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BPH medication

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
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
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
Mohammad Reza Razzaghi, Morteza Fallah Karkan, Saleh Ghiasy, Babak Javanmard
The usage of laser in medicine is not recent, and its history in urology goes back to 40 years ago. For the last 2 decades, common uses of laser have been treatments of subjects with urolithiasis, bladder tumors, benign prostatic enlargement, lesions of the genitalia and urinary tract strictures. To evaluate laser application in urology in Iran, we reviewed all of the Iranian literature on the topic. This study was designed to retrieve all studies on laser application in urology in Iran, regardless of publication status or language, covering years 1990-2017...
2018: Journal of Lasers in Medical Sciences
Roderick MacDonald, Michelle Brasure, Philipp Dahm, Carin M Olson, Victoria A Nelson, Howard A Fink, Michael C Risk, Bruce Rwabasonga, Timothy J Wilt
We conducted a systematic review to evaluate the efficacy and adverse effects of newer drugs used to treat lower urinary tract symptoms (LUTS). The drugs were either Food and Drug Administration (FDA) approved for benign prostatic hyperplasia (BPH) or not FDA approved for BPH but have been evaluated for treatment of BPH since 2008. We searched bibliographic databases through September 2017. We included randomized controlled trials (RCTs) lasting one month or longer published in English. Outcomes of interest were LUTS assessed by validated measures...
February 2, 2018: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
Neal Shore, Ronald Tutrone, Mitchell Efros, Mohamed Bidair, Barton Wachs, Susan Kalota, Sheldon Freedman, James Bailen, Richard Levin, Stephen Richardson, Jed Kaminetsky, Jeffrey Snyder, Barry Shepard, Kenneth Goldberg, Alan Hay, Steven Gange, Ivan Grunberger
PURPOSE: These studies were undertaken to determine if fexapotide triflutate 2.5 mg transrectal injectable (FT) has significant long-term (LT) safety and efficacy for the treatment of benign prostatic hyperplasia (BPH). METHODS: Two placebo controlled double-blind randomized parallel group trials with 995 BPH patients at 72 sites treated 3:2 FT:placebo, with open-label FT crossover (CO) re-injection in 2 trials n = 344 and long-term follow-up (LF) 2-6.75 years (mean 3...
January 29, 2018: World Journal of Urology
Peng Xu, Abai Xu, Binshen Chen, Shaobo Zheng, Yawen Xu, Hulin Li, Haiyan Shen, Chunxiao Liu
Objective: According to the EAU Guidelines, transurethral resection of the prostate (TURP) has so far still been considered as the gold standard for surgical treatment for patients with obstructing clinical benign prostate hyperplasia (BPH). However, its relatively high rate of complications and postoperative recurrence necessitates further modification and innovation on the surgery technique. We reported the patient outcomes with our technique. Methods: We retrospectively analyzed 52 patients with obstructing clinical BPH who underwent bipolar transurethral enucleation and resection of the prostate (B-TUERP) between March 2015 and September 2015...
January 2018: Asian Journal of Urology
Ramalingam Manickam, Sivasankaran Nachimuthu, Senthil Kallappan, Mizar G Pai
Symptomatic benign prostatic hyperplasia (BPH) is managed medically worldwide, but transurethral resection of prostate (TURP) is the gold standard in refractory cases. Holmium laser enucleation of prostate (HoLEP), laser vaporization are other options which are widely practiced. However in larger glands which are more than 80 g, open adenomectomy is still practiced. Laparoscopic adenomectomy is a minimally invasive option in such circumstances. This article explains about different techniques in minimally invasive adenomectomy and the role for this procedure today...
January 2018: Asian Journal of Urology
Eric H Kim, John A Brockman, Gerald L Andriole
Benign prostatic hyperplasia (BPH) is characterized by an enlarged prostate, lower urinary tract symptoms (LUTS), and a decreased urinary flow rate. Common in older men, BPH is a progressive disease that can eventually lead to complications including acute urinary retention (AUR) and the need for BPH-related surgery. Both normal and abnormal prostate growth is driven by the androgen dihydrotestosterone (DHT), which is formed from testosterone under the influence of 5-alpha reductase. Thus, 5-alpha reductase inhibitors (5-ARIs) effectively reduce the serum and intraprostatic concentration of DHT, causing an involution of prostate tissue...
January 2018: Asian Journal of Urology
Aldo E Calogero, Giovanni Burgio, Rosita A Condorelli, Rossella Cannarella, Sandro La Vignera
This article summarizes years of challenging research on erectile dysfunction (ED), a condition that has an important social and cultural relevance. Preclinical and clinical research progress has led to new therapeutic approaches to ED in patients with different comorbidities and particularly in those with low urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). These goals were possible only by combined work of specialists and researchers of different and intertwined medical disciplines. Currently, tadalafil (5 mg/d) is the best choice; other phosphodiesterase-5 inhibitors (PDE5i) are not included among options, despite the growing evidence of therapeutic effects...
January 29, 2018: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
Zhilei Qiu, Changcun Zhang, Xinsheng Wang, Kai Cheng, Xin Liang, Dawen Wang, Sichuan Hou, Xinsheng Wang
Introduction: Non-surgical minimally invasive treatments are greatly needed for patients with symptomatic benign prostatic hyperplasia (BPH), for whom medical treatment has failed and surgery is contraindicated. This study retrospectively evaluated the efficacy and safety of super-selective prostatic artery embolization (PAE) for BPH, relative to transurethral resection of the prostate (TURP). Aim: To clinically evaluate the efficacy and safety of super-selective PAE for BPH, relative to TURP...
December 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Jing Li, Yanxin Tian, Shimeng Guo, Haifeng Gu, Qianting Yuan, Xin Xie
Benign prostatic hyperplasia (BPH) is an age-related disease, affecting a majority of elderly men worldwide. Medical management of BPH is an alternative to surgical treatment of this disease. Currently, α1-adrenergic receptor (α1-AR) antagonists are among the first line drugs to treat BPH by reducing the tension of urinary track and thus the obstructive symptoms in voiding. In drug development, old male dogs with spontaneous BPH are considered the golden standard of the animal models. However, old dogs (>6 years) are expensive and not all old dogs develop BPH...
2018: PloS One
James C Ulchaker, Melissa S Martinson
Objective: To conduct a cost-effectiveness analysis from payers' perspectives of six treatments for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and to examine positioning of these modalities in the marketplace for the best use of health care funds and quality-of-life benefits for patients. Methods: The economic analysis was conducted with a Markov model to compare combination prescription drug therapy (ComboRx), minimally invasive therapies (MITs) including convective radiofrequency (RF) water vapor thermal therapy (Rezūm®), conductive RF thermal therapy (Prostiva®), and prostatic urethral lift (UroLift®), and invasive surgical procedures including photovaporization of the prostate (Greenlight® PVP) and transurethral resection of the prostate (TURP)...
2018: ClinicoEconomics and Outcomes Research: CEOR
Ryosuke Takahashi, Minoru Miyazato, Hisae Nishii, Yasuhiro Sumino, Kazuo Takayama, Masako Onzuka, Takuma Oshiro, Seiichi Saito, Naohiro Fujimoto, Hiromitsu Mimata, Masatoshi Eto
OBJECTIVES: Effect of tadalafil on lower urinary tract symptoms (LUTS), erectile function and quality of life (QoL) were prospectively evaluated in patients with benign prostatic hyperplasia (BPH) at multicenter. METHODS: Eligible men were ≥40 years who had no treatment with alpha-blocker for BPH, with total International Prostate Symptom Score (IPSS) ≥8, IPSS-QOL ≥2 and prostate volume ≥20 mL. Data were collected on age, body mass index (BMI), and prostate specific antigen (PSA)...
January 2018: Lower Urinary Tract Symptoms
Yinghui Duan, James J Grady, Peter C Albertsen, Z Helen Wu
PURPOSE: Clinicians use tamsulosin, an α1-adrenoceptor antagonist, to manage symptomatic benign prostatic hyperplasia (BPH). Because α1-adrenoceptors are also present in the brain, the potential exists for adverse effects on cognitive functions. We explored the association between tamsulosin use and dementia risk. METHODS: We used Medicare data (2006-2012) to conduct a cohort study among patients aged ≥65 years and diagnosed with BPH. Men taking tamsulosin (n = 253 136) were matched at a 1:1 ratio using propensity-scores to each of 6 comparison cohorts: patients who used no BPH-medication (n = 180 926), and patients who used the following alternative-BPH-medications: doxazosin (n = 28 581), terazosin (n = 23 858), alfuzosin (n = 17 934), dutasteride (n = 34 027), and finasteride (n = 38 767)...
January 9, 2018: Pharmacoepidemiology and Drug Safety
Daniel Mollengarden, Kenneth Goldberg, Daniel Wong, Claus Roehrborn
BACKGROUND: Convective radiofrequency water vapor thermal therapy with the Rezūm system is a relatively new treatment for benign prostatic hyperplasia (BPH). We present results from a single surgeon in an office setting. METHODS: A retrospective review of 129 patients from a single surgeon who underwent the Rezūm procedure was performed. All patients were at least 4 months out from treatment. International prostate symptom scores (IPSS), maximum flow rates (Qmax), residual urine volumes, medication usage, and adverse events were monitored...
December 27, 2017: Prostate Cancer and Prostatic Diseases
Ville Kukko, Antti Kaipia, Kirsi Talala, Kimmo Taari, Teuvo L J Tammela, Anssi Auvinen, Teemu J Murtola
BACKGROUND: Metabolic syndrome and obesity are linked with hyperuricemia, and it has also been proposed that oxidative stress associated with hyperuricemia may promote benign prostatic hyperplasia (BPH). However, it is currently unknown whether use of antihyperuricemic medication is associated with risk of developing BPH. We studied the association between BPH and use of antihyperuricemic allopurinol in a Finnish population-based cohort. METHODS: The study cohort consisted of 74,754 men originally identified for the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC)...
December 22, 2017: Prostate Cancer and Prostatic Diseases
Michelle Quintero-García, Evangelina Delgado-González, Ana Sánchez-Tusie, Mario Vázquez, Carmen Aceves, Brenda Anguiano
Oxidative stress and inflammation are involved in the development and/or progression of benign prostatic hyperplasia (BPH). Molecular iodine (I2) induces antiproliferative and apoptotic effects in prostate cancer cells, but it is unknown if I2 regulates oxidative stress in the normal and/or tumoral prostate. The purpose of this study was to analyze the effects of I2 and celecoxib (Cxb) on oxidative stress and inflammation in a model of prostatic hyperplasia. Cxb was used as positive control of cyclooxygenase-2 (COX-2) inhibition...
December 14, 2017: Free Radical Biology & Medicine
Hanaa Mahmoud Mohamed, Magdy Sayed Aly, Tarek Dardeer Hussein
Background: Benign prostate hyperplasia (BPH) is a classical age-related disease of the prostate, present in 20% of men at the age of 40 years with progression to 70% by the age of 60 years. BPH is associated with various lower urinary tract symptoms, which affect their day-to-day life. Materials and methods: Our objective was to evaluate the association between HER-2/neu, c-myc, p53, and clinicopathological variables in 45 patients diagnosed with benign prostatic hyperplasia using fluorescence in situ hybridization (FISH)...
2017: German Medical Science: GMS E-journal
Abdulmaged M Traish
Androgens are steroid hormones with pleotropic and diverse biochemical and physiological functions, and androgen deficiency exerts a negative impact on human health. Testosterone (T) either directly or via its transformation into the more potent metabolite 5α-dihydrotestosterone (5α-DHT) or via aromatization into estradiol (E2 ) modulates important biochemical signaling pathways of human physiology and plays a critical role in the growth and/or maintenance of functions in a host of tissues and organs. T and 5α-DHT play an important role in regulating physiology of the muscle, adipose tissue, liver, bone, and central nervous system, as well as reproductive and sexual functions...
2017: Advances in Experimental Medicine and Biology
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