Jayaram S, Jazayeri SB, Jema AT, Kabir A, Karaye IM, Khader YS, Khan EA, Landires I, Lee SW, Lee SWH, Lim SS, Lobo SW, Majeed A, Malekpour MR, Malih N, Malik AA, Mehrabi Nasab E, Mestrovic T, Michalek IM, Mihrtie GN, Mirza-Aghazadeh-Attari M, Misganaw AT, Mokdad AH, Molokhia M, Murray CJL, Narasimha Swamy S, Nguyen SH, Nowroozi A, Nuñez-Samudio V, Owolabi MO, Pawar S, Perico N, Rawaf DL, Rawaf S, Rawassizadeh R, Remuzzi G, Sahebkar A, Sampath C, Shetty JK, Sibhat MM, Singh JA, Tan KK, Temesgen G, Tolani MA, Tovani-Palone MR, Valadan Tahbaz S, Valizadeh R, Vo B, Vu LG, Yang L, Yazdanpanah F, Yigit A, Yiğit V, Yunusa I, Zahir M, Vos T, Dirac MA. The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. THE LANCET. HEALTHY LONGEVITY 2022; 3:e754-e776. [PMID: 36273485 PMCID: PMC9640930 DOI: 10.1016/s2666-7568(22)00213-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Benign prostatic hyperplasia is a common urological disease affecting older men worldwide, but comprehensive data about the global, regional, and national burden of benign prostatic hyperplasia and its trends over time are scarce. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated global trends in, and prevalence of, benign prostatic hyperplasia and disability-adjusted life-years (DALYs) due to benign prostatic hyperplasia, in 21 regions and 204 countries and territories from 2000 to 2019. METHODS This study was conducted with GBD 2019 analytical and modelling strategies. Primary prevalence data came from claims from three countries and from hospital inpatient encounters from 45 locations. A Bayesian meta-regression modelling tool, DisMod-MR version 2.1, was used to estimate the age-specific, location-specific, and year-specific prevalence of benign prostatic hyperplasia. Age-standardised prevalence was calculated by the direct method using the GBD reference population. Years lived with disability (YLDs) due to benign prostatic hyperplasia were estimated by multiplying the disability weight by the symptomatic proportion of the prevalence of benign prostatic hyperplasia. Because we did not estimate years of life lost associated with benign prostatic hyperplasia, disability-adjusted life-years (DALYs) equalled YLDs. The final estimates were compared across Socio-demographic Index (SDI) quintiles. The 95% uncertainty intervals (UIs) were estimated as the 25th and 975th of 1000 ordered draws from a bootstrap distribution. FINDINGS Globally, there were 94·0 million (95% UI 73·2 to 118) prevalent cases of benign prostatic hyperplasia in 2019, compared with 51·1 million (43·1 to 69·3) cases in 2000. The age-standardised prevalence of benign prostatic hyperplasia was 2480 (1940 to 3090) per 100 000 people. Although the global number of prevalent cases increased by 70·5% (68·6 to 72·7) between 2000 and 2019, the global age-standardised prevalence remained stable (-0·770% [-1·56 to 0·0912]). The age-standardised prevalence in 2019 ranged from 6480 (5130 to 8080) per 100 000 in eastern Europe to 987 (732 to 1320) per 100 000 in north Africa and the Middle East. All five SDI quintiles observed an increase in the absolute DALY burden between 2000 and 2019. The most rapid increases in the absolute DALY burden were seen in the middle SDI quintile (94·7% [91·8 to 97·6]), the low-middle SDI quintile (77·3% [74·1 to 81·2]), and the low SDI quintile (77·7% [72·9 to 83·2]). Between 2000 and 2019, age-standardised DALY rates changed less, but the three lower SDI quintiles (low, low-middle, and middle) saw small increases, and the two higher SDI quintiles (high and high-middle SDI) saw small decreases. INTERPRETATION The absolute burden of benign prostatic hyperplasia is rising at an alarming rate in most of the world, particularly in low-income and middle-income countries that are currently undergoing rapid demographic and epidemiological changes. As more people are living longer worldwide, the absolute burden of benign prostatic hyperplasia is expected to continue to rise in the coming years, highlighting the importance of monitoring and planning for future health system strain. FUNDING Bill & Melinda Gates Foundation. TRANSLATION For the Amharic translation of the abstract see Supplementary Materials section.
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Leitão C, Matos B, Roque F, Herdeiro MT, Fardilha M. The Impact of Lifestyle on Prostate Cancer: A Road to the Discovery of New Biomarkers. J Clin Med 2022; 11:2925. [PMID: 35629050 PMCID: PMC9148038 DOI: 10.3390/jcm11102925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
Prostate cancer (PCa) is one of the most common cancers among men, and its incidence has been rising through the years. Several risk factors have been associated with this disease and unhealthy lifestyles and inflammation were appointed as major contributors for PCa development, progression, and severity. Despite the advantages associated with the currently used diagnostic tools [prostate-specific antigen(PSA) serum levels and digital rectal examination (DRE)], the development of effective approaches for PCa diagnosis is still necessary. Finding lifestyle-associated proteins that may predict the development of PCa seems to be a promising strategy to improve PCa diagnosis. In this context, several biomarkers have been identified, including circulating biomarkers (CRP, insulin, C-peptide, TNFα-R2, adiponectin, IL-6, total PSA, free PSA, and p2PSA), urine biomarkers (PCA3, guanidine, phenylacetylglycine, and glycine), proteins expressed in exosomes (afamin, vitamin D-binding protein, and filamin A), and miRNAs expressed in prostate tissue (miRNA-21, miRNA-101, and miRNA-182). In conclusion, exploring the impact of lifestyle and inflammation on PCa development and progression may open doors to the identification of new biomarkers. The discovery of new PCa diagnostic biomarkers should contribute to reduce overdiagnosis and overtreatment.
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Affiliation(s)
- Catarina Leitão
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; (C.L.); (M.T.H.)
| | - Bárbara Matos
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (CI-IPOP), Portuguese Institute of Oncology of Porto (IPO Porto), 4200-072 Porto, Portugal;
- Laboratory of Signal Transduction, Department of Medical Sciences, Institute of Biomedicine—iBiMED, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Doutor Francisco Sá Carneiro, 6300-559 Guarda, Portugal;
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; (C.L.); (M.T.H.)
| | - Margarida Fardilha
- Laboratory of Signal Transduction, Department of Medical Sciences, Institute of Biomedicine—iBiMED, University of Aveiro, 3810-193 Aveiro, Portugal
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The relationship between the gut microbiota, benign prostatic hyperplasia, and erectile dysfunction. Int J Impot Res 2022:10.1038/s41443-022-00569-1. [PMID: 35418604 DOI: 10.1038/s41443-022-00569-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022]
Abstract
Microbiota is defined as the group of commensal microorganisms that inhabit a specific human body site. The composition of each individual's gastrointestinal microbiota is influenced by several factors such as age, diet, lifestyle, and drug intake, but an increasing number of studies have shown that the differences between a healthy microbiota and a dysbiotic one can be related to different diseases such as benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). The aim of this review is to give an overview of the role of the gut microbiota on BPH and ED. Gut microbiota modifications can influence prostate health indirectly by the activation of the immune system and the production of proinflammatory cytokines such as IL-17, IL-23, TNF-alpha, and IFN-gamma, which are able to promote an inflammatory state. Gut dysbiosis may lead to the onset of ED by the alteration of hormone levels and metabolic profiles, the modulation of stress/anxiety-mediated sexual dysfunction, the development of altered metabolic conditions such as obesity and diabetes mellitus, and the development of hypertension. In conclusion, much evidence suggests that the intestinal microbiota has an influence on various pathologies including BPH and ED.
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Adriansyah IA, Afriansyah A, Siregar MAR, Purnomo N, Mirza H, Seno DH. Efficacy of holmium laser enucleation of the prostate in patients with detrusor underactivity: systematic review and meta-analysis. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Benign prostatic hyperplasia (BPH) is commonly found in the aging male. Treatment of BPH can be in form of conservative or surgical intervention. Transurethral resection of the prostate (TURP) is the gold-standard treatment for BPH according to the guideline. However, there is no evidence that there is a benefit for TURP in patients with detrusor underactivity (DUA). Holmium laser enucleation (HoLEP) is theorized to have a better outcome due to its property of complete prostate enucleation. Therefore, this meta-analysis aims to determine the benefit of HoLEP for BPH patients with DUA.
Main body
We performed systematic literature searching from five databases including PubMed, Scopus, Embase, Science Direct, and Web of Science for articles up to 31 December 2020 for relevant studies. A total of five articles are eligible for this meta-analysis. A total of 2.180 subjects participated in all of the studies included. Two studies comparing patients with and without DUA that was treated with HoLEP, two studies comparing HoLEP with other surgical approaches for BPH, and one study comparing both parameters. IPSS score reduction is significantly higher in the patients with DUA (Mean Difference = 3.28, 95% CI 1.91 to 4.64, p < 0.01). Qmax and PVR are not significantly different between both groups. HoLEP also showed better improvement in IPSS and Qmax compared to TURP (IPSS: Mean Difference = -4.80, 95% CI − 7.83 to − 1.77, p = 0.002; Qmax: Mean Difference = 4.20, 95% CI 0.58 to 7.82, p = 0.02) and PVP (IPSS: Mean Difference = − 2.47, 95% CI − 4.47 to − 0.47, p = 0.02; Qmax: Mean Difference = 2.31, 95% CI 0.34 to 4.28, p = 0.02).
Conclusion
HoLEP showed better improvement in IPSS scores in patients with DUA. HoLEP can be considered to be performed in the BPH patients with DUA for better outcomes for the patients.
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Bhat SA, Rather SA, Islam N. An overview of benign prostatic hyperplasia and its appreciation in Greco-Arab (Unani) system of medicine. Asian J Urol 2021; 9:109-118. [PMID: 35509487 PMCID: PMC9051355 DOI: 10.1016/j.ajur.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/30/2020] [Accepted: 07/29/2020] [Indexed: 11/26/2022] Open
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Tobaiqy M, Aalam W, Banji D, Al Haleem ENA. Intraoperative Floppy Iris Syndrome Induced by Tamsulosin: The Risk and Preventive Strategies. Middle East Afr J Ophthalmol 2021; 28:51-56. [PMID: 34321822 PMCID: PMC8270016 DOI: 10.4103/meajo.meajo_561_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/04/2022] Open
Abstract
Tamsulosin is an antagonist of a subtype-specific alpha-1A- and alpha-1D-adrenoceptor (AR) that is expressed in the prostate gland, urethra, and bladder. Several reports have shown a possible relationship between ophthalmologic adverse effects and the use of alpha-1-receptor medicines, including tamsulosin. This descriptive review evaluates the intraoperative floppy iris syndrome (IFIS) associated with tamsulosin. A search of the Medline and PubMed databases was conducted to identify control trials, case reports, and observational examinations published in English. The publication dates were restricted (January 1, 2000, to January 1, 2020). Keywords (tamsulosin, alpha-blocker, ocular, eye, adverse reaction, and IFIS) were used in the searches. The searches identified 66 studies including in vitro or in vivo studies, trials, and observational studies. Twenty-two (33.33%) studies were articles citing tamsulosin and IFIS as having confirmed potential risk to ocular safety. The results of this review, including a comprehensive summary of published research on tamsulosin use in different populations, have identified several articles showing associations between tamsulosin and IFIS that merit further investigation. Suspending of potential causative pharmacological treatment of IFIS before ocular surgery including tamsulosin, proper identification of at-risk patients, preoperative prophylaxis treatments, and surgical technique modifications clearly can mitigate the anticipated risk of IFIS induced by tamsulosin.
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Affiliation(s)
- Mansour Tobaiqy
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia
| | - Waseem Aalam
- Department of Ophthalmology, College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia
| | - David Banji
- Department of Pharmacy Practice, Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Ekram N Abd Al Haleem
- Department of Pharmacology and Toxicology, College of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt
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Wu Y, Ding Y, Cao QF, Qian SB, Wang C, Duan HQ, Gu J, Shen HB. The relationship between glucose homeostasis status and prostate size in aging Chinese males with benign prostatic hyperplasia. World J Urol 2020; 38:2923-2931. [PMID: 31965286 PMCID: PMC7644519 DOI: 10.1007/s00345-020-03084-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/06/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Increasing evidence shows that many metabolic factors are involved in the progression of benign prostatic hyperplasia (BPH). We aimed to assess the relationship between the status of glucose homeostasis and prostate size in aging Chinese males undergoing transurethral resection of the prostate (TURP) for BPH. METHODS A total of 1006 medical records of BPH patients undergoing TURP were reviewed. Prostate size was measured by transrectal ultrasound. Annual total prostate (TP) and transitional zone (TZ) growth rates were calculated. According to the American Diabetes Association criteria, the patients were categorized as normoglycemic, prediabetic, or diabetic. Levels of glucose homeostasis and other variables were considered independent variables in an effort to evaluate any potential correlations using non-adjusted and multivariate-adjusted regression models. RESULTS A total of 659 individuals were included in the study. BPH patients < 70 years old and ≥ 70 years old in the normoglycemic group had a stable prostate growth rate. The change in prostate size in those younger than 70 years, however, was faster in the prediabetic and diabetic group. Further analysis revealed that abnormal glucose homeostasis was positively correlated with prostate size. In those younger than 70 years, compared with the normal glucose group, the adjusted odds ratio (OR) for TP and TZ enlargement in the prediabetic group was 2.27 (95%CI 1.29-4.00) and 3.19 (95%CI 1.78-5.72), respectively, and the adjusted ORs were 4.74 (95%CI 2.18-10.30) and 6.16 (95%CI 2.70-14.06), respectively, for men with diabetes. However there was no significant difference among men aged ≥ 70 years. CONCLUSIONS Among patients undergoing TURP, the prostate volume and growth rate were affected by different status of glucose homeostasis. Hyperglycemia may play an important role in prostate growth.
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Affiliation(s)
- Y Wu
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Y Ding
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Q F Cao
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - S B Qian
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - C Wang
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - H Q Duan
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - J Gu
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - H B Shen
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
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Chen X, Man Q, Wei X, Ren X, Li G, Lu Z, Zhang X, Qin C. Predictive value of preoperative comprehensive evaluation on the efficacy of HoLEP. Transl Androl Urol 2020; 9:1603-1610. [PMID: 32944522 PMCID: PMC7475670 DOI: 10.21037/tau-20-504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background With the aging of the population, prostate hyperplasia is more and more perplexing to the old men. This study aimed to evaluate the predictive value of international prostatic symptom score-voiding/storage score ratio (IPSS-V/S), urodynamic examination, intravesical prostatic protrusion (IPP) and residual urine volume (RUV) on the efficacy of holmium laser enucleation of the prostate (HoLEP) before operation. Methods Ninety-six patients with benign prostatic hyperplasia (BPH) were enrolled in this study. Each patient was diagnosed as BPH and completed all the evaluations as described above before the same urologist surgeon performed HoLEP. Three months later, another IPSS questionnaire would be finished by each patient to assess the efficacy of the operation. According to the results of IPSS after operation, the group with significant effect and the group with poor effect were divided. Then compare the difference of preoperative examination results between the two groups. Results In single factor analysis, the differences of the age, voiding symptom score, V/S, RUV, Qmax and IPP between the two groups were statistically significant (P<0.05). While there was no significant difference in IPSS score and score of urine storage period. In the logistic regression analysis, the age of patients, V/S, RUV, IPP and Qmax can establish a good prediction model. In this model, the younger the patients are, the less the RUV is, the larger the V/S and IPP are, the more likely they are to achieve good efficacy of HoLEP. Conclusions In conclusion, HoLEP was more effective in BPH patients with younger age, more IPP, less RUV, less Qmax and those whose IPSS score was mainly based on voiding symptoms.
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Affiliation(s)
- Xinglin Chen
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiuhong Man
- Department of Clinical Laboratory, Shanghai Fourth People's Hospital Affiliated to School of Medicine, Tongji University, Shanghai, China
| | - Xiyi Wei
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaohan Ren
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guangyao Li
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhongwen Lu
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xu Zhang
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chao Qin
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Kohestani Y, Kohestani B, Shirmohamadi Z, Faghani M. Effect of tamsulosin on testis histopathology and serum hormones in adult rats: Experimental study. Int J Reprod Biomed 2020; 18:531-538. [PMID: 32803117 PMCID: PMC7385916 DOI: 10.18502/ijrm.v13i7.7370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/12/2019] [Accepted: 01/14/2020] [Indexed: 01/18/2023] Open
Abstract
Background Tamsulosin is an inhibitory factor of alpha-adrenergic receptors that is used for relieving of the clinical symptoms and management of acute urinary retention. Objective The aim of this study was to evaluate the effects of tamsulosin on the endocrine axis and testicular tissue in adult male rats. Materials and Methods In this experimental study, 30 adult male Wistar rats (weighing 250-300 gr) were divided into three groups: 1) control (received distilled water), 2) experimental 1 (received 0.2 mg/kg/day tamsulosin) and 3) experimental 2 (received 0.4 mg/kg/day tamsulosin) through oral gavage for 28 days. Serum hormones level and testicular histopathology were evaluated at the end of the experiment. Results In this study, the testicular weight decreased significantly in the experimental groups compared to the control group. A significant decrease was seen in testicular weight (p = 0.004) and the number of Leydig cells in tamsulosin-treated groups (p = 0.012). Tamsulosin improved the hormone profile in experimental groups. Also, higher dose of tamsulosin significantly changed the number of Leydig, spermatogonia cells, the thickness of germinal layer, and the diameter of the seminiferous tubules. Conclusion Results showed that using tamsulosin, possibly reduces the testosterone concentration through adrenergic axis system and in turn has destructive effects on proliferative activity of germ cells.
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Affiliation(s)
- Yegane Kohestani
- Department of Anatomical Sciences, Bandar-Anzali Pardis, Faculty of Medicine, Guilan University of Medical Sciences, Bandar-Anzali, Iran
| | - Bentolhoda Kohestani
- Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Shirmohamadi
- Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Faghani
- Department of Anatomical Sciences, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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14
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Kusuma Duarsa GW, Sari YA, Gde Oka AA, Santosa KB, Yudiana IW, Wisnu Tirtayasa PM, Putra Pramana IB, Kloping YP. Serum testosterone and prostate-specific antigen levels are major risk factors for prostatic volume increase among benign prostatic hyperplasia patients. Asian J Urol 2020; 8:289-297. [PMID: 34401336 PMCID: PMC8356038 DOI: 10.1016/j.ajur.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/09/2020] [Accepted: 04/22/2020] [Indexed: 11/15/2022] Open
Abstract
Objective Benign prostatic hyperplasia (BPH) is one of the most common diseases found among elderly men. Even though multiple risk factors of BPH have been identified in the past, the risk factors which have a direct impact on prostate volume have not been identified. In this study, we aim to determine the most significant contributing risk factors to prostate volume enlargement by analyzing possible associated risk factors previously studied. Methods This is a quantitative study with an analytical observational design, performed using a retrospective cohort approach. Total sampling was performed on 83 patients who underwent transurethral resection of the prostate (TURP) in Sanglah General Hospital from January to February 2019. Bivariate analysis is performed to examine each variable's association with prostate volume followed by a multivariate analysis. All variables were reassessed with path analysis to measure the direct effects, indirect effects, and total effects on prostate volume. Results Bivariate analysis shows that serum testosterone (R=0.208; p=0.059) and prostate-specific antigen (PSA) level (R=0.626; p=0.001) have a significant association with prostate volume. Multivariate analysis shows that serum PSA (B=1.4; p=0.001; 95% confidence interval [95% CI]=1.039–1.770) and testosterone (B=0.024; p=0.005; 95% CI=0.008–0.041) levels are significant among all the analyzed risk factors. There is a significant and strong effect of PSA to prostate volume (c=0.636; p=0.001) whereas testosterone has a significant albeit weak effect to prostate volume (c=0.246; p=0.009) based on the total effect of the path analysis. Conclusion Serum testosterone and PSA levels are significantly associated with prostatic volume increase among BPH patients.
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Affiliation(s)
- Gede Wirya Kusuma Duarsa
- Department of Urology, Sanglah General Hospital, Faculty of Medical and Health Sciences of Udayana University, Denpasar, Bali, Indonesia
- Corresponding author.
| | - Yudit Anastasia Sari
- General Surgery Department, Faculty of Medicine Udayana University, Denpasar, Bali, Indonesia
| | - Anak Agung Gde Oka
- Department of Urology, Sanglah General Hospital, Faculty of Medical and Health Sciences of Udayana University, Denpasar, Bali, Indonesia
| | - Kadek Budi Santosa
- Department of Urology, Sanglah General Hospital, Faculty of Medical and Health Sciences of Udayana University, Denpasar, Bali, Indonesia
| | - I Wayan Yudiana
- Department of Urology, Sanglah General Hospital, Faculty of Medical and Health Sciences of Udayana University, Denpasar, Bali, Indonesia
| | - Pande Made Wisnu Tirtayasa
- Department of Urology, Sanglah General Hospital, Faculty of Medical and Health Sciences of Udayana University, Denpasar, Bali, Indonesia
| | - Ida Bagus Putra Pramana
- Department of Urology, Sanglah General Hospital, Faculty of Medical and Health Sciences of Udayana University, Denpasar, Bali, Indonesia
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Brennen WN, Isaacs JT. Mesenchymal stem cells and the embryonic reawakening theory of BPH. Nat Rev Urol 2019; 15:703-715. [PMID: 30214054 DOI: 10.1038/s41585-018-0087-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The prostate is the only organ in a man that continues to grow with age. John McNeal proposed, 40 years ago, that this BPH is characterized by an age-related reinitiation of benign neoplastic growth selectively in developmentally abortive distal ducts within the prostate transition-periurethral zone (TPZ), owing to a reawakening of inductive stroma selectively within these zones. An innovative variant of this hypothesis is that, owing to its location, the TPZ is continuously exposed to urinary components and/or autoantigens, which produces an inflammatory TPZ microenvironment that promotes recruitment of bone marrow-derived mesenchymal stem cells (MSCs) and generates a paracrine-inductive stroma that reinitiates benign neoplastic nodular growth. In support of this hypothesis, MSCs infiltrate human BPH tissue and have the ability to stimulate epithelial stem cell growth. These results provide a framework for defining both the aetiology of BPH in ageing men and insights into new therapeutic approaches.
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Affiliation(s)
- W Nathaniel Brennen
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, USA.
| | - John T Isaacs
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, USA. .,Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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The new kids on the block: prostatic urethral lift (Urolift) and convective water vapor energy ablation (Rezūm). Curr Opin Urol 2019. [PMID: 29538166 DOI: 10.1097/mou.0000000000000502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The main objective of novel minimally invasive treatment options is to provide relief of bothersome lower urinary tract symptoms (LUTS) equally effective to current standard techniques, but with a more favorable safety profile. Here we present the first clinical experience with the prostatic urethral lift (Urolift) and the convective water vapor energy ablation (Rezūm). RECENT FINDINGS Urolift offers rapid and durable relief of LUTS with complete preservation of sexual function. It is not as effective as the reference method transurethral resection of the prostate (TURP) in terms of symptom relief and urodynamic parameters, but it in selected patients with special interest in sexual activity and rapid recovery it may be an attractive option. The Rezūm system also offers rapid and safe relief of LUTS without compromising sexual function. But it targets all critical prostatic zones including an obstructive middle lobe. SUMMARY In selected patients with bothersome LUTS, who seek a minimally invasive procedure offering a fast return to daily activity and complete preservation of sexual function, Urolift is a good option. First 3-year clinical data on Rezūm demonstrated efficacy and safety in a prospective randomized, sham-controlled trial. It addresses all critical zones of benign prostatic obstruction including the middle lobe without compromising sexual function. Long-term data and the direct comparison with the reference method TURP are missing to define its role in the surgical spectrum of minimally invasive treatment options.
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17
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Kosilov K, Kuzina I, Kuznetsov V, Gainullina Y, Kosilova L, Prokofyeva A, Loparev S. Cognitive functions and health-related quality of life in men with benign prostatic hyperplasia and symptoms of overactive bladder when treated with a combination of tamsulosin and solifenacin in a higher dosage. Aging Male 2018; 21:121-129. [PMID: 29113548 DOI: 10.1080/13685538.2017.1398723] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AIM To study the cognitive functions and health-related quality of life (HRQoL) in individuals taking a combination of tamsulosin and solifenacin in a higher dosage. METHODS All patients (n = 262) were assigned to group A (N = 93, tamsulosin 0.4 mg + solifenacin 10 mg per day), group B (N = 83, tamsulosin 0.4 mg + solifenacin 20 mg), and control group C (N = 86; tamsulosin 0.4 mg + placebo). The lower urinary tract (LUT) condition was assessed on the scales International Prostate Symptom Score, Over Active Bladder Awareness Tool and uroflowmetry. The state of cognitive status was assessed on the scales Mini-mental State Examination, Controlled Oral Word Association Test, Wechsler Adult Intelligence Scale-Revised, Wechsler III, Color Trails Test, California Verbal Learning Test. RESULTS The values of cognitive function indicators in the individuals from all groups after treatment did not significantly differ from the respective values at the baseline (p > .05). The values of most HRQoL parameters of the functional state of the LUT significantly improved in groups A and B. A significant correlation between the state of cognitive status and HRQoL, as well as LUT was absent (r <0.3). CONCLUSION The combination of solifenacin in a double dosage along with tamsulosin can be recommended for elderly benign prostatic hyperplasia patients with overactive bladder symptoms.
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Affiliation(s)
- Kirill Kosilov
- a Department of Social Sciences, School of Humanities , Far Eastern Federal University , Vladivostok , Russian Federation
- b Department of Public Health , Pacific State Medical University , Vladivostok , Russian Federation
| | - Irina Kuzina
- c Department of Social Science , Far Eastern Federal University , Vladivostok , Russian Federation
| | - Vladimir Kuznetsov
- b Department of Public Health , Pacific State Medical University , Vladivostok , Russian Federation
| | - Yuliya Gainullina
- a Department of Social Sciences, School of Humanities , Far Eastern Federal University , Vladivostok , Russian Federation
| | - Liliya Kosilova
- d Department of Functional Diagnostics , Med. Association № 2 of Vladivostok-city , Vladivostok , Russian Federation
| | - Alexandra Prokofyeva
- c Department of Social Science , Far Eastern Federal University , Vladivostok , Russian Federation
| | - Sergey Loparev
- e Department of Urology , City Polyclinic № 3 , Vladivostok , Russian Federation
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Heidler S, Drerup M, Lusuardi L, Bannert U, Bretterbauer K, Bures J, Dietersdorfer F, Dlouhy-Schütz E, Hessler C, Karpf R, Mittellehner LA, Mitlöhner B, Schwarz S, Thomay G, Lösch G, Freibauer C, Albrecht W. The Correlation of Prostate Volume and Prostate-specific Antigen Levels With Positive Bacterial Prostate Tissue Cultures. Urology 2018. [DOI: 10.1016/j.urology.2018.02.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Tilling K, Lawton M, Robertson N, Tremlett H, Zhu F, Harding K, Oger J, Ben-Shlomo Y. Modelling disease progression in relapsing-remitting onset multiple sclerosis using multilevel models applied to longitudinal data from two natural history cohorts and one treated cohort. Health Technol Assess 2018; 20:1-48. [PMID: 27817792 DOI: 10.3310/hta20810] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The ability to better predict disease progression represents a major unmet need in multiple sclerosis (MS), and would help to inform therapeutic and management choices. OBJECTIVES To develop multilevel models using longitudinal data on disease progression in patients with relapsing-remitting MS (RRMS) or secondary-progressive MS (SPMS); and to use these models to estimate the association of disease-modifying therapy (DMT) with progression. DESIGN Secondary analysis of three MS cohorts. SETTING Two natural history cohorts: University of Wales Multiple Sclerosis (UoWMS) cohort, UK, and British Columbia Multiple Sclerosis (BCMS) cohort, Canada. One observational DMT-treated cohort: UK MS risk-sharing scheme (RSS). PARTICIPANTS The UoWMS database has > 2000 MS patients and the BCMS database (as of 2009) has > 5900 MS patients. All participants who had definite MS (RRMS/SPMS), who reached the criteria set out by the Association of British Neurologists (ABN) for eligibility for DMT [i.e. age ≥ 18 years, Expanded Disability Status Scale (EDSS) score of ≤ 6.5, occurrence of two or more relapses in the previous 2 years] and who had at least two repeated outcome measures were included: 404 patients for the UoWMS cohort and 978 patients for the BCMS cohort. Through the UK MS RSS scheme, 5583 DMT-treated patients were recruited, with the analysis sample being the 4137 who had RRMS and were eligible and treated at baseline, with at least one valid EDSS score post baseline. MAIN OUTCOME MEASURES EDSS score observations post ABN eligibility. METHODS We used multilevel models in the development cohort (UoWMS) to develop a model for EDSS score with time since ABN eligibility, allowing for covariates and appropriate transformation of outcome and/or time. These methods were then applied to the BCMS cohort to obtain a 'natural history' model for changes in the EDSS score with time. We then used this natural history model to predict the trajectories of EDSS score in treated patients in the UK MS RSS database. Differences between the progression predicted by the natural history model and the progression observed at 6 years' follow-up for the UK MS RSS cohort were used as indicators of the effectiveness of the DMTs. Previously developed utility scores were assigned to each EDSS score, and differences in utility also examined. RESULTS The model best fitting the UoWMS data showed a non-linear increase in EDSS score over time since ABN eligibility. This model fitted the BCMS cohort data well, with similar coefficients, and the BCMS model predicted EDSS score in UoWMS data with little evidence of bias. Using the natural history model predicts EDSS score in a treated cohort (UK MS RSS) higher than that observed [by 0.59 points (95% confidence interval 0.54 to 0.64 points)] at 6 years post treatment. LIMITATIONS Only two natural history cohorts were compared, limiting generalisability. The comparison of a treated cohort with untreated cohorts is observational, thus limiting conclusions about causality. CONCLUSIONS EDSS score progression in two natural history cohorts of MS patients showed a similar pattern. Progression in the natural history cohorts was slightly faster than EDSS score progression in the DMT-treated cohort, up to 6 years post treatment. FUTURE WORK Long-term follow-up of randomised controlled trials is needed to replicate these findings and examine duration of any treatment effect. FUNDING DETAILS The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Kate Tilling
- School of Social and Community Medicine, Bristol University, Bristol, UK
| | - Michael Lawton
- School of Social and Community Medicine, Bristol University, Bristol, UK
| | - Neil Robertson
- Department of Neurology, Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Helen Tremlett
- Faculty of Medicine, Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Feng Zhu
- Faculty of Medicine, Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Katharine Harding
- Department of Neurology, Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Joel Oger
- Faculty of Medicine, Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, Bristol University, Bristol, UK
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20
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Tomasetti C, Li L, Vogelstein B. Stem cell divisions, somatic mutations, cancer etiology, and cancer prevention. Science 2017; 355:1330-1334. [PMID: 28336671 DOI: 10.1126/science.aaf9011] [Citation(s) in RCA: 624] [Impact Index Per Article: 89.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 02/01/2017] [Indexed: 12/16/2022]
Abstract
Cancers are caused by mutations that may be inherited, induced by environmental factors, or result from DNA replication errors (R). We studied the relationship between the number of normal stem cell divisions and the risk of 17 cancer types in 69 countries throughout the world. The data revealed a strong correlation (median = 0.80) between cancer incidence and normal stem cell divisions in all countries, regardless of their environment. The major role of R mutations in cancer etiology was supported by an independent approach, based solely on cancer genome sequencing and epidemiological data, which suggested that R mutations are responsible for two-thirds of the mutations in human cancers. All of these results are consistent with epidemiological estimates of the fraction of cancers that can be prevented by changes in the environment. Moreover, they accentuate the importance of early detection and intervention to reduce deaths from the many cancers arising from unavoidable R mutations.
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Affiliation(s)
- Cristian Tomasetti
- Division of Biostatistics and Bioinformatics, Department of Oncology, Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, 550 North Broadway, Baltimore, MD 21205, USA. .,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Lu Li
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Bert Vogelstein
- Ludwig Center and Howard Hughes Medical Institute, Johns Hopkins Kimmel Cancer Center, 1650 Orleans Street, Baltimore, MD 21205, USA.
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21
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Magistro G, Stief CG, Gratzke C. Prostatic Urethral Lift Versus Transurethral Resection of the Prostate (TURP). Curr Urol Rep 2017; 18:82. [PMID: 28852996 DOI: 10.1007/s11934-017-0725-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) represent one of the most common bothersome conditions impairing quality of life in men. Its management comprises conservative treatment, pharmacotherapy, and various surgical techniques. Medication and surgical procedures provide meaningful relief of LUTS, but their therapeutic efficacy has to be counterbalanced against the associated adverse events and morbidity. With the advent of novel minimally invasive treatment options, the surgical standards are challenged for at least equally effective approaches with a much more favorable safety profile. Clinical randomized controlled trials confirmed that PUL is able to provide rapid and durable relief of LUTS without compromising sexual function. However, in order to define the value and true benefit of a novel technique among established surgical procedures, the direct comparison with the reference method TURP is necessary. This was the main objective of the BPH6 study, which evaluated symptom relief, recovery experience, sexual function, urinary continence, and safety of PUL compared to TURP. Over a 2-year follow-up, no relevant negative impact on erectile function, urinary continence, and treatment-related safety was observed for both procedures. Improvement of LUTS was better after TURP, whereas PUL turned out to be superior in terms of quality of recovery, ejaculatory function, and quality of sleep. PUL can be considered in selected patients with bothersome LUTS, with special interest in the complete preservation of sexual function and a rapid and smooth return to daily activity.
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Affiliation(s)
- Giuseppe Magistro
- Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Christian Gratzke
- Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany.
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22
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Cao N, Lu Q, Si J, Wang X, Ni J, Chen L, Gu B, Hu B. The Characteristics of the Transitional Zone in Prostate Growth With Age. Urology 2017; 105:136-140. [DOI: 10.1016/j.urology.2017.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/26/2017] [Accepted: 03/04/2017] [Indexed: 10/19/2022]
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23
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Lim KB. Epidemiology of clinical benign prostatic hyperplasia. Asian J Urol 2017; 4:148-151. [PMID: 29264223 PMCID: PMC5717991 DOI: 10.1016/j.ajur.2017.06.004] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022] Open
Abstract
Clinical benign prostatic hyperplasia (BPH) is one of the most common diseases in ageing men and the most common cause of lower urinary tract symptoms (LUTS). The prevalence of BPH increases after the age of 40 years, with a prevalence of 8%-60% at age 90 years. Some data have suggested that there is decreased risk among the Asians compared to the western white population. Genetics, diet and life style may play a role here. Recent reports suggest the strong relationship of clinical BPH with metabolic syndrome and erectile dysfunction, as well as the possible role of inflammation as a cause of the prostatic hyperplasia. Lifestyle changes including exercise and diet are important strategies in controlling this common ailment.
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Affiliation(s)
- Kok Bin Lim
- Raffles Urology Centre, Raffles Hospital, Singapore
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24
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Prostate volume growth rate changes over time: Results from men 18 to 92 years old in a longitudinal community-based study. ACTA ACUST UNITED AC 2016; 36:796-800. [PMID: 27924517 DOI: 10.1007/s11596-016-1664-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 03/09/2016] [Indexed: 10/18/2022]
Abstract
Previous investigations have shown that changes in total prostate volume (TPV) are highly variable among aging men, and a considerable proportion of aging men have a stable or decreasing prostate size. Although there is an abundance of literature describing prostatic enlargement in association with benign prostatic hyperplasia, less is known about the appropriate age cut-off points for TPV growth rate. In this community-based cohort study, TPV was examined once a year in men who had consecutive health checkup, during a follow-up of 4 years. A total of 5058 men (age 18-92 years old) were included. We applied multiple regression analyses to estimate the correlation between TPV growth rate and age. Overall, 3232 (63.9%) men had prostate growth, and 1826 (36.1%) had a stable or decreased TPV during the study period. The TPV growth rate was correlated negatively with baseline TPV (r=-0.32, P<0.001). Among 2620 men with baseline TPV <15 cm3, the TPV growth rate increased with age (β=0.98, 95% CI: 0.77%-1.18%) only up to 53 years old. Among 2188 men with baseline TPV of 15-33.6 cm3, the TPV growth rate increased with age (β=0.84, 95% CI, 0.66%-1.01%) only up to 61 years old after adjusting for factors of hypertension, obesity, baseline TPV, diabetes mellitus and dyslipidemia. In this longitudinal study, the TPV growth rate increased negatively with baseline TPV, only extending to a certain age and not beyond. Further research is needed to identify the mechanism underlying such differences in prostate growth.
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25
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Tissue-scale, personalized modeling and simulation of prostate cancer growth. Proc Natl Acad Sci U S A 2016; 113:E7663-E7671. [PMID: 27856758 DOI: 10.1073/pnas.1615791113] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Recently, mathematical modeling and simulation of diseases and their treatments have enabled the prediction of clinical outcomes and the design of optimal therapies on a personalized (i.e., patient-specific) basis. This new trend in medical research has been termed "predictive medicine." Prostate cancer (PCa) is a major health problem and an ideal candidate to explore tissue-scale, personalized modeling of cancer growth for two main reasons: First, it is a small organ, and, second, tumor growth can be estimated by measuring serum prostate-specific antigen (PSA, a PCa biomarker in blood), which may enable in vivo validation. In this paper, we present a simple continuous model that reproduces the growth patterns of PCa. We use the phase-field method to account for the transformation of healthy cells to cancer cells and use diffusion-reaction equations to compute nutrient consumption and PSA production. To accurately and efficiently compute tumor growth, our simulations leverage isogeometric analysis (IGA). Our model is shown to reproduce a known shape instability from a spheroidal pattern to fingered growth. Results of our computations indicate that such shift is a tumor response to escape starvation, hypoxia, and, eventually, necrosis. Thus, branching enables the tumor to minimize the distance from inner cells to external nutrients, contributing to cancer survival and further development. We have also used our model to perform tissue-scale, personalized simulation of a PCa patient, based on prostatic anatomy extracted from computed tomography images. This simulation shows tumor progression similar to that seen in clinical practice.
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Magistro G, Strittmatter F, Herlemann A, Weinhold P, Stief CG, Gratzke C. Minimally Invasive Treatment for Male Lower Urinary Tract Symptoms: the Prostatic Urethral Lift. CURRENT BLADDER DYSFUNCTION REPORTS 2016. [DOI: 10.1007/s11884-016-0360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Park J, Lee DG, Suh B, Cho SY, Chang IH, Paick SH, Lee HL. Establishment of Reference Ranges for Prostate Volume and Annual Prostate Volume Change Rate in Korean Adult Men: Analyses of a Nationwide Screening Population. J Korean Med Sci 2015; 30:1136-42. [PMID: 26240492 PMCID: PMC4520945 DOI: 10.3346/jkms.2015.30.8.1136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 05/27/2015] [Indexed: 11/20/2022] Open
Abstract
We aimed to determine normal reference ranges for prostate volume (PV) and annual PV change rate in a Korean nationwide screening population. Data from men who underwent a routine health check-up were collected from 13 university hospitals. The cohort comprised men aged ≥40 yr who had undergone 2 or more serial transrectal ultrasonographies. Men with initial PV>100 mL; serum PSA level>10 ng/mL; PV reduction>20% compared with initial PV, or who had history of prostate cancer or prostate surgery, were excluded. Linear regression and mixed effects regression analyses were used to predict mean PV and longitudinal change in PV over time. A total of 2,967 men formed the study cohort. Age, body mass index (BMI), and serum prostate-specific antigen (PSA) level were found to be significant predictors of PV. A predicted PV table, with a 95% confidence interval (CIs), was developed after adjusting for these 3 variables. Annual PV change rate was 0.51 mL/year (95% CI, 0.47-0.55). Annual PV change rate according to age was 0.68 mL/year, 0.84 mL/year, 1.09 mL/year, and 0.50 mL/year for subjects in their 40s, 50s, 60s, and ≥70 yr, respectively. Predicted annual PV change rate differed depending on age, BMI, serum PSA level and baseline PV. From a nationwide screening database, we established age-, PSA-, and BMI-specific reference ranges for PV and annual PV change rate in Korean men. Our newly established reference ranges for PV and annual PV change rate will be valuable in interpreting PV data in Korean men.
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Affiliation(s)
- Jinsung Park
- Department of Urology, Eulji University Hospital, Daejeon, Korea
| | - Dong-Gi Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Beomseok Suh
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sung Yong Cho
- Department of Urology, Boramae Medical Center, Seoul, Korea
| | - In Ho Chang
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sung Hyun Paick
- Department of Urology, Konkuk University Hospital, Seoul, Korea
| | - Hyung-Lae Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
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Magistro G, Stief CG, Gratzke C. New intraprostatic injectables and prostatic urethral lift for male LUTS. Nat Rev Urol 2015. [PMID: 26195444 DOI: 10.1038/nrurol.2015.169] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Treatment modalities for male lower urinary tract symptoms (LUTS) comprise a broad spectrum of medical and surgical options. Interest is growing in minimally invasive treatment options, which should ideally be performed in an outpatient setting and have a short recovery time, durable efficacy and a good safety profile. The preservation of all aspects of sexual function, including antegrade ejaculation, seems to be increasingly important for patients. Initial experimental data on new minimally invasive procedures-such as the intraprostatic injection of novel agents including botulinum neurotoxin A (BoNT-A), NX-1207 and PRX302-were promising, but clinical trials have not confirmed the findings. Trials of the mechanical prostatic urethral lift device-Urolift(®) (Neotract, Inc., USA)-have been positive, but further long-term results are needed to confirm its beneficial effects.
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Affiliation(s)
- Giuseppe Magistro
- Urologische Klinik und Poliklinik, Klinikum der Universität München-Campus Grosshadern, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Christian G Stief
- Urologische Klinik und Poliklinik, Klinikum der Universität München-Campus Grosshadern, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Christian Gratzke
- Urologische Klinik und Poliklinik, Klinikum der Universität München-Campus Grosshadern, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Effectiveness of Solifenacin and Trospium for Managing of Severe Symptoms of Overactive Bladder in Patients With Benign Prostatic Hyperplasia. Am J Mens Health 2015; 10:157-63. [DOI: 10.1177/1557988315595692] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research is aimed to study the possibility of management of severe symptoms of overactive bladder (OAB) with solifenacin and trospium in patients who receive treatment with tamsulosin due to benign prostatic hyperplasia (BPH). The 338 men more than 50 years old (average age 58.4 years) diagnosed with BPH and severe symptoms of OAB were enrolled in the study. Over three episodes of urinary incontinence per day (registration according to bladder diaries), International Prostate Symptom Score over 19, OAB-V8 questionnaire score over 32, and urodynamic disorders diagnosed using cystometry and uroflowmetry were taken as a criterion of severe symptoms of OAB. Patients of the main group during 2 months received treatment with daily combination of solifenacin 5 mg and trospium 5 mg simultaneously with tamsulosin 0.4 mg. Patients of the control group were treated only with tamsulosin. First endpoint is a quantitative assessment of patients with BPH having severe symptoms of OAB. Second endpoint is a state of the patients’ lower urinary tract after the treatment. In the main group, most of urodynamic indices normalized significantly. Number of episodes of incontinence reduced from middle level 3.4 (0.8) per day to 0.9 (0.7) per day. In the control group changes of urodynamic indices were not significant. Quantity of side effects did not exceed the level which is common for antimuscarinic monotherapy. Therefore, percentage of patients with severe symptoms of OAB is not less than 44% of all cases of prostatic hyperplasia accompanied by OAB symptoms. Combination of trospium and solifenacin in standard doses is an efficient and safe method of management of severe symptoms of OAB in the course of the treatment of with tamsulosin in patients more than 50 years of age.
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Teles P, Barros S, Cardoso S, Facure A, da Rosa LAR, Santos M, Pereira P, Vaz P, Zankl M. A dosimetric study of prostate brachytherapy using Monte Carlo simulations with a voxel phantom, measurements and a comparison with a treatment planning procedure. RADIATION PROTECTION DOSIMETRY 2015; 165:482-487. [PMID: 25870437 DOI: 10.1093/rpd/ncv055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In prostate brachytherapy treatments, there is an initial swelling of the prostate of the patient due to an oedema related to the insertion of the seeds. The variation of the prostate volume can lead to variations in the final prescribed dose in treatment planning procedures. As such, it is important to understand their influence for dose optimisation purposes. This work reports on a dosimetric study of the swelling of the prostate in prostate brachytherapy using Monte Carlo simulations. Dosimetric measurements performed on a physical anthropomorphic tissue-equivalent prostate phantom and thermoluminescent dosimeters (TLDs) were used to validate the MC model. Finally the MC model was also used to simulate prostate swelling in a real treatment planning procedure. The obtained results indicate that the parameters mentioned above represent a source of uncertainty in dose assessment in prostate brachytherapy, and can be detrimental to a correct dose evaluation in treatment plannings, and that these parameters can be accurately determined by means of MC simulations with a voxel phantom.
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Affiliation(s)
- P Teles
- CTN Pólo de Loures, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10 (km 139,7), 2695-066 Bobadela, LRS, Portugal
| | - S Barros
- CTN Pólo de Loures, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10 (km 139,7), 2695-066 Bobadela, LRS, Portugal
| | - S Cardoso
- Universidade Federal do Rio de Janeiro, Av. Pedro Calmon, 550, Rio de Janeiro 21941-901, Brazil
| | - A Facure
- Comissão Nacional de Energia Nuclear, Rua Gal Severiano, 90, Rio de Janeiro 22290-901, Brazil
| | - L A R da Rosa
- Instituto de Radioproteção e Dosimetria, Av. Salvador Allende, Rio de Janeiro 22780-160, Brazil
| | - M Santos
- Instituto de Radioproteção e Dosimetria, Av. Salvador Allende, Rio de Janeiro 22780-160, Brazil
| | - P Pereira
- Dosimetrika, Avenida Olegário Maciel, 231 - Barra da Tijuca, Rio de Janeiro, 22621-200, Brazil
| | - P Vaz
- CTN Pólo de Loures, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10 (km 139,7), 2695-066 Bobadela, LRS, Portugal
| | - M Zankl
- Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
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Fukuta F, Masumori N. A Review of Naftopidil for Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia. CURRENT BLADDER DYSFUNCTION REPORTS 2015. [DOI: 10.1007/s11884-015-0293-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Patel ND, Parsons JK. Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian J Urol 2014; 30:170-6. [PMID: 24744516 PMCID: PMC3989819 DOI: 10.4103/0970-1591.126900] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors – including age, genetics and geography – play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies.
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Affiliation(s)
- Nishant D Patel
- Department of Urology, Moores UCSD Cancer Center, University of California, San Diego, and Section of Surgery, VA San, USA
| | - J Kellogg Parsons
- Department of Urology, Moores UCSD Cancer Center, University of California, San Diego, and Section of Surgery, VA San, USA
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De Coninck V, Braeckman J, Michielsen D. Prostate HistoScanning: a screening tool for prostate cancer? Int J Urol 2013; 20:1184-90. [PMID: 23594146 DOI: 10.1111/iju.12148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 02/25/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate Prostate HistoScanning as a screening tool for prostate cancer in a pilot study. METHODS During a 6-month period, 94 men with normal or suspicious digital rectal examination, normal or elevated prostate-specific antigen, or an increased prostate-specific antigen velocity were examined with Prostate HistoScanning. Based on these parameters and HistoScanning analysis, 41 men were referred for prostate biopsy under computer-aided ultrasonographic guidance. The number of random biopsy cores varied depending on the prostate volume. Targeted biopsies were taken in the case of computer-aided ultrasonographic area suspicious for malignancy. A logistic regression analysis was carried out to estimate the probability of resulting in a positive prostate biopsy based on the HistoScanning findings. RESULTS Following a logistic regression analysis, after adjusting for age, digital rectal examination, serum prostate-specific antigen level, prostate volume and tumor lesion volume, every cancer volume increase of 1 mL estimated by HistoScanning was associated with a nearly threefold increase in the probability of resulting in a positive biopsy (odds ratio 2.9; 95% confidence interval 1.2-7.0; P-value 0.02). Prostate cancer was found in 17 of 41 men (41%). In patients with cancer, computer-aided ultrasonography-guided biopsy was 4.5-fold more likely to detect cancer than random biopsy. The prostate cancer detection rate for random biopsy and directed biopsy was 13% and 58%, respectively. HistoScanning-guided biopsy significantly decreased the number of biopsies necessary (P-value <0.0001). CONCLUSIONS Our findings suggest that Prostate HistoScanning might be helpful for the selection of patients in whom prostate biopsies are necessary. This imaging technique can be used to direct biopsies in specific regions of the prostate with a higher cancer detection rate.
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Affiliation(s)
- Vincent De Coninck
- Department of Urology, UZ Brussel, Free University of Brussels, Brussels, Belgium
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Natural History of Lower Urinary Tract Symptoms Secondary to BPH. CURRENT BLADDER DYSFUNCTION REPORTS 2013. [DOI: 10.1007/s11884-013-0180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sehrawat A, Shimada K, Rabin Y. Generating prostate models by means of geometric deformation with application to computerized training of cryosurgery. Int J Comput Assist Radiol Surg 2013; 8:301-12. [PMID: 22782183 PMCID: PMC4037744 DOI: 10.1007/s11548-012-0780-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 06/21/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE As a part of an ongoing project to develop computerized training tools for cryosurgery, the objective of the current study is twofold: to compile literature data on the likelihood of cancer tumor growth and its effect on the prostate shape and to present a deformation scheme for a 3D organ template in order to generate clinically relevant prostate models. The long-term objective of this study is to develop a database of prostate models for computerized training. METHODS Cryosurgery is typically performed on patients with localized prostate cancer found in stage T3 or earlier. The distribution of key geometric features likely to be found in the prostate at stage T3 is integrated into a 3D prostate template by employing the extended free-form deformation (EFFD) method. The applied scheme combines two steps: pre-selecting a set of geometric parameter values and manipulating the lattice control points until the prostate model meets the desired criteria. RESULTS Examples for model generation are displayed, based on two 3D prostate templates previously obtained from ultrasound imaging. These examples include selected cases with unilateral and bilateral stage T3 tumor growth, suitable for incorporation into a training database. CONCLUSIONS EFFD is an efficient method for rapid generation of prostate models. The compiled criteria for model generation do not lead to a unique shape since the contours for template deformation are randomly selected. Nevertheless, these criteria do lead to shapes resembling cancer growth, as various growth histories can lead to a tumor characterized by the same key parameter values.
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Affiliation(s)
- Anjali Sehrawat
- Department of Mechanical Engineering Carnegie Mellon University Pittsburgh, PA 15213
| | - Kenji Shimada
- Department of Mechanical Engineering Carnegie Mellon University Pittsburgh, PA 15213
| | - Yoed Rabin
- Department of Mechanical Engineering Carnegie Mellon University Pittsburgh, PA 15213
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de Zeeuw S, Hop W, Huang Foen Chung J, van Mastrigt R. Longitudinal changes in isovolumetric bladder pressure in response to age-related prostate growth in 1,020 healthy male volunteers. Neurourol Urodyn 2013; 33:78-84. [PMID: 23423651 DOI: 10.1002/nau.22379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 01/07/2013] [Indexed: 11/11/2022]
Abstract
AIM To non-invasively study if compensation and decompensation occurs in the urinary bladder of healthy male volunteers in response to benign prostatic enlargement (BPE) using the condom catheter method. METHODS Between 2001 and 2010, 1,020 healthy male volunteers were included in a longitudinal study based on three non-invasive urodynamic examinations during a 5-year follow-up. Inclusion criteria were an informed consent, the ability to void in a normal standing position and a minimum free flow rate of 5.4 ml/sec. Study parameters were prostate volume (PV), maximum free urinary flow rate (Q(max)) and bladder contractility, quantified by the maximum isovolumetric bladder pressure, measured in the condom (P(cond.max)). Volunteers also completed the International Prostate Symptom Score Form (IPSS). RESULTS Within limitations, the included volunteers had a flat age distribution between 38 and 72 years. This made it possible to combine longitudinal analysis in a 5-year observation interval, with cross sectional analysis in a 35-year age range. Longitudinal analysis showed that with increasing age, PV increased with 1.9% per year, whereas Qmax decreased with 1.1% per year. IPSS increased with 1.1% per year when volunteers were older than 55 years. P(cond.max) increased during the 5-year longitudinal follow-up, but not in the cross sectional analysis. CONCLUSIONS The difference between cross sectional and longitudinal results of the P(cond.max) may have been caused by compensation of the urinary bladder resulting in a selection effect. This would imply that compensation is a relatively fast process, taking approximately 5 years.
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Affiliation(s)
- Sandra de Zeeuw
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
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Zhang SJ, Qian HN, Zhao Y, Sun K, Wang HQ, Liang GQ, Li FH, Li Z. Relationship between age and prostate size. Asian J Androl 2012; 15:116-20. [PMID: 23223031 DOI: 10.1038/aja.2012.127] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In a community-based study, the relationship between age and human prostate size was investigated in a population of men between the ages of 40 and 70 years to determine the normal prostate increase curve equation. One thousand male volunteers were randomly recruited from the Shanghai community, and the length, width, height, volume of the transition zone (TZ) and the whole prostates were measured by transrectal ultrasound (TRUS). Each volunteer was evaluated by the International Prostate Symptom Score (IPSS). Among those who completed the examination, the mean prostate parameters were all positively associated with increased age. There were statistically significant differences between each age group (P<0.05). The mean transition zone volume (TZV) had a higher increase rate with age than the mean total prostate volume (TPV), indicating that the enlargement of the TZ contributed the most to the increase in TPV. While all prostate parameters were positively correlated with the IPSS, the strongest correlation was associated with the TZ length (TZL) and TZV. The growth curve equations for prostate width, height and length were also positively associated with increasing age.
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Affiliation(s)
- Shi-Jun Zhang
- Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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Fukuta F, Masumori N, Mori M, Tsukamoto T. Incidence and risk of treatment for benign prostatic hyperplasia in Japanese men: a 15-year longitudinal community-based study. Int J Urol 2012; 20:100-6. [PMID: 23106204 DOI: 10.1111/j.1442-2042.2012.03215.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 09/27/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the incidence of and the risk factors for treatment in Japanese men with benign prostatic hyperplasia/lower urinary tract symptoms enrolled into a longitudinal community-based study. METHODS A total of 267 of 319 men aged 40-79 years were eligible for this study, with nearly 15 years of follow up. Their medical records were checked to look for any medical treatment for benign prostatic hyperplasia/lower urinary tract symptoms. The risk of treatment for benign prostatic hyperplasia/lower urinary tract symptoms was determined by calculating the hazard ratio using the Cox proportional hazards model. Five baseline parameters were considered: the International Prostate Symptom Score, the peak urinary flow rate, the prostate volume, the serum prostate-specific antigen and the internal prostatic architecture on transrectal ultrasonography. RESULTS Data were successfully collected for 171 men (64%; 121 survivors and 50 deceased). During approximately 1900 person-years of follow up, the overall incidence of treatment for benign prostatic hyperplasia/lower urinary tract symptoms was 15.4/1000 person-years. All five parameters were statistically significant predictors of future treatment for benign prostatic hyperplasia/lower urinary tract symptoms: International Prostate Symptom Score greater than 7 (hazard ratio 6.2, P < 0.001), prostate volume greater than 30 mL (hazard ratio 4.3, P = 0.002), peak urinary flow rate less than 12 mL/s (hazard ratio 4.4, P < 0.001), prostate-specific antigen greater than 1.4 ng/mL (hazard ratio 4.0, P < 0.001) and internal prostatic architecture group 3 (hazard ratio 3.2, P = 0.002). CONCLUSIONS Severity of lower urinary tract symptoms, decreased peak urinary flow rate, enlarged prostate volume, high prostate-specific antigen value and internal prostatic architecture at baseline are independent risk factors for treatment in Japanese men presenting with benign prostatic hyperplasia/lower urinary tract symptoms.
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Affiliation(s)
- Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Abstract
OBJECTIVES To review prostate anatomy, epidemiology and risk factors, presentation and diagnosis, staging and treatment, emerging therapies, and patient education. DATA SOURCES Review of current and classic literature. CONCLUSION Patients must be educated regarding screening recommendations and offered evidence-based guidance regarding the risks, benefits, and alternatives to treatment. Adverse effects of treatment may impact quality of life. IMPLICATIONS FOR NURSING PRACTICE As the incidence of prostate cancer continues to rise, nurses will play an essential role in the treatment and counseling of men facing this malignancy. Nursing research will also be necessary to further investigate quality-of-life concerns and evidence-based practice regarding symptom management.
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Affiliation(s)
- Mary Weinstein Dunn
- UNC Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Mathematical modeling of prostate cancer progression in response to androgen ablation therapy. Proc Natl Acad Sci U S A 2011; 108:19701-6. [PMID: 22106268 DOI: 10.1073/pnas.1115750108] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Prostate cancer progression depends in part on the complex interactions between testosterone, its active metabolite DHT, and androgen receptors. In a metastatic setting, the first line of treatment is the elimination of testosterone. However, such interventions are not curative because cancer cells evolve via multiple mechanisms to a castrate-resistant state, allowing progression to a lethal outcome. It is hypothesized that administration of antiandrogen therapy in an intermittent, as opposed to continuous, manner may bestow improved disease control with fewer treatment-related toxicities. The present study develops a biochemically motivated mathematical model of antiandrogen therapy that can be tested prospectively as a predictive tool. The model includes "personalized" parameters, which address the heterogeneity in the predicted course of the disease under various androgen-deprivation schedules. Model simulations are able to capture a variety of clinically observed outcomes for "average" patient data under different intermittent schedules. The model predicts that in the absence of a competitive advantage of androgen-dependent cancer cells over castration-resistant cancer cells, intermittent scheduling can lead to more rapid treatment failure as compared to continuous treatment. However, increasing a competitive advantage for hormone-sensitive cells swings the balance in favor of intermittent scheduling, delaying the acquisition of genetic or epigenetic alterations empowering androgen resistance. Given the near universal prevalence of antiandrogen treatment failure in the absence of competing mortality, such modeling has the potential of developing into a useful tool for incorporation into clinical research trials and ultimately as a prognostic tool for individual patients.
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Percent tumor volume predicts biochemical recurrence after radical prostatectomy: multi-institutional data analysis. Int J Clin Oncol 2011; 17:355-60. [DOI: 10.1007/s10147-011-0295-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 07/19/2011] [Indexed: 10/18/2022]
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Betrouni N, Iancu A, Puech P, Mordon S, Makni N. ProstAtlas: a digital morphologic atlas of the prostate. Eur J Radiol 2011; 81:1969-75. [PMID: 21632192 DOI: 10.1016/j.ejrad.2011.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 05/05/2011] [Indexed: 10/18/2022]
Abstract
Computer-aided medical interventions and medical robotics for prostate cancer have known an increasing interest and research activity. However before the routine deployment of these procedures in clinical practice becomes a reality, in vivo and in silico validations must be undertaken. In this study, we developed a digital morphologic atlas of the prostate. We were interested by the gland, the peripheral zone and the central gland. Starting from an image base collected from 30 selected patients, a mean shape and most important deformations for each structure were deduced using principal component analysis. The usefulness of this atlas was highlighted in two applications: image simulation and physical phantom design.
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Affiliation(s)
- N Betrouni
- Inserm, U703, 152, rue du Docteur Yersin, 59120 Loos, France.
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Fukuta F, Masumori N, Mori M, Tsukamoto T. Internal prostatic architecture on transrectal ultrasonography predicts future prostatic growth: natural history of prostatic hyperplasia in a 15-year longitudinal community-based study. Prostate 2011; 71:597-603. [PMID: 20945406 DOI: 10.1002/pros.21275] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 08/24/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND From 1992 to 1993, we conducted a cross-sectional community-based study to clarify the prevalence of benign prostatic hyperplasia in Japanese men aged 40-79. Based on the results, we hypothesized that the internal prostatic architecture (IPA) on transrectal ultrasonography (TRUS) would predict future prostatic growth. We investigated the changes in prostate volume (PV) over time and validated our hypothesis on predictors for future prostatic growth. METHODS Of 319 participants in the initial study, the PV of 104 men was evaluated by TRUS with approximately a 15-year follow-up in the current study. We categorized prostates into three groups based on the IPA: group 1, invisible transition zone (TZ); group 2, visible TZ with an unclear border; and group 3, visible TZ with a clear border. RESULTS Overall PV significantly increased from 17.4 ml to 23.9 ml (P < 0.001). The median PV changes by age decade (40s, 50s, 60s, and 70s) were 5.5, 5.6, 8.6, and 11.1 ml, respectively. Those by baseline PV < 20 ml, 20-25 ml, and ≥ 25 ml were 5.3, 9.8, and 14.7 ml, respectively. Those by baseline IPA for group 1, group 2, and group 3 were 4.7, 6.5, and 17.3 ml, respectively. Multiple linear regression analysis indicated that PV (P = 0.027) and the IPA (P < 0.001) at baseline were independent predictors for future prostatic growth. CONCLUSIONS This was the first study by longitudinal community-based study that the PV in Japanese men increased during 15 years. The IPA on TRUS is useful for predicting future prostatic growth.
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Affiliation(s)
- Fumimasa Fukuta
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
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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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Zhang Y, Wang Y, Zhang P, Zhang XD, Yang Y. Extended-release doxazosin for treatment of renal transplant recipients with benign prostatic hyperplasia. Transplant Proc 2009; 41:3747-51. [PMID: 19917379 DOI: 10.1016/j.transproceed.2009.06.199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2009] [Revised: 06/13/2009] [Accepted: 06/24/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED We studied living-related donor renal transplant recipients with benign prostatic hyperplasia (BPH). No prisoners were used in the study either as donors or recipients. We sought to assess the effectiveness and safety of extended-release doxazosin for treatment of renal transplant recipients with BPH. METHODS Forty-six recipients were diagnosed with BPH. Their transplanted kidney functions were stable. They received 4 or 8 mg/d of extended-release doxazosin orally. After 2, 4, 12, and 24 weeks, changes in the International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow rate (Q(max)), residual urine, blood pressure, renal graft function, and trough immunosuppressant concentrations were analyzed by a prospective, self-calibrated method. RESULTS The effectiveness rate of extended-release doxazosin in renal transplant recipients with BPH was 63.04% (29/46). Compared with their status before they took doxazosin, IPSS and residual urine decreased significantly, whereas Q(max) and QoL increased significantly at 2, 4, 12, and 24 weeks after treatment (P < .01). In 15 renal transplant recipients with hypertension, systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly decreased at 2, 4, 12, and 24 weeks after treatment (P < .01); blood pressure became normal in 10 patients (66.67%). The differences in renal graft function and trough concentration of immunosuppressants before versus after treatment were not significant. CONCLUSION Extended-release doxazosin treatment was effective and safe in renal transplant recipients with BPH. The drug not only had no influence on renal graft function and trough concentrations of immunosuppressant, but improved hypertension in these patients.
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Affiliation(s)
- Y Zhang
- Urology Department, Capital Medical University, Beijing, China
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46
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Loeb S, Kettermann A, Carter HB, Ferrucci L, Metter EJ, Walsh PC. Prostate volume changes over time: results from the Baltimore Longitudinal Study of Aging. J Urol 2009; 182:1458-62. [PMID: 19683305 DOI: 10.1016/j.juro.2009.06.047] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE According to a 1944 publication by Swyer benign prostatic hyperplasia develops in some men after age 45 with further prostatic growth whereas in other men prostate size remains stable or decreases with advancing age. Although there is an abundance of literature describing prostatic enlargement in association with benign prostatic hyperplasia, less is known about the phenomenon of prostate atrophy. MATERIALS AND METHODS In the Baltimore Longitudinal Study of Aging serial pelvic magnetic resonance imaging was performed in men without prostate cancer beginning in 1993. From this population we retrospectively identified 278 men with 2 or more magnetic resonance imaging determined prostate volume measurements to examine differential growth rates in a cohort of community men over time. RESULTS Median age was 58 years and median prostate size was 28 cc at study entry. At a median followup of 4.3 years prostate size increased in 61.9% and remained stable or decreased in 38.1% of men. The median rate of volume change was 0.6 cc per year (range -9.9 to 62.1), corresponding to a median growth rate of 2.5% per year (range -29.2 to 176.4%). During followup 64.6% of men with an initial prostate size less than 40 cc had prostate growth compared to only 50.9% of men with an initial prostate size of 40 cc or greater. CONCLUSIONS These results suggest that changes in prostate size are highly variable among aging men. Although benign prostatic hyperplasia is common, a considerable proportion of aging men have a stable or decreasing prostate size. Further research is needed to identify the underlying mechanism for such differences in prostate growth.
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Affiliation(s)
- Stacy Loeb
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
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Chung JS, Byun SS, Han BK, Jeong SJ, Hong SK, Lee SE. Changes in prostate-specific antigen levels and prostate volume in octogenarian men: community-based study. Urology 2009; 73:1270-3. [PMID: 19371943 DOI: 10.1016/j.urology.2008.07.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Revised: 07/24/2008] [Accepted: 07/29/2008] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine the change in prostate-specific antigen (PSA) levels and prostate volume (PV) in octogenarian men compared with those in septuagenarian men and evaluate the possibility of PSA as a surrogate marker for PV in octogenarian men. METHODS A total of 441 men were recruited from whom random and selected oldest-old samples (age >or=85 years) from the Korean Longitudinal Study on Health and Aging, which was a population-based, prospective cohort study on health, aging, and common geriatric diseases of Koreans >or=65 years old. Men in their 70s (n = 136, 70-79 years) and 80s (n = 125, 80-89 years) were included. The PV was measured by transrectal ultrasonography, and the PSA level was determined using immunoradioassay. RESULTS No significant differences were found in the serum PSA levels between the men in their 70s and 80s (P = .128). However, the 95th percentile of the serum PSA level was 5.23 and 6.60 ng/mL in those in their 70s and 80s, respectively. The men in their 80s had a greater total PV and transitional volume than did men in their 70s (P = .026 and P = .009, respectively). The PV and PSA level correlated with age (P = .034), and the increase in PV stratified by PSA was statistically significant (P < .0001). CONCLUSIONS Although the PV had increased steadily in octogenarian men, the serum PSA level of men in their 80s did not show a significant difference compared with men in their 70s. We suggest that PSA is a good surrogate marker for PV, even in octogenarian men.
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Affiliation(s)
- Jae Seung Chung
- Department of Urology, Pochon Cha University College of Medicine, Seongnam, Korea
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