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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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Umbehr MH, Wagg A, Habib MH, Antonelli JA, Chughtai B, Jang TL, Kaldany A, Saraiya B, Stephenson RD, Sze C, Wiedemann A, Jones CA, Schlögl M. Top Ten Tips Palliative Care Clinicians Should Know About Urological Care. J Palliat Med 2023; 26:264-269. [PMID: 36579919 DOI: 10.1089/jpm.2022.0467] [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: 12/30/2022] Open
Abstract
Patients receiving palliative care (PC) can present with or develop a host of urological needs or complications. These needs can include attention to sexual health, urinary incontinence, genitourinary bleeding, and urinary tract obstruction by benign, malignant, or urinary stone diseases. These varied conditions require that PC clinicians understand invasive and noninvasive medical, surgical, and radiation options for treatment. This article, written by a team of urologists, geriatricians, and PC specialists, offers information and guidance to PC teams in an accessible "Top Ten Tips" format to increase comfort with and skills around assessment, evaluation, and specialist referral for urological conditions common in the PC setting.
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Affiliation(s)
- Martin H Umbehr
- Department of Urology, Municipal Hospital of Zurich, Zurich, Switzerland
| | - Adrian Wagg
- Department of Medicine, Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Muhammad Hamza Habib
- Cancer Institute of New Jersey, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
| | - Jodi A Antonelli
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Bilal Chughtai
- Department of Urology, Weil Cornell Medicine-New York Presbyterian Hospital, New York, New York, USA
| | - Thomas L Jang
- Division of Urology and Section of Urologic Oncology, Rutgers Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Alain Kaldany
- Division of Urology and Section of Urologic Oncology, Rutgers Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Biren Saraiya
- Cancer Institute of New Jersey, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
| | - Ryan D Stephenson
- Cancer Institute of New Jersey, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
| | - Christina Sze
- Department of Urology, Weil Cornell Medicine-New York Presbyterian Hospital, New York, New York, USA
| | - Andreas Wiedemann
- Faculty of Health, Department of Humane Medicine, University of Witten/Herdecke, Witten, Germany.,Department of Urology, Evangelic Hospital of Witten, Witten, Germany
| | - Christopher A Jones
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mathias Schlögl
- Division of Geriatric Medicine, Clinic Barmelweid, Barmelweid, Switzerland.,University Clinic for Acute Geriatrics City Hospital Waid, Zurich, Switzerland
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Subrata SA. Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2020. [DOI: 10.1111/ijun.12216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sumarno A. Subrata
- Doctoral Candidate in Doctor of Philosophy Program in NursingInternational and Collaborative Program with Foreign University Program, Mahidol University Nakhon Pathom Thailand
- Department of Nursing and Wound Research Center, Faculty of Health SciencesUniversitas Muhammadiyah Magelang Magelang Indonesia
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Leoci R, Aiudi G, Silvestre F, Lissner E, Lacalandra GM. Effect of pulsed electromagnetic field therapy on prostate volume and vascularity in the treatment of benign prostatic hyperplasia: a pilot study in a canine model. Prostate 2014; 74:1132-41. [PMID: 24913937 PMCID: PMC4145661 DOI: 10.1002/pros.22829] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 05/02/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is a result of urogenital aging. Recent studies suggest that an age-related impairment of the blood supply to the lower urinary tract plays a role in the development of BPH and thus may be a contributing factor in the pathogenesis of BPH. The canine prostate is a model for understanding abnormal growth of the human prostate gland. We studied the efficacy of pulsed electromagnetic field therapy (PEMF) in dogs to modify prostate blood flow and evaluated its effect on BPH. METHODS PEMF (5 min, twice a day for 3 weeks) was performed on 20 dogs affected by BPH. Prostatic volume, Doppler assessment by ultrasonography, libido, semen quality, testosterone levels, and seminal plasma volume, composition and pH were evaluated before and after treatment. RESULTS The 3 weeks of PEMF produced a significant reduction in prostatic volume (average 57%) without any interference with semen quality, testosterone levels or libido. Doppler parameters showed a reduction of peripheral resistances and a progressive reduction throughout the trial of the systolic peak velocity, end-diastolic velocity, mean velocity, mean, and peak gradient of the blood flow in the dorsal branch of the prostatic artery. The pulsatility index and the resistance index did not vary significantly over time. CONCLUSIONS The efficacy of PEMF on BPH in dogs, with no side effects, suggests the suitability of this treatment in humans and supports the hypothesis that impairment of blood supply to the lower urinary tract may be a causative factor in the development of BPH.
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Affiliation(s)
- Raffaella Leoci
- Department of Emergency and Organ Transplantation (DETO), Section of Veterinary Clinic and Animal Production, University of Bari Aldo MoroValenzano, Bari, Italy
- *Correspondence to: Raffaella Leoci, PhD, Department of Emergency and Organ Transplantation (DETO), Section of Veterinary Clinic and Animal Production, University of Bari Aldo Moro, SP per Casamassima km 3, Valenzano, Bari, Italy. E-mail:
| | - Giulio Aiudi
- Department of Emergency and Organ Transplantation (DETO), Section of Veterinary Clinic and Animal Production, University of Bari Aldo MoroValenzano, Bari, Italy
| | - Fabio Silvestre
- Department of Emergency and Organ Transplantation (DETO), Section of Veterinary Clinic and Animal Production, University of Bari Aldo MoroValenzano, Bari, Italy
| | | | - Giovanni Michele Lacalandra
- Department of Emergency and Organ Transplantation (DETO), Section of Veterinary Clinic and Animal Production, University of Bari Aldo MoroValenzano, Bari, Italy
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Superselective α-adrenergic blockers versus transurethral resection of the prostate: a prospective comparison of health-related quality of life outcome after treating patients with benign prostatic hyperplasia. Qual Life Res 2012; 22:1287-93. [PMID: 22948258 DOI: 10.1007/s11136-012-0259-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE We prospectively evaluated the impact of transurethral resection of the prostate (TURP) versus superselective α-adrenergic blocker treatment on health-related quality of life (HRQOL) in men with clinically diagnosed benign prostatic hyperplasia (BPH). PATIENTS AND METHODS A total of 219 patients with lower urinary tract symptoms (LUTS) caused by BPH were recruited in this study. Treatment modalities consisted of standard TURP (n = 104) and tamsulosin medical treatment (n = 115). HRQOL was assessed by SF-36-Item Health Survey 1.0. LUTS were estimated by The International Prostate Symptom Score. Patients' outcome 4 weeks after treatment was compared to pre-treatment status and to that of the other group. Statistically significant changes in each HRQOL scale from baseline to follow-up period were investigated. RESULTS Baseline characteristics were similar in both groups except for the duration of disease before treatment that was longer in TURP group. Both treatments resulted in statistically significant improvements from pre-treatment in all scales of QOL after 4 weeks, with no significant differences observed between the two groups. In medical treatment group, there was a significant association between higher educational level and better QOL in all 8 scales. Our outcomes revealed a significant decrease in the IPSS in both groups but this improvement was more evident in TURP group. CONCLUSION All scales concerning HRQOL were favorably improved 4 weeks after both surgical and medical treatment, and no significant differences were observed between these two treatment modalities for patients with symptomatic BPH. This information may aid patients when deciding which treatment option to take.
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Djavan B, Dianat SS, Kazzazi A. Effect of combination treatment on patient-related outcome measures in benign prostatic hyperplasia: clinical utility of dutasteride and tamsulosin. PATIENT-RELATED OUTCOME MEASURES 2011; 2:71-9. [PMID: 22915969 PMCID: PMC3417924 DOI: 10.2147/prom.s13062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND Benign prostatic hyperplasia, the fourth most commonly diagnosed medical condition in the elderly, is a major underlying cause of lower urinary tract symptoms in men. Medical therapy is usually the first therapeutic option. Combination therapy is increasingly used for better symptom relief and outcome. METHODS We searched the literature using the MEDLINE database for the efficacy of combination therapy in men with benign prostatic hyperplasia in terms of symptom improvement and impact on quality of life. RESULTS Combination therapy with dutasteride and tamsulosin not only provides better symptom improvement and improved urinary flow rate, but is also associated with a more favorable impact on quality of life and patient satisfaction with treatment than monotherapy. Combination therapy also reduces the risk of events related to disease progression, such as acute urinary retention and benign prostatic hyperplasia-related surgery. CONCLUSION Combination therapy with dutasteride and tamsulosin is highly efficacious as medical therapy for benign prostatic hyperplasia in patients with moderate-to-severe lower urinary tract symptoms.
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Affiliation(s)
- Bob Djavan
- New York University, Department of Urology, New York, USA
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Pelton K, Di Vizio D, Insabato L, Schaffner CP, Freeman MR, Solomon KR. Ezetimibe Reduces Enlarged Prostate in an Animal Model of Benign Prostatic Hyperplasia. J Urol 2010; 184:1555-9. [DOI: 10.1016/j.juro.2010.05.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Kristine Pelton
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Dolores Di Vizio
- Urological Diseases Research Center, Department of Urology, Harvard Medical School, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Luigi Insabato
- Biomorphological and Functional Science, Anatomic Pathology Section, Faculty of Medicine, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Carl P. Schaffner
- Department of Microbiology and Biochemistry, Waksman Institute, Rutgers, State University of New Jersey, New Brunswick, New Jersey
| | - Michael R. Freeman
- Urological Diseases Research Center, Department of Urology, Harvard Medical School, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts
| | - Keith R. Solomon
- Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
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MacDiarmid SA, Hill LA, Volinn W, Hoel G. Lack of Pharmacodynamic Interaction of Silodosin, a Highly Selective α1a-Adrenoceptor Antagonist, With the Phosphodiesterase-5 Inhibitors Sildenafil and Tadalafil in Healthy Men. Urology 2010; 75:520-5. [DOI: 10.1016/j.urology.2009.10.042] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 10/16/2009] [Accepted: 10/23/2009] [Indexed: 10/19/2022]
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