Incidence Of Benign Prostatic Hyperplasia Research Articles

Polygenic risk score predicting susceptibility and outcome of benign prostatic hyperplasia in the Han Chinese.

Given the high prevalence of BPH among elderly men, pinpointing those at elevated risk can aid in early intervention and effective management. This study aimed to explore that polygenic risk score (PRS) is effective in predicting benign prostatic hyperplasia (BPH) incidence, prognosis and risk of operation in Han Chinese. A retrospective cohort study included 12,474 male participants (6,237 with BPH and 6,237 non-BPH controls) from the Taiwan Precision Medicine Initiative (TPMI). Genotyping was performed using the Affymetrix Genome-Wide TWB 2.0 SNP Array. PRS was calculated using PGS001865, comprising 1,712 single nucleotide polymorphisms. Logistic regression models assessed the association between PRS and BPH incidence, adjusting for age and prostate-specific antigen (PSA) levels. The study also examined the relationship between PSA, prostate volume, and response to 5-α-reductase inhibitor (5ARI) treatment, as well as the association between PRS and the risk of TURP. Individuals in the highest PRS quartile (Q4) had a significantly higher risk of BPH compared to the lowest quartile (Q1) (OR = 1.51, 95% CI = 1.274-1.783, p < 0.0001), after adjusting for PSA level. The Q4 group exhibited larger prostate volumes and a smaller volume reduction after 5ARI treatment. The Q1 group had a lower cumulative TURP probability at 3, 5, and 10 years compared to the Q4 group. PRS Q4 was an independent risk factor for TURP. In this Han Chinese cohort, higher PRS was associated with an increased susceptibility to BPH, larger prostate volumes, poorer response to 5ARI treatment, and a higher risk of TURP. Larger prospective studies with longer follow-up are warranted to further validate these findings.

Association of sleep traits with benign prostatic hyperplasia in middle-aged and elderly men: A prospective analysis in UK Biobank.

The association of sleep traits (insomnia, sleep duration, chronotype, daytime sleepiness, and snoring) with benign prostatic hyperplasia (BPH) is unclear. This research aimed to examine the effects of sleep traits on BPH risk. A total of 170 241 men aged 38 to 73 years from UK Biobank were included. An overall healthy sleep score was created based on five sleep traits. A Cox regression model was utilized to compute adjusted hazard ratios (HRs) and population attributable fractions (PAFs) with 95% confidence intervals (CIs) for BPH risk in relation to sleep traits. During a median of 12.0 years follow-up, 13 026 incident BPH cases occurred. We observed that sleep duration (7-8 h/d; HR 0.95; 95% CI 0.92-0.99), no frequent insomnia (HR 0.71; 95% CI 0.69-0.74), and no frequent daytime sleepiness (HR 0.86; 95% CI 0.79-0.93) were significantly related to reduced BPH risk. Each one-point increment of the healthy sleep score was related to a decreased BPH risk, with an adjusted HR of 0.90 (95% CI 0.89-0.92). The multivariable-adjusted HR in men adopting five versus zero to one low-risk sleep traits was 0.68 (95% CI 0.61-0.75) for BPH risk. Estimates of the PAF indicated that 9.1% (95% CI 5.8-12.5%) of BPH cases would be prevented if all individuals had adopted all five low-risk sleep traits, assuming causality. Our study indicates an association between a healthy sleep pattern and a lower risk of BPH, emphasizing the importance of adhering to such patterns for potentially reducing BPH risk. Geriatr Gerontol Int 2024; ••: ••-••.

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.

Rezūm water vapor thermal therapy in patients with benign prostatic hyperplasia: Initial real-world data from Japan.

Benign prostatic hyperplasia (BPH) is prevalent in older men. As surgery can be high risk in this group, minimally invasive procedures are preferrable. This study aimed to assess the initial results of minimally invasive Rezūm water vapor thermal therapy (WVTT) in patients with BPH. This single-center retrospective study included 25 consecutive patients with BPH who underwent WVTT between September 2022 and July 2023. Parameters including age, Charlson Comorbidity Index and Geriatric 8 (G8) scores, operative time, and number of vapor injections were evaluated. The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score, and Core Lower Urinary Tract Symptom Score (CLSS) were used to assess symptoms before the procedure, and at 1 and 3 months after it. Urinary function indicators such as single voiding volume, maximum flow rate (MFR), and post-void residual volume were assessed at the same time points. The mean patient age was 76.0 years and the mean prostate volume was 54.8 mL. The mean G8 score was 14.4 and the Charlson Comorbidity Index score averaged 1.2. The mean operative time was 6.84 min, and included a mean of 4.8 vapor injections. Three months after WVTT, significant improvements were observed in the maximum flow rate (P = .02), post-void residual volume (P = .001), and urine volume (P < .001), as well as in the IPSS incomplete emptying (P = .01) and weak stream (P = .01) domains. No significant changes were observed in the remaining IPSS domains or in the Overactive Bladder Symptom Score or CLSS. This study provides the first report on Rezūm WVTT outcomes in Japan using the CLSS assessment tool. The initial results indicate a promising experience with this new treatment method. With a rapidly aging population, the incidence of BPH is expected to increase, making the minimally invasive Rezūm system a valuable addition to BPH treatment options.

Benign prostatic hyperplasia burden comparison between China and United States based on the Global Burden of Disease Study 2019.

To determine the difference in the burden of benign prostatic hyperplasia (BPH) between China and the United States from 1990 to 2019. The prevalence, incidence, Years Lived with Disability (YLD), and their age-standardized rates for BPH in China and USA from 1990 to 2019 were based on the Global Burden of Disease Study 2019 (GBD 2019). The annual percentage changes (APC) of the age-standardized incidence rate (ASIR) and the age-standardized YLD rates (ASYR) were calculated using joinpoint regression analysis. The YLD numbers of six urinary tract diseases were also compared in both countries. The absolute burden of BPH increased continuously in both countries, but it was much higher in China than in the United States. The ASIR and ASYR of BPH decreased in China but remained stable or decreased slightly in the United States. BPH incidence and YLD rates decreased in all age groups in China from 1990 to 2019. In the USA, they varied by age group. BPH caused more YLD number than any other urinary tract disease in China. In the USA, prostate cancer (PCa) caused more YLDs than BPH. This research reveals marked BPH burden differences between China and the US (1990-2019). China's higher burden necessitates targeted interventions, while unique trends in both countries demand tailored strategies. These insights enhance understanding of BPH dynamics, informing effective interventions across diverse contexts.

Comparative evaluation of the results of antibiotic prophylaxis of early postoperative complications of transurethral resection of the prostate in patients with benign prostatic hyperplasia

in Ukraine in 2021, the incidence of benign prostatic hyperplasia (BPH) was 321.6 per 100,000 population. Almost 17,000 operations on prostate gland have been performed, a significant proportion of which are transurethral resection (TURP). It has been proven that the most frequent early complications after surgical interventions on the prostate gland are the development of an acute inflammatory process in the genitourinary organs, bleeding from the area of there removed hyperplastic tissue of the prostate gland. Inflammatory diseases of the urogenital tract in men are characterized by a variety of etiological agents, the presence of mixed infections, and the growing importance of pathogens of sexually transmitted diseases. To improve the results of TURP in patients with BPH complicated by acute urinary retention by optimizing antibacterial prophylaxis of postoperative complications in the early postoperative period. The study is based on the results of the analysis of surgical treatment of 179 patients with BPH complicated by acute urinary retention who underwent TURP. The age of the patients varied from 51 to 84 years, the average age was 64.9±5.1 years. Patients were divided into two groups: Group I – 85 operated patients who were prescribed ceftriaxone (1.0 parenterally once a day) in the early postoperative period; Group II – 94 patients, in the early postoperative period got levofloxacin (500 mg IV for 3-5 days with subsequent transition to oral administration, once a day). The analysis of the obtained data established that in the early postoperative period 43 (24.1%) patients had complications. The most frequent complication was long-term macrohematuria, which was observed in 23 (12.9%) patients. Exacerbation of chronic pyelonephritis occurred in 13 (7.3%) operated patients, acute urethritis developed in 7 (3.9%) patients, acute orchiepididymitis was observed in 9 (5.0%) patients. The over all frequency of complications in patients with BPH who received levofloxacin in the early postoperative period was statistically significantly lower than in patients who were prescribed ceftriaxone. In particular, the use of levofloxacin in patients of the II group, with the aim of antibiotic prophylaxis of postoperative complications after TURP, made it possible to reduce the frequency of the latter by 60% (1.6 times), in relation to the patients of the I group. The use of levofloxacin for the prevention of early postoperative complications after TURP inpatients with BPH complicated by acute urinary retention improves the results of surgical treatment by reducing the frequency of complications in the postoperative period by 60%.

Prostatic Artery Embolization (PAE)

Benign prostatic hyperplasia (BPH) is a common condition affecting the majority of men over 60 years of age. BPH incidence increases with age and often leads to lower urinary tract symptoms including frequency, urgency, and straining. In patients that do not respond to pharmacological therapy, options include transurethral procedures such as transurethral resection (TURP) or photovaporization, surgical prostatectomy and prostate artery embolization (PAE). The goal of PAE is to occlude arterial supply to the prostate by selective catheterization and subsequent embolization, most commonly with spherical tris-acryl gelatin microspheres. Over weeks to months, reduced blood flow leads to necrosis of prostatic adenomatous tissue, resulting in reduction of prostate size and decreased urethral impingement, eventually allowing for long-term resolution of symptoms in a majority of patients. Advantages of this technique compared with the standard surgical option, TURP, include faster recovery times, fewer side effects, and lower complication rates with near equal efficacy.

The Cardiovascular Safety of Five-Alpha-Reductase Inhibitors Among Men with Benign Prostatic Hyperplasia: A Population-Based Cohort Study

BackgroundFive-alpha reductase inhibitors (5αRIs) are used to treat benign prostatic hyperplasia (BPH). However, the cardiovascular effects of 5αRIs remain poorly understood. The study objective was to compare the rate of hospitalization for heart failure among men with BPH prescribed 5αRIs to that of men with BPH not prescribed BPH medications. MethodsUsing the Clinical Practice Research Datalink linked with hospitalization and vital statistics data, we conducted a population-based cohort study among patients newly diagnosed with BPH. We defined exposure as the current use of 5αRIs, current use of alpha-blockers, and no current use of BPH medications in a time-varying approach. The primary endpoint was hospitalization for heart failure, and secondary endpoints were myocardial infarction, stroke, and cardiovascular death. We used time-dependent Cox-proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). ResultsOur cohort included 94,440 men with incident BPH. A total of 3893 hospitalizations for heart failure occurred over 527,660 person-years of follow-up (incidence rate 7.38; 95% CI, 7.15-7.61, per 1000 person-years). Compared with no current use of BPH medications, current use of 5αRIs was not associated with an increased risk of hospitalization for heart failure (HR 0.94; 95% CI, 0.86-1.03), myocardial infarction (HR 0.92; 95% CI, 0.81-1.05), stroke (HR 0.94; 95% CI, 0.85-1.05), or cardiovascular death (HR 0.89; 95% CI, 0.80-0.99). ConclusionsThe use of 5αRIs was not associated with an increased risk of hospitalization for heart failure, myocardial infarction, stroke, or cardiovascular death compared with non-use.

The nano-micellar curcumin improves International Prostate Symptoms Score (IPSS) in patients with benign prostatic hyperplasia: a randomized clinical trial.

Benign prostatic hyperplasia (BPH) is the main prevalent disorder in men over forty years, usually revealing itself with lower urinary tract symptoms. Despite the existence of different treatments, the incidence of BPH is increasing, so further studies for better management are a necessity. This research was designed to assay the effectiveness of nano-micellar curcumin on biomedical indicators of patients with BPH. The present research was a double-blind, randomized, and placebo-controlled trial that enrolled fifty-two patients with BPH between June 2021 and December 2021. Participants were randomized to receive 160mg/d nano-micellar curcumin (n = 26) or placebo (n = 26) as soft gel during 3months. Primary end point was changes in International Prostate Symptoms Score (IPSS). Data gathering was occurred using a standard inquiry form and measuring other biomedical parameters based on routine laboratory techniques. To compare the distribution of demographics and covariates, independent t-test and Chi-square were used. Nano-micellar curcumin had significant effect on IPSS (p value: 0.010), low effect on high-sensitive C-reactive protein (hs-CRP) (p value: 0.032), and low to intermediate effect on malondialdehyde (MDA) (p value: 0.014) level as secondary end points after the intervention. The effect of nano-micellar curcumin on other parameters was negligible. Overall, this trial indicated 3-month intake of nano-micellar curcumin had considerable effects on IPSS as the most common clinical symptom and also two biomedical parameters including serum hs-CRP and MDA. http://www.irct.ir : IRCT20170430033730N3.

Association between sleep quality and benign prostate hyperplasia among middle-aged and older men in India

BackgroundThe association between sleep quality and benign prostate hyperplasia (BPH) has rarely been studied. The aim of this study was to examine the relationship between sleep quality and BPH among middle-aged and older men in India.MethodsThis study used data from men over 45 years old in Wave 1 (2017–2018) of the Longitudinal Aging Study in India (LASI). Benign prostate hyperplasia was self-reported, and sleep symptoms were assessed using five questions modified from the Jenkins Sleep Scale. A total of 30,909 male participants were finally included. Multivariate logistic regression analysis, subgroup analysis, and interaction tests were performed.ResultsTotal 453 (1.49%) men reported benign prostatic hyperplasia and have higher sleep quality score (9.25 ± 3.89 vs. 8.13 ± 3.46). The results revealed that the sleep quality score and risk of benign prostatic hyperplasia were significantly correlated after adjusting for all confounding factors (OR:1.057, 95% CI: 1.031–1.084, p < 0.001]. After dividing people into four groups based on the quartile of sleep quality scores, compared with the first quartile group, the third quartile group was 1.32 times, and the fourth quartile group was 1.615 times more likely to develop benign prostate hyperplasia. A significant interaction effect of alcohol consumption was observed. (p for interaction < 0.05).ConclusionWorse sleep quality was significantly associated with a higher incidence of benign prostatic hyperplasia among middle-aged and older Indian men. A further prospective study is needed to clarify this association and explore potential mechanisms.

Safety profile of colocasia esculenta tuber extracts in benign prostate hyperplasia

IntroductionThis study was motivated by the increasing global incidence of benign prostatic hyperplasia (BPH) and the promising potential of nutraceuticals as complementary therapies in ameliorating its burden. We report the safety profile of C. esculenta tuber extracts, a novel nutraceutical in benign prostate hyperplasia in a rat model.MethodsIn this study, forty-five male albino rats were randomly assigned to 9 groups of 5 rats each. Group 1 (normal control) received olive oil and normal saline. Group 2 (BPH untreated group) received 3 mg/kg of testosterone propionate (TP) and normal saline, and group 3 (positive control) received 3 mg/kg of TP and 5 mg/kg of finasteride. Treatment groups 4, 5, 6, 7, 8, and 9 received 3 mg/kg of TP and a middle dose (200 mg/kg) of LD50 of ethanol crude tuber extract of C. esculenta (ECTECE) or hexane, dichloromethane, butanone, ethyl acetate and aqueous fractions of ECTECE respectively for a period of 28 days.ResultsThe negative controls showed a significant (p < 0.05) increase in mean relative prostate weight (approximately 5 times) as well as a reduction in relative testes weight (approximately 1.4 times less). There was no significant (p > 0.05) difference in the mean relative weights of most vital organs: liver, kidneys, and heart. This was also observed in hematological parameters: RBC, hemoglobin, HCT, MCV, MCH, MCHC, and platelets counts. In general, we note that the effects of the well-established drug finasteride on the biochemical parameters and histology of selected organs are comparable to those of C. esculenta fractions.ConclusionThis study demonstrates that C. esculenta tuber extracts provide potentially safe nutraceutical if applied in the management of benign prostate hyperplasia based on a rat model.

Prostate specific antigen in the serum of men ≥ 50 years old with benign prostatic hyperplasia and some related factors

Background: Men over 50 years old often have lower urinary tract symptoms and most of them are caused by benign prostatic hyperplasia (BPH). The incidence of benign prostatic hyperplasia increases with age. Besides benign prostate disease, the incidence of prostate cancer is increasing in Vietnam and ranks 7th according to GLOBOCAN 2020 estimates. Recognizing the characteristics of prostate-specific antigens will help in the diagnosis, treatment and monitoring of patients with prostatic pathologies are effective and accurate. The study aims to study the clinical and subclinical characteristics of patients with benign prostatic hyperplasia with lower urinary tract symptoms and investigate the characteristics of the concentration of prostate-specific antigens and some related factors. Subjects and methods: A descriptive cross-sectional study of 90 male patients aged 50 years and older with lower urinary tract symptoms due to benign prostatic hyperplasia. Record clinical features, ultrasound to measure prostatic volume, uroflowmetry, and serum PSA levels to be quantified. Evaluate the correlation between tPSA concentration with some factors such as: age, prostatic volume. Results: The most common age groups were 60 - 69 years old and 70 - 79 years old, patients were admitted to the hospital when they had moderate to severe urinary disorders, the average IPSS score was 19.0 ± 6.9; average QoL score 3.5 ± 1.1. The most common lower urinary tract symptoms were feeling of incomplete urination (86.7%), weak urine stream (84.4%), urinary exertion (81.1%), nocturia (80.0%). The mean prostate volume measured by ultrasound was 36.13 ± 10.86 ml. The mean bladder residual volume was 96.0 ± 47.6 ml, the mean Qmax was 12.7 ± 5.3 ml/s, the mean Qave was 5.6 ± 2.4 ml/s. Most patients had total PSA &lt; 4 ng/ml, accounting for 73.3%. Conclusion: Most of the benign prostatic hyperplasia had total prostate-specific antigen &lt; 4 ng/ml, accounting for 73.3%, only 3.3% of patients exceeded the level &gt; 10 ng/ml. There was no statistically significant relationship between total prostate-specific antigen levels and patient age. Total prostate-specific antigen concentration was related to the patient’s prostate volume (p &lt; 0.05). Key words: prostate, benign prostatic hyperplasia (BPH).

(065) The Impact of Testosterone-Replacement Therapy (TRT) on Benign Prostatic Hyperplasia (BPH) Incidence and Need for Interventions in Hypogonadal Men

Abstract Introduction Investigations on the application of testosterone-replacement therapy (TRT) in hypogonadal men with benign prostatic hyperplasia (BPH) show contrasting results. While some studies reported increased prostate-related events with TRT, recent evidence suggested that TRT can alleviate BPH symptoms in hypogonadal men. Objective Our main objective was to determine the impact of TRT on BPH incidence in a large cohort of hypogonadal men. We also evaluated the relationship between TRT in hypogonadal men and the need for BPH interventions. Methods This retrospective case-control study used the 2011-2020 IBM MarketScan database to identify males above 18 years old with a hypogonadism diagnosis, and determine if they received TRT. We used ICD-9, -10, CPT, HCPCS, and NDC codes to identify diagnoses, interventions, and medications. We excluded individuals who were diagnosed with congenital genetic disorders (e.g. chromosomal abnormalities), hypothalamic-pituitary disorders, or prostatic adenocarcinoma. BPH diagnosis was the primary outcome of this study, and BPH treatment was the secondary outcome. We ran cox proportional hazard (CPH) models from initial hypogonadism diagnosis to BPH occurrence to investigate the effect of TRT on the development of BPH. We also used CPH models from time of BPH diagnosis to first intervention, to evaluate the impact of TRT on BPH interventions. In all models we controlled for age, geographic region, population density, and comorbidities. We included TRT within the last 6 as a time-varying covariate in the models. For BPH occurrence there was non-proportionality in the effect of TRT. Thus, we ran two CPH models for BPH occurrence, one from first hypogonadism diagnosis to 912 days (2.5 years), and one from 2.5 years to the end of enrollment. Results In our total cohort of 882570 hypogonadal men, 157185 (17.8%) were diagnosed with BPH. Hyperlipidemia was the most common comorbidity detected in 84% and 68% of hypogonadal men with and without BPH respectively. For the first 2.5 years after hypogonadism diagnosis, there was no significant difference for development of BPH between patients on TRT and those who were not on TRT (HR 1.00, 95%CI 0.98-1.01, p=0.66). However, from 2.5 years onward, men who were on TRT had a 32% greater chance for development of BPH (HR 1.32, 95%CI 1.28-1.36, p&amp;lt;0.001). Hypogonadal men with BPH who received TRT showed no significant difference for BPH interventions compared to those who were not on TRT (HR 0.95, 95%CI 0.89-1, p=0.08). Conclusions In the long term, TRT can increase the risk of development of BPH in hypogonadal men. On the other hand, TRT in hypogonadal men with BPH does not change the need for BPH interventions. Our findings indicate that TRT should be used with caution in hypogonadal men who are at risk of developing BPH but further work is needed to clarify this relationship. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Educational/Research grant: Acerus, Coloplast, Endo, Boston Scientific; Consultant: Turtle Health; Hold equity: StreamDx, FirmTech, Maximus.

Retrospective Cohort Trial of the Effectiveness of Plasma Surgery for Benign Prostatic Hyperplasia of Large and Giant Sizes

Background. Over the past 10 years, the incidence of benign prostatic hyperplasia (BPH) over 80 cm3 has increased 34 times. With indications for surgical treatment, transurethral methods are increasingly used today with the use of laser or plasma techniques for resection and enucleation of the prostate. The article presents a comparative analysis of the results of plasma transurethral enucleation of the prostate (P-TUEP) and open prostatectomy, methods of surgical and drug prevention of dysuric complications, which indicates the primacy of the choice of P-TUEP in large and giant BPH surgery. Aims to prove the effectiveness of the use of plasma surgical methods and the scheme of complex medical postoperative prevention of late dysuric and cicatricial complications in the treatment of benign prostatic hyperplasia of large and giant sizes. Methods. The design of a retrospective cohort trial included several stages conducted at the urological center of the clinical hospital RZD-Medicine, Nizhny Novgorod in 20082019. The object of the study were patients with a confirmed diagnosis of large BPH (over 80 cm3) and giant (over 250 cm3) size, divided into the main and control groups according to the methods of surgical intervention and postoperative prevention of dysuric complications. The selection of patients was carried out by the method of paired design with an equal number of observations and maximum comparability of the initial parameters. Data analysis was carried out using the methods of parametric and nonparametric statistics, multivariate statistical analysis. Results. Comparison of the results of P-TUEP (n = 122) and open prostatectomy (n = 122) in groups of patients with large and giant BPH showed the possibility of reducing intraoperative blood loss by 1.5 times, the duration of bladder catheterization by 3.8 times, the frequency of early postoperative complications by 1.7 times and the duration of hospitalization by 2.9 times, which significantly saves hospital costs. Modification of the initial stage of P-TUEP, which consists in creating access to the prostate using new anatomical landmarks to maximize the preservation of the anterior fibrostromal complex, reduces the risk of trauma to the external urethral sphincter, which was proven by a three-fold decrease in the frequency of stress incontinence after surgery. In order to prevent late dysuric and cicatricial complications of P-TUEP, a scheme of complex medical postoperative prophylaxis with the use of a hyaluronic acid preparation was developed. It has been histologically and clinically confirmed that instillations of a hyaluronic acid solution into the bladder in combination with standard postoperative therapy make it possible to accelerate reparative processes by 24 times and get rid of irritative symptoms at 612 postoperative weeks, depending on the volume of removed BPH. Conclusion. The validity of the use, clinical and economic efficiency, high safety profile and the primacy of the choice of P-TUEP in surgery of large and giant BPH, including its modified technique and a comprehensive scheme of drug prevention of late complications, have been proven.

5α-Reductase Inhibitors and Risk of Kidney and Bladder Cancers in Men with Benign Prostatic Hyperplasia: A Population-Based Cohort Study.

Preclinical evidence suggests that 5α-reductase inhibitors (5ARi), commonly used to treat benign prostatic hyperplasia (BPH), are associated with reduced incidence of certain urologic cancers, yet epidemiologic studies are conflicting. This study aimed to determine whether 5ARi's are associated with a reduced risk of kidney and bladder cancers. We conducted a new-user active-comparator cohort study in the United Kingdom Clinical Practice Research Datalink. From a base cohort of patients with incident BPH, new users of 5ARi's and α-blockers were identified. Patients were followed up until a first ever diagnosis of kidney or bladder cancer, death from any cause, end of registration, or December 31, 2017. Cox proportional hazards models were used to calculate HRs and 95% confidence intervals (CI) for incident kidney and bladder cancer. There were 5,414 and 37,681 new users of 5ARi's and α-blockers, respectively. During a mean follow-up of 6.3 years, we found no association between the use of 5ARi's and kidney (adjusted HR, 1.26; 95% CI, 0.74-2.12; n = 23) or bladder (adjusted HR, 0.89; 95% CI, 0.64-1.23; n = 57) cancer risk compared with α-blockers. Similar results were observed across sensitivity analyses. In this study, we found no association between the use of 5ARi's and kidney or bladder cancer incidence in men with BPH when compared with α-blocker use. The findings of this study indicate that 5ARi's are unlikely to reduce kidney or bladder cancer risk.

Povezanost kvaliteta života i nivoa vitamina D kod benigne hiperplazije prostate

Introduction: Epidemiological studies have suggested an association between vitamin D deficiency and benign prostatic hyperplasia (BPH). The prevalence of vitamin D deficiency in the male population with urological symptoms suggests a relationship between BPH and vitamin D. Methods: This paper will present information from relevant professional/scientific sources regarding the correlation of vitamin D levels with symptom intensity and quality of life of patients with BPH, as well as patient education and health care. Topic: The incidence of BPH is increasing with ageto such extent that it is unusual to find a histologically normal prostate in a man over 70 years of age, thus rising a question whether it should be considered an abnormality at all. From the beginning, the disease was classified as "the agony of the aged man" because benign gland enlargement carries a significant risk of morbidity due to urinary flow obstruction. Due to the long course of benign prostate hyperplasia, which significantly affects the quality of life and quality of sleep, the mental pressure in patients increases, resulting from both physical and mental pain. Therefore, the priority is to focus on medical measures which would improve the quality of life of elderly patients with BPH. Conclusion: After reviewing the literature, we came to the conclusion that the level of vitamin D is responsible for the quality of life of patients with benign prostatic hyperplasia. Health care integration emphasizes the integration of existing resources within the overall health policy planning, and professionally trained medical staff provides medical treatment, rehabilitation, home care, psychological counseling and hospital care for elderly patients with chronic diseases and semi-disabled, disabled and oncological patients.

BPH Patofizyolojisi

Benign prostatic hyperplasia (BPH) is histological changes in the prostate that result in increased prostate volume and lower urinary tract symptoms. Although there are several reasons for the development of LUTS in BPH, the most important reason is the enlargement of the prostate gland. In addition, it has not been clarified why prostate size differs between individuals and why similar sizes cause different severity of LUTS. The aging of the world population has made BPH one of the most common diseases in men. The increase in the incidence of BPH has increased its socioeconomic cost. However, since its pathophysiology has not been fully elucidated, a new medical treatment alternative has not been established for years. In this review, possible different mechanisms that cause BPH to occur were examined and the literature on these mechanisms was reviewed. Keywords: prostate, hyperplasia, pathophysiology, androgens, inflamation

Triglyceride to high-density lipoprotein cholesterol ratio and total cholesterol to high-density lipoprotein cholesterol ratio and risk of benign prostatic hyperplasia in Chinese male subjects.

BackgroundLipid metabolism disorders contribute to the risk factor of prostatic hyperplasia. Lipid ratios have also attracted a lot of attention. Yet, research about the correlation of lipid ratios with prostatic hyperplasia is limited. Hence, the aim of this study was to investigate the association of lipid ratios with the risk of benign prostatic hyperplasia (BPH) in Chinese male subjects.MethodsHealthy men who underwent routine health check-ups from January 2017 to December 2019 were recruited. Twenty-four thousand nine hundred sixty-two individuals were finally enrolled in this research. Binary logistic regression analysis was performed to investigate the relationship between lipid ratios and BPH in Chinese adults.ResultsAfter health examinations for more than 2 years, 18.46% of subjects were ascertained as incident BPH cases. Higher age, body mass index (BMI), prostate-specific antigen (PSA), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio, and lower high-density lipoprotein cholesterol (HDL-C) were significantly associated with BPH risk, while total cholesterol (TC) was not significant. When quartiles of TG/HDL-C and TC/HDL-C were analyzed in multivariable model, higher TG/HDL-C and TC/HDL-C were associated with a risk of BPH (odds ratio [OR] = 2.11; 95% confidence interval [CI]: 1.89, 2.36; P-trend < 0.001; and OR = 1.67; 95% CI: 1.50, 1.85; P-trend < 0.001, respectively). In addition, stratified analyses based on the general population exhibited that with increasing age (≥35 years) the relationship of TG/HDL-C ratio with BPH risk was dominantly positive (all P-trend < 0.001, P-interaction = 0.001), and significant associations were also found in blood pressure strata and FBG strata (all P-trend < 0.001), except men with BMI ≥ 28 kg/m2 were slightly weakened (OR = 2.01, 95% CI: 1.41, 2.85; P-trend = 0.04). Moreover, there were significant associations between quartiles of TC/HDL-C and the risk of BPH was observed mainly in age 55–64 years, BMI 18.5–23.9 Kg/m2, blood pressure strata, and FBG strata. However, the P-value for a linear trend among those with BMI ≥ 28 Kg/m2 in which participants at the highest quartile of TC/HDL-C had an OR of 1.45 (95% CI: 1.09, 1.93) was 0.594. Additionally, higher TG/HDL-C ratio (≥0.65) may be a risk factor for BPH in China adults of different age decades (≥35 years) with normal TG and HDL-C.ConclusionsTG/HDL-C and TC/HDL-C were associated with BPH risk, TG/HDL-C was a powerful independent risk factor for BPH in Chinese adults, and higher TG/HDL-C ratio should be valued in male subjects with normal TG and HDL-C levels.

Carpal tunnel syndrome and trigger finger as related to benign prostatic hyperplasia: A retrospective nationwide cohort investigation.

To describe the incidence of benign prostatic hyperplasia (BPH) after a diagnosis of carpal tunnel syndrome or trigger finger. We performed a retrospective study on national health registry comparing the incidence of BPH between a cohort of 9720 study patients and a comparison cohort of 38,880 control individuals. The crude hazard ratio (HR) and the adjusted HR were estimated by the univariable and the multivariable Cox proportional hazard model, respectively. The risks of BPH in different age groups and patients with or without comorbidities were also investigated. The cumulative incidence curves were obtained by the Kaplan-Meier method and assessed by the Log-rank test. Compared to the control cohort, patients with carpal tunnel syndrome increased the risk of BPH by 1.36 times (95% confidence intervals [CI] = 1.29, 1.43). Patients only diagnosed with trigger finger raised the risk of BPH by 1.31 times (95% CI = 1.22, 1.40). The HR of BPH for patients with both carpal tunnel syndrome and trigger finger relative to the controls was 1.43 (95% CI = 1.33, 1.54). We concluded that the likelihood of developing BPH was increased in patients with carpal tunnel syndrome or trigger finger.

THE FACTORS ASSOCIATED WITH THE INCIDENCE OF BENIGN PROSTATIC HYPERPLASIA

Benign prostatic Hyperplasia (BPH) is an enlargement of the gland and cellular tissue of the prostate gland associated with endocrine changes related to the aging process, this condition is thought to be influenced by factors such as age, weight, smoking history, history of consuming drugs that trigger libido, history of diabetes mellitus (DM), cardiac history. The purpose of this study was to determine the factors associated with the incidence of BPH. This study used a quantitative analytical method with a cross sectional approach, this sample was taken using accidental sampling technique. The sample in this study were urological patients who were hospitalized at the surgical IRNA of Dr. Mohammad Hosein Hospital Palembang, totaling 61 respondents with a mean age of 70 years (0.30027). The results of the Chi-squere test showed a significant relationship between age and the incidence of BPH (p= 0.02), there was a relationship between body weight and the incidence of BPH (p=0.007), there was a relationship between smoking history and the incidence of BPH (p= 0.02) , there was a history of consuming libido-triggering drugs with the incidence of BPH (p= 0.05), there was no relationship between a history of diabetes mellitus and the incidence of BPH (p=1.00), there was no significant relationship between a history of heart disease and the incidence of BPH (p= 0.383). It is hoped that nurse practitioners can optimize themselves as educators in providing information about BPH, especially factors related to the incidence of BPH.