Benign prostatic hyperplasia and lower urinary tract symptoms in African Americans and Latinos: treatment in the context of common comorbidities.

Benign prostatic hyperplasia (BPH), with accompanying lower urinary tract symptoms (LUTS), is a common age-related condition associated with a variety of cardiovascular, metabolic, and sexual comorbidities. While there is debate, in the United States race and ethnicity, particularly among Latinos and African American men, may confer an elevated risk for BPH and LUTS. Hypertension and deficits in sexual health are more common among African American men, while both Latino and African American men experience more metabolic-related disorders, including diabetes mellitus, insulin resistance, and end-stage renal disease. Although socioeconomic factors may play a significant role in these disparities, pathological and genetic variations between patients of different races and ethnicities are additional factors in the development of BPH. The proliferation of available treatments for BPH demands greater discernment in treatment selection, and comorbidities represent a central criterion upon which choice of appropriate BPH therapy should be based. This article reviews common comorbidities in minority populations, describes challenges to BPH management, and discusses medical, surgical, and phytotherapeutic treatment options.

Prostatitis: ¿infección, alteración neuromuscular o síndrome doloroso? La adecuada clasificación del paciente es clave / Prostatitis: infection, altered or neuromuscular pain syndrome? The proper classification of the patient is key

La prostatitis en un término muy amplio utilizado para describir la inflamación de la próstata con una variedad de síntoma urinarios bajos, molestias en la actividad sexual y disfunción. Es una condición que afecta entre el 5 y 10 por cien de la población masculina y es el diagnostico urológico más común en menores de 50 años. La prostatitis se clasifica en cuatro categorías, incluyendo sus formas aguda y crónica bacterianas, una crónica abacteriana y una asintomática. Las formas bacterianas son más fáciles de diagnosticar y tratar, pero no es usual que los síntomas del paciente estén claramente relacionados con una condición infecciosa, tanto así que la prostatitis crónica abacteriana (también conocida como síndrome de dolor pélvico crónico), es la forma más prevalente y menos entendida, así como también es la que implica un mayor reto diagnóstico y terapéutico. Esta forma de prostatitis puede responder a terapias no centradas en la próstata como terapia física, liberación de puntos gatillo miofasciales y terapias de relajación. Teniendo en cuenta que hay múltiples formas de prostatitis, es necesario tener presentes las múltiples modalidades terapéuticas, hacer un enfoque diagnostico apropiado y hacer un diagnóstico diferencial adecuado , con miras a tener un manejo efectivo.

Identifying and treating premature ejaculation: importance of the sexual history.

Premature ejaculation (PE) is one of the most common sexual dysfunctions in men, with prevalence rates ranging from 21% to 31%. Because many physicians do not inquire about sexual dysfunction and patients are reluctant to offer it as a medical complaint, PE is underreported in clinical practice. A sexual history is therefore necessary to uncover the diagnosis. PE can have a significant impact on the quality of life of the patient and his sexual partner, and may lead to psychological distress and loss of self-esteem. It appears that PE has no single etiology, and treatments have been based on both its neurophysiologic and behavioral components. Although no therapies are currently approved for PE by the US Food and Drug Administration, medications that have shown some success include selective serotonin reuptake inhibitors, tricyclic antidepressants, phosphodiesterase type 5 inhibitors, and topical anesthetics. Behavioral techniques have been the mainstay of PE treatment, and include techniques to decrease sensory input.

Prostatitis: Infection, neuromuscular disorder, or pain syndrome? Proper patient classification is key.

Prostatitis is a broad term used to describe inflammation of the prostate that may be associated with a myriad of lower urinary tract symptoms and symptoms of sexual discomfort and dysfunction. The condition affects 5% to 10% of the male population and is the most common urologic diagnosis in men younger than 50 years. Prostatitis is classified into four categories, including acute and chronic bacterial forms, a chronic abacterial form, and an asymptomatic form. The bacterial forms are more readily recognized and treated, but symptoms in most affected men are not found to have an infectious cause. Indeed, chronic abacterial prostatitis (also known as chronic pelvic pain syndrome) is both the most prevalent form and also the least understood and the most challenging to evaluate and treat. This form of prostatitis may respond to non-prostate-centered treatment strategies such as physical therapy, myofascial trigger point release, and relaxation techniques. Because the various forms of prostatitis call for vastly different treatment approaches, appropriate evaluation, testing, and differential diagnosis are crucial to effective management.

The cellular distribution of fluorescently labeled arrestins provides a robust, sensitive, and universal assay for screening G protein-coupled receptors.

G protein-coupled receptors (GPCRs) have proven to be a rich source of therapeutic targets; therefore, finding compounds that regulate these receptors is a critical goal in drug discovery. The Transfluor technology utilizes the redistribution of fluorescently labeled arrestins from the cytoplasm to agonist-occupied receptors at the plasma membrane to monitor quantitatively the activation or inactivation of GPCRs. Here, we show that the Transfluor technology can be quantitated on the INCell Analyzer system (INCAS) using the vasopressin V(2) receptor (V(2)R), which binds arrestin with high affinity, and the beta(2)-adrenergic receptor (beta(2)AR), which binds arrestin with low affinity. U2OS cells stably expressing an arrestin-green fluorescent protein conjugate and either the V(2)R or the beta(2)AR were plated in 96-well plastic plates and analyzed by the INCAS at a screening rate of 5 min per plate. Agonist dose-response and antagonist dose-inhibition curves revealed signal-to-background ratios of approximately 25:1 and 8:1 for the V(2)R and beta(2)AR, respectively. EC(50) values agreed closely with K(d) values reported in the literature for the different receptor agonists. In addition, small amounts of arrestin translocation induced by sub-EC(50) doses of agonist were distinguished from the background noise of untreated cells. Furthermore, differences in the magnitude of arrestin translocation distinguished partial agonists from full agonists, and Z' values for these ligands were >0.5. These data show that the Transfluor technology, combined with an automated image analysis system, provides a direct, robust, and universal assay for high throughput screening of known and orphan GPCRs.