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Çakıroğlu B. Minimally invasive connective water vapor energy method for benign prostatic hyperplasia. Urologia 2024; 91:298-305. [PMID: 38069654 DOI: 10.1177/03915603231216191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
The Rezūm system has emerged as a promising treatment option for benign prostatic hyperplasia (BPH) by employing endoscopic removal of prostate tissue. This meta-analysis aimed to evaluate the benefits and drawbacks of Rezūm therapy in recent studies. A systematic literature search was conducted in EMBASE, PubMed, and the Cochrane Library databases until December 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search utilized keywords such as water vapor thermal therapy, Rezūm, convective water vapor thermal therapy, and convective radiofrequency water vapor thermal therapy. A total of 21 studies were included in the analysis, comprising 5 prospective randomized studies, 2 case series, 2 randomized controlled trials, 1 crossover study, and 11 retrospective studies. The collective sample involved 2090 patients with a mean follow-up period of 14.42 ± 18.08 (1-72) months and a mean age of 68.12 ± 4.79 years. Significant improvements were reported in the International Prostate Symptom Score (IPSS), quality of life (QoL), maximal flow rate (Qmax), postvoid residual urine volume (PVR), prostate volume (PV), and International Erectile Index Function (IIEF) values. Unlike other BPH treatments that often require general or regional anesthesia, the connective water vapor energy system can be administered with sedo-analgesia and local anesthesia, potentially leading to improved sexual function scores. Considering the relief of symptoms, Rezūm therapy may serve as a viable alternative to transurethral surgery for patients with prostate volumes ranging from <30 to >80 cc.
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Affiliation(s)
- Basri Çakıroğlu
- Urology Department, Hisar Intercontinental Hospital, Istanbul, Turkey
- Istanbul Galata University, Istanbul, Turkey
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2
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Abubakar M, Prasad R, Salim SS, Basavaraju D, Khan M, Lateef IK, Furqan A, Raza S, Gupta I, Singla D, Adil H, Naeem A. Orthostatic Hypotension in Benign Prostatic Hyperplasia Patients and Its Association With Alpha-1 Antagonist Use: A Comprehensive Literature Review. Cureus 2023; 15:e44097. [PMID: 37750139 PMCID: PMC10518119 DOI: 10.7759/cureus.44097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
Orthostatic hypotension (OH) is frequently observed in benign prostatic hyperplasia (BPH) patients undergoing alpha-1 adrenergic antagonist (A1AA) therapy. While previous studies have acknowledged the prevalence of OH in BPH patients on A1AAs, limited data exist on ranking the safety of different A1AAs. This comprehensive review explores the underlying mechanisms of OH, examines numerous factors influencing its development, and provides insights into effective treatment strategies such as hydration, gradual postural changes, leg exercises, compression stockings, and tilt-table training for BPH management. The review highlights the significance of individualized care, interdisciplinary collaboration, and further research to optimize A1AA treatment, improve patient outcomes, and enhance quality of life.
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Affiliation(s)
- Muhammad Abubakar
- Department of Internal Medicine, Siddique Sadiq Memorial Trust Hospital, Gujranwala, PAK
- Department of Internal Medicine, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, PAK
| | - Rachna Prasad
- Department of Internal Medicine, Stanley Medical College, Chennai, IND
| | - Siffat S Salim
- Department of Surgery, Holy Family Red Crescent Medical College Hospital, Dhaka, BGD
| | - Deepak Basavaraju
- Department of Internal Medicine, Mysore Medical College and Research Institute, Mysore, IND
| | - Munazza Khan
- Department of Internal Medicine, Medical University Pleven, Pleven, BGR
| | - Ibrahim K Lateef
- Department of Internal Medicine, Medical University Pleven, Pleven, BGR
| | - Ahmad Furqan
- Department of Internal Medicine, Lahore Medical and Dental College, Lahore, PAK
| | - Saud Raza
- Department of Internal Medicine, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, PAK
| | - Ishita Gupta
- Department of Internal Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND
| | - Deepak Singla
- Department of Internal Medicine, Government Medical College, Patiala, Patiala, IND
| | - Hira Adil
- Department of Community Medicine, Khyber Girls Medical College, Peshawar, PAK
| | - Ather Naeem
- Department of Cardiology, Punjab Institute of Cardiology, Lahore, PAK
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3
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Min L, Ha JK, Aubert CE, Hofer TP, Sussman JB, Langa KM, Tinetti M, Kim HM, Maciejewski ML, Gillon L, Larkin A, Chan CL, Kerr EA, Bravata D, Cushman WC. A Method to Quantify Mean Hypertension Treatment Daily Dose Intensity Using Health Care System Data. JAMA Netw Open 2021; 4:e2034059. [PMID: 33449097 PMCID: PMC7811181 DOI: 10.1001/jamanetworkopen.2020.34059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/28/2020] [Indexed: 12/27/2022] Open
Abstract
Importance Simple measures of hypertension treatment, such as achievement of blood pressure (BP) targets, ignore the intensity of treatment once the BP target is met. High-intensity treatment involves increased treatment burden and can be associated with potential adverse effects in older adults. A method was previously developed to identify older patients receiving intense hypertension treatment by low BP and number of BP medications using national Veterans Health Administration and Medicare Part D administrative pharmacy data to evaluate which BP medications a patient is likely taking on any given day. Objective To further develop and validate a method to more precisely quantify dose intensity of hypertension treatment using only health system administrative pharmacy fill data. Design, Setting, and Participants Observational, cross-sectional study of 319 randomly selected older veterans in the national Veterans Health Administration health care system who were taking multiple BP-lowering medications and had a total of 3625 ambulatory care visits from July 1, 2011, to June 30, 2013. Measure development and medical record review occurred January 1, 2017, through November 30, 2018, and data analysis was conducted from December 1, 2019, to August 31, 2020. Main Outcomes and Measures For each BP-lowering medication, a moderate hypertension daily dose (HDD) was defined as half the maximum dose above which no further clinical benefit has been demonstrated by that medication in hypertension trials. Patients' total HDD was calculated using pharmacy data (pharmacy HDDs), accounting for substantial delays in refills (>30 days) when a patient's pill supply was stretched (eg, cutting existing pills in half). As an external comparison, the pharmacy HDDs were correlated with doses manually extracted from clinicians' visit notes (clinically noted HDDs). How well the pharmacy HDDs correlated with clinically noted HDDs was calculated (using C statistics). To facilitate interpretation, HDDs were described in association with the number of medications. Results A total of 316 patients (99.1%) were male; the mean (SD) age was 75.6 (7.2) years. Pharmacy HDDs were highly correlated (r = 0.92) with clinically noted HDDs, with a mean (SD) of 2.7 (1.8) for pharmacy HDDs and 2.8 (1.8) for clinically noted HDDs. Pharmacy HDDs correlated with high-intensity, clinically noted HDDs ranging from a C statistic of 92.8% (95% CI, 92.0%-93.7%) for 2 or more clinically noted HDDs to 88.1% (95% CI, 85.5%-90.6%) for 6 or more clinically noted HDDs. Conclusions and Relevance This study suggests that health system pharmacy data may be used to accurately quantify hypertension regimen dose intensity. Together with clinic-measured BP, this tool can be used in future health system-based research or quality improvement efforts to fine-tune, manage, and optimize hypertension treatment in older adults.
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Affiliation(s)
- Lillian Min
- Veterans Affairs Geriatric Research, Education, and Clinical Center, Veterans Affairs Ann Arbor Medical Center, Ann Arbor, Michigan
- Division of Geriatric and Palliative Medicine, Department of Medicine, University of Michigan, Ann Arbor
- Veterans Affairs Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Jin-Kyung Ha
- Division of Geriatric and Palliative Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - Carole E. Aubert
- Veterans Affairs Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Department of General Internal Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Healthcare, University of Bern, Bern, Switzerland
| | - Timothy P. Hofer
- Veterans Affairs Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Division of General Internal Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Jeremy B. Sussman
- Veterans Affairs Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Division of General Internal Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Kenneth M. Langa
- Veterans Affairs Geriatric Research, Education, and Clinical Center, Veterans Affairs Ann Arbor Medical Center, Ann Arbor, Michigan
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Division of General Internal Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
- Institute for Social Research, University of Michigan, Ann Arbor
| | - Mary Tinetti
- Section of Geriatrics, Department of Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Hyungjin Myra Kim
- Consulting for Statistics, Computing & Analytics Research, University of Michigan, Ann Arbor
- Department of Biostatistics, University of Michigan Medical School, Ann Arbor
| | - Matthew L. Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation, Veterans Affairs Healthcare System, Durham, North Carolina
- Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Leah Gillon
- Veterans Affairs Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan
| | - Angela Larkin
- Veterans Affairs Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan
| | - Chiao-Li Chan
- Division of Geriatric and Palliative Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - Eve A. Kerr
- Veterans Affairs Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Division of General Internal Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Dawn Bravata
- Veterans Affairs Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana
- Department of Medicine, Indiana University School of Medicine, Indianapolis
- Department of Neurology, Indiana University School of Medicine, Indianapolis
- Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana
| | - William C. Cushman
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
- Medical Service, Memphis Veterans Affairs Medical Center, Memphis, Tennessee
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Kalejaiye O, Almekaty K, Blecher G, Minhas S. Premature ejaculation: challenging new and the old concepts. F1000Res 2017; 6:2084. [PMID: 29259775 PMCID: PMC5717471 DOI: 10.12688/f1000research.12150.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 01/23/2023] Open
Abstract
Premature ejaculation remains a difficult condition to manage for patients, their partners, and the clinician. Whilst prevalence rates are estimated to be 20-40%, determining a diagnosis of premature ejaculation is difficult, as the definition remains both subjective and ill-defined in the clinical context. As our understanding of the ejaculatory pathway has improved, new opportunities to treat the condition have evolved with mixed results. In this review, we explore some of these controversies surrounding the aetiology, diagnosis, and treatment of this condition and discuss potential novel therapeutic options.
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Affiliation(s)
- Odunayo Kalejaiye
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
| | - Khaled Almekaty
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
- Urology Department, University of Tanta, Tanta, Egypt
| | - Gideon Blecher
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
| | - Suks Minhas
- Department of Andrology, University College London Medical School, London, W1G 8PH, UK
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Manjunatha R, Pundarikaksha HP, Madhusudhana HR, Amarkumar J, Hanumantharaju BK. A randomized, comparative, open-label study of efficacy and tolerability of alfuzosin, tamsulosin and silodosin in benign prostatic hyperplasia. Indian J Pharmacol 2017; 48:134-40. [PMID: 27127315 PMCID: PMC4825428 DOI: 10.4103/0253-7613.178825] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Benign prostatic hyperplasia (BPH) is a common and progressive disease affecting elderly males, often associated with lower urinary tract symptoms (LUTS). α1-blockers are the mainstay in symptomatic therapy of BPH. Because of their greater uroselectivity and minimal hemodynamic effects, alfuzosin, tamsulosin, and silodosin are generally preferred. The aim of this study was to compare the efficacy and tolerability of alfuzosin, tamsulosin, and silodosin in patients with BPH and LUTS. METHODS Ninety subjects with BPH and LUTS were randomized into three groups of thirty in each, to receive alfuzosin sustained release (SR) 10 mg, tamsulosin 0.4 mg, or silodosin 8 mg for 12 weeks. The primary outcome measure was a change in the International Prostate Symptom Score (IPSS), and the secondary outcome measures were changes in individual subjective symptom scores, quality of life score (QLS), and peak flow rate (Qmax) from baseline. The treatment response was monitored at 2, 4, 8, and 12 weeks. RESULTS IPSS improved by 88.18%, 72.12%, and 82.23% in alfuzosin SR, tamsulosin and silodosin groups (P < 0.001) at 12 weeks. Improvement in QLS was >75% in all the three groups (P < 0.001). A significant improvement in Qmax was seen with alfuzosin and tamsulosin (P = 0.025 and P < 0.001) but not with silodosin (P = 0.153). However, the intergroup differences in IPSS, QLS, and Qmax were not significant. Ejaculatory dysfunction was more common with silodosin and corrected QT (QTc) prolongation occurred only with alfuzosin (two subjects) and tamsulosin (three subjects). CONCLUSION Alfuzosin, tamsulosin, and silodosin showed similar efficacy in improvement of LUTS secondary to BPH, with good tolerability, acceptability, and minimum hemodynamic adverse effects. Alfuzosin, tamsulosin, and silodosin are comparable in efficacy in symptomatic management of BPH. The occurrence of QTc prolongation in three subjects with tamsulosin in the present study is an unexpected adverse event as there are no reports of QTc prolongation with tamsulosin in any of the previous studies.
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Affiliation(s)
- R Manjunatha
- Department of Pharmacology, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India
| | - H P Pundarikaksha
- Department of Pharmacology, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India
| | - H R Madhusudhana
- Department of Urology, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
| | - J Amarkumar
- Department of Urology, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
| | - B K Hanumantharaju
- Department of Urology, Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India
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6
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Abstract
Over the past 20−30 years, the premature ejaculation (PE) treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Pharmacotherapy for PE predominantly targets the multiple neurotransmitters and receptors involved in the control of ejaculation which include serotonin, dopamine, oxytocin, norepinephrine, gamma amino-butyric acid (GABA) and nitric oxide (NO). The objective of this article is to review emerging PE interventions contemporary data on the treatment of PE was reviewed and critiqued using the principles of evidence-based medicine. Multiple well-controlled evidence-based studies have demonstrated the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) in delaying ejaculation, confirming their role as first-line agents for the medical treatment of lifelong and acquired PE. Daily dosing of SSRIs is likely to be associated with superior fold increases in IELT compared to on-demand SSRIs. On-demand SSRIs are less effective but may fulfill the treatment goals of many patients. Integrated pharmacotherapy and CBT may achieve superior treatment outcomes in some patients. PDE-5 inhibitors alone or in combination with SSRIs should be limited to men with acquired PE secondary to co-morbid ED. New on-demand rapid acting SSRIs, oxytocin receptor antagonists, or single agents that target multiple receptors may form the foundation of more effective future on-demand medication. Current evidence confirms the efficacy and safety of dapoxetine, off-label SSRI drugs, tramadol and topical anaesthetics drugs. Treatment with α1-adrenoceptor antagonists cannot be recommended until the results of large well-designed RCTs are published in major international peer-reviewed medical journals. As our understanding of the neurochemical control of ejaculation improves, new therapeutic targets and candidate molecules will be identified which may increase our pharmacotherapeutic armamentarium.
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Affiliation(s)
- Chris G McMahon
- Australian Centre for Sexual Health, Sydney, NSW 2065, Australia
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Đorđević I, Milutinović M, Kostić M, Đorđević B, Dimitrijević M, Stošić N, Ranđelović M, Banković S, Kitić D. PHYTOTHERAPEUTIC APPROACH TO BENIGN PROSTATIC HYPERPLASIA TREATMENT BY PUMPKIN SEED (CUCURBITA PEPO L., CUCURBITACEAE). ACTA MEDICA MEDIANAE 2016. [DOI: 10.5633/amm.2016.0310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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9
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Abstract
INTRODUCTION Over the past 20-30 years, the premature ejaculation (PE) treatment paradigm, previously limited to behavioral psychotherapy, has expanded to include drug treatment. Pharmacotherapy for PE predominantly targets the multiple neurotransmitters and receptors involved in the control of ejaculation, which include serotonin, dopamine, oxytocin, norepinephrine, gamma amino-butyric acid (GABA) and nitric oxide (NO). AIM The objective of this article is to review current and emerging PE interventions. METHODS Contemporary data on the treatment of PE were reviewed and critiqued using the principles of evidence-based medicine. MAIN OUTCOME MEASURE Integrated pharmacotherapy and cognitive behavioral therapy (CBT) may achieve superior treatment outcomes in some patients. Phosphodiesterase type 5 inhibitors alone or in combination with selective serotonin reuptake inhibitors (SSRIs) should be limited to men with acquired PE secondary to comorbid erectile dysfunction (ED). New on-demand rapid-acting SSRIs, oxytocin receptor antagonists, or single agents that target multiple receptors may form the foundation of more effective future on-demand medication. RESULTS Multiple well-controlled evidence-based studies have demonstrated the efficacy and safety of SSRIs in delaying ejaculation, confirming their role as first-line agents for the medical treatment of lifelong and acquired PE. Daily dosing of SSRIs is likely to be associated with superior fold increases in intravaginal ejaculation latency time compared with on-demand SSRIs. On-demand SSRIs are less effective but may fulfill the treatment goals of many patients. CONCLUSIONS Current evidence suggests that psychosexual CBT has a limited role in the contemporary management of PE and confirms the efficacy and safety of dapoxetine, off-label SSRI drugs, and topical anesthetics drugs. Treatment with tramadol, α1-adrenoceptor antagonists cannot be recommended until the results of large, well-designed randomized controlled trials are published in major international peer-reviewed medical journals. As our understanding of the neurochemical control of ejaculation improves, new therapeutic targets and candidate molecules will be identified, which may increase our pharmacotherepeutic armamentarium. McMahon CG. Current and emerging treatments for premature ejaculation. Sex Med Rev 2015;3:183-202.
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Affiliation(s)
- Chris G McMahon
- Australian Centre for Sexual Health, Sydney, NSW, Australia.
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Pande S, Hazra A, Kundu AK. Evaluation of silodosin in comparison to tamsulosin in benign prostatic hyperplasia: a randomized controlled trial. Indian J Pharmacol 2015; 46:601-7. [PMID: 25538330 PMCID: PMC4264074 DOI: 10.4103/0253-7613.144912] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/08/2014] [Accepted: 10/04/2014] [Indexed: 11/13/2022] Open
Abstract
Objectives: Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms in elderly men. Selective alfa1-adrenergic antagonists are now first-line drugs in the medical management of BPH. We conducted a single-blind, parallel group, randomized, controlled trial to compare the effectiveness and safety of the new alfa1-blocker silodosin versus the established drug tamsulosin in symptomatic BPH. Materials and Methods: Ambulatory male BPH patients, aged above 50 years, were recruited on the basis of International Prostate Symptom Score (IPSS). Subjects were randomized in 1:1 ratio to receive either tamsulosin 0.4 mg controlled release or silodosin 8 mg once daily after dinner for 12 weeks. Primary outcome measure was reduction in IPSS. Proportion of subjects who achieved IPSS <8, change in prostate size as assessed by ultrasonography and changes in peak urine flow rate and allied uroflowmetry parameters, were secondary effectiveness variables. Treatment emergent adverse events were recorded. Results: Data of 53 subjects – 26 on silodosin and 27 on tamsulosin were analyzed. Final IPSS at 12-week was significantly less than baseline for both groups. However, groups remained comparable in terms of IPSS at all visits. There was a significant impact on sexual function (assessed by IPSS sexual function score) in silodosin arm compared with tamsulosin. Prostate size and uroflowmetry parameters did not change. Both treatments were well-tolerated. Retrograde ejaculation was encountered only with silodosin and postural hypotension only with tamsulosin. Conclusions: Silodosin is comparable to tamsulosin in the treatment of BPH in Indian men. However, retrograde ejaculation may be troublesome for sexually active patients.
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Affiliation(s)
- Satabdi Pande
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Anup Kumar Kundu
- Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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11
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What do we know about phytotherapy of benign prostatic hyperplasia? Life Sci 2015; 126:42-56. [DOI: 10.1016/j.lfs.2015.01.023] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/22/2014] [Accepted: 01/21/2015] [Indexed: 02/08/2023]
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Zhu LL, Feng ZJ, Zhou Q. Personalized therapeutics of α₁-blockers in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Clin Interv Aging 2015; 10:621-2. [PMID: 25848238 PMCID: PMC4381895 DOI: 10.2147/cia.s82435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Ling-ling Zhu
- Geriatric VIP Ward, Division of Nursing, Zhejiang University, Hangzhou, People’s Republic of China
| | - Zhi-jun Feng
- Department of Urology Surgery, Zhejiang University, Hangzhou, People’s Republic of China
| | - Quan Zhou
- Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
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Moon KH, Song PH, Yang DY, Park NC, Kim SW, Lee SW, Kim SW, Moon DG, Park JK, Ahn TY, Park K. Efficacy and Safety of the Selective α1A-Adrenoceptor Blocker Silodosin for Severe Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Prospective, Single-Open-Label, Multicenter Study in Korea. Korean J Urol 2014; 55:335-40. [PMID: 24868338 PMCID: PMC4026660 DOI: 10.4111/kju.2014.55.5.335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/18/2014] [Indexed: 11/20/2022] Open
Abstract
Purpose To evaluate the efficacy and safety of silodosin 8 mg once daily in a 12-week treatment of subjects with severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Materials and Methods A total of 100 subjects from 10 urology centers in Korea were included in this study. The inclusion criteria were as follows: age ≥50 years, International Prostate Symptom Score (IPSS) ≥20, quality of life (QoL) score ≥3, urine volume ≥120 mL and maximal urinary flow rate (Qmax) <15 mL/s, and postvoid residual volume (PVR) <100 mL. We assessed the improvement of LUTS with change in IPSS, QoL score, Qmax, PVR, and adverse events at baseline and 4 and 12 weeks after treatment with silodosin 8 mg once daily. Results The IPSS values were 23.27±3.34, 15.89±6.26, and 13.80±6.31 at baseline, 4, and 12 weeks, respectively, with significant improvements (p<0.0001, p=0.0214, respectively). QoL scores were 4.44±0.85, 3.38±1.20, and 3.04±1.20 at baseline, 4, and 12 weeks, respectively, and the differences were statistically significant (p<0.0001). There was a significant difference in Qmax between baseline and 12 weeks (p<0.0001) but not in PVR (p=0.9404) during the clinical trial. The most frequent adverse event in this study was ejaculation failure with 13 cases. However, no subject dropped out because of ejaculation failure, and in 12 of the 13 cases it was fully resolved without further treatment. Conclusions Silodosin 8 mg once daily may be effective and safe in Korean patients with severe LUTS associated with BPH.
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Affiliation(s)
- Ki Hak Moon
- Department of Urology, Yeungnam University Hospital, Daegu, Korea
| | - Phil Hyun Song
- Department of Urology, Yeungnam University Hospital, Daegu, Korea
| | - Dae Yul Yang
- Department of Urology, Hallym University Medical Center, Seoul, Korea
| | - Nam Cheol Park
- Department of Urology, Pusan National University Hospital, Busan, Korea
| | - Soo Woong Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Sung Won Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Jong Kwan Park
- Department of Urology, Chonbuk National University Medical School, Institute for Medical Sciences, Chonbuk National University and Biomedical Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital, Jeonju, Korea
| | - Tai Young Ahn
- Department of Urology, Asan Medical Center, Seoul, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
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14
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[Evolution of lower urinary tract symptoms under silodosin: factors influencing patients' satisfaction]. Prog Urol 2014; 24:196-202. [PMID: 24560210 DOI: 10.1016/j.purol.2013.12.002] [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: 10/25/2013] [Revised: 11/01/2013] [Accepted: 12/08/2013] [Indexed: 02/02/2023]
Abstract
UNLABELLED The objective of this study was to analyze the efficacy and safety of silodosin in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) in current urologic practice. METHOD This was a prospective observational study conducted by 272 urologists on patients treated by silodosin for BPH. The parameters evaluated were the weighted IPSS score, the IPSS question 8 related to quality of life, the USP score and the Athens Insomnia Scale (AIS) measured at treatment initiation and after 3 months. RESULTS Nine hundred and fourteen patients whose average age was 66 years with LUTS for 3.3 years were analyzed. After 3 months of treatment, a significant decrease in IPSS (from 16.2 ± 6.1 to 9.7 ± 5.5, P<0.0001) and USP score (from 10.6 ± 5.1 to 6 0 ± 4.6, P<0.0001) were observed, quality of life (from 67.1% to 14.4% of unsatisfied patients, P<0.0001) and sleep were significantly improved (from 49.2% to 28.9% patients with insomnia, P<0.0001). Among the patients, 21.2% experienced at least one adverse event. The most frequent were abnormal ejaculation (17.2%). And 7.1% discontinued the treatment for this reason. After 3 months of treatment silodosin was continued in 86.9% of patients. CONCLUSION This large study confirmed the efficacy of silodosin in LUTS associated with BPH with a safety profile that does not affect patient satisfaction.
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Medved M, Sammet S, Yousuf A, Oto A. MR imaging of the prostate and adjacent anatomic structures before, during, and after ejaculation: qualitative and quantitative evaluation. Radiology 2014; 271:452-60. [PMID: 24495265 DOI: 10.1148/radiol.14131374] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To determine the possibility of obtaining high-quality magnetic resonance (MR) images before, during, and immediately after ejaculation and detecting measurable changes in quantitative MR imaging parameters after ejaculation. MATERIALS AND METHODS In this prospective, institutional review board-approved, HIPAA-compliant study, eight young healthy volunteers (median age, 22.5 years), after providing informed consent, underwent MR imaging while masturbating to the point of ejaculation. A 1.5-T MR imaging unit was used, with an eight-channel surface coil and a dynamic single-shot fast spin-echo sequence. In addition, a quantitative MR imaging protocol that allowed calculation of T1, T2, and apparent diffusion coefficient (ADC) values was applied before and after ejaculation. Volumes of the prostate and seminal vesicles (SV) were calculated by using whole-volume segmentation on T2-weighted images, both before and after ejaculation. Pre- and postejaculation changes in quantitative MR parameters and measured volumes were evaluated by using the Wilcoxon signed rank test with Bonferroni adjustment. RESULTS There was no significant change in prostate volumes on pre- and postejaculation images, while the SV contracted by 41% on average (median, 44.5%; P = .004). No changes before and after ejaculation were observed in T1 values or in T2 and ADC values in the central gland, while T2 and ADC values were significantly reduced in the peripheral zone by 12% and 14%, respectively (median, 13% and 14.5%, respectively; P = .004). CONCLUSION Successful dynamic MR imaging of ejaculation events and the ability to visualize internal sphincter closure, passage of ejaculate, and significant changes in SV volumes were demonstrated. Significant changes in peripheral zone T2 and ADC values were observed.
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Affiliation(s)
- Milica Medved
- From the Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637
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Angelini L, Castagnetti M, Rigamonti W. Painful Orgasm in an Adolescent after Seminal-Sparing Cystoprostatectomy: A Puzzling Symptom. Urol Int 2014; 94:366-8. [DOI: 10.1159/000354404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 07/16/2013] [Indexed: 11/19/2022]
Abstract
An 18-year-old boy, followed up after seminal-sparing cystectomy for bladder rhabdomyosarcoma, presented complaining of recurrent episodes of left scrotal/inguinal pain arising after orgasms. Full work-up ruled out disease recurrence, but showed enlarged seminal vesicles. Ligation of the vas deferens was unsuccessful. The patient was started on α-blockers to reduce vas contractions with improvement of symptoms. The possible pathophysiology and treatments of this symptom are discussed.
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Inci M, Sarli B, Davarci M, Yalcinkaya FR, Rifaioğlu MM, Davran R, Arica S, Motor S, DemirbaŞ O. Relationship between endothelial dysfunction and nocturia with benign prostatic hyperplasia. Scand J Urol 2013; 47:384-9. [DOI: 10.3109/21681805.2012.762038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Current world literature. Curr Opin Urol 2012. [PMID: 23202289 DOI: 10.1097/mou.0b013e32835bb149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yoshida M, Kudoh J, Homma Y, Kawabe K. New clinical evidence of silodosin, an α1A selective adrenoceptor antagonist, in the treatment for lower urinary tract symptoms. Int J Urol 2012; 19:306-16. [DOI: 10.1111/j.1442-2042.2011.02957.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Sato Y, Tanda H, Nakajima H, Nitta T, Akagashi K, Hanzawa T, Tobe M, Haga K, Uchida K, Honma I. Silodosin and its potential for treating premature ejaculation: A preliminary report. Int J Urol 2011; 19:268-72. [DOI: 10.1111/j.1442-2042.2011.02941.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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