Diagnosis and treatment of benign prostate hyperplasia in Asia

Clinical optimal dose of solifenacin succinate for nursing patients after transurethral resection of the prostate during the perioperative period

Transurethral plasma kinetic resection is an efficient and safe surgery for the treatment of benign prostatic hyperplasia. Solifenacin succinate (SOL) is safe and clinically efficient for patients who endure transurethral resection of the prostate (TURP) during the perioperative period. The objective of this study was to evaluate the clinical optimal dose of SOL for nursing patients after TURP during the perioperative period. Patients were recruited and randomized into three groups: SOL (3 mg), SOL (6 mg), and SOL (10 mg). All patients received medical care for 3 weeks after TURP. Levels of inflammatory cytokines, including IL-6, epithelial neutrophil activation peptide-7 (ENA-7), tumor necrosis factor (TNF)-α, interleukin (IL)-2, IL-17 and IL-8, were investigated in the patients of all three groups. The efficacy of SOL was analyzed via the following scores: International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OBSS), short-form voiding (SFV) and storage score (TS) of International Continence Society (ICS). Outcomes showed that IL-2 and ENA-7 plasma concentration levels were upregulated, whereas TNF-α, IL-6, IL-17 and IL-8 were downregulated, in all three groups. The findings showed that patients that received SOL (6 mg) exhibited significant improvements compared to the other patient groups from baseline to the end of treatment, as determined by IPSS, OBSS, ICS, SFV, TS (P<0.01). In conclusion, these results indicate that SOL (6 mg) is the optimal dose for patients who undergo TURP during the perioperative period. Notably, treatment with SOL (6 mg) exhibited significant additional benefits in terms of lower urinary tract symptoms during the early recovery period after TURP, suggesting SOL is clinically significant for nursing patients who suffer have undergone TURP during the perioperative period.

Medical therapy for clinical benign prostatic hyperplasia: α1 Antagonists, 5α reductase inhibitors and their combination

Medical therapy for clinical benign prostatic hyperplasia (BPH) has advanced significantly in the last 2 decades. Many new α1 antagonists and 5α reductase inhibitors (5ARi) are now commercially available. The practicing urologist must decide on the most appropriate medication for his patients, taking into consideration various factors like efficacy, dosing regime, adverse effects, cost, patient's socioeconomic background, expectations, drug availability and his own clinical experience. The use of combination therapy added further to the complexity in clinical judgment when prescribing. We highlight some of the key points in prescribing α1 antagonists, 5ARi and their combination, based on our viewpoints and experience as urologists in an Asian clinical setting.

Management of BPH then 2000 and now 2016 - From BPH to BPO

The diagnosis and treatment of benign prostatic obstruction (BPO) is based on a number of well-known lower urinary tract symptoms (LUTS) feared by all ageing males with functional testes. The ascent of modern urology turned this disease from lethal into an annoying but treatable health problem in the previous century. We are able to relieve the great majority of patients from their bothersome symptoms to a respectable quality of life by medication or removal of the obstructive part of the enlarged prostate. We can be proud of some progress made in the new millennium to reach a correct diagnosis and subsequent choice of treatment aiming for quality of life and cost-efficiency for public health. Still it remains symptomatic treatment and we expect the new generation of urologists to close some gaps in our knowledge on the regulation of prostatic growth to focus on prevention and elimination of the disease in the foreseeable future.