Features Of Benign Prostatic Hyperplasia Research Articles

Radiogenomic analysis of ultrasound phenotypic features coupled to proteomes predicts metastatic risk in primary prostate cancer

BackgroundPrimary prostate cancer with metastasis has a poor prognosis, so assessing its risk of metastasis is essential.MethodsThis study combined comprehensive ultrasound features with tissue proteomic analysis to obtain biomarkers and practical diagnostic image features that signify prostate cancer metastasis.ResultsIn this study, 17 ultrasound image features of benign prostatic hyperplasia (BPH), primary prostate cancer without metastasis (PPCWOM), and primary prostate cancer with metastasis (PPCWM) were comprehensively analyzed and combined with the corresponding tissue proteome data to perform weighted gene co-expression network analysis (WGCNA), which resulted in two modules highly correlated with the ultrasound phenotype. We screened proteins with temporal expression trends based on the progression of the disease from BPH to PPCWOM and ultimately to PPCWM from two modules and obtained a protein that can promote prostate cancer metastasis. Subsequently, four ultrasound image features significantly associated with the metastatic biomarker HNRNPC (Heterogeneous nuclear ribonucleoprotein C) were identified by analyzing the correlation between the protein and ultrasound image features. The biomarker HNRNPC showed a significant difference in the five-year survival rate of prostate cancer patients (p < 0.0053). On the other hand, we validated the diagnostic efficiency of the four ultrasound image features in clinical data from 112 patients with PPCWOM and 150 patients with PPCWM, obtaining a combined diagnostic AUC of 0.904. In summary, using ultrasound imaging features for predicting whether prostate cancer is metastatic has many applications.ConclusionThe above study reveals noninvasive ultrasound image biomarkers and their underlying biological significance, which provide a basis for early diagnosis, treatment, and prognosis of primary prostate cancer with metastasis.

Correlation Of Age Factors With Incidence Rates Of Benign Enlarged Prostate Disease At Royal Prima Rsu In 2022

Benign prostatic hyperplasia is a condition where stromal and epithelial contributions are proliferative. The clinical features of benign prostatic hyperplasia are prostate enlargement, lower urinary tract complaints, and bladder obstruction. Several factors are thought to increase the risk of benign prostate hyperplasia, including age, family history, obesity, physical activity, diabetes, diet, smoking and alcohol consumption. This study aims to determine the relationship between age factors and the incidence of benign prostatic hyperplasia disease at RSU Royal Prima Medan. This study used quantitative research with a cross-sectional approach. The sampling technique in this study used a total sampling technique. This study analyzed a sample of 32 data using univariate and bivariate tests using Chi-Square. Based on the univariate test, it is known that the incidence of benign prostatic hyperplasia mostly occurs at the age of 61-70 years, as many as 15 people (46.9%). Based on the results of ultrasound, the size of the prostate volume is mostly 61 - 80 ml, as many as 15 people (46.9%). Based on the bivariate test using Chi-Square, the p-value is 0.023 (p&lt;0.05), so it can be concluded that there is a significant relationship between age and benign prostatic hyperplasia.

The Effect of Karkatibeejadi Churna by Internal Administration in Mutraghata with special reference to Benign Prostatic Hyperplasia

Benign Prostatic Hyperplasia is a non-malignant enlargement of the prostate gland caused by excessive growth of prostatic tissue. The main symptoms of BPH include hesitancy, frequency, urgency, weak stream urination, straining and nocturia. These together termed as LUTS. We cannot see a single disease in Ayurveda which shows all the features of benign prostatic hyperplasia. Mutragranthi is one among the 12 types of Mutraghatas which can be compared with benign prostatic hyperplasia due to its similarities in morphological, anatomical, and clinical features. Lower urinary symptoms in patients are very troublesome which affects their daily routine and sleep pattern and a negative impact on their quality of life. Embarrassment and the treatment cost prevent them to take timely treatment. In modern system of medicines, the treatment of BPH is done by conservative and surgical therapies. These methods have significant complications and are too expensive. Karkatibeejadi churna is mentioned in Bhaishajyaratnavali in Mutraghata prakarana. The ingredients of this Choorna are easily available and easy to prepare and consume. This case study was done in a participant of age 67 years with symptoms of benign prostatic hyperplasia which was confirmed by USG in search of an effective, cost effective conservative treatment. The Choorna was given for 60 days and assessments were done on 0th, 16th 31st, 46th and 61st days and the result showed significant reduction in symptoms, prostate volume and post void residual urine of benign prostatic hyperplasia.

Three-dimensional measurement and analysis of benign prostatic hyperplasia.

BackgroundThe volume and thickness of intravesical prostatic protrusion and other characteristics of benign prostatic hyperplasia have not been investigated. We determine the effects of age and prostate volume on anatomical features of benign prostatic hyperplasia using three-dimensional measurement in this study.MethodsThis retrospective study included a total of 98 patients with benign prostatic hyperplasia. Three-dimensional models of prostate, central gland, peripheral zone, intravesical prostatic protrusion, prostatic urethra and bladder were reconstructed according to pelvic T2-weighted magnetic resonance imaging of these patients. The models were used to measure the intravesical prostatic protrusion volume, intravesical prostatic protrusion thickness, intravesical prostatic protrusion index, intravesical prostatic protrusion, prostate volume, peripheral zone volume, peripheral zone thickness, peripheral zone index, prostatic urethra thickness, the angle and distance of distal prostatic urethra with regard to coronal plane and sagittal plane and so on.ResultsIntravesical prostatic protrusion volume, intravesical prostatic protrusion thickness and peripheral zone volume of prostate volume >80 mL group were significantly higher than these in prostate volume <80 mL group (P<0.001, 0.01, 0.01, respectively). These parameters significantly increased with age (P<0.001, 0.01, 0.05, respectively). Peripheral zone index was significantly lower of prostate volume >80 mL group than these in prostate volume <80 mL group (P<0.05). Peripheral zone index significantly decreased with age (P<0.01). Intravesical prostatic protrusion index had no significant difference in all age groups. Peripheral zone thickness and prostatic urethra thickness had no significant difference in all groups. The distance and angle of distal prostatic urethra prostatic urethra with regard to coronal plane were significantly higher than these with regard to sagittal plane (both P<0.001).ConclusionsThe rearward slope of the prostatic urethra is greater than the left or right offset during the process of benign prostatic hyperplasia. Three-dimensional measurement provides good supports for further clinical and scientific research.

Morphologic features of benign prostatic hyperplasia depending on the size of intravesical prostatic protrusion

Relevance. Benign prostatic hyperplasia (BPH) is characterized by the presence of stromal and glandular hyperplasia in the periurethral and transitional zones. To describe the nature of intravesical growth of prostate tissue, an index of intravesical prostatic protrusion (IPP) was proposed. Clinically, men with an IPP measuring 10 mm or more are less likely to respond to α1-blocker therapy and 5α-reductase inhibitors. Thus, the description of the morphological features of the prostate depending on IPP grade is an actual issue. Purpose: to identify features of the morphological structure of the IPP in men with BPH. Materials and methods. Surgical treatment of the clinical form of BPH was performed to 30 men. Patients were divided into 2 groups: 1st group had IPP less than 10 mm (n = 12) and the 2nd group had IPP 10 mm or more (n = 18). In this study we evaluated the age, prostate volume and the value of IPP. The material for morphological investigation was obtained with transurethral resection of the prostate from the IPP zone. For light-optical examination, the preparations were stained with hematoxylin-eosin for routine evaluation of the structure of the prostate gland and for Van Gieson to estimate the proportion of the muscular and fibrous components of the stroma. The quantification of structural indicators was carried out by means of the television image analyzer MEKOS-TS2 in an automatic mode. Results: The groups were similar in age and prostate volume. In the group with IPP value of 10 mm or more, the proportion of the stromal component in the IPP zone was 77.5 ± 11.0%, the proportion of the glandular component was 22.5 ± 11.0%, respectively. In the group of men with IPP less than 10 mm, the proportion of the stromal component in the IPP zone was 96.0  1.5%, the proportion of the glandular component was 4.0 ± 1.5%, respectively (p &lt; 0.05). It was also found that with an increase in IPP there is a tendency to decrease the proportion of the muscular component of the stroma. Conclusion: In men with BPH, with an increase in the value of intravesical prostatic protrusion in this zone, a relative increase in the proportion of the glandular component and a decrease in the proportion of the stromal component is proved, as well as a tendency to reduce the proportion of the muscular component of the stroma. (For citation: Krivoborodov GG, Raksha AP, Efremov NS, et al. Morphologic features of benign prostatic hyperplasia depending on the size of intravesical prostatic protrusion. Urologicheskie vedomosti. 2017;7(4):17-23. doi: 10.17816/uroved7417-23).

Association Study of Polymorphisms of Epidermal Growth Factor and Epidermal Growth Factor Receptor With Benign Prostatic Hyperplasia in a Korean Population.

PurposeRecent studies have suggested that specific single-nucleotide polymorphisms (SNPs) contribute to the clinical features of benign prostatic hyperplasia (BPH). In this study, we investigated the relationships of genetic polymorphisms of the epidermal growth factor (EGF) gene and the epidermal growth factor receptor (EGFR) gene with BPH.MethodsA total of 218 patients with BPH were enrolled in this study. We evaluated the relationship between eight SNPs in the EGF and EGFR genes and prostate volume, prostate-specific antigen (PSA), and International Prostate Symptom Score of BPH patients. Each SNP was genotyped by direct sequencing. Statistical analysis applying codominant, dominant, recessive, and log-additive models was performed via logistic regression.ResultsThe rs11568943 and rs11569017 SNPs in the EGF gene showed significant associations with prostate volume (rs11568943: P=0.038 in the log-additive model, P=0.024 in the allele distribution; rs11569017, P=0.031 in the dominant model, P=0.028 in the log-additive model, P=0.020 in the allele distribution). Additionally, the rs3756261, rs11568943, and rs11569017 SNPs of the EGF gene and the rs2293347 SNP of the EGFR gene were associated with PSA levels (P<0.05 in each model, respectively).ConclusionsThese results suggest that the EGF gene may affect prostate volume. In addition, the EGF and EGFR genes may be associated with PSA levels in patients with BPH.

The Prevalence of Prostatic Stromal Tumor of Uncertain Malignant Potential in Specimens Diagnosed as Prostatic Hyperplasia.

Prostatic stromal tumors of uncertain malignant potential (STUMPs) are rare tumors arising from the specialized prostatic stroma. These tumors share certain histological and clinical features of benign prostatic hyperplasia, resulting in misdiagnosis of STUMP as prostatic hyperplasia. However, in contrast to prostatic hyperplasia, occasional cases have been documented to recur rapidly after resection and few of them have progressed to prostatic stromal sarcoma and distant metastasis. In this study, we aimed to estimate the prevalence of prostatic STUMP in specimens initially diagnosed as prostatic hyperplasia. A total of 702 consecutive pathology slides with a diagnosis of prostatic hyperplasia between 2009 to 2014 in specimens were obtained by prostatectomy or trans- urethral resection of the prostate. Those slides were submitted to Faghihi hospital, affiliated to Shiraz University of Medical Sciences, and were reviewed retrospectively in order to search the findings in favor of STUMP. Based on histological findings, STUMP was identified in 3 cases (0.43%), which revealed hypercellular stroma, infiltrating between the hyperplastic glands. Cells showed some degree of pleomorphism, nuclei with vesicular chromatin and few mitotic figures. No recurrence was reported in patients. Although STUMP can be histologically and clinically misdiagnosed as BPH, the differences in prognosis and treatment modalities highlight the importance of rendering the correct diagnosis.

Molecular classification of benign prostatic hyperplasia: A gene expression profiling study in a rat model.

To characterize the molecular features of benign prostatic hyperplasia by carrying out a gene expression profiling analysis in a rat model. Fetal urogenital sinus isolated from 20-day-old male rat embryo was implanted into a pubertal male rat ventral prostate. The implanted urogenital sinus grew time-dependently, and the pathological findings at 3 weeks after implantation showed epithelial hyperplasia as well as stromal hyperplasia. Whole-genome oligonucleotide microarray analysis utilizing approximately 30 000 oligonucleotide probes was carried out using prostate specimens during the prostate growth process (3 weeks after implantation). Microarray analyses showed 926 upregulated (>2-fold change, P < 0.01) and 3217 downregulated genes (<0.5-fold change, P < 0.01) in benign prostatic hyperplasia specimens compared with normal prostate. Gene ontology analyses of upregulated genes showed predominant genetic themes of involvement in development (162 genes, P = 2.01 × 10(-4) ), response to stimulus (163 genes, P = 7.37 × 10(-13) ) and growth (32 genes, P = 1.93 × 10(-5) ). When we used both normal prostate and non-transplanted urogenital sinuses as controls to identify benign prostatic hyperplasia-specific genes, 507 and 406 genes were upregulated and downregulated, respectively. Functional network and pathway analyses showed that genes associated with apoptosis modulation by heat shock protein 70, interleukin-1, interleukin-2 and interleukin-5 signaling pathways, KIT signaling pathway, and secretin-like G-protein-coupled receptors, class B, were relatively activated during the growth process in the benign prostatic hyperplasia specimens. In contrast, genes associated with cholesterol biosynthesis were relatively inactivated. Our microarray analyses of the benign prostatic hyperplasia model rat might aid in clarifying the molecular mechanism of benign prostatic hyperplasia progression, and identifying molecular targets for benign prostatic hyperplasia treatment.

Elevated expression of HIF-lα in actively growing prostate tissues is associated with clinical features of benign prostatic hyperplasia.

BackgroundBenign prostatic hyperplasia (BPH) is one of the most common diseases in middle-age or older men. Increasing evidence has shown that BPH is associated with hypoxia microenvironment.MethodsWe retrospectively collected patient data and tissue samples from fetal prostates(FP), normal prostates(NP), intra-acinar of BPH, peri-acinar of BPH, prostate cancers and sarcomas of prostate. The expression of HIF-1α, as well as VEGF was visualized by immunohistochemistry and statistically analyzed with clinical parameters.ResultsExpression of HIF-lα was observed in intra-acinar of BPH (69.5%), prostate cancer (85.7%) and all FPs, while NP and peri-acinar of BPH tissues were all stained negative. HIF-lα levels in FPs and the malignant tumors were higher than BPH tissues(p < 0.05), and the expression of HIF-lα in intra-acinar of BPH was higher than NP and peri-acinar of BPH (p < 0.05). The expression of HIF-lα was correlated with the weight of intra-acinar of prostate (p < 0.05). And patients with prostate weight larger that 72.45g were prone to have HIF-lα moderate-positive expression, according to the ROC curve (AUC = 0.734, 95%CI = 0.630-0.838). Moreover, the risk of acute urine retention (AUR) for HIF-lα moderate-positive patients increased significantly (OR=5.517, 95%CI = 2.434-12.504).ConclusionsHIF-lα expression is increased in highly proliferative prostate tissues and correlated with the weight of intra-acinar prostate. Moreover, HIF-lα is also an independent risk factor for AUR occurrence in BPH patients.

Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications.

Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

SIGIRR/TIR8, an important regulator of TLR4 and IL-1R–mediated NF-κB activation, predicts biochemical recurrence after prostatectomy in low-grade prostate carcinomas

Single Ig IL-1-related receptor (SIGIRR) is a negative regulator of toll-like receptor 4 and IL-1-mediated activation of nuclear factor κ-light-chain enhancer of activated B cells. The purpose of this study was to qualitatively and quantitatively determine SIGIRR protein expression in human prostate tissues and associate SIGIRR expression with clinical parameters. SIGIRR expression was quantified in glandular prostate tissue using immunohistochemistry and multispectral imaging, and expression was evaluated in relation to clinicopathological features of benign prostatic hyperplasia and prostate cancer (PCa). Subgroupings of low Gleason score (≤ 6 and 3 + 4) and high Gleason score (4 + 3 and ≥ 8) were used for patient outcomes. SIGIRR was predominantly expressed in the cytoplasm and nucleus of the prostatic epithelium with little expression within the stroma. Compared with normal prostate, cytoplasmic SIGIRR expression was similar in benign prostatic hyperplasia, high-grade prostatic intraepithelial neoplasia, PCa, and metastases. A decrease in nuclear expression was found in metastasis samples (P = .04). Changes in SIGIRR expression were not associated with Gleason score, pathological stage, tumor volume, surgical margin status, or serum prostate-specific antigen (P > .05). Nuclear (P = .96) and cytoplasmic (P = .89) SIGIRR expressions were not related to patient outcomes in univariable analysis, but in the analysis of patients with low Gleason scores, high cytoplasmic SIGIRR expression was associated with biochemical recurrence in both univariable (P = .01) and multivariable (hazard ratio, 2.31 [95% confidence interval 1.05-5.06]; P = .04) analyses. Similarly, in multivariable analysis of only low-stage (pT2) tumors, SIGIRR independently predicted biochemical recurrence (P = .009). We conclude that SIGIRR predicts biochemical recurrence in patients with low Gleason score and low pathological stage PCa.

Spontaneous hyperplasia of the ventral lobe of the prostate in aging genetically hypertensive rats.

Recent studies have shown that the prostatic autonomic innervation takes part in its homeostasis and growth. Other works showed that spontaneously hypertensive rats (SHR) show excessive sympathetic activity, accompanied by lower urinary tract symptoms, increased growth capacity of prostatic stromal cells, and increased levels of androgens and their receptors. Furthermore, young SHR were reported to present incipient stages of benign prostatic hyperplasia (BPH). The aim of the present study was to examine whether this strain indeed develops spontaneous BPH with age, and can thus serve as a genuine natural model for this disorder. For this purpose, ventral lobes of prostates of one-year-old, male SHR and their normotensive counterparts, Wistar Kyoto (WKY) rats, were examined histopathologically, and the degree of hyperplasia was evaluated according to a score-chart protocol (histoscore). SHR exhibited severe adenomatous spontaneous BPH, characterized by piling-up of epithelial cells, with papillary formations, accompanied by a mild increase in the amount of fibrocytes and smooth muscle cells in the stroma. This was reflected by histoscore values of 38 +/-2. Thickening of prostatic arterioles also was noted, as well as mild chronic inflammatory exudate. WKY rats did not show any of these features of BPH despite their age (histoscore 17 +/- 3, significantly different from that of SHR). We conclude that SHR can serve as a rodent model for the spontaneous development of BPH with age, most probably due to the excessive neuroendocrine activity characteristic of this rat strain.

Bladder dysfunction in patients with benign prostatic hyperplasia: relevance of cystometry as prognostic indicator of the outcome after prostatectomy.

We correlated cystometric findings to the clinical features of benign prostatic hyperplasia (BPH) and compared them in terms of outcome after prostatectomy. Cystometric findings obtained from 78 patients who underwent prostatectomy were correlated with clinical features in BPH patients. In 41 consecutive patients of this group, prospective periodical cystometry was also performed. Low bladder compliance correlated significantly with an increase in age and prostate volume, detrusor instability and impaired contractility. Low compliance also correlated with irritative symptoms, decreased maximum flow rate, increased post-void residual urine and an increase in the American Urological Association symptom score. Postoperative persistent incontinence was associated with low bladder compliance and detrusor instability. In a prospective study, bladder dysfunction was not completely restored in 53% of patients examined at a mean interval of 7.7 months after prostatectomy. Among the cystometric parameters investigated, low compliance was the most relevant to the clinical features of BPH and had some predictive value for the outcome after prostatectomy. In about half of the BPH patients with bladder dysfunction preoperatively, this condition was irreversible for a significant period of time after prostatectomy, in spite of surgical relief of the infravesical obstruction.

Quantitation of the Prostatic Intra-Epithelial Neoplasia: Analysis of the Nucleolar Size, Number and Location

Correlation has previously been demonstrated between qualitative and quantitative architectural and cytological features of the prostatic intra-epithelial neoplasia. In the present study, a standard Zeiss microscope and a horizontal eyepiece micrometer were used in an attempt to quantitatively define the size, number and location of nucleoli in relation to the degree of prostatic intra-epithelial neoplasia and associated benign prostatic hyperplasia and adenocarcinoma. In total, 20 prostatectomies, where features of benign prostatic hyperplasia (20 cases), prostatic intra-epithelial neoplasia of grade 1 (10 cases) and grade 2 (10 cases), and adenocarcinoma (20 cases) were present, were studied. The quantitative analysis showed that, going from benign prostatic hyperplasia to prostatic intra-epithelial neoplasia of grade 1 and 2, and to adenocarcinoma, the values of the size-related nucleolar features, are progressively greater; when considering the frequency-related nucleolar features, the percentage of nucleolated nuclei increased sharply. This was associated with the decrease in the proportion of mononucleolated nuclei and increase in nuclei with two and three nucleoli. When considering the location-related nucleolar features, the degree of shift of the nucleoli to the periphery of the nucleus increased. Among all the quantitative features, the most evident changes in the nucleolar size were expressed by the nucleolar hypertrophy index after including in the calculation only those nucleoli with a diameter larger than 3 arbitrary units, whereas the percentage of nucleolated nuclei and the proportion of nuclei with two and three nucleoli best represented the modifications to the frequency.(ABSTRACT TRUNCATED AT 250 WORDS)

Cytology of the Canine Reproductive System

The methods for semen collection, its laboratory examination, and the interpretation of findings are presented in this article. The lack of comprehensive data for normal dogs and the lack of data associating actual percentages of spermatozoa with specific abnormalities with fertility or infertility are highlighted. Consequently, there is a need for standardization and completeness of semen examination procedures, especially in studies destined for publication. Collection and analysis of prostatic samples then is discussed, and the distinguishing cytological features of benign prostatic hyperplasia, prostatic adenocarcinoma, prostatis (including prostatic abscessation), and prostatic cysts are presented. This is followed by an assessment of the clinical usefulness of vaginal cytology, particularly to assist in the management of normal canine reproduction and in the diagnosis of reproductive disorders. The ways in which vaginal smears can facilitate the diagnosis of the stage of the estrous cycle and the diagnosis of abnormalities of the cycle and other disorders of reproduction are presented. Further consideration is given to its use to estimate the time of ovulation retrospectively and estimate the time of whelping prospectively. Finally, two specific diseases that can affect dogs and bitches are reviewed, namely, canine brucellosis and transmissible venereal tumor.

Organ culture of benign nodular hyperplasia of human prostate in chemically-defined medium.

Explants of hyperplastic prostatic tissue from 27 men aged 55 to 85 years were maintained in organ culture in a chemically-defined medium (Trowell T8) for periods ranging from 2 to 12 days. The histological features of benign nodular hyperplasia were regularly preserved during culture periods of up to 6 days in vitro. The fibromuscular stroma survived less well than the acinar epithelium. Explants were often covered by cuboidal or fusiform cells (edge cells) which were frequently continuous with the epithelium of acini trans-sected at the explant surface. Colcemid studies revealed multiple arrested mitotic figures in the hyperplastic glandular epithelium from one of four prostates, whereas mitotic figures were never seen in tissues cultured in unsupplemented T8 medium. DNA-synthesis in acinar epithelium and edge cells, shown autoradiographically by the incorporation of 3H-thymidine into cell nuclei, was regularly present in explants cultured for 4 days. The incorporation of 3H-uridine was demonstrable in acinar epithelium as well as stromal cells after 6 days in vitro. In the present short-term experiments, the glandular epithelium retained the histological features of benign prostatic hyperplasia and the ability to synthetise DNA and RNA despite diffuse degeneration of the fibromuscular stroma. The organ culture technique with chemically-defined medium should have considerable value for the study of the diseased human prostate and its responses to defined external influences.