SEARCH · PubMed Health

Results for “benign prostatic hyperplasia”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources

PubMed2003

Quality of life and sexual function in patients with benign prostatic hyperplasia.

Incidence of benign prostatic hyperplasia (BPH), one of the most common conditions affecting adult men, increases dramatically after the age of 50. The various symptoms of BPH, which include lower urinary tract symptoms (LUTS), can adversely affect quality of life (QOL). Many men with BPH and LUTS wait until symptoms become significantly bothersome before seeking medical attention. Evaluating the exact severity and significance of symptoms has been difficult with previous methodology. Over the last decade, assessment tools have become available to quantify the symptoms of BPH and LUTS. This article addresses the impact of BPH, its management, and the overall effects it has on QOL.

Journal Article↗

PubMed1989

[Prognosis of the prostatectomy of benign prostatic hyperplasia].

Surgery of benign prostatic hyperplasia has been performed in 484 cases during a period of 10 years from January 1978 to December 1987; these 484 cases comprised 345 to transurethral resection, 130 of subcapsular extirpation and 9 of cryosurgery. Their period of prognosis was examined; 10-year survival rate was 88.9, 95.7, 60.4, 55.8 and 42.8% for 55-59, 60-64, 65-69, 70-74 and 75-79 years, respectively, 8-year and 7-year survival rates being 31.7 and 66.7% for 80-84 85-89 years, respectively. Survival rate by age bracket was compared in terms terms of electrocardiogram (ECG), pulmonary function and possible anomalies and operative blood transfusion. The group of patients with abnormal ECG and pulmonary function showed a significant decreasing survival rate with aging. The aged patients showed no difference in survival rate according to possible blood transfusion. Examination of the cause of death revealed predominant involvement of cardiopathy and cerebrovascular disorder, with comparatively less due to cancers. In terms of postoperative conditions of life of these patients and a long period prognosis of their urination, more 75% of them are living in good condition and 70% are in a state of satisfactory urination.

Age Factors↗

PubMed1993

[Economic public health aspects of benign prostatic hyperplasia in Austria].

Benign prostatic hyperplasia (BPH) is one of the most frequent diseases in advanced aged men. The introduction of a new coding system (ICD-VESKA) in 1989 made it possible to analyze the number of hospitalized cases and to calculate the costs of inpatient care. In 1990 10,710 BPH cases were treated within Austrian hospitals. Controlling for multiple entries 9,742 individual patients (269.4 per 100,000) were treated 138,761 days. Case fatality was 0.5% (46 deaths). The number of inpatients comprises only the top 1,3% of morbidity, the total number is estimated with 770,000 patients. Based on the official nursing fees total costs in public affiliated hospitals were AS 250 millions. Including private hospitals total costs increase to AS 306 millions. The inpatient care of BPH represents only a small proportion of the total health and economic burden, which obviously mainly occurs in the outpatient system. Therefore BPH is one of the diseases of which social and economic importance is usually underestimated due to a lack of information.

Adolescent↗

PubMed1994

Role of the sympathetic nervous system in hypertension and benign prostatic hyperplasia.

Hypertension and benign prostatic hyperplasia (BPH) have a number of features in common. For example, both occur with increasing frequency in the elderly, and both are a major source of health expenditure worldwide. However, the most striking feature linking hypertension and BPH is the aetiological role of the sympathetic nervous system. Sympathetic tone mediated by the alpha-receptor is vital in the control of blood pressure. By selectively inhibiting the alpha 1-adrenoceptors in the vasculature, thereby inhibiting the response to epinephrine and norepinephrine and thus reducing peripheral resistance, selective alpha 1-inhibitors such as doxazosin produce a physiological reduction in blood pressure. Receptors of the alpha 1 subtype are also found in the prostate, the urethra and bladder neck. Doxazosin, by reducing the tone of the prostatic smooth muscle, has the potential to improve urinary flow rate, as well as the obstructive and irritative symptoms characteristic of BPH.

Adrenergic alpha-Antagonists↗

PubMed1994

Alpha-1 receptor mediated smooth muscle regulation in benign prostatic hyperplasia.

Symptoms in benign prostatic hyperplasia (BPH) are partially caused by an increased prostatic smooth muscle tone. This tone depends on extra- and intracellular Ca2+ stores and is regulated by various second messenger pathways. We investigated the role of intracellular Ca2+ stores and cyclic 3'-5' adenosine monophosphate (cAMP) in BPH. Contractions elicited by the specific alpha 1-receptor agonist phenylephrine (PE) were inhibited by the selective alpha 1-receptor antagonists prazosin and YM 617. To elucidate the contribution of intracellular Ca2+ stores to the alpha 1-receptor induced contraction nifedipine, a blocker of voltage dependent L-type Ca2+ channels (VDCC) was applied and found to inhibit the PE induced contractions up to 65%. To further confirm the participation of intracellular Ca2+ stores, we applied ryanodine (10 microM) which reduced the alpha 1-receptor mediated contractions up to 80%. The remaining contraction was sensitive to nifedipine. The cAMP pathway mediating smooth muscle relaxation by regulating intracellular Ca2+ concentrations ([Ca2+]i) was also investigated. Nonspecific phosphodiesterase (PDE) inhibitors such as papaverine (0.5 mM) and theophylline (1 mM) and the specific PDE inhibitor milrinone (0.5 mM), all of which prevent degradation of cAMP, suppressed the PE induced contractions by 82%, 91% and 68%, respectively. Forskolin (50 microM), an activator of adenylylecyclase (AC), inhibited the PE induced contractions by 83%. The membrane permeable cAMP analog, N6-2'-0-dibutyryladenosine derivative (dBcAMP) also reduced the PE induced response by 70%.

Adrenergic alpha-Antagonists↗

PubMed1996

Medical management of benign prostatic hyperplasia: a review.

Benign prostatic hyperplasia (BPH) is a common disease affecting elderly men with 70% of men over 70 years showing microscopic evidence of hyperplasia. Transurethral resection of the prostate is the gold standard treatment. Medical management of BPH has involved the use of plant extracts, amino acids, kampo and animal organ preparations in various countries with unsatisfactory results. The use of alpha adrenergic antagonists dates back twenty years representing a major breakthrough in the treatment by relaxation of the dynamic contraction of smooth muscle component of prostatic obstruction. The evolution of alpha antagonist therapy resulted in clinical trials with selective antagonists such as prazosin, alfuzosin, indoramin, terazosin and doxazosin all of which achieve similar effective relief of obstructive symptoms as phenoxybenzamine, but with fewer side effects related to postural hypotension. 5-alpha reductase inhibitors, finasteride and episteride, recently synthesised act on the static component of obstruction caused by the enlarging prostate. They inhibit conversion of testosterone to the potent intracellular androgen dihydrotestosterone (DHT) resulting in the reduction of prostate volume and improvement of obstructive symptoms. Clinical trials with finasteride for three years indicate that 63% of patients had a reduction of greater than 20% in prostatic volume and 42% had a decrease of greater than 30% with a mean increase peak flow rate of 2.4 mls/s equivalent, to 20 years reversal of disease progression.

Adrenergic alpha-Antagonists↗

PubMed1995

Endocrine therapy for benign prostatic hyperplasia in the 90's.

Endocrine therapy by means of castration for benign prostatic hyperplasia was introduced already in the middle of the 19th century. The technique was never popularized and was abandoned following the introduction of safe surgical techniques. In the second half of this century, small series of various endocrine treatments have been reported, mainly using progestational agents. The hormone dependency of the prostate is unique, since testosterone itself is not very active on the prostate cells but has to be converted to 5 alpha-dihydrotestosterone, which is almost ten times as effective an androgen in the prostate cell. By blocking this conversion, highly specific antiandrogenic effect will be obtained in the prostate but not in other organs of the body. The first 5 alpha-reductase inhibitor, finasteride, has proven effective in reducing prostate DHT. In large clinical trials, it has shown to reduce prostate size, improve urinary flow and reduce symptom score, statistically significantly better than placebo. The effect is sustained over at least 3 years. In a double-blind, randomized, placebo-controlled study over 2 years, patients were similarly improved in the finasteride group, whereas they deteriorated in the placebo group. This indicates that finasteride is able to halt the progression of the natural course of benign prostatic hyperplasia. Benign prostatic hyperplasia, generally believed to be a stromal disease, is potentially dependent on estrogens for its development. By blocking aromatization of testosterone to estrogen in the prostate cells, a hypothetical beneficial effect on the disease process should be gained. Results from phase II-studies have been promising. However, in placebo-controlled studies, aromatase inhibitors did not perform better than placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Androstenedione↗

PubMed1993

A comparison of quality of life with patient reported symptoms and objective findings in men with benign prostatic hyperplasia. The Department of Veterans Affairs Cooperative Study of transurethral resection for benign prostatic hyperplasia.

As part of a randomized, controlled, trial conducted by the Department of Veterans Affairs Cooperative Studies Program comparing the effectiveness of transurethral resection of the prostate to watchful waiting, we evaluated 707 men with mild to severe symptoms of benign prostatic hyperplasia (BPH). We examine the relationships among patient reported symptoms, quality of life responses, peak urine flow rates and post-void residual urine estimates. Correlations among responses to symptom and quality of life interviews, urine flow results and residual urine volume were low (less than 0.20). However, multivariate correlation analysis showed that patient reported irritative symptoms, such as urgency, frequency and nocturia, were associated with quality of life responses, while patient reported obstructive symptoms, peak urinary flow rates and post-void urine estimates were unrelated to diminished quality of life. Since the extent to which BPH interferes with the life-style is likely to influence the decision of the patient to seek medical evaluation, the lack of association between quality of life and obstructive symptoms may result in misdirected diagnostic evaluations. This may have a large role in the controversies regarding assessments of symptomatic BPH, guidelines for surgical intervention and outcomes of treatment. Further study is required to determine the influence of diminished quality of life and irritative symptoms on the outcomes of treatments for BPH.

Aged↗

PubMed2002

Dihydrotestosterone and the concept of 5alpha-reductase inhibition in human benign prostatic hyperplasia.

The development of human benign prostatic hyperplasia (BPH) clearly requires a combination of testicular androgens and the ageing process. Although the role of androgens as the causative factor for human benign prostatic hyperplasia is debated, they undoubtedly play, at least, a permissive role. The principal prostatic androgen is dihydrotestosterone. Although not elevated in human benign prostatic hyperplasia, dihydrotestosterone levels in the prostate remain at a normal level with ageing, despite a decrease in the plasma testosterone. Dihydrotestosterone (DHT) is generated by a reduction in testosterone. Two isoenzymes of 5alpha-reductase have been discovered. Type 1 is present in most tissues in the body where 5alpha-reductase is expressed, and is the dominant form in sebaceous glands. Type 2 5alpha-reductase is the dominant isoenzyme in genital tissues, including the prostate. Finasteride is a 5alpha-reductase inhibitor that has been used to treat BPH and male-pattern baldness. At doses used clinically, its major effect is to suppress type 2 5alpha-reductase, because it has a much lower affinity for the type 1 isoenzyme. Finasteride suppresses DHT by about 70% in serum and by as much as 85%-90% in the prostate. The remaining DHT in the prostate is likely to be the result of type 1 5alpha-reductase. The suppression of both 5alpha-reductase isoenzymes with GI198745 results in greater and more consistent containment of serum dihydrotestosterone than that observed with a selective inhibitor of type 2 5alpha-reductase. Physiological and clinical studies comparing dual 5alpha-reductase inhibitors, such as GI198745, with selective type 2, such as finasteride, will be needed to determine the clinical relevance of type 1 5alpha-reductase within the prostate. There have been two large, international multicentre, phase III trials published documenting the safety and efficacy of finasteride in treating human benign prostatic hyperplasia. Combining these two studies, randomised, controlled data are available for 12 months. Non-controlled extension of these data from a subset of patients, who elected to continue on the drug for 3, 4 and 5 years, are also available. Long-term medical therapy with finasteride can reduce clinically significant endpoints, such as acute urinary retention or surgery. According to the meta-analysis of six randomised, clinical trials with finasteride, finasteride is most effective in men with large prostates. A more effective dual inhibitor of type 1 and 2 human 5alpha-reductase may lower circulating dihydrotestosterone to a greater extent than finasteride and show advantages in treating human benign prostatic hyperplasia and other disease states that depend on dihydrotestosterone. A clinical evaluation of potent dual 5alpha-reductase inhibitors may help to define the relative roles of human type 1 and 2 5alpha-reductase in the pathophysiology of benign prostatic hyperplasia and other androgen-dependent diseases.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

PubMed1999

[Incidence of benign prostatic hyperplasia and hepatic cirrhosis].

We studied the incidence of benign hyperplasia of the prostate and hepatic cirrhosis in an ambulatory cohort. Undisturbed androgen production is one of the prerequisites for the development of benign prostatic hyperplasia. The disturbed metabolic activity of the cirrhotic liver causes often hypoandrogenism. Therefore a decreased incidence of prostatic hyperplasia is expected for patients with cirrhosis. All male patients of european origin over 40 newly admitted for treatment at the medical outpatient clinic in Zürich during a period of 6 months were enrolled. From a cohort of 2038 males over 40 a benign prostatic hyperplasia was diagnosed in 124. Nine had cirrhosis of the liver. In 6 patients cirrhosis was found in addition to benign prostatic hyperplasia. The study also confirmed an increased incidence of benign prostatic hyperplasia with age. The incidence of cirrhosis, however, decreased with age in our study, probably as a consequence of reduced life expectancy of the cirrhotic patient. The combined incidence of benign prostatic hyperplasia and hepatic cirrhosis became less common with age than benign prostatic hyperplasia alone. This corresponded to our expectations. This collection of epidemiologic data on benign prostatic hyperplasia and hepatic cirrhosis disclosed several difficulties that should be considered for future studies.

Adult↗

PubMed1996

[Urodynamic changes after transureteral microwave thermotherapy of benign prostatic hyperplasia].

In 32 patients with benign prostate hyperplasia different urodynamic parameters were investigated before treatment by transurethral microwave thermotherapy and after this treatment. After three months positive changes were recorded as regards the storage as well as micturition phase which did not change during the subsequent six months. Transurethral microwave therapy is a suitable therapeutic method of benign hyperplasia of the prostate in mildly obstructive patients.

Aged↗

PubMed2006

Prevention of benign prostatic hyperplasia disease.

PURPOSE: We reviewed the evidence that benign prostatic hyperplasia is a progressive condition and men at risk for benign prostatic hyperplasia disease can be identified, treated and protected to a meaningful extent regardless of symptom status. MATERIALS AND METHODS: The MEDLINE database was searched in 4 areas of interest relating to benign prostatic hyperplasia, including 1) progression of clinical manifestations with age, especially in regard to baseline symptom status, 2) the incidence of complications due to disease progression, 3) the use of predictive factors that may help identify men at risk for disease progression and 4) the prevention of benign prostatic hyperplasia disease with medical therapy. RESULTS: Tissue changes in the prostate (benign prostatic hyperplasia) are inevitable consequences of aging. However, benign prostatic hyperplasia disease, which we define as a life altering urinary condition requiring medical intervention, is predictable and preventable. Benign prostatic hyperplasia disease progression is associated with increasing prostate volume, decreasing urinary flow, symptomatic deterioration often to the point of major life-style interference and serious complications, eg acute urinary retention and the need for surgery. The risk of benign prostatic hyperplasia disease progression was found to be directly related to prostate volume and its surrogate marker, serum prostate specific antigen, after prostate cancer is excluded. Other factors, eg baseline symptoms and the flow rate, were found to be less relevant compared with prostate specific antigen greater than 1.5 ng/ml for predicting benign prostatic hyperplasia disease morbidity. CONCLUSIONS: Men at risk for benign prostatic hyperplasia disease can be identified using prostate specific antigen greater than 1.5 ng/ml as a surrogate marker of prostate volume. In men at risk with prostate specific antigen greater than 1.5 ng/ml 5alpha-reductase inhibitors have potential value for benign prostatic hyperplasia disease prevention regardless of symptom status.

Adult↗

PubMedDate not supplied

[Changes in prostatic circulation in response to laser therapy and magnetic therapy in patients with benign prostatic hyperplasia].

The results of preoperative preparation were analysed in 59 patients with prostatic benign hyperplasia (PBH) subjected to TUR. Treatment outcomes were assessed by transrectal ultrasound (color Doppler mapping) in two groups of patients. Group 1 received combined therapy including transrectal laser radiation of the prostate, group 2--transrectal magnetotherapy. The analysis showed that laser radiation reduced insignificantly the size of the prostate and adenomatous node, improved microcirculation and circulation in the prostate. This resulted in relief of inflammation and reduction of the number of postoperative inflammatory complications. Transrectal magnetotherapy has a positive effect on vascularization and hemodynamics of the prostate, local immunity, contamination of the tissues with pathogenic flora.

Aged↗

PubMed2000

[Interstitial laser therapy in benign prostatic hyperplasia].

The interstitial laser therapy is a low invasivity system for prostatic benign hyperplasia. We report our experience with Indigo 830e new system where diode laser and optical temperature sensor warrant a laser-induced interstitial thermal therapy able to continuously adjust energy delivery to the tissue.

Aged↗

PubMed1987

Relationship between echogram and histology of benign prostatic hyperplasia.

Echograms of benign hyperplastic prostates by means of transrectal ultrasonography were evaluated according to their ability to distinguish between internal and external glands. Of the 112 benign prostatic hyperplasia (BPH) cases, we could distinguish between internal and external glands in 43 cases (38.4%). In 24 of all BPH cases, their preoperative echograms and postoperative histologies were compared. The result was that it was difficult to distinguish between internal and external glands in the many chronic-inflammatory infiltrates.

Humans↗

PubMedDate not supplied

[Prostatic benign hyperplasia].

After reviewing the clinical, diagnostic and therapeutic attitude related to Benign Prostatic Hyperplasia, the authors present the guidelines for Generalists, in terms of practical handling and when and how to refer their patients to the Urology consultation. Based on the criteria presented, Generalists must refer their patients to the Urology consultation in the presence of mild or severe symptoms, ages below 50 years, diabetes or neurological disturbances, disturbed voiding, palpable bladder, palpable nodule or a diffusely hardened or asymmetric gland revealed by digital rectal examination, hematuria, urinary tract infection, renal impairment or PSA above 4 nglml in patients aged below 70 years.

Algorithms↗

PubMed2000

Comparison of prazosin, terazosin and tamsulosin in the treatment of symptomatic benign prostatic hyperplasia: a short-term open, randomized multicenter study. BPH Medical Therapy Study Group. Benign prostatic hyperplasia.

BACKGROUND: The objective of this open randomized clinical study was to compare the short-term efficacy and safety of three alpha-1 blockers, prazosin, terazosin and tamsulosin, in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). METHODS: The study comprised 121 patients with symptomatic BPH who were randomized to receive 0.5 mg of prazosin twice daily, 0.5 mg of terazosin twice daily or 0.1 mg of tamsulosin once daily for the initial 2 weeks. The doses were doubled for the next 2 weeks. The primary variables assessed were a symptom score, changes in maximum and average urinary flow rate (Qmax and Qave), postvoid residual urine volume and blood pressure. RESULTS: The percentage changes in the total symptom score from baseline were 38, 39 and 26% at 4 weeks by prazosin, terazosin and tamsulosin, respectively. Terazosin produced significantly higher improvement in four out of nine individual symptoms than tamsulosin (P < 0.05). A significant increase in Qmax or Qave in uroflowmetry was obtained in the prazosin and tamsulosin groups. Blood pressure remained unchanged in normotensive patients, but significantly decreased in hypertensive patients except for the tamsulosin group. Adverse events were minimal in all treatment groups. CONCLUSIONS: The efficacy and safety profiles were different among the alpha-1 blockers at standard doses. Tamsulosin appears to be safer than the others for aged patients or patients with hypertension who have impaired blood pressure regulation, while terazosin is significantly effective in improving symptomatic score when compared with the others examined. It is recommended that the alpha-1 blocking agent and its optimal dose are selected on the basis of the baseline characteristics of the patients with symptomatic BPH.

Adrenergic alpha-Antagonists↗

PubMed2001

Apoptotic regression of prostatic tissue induced by short-term doxazosin treatment in benign prostatic hyperplasia.

OBJECTIVES: Benign enlargement of the prostate comprises both hypertrophy and in particular hyperplasia of prostatic stromal and glandular compartments. Alpha adrenergic blockade has been shown to be effective in the management of BPH. Recent investigations have shown that this effect may in part be due to apoptosis. METHODS: A total of 29 patients who were symptomatic due to BPH were enrolled into this prospective placebo controlled, double-blind randomized study and underwent prostatectomy at the end of the 4th week. Clinical efficacy was evaluated by a set of detailed investigations. Surgical specimens were analyzed by immunohistochemistry and tissue components of stroma, smooth muscle and glandular epithelium were calculated by a software on a computer after representative areas were scanned and captured as high resolution images. Apoptosis in each tissue specimen was analyzed by Terminal Deoxynucleotidyl Transferase End Labelling (TUNEL) method utilizing Biotin-16-dUTP. RESULTS: Both groups were similar in terms of baseline evaluation in all aspects. There was a steady decline in patients' urinary complaints as evidenced by International Prostate Symptom Score System (IPSS) in the doxazosin group compared to placebo. Uroflowmetric investigations on patients revealed that maximum flow rates in the active drug group increased throughout the study. Mean PSA levels decreased by 14% at the end of the study in the doxazosin group, while it increased by 11% in the placebo group. Average stroma to epithelial ratio in the doxazosin group was 2:1 in comparison to a value of 1:1 in the placebo group. The rate of apoptosis was 2.2% and 3.2% for the epithelial and stromal compartments, respectively, in the doxazosin group, and 1.2% and 2.7% for the placebo arm. CONCLUSIONS: These data suggest apoptosis as the possible underlying molecular mechanism partly responsible for the clinical efficacy and morphological changes induced by doxazosin treatment in BPH.

Adrenergic alpha-Antagonists↗