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Benign prostatic hyperplasia (BPH) is highly prevalent and associated with a significant impact on individuals’ well-being. Initial management involves various medications, but their benefits can be limited by side effects, particularly concerning young people. In this context, novel and better-tolerated therapeutic strategies have been proposed, thus including the modulation of the gut microbiome through probiotic ingestion. We aimed to examine the available evidence linking the urinary microbiome to lower urinary tract symptoms (LUTS) and to evaluate the possible usefulness of probiotic supplementation as a novel treatment option for LUTS/BPH. A narrative review design was preferred to fulfill our purpose. The search strategy included a range of terms, e.g., “microbiome,” “microbiota,” “urobiome,” AND/OR “probiotics” AND “benign prostatic hyperplasia,” “benign prostatic enlargement,” “lower urinary tract symptoms.” A range of studies aimed to investigate the possible impact of urinary microbiome on BPH. Gut and/or urinary dysbiosis can alter the gut permeability and initiate/maintain inflammatory and oxidative processes in the prostate, which may contribute to the cell-hyper-proliferation leading to BPH. The modulation of the urinary and/or gut microbiome through probiotic supplementation seems to provide levels of clinical effectiveness in the management of BPH. Although different probiotics have been tested, a combination of B. Longum and F. Psychaerophilum seems to be particularly promising due to their capability of modulating both the inflammatory pathway and the intestinal barrier permeability. Gut and/or urinary microbiome dysbiosis is most likely contributing to the BPH pathogenesis. Even though only scarce evidence on the potential usefulness of probiotic supplementation in the management of BPH is currently available, the available studies seem to provide encouraging results. Further prospective trials are warranted in order to confirm these findings and to clarify which probiotic strains are more suitable for supplementation in this setting. [ABSTRACT FROM AUTHOR]

Introduction: 5-phosphodiesterase inhibitors (PDE-5I) have been investigated as a treatment for urinary dysfunction for almost a decade. The general perception is that they play a significant role in managing lower urinary tract symptoms (LUTS), particularly those associated with benign prostatic hyperplasia (BPH). However, the specific biochemical processes by which PDE-5I repairs urinary function are still poorly understood and there is little instrumental evidence of significant improvement in urinary symptoms. Therefore, we explore the role of 5-phosphodiesterase inhibitors (PDE-5I) as complementary to the conventional treatment of symptomatic BPH; we provide the suggested biological procedures involved in the association between PDE-5 inhibitor use and improvement in LUTS; and we propose new approaches to this topic. Material and Methods: A systematic search for clinical trials, experimental studies, and systematic reviews was performed in electronic libraries (PubMed, EMBASE, Scopus) using the terms "benign prostate hypertrophy", "benign prostate hyperplasia", "lower urinary tract symptoms", "storage symptoms", "voiding symptoms", "bladder outlet obstruction" and the keywords "mechanism of action", "synergy", "PDE-5 inhibitor", "alpha1-adrenergic antagonist", "5-alpha-reductase inhibitors" in various combinations. There was no restriction on publication date. Results: To date, only a few randomized studies have been published in which the effect of the combination of a conventional drug for the treatment of symptomatic BPH and a PDE-5I was investigated. Almost all showed significant improvement in IPSS and QoL. Some studies showed significant improvements in maximum urine flow (Qmax) and postvoiding residual volume (PVR) with combination therapy compared with a single agent alone. Conclusions: PDE-5I seems effective in relieving symptoms of some BPH patients when administered as complementary to agents currently used to treat BPH. However, the mechanism of action of PDE-5 inhibitors in LUTS remains poorly understood and it is difficult to determine the specific subset of BPH patients who will benefit from the combination of PDE-5 inhibitors with the current treatment. Well-designed, sufficiently informative comparative studies focusing on specific target group profiles (age, urogenital parameters) are needed to define new therapeutic options. [ABSTRACT FROM AUTHOR]

Objective: We aim to report the learning curve and experience performing holmium laser enucleation of the prostate (HoLEP) from a resident standpoint trained at a tertiary high-volume center. Methods: An electronic survey was distributed to 10 surveyees that included recently graduated chief residents trained at Indiana University in the past 3 years i.e., between 2020 and 2022 with a 100% response rate. The questionnaire focused on HoLEP training experience based on a recently established mentorship curriculum in training the residents through each individual step of the surgery. Results: The average learning curve for performing HoLEP was reported to be greater than 25 cases with 50% of the residents reporting >50 cases to master the technique. The surgical difficulty of steps of the HoLEP were rated on a subjective scale of 1–5: 1 = very easy, 2 = easy, 3 = neutral, 4 = hard, and 5 = very hard. The common challenging steps in decreasing the order of difficulty as reported are performing apical enucleation, joining anterior and posterior planes, and dividing anterior commissure with a mean rating of 3.5, 3.1, and 3.1, respectively. The most difficult aspect of the surgery to master was performing apical dissection (60%). Comparing operative parameters for HoLEP with transurethral resection of the prostate in aspects of resection volume and times, 70% of candidates reported it better for HoLEP whereas 20% had similar times for both procedures. A total of 90% of the residents felt confident to offer HoLEP as part of their practice without the need for any further training. Regarding the initial challenge of including HoLEP surgery in practice, the majority (60%) reported difficulty with equipment set up in their practice while 20% reported difficulty maintaining efficient operating room (OR) times and turnover. Conclusion: We believe HoLEP can be performed immediately after residency training and incorporated into practice with high volume, repeated exposure to HoLEP surgery throughout residency based on study results. The average learning curve reported for performing HoLEP was greater than 25 cases. [ABSTRACT FROM AUTHOR]

Objective: To determine the relationship between the prostate volume and the serum values of prostate specific antigen among patients in the "grey zone", classified according to their age group. Gray zone represents serum prostate specific antigen values between 4.1 ng/ml to 10 ng/ml. Material and Methods: Prospective and retrospective 1420 patients classified in four age-groups with LUTS (Lower Urinary Tract Symptoms) were analyzed. Patients were treated for Benign Prostate Hyperplasia (BPH) in the urology clinical at the University Clinical Center of Kosovo during the period of January 2010-October 2020. Data were recorded from patients according to age, prostate size estimated by trans abdominal ultrasound using 3.5 MHz ultrasonography, according to the ellipsoid formula, V = D1 × D2 × D3/2.5, Volume of prostate (V)=T × AP × CC × Pi/6 where T=Transverse diameter, AP=Antero Posterior diameter, CC=Cranial Caudal diameter. Patients with confirmed prostate cancer were excluded from the study. Statistical analyses used t-test and ANOVA (Analysis of Variance) with 95% and 99% confidence intervals. Results: For the grey zone patients, these mean values were 44.6 cm3 and 5.9 ng/mL. Conclusions: The data provide evidence to support that prostate volume and serum Prostate Specific Antigen (PSA) concentration significantly correlate with aging and within the grey zone patients. [ABSTRACT FROM AUTHOR]

Introduction: 5-phosphodiesterase inhibitors (PDE-5I) have been investigated as a treatment for urinary dysfunction for almost a decade. The general perception is that they play a significant role in managing lower urinary tract symptoms (LUTS), particularly those associated with benign prostatic hyperplasia (BPH). However, the specific biochemical processes by which PDE-5I repairs urinary function are still poorly understood and there is little instrumental evidence of significant improvement in urinary symptoms. Therefore, we explore the role of 5-phosphodiesterase inhibitors (PDE-5I) as complementary to the conventional treatment of symptomatic BPH; we provide the suggested biological procedures involved in the association between PDE-5 inhibitor use and improvement in LUTS; and we propose new approaches to this topic. Material and Methods: A systematic search for clinical trials, experimental studies, and systematic reviews was performed in electronic libraries (PubMed, EMBASE, Scopus) using the terms “benign prostate hypertrophy”, “benign prostate hyperplasia”, “lower urinary tract symptoms”, “storage symptoms”, “voiding symptoms”, “bladder outlet obstruction” and the keywords “mechanism of action”, “synergy”, “PDE-5 inhibitor”, “alpha1-adrenergic antagonist”, “5-alpha-reductase inhibitors” in various combinations. There was no restriction on publication date. Results: To date, only a few randomized studies have been published in which the effect of the combination of a conventional drug for the treatment of symptomatic BPH and a PDE-5I was investigated. Almost all showed significant improvement in IPSS and QoL. Some studies showed significant improvements in maximum urine flow (Qmax) and postvoiding residual volume (PVR) with combination therapy compared with a single agent alone. Conclusions: PDE-5I seems effective in relieving symptoms of some BPH patients when administered as complementary to agents currently used to treat BPH. However, the mechanism of action of PDE-5 inhibitors in LUTS remains poorly understood and it is difficult to determine the specific subset of BPH patients who will benefit from the combination of PDE-5 inhibitors with the current treatment. Well-designed, sufficiently informative comparative studies focusing on specific target group profiles (age, urogenital parameters) are needed to define new therapeutic options.

Benign prostate hypertrophy (BPH) is one of the most common causes of lower urinary tract symptoms (LUTS) in elderly men. BPH is caused by a combination of the proliferation of the prostate and obstruction of the lower urinary tract. Patients benefitted from both standard treatment and nurse-directed education programs; however, the improvement in symptom severity and physical component of quality of life were greater in patients who received the nursedirected education program. [ABSTRACT FROM AUTHOR]

Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by pain and stiffness around the shoulders and hip girdles, an elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) and a dramatic response to corticosteroids. It is usually seen in adults aged over 50 years; about 30% also have giant cell arteritis. Its etiology is unknown. A 72-year-old male received water vapor therapy, a novel, minimally invasive therapy for benign prostate hypertrophy (BPH). On postoperative day 1, he developed severe shoulder pain and weakness, with difficulty with lifting his arms above his head, and hip pain and weakness, with difficulty getting out of a bed or chair. Laboratory results showed elevated ESR and CRP, but a normal creatine kinase level. The patient received low-dose prednisone and had prompt symptom relief. This case illustrates that a diagnosis of PMR after water vapor therapy can be easily overlooked.

Introduction: Prostate cancer carries a high morbidity and mortality especially when not diagnosed early. Patients in resource limited countries tend to be diagnosed late and hence delayed surgery for benign prostate hypertrophy (BPH). Method: This was a retrospective study, from 1st January 2019 to 31st December 2020, on patients who underwent prostatectomy. Demographic and clinical data were extracted from their medical records. Results: This study involved 101 patients who had had simple open prostatectomy. Ages ranged from 49 to 98 years, mean 68 +/- 8.98 years. The largest group (37.6%) was aged 71- 80 years, p=0.001. Two thirds (66%), presented with urinary retention, p=0.03. Histopathological examination showed that 49.5% had BPH. Prostate cancer was found in 28.8%, p=0.082. Almost half (49.5%) were diagnosed histopathologically as having BPH. Prostate cancer made up 28.8% with most patients in the age range 61-80 years, p= 0.456. Conclusion: The prevalence of prostate cancer remains high among patients undergoing prostatectomy for suspected BPH. A national awareness campaign coupled with targeted screening of patients above 40 years could increase early detection of prostate cancer and reduce morbidity and mortality.

Background:Prostatic lesions account for the major afflictions in the geriatric population worldwide. Prostate specific antigen can be used for screening but histopathology remains the gold standard for differentiating benign and malignant prostatic enlargements and definite diagnosis. Furthermore, a precise pathologic evaluation of the prostatectomy specimen can provide additional prognostic factors including pathological stages and surgical margin status. Methods: A systematic search identified 306 prostatic specimens submitted in the department over a time period of three years (January 2019-December 2021). Relevant clinical data, PSA level and H&E stained sections were examined for microscopic details and diagnosis. Results: Benign Prostate Hypertrophy (BHP) was the most common prostatic lesion and accounted for 83% of all cases. The age range was 49 to 90 years with a peak age group between 6th-7th decade. BPH associated with prostatitis and basal cell hyperplasia was seen in 57.8% and 3.3% cases respectively. A single case of non-specific granulomatous prostatitis was seen. Malignant tumours constituted 15.7% of all prostatic specimen. Adenocarcinoma was the histopathological subtype in all primary tumours. A single case of metastatic deposits from bladder tumour was recorded. Gleason score 7 was the most frequent (38.2.8%) in occurrence. Most adenocarcinomas were moderately differentiated (55.3%). Prostate Intraepithelial neoplasia (pre malignant lesion) was seen in 1.3 % of cases. Conclusion: Benign Prostate lesions occur more frequently when compared to malignant ones. Major proportion of benign lesions was contributed by Benign prostate hypertrophy. A pathologist's awareness of the benign mimics is important for the diagnosis of Prostate carcinoma. [ABSTRACT FROM AUTHOR]

Background: The endovascular treatment of symptomatic benign prostate hypertrophy (BPH) by prostatic artery embolization (PAE) is one of the new treatments proposed. PAE is a minimally invasive alternative that has been shown to successfully treat lower urinary tract symptoms in BPH patients by causing infarction and necrosis of hyperplastic adenomatous tissue, which decompresses urethral impingement and improves obstructive symptoms. The aim of this study was to evaluate the effectiveness and efficacy of PAE in relieving symptoms in patients with symptomatic BPH. Materials and Methods: The material for the study was collected from 2019 to 2022. A total of 70 men with BPH and PAE were studied. Patients underwent an urological examination to measure the International Prostate Symptom Score (IPSS), Quality of Life score (QoL), International Index of Erectile Function short form (IIEF-5), uroflowmetry with Qmax, prostatic volume (PV), and post-void residual volume (PVR) measurements. Statistical analysis for dependent samples was applied. Measured parameters at 2 months and 6 months follow-up were compared to baseline. Results: At baseline, the age of the male (N = 70) subjects was 74 ± 9.6 years with a median of 73.8, but fluctuated from 53 to 90 years. The mean of PV was almost 111 mL and the Qmax was close to 7.7 mL/s. The average PVR was 107.6 mL. The IPSS score mean was 21.3 points and the QoL score was 4.53 points. The IIEF-5 questionnaire score was almost 1.8 points, which shows severe erectile dysfunction. The mean value of the PSA level was 5.8 ng/mL. After 2 and 6 months of PAE, all indicators and scores except erectile function significantly improved. Conclusions: The outcomes of our study show promising results for patients with benign prostatic hyperplasia after PAE. The main prostate-related parameters (PV, Qmax, PVR, IPSS) improved significantly 6 months after embolization. [ABSTRACT FROM AUTHOR]

Background: Prostatic lesions account for the major afflictions in the geriatric population worldwide. Prostate specific antigen can be used for screening but histopathology remains the gold standard for differentiating benign and malignant prostatic enlargements and definite diagnosis. Furthermore, a precise pathologic evaluation of the prostatectomy specimen can provide additional prognostic factors including pathological stages and surgical margin status. Methods: A systematic search identified 306 prostatic specimens submitted in the department over a time period of three years (January 2019-December 2021). Relevant clinical data, PSA level and H&E-stained sections were examined for microscopic details and diagnosis. Results: Benign Prostate Hypertrophy (BHP) was the most common prostatic lesion and accounted for 83% of all cases. The age range was 49 to 90 years with a peak age group between 6th-7th decade. BPH associated with prostatitis and basal cell hyperplasia was seen in 57.8% and 3.3% cases respectively. A single case of non-specific granulomatous prostatitis was seen. Malignant tumours constituted 15.7% of all prostatic specimen. Adenocarcinoma was the histopathological subtype in all primary tumours. A single case of metastatic deposits from bladder tumour was recorded. Gleason score 7 was the most frequent (38.2.8%) in occurrence. Most adenocarcinomas were moderately differentiated (55.3%). Prostate Intraepithelial neoplasia (pre malignant lesion) was seen in 1.3 % of cases. Conclusion: Benign Prostate lesions occur more frequently when compared to malignant ones. Major proportion of benign lesions was contributed by Benign prostate hypertrophy. A pathologist's awareness of the benign mimics is important for the diagnosis of Prostate carcinoma.

Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by pain and stiffness around the shoulders and hip girdles, an elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) and a dramatic response to corticosteroids. It is usually seen in adults aged over 50 years; about 30% also have giant cell arteritis. Its etiology is unknown. A 72-year-old male received water vapor therapy, a novel, minimally invasive therapy for benign prostate hypertrophy (BPH). On postoperative day 1, he developed severe shoulder pain and weakness, with difficulty with lifting his arms above his head, and hip pain and weakness, with difficulty getting out of a bed or chair. Laboratory results showed elevated ESR and CRP, but a normal creatine kinase level. The patient received low-dose prednisone and had prompt symptom relief. This case illustrates that a diagnosis of PMR after water vapor therapy can be easily overlooked. [ABSTRACT FROM AUTHOR]

It is well-established that the beneficial properties of single phytonutrients can be better attained when they are taken with the complex of the molecules present in their natural milieu. Tomato, the fruit providing the most comprehensive complex of prostate-health-preserving micronutrients, has been shown to be superior to its single-nutrient counterparts in decreasing the incidence of age-related prostate diseases. Herein, we describe a novel tomato food supplement enriched with olive polyphenols, containing cis-lycopene concentrations far exceeding those present in industry-produced tomato commodities. The supplement, endowed with antioxidant activity comparable to that of N-acetylcysteine, significantly reduced, in experimental animals, the blood levels of prostate-cancer-promoting cytokines. In prospective, randomized, double-blinded, placebo-controlled studies performed on patients affected by benign prostatic hyperplasia, its uptake significantly improved urinary symptoms and quality of life. Therefore, this supplement can complement and, in some cases, be an alternative to current benign prostatic hyperplasia management. Furthermore, the product suppressed carcinogenesis in the TRAMP mouse model of human prostate cancer and interfered with prostate cancer molecular signaling. Thus, it may offer a step forward in exploring the potential of tomato consumption to delay or prevent the onset of age-related prostate diseases in high-risk individuals. [ABSTRACT FROM AUTHOR]

Background: Benign prostatic hyperplasia (BPH) is a common disease in elderly men. Monopolar transurethral resection of prostate (M-TURP) is considered the gold standard for the treatment of bladder outlet obstruction due to BPH. Its modification, bipolar TURP (B-TURP), promises to overcome its most prominent drawbacks, such as bleeding and dilutional hyponatremia. Aims and Objectives: This study aims to study the feasibility, effectiveness, and safety of B-TURP over M-TURP. Materials and Methods: A total of 110 patients with BPH were prospectively randomly assigned to undergo B-TURP (55) or M-TURP (55). Patient characteristics of the two groups were similar. Hemoglobin was measured preoperatively and postoperatively. IPSS, maximal flow rate, and post-void residual urine volume were assessed preoperatively. Duration of surgery, mean weight of resected tissue, mean irrigation fluid used, mean drop in hemoglobin, mean change in sodium, and mean post-operative irrigation used were also compared. Results: Duration of resection time was significantly shorter in M-TURP (P=0.0034). The mean change in sodium and mean post-operative irrigation used were significantly lower in bipolar group with P

The classical transurethral resection syndrome as described with monopolar prostate resection has become rare since the switch to bipolar resection and even more so since the introduction of HoLEP. We report a case of a 74-year-old male patient who presented with an irrigation fluid absorption syndrome during a HoLEP for benign prostate hypertrophy. Biochemically this presented as metabolic acidosis and hyperchloremia instead of hyponatremia. He was treated with diuretics and had a swift recovery.

Background: The endovascular treatment of symptomatic benign prostate hypertrophy (BPH) by prostatic artery embolization (PAE) is one of the new treatments proposed. PAE is a minimally invasive alternative that has been shown to successfully treat lower urinary tract symptoms in BPH patients by causing infarction and necrosis of hyperplastic adenomatous tissue, which decompresses urethral impingement and improves obstructive symptoms. The aim of this study was to evaluate the effectiveness and efficacy of PAE in relieving symptoms in patients with symptomatic BPH. Materials and Methods: The material for the study was collected from 2019 to 2022. A total of 70 men with BPH and PAE were studied. Patients underwent an urological examination to measure the International Prostate Symptom Score (IPSS), Quality of Life score (QoL), International Index of Erectile Function short form (IIEF-5), uroflowmetry with Qmax, prostatic volume (PV), and post-void residual volume (PVR) measurements. Statistical analysis for dependent samples was applied. Measured parameters at 2 months and 6 months follow-up were compared to baseline. Results: At baseline, the age of the male (N = 70) subjects was 74 ± 9.6 years with a median of 73.8, but fluctuated from 53 to 90 years. The mean of PV was almost 111 mL and the Qmax was close to 7.7 mL/s. The average PVR was 107.6 mL. The IPSS score mean was 21.3 points and the QoL score was 4.53 points. The IIEF-5 questionnaire score was almost 1.8 points, which shows severe erectile dysfunction. The mean value of the PSA level was 5.8 ng/mL. After 2 and 6 months of PAE, all indicators and scores except erectile function significantly improved. Conclusions: The outcomes of our study show promising results for patients with benign prostatic hyperplasia after PAE. The main prostate-related parameters (PV, Qmax, PVR, IPSS) improved significantly 6 months after embolization.

Background: As men’s life expectancy increases, benign prostatic hyperplasia (BPH) is the significant cause of morbidity. BPH generally involves the central region of the prostate which gradually enlarges. Due to the central hypertrophic change of prostate the urethra is compressed and urinary outflow obstruction develops. Predictive risk factors associated with chance of developing urinary retention includes age, symptoms, urinary flow rate and prostate size. Estimation of accurate intravesical, residual urine has significant importance and serves as an index of adequacy of bladder emptying. Aims and Objectives: The study aimed to measure the post void residual urine volume with age in Prostate outflow obstruction and compare the prostate volume and post void residual urine with age by ultrasonography. Materials and Methods: The present study was performed in 100 patients. Transrectal ultrasonography was performed using 7.5 MHZ transrectal probe. Prostate volume was calculated with the help of inbuilt software, by measuring 3 dimensions of prostate in transverse and longitudinal sections. Transabdominal suprapubic ultrasound was done to measure post void residual urine. Results: It was seen that in the lower age groups, the prostate size was smaller, while in the higher age group it was higher (p>0.001). Minimum post void residual urine was seen in age group of 40-49 years (3.42 -+2.23ml). while maximum mean value was seen in the 70-79 years of age. Statistically a significant difference in mean was seen among different age groups (p

Abstract 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

Background: As men's life expectancy increases, benign prostatic hyperplasia (BPH) is the significant cause of morbidity. BPH generally involves the central region of the prostate which gradually enlarges. Due to the central hypertrophic change of prostate the urethra is compressed and urinary outflow obstruction develops. Predictive risk factors associated with chance of developing urinary retention includes age, symptoms, urinary flow rate and prostate size. Estimation of accurate intravesical, residual urine has significant importance and serves as an index of adequacy of bladder emptying. Aims and Objectives: The study aimed to measure the post void residual urine volume with age in Prostate outflow obstruction and compare the prostate volume and post void residual urine with age by ultrasonography. Materials and Methods: The present study was performed in 100 patients. Transrectal ultrasonography was performed using 7.5 MHZ transrectal probe. Prostate volume was calculated with the help of inbuilt software, by measuring 3 dimensions of prostate in transverse and longitudinal sections. Transabdominal suprapubic ultrasound was done to measure post void residual urine. Results: It was seen that in the lower age groups, the prostate size was smaller, while in the higher age group it was higher (p>0.001). Minimum post void residual urine was seen in age group of 40- 49 years (3.42 -+2.23ml). while maximum mean value was seen in the 70-79 years of age. Statistically a significant difference in mean was seen among different age groups (p<0.001). Conclusion: There is a significant correlation between age and post void residual urine volume and prostatic volume. The present study showed that PVRUV is a novel accurate non-invasive test for predicting prostate biopsy outcome that can easily be used by clinicians, alone or in combination with Prostate Volume in the decision-making for treatment. [ABSTRACT FROM AUTHOR]

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 < 42.9 cm3 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. [ABSTRACT FROM AUTHOR]

Purpose: Although numerous studies have observed an inverse relationship between the size of benign prostate hypertrophy (BPH) and the incidence of prostate cancer (PCa), few studies have explored specific mechanisms by which BPH and PCa may influence one another. In a recent study, one possibility has been brought up that growth in the transition zone due to BPH may cause pressure-induced fibrotic changes in the peripheral zone, an area where 80% of cancer occurs, leading to gland atrophy and the thickening of the prostatic capsule. To shed more light on this phenomenon, we conducted a pilot study examining the quantitative and qualitative histo-anatomical changes that occur in the peripheral zone associated with BPH. Methods: Thirty-nine prostate specimens of various sizes were selected from patients who had undergone radical prostatectomies. Each prostate was evaluated in six different locations along the dorsal aspect of the peripheral zone by measuring the thickness of the peripheral fibrotic zone (prostate capsule) and its association with gland atrophy. Multiple regression analysis was performed to determine the relationship between prostate size and the average thickness of the prostate capsule. Results: Multiple regression analysis revealed a strong, positive relationship between prostate size and average capsule thickness with a Pearson coefficient of 0.707 (p < 0.05). Fibrotic histo-anatomical changes were spatially associated with gland atrophy: glands found within the peripheral fibrotic zone appeared elongated and atrophic. Conclusion: The results suggest that BPH may be associated with the development of fibrotic material and atrophy of glands within the peripheral zone. Because this atrophy involves glands where 80% of prostate cancer originates, this potentially explains the inverse relationship between PCa and BPH. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Abstract: Benign prostate hypertrophy (BPH) is among the most common diseases with a huge impact on the quality of life of elderly men. There is a current need for the development of well‐tolerated and effective preventive strategies to improve the clinical outcome. Caffeic acid phenethyl ester (CAPE) is an important active ingredient isolated from honey‐bee propolis with potent anti‐proliferative, anti‐inflammatory and antioxidant effects. These properties promote CAPE as a promising candidate to be tested as an alternative therapy for BPH, which is still uninvestigated. Herein, we tested the ability of CAPE to guard against testosterone‐induced BPH and investigated the involvement of IGF1‐R/Akt/β‐catenin signaling as a protective mechanism in testosterone‐induced BPH rat model. Treatment with CAPE reduced testosterone‐induced increase in the prostate index and histopathological alterations. In addition, co‐treatment with CAPE significantly suppressed insulin‐like growth factor‐1 receptor (IGF‐1R)/Akt/β‐catenin/cyclinD1 axis as well as tumor necrosis factor‐α level and nuclear factor (NF)‐kB activity. Furthermore, the treatment with CAPE replenished the antioxidant defense systems, superoxide dismutase (SOD) and reduced glutathione (GSH) with subsequent reduction in prostate tissue lipid peroxides. This study highlights the potential merit of CAPE‐enriched propolis formulations to protect elderly men against the development of BPH. © 2018 IUBMB Life, 70(6):519–528, 2018 [ABSTRACT FROM AUTHOR]

This study was included investigation the effects of prostate gland on lipid metabolism and other parameters Blood sample were collected from (37) male patient ( (20) cancer prostate ,(17) with benign prostate hypertrophy ) and (25) from control serum prostate specific antigen (PSA) was determined by Enzyme linked immunoabsorbent assay (ELISA method) ,C.R.Protein by agglutination test and lipid profile include (total cholesterol, triglycerides, high density lipoprotein(HDL), Low density lipoprotein(LDL), Very low density lipoprotein (VLDL) and Risk factors were done.The result showed the value of TPSA,CRP,T.cholesterol,Triglycerides and risk factors increase significantly in patient group compard to control group , while HDL value decrease in patient group. The result of this study explain the relation ship between the incrase of TPSA and risk factor which lead to arterosclerosis in men .