Effects of isosorbide dinitrate on the urinary flow rate in patients with benign prostatic hyperplasia.

PURPOSE: To compare the immediate effects of a systemic nitric oxide (NO) donor with placebo on the uroflowmetric parameters in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Eighty patients with the mean age of 61.5 years (range, 49 to 74 years) who suffered from BPH were enrolled in the study. We examined peak flow rate, average flow rate, and residual urine in all the patients. Then, patients were randomized to receive either 20 mg sublingual isosorbide dinitrate (ISDN) (n = 40) or placebo (n = 40) 20 minutes prior to the second uroflowmetry, which was performed one day after the first test. RESULTS: The mean peak flow rate increased from 7.6 ± 0.41 mL/s to 10.2 ± 0.54 mL/s (P = .013) in the ISDN group, while it increased +0.40 mL/s in the placebo group (P > .05). Mean residual urine volume decreased significantly from 51 ± 3.1 mL to 29 ± 2.9 mL and from 56 ± 4.1 to 51 ± 2.6 in the ISDN (P = .02) and the placebo groups (P > .05), respectively. At baseline, the mean arterial pressure was 95 ± 2.1 mmHg and under the influence of the NO-donor, it decreased to 83 ± 1.9 mmHg, which was significant (P < .001). No significant changes of micturition parameters were found in the placebo group. CONCLUSION: Organic nitrates influence micturition parameters in patients with BPH. This new approach could offer a potential pharmacological option to treat obstructive lower urinary tract symptoms.

Celecoxib for treatment of nocturia caused by benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled study.

OBJECTIVES: Nocturia is a well-recognized symptom of benign prostatic hyperplasia (BPH), which is commonly treated by alpha(1)-blockers and/or 5alpha-reductase inhibitors. However, the effectiveness of these drugs for nocturia has been reported to be only 25%-39%. The aim of this study was to investigate the efficacy of celecoxib, a cyclooxygenase-2 inhibitor, in the treatment of patients with BPH complaining of nocturia. METHODS: This was a prospective, randomized, double-blind, placebo-controlled study. A total of 80 men with lower urinary tract symptoms and BPH were entered into the study and were randomized to receive celecoxib, 100 mg at 9 pm vs placebo for 1 month. The inclusion criteria also included a total International Prostate Symptom Score >8 and complaints of >or=2 voids nightly. The efficacy and safety of the treatment were assessed by changes in the urinary flow and symptoms between baseline and 1 month of follow-up. RESULTS: In the celecoxib group (n = 40), the mean nocturnal frequency (+/-SD) decreased from 5.17 +/- 2.1 to 2.5 +/- 1.9 (P < .0001), and the mean International Prostate Symptom Score (+/-SD) decreased from 18.2 +/- 3.4 to 15.5 +/- 4.2 (P < .0001). In the control group (n = 40), the mean nocturnal frequency (+/-SD) decreased from 5.30 +/- 2.4 to 5.12 +/- 1.9 (P > .05), and the mean International Prostate Symptom Score (+/-SD) decreased from 18.4 +/- 3.1 to 18 +/- 3.9 (P > .05). A statistically significant difference was found between the 2 groups (P < .0001). No statistically significant differences were found in the changes in the peak flow rate between the celecoxib and control groups or in celecoxib group between baseline and 1 month (P > .05). No significant side effects were reported. CONCLUSIONS: Celecoxib is effective in the treatment of patients with BPH complaining of refractory nocturia. Our results suggest a novel treatment option for this common condition.

Comparison of prevalence of varicocele in first-degree relatives of patients with varicocele and male kidney donors.

OBJECTIVES: To evaluate hereditary behavior of varicocele through comparison of prevalence of disease in first-degree relatives of patients with known varicocele and normal healthy kidney donation volunteers. METHODS: Sixty-two patients with known varicocele who admitted for surgery in Razi Hospital between September 2005 and October 2006 were enrolled in the study. The patients were asked to refer for examination healthy available first-degree relatives (n = 88). A group of 100 men referred for voluntary kidney donation were selected as control group and assessed for varicocele. RESULTS: Of the 88 first-degree relatives of patients with a known varicocele, 40 (45.4%) had a clinically palpable varicocele on physical examination. This was significantly greater than the 11 (11%) of 100 men in the control group (P <0.001). Of the first-degree relatives, 32 (55.1%) of 58 brothers and 8 (26.6%) of 30 fathers had palpable varicocele. CONCLUSIONS: Clinical varicoceles are more prevalent among first-degree relatives (particularly brothers) of patients with known varicoceles and may be an indicator of hereditary behavior of the disease and necessity of screening for male family members.