Biomedical subjects

R Harkaway

Publications and source records attributed to R Harkaway.

4 recordsLinked to original sources

PubMed2006

Enlarged prostate: a landmark national survey of its prevalence and impact on US men and their partners.

This questionnaire-based survey evaluated the frequency and severity of lower urinary tract symptoms (LUTS) and the prevalence of enlarged prostate (EP) diagnosis and its impact on quality of life and spousal relationships among >1000 American men aged >50 years. A quarter of men suffered moderate to severe LUTS and 55% of those consulting a doctor had EP. EP negatively affected patient quality of life and caused relationship strain with spouses. These findings confirm that LUTS and EP are prevalent in the US population, affecting both patient and spouse, and may help in developing management strategies for EP.

Aged↗

PubMed2004

5-Alpha reductase inhibition provides superior benefits to alpha blockade by preventing AUR and BPH-related surgery.

OBJECTIVES: This analysis examines the relative effectiveness of current medical therapies for BPH in preventing AUR, AUR-related catheterisation and surgery in real-life clinical practice. METHODS: This is a retrospective analysis of observational data from the General Practice Research Database (UK) (GPRD). The cohort contains 4500 patients experiencing BPH or lower urinary tract symptoms strongly suggestive of BPH, aged over 50 years, who were prescribed a 5ARI (finasteride) or an alpha-blocker (alfuzosin, doxazosin, indoramin, prazosin, tamsulosin, terazosin) as their first BPH treatment between 1996 and 1999 inclusive. Cox regression and competing risks analyses, adjusted for age and year of first treatment, followed patients from the start of their first BPH treatment to AUR, catheterisation or surgery, or censoring. RESULTS: Patients prescribed an alpha-blocker were significantly more likely to experience AUR (hazard ratio 2.32, 95%CI 1.37, 3.94) or surgery (hazard ratio 1.78, 95%CI 1.30, 2.44) than patients prescribed a 5ARI. These differences were sustained with sensitivity analyses. CONCLUSION: Real-life clinical practice shows that significantly fewer BPH patients prescribed a 5ARI experienced serious complications associated with the progression of BPH compared with those prescribed an alpha-blocker.

5-alpha Reductase Inhibitors↗

PubMed1994

Pharmacologic erection: time-dependent changes in the corporal environment.

Priapism is a persistent erection which fails to subside after climax and is accompanied by penile pain and tenderness. The most common form of priapism to confront contemporary urologists is persistence of erection following pharmacologic stimulation. We reviewed our experience over 18 months with initial diagnostic intracavernous challenges of prostaglandin E1. Three-hundred and sixty-six new impotence patients presented to our center and underwent PGE1/color duplex Doppler assessment; 14 patients developed persistent rigidity of two or more hours accompanied by penile discomfort. Each of these patients was successfully managed with penile aspiration and direct corporal instillation of the alpha-adrenergic agonist phenylephrine. The mean PGE1 dosage injected was 6 micrograms and mean duration of erection preceding aspiration 180 minutes. Penile blood gases were obtained from the initial aspirate in all cases. The duration of pharmacologic erections were correlated with the partial pressures of oxygen, carbon dioxide, bicarbonate and the pH using linear regression analysis. There was a clear trend towards deoxygenation, acidosis, and hypercarbia with prolonged erection (105-342 minutes). The relationship between duration of pharmacologic erection and acidosis/hypercarbia was highly significant.

Adult↗

PubMed1990

Comparison of urinary bladder function in sexually mature and immature male and female rats.

Although studies exist using both male and female rats, there are virtually no studies that compare male and female bladder function. In this initial study, in-vivo and in-vitro urinary bladder function was investigated in two age groups of male and female rats (sexually immature and sexually mature). These studies compare in-vivo micturition behavior (water intake, urine output, frequency and volume per micturition); and in-vitro whole bladder function (bladder volume/pressure relationships, the ability of the in-vitro bladders to generate pressure and empty in response to bethanechol and field stimulation). The results can be summarized as follows: 1) The 24 hour water intake, urine output, and volume per micturition for the mature male rats was significantly greater than that of the mature females with no significant differences among the immature females, mature females, or immature males. 2) There were no significant differences in the frequency of micturition between the 4 groups. 3) Although the average plateau pressures (cystometrograms) of the immature and mature female bladders were greater than that of the immature and mature male bladders, the compliance was similar for all groups. 4) The maximum pressure response of the mature female bladder was significantly greater than pressures generated by bladders in the other three groups; there were no age or sex related differences in the bethanechol log ED50 values. 5) There were no age or sex-related differences in the bethanechol log ED50 values or maximal expulsion responses. 6) Field stimulated bladders from mature animals generated significantly greater intravesical pressures than bladders from immature animals, but, there were no significant differences in maximal pressures attained between mature male and female bladders nor between immature male and female bladders. In conclusion, micturition behavior, and the maximal pressure response to bethanechol changed dramatically with sexual maturity. These results are consistent with the idea that estrogen and other hormones may have a marked influence on bladder function and micturition behavior.

Animals↗