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Minagawa T. Recent developments in diagnostic ultrasound for lower urinary tract function. J Med Ultrason (2001) 2024:10.1007/s10396-024-01494-0. [PMID: 39327335 DOI: 10.1007/s10396-024-01494-0] [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: 07/05/2024] [Accepted: 08/05/2024] [Indexed: 09/28/2024]
Abstract
Ultrasonography (US) is an essential tool in the clinical management of lower urinary tract dysfunction (LUTD), including lower urinary tract symptoms, overactive bladder, and benign prostatic hyperplasia, in which prostatic volume and post-void residual volume are routinely used to evaluate the pathophysiological characteristics of afflicted patients. US can also be employed to diagnose hydronephrosis and bladder calculus as complications of severe LUTD. Moreover, US is essential for identifying pathophysiological characteristics and surgical indications, predicting disease development and drug efficacy, and monitoring bladder function improvement by means of such parameters as bladder wall thickness, prostatic urethral length, intravesical prostatic protrusion, and prostatic urethral angulation/angle. Herein, I narratively review the recent advances in US approaches for the management of LUTD, especially in adult males.
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Affiliation(s)
- Tomonori Minagawa
- Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
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Zhang T, Mao C, Chang Y, Lyu J, Zhao D, Ding S. Hypoxia activates the hypoxia-inducible factor-1α/vascular endothelial growth factor pathway in a prostatic stromal cell line: A mechanism for the pathogenesis of benign prostatic hyperplasia. Curr Urol 2024; 18:185-193. [PMID: 39219634 PMCID: PMC11337991 DOI: 10.1097/cu9.0000000000000233] [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: 05/07/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2024] Open
Abstract
Background The development of benign prostatic hyperplasia (BPH) is closely related to hypoxia in the prostatic stroma, and the hypoxia-inducible factor-1α/vascular endothelial growth factor (HIF-1α/VEGF) pathway has been shown to significantly activate in response to hypoxia. The underlying mechanism for activation of this pathway in the pathogenesis of BPH remains unclear. Materials and methods We constructed HIF-1α overexpression and knockdown BPH stromal (WPMY-1) and epithelial (BPH-1) cell lines, which were cultured under different oxygen conditions (hypoxia, normoxia, and hypoxia + HIF-1α inhibitor). Quantitative real-time polymerase chain reaction (qPCR) and Western blotting were applied to detect the expression of the HIF-1α/VEGF pathway. Cell proliferation and apoptosis were analyzed by Cell Counting Kit-8 and flow cytometry. We used the miRWalk 2.0 database and Western blotting to predict the potential miRNA that selectively targets the HIF-1α/VEGF pathway, and verified the prediction by qPCR and dual-luciferase assays. Results In a BPH stromal cell line (WPMY-1), the expression of VEGF was in accordance with HIF-1α levels, elevated in the overexpression cells and decreased in the knockdown cells. Hypoxia-induced HIF-1α overexpression, which could be reversed by a HIF-1α inhibitor. Moreover, the HIF-1α inhibitor significantly depressed cellular proliferation and promoted apoptosis in hypoxic conditions, assessed by Cell Counting Kit-8 and flow cytometry. However, in the BPH epithelial cell line (BPH-1), the expression level of HIF-1α did not influence the expression of VEGF. Finally, a potential miRNA, miR-17-5p, regulating the HIF-1α/VEGF pathway was predicted from the miRWalk 2.0 database and Western blotting, and verified by qPCR and dual-luciferase assay. Conclusions In hypoxia, activation of the HIF-1α/VEGF pathway plays a crucial role in regulating cell proliferation in a BPH stromal cell line. Regulation by miR-17-5p may be the potential mechanism for the activation of this pathway. Regulation of this pathway may be involved in the pathogenesis of BPH.
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Affiliation(s)
- Tao Zhang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Changlin Mao
- Department of Urology, Mindong Hospital Affiliated to Fujian Medical University, Fuan, China
| | - Yao Chang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jiaju Lyu
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Delong Zhao
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Sentai Ding
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Tanaka K, Hitosugi M, Takaso M, Nakamura M, Takeda A. Affecting Factors of Prostate Volume in Forensic Autopsied Decedents. Healthcare (Basel) 2023; 11:healthcare11101486. [PMID: 37239771 DOI: 10.3390/healthcare11101486] [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: 03/23/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Because decedents undergoing forensic autopsies would have behaved normally before death, prostate volume according to age group can be confirmed with forensic autopsy materials. The objectives of this study were to first confirm the current prostate volume by age and then determine diseases that can influence prostate volume using forensic autopsy materials. Prostate specimens were collected from forensic autopsies performed at Shiga University of Medical Science, Japan, between January 2015 and December 2019. Overall, 207 decedents were included in the study. Prostate volume was measured by the Archimedes' principle. Concomitant diseases were determined by the past medical histories and autopsy results. The mean crude prostate volume was 29.1 ± 10.3 mL (range, 2.8-88.0 mL). The crude prostate volume increased with age. The mean corrected prostate volume (divided by body surface area) was significantly higher in patients with atherosclerosis than in those without. However, multiple regression analysis revealed that only age influenced the corrected prostate volume. Age was the only significant influencing factor for prostate volume. We propose applying age estimation using prostate volume for forensic medicine purposes. Because prostate volume was not influenced by concomitant disease, it would be valuable to estimate the decedent's age using the prostate volume.
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Affiliation(s)
- Kota Tanaka
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Masahito Hitosugi
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Marin Takaso
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Mami Nakamura
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Arisa Takeda
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
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Onigbinde SO, Asaleye CM, Salako AA, Idowu BM, Onigbinde AO, Laoye A. The effect of systemic hypertension on prostatic artery resistive indices in patients with benign prostate enlargement. Prostate Int 2023; 11:46-50. [PMID: 36910898 PMCID: PMC9995693 DOI: 10.1016/j.prnil.2022.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 10/14/2022] Open
Abstract
Background To investigate the effect of systemic hypertension on the prostatic artery resistive indices by a comparative ultrasonographic evaluation of the prostate gland in normotensive and hypertensive patients with benign prostatic enlargement (BPE). Materials and methods The participants had BPE and presented at the outpatient urologic clinic of a tertiary hospital. They were divided into normotensive and hypertensive groups. Each group had fifty patients. Calculation of international prostate symptom score, measurement of blood pressure, and transrectal ultrasonographic evaluation were done. Results The mean age for the normotensive and hypertensive groups were 66.9 ± 9.8 and 66.0 ± 10.7 years, respectively (P = 0.662). Patients with hypertensive BPE had a significantly higher mean transitional zone volume, transitional zone index, presumed circle area ratio, quality of life score, and prostatic arterial resistive indices than the age-matched normotensive BPE patients. Conclusion Patients with BPE and with hypertension had significantly higher prostate arteries resistive indices than normotensives with BPE. Even in patients with BPE and controlled hypertension, the prostatic artery resistance indices were still elevated than that of normotensive men with BPE.
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Affiliation(s)
- Stephen O Onigbinde
- Department of Anatomical Sciences, School of Medicine, St George's University, Grenada
| | - Christianah M Asaleye
- Department of Radiology, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Abdulkadir A Salako
- Department of Surgery, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Bukunmi M Idowu
- Department of Radiology, Union Diagnostics and Clinical Services Plc, Yaba, Lagos, Nigeria
| | - Abimbola O Onigbinde
- Department of Physiology, Neurology and Behavioral Sciences, School of Medicine, St George's University, Grenada
| | - Adeyinka Laoye
- Urology Department, Doncaster and Bassetlaw Teaching Hospitals NHS Found, South Yorkshire, United Kingdom
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Oxidative Stress Links Aging-Associated Cardiovascular Diseases and Prostatic Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5896136. [PMID: 34336107 PMCID: PMC8313344 DOI: 10.1155/2021/5896136] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/17/2021] [Accepted: 07/03/2021] [Indexed: 11/29/2022]
Abstract
The incidence of chronic aging-associated diseases, especially cardiovascular and prostatic diseases, is increasing with the aging of society. Evidence indicates that cardiovascular diseases usually coexist with prostatic diseases or increase its risk, while the pathological mechanisms of these diseases are unknown. Oxidative stress plays an important role in the development of both cardiovascular and prostatic diseases. The levels of oxidative stress biomarkers are higher in patients with cardiovascular diseases, and these also contribute to the development of prostatic diseases, suggesting cardiovascular diseases may increase the risk of prostatic diseases via oxidative stress. This review summarizes the role of oxidative stress in cardiovascular and prostatic diseases and also focuses on the main shared pathways underlying these diseases, in order to provide potential prevention and treatment targets.
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Quiros-Roldan E, Carriero C, Paghera S, Degli Antoni M, Fiorini C, Quaresima V, Castelli F, Imberti L. Symptoms and quality of life in HIV-infected patients with benign prostatic hyperplasia are improved by the consumption of a newly developed whole tomato-based food supplement. A phase II prospective, randomized double-blinded, placebo-controlled study. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104495] [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] Open
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Shimizu S, Nagao Y, Kataoka T, Kamada S, Shimizu T, Higashi Y, Saito M. Protective effects of tadalafil on prostatic hyperplasia in spontaneously hypertensive rats. Eur J Pharmacol 2020; 882:173313. [DOI: 10.1016/j.ejphar.2020.173313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 02/06/2023]
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Increased One-Year Recurrent Ischemic Stroke after First-Ever Ischemic Stroke in Males with Benign Prostatic Hyperplasia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155360. [PMID: 32722374 PMCID: PMC7432020 DOI: 10.3390/ijerph17155360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022]
Abstract
(1) Background: Patients with benign prostatic hyperplasia (BPH) were questioned about quality of life and sleep. Most BPH patients were treated with alpha-1 adrenergic receptor antagonists, which could improve cerebral blood flow for 1–2 months. Patients with ischemic stroke (IS) could experience cerebral autoregulation impairment for six months. The relationship between BPH and recurrent IS remains unclear. The aim of this study was to determine the risk of one-year recurrent IS conferred by BPH. (2) Methods: We used data from the Taiwanese National Health Insurance Database to identify newly diagnosed IS cases entered from 1 January 2008 to 31 December 2008. Patients were followed until the recurrent IS event or 365 days after the first hospitalization. The risk factors associated with one-year recurrent IS were assessed using Cox proportional hazards regression. (3) Results: Patients with BPH had a higher risk of recurrent IS (12.11% versus 8.15%) (adjusted hazard ratio (HR): 1.352; 95% confidence interval (CI): 1.028–1.78, p = 0.031). Other risk factors included hyperlipidemia (adjusted HR: 1.338; 95% CI: 1.022–1.751, p = 0.034), coronary artery disease (adjusted HR: 1.487; 95% CI: 1.128–1.961, p = 0.005), chronic obstructive pulmonary disease (adjusted HR: 1.499; 95% CI: 1.075–2.091, p = 0.017), and chronic kidney disease (adjusted HR: 1.523; 95% CI: 1.033–2.244, p = 0.033). (4) Conclusion: Patients with BPH who had these risk factors had an increased risk of one-year recurrent IS. The modification of risk factors may prevent recurrent IS.
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Yang T, Huang Y, Zhou Y, Chen S, Wang H, Hu Y, Liu J, Jiang Z, Lu Q, Yin X. Simultaneous quantification of oestrogens and androgens in the serum of patients with benign prostatic hyperplasia by liquid chromatography-Tandem mass spectrometry. Andrologia 2020; 52:e13611. [PMID: 32441855 DOI: 10.1111/and.13611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 12/15/2022] Open
Abstract
Benign prostate hyperplasia (BPH) is a common disease in elderly men. It has been found that the occurrence of BPH was closely related to dysregulated steroid hormones. Here, a rapid, sensitive, accurate and specific method for the quantitative profiling of five androgens in man serum was developed and validated by the use of liquid chromatography-tandem mass spectrometry (LC-MS/MS). Using this method, dehydroepiandrosterone (DHEA), androstenedione (A4), testosterone (T), androsterone (A), dihydrotestosterone (DHT), oestrone (E1) and oestradiol (E2) were quantified in serum from man with and without BPH. BPH patients were characterised by the decreases in DHEA, A4 and T as well as increases in DHT, E2 and E1 in serum. Meanwhile, DHEA and DHT in serum were screened as sensitive biomarkers of BPH patients. This study will provide a new perspective of dysregulated steroid hormones for the diagnosis and prevention of BPH.
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Affiliation(s)
- Tingting Yang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Yuhan Huang
- Department of Pharmacy, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yi Zhou
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Shangxiu Chen
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Haiyan Wang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Yinlu Hu
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Junjie Liu
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhenzhou Jiang
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Qian Lu
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
| | - Xiaoxing Yin
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
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Mubenga LE, Hermans MP, Chimanuka D, Muhindo L, Cikomola J, Bahizire E, Tombal B. Anthropometric and cardiometabolic correlates of prostate volume among diabetic and non-diabetic subjects in South-Kivu. Diabetes Metab Syndr 2019; 13:350-355. [PMID: 30641724 DOI: 10.1016/j.dsx.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 10/09/2018] [Indexed: 11/26/2022]
Affiliation(s)
- L E Mubenga
- Department of Urology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - M P Hermans
- Division of Endocrinology and Nutrition, Cliniques Universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - D Chimanuka
- Department of Urology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - L Muhindo
- Department of Urology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - J Cikomola
- Division of Endocrinology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - E Bahizire
- Center of Research in Epidemiology and Biostatistics and Clinical Research. Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya; Centre de Recherche en Sciences Naturelles de Lwiro, Bukavu, Democratic Republic of Congo.
| | - B Tombal
- Department of Urology, Université Catholique de Louvain (UCL), Brussels, Belgium.
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Wu KY, Tsai YS, Chen CH, Chen IH, Tzai TS, Tong YC. Association of Prostate Blood Flow with Male Lower Urinary Tract Symptoms. Urol Int 2016; 97:352-357. [PMID: 27632556 DOI: 10.1159/000449233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/17/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate the association of prostate blood flow (PBF) with lower urinary tract symptoms (LUTS) in aged males using Doppler spectral waveform (DSW) analysis. PATIENTS AND METHODS We performed a prospective analysis involving 133 aged males with clinical diagnosis of LUTS. DSW parameters (peak-systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI)) were measured at bilateral neurovascular bundles (NVB), periurethral, and capsular branches by Doppler transrectal ultrasound with the patient in the right lateral decubitus position. The associations of PBF parameters and the International Prostate Symptom Score (IPSS) were analyzed. RESULTS Overall, total IPSS scores were significantly correlated with the RI of bilateral NVB vessels (r2 = 0.03, 0.04; p = 0.04, 0.02, respectively), and PSV of left NVB vessels. PSV of bilateral NVB vessels were associated with the storage score (p = 0.022 and p = 0.016), but not with the voiding score. The sum of the frequency and urgency score was also associated with EDV of both capsular and urethral branches (p = 0.043 and p = 0.009, respectively), and PSV of NVB vessels on both sides (p = 0.045 and p = 0.019, respectively). CONCLUSIONS There is an association between PBF and LUTS, especially with storage symptoms. The findings may provide some insights in understanding the underlying pathophysiology of lower urinary tract dysfunction.
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Affiliation(s)
- Kuan-Yu Wu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract
We evaluated the impact of total prostate volume (TPV) on the international index of erectile function-5 (IIEF) and the premature ejaculation diagnostic tool (PEDT). A cross-sectional study was conducted that included 8336 men who had participated in a health examination. PEDT, IIEF and transrectal ultrasonography were used. A full metabolic work-up and serum testosterone level checks were also performed. The median age of participants was 51.0 years. In total, 40.1% had IIEF scores ≤16. Additionally, 24.7% were classified as demonstrating premature ejaculation (PE) (PEDT > 10). The severity of erectile dysfunction (ED) significantly increased with the TPV (p trend < 0.001). After adjusting for potential confounding factors, the odds ratio (OR) for IIEF scores ≤ 16 significantly increased in the group with TPVs of 30-39 cm(3) and the group with TPVs ≥ 40 cm(3) compared with the group with TPVs ≤ 19 cm(3) (TPV 30-39 cm(3), OR: 1.204, 95% confidence interval: 1.034-1.403; TPV ≥ 40 cm(3), OR: 1.326: 95% confidence interval: 1.051-1.733) and this relationship was maintained after adjusting for propensity score (TPV ≥ 30 cm(3), OR: 1.138: 95% confidence interval: 1.012-1.280). However, neither PEDT nor PE was correlated with TPV. In conclusion, TPV is significantly and independently correlated with IIEF but not with PEDT. Future investigations should explore the temporal relationship between TPV and ED.
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Affiliation(s)
- Jun Ho Lee
- a Department of Urology , National Police Hospital , Seoul , Korea and
| | - Sung Won Lee
- b Department of Urology , Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine , Seoul , Korea
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Abstract
Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) commonly affect older men. Age-related changes associated with metabolic disturbances, changes in hormone balance, and chronic inflammation may cause BPH development. The diagnosis of BPH hinges on a thorough medical history and focused physical examination, with attention to other conditions that may be causing LUTS. Digital rectal examination and urinalysis should be performed. Other testing may be considered depending on presentation of symptoms, including prostate-specific antigen, serum creatinine, urine cytology, imaging, cystourethroscopy, post-void residual, and pressure-flow studies. Many medical and surgical treatment options exist. Surgery should be reserved for patients who either have failed medical management or have complications from BPH, such as recurrent urinary tract infections, refractory urinary retention, bladder stones, or renal insufficiency as a result of obstructive uropathy.
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Affiliation(s)
- Eric H Kim
- Washington University School of Medicine, St. Louis, Missouri 63110; , ,
| | - Jeffrey A Larson
- Washington University School of Medicine, St. Louis, Missouri 63110; , ,
| | - Gerald L Andriole
- Washington University School of Medicine, St. Louis, Missouri 63110; , ,
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Ischemia in Pelvic Organs as an Independent Pathogenic Factor in the Development of Benign Prostatic Hyperplasia and Urinary Bladder Dysfunction. Bull Exp Biol Med 2015; 158:718-22. [DOI: 10.1007/s10517-015-2845-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Indexed: 11/29/2022]
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Association between prostatic resistive index and cardiovascular risk factors in patients with benign prostatic hyperplasia. Kaohsiung J Med Sci 2015; 31:194-8. [PMID: 25835275 DOI: 10.1016/j.kjms.2014.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 10/15/2014] [Accepted: 12/05/2014] [Indexed: 11/21/2022] Open
Abstract
We evaluated the relationship between prostatic resistive index (RI) and cardiovascular system (CVS) risk factors in patients with benign prostatic hyperplasia. The study included 120 patients who were attending our outpatient clinic with lower urinary tract symptoms related to benign prostatic hyperplasia. The clinical, laboratory, anthropometric data, and CVS risk factors (hypertension, diabetes mellitus, metabolic syndrome, history of CVS events, and smoking) of the patients were evaluated regarding the association between prostate RI level by regression analyses. The prostatic RI levels of the patients were measured using power Doppler imaging. In univariate regression analysis, there were statistically significant relationships between prostatic RI levels and the patients' age, International Prostate Symptom Score, hip circumference, fasting blood glucose, prostate specific antigen, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total prostate volume, uroflowmetric maximal flow rate, and all investigated CVS risk factors (p < 0.05). The prostatic RI levels were found to be associated with fasting blood glucose and total prostate volume, and also with CVS risk factors including only metabolic syndrome and cigarette smoking in the multivariate regression analysis. Our results showed that prostatic RI level is significantly related to metabolic syndrome and smoking among the investigated CVS risk factors.
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Blankstein U, Chughtai B, Elterman DS. Relationship Between the Metabolic Syndrome and BPH-Related Voiding Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2014. [DOI: 10.1007/s11884-014-0230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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HWANG EC, KIM SO, NAM DH, YU HS, HWANG I, JUNG SI, KANG TW, KWON DD, KIM GS. Men with Hypertension are More Likely to Have Severe Lower Urinary Tract Symptoms and Large Prostate Volume. Low Urin Tract Symptoms 2013; 7:32-6. [DOI: 10.1111/luts.12046] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 09/29/2013] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Eu Chang HWANG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Sun-Ouck KIM
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Deok-Hyun NAM
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Ho Song YU
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Insang HWANG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Seung Il JUNG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Taek Won KANG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Dong Deuk KWON
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
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Capitanio U, Salonia A, Briganti A, Montorsi F. Silodosin in the management of lower urinary tract symptoms as a result of benign prostatic hyperplasia: who are the best candidates. Int J Clin Pract 2013; 67:544-51. [PMID: 23409749 DOI: 10.1111/ijcp.12135] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 01/18/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND As the clinical effects of the available α1-adrenoceptors (ARs) blockers are usually considered comparable for treatment in patients suffering from lower urinary tract symptoms (LUTS) secondary to prostatic enlargement, officially recognised guidelines do not make specific recommendations regarding the choice of which agent should be considered according to the patient's characteristics. AIM To analyse data supporting the use of silodosin, a highly selective once-daily dosing α1-ARs blocker, in different daily clinical practice scenarios. MATERIALS AND METHODS A structured literature review was performed using data retrieved from articles assessing the role of silodosin in the management of LUTS secondary to benign prostatic hyperplasia (BPH). A literature search of English language publications was performed using MEDLINE(®) and Web of Science from 2000 to 2012 using the terms LUTS; BPH; silodosin; α1-ARs blockers. The papers with the highest level of evidence were identified and represent the basis of the present review. RESULTS Available data coming from basic research analyses, randomised trials and prospective studies showed that silodosin is efficacious for the initial management of patients with LUTS. Clinical developmental safety data from patients receiving silodosin with concomitant antihypertensive therapy do not indicate an increase in risk of orthostatic hypotension. In this context, a recent study demonstrated that silodosin can be safely administered to patients who are consensually assuming phosphodiesterase type 5 inhibitors. A recent randomised crossover study comparing the efficacy of silodosin and tamsulosin in patients with LUTS showed that further significant improvement was observed after switching to silodosin treatment, while worsening or little improvement was observed after switching to tamsulosin treatment. Preliminary results seem to demonstrate a potential role of silodosin in the treatment of chronic prostatitis/chronic pelvic pain syndrome and to facilitate ureteral stone passage, as well. DISCUSSION When considering the above cited pharmacological and clinical characteristics of the drug, silodosin can be considered in the following clinical scenario: patients suffering from moderate-severe nocturia, patients with low normal blood pressure levels and patients concomitantly treated with antihypertensive medications, patients concomitantly treated with phosphodiesterase type 5 inhibitors, patients not satisfied (for efficacy or tolerability) with previous treatment with other α1-ARs blockers. CONCLUSION Silodosin is efficacious for the initial management of patients with LUTS. Silodosin has a good cardiovascular safety profile and can be considered an option in patients with cardiovascular co-morbidities. It seems to be especially beneficial in patients with nocturia alone or presenting with the symptomatic trial nocturia-frequency-incomplete emptying. Patients on phosphodiesterase type 5 inhibitors treatment can be safely managed with silodosin.
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Affiliation(s)
- U Capitanio
- Department of Urology, Vita Salute San Raffaele University, Milan, Italy
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Tabatabaei S, Talab SS, Zangi M, Woo HH. Office evaluation of male patients with lower urinary tract symptoms. Curr Urol Rep 2012; 13:474-81. [PMID: 23015073 DOI: 10.1007/s11934-012-0283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) are one of the most common urologic disorders in men. Accurate history-taking and focused physical examination allows us to diagnose the majority of cases. A better understanding of risk factors helps us tailor our treatment and predict outcomes more accurately. Population studies are crucial in our understanding of LUTS/BPH natural history. Temporary prostatic urethral stents that are used for the management of urinary retention may also be used for evaluation of patients with detrusor hypo-contractility. The use of ultrasound to measure intravesical prostatic protrusion (IPP) and the Doppler study for prostate capsular artery resistive index are promising. Near-infrared spectroscopy (NIRS) examines the tissue oxygenation that may be affected by bladder outlet obstruction. The mathematical algorithm needs some fine-tuning, and its reproducibility is debatable. Serum and urinary biomarkers may help us to diagnose the disorder, and more effectively monitor patients' response to therapy. Among all, IPP is clinically more applicable at this time.
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Affiliation(s)
- Shahin Tabatabaei
- Department of Urology, Harvard Medical School, Massachusetts General Hospital, Boston, 02114, USA.
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Lee LM, Tsai TC, Chung HH, Tong YC, Cheng JT. Prostatic relaxation induced by agmatine is decreased in spontaneously hypertensive rats. BJU Int 2012; 110:E253-8. [PMID: 22587433 DOI: 10.1111/j.1464-410x.2012.11196.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED What's known on the subject? and What does the study add? Neurotransmitters are known to control prostate contractility. Agmatine is one of them and induces relaxation through imidazoline receptors. The paper shows that the action of agmatine is reduced in hypertensive rats, and that this change is related to the decrease of ATP-sensitive potassium channels in the prostate. The findings can increase our understanding of the possible underlying mechanism for the development of clinical benign prostatic hyperplasia. OBJECTIVES To compare agmatine-induced prostatic relaxation in hypertensive and control rats. To investigate the responsible mechanism(s) and the role of the ATP-sensitive potassium channel. METHODS Prostate strips were isolated from male spontaneously hypertensive (SH) rats and normal Wistar-Kyoto (WKY) rats for measurement of isometric tension. The strips were precontracted with 1 µmol/L phenylephrine or 50 mmol/L KCl. Dose-dependent relaxation of the prostatic strips was studied by cumulative administration of agmatine, 1 to 100 µmol/L, into the organ bath. Effects of specific antagonists on agmatine-induced relaxation were studied. Western blotting analysis was used to measure the gene expression of the ATP-sensitive potassium channel in the rat prostate. RESULTS Prostatic relaxation induced by agmatine was markedly reduced in SH rats compared with WKY rats. The relaxation caused by agmatine was abolished by BU224, a selective imidazoline I(2)-receptor antagonist, but was not modified by efaroxan at a dose sufficient to block imidazoline I(1)-receptors. The relaxation induced by diazoxide at a concentration sufficient to activate ATP-sensitive potassium channels was markedly reduced in the SH rat prostate. Expressions of ATP-sensitive potassium channel sulphonylurea receptor and inwardly rectifying potassium channel (Kir) 6.2 subunits were both decreased in the prostate of SH rats. CONCLUSION The decrease of agmatine-induced prostatic relaxation in SH rats is related to the change in ATP-sensitive potassium channels.
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Affiliation(s)
- Liang-Ming Lee
- Department of Urology, College of Medicine, Taipei Medical University-Wan-Fang Hospital, Wang-Fang, Taipei City, Taiwan
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