Variation of inflammatory indexes in patients with chronic abacterial prostatitis treated with an herbal compound/extract.

INTRODUCTION: Inflammation is a highly prevalent finding in the prostate. Men with inflammation have higher IPSS score and increased prostate size. For men with prostatic inflammation, there is a significantly increased risk of developing acute urinary retention and the need of a surgical approach to the disease. Some laboratory tests (i.e. fibrinogen, C-reactive protein), can play a role in identifying patients at greatest risk of complications and adverse outcomes after surgery. There have been several experiences exploring the role of nutraceutical approach to the prostate inflammation. Aim of our study were to describe the variation in symptoms and inflammatory indexes in men affected by chronic abacterial prostatitis, treated with an herbal extract containing Curcuma Longa 500 mg, Boswellia 300 mg, Urtica dioica 240 mg, Pinus pinaster 200 mg and glycine max 70 mg. MATERIALS AND METHODS: A prospective multicenter study was conducted from February 2021 and March 2022. One hundred patients, with a diagnosis of Chronic Prostatitis were enrolled in a multicentric phase III observational study. They were treated with the herbal extract, one capsule per day, for 60 days. No placebo arm was included. In each patient, inflammatory indexes, PSA, prostate volume, IIEF-5, PUF, uroflowmetry (Qmax), IPSS-QoL, NIH-CPPS were registered and statistically compared at baseline and at the follow up visit. RESULTS: The variation obtained on the inflammation indexes showed a global improvement after treatment, including the PSA reduction. We also recorded a significant improvement on IPSS-QoL, NIH-CPPS, PUF and Qmax scores. CONCLUSIONS: The herbal extract considered in our study may represent a promising and safe therapeutic agent leading to a reduction of inflammation markers, and could be used in the treatment of prostatitis and benign prostatic hyperplasia.

How effective is extracorporeal shock wave lithotripsy of ureteral stones with Dornier Lithotripter S EMSE 220F-XXP? A prospective and preliminary assessment.

AIM: To report our preliminary series with the Doli S EMSE 220F-XXP, the upgraded version of the previous Dornier Lithotripter S EMSE 220, for treatment of ureteral stones. METHODS: Since July 2006, a total of 200 patients with ureteral stones were submitted to shock wave lithotripsy (SWL) with Doli S EMSE 220F-XXP. Mean stone size was 9.3 mm (range 6-18 mm). Ureteral stone location was proximal in 75, middle in 34, and distal in 91. Follow-up was carried out at 6 weeks after the treatment, by means of kidney-ureter-bladder (KUB) film and ultrasound, or helical computed tomography (CT). RESULTS: The overall stone-free rate was 89.5%, and the effectiveness quotient was 80. Stratifying by stone site, the stone-free rate was 93.3, 67.6, and 94.5% for proximal, middle, and distal location, respectively. Mean number of sessions per patient was 1.14. Analgesia with intravenous ketorolac or tramadol was required in 42.5% of cases. No significant side-effects were recorded. CONCLUSIONS: The new Doli S EMSE 220F-XXP provides similar characteristics to the Doli S EMSE 220 in terms of safety and lack of major complications, when dealing with ureteral stones; the improvement in stone disintegration is particularly evident for distal location, for which the number of pulses and the intensity of treatment can be greatly increased and the upgraded power of the device can be widely applied.

Retrospective descriptive analysis of the physiological kinetics of prostate-specific antigen in men older than 75 years.

Several studies have compared prostate-specific antigen (PSA) kinetics in men with and without cancer, but there has been no adequate analysis of the longitudinal variation in PSA. The aim of this study was to assess the fluctuations in PSA in a cohort of elderly men in an attempt to define a physiological pattern of PSA kinetics. We searched a specific cohort of patients aged > 75 years and with PSA value < 2.0 ng mL(-1). A history of all PSA values over the past 10 years was compiled for each patient to create a database of patients fitting the following criteria: (1) minimum of five PSA measurements, (2) over at least 5 years. Exclusion criteria were: (1) PSA < 0.2 ng mL(-1) at each measurement and (2) having had more than one PSA test per year. In all, 1 327 patients (mean age: 78.52 years) fit the inclusion criteria. The mean variation from the first to the last PSA test was 0.05 +/- 0.43, with a mean follow-up of 6.79 +/- 1.71 years. Over the same period, the mean fluctuation from the lowest to the highest PSA value was 0.04 +/- 0.55 (P = 0.925). The mean annual PSA velocity (PSAV) was calculated by dividing the mean variation from the first to the last PSA test by the number of years of observation for each patient and was set at 0.0104 +/- 0.1050. Concluding, in a large-scale cohort of elderly individuals considered healthy and evaluated for a considerable follow-up, the average annual PSAV as well as the average fluctuation from the lowest to the highest PSA value are insignificant.