Between Benign Prostatic Hyperplasia Research Articles

Benign Prostatic Hyperplasia and the Risk of Falls in Older Men: Insights From a Population-Based Study on Geriatric Morbid Conditions.

The purpose of this study was to explore the association between benign prostatic hyperplasia (BPH) and the incidence of falls from the perspective of geriatric morbid conditions. Data were sourced from the triennial National Survey of Older Koreans conducted by the Ministry of Health and Welfare (2017-2020). In total, 8,135 male participants aged 65 and older were included, and information was gathered through questionnaires and physical measurements. Logistic regression analysis was utilized to determine the impact of BPH on the risk of falls, and subgroup analyses were conducted to examine the influence of BPH on specific types of falls. Of the participants, 15.2% (1,238 of 8,135) reported that their BPH treatment exceeded 3 months, and 8.0% (648 of 8,135) reported experiencing falls, with 61.4% (398/648) of these falls resulting in injuries. A significant association was identified between BPH and both falls (odds ratio [OR], 1.798; 95% confidence interval [CI], 1.479-2.185) and falls with injuries (OR, 2.133; 95% CI, 1.689-2.694). A subgroup analysis indicated a correlation between BPH and falls in groups having one (OR, 1.912; 95% CI, 1.356-2.694) and 2 or more conditions (OR, 1.856; 95% CI, 1.455-2.367) involving visual and auditory impairments, cognitive decline, depression, lower motor weakness, and limitations in daily activities. The findings indicate that BPH contributes to the incidence of falls among older men, particularly those with comorbid conditions. Considering the heightened fall risk among elderly individuals suffering from multiple morbidities, particularly those with BPH, targeted interventions are essential for mitigating the risk of falls in this vulnerable group.

The Origin of BPH and Prostate Cancer in Different Prostate Zones and the Impact on the Incidence of Prostate Cancer: A Systematic Review and Update of the Literature for Urologists and Clinicians

Background and objectivesNumerous clinical studies over recent years have reported an inverse relationship between benign prostatic hyperplasia (BPH) size and the incidence of prostate cancer (PCa), leading to the clinical hypothesis that the expanding BPH zone damages the glandular tissue where PCa predominately develops. This systematic review aims to establish a historical basis and reference on the zonal origin of BPH and prostate cancer (PCa) within the prostate.

Correlation Between Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Renal Function in Elderly Men Aged 80 Years and Older.

To investigate the relationship between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and renal function in elderly men aged 80 years and older. We selected 389 elderly men aged 80-97 years with BPH/LUTS hospitalized at The Second Division of General Geriatrics, The First Affiliated Hospital of Zhengzhou University, between July 2018 and July 2020. In the cross-sectional study, patients were divided into the treatment (233 patients) and non-treatment (156 patients) groups based on whether they received treatment for BPH/LUTS. In the prospective self-case-control study, we included 129 of the non-treatment group patients who received oral BPH/LUTS medication and completed the 6-month outpatient follow-up. We compared prostate indicators and renal function in the cross-sectional study and baseline and after-treatment data in the prospective self-case-control study. Multiple linear regression analysis was performed for risk factors affecting renal function before and after BPH/LUTS treatment. In the cross-sectional study, renal function was significantly better in the treatment group than in the non-treatment group. In the subgroup analysis of the prospective self-case-control study, renal function significantly improved after treatment among patients with hypertension and those with chronic kidney disease (CKD) 3a, but not in the entire cohort. Multivariable linear regression analysis showed that hypertension (β=2.06, 95% CI 0.40 to 3.71) and CKD 3a (β=17.16, 95% CI 15.53 to 18.79) were independent risk factors for creatinine differences before and after treatment, whereas hypertension (β=-2.27, 95% CI -3.65 to -0.89), CKD 3a (β=-11.93, 95% CI -13.29 to -10.58), and baseline prostate volume (β=-0.11, 95% CI -0.20 to -0.02) were independent risk factors for estimated glomerular filtration rate differences before and after treatment. Treatment for moderate and severe BPH/LUTS can improve renal function in elderly patients with hypertension or CKD 3a.

Shared Inherited Genetics of Benign Prostatic Hyperplasia and Prostate Cancer

BackgroundThe association between benign prostatic hyperplasia (BPH) and prostate cancer (PCa) remains controversial, largely due to a detection bias in traditional observational studies. ObjectiveTo assess the association between BPH and PCa using inherited single nucleotide polymorphisms (SNPs). Design, setting, and participantsThe participants were White men from the population-based UK Biobank (UKB). Outcome measurements and statistical analysisThe association between BPH and PCa was tested for (1) phenotypic correlation using chi-square, (2) genetic correlation (rg) based on genome-wide SNPs using linkage disequilibrium score regression, and (3) cross-disease genetic associations based on known risk-associated SNPs (15 for BPH and 239 for PCa), individually and cumulatively using genetic risk score (GRS). Results and limitationsAmong 214717 White men in the UKB, 24623 (11%) and 14311 (6.7%) had a diagnosis of BPH and PCa, respectively. Diagnoses of these two diseases were significantly correlated (χ2 = 1862.80, p < 0.001). A significant genetic correlation was found (rg = 0.16; 95% confidence interval 0.03–0.28, p = 0.01). In addition, significant cross-disease genetic associations for established risk-associated SNPs were also found. Among the 250 established genome-wide association study–significant SNPs of PCa or BPH, 49 were significantly associated with the risk of the other disease at p < 0.05, significantly more than expected by chance (N = 12, p < 0.001; χ2 test). Furthermore, significant cross-disease GRS associations were also found; GRSBPH was significantly associated with PCa risk (odds ratio [OR] = 1.26 [1.18–1.36], p < 0.001), and GRSPCa was significantly associated with BPH risk (OR = 1.03 [1.02–1.04], p < 0.001). Moreover, GRSBPH was significantly and inversely associated with lethal PCa risk in a PCa case-case analysis (OR = 0.58 [0.41–0.81], p = 0.002). Only White men were studied. ConclusionsBPH and PCa share common inherited genetics, which suggests that the phenotypic association of these two diseases in observational studies is not entirely caused by the detection bias. Patient summaryFor the first time, we found that benign prostatic hyperplasia and prostate cancer are genetically related. This finding may have implications in disease etiology and risk stratification.

PD46-06 SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA WITH IMMUNE-ENRICHED LANDSCAPES SHOW LOWER INCIDENCE OF PROSTATE CANCER DEVELOPMENT

You have accessJournal of UrologyCME1 May 2022PD46-06 SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA WITH IMMUNE-ENRICHED LANDSCAPES SHOW LOWER INCIDENCE OF PROSTATE CANCER DEVELOPMENT Nimrod Barashi Gozal, Tiandao Li, Bo Zhang, Charles Nottingham, Gerald Andriole, Kiran Mahajan, and Eric Kim Nimrod Barashi GozalNimrod Barashi Gozal More articles by this author , Tiandao LiTiandao Li More articles by this author , Bo ZhangBo Zhang More articles by this author , Charles NottinghamCharles Nottingham More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , Kiran MahajanKiran Mahajan More articles by this author , and Eric KimEric Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002614.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The association between benign prostatic hyperplasia (BPH) and prostate cancer (PCa) has not been confirmed. However, these two entities share multiple risk factors like chronic inflammation, metabolic disorders, and androgen-dependent growth. Therefore, an association at a molecular level is at least possible, if not likely. We sought to identify variations in gene expression that could help elucidate some of the pathways for development of PCa in patients with BPH. METHODS: We included 98 men with BPH, positive prostate MRI (PIRADS ≥4), and subsequent negative targeted biopsy from 11/2014 – 01/2018. RNA sequencing was performed on tissue cores from the MRI lesion, as well as cores from a distant region (n=2 biopsy regions per patient). All patients were followed for at least 3 years to identify those who went on to develop PCa. We compared the genetic profiles of those who did not develop PCa (“BPH-only”) vs. those who did (“BPH/PCa”). Then, we identified the subset of men with BPH who had the highest AUA symptom scores (AUAss) and compared their gene expression to the group with PCa. RESULTS: At a median follow up of 47.5 months, 83 men had no evidence of cancer and 15 had BPH/PCa. We compared gene expressions of 14 men with symptomatic BPH (AUAss ≥18) vs. 15 with BPH/PCa. There were two clusters of genes, suggesting the two groups had distinctive molecular features. Differential analysis revealed genes that were upregulated in BPH-only and downregulated in BPH/PCa, and vice versa (Figure 1). Symptomatic BPH men had upregulation of T-cell activation markers (TCR-CD3, PKC theta, ZAP70, LCK) and chemokine receptor expression. In contrast, men with BPH/PCa had upregulation of NKX3-1 and HOXB13 transcription factors associated with luminal epithelial progenitors, but depleted of immune cells, suggesting a cell-autonomous role in immune evasion. CONCLUSIONS: Symptomatic BPH with immune-enriched landscapes may support anti-tumor immunity. Furthermore, RNA sequencing of benign biopsy tissue showing upregulation of NKX3-1 and HOXB13 with absence of T-cells, might help identifying men who are at higher risk of developing PCa, which could help tailoring their treatment and potentially prevent the development of PCa. Source of Funding: Midwest Stone Institute © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e790 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nimrod Barashi Gozal More articles by this author Tiandao Li More articles by this author Bo Zhang More articles by this author Charles Nottingham More articles by this author Gerald Andriole More articles by this author Kiran Mahajan More articles by this author Eric Kim More articles by this author Expand All Advertisement PDF DownloadLoading ...

Is There A Prognostic Significance For Copper, Beryllium, Boron, Titanium And Vanadium Ions In Prostate Cancer?

Aim: There are several epidemiological, clinical and experimental studies that relate heavy metal exposure to Prostatic adenocarcinoma (PCa). In this study, the relationship between benign prostatic hyperplasia (BPH) and PCa, some metal/nonmetal concentrations at the level of the histopathological diagnosis was investigated. Materials and Methods: Seventy-one patients were included in this study. The samples taken from the paraffin blocks of the patients were subjected to microwave digestion, and the samples were analyzed via Inductively coupled plasma mass spectrometry (ICP-MS) to determine the level of tissue concentrations of platinum, thallium, lead, molybdenum, cadmium, selenium77, selenium82, iron, potassium, lithium, beryllium, boron, sodium, magnesium, phosphorus, calcium, titanium, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, strontium, tin, and antimony. The findings were analyzed with SPSS. Results: When metal/nonmetal levels in prostate tissue were examined in BPH and malignant patient groups, a statistically significant difference was found in the levels of lithium (p=0.006), beryllium (p=0.02), boron (p=0.001), sodium (p=0.009), magnesium (p=0.001), phosphorus (p=0.001), calcium (p=0.001), titanium (p=0.004), vanadium (p=0.001), chromium (p=0.04), manganese (p=0.02), cobalt (p=0.003), nickel (p=0.005), copper (p=0.019), zinc (p=0.001), arsenic (p=0.002),strontium (p=0.001), tin (p=0.002) and antimony (p=0.001). Beryllium, boron, titanium and vanadium concentrations were at least five times higher in BPH tissues. When tissue metal/nonmetal levels were compared according to the new Gleason prognostic grade grouping, a significant positive correlation was found between tissue copper levels and grade (p = 0.02). Conclusion: This study showed that beryllium, boron, titanium, and vanadium are five times or more in benign prostatic hyperplasia. It also showed that the histological grade increased with increasing copper concentration. Metal concentrations should be considered for prognosis in PCa.

Inflammation induced by lipopolysaccharide advanced androgen receptor expression and epithelial-mesenchymal transition progress in prostatitis and prostate cancer.

BackgroundTo explore the mechanism of prostatic inflammation on prostate cancer (PCa) by comparing the changes of prostate epithelial cells and PCa cells in an inflammatory environment.MethodsFirst, immunohistochemistry (IHC) was used to compare the level of expression of TNF-α, IL-1β, IL-6, and TGF-β between benign prostatic hyperplasia (BPH), prostatitis, and PCa. Then primary prostate epithelial cells were sampled from patients who were suspected of PCa and had histological prostatitis (HP) confirmed by pathological biopsy. Lipopolysaccharide (LPS) or BAY11-7082 were used to investigate the change of androgen receptor (AR) and AR-mediated transcription, epithelial-mesenchymal transition (EMT) in primary prostate epithelial cells, and lymph node carcinoma of the prostate (LNCap) cells.ResultsTNF-α, IL-1β, IL-6, and TGF-β were significantly increased in HP and PCa compared with those in BPH patients. The proliferation of primary prostate epithelial cells and LNCap cells got the inflection point at LPS 10 µg/mL. In an inflammatory environment with 10 µg/mL LPS, both primary prostate epithelial cell and LNCap cell viability increased, and AR, AR-mediated transcription, and EMT processes were significantly increased. Inhibitors of NF-κB with 10 nM BAY11-7082 decreased AR, AR-mediated transcription, and EMT processes.ConclusionsNF-κB regulates AR expression and EMT in prostatitis and PCa, and NF-κB inhibitors may have potential therapeutic value.

A state-of-art review on the preservation of sexual function among various minimally invasive surgical treatments for benign prostatic hyperplasia: Impact on erectile and ejaculatory domains

There is a strong association between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and sexual dysfunction. While transurethral resection of the prostate (TURP) is considered the standard BPH treatment, it is however associated with a high rate of erectile and ejaculatory dysfunctions. Over the past decade, new and novel minimally invasive BPH therapies have been shown to improve various parameters of voiding domains while minimizing adverse sexual effects. These minimally invasive BPH therapies can be largely be divided into those with cavitating technology (Rezum, Histotripsy, Aquablation), intra-prostatic injections (Botulinum neurotoxin Type A, Fexapotide Triflutate, prostate specific antigen-activated protoxin PRX-302), and mechanical devices which include intraprostatic stents (Urospinal 2™, Memotherm™, Memokath™, and Allium triangular prostatic stent™) and intraprostatic devices (iTIND™, Urolift™), as well as prostatic artery embolization. Published literature on these technologies showed reasonable preservation of erectile function with limited data reported on ejaculatory domain. Further validation of the performance of these novel minimally invasive treatment options for LUTS due to BPH in well-designed and multi-centre studies are desired, to evaluate their role (or lack of such a role) in clinical practice and whether these BPH therapies can provide equivalent standard or better than TURP.

Mechanistic targets for BPH and prostate cancer-a review.

All men, almost, suffer from prostatic disorders in average life expectancy. In the year of 1950s, the first autopsy of prostate gland discovered the link between Benign prostatic hyperplasia (BPH) and Prostate Cancer (PCa). After that, many histology, biochemistry, epidemiology studies explained the association and associated risk factor for the same. From the various scientific evidence, it is proved that both diseases share some common transcription factors and signalling pathways. Still, BPH cannot be considered as the first step of PCa progression. To define, the relationship between both of the diseases, a well-defined large epidemiological study is needed. Along with androgen signalling, imbalanced apoptosis, oxidative stress, and microbial infection also crucial factors that significantly affect the pathogenesis of BPH. Various signalling pathways are involved in the progression of BPH. Androgen signalling is the driving force for the progress of PCa. In PCa androgen signalling is upregulated as compared to a healthy prostate. Some dominant Androgen-regulated genes and their functions have been discussed in this work.

Altered staining patterns and expression level of Engrailed-2 in benign prostatic hyperplasia and prostate Cancer predict prostatic disease progression

BackgroundProstate cancer (PC), a common malignant tumor, is the second-leading cause of cancer death among American men. Its successful treatment greatly relies on the early diagnose. Engrailed-2 (EN2) has been confirmed being existed with a high level in the urine of PC patients. In this study, to explore the application of EN2 in PC, we detected the immunohistochemical staining difference and EN2 expression level between benign prostatic hyperplasia (BPH) and PC.MethodsWe developed a monoclonal antibody against the helix 3 in EN2 and confirmed its specificity with Western blotting (WB) and immunofluorescence detecting the subcellular localization of endogenous and exogenous EN2 in three PC cell lines (LNCap, PC3, and DU145). We conducted immunohistochemical staining using this homemade antibody, and RT-PCR to detect the expression of EN2 in 25 PC and 25 BPH cases, and analyzed the correlation of EN2 expression and PC clinical staging.ResultsThe results of WB and immunofluorescence showed our homemade EN2 monoclonal antibody could specifically bind endogenous and exogenous EN2 protein in three different PC cell lines. Endogenous EN2 was generally expressed in the cytoplasm and exogenous EN2 mostly existed in the nucleus of these cell lines. Immunohistochemical staining in PC had extremely stronger signals than that in BPH, suggesting a higher EN2 expression level in PC, which was confirmed by RT-PCR. Interestingly, the stained areas in BPH tissues were mainly in nucleus and cytoplasm, while in PC tissues were mainly on cytomembrane. Moreover, the expression level of EN2 was positively correlated with the PC clinical staging.ConclusionUsing our homemade EN2 antibody, we have found different staining patterns and expression level of EN2 in BPH and PC,which may be helpful to predict prostatic disease progression.

Increased Plasmatic Levels of PSA-Expressing Exosomes Distinguish Prostate Cancer Patients from Benign Prostatic Hyperplasia: A Prospective Study.

Prostate Specific Antigen (PSA) fails to discriminate between benign prostatic hyperplasia (BPH) and Prostate Cancer (PCa), resulting in large numbers of unnecessary biopsies and missed cancer diagnoses. Nanovesicles called exosomes are directly detectable in patient plasma and here we explore the potential use of plasmatic exosomes expressing PSA (Exo-PSA) in distinguishing healthy individuals, BPH, and PCa. Exosomes were obtained from plasma samples of 80 PCa, 80 BPH, and 80 healthy donors (CTR). Nanoparticle Tracking Analysis (NTA), immunocapture-based ELISA (IC-ELISA), and nanoscale flow-cytometry (NSFC), were exploited to detect and characterize plasmatic exosomes. Statistical analysis showed that plasmatic exosomes expressing both CD81 and PSA were significantly higher in PCa as compared to both BPH and CTR, reaching 100% specificity and sensitivity in distinguishing PCa patients from healthy individuals. IC-ELISA, NSFC, and Exo-PSA consensus score (EXOMIX) showed 98% to 100% specificity and sensitivity for BPH-PCa discrimination. This study outperforms the conventional PSA test with a minimally invasive widely exploitable approach.

Risk of amyotrophic lateral sclerosis and other motor neuron disease among men with benign prostatic hyperplasia: a population-based cohort study

ObjectivesAmyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder. Sleep disturbance may interfere with clearance of abnormal proteins that aggregate in neurodegenerative diseases. The objective of this study was...

Prostate imaging features that indicate benign or malignant pathology on biopsy.

Accurate diagnosis of clinically significant prostate cancer is essential in identifying patients who should be offered treatment with curative intent. Modifications to the Gleason grading system in recent years show that accurate grading and reporting at needle biopsy can improve identification of clinically significant prostate cancers. Extracapsular extension of prostate cancer has been demonstrated to be an adverse prognostic factor with greater risk of metastatic spread than organ-confined disease. Tumor volume may be an independent prognostic factor and should be considered in conjunction with other factors. Multi-parametric magnetic resonance imaging (MP-MRI) has become an increasingly important tool in the diagnosis and characterization of prostate cancer. MP-MRI allows T2-weighted (T2W) anatomical imaging to be combined with functional and physiological assessment. Diffusion-weighted imaging (DWI) has shown greater sensitivity, specificity and negative predictive value compared to prostate specific antigen (PSA) testing and T2W imaging alone and has a more positive correlation with Gleason score and tumour volume. Dynamic gadolinium contrast-enhanced (DCE) imaging can exhibit difficulties in distinguishing prostatitis from malignancy in the peripheral zone, and between benign prostatic hyperplasia (BPH) and malignancies in the transition zone (TZ). Computer aided diagnosis utilizes software to aid radiologists in detecting and diagnosing abnormalities from diagnostic imaging. New techniques of quantitative MRI, such as VERDICT MRI use tissue-specific factors to delineate different cellular and microstructural phenotypes, characterizing tissue properties with greater detail. Proton MR spectroscopic imaging (MRSI) is a more technically challenging imaging modality than DCE and DWI MRI. Over the last decade, choline and prostate-specific membrane antigen (PSMA) positron emission tomography (PET) have developed as better tools for staging than conventional imaging. While hyperpolarized MRI shows promise in improving the imaging and differentiation of benign and malignant lesions there is further work required. Accurate reading and interpretation of diagnostic investigations is key to accurate identification of abnormal areas requiring biopsy, sparing those in whom benign or indolent disease can be managed by non-invasive means. Embracing and advancing existing technologies is essential in furthering this process.

Benign prostatic hyperplasia and intraprostatic inflammation are associated with liver inflammation: it's time for prevention.

Some evidences have supported the link between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and inflammation. In this study, we aimed to evaluate the association between prostatic inflammation (PI) and non-alcoholic steatohepatitis (NASH) evaluated by a non-invasive scores in a cohort of patients affected by BPH/LUTS. Between January 2012 and January 2016, we conducted a prospective study in a single academic outpatient clinic on 132 consecutive patients who underwent surgery for lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO). A non-invasive non-alcoholic steatohepatitis score (NASH score) was calculated, and PI was evaluated through the Irani score. Patients with a NASH score>1.05 had an average larger prostate volume (55 vs. 45cc, p<0.05), a greater waist circumference (103 vs. 93.5cm, p<0.01), and high values of blood glucose, triglycerides, insulin, and BMI compared to patients without NASH; 36% of patients with an Irani score≥4 had NASH compared to 16.1% of patients who had a NASH score<1.05 (p<0.05). We found that non-alcoholic steatohepatitis (NASH≥1.05) was an independent risk factor for Irani score ≥4 (OR: 3.24; p<0.05) and of prostate volume ≥ 40cc (OR: 13.99; p<0.01). LUTS/BPH and NASH can be closely related, underlying common triggers of induction. In particular, inflammation seems to be associated with both conditions and with prostate gland overgrowth. Early identification of this class of patients could play a key role in preventing complications related to disease progression.

Association of benign prostatic hyperplasia and subsequent risk of bladder cancer: an Asian population cohort study.

Few studies discussed the link between benign prostatic hyperplasia (BPH) and bladder cancer. We performed this cohort study to investigate whether there is an association between BPH and subsequent risk of bladder cancer. We identified 35,092 study subjects including 17546 BPH patients and 17546 comparisons from the National Health Insurance database. The comparison cohort was frequency matched with age and index-year. We measured subsequent bladder cancer rates (per 1000 person-years) in two cohorts. Attributable risks (ARs) was calculated based on the bladder cancer rates in two cohorts. The hazard ratios (HRs) and 95% confidence intervals (CIs) for bladder cancer were estimated via Cox proportional hazard regression. BPH patients had a higher bladder cancer rate than comparisons (AR=0.81 per 1000 person-years) and exhibited 4.69- and 4.11-fold increases in bladder cancer risk in the crude and adjusted Cox models, respectively (95% CIs=4.15-6.99 and 2.70-6.26). The AR was highest in patients aged 65-74years old (AR=1.33). BPH patients with chronic kidney disease were at an elevated bladder cancer risk. Regarding the association between bladder cancer and transurethral prostatectomy (TURP), BPH patients who underwent TURP were at a higher risk of bladder cancer (AR=1.69; HR=6.17, 95% CI=3.68-10.3) than those who did not (AR=0.69; HR=3.73, 95% CI=2.43-5.74). In this study, BPH patients were found to have an increased risk of subsequent bladder cancer. Based on the limitations of retrospective nature, further studies are needed.

The association of benign prostatic hyperplasia with lower urinary tract stones in adult men: A retrospective multicenter study

ObjectiveTo examine the relationship between benign prostatic hyperplasia (BPH) and the presence of lower urinary tract stones. MethodsWe retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period. We divided the patients into two groups based on the location of urinary stones: Group 1 (bladder calculi) and Group 2 (urethral calculi). We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones. ResultsOf 221 patients, 194 (87.8%) had bladder calculi and 27 (12.2%) had urethral calculi. The mean age of Group 1 was higher than that of Group 2 (68.96 ± 12.11 years vs. 55.74 ± 14.20 years, p < 0.001). The mean prostate volume of Group 1 was higher than that of Group 2 (44.47 ± 27.14 mL vs. 24.70 ± 6.41 mL, respectively, p < 0.001). Multivariate logistic regression showed that age (OR = 1.075, 95%CI: 1.023–1.129) and prostate volume (OR = 1.069, 95%CI: 1.017–1.123) were independently associated with increased risk for bladder calculi. Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi (OR = 3.468, 95%CI: 1.093–10.999). ConclusionAge and prostate volume are independent risk factors for bladder calculi. In addition, men with upper urinary tract disease are at greater risk for urethral calculi, which may migrate from the upper urinary tract rather than from the bladder.

Patterns of Benign Prostate Hyperplasia Based on Magnetic Resonance Imaging Are Correlated With Lower Urinary Tract Symptoms and Continence in Men Undergoing a Robot-assisted Radical Prostatectomy for Prostate Cancer

To investigate the association between benign prostatic hyperplasia (BPH) patterns, classified by magnetic resonance imaging (MRI), with lower urinary tract symptoms (LUTS) or continence, preoperatively and after robot-assisted laparoscopic radical prostatectomy (RARP). This retrospective study included 49 prostate cancer patients, with prostate size >47 cm3, who underwent an endorectal MRI followed by RARP. Five BPH patterns were identified according to Wasserman, and additional prostate measurements were recorded. LUTS were assessed using the International Prostate Symptom Score and the PR25-LUTS-Questionnaire score. Continence was assessed using the International Consultation of Incontinence Questionnaire-Short Form. BPH pattern 3 (44.9%) was identified most common, followed by pattern 5 (26.6%), 1 (24.5%), and 2 and 4 (both 2%). BPH patterns were significant predictors of preoperative LUTS, with pedunculated with bilateral transition zone (TZ) and retrourethral enlargement (pattern 5) causing more severe symptoms compared with bilateral TZ and retrourethral enlargement (pattern 3) and bilateral TZ enlargement (pattern 1), whereas pattern 3 was additionally associated with more voiding symptoms compared with pattern 1. None of the BPH patterns was predictive of postoperative LUTS and continence. Independent predictors of continence at 12 months were lower preoperative PR25-LUTS score (P = .022) and longer membranous urethral length (P = .025). MRI is useful for classifying patients in BPH patterns which are strongly associated with preoperative LUTS. However, BPH patterns did not predict remnant LUTS or postoperative incontinence. Postoperative continence status was only associated with preoperative LUTS and membranous urethra length.

Analysis of urinary PSA glycosylation is not indicative of high-risk prostate cancer

The levels of core fucosylation and α2,3-linked sialic acid in serum Prostate Specific Antigen (PSA), using the lectins Pholiota squarrosa lectin (PhoSL) and Sambucus nigra agglutinin (SNA), can discriminate between Benign Prostatic Hyperplasia (BPH) and indolent prostate cancer (PCa) from aggressive PCa. In the present work we evaluated whether these glycosylation determinants could also be altered in urinary PSA obtained after digital rectal examination (DRE) and could also be useful for diagnosis determinations. For this purpose, α2,6-sialic acid and α1,6-fucose levels of urinary PSA from 53 patients, 18 biopsy-negative and 35 PCa patients of different aggressiveness degree, were analyzed by sandwich ELLA (Enzyme Linked Lectin Assay) using PhoSL and SNA. Changes in the levels of specific glycosylation determinants, that in serum PSA samples were indicative of PCa aggressiveness, were not found in PSA from DRE urine samples. Although urine is a simpler matrix for analyzing PSA glycosylation compared to serum, an immunopurification step was necessary to specifically detect the glycans on the PSA molecule. Those specific glycosylation determinants on urinary PSA were however not useful to improve PCa diagnosis. This could be probably due to the low proportion of PSA from the tumor in urine samples, which precludes the identification of aberrantly glycosylated PSA.

Quantification of Arachidonic Acid and Its Metabolites in Rat Tissues by UHPLC-MS/MS: Application for the Identification of Potential Biomarkers of Benign Prostatic Hyperplasia.

To evaluate the potential relationship between benign prostatic hyperplasia (BPH) and the arachidonic acid (AA) metabolome, a UHPLC—MS/MS method has been developed and validated for simultaneous determination of AA and its cyclooxygenase(COX) and lipoxygenase(LOX) pathway metabolites (15-HETE, 12-HETE, TXA2, 5-HETE, AA, PGI2, PGF2α, 8-HETE, PGD2, PGE2 and LTB4) in rat tissues. The analytes were extracted from tissue samples with a protein precipitation procedure and then separated on a Shim-pack XR-ODSC18 column with 0.05% formic acid in water (pH adjusted with dilute ammonia) and methanol:acetonitrile (20:80, v/v). Detection was performed on a UHPLC—MS/MS system with electrospray negative ionization (ESI) and a multiple reaction-monitoring mode. The lower limits of quantification (LLOQ) were 0.25–50 ng/mL for all of the analytes in the prostate, seminal, bladder, liver and kidney tissues. The absolute recoveries of the analytes from all of the tissues were more than 50%. By means of the method developed, the AA metabolites in tissue samples from Sham and BPH group rats were determined. The eleven biomarkers in the BPH group prostate, seminal, bladder, liver and kidney tissues were significantly higher than those of the sham group, indicating that BPH fortified the inducible expression of COX and LOX, as well as increased the production of AA and eicosanoids. The method described here offers a useful tool for the evaluation of complex regulatory eicosanoids responses in vivo.

Disorder, Promiscuous Interactions, and Stochasticity Regulate State Switching in the Unstable Prostate.

A causal link between benign prostatic hyperplasia (BPH) and prostate cancer has long been suspected but not widely accepted. A new model is proposed that supports such a connection. In contrast to the prevailing wisdom, our model, that draws on dynamical systems theory, suggests that in response to stress, epithelial cells in the unstable gland can give rise to both types of diseases via a phenotypic switching mechanism. The central idea is that phenotypic switching is a stochastic process which exploits the plasticity of the epithelial cell. It is driven by 'noise' contributed by the conformational dynamics of proteins that are intrinsically disordered. In a system that is noisy when stressed, disorder promotes promiscuity, unmasks latent information, and rewires the network to cause phenotypic switching. Cells with newly acquired phenotypes can transcend the traditional zonal boundaries to give rise to BPH or prostate cancer depending on the microenvironment. Establishing causality between the two diseases may provide us with an opportunity to better understand their etiology and guide prevention and treatment strategies. J. Cell. Biochem. 117: 2235-2240, 2016. © 2016 Wiley Periodicals, Inc.