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BPH treatments

Tim Large, Amy E Krambeck
PURPOSE OF REVIEW: Holmium laser enucleation of the prostate (HoLEP) has been a mainstay therapy for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) for nearly 20 years. We briefly review current and sentinel publications that provide outcomes data after HoLEP. RECENT FINDINGS: Current literature continues to support HoLEP as a versatile and durable surgical option for men with LUTS secondary to BPH. Despite evidence supporting durable symptom relief beyond 10 years even in large prostate glands, HoLEP is still not widely available to all patients...
March 13, 2018: Current Opinion in Urology
Feng Li, Laura E Pascal, Jianhua Zhou, Yibin Zhou, Ke Wang, Anil V Parwani, Rajiv Dhir, Peng Guo, Dalin He, Joel B Nelson, Zhou Wang
The mechanisms involved in the development of benign prostatic hyperplasia (BPH) are poorly understood. One potential mechanism involved in BPH pathogenesis may involve altered expression of genes related to apoptosis and proliferation because reduced cell death and increased proliferation are thought to contribute to prostatic enlargement. This study examined the expression of B-cell lymphoma 2 (BCL-2) and B-cell lymphoma-extra large (BCL-XL), two important anti-apoptosis factors that are also capable of inhibiting cell proliferation via accelerated G1 arrest or delayed G1/S transition, using immunostaining in simple prostatectomy BPH specimens from patients naïve to androgen manipulation...
2018: American Journal of Clinical and Experimental Urology
Joseph Acquaye, Michael S Borofsky
PURPOSE OF REVIEW: As benign prostatic hypertrophy (BPH) becomes a more common disease, there has been a dramatic rise in the number of investigational procedures being developed to manage it. We seek to present an overview of the most recently developed treatments and present clinical data related to application wherever available. RECENT FINDINGS: As a greater number of treatments become available for BPH, improved diagnostic testing could prove beneficial in helping guide patient selection...
March 9, 2018: Current Opinion in Urology
Joo Yong Lee, Kang Su Cho
PURPOSE OF REVIEW: The use of 5-alpha reductase inhibitors (5ARIs) for the treatment of benign prostatic hyperplasia (BPH) and other diseases has been proposed and studied. However, the controversy about its benefits and harms for other diseases has persisted. In this review, we will discuss the newly identified effects of 5ARIs based on recently published studies. RECENT FINDINGS: These drugs are currently recommended in clinical guidelines for BPH. However, the reporting of adverse effects, including sexual dysfunction as well as neurologic, endocrine, and cardiovascular effects, have been controversial...
March 9, 2018: Current Opinion in Urology
Dorien Reijnders, Chin-Chi Liu, Xinjing Xu, Anna Zhao, Kelsey Olson, Scott D Butler, Nataki C Douglas, Jenny L Sones
Preeclampsia (PE), a hypertensive disease of pregnancy, is a leading cause of fetal and maternal morbidity/mortality. Early angiogenic and inflammatory disturbances within the placenta are thought to underlie the development of the maternal PE syndrome and poor pregnancy outcomes. However, the exact etiology remains largely unknown. Here, we use the BPH/5 mouse model of PE to elucidate the way in which inflammation early in pregnancy contributes to abnormal expression of angiogenic factors at the maternal-fetal interface...
March 9, 2018: Physiological Genomics
Eunsook Park, Mee-Young Lee, Woo-Young Jeon, Chang-Seob Seo, Sooseong You, Hyeun-Kyoo Shin
ETHNOPHARMACOLOGICAL RELEVANCE: Paljung-san is a traditional herbal medicine used widely for the treatment of urogenital diseases in East Asia. However, scientific evidence of the efficacy of Paljung-san and its mechanisms of action against benign prostatic hyperplasia (BPH) is not clearly established. AIM OF THE STUDY: We investigated the inhibitory effect of Paljung-san water extract (PSWE) and its mechanisms against BPH in vitro and in vivo. MATERIALS AND METHODS: Active compounds of PSWE were analyzed quantitatively by High-performance liquid chromatography (HPLC)...
February 28, 2018: Journal of Ethnopharmacology
Saturnino Napal Lecumberri, Iñigo Insausti Gorbea, Ana Sáez de Ocáriz García, Saioa Solchaga Álvarez, José Luis Cebrián Lostal, Raquel Monreal Beortegui, Pedro José Giral Villalta, Fermín Urtasun Grijalba
Background: Benign prostatic hyperplasia (BPH) is a prevalent disease associated with lower urinary tract symptoms (LUTS). The standard of care for moderate-to-severe LUTS unresponsive to pharmacological treatment is the transurethral resection of the prostate (TURP). However, this intervention is not exempt from complications. Prostatic artery embolization (PAE) has been described as a new, effective and safe procedure for the treatment of LUTS secondary to BPH. To date, only one clinical trial has been published on the use of PAE for LUTS, but the study was methodologically flawed in terms of safety monitoring...
2018: Research and Reports in Urology
Jae Hoon Chung, Cheol Young Oh, Jae Heon Kim, U-Syn Ha, Tae Hyo Kim, Seung Hwan Lee, Jun Hyun Han, Jae Hyun Bae, In Ho Chang, Deok Hyun Han, Tag Keun Yoo, Jae Il Chung, Sae Woong Kim, Jina Jung, Yong-Il Kim, Seung Wook Lee
OBJECTIVE: To verify the efficacy and safety of tamsulosin 0.4 mg and tamsulosin 0.2 mg compared with those of placebo in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). METHODS: A total of 494 patients from multiple centers participated in this double-blind, randomized, phase 3 trial. The eligible patients were randomly assigned to the tamsulosin 0.4 mg group, tamsulosin 0.2 mg group, or placebo group...
February 28, 2018: Current Medical Research and Opinion
Seyedeh Maryam Seyedolmohadessin, Mohammad Taghi Akbari, Zahra Nourmohammadi, Abbas Basiri, Gholamreza Pourmand
Background: Prostate cancer is the second form of cancer among men worldwide. For early cancer detection, we should identify tumors in initial stages before the physical signs become visible. The present study aims to evaluate the diagnostic value of cell-free DNA (cfDNA), its comparison with prostate-specific antigen (PSA) level in prostate cancer screening and also in patients with localized prostate cancer, metastatic form, and benign prostatic hyperplasia (BPH). Methods: The participants of this study were selected from 126 patients with genitourinary symptoms suspected prostate cancer, rising PSA, and/or abnormal rectal examination results and 10 healthy subjects as controls...
February 24, 2018: Iranian Biomedical Journal
Mehmet Sarier, Ibrahim Duman, Suleyman Kilic, Yucel Yuksel, Meltem Demir, Mesut Aslan, Levent Yucetin, Sabri Tekin, Asuman Havva Yavuz, Mestan Emek
PURPOSE: The aim of this study is to compare the results of transurethral incision of the prostate (TUIP) and transurethral resection of the prostate (TURP) for the surgical treatment of benign prostate hyperplasia (BPH) in patients with renal transplantation. MATERIALS AND METHODS: Between April 2009 and May 2016, BPH patients with renal transplants whose prostate volumes were less than 30 cm3 were treated surgically. Forty-seven patients received TURP and 32 received TUIP...
February 18, 2018: Urology Journal
Yuan-Hong Jiang, Chung-Cheng Wang, Hann-Chorng Kuo
OBJECTIVE: To analyze the underlying lower urinary tract dysfunctions by video-urodynamic studies in men who have persistent storage symptoms after initial drug therapy for lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). METHODS: The medical records of 614 men ≥40 years of age with LUTS and an International Prostate Symptom Score of ≥8 were retrospectively analyzed. All patients had persistent storage symptoms after medical treatment for at least 6 months...
2018: PloS One
Amit Sethi, Lingdao Sha, Neeraj Kumar, Virgilia Macias, Ryan J Deaton, Peter H Gann
OBJECTIVE: To determine whether a computer vision-based approach applied to H&E prostate biopsy images can distinguish dutasteride-treated tissue from placebo, and identify features associated with degree of responsiveness to 5α-reductase inhibitor (5ARI) therapy. SUBJECTS AND METHODS: Our study population comprised 100 treatment-compliant men without prostate cancer assigned to dutasteride or placebo in the REDUCE trial who had slides available from mandatory Year 4 biopsies...
February 20, 2018: BJU International
Tarek A Ahmed, Ahmed M Al-Abd
Finasteride (FSD), a specific competitive inhibitor of the steroid type-II 5α-reductase enzyme, is used in treatment of benign prostate hyperplasia (BPH) and male pattern baldness. The drug is of limited solubility that affect its dissolution and bioavailability. The aim was to study the effect of FSD particle size reduction on the pharmacokinetic, tissue distribution and cellular permeation. An optimized drug micro- and nano-particles were developed, characterized, administered to group of rats, and systemic pharmacokinetic and tissue distribution within target and not-target organs were determined using near-infrared (NIR) spectroscopy technique...
November 2018: Drug Delivery
Martin Schoenthaler, Karl-Dietrich Sievert, Dominik Stefan Schoeb, Arkadiusz Miernik, Thomas Kunit, Simon Hein, Thomas R W Herrmann, Konrad Wilhelm
PURPOSE: The aim of the study was to evaluate the feasibility and safety of combining prostatic urethral lift (PUL) and a limited resection of the prostatic middle lobe or bladder neck incision in the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). METHODS: Twenty-eight patients were treated at two tertiary centers and followed prospectively. Patient evaluations included patient characteristics, relief of LUTS symptoms, erectile and ejaculatory function, continence, operative time and adverse events...
February 15, 2018: World Journal of Urology
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
Pei-Shan Yang, Chien-Lun Chen, Chen-Pang Hou, Yu-Hsiang Lin, Ke-Hung Tsui
Purpose: The aim of this study was to investigate the efficacy and tolerability of switching from 0.2 mg tamsulosin to 0.4 mg tamsulosin oral controlled absorption system (OCAS) over a 12-week period in Taiwanese men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Patients and methods: Taiwanese male patients who were dissatisfied with treatment with 0.2 mg tamsulosin were enrolled in this clinical study and switched to 0...
2018: Clinical Interventions in Aging
Asma Jabeen, Brandon Reeder, Soleiman Hisaindee, Salman Ashraf, Naeema Al Darmaki, Sinan Battah, Sulaiman Al-Zuhair
BACKGROUND: There is an increasing need to find natural bioactive compounds for pharmaceutical applications, because they have less harmful side effects compared to their chemical alternatives. Microalgae (MA) have been identified as a promising source for these bioactive compounds, and this work aimed to evaluate the anti-proliferative effects of semi-purified protein extracted from MA against several tumor cell lines. METHODS: Tested samples comprised MA cell extracts treated with cellulase and lysozyme, prior to extraction...
December 2017: Biomedical Journal
Dmitry Victorovich Enikeev, Petr Vitalievich Glybochko, Zhamshid Okhunov, Yuriy Gennadievich Alyaev, Leonid Mikhailovich Rapoport, Dmitry Tsarichenko, Mikhail Elikovich Enikeev, Nikolay Ivanovich Sorokin, Alim Mukhamedovich Dymov, Mark Sergeevich Taratkin
INTRODUCTION: Endoscopic enucleation of the prostate (EEP) has been recognized as a viable, treatment modality for men with benign prostatic hyperplasia (BPH). The aim of our study was to compare the efficacy and functional outcomes of three different techniques of EEP including monopolar enucleation (MEP), holmium (HoLEP) and thulium laser enucleation (ThuLEP). METHODS: The study consisted of a retrospective comparison of pre- and postoperative parameters in men undergoing three types of EEP: MEP, HoLEP, and ThuLEP...
February 12, 2018: Journal of Endourology
Isaac Eliaz, Elaine Weil, Barry Wilk
Context • Benign prostatic hyperplasia (BPH) produces lower urinary tract symptoms (LUTS) that diminish quality of life. Conventional treatments are often accompanied by adverse side effects. By contrast, consumers of phytochemicals-based dietary supplements often report a reduction in symptoms without side effects. The field needs studies that quantify the strength and character of perceived benefits. Objectives • The study intended to quantify the character and strength of perceived improvements in LUTS in men, after the consumption of a prostate health supplement...
February 10, 2018: Alternative Therapies in Health and Medicine
Li-Jun Zhu, Xiao-Fei Li, Chao Liu, Cheng-Yu Lyu
OBJECTIVE: To evaluate the clinical results of locking proximal femur plate(LPFP), proximal femoral nail antirotation(PFNA) and bipolar hemiarthroplasty(BPH) in the treatment of femoral intertrochanteric fractures in elderly patients. METHODS: Retrospective analysis of the 86 elderly patients with femoral intertrochanteric fractures during June 2011 and August 2016 were enrolled in this study. The patients were divided into 3 groups: 26 cases in LPFP group included 10 males and 16 females with an average age of (72...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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