Benign Prostatic Hypertrophy Patients Research Articles

Measurement of PDE5 concentration in human serum: proof-of-concept and validation of methodology in control and prostate cancer patients.

We aimed to investigate if the type 5 phosphodiesterase (PDE5), an enzyme with cardinal biological functions in sexual and cardiovascular health, can be detected and quantited in human serum. Blood samples were collected from control male and female subjects. PDE5 levels were measured by a specific ELISA kit. ROC curves weighted for age and serum levels of PSA (male subjects), or age (female subjects) were used to identify the predictive ability in the detection of PCa. Sensitivity, specificity, PPV and NPV values were determined for cut-off value determined during ROC curve analysis. 41 control male subjects, 18 control female subjects, and 55 consecutive subjects, of which 25 were affected by benign prostatic hypertrophy (BPH) and 30 with histologically confirmed prostate cancer (PCa), were studied. PDE5 serum levels were detectable in all subjects (range: 5 to 65 ng/ml). Analysis by MANCOVA identified a significant difference in serum PDE5 between control subjects or hyperplasia patients and PCa patients. Marginal means of serum PDE5 concentrations showed a significant difference (p < 0.001). The ROC curve demonstrated that PDE5 serum levels can predict men with or without PCa, with 0.806 AUC value (p < 0.0001). Using a 12.705 ng/ml PDE5 serum cut-off yielded sensitivity, specificity, PPV, and NPV of 83.3%, 77.27%, 62.5%, and 91.1% in detecting men with histologically proven PCa, respectively. We demonstrated, for the first time, that PDE5 levels can be detected in human sera and that PCa patients have significantly higher PDE5 concentration compared to BPH patients or male and female controls. While serum PDE5 level measurement may open new research avenues, the clinical relevance of PDE5 levels in PCa patients deserves further investigation.

Prostatic Artery Embolization as a Treatment Option for Symptomatic Benign Prostatic Hyperplasia: Results from the Prospective Follow-Up Study in Lithuania.

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.

Effects of the beta-blocker carvedilol on arrhythmia and long-term clinical outcomes in benign prostate hypertrophy patients.

Benign prostatic hypertrophy (BPH) is associated with autonomic dysfunction and sympathetic nervous system mediated by the alpha receptor. However, limited data exist regarding the effects of the beta-blocker (BB) carvedilol on arrhythmia and urologic outcomes in BPH patients. Our database of patients diagnosed with BPH from 2015 to 2020 was used to obtain echocardiography and electrocardiogram data. Inclusion criteria were BPH patients taking BBs. International Prostate Symptom Score questionnaire were used to evaluate the urinary symptoms and quality of life. Among 448 patients with BPH (69.2 ± 10.9 years) taking BBs, 219 patients took carvedilol (48.9%) and 229 patients took a non-carvedilol BB (51.1%; bisoprolol, 184 patients, 80% or nebivolol, 45 patients, 20%). Difference in the baseline characteristics was not observed. During the median 36-month follow-up, a lower incidence of arrhythmic events (P = .029), total urologic events (P < .001), and less use of additive alpha-blocker was observed in the carvedilol group (P = .022). In multivariate analysis, less carvedilol use (P = .019), heart failure (P < .001), stroke (P < .001), and cardiomyopathy (P = .046) were independent risk factors for arrhythmic events. In addition, less carvedilol use (P = .009) and older age (P = .005) were independent risk factors for urologic events based on BB type at the median 36-month follow-up. The use of carvedilol was associated with less arrhythmic events in BPH patients with palpitation and decreased the incidence of urologic events in BPH compared with the use of non-carvedilol BBs in long-term follow-up.

MP24-02 CLUSTER ANALYSIS IDENTIFIES BENIGN PROSTATIC HYPERTROPHY CLINICAL PHENOTYPES

You have accessJournal of UrologyCME1 Apr 2023MP24-02 CLUSTER ANALYSIS IDENTIFIES BENIGN PROSTATIC HYPERTROPHY CLINICAL PHENOTYPES Matthew Simmons, Nathaniel Taylor, W Carter Reed, Pablo Santamaria, Zachary Klaassen, Sherita King, and Martha Terris Matthew SimmonsMatthew Simmons More articles by this author , Nathaniel TaylorNathaniel Taylor More articles by this author , W Carter ReedW Carter Reed More articles by this author , Pablo SantamariaPablo Santamaria More articles by this author , Zachary KlaassenZachary Klaassen More articles by this author , Sherita KingSherita King More articles by this author , and Martha TerrisMartha Terris More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003249.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign prostatic hypertrophy (BPH) is a heterogeneous disease that is affected by multiple variables including infection, genetics and inflammation. This study assessed whether hierarchical cluster analysis could better characterize BPH patients. METHODS: Patients who underwent TURP or simple prostatectomy between January 2017 to August 2022 were reviewed. 92 patients who had CT imaging within 18m of surgery were selected. CT-based prostate volumes (PV) were calculated using the ellipsoid volume formula (L*W*H*(π/6)). Metabolic syndrome score (MetX) was calculated by adding normalized BMI score to the number of metabolic syndrome-related diseases present (i.e., hypertension, hyperlipidemia, type II diabetes mellitus each disease given a score of 1). Data were scaled using Z transformation. Hierarchical clustering was conducted with Heatmapper software using average linkage and Pearson distance measurement methodology. RESULTS: Mean age of the cohort was 68 (SD=8.5), and 40% were African American. Hypertension, hyperlipidemia and type II diabetes mellitus were present in 73%, 58% and 32% of patients, respectively. Mean prostate volume was 84 ml (SD=56). Median lobes (ML) were present in 26%. Intraprostatic calcifications (IPCs) were present in 37%. Clustering revealed three clear groupings. Group 1 cnsisted of men with IPCs. These men had lower than average age, PV, and MetX scores. Group 2 consisted of men with either MLs or high PV without concomitant high MetX score. Two categories of men were included in Group 2 - younger than average men with MLs; and older than average men men with high PVs. Group 3 consisted of men with high MetX score. Age and PV was lower than average in this group. CONCLUSIONS: Cluster analysis identified three distinct clinical phenotypes of BPH. Classification of BPH subtypes may allow for improved diagnosis and therapy. Future studies will correlate molecular subtyping data and clinical outcomes data to further validate findings. Source of Funding: Medical College of Georgia © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e317 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Simmons More articles by this author Nathaniel Taylor More articles by this author W Carter Reed More articles by this author Pablo Santamaria More articles by this author Zachary Klaassen More articles by this author Sherita King More articles by this author Martha Terris More articles by this author Expand All Advertisement PDF downloadLoading ...

Copy number variation of urine exfoliated cells by low-coverage whole genome sequencing for diagnosis of prostate adenocarcinoma: a prospective cohort study.

BackgroundNon-invasive, especially the urine-based diagnosis of prostate cancer (PCa) remains challenging. Although prostate cancer antigen (PSA) is widely used in prostate cancer screening, the false positives may result in unnecessary invasive procedures. PSA elevated patients are triaged to further evaluation of free/total PSA ratio (f/t PSA), to find out potential clinically significant PCa before undergoing invasive procedures. Genomic instability, especially chromosomal copy number variations (CNVs) were proved much more tumor specific. Here we performed a prospective study to evaluate the diagnostic value of CNV via urine-exfoliated cell DNA analysis in PCa.MethodsWe enrolled 28 PSA elevated patients (≥ 4 ng/ml), including 16 PCa, 9 benign prostate hypertrophy (BPH) and 3 prostatic intraepithelial neoplasia (PIN). Fresh initial portion urine was collected after hospital admission. Urine exfoliated cell DNA was analyzed by low coverage Whole Genome Sequencing, followed by CNV genotyping by the prostate cancer chromosomal aneuploidy detector (ProCAD). CNVs were quantified in absolute z-score (|Z|). Serum free/total PSA ratio (f/t PSA) was reported altogether.ResultsIn patients with PCa, the most frequent CNV events were chr3q gain (n = 2), chr8q gain (n = 2), chr2q loss (n = 4), and chr18q loss (n = 3). CNVs were found in 81.2% (95% Confidence Interval (CI) 53.7–95.0%) PCa. No CNV was identified in BPH patients. A diagnosis model was established by incorporating all CNVs. At the optimal cutoff of |Z|≥ 2.50, the model reached an AUC of 0.91 (95% CI 0.83–0.99), a sensitivity of 81.2% and a specificity of 100%. The CNV approach significantly outperformed f/t PSA (AUC = 0.62, P = 0.012). Further analyses showed that the CNV positive rate was significantly correlated with tumor grade. CNVs were found in 90.9% (95% CI 57.1–99.5%) high grade tumors and 60.0% (95% CI 17.0–92.7%) low grade tumors. No statistical significance was found for patient age, BMI, disease history and family history.ConclusionsUrine exfoliated cells harbor enriched CNV features in PCa patients. Urine detection of CNV might be a biomarker for PCa diagnosis, especially in terms of the clinically significant high-grade tumors.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12920-022-01253-5.

Correlation between Prostate Specific Antigen (PSA) Level and Various Prostatic Diseases on Biopsies: A Retrospective Study

Introduction: The prostate is a pear-shaped glandular organ that adds part of fluid to semen. The prostate consists of stromal and glandular components. Prostate needle biopsy is performed either transrectal ultrasound (TRUS) guided or transurethral routes. PSA is a glycoprotein produced by secretory cells. Normally the PSA levels are less than 4.0ng/ml.&#x0D; Aim: The main aim of the study is to find out the correlation between various pathological lesions occur in the prostate and serum Prostate Specific Antigen (PSA) level.&#x0D; Study Design: A retrospective study.&#x0D; Place and Duration of Study: Department of Pathology,Saveetha Medical college and Hospital, between January 2019 and December 2019.&#x0D; Methodology: A retrospective study of 84 prostatic biopsies for a period of 1 year in the year 2019 was carried out. All specimens subjected for histopathological examination and the relevant clinical data and Serum PSA values correlation was done.&#x0D; Results: Commonest age group being 61-70 years. Difficulty in micturition was the most common presentation .Most common lesion found was Benign Prostatic Hypertrophy(BPH) constituting 67 cases (71.42%) followed by BPH with prostatitis 17 cases (20.23%), adenocarcinoma 6 cases (7.14%) and 1 case of Prostatic Intraepithelial Neoplasia (PIN) (1.19%). BPH patients, had S.PSA levels in the range of 4.1-15 ng/ml. Three cases of adenocarcinoma showed very high levels of S.PSA (&gt;100 ng/ml) with the Gleason score of 9(5+4).&#x0D; Conclusion: Both benign and malignant pathologies can cause an increase in serum PSA levels, but the chances of finding malignancy increases with rising values of PSA. But in the management of prostatic cancer the histopathological diagnosis and grading plays a definitive role.

Evaluation of static and dynamic Pupillometry changes in men using Silodosin for benign prostatic hypertrophy

BackgroundIntraoperative floppy iris syndrome is a variant of the small pupil syndrome that has been observed during cataract surgery in some patients currently or previously treated with α1 adrenergic blockers. It is important for cataract surgeons to predict the probable complications preoperatively. Our study aims to evaluate the static and dynamic pupil characteristics of patients treated with silodosin—a selective α1 adrenergic blocker—for benign prostate hypertrophy (BPH) and to compare these values with healthy subjects using an automatic quantitative pupillometry system.MethodsA total of 74 BPH patients treated with silodosin for six months (group 1) and 30 healthy subjects (group 2) were enrolled in this prospective multidisciplinary cross-sectional study. Static and dynamic pupillometric measurements were obtained under optimized conditions, and the results were compared between the two groups.ResultsSeventy-four male patients with a mean age of 63,35 ± 7,21 (46–77) years with BPH treated with silodosin and 30 normal male subjects with a mean age of 63,07 ± 4,73 (52–71) years were analyzed. There were statistically significant differences between the groups with regard to scotopic pupil diameter (PD), high photopic PD, and low photopic PD (p < 0.001, for each one). The patient group had statistically significant higher values of amplitude and velocity of pupil contraction and lower values of duration of pupil contraction and latency as well as duration and velocity of pupil dilation.ConclusionThe static and dynamic pupil characteristics of subjects treated with silodosin for BPH are different from those of healthy eyes. In addition, our results may have shed light on the risk for intraoperative floppy iris syndrome (IFIS) before cataract surgery; thus, surgeons can be alert and take precautions.

Risk Factors for Prostate Volume Progression After Prostate-Transurethral Resection.

BackgroundMany factors could contribute to the cases of residual benign prostate hypertrophy (BPH) volume after transurethral resection of the prostate (TURP), such as age, obesity, testosterone level, and inflammation. The goal of this study was to determine the risk of tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β) in prostate tissue, serum prostate-specific antigen (PSA), serum testosterone, and age in promoting prostate volume progression after TURP.Patients and MethodsThis was a prospective cohort study on 83 BPH patients who underwent TURP at five hospitals in Bali, Indonesia. Trans-rectal ultrasonography (TRUS) was carried out to examine the prostate’s size. Three years after, we redo the TRUS examination to collect the data of the latest prostate size. TNF-α, TGF-β, serum PSA, testosterone, and age were registered for analysis. We used Pearson’s and Spearman’s correlation tests and multivariate analytic linear regression test (coefficient β) by SPSS 13.0 software.ResultsAge, testosterone, PSA, TNF-α, TGF-β were positively correlated to prostate’s volume progression. The prostate volume was strongly correlated with age (r= 0.749, p <0.001), PSA level (r=0.896, p <0.001), testosterone level (r=0.818, p <0.001), and TGF-β (r=0.609, p <0.001). The TNF-α level has a weak correlation to prostate’s volume progression (r=0.392, p <0.001).ConclusionTNF-α, TGF-β, PSA, testosterone, and age were significant as the risk factors in promoting the prostate volume progression after TURP.

Drugs and herbs in two divergent lines of benign prostatic hyperplasia therapy

Prostatic adenoma, or benign prostate hypertrophy (BPH), is a natural and common disease in elderly men. Its etiology is multifactorial. BPH is associated with annoying symptoms and morbid complications. The treatment of BPH with drugs, or synthetic chemicals, damages hepatic and renal tissues developing cirrhosis and kidney failure. As an alternative, there has been recourse to the use of medicinal plants or natural health. Pumpkin seeds, nettle leaves and soybeans have been proven to be potent against pain and discomfort in BPH patients. Moreover, plants used at high doses during a long period as treatment, may be toxic and complicate the lifestyle of BPH patients. Both, drugs and plants, used without precaution is a dilemma of prevention and toxicity. The patients simultaneously consume the drug and plants to anticipate healing. Combined drug-plant therapy could have harmful effects on health due to an accumulating antagonistic synergy of chemical and natural.

Day Temperature Difference and Aggravation of Low Urinary Tract Symptom in Benign Prostate Hypertrophy Patients in Korea: A National Health Insurance Service-National Cohort-based Study

To investigate the symptom deterioration of patients with benign prostatic hyperplasia (BPH) according to the difference in daily temperature. From the National Health Insurance Service database, we collected and analyzed data on patients with BPH in 6 major metropolitan areas in Korea between January 2008 and December 2017. We investigated the rate of emergency room visits as well as the rate of urethral catheter insertion. In total, 1,446,465 patients were enrolled in this study. When the daily temperature difference was below 4°C, 28.5 patients visited the emergency room daily, while 42.2 patients visited the emergency room daily when the daily temperature difference exceeded 14°C. When the daily temperature difference was more than 14°C, about 48.0% more patients visited the emergency room than when the daily temperature difference was below 4°C. After visiting the emergency room, there were 11.9 patients who had a catheter inserted daily at the daily temperature difference below 4°C. When the daily temperature difference was more than 14°C, the number of catheter insertion cases was 17.8 patients daily, which was 49.2% higher than that of below 4°C. By time, surgery was performed most frequently within 3 months after visiting the emergency room. Day temperature difference appear to be related to the Lower urinary tract symptom of BPH patients.

Evaluation of urethral stricture after transurethral resection of the prostate in benign prostatic hypertrophy patients

Evaluation of urethral stricture after transurethral resection of the prostate in benign prostatic hypertrophy patients

Selection and Validation of an SUV &lt;sub&gt;max&lt;/sub&gt; Cutoff Value to Discriminate Prostate Cancer From Benign Prostate Hypertrophy by &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA PET/CT: A Real-World Study

Background: The aims of the present study were to perform immunohistochemistry (IHC)-based validation of prostate-specific membrane antigen (PSMA) expression measured by 68Ga-PSMA PET/CT and to select and validate a maximum standardized uptake value (SUVmax) cutoff to discriminate prostate cancer (PC) from benign prostate hypertrophy (BPH). Methods: A retrospective analysis based on symptoms and elevated total prostate-specific antigen (tPSA) was performed to assess 102 patients with suspected PC in a large tertiary care hospital in China who underwent 68Ga-PSMA-11 PET/CT. A volume of interest (VOI) was selected according to the highest uptake of 68Ga-PSMA to generate an SUVmax and was subsequently evaluated. The 68Ga-PSMA PET/CT results were compared with the histopathological results. Receiver operating characteristic (ROC) curve analysis was used to generate an SUVmax cutoff value for discrimination between PC and BPH. External validation was performed prospectively in 113 patients with suspected PC. Results: In accordance with the PSMA IHC staining results, PC patients had higher SUVmax values than BPH patients. There was a strongly positive correlation between the SUVmax and PSMA expression ( r s =0.734, P 4.70 in the validation group was 84.96%. Conclusion: The 68Ga-PSMA PET/CT SUVmax is strongly positively correlated with PSMA expression, as validated by IHC. We selected and validated the best SUVmax cutoff value (4.70) for discriminating PC from BPH with high accuracy. Funding Statement: This work was supported by the National Natural Science Foundation of China (grant numbers 81772734, 81971646, 91959208 and 81871379). Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: This retrospective chart review study involving human participants was performed in accordance with the ethical standards of the institutional and national research committee and with the Declaration of Helsinki. The Ethics Committee of the Fourth Military Medical University approved the study protocol and all patients provided written informed consent for retrospective use of their data.

Sleep Quality Improvement of Benign Prostate Hyperplasia Patients After Transuretral Resection of Prostate

ABSTRACT&#x0D; Introduction. Nocturia is lower urinary tract symptoms on benign prostat hyperplasia patients that made him asleep at night to urinate. This condition impacted on many level of patient life, which are quality of life, quality of sleep, daytime function, morbidity and mortality and nocturia has the biggest impact on patient sleep quality.&#x0D; Methods. This is an observational study including 30 patient of benign prostat hyperplasia undergoing transurethral resection of the prostate as research subjects. All patient were assessed using the Pittsburgh sleep quality index and international prostate symptom score at baseline and 2 month after transuretral resection of the prostate&#x0D; Results. A total 23 patients (76,7%) had a sleep disorder as a score of 5 or more on Pittsburgh sleep quality index score. After the transurethral resection of the prostate, pittsburgh sleep quality index score of 12 patient have decreased (less than 5) and 11 others with persistent sleep disorder. Pittsburgh sleep quality index significantly decreased after transurethral resection of the prostate from ±9,36 to ±5,03 (p-value 0,000). Nocturia also significantly decreased after transuretral resection of the prostate from ±3,46 to ±2,40 (P value 0,003). Lower urinary track symptoms in this patient also getting better after surgery. The international prostat symtoms score decreased after transurethral resection of the prostat from ±21,80 to ±7,67 with P value 0,000&#x0D; Conclusion. Transuretral resection of prostate improves sleep quality dan decreased lower urinary track symptoms in benign prostate hypertrophy patients.

Role of Acoustic Radiation Force Impulse (ARFI) Elastography in Determination of Severity of Benign Prostate Hyperplasia.

BackgroundThe 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/MethodsSixty 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.ResultsThe 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<0.01). The SWV values of the central area of prostate were higher in the severe BPH group compared to the mild-to-moderate BPH group (2.62±0.58 and 2.25±0.55, p=0.02).ConclusionsOur ARFI elastography results indicated that the central prostate SWV values of BPH patients were significantly higher relative to those of a healthy control group. The central prostate SWV values increased in proportion to the increased severity of BPH. Measurement of SWV by ARFI technology constitutes a non-invasive alternative to other methods for the determination of BPH severity.

English

INTRODUCTION : Intravesical prostatic protrusion (IVPP) is represented as a severe parameter of the Bladder outlet obstruction (BOO) due to Benign prostatic hypertrophy (BPH) traditionally and it is considered based on the experience that it can be cured only by surgical management. But till date it is not made standard in various association guidelines and in standard textbooks except for a few publications in literature. In symptomatic Benign prostatic hypertrophy patients, there is no consensus or clear practical guidelines to define the presence and severity of obstruction, other than the pressure-flow study. The latter has been traditionally regarded as the 'reference' gold standard but the technique is invasive, uncomfortable for the patient, time-consuming and expensive and not available, especially in most developing countries. The various standard non invasive measures used for finding the severity of Bladder outlet obstruction due to Benign prostatic hypertrophy are IPSS score(International prostatic symptoms score), Uroflowmetry and Postvoid residual urine estimation(PVR). Eventhough these are not considered significant to asses the severity of Bladder outlet obstruction on individual basis they are at present used in combination to asses the severity. Each one has their own pitfalls to be a single standard non invasive mode for assessing the severity of Bladder outlet obstruction due to Benign prostatic hypertrophy. Cystoscopy and Pressure flow study are reliable in assessing the severity of Bladder outlet obstruction due to Benign prostatic hypertrophy but both are invasive. AIM : To correlate Intravesical prostatic protrusion(IVPP) with International prostate symptoms score (IPSS),Quality of life index(QOL), Uroflowmetry, Postvoid urine (PVR) and Pressure Flow study (PFS) and to asses whether the presence and increasing grades of Intravesical prostatic protrusion are directly correlated with the severity of Bladder outlet obstruction due to Benign prostatic hypertrophy. Response of patients with Intravesical prostatic protrusion of same grade to surgical therapy and drug therapy are compared to decide which modality of management is best. MATERIALS AND METHODS : 1. Prospective study. 2. Period of study is from June 2006 to June 2009. 3. Age Range- 50 to 80 years. 4. The sample size is 100. 5. The patients with co morbid illness such as Diabetes Mellitus (DM), Hypertension (HTN) ,Tuberculosis (TB) etc and associated neurological conditions are excluded from the study. Patients with a known history of previous lower urinary tract surgery, prostate or bladder carcinoma, bladder calculi, or neurological deficit are also excluded from the study. CONCLUSION : The increasing grades of IVPP are significantly directly correlated with IPSS score, Q max and Postvoid residual. Among the three Qmax is the best correlated one. The Prostatic volume and QOL index do not correlate well with IVPP. 2. IVPP have a very good positive and negative predictive value and also a good accuracy rate in comparison with all other parameters in predicting the BOO. This is especially very significant in increasing grades of protrusion. Thus the IVPP correlates significantly with BOO; it should be used as one of the variables initially assessed in men with LUTS, being a less invasive (than pressure-flow studies in every patient) and a more cost-effective way to stratify patients with LUTS for further management. The surgical intervention statistically proved to be superior to medical treatment in IVPP patients, especially most significant in Grade II & III IVPP patients. In patients presented with AUR along with IVPP surgery proved the efficacy for succeful trial voiding. The patients failed medical treatment voided succefully after TURP.

A Magnetic Bead-Based Sensor for the Quantification of Multiple Prostate Cancer Biomarkers

Novel biomarker assays and upgraded analytical tools are urgently needed to accurately discriminate benign prostatic hypertrophy (BPH) from prostate cancer (CaP). To address this unmet clinical need, we report a piezeoelectric/magnetic bead-based assay to quantitate prostate specific antigen (PSA; free and total), prostatic acid phosphatase, carbonic anhydrase 1 (CA1), osteonectin, IL-6 soluble receptor (IL-6sr), and spondin-2. We used the sensor to measure these seven proteins in serum samples from 120 benign prostate hypertrophy patients and 100 Gleason score 6 and 7 CaP using serum samples previously collected and banked. The results were analyzed with receiver operator characteristic curve analysis. There were significant differences between BPH and CaP patients in the PSA, CA1, and spondin-2 assays. The highest AUC discrimination was achieved with a spondin-2 OR free/total PSA operation—the area under the curve was 0.84 with a p value below 10−6. Some of these data seem to contradict previous reports and highlight the importance of sample selection and proper assay building in the development of biomarker measurement schemes. This bead-based system offers important advantages in assay building including low cost, high throughput, and rapid identification of an optimal matched antibody pair.

Genetic variability at promoters of IL-18 (pro-) and IL-10 (anti-) inflammatory gene affects susceptibility and their circulating serum levels: An explorative study of prostate cancer patients in North Indian populations

Inflammation is an important hallmark of all types of cancers with a well-established role in carcinogenesis. The net inflammatory response is determined by the balance between pro- and anti-inflammatory cytokines, the levels of which may be affected by the genetic make-up.Interleukin (IL)-18, a pro-inflammatory cytokine expressed by various cells including those of the prostate, is a key mediator of anti-cancer immune response. IL-10, an anti-inflammatory cytokine associated with tumour malignancy, causes escape from immune surveillance. This study hypothesizes that genetic variants of IL-18 (−607 C/A and −137 G/T) and IL-10 (−819 C/T and −592 C/A) may influence the circulating levels of these interleukins, thereby generating susceptibility risk to prostate cancer.The study was conducted on 676 subjects (controls and patients of prostate cancer (PCa): 291 each; and 94 patients with benign prostate hypertrophy (BPH)). Genotyping was performed by PCR-RFLP and Real-Time PCR probe-based method. Circulating interleukin levels were obtained by ELISA.Circulating IL-18 levels were significantly elevated in cancer and BPH patients carrying GG genotypes for −137 of IL-18. The trend of circulating IL-18 levels was GG>GC>CC, observed in all groups. The −137 genetic variants of IL-18 significantly associated with PCa risk were GC, CC, and GC+CC, compared to GG (OR: 1.71, 95% CI: 1.20–2.46; OR: 3.35, 95% CI: 2.03–5.53; and OR: 2.05, 95% CI: 1.46–2.87, respectively). A significant association of AA and CA+AA against CC genotype was observed at −607 locus of IL-18 (OR: 0.46, 95%CI: 0.29–0.72; OR: 0.61, 95% CI: 0.41–0.90, respectively).Significantly elevated levels of IL-10 were observed with TT (wild) genotype at −819 of IL-10, compared to the CC (homozygous mutant) genotype in all three groups of subjects. However, no significant association was found between IL-10 promoter genotypes and PCa risk.We conclude that genetic variants of IL-18 and IL-10 promoters influence the circulating levels of these interleukins. Variations at −137 and −607 loci of IL-18 are associated with susceptibility to PCa.

Long noncoding RNA PCA3 gene promoter region is related to the risk of prostate cancer on Chinese males

IntroductionLong noncoding RNA prostate cancer gene antigen 3 (PCA3) is one of the most prostate cancer-specific genes at present. Consequently, the prostate-specific expression and the sharp up-regulation of PCA3 RNA in prostate cancer suggest a unique transcriptional regulation, which possibly can be attributed to promoter polymorphism. In this study, we investigated a short tandem repeat (STR) polymorphism of TAAA in the promoter region of PCA3 gene found in our previous study in prostate cancer (PCa) patients and benign prostatic hypertrophy (BPH) patients, aiming to evaluate the association between the STR and increased risk for PCa. Material and methods120 PCa cases and 120 benign prostatic hypertrophy (BPH) cases were identified among participants. The region encompassing the TAAA repeat was amplified with a specific primer set we designed and screened by PCR-based cloning and sequencing in paired peripheral blood leukocytes and prostate tissues. Genotype-specific risks were estimated as odds ratios (ORs) associated with 95% confidence intervals (CIs) and adjusted for age by means of unconditional logistic regression. Results5 PCA3 TAAA STR polymorphisms and 8 genotypes were found in both peripheral blood leukocytes and prostate tissues, the carriers with more TAAA repeats were associated with increased risk for PCa than individuals having less TAAA repeats. Interestingly, 18 (15.0%) of 120 PCa patients had more (TAAA)n repeats in prostate tissues than that in peripheral blood leukocytes, and 3 (2.5%) of 120 had less (TAAA)n repeats in prostate tissues. ConclusionsThe results of this study suggest that short tandem repeat polymorphism of TAAA in the promoter region of PCA3 gene is a risk-increasing factor for prostate cancer in the Chinese population. In addition to the hereditary factor, the insertion mutation of (TAAA)n in a local tissue maybe another mechanism of the onset of PCa.

Bipolar transurethral resection versus monopolar transurethral resection for benign prostatic hypertrophy: a systematic review and meta-analysis.

To evaluate the efficacy and safety of monopolar (M-TURP) and bipolar (B-TURP) transurethral resection of the prostate in benign prostatic hypertrophy (BPH) patients. Eligible randomized controlled trials (RCTs) were identified from electronic databases without language restrictions. Database search, quality assessment, and data extraction were independently performed. The primary postoperative outcomes of topical M-TURP and B-TURP were maximum flow rate (Qmax) and/or International Prostate Symptom Score (IPSS). Safety was estimated by TUR syndrome; need for transfusion; clot retention; bladder neck contracture (BNC); urethral stricture (US); and catheter removal time. Efficacy and safety were investigated using the Review Manager. Thirty-one trials met the inclusion criteria. Pooled analysis revealed significant difference in efficacy between the M-TURP and B-TURP groups. Safety analysis revealed significant improvement in the TUR syndrome with B-TURP than with M-TURP. Pooled analysis revealed that clot retention was significantly higher in M-TURP than in B-TURP. Moreover, pooled analysis revealed no significant difference between both groups in the blood transfusion frequency or late complications (urethral strictures) and bladder neck constriction. This systematic review indicates that B-TURP was significantly better in the result of Qmax and for decreasing the incidence of TUR syndrome and clot retention. No significant differences were observed in the nature of adverse events such as transfusions, retention after catheter removal, and urethral complications between both groups. Thus, B-TURP is the next generation "gold standard" for benign prostatic obstruction (BPO) because it is associated with a lower rate of clinically relevant complications such as TUR syndrome and clot retention.

High Incidence of Severe Erectile Dysfunction in Benign Prostatic Hyperplasia Patients

Abstract 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