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Introduction:The inverse relationship between benign prostate hypertrophy and incidence/severity of prostate cancer is well documented in the clinical literature. However, this phenomenon i...

Background Studies have shown that human polyomavirus infection may be associated with various human cancers. We investigated the potential relationship between the prevalence of JCPyVor BKPyV and prostate cancer (PC) in patients from Taiwan. Methods Patients with PC and benign prostate hypertrophy (BPH; 76 and 30 patients, respectively) were recruited for this study. Paraffin-embedded tissues and clinical information of the patients were obtained. The tissue sections were used for viral DNA detection and immunohistochemistry analysis was performed for examining viral large T (LT) and VP1 proteins. Regression analysis was used to evaluate the relationship between the clinical characteristics of the patients and the risk of JCPyV/BKPyV infection. Results The prevalence of JCPyV/BKPyV DNA was different in PC and BPH tissues (27/76 [35.52%] and 2/30 [6.7%], respectively, p = 0.003)]. The LT and VP1 proteins were detected in 27 (35.52%) and 29 PC (38.2%) specimens, respectively, but neither protein was detected in BPH samples (p p = 0.003). Patients with PC showing high levels of prostate-specific antigen and high Gleason scores were associated with a high risk of viral infection (ORs 1.1, 95% CI 1.000–1.003; p = 0.045 and ORs 6.18, 95% CI 1.26–30.33, p = 0.025, respectively). The expression of LT protein associated with the risk of PC increased 2923.39-fold (95% CI 51.19–166,963.62, p Conclusions The findings indicate that JCPyV infection in PC cells may be associated with prostate cancer progression and prognosis. Graphical abstract

Giant multilocular cystadenomas of the prostate or seminal vesicles are rarely reported in literature. We present a case of a 76-year-old male presenting with lower urinary tract symptoms initially perceived as symptoms of benign prostatic hyperplasia. The patient was investigated by employing a multimodality imaging approach of the prostate that included ultrasound, computed tomography, and magnetic resonance imaging, which resulted in an incidental finding of large multiloculated benign cysts originating from the prostate, confirmed by pathological study. This case report highlights the multimodality imaging approach in the detection and diagnosis of this rare disease. Keywords: Multilocular cystadenoma, Prostate, Seminal vesicles, Pelvis, Benign prostate hypertrophy

This article demonstrates the use of a representative commercially available automated vessel-tracking software originally intended for liver-only application (Vessel Assist Flight Plan for Liver; GE) in 4 patients. Treatment settings included embolization of small bowel hemorrhage source, treatment of renal cell carcinoma, management of symptomatic benign prostate hypertrophy, and detection with subsequent closure of a mesenteric pseudoaneurysm. All patients were treated successfully.

Backgrounds The aim of the present study was to investigate the perioperative parameters associated with bladder neck contracture (BNC) after transurethral surgery of the prostate and to compare the incidence of BNC after transurethral resection of the prostate (TURP) or Thulium vaporesection (resection group) versus Thulium vapoenucleation or enucleation of the prostate (enucleation group). Methods Between March 2008 and March 2020, 2363 patients received TURP and 1656 patients received transurethral surgery of the prostate with Thulium laser (ThuP) at Mackay Memorial Hospital. A total of 62 patients developed BNC. These BNC patients were age-and operation-matched to 124 randomly sampled TURP/ThuP controls without BNC. A 1:1 propensity score matching model was used to evaluate the difference in incidence of BNC. Results Our study demonstrated that a greater proportion of BNC patients had history of cerebrovascular accidents (11/62 vs. 7/124, p = 0.009), coronary artery disease (14/48 vs. 16/108, p = 0.03), chronic kidney disease (14/62 vs. 11/124, p = 0.01), and two or more comorbidities (29/62 vs. 27/124, p = 0.001) compared with NBNC patients. Multivariate analysis showed that smaller prostate volume (OR 0.96 (0.94–0.99), p = 0.008) and recatherization (OR 5.6 (1.02–30.6), p = 0.047) were significantly associated with BNC. A ROC curve predicted that a prostate volume 3 was associated with a notably higher rate of BNC. The propensity score matching model reported there was no difference in incidence between resection and enucleation groups. Conclusion This study demonstrated that incidence of BNC was the same in different surgical techniques and that low prostate volume, recatherization and ≥ 2 comorbidities were positively correlated with the development of BNC after TURP or ThuP.

Aim: Many studies support an inverse relationship between benign prostate hypertrophy (BPH) size and incidence of prostate cancer (PCa), but the causal link between these conditions is poorly understood. Recent studies suggest that a growing transition zone (TZ) in the prostate may induce pressure on the outer peripheral zone (PZ), leading to atrophy of the glandular tissue where PCa often originates, providing a possible explanation for this interaction. To further investigate this phenomenon, our pilot study uses magnetic resonance imaging (MRI) to examine quantitative zonal changes in a consecutive cohort of prostates. Methods: MRI scans of male patients [ n = 204, 61.57 ± 13.90 years, average body mass index (BMI) 29.05 kg/m2] with various prostate sizes were analyzed statistically to identify possible associations between prostate parameters, such as total prostate volume (TPV) and peripheral zone thickness (PZT). Results: TPV and PZT demonstrated a weak, inverse correlation ( r = −0.21, p = 0.002). However, when examining the plotted data, the relationship between TPV and PZT was significantly different when the cohort was divided into two groups; lower TPV: ⩽87.5 ml ( n = 188, TPV xˉ = 36.01 ± 18.18 ml), and higher TPV: >87.5 ml ( n = 17, TPV xˉ = 125.69 ± 41.13 ml). Average PZT differed significantly between these groups (z = −3.5554, p = 0.0004). Conclusions: PZT was significantly different for patients with lower versus higher TPVs, suggesting that, above a certain point of BPH growth, the PZ is unable to withstand pressure from an expanding TZ, supporting the notion that growing BPH causes compression of the PZ glandular tissue, and, therefore, BPH may be protective against PCa.

Introduction: Prostate cancer (PCa) is the second most commonly diagnosed cancer and the sixth most common cause of cancer-related mortality among men worldwide. Obesity increases the prevalence and mortality of multiple cancers. Consequently, the relationship between obesity and cancer is receiving more and more attention. Objective: To evaluate the impact of body mass index (BMI) on prostate cancer detection and aggressiveness in Cameroonian population. Methodology: This was a comparative cross-sectional study carried out at the hospitals in Cameroon. The study included Cameroonians who underwent prostate biopsies during a 9-year period, from 2008 to 2016. We analysed the BMI, age, prostate volume, and PSA of patients with prostate cancer in comparison with patients with benign prostate tissue who underwent prostate biopsies. Data entry was performed using CSpro 6.3.2, analysis was done using SPSS version 23.0. Results: A total of 316 patients were included in our study, 158 PCa and 158 BPH. The patients had a mean age ± standard deviation of 67.8 ± 10.32 with a modal class of 61 and 70 years. In our study, the mean age ± SD of the PCa group (71.48 ± 8.96) was significantly greater than that of the BPH group (64.17 ± 10.31) (p 0.05). The median total PSA and the median PSA f/t ratio was significantly different in both groups (p

Prostate cancer (PCa) is one of the most common cancers in male population. Multiparametric prostate magnetic resonance imaging (mp-MRI) has assumed a primary role in the diagnosis of PCa, combining morphological and functional data. Among different sequences, functional diffusion weighted imaging (DWI) is a powerful clinical tool which provides information about tissue on a cellular level. However, there is a considerable overlap between either BPH (Benign Prostate Hypertrophy) and prostatic cancer condition, as a different DWI signal intensity could be shown in the normal architecture gland. Apparent diffusion coefficient (ADC) has shown an increasing accuracy in addition to the DWI analysis in detection and localization of PCa. Notably, ADC maps derived DWI sequences has shown an overall high correlation with Gleason score (GS), considering the importance of an accurate grading of focal lesion, as main predictor factor. Furthermore, beyond the comparative analysis with DWI, ADC values has proven to be an useful marker of tumor aggressiveness, providing quantitative information on tumor characteristics according with GS and Gleason pattern, even more strenuous data are needed in order to verify which ADC analysis is more accurate.

Background Three-quarters of aged men experience lower urinary tract symptoms with benign prostate hypertrophy (BPH). Transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) are standard endosurgical procedures in patients with BPH. Previous studies reported better results in patients undergoing HoLEP than in those undergoing TURP. Methods This study compared the efficiency and safety of conventional morcellation and morcellation performed after X-incision during enucleation, a newly added technique in HoLEP. Overall, 174 patients were selected as the final study population. The populations were stratified with respect to resected volumes. A t-test were used to compare the conventional morcellation and X-incision procedure groups. Results In morcellation times and rates, there were significant differences in stratified resected mass (g) between the groups. The results also showed a decreased incidence of bladder injury as a surgical complication. Conclusion We believe morcellation performed after X-incision procedure during enucleation is efficient and safe for older adults with BPH.

International audience; Objective - To assess the association between 5α-reductase inhibitor (5-ARI) use and high grade (Gleason score 8-10) prostate cancer. Patients and methods - We conducted a population-based nested matched case-control study using the French national health insurance database linked to data from all pathology laboratories in Brittany, France. Among 74 596 patients with ≥1 drug reimbursement for symptomatic benign prostate hypertrophy (BPH) between 1 January 2010 and 31 December 2011, 767 incident prostate cancer cases between 1 January 2012 and 31 December 2013 were matched according to age and delay between the first observed delivery of drug for BPH (5-ARIs, α-blockers or phytotherapy) and diagnostic date of the case to five control patients, using an incidence density sampling design. Results - A total of 963 patients (153 cases, 810 controls) had been exposed to 5-ARIs. A significant heterogeneity (P = 0.005) was detected across cancer grades when estimating the association between prostate cancer and long-term (≥2 years) 5-ARI use vs no 5-ARI exposure: adjusted conditional odds ratio 1.76 (95% confidence interval [CI] 0.97-3.21) for Gleason score ≥8 and 0.64 (95% CI 0.44-0.93) for Gleason score < 8. Conclusion - Our results indicate an increased risk of high grade and a decreased risk of low grade prostate cancer associated with 5-ARI use. Patients treated for >2 years with 5-ARIs should be informed about the increased risk of development of high grade disease.

The histoculture drug response assay (HDRA) has been adapted to determine androgen sensitivity in Gelfoam histoculture of human benign prostatic tissue as well as prostate cancer. Gelfoam histoculture was used to measure androgen-independent and androgen-dependent growth of benign and malignant prostate tissue. The androgen-sensitivity index was significantly higher in 23 paired specimens of prostate cancer compared to benign prostate hypertrophy (BPH). Genistein decreased the androgen-sensitivity index of BPH and prostate cancer in Gelfoam® histoculture in a dose-dependent manner.

WOS:000423752200014 PubMed: 28853814 Purpose: Congenital and acquired pathologies of the seminal vesicles (SV) are rare diseases. The diagnosis of SV anomalies is frequently delayed or wrong due to the rarity of these diseases and the lack of adequate evaluation of SV pathology. For this reason, we aimed to comprehensively evaluate SV pathologies and accompanying genitourinary system abnormalities. Materials and Methods: Between March 2012 and December 2015, 1455 male patients with different provisional diagnosis underwent MRI. Congenital and acquired pathology of the SV was identified in 42 of these patients. The patients were categorized according to their SV pathologies. The patients were analyzed in terms of genitourinary system findings associated with SV pathologies. Results: SV pathologies were accompanied by other genitourinary system findings. Congenital SV pathologies were bilateral or predominantly in the left SV. Patients with bilateral SV hypoplasia were diagnosed at an earlier age compared to patients with unilateral SV agenesis. There was a significant association between abnormal signal intensity in the SV and benign prostate hypertrophy (BPH) and patient age. Conclusion: SV pathologies are rare diseases of the genitourinary system. The association between seminal vesicle pathology and other genitourinary system diseases requires complete genitourinary system evaluation that includes the seminal vesicles.

Objectives Elderly patients seem vulnerable to digoxin toxicity because of their diminished organ functions and tendency to encounter drug interactions. The aim of this research was to explore the extent of the concurrent use of digoxin with Chinese medications (CMs), its contributing factors, and the relevant consequences. Methods A retrospective population-based cohort study was conducted using Longitudinal Health Insurance databases in Taiwan. Those elderly patients being prescribed with digoxin in outpatient settings in 2006 were evaluated for the incidence, prevalence, and duration of concurrent use with concentrated CMs in 2006. After 1:1 random matching to select the corresponding digoxin-only elderly users, univariate and multivariate logistic regression analyses were performed to explore factors associated with concomitant incident digoxin-CM use and incident digoxin-specific CM use. The relevant clinical and economic outcomes for a 3-month follow-up period from the initial exposure of incident digoxin-CM use were compared. Results Of 185,076 elderly, 6,374 were prescribed with digoxin and 789 were CM-digoxin users in 2006. The prevalence and incidence of concomitant CM use among digoxin elderly users were 0.43% and 0.22%, respectively. Although the other factors were not statistically significantly associated with incident CM-digoxin use, patients with heart diseases and with benign prostate hypertrophy had an increased likelihood of incident CM-digoxin use of 115% and 102%, respectively. Almost all the concerned clinical and economic outcomes were not statistically significantly different between incident exposure or not, except for the use of potassium-sparing and nonsteroidal anti-inflammatory drugs. Conclusions There was a relatively low incidence of digoxin-CM use among the elderly in Taiwan. Although no significant effects on clinical and economic outcomes occurred, it is necessary to monitor potential side effects of digoxin more aggressively for those vulnerable elderly using digoxin with CMs, especially for those who tended to expose to incident digoxin-CM use elderly patients.

The aim of this study was to determine whether there are correlations between medication use for lower urinary tract symptoms/benign prostate hypertrophy (LUTS/BPH) and alteration in incidence and indications for transurethral resection of the prostate (TURP).The number of TURP patients between 1984 and 2008 in Iceland was obtained from hospital registries. The number of defined daily doses (DDDs) of 5-alpha-reductase inhibitors (5aRIs) and alpha-blockers (ABs) sold was obtained from the Icelandic Medicines Control Agency. Charts of all surgical BPH patients in Iceland from 1998 to 2008 were retrospectively reviewed. The main outcomes measures were: DDDs sold of 5aRIs and ABs, total numbers of TURP, indications for TURP and complications.After the introduction of ABs and 5aRIs, sales increased annually at a near linear rate. TURP rates peaked in 1992, then declined. In 2008, 81 and 3.4 of 1000 men over the age of 50 used LUTS/BPH medications or underwent TURP, respectively. There was an inverse correlation between LUTS/BPH medication use and (i) overall TURP (R(2) = 0.85), (ii) TURP done for absolute indications (R(2) = 0.91), and (iii) LUTS with (R(2) = 0.77) and (iv) without previous medical therapy (R(2) = 0.75). As medication use rose, fewer TURPs were performed for previous history of urinary retention, and more for recurrent urinary tract infections.Increased use of ABs and 5aRIs in the Icelandic population correlated with decreasing incidences of TURP procedures for both LUTS and absolute indications. The sequelae of BPH and indications for TURP are changing as medication use increases, although a clear causative link is hard to establish.

Resume La resection transuretrale de prostate (RTUP) reste le traitement chirurgical de reference de l’hypertrophie prostatique compliquee ou refractaire au traitement medical. La photovaporisation prostatique (PVP) au laser Greenlight ® a ete developpee dans le but d’ameliorer la securite de l’hemostase. Le but de ce travail etait de rapporter les resultats de la PVP a partir de la litterature. Materiel et methode Une revue systematique de la litterature sur la base de recherche Pubmed etait effectuee en utilisant les mots cles : benign prostate hyperplasia ; greenlight ; photovaporisation ; Laser ; IPSS score ; endoscopicsurgery ; morbidity ; complication . Les etudes prospectives et retrospectives etaient selectionnees a partir de la premiere utilisation chez l’homme en 1998. Resultats Certains parametres techniques sont bien definis (vitesse de rotation de la fibre, angle d’attaque et distance avec le tissu) mais d’autres restent debattus (nombre de joules par volume prostatique). Versus RTUP, la PVP offrirait les memes resultats fonctionnels a moyen terme mais avec un risque de saignement plus faible. L’heterogeneite des techniques d’evaluation et des populations etudiees rend difficile l’evaluation de la fonction erectile mais elle ne semblerait pas associee a un risque accru versus RTUP. L’absence de materiel histologique devrait motiver un depistage du cancer de prostate avant PVP. L’economie generee par la diminution de la duree moyenne de sejour n’a pas ete formellement analysee en France. Conclusion La PVP est une technique sure. Le nouveau generateur XPS semble arrive a maturite. Son developpement permettra certainement d’obtenir une evaluation a long terme avec des niveaux de preuve satisfaisants.

BACKGROUND The aim of this study was to investigate the potential contribution of acoustic radiation force impulse (ARFI) elastography to the determination of the severity of benign prostate hypertrophy (BPH) by performing shear wave velocity (SWV) measurements of the prostate using ARFI technology. MATERIAL AND METHODS Sixty BPH patients and 40 healthy volunteers were included in this study. SWV measurements of the prostate were performed by transabdominal ultrasonography (US), both in the BPH patients and control subjects. The BPH patients also underwent uroflowmetry measurements. Using the International Prostate Symptom Score (IPSS), the BPH patients were divided into two subgroups, a mild-to-moderate BPH group and a severe BPH group, to compare SWV values. RESULTS The BPH patients had higher SWV values for the central area of the prostate compared to the control subjects (2.52±0.59 m/s and 1.47±0.42 m/s, p

Hypovitaminosis D is increasingly recognized as a cofactor in several diseases. In addition to bone homeostasis, vitamin D status influences immune system, muscle activity and cell differentiation in different tissues. Vitamin D is produced in the skin upon exposure to UVB rays, and sufficient levels of serum 25(OH)D are dependent mostly on adequate sun exposure, and then on specific physiologic variables, including skin type, age and Body Mass Index (BMI). In contrast with common belief, epidemiologic data are demonstrating that hypovitaminosis D must be a clinical concern not only in northern Countries. In our study, we investigated vitamin D status in a male population enrolled in a urology clinic of central Italy. In addition, we evaluated the correlation between vitamin D status and UVB irradiance measured in our region. The two principal pathologies in the 95 enrolled patients (mean age 66years) were benign prostate hypertrophy and prostate carcinoma. >50% of patients had serum 25(OH)D values in the deficient range (

金沢大学附属病院泌尿器科, Purpose. We performed a randomised controlled study regarding the effects of androgen replacement therapy (ART) on lower urinary tract symptoms (LUTS) in hypogonadal men with benign prostate hypertrophy (BPH). Methods. Fifty-two patients with hypogonadism and BPH were randomly assigned to receive testosterone (ART group) as 250 mg of testosterone enanthate every 4 weeks or to the untreated control group. We compared International Prostate Symptom Score (IPSS), uroflowmetry data, post-voiding residual volume (PVR) and systemic muscle volume at baseline and 12 months after treatment. Results. Forty-six patients (ART group, n=23; control, n=23) were included in the analysis. At the 12-month visit, IPSS showed a significant decrease compared with baseline in the ART group (15.7±8.7 vs. 12.5 ± 9.5; p < 0.05). No significant changes were observed in the control group. The ART group also showed improvement in maximum flow rate and voided volume (p < 0.05), whereas no significant improvements were observed in the controls. PVR showed no significant changes in either group. In addition, the ART group showed significant enhancement of mean muscle volume (p < 0.05), whereas no significant changes were seen in the controls. Conclusion. ART improved LUTS in hypogonadal men with mild BPH. © 2010 Informa UK, Ltd.

Generally, in Europe quality assurance is demanded increasingly in health care settings. European Health Act specifies new demands concerning quality assurance through documentation, monitoring of health services and follow-up considering patient flow and optimal use of resources. The aim of this study was to investigate the agreement between European guidelines and clinical practice and the association between patient satisfaction and level of documentation, recommendations and improvements of voiding function in patients with benign prostate hypertrophy (BPH). The study population encompassed men between 60 and 80 years referred to specialist treatment due to lower urinary tract symptoms. Random samples of 250 medical records were extracted from national registers. Indicators were reported as proportions. Bivariate and multivariate analyses were reported as odds ratio with a 95% confidence interval. A total of 178 patient pathways were included, and the overall documentation rate was 77%. Agreement between national recommendations and clinical practice was found in 38%. No significant associations were found regarding patient satisfaction and level of documentation, adherence to national guidelines and improvements of the voiding function. There is a need for stringency in quality assessment and reporting indicators to national databases and increased application of European evidence-based guidelines. More complete are necessary for decision-makers in the future to qualify management of BPH rehabilitation ensuring the quality of the individual patient pathways.

Background Prostate cancer (Pca) disease burden is highest among male blacks. Oxidative stress due to hemoglobin-related oxygen reactive species is a risk factor for cancer development. The polymorphic haptoglobin (Hp) protein inhibits hemoglobin-related oxidative stress. The antioxidant capacity of Hp is genetically determined. We studied the effect of Hp polymorphism on susceptibility to Pca. Subjects and methods In a case–control study, 201 participants (60 hospital-based controls, 62 benign prostate hypertrophy (BPH) and 79 prostate cancer (Pca) patients were studied. Serum prostate specific antigen (PSA) was measured using an immunoradiometric assay and Hp phenotype was determined using starch gel electrophoresis. Haptoglobin phenotype distribution was compared between groups according to disease state. Results Serum PSA concentrations were markedly elevated in BPH and Pca patients compared to control subjects. Overall, Hp 1–1 was present in 50 individuals (25%), Hp 2–1 in 91 persons (46%) and 46 subjects (23%) had Hp 2–2. Thirteen individuals (6%) were anhaptoglobinaemic. The Hp1 allele frequency was not significantly different according to clinical history; 0.472 (95% CI 0.343–0.601), 0.567 (95% CI 0.395–0.619) and 0.507 (95% CI 0.441–0.693) for control group, BPH and Pca patients, respectively. Conclusion Our results suggest that Hp polymorphism is neither associated with risk of developing Pca nor outcome of the disease.

Jack is a 78-year-old retired salesman who presents with a 3-week history of left lower back pain that began without any identifiable inciting cause. Jack has a past medical history that includes coronary artery disease with two stents placed, hypertension, diabetes type II, benign prostate hypertrophy, chronic obstructive pulmonary disease, gall bladder surgery, and diverticulitis. Although his medical history is significant, Jack considers himself to be “pretty healthy all things considered.”

The aim of this study is to evaluate the accuracy of three-dimensional (3D) ultrasound in comparison with conventional bidimensional (2D) sonography in prostatic calculations. The study was performed using a Kretztechnik Voluson 530D machine with a 7.5 MHz endocavitary transducer. From March 1998 to March 2000, we examined 80 patients (63–74 years, mean 68 years). There were 59 patients with benign prostate hypertrophy (BPH) and 21 with prostate cancer awaiting a radical prostatectomy. The mean absolute error in 3D ultrasound measurement was ±0.2–3 mL. (range of error was 6.5%). Volume measurement using 2D ultrasound methods was much less accurate than 3D ultrasound methods: ±0.4–5 mL. (range of error was 35%). Both 2D and 3D measurements show that the margin of error depends on the frequent presence of a third prostatic lobe, on the morphology, and on the size of the prostatic gland. The precise estimation of prostate volumes may provide information on the real effectiveness of some therapies that act on the reduction in volume of benign alteration, such as in prostatic hypertrophy, and may eliminate the current limits of 2D sonography with a significant clinical contribution for virtually no extra cost.

A retrospective study was carried out on patients with gastrointestinal complaints, who were accidentally found to have varying degrees of hydronephrosis between October 1989 and April 1991. The criteria for hydronephrosis given by Ellenbogen et al were used for ultrasonographic diagnosis. Grade 0 and 1 were classified as mild degree and grade 2 and 3 as moderate and severe, respectively. The causes of hydronephrosis were determined by intravenous pyelography, retrograde pyelography, and/or computed tomography. Of 44 patients with hydronephrosis who had complete studies, 20 had a mild degree of hydronephrosis, 18 had a moderate degree, and 6 had a severe degree. All 24 patients with moderate and severe degrees of hydronephrosis had obstruction as the etiology, but only 50% of the cases with mild hydronephrosis were found to have pathological lesions. Urolithiasis (79.4%) was the most common cause of hydronephrosis in this study. Benign prostate hypertrophy, carcinomas, external compression, and tuberculosis followed. Hydronephrosis found accidentally by sonography in the patients with gastrointestinal complaints is significant.

The significance of six sextant ultrasound guided biopsies of the prostate (SS-biopsy) was evaluated in a total of 114 patients. The presence of prostate cancer was suspected (Pca) in 59 subjects through mass screening (MS) for Pca and in 47 patients in out-patient clinics (OPC). The recurrence (REC) was suspected in 3 patients diagnosed previously as Pca. All of them had elevated PSA, abnormal digital rectal examination (DRE) and/or abnormal transrectal ultrasonography (TRUS). All of these tests in 5 patients with benign prostate hypertrophy (BPH) were normal. Moreover, in 34 patients among them, oriented biopsies were performed to the area where Pca was suspected by DRE and or TRUS. Twelve Pca patients were detected in MS group (20.3%), 17 Pcas in OPC group (36.2%) and 3 Pcas in REC group (100%). No Pca patients were detected in BPH group. In 12 Pca patients with T1 or T2, only one Pca patient (8.3%) had over 3 Pca samples among the samples obtained by SS-biopsy. In 20 patients with T3 or T4, 13 patients (65%) had over 3 Pca samples. There was significant relationship between T category and Pca sample numbers among 6 samples obtained by SS-biopsy (p < 0.01). Ten of 12 Pca patients in MS group (83.3%) and 8 of 17 patients in OPC group (47.1%) had less 3 Pca samples. Pca was detected in 9 of 34 patients examined by the oriented biopsy. However al of these Pca were detected by SS-biopsy. It may be not necessary to examine Pca suspected patients by the oriented biopsy if they were examined by this SS-biopsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Tai chi exercise has been recommended as suitable for the improvement of health in the elderly. The purpose of this study was to investigate the effects of tai chi on lower urinary tract symptoms (LUTSs), quality of life (QoL), and sex hormone levels in patients with benign prostate hypertrophy (BPH). The elderly patients with BPH were randomized to receive tai chi or usual care. Fifty-six participants were randomized into either the tai chi group (n=28) or the control group (n=28). After 12 weeks of treatment, the tai chi group showed significant improvement in LUTS and QoL. There was a significant effect of tai chi on testosterone but no significant effect on insulin or glucose. No serious adverse events were observed during the study period. In conclusion, our results suggest that 12 weeks of tai chi may improve LUTS and QoL in elderly patients with BPH.

Up to now control of the microwave heating of the prostate was only possible with rectal or urethral surface catheters. This problem has finally been solved with the help of the Prostcare apparatus (Bruker Spectrospin, Wissembourg, France) and radiometry: the prostate can be treated by the urethral or endorectal route with a 915-MHz generator and coaxial antennae, a unique device which allows us to measure real intraprostatic temperature, to regulate the microwave emission power and to eliminate classic surface controls. A sole antenna is used for the urethral catheter; it is introduced within the Foley-type probe and allows us to heat and measure the heat (radiometry). In this preliminary report, we present clinical results of the first 105 treated patients over 18 months by the transurethral route in a single 1-hour session: 7 have a protuberant median lobe and the treatment is without any effect; 76 patients can be analyzed and the Madsen score before treatment, at 3 months and at 6 months moves from 11.2 to 2.5 and 3.1, the maximum flow rate from 9.6 to 12.3 and 12.5 ml/s, the residue decreases from 102 to 68 and 53 ml. The session is well tolerated and patients mention that the effects are better than those of medical treatment. Hyperthermia is a simple method that will find its place between medical and surgical treatment once the numerous randomized studies have determined the most suitable therapeutic procedures.

Elevated vascular endothelial growth factor (VEGF) blood concentration reflects its prostatic production, making this a potentially interesting tumour marker to support the decision of submitting a patient for prostatic biopsy. The objective was to review systematically the evidence on the role of VEGF blood concentration in prostate cancer detection. Published studies addressing the relation between serum or plasma VEGF levels and prostate cancer were identified by searching Pubmed, ISI Web of Knowledge, SCOPUS and LILACS up to January 2010, and reviewed following a standardized protocol. Three studies reported higher plasma VEGF (pg/ml) in patients with localized prostate cancer than in healthy controls (7.0 vs. 0.0, 9.9 vs. 2.2, and 210 vs. 26.5, P

You are asked to evaluate an 80-year-old retired railroad porter who stumbled and fell while walking his dog. He has left upper extremity and forehead abrasions. According to his family, he lives alone and is completely independent. The patient denies any medical problems with the exception of diabetes mellitus and benign prostate hypertrophy. He has a normal mental status and is hemodynamically stable. Outside of the abrasion, patient’s physical examination is unremarkable. Which of the following should be the management plan for this patient? (A) Overnight observation in the hospital (B) Outpatient management (C) Refer patient to a rehabilitation center (D) Obtain plain radiography of the head (E) Obtain head computed tomography scan

Aim: To investigate the frequency of atypical adenomatous hyperplasia (AAH) and its associations with benign prostate hypertrophy (BPH) and latent histological carcinoma of the prostate (LPC) in autopsy material. Methods: Two hundred and twelve prostate specimens obtained from autopsy material were subjected to whole mount analysis in an attempt to investigate the associations among BPH, AAH and LPC. Results: Most histological carcinomas and AAH lesions were found in enlarged prostates with intense hypertrophy. No statistically significant relation was found between BPH and the main characteristics of LPC, such as tumor volume, histological differentiation and biological behavior. Our data regarding multi-focal tumors showed a tendency for multi-focal carcinomas to develop in larger prostates, and a tendency of AAH lesions to develop in larger prostates. No statistically significant relation was found between AAH and LPC. Conclusion: There seems not any causative aetiopathogenetical or topographical relation between AAH lesions and prostate adenocarcinoma. AAH lesion seems to be a well-defined mimicker of prostatic adenocarcinoma, and the reported association of AAH with prostatic carcinoma could probably be an epiphenomenon.

Benign prostate hypertrophy (BPH) is the most common benign tumor in men due to obstruction of the urethra and, finally, uremia. Malondialdehyde (MDA) is a product derived from peroxidation of polyunsaturated fatty acids and related esters. Evaluation of MDA in serum represents a non-invasive biomarker of oxidative stress. Prostate-specific antigen (PSA) is a sensitive marker for prostatic hypertrophy and cancer. We analyzed MDA serum levels to evaluate the oxidative stress in BPH. To this end, 22 BPH patients and 22 healthy donors were enrolled. Data show an increase of MDA level in BPH patients and a positive correlation between PSA and MDA levels. In conclusion, we describe a previously unknown relationship between PSA and MDA as an index of inflammation and oxidative stress in BPH.

Although general consensus exists that percent free prostate-specific antigen (PSA) is superior to total immunoreactive PSA for prostate cancer (CaP) detection, its diagnostic performance is not yet well established. Analytical problems may account for difficulties in evaluating percent free PSA because the free PSA concentration is substantially lower than that of total PSA. The aim of the present study was to establish the diagnostic performances of the IMMULITE percent free PSA assay from Diagnostics Products Corp. under experimental conditions optimized to minimize analytical variability. Eighty-five patients with untreated primary CaP and 261 with untreated benign prostate hypertrophy (BPH) were prospectively enrolled. The Diagnostics Products IMMULITE total (Third Generation) and free PSA were measured by the same technician, using the same instrument and the same reagent batch. We calculated the post-test probability to express how the likelihood of the diagnosis of CaP changed after the percent free PSA was determined. Areas under the ROC curves of percent free PSA were better than those of total PSA in every evaluated range of total PSA. The percent free PSA could have reduced the rate of unnecessary biopsies by 47% in patients with total PSA ≥4 μg/L with only 3.8% false-negative results. The post-test probability of percent free PSA was, however, 4 μg/L. However, the post-test probability provided by percent free PSA is relatively low in asymptomatic patients 50–70 years of age.

Introduction:: Erectile Dysfunction (ED) and Benign Prostate Hypertrophy (BPH) are two health-related problems which are experienced by men aged over forty years. BPH and ED highly affect a man’s quality of life (QoL). It is necessary to conduct research on the correlations between BPH and ED by using two kinds of valid scores, i.e. the International Prostate Symptoms Scores (IPSS) to determine the severity of BPH and the International Index of Erectile Function-5 (IIEF-5) to screen the existence of ED in BPH patients. Objectives: The aim of this study is to identify the symptoms of BPH patients with ED and the correlations between ED and BPH by using IPSS, IIEF-5 and QoL. Materials and Methods: This is a cross-sectional study which analyzes correlations between the severity of BPH and the severity ED by using IPSS and IIEF-5 in the Urology Clinic of Arifin Achmad Regional General Hospital. Results: Sixty (60) subjects fulfilled the inclusion criteria. The highest incidence of ED is present in BPH patients in the age group of 60-69 years (38.3%). In this group, 90% of all BPH patients were diagnosed with ED. The degree of BPH and ED experienced by these patients are also mostly severe, namely 53.3% and 40% respectively. The QoL scores are also mostly unsatisfied (58.3%) with the Spearman test also showing that significant and strong correlations do exist between the severities of BPH and ED (r = 0.836, p

Dykes TM, Stone A, Canby-Hagino E= 78-year-old man with a history of benign prostate hypertrophy presented with a painless, firm right scrotal mass on routine physical examination. Scrotal sonography (Figs. 1A and 1B) with a linear 10-MHz transducer showed a focally enlarged lower pole of the epididymis with heterogeneous echotexture compared with the rest of the epididymis and a moderate-sized right hydrocele. Directly contiguous with the lower pole epididymal mass was a 1.8-cm hypoechoic mass in the lower pole of the right testicle. There was also a subtle, striated echotexture pattern in the right testicle compared with the left. The left testicle and epididymis were normal except for small epididymal head cysts and a small hydrocele. Because of the concern for a primary testicular neoplasm, abdominal and pelvic CT was performed and showed no retroperitoneal lymphadenopathy. Right orchiectomy was performed. The result of gross pathologic examination was a 1.3cm, yellow-tan cerebriform mass within the inferior medial pole of the right testis arising at the junction of the distal epididymis and the lower pole testis. The tumor appeared to involve the epididymis but did not extend through the tunica vaginalis. There was also a 2.0-cm pale area in the upper right testicular pole. Representative sections from the distal

We experienced a case of mucin producing prostate carcinoma, which occurred 46-year-old male patient. Serum tumor markers of prostate carcinoma were all in normal levels, and physical findings were similar to those of benign prostate hypertrophy. Histopathological study showed poorly differentiated mucinous adenocarcinoma occupying more than 30% of specimen. In literatures there seemed two types of mucin producing prostate carcinoma, the one is different from usual prostate carcinoma as our case and the other is a subtype of usual one, and so it was suggested that we must respect to this point on diagnosis and therapy of it.

Background Over the past years laser technology has played a predominant role in prostate surgery, for the treatment of benign prostate hypertrophy (BPH). Various laser devices have been introduced in clinical practice, showing good results in terms of complications and urodynamic outcomes efficacy compared with TURP and Open Prostatectomy. In this study we describe the efficacy and the safety profile of a novel laser technique, ThuLEP (Thulium Laser Enucleation of Prostate) that permits a complete anatomical endoscopic enucleation of prostatic adenoma independently to prostate size. Methods 148 patients with a mean age of 68.2 years were enrolled between September 2009 and March 2012 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), International Index of Erectile Function-5 (IIEF-5), Quality of Life (QoL), PSA values, urine analysis and urine culture, uroflowmetry. The same evaluation was conducted after a 12 month follow-up. ThuLEP was performed by 2 expert surgeons. Results Our data showed a better post-operative outcome in terms of catheter removal, blood loss, TURP syndrome, clot retention and residual tissue compared to large series of TURP and OP. Only 1.3% of patients had bladder wall injury during morcellation. I-PSS, Qmax, Prostate Volume, QoL and PVR showed a highly significant improvement at 12 month follow-up in comparison to preoperative assessment. Conclusion ThuLEP represent an innovative option in patients with BPH. It is a size independent surgical endoscopic technique and it can be considered the real alternative, at this time, to TURP and even more to Open Prostatectomy for large prostate, with a complete removal of adenoma and with a low complication rate.

Of 160 newly diagnosed cases of prostate cancer during last 11 years, six (3.75%) had a prior subcapsular prostatectomy. Digital rectal examination in these six cases revealed a significant prostatic abnormality and multiple bone metastases were showed. Histological examination by step-section technique was done retrospectively using surgical materials from subcapsular prostatectomy. Two cases of incidental carcinoma were detected histologically. One showed stage A1 and another stage A2. Continuous observation should be performed after prostatectomy, even if the surgical specimens revealed no carcinoma.

65 consecutive cases with symptomatic benign prostate hypertrophy were treated with transurethral radiowave thermotherapy (TURF) using the Thermex-II at a temperature of 44.5-degrees-C. We report uroflowmetry and symptom scores after a follow-up of 6 months. The mean age was 63 years, the mean maximal flow (Q(max)) was 8.3 ml/s, mean voided volume was 195.6 ml, mean residual urine was 60.7 ml and the mean Madsen symptom score 9.7. Values at baseline and at 1, 3 and 6 months after TURF are discussed. The mean subjective symptom score dropped to 6.3 (p

Saturable binding sites for radioiodinated epidermal growth factor (EGF) have been quantified in surgical specimens of benign prostate hypertrophy (BPH), histologically normal (HN) prostate, and prostate cancer. Values for EGF binding did not differ significantly between HN prostate and prostate cancer, although dedifferentiated samples tended to higher levels. These were coincident with lower comparative levels of androgen receptors. Unfractionated BPH tissue contained lower levels of EGF binding than either HN or carcinomatous prostate, but in separated epithelial cells EGF binding fell into the same range. Saturation analyses showed two affinity classes of binding in all except dedifferentiated tissues.

CLINICAL experience with the male sex hormones or androgens as substi-tute therapy for hypogonadism has received attention in only a few reports, and these mostly during the past year. With the introduction of purified and synthetic hormones, it becomes feasible to investigate with greater certainty the influence of the androgens on the genital structures. The purpose of this study is to present the results of two years’ experience with synthetic testosterone propionate in the treatment of hypogenitalism, both prepuberal and adult types, impotency, symptoms of sexual decline, benign prostate hypertrophy, and gynecomastia. This report is based on the observation of a group of 54 males ranging in age from 7 to 75 years, and showing various forms of genital hypoplasia and malfunctions of the sex organs. The material presented here summarises the pertinent facts of 15 selected cases as typical of the group, which are dis-tributed as follows

Levels of dihydrotestosterone (DHT) have been measured in prostate tissue from both treated and untreated patients with cancer of the prostate and have been compared with values found in untreated benign prostate hypertrophy (BPH) and a variety of non–androgen target tissues. Average DHT in 17 patients with untreated cancer was 3.2 ng/g compared with an average of 5.0 ng/g in 17 patients with BPH (P

Sulphamethoxazole and trimethoprim concentrations were measured in 19 enucleated human prostate glands. Good concentrations of sulphamethoxazole were found after 4 days of treatment: the ratio of plasma concentration to that of prostate varied from 1-25 to 3-29. The trimethoprim concentrations were 2 to 3 times higher in the prostate than in the plasma. These high concentrations were reached very rapidly after the first dose of trimethoprim. The results are compared with date from the literature. The combination sulphamethoxazole-trimethoprim should be of value in the treatment of bacterial prostatitis.

Publisher Summary This chapter elaborates that androgen therapy causes a specific and desirable response in certain situations; in other situations, it elicits a response in which it is not the drug of choice, and in another situation, the response elicited is highly undesirable. There are a number of situations in which testosterone has been repeatedly applied and found to have no specific beneficial effect and in which it may even prove to be harmful. These include the use of testosterone in psychogenic impotence, homosexuality, angina pectoris, and benign prostate hypertrophy. Testosterone has been used in many other conditions, such as tinea capitis infestation, peptic ulcer, hypertension, and diabetes mellitus in which little benefit from its use could be expected. The use of steroid hormones for their protein anabolic effects is being systematically investigated in many qualified laboratories and answers should be forthcoming in the near future.