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Heidenberg DJ, Choudry MM, Cheney SM. Reply to Editorial Comment on "The Impact of Standard vs Early Apical Release HoLEP Technique on Postoperative Incontinence and Quality of Life". Urology 2024:S0090-4295(24)00350-9. [PMID: 38729269 DOI: 10.1016/j.urology.2024.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
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Fayou Z, Jiude Z, Shuxian Z, Yajun S, Wei X, Jia Y, Fan S, Yueling X, Renrui H, Xiaolei T. 1470 nm laser is better for prostate hyperplasia treatment with different volume size via transurethral enucleation. BMC Surg 2023; 23:356. [PMID: 37990316 PMCID: PMC10664299 DOI: 10.1186/s12893-023-02266-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION The large amount of intraoperative bleeding and the high incidence of postoperative hematuria are still common factors affecting the prostate surgery treatment effect. Our research aimed to observe the effect of prostatic enucleation using 1,470 nm semiconductor laser on the amount of bleeding in patients with different sizes of prostate hyperplasia. METHODS According to the size of the prostate, forty eligible patients with benign prostatic hyperplasia (BPH) were enrolled and divided into low and high volume group in this study. Hemoglobin decline, urinating condition, complications and erectile function were collected and compared before and after surgery. RESULTS Our data showed that hemoglobin decline was (10.0 ± 6.2) g/L and (12.1 ± 7.8) g/L, respectively for two group after surgery (P = 0.363). Urination was significantly improved following surgery in both groups of patients (P < 0.05), and no permanent urinary incontinence and sexual dysfunction and so no serious complications occurred. CONCLUSION The above results suggested that prostatic enucleation using 1,470 nm semiconductor laser can be safe and effective for prostatic hyperplasia, and this surgery produced no significant effect on the amount of bleeding in whatever size of the prostate.
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Affiliation(s)
- Zhou Fayou
- Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Zheng Jiude
- Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Zhang Shuxian
- Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Shen Yajun
- Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Xu Wei
- Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Yu Jia
- Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Su Fan
- Centre for Translational Medicine, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
- Vascular disease research center & Basic Medical Laboratory, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Xiong Yueling
- Centre for Translational Medicine, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
- Vascular disease research center & Basic Medical Laboratory, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Han Renrui
- Research Office of Wannan Medical College, Wuhu, 241000, China
| | - Tang Xiaolei
- Centre for Translational Medicine, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China.
- Vascular disease research center & Basic Medical Laboratory, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China.
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Obinata D, Uehara R, Hashimoto S, Nakahara K, Yoshizawa T, Mochida J, Yamaguchi K, Takahashi S. Initial experience with prostatic urethral lift versus enucleation of the prostate: a retrospective comparative study. BMC Urol 2023; 23:188. [PMID: 37980529 PMCID: PMC10657556 DOI: 10.1186/s12894-023-01366-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND This study aimed to assess initial results and patient characteristics of prostatic urethral lift (PUL) compared with those of bipolar transurethral enucleation of the prostate (TUEB) in the treatment of benign prostatic hyperplasia (BPH) in older patients. METHODS This retrospective study was conducted at a single institution and involved 25 consecutive patients with BPH who underwent PUL between April 2022 and May 2023. Patient characteristics, operative details, and pre- and postoperative symptom scores were evaluated. The results were compared with those of a previously reported TUEB group (n = 55). RESULTS The mean age of the patients in the PUL group was 74.6 years, and the mean prostate volume was 47.5 ml. The PUL procedure significantly improved urinary symptoms, particularly incomplete emptying (p = 0.041), intermittency (p = 0.005), and weak stream (p = 0.001). The PUL group had higher comorbidity scores (p = 0.048) and included older patients (p = 0.002) than the TUEB group. TUEB showed better improvements in some symptoms and maximum flow rate (p = 0.01) than PUL; however, PUL had a shorter operative time and fewer complications than TUEB (p < 0.001). CONCLUSION The initial results demonstrate the efficacy and safety of PUL in older patients with BPH. Despite TUEB showing better outcomes in certain aspects than PUL, PUL offers advantages such as shorter operative time and fewer complications. Therefore, PUL can be considered a viable option for high-risk older patients with BPH.
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Affiliation(s)
- Daisuke Obinata
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
| | - Rio Uehara
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Sho Hashimoto
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Ken Nakahara
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tsuyoshi Yoshizawa
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Junichi Mochida
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Kenya Yamaguchi
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
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Wong HPN, So WZ, Senthamil Selvan V, Lee JY, Ho CERH, Tiong HY. A cross-sectional quality assessment of TikTok content on benign prostatic hyperplasia. World J Urol 2023; 41:3051-3057. [PMID: 37728744 DOI: 10.1007/s00345-023-04601-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND With an increasing reliance on online sources for medical information, we studied the quality and completeness of health literacy videos on TikTok regarding BPH. METHODS A cross-sectional systematic evaluation of TikTok videos using the search term "Benign Prostatic Hyperplasia" was performed on 14th April 2023, and included 49 patient information and educational videos. The videos were then analysed by two reviewers and scored using two instruments: the DISCERN instrument and a completeness analysis. RESULTS Of the 49 videos, 38 were created by healthcare professionals (HCPs). The average length of each video was 62.7 ± 59.3 s, with a large average number of total views (24,990.1 ± 109,534.9 views). The DISCERN score trended higher in every category in videos published by HCPs compared to non-HCPs, with HCPs providing a statistically significant increase in reliability (19.0,14.6, p < 0.05) and total score (29.4,23, p < 0.05). Majority of videos were deemed as poor or worse (91.8%) in quality. The completeness of the videos' content was also evaluated across five categories with an average score of 2.53 ± 2.1 out of the maximum 12. The DISCERN scores did not correlate with the degree of completeness of the videos (r = 0.226). CONCLUSION BPH videos on TikTok have a wide reach, but the videos are mostly of low quality and completeness. Future videos should be made with quality and completeness in mind given the large viewership and more can be done to evaluate the extent of BPH misinformation and its impact on patients.
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Affiliation(s)
- Hoi Pong Nicholas Wong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | - Wei Zheng So
- Department of Urology, National University Hospital, Singapore, Singapore
| | | | - Jing Yang Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Ho Yee Tiong
- Department of Urology, National University Hospital, Singapore, Singapore
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Peng YN, Jin L, Peng EJ, Zhang L. Perioperative care based on roy adaptation model in elderly patients with benign prostatic hyperplasia: impact on psychological well-being, pain, and quality of life. BMC Urol 2023; 23:172. [PMID: 37891515 PMCID: PMC10612228 DOI: 10.1186/s12894-023-01343-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
PURPOSE This study aimed to assess the impact of perioperative care based on the Roy Adaptation Model (RAM) on psychological well-being, postoperative pain, and health-related quality of life (HRQoL) in elderly patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection of the prostate (TURP). METHODS A total of 160 elderly patients diagnosed with BPH between June 2021 and June 2022 and scheduled for TURP were randomly assigned to either the routine care group (n = 80) or the RAM group (n = 80). The RAM group received standard care supplemented with interventions based on the RAM model. Negative emotions measured by the Hospital Anxiety and Depression Scale (HADS), pain intensity by the Visual Analog Scale (VAS), and HRQoL by the 36-Item Short Form Health Survey (SF-36) were measured at the preoperative visit (T0), at 30 days (T1), and at 3 months of (T2) follow‑up. RESULTS Repeated measures ANOVA revealed significant differences in psychological well-being, postoperative pain intensity, and HRQoL within both the routine care and RAM groups across the three time points. Holm-Sidak's multiple comparisons test confirmed significant differences between each time point for both groups. The RAM intervention led to significant reductions in anxiety and depression levels, alleviation of postoperative pain intensity, and improvements in various domains of HRQoL at T1 and T2 compared to routine care. CONCLUSION Incorporating the RAM model into perioperative care for elderly patients undergoing TURP for BPH has shown promising results in improving psychological well-being, reducing postoperative pain intensity, and enhancing HRQoL.
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Affiliation(s)
- Ya-Ni Peng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Lu Jin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - E-Jun Peng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China
| | - Li Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, China.
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Tavassoli N, Vojdani A, Salimi-Namin S, Khadem-Rezaiyan M, Kalantari M, Youssefi M. Human BKV large T genome detection in prostate cancer and benign prostatic hyperplasia tissue samples by nested PCR: A case-control study. Mol Biol Res Commun 2023; 12:149-154. [PMID: 37886738 PMCID: PMC10599593 DOI: 10.22099/mbrc.2023.47537.1836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Human BK polyomavirus (BKPyV) is a latent infectious agent in the genitourinary tract associated with hemorrhagic cystitis and nephropathy. This virus can be a risk factor for various human malignancies, including prostate cancer (PCa). It may contribute to prostate cancer development, as it demonstrates oncogenic properties by encoding oncoproteins. This study assessed the prevalence of this virus in benign and malignant prostate tissues. Between 2009 and 2019, 49 formalin-fixed paraffin-embedded (FFPE) PCa and 49 benign prostatic hyperplasia (BPH) samples were gathered from the pathology department of a tertiary care university hospital. They were used as cases and controls, respectively. After deparaffinization and DNA extraction, nested PCR was applied to identify the BKPyVgp5 gene (LTAg) using inner and outer primers. The nested PCR showed a 278-bp bond corresponding to the BKPyVgp5 genome (LTAg) in 53.1% (26/49) of PCa and 14.3% (7/49) of BPH (p<0.001). The presence of BKV was significantly associated with an increased risk of PCa development (OR=6.78, 95% CI=2.55-18.02, p<0.001). The BKV LTAg gene was significantly more prevalent in PCa samples than in BPH samples. These results demonstrate the presence of the virus in prostate cancer tissues.
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Affiliation(s)
- Narges Tavassoli
- Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Contributed equally as first authors
| | - Arastoo Vojdani
- Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Contributed equally as first authors
| | - Sara Salimi-Namin
- Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khadem-Rezaiyan
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoudreza Kalantari
- Department of Pathology, Mashhad Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Youssefi
- Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Bhatia S, Acharya V, Jalaeian H, Kumar J, Bryant E, Richardson A, Malkova K, Harward S, Sinha V, Kably I, Kava BR. Effect of Prostate Artery Embolization on Erectile Function - A Single Center Experience of 167 Patients. J Sex Med 2022; 19:594-602. [PMID: 35184995 DOI: 10.1016/j.jsxm.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prostate artery embolization (PAE) is an emerging therapy for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). AIM This retrospective study was conducted to assess the effect of prostate artery embolization (PAE) on erectile function in a cohort of patients with LUTS attributable to BPH at 3-months after the procedure. METHODS A retrospective review was performed on 167 patients who underwent PAE. Data collected included Sexual Health Inventory in Men (SHIM) scores at 3, 6, and 12 months post-PAE, in conjunction with the International Prostate Symptom Scores (IPSS), Quality of Life (QoL) scores, and prostate volumes. Primary outcome was erectile function as assessed by SHIM scores at 3 months after PAE. An analysis was performed to identify patients with a ±5-point SHIM change to group them according to this minimum clinically significant difference in erectile function. Adverse events were recorded using the Clavien-Dindo (CD) classification. OUTCOMES At 3 months following PAE, median IPSS decreased by 16.0 [IQR, 9.0-22.0] points, median QOL decreased by 4.0 [IQR, 2.0-5.0] points, and median prostate volume decreased by 33 g [IQR, 14-55]. RESULTS Median SHIM score was 17.0 [IQR, 12.0-22.0] at baseline, 18.0 [IQR, 14.0-23.0] at 3 months [P = .031], 19.0 [IQR, 14.5-21.5] at 6 months [P = .106] and 20 [IQR, 16.0-24.0] at 12 months [P = .010] following PAE. In patients with no erectile dysfunction (ED) at baseline, 21% (n = 9) reported some degree of decline in erectile function post-PAE. However, 38% (n = 40) of patients who presented with mild-to-moderate ED reported improvement in their erectile function 3 months following PAE. Overall, the changes in baseline SHIM score were relatively small; 82% (n = 137) of patients did not have more than 5 points of change in their SHIM scores at 3 months following PAE. CLINICAL IMPLICATIONS Our findings suggest PAE has no adverse impact on erectile function for most patients. STRENGTHS & LIMITATIONS The study was performed at a single center with 1 operator's experience, and is retrospective with no control group. CONCLUSION Findings suggest that prostate artery embolization has no adverse effect on erectile function in the majority of patients with LUTS attributable to BPH at 3 months after the procedure. Bhatia S, Acharya V, Jalaeian H, et al., Effect of Prostate Artery Embolization on Erectile Function - A Single Center Experience of 167 Patients. J Sex Med 2022;19:594-602.
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Affiliation(s)
- Shivank Bhatia
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Vedant Acharya
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Jessica Kumar
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA.
| | - Evan Bryant
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Andrew Richardson
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Kseniia Malkova
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Sardis Harward
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Vishal Sinha
- Weill Cornell Department of Radiology, New York, NY, USA
| | - Issam Kably
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Bruce R Kava
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
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Lee JW, Kim JH. Drug Prescription Patterns During Initial Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Study Based on Health Insurance Review and Assessment Database. J Korean Med Sci 2022; 37:e95. [PMID: 35347903 PMCID: PMC8960941 DOI: 10.3346/jkms.2022.37.e95] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/02/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To evaluate the drug prescription patterns for men diagnosed with benign prostatic hyperplasia (BPH) in Korea. METHODS We extracted the data of 3% of the national patient samples including men aged ≥ 40 years between 2012 and 2017 from the Health Insurance Review and Assessment database and investigated the drugs prescribed for men with the BPH code N40. Men with a diagnosis of BPH but not receiving treatment were excluded. The primary outcome was the drugs prescribed and the changes in drug prescription pattern over 6 years for men first diagnosed with BPH. RESULTS Alpha blockers were the most commonly prescribed drugs in men with BPH, and tamsulosin was the most common. The proportion of prescriptions increased steadily. The number of prescriptions for anticholinergics (ACH) increased, but decreased with the start of mirabegron prescriptions in 2015. Prescriptions of mirabegron are increasing rapidly and replacing ACH. Based on the prescription pattern by drug category, alpha blocker monotherapy decreased, whereas combination therapies such as alpha blocker + 5-alpha-reductase inhibitors (5ARI), and alpha blocker + 5ARI + ACH increased steadily. As for the number of prescriptions by drug ingredient, tamsulosin monotherapy was the most common, and the combination therapy of tamsulosin and mirabegron increased. CONCLUSION Alpha blockers were the most commonly prescribed drug for men first diagnosed with BPH in Korea from 2012 to 2017, and tamsulosin was the most common alpha blocker. Prescriptions of combination therapy and mirabegron are gradually increasing.
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Affiliation(s)
- Jeong Woo Lee
- Department of Urology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
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McVary KT, El-Arabi A, Roehrborn C. Preservation of Sexual Function 5 Years After Water Vapor Thermal Therapy for Benign Prostatic Hyperplasia. Sex Med 2021; 9:100454. [PMID: 34731779 PMCID: PMC8766265 DOI: 10.1016/j.esxm.2021.100454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
Background Erectile dysfunction (ED) and ejaculatory dysfunction (EjD) are known outcomes of traditional surgery and some pharmacotherapies for treatment of benign prostatic hyperplasia (BPH). Minimally invasive treatment options, including water vapor thermal therapy (WVTT), are now available to treat lower urinary tract symptoms (LUTS) due to BPH. Aim The objective of this analysis was to evaluate long-term impact of a single water vapor thermal therapy procedure on erectile and ejaculatory function in subjects enrolled in the Rezum II prospective, multicenter, randomized, blinded controlled trial. Methods Fifteen centers enrolled 197 subjects with International Prostate Symptom Score (IPSS) ≥ 13, maximum flow rate (Qmax) ≤ 15 mL/s, and prostate volume 30–80 cc. Subjects were randomized (2:1) to (WVTT) or sham procedure (control) and followed for 5 years. Erectile and ejaculatory functions were quantitatively assessed at baseline and yearly thereafter. After 3 months, control subjects could opt to requalify for cross-over to WVTT and were followed for 5 years. Results of the per protocol analysis were reported previously. The current post hoc analysis was performed on all treated subjects who were sexually active at baseline with no other surgical or medical management for BPH during the 5-year study period. Outcomes LUTS was evaluated using IPSS, Benign Prostatic Hyperplasia Impact Index (BPHII), and Qmax. Sexual function was assessed using the International Index of Erectile Function (IIEF-EF) and Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD). Results A total of 197 subjects (136 treated, 61 control) were enrolled in the study, and 53 control subjects opted to cross-over and receive WVTT. All subgroups experienced significant, durable improvement in IPSS (P < .0001). Subjects with normal sexual function at baseline had little change in function over 5 years (IIEF-EF: −2.4 ± 8.9, P = .1414; MSHQ-EjD Function: −1.6 ± 3.2, P = .0083; MSHQ-EjD Bother: −0.5 ± 1.6, P = .1107). Subjects with baseline medical history of ED and EjD showed slight decline over time that was not clinically significant (ED, IIEF-EF: −3.0 ± 10.1, P = .1259; MSHQ EjD Function: −2.3 ± 4.7, P = .0158; MSHQ-EjD Bother: −0.1 ± 2.6, P = .7764; EjD, IIEF-EF: −4.1 ± 9.2, P = .0127; MSHQ EjD Function: −1.6 ± 4.8, P = .1970; MSHQ-EjD Bother: −0.4 ± 2.6, P = .440). Clinical Implications Treatment for BPH with Rezum durably improved IPSS without clinically significant impact on sexual function. Patients with baseline ED/EjD may expect continued decline from other causes but are unimpacted by the therapy. Strengths & Limitations, Conclusion The results are limited by the post-hoc nature of the analysis and attrition over the 5-year follow-up but provide long-term evidence of durable outcomes after treatment with Rezum without impact on sexual function scores. McVary KT, El-Arabi A, Roehrborn C. Preservation of Sexual Function 5 Years After Water Vapor Thermal Therapy for Benign Prostatic Hyperplasia. Sex Med 2021;9:100454.
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Affiliation(s)
- Kevin T McVary
- Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA.
| | - Ahmad El-Arabi
- Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
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Galla N, Maron SZ, Voutsinas N, Sher A, Tangel M, Jue JS, Sharma H, Lookstein RA, Fischman AM, Rastinehad AR. Adjunctive Coil Embolization of the Prostatic Arteries After Particle Embolization for Prostatic Artery Embolization. Cardiovasc Intervent Radiol 2021; 44:1994-1998. [PMID: 34561744 PMCID: PMC8475843 DOI: 10.1007/s00270-021-02964-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the feasibility, safety and short-term results of prostatic artery embolization (PAE) performed with adjunctive coil embolization of the main prostatic arteries (PA) following particle embolization. MATERIALS AND METHODS A total of 95 patients who underwent PAE with adjunctive bilateral coil embolization of the PAs following particle embolization between September 2018 and May 2021 were included. The patients had a mean prostate size of 115 ± 64 ml, 18/95 with hematuria symptoms, and 16/95 with indwelling urinary catheters. Coil embolization was performed in the main PAs prior to the bifurcation into the anteromedial and posterolateral branches using detachable microcoils. International Prostate Symptoms Score (IPSS), quality of life (QOL), maximum flow rate (Qmax) and adverse events were recorded. RESULTS IPSS were improved by - 11.2 ± 7.9 (n = 49, P < 0.001) and QOL by - 2.4 ± 1.8 (n = 49, P < 0.001) over a mean follow-up of 10.7 ± 7.9 weeks. Qmax did not demonstrate statistical significance. Twelve patients with hematuria (67%) showed improvement or resolution and twelve patients with indwelling or intermittent catheters (75%) were no longer catheter dependent. Two patients underwent a repeat PAE. There were no adverse events which were attributable to coil embolization. CONCLUSION Adjunctive coil embolization of the main PAs following particle embolization is a technically feasible technique with similar short-term clinical outcomes compared to prior studies. This novel technique warrants further prospective investigation with controls.
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Affiliation(s)
- Naveen Galla
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA
| | - Samuel Z Maron
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA
| | - Nicholas Voutsinas
- Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York, NY, 11040, USA
| | - Alex Sher
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA
| | - Matthew Tangel
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA
| | - Joshua S Jue
- Lenox Hill Hospital, Northwell Health, New York, NY, 10022, USA
| | - Himanshu Sharma
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA
| | - Robert A Lookstein
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA
| | - Aaron M Fischman
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA.
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11
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Bauer SR, Harrison SL, Cawthon PM, Senders A, Kenfield SA, Suskind AM, McCulloch CE, Covinsky K, Marshall LM. Longitudinal Changes in Adiposity and Lower Urinary Tract Symptoms Among Older Men. J Gerontol A Biol Sci Med Sci 2021; 77:2102-2109. [PMID: 34375402 PMCID: PMC9536446 DOI: 10.1093/gerona/glab227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adiposity increases risk for male lower urinary tract symptoms (LUTS), although longitudinal studies have produced conflicting results. No prior studies have evaluated longitudinal associations of changes in adiposity with concurrent LUTS severity among older men. METHODS We used repeated adiposity measurements from dual-energy x-ray absorptiometry (DXA), body mass index (BMI), and American Urological Association Symptom Index (AUASI) measured at four study visits over a 9-year period among 5949 men enrolled in the Osteoporotic Fractures in Men (MrOS) study. Linear mixed effect models adjusted for age, health-related behaviors, and comorbidities were created to evaluate the association between baseline and change in visceral adipose tissue (VAT) area, total fat mass, and BMI with change in LUTS severity measured by the AUASI. RESULTS A non-linear association was observed between baseline VAT area and change in AUASI: men in baseline VAT tertile (T) 2 had a lower annual increase in AUASI score compared to men in T1 and T3 (T2 versus T1: β=-0.07; 95% CI -0.12, -0.03; P= 0.008; T3 versus T1: NS) but differences were small. No significant associations were observed between change in VAT area and change in AUASI score. Neither baseline tertiles nor change in total fat mass or BMI were associated with change in AUASI score. CONCLUSIONS Changes in VAT area, total fat mass, and BMI were not associated with change in LUTS severity in this cohort. Thus, despite other health benefits, interventions targeting adiposity alone are unlikely to be effective for preventing or treating LUTS among older men.
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Affiliation(s)
- Scott R Bauer
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA.,Department of Urology, University of California, San Francisco, CA.,San Francisco VA Medical Center, San Francisco, CA
| | | | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Angela Senders
- Oregon Health and Science University-Portland State University School of Public Health, Portland OR
| | | | - Anne M Suskind
- Department of Urology, University of California, San Francisco, CA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Kenneth Covinsky
- San Francisco VA Medical Center, San Francisco, CA.,Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA
| | - Lynn M Marshall
- Oregon Health and Science University-Portland State University School of Public Health, Portland OR.,Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR
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12
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Guzmán-Esquivel J, Delgado-Enciso I, Guzmán-Solórzano JA, Urtiz-Licea AJ, Parra-Lomeli H, Ríos-Bracamontes EF, Murillo-Zamora E. Erectile dysfunction, lower urinary tract symptoms, and quality of life in men above 50 years of age. ARCH ESP UROL 2021; 74:224-230. [PMID: 33650537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are relevant health problems worldwide, especially in men 50 years of age and older. With the increase in life expectancy, their prevalence is expected to rise in the coming years. AIM To estimate the prevalence of LUTS and ED in adults 50 years of age and older and evaluate their relation to quality of life. MATERIALS AND METHODS An analytic cross-section-al study was conducted through a personal interview with the participants. Erectile dysfunction (IIEF-5), prostate symptom (IPSS), and quality of life (EuroQoL) questionnaires were employed. The frequency and grade of LUTS and ED were evaluated and correlated with health-related quality of life perception in 300 men above 50 years of age. Summary measures were calculated. The association of LUTS and ED with quality of life was evaluated with prevalence odds ratios (ORs) and 95% confidence intervals (CIs), calculated using unconditional logistic regression models. RESULTS Information on 300 subjects was analyzed. The general prevalence of LUTS and ED was 88.3% and 81.7%, respectively. Quality of life was classified as very poor - regular (≤ 60 points) in 18.3% of the subjects. In the multiple analysis, the presence of moderate LUTS (OR = 5.27, 1.08 - 9.73) or severe LUTS (OR = 7.05, 1.84-10.34) was associated with an increase in the possibility of presenting with a lower quality of life. CONCLUSION Our findings suggest that erectile dysfunction and prostate symptoms were frequent events in the population studied, as was a low perception of quality of life. The opportune and efficacious treatment of those pathologies can potentially improve the individual and social dynamics of the persons affected.
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Affiliation(s)
- José Guzmán-Esquivel
- Unidad de Investigación en Epidemiología Clínica. IMSS. Delegación Colima. México
| | | | | | | | | | | | - Efrén Murillo-Zamora
- Departamento de Epidemiología. Unidad de Medicina Familiar. Instituto Mexicano del Seguro Social. Colima. México
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Matsuda Y, Kobayashi K, Fukuta F, Takayanagi A, Hashimoto K, Tanaka T, Masumori N. Which Happens Earlier, Lower Urinary Tract Symptoms or Erectile Dysfunction? Sex Med 2021; 9:100275. [PMID: 33540364 DOI: 10.1016/j.esxm.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Although an association between erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) has been suggested, it was not clarified whether LUTS developed before ED or vice versa. Aim To clarify whether LUTS develop before ED or vice versa and which symptoms predicted the onset of the other condition in a longitudinal community-based study. Methods We conducted a longitudinal community-based study on LUTS and ED in aged Japanese men. A follow-up study was conducted to determine their longitudinal changes of LUTS and ED after 15 years. Erectile function was evaluated using a validated questionnaire. LUTS were evaluated based on the International Prostate Symptom Score, quality of life index, and prostate volume. Main outcome measure We evaluated the baseline symptoms among the participants who had LUTS and ED in the follow-up survey and what prior symptoms could predict the onset of the other condition using the data from a long-term longitudinal survey. Results A total of 108 men were enrolled in this study. Of the 47 men having both LUTS and ED in the follow-up study, men having only LUTS (n = 16) were more frequent than those having only ED (n = 6) in the initial study. Likewise, of the 38 men having both nocturia and ED at the time of the follow-up study, those having only nocturia (n = 12) were more frequent than those having only ED (n = 5) in the initial study. In multivariable analysis, age 60 years or older (odds ratio: 7.10, 95% CI: 2.09-24.13) and nocturia (odds ratio: 15.83, 95% CI: 3.05-82.15) were independent predictors for the onset of ED. Conclusion There were more men with prior onset of LUTS, especially nocturia, than men with prior onset of ED among those with both ED and LUTS in this long-term longitudinal study. Nocturia may be a predictor of subsequent ED. Matsuda Y, Kobayashi K, Fukuta F, et al. Which Happens Earlier, Lower Urinary Tract Symptoms or Erectile Dysfunction?. J Sex Med 2021;9:100275.
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14
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Bhojani N, Yafi FA, Misrai V, Rijo E, Chughtai B, Zorn KC, Elterman D. Review of Sexual Preservation After Novel Benign Prostatic Hyperplasia Surgical Treatment Modalities From Food and Drug Administration Clinical Trials. Sex Med Rev 2020; 9:169-173. [PMID: 33309271 DOI: 10.1016/j.sxmr.2020.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Traditional benign prostatic hyperplasia treatment options, such as transurethral resection of the prostate and laser, have focused on addressing urinary symptoms for men; however, these options are associated with a high risk of sexual dysfunction. OBJECTIVE The objective of this study was to assess newer technologies (Aquablation therapy, UroLift, and Rezum) for the treatment of benign prostatic hyperplasia and the impact of preserving sexual function compared with transurethral resection of the prostate. METHODS A comprehensive review of Food and Drug Administration randomized studies from each of the technologies was carried out. A comparison of 3-year outcomes for International Index of Erectile Function-5 and Male Sexual Health Questionnaire Ejaculatory Function domain short form was analyzed. RESULTS Aquablation and prostatic urethral lift were the only therapies to show permanent sexual function preservation in both Male Sexual Health Questionnaire Ejaculatory Function domain short form (ejaculatory function) and International Index of Erectile Function-5 (erectile function) at 3 years after treatment. CONCLUSION For prostates less than 80 cc, Aquablation and prostatic urethral lift were able to demonstrate permanent sexual function preservation in both Male Sexual Health Questionnaire Ejaculatory Function domain short form (ejaculatory function) and International Index of Erectile Function-5 (erectile function) at 3 years after treatment. Bhojani N, Yafi FA, Misrai V, et al. Review of Sexual Preservation After Novel Benign Prostatic Hyperplasia Surgical Treatment Modalities From Food and Drug Administration Clinical Trials. Sex Med Rev 2021;9:169-173.
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Affiliation(s)
- Naeem Bhojani
- Division of Urology, Centre hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada.
| | - Faysal A Yafi
- Department of Urology, University of California Irvine, Irvine, CA, USA
| | - Vincent Misrai
- Department of Urology, Clinique Pasteur, Toulouse, France
| | - Enrique Rijo
- Department of Urology, Hospital Quiron Salud, Barcelona, Spain
| | - Bilal Chughtai
- Department of Urology, Weill Cornell Medical College, New York Presbyterian, New York, USA
| | - Kevin C Zorn
- Division of Urology, Centre hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada
| | - Dean Elterman
- Division of Urology, University Health Network (UHN), University of Toronto, Toronto, ON, Canada
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15
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Melandri M, Alonge S. Highlights on the Canine Prostatic Specific Esterase (CPSE): A diagnostic and screening tool in veterinary andrology. Vet Med Sci 2020; 7:35-40. [PMID: 32881401 PMCID: PMC7840190 DOI: 10.1002/vms3.349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/16/2020] [Indexed: 12/17/2022] Open
Abstract
In the last years, the need to look for an accurate and precise diagnosis of prostatic diseases in dogs has grown. Among other diagnostic tools, the seric CPSE has been studied and identified as a valid and specific biomarker for prostatic disorders, since it can result significantly more elevated in dogs affected by several prostatic abnormalities, such as benign prostatic hyperplasia, bacterial prostatitis and prostatic carcinoma. Therefore, dosing CPSE in serum represents a new diagnostic and screening tool. Dosing CPSE in everyday clinical practice has three objectives: (a) the diagnosis of benign prostatic hyperplasia; (b) the preventive screening of prostatic disorders in healthy dogs; (c) the medical follow‐up in subjects with prostatic disorders during and after medical therapy. Neither circadian rhythms nor transrectal palpation performed during the andrological examination do affect CPSE. A sexual rest of at least 24 hr before dosing CPSE is recommended as it is affected by ejaculation.
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Affiliation(s)
- Monica Melandri
- Società Veterinaria "Il Melograno" Srl, Sesto Calende, Varese, Italy
| | - Salvatore Alonge
- Società Veterinaria "Il Melograno" Srl, Sesto Calende, Varese, Italy
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16
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De León LE, Patil N, Hartigan PM, White A, Bravo-Iñiguez CE, Fox S, Tarascio J, Swanson SJ, Bueno R, Jaklitsch MT. Risk of Urinary Recatheterization for Thoracic Surgical Patients with Epidural Anesthesia. J Surg Res (Houst) 2020; 3:163-171. [PMID: 32776012 PMCID: PMC7409986 DOI: 10.26502/jsr.10020068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Current quality guidelines recommend the removal of urinary catheters on or before postoperative day two, to prevent catheter-associated urinary tract infections (CAUTI). The goal of this study was to evaluate the impact urinary catheter removal on the need for urinary recatheterization (UR) of patients with epidural anesthesia undergoing thoracic surgery. Materials and Methods: All patients undergoing thoracic surgery between November 4th, 2017 and January 9th, 2018 who had a urinary catheter placed at the time of intervention were prospectively evaluated. Patient characteristics including: history of benign prostatic hyperplasia (BPH), catheter related variables and rates of UR were collected through chart review and daily visits to the wards. BPH was defined as history of transurethral resection of the prostate or treatment with selective α1-adrenergic receptor antagonists. Results: Over a two-month period 267 patients were included, 124 (46%) were male. Epidural catheters were placed in 88 (33%) patients. Median duration of urinary catheters for the cohort was 1 day (0 days – 18 days), and it was significantly higher in patients with epidural anesthesia (Table 1). Overall 20 (7%) patients required UR. On initial analysis, there was no statistical difference in the rate of UR among patients with and without epidural catheters [9/88 (10%) vs 11/179 (6%), p=0.23). The rate of UR was higher in males than in females (14/124 (11%) vs 6/143 (4%), p=0.03). Fifteen (12%) patients had a diagnosis of BPH. The rate of UR was three-times higher in this group than in those without BPH [4/15 (27%) vs 10/109 (9%) p=0.05]. Four (1%) patients developed a CAUTI during follow-up, and the rate of CAUTI was not different between those with and without epidural catheters. Conclusion: Urinary catheters in patients with thoracic epidural anesthesia can be safely removed, as evidenced by low reinsertion and infection rates. Removal of urinary catheters in patients with a history of BPH should be carefully evaluated, as over 1/4 will require urinary recatheterization in this subgroup. Further study of this group is needed to avoid unnecessary patient discomfort associated with recatheterization.
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Affiliation(s)
- Luis E. De León
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Namrata Patil
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Philip M. Hartigan
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Abby White
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Carlos E. Bravo-Iñiguez
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sam Fox
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeffrey Tarascio
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Scott J. Swanson
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Raphael Bueno
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael T. Jaklitsch
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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17
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Sebastianelli A, Spatafora P, Frizzi J, Saleh O, De Nunzio C, Tubaro A, Vignozzi L, Maggi M, Serni S, McVary KT, Kaplan SA, Gravas S, Chapple C, Gacci M. Which Drug to Discontinue 3 Months After Combination Therapy of Tadalafil plus Tamsulosin for Men with Lower Urinary Tract Symptom and Erectile Dysfunction? Results of a Prospective Observational Trial. Eur Urol Focus 2019; 7:432-439. [PMID: 31606473 DOI: 10.1016/j.euf.2019.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/08/2019] [Accepted: 09/24/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Safety and efficacy of tamsulosin and tadalafil for men with benign prostatic enlargement (BPE) and/or erectile dysfunction (ED) are defined. However, there are only a few pilot studies on combination therapy with these drugs for men with lower urinary tract symptom (LUTS)/BPE and ED. Moreover, preliminary reports are limited to 12 wk, without any information about subsequent therapies. OBJECTIVE To evaluate the impact of discontinuation of tamsulosin versus tadalafil 12 wk after combination therapy. DESIGN, SETTING, AND PARTICIPANTS Fifty consecutive patients with moderate-to-severe LUTS (International Prostate Symptom Score [IPSS] > 7) and mild-to-severe ED (International Index of Erectile Function-5 [IIEF-5] < 22) were treated with combination therapy (tamsulosin 0.4mg/d plus tadalafil 5mg/d) for 12 wk. After 12 wk, 25 patients discontinued tamsulosin (Group TAD), while 25 patients discontinued tadalafil (Group TAM). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Efficacy variables were IPSS (total, voiding, storage) and IIEF-5. Paired samples t test and analysis of variance were used. RESULTS AND LIMITATIONS Groups TAD and TAM presented similar features (age, BMI, metabolic profile) including symptoms scores at baseline. Similar and significant improvements in IPSS (total, voiding, and storage) and IIEF-5 were recorded in both groups after 12 wk of combination therapy (all p< 0.001). Total IPSS was similar between the two groups at the end of the trial. However, we found between-group significant differences from baseline to 24 wk and from 12 to 24 wk in storage-IPSS (Group TAD: -3.32 vs Group TAM: -1.24, p= 0.002; Group TAD: +0.24 vs Group TAM: +1.20, p= 0.040, respectively) and in IIEF-5 (Group TAD: +4.64 vs Group TAM: +0.16, p< 0.001; Group TAD: -1.64 vs Group TAM: -4.40, p= 0.003). No significant treatment-related adverse event was recorded in both groups. CONCLUSIONS After 12 wk of combination therapy, monotherapy with tadalafil for further 12 wk allows to preserve the improvement of storage IPSS and IIEF-5, in addition to total IPSS. PATIENT SUMMARY In this report we evaluated the discontinuation of tamsulosin or tadalafil after 12 wk of combination therapy. We found that tadalafil monotherapy, for a further 12 wk, aids in retaining the improvement of storage symptoms and erectile function.
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Affiliation(s)
- Arcangelo Sebastianelli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Pietro Spatafora
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Jacopo Frizzi
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Omar Saleh
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy
| | - Linda Vignozzi
- Department of Clinical Physiopathology, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Clinical Physiopathology, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Kevin T McVary
- Center for Male Health, Department of Urology, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Steven A Kaplan
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Stavros Gravas
- Department of Urology, University of Thessaly, Larissa, Greece
| | - Christopher Chapple
- Department of Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Mauro Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy.
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Abstract
This review provides a brief overview of and commentary on currently available technology for the surgical treatment of obstructive benign prostatic hyperplasia causing lower urinary tract symptoms. This review provides references relevant to review and understand current technology that is clinically available.
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Affiliation(s)
- Alexis E Te
- Weill Medical College of Cornell University, Ithaca, NY, USA.,Urology Program, Iris Cantor Men's Health Center, 425 East 61st Street, 12th Floor, New York, NY, 10065, USA.,Brady Prostate Center and Urodynamics Laboratory, 525 East 68th Street, 9th Floor, New York, NY, 10065, USA
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19
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Abstract
BACKGROUND Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is the fourth most common and the fifth most costly disease in men aged 50 years or older. Despite the high prevalence of LUTS/BPH in clinical practice and evidence-based guideline recommendations, there are still plenty of misconceptions on the terminology and pathophysiology of the disease, leading to false assumptions and malpractice. OBJECTIVES Listing of commonly used false assumptions and clarification of the correct terminology and pathophysiology. MATERIALS AND METHODS Critical reflection of 12 selected fake news based on PubMed search. RESULTS Average prostate weight in healthy men is 20 g but varies between 8-40 g. The BPH-disease does not progress in stages; therefore, the BPH-classifications according Alken or Vahlensieck should not be used anymore. There is only a weak and inconsistent relationship between bladder outlet obstruction (BOO) and prostate size, diverticula/pseudo-diverticula, postvoid residual, urinary retention or renal insufficiency, which is too unreliable for BOO-diagnosis in the individual patient. Urethro-cystoscopy with grading of the degrees of occlusion of the prostatic urethra and bladder trabeculation is insufficient for BOO-diagnosis. There is no clinically relevant reduction of BOO with licensed BPH-drugs and no convincing data that prostate resection (TURP) has to be complete until the surgical capsule in order to obtain optimal results. CONCLUSIONS The reasons for the persistent use of wrong terminology and pathophysiology are diverse. One reason is lack of implementation of evidence-based guidelines into clinical practice due to lack of knowledge, individual beliefs, costs, availability and reimbursement policies. Another reason is the increasing focus on oncology, coupled with underrepresented education and training on BPH.
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20
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Ke Z, Wang L, Min XD, Feng ZY, Kang Z, Zhang PP, Li BS, You HJ, Hou SC. Diagnostic Performance and Interobserver Consistency of the Prostate Imaging Reporting and Data System Version 2: A Study on Six Prostate Radiologists with Different Experiences from Half a Year to 17 Years. Chin Med J (Engl) 2018; 131:1666-1673. [PMID: 29998885 PMCID: PMC6048930 DOI: 10.4103/0366-6999.235872] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) is to diminish variation in the interpretation and reporting of prostate imaging, especially among readers with varied experience levels. This study aimed to retrospectively analyze diagnostic consistency and accuracy for prostate disease among six radiologists with different experience levels from a single center and to evaluate the diagnostic performance of PI-RADS v2 scores in the detection of clinically significant prostate cancer (PCa). Methods: From December 2014 to March 2016, 84 PCa patients and 99 benign prostatic shyperplasia patients who underwent 3.0T multiparametric magnetic resonance imaging before biopsy were included in our study. All patients received evaluation according to the PI-RADS v2 scale (1–5 scores) from six blinded readers (with 6 months and 2, 3, 4, 5, or 17 years of experience, respectively, the last reader was a reviewer/contributor for the PI-RADS v2). The correlation among the readers' scores and the Gleason score (GS) was determined with the Kendall test. Intra-/inter-observer agreement was evaluated using κ statistics, while receiver operating characteristic curve and area under the curve analyses were performed to evaluate the diagnostic performance of the scores. Results: Based on the PI-RADS v2, the median κ score and standard error among all possible pairs of readers were 0.506 and 0.043, respectively; the average correlation between the six readers' scores and the GS was positive, exhibiting weak-to-moderate strength (r = 0.391, P = 0.006). The AUC values of the six radiologists were 0.883, 0.924, 0.927, 0.932, 0.929, and 0.947, respectively. Conclusion: The inter-reader agreement for the PI-RADS v2 among the six readers with different experience is weak to moderate. Different experience levels affect the interpretation of MRI images.
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Affiliation(s)
- Zan Ke
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Liang Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiang-De Min
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zhao-Yan Feng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zhen Kang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Pei-Pei Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Ba-Sen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Hui-Juan You
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Sheng-Chao Hou
- Department of Library, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
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Takahashi H, Masuoka S, Nasu K, Mori K, Kojima T, Fukuda K, Takahashi K, Ishiguro T, Hosokawa T, Minami M. Sorafenib-induced Prostate Volume Reduction, a New Adverse Effect Detected by Imaging: A Pilot Study. J Belg Soc Radiol 2018; 102:69. [PMID: 30386849 DOI: 10.5334/jbsr.1607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Sorafenib has been used in the treatment of advanced hepatocellular carcinoma (HCC) and renal cell carcinoma (RCC). Sorafenib-associated organ reduction have been reported on imaging, such as thyroid, pancreas and muscle, but there has been no research on prostate volume reduction (PVR). Methods We retrospectively analyzed 26 patients (twenty with HCC and six patients with RCC) who underwent sorafenib therapy for 31 to 1225 days (median, 100 days). PVR was estimated by two independent readers using CT volumetry. Results The sum of all prostate volumes measured by reader 1 was 24.2 ± 13.8 cm3 on the baseline CT and 20.4 ± 10.6 cm3 on the follow-up CT (p < 0.001), and that measured by reader 2 was 22.3 ± 13.9 cm3 on the baseline CT and 19.2 ± 10.6 cm3 on the follow-up CT (p < 0.001). The concordance correlation coefficient for the prostate volume measured by the two readers was 0.95 on the baseline CT scans and 0.94 on the follow-up CT scans. Sorafenib-associated PVR demonstrated slight dependence to the exposure time (r = -0.23). One patient with benign prostatic hyperplasia (BPH) showed PVR (from 80.4 to 61.5 cm3 [reader 1]; 83.4 to 61.6 cm3 [reader 2]) after sorafenib administration. Sorafenib-associated PVR occurred in patients both with and without underlying liver dysfunction with relative prostate volume changes of 86.7 ± 12.0% and 85.0 ± 9.0%, respectively. Conclusion Our study demonstrated significant PVR with sorafenib treatment in patients regardless of the presence of BPH and underlying liver dysfunction.
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Gupta NK, Gange SN, McVary KT. New and Emerging Technologies in Treatment of Lower Urinary Tract Symptoms From Benign Prostatic Hyperplasia. Sex Med Rev 2018; 7:491-498. [PMID: 29606553 DOI: 10.1016/j.sxmr.2018.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 01/31/2018] [Accepted: 02/12/2018] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Lower urinary tract symptoms (LUTS) from bladder outlet obstruction from benign prostatic hyperplasia (BPH) occur in a large percentage of urologic patients. Treatment of this condition with medical and surgical therapy provides symptom relief but has serious adverse effects and causes sexual dysfunction. New technologies to treat BPH-associated LUTS aim to effectively treat urinary symptoms and minimize side effects and sexual dysfunction. AIM To review the efficacy of new and emerging therapies for treatment of LUTS from BPH. METHODS A literature search was performed to identify therapies for LUTS from BPH with early outcomes data within the past 5 years. MAIN OUTCOME MEASURES Improvement in International Prostate Symptom Score (IPSS) and effect on sexual functions such as erectile and ejaculatory functions as measured on the International Index of Erectile Function and the Male Sexual Health Questionnaire. RESULTS Technologies introduced within the past 5 years include techniques using intraprostatic injectables, mechanical devices, and prostatic tissue ablation. Most technologies remain in the development phase and have only phase I and II studies available that show promising alleviation of urinary symptoms. Injectables have not typically surpassed placebo or sham effects, although special cohorts could be exceptions. Thus far, convective water vapor ablation therapy and prostatic urethral lift have shown the most promise, with short- and medium-term data available on phase III studies demonstrating significant improvement in IPSS with minimal impact on sexual function. Many of these technologies are limited in their potential treatment population by prostate size and conformation, whereas other therapies might be more generalizable. CONCLUSION Many new technologies aim to treat LUTS from BPH and minimize sexual side effects. Most therapies remain experimental, although prostatic urethral lift and water vapor ablation therapy have been brought to market and show promise. Long-term durability of symptom relief remains to be demonstrated. Gupta NK, Gange SN, McVary KT. New and Emerging Technologies in Treatment of Lower Urinary Tract Symptoms From Benign Prostatic Hyperplasia. Sex Med Rev 2018;7:491-498.
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Affiliation(s)
- Nikhil K Gupta
- Division of Urology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | - Kevin T McVary
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
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Kim SW, Park NC, Lee SW, Yang DY, Park JK, Moon DG, Yang SK, Lee SW, Moon KH, Ahn TY, Kim SW, Park K, Min KS, Ryu JK, Son H, Jung J, Hyun JS. Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil for Patients With Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Randomized, Double-Blinded, Active-Controlled Trial. J Sex Med 2018; 14:1018-1027. [PMID: 28760246 DOI: 10.1016/j.jsxm.2017.06.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/24/2017] [Accepted: 06/18/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Phosphodiesterase type 5 inhibitors and α-adrenergic blocking agents (α-blockers) are widely used for the treatment of erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). AIMS To assess the efficacy and safety of fixed-dose combinations (FDCs) of tamsulosin and tadalafil compared with tadalafil monotherapy in patients with comorbid BPH-associated LUTS and ED. METHODS A randomized, double-blinded, active-controlled trial was conducted of 510 men with BPH-associated LUTS and ED. Patients were treated with FDCs of tamsulosin 0.4 mg plus tadalafil 5 mg (FDC 0.4/5 mg), tamsulosin 0.2 mg plus tadalafil 5 mg (FDC 0.2/5 mg), or tadalafil 5 mg for a 12-week treatment period. For a subsequent 12-week extension period, the patients were administered FDC 0.4/5 mg. OUTCOMES The primary outcomes were changes from baseline in total International Prostate Symptom Score (IPSS) and International Index of Erectile Function erectile function domain (IIEF-EF) score at week 12 to prove superiority and non-inferiority of FDCs compared with tadalafil 5 mg. The safety assessments were adverse reactions, laboratory test results, and vital signs at week 24. RESULTS The mean changes in total IPSS and IIEF-EF scores were -9.46 and 9.17 for FDC 0.4/5 mg and -8.14 and 9.49 for tadalafil 5 mg, respectively, which indicated superiority in LUTS improvement (P = .0320) and non-inferiority in ED treatment with FDC 0.4/5 mg compared with tadalafil 5 mg. However, the results from FDC 0.2/5 mg failed to demonstrate superiority in LUTS improvement. No clinically significant adverse events regarding the investigational products were observed during the 24-week period. CLINICAL IMPLICATIONS The FDC 0.4/5 mg is the first combined formulation of an α-blocker and a phosphodiesterase type 5 inhibitor that offers benefits in patient compliance and as add-on therapy in patients with comorbid BPH-associated LUTS and ED. STRENGTHS AND LIMITATIONS The study clearly demonstrated the advantage of FDC 0.4/5 mg. The main advantage of FDC 0.4/5 mg was the enhanced efficacy on BPH-associated LUTS comorbidity with ED, the lower incidence of side effects, and the simplification and convenience of therapy, which led to better overall patient compliance. However, the lack of a tamsulosin monotherapy control group was a limitation of this study. CONCLUSION The FDC 0.4/5 mg therapy was safe, well tolerated, and efficacious, indicating that combination therapy could provide clinical benefits for patients with BPH-associated LUTS complaints and ameliorate the comorbidity of ED. Kim SW, Park NC, Lee SW, et al. Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil for Patients With Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Randomized, Double-Blinded, Active-Controlled Trial. J Sex Med 2017;14:1018-1027.
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Affiliation(s)
- Sae Woong Kim
- Department of Urology, The Catholic University College of Medicine, Seoul, Korea
| | - Nam Cheol Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Seung Wook Lee
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Dae Yul Yang
- Department of Urology, Hallym University College of Medicine, Seoul, Korea
| | - Jong Kwan Park
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Sang-Kuk Yang
- Department of Urology, Konkuk University School of Medicine, Seoul, Korea
| | - Sung Won Lee
- Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Hak Moon
- Department of Urology, Yeungnam University College of Medicine, Daegu, Korea
| | - Tai Young Ahn
- Department of Urology, Ulsan University College of Medicine, Seoul, Korea
| | - Soo Woong Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Kweon Sik Min
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | - Ji-Kan Ryu
- Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Hankil Son
- Clinical Research Team, Hanmi Pharmaceutical Co, Ltd, Seoul, Korea
| | - Jina Jung
- Clinical Research Team, Hanmi Pharmaceutical Co, Ltd, Seoul, Korea
| | - Jae Seog Hyun
- Department of Urology, Gyeongsang National University College of Medicine and Hospital, Jinju, Korea.
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Asare GA, Andam SE, Asare-Anane H, Ammanquah S, Anang-Quartey Y, Afriyie DK, Musah I. Lipid associated antioxidants: arylesterase and paraoxonase-1 in benign prostatic hyperplasia treatment-naïve patients. Prostate Int 2017; 6:36-40. [PMID: 29556488 PMCID: PMC5857163 DOI: 10.1016/j.prnil.2017.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/31/2017] [Accepted: 04/11/2017] [Indexed: 12/27/2022] Open
Abstract
Background Oxidative stress and antioxidants have been implicated in many diseases including prostate cancer and benign prostatic hyperplasia (BPH). Lipid peroxidation contributes to oxidative stress. However, new and emerging antioxidants such as paraoxonase 1 (PON1) and arylesterase (ARE) associated with lipoprotein peroxidation have not been examined in BPH patients. PON1 and ARE, a high-density lipoprotein (HDL) cholesterol-bound enzyme system of antioxidants, protect low-density lipoprotein (LDL) cholesterol and HDL from oxidation by hydrolysis. The study primarily determined paraoxonase (PON1) and ARE activities in BPH treatment-naïve patients. Materials and methods Sixty newly diagnosed patients (treatment-naïve) alongside 30 apparently healthy controls were recruited. Blood examinations included lipid profile (total cholesterol, triglycerides, LDL, HDL), glutathione peroxidase, PON1, ARE, and prostate specific antigen (PSA). Prostate volume and International Prostate Symptoms Score (IPSS) were determined. Results PSA was significantly different between patient and control groups (P < 0.0001). Total cholesterol, triglycerides, and LDL were significantly higher in the patient group (P = 0.002, P < 0.001, P = 0.003, respectively). Glutathione peroxidase was very low in the patient group compared to the control group (5.65 ± 2.30 ng/mL and 17.43 ± 10.98 ng/mL, respectively). Although PON1 was higher in the patient group (50.22 ± 19.68/61.30 ± 29.55 ng/mL; P > 0.05), ARE was significantly lower in the patient group (61.31 ± 21.76/49.30 ± 19.82 ng/mL; P = 0.0098). No correlation was established between antioxidants and the lipid profile except for the LDL and PON1 patient group (r = 0.1486, P = 0.0374). Similarly, a weak correlation was also established between PSA and LDL in the patient group (r = –0.275, P = 0.033). PON1/HDL ratio was not significantly different. However, the ARE/HDL ratio was significantly lower in the patient group (P < 0.0001). Conclusion These results signify the presence of a higher lipoprotein peroxidation activity and lower lipid-associated antioxidant activity in the patient group. The ARE/HDL ratio is a better indicator of the HDL associated antioxidant than the PON1/HDL ratio or the individual antioxidants (PON1 and ARE) as reported by others.
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Affiliation(s)
- George Awuku Asare
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Sabina Ekua Andam
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Henry Asare-Anane
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Seth Ammanquah
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Yvonne Anang-Quartey
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Daniel K Afriyie
- Department of Pharmacy, Ghana Police Hospital, Cantonments, Ghana
| | - Iddis Musah
- Department of Urology, Ghana Police Hospital, Cantonments, Ghana
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Sarbishegi M, Khajavi O, Arab MR. Withania coagulans Extract Induces Cell Apoptosis and Inhibits COX-2 Expression in a Rat Model of Benign Prostatic Hyperplasia. Nephrourol Mon 2016; 8:e39284. [PMID: 27878112 PMCID: PMC5111096 DOI: 10.5812/numonthly.39284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 06/25/2016] [Indexed: 12/11/2022] Open
Abstract
Background Phytotherapy is a popular treatment option in cases of benign prostatic hyperplasia (BPH), with many different herbal products being used for the treatment of this condition. Withania coagulans (WC) is an herbal medicine that has shown anti-tumoral, anti-inflammatory, and antioxidant effects. Objectives This study examined the effect of Withania coagulans extract (WCE) on prostatic cell apoptosis and cyclooxygenase-2 (COX-2) expression in cases of benign prostatic hyperplasia (BPH) in rats. Methods Forty Wistar rats were equally divided into five groups: control, sham, BPH, BPH + WCE, and BPH + CLX (celecoxib) as a positive control group. The induction of BPH was achieved via the subcutaneous injection of 3 mg/kg of testosterone propionate (TP) daily for 28 days. The animals received WCE, celecoxib, or distilled water by oral gavage accompanied by the TP injection. After four weeks, the prostate glands of the rats were weighed to measure the prostatic index (PI). The ventral lobes of the prostates were dissected and processed with paraffin blocks in order to study the number of mast cells. A TUNEL analysis was performed to evaluate the cell apoptosis, while the expression of COX-2 was examined using immunohistochemistry. Results BPH was obvious in the ventral lobe of the prostate, and the administration of WCE markedly decreased the PI and the number of mast cells (P < 0.001) in the BPH rats. Additionally, the WCE treatment induced prostatic cell apoptosis when compared to the BPH group. Furthermore, following the WCE treatment, the expression of COX-2 in the prostatic tissues was significantly decreased when compared to the BPH groups. Conclusions According to the results of this study, WCE was effective in the treatment of BPH in rats. It may therefore have beneficial effects in the treatment of patients with BPH.
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Affiliation(s)
- Maryam Sarbishegi
- Cellular and Molecular Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Department of Anatomy, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Maryam Sarbishegi, Department of Anatomy, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-3329571519, Fax: +98-33291124, E-mail:
| | - Ozra Khajavi
- Department of Anatomy, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Mohammad Reza Arab
- Cellular and Molecular Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Department of Anatomy, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
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Lamers RED, Cuypers M, Garvelink MM, de Vries M, Bosch JLHR, Kil PJM. Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study. Patient Educ Couns 2016; 99:1249-1256. [PMID: 26899631 DOI: 10.1016/j.pec.2016.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/27/2015] [Accepted: 02/06/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). METHODS From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2: Identifying patients' needs and expectations, 3: Development of DA content and structure, 4: Usability testing with LUTS/BPH patients. RESULTS 1 (N=15): Dutch urologists reached consensus on 61% of the statements concerning users' criteria, decision options, structure, and medical content. 2 (N=24): Consensus was reached in 69% on statements concerning the need for improvement of information provision, the need for DA development and that the DA should clarify patients' preferences. 3: DA development based on results from stage 1 and stage 2. 4 (N=10): Pros of the DA were clear information provision, systematic design and easy to read and re-read. CONCLUSION A LUTS/BPH DA containing VCEs(**) was developed in cooperation with urologists and patients following a structured 4 stage method and was stated to be well accepted. PRACTICE IMPLICATIONS This method can be adopted for the development of DAs to support other medical decision issues.
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Affiliation(s)
- Romy E D Lamers
- Department of Urology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC Tilburg, The Netherlands.
| | - Maarten Cuypers
- Department of Social Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands.
| | | | - Marieke de Vries
- Department of Social Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands; Radboud University, Institute for Computing and Information Sciences (iCIS), Nijmegen, The Netherlands.
| | - J L H Ruud Bosch
- Department of Urology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Paul J M Kil
- Department of Urology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC Tilburg, The Netherlands.
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Mulhall JP, Brock GB, Glina S, Baygani S, Donatucci CF, Maggi M. Impact of Baseline Total Testosterone Level on Successful Treatment of Sexual Dysfunction in Men Taking Once-Daily Tadalafil 5 mg for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia: An Integrated Analysis of Three Randomized Controlled Trials. J Sex Med 2016; 13:843-51. [PMID: 27017071 DOI: 10.1016/j.jsxm.2016.02.163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/08/2016] [Accepted: 02/13/2016] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Controversy exists as to whether erectile response to phosphodiesterase type 5 inhibitors is compromised in men with low total testosterone (TT) levels. This is amplified by reports of improved response to phosphodiesterase type 5 inhibitor therapy after coadministration of testosterone replacement therapy in hypogonadal men unresponsive to phosphodiesterase type 5 inhibitors. AIM To determine whether TT and luteinizing hormone levels influence efficacy of tadalafil for erectile dysfunction in men with concomitant lower urinary tract symptoms and benign prostatic hyperplasia. METHODS This integrated analysis included 1,075 men randomized to once-daily tadalafil 5 mg (n = 540) or placebo (n = 535) for 12 weeks in three prospective clinical trials who had not received concomitant testosterone replacement therapy. Subjects were categorized at baseline by low vs normal TT levels (n = 1,049; <300 vs ≥300 ng/dL) and normal vs high luteinizing hormone levels (n = 1,058; ≤9.4 vs >9.4 mIU/mL). Treatment-group differences in International Index of Erectile Function (IIEF) by hormone subgroups were assessed using analysis of covariance. MAIN OUTCOME MEASURES Changes in IIEF erectile function domain and other domain scores. RESULTS The overall study population was comprised primarily of white men (>86%) with a mean age range of 64 to 70 years. Median baseline TT level in the integrated population was 355 ng/dL; levels were lower than 300 ng/dL (cutoff for normal) in 32.4% of men. Men with low TT levels reported diabetes (21.8%), cardiovascular disease (54.1%), and hypertension (49.1%) numerically more often than men with normal TT levels (10.6%, 43.2%, and 36.7%, respectively). Low TT and high luteinizing hormone levels were associated with numerically, but not statistically significantly, lower 12-week IIEF domain scores compared with those with normal levels. Changes in most 12-week IIEF domain scores showed that tadalafil was significantly more effective than placebo (P < .02). CONCLUSION Low TT levels at baseline did not negatively influence response to tadalafil in men of advancing age with concomitant lower urinary tract symptoms and benign prostatic hyperplasia and erectile dysfunction.
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Affiliation(s)
- John P Mulhall
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Sidney Glina
- Department of Urology, Instituto H. Ellis, São Paulo, SP, Brazil
| | - Simin Baygani
- Lilly Research Laboratories, Eli Lilly and Co., Indianapolis, IN, USA
| | - Craig F Donatucci
- Lilly Research Laboratories, Eli Lilly and Co., Indianapolis, IN, USA.
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Sarbishegi M, Khani M, Salimi S, Valizadeh M, Sargolzaei Aval F. Antiproliferative and Antioxidant Effects of Withania coagulans Extract on Benign Prostatic Hyperplasia in Rats. Nephrourol Mon 2016; 8:e33180. [PMID: 26981498 PMCID: PMC4779590 DOI: 10.5812/numonthly.33180] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/07/2015] [Indexed: 12/13/2022] Open
Abstract
Background: Benign prostate hyperplasia (BPH) is a common urological disorder in elderly men. Phytotherapy is frequently used to alleviate the symptoms of this condition. Objectives: The present study investigated the effect of Withania coagulans extract (WCE), which is known to have antioxidant, anti-inflammatory, antihyperglycemic, and anti-cancer properties, on testosterone-induced BPH in rats. Materials and Methods: Forty Wistar rats were divided into five groups (each n = 8): the control group, the untreated BPH group, and three WCE-treated groups (WCE250, 500, and 1000). BPH was induced with 3 mg/kg subcutaneous injections of testosterone propionate for four weeks. WCE was concomitantly administrated by oral gavage. At the end of the induction schedule, the animals were sacrificed and their prostate glands were dissected, weighed, and fixed for histological examination (H&E and proliferating cell nuclear antigen [PCNA] staining). Half of each sample was prepared for measurement of malondialdehyde (MDA) and total antioxidant capacity (TAC) levels in the prostate. Results: The present study revealed that BPH caused elevation of MDA levels, suppression of TAC levels, and increased PCNA expression in the prostate gland. Interestingly, in a dose-dependent manner, WCE caused decreased MDA levels and increased TAC levels in the prostate gland, compared to the untreated BPH group. Histopathological examinations showed a reduction in PCNA expression in the prostate epithelium of the WCE animals. Conclusions: W. coagulans inhibits the development of BPH can be useful for the treatment of this condition.
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Affiliation(s)
- Maryam Sarbishegi
- Department of Anatomy, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Maryam Sarbishegi, Department of Anatomy, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-33295715; +98-9195535681, Fax: +98-33291124, E-mail:
| | - Mohaddeseh Khani
- Department of Anatomy, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Saeedeh Salimi
- Cellular and Molecular Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Mohharam Valizadeh
- Department of Medicinal and Aromatic Plant, High Complex Education of Saravan, Saravan, IR Iran
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Park J, Lee DG, Suh B, Cho SY, Chang IH, Paick SH, Lee HL. Establishment of Reference Ranges for Prostate Volume and Annual Prostate Volume Change Rate in Korean Adult Men: Analyses of a Nationwide Screening Population. J Korean Med Sci 2015; 30:1136-42. [PMID: 26240492 PMCID: PMC4520945 DOI: 10.3346/jkms.2015.30.8.1136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 05/27/2015] [Indexed: 11/20/2022] Open
Abstract
We aimed to determine normal reference ranges for prostate volume (PV) and annual PV change rate in a Korean nationwide screening population. Data from men who underwent a routine health check-up were collected from 13 university hospitals. The cohort comprised men aged ≥40 yr who had undergone 2 or more serial transrectal ultrasonographies. Men with initial PV>100 mL; serum PSA level>10 ng/mL; PV reduction>20% compared with initial PV, or who had history of prostate cancer or prostate surgery, were excluded. Linear regression and mixed effects regression analyses were used to predict mean PV and longitudinal change in PV over time. A total of 2,967 men formed the study cohort. Age, body mass index (BMI), and serum prostate-specific antigen (PSA) level were found to be significant predictors of PV. A predicted PV table, with a 95% confidence interval (CIs), was developed after adjusting for these 3 variables. Annual PV change rate was 0.51 mL/year (95% CI, 0.47-0.55). Annual PV change rate according to age was 0.68 mL/year, 0.84 mL/year, 1.09 mL/year, and 0.50 mL/year for subjects in their 40s, 50s, 60s, and ≥70 yr, respectively. Predicted annual PV change rate differed depending on age, BMI, serum PSA level and baseline PV. From a nationwide screening database, we established age-, PSA-, and BMI-specific reference ranges for PV and annual PV change rate in Korean men. Our newly established reference ranges for PV and annual PV change rate will be valuable in interpreting PV data in Korean men.
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Affiliation(s)
- Jinsung Park
- Department of Urology, Eulji University Hospital, Daejeon, Korea
| | - Dong-Gi Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Beomseok Suh
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sung Yong Cho
- Department of Urology, Boramae Medical Center, Seoul, Korea
| | - In Ho Chang
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sung Hyun Paick
- Department of Urology, Konkuk University Hospital, Seoul, Korea
| | - Hyung-Lae Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
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Imani F, Moghaddam Y, Shariat Moharari R, Etezadi F, Khajavi MR, Hosseini SR. Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy. Anesth Pain Med 2015; 5:e22568. [PMID: 26161317 PMCID: PMC4493733 DOI: 10.5812/aapm.5(3)2015.22568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/01/2014] [Accepted: 10/04/2014] [Indexed: 12/02/2022] Open
Abstract
Background: TRUS-guided needle biopsy of the prostate gland is the current standard method used for diagnosis of prostate cancer. Pain control during this procedure is through the use of i.v. sedation or local anaesthetic (LA), depending on clinician preference. Objectives: The aim of this study was to evaluate the effectiveness of intrarectal lidocaine, lidocaine-diltiazem and lidocaine-meperidine-diltiazem gel for anesthetizing transrectal ultrasound guided prostate biopsy. Patients and Methods: In a randomized double-blind clinical trial, 100 consecutive patients were divided into three groups. The patients received one of the gels before transrectal ultrasound guided prostate needle biopsy: group A, intrarectal and perianal lidocaine, gel 1 g; group B, intrarectal lidocaine gel, 1 g, + perianal diltiazem, 1 g; group C, intrarectal lidocaine gel, 1 g, + meperidine, 25 mg, and perianal diltiazem, 1 g. Visual analog pain scale was used to estimate pain during probe insertion and biopsy. Heart rate and blood pressure during probe insertion and biopsy were recorded too. Results: The mean of visual analog pain scale was 4.5 in group A, 3.5 in group B, and 2.0 in group C during probe insertion (P value = 0.01). The mean of visual analog pain scale was 5.1 in group A, 3.5 group B, and 2.5 in group C during biopsy (P value = 0.001). The groups were comparable for patients' age, weight, serum prostate-specific antigen (PSA), and prostate size (P > 0.05). No side effects of meperidine and lidocaine including drowsiness, dizziness, tinnitus and light-headedness or requiring assistance for activity were noted. Conclusions: Lidocaine-meperidine-diltiazem gel provides significantly better pain control than lidocaine-diltiazem gel and lidocaine gel alone during transrectal ultrasound guided prostate biopsy and probe insertion. This mixture gel is safe, easy to administer and well accepted by patients.
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Affiliation(s)
- Farsad Imani
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Moghaddam
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shariat Moharari
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Etezadi
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Khajavi
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Hosseini
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Seyed Reza Hosseini, Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9122083800, E-mail:
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Ammar AE, Esmat A, Hassona MDH, Tadros MG, Abdel-Naim AB, Guns EST. The effect of pomegranate fruit extract on testosterone-induced BPH in rats. Prostate 2015; 75:679-92. [PMID: 25620586 DOI: 10.1002/pros.22951] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 12/04/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) affects many men after the age of 50 years. Inflammation and oxidative stress along with apoptotic changes are thought to play an important role in the pathology of BPH. Pomegranate contains a variety of polyphenolic compounds that have been studied in a medley of diseases for their anti-oxidant, anti-inflammatory and pro-apoptotic properties. Therefore, this study examined the effect of Pomegranate Fruit Extract (PFE) on the development of BPH using a testosterone-induced BPH model in rats. METHODS A total of 48 rats were randomly divided into six groups of eight, one group served as the control, BPH was induced by testosterone 3 mg/kg S.C. daily in four groups, three of them received PFE by oral gavage daily at doses of 25, 50, and 100 mg/kg respectively, while one group received PFE at a dose of 50 mg/kg without induction of BPH. RESULTS PFE at a dose of 100 mg/kg was the most effective in decreasing testosterone-induced increase in prostate weight, prostate weight/body weight ratio, and PAP levels by 30.8%, 55%, and 68% respectively and in preventing the accompanying histological changes. In the BPH model, testosterone significantly decreased GSH, SOD, and CAT to 0.45, 0.64, and 0.88 of the control group values respectively, and significantly increased MDA by >6-fold. In combination with testosterone, PFE dosed at 100 mg/kg significantly increased GSH, SOD, and CAT to 0.83, 0.92, and 0.93 of the control group values respectively, whereas MDA was significantly decreased by 72% compared with the testosterone treated group. In addition to this, at the range of doses studied, PFE lowered COX-II, iNOS, Ki-67 expression, and increased apoptotic index. CONCLUSION The current findings elucidate the effectiveness of PFE in preventing testosterone-induced BPH in rats. This could be attributed, at least partly, to its anti-oxidant, anti-inflammatory, and pro-apoptotic properties.
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Affiliation(s)
- Amr E Ammar
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt; Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Suh B, Shin DW, Hwang SS, Choi HC, Kwon H, Cho B, Park JH. Alcohol is longitudinally associated with lower urinary tract symptoms partially via high-density lipoprotein. Alcohol Clin Exp Res 2014; 38:2878-83. [PMID: 25399519 DOI: 10.1111/acer.12564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 08/31/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies on the association of alcohol consumption with lower urinary tract symptoms (LUTS) have been inconsistent, and none took into account the dynamic nature of LUTS, fluctuating over time. The purpose of the study was to determine the longitudinal association of alcohol consumption with LUTS. METHODS We used generalized estimating equations to analyze the longitudinal association of alcohol consumption with LUTS in a longitudinal study of 9,712 healthy men 30 years or older who visited our institution multiple times for routine comprehensive health evaluations, with an average follow-up period of 27.9 months. RESULTS Light-moderate alcohol consumption (0.1 to 29 g/d) was associated with decreased likelihood of moderate-severe LUTS, whereas heavy alcohol consumption (≥30 g/d) was associated with increased likelihood of moderate-severe LUTS in a dose-dependent manner. Compared to those with 0 g/d alcohol intake, subjects who drank 0.1 to 9.9, 10 to 19.9, 20 to 29.9, 30 to 39.9, or ≥40 g/d of alcohol were in general significantly associated with moderate-severe LUTS with adjusted odds ratio (95% confidence interval) as follows respectively: 0.94 (0.87 to 1.02), 1.00 (0.91 to 1.09), 0.85 (0.77 to 0.93), 1.08 (0.98 to 1.19), and 1.31 (1.19 to 1.44). However, the protective association of light-moderate alcohol consumption with LUTS was greatly attenuated when serum high-density lipoprotein (HDL) was added to the analysis, specifically for voiding symptoms. CONCLUSIONS We show strong evidence there is longitudinal association of alcohol consumption with LUTS. The protective effect of light-moderate alcohol consumption on LUTS is in part modulated by HDL as a confounder, similar to its effect on coronary heart disease.
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Affiliation(s)
- Beomseok Suh
- Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea
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Yang YJ, Koh JS, Ko HJ, Cho KJ, Kim JC, Lee SJ, Pae CU. The influence of depression, anxiety and somatization on the clinical symptoms and treatment response in patients with symptoms of lower urinary tract symptoms suggestive of benign prostatic hyperplasia. J Korean Med Sci 2014; 29:1145-51. [PMID: 25120327 PMCID: PMC4129209 DOI: 10.3346/jkms.2014.29.8.1145] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 05/08/2014] [Indexed: 11/20/2022] Open
Abstract
This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (≤ 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
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Affiliation(s)
- Yong June Yang
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jun Sung Koh
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyo Jung Ko
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Korea
| | - Kang Joon Cho
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Joon Chul Kim
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Soo-Jung Lee
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chi-Un Pae
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Maliakal J, Mousa EE, Menon V. Giant Prostatic Hyperplasia: Fourth largest prostate reported in medical literature. Sultan Qaboos Univ Med J 2014; 14:e253-e256. [PMID: 24790752 PMCID: PMC3997546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/11/2013] [Accepted: 01/16/2014] [Indexed: 06/03/2023] Open
Abstract
A giant prostatic hyperplasia (GPH) weighing more than 700 g is a rare entity. It is believed that only eight such cases have been previously reported in the medical literature. This case report concerns a patient with a GPH weighing 740 g which was successfully removed by suprapubic prostatectomy. To our knowledge, this is the fourth largest benign prostatic enlargement ever reported in the literature.
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Yan H, Zong H, Cui Y, Li N, Zhang Y. The efficacy of PDE5 inhibitors alone or in combination with alpha-blockers for the treatment of erectile dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and meta-analysis. J Sex Med 2014; 11:1539-45. [PMID: 24621088 DOI: 10.1111/jsm.12499] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) are both highly prevalent in aging men. Alpha-blockers and PDE-5 inhibitors are widely used for the treatment of LUTS/benign prostatic hyperplasia (BPH) and ED. AIM The purpose of this meta-analysis was to evaluate the efficacy of phosphodiesterase type 5 (PDE5) inhibitors alone or in combination with alpha-blockers for the treatment of ED and LUTS. METHODS The databases MEDLINE, EMBASE, PubMed, the Cochrane Controlled Trial Register of Controlled Trials, and the Chinese Biological Medical Database were searched to identify randomized controlled trials that referred to the use of a combination of PDE5 inhibitors and alpha-blockers for the treatment of ED and LUTS associated with BPH. A systematic review and meta-analysis was conducted. MAIN OUTCOME MEASURES International Prostate Symptom Score (IPSS), the maximum flow rate (Qmax), and International Index of Erectile Function-Erectile Function (IIEF-EF) domain score were used in this meta-analysis. RESULTS Seven publications involving 515 patients were included in the meta-analysis. In the analysis, we found significantly improved IIEF, IPSS, and Qmax values in the combination use group compared with the use of PDE5 inhibitors alone (P = 0.04, 0.004, 0.007, respectively). CONCLUSIONS The combined use of PDE5 inhibitors and alpha-blockers results in additive favorable effects in men with ED and LUTS suggestive of BPH compared with PDE5 inhibitor monotherapy. The alpha-blockers may enhance the efficacy of the PDE5 inhibitors, which is beneficial for the treatment of ED and LUTS.
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Affiliation(s)
- Huilei Yan
- Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China
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Suhani, Gupta S, Gupta A, Saha S, Mahapatra L, Srivastava U. Outcome of surgery for benign prostatic hyperplasia-is it predictable? J Clin Diagn Res 2014; 7:2859-62. [PMID: 24551658 DOI: 10.7860/jcdr/2013/7606.3888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 10/29/2013] [Indexed: 11/24/2022]
Abstract
AIM The study was done to evaluate the pre-operative and intra operative factors which influence the post-operative outcome in patients undergoing surgery for Benign Prostatic Hyperplasia (BPH). SETTING AND DESIGN It was carried out prospectively at a university college hospital in northern India. MATERIAL & METHODS The study was carried out prospectively in 31 patients who underwent surgery for BPH (TURP - 50, Open Prostatectomy - 10). Various pre-operative and intra-operative parameters were studied by means of a detailed history and examination, IPS score, urodynamic evaluation & cystoscopic examination. Their effect on post-operative outcome was evaluated by measuring changes in IPSS, maximum and average flow rates, and fall in PSA values. STATISTICAL ANALYSIS Repeated measure ANNOVA was applied to calculate the significance of preoperative factors on post operative outcome (IPSS, Q max and Q av). RESULTS All parameters studied in the patients improved significantly following surgery. Patients who had pre-operative urinary retention and catheter at the time of surgery had significant improvement in both subjective (IPSS ,p=.oo4) and objective (maximum & average flow rates p=.04) parameters studied. Patients with larger prostrate had a significantly better maximum flow rate (p=.03) and IPSS at 3 months post-operatively. Similarly, patients with larger bladder capacity (more than 150 ml), better compliance (more than 6 ml per cm of water) and lower post-voidal residue (less than 60ml) had better post-operative outcome. CONCLUSION Patients with pre-operative urinary retention, shorter duration of bladder catheterization, lower post voidal residue, high IPSS score, larger prostrate, larger bladder capacity and compliance had a significantly better outcome following surgery for BPH as assessed by various parameters studied.
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Affiliation(s)
- Suhani
- Senior Resident, LHMC & SSKH , Formerly Junior Resident, UCMS & GTBH, Delhi, India
| | - Sanjay Gupta
- Professor of Surgery & Surgical Unit Head, UCMS & GTBH , Delhi, India
| | - Arun Gupta
- Professor, Department of Surgery & Surgical Unit Head , UCMS & GTBH , Delhi, India
| | - Sudipta Saha
- Assistant Professor, Department of Surgery, LHMC @ SSKH, New Delhi . Formerly lecturer, UCMS & GTBH , Delhi, India
| | | | - Uk Srivastava
- Former Professor, Department of Surgery and Surgical Unit Head, UCMS & GTBH , Delhi, India
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Haj-Ahmad TA, Abdalla MA, Haj-Ahmad Y. Potential Urinary miRNA Biomarker Candidates for the Accurate Detection of Prostate Cancer among Benign Prostatic Hyperplasia Patients. J Cancer 2014; 5:182-91. [PMID: 24563673 PMCID: PMC3931266 DOI: 10.7150/jca.6799] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 11/22/2013] [Indexed: 01/27/2023] Open
Abstract
MicroRNAs (miRNAs) are a class of short (~22nt), single stranded RNA molecules that function as post-transcriptional regulators of gene expression. MiRNAs can regulate a variety of important biological pathways, including: cellular proliferation, differentiation and apoptosis. Profiling of miRNA expression patterns was shown to be more useful than the equivalent mRNA profiles for characterizing poorly differentiated tumours. As such, miRNA expression “signatures” are expected to offer serious potential for diagnosing and prognosing cancers of any provenance. The aim of this study was to investigate the potential of using deregulation of urinary miRNAs in order to detect Prostate Cancer (PCa) among Benign Prostatic Hyperplasia (BPH). To identify the miRNA signatures specific for PCa, miRNA expression profiling of 8 PCa patients, 12 BPH patients and 10 healthy males was carried out using whole genome expression profiling. Differential expression of two individual miRNAs between healthy males and BPH patients was detected and found to possibly target genes related to PCa development and progression. The sensitivity and specificity of miR-1825 for detecting PCa among BPH individuals was found to be 60% and 69%, respectively. Whereas, the sensitivity and specificity of miR-484 were 80% and 19%, respectively. Additionally, the sensitivity and specificity for miR-1825/484 in tandem were 45% and 75%, respectively. The proposed PCa miRNA signatures may therefore be of great value for the accurate diagnosis of PCa and BPH. This exploratory study has identified several possible targets that merit further investigation towards the development and validation of diagnostically useful, non-invasive, urine-based tests that might not only help diagnose PCa but also possibly help differentiate it from BPH.
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Affiliation(s)
- Taha A Haj-Ahmad
- 1. Centre for Biotechnology, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Moemen Ak Abdalla
- 2. Department of Biochemistry, Faculty of Science, Alexandria University, Egypt
| | - Yousef Haj-Ahmad
- 1. Centre for Biotechnology, Brock University, St. Catharines, ON, L2S 3A1, Canada
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Bechara A, Casabe A, Rodriguez Baigorri G, Cobreros C. Effectiveness of tadalafil 5 mg once daily in the treatment of men with lower urinary tract symptoms suggestive to benign prostatic hyperplasia with or without erectile dysfunction: results from naturalistic observational TadaLutsEd study. J Sex Med 2013; 11:498-505. [PMID: 24224728 DOI: 10.1111/jsm.12386] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Naturalistic clinical trials provide data on the effectiveness of drugs in nonexperimental and everyday situations and are extremely helpful for decision-making purposes and for confirming experimental findings in clinical trials. No data have been published from naturalistic studies performed in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) with or without erectile dysfunction (ED) and treated with phosphodiesterase type 5 inhibitors. AIM The aim of this study (TadaLutsEd Study) was to assess, in the context of medical practice, the effectiveness of tadalafil 5 mg once daily in patients with LUTS/BPH with or without erectile dysfunction. METHODS The study was a 6-week uncontrolled, prospective, open-label, multicentric, observational study. The patient population involved sexually active males aged ≥ 50 years, diagnosed with LUTS/BPH with or without concomitant ED, and treated with tadalafil 5 mg daily in accordance with standard urological practice. MAIN OUTCOME MEASURES Effectiveness was assessed through the self-administered International Prostate Symptom Score (IPSS) questionnaire; quality of life was evaluated through the IPSS quality of life section (IPSS-QoL). The patients were also evaluated with the International Index of Erectile Function (IIEF-5). Adverse events were recorded. Statistical analyses using paired data samples was applied (Wilcoxon signed-ranks test). RESULTS Sixty-two patients (mean age 62.2 years) completed the treatment, of whom 85.5% showed improvement in their urinary symptoms. Pre- and post-treatment differences in the IPSS, IPSS-QoL, and IIEF-5 scores were statistically significant at 4.4, 1, and 5.4 points, respectively (P < 0.0001). Tadalafil was well tolerated, and adverse events were mild, with a discontinuation rate of 1.6%. CONCLUSION According to study results, the use of tadalafil 5 mg once daily in a nonselected patient population with LUTS/BPH with or without ED led to improvements in terms of symptoms and quality of life and exhibited a safety profile similar to that obtained in controlled tadalafil clinical trials.
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Affiliation(s)
- Amado Bechara
- División Urología, Hospital Durand, Buenos Aires, Argentina
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Singh DV, Mete UK, Mandal AK, Singh SK. A comparative randomized prospective study to evaluate efficacy and safety of combination of tamsulosin and tadalafil vs. tamsulosin or tadalafil alone in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. J Sex Med 2013; 11:187-96. [PMID: 24165272 DOI: 10.1111/jsm.12357] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and erectile dysfunction are common disorders of advancing age. AIM To evaluate the efficacy and safety of tamsulosin and tadalafil in patients with LUTS due to BPH. METHODS In this prospective randomized study, 133 men complaining of LUTS due to BPH were included. Forty-five patients received tamsulosin 0.4 mg/day alone (Group A), 44 patients received tadalafil 10 mg/day (Group B), and combination therapy (tamsulosin and tadalafil both) was instituted in 44 patients (Group C). After a 2-week medication free run-in period, they were evaluated for International Prostatic Symptom Score (IPSS), International Index of Erectile Function score (IIEF5), quality of life (IPSS QoL), maximum urinary flow rate (Qmax), post-void residual urine (PVR) volume, and safety parameters before and at 3 months of treatment. MAIN OUTCOME MEASURES There were primary (IPSS, IPSS QoL index, Qmax, and PVR) and secondary (erectile function [EF] domain scores from IIEF5) efficacy end points. Safety assessment included laboratory tests and patient's reporting of adverse event. RESULTS A significant improvement in IPSS score was observed in all the 3 groups A, B, and C (-50.90%, P < 0.05; -33.50%, P < 0.05; and -53.90%, P < 0.05, respectively). IIEF5 score increased significantly in these three groups (+39.28%, P < 0.05; +45.96%, P < 0.05; and +60.23%, P < 0.05, respectively). A significant increase in Qmax and decrease in PVR were also observed (33.99%, P < 0.05; 29.78%, P < 0.05; and 37.04%, P < 0.05) and (-60.90%, P < 0.05; -49.45%, P < 0.05; and -62.97%, P < 0.05, respectively). The QoL scores improved significantly (-73.35%, P < 0.05; -70.26%, P < 0.05; and -79.65%, P < 0.05, respectively). Side effects were dyspepsia, heartburn, headache, flushing, myalgia, and backache. Adverse effect dropout was 3.7%. No participant experienced any severe or serious adverse events. CONCLUSIONS In patients with LUTS due to BPH, tamsulosin and tadalafil alone or in combination cause a significant improvement in patients with LUTS. Their EF also improves with these medications. The improvement is better with combination therapy compared with single agent alone.
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Affiliation(s)
- Dig Vijay Singh
- Department of Urology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
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Porst H, Roehrborn CG, Secrest RJ, Esler A, Viktrup L. Effects of tadalafil on lower urinary tract symptoms secondary to benign prostatic hyperplasia and on erectile dysfunction in sexually active men with both conditions: analyses of pooled data from four randomized, placebo-controlled tadalafil clinical studies. J Sex Med 2013; 10:2044-52. [PMID: 23782459 DOI: 10.1111/jsm.12212] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) and lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are common in aging males and frequently occur together. Tadalafil has demonstrated efficacy in treating both conditions. AIM The study aims to evaluate the efficacy and safety of tadalafil 5 mg once daily vs. placebo over 12 weeks in treating both LUTS/BPH and ED in sexually active men. We also assessed relationships of baseline disease severity and prostate specific antigen (PSA) to outcomes. METHODS Data were pooled from four multinational, randomized studies of men ≥45 years with LUTS/BPH, with analyses restricted to sexually active men with ED. Randomization (baseline) followed a 4-week placebo run-in; changes from baseline were assessed vs. placebo using analysis of covariance. MAIN OUTCOME MEASURES International Prostate Symptom Score (IPSS), IPSS subscores, Quality-of-Life Index (IPSS-QoL), BPH Impact Index (BII), and International Index of Erectile Function-Erectile Function (IIEF-EF) Domain score were used in this study. RESULTS Tadalafil (N = 505) significantly improved total IPSS vs. placebo (N = 521); mean changes from baseline were -6.0 and -3.6, respectively (P < 0.001). Improvements in IIEF-EF Domain score (tadalafil, 6.4; placebo, 1.4) were also significant vs. placebo, as were the IPSS storage and voiding subscores, IPSS-QoL, and BII (all P < 0.001). No significant impact of baseline ED severity or PSA category on IPSS response was observed (interaction P values, 0.463 and 0.149, respectively). Similarly, improvement in IIEF-EF Domain score was not significantly impacted by baseline LUTS/BPH severity or PSA category (interaction P values, 0.926 and 0.230, respectively). Improvements in IPSS and IIEF-EF Domain score during treatment were weakly correlated (r = -0.229). Treatment-emergent adverse events were consistent with previous reports. CONCLUSIONS Tadalafil was efficacious and well tolerated in treating ED and LUTS/BPH in sexually active men with both conditions. Improvements in both conditions were significant regardless of baseline severity. Improvements in the total IPSS and the IIEF-EF Domain score were weakly correlated.
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Affiliation(s)
- Hartmut Porst
- Private Practice of Urology and Andrology, Hamburg, Germany.
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Lee F, Badalament RA, Hu C, Bousho I, Tsodikov A. Prostate cancers detected during 5α-reductase inhibitor use are smaller, de-differentiated, but confined when compared to controls. J Cancer 2012; 3:122-8. [PMID: 22408685 PMCID: PMC3297839 DOI: 10.7150/jca.4123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 03/04/2012] [Indexed: 11/24/2022] Open
Abstract
Rationale: To compare cancers detected during use of 5α-reductase inhibitors (5αRI) with cancers detected in untreated controls stratified for tumor size. Methods: Prostate biopsies were performed on 235 consecutive patients “for cause” (elevated or rising PSA, positive digital rectal examination, or focal hypoechoic lesion). Fifty patients were excluded for a prior diagnosis of cancer, leaving 185 as the study group (5αRI=41, control=144). Patients in the 5αRI group had been treated for a mean of 3.5 years. Cancer was ultimately diagnosed in 114/185 patients. Results: Cancer was diagnosed in 31/41 (76%) of patients treated with 5αRI and 83/144 (58%) of the control group (p=0.04). Control tumors were larger (14.3 mm) than those in 5αRI treated patients (9.4 mm, p=0.0007). No differences in mean PSA or PSA kinetics were detected between groups. For tumors less than 1.0 cm, the proportion of high grade cancers (Gleason 7-10 and Gleason 4+3-10) was higher in 5αRI subjects than in controls (p<0.05). Fewer 5αRI patients had proven extracapsular extension than controls, but this difference did not reach statistical significance (p=0.13). Normal DNA ploidy was more likely to be diagnosed in the 5αRI group versus controls, but this difference was not statistically significant (81% vs. 65%, p=0.14). Conclusions: Cancers diagnosed in patients presenting “for cause” treated with 5αRI drugs are more likely to be de-differentiated compared to controls. However, these tumors are also smaller and less likely to have extracapsular extension and abnormal DNA ploidy than controls.
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Affiliation(s)
- Fred Lee
- 1. Rochester Urology, PC, Rochester Hills, MI
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Yoo KH, Kim SK, Chung JH, Chang SG. Association of IL10, IL10RA, and IL10RB polymorphisms with benign prostate hyperplasia in Korean population. J Korean Med Sci 2011; 26:659-64. [PMID: 21532858 PMCID: PMC3082119 DOI: 10.3346/jkms.2011.26.5.659] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 03/15/2011] [Indexed: 12/04/2022] Open
Abstract
Cytokines such as interleukin 10 (IL10) may play an important role in the process of inflammation. The aim of this study was to analyze the association between IL10, IL10RA and IL10RB single nucleotide polymorphisms (SNPs), and benign prostate hyperplasia (BPH) in Korean population. All patients with BPH were divided into two groups according to international prostate symptom score (IPSS), prostate specific antigen (PSA) level, Q(max), and prostate volume. We selected two IL10 SNPs (rs1518111 and rs1554286), three IL10RA SNPs (rs2256111, rs4252243, and rs2228054), and two IL10RB SNPs (rs999788 and rs2834167). Genotypes of seven SNPs were determined through direct sequencing. The G/G genotype of IL10RB polymorphism (rs2834167) was associated with a high PSA level compared with the A/G + A/A genotypes (P = 0.009). Of IL10 SNP, the A/A genotype of rs1518111 and T/T genotype of rs1554286 were associated with small prostate volume, respectively (P = 0.011, P = 0.014). Moreover, the T/T genotype of IL10RB polymorphism (rs999788) was associated with high prostatic volume compared with the T/C + C/C genotypes (P = 0.033). The linkage disequilibrium (LD) blocks were formed in IL10 and IL10RA. However, haplotypes in the LD block were not associated with BPH. It is concluded that there is a strong association between the IL10 and IL10RB SNPs, and BPH in Korean population.
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Affiliation(s)
- Koo Han Yoo
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Su Kang Kim
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Joo-Ho Chung
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sung-Goo Chang
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
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Omrani MD, Bazargani S, Bagheri M, Yazdan-nejad H. Association of catechol-o-methyl transferase gene polymorphism with prostate cancer and benign prostatic hyperplasia. J Res Med Sci 2009; 14:217-22. [PMID: 21772887 PMCID: PMC3129108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2008] [Accepted: 03/03/2009] [Indexed: 11/10/2022]
Abstract
BACKGROUND A single nucleotide variation within catechol-o-methyl transferase (COMT) gene may alter the COMT enzyme activity level. Polymorphism of Val158Met in the COMT gene has been related to malignancy. In this regard, a study was carried out to find a possible association between the COMT gene polymorphism in patients with sporadic prostate cancer (PCa) and benign prostatic hyperplasia (BPH). METHODS All types of COMT158 Val/Met polymorphism were carried out using ASO-PCR method in 41 patients with prostate cancer, 193 patients with benign prostatic hyperplasia and 107 healthy male individuals. RESULTS The results of this study showed that the frequency of low producer allele A at codon 158 of the COMT gene is significantly different in BPH group compared to normal male control group (OR, 95% CI, p value 1.95: 1.46, 2.44, 0.021, respectively). However no significant difference was noticed when the comparison was made between prostate cancer group and normal male control group and also between BPH and PCa groups. CONCLUSIONS Decreased level of catechol-o-methyl transferase gene activity may play a possible role in benign prostatic hyperplasia development but not in prostate cancer. Increased level of COMT gene activity has a protective role against BPH.
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Affiliation(s)
- Mir Davood Omrani
- Department of Genetics, Urmia University of Medical Sciences, Urmia, Iran,Correspondencing Author E-mail:
| | - Soroush Bazargani
- Department of Urology, Urmia University of Medical Sciences, Urmia, Iran
| | - Morteza Bagheri
- Department of Genetics, Urmia University of Medical Sciences, Urmia, Iran
| | - Hamed Yazdan-nejad
- Department of Urology, Urmia University of Medical Sciences, Urmia, Iran
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