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Background The Qianlie Shule capsule is a classical Chinese medicine compound preparation frequently used in therapeutic settings to alleviate astringent pain in the urethra, prostatic hypertrophy, and chronic prostatitis or urinary frequency. However, a comprehensive analysis of the chemical composition of Qianlie Shule capsules has not been reported. Objective To establish a quick and effective analytical method based on hybrid quadrupole-orbitrap mass spectrometry ultrahigh-performance liquid chromatography (UPLC-Q-Orbitrap-MS/MS) for the identification and characterization of chemical components in Qianlie Shule capsules. Method Using ultrahigh-performance liquid chromatography with hybrid quadrupole-orbitrap mass spectrometry and data post-processing, the samples of Qianlie Shule capsules were examined. First, the whole extract of the Qianlie Shule capsules was separated using a UPLC machine, and the fragmentation data were collected in both positive and negative ion mode. The target molecule is then quickly identified by comparing the fragmentation information of the neutral loss (NLs) and characteristic fragments (CFs) reported in the literature. Results A total of 145 chemical components were identified. It includes flavonoids, triterpenoids, phenylpropanoids, organic acids, alkaloids, phenylethanoids, iridoids, and anthraquinones. Conclusions This study is a method for the rapid qualitative analysis of the chemical composition of Qianlie Shule capsules, which provides a method for the rapid, sensitive, and high-throughput identification of the prescription components of Chinese medicine. Highlights Systematic identification of the chemical composition of QLSL capsules provides a theoretical basis for studying the substance basis of QLSL capsules and the improvement of the quality control level. [ABSTRACT FROM AUTHOR]

Robot-assisted radical prostatectomy (RARP) is difficult in patients with benign prostatic hyperplasia (BPH), a condition causing frequent urination, because of the large prostate volume and particularly true when BPH is accompanied by an enlarged middle lobe. To overcome this difficulty, some surgeons elevate the middle lobe with a third arm or tow the urethral catheter to the edge to identify the resection line. Herein, we describe a method for lifting a prostate with an enlarged middle lobe, which was successfully applied in a patient with prostate cancer and BPH. This technique can help identify the resection line between the bladder and prostate, reducing surgical difficulty and the number of unnecessary sutures. [ABSTRACT FROM AUTHOR]

Benign Prostatic Hypertrophy (BPH) affects at least one-third of men over 60 years. A giant prostatic hyperplasia (GPH) is a prostate enlargement that exceeds 500 g. We present a case of a 72-year-old man with a GPH volume of 1280 ml, referred to our hospital for a worsening of the lower urinary tract symptoms (LUTS), bilateral loin pain and kidney failure. Although the patient had a negligible post-void residual urine, he had bilateral hydronephrosis. The patient was managed conservatory because of a high anesthesiologic risk but a bilateral percutaneous nephrostomy was placed soon due to kidney function worsening. The presence of serious comorbidities and the resolution of the loin pain and the renal failure, achieved first with the nephrostomy and then with periodic replacement of ureteral stents, along with an improvement of the LUTS obtained with medical therapy, have oriented us towards a conservative management of the patient. [ABSTRACT FROM AUTHOR]

Benign prostatic hyperplasia (BPH) and benign prostatic enlargement (BPE) are common disorders in aging men and cause lower urinary tract symptoms. Hypertension induces atherosclerosis in the blood vessels of the lower urinary tract, subsequently following by the development of BPH and BPE. Clinical study demonstrated that anti-hypertensive drug angiotensin II type 1 receptor blocker (ARB) treatment improved storage and voiding scores in male patients with hypertension, whereas other antihypertensive drugs were not effective. ARB could improve prostatic hyperplasia independent of reducing blood pressure. Spontaneously hypertensive rats (SHRs) are widely used as genetically hypertensive model. SHRs also demonstrate decreased prostatic blood flow and develop glandular epithelial hyperplasia and morphological abnormalities in the ventral prostate. We examined the effects of an ARB, losartan on glandular epithelial prostatic hyperplasia in SHRs. Thirty-six-weeks old male SHRs were orally treated with losartan (3 or 10 mg/kg/day) or vehicle once daily for 18 weeks. Wistar Kyoto rats (WKYs) were treated with vehicle were used as controls (n = 8). After the oral treatment, effects of losartan were evaluated by measuring prostate weight, blood pressure, and prostatic blood flow. The tissue levels of malondialdehyde (oxidative stress marker; MDA), interleukin-6 (inflammatory cytokine; IL-6), and basic fibroblast growth factor (bFGF) levels in ventral prostate were measured by colorimetric assay and ELISA assay. Histological analysis for the ventral prostate was performed by hematoxylin and eosin (HE) staining and TdT-mediated dUTP nick-end labeling (TUNEL) assay. The glandular epithelial area was determined by HE staining. TUNEL assay was performed to quantify the degree of apoptosis. The statistical differences were determined using one-way analysis of variance followed by the Tukey-Kramer test. Histological data were analyzed using the nonparametric Kruskal-Wallis test followed by the Mann-Whitney U test with Bonferroni's correction for multiple comparison. Body weight did not significantly differ among the groups. The vehicle treated SHRs had significantly higher prostate weight, prostate weight/body weight ratio (PBR), blood pressure, glandular epithelial area, and tissue MDA, IL-6, and bFGF levels in the ventral prostate and lower prostatic blood flow compared to the vehicle treated WKYs. Treatment with losartan significantly decreased PBR and improved prostatic blood flow and glandular epithelial area as well as tissue MDA, IL-6, and bFGF levels in the SHR ventral prostate without affecting blood pressure. High-dose losartan significantly decreased blood pressure and increased TUNEL-positive cells in the ventral prostate in SHRs. Chronic losartan treatment could improve glandular epithelial prostatic hyperplasia via recovery of reduced prostatic blood flow and induction of apoptosis in the ventral prostate in SHRs. Losartan might improve not only hypertension but also prostatic hyperplasia in humans. Work supported by industry: no. [ABSTRACT FROM AUTHOR]

Introduction Patients with hypospadias are treated surgically during childhood, which has the intention of enabling a satisfactory sexual life in adulthood. However, it is unclear whether patients with corrected hypospadias can lead a satisfactory sexual life and sustain a marital relationship and produce offspring. Aim To evaluate factors associated with achievement of sexual intercourse, marriage, and paternity in patients with hypospadias who have reached adulthood. Methods Self-completion questionnaires were mailed in April 2012 to patients with hypospadias at least 18 years old who had been treated at our institution during childhood from 1973 through 1998 by a single surgeon and the same surgical policy. Assessments included the International Prostate Symptom Score, the International Index for Erectile Function-5, and non-validated questions related to current social and physical status and sexual, marital, and paternity experiences. Candidate factors were extracted from patients’ neonatal data, surgical findings and results, and current physical and social status obtained by the questionnaires. Main Outcome Measures Candidate factors associated with heterosexual intercourse, marriage, and paternity experiences were analyzed using univariate and multivariate proportional hazard models and log-rank test of Kaplan-Meier curves. Results Of the 518 patients contacted, 108 (age = 18–50 years, median = 28 years) met the inclusion criteria. Two- and one-stage repairs were performed as the initial treatment in 79 and 12, respectively, and 17 of the analyzed cases were reoperations for patients initially treated elsewhere. Fifty-seven patients had the milder type (31 glandular, 26 penile), 36 had the proximal type (13 penoscrotal, 23 scrotal-perineal), and 15 had an unknown type. Multivariate analyses by Cox proportional hazard model and log-rank tests confirmed that experience of sexual intercourse was associated with the milder type of hypospadias ( P = .025 and .0076 respectively), marriage was associated with stable employment ( P = .020 and .026, respectively), and paternity was associated with the absence of additional surgery after completion of the initial repair ( P = .013 by multivariate analysis). Conclusion There was scant overlap of factors associated with the three events. The present findings provide reference information for surgeons and parents regarding future sexual and marriage experiences of children treated for hypospadias. [ABSTRACT FROM AUTHOR]

Introduction Most surgical treatments for male lower urinary tract symptoms and benign prostatic hyperplasia affect erectile and ejaculatory functions negatively, leading to patient dissatisfaction. Aim To determine whether water vapor thermal therapy, when conducted in a randomized controlled trial, would significantly improve lower urinary tract symptoms secondary to benign prostatic hyperplasia and urinary flow rate while preserving erectile and ejaculatory functions. Methods Men at least 50 years old with International Prostate Symptom Scores of at least 13, a peak flow rate of at least 5 to no higher than 15 mL/s, and prostate volume of 30 to 80 cm 3 were randomized 2:1 between Rezūm System thermal therapy and control. Thermal water vapor (103°C) was injected into lateral and median lobes as required for treatment of benign prostatic hyperplasia. The control procedure entailed rigid cystoscopy with simulated active treatment sounds. Main Outcome Measures Blinded group (active = 136, control = 61) comparison occurred at 3 months and the active arm was followed to 12 months for International Prostate Symptom Score, peak flow rate, and sexual function using the International Index of Erectile Function and the Male Sexual Health Questionnaire for Ejaculatory Function. The minimal clinically important difference in erectile function perceived by subjects as beneficial was determined for each erectile function severity category. Subjects not sexually active were censored from sexual function analysis. Results No treatment- or device-related de novo erectile dysfunction occurred after thermal therapy. International Index of Erectile Function and Male Sexual Health Questionnaire for Ejaculatory Function scores were not different from the control group at 3 months or from baseline at 1 year. Ejaculatory bother score improved 31% over baseline ( P = .0011). Also, 32% of subjects achieved minimal clinically important differences in erectile function scores at 3 months, and 27% at 1 year, including those with moderate to severe erectile dysfunction. International Prostate Symptom Score and peak flow rate were significantly superior to controls at 3 months and throughout 1 year ( P < .0001). Conclusion Convective water vapor thermal therapy provides sustainable improvements for 12 months to lower urinary tract symptoms and urinary flow while preserving erectile and ejaculatory functions. [ABSTRACT FROM AUTHOR]

Context: Disorders of the prostate gland are more prevalent in patients with acromegaly. GH-insulin-like growth factor 1 (IGF1) axis plays an additive role in prostatic growth and development. Objective: To correlate the structural and histopathological changes of the prostate and prostatic symptoms with GH/IGF1 in patients with acromegaly. Design: Case-control study, from January 2012 to November 2013. Setting: Tertiary referral centre university hospital in Northern India. Patients: Fifty-three men with acromegaly and 50 healthy men matched for age and BMI. main outcome measures: International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA) levels, dimensions of the prostate on trans-rectal ultrasonography, parameters on uroflowmetry, and immunopositivity with anti-IGF1 antibody in prostatic tissue biopsies. Results: Despite low serum testosterone levels (8.9 nmol/l vs 14.3 nmol/l, acromegaly vs control), patients with acromegaly had marginally higher IPSS, PSA levels, and grades of enlarged prostate and obstructive features on uroflowmetry compared with controls. Dimensions of the prostate on ultrasonography were also significantly higher in patients. These changes were present irrespective of age, current gonadal status, and disease activity. Evidence of prostatic hyperplasia on biopsy was seen in six of 14 patients (42.8%) who underwent prostatic biopsy while it was absent in the controls. Immunohistochemistry with anti-IGF1 antibody showed moderate positivity in all the 14 patients who underwent biopsy with benign prostatic hyperplasia, compared with mild positivity in 21% of controls. Similarly, 14 control patients with prostatic malignancies showed variable positivity, four patients had strong, two each had mild and moderate positivity, while six were negative. Conclusions: In patients with acromegaly, there is a higher frequency of structural changes in the prostate, along with greater prostatic volume and obstructive features, compared with healthy controls, irrespective of age, gonadal status, and disease activity. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. We investigated the prostatic urethral lift, a novel, minimally invasive treatment for symptomatic lower urinary tract complaints presumed to be from benign prostatic hyperplasia (BPH), which aims to mechanically open the prostatic urethra without ablation or resection. We hypothesized that this novel approach would not degrade erectile or ejaculatory function. Aims. We sought to determine the effect of the prostatic urethral lift procedure on erectile and ejaculatory function. Methods. The procedure was performed on 64 men in Australia with an average age of 66.9 years and an average duration of lower urinary tract symptom (LUTS) of 4.7 years. Primary inclusion criteria included International Prostate Symptom Score (IPSS) > 13, Qmax of 5-12 mL/second, and prostate specific antigen (PSA) < 10 ng/mL. Baseline IPSS was 22.9 ± 5.4 (N = 64). There were no inclusion criteria for sexual function. Baseline Sexual Health Inventory for Men (SHIM) was 11.7 ± 8.6 (N = 58); baseline Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) function score was 9.0 ± 3.7 (N = 46); and lack of sexual activity or unwillingness to answer sexual function questionnaires accounted for the reduced sample size in the sexual function instruments. Implants were placed to separate encroaching lateral prostatic lobes. Main Outcome Measures. Patients were evaluated at 6 weeks and 3, 6, and 12 months postprocedure via the SHIM and MSHQ-EjD instruments. Results. There was no evidence of degradation in sexual function after treatment for LUTS with the prostatic urethral lift procedure. Erectile function, as measured by SHIM, was slightly increased at all time points as compared with baseline. No patient reported retrograde ejaculation at any follow-up visit. Conclusions. We demonstrated significant improvement in LUTS with no evidence of degradation in erectile or ejaculatory function after treatment with the prostatic urethral lift procedure. This procedure warrants further study as a new option for patients underserved by current treatments for LUTS/BPH. Woo HH, Bolton DM, Laborde E, Jack G, Chin PT, Rashid P, Thavaseelan J, and McVary KT. Preservation of sexual function with the prostatic urethral lift: A novel treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Sex Med 2012;9:568-575. [ABSTRACT FROM AUTHOR]

Summary Evidence synthesis, both qualitatively and quantitatively through meta-analysis, is central to the development of evidence-based medicine. Unfortunately, meta-analysis is often complicated by the suspicion that the available studies represent a biased subset of the evidence, possibly due to publication bias or other systematically different effects in small studies. A number of statistical methods have been proposed to address this, among which the trim-and-fill method and the Copas selection model are two of the most widely discussed. However, both methods have drawbacks: the trim-and-fill method is based on strong assumptions about the symmetry of the funnel plot; the Copas selection model is less accessible to systematic reviewers, and sometimes encounters estimation problems. In this article, we adopt a logistic selection model, and show how treatment effects can be rapidly estimated via multiple imputation. Specifically, we impute studies under a missing at random assumption, and then reweight to obtain estimates under nonrandom selection. Our proposal is computationally straightforward. It allows users to increase selection while monitoring the extent of remaining funnel plot asymmetry, and also visualize the results using the funnel plot. We illustrate our approach using a small meta-analysis of benign prostatic hyperplasia. [ABSTRACT FROM AUTHOR]

The authors examined the relation of parental age at birth to the risk of prostate cancer among sons with the use of data from the Framingham Study. During 42 years of follow-up (1949–1993), 141 prostate cancer cases occurred in 2, 164 men. All but six cases were confirmed by histologic report. The incidence rate of prostate cancer increased from 1.70 per 1, 000 person-years among sons in the lowest quartile of paternal age (<27 years), to 2.00, 2.32, and 2.74 among those of each increased paternal age category (27-<32, 32-<38, and ≥38 years). respectively. After adjustment for age and other covariates, men in the second, third, and oldest quartiles of paternal age had 1.2, 1.3, and 1.7 times increased risk of prostate cancer compared with men in the youngest quartile (p for trend = 0.049). Further adjustment for maternal age did not change the relation materially. The association of older paternal age with risk of early-onset prostate cancer (≥65 years) appeared stronger than that with late-onset disease (≥65 years). No increased risk of prostate cancer was observed among subjects in the older maternal age category. The effect of increased paternal age on prostate cancer risk may operate through increased germ cell mutation rate or by mechanisms not yet defined. Am J Epidemiol 1999; 150: 1208-12. [ABSTRACT FROM PUBLISHER]

Non-traumatic ureteral rupture has been reported more frequently, resulting from increased intraluminal pressures from distal urinary tract obstruction. We report the case of a 77-year-old man presenting with chronic urinary retention secondary to massive prostatic enlargement through acute kidney injury. Ultrasound scan detected a shallowleft perinephric fluid collection with a possible bladder mass, demonstrated on flexible cystoscopy to be a massive median lobe of prostate. Computed tomography confirmed extravasation of urine from the left proximal ureter. In the absence of specific symptoms, the patient had successful conservative management with antibiotics and urinary catheterization for his acute episode, although declined further surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Chronic Obstructive Pulmonary Disease (COPD) predominantly prevalent in men, is a chronic inflammatory disorder of the airway and lungs. COPD is associated with increased risk of Benign prostatic hyperplasia (BPH). Judging from the association between COPD and BPH in ageing male population, and the samilarities between receptors in airways and the urinary bladder. Objectives: the aim of the study was to show the effect of treatment of symptomatic BPH on the airways of COPD patients by spirometric assessment before and after starting treatment of BPH. Patients and Methods: The present study was conducted upon 60 subjects during the period from March 2019 to August 2019 in Ain Sham University Hospitals. Type of Study: prospective study, there were two groups of patients first group received tamsulosin and the second group received tamsulosin and solifenacin Results: By comparison of the two groups, there was non-significant change. as regard percent of change of forced vital capacity (FVC), first group’s median was 7.9% and second group median was 5.6%. as regard percent of change of forced expiratory volume 1 (FEV1), in first group’s median was 5.7% and second group’s median was 7.4%. Conclusion: There was significant improvement in spirometric values in each group before and after starting treatment, but by comparison between the two groups, there was insignificant change. [ABSTRACT FROM AUTHOR]

The article studies the relationship between Erectile Dysfunction (ED), Lower Urinary Tract Symptoms (LUTS), and Benign Prostatic Hypertrophy (BPH) that cause sexual disorders among aged men. The paper states that autonomic hyperactivity effects the LUTS, prostate growth, and ED. Providing the alternative pathway mechanisms such as Rho-kinase activation, endothelin activity, pelvic atherosclerosis, the author concludes that the combination of these mechanisms could reduce incidence of ED.

Conflict of Interest. Francesco Montorsi: Consultant for Pfizer Inc, GSK, Lilly Icos, Bayer, and AMS. Jackie Corbin: Supported by NIH DK40029 and DK58277; speaker for Pfizer Inc. and Bayer/GSK; research support from ICOS and Bayer. Stephen Phillips: Employee of Pfizer Inc., and investment interest (stock holder and share options). Introduction. With the success of Phosphodiesterase (PDE) type 5 inhibitors (i.e., sildenafil, tadalafil, vardenafil) in the treatment of erectile dysfunction (ED), PDEs are considered attractive targets for drug intervention in the urogenital tract. Aim. To review the role of PDEs, which exist as a superfamily of enzymes comprising 11 distinct families, in the urogenital system, focusing on anatomical locations, functions and dysfunctions, potential disorders that could be treated, and any promising new selective PDE inhibitors under development. Methods. Included are (i) abstracts from 2001, 2002, and 2003; (ii) a MEDLINE search from 1996 through December 2003; and (iii) a pipeline search for therapeutics in development. Data from animal experiments are presented when there is a paucity of human data, but with the caveat that the distribution of PDE isozymes in a specific tissue can vary between species. Results. PDE mRNA and protein have been localized throughout the normal human urogenital tract. Double-blind, placebo-controlled studies suggest possible new clinical roles for sildenafil, including prophylaxis to preserve penile smooth muscle and erectile function after radical prostatectomy, and treatment of ejaculatory delay secondary to serotonergic reuptake inhibitor antidepressant therapy. Open-label studies suggest a potential clinical role for: vinpocetine (a PDE1 inhibitor) in the treatment of incontinence and low-compliance bladder; and sildenafil in the treatment of premature ejaculation, prostate-related lower urinary tract symptoms, and in women who have had unsuccessful in vitro fertilization. Several new orally administered PDE5 inhibitors are in early clinical development for the treatment of ED. Potential indications for PDE inhibitors that are suggested by preclinical data include Peyronie's disease, ureteral colic, male and female birth control, and prevention of preterm labor. Conclusions. Drug selectivity and differential PDE tissue distribution allow for potential targeted intervention for numerous disorders related to the urogenital tract. [ABSTRACT FROM AUTHOR]

Reports on the impact of prostatism and benign prostatic hyperplasia (BPH) on elderly men living in the community. Prevalence of BPH; Urinary symptoms; Interference with daily activities; Factors causing high prevalence of urinary symptoms which increase with advancing age; management of the illness.

Benign prostatic hyperplasia (BHP) is a local disturbance in the prostate that may involve an intlammatory infiltrate predominantly composed of activated lymphocytes and macrophages. The activation and proliferative response of T lymphocytes to different mitogenic signals has been analysed in periphheral blood mononuclear cells (PMBC) from 45 patients with BHP and 55 healthy controls. The PBMC obtained from llic patients showed a significant specific impairment in proliferation, CD25 expression and lL-2 production in response to stimulation with lectins (phytohaemagglutinin (PHA), concanavalin A (Con A)), that was not corrected by the addition of IL-2 or phorbol esters (phorbol myristate)acetate (PMA)). Also, the CD28 response was defective in patient PBMC. Activation with anti-CD.1 or anti-CD2 MoAbs was normal, but the addition of PMA to these stimuli provoked a significant defective response. Only the use of transmembrane stimuli (PMA and ionomycin) elicited responses similar to those found in the control group. The results indicate that peripheral T lymphocytes from BPH patients show a functional impairment that is mainly explained by an alteration of membrane signals (PHA. CD28) and is distal to protein kinase C (PKC) activation. [ABSTRACT FROM AUTHOR]

Background: benign prostatic hyperplasia (BPH) is a disorder histologically characterized as the nonmalignant hyperplasia of prostatic cells. Most of patients with benign prostate hyperplasia present with lower urinary tract symptoms (LUTS). Aim of the study: to assess the efficacy and safety of fixed-dose combinations therapy of Tamsulosin & Tadalafil versus Tadalafil alone in treatment for BPH patient with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Patients and Methods: this is a randomized controlled clinical study at Urology Department, Faculty of Medicine, Ain Shams University (El Demerdash Hospital) & Damanhour National Institute Hospital from 1-1-2018 till 1-9-2018. It concluded men of 45 years old or older with a history of LUTS secondary to BPH of at least 6 months were eligible for this study. Patients agreed not to use BPH medications during the research other than the study medications. Results: the study showed that the fixed-dose combinations of Tamsulosin and Tadalafil significantly improve IPSS score and Qmax more than with Tadalafil 5 mg/day alone. Furthermore, PVRU significantly decreased with the fixed-dose combinations of Tamsulosin and Tadalafil more than with Tadalafil alone. Fixed-dose combinations of Tamsulosin 0.4mg plus Tadalafil 5mg were determined to be safe, efficacious, and well tolerated in the subjects investigated, which suggests the new fixed-dose combinations therapy can offer clinically relevant benefits for patients with LUTS complaints and desiring amelioration for comorbid ED complaints. Conclusion: the study shows that the fixed-dose combination of Tamsulosin 0.4mg/day and Tadalafil 5mg/day are significantly superior to Tadalafil 5mg/day alone for the treatment of BPH patients with LUTS and non-inferiority in treatment of ED Without showing any clinically significant safety issues, supporting favorable benefit-risk balance of the fixed-dose combinations of therapy for the treatment of BPH patients with LUTS and ED because of its synergistic effects, well toleration and its safety. [ABSTRACT FROM AUTHOR]

In contrast, the Prostatic Urethral Lift (PUL) has been shown to deliver rapid and significant symptom improvement with low morbidity and preservation of sexual function. To evaluate symptom response and sexual function results of PUL across all types of prostate enlargement including obstructive median lobe (OML) the MedLift trail was undertaken. [Extracted from the article]

Presents news on health and aging as of September 2004. Impact of benign prostatic hypertrophy on the quality of life of older males; Comparison between religious conviction and health in several Israeli employees; Benefits of closed surgery to old people.

A 57-year-old male retired Army Colonel living in Virginia presented to Bethesda Naval Hospital for evaluation of a 4-day history of swelling and pain in both ankles. Swelling initially began in the left ankle and progressed to involve the right ankle and mid-foot region. Aggravating factors included dorsiflexion of the foot and weight bearing. His recent past medical history was significant for prostatitis that was diagnosed 2 months earlier. Other chronic medical problems included hypertension, benign prostatic hypertrophy, and gastroesophageal reflux. He was taking omeprazole, lisinopril, enteric coated aspirin, tamsulosin, and levofloxacin. The patient recalls a single episode of fevers and chills 1 day prior to the onset of the foot and ankle pain. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 69-year-old man with an erythematous patch on the thenar eminence of his right palm. It mentions that the patient has a medical history of recurrent otitis, hepatitis and treated prostatic hyperplasia as well as systemic therapy with antimycotics for onychomycosis treatment. It also notes his diagnosis with circumscribed acral hypokeratosis (CAH) which is considered an infrequent benign dermatosis.

ABSTRACT Introduction. Recent data have shown that plasmakinetic enucleation of the prostate (PKEP) is a novel and effective procedure for symptomatic benign prostatic hyperplasia (BPH); however, data on patient sexual function after PKEP remain scarce. Aims. This study aims to evaluate the impact of PKEP on sexual function in men with lower urinary tract symptoms because of BPH. Methods. One hundred eighty-six consecutive patients who underwent the PKEP procedure were prospectively enrolled in this study. The International Index of Erectile Function (IIEF-15) and the International Prostate Symptom Score with quality of life scores were completed and compared preoperatively and at 1, 3, 6, and 12 months postoperatively. At each follow-up visit, maximum urinary flow rates, transrectal ultrasound-assessed prostate volume, postvoid residual urine volume, and serum prostate-specific antigen level were also measured and compared with the baseline. Main Outcome Measures. The IIEF global score and its five domains scores were evaluated for each patient, and the Friedman test or chi-square test was used to identify changes from the baseline. Results. There was a slight and nonsignificant increase in the IIEF global score and four of its five domains scores (i.e., erectile function, intercourse satisfaction, sexual desire, and overall satisfaction) at each postoperative assessment ( P > 0.05 for all). However, a statistically significant reduction was observed in the orgasmic function domain score of IIEF at 3 months ( P = 0.016), 6 months ( P < 0.001), and 12 months ( P < 0.001), respectively, along with the corresponding retrograde ejaculation rates of 48.7%, 49.4%, and 48.8%. Conclusions. PKEP has no negative influence on the quality of erections measured by the self-administered IIEF questionnaire, but it significantly lowers the orgasmic function domain score, reflecting probably postoperative retrograde ejaculation. These findings are important in preoperative counseling of the patients undergoing PKEP for symptomatic BPH. Zhao Z, Ma W, Xuan X, Ou L, Liang Y, and Zeng G. Impact of plasmakinetic enucleation of the prostate (PKEP) on sexual function: Results of a prospective trial. J Sex Med 2012;9:1473-1481. [ABSTRACT FROM AUTHOR]

Presents an abstract of the report `Does urodynamic data from patients with benign prostatic hypertrophy correlate with prostatic collagen, muscle and glandular content?,' by K.J. Ng et al, presented during the Autumn Meeting of the British Geriatrics Society on October 13 and 14, 1995 in London, England.