Prostatic Hyperplasia Patients Research Articles

The P.R.OS.T.A.T.E Nomogram for the Preoperative Prediction of Clinical Efficacy of Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Patients.

PurposeTransurethral resection of the prostate (TURP) is often indicated for benign prostatic hyperplasia (BPH). Some patients, however, fail to adequately respond to these interventions. Accordingly, a powerful prediction model for TURP efficacy is warranted. This study aimed to create a nomogram with preoperative parameters for the prediction of individual TURP efficacy.MethodsClinical data from 356 BPH subjects who underwent TURP were retrospectively collected between November 2015 and June 2021 for nomogram development. The prediction model was developed using multivariable logistic regression analysis and presented as a nomogram. Nomogram performance was assessed through calibration curves and the concordance index (C-index). An independent validation cohort containing 177 consecutive patients in the corresponding period was used for external validation. The optimal cutoff value was determined through receiver operating characteristic curve (ROC) analysis by maximizing the Youden index, and its accuracy was assessed through sensitivity, specificity and predictive values.ResultsIn multivariate analysis of the primary cohort, the independent factors for TURP efficacy were age, International Prostate Symptom Score (IPSS), intravesical prostatic protrusion (IPP), bladder wall thickness (BWT), peripheral zone thickness (PT) and transitional zone thickness (TT), all of which were included in the nomogram. The calibration curve for survival probability showed good agreement between the nomogram predictions and actual observations. The C-index for predicting TURP efficacy was 0.860 (95% confidence interval [CI], 0.808–0.911). The optimal cutoff total nomogram score was 177, with a maximum Youden index of 0.643. The sensitivity, specificity, positive predictive value, and negative predictive value for predicting TURP efficacy were 70.6%, 75.6%, 90.6%, and 43.7% in the validation cohort, respectively. Logistic regression analysis in the validation cohort demonstrated that the area under the curve (AUC) was 0.806 (95% CI, 0.733–0.879).ConclusionThe P.R.OS.T.A.T.E nomogram objectively and accurately predicted TURP efficacy, thereby facilitating the clinical decision-making process.

Magnetic resonance imaging of benign prostatic hyperplasia patients

The present study was conducted for assessing Magnetic resonance imaging findings of benign prostatic hyperplasia (BPH) patients. The present study was conducted for assessing Magnetic resonance imaging findings of benign prostatic hyperplasia patients. Data of a total of 25 patients with BPH were enrolled. Complete demographic details of all the patients were evaluated. Wasserman NF et al classified BPH types on MRI as follows: type 0, an equal to or less than 25 cm3 prostate showing little or no zonal enlargement; type 1, bilateral TZ enlargement; type 2, retrourethral enlargement; type 3, bilateral TZ and retrourethral enlargement; type 4, solitary or multiple pedunculated enlargement; type 5, pedunculated with bilateral TZ and/or retrourethral enlargement; type 6, subtrigonal or ectopic enlargement; and type 7, other combinations of enlargements. All the details were recorded in Microsoft excel sheet and were assessed using SPSS software. Out of 25 patients, 28 percent and 24 percent of the patients were type 2 and type 4 according to classification as per MRI finding. 20 percent and 16 percent of the patients were type 3 and type 6, whereas 12 percent were type 5 according to classification as per MRI finding.

Effects of Saw Palmetto Therapy on some Inflammatory Biomarkers in a Sample of Iraqi Male with Symptomatic Benign Prostatic Hyperplasia

Background Saw palmetto contains powerful anti-inflammatory components commonly used in Benign prostatic hyperplasia (BPH) patients with symptoms. The current study was designed to assess the effectiveness of saw palmetto alone or supplementation
 
 therapy with tamsulosin via measurement of some inflammatory biomarker in male with lower urinary tract symptoms (LUTS) consistent with (BPH).
 Methods The present study is an interventional prospective randomized enrolled newly diagnosed patients with moderate to severe symptomatic BPH. The eligible 60 patients were allocated into (3) groups, each group with (20) patients; Group (1) treated with Saw palmetto cap (320 mg); Group (2) treated with Saw palmetto cap (320 mg) and tamsulosin (0.4mg); Group (3) treated with tamsulosin (0.4mg), protocols to be given once daily for 12 weeks. Measurement of prostate specific antigen (PSA), C-reactive protein (CRP), and interleukin 6 (IL-6) was done.
 Results There was significant decrease in the serum PSA, CRP and IL-6 level (P<0.01) in group1 and 2 patients only after treatment when compared to pretreatment. Patients on combination therapy presented with high percent of change compared to other groups. No change in CRP and IL-6 level in patients on tamsulosin alone.
 Conclusion From the findings of the present study, phytotherapy with Saw Palmetto alone or as supplement produced significant 3 months drop in both inflammatory markers, the total CRP level and IL-6 level. Also produced significant decrease in PSA level, and may substitute the conventional therapy in mild disease status.

Clinical Significance of Intravesical Prostatic Protrusion Index in Patients with Clinical Diagnosis of Benign Prostatic Hyperplasia

Background: To investigate the clinical significance of the intravesical prostatic protrusion (IPP) index in benign prostatic hyperplasia (BPH) patients to clarify its diagnostic value in predicting the clinical and structural abnormalities of the prostate. Methods: In this descriptive and analytical cross-sectional study, every man older than 50 years with lower urinary tract symptoms (LUTS), predominantly voiding or obstructive, suggestive of BPH were included. The patients were evaluated to determine the following indices: International Prostate Symptom Score (IPSS) index, quality of life (QoL), prostate volume (PV) and postvoid residual urine (PVR), serum PSA level, and the maximum urinary flow rate (Qmax) obtained by uroflowmetry. Subsequently, the assessment of the IPP index was conducted by transabdominal ultrasonography. The categorization of the IPP index was done into 3 grades: Grade one (below 5 mm), grade two (between 5 and 10 mm), and grade three (greater than 10 mm). Results: A significant direct correlation between the IPP and IPSS, QoL, PV, PVR, and serum PSA, as well as inversely with the Qmax, was detected before and after medical treatment. Also, the need for surgical intervention increased significantly with the IPP index. Conclusions: The IPP can be used to evaluate and predict the severity of symptoms and outcomes in patients with clinical BPH.

Nowoczesna terapia skojarzona tadalafilem i tamsulozyną jako schemat leczenia u mężczyzn z objawami ze strony dolnych dróg moczowych

Based on the available scientific research, tadalafil administered daily at a dose of 5 mg is safe and effective in the treatment of men with lower urinary tract symptoms and erectile dysfunction, compared to placebo or tamsulosin alone. The combination of 5 mg tadalafil and 0.4 mg tamsulosin daily allows for a better lower urinary tract symptoms improvement compared to monotherapy drugs, even with an increased, but acceptable and tolerable side effects. When tamsulosin or tadalafil is discontinued, lower urinary tract symptoms are significantly worsened compared to baseline in patients previously treated with combination therapy. Tadalafil 5 mg should be considered as one of the primary treatment options in lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction patients as it has an excellent tolerability, safety, and efficacy profile, both as monotherapy and in combination with 0.4 mg tamsulosin. Better effectiveness in alleviating lower urinary tract symptoms was observed with combination therapy while maintaining sexual function. Continuing to switch to monotherapy maintains lower urinary tract symptoms relief, but only tadalafil is able to maintain erectile dysfunction improvement. Our results support evidence of an increasingly tailored and modular lower urinary tract symptoms treatment.

Risk factors for pharmacotherapy for storage symptoms after transurethral resection of the prostate in patients with benign prostatic hyperplasia.

Postoperative persistence of storage symptoms after transurethral resection of the prostate (TURP) is bothersome, and evidence of its cause is sparse. We sought to analyze risk factors for using antimuscarinics or beta-3 agonists after TURP in benign prostatic hyperplasia (BPH) patients. BPH patients who underwent TURP and were followed up for >6months after surgery were retrospectively enrolled. Postoperative pharmacotherapy for storage symptoms was defined as the prescription of antimuscarinics or beta-3 agonists within 3months after TURP for >3months. Preoperative and perioperative variables were evaluated for their effect on the postoperative prescription of antimuscarinics or beta-3 agonists. Of the 376 patients, 45 (12.0%) received postoperative pharmacotherapy for storage symptoms. Patients who underwent bipolar TURP were significantly more likely to receive postoperative pharmacotherapy than those who underwent monopolar TURP (15.7% vs 6.9%; P=0.01). Significantly more patients with intravesical prostatic protrusions >1cm used postoperative pharmacotherapy than those with protrusions of ≤1cm (14.4% vs 5.2% respectively; P=0.02). Multivariate logistic regression analysis revealed age >75 years (odds ratio [OR] 3.04; 95% CI 1.29-7.16; P=0.011), intravesical prostatic protrusion >1cm (OR, 3.48; 95% CI, 1.32-9.15; P=0.012), and bipolar transurethral resection (OR 4.25; 95% CI 1.53-11.80; P=0.005) as significant risk factors for postoperative pharmacotherapy. Advanced age, intravesical prostatic protrusion, and bipolar TURP were significantly associated with postoperative pharmacotherapy for storage symptoms after TURP in BPH patients. Therefore, patients with these risk factors might be informed about the risk of postoperative storage symptoms that may require medications after TURP.

Genetic variant located on chromosome 17p12 contributes to prostate cancer onset and biochemical recurrence

The genetic contribution to prostate cancer (PC) onset and clinical heterogeneity has an important impact on the disease stratification accuracy. Despite the fact that radical prostatectomy (RP) is an effective treatment for localized PC, a considerable number of individuals develop biochemical recurrence (BCR) following surgery. In the present study, we decided to investigate the significance of genetic variability in a homogeneous group of Romanian men and to determine if genotyping could provide information regarding the possible implications of rs4054823 susceptibility loci in PC progression and outcome. A total of 78 samples from both PC and benign prostatic hyperplasia (BPH) patients were genotyped. The genotype frequencies were examined to see if there was a link between the 17p12 SNP and PC disease. When compared to the BPH group, the PC group had a significantly higher frequency of the T risk variant (P = 0.0056) and TT genotype (P = 0.0164). Subsequent analysis revealed that the TT genotype had a significantly higher frequency among younger PC patients based on their age at diagnosis and that it was related with a greater probability of BCR (P = 0.02). According to our findings, the TT genotype appears to be a risk factor for early-onset PC and a potential predictor for BCR after RP.

Comprehensive biomarker profiles and chemometric filtering of urinary metabolomics for effective discrimination of prostate carcinoma from benign hyperplasia

Prostate cancer (PCa) is the most commonly diagnosed cancer in male individuals, principally affecting men over 50 years old, and is the leading cause of cancer-related deaths. Actually, the measurement of prostate-specific antigen level in blood is affected by limited sensitivity and specificity and cannot discriminate PCa from benign prostatic hyperplasia patients (BPH). In the present paper, 20 urine samples from BPH patients and 20 from PCa patients were investigated to develop a metabolomics strategy useful to distinguish malignancy from benign hyperplasia. A UHPLC-HRMS untargeted approach was carried out to generate two large sets of candidate biomarkers. After mass spectrometric analysis, an innovative chemometric data treatment was employed involving PLS-DA classification with repeated double cross-validation and permutation test to provide a rigorously validated PLS-DA model. Simultaneously, this chemometric approach filtered out the most effective biomarkers and optimized their relative weights to yield the highest classification efficiency. An unprecedented portfolio of prostate carcinoma biomarkers was tentatively identified including 22 and 47 alleged candidates from positive and negative ion electrospray (ESI+ and ESI−) datasets. The PLS-DA model based on the 22 ESI+ biomarkers provided a sensitivity of 95 ± 1% and a specificity of 83 ± 3%, while that from the 47 ESI− biomarkers yielded an 88 ± 3% sensitivity and a 91 ± 2% specificity. Many alleged biomarkers were annotated, belonging to the classes of carnitine and glutamine metabolites, C21 steroids, amino acids, acetylcholine, carboxyethyl-hydroxychroman, and dihydro(iso)ferulic acid.

Association between benign prostatic hyperplasia and suicide in South Korea: A nationwide retrospective cohort study.

Benign prostatic hyperplasia is a commonly diagnosed disease in elderly men, but elderly men with benign prostatic hyperplasia are more likely to have a lower quality of life and depressive symptoms. This study aims to examine the association benign prostatic hyperplasia patients with suicide death relative to a control group comprising individuals without benign prostatic hyperplasia. We used the Korean National Health Insurance Service-National Sample Cohort from 2006 to 2015 comprising of 193,785 Korean adults ≥40 years old, and followed-up for suicide death during the 8.7 years period. Cox-proportional hazard model was used to estimate hazard ratios for suicide among patients with benign prostatic hyperplasia. From 2006 to 2010, a total of 32,215 people were newly diagnosed with benign prostatic hyperplasia. The suicide rate of people without benign prostatic hyperplasia was 61.6 per 100,000 person-years, whereas that of patients with benign prostatic hyperplasia was 97.3 per 100,000 person-years, 1.58 times higher than the control group (p<0.01). After adjusting for covariates, the hazard ratio for suicide among patients with benign prostatic hyperplasia was 1.47 (95% C.I. = 1.21 to 1.78; p<0.01) compared to people without benign prostatic hyperplasia. For men without mental disorders, the hazard ratio for suicide among patients with benign prostatic hyperplasia was 1.36 (95% CI = 1.05 to 1.76) compared to control group after adjusting for multiple covariates. Our study suggests that men with benign prostatic hyperplasia had a higher probability of suicide compared to men without benign prostatic hyperplasia in South Korea. This study suggests that physicians may be aware that men newly diagnosed with benign prostatic hyperplasia had high probability of suicide.

Prognostic Value of Long Noncoding RNA SNHG11 in Patients with Prostate Cancer.

The present study was aimed to explore the prognostic value of long noncoding RNA SNHG11 in prostate cancer, study its expression, and assess its effect on tumor progression. One hundred and twenty prostate cancer patients and 45 cases of benign prostate hyperplasia (BPH) patients were collected. RT-qPCR was used to test the expression of SNHG11 in prostate cancer and BPH tissues, as well as in cell lines. Kaplan-Meier survival analysis and Cox regression assays were introduced to evaluate the prognostic meaning of SNHG11 in prostate cancer. The CCK-8 assays were performed to explore the effect of SNHG11 on prostate cancer cell proliferation, and a Transwell assay was conducted to access the influence of SNHG11 on prostate cancer cell migration and invasion. SNHG11 expression level was upregulated both in prostate cancer tissues and cell lines. Overexpression of SNHG11 was significantly associated with Gleason score, clinical T stage, surgical margin status, and lymph node metastasis. Patients with high SNHG11 expression levels led to a shorter overall survival time and biochemical recurrence-free survival when compared with those of low expression levels. Multivariate Cox regression results suggested that SNHG11 has the potential to act as a prognostic marker for prostate cancer patients. Knockdown of SNHG11 suppressed 22RV1 cell proliferation, migration, and invasion. In conclusion, SNHG11 is upregulated in prostate cancer patients and predicts an unfavorable prognosis for prostate cancer patients. Its knockdown can weaken prostate cancer cell metastasis and growth in vitro.

The relationship of benign prostatic hyperplasia's symptoms severity with the risk of developing atrial fibrillation.

BackgroundAttention is drawn to the increased incidence of atrial fibrillation (AF) in benign prostatic hyperplasia (BPH) patients recently. Early predicting of AF in these patients can help in decreasing its clinical consequences. The aim of our study is to determine the association between BPH symptoms and AF predictors atrial electromechanical delay (AEMD) and the P‐wave dispersion (PWD).Methods218 healthy individuals recently diagnosed with BPH were assigned into three groups according to symptoms severity using the International prostate symptom score (IPSS) questionnaire. The first group with mild symptoms (IPSS score between 0 and 7, n = 78), the second group with moderate symptoms (IPSS score between 8 and 19, n = 86), and the third group with severe symptoms (IPSS score between 20 and 35, n = 54). PWD and AEMD calculations were performed for all participants.ResultsThere were statistically significant differences between the three groups in terms of AEMD and PWD (p < .01 and p < .01, respectively). In all three study groups, a significant positive correlation was observed between IPSS questionnaire scores and both AEMD and PWD (for AEMD r = .29, p = .013 and for PWD r = .27, p = .017). On the other hand, there were significant differences between the three groups in terms of the inflammatory markers C‐reactive protein (CRP) and fibrinogen (p < .01 and p < .01, respectively) and in terms of serum testosterone levels (p < .01).ConclusionsWe concluded that periodic evaluation of patients with BPH in terms of symptoms severity can be helpful not only from urological aspect, but also in the early prediction of possible serious cardiovascular morbidity and mortality.

Evaluating Patient Preferences in Benign Prostatic Hyperplasia Treatment Using Conjoint Analysis

ObjectiveTo quantify benign prostatic hyperplasia (BPH) patient preferences to promote guidelines-compliant, patient-centered care. Discordance between patient and urologist priorities for the treatment of BPH hinders patient-centered care. Physician assumptions regarding patient preferences lead to dissatisfied patients; a poor outcome in any quality of life surgery. American Urologic Association guidelines urge urologists to consider patient preferences when recommending a BPH treatment. MethodsIn this cross-sectional, online survey study using researchmatch.org, participants were required to decide between theoretical BPH treatments in a balanced, choice-based conjoint analysis. The treatments had varying levels of four attributes: efficacy, recovery difficulty, risk of complications (Clavien-Dindo 2+), and risk of de novo ejaculatory dysfunction. Demographic information and International Prostate Symptom Score were collected and analyzed using comparative statistics. Each attribute was analyzed using a conditional logit model, and attribute importance (range in utility between attribute-levels) was calculated. ResultsOut of 1235 recruited participants, 812 (66%) completed the study. Median International Prostate Symptom Score and age was 6 (IQR 3-12) and 56 (IQR 38-67), respectively. Complication risk was the most important attribute, followed by efficacy, recovery difficulty, and risk of ejaculatory dysfunction. In a subgroup analysis of age quartiles, participants age <38 and >67 held efficacy (31%) and complication risk (47%) to the highest relative importance, respectively. ConclusionMales valued BPH treatments that minimize complication risks, while ejaculatory dysfunction was least impactful. Variation in results between age subgroups emphasizes the need for individualized care to maximize patient satisfaction.

The efficacy and safety of desmopressin acetate applied for nocturia in benign prostatic hyperplasia patients: A systematic review and meta‐analysis

AbstractBackgroundDesmopressin acetate was recommended for nocturia in benign prostatic hyperplasia (BPH) patients recently, but its effect and safety is still controversial. We aimed to establish a systematic review and meta‐analysis to confirm its effect on symptom relief and adverse effects.MethodsA systematic search was performed in PubMed, Cochrane Library, EMBASE, Medline, Web of Science and Science Direct databases from January 2000 to October 2021 for controlled trials of BPH patients comparing oral desmopressin with control groups. The mean difference (MD) and odds ratio (OR) were meta‐analyzed.ResultsFour articles with 500 patients were included. Significantly greater benefit was detected for the desmopressin group in the improvement of nocturia (P = .004), international prostate symptom score – storage (IPSS‐S) (P = .03), and quality of life (QoL) (P = .04) scores. Patients treated with desmopressin were at higher risk than the control group for short‐term adverse events (P &lt; .001), including nausea (4.71%, P = .04), headache (20%, P &lt; .00001), dizziness (5.88%, P = .02) and hyponatremia (4.71%, P = .04), but the long‐term incidence might decrease.ConclusionDesmopressin acetate can reduce nocturia frequency and improve the IPSS‐S and QoL score in BPH patients. Some adverse reactions of desmopressin, such as hyponatremia, headache, dizziness and nausea, may be mild and short‐term. No significant difference of desmopressin was found in improving the overall IPSS score and maximum urine flow.

Prostate Volume Measurement by Ultrasonography Over 40 Years Age of Bangladeshi Population

Background: Benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy, is a histologic diagnosis status characterized by proliferation of the ‘glandular elements’ of the prostate, which may lead to an enlarged prostate gland. In many studies, people over the age of 40 years found as the most vulnerable for BPH. Ultrasonography is a prominent method to determine prostate volume or size. Aim of the study: The aim of the present study was to evaluate the prostate volume measurement for the Bangladeshi population over the age of 40 years by ultrasonography.Methods:This prospective, observational study was conducted in the Department of Anatomy, Chattogram Medical College Hospital, Chattogram, Bangladesh during the period from January 2019 to December 2020. In total 157 suspected patients of benign prostatic hyperplasia were selected as the study population. All patients were clinically diagnosed for BPH, based on the present prostate symptoms and digital rectal examination. To measure the prostate volume, abdominal ultrasonography was performed for all the patients. After enucleation, another ultrasonogram was performed for all the patients to measure the existing sizes of the prostates of the patients. All the data were processed, analyzed, and disseminated by MS-word and SPSS programs as per need.Results:Finally, in this study in analyzing the volumes of the prostates of the participants according to the abdominal ultra-sonographic reports of pre-operative stage we observed, in 9%, 34%, 31%, 30%, 21% and 32% patients, the prostate sizes (In cc) were &lt;20, 21-40, 41-60, 61-80, 81-100 and &gt;100 cc respectively. On the other hand, after enucleation, in 11.46%, 24.20%, 28.66%, 27.39%, 7.01% and 1.27% patients, the prostate sizes (In cc) were found &lt;20, 21-40, 41-60, 61-80, 81-100 and &gt;100 cc respectively. The mean changes of prostate sizes between pre- and post-operative stages among the participant was not significant where the P value was found 0.464.Conclusion:The findings of this study support the applications of abdominal ultrasonographic evaluation for suspected benign prostatic hyperplasia patients to know about the exact volumes of their prostates for selecting the appropriate surgical approach.

Impact of drug use on patient symptom score and quality of life in benign prostatic hyperplasia patients

Introduction: To assess the drug use pattern for treating benign prostatic hyperplasia (BPH) patients and its impact on patient symptom score and quality of life (QoL) of these patients. Materials and Methods: After getting approval from the Indian Council of Medical Research, Institutional Ethics Committee and after obtaining written informed consent from 103 BPH patients, their demographic data, drugs prescribed to them, and scores of International Prostate Symptom Score (IPSS) and Benign Prostatic Hyperplasia Impact Index (BII) were recorded. Patients were reassessed for changes in scores of IPSS, BII, and drug prescription (if any) on the 15th, 30th, and 60th days. Results: 68.93% of patients received drug as a single entity. Patients were classified according to their presenting symptoms as severe, low moderate, and mild with a mean total IPSS score of 16.73% ± 6.6. 37.86% of patients were dissatisfied with QoL and 24.27% of patients had mixed opinion with a mean score of 3.39 ± 1.08. There was a low, medium, moderate, and high total score of BII with a mean BII score of 4.02 ± 2.51. Significant changes were seen in total BII score and frequency of urination on day 15; weak stream, nocturia, total score, and QoL on day 30; and intermittency and urgency on day 60. Incomplete emptying of bladder and straining showed nonsignificant changes. Age and total IPSS score, age and QoL, and age and total BII score showed a negative correlation. Total IPSS score and QoL, total IPSS and BII score, and QoL and total BII score showed a positive correlation. Conclusion: Nonsurgical pharmacological intervention had a positive impact on the IPSS and BII score and health-related QoL in BPH patients.

Study on the effect of completely preserving the ejaculatory duct during prostatectomy on reducing postoperative retrograde ejaculation in benign prostatic hyperplasia patients.

Preserving the sexual function of benign prostatic hyperplasia (BPH) patients and reducing the incidence of postoperative retrograde ejaculation are critical for BPH patients with sexual needs. To explore the effect of complete preservation of the seminal tract during transurethral prostatectomy (TURP) on reducing retrograde ejaculation in BPH patients. BPH patients meeting the inclusion criteria were randomly divided into the Control group (traditional TURP) and the Experimental group (complete reserved ejaculatory duct) in a ratio of 1 : 1. Finally, data of 64 BPH patients - 34 in the Control group and 30 in the Experimental group - were analyzed. We measured the preoperative and postoperative maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), Quality of Life (QOL) score, semen volume, and ejaculation function. Compared with pre-operation values, patients in the two groups exhibited increased Qmax and decreased IPSS and QOL scores after the operation. However, there was no significant difference in Qmax, IPSS, or QOL between the Control and Experimental groups after the operation. The two groups of patients had a significant reduction in postoperative ejaculation. Compared with the Control group, the semen volume of patients was higher, and the incidence of retrograde ejaculation was lower in the Experimental group. Prostatectomy with complete preservation of the seminal tract is not different from conventional electrosurgical resection in improving urination symptoms, while the incidence of retrograde ejaculation is significantly lower.

A correlative study of iron metabolism based on q-Dixon MRI in benign prostatic hyperplasia and prostate cancer.

Clinical staging, Gleason score, and prostate-specific antigen (PSA) have been accepted as factors for evaluating the prognosis of prostate cancer (PCa). With the in-depth study of iron metabolism and the development of multiparametric magnetic resonance imaging technology, we used q-Dixon magnetic resonance imaging (MRI) to measure the iron content of the PCa patients' lesions, and used enzyme-linked immunosorbent assay (ELISA) to measure the iron metabolism indicators in the patients' serum samples, combined with the patients' postoperative clinical data for analysis. We found that the serum indexes were correlated with the T2 star values, International Society of Urological Pathology (ISUP) grade, and pathological classification in PCa patients (all P &lt; 0.001) but not in benign prostatic hyperplasia (BPH) patients (all P &gt; 0.05). The utilization of q-Dixon-based MRI and serum indexes allows the noninvasive measurement of iron content in prostate lesions and the assessment of differential iron metabolism between PCa and BPH, which may be helpful for evaluating the prognosis of PCa.

ERECTILE FUNCTION OF BPH PATIENTS UNDERGOING A LASER PROCEDURE COMPARED TO A STANDARD TRANSURETHRAL RESECTION OF THE PROSTATE (TURP): A SYSTEMATIC REVIEW AND META-ANALYSIS

Transurethral Resection of Prostate (TURP) has been the gold standard of surgical management in Benign Prostatic Hyperplasia (BPH) patients. Various techniques, including laser therapy, have been developed to provide a safe alternative to TURP. The effect of the laser on the patient's erectile function, however, is still unknown. The aim of this study is to evaluate the erectile function of individuals with BPH undergoing surgical intervention with laser procedure compared to the standard TURP procedure. A systematic search was conducted through PubMed and Science-Direct databases up to September 2021. All studies comparing laser therapy to TURP for patients with BPH and reporting the final International Index of Erectile Function (IIEF) and change of IIEF were included in this study. A total of three Randomized Controlled Trials (RCTs) and one retrospective study were included in the final analysis. According to the meta-analysis, laser therapy had a similar final IIEF score during the 12-month follow-up compared to the TURP procedure in the subgroup of IIEF-15, IIEF-5, and the combined analysis (p=0.62, p=0.72, p=0.79, respectively). The change of IIEF from baseline was similar among both modalities (p = 0.8). The effect of laser therapy on erection function was similar to the TURP procedure.

The Predictive Value of Non-Invasive Urodynamic Parameters for the Curative Effect of TURP

Purpose: To explore the predictive value of non-invasive urodynamic parameters for the efficacy of transurethral resection of the prostate (TURP). Methods: 121 cases, Benign prostatic hyperplasia (BPH) patients were assessed retrospectively and were divided into good prognosis (group A) and poor prognosis (group B) according to the degree of improvement in maximum urinary flow rate, and the changes in ultrasound and non-invasive urodynamic parameters between the two groups were explored. Results: The PV, IPP, and PVR of group A were lower than those of group B (P＜0.05), and Qmax of group A was greater than group B (P＜0.05). The difference was statistically significant (P＜0.05); There was no significant difference in DWT, age, and IPSS(P＞0.05). The ROC curve analyzes the diagnostic efficacy of each parameter in the diagnosis of the efficacy of TURP, and the results are ranked in order of 1/Qmax (AUC=0.777), PV (AUC=0.715), PVR (AUC=0.642), IPP (AUC=0.629), Of which 1/Qmax has the best diagnostic efficiency, and it AUC=0.777, the best cutoff value is 0.12, the sensitivity is 0.81, and the specificity is 0.571. Conclusion: Preoperative application of non-invasive urodynamic parameters in BPH patients can better predict postoperative efficacy, especially Qmax has the best predictive effect.

Determination of miRNA expression profile in patients with prostate cancer and benign prostate hyperplasia.

It is a known fact that the role of microRNAs (miRNA) has a very important place in cancer development and progression. miRNAs target a significant part of pathways as well as genes. This study aimed to compare the differential expression profiles of miRNAs in prostate cancer and benign prostatic hyperplasia patients. Peripheral blood mononuclear cells (PBMCs) and tissue samples were collected from prostate cancer (PCa) (n: 20) and benign prostatic hyperplasia (BPH) (n: 20) patients. Total RNA isolation was performed. As a result of the RNA concentration and purity measurement, each patient group was pooled, and the miRNAs profiles comparison was performed with the Affymetrix Microarray System. In tissue samples, 37 different expressed miRNAs were identified in PCa patients compared to BPH patients. In PBMCs samples, 27 different expressed miRNAs were identified in PCa patients compared to benign prostatic hyperplasia patients. As a result of the comparison of tissue and PBMCs samples, it was determined that down regülated hsa-miR-494-3p, hsa-miR-3128, hsa-miR-8084 were common miRNAs. 3 (HIF1A, NHS,INSL4) targets identified for hsa-miR-494-3p, 2 (HIF1A, AVRP1A) for hsa-miR-3128, 3 (AVRP1A, NHS, INSL4) for hsa-miR-8084. Our results suggested that determined common hsa-miR-494-3p, hsa-miR-3128, hsa-miR-8084 and their target HIF1A, AVRP1A, NHS, INSL4 may play a crucial role in therapeutic and early diagnostic strategies for prostate cancer. The present study may represent the first in-depth analysis of PBMCs and tissue samples miRNA profiles.