Variation of prostatic morphology in Chinese benign prostatic hyperplasia patients of different age decades

Analysis of Postoperative Urinary Incontinence and Influencing Factors of Transurethral Holmium Laser Enucleation of the Prostate

INTRODUCTION

Aims of the study were to investigate the related factors of urinary incontinence after transurethral holmium laser enucleation of the prostate (HoLEP) and to provide guidance for clinical urinary control of HoLEP.

METHODS

The clinical data of 548 patients who underwent HoLEP were retrospectively analyzed. The patients were followed up for the occurrence of urinary incontinence in the short term (2 weeks), medium term (3 months), and long term (6 months) after HoLEP.

RESULTS

Among the 548 benign prostatic hyperplasia patients, 79 cases (14.42%) had urinary incontinence at 2 weeks, 19 cases (3.47%) at 3 months, and 2 cases (0.36%) at 6 months after surgery. Logistic regression analysis showed that age, prostate volume, diabetes mellitus, operation time, prostate tissue weight, and histological prostatitis were risk factors for recent urinary incontinence (p < 0.05). Age, diabetes, and operation time were risk factors for mid-term urinary incontinence (p < 0.05). The incidence of long-term urinary incontinence was low and no risk factor analysis was performed.

CONCLUSIONS

For good urinary control after HoLEP, in addition to surgery-related factors such as surgical skills, proficiency, and precise anatomy, patients' risk factors should also be paid attention to in order to improve postoperative urinary control more effectively and reduce the incidence of urinary incontinence.

Analysis of platelet and monocyte-to-lymphocyte ratio and diabetes mellitus with benign prostatic enlargement

Background

The etiology of benign prostatic hyperplasia (BPH) is still elusive. The aim of this study was to provide preventive and prognostic parameters associated with diabetes mellitus with benign prostatic enlargement (BPE).

Methods

Diabetic patients were collected retrospectively from February 2021 to December 2022, including monocyte-to-lymphocyte ratio (MLR). Diabetic patients were divided into two groups by whether the prostate volume was greater than or equal to 30 ml, which were diabetes mellitus without BPE (DM) and diabetes mellitus with BPE (DM+BPE). The baseline characteristics were compared, the risk and protective factors associated with DM+BPE were determined using univariate and multivariate logistic regression, and the parameters associated with prostate volume were determined using correlation analysis.

Results

Of the 671 patients collected, age and prostate volume were significantly higher in the DM+BPE than in the DM; MLR was higher in the DM+BPE than in the DM; and platelet was significantly lower in the DM+BPE than in the DM. Univariate logistic regression showed that age was a risk factor, while protective factors for DM+BPE were lymphocytes and platelet. Multifactorial logistic regression showed that age was a risk factor, while platelet was the protective factor for DM+BPE. In the total overall (n=671), prostate volume was positively correlated with age. Prostate volume was negatively correlated with lymphocytes and platelet. In DM+BPE (n=142), prostate volume was positively correlated with age and MLR.

Conclusion

Platelet was a protective factor for DM+BPE and was negatively correlated with prostate volume, whereas MLR was positively correlated with prostate volume in DM+BPE.

Combination of Lycopene and Curcumin Synergistically Alleviates Testosterone-Propionate-Induced Benign Prostatic Hyperplasia in Sprague Dawley Rats via Modulating Inflammation and Proliferation

BACKGROUND

Benign prostatic hyperplasia (BPH) is a progressive urological disease occurring in middle-aged and elderly men, which can be characterized by the non-malignant overgrowth of stromal and epithelial cells in the transition zone of the prostate. Previous studies have demonstrated that lycopene can inhibit proliferation, while curcumin can strongly inhibit inflammation. This study aims to determine the inhibitory effect of the combination of lycopene and curcumin on BPH.

METHOD

To induce BPH models in vitro and in vivo, the BPH-1 cell line and Sprague Dawley (SD) rats were used, respectively. Rats were divided into six groups and treated daily with a vehicle, lycopene (12.5 mg/kg), curcumin (2.4 mg/kg), a combination of lycopene and curcumin (12.5 mg/kg + 2.4 mg/kg) or finasteride (5 mg/kg). Histologic sections were examined via hematoxylin and eosin (H&E) staining and immunohistochemistry. Hormone and inflammatory indicators were detected via ELISA. Network pharmacology analysis was used to fully predict the therapeutic mechanism of the combination of lycopene and curcumin on BPH.

RESULTS

Combination treatment significantly attenuated prostate hyperplasia, alleviated BPH pathological features and decreased the expression of Ki-67 in rats. The upregulation of the expression of testosterone, dihydrotestosterone (DHT), 5α-reductase, estradiol (E2) and prostate-specific antigen (PSA) in BPH rats was significantly blocked by the combination treatment. The expression levels of inflammatory factors including interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α were strongly inhibited by the combination treatment. From the network pharmacology analysis, it was found that the main targets for inhibiting BPH are AKT1, TNF, EGFR, STAT3 and PTGS2, which are enriched in pathways in cancer.

CONCLUSION

The lycopene and curcumin combination is a potential and more effective agent to prevent or treat BPH.

Combination of Ligustri Lucidi Fructus with Ecliptae Herba and their phytoestrogen or phytoandrogen like active pharmaceutical ingredients alleviate oestrogen/testosterone-induced benign prostatic hyperplasia through regulating steroid 5-α-reductase

BACKGROUND

Benign prostatic hyperplasia (BPH) is a urinary system disease with high prevalence among the middle and elder men. In BPH, proliferation of prostate cells and the imbanlance between androgen and estrogen are both important inducers. Previous studies have demonstrated that compounds from Ligustri Lucidi Fructus (LLF) and Ecliptae Herba (EH) are of phytoestrogenic or phytoandrogenic activities. The combination of LLF with EH at the ratio of 1:1 on crude drugs quantity is called Erzhi formula (EZF), which is used for in vivo research of our study.

PURPOSE

This study aimed to investigate potential mechanisms of EZF and its active pharmaceutical ingredients on BPH in vitro and in vivo.

METHODS

Therapeutic effects of EZF was evaluated in E₂/testosterone (1:100) induced BPH rats model. The pathological changes of prostate, concentrations of testosterone, DHT, E₂, PSA in rats' plasma and prostate were detected. The expressions of PCNA, AR, ERα, ERβ, SRD5A1, SRD5A2 were measured in BPH rat prostates and E₂-stimulated human benign prostatic epithelial cells (BPH-1).

RESULTS

EZF treatment significantly attenuated rat prostate enlargement, alleviated BPH pathological features, and decreased the expression of PCNA. The up-regulation of AR, ERα, SRD5A1/2 expressions, and down-regulation of ERβ expression at prostate of rat BPH model were significantly blocked by EZF administration. The expression levels of testosterone, DHT, E₂, PSA were strongly inhibited by EZF treatment. At the cellular level, ligustrosidic acid and echinocystic acid inhibited E₂-induced BPH-1 cell proliferation and PCNA expressions, which were consistent with the results in vivo. And these two ingredients also down-regulated the expressions of AR, ERα, SRD5A1/2 and up-regulated the expression of ERβ in BPH-1 cells.

CONCLUSION

EZF, ligustrosidic acid from LLF and echinocystic acid from EH showed inhibitive effects on BPH via down-regulating prostatic AR, ERα, SRD5A1/2 expressions and up-regulating ERβ expression.

Correlation of prostatic morphological parameters and clinical progression in aging Chinese men with benign prostatic hyperplasia: Results from a cross-sectional study

OBJECTIVES

Our study aimed to investigate the correlation of prostatic morphological parameters and benign prostatic hyperplasia (BPH) clinical progression in aging Chinese men.

METHODS

In this retrospective study, a total of 1038 patients were reviewed. Prostatic morphology was measured by transrectal ultrasound (TRUS). Detailed medical history of all candidates was recorded and analyzed after being classified by specific prostatic measurements. Univariate and multivariate logistic regression analyses were used to estimate the correlation between variables.

RESULTS

The cumulative incidence of BPH clinical progression was 63.68% (661/1038) in the study population. Prostate volume (PV), transitional zone volume (TZV), transitional zone index (TZI), and intravesical prostatic protrusion (IPP) were all positively associated with BPH progression (all p < .001). Patients with a PV > 60 ml, TZV > 15 ml, TZI > 0.5, or IPP > 5 mm had a significantly higher possibility of overall BPH clinical progression (adjusted odds ratio (OR): 2.485, 1.678, 1.886, and 1.924, respectively; 95% confidence interval (CI): 1.559-3.960, 1.131-2.489, 1.379-2.579, and 1.357-2.728, correspondingly).

CONCLUSION

Prostatic morphological parameters are significantly associated with BPH clinical progression. Patients with larger prostatic morphological parameters are more easily prone to clinical progress. As a result, reasonable managements should be timely considered for those patients before clinical progression occurs.