Cases Of Benign Prostatic Hyperplasia Research Articles

CD44 expression in Prostatic lesions: A prognostic guide

BACKGROUND AND AIMS: The cell surface glycoprotein CD44 plays an important role in mediating cell to cell and cell to matrix interaction, hence promoting the maintenance of tissue integrity and inhibiting tumour metastasis. The present study is aimed to evaluate the expression of CD44 by immunohistochemistry in prostatic core biopsies and transurethral resection of prostate (TURP) specimens in prostatic lesions. METHODS: A total of 63 prostatic samples were enrolled in the study which included cases of benign prostatic hyperplasia, prostatic intraepithelial neoplasia and prostatic adenocarcinoma. Immunohistochemical expression of CD44 was studied to assess its association with histopathological findings and clinical data in the aforementioned samples. RESULTS: CD44 expression was strongly expressed in inflammatory and non-neoplastic cells as compared to neoplastic cells. Within the later, intensity of CD44 expression was stronger in well-differentiated than in poorly differentiated tumours. Loss of CD44 expression was associated with greater tumour aggressiveness. The positive expression of CD44 expression on immunohistochemistry was strongly associated with lower S. PSA levels, Gleason’s scores & grades. Consequently, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of negative CD44 expression for the diagnosis of prostatic adenocarcinoma were 93.3%,79.3%,82.4%,92% and 86.4% respectively. CONCLUSION: There is a great requirement for markers that distinguish slowly progressive from rapidly progressive prostate cancers in paraffin-embedded tissues. CD44 promotes the maintenance of tissue integrity and its expression in prostate cancer is associated with reduced tumour aggressiveness. The up-regulation of the expression of CD44 by certain microRNAs can be utilized as a novel therapeutic agent against prostatic adenocarcinoma.

Effect of metabolic syndrome on treatment outcome of lower urinary tract symptoms in males due to benign prostatic hyperplasia

Lower urinary tract symptoms in males are mostly due to benign prostatic hyperplasia and overactive bladder. Approximately three-fourths of them require medical management with drugs like a1blockers and 5-a reductase inhibitors. Metabolic syndrome[MeS] as a comorbidity has been documented with a number of cases of benign prostatic hyperplasia [BPH]. The present study finds MeS as a potential risk factor for BPH and compares the effectiveness of BPH medications among those with and /or without underlying MeS. Patients were evaluated basing on the parameters like biochemical findings and clinical symptoms using IPSS Score, Quality of Life Score, prostate volume using Ultrasound abdomen and pelvis. Our study revealed that, waist circumference, BMI, FBS, Total Cholesterol, HDL cholesterol, LDL cholesterol & HOMA-IR were the significantly associated with the clinical outcome in the MetS +ve patients having BPH. MetS significantly affects the response to medical treatment of BPH as revealed from the IPSS Score, prostate volume and quality of life index. It also emphasizes that MetS evaluation should be an integral part of the standard assessment of male patients with LUTS as well as a new domain in clinical and basic research. Keywords: Metabolic syndrome, Urinary tract, Benign prostatic hyperplasia.

Significance of neutrophil to lymphocyte ratio in prostate lesions with special reference to prostate cancer

Aim: To study the significance of neutrophil- lymphocyte ratio (N:L ratio) in prostate lesions, especially in cases of prostate cancer (PCa). Materials and Methods: Fifty cases of PCa and fifty cases of benign prostatic hyperplasia (BPH), diagnosed on transurethral resection of prostate biopsies were included in the study. Hematological parameters were recorded, N:L ratio was calculated in all cases and values were compared between BPH and PCa, further association between pathological characters of PCa and N:L ratio values was studied. Results: In the present study, we found a statistically significant high N:L ratio in PCa cases as compared with BPH cases (p=0.008). We also found a significant difference in the PSA values (p

The Association between Prostate-Specific Antigen Velocity (PSAV), Value and Acceleration, and of the Free PSA/Total PSA Index or Ratio, with Prostate Conditions.

Introduction: Prostate-specific antigen velocity (PSAV) is used to monitor men with clinical suspicion of prostate cancer (PCa), with a normal cut-off point of 0.3–0.5 ng/mL/year. The aim of the study is to establish the predictive capacity of PSAV (value and acceleration) and of the free PSA/total PSA index or ratio. Method: Prospective multicentre observational study in 2035 men of over 47 years of age. Inclusion criteria: men who wished to be informed on the health of their prostate. Exclusion criteria: men with a previously diagnosed prostate condition. Groups: GA: (n = 518): men with serum PSA equal to or greater than 2.01 ng/mL. GB: (n = 775): men with serum PSA greater than or equal to 0.78 ng/mL and less than 2.01 ng/mL. GC: (n = 742): men with serum PSA less than 0.78 ng/mL. Variables: prostate-specific antigen (PSA); age; body mass index (BMI); PSA velocity (PSAV) (ng/mL per year); free PSA/total PSA index (iPSA); PSAV acceleration (increasing: positive, or decreasing: negative); prostate diagnosis (benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN), or infectious and non-infectious prostatitis and prostatic adenocarcinoma (PCa)); de novo diagnoses of urinary tract diseases or conditions; concomitant treatments, diseases and conditions; final diagnosis of prostate health. Results: Mean age 62.35 years (SD 8.12), median 61 (47–94); age was lowest in GC. Mean BMI was 27.89 kg/m2 (SD 3.96), median 27.58 (18.56–57.13); no differences between groups. Mean PSAV was 0.69, SD 2.16, median 0.13 (0.001–34.46); PSAV was lowest in GC. Mean iPSA was 27.39 u/L (SD 14.25), median 24.29 (3.7–115); iPSA was lowest in GA. PSAV had more positive acceleration in GA and more negative acceleration in GC. There were 1600 (78.62%) cases of normal prostate or BPH, 322 (15.82%) cases of PIN or non-infectious prostatitis, and 113 (5.55%) cases of PCa. There were more cases of BPH in GC and more cases of PIN or prostatitis and cancer in GA (p = 0.00001). De novo diagnoses: 15 cases of urinary incontinence (UI), 16 discomfort/pain in LUT, 112 cases of voiding disorders, 12 urethral strictures, 19 hematuria, 51 cystitis, 3 pyelonephritis, 4 pelvic inflammatory disease; no differences were found between groups. In the multivariate analysis, PSAV and the direction of PSAV acceleration (positive or negative) were the variables which were correlated most strongly with prostate health. iPSA was associated with the presence of prostatitis, PCa, and BPH. Men in GA had more prostatitis, PCa, treatment with alpha blockers, and history of previous smoking. GB had more cases of BPH and more positive acceleration of PSAV. GC had more normal prostates, more BPH, more use of ranitidine, and more PSAV with negative acceleration. Conclusions: PSAV, direction of PSAV acceleration, and iPSA in PSA cut-off points of 0.78 ng/mL and 2.01 ng/mL in a priori healthy men over 47 predict the probability of benign or malignant pathology of the prostate.

The Value of P504s, 34βE12, Ki-67 and PSA in Diagnosis and Prognosis of Prostate Cancer

Background: In recent years, the incidence of prostate cancer (PCa) is increasing. Advanced PCa has a poor prognosis and high cost, which seriously affects the quality of life of patients. Therefore, how to improve the diagnosis rate and prognosis of early PCa is the focus of clinical research. This paper aims to investigate the value of P504s, 34βE12, Ki-67 and prostate-specific antigen (PSA) in the diagnosis and prognosis of PCa.
 Objective: To investigate the expression of P504s, 34βE12, Ki67 and PSA in prostate tissues and their clinical significance.
 Methods: Twenty four cases in the study group were selected from PCa confirmed by pathology in the urology department of Chengde Affiliated Hospital from October 2018 to August 2020, and 33 cases of Benign Prostate Hyperplasia (BPH) confirmed by pathology in the same period were selected as the control group. The expression of P504s, 34βE12 and Ki-67 in prostate tissues were determined by immunohistochemistry.
 Results: The positive expression rates of P504s, 34βE12 and TPSA or F/TPSA in PCa patients were 95.8%, 12.5% and 87.5%, respectively. The positive rates in BPH patients were 9.1%, 93.9% and 27.3%. The difference between the two groups was statistically significant (p<0.05). PCa bone or lymph node metastasis was positively correlated with Ki-67 (r=0.423, p<0.05) and Gleason score (r=0.446, p<0.05), indicating a stronger correlation with Gleasonscore.
 Conclusion: The combined detection of P504s, 34βE12 and PSA is helpful for the diagnosis and differential diagnosis of PCa. High Gleason score and ki-67 expression may indicate high risk of PCa metastasis and poor prognosis.

Surface brachytherapy in Skin Cancer with High Dose Rate Remote After Loader: An Experience from NCHRC

Background: In recent years, the incidence of prostate cancer (PCa) is increasing. Advanced PCa has a poor prognosis and high cost, which seriously affects the quality of life of patients. Therefore, how to improve the diagnosis rate and prognosis of early PCa is the focus of clinical research. This paper aims to investigate the value of P504s, 34βE12, Ki-67 and prostate-specific antigen (PSA) in the diagnosis and prognosis of PCa.
 Objective: To investigate the expression of P504s, 34βE12, Ki67 and PSA in prostate tissues and their clinical significance.
 Methods: Twenty four cases in the study group were selected from PCa confirmed by pathology in the urology department of Chengde Affiliated Hospital from October 2018 to August 2020, and 33 cases of Benign Prostate Hyperplasia (BPH) confirmed by pathology in the same period were selected as the control group. The expression of P504s, 34βE12 and Ki-67 in prostate tissues were determined by immunohistochemistry.
 Results: The positive expression rates of P504s, 34βE12 and TPSA or F/TPSA in PCa patients were 95.8%, 12.5%and 87.5%, respectively. The positive rates in BPH patients were 9.1%, 93.9% and 27.3%, The difference between the two groups was statistically significant (p<0.05). PCa bone or lymph node metastasis was positively correlated with Ki-67 (r=0.423, p<0.05) and Gleason score (r=0.446, p<0.05), indicating a stronger correlation with Gleasonscore.
 Conclusion: The combined detection of P504s, 34βE12 and PSA is helpful for the diagnosis and differential diagnosis of PCa. High Gleason score and ki-67 expression may indicate high risk of PCa metastasis and poor prognosis.

Urodynamic Pressure-Flow Study (Pfs) for the Prediction of Surgical Outcome in Bph With Urinary Retention

Introduction: Urinary retention can be either chronic or acute in onset. Urinary retention can result from impaired detrusor contractility or obstruction of bladder outlet. Twenty five to 30% of men with decreased flow are not obstructed 1. Either uroflowmetry or post-void residue (PVR) can not differentiate obstruction from impaired detrusor contractility. In this study, an effort has been paid to know the usefulness of pressure-flow study in urinary retention due to suspected benign prostatic hyperplasia(BPH) cases for predicting the outcome of surgery. Methods: This is a before after clinical study, conducted in Bangabandhu Sheikh Mujib Medical University, Dhaka. Total 32 patients were selected for the study. Patients age ranges from 49-78 years.Patients with chronic and refractory urinary retention due to BPH were enrolled for the study. They were divided into group A (pre-operative) and group B (Post-operative). TURP was done in all 32 patients by single surgeon. Study variables were detrusor pressure at maximum flow (Pdet@Qmax), bladder outlet obstruction index(BOOI), bladder contractility index( BCI) and post void residue (PVR). Result: Total number of patients was 32. Age ranges from 49-78 years. Twenty one (65.6%) had BPH with chronic retention and 11 (34.4%) had BPH with refractory retention.Pdet@Qmax between Group A and Group B was highly significant (p=0.001). But difference is not significant in Pdet@Qmax d” 40 subgroup of patients (p=0.673). Bladder outlet obstruction index between Group A and Group B is highly significantly (p=0.001), but, that does not observed in BOOI <20 subgroup(p=0.600). Bladder contractility index in both Normal (BCI 100-150) and strong ( BCI >150 ) subgroups are significant ( p=0.001 and 0.001 respectively ). But it is not significant in BCI<100 sub group (p=0.021). Post void residue between Group A and Group B is highly significant (p=0.001). But in PVR >300m subgroup, difference is insignificant (p=0.120). Conclusion: In this study, overall favorable outcome observed in all patients after TURP but Pdet@Qmax <40 cm of water, BOOI <20, BCI <100 and PVR >300 ml groups of patients are at high risk of unfavorable clinical outcome after TURP. With the help of presence flow study (PFS) prior knowledge of these factors, it is possible to predict postoperative outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.74-77

Association of chronic periodontitis with prostatic hyperplasia and prostatitis: A population-based cohort study in Taiwan.

Association between periodontitis and prostate diseases of benign prostatic hyperplasia (BPH) and prostatitis is uncertain. From the National Health Insurance Research Database of Taiwan, 5,510 patients with newly diagnosed chronic periodontitis and participated in therapies were selected from 2000 to 2015 as cohort 1. Matched with age and index year, 5,510 patients with periodontitis diagnosis without therapy were selected as cohort 2, and 5,510 participants without diagnosis were used as control. Cox proportional hazard and survival analysis were performed to compare the risks and the survival probabilities among cohorts. In two periodontitis cohorts, 636 and 638 participants compared with 550 in control (1,174 and 1,187versus 989 per 100,000 person-years) had prostate disorder. Difference was identified for prostatitis (n=68, 70versus 34; rate=125, 130versus 61 /100,000 person-years; P<0.001) but not for BPH (n=577, 575, versus 529; rate=1,065, 1,070versus 951 /100,000 person-years, respectively). Different survival probabilities for prostate disorder and prostatitis, but not for BPH, were observed among cohorts. Periodontitis patients were more likely to develop prostate disorder after adjustment (adjusted hazard ratio [aHR] of 2.590 to 2.641 by competing model). With stratification, risks between two periodontitis cohorts exhibited no difference. When BPH cases were excluded, the aHRs for prostatitis were 4.611 to 4.798. Despite treatment, the patients with periodontitis had higher risk of developing prostatitis than patients without periodontitis.

Low reduction of prostate volume is a significant predictor of prostate cancer at subsequent biopsy in patients with dutasteride: A retrospective study.

Appropriate decision of prostate biopsy in men with 5α‐reductase inhibitor (5AR inhibitor) is still unclear to avoid unnecessary biopsy. We retrospectively investigated patients with initial PSA 4.0 ng/ml or more and underwent subsequent prostate biopsy following dutasteride treatment. From September 2009 to August 2018, 399 cases of benign prostate hyperplasia (BPH) were treated with dutasteride in our department. Of the total, 36 cases with elevated pre‐treatment PSA (4.0 ng/ml or more) and underwent subsequent prostate biopsy were included into this study. We evaluated PSA kinetics and changing prostate volumes (PV), and detection of prostate cancer. Overall, average PSA reduced by half at 6 months from dosing. Pre‐treatment biopsy was performed in 17 of 36 cases, and all were diagnosed as having no malignancy. After treatment, prostate cancer was detected in 15 cases by subsequent biopsy. Fourteen of 15 cases were clinically significant cancer (Gleason score 7 or more). Logistic regression analysis detected a nominal association between prostate cancer detection and three variants, PSAD, PV reduction (1–Before/After PV) and abnormal MRI findings. In addition to abnormal MRI findings and pre‐treatment of high PSAD, the case with low reduction of PV after treatment should consider performing prostate biopsy.

Relationship of Prostate-Specific Antigen (PSA) and Prostate Volume in Patients with Biopsy Proven Benign Prostatic Hyperplasia (BPH)

Abstract Benign prostatic hyperplasia (BPH) is one of the most common benign tumors in men with prevalence ranging from 50% for men in their 60s to 90% for men in their 80s. The researcher sought to determine the relationship of prostate-specific antigen (PSA) and prostate volume in patients with benign prostatic hyperplasia. This study was based on 33 cases of benign prostatic hyperplasia in the Department of Urology, RSUD Dr. Soetomo Surabaya that diagnosed by histopathology examination. Cases with malignancy, acute urinary retention and prostatitis were excluded. The variables of prostate-specific antigen and prostate volume were examined. The results of this study found that 33 men were enrolled with mean PSA 16,04 ng/ml and a mean prostate volume of 49,13 ml. Overall, 84,8% had PSA level &gt;4 ng/ml and 90,9% had prostate volume &gt;25 ml. Prostate-specific antigen has significant correlation with prostate volume (p=0,019; r=0,362). This study concluded that prostate-specific antigen and prostate volume showed a significant correlation. Keywords : benign prostatic hyperplasia, prostate specific antigen, prostate volumeCorrespondence : anny_sr@fk.unair.ac.id

BIPOLAR TRANSURETHRAL RESECTION OF PROSTATE VERSUS OPEN PROSTATECTOMY IN PATIENTS WITH PROSTATIC VOLUMES FROM 80-120 GM: A PROSPECTIVE RANDOMIZED STUDY.

Background: Transurethral resection of the prostate (TURP) is still considered the gold standard in the treatment of benign prostatic hyperplasia (BPH). However, open prostatectomy is indicated for prostate glands over 80 ml. There have been few reports concerning the use of TURP for large prostate glands over 100 ml. Objective: To prospectively compare the effectiveness and safety of bipolar TURP and open prostatectomy in prostate glands ranging from 80-120 ml. Patients and Methods: We reviewed the data of 60 patients with prostate glands ranging from 80-120 ml. which were randomized 30 patients underwent bipolar TURP (group A), and another 30 underwent open prostatectomy (group B). Preoperative International Prostate Symptom Score (IPSS), flow rate (Qmax), prostate volume, resected tissue volume, and operative time were documented. Postoperative hemoglobin, serum sodium change, hospital stay, duration of catheter indwelling and postoperative 6-month IPSS and Qmax were evaluated. Results: The Bipolar TURP (B-TURP) and open prostatectomy (OP) emphasized similar mean operating durations as well as the mean hemoglobin drop, catheterization period and hospital stay were significantly improved for bipolar group. During the follow up period, no statistically significant difference was determined in terms of IPSS, Qmax, QOL, PVRU between the two series. Conclusion: Bipolar TURP represented a promising endoscopic approach in very large BPH cases compared with standard open prostatectomy as patients benefited from significantly satisfactory follow up symptom scores and voiding parameters.

BIPOLAR TRANSURETHRAL RESECTION OF PROSTATE VERSUS OPEN PROSTATECTOMY IN PATIENTS WITH PROSTATIC VOLUMES FROM 80-120 GM: A PROSPECTIVE RANDOMIZED STUDY.

Background: Transurethral resection of the prostate (TURP) is still considered the gold standard in the treatment of benign prostatic hyperplasia (BPH). However, open prostatectomy is indicated for prostate glands over 80 ml. There have been few reports concerning the use of TURP for large prostate glands over 100 ml. Objective: To prospectively compare the effectiveness and safety of bipolar TURP and open prostatectomy in prostate glands ranging from 80-120 ml. Patients and Methods: We reviewed the data of 60 patients with prostate glands ranging from 80-120 ml. which were randomized 30 patients underwent bipolar TURP (group A), and another 30 underwent open prostatectomy (group B). Preoperative International Prostate Symptom Score (IPSS), flow rate (Qmax), prostate volume, resected tissue volume, and operative time were documented. Postoperative hemoglobin, serum sodium change, hospital stay, duration of catheter indwelling and postoperative 6-month IPSS and Qmax were evaluated. Results: The Bipolar TURP (B-TURP) and open prostatectomy (OP) emphasized similar mean operating durations as well as the mean hemoglobin drop, catheterization period and hospital stay were significantly improved for bipolar group. During the follow up period, no statistically significant difference was determined in terms of IPSS, Qmax, QOL, PVRU between the two series. Conclusion: Bipolar TURP represented a promising endoscopic approach in very large BPH cases compared with standard open prostatectomy as patients benefited from significantly satisfactory follow up symptom scores and voiding parameters.

Diagnostic Value of Cytokeratin 34 beta E12 (Ck34βE12) and α-Methylacyl-CoA racemase (AMACR) Immunohistochemical Expression in Prostatic Lesions.

Background & Objective:Some prostatic lesions contain small suspicious foci for prostatic carcinoma in which the morphological features are equivocal. Two immunohistochemical markers namely, cytokeratin 34 beta E12 (Ck34βE12) and α-Methylacyl-CoA racemase (AMACR), were evaluated in these lesions for a definitive diagnosis and avoiding misdiagnosis or overdiagnosis of prostatic carcinoma.Methods:A total of 90 paraffin embedded blocks of prostatic tissue were selected and categorized into three groups as follows: 50 cases of benign prostatic hyperplasia (BPH), 20 cases of prostatic carcinoma, and 20 cases of benign prostatic lesions with suspicious foci labeled as ASAP (atypical small acinar proliferation) that occupy not more than 5% of the lesion. These cases were revised for histopathological diagnosis and stained with two immunohistochemical markers: Ck34βE12 and AMACR.Results:While 92.9% of BPH were positive for Ck34βE12, 96% of prostatic carcinoma were negative for this marker (P=0.0001). Regarding AMACR, 92.9% of BPH cases were negative, but 92% of prostatic carcinoma cases were positive for this marker (P=0.0001). Out of 20 cases of BPH, 15 cases containing suspicious foci showed Ck34βE12+/AMACR- (diagnosis: benign), but 5 cases were Ck34βE12-/AMACR+, for which the diagnosis changed to prostatic carcinoma (P=0.04).Conclusion:Immunohistochemical staining with Ck34βE12 and AMACR improved the diagnostic performance and increased confidence level for establishing definite diagnosis in cases with suspicious foci, in which the morphological features were equivocal. This could help to avoid misdiagnosis or overdiagnosis of prostatic carcinoma that would eventually improve the management of the patient and subsequently the prognosis.

PTEN Loss in a Prostate Cancer Cohort From Jordan.

Deletion of phosphatase and tensin homolog (PTEN) in prostate cancer has been associated with early biochemical recurrence, increased metastatic potential, and androgen independence. We evaluated the status of PTEN loss in a cohort of prostate cancer patients from Jordan. We investigated 71 patients with prostate cancer and 52 control subjects with benign prostatic hyperplasia (BPH). PTEN status was assessed by immunohistochemistry. PTEN mutations on exons 1, 2, 5, and 8 were also evaluated by polymerase chain reaction single-stranded conformation polymorphism (PCR-SSCP). We found PTEN loss in 42 of 71 (59.2%) evaluated prostate cancer cases by immunohistochemistry. In contrast, 51 of 52 BPH (98.1%) cases had an intact PTEN. In a subset of 24 prostate cancer cases evaluated by PCR-SSCP, we found PTEN mutations in 15 (62.5%) cases, whereas 22 (91.7%) of BPH controls lacked PTEN mutations. Exon 5 was the most frequently mutated exon (37.5%). Although the loss of PTEN was not significantly correlated with the Gleason Score (GS) or the World Health Organization (WHO)-International Society of Urological Pathology (ISUP) Grade Group (GG), we found higher frequency of PTEN loss (64%) in patients with GS≥4+3/GG≥3, compared with patients with GS≤3+4/GG≤2 (47.6%). In this first study to address the question of PTEN loss in a predominantly Arab population, we documented the frequency of PTEN loss in prostate cancer patients from Jordan, which was found to be higher than in comparable cohorts from East Asia, and was at the higher end of the range of reported frequency of PTEN loss in respective cohorts from North America and Western Europe. Although there was more frequent PTEN loss in cancers with higher GS/GG, this was not statistically significant.

The role of clean intermittent catheterization in the treatment for detrusor underactivity

ObjectiveTo study the influence of clean intermittent catheterization (CIC) on the lower urinary tract function in patients with urinary retention (UR) due to detrusor underactivity (DU). Material and methodsA longitudinal study was carried out on 49 patients (28 men, 21 women) of mean age 55years, who underwent CIC for UR secondary to DU. The mean CIC frequency was 3.15 times/day. Patients’ clinical data were collected, and they underwent urodynamic study before and after CIC, with a mean interval of 4years. Fisher's exact test was used for the analysis of categorical variables and Student's t test for parametric variables. The level of significance was set at 0.05 for a two-tailed test. ResultsThe second urodynamic study showed a significantly increased bladder compliance, the Bladder Outlet Obstruction Index (BOOI) and the Bladder Contractility Index (BCI) also increased but without reaching statistical significance. There was a significantly higher percentage of benign prostatic hyperplasia (BPH) and acontractile detrusor cases among the group of patients whose BCI improved after CIC, with significantly lower CIC time. ConclusionsCIC improved bladder compliance in the patients of our series. The BCI improved in BPH patients and in patients with acontractile detrusor.

The Significance of Aldehyde Dehydrogenase 1A1 Expression in Benign Prostatic Hyperplasia, Prostatic Intraepithelial Neoplasia and Prostatic Adenocarcinoma

Background: Prostatic carcinoma contains a small population of cancer stem cells (CSCs) that promote tumor growth, maintenance, and progression. CSC markers could provide a prognostic tool for human malignancies. Therefore, CSCs may have a role in prostatic carcinoma. This study aimed to evaluate the expression patterns and significance of stem cell marker aldehyde dehydrogenase 1A1 (ALDH1A1) in prostatic adenocarcinoma. Methods: This is a retrospective study performed upon 60 cases grouped as; 10 cases (16.7%) of benign prostatic hyperplasia (BPH), 6 cases (10%) of high-grade prostatic intraepithelial neoplasia (HGPIN) and 44 cases (73.3%) of prostatic adenocarcinoma (PCa) of different Gleason scores. Immunohistochemistry was applied on formalin-fixed, paraffin-embedded blocks using ALDH1A1. The relation between ALDH1A1 expression and clinicopathologic parameters was assessed. Results: Low expression of ALDH1A1 was seen in all cases (100%) of BPH, 5/6 (83.3%) of HGPIN and 12/44 (27.3%) of PCa, while high expression was in 1/6 case (16.7%) of HGPIN and 32/44 (72.2%) of PCa cases. There were significant relations between the expression levels of ALDH1A1 in PCa compared with HGPIN and BPH cases (P<0.01). ALDH1A1 expression showed highly significant associations with pre-operative serum PSA level, Gleason score, Gleason Grade Group (P<0.01) and was significantly associated with perineural invasion and tumor stage (P<0.05). No significant relations were found between ALDH1A1 expression and patients` age, capsular invasion, lymphovascular invasion, depth of invasion (pT) or lymph node metastasis. Conclusion: ALDH1A1 is a prostate CSC marker, could be involved in tumorigenesis and progression of prostatic adenocarcinoma

El cateterismo vesical intermitente en la insuficiencia contráctil del detrusor

ObjectiveTo study the influence of clean intermittent catheterization (CIC) on the lower urinary tract function in patients with urinary retention (UR) due to detrusor underactivity (DU). Material and methodsA longitudinal study was carried out on 49 patients (28 men, 21 women) of mean age 55years, who underwent CIC for UR secondary to DU. The mean CIC frequency was 3.15 times/day. Patients’ clinical data were collected, and they underwent urodynamic study before and after CIC, with a mean interval of 4years. Fisher's exact test was used for the analysis of categorical variables and Student's t test for parametric variables. The level of significance was set at 0.05 for a two-tailed test. ResultsThe second urodynamic study showed a significantly increased bladder compliance, the Bladder Outlet Obstruction Index (BOOI) and the Bladder Contractility Index (BCI) also increased but without reaching statistical significance. There was a significantly higher percentage of benign prostatic hyperplasia (BPH) and acontractile detrusor cases among the group of patients whose BCI improved after CIC, with significantly lower CIC time. ConclusionsCIC improved bladder compliance in the patients of our series. The BCI improved in BPH patients and in patients with acontractile detrusor.

Efficacy and Safety of 1470-nm Diode Laser Enucleation of the Prostate in Individuals With Benign Prostatic Hyperplasia Continuously Administered Oral Anticoagulants or Antiplatelet Drugs

ObjectiveTo evaluate the efficacy and safety of 1470-nm Diode Laser Enucleation of the Prostate (DiLEP) in patients with benign prostatic hyperplasia continuously receiving oral anticoagulants or antiplatelet drugs. MethodsFrom January 2016 to June 2017, 144 patients were submitted to 1470-nm DiLEP, including 49 (34.0%) continuously administered anticoagulants or antiplatelet drugs per os due to cardiac and/or cerebrovascular diseases (group A), while 95 (66.0%) were not (group B). Evaluation was performed preoperatively, and at postoperative 3, 6, and 12 months, respectively. Patient baseline features, operative data, perioperative complications, and postsurgical outcomes were assessed. ResultsBoth groups had comparable preoperative parameters, except age (77.3 ± 7.5 vs 73.2 ± 8.8 years, P = .007). Meanwhile, surgical time, sodium decrease, catheterization duration, and hospital stay markedly differed between the 2 groups. In comparison with group B, group A patients had statistically higher blood loss (14.9 ± 7.3 g/L vs 10.2 ± 7.0 g/L, P < .001) and increased bladder irrigation time (21.1 ± 10.9 hours vs 16.1 ± 9.0 hours, P = .004). One case required blood transfusion in group A, because of moderate anemia preoperatively. Both groups showed similar blood transfusion and complication rates. International Prostate Symptom Score, quality of life score, maximum flow rate, and postvoid residual were markedly improved in both groups at 3-, 6-, and 12-month follow-up postoperatively compared with baseline values. However, no statistically significant differences were observed between the 2 groups in various assessment parameters at follow-up (P > .05). ConclusionThese findings demonstrated that 1470-nm DiLEP is efficient and safe in benign prostatic hyperplasia cases receiving continuous oral anticoagulant or antiplatelet drugs. Anticoagulation therapy did not significantly influence the results and complication rates.

Explore: The Value of Prostatic Calculi in Prostate Surgery

Objective To explore the significance of prostatic calculi in prostate surgery. Methods During the beginning of 2010 to the end of 2017, a retrospective analysis was made of 821 cases of benign prostatic hyperplasia (BPH) with prostatic calculi admitted to our hospital. During 2010 to 2015, transurethral resection of the prostate (TURP) was performed. And then, from 2015 to 2017, it was replaced as transurethral laser vaporization of the prostate (TULVP). There were 5 converted to open. We should remove the prostate tissue til the surgical capsule by electrocision or vaporization. If annular fibrous tissue or prostatic calculi are encountered during the operation, the calculi will be exfoliated, and then stop operation. Results All the operations were successfully completed, with an average times of 47 minutes (22-117 minutes), bleeding of 50ml (15-350 ml), indwelling catheter for 5.7 days (3-10 days), and continuous bladder irrigation for 1.3 days (1-5 days). During the follow-up period of 0.4-5 years, the urination symptoms and quality of life of the post-operation patients were significantly improved. Conclusions Prostate calculi can be used as a marker of the depth of operation for BPH.

Immunoexpression of estrogen receptor-β and progesterone receptor in prostate adenocarcinoma, does it inhibit neoplastic proliferation and invasion?

The roles of estrogen and progesterone in human prostate carcinogenesis have been only recently recognized. This study was conducted to evaluate the expressions of esterone receptor-beta (ER-β), progesterone receptor (PR), and Ki-67 in benign and malignant lesions of the prostate. The study was conducted at a tertiary care hospital. It was an analytical cross-sectional study. We selected a total of 39 cases including 26 cases of benign prostatic hyperplasia and 13 cases of adenocarcinoma prostate. The proportion of cases showing expression for ER-β, PR, and Ki-67 was noted for both groups. A difference in immunoexpression between benign and malignant cases was evaluated. Association between receptor expression and Gleason grade was evaluated for malignant cases. To compare the difference in expressions of ER-β, PR, and Ki-67 Mann-Whitney U test was used. Association between ER-β, PR, and Ki-67 expression and Gleason grade was analyzed using the Chi-square test. ER-β expression was seen in all benign and malignant cases, whereas the majority of the malignant cases (61.54%) were negative for progesterone expression. Epithelial expressions of ER-β and PR were significantly higher in benign as compared with malignant lesions. Malignant cases showed a significantly higher expression of Ki-67. However, we did not find any association between the expressions of these markers with Gleason grade. The expressions of ER-β and PR were significantly higher in the epithelium in benign cases as compared with malignant cases. Ki-67 expression was significantly higher in the malignant group as compared with the benign group.