Clinical significance of distally located periurethral calcification in patients with lower urinary tract symptoms of benign prostate hyperplasia / 亚洲男科学杂志(英文版)

This study evaluated the association of periurethral calcification (PUC) with uroflowmetric parameters and symptom severity in male patients with lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH). The data were collected from a prospectively maintained database of 1321 men with LUTS of BPH who visited Chonnam National University Hospital (Gwang-ju, Korea) from January 2015 to December 2019. PUC severity and location were evaluated on the midsagittal plane during transrectal ultrasonography. Relationships among age, prostate-related parameters, International Prostate Symptom Score (IPSS), and uroflowmetric parameters were assessed. Among the 1321 patients in this study, 530 (40.1%) had PUC. Patients with PUC had significantly higher IPSS (mean ± standard deviation [s.d.]: 15.1 ± 8.7 vs 13.1 ± 7.9; P < 0.001) and lower peak flow rate (Qmax; mean ± s.d.: 12.4 ± 6.6 ml s-1 vs 14.7 ± 13.3 ml s-1; P < 0.001), compared with patients who did not have PUC. Analyses according to PUC severity revealed that patients with severe PUC had higher prostate-specific antigen (PSA) level (P = 0.009), higher total IPSS (P < 0.001), lower Qmax (P = 0.002), and smaller prostate volume (P < 0.001), compared with patients who had non-severe (mild or moderate) PUC. Multivariate analysis showed that distal PUC was independently associated with high total IPSS (P = 0.02), voiding symptom score (P = 0.04), and storage symptom score (P = 0.023), and low Qmax (P = 0.015). In conclusion, PUC was significantly associated with worse LUTS parameters in terms of IPSS and Qmax. Furthermore, distally located PUC was independently associated with worse LUTS of BPH in men.

Comparison of the predictive value of anthropometric indicators for the risk of benign prostatic hyperplasia in southern China / 亚洲男科学杂志(英文版)

This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia (BPH). Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital, Central South University (Changsha, China) from June to December 2020 were enrolled in this study. The characteristic data were collected, including basic anthropometric indices, lipid parameters, six anthropometric indicators, prostate-specific antigen, and total prostate volume. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for all anthropometric parameters and BPH were calculated using binary logistic regression. To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values, receiver operating characteristic (ROC) curves and the related areas under the curves (AUCs) were utilized. All six indicators had diagnostic value for BPH (all P ≤ 0.001). The visceral adiposity index (VAI; AUC: 0.797, 95% CI: 0.759-0.834) had the highest AUC and therefore the highest diagnostic value. This was followed by the cardiometabolic index (CMI; AUC: 0.792, 95% CI: 0.753-0.831), lipid accumulation product (LAP; AUC: 0.766, 95% CI: 0.723-0.809), waist-to-hip ratio (WHR; AUC: 0.660, 95% CI: 0.609-0.712), waist-to-height ratio (WHtR; AUC: 0.639, 95% CI: 0.587-0.691), and body mass index (BMI; AUC: 0.592, 95% CI: 0.540-0.643). The sensitivity of CMI was the highest (92.1%), and WHtR had the highest specificity of 94.1%. CMI consistently showed the highest OR in the binary logistic regression analysis. BMI, WHtR, WHR, VAI, CMI, and LAP all influence the occurrence of BPH in middle-aged and older men (all P ≤ 0.001), and CMI is the best predictor of BPH.

Laparoscopic simple prostatectomy for large volume benign prostate hyperplasia: a report of 30 cases / 现代泌尿外科杂志

【Objective】 To investigate the feasibility of laparoscopic simple prostatectomy (LSP) in the treatment of large volume benign prostate hyperplasia (BPH). 【Methods】 Clinical and follow-up data of 30 patients with large volume BPH treated with LSP in our hospital during Feb.2019 and Dec.2021 were retrospectively analyzed. All patients underwent extraperitoneal LSP operation. The perioperative and 1-12 month postoperative follow-up data were analyzed. 【Results】 The average prostate volume was (92.4±38.9) mL, operation time (125±45) min, and weight of resected prostate (60.25±16.90) g. The hemoglobin decreased by (12.21±7.25) g/d after operation. No blood transfusion was needed. There was no need for bladder irrigation after operation in 21 cases (70%), and 9 cases (30%) had bladder irrigation time of (0.95±0.49) d. The postoperative catheter indwelling time was (6.92±2.51) d, and hospital stay (5.36±1.63) d. During the follow-up of (9.25±5.4) months, there was 1 case of postoperative intestinal obstruction (Clavien-Dindo grade II), 1 case of transient urinary incontinence (Clavien-Dindo grade I), and 1 case of delayed hematuria (Clavien-Dindo grade I). No urethral stricture occurred. The maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS) and quality of life (QoL) 3 months after operation were significantly improved compared with those before operation (P0.05). 【Conclusion】 LSP is safe and effective in the treatment of large volume BPH. It has advantages of complete resection of glands, minor bleeding and short postoperative bladder irrigation time. However, it still needs to be confirmed by a prospective control study of large samples.

Learning experience of holmium laser enucleation of the prostate in county-level hospitals / 现代泌尿外科杂志

【Objective】 To introduce the learning experience of holmium laser enucleation of prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) in county-level hospitals. 【Methods】 The clinical data of 500 cases of BPH treated with HoLEP during May 2018 and Dec.2022 were retrospectively analyzed. The learning curve was divided into three stages: learning, maturity and proficiency stages. In each stage, the operation time, postoperative bladder irrigation time and rate of urinary incontinence of 20 patients were analyzed. 【Results】 All operations were performed by the same surgeon. During the learning stage, the operation time and bladder irrigation time were significantly longer, and the rate of urinary incontinence was significantly higher. At the proficiency stage, the operation time, bladder irrigation time, and rate of urinary incontinence were significantly improved. 【Conclusion】 HoLEP technique needs to be developed step by step with a certain learning curve. Continuous learning and mastery of key technical points are necessary for surgeons in county-level hospitals to avoid postoperative urinary incontinence.

Influencing factors of lower urinary tract symptoms in patients with prostate hyperplasia after transurethral holmium laser enucleation / 中华全科医师杂志

A total of 360 patients with prostate hyperplasia underwent transurethral holmium laser enucleation of the prostate in Department of Urology of Jinhua People′s Hospital from July 2019 to December 2022. Among 360 patients, lower urinary tract symptoms occurred one month after operation in 40 cases with an incidence rate of 11.11%. The age, body mass index (BMI), course of disease, nature of disease, preoperative prostate volume, postoperative prostate volume, preoperative IPSS score, postoperative IPSS score, preoperative maximum urine flow rate, postoperative maximum urine flow rate, preoperative residual urine volume, postoperative residual urine volume, postoperative urinary tract infection, operative time, postoperative catheter retention time were compared between patients with lower urinary tract symptoms (study group) and those without (control group). There were significant differences in the course of disease, preoperative prostate volume, preoperative IPSS score, preoperative maximum urine flow rate, preoperative residual urine volume, postoperative urinary tract infection and postoperative catheter retention time between two groups ( t=28.01, 6.35, 8.79, 17.92, 34.84, 11.45;all P<0.05). Multivariate logistic analysis showed that the course of disease, preoperative prostate volume, preoperative IPSS score, postoperative urinary tract infection, and postoperative catheter retention time were independent risk factors for postoperative lower urinary tract symptoms ( OR=6.964, 3.442, 1.944, 4.836, 4.225, 4.894; all P<0.05); while the preoperative maximum urinary flow rate was the protective factor( OR=0.043, P<0.05). The incidence of postoperative lower urinary tract symptoms in patients undergoing transurethral holmium laser enucleation of prostate is high. Effective protective measures should be taken based on the risk factors to reduce the incidence of postoperative lower urinary tract symptoms and to promote the early recovery of patients.

Clinical approach and diagnosing bladder stone in a 74-year-old man patient: a case report

This article reports a 74-year-old man came to the emergency department with complaint blood in urine, urinary tract symptom such as nocturia, frequency urgency, and cloudy urine.Physical examination showed suprapubic area was hard on palpation. The abdominal X-ray of the patient showed an opaque stone in the bladder. An ultrasound scan showed a multiple bladder stone with the longest stone 1.59 cm in size. Bilateral kidney cyst and the prostate was enlarged with volume �3.85 cc, IPP 2.29 cm. Entirestoneeliminationand eradicationrelatedBPH and urinary tract infections (UTIs) arethe principalgoalof theremedy. The patient was treated with Lithotripsy, antibiotics, alpha-blockers, antihypertension medications and showed clinical remission.

LYMPHOEPITHELIOMA LIKE CARCINOMA OF URINARY BLADDER: A RARE CASE REPORT

Urinary bladder neoplasm is the 10 most common cancer in the world, predominantly affecting males. Nowadays incidence of urinary bladder carcinoma in female has increased. It is a uncommon type carcinoma of urinary bladder. It resembles to non-keratinizing carcinoma of nasopharynx. This study report a case of 65 years old male presented with painless gross hematuria for 3 weeks. Patient was a known case of Meckel's diverticulum. Ultrasonography and cystoscopy showed a mass on lateral wall of urinary bladder measuring 3x3 cm . A radical cystectomy of the urinary bladder tumor was done. He was diagnosed as case of lymphoepithelioma like carcinoma of urinary bladder along with benign prostate hyperplasia and Meckel's diverticulum was made with stage 2. According to the WHO classification criteria, Lymphoepithelioma like carcinoma is a subtype of undifferentiated carcinomas. Immunohistochemical stains are helpful to differentiate Lymphoepithelioma from primary lymphoma of the bladder. Differentiation of LELCB from urothelial carcinoma is important, since it has better prognosis compared to pure urothelial carcinoma. It is important to diagnose this neoplasm for therapeutic as well as prognostic purpose.

Assessment of Utility of Immunohistochemical Marker Prostein for Evaluation of Primary and Metastatic Prostatic Carcinomas

Background: To assess utility of immunohistochemical marker prostein for evaluation of primary and metastatic prostatic carcinomas.Methods:Fifty- six samples of clinically suspected carcinoma prostate was included. Immunohistochemistry (IHC) was performed for assessment of Prostein (P501S). The intensity of positivity was scored from 0 to 3 as follows: score 0 = non-stained; score 1 = weak; score 2 = moderate; and score 3 = strong. The percentage of positively stained cells for each staining intensity was estimated in the respective lesions.Results:Age group 18-28 years comprised of 6 patients, 28-38 years had 12, 38- 48 years had 16 and >48 years had 22 cases. Type of cases were normal prostatic epithelium in 11, benign prostate hyperplasia in 23, HGPIN in 10, primary prostatic adenocarcinoma in 7 and metastatic prostatic adenocarcinoma in 5 cases. Prostein expression was seen in 100% in normal prostatic epithelium with intensity score of 1.8-2.1, benign prostate hyperplasia having 2-2.7, HGPIN with 2-2.3, primary prostatic adenocarcinoma having 1-1.6 and metastatic prostatic adenocarcinoma with 0.8-1.4 intensity score. Conclusion:Prostein is a new prostate specific marker which showed 100% sensitivity and specificity to identify normal and prostatic lesions.

The extract of Celtis choseniana Nakai alleviates testosterone-induced benign prostatic hyperplasia through inhibiting 5α reductase type 2 and the Akt/NF-κB/AR pathway / 中国天然药物

Benign prostatic hyperplasia (BPH) is a chronic male disease characterized by the enlarged prostate. Celtis chosenianaNakai (C. choseniana) is medicinally used to alleviate pain, gastric disease, and lung abscess. In this study, the effect of C. choseniana extract on BPH was investigated using testosterone-induced rats. Sprague Dawley rats were divided into five groups: control, BPH (testosterone 5 mg·kg-1), Fina (finasteride 2 mg·kg-1), and C. choseniana (50 and 100 mg·kg-1). After four weeks of TP treatment with finasteride or C. choseniana, prostate weights and DHT levels were measured. In addition, the prostates were histopathologically examined and measured for protein kinase B (Akt)/nuclear factor-κB (NF-κB)/AR signaling, proliferation, apoptosis, and autophagy. Prostate weight and epithelial thickness were reduced in the C. choseniana groups compared with that in the BPH group. The extract of C. choseniana acted as a 5α reductase inhibitor, reducing DHT levels in the prostate. Furthermore, the extract of C. choseniana blocked the activation of p-Akt, nuclear NF-κB activation and reduced the expression of AR and PSA compared with BPH. Moreover, the expression of Bax, PARP-1, and p53 increased, while the expression of bcl-2 decreased. The present study demonstrated that C. choseniana extract alleviated testosterone-induced BPH by suppressing 5α reductase and Akt/NF-κB activation, reducing AR signaling and inducing apoptosis and autophagy in the prostate. These results suggested that C. choseniana probably contain potential herbal agents to alleviate BPH.

Treatment of benign prostate hyperplasia combined with mild urethra stenosis / 中华泌尿外科杂志

We retrospectively analyzed the clinical data of 21 patients diagnosed with BPH combined with mild urethra stenosis from January 2018 to December 2020. 12 patients underwent holmium laser enucleation of prostate (HoLEP). There were 3 cases of serious urethra stenosis requiring repeat surgical treatment after surgery, 9 cases of unobstructed voiding, 4 cases of reverse ejaculation and 2 cases of temporary urinary incontinence. 9 patients underwent laparoscopic simple prostatectomy (LSP) and all patients had unobstructed voiding. There were no cases of severe urethral stricture, temporary urinary incontinence and retrograde ejaculation in LSP group. LSP has reduced the risk of a repeat urethral surgery because of transurethral operation increasing the degree of urethra stenosis.

Complicaciones postoperatorias en pacientes con hiperplasia benigna de próstata según técnica quirúrgica

RESUMEN Introducción: La hiperplasia benigna de próstata tiene elevada prevalencia en mayores de 50 años. En quienes fracasa o es mal tolerado el tratamiento médico, se plantea cirugía. Objetivo: Analizar las complicaciones postoperatorias en pacientes operados por hiperplasia benigna de próstata, según diferentes técnicas. Métodos: Se analizaron 161 historias clínicas de pacientes de 60 o más años de edad, con diagnóstico de hiperplasia benigna prostática, intervenidos quirúrgicamente con las técnicas: adenomectomía abierta transvesical, retropúbica y endoscópica monopolar. Resultados: La variación de la hemoglobina ≥ 3mg/dl, con la técnica transvesical fue 17 % y con la retropúbica 27,3 %. El tiempo de sondaje vesical ≤ 4 días en la transvesical un 48,9 %; > 4 a < 7 días en la retropúbica en 59,1 % y ≤ 4 días en la endoscópica monopolar 68,5 %. La estancia hospitalaria ≥ de 5 días, en la transvesical 51,1 % y en la retropúbica 59,9 %; de 1 a < 3 días, con la endoscópica monopolar, 58,7 %. La infección del tracto urinario fue más frecuente con la transvesical (31,9 %), la infección del sitio operatorio (17 %); mientras que la orquiepididimitis fue más frecuente en la retropúbica (40,9 %). El síndrome posresección transuretral prostática monopolar, se presentó en el 17,4 % de los operados. Conclusión: La adenomectomía retropúbica fue la técnica quirúrgica con mayor frecuencia de complicaciones y la resección transuretral la de menor frecuencia. La retención aguda de orina por técnica retropúbica, fue la complicación más frecuente.

ABSTRACT Introduction: Benign prostate hyperplasia has a high prevalence in people over 50 years of age. In those who fail or is poorly tolerated medical treatment, surgery is considered. Objective: To analyze postoperative complications in patients operated on for benign prostatic hyperplasia, according to different techniques. Methods: 161 medical records of patients 60 years of age or older, with a diagnosis of benign prostatic hyperplasia, who underwent surgery with the techniques: open transvesical, retropubic and monopolar endoscopic adenomectomy were analyzed. Results: The variation of hemoglobin ≥ 3mg / dl, with the transvesical technique was 17% and with the retropubic one 27.3%. The time of bladder catheterization ≤ 4 days in the transvesical one 48.9%; > 4 to <7 days in the retropubic in 59.1% and ≤ 4 days in the monopolar endoscopic 68.5%. The hospital stay ≥ 5 days, in the transvesical 51.1% and in the retropubic 59.9%; from 1 to <3 days, with the monopolar endoscopic, 58.7%. Urinary tract infection was more frequent with transvesical (31.9%), surgical site infection (17%); while epididymo-orchitis was more frequent in retropubic (40.9%). Monopolar prostatic transurethral post-resection syndrome appeared in 17.4% of those operated on. Conclusion: Retropubic adenomectomy was the surgical technique with the highest frequency of complications and transurethral resection the least frequent. Acute retention of urine by retropubic technique was the most frequent complication.

The clinical research of five-step 180W XPS greenlight photoselective vaporization of the prostate for large volume benign prostatic hyperplasia / 中华泌尿外科杂志

Objective:To explore the efficacy and safety of five-step 180W XPS greenlight photoselective vaporization of prostate (PVP)for large volume (≥80ml) benign prostatic hyperplasia.Methods:A total of 240 BPH patients (PV≥ 80 ml), treated with five-step 180W XPS PVP from June 2017 to May 2019 in our center, were reviewed retrospectively. The average age was (70.18±7.71) years old, and 129 cases were over 70 years old. The average body mass index was (24.91±2.98 )kg/m 2. The median international prostate symptom score (IPSS) was 23 (20, 26) and the quality of life (QOL) score was 5 (4, 5) points. Besides, the preoperative median prostate volume (PV) was 98.29 (86.49, 116.32) ml, the median maximum urinary flow rate (Q max)was 6 (4, 8) ml/s and postvoid residual urine volume (PVR) was 120 (30, 200) ml. All patients underwent 180W XPS five-step method PVP operation according to the following method. The first step is vaporization of 1-2 o′clock (left lobe) and 10-11 o′clock (right lobe) in order to establish operating channel. The second step is vaporization of the lateral lobe layer by layer from the ventral side to the dorsal side. The third step is channel establishment of 5/7 o′clock mid lobe parasulcus. The forth step is ablation of the middle lobe laterally. The fifth step is vaporization of the apex of the prostate and trimming. The IPSS score, QOL score, Q max and PVR were evaluated 12 months later after the PVP operation. Results:All the 240 cases were treated by five-step 180W XPS PVP operation successfully. The median operation time and laser time were 83 (73, 98.75) min and 66 (60, 76) min. Capsular perforation was found in 3 cases, which occurred in the trimming stage. There were 9 cases treated with TURP to stop bleeding, and no cases suffered blood transfusion. Twenty-two patients underwent bladder irrigation for 6 to 24 hours after the operation, and the median catheter indwelling time and post-operative hospital stay were 3 (3, 4) days and 4 (3, 5) days respectively. Twenty-six patients suffered urinary incontinence, including 22 cases of urinary incontinence and 4 cases of stress urinary incontinence. In addition, there was no severe hematuria, severe bladder irritation or urinary retention among the patients. The postoperative IPSS score was 5(4, 7), QOL score 1(1, 2), Q max 18(15, 20)ml/s and PVR 10(0, 30)ml, which were all significantly improved compared with those before surgery ( P<0.01). None second PVP surgery was performed. Conclusions:The five-step 180W XPS PVP operation has the advantages of improving lower urinary tract symptoms, less blood loss and low incidence of perioperative adverse events. It is easy to use, which is a reliable minimally surgery.

Peripheral zone PSA density: a predominant variable to improve prostate cancer detection efficiency in men with PSA higher than 4 ng ml / 亚洲男科学杂志(英文版)

To improve the diagnostic efficiency of prostate cancer (PCa) and reduce unnecessary biopsies, we defined and analyzed the diagnostic efficiency of peripheral zone prostate-specific antigen (PSA) density (PZ-PSAD). Patients who underwent systematic 12-core prostate biopsies in Shanghai General Hospital (Shanghai, China) between January 2012 and January 2018 were retrospectively identified (n = 529). Another group of patients with benign prostatic hyperplasia (n = 100) were randomly preselected to obtain the PSA density of the non-PCa cohort (N-PSAD). Prostate volumes and transition zone volumes were measured using multiparameter magnetic resonance imaging (mpMRI) and were combined with PSA and N-PSAD to obtain the PZ-PSAD from a specific algorithm. Receiver operating characteristic (ROC) curve analysis was used to assess the PCa detection efficiency in patients stratified by PSA level, and the area under the ROC curve (AUC) of PZ-PSAD was higher than that of PSA, PSA density (PSAD), and transition zone PSA density (TZ-PSAD). PZ-PSAD could amend the diagnosis for more than half of the patients with inaccurate transrectal ultrasonography (TRUS) and mpMRI results. When TRUS and mpMRI findings were ambiguous to predict PCa (PIRADS score ≤3), PZ-PSAD could increase the positive rate of biopsy from 21.7% to 54.7%, and help 63.8% (150/235) of patients avoid unnecessary prostate biopsy. In patients whose PSA was 4.0-10.0 ng ml

Impact of immune inflammation on the proliferation and apoptosis of benign prostatic hyperplasia cells / 中华男科学杂志

Objective@#To investigate the impact of macrophage-induced immune inflammation on the proliferation and apoptosis of BPH cells and its possible mechanism.@*METHODS@#Macrophages were stimulated with phorbol myristate acetate, co-cultured with BPH-1 cells, and then treated with the androgen receptor (AR) inhibitor or anti-CD40L antibody. The immunohistochemical biomarkers of the T lymphocytes (CD4 and CD8), B lymphocyte (CD20) and macrophages (CD68), AR, CD40/CD40L, and inflammatory factors IL-1, IL-6 and TNF-α were measured before and after treatment. The proliferation and apoptosis of the cells were observed by MTT assay, colony-forming assay and flow cytometry, and the expressions of cell apoptosis- and MAPK signaling pathway-related proteins were determined by qRT-PCR and Western blot.@*RESULTS@#Significantly increased proliferation and decreased apoptosis of the cells, up-regulated expressions of Bcl-2, IL-1, IL-6, TNF-α, AR, CD40 and CD40L, and down-regulated expression of Bax were observed in the BPH-1 cells co-cultured with macrophages (the M-BPH-1 group) compared with those in the blank control (B-BPH-1) group (P < 0.01). In comparison with the BPH-1 cells treated with normal saline, those treated with either low-dose CD40L (L-CD40L) or high-dose CD40L (H-CD40L) showed markedly inhibited proliferation, increased apoptosis, up-regulated expression of Bax, and down-regulated expressions of Bcl-2, IL-1, IL-6 and TNF-α (P < 0.01), and those in the low- and high-dose AR (L-AR and H-AR) inhibitor groups exhibited remarkably reduced proliferation, increased apoptosis, down-regulated expressions of Bcl-2, IL-1, IL-6 and TNF-α, and up-regulated expression of Bax (P < 0.01). The phosphorylation levels of JNK, ERK and P38 were significantly elevated in the M-BPH-1 group, but declined in the H-CD40L and the H-AR inhibitor groups compared with those in the B-BPH-1 group, all in a concentration-dependent manner (P < 0.01).@*CONCLUSIONS@#Macrophage-induced immune inflammation regulates AR and CD40/CD40L expressions and promotes the proliferation and inhibits the apoptosis of BPH-1 cells by activating the MAPK signaling pathway. /.

Embozene Loaded Prostatic Artery Embolization

@#Herein is a case report of a 70 years old man with a tenacious benign prostatic hyperplasia (BPH). The aim of this manuscript is to briefly discuss the usage and advantage of EmbozeneTM Microsphere in embolization of the prostate arteries in the treatment of failed medical and surgical therapy for BPH.

Evaluation of Prostate Specific Antigen Levels and Its Correlation with Histopathological Findings in a Tertiary Care Hospital in Bihar

Background: Diseases primarily inflicting prostate gland areinflammation, benign prostatic hyperplasia and cancer.Prostate specific antigen is a glycoprotein and is expressed byboth normal and neoplastic prostate tissue. It has been widelyused in the diagnosis and management of patients withprostatic cancer. Studies from various research workersdiscuss the proportion of prostatic disorder among Indianstates like Delhi, Mumbai, Bangalore, Chennai, Gujrat etc butthere is paucity of data from the rural areas. The present studywas conducted to find out the patterns of prevalence ofprostatic lesions among people of Rohtas district of Bihar andto correlate histology with respect to serum PSA levels inbiopsy specimens of men with prostatic disease.Materials and Methods: The study included 153 prostatictissue specimens (both transurethral resection of the prostateand prostatic biopsies) received in the Department ofPathology, over the period of 2-year from October 2017 toSeptember 2019. Relevant clinical data and serum PSA valuewas recorded, and Gleason’s microscopic grading was used tograde malignant lesions. Statistical analysis was performed inMicrosoft office excel 2007.Results: Mean age of presentation was 63 ± 10.56 years withmaximum incidence in the seventh decade of life. Onhistopathological examination, 52.9% had benign prostatichyperplasia, 35.9% had BPH with chronic prostatitis and 8.5%had adenocarcinoma. Other lesions encountered were highgrade prostate intraepithelial neoplasia (3 cases), sarcomatoidcarcinoma (1 case). Inflammatory pathology (55/153) wascommon at all PSA levels. Patients with PSA >20 ng/ml werewere more likely to show cancer. There exists a positivecorrelation between the increasing PSA levels and chances ofadenocarcinoma, the findings were statistically significant.Conclusion: Our study suggests that most frequentlyencountered prostatic lesion was BHP, commonly seen in theage group of 51-60 year The malignant lesions were commonamong the males of more than 60 years. Strong correlation ofprostate specific antigen levels of > 20.1 ng/ml with carcinomaprostate was seen.

Study on effect of extract from Tibetan medicine Urtica hyperborean on anti-prostatic hyperplasia / 中国中药杂志

In this study,mouse models of benign prostatic hyperplasia induced by subcutaneous injection of testosterone propionate was used to investigate the therapeutic effect and mechanism of Urtica hyperborean( UW) extracts on prostate hyperplasia in mice. The effects of UW extracts on prostate index,serum epidermal growth factor( EGF) and dihydrotestosterone( DHT) in model mice were observed,and the EGF and anti-apoptotic factor( Bcl-2) mRNA expression levels were detected as well as pathological changes in prostate tissue. The results showed that the ethyl acetate extraction and alcohol soluble fraction of the UW could significantly reduce the prostate index,reduce the serum DHT and EGF levels( P<0. 01),and significantly decrease the EGF and Bcl-2 mRNA expression( P<0. 01),significantly improved the morphological structure of prostate tissue. The above results confirmed that ethyl acetate extract and alcohol-soluble parts of UW have a good preventive effect on mice prostatic hyperplasia model,and its mechanism may be to reduce androgen levels by regulating polypeptide growth factors and/or inhibiting cell hyperproliferation and promoting apoptosis. This study laid the foundation for the further research on UW.

Albizzia julibrissin Suppresses Testosterone-induced Benign Prostatic Hyperplasia by Regulating 5α-Reductase Type 2 – Androgen Receptor Pathway

Albizzia julibrissin (AJ) is an herbal medicine that shows low toxicity, promotes promoting blood circulation and mitigates the inflammation and has mild side effects. Benign prostate hyperplasia (BPH) is one of the most common diseases that occurs in older males and often results in lower urinary tract symptoms. This study was conducted to evaluate the protective effect of AJ against BPH using LNCaP cells and Sprague Dawley rats treated with testosterone. Treatment with AJ extract reduced the expression of androgen receptor (AR) and prostate-specific antigen (PSA) in vitro. In vivo, rats were divided into 6 groups: 1 (Normal Control); 2 (Testosterone propionate (TP) alone); 3 (TP + finasteride); 4 (TP + AJ 10 mg/kg); 5 (TP + AJ 50 mg/kg); 6 (TP + AJ 300 mg/kg). The groups treated with AJ showed reduced the relative prostate weights and BPH-related proteins were altered, with decreased AR, PSA and proliferating cell nuclear antigen (PCNA) observed by western blot. Histopathological analysis revealed the therapeutic effect of AJ, with a decreased thickness of epithelial cells and reduced level of PCNA and 5α-reductase type 2. These results suggest that AJ extract could ameliorate testosterone-induced benign prostatic hyperplasia.

A comparative study of efficacy of tadalafil and alfuzosin regimens in patients of benign prostate hyperplasia

Background: Aim of the study was to compare efficacy of Tadalafil and Alfuzosin regimens in patients of Benign Prostate Hyperplasia.Methods: It was a comparative, prospective, observational, non-invasive, parallel and randomised study conducted at the Outpatient Department of Urology, Rajindra Hospital, Patiala. 60 patients diagnosed with Benign Prostate Hyperplasia along with Lower Urinary Tract Symptoms, out which, 30 patients, consuming Tadalafil and 30 patients consuming Alfuzosin were considered. History regarding the concerned disease and the compliance of treatment was taken. Symptom scores were assessed with the help of International Prostate Symptom Score, Quality of Lifestyle Score and Erectile Dysfunction Score. Physical examination consisting of Focused Neurological Examination along with Digital Rectal Examination were conducted. Parameters like Renal Function Test, Urine analysis, Ultrasound of Prostate and uroflowmetry were also considered.Results: The mean age selected for study was 64 years for Tadalafil and Alfuzosin group. The mean level of IPS Score, Qol Score and ED Score at the first day of inclusion of patients were 23.96±4.49, 4±0.78, and 25.33±4.02 respectively for Tadalafil group and regarding Alfuzosin group they were 25.23±4.84, 3.56±0.81, and 26.1±4.04 respectively. Follow ups were conducted at 15 days, 1 month and 3 months for both the groups which were found to be statistically significant after 3 months and Alfuzosin showed a favourable result.Conclusions: Alfuzosin 10mg given at daily dose was found to have higher efficacy than Tadalafil (5mg).

Inhibitory effects of Pycnogenol®, a pine bark extract, in a rat model of testosterone propionate-induced benign prostatic hyperplasia / 한국실험동물학회지

Benign prostate hyperplasia (BPH) is a male reproductive disease that has gained increasing importance in recent years. The present study investigated whether Pycnogenol® (PYC), a standardized French maritime pine bark extract, could prevent BPH induced by testosterone propionate (TP) in rats. Male Sprague-Dawley rats were randomly divided into five groups of six rats. One group was used as a normal control rats and the other groups received subcutaneous injections of TP for 4 weeks to induce BPH. In the two treatment groups, PYC (20 or 40 mg/kg) was administered daily for 4 weeks by oral gavage concurrently with the induction of TP. All rats were sacrificed at the scheduled termination time, the prostates were weighed, and histopathologic examinations were conducted. Dihydrotestosterone (DHT) levels in serum and the prostate were measured, and the expression of proliferating cell nuclear antigen (PCNA) and Ki-67 proteins was investigated. BPH-treated animals showed increases in the relative weight of the prostate, higher concentrations of DHT in serum and the prostate, and higher expression of PCNA and Ki-67 in the prostate; in contrast, PYC-treated animals had significant reductions in these factors compared with the BPH animals. These findings indicated that PYC inhibited the development of BPH and that this was closely associated with a reduction in DHT concentration.