Ultra Sonographic Prostate Volume Measurement of Patients Over 40 Years in Age: A Single Center Study

Background: Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. The objective of the study was to evaluate the prostate volume measurement for the Bangladeshi population over the age of 40 years by ultrasonography.Material & Methods:This prospective, observational study was conducted in the Department of Anatomy, Chattogram International Medical College (CIMC), Chattogram, Bangladesh during the period from January 2019 to December 2020. In total 157 suspected patients of benign prostatic hyperplasia were selected as the study population. All patients were clinically diagnosed for BPH, based on the present prostate symptoms and digital rectal examination. To measure the prostate volume, abdominal ultrasonography was performed for all the patients. After enucleation, another ultrasonogram was performed for all the patients to measure the existing sizes of the prostates of the patients. All the data were processed, analyzed, and disseminated by MS-word and SPSS programs as per need.Results:Finally, in this study in analyzing the volumes of the prostates of the participants according to the abdominal ultra-sonographic reports of pre-operative stage we observed, in 9%, 34%, 31%, 30%, 21% and 32% patients, the prostate sizes (In cc) were <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. On the other hand, after enucleation, in 11.46%, 24.20%, 28.66%, 27.39%, 7.01% and 1.27% patients, the prostate sizes (In cc) were found <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. The mean changes of prostate sizes between pre- and post-operative stages among the participant was not significant where the P value was found 0.464.Conclusion:The findings of this study support the applications of abdominal ultrasonographic evaluation for suspected benign prostatic hyperplasia patients to know about the exact volumes of their prostates for selecting the appropriate surgical approach.

Effect of Paribhadra Paneeyakshara in Mutraghata Caused by Benign Prostatic Hyperplasia- A Case Report

Benign Prostatic Hyperplasia is a troublesome disease that bothers the population of ageing men by decreasing their quality of life. It is an abnormal growth involving the submucosal glands of prostate. The disease interferes with the normal daily activities and sleep pattern and hence is a matter of concern to the medical field. The symptoms of Benign Prostatic Hyperplasia closely coincide with the symptoms of Mutraghata (urinary obstruction) explained in Ayurveda. When taking the obstructive pathology into consideration, Paneeyakshara Prayoga (alkali for internal administration) is classically mentioned as a treatment option. This work is a case study on the effect of Paneeyakshara prepared out of Paribhadra (Erythrina indica) which is a drug possessing Vatakaphahara (alleviate Vata and Kapha Dosha) and Shophahara Karma (pacify inflammatory swellings) in Mutraghata caused by Benign Prostatic Hyperplasia. A 66-year-old male who presented with the signs and symptoms of Benign Prostatic Hyperplasia was administered with 500 mg of Paribhadra Paneeyakshara with 1 gram of Guda (jaggery), morning and evening, half an hour before food for a period of 45 days. Assessment was done before and after treatment based on the IPSS (International Prostate Symptom Score) of the American Urological Association and the Ultrasound abdomen findings. The post- interventional assessment showed a lowered IPS Score and reduced USG parameters indicating the efficacy of Paribhadra Paneeyakshara in reducing Mutraghata caused by Benign Prostatic Hyperplasia.

Prostate Volume Measurement by Ultrasonography Over 40 Years Age of Bangladeshi Population

Background: Benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy, is a histologic diagnosis status characterized by proliferation of the 慻landular elements� of the prostate, which may lead to an enlarged prostate gland. In many studies, people over the age of 40 years found as the most vulnerable for BPH. Ultrasonography is a prominent method to determine prostate volume or size. Aim of the study: The aim of the present study was to evaluate the prostate volume measurement for the Bangladeshi population over the age of 40 years by ultrasonography.Methods:This prospective, observational study was conducted in the Department of Anatomy, Chattogram Medical College Hospital, Chattogram, Bangladesh during the period from January 2019 to December 2020. In total 157 suspected patients of benign prostatic hyperplasia were selected as the study population. All patients were clinically diagnosed for BPH, based on the present prostate symptoms and digital rectal examination. To measure the prostate volume, abdominal ultrasonography was performed for all the patients. After enucleation, another ultrasonogram was performed for all the patients to measure the existing sizes of the prostates of the patients. All the data were processed, analyzed, and disseminated by MS-word and SPSS programs as per need.Results:Finally, in this study in analyzing the volumes of the prostates of the participants according to the abdominal ultra-sonographic reports of pre-operative stage we observed, in 9%, 34%, 31%, 30%, 21% and 32% patients, the prostate sizes (In cc) were <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. On the other hand, after enucleation, in 11.46%, 24.20%, 28.66%, 27.39%, 7.01% and 1.27% patients, the prostate sizes (In cc) were found <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. The mean changes of prostate sizes between pre- and post-operative stages among the participant was not significant where the P value was found 0.464.Conclusion:The findings of this study support the applications of abdominal ultrasonographic evaluation for suspected benign prostatic hyperplasia patients to know about the exact volumes of their prostates for selecting the appropriate surgical approach.

Clinical Research on Treatment of Benign Prostatic Hyperplasia with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Benign prostatic hyperplasia （BPH）， a common disease in urology and andrology， is mainly manifested as enlarged prostate glands， bladder outlet obstruction， and lower urinary tract symptoms（LUTS）， which seriously affects the quality of life of middle-aged and elderly men. This disease falls into the categories of "retention of urine" and "prostatic hypertrophy" in traditional Chinese medicine （TCM）. In recent years，many doctors have put forward their understandings of BPH based on academic classics and their clinical experience. Clinical research on the treatment of BPH with TCM has become increasingly abundant. The basic pathogenesis of BPH lies in the disturbance of Qi transformation in the bladder and poor blood circulation due to kidney Qi deficiency in the aged. The disease is located in the kidney and the bladder and is related to the dysfunction of the lung and the kidney. It is basically characterized by deficiency in origin and excess in superficiality. A large number of clinical research reports have proved that TCM is efficient in alleviating the clinical symptoms of BPH patients， improving their quality of life， reducing the volume of the prostate， and decreasing postoperative complications. In addition， the external treatment methods of TCM， such as acupuncture therapy， moxibustion， hot water bathing， acupoint application， anal suppository， and enema therapy， are also widely used in clinical practice， demonstrating the diverse ways of TCM in treating BPH. TCM and western medicine complement each other's advantages in the treatment of BPH， thus enhancing the clinical efficacy and reducing the occurrence of long-term complications. This study reviewed the etiology， pathogenesis， and treatment progress of BPH with TCM in recent years， and summarized the current research status. From three aspects of producing high-quality clinical research， standardizing the clinical diagnosis and treatment of TCM， and combining cutting-edge research to explore the mechanism of TCM， it provided suggestions for clinical research on the treatment of BPH with TCM to promote the development and application of TCM in the treatment of this disease.

Índice de Salud Prostática (phi) / Prostate Health Index (phi)

El antígeno específico de próstata (PSA, del inglés, Prostate Specific Antigen) es una glicoproteína producida por la próstata, y es el marcador tumoral de mayor uso. Sin embargo, su baja especificidad para diferenciar entre cáncer de próstata y otras alteraciones no malignas, como la hipertrofia benigna de la próstata (HBP) y la prostatitis aguda, limitan su utilidad diagnóstica

Prostate Specific Antigen (PSA) is a glycoprotein produced by the prostate and is the most widely used tumor marker. However, its low specificity to differentiate between prostate cancer and other non-malignant conditions, such as benign prostate hypertrophy (BPH) and acute prostatitis, limits its diagnostic utility

Effect of rape flower on benign prostatic hyperplasia in rats

We were carried out to investigate the efficacy of Rape (Rapeseed, Brassica napus L.) flower on BPH (benign prostatic hyperplasia) in rats. We found that the extract from Rape flower prevented hyperplasia in testosterone-induced BPH model, the relevant animal model of human BPH. Extract reduced the weight of prostate and induced significantly cell apoptosis in prostate in BPH model. In addition, the extract controlled expression of TGF-ß1 in prostate gland and promoted urinary output in dose-dependence in BPH model. Our data provide that Rape flower may be useful for treatment of BPH

Influencia de la modalidad de respuesta, edad y nivel de educación en el cuestionario internacional de síntomas prostáticos (IPSS) / Influence of the response modality, age and level of education in the international prostate symptoms questionnaire (IPSS)

OBJETIVOS: evaluar la influencia de la modalidad de respuesta (paciente vs. asistido por urólogo) en el cuestionario IPSS (International Prostate Symptom Score) y su relación con la edad y nivel de educación. MATERIALES Y MÉTODOS: Análisis prospectivo de 74 pacientes que acudieron a la consulta de urología por síntomas de Hiperplasia Prostática Benigna (HPB) con o sin tratamiento para su patología y que no hayan completado anteriormente el cuestionario internacional de síntomas prostáticos (IPSS). Los cuestionarios fueron completados en la misma consulta urológica, primero por el paciente y luego con ayuda del urólogo. Se categorizó por edad y nivel de educación. Se evaluó la diferencia entre los puntajes de IPSS obtenidos con la forma autocompletada y con asistencia del urólogo y si esta diferencia estaba relacionada con la edad y con el nivel de educación. Los datos fueron analizados utilizando test no paramétrico para datos apareados de Wilcoxon. RESULTADOS: no se encontró diferencia estadísticamente significativa entre el cuestionario completado por el paciente y el asistido por el urólogo. La media del score total fue de 13,66, y 13,67, respectivamente (p: 0.86). Al analizar los subgrupos, con respecto a la edad y al nivel de educación, tampoco se encontraron diferencias estadísticamente significativas. CONCLUSIÓN: en nuestra población de estudio, el cuestionario IPSS no fue influenciado por la modalidad de administración, tampoco por la edad ni por el nivel de educación.

OBJECTIVES: to evaluate the influence of the response modality (patient vs. urologist-assisted) in the IPSS questionnaire (international prostate symptom score) and its relationship with age and education level. MATERIALS AND METHODS: Prospective analysis of 74 patients who came to the urology clinic for symptoms of Benign Prostatic Hyperplasia (BPH) with or without treatment for their pathology and who have not previously completed the international prostate symptoms questionnaire (IPSS). The questionnaires were completed in the same urological consultation, first by the patient and then with the help of the urologist. It was categorized by age and education level. The difference between the IPSS scores obtained with the self-completed form and with the assistance of the urologist and whether this difference was related to age and level of education was evaluated. The data were analyzed using non-parametric test for paired Wilcoxon data. RESULTS: no statistically significant difference was found between the questionnaire completed by the patient and the one assisted by the urologist. The average of the total score was 13.66, and 13.67, respectively (p: 0.86). When analyzing the subgroups, regarding age and level of education, no statistically significant differences were found. CONCLUSION: In our study population, the IPSS questionnaire was not influenced by the modality of administration, neither by age nor by level of education.

Inhibition of LIM kinase reduces contraction and proliferation in bladder smooth muscle

Overactive bladder (OAB) is the most bothersome symptom in lower urinary tract symptoms (LUTS). Current pharmacologic treatment aims to inhibit detrusor contraction; however, shows unsatisfied efficacy and high discontinuation rate. LIM kinases (LIMKs) promote smooth muscle contraction in the prostate; however, their function in the bladder smooth muscle remains unclear. Here, we studied effects of the LIMK inhibitors on bladder smooth muscle contraction and proliferation both

Histopathological study of prostatic lesions in correlation with serum prostate specific antigen levels in elderly men

Background: Prostatic lesions are common among elderly men with urinary complaints. Variety of prostatic lesions range from inflammatory, benign to malignant pathologies. The Prostate specific antigen (PSA) is secreted by glandular epithelium of prostate shows raised serum levels in these pathologies. Usually significant rise is commonly associated with Prostatic adenocarcinomas (PCa) with exceptions.Methods: In this retrospective study, total 63 diagnosed cases of prostatic lesions over a one-year period for which serum PSA levels were available, were selected. Cases without serum PSA levels & inadequate biopsies were excluded. Histological diagnosis of prostatic lesions reconfirmed and its correlation with serum PSA was done.Results: Study included patients with mean age 67.84 years (range: 48-60) at the time of diagnosis. Benign lesions were commonest prostatic lesions accounting for total 54 cases (85.71%) out of which 38 were of Benign prostatic hyperplasia (BPH), 14 cases of BPH with prostatitis while single case each for BPH with granulomatous prostatitis and basal cell hyperplasia. Mean PSA value for benign lesions was 6.57 ng/ml. Total 8 were malignant which included 7 (11.11%) PCa while single (1.59%) case of metastatic transitional cell carcinoma. Mean PSA for PCa were 35.05 ng/ml. Single case (1.59%) of high grade prostatic intraepithelial neoplasia also detected.Conclusion: Common age group at the time of presentation of prostatic pathologies is 60-70 years. The most common prostatic lesions are benign predominantly BPH. PCa are commonest malignancies. Elevated PSA levels >20 ng/ml are commonly observed in PCa. However lower or normal values don’t rule out PCa.

Role of preoperative assessment of serum sodium in transurethral resection of prostate to avoid transurethral resection of prostate syndrome: a comparative study

Background: Transurethral resection of prostate syndrome (TURP) syndrome is an iatrogenic complication caused by absorption of the irrigating fluid which is used to distend the bladder during surgery.Methods: A total of 100 patients with benign prostatic hyperplasia (BPH) were taken for study. Study was done in tertiary care centre in Gujarat from January 2016 to December 2017. They were evaluated pre-operative and post-operative for sodium concentration.Results: In this study most of the patients i.e. 32 were seen in age group 61- 65 years.31% cases have developed hyponatremia out of 6% were having serum sodium level <125 mEq/l. 56% of cases were having prostate gland <40 cc. In 70% cases, TURP was completed within 60 minutes, while 30% cases required more than 60 minutes time. 13 were seen in age group 51 to 60 years, means 40.62% patients of this age group (13/32) and 12 patients were seen in age group 71-80 years, means 52.17% patients of this age group (12/23) were having post-operative hyponatremia. Out of 31 patients, 20 patients (64.52%) were having prostate size more than 60 cc and 11 patients (35.48%) were having prostate size between 46 to 60 cc.Conclusions: From present study, it is concluded that electrolyte derangement occurs in older patients, with larger amount of tissue and longer time of resection and higher volume of irrigation fluid. It was also noticed that chances of electrolyte derangement are higher in patients with co-morbid conditions.

Effect of modified holmium laser enucleation of the prostate on sexual function in the treatment of benign prostatic hyperplasia / 上海交通大学学报（医学版）

Objective : To study the effect of modified holmium laser enucleation of the prostate (HoLEP) on sexual function in patients with benign prostatic hyperplasia (BPH). Methods ¡¤ The clinical data of 167 middle-aged and elderly patients with BPH treated by modified HoLEP from Feb. 2017 to Oct. 2018 were retrospectively analyzed. According to the status of sexual activity after operation, the patients were divided into study group who had sex (65 cases) and control group who had no sex (102 cases). The risk factors of sexual activity after operation in the two groups were analyzed. The changes of erectile function and ejaculatory function in the study group before and after operation were recorded and analyzed by international index of erectile function (IIEF-5) score, erection hardness score (EHS) model and ejaculatory function question-naire. Results ¡¤ There were no significant differences between the two groups in the stress urinary incontinence, postoperative hospitalization time, weight of enucleated prostate, crush time, total prostate specific antigen, preoperative urinary retention and enucleation time. The patients in the study group were younger than those in the control group (P=0.000). There were no significant differences in IIEF-5 score and EHS in the study group before and 1, 3, 6 months after operation. There were no significant differences in shorten ejaculation latency, ejaculation pain and ejaculation with or without semen in the study group before and after operation, but the patients of decreased semen volume increased from 41.82% (23/55) to 92.73% (51/55) (P=0.000). Conclusion ¡¤ Age is a risk factor in BPH patients, whether there is sexual activity after modified HoLEP or not. The modified HoLEP has no significant effect on erectile function, but the effect on ejaculatory function is the decrease of ejacu-lated semen volume.

To compare the efficacy and safety of silodosin and dutasteride combination with alfuzosin and dutasteride combination in patients of benign prostatic hyperplasia: a randomized, open label study

Background: BPH is a major cause of bothersome lower urinary tract symptoms (LUTS) and affects quality of life (QoL) which deteriorates if not taken care with the passage of time. The aim and objective of the study was to compare the efficacy and safety of combination of silodosin and dutasteride with the combination of alfuzosin and dutasteride in patients of BPH.Methods: A randomized, open label, intention to treat study was carried out on newly diagnosed patients of BPH. Patients were randomly divided into two groups and followed up to 12 weeks. Group 1 of patients received a combination of silodosin 8 mg and dutasteride 0.5 mg (SD) (n=20) while the patients of group 2 received combination of alfuzosin 10 mg and dutasteride 0.5 mg (AD) (n=20). Primary endpoint was measured by changes in the mean baseline International prostate symptom score (I-PSS) and uroflowmetry and secondary outcome with changes observed on ultrasonography.Results: IPSS and IPSS-QOL significantly improved in both the treatment groups (p <0.001) along with mean maximum flow rate (Qmax) and mean average flow rate (Qavg). Prostate volume and residual urine volume showed a significant improvement in both the treatment groups at 12 weeks. However, the intergroup differences in IPSS, uroflowmetry and USG parameters were not significant. Both treatments were well tolerated.Conclusions: The current study established that both the drug combinations i.e. silodosin and dutasteride (SD) and alfuzosin and dutasteride (AD) largely have a comparable effect on both the dynamic and static components of BPH. Further, both drug combinations appear to have a comparable safety profile.

Quantification of the Bioactive Components of the Rhizomes of Curcuma wenyujin and Assessment of Its Anti-inflammatory Effect in Benign Prostatic Hyperplasia-1 Cells

In this study, the marker compounds of Curcumae Rhizoma (CR) were simultaneously quantified by high-performance liquid chromatography equipped with a photodiode array detector and the anti-inflammatory effects of CR extract and marker compounds in human benign prostatic hyperplasia epithelial-1 (BPH-1) cell lines were investigated. The marker components (4S,5S)-(+)-germacrone-4,5-epoxide, furanodienone, and germacrone, were separated on Gemini C₁₈ columns (250 mm × 4.6 mm, 5 µm) at 40 ℃ by using a gradient of two mobile phases eluting at 1.0 mL/min. Prostaglandin E₂ (PGE₂) levels in Human BPH-1 cells were determined with an ELISA kit. The coefficients of determination in a calibration curve of each analyte were all 0.9997. The limits of detection and quantification of the three compounds were 0.10 – 0.32 µg/mL and 0.30 – 0.98 µg/mL, respectively. The content of three compounds, (4S,5S)-(+)-germacrone-4,5-epoxide, furanodienone, and germacrone, in the CR sample were found to be 5.79 – 5.92 mg/g, 4.72 – 4.86 mg/g, and 1.06 – 1.09 mg/g, respectively. Regarding pharmacological activity against benign prostatic hyperplasia, CR and its components significantly suppressed PGE₂ levels of BPH-1 cells. The established analysis method will help to improve quality assessment of CR samples and related products. In addition, CR and its components exhibit anti-inflammatory activity in BPH-1 cells, suggesting the inhibitory efficacy of these compounds against the pathogenesis of BPH.

A Clinical Study On Effect Of Gokshura Kwatha In The Management Of Mutraghata W. S. R. To B.p.h

Introduction: 慚utraghata� can be equated with group of obstructive uropathic disorders. As explained in Sushrutha Samhitha, it is of 12 types and 慥atasthila� is one among them, which is closely similar to Benign Prostatic Hyperplasia. BPH is a progressive disease of advancing age. Histologically the inner zone of the periurethral gland undergoes hypertrophy and an adenoma is formed. Usually men around 60 years, suffer from mild, moderate and severe grade of BPH. Objectives: To evaluate the efficacy of Gokshura kwatha in the management of Mutragatha/ B.P.H. and to improve quality of life of BPH sufferer. Method: It is a single blind, clinical study on diagnosed cases of B.P.H, Gokshura kwatha was given for 60 days (20ml BD) with Sita and honey with follow-up of 4 months. Changes in subjective criteria (by IPSS Index) and objective criteria (by USG) were recorded before and after treatment. Result: Gokshurakwatha shown more significant relief on associated symptoms of Mutraghata including, burning sensation, painful micturition, pus and blood discharge etc. Interpretation: On the basis of the beneficial effects of Gokshura kwatha churna, it can be opined that it gives good result symptomatically. Conclusion: The subjective features were relieved significantly. But observed, no much difference in the objective criteria. The effect of Gokshurakwatha on the straining significantly reduced, prostate size has not reduced significantly. As for follow up period, relief of symptoms observed to be sustained up to one month in majority of patients.

Relationship Between Grades Of Prostatomegaly On Dre And Prostate Volume On Sonography With Lower Urinary Tract Symptoms: To Believe Your Finger Or The Ultrasound Probe!!!

Elderly men presenting with Lower Urinary Tract Symptoms (LUTS) constitutes around a third of urological practice with prevalence as high as 10-41 % in men older than 40 years. Its adverse impact on the Quality of Life (QoL) makes it imperative for the clinician to guide therapy based on sound diagnostic principles. Clinical evaluation of LUTS secondary to BPH involves International Prostate Symptom Score (IPSS) assessment, digital rectal examination (DRE), urodynamics and sonological evaluation of prostate. Our study aims to correlate the grades of prostatomegaly on DRE and prostate volume on sonography with LUTS assessed by IPSS in elderly males.

Clinical study on transurethral laser shovel type vapor-resection-enucleation of the prostate based on the inter-layer of surgical capsule for the treatment of benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of transurethral laser shovel type vaporresection-enucleation of the prostate (LS-VREP) based on the inter-layer of surgical capsule for the treatment of benign prostatic hyperplasia (BPH),which was less 80 g weight.Methods From September 2013 to August 2016,a retrospective study was performed including 1 369 cases of BPH patients,who were treated by 120-160 W transurethral laser (straight green-light) shovel type vapor-resection-enucleation of the prostate (LS-VREP group,n =1 008) and transurethral resection of the prostate (TURP group,n =361).The preoperative data,including average age,prostate weight,IPSS,QOL,Qmax and PVR was reviewed.There was no significant difference of the above data between the two groups (P ＞ 0.05).Operative time,changes of hemoglobin and serum sodium concentration,postoperative bladder irrigation time,catheter indwelling duration,hospital stay,pre-and 3 months post-operative IPSS,QOL,Q PVR were recorded.In addition,complications were monitored.Results Mean operation time of LS-VREP group was (46.1 ± 18.6) min,while TURP group was (48.2 ± 15.2) min,and there was no difference between the two groups (P ＞ 0.05).Post-operative mean hemoglobin concentration and serum sodium concentration of LS-VREP group decreased (1.6 ± 1.2) g/L and (1.2 ± 0.6) mmol/L respectively,while those of TURP group decreased (5.7 ± 3.6) g/L and (3.2 ± 1.2) mmol/L,and the differences were statistically significant (P ＜ 0.05).Mean post-operative catheter indwelling time,and post-operative hospital stay of LS-VREP group was (42.9 ± 12.7) h and (3.2 ± 0.6) d,while TURP group was (65.7 ± 15.4) h and (5.4 ± 1.2) d,and the differences were statistically significant (P ＜ 0.05).Comparatively IPSS,QOL,Qmax and PVR were all improved significantly in both groups at 3 months after operation (P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After three months' follow-up of post-operation,as for the complication rate,including TURS,bleeding requiring reoperation,incontinence,dysuria and erectile dysfunction,LS-VREP group (15/1 008) was less than that of TURP group (30/361,P ＜ 0.05).Conclusions The LS-VREP based on the inter-layer of surgical capsule is safe and effective for the treatment of BPH patients whose prostate weight was less than 80 g.LS-VREP showed less intraoperative bleeding,faster postoperative recovery,and high safety,which is considered a safe,effective and optimized minimally invasive surgery.

Clinical Efficacy and Safety of Naftopidil Treatment for Patients with Benign Prostatic Hyperplasia and Hypertension: A Prospective, Open-Label Study

PURPOSE: To investigate the efficacy and safety of naftopidil for benign prostatic hyperplasia (BPH) patients, mainly focusing on changes in blood pressure (BP). MATERIALS AND METHODS: Of a total of 118 patients, 90 normotensive (NT) and 28 hypertensive (HT) patients were randomly assigned to be treated with naftopidil 50 mg or 75 mg for 12 weeks, once-daily. Safety and efficacy were assessed by analyzing changes from baseline in systolic/diastolic BP and total International Prostate Symptom Score (IPSS) at 4 and 12 weeks. Adverse events (AEs), obstructive/irritative subscores, quality of life (QoL) score, maximum urinary flow rate (Qmax), and benefit, satisfaction with treatment, and willingness to continue treatment (BSW) questionnaire were also analyzed. RESULTS: Naftopidil treatment decreased mean systolic BP by 18.7 mm Hg for the HT 50 mg group (p86% of all patients agreed to continue their current medications. CONCLUSION: Our results suggest that naftopidil treatment in BPH patients with hypertension allows for optimal management of BP within the normal range.

Drug therapy for benign prostatic hyperplasia and individualized drug regime / 药学实践杂志

Objective To review the drug therapies for benign prostatic hyperplasia (BPH) and provide a reference for clinical individualized medication regime.Methods The mechanisms and clinical indications of commonly used BPH medications and some new drugs were discussed.The challenges for BPH therapies were also explored.Results α-receptor inhibitors and 5α-reductase inhibitors have the best effect for BPH.Surgery is needed for the BPH patients who are not responsive to the drug therapy.Conclusion Individualized medication programs reduce the medication waste and give patients the best treatment options.

Diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia: a Meta-analysis / 中国内镜杂志

Objective To systematically review and evaluate the perioperative indicators and surgical curative effect of 980 nm diode laser vaporization of prostate and transurethral resesction of prostate (TURP) in treating benign prostatic hyperplasia (BPH). Methods Retrieved published comparative studies 980 nm diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia, and pooled the data from eligible studies. The statistical analysis was performed using Revman 5.3 software. Results Six trials including 839 patients were eligible to the criteria (450 in 980 nm diode laser group and 389 in TURP group). The baseline of patients characteristics were comparable in all the studies. Meta analysis showed that: the operative time was not significantly different between the 980 nm diode laser group and TURP group [SMD = 0.11, 95 ~ CI (-0.52,0.74), P > 0.05]; Compared with TURP group, 980 nm diode laser group has shorter hospital stays [SMD = -1.95, 95%CI (-3.42, -0.48), P 0.05], QOL [SMD = 0.00, 95%CI (-0.57, 0.57), P > 0.05] and Qmax [SMD = 0.06, 95%CI (-0.26, 0.37), P > 0.05]. Conclusion 980 nm diode laser vaporization of prostate is safe and effective in treating benign prostatic hyperplasia, and compared with TURP, it has advantages in shorter hospital stays and shorter catheterization time.

Inflammatory Responses in a Benign Prostatic Hyperplasia Epithelial Cell Line (BPH-1) Infected with Trichomonas vaginalis

Trichomonas vaginalis causes the most prevalent sexually transmitted infection worldwide. Trichomonads have been detected in prostatic tissues from prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Chronic prostatic inflammation is known as a risk factor for prostate enlargement, benign prostatic hyperplasia symptoms, and acute urinary retention. Our aim was to investigate whether T. vaginalis could induce inflammatory responses in cells of a benign prostatic hyperplasia epithelial cell line (BPH-1). When BPH-1 cells were infected with T. vaginalis, the protein and mRNA of inflammatory cytokines, such as CXCL8, CCL2, IL-1β, and IL-6, were increased. The activities of TLR4, ROS, MAPK, JAK2/STAT3, and NF-κB were also increased, whereas inhibitors of ROS, MAPK, PI3K, NF-κB, and anti-TLR4 antibody decreased the production of the 4 cytokines although the extent of inhibition differed. However, a JAK2 inhibitor inhibited only IL-6 production. Culture supernatants of the BPH-1 cells that had been incubated with live T. vaginalis (trichomonad-conditioned medium, TCM) contained the 4 cytokines and induced the migration of human monocytes (THP-1 cells) and mast cells (HMC-1 cells). TCM conditioned by BPH-1 cells pretreated with NF-κB inhibitor showed decreased levels of cytokines and induced less migration. Therefore, it is suggested that these cytokines are involved in migration of inflammatory cells. These results suggest that T. vaginalis infection of BPH patients may cause inflammation, which may induce lower urinary tract symptoms (LUTS).