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Objective: To evaluate the results of the prostate-specific antigen (PSA) test used in prostate cancer screening. Methods: This retrospective study was conducted on a total of 1106 male individuals, including 615 people (55.6%) aged 40-54, 379 people (34.3%) aged 55-69, and 112 individuals (10.1%) aged 70 and over. In the study, prostate-specific antigen (PSA) blood test results were performed on a total of 1106 male individuals aged 40 and over registered in the Uludag University Family Health Center, Bursa, Turkey during the 5-years between June 1, 2018, and May 31, 2023, were taken from the database and analyzed. Relationships with sociodemographic characteristics, comorbidities, and risk factors were examined. Data was analyzed using SPSS 25. Results: About 15.5% of the participants were married, 78.4% were single, and 6% were separated from their spouses or widows. The PSA values of the patients referred to the urologist were found to be significantly different between the ages of 55 and 69. It was determined that the PSA levels of the patients with benign prostatic hypertrophy and prostate cancer were higher than the patients without any finding, and the mean was 6.81±4.39 (p=0.01). Conclusion: In our study, it is important to diagnose benign prostatic hypertrophy or prostate cancer in patients aged 55-69 years, whose mean PSA levels were 6.81±4.39, and referred to a urologist. As a contribution to the discussions in the literature, we recommend that the patient with symptoms be referred to the urologist after the test request and the joint decision with the family physician. [ABSTRACT FROM AUTHOR]

Objectives: To assess disobstructive proficiency of BPH3 trifecta in RASP according to different techniques. Methods: Baseline prostate volume (PV), uroflowmetry parameters and Validated questionnaires: IIEF, Incontinence severity index score (ISI), International prostatic symptoms score (IPSS), MSHQ, Quality of recovery (QOR), were recorded preoperatively and 12 months postoperatively. RASP was conducted using both the urethra-sparing (Madigan) technique and a non-urethral-sparing transvesical (Freyer) approach. Two groups were evaluated for achievement rates in terms of BPH-3 and BPH-6. BPH-3 was defined by a combination of: a reduction of ⩾30% in IPSS compared to baseline, ISI score ⩽ 4, and absence of complications beyond Clavien grade 1. Results: About 158 patients underwent RASP, with 93 undergoing the Madigan procedure and 65 the Freyer approach. Patients in the Madigan group were younger, with lower PV, baseline IPSS score, overactive symptoms (ISI score), but higher MSHQ and IIEF score, when compared to the Freyer population (all p < 0.02). At 12-month follow-up, patients who underwent the Madigan procedure reported shorter bladder irrigation time and time to catheter removal (both p < 0.001). As expected, Madigan patients also demonstrated superior postoperative IIEF and MSHQ scores (all p < 0.001). Postoperative complication incidence was higher in the Madigan cohort, mainly due to UTI (p < 0.001). Although there were no differences in postoperative IPSS and Q-max between groups, the Madigan cohort presented with higher post void residue (p < 0.001). BPH6 achievement was higher in the Madigan cohort (48% vs 28%) (p < 0.001), while no difference was observed in BPH3 achievement rate. Conclusion: The BPH3 composite trifecta appears to be more suitable than BPH6 in assessing the proficiency in disobstructive symptoms relief after RASP. [ABSTRACT FROM AUTHOR]

Objective: Perioperative neurocognitive disorders (PND) are a group of prevalent neurological complications that often occur in elderly individuals following major or emergency surgical procedures. The etiologies are not fully understood. This study endeavored to investigate novel targets and prediction methods for the occurrence of PND. Methods: A total of 229 elderly patients diagnosed with prostatic hyperplasia who underwent transurethral resection of the prostate (TURP) combined with spinal cord and epidural analgesia were included in this study. The patients were divided into two groups, the PND group and non-PND group, based on the Z-score method. According to the principle of maintaining consistency between preoperative and intraoperative conditions, three patients from each group were randomly chosen for serum sample collection. isobaric tags for relative and absolute quantification (iTRAQ) proteomics technology was employed to analyze and identify the proteins that exhibited differential expression in the serum samples from the two groups. Bioinformatics analysis was performed on the proteins that exhibited differential expression. Results: Among the 1101 serum proteins analyzed in the PND and non-PND groups, eight differentially expressed proteins were identified in PND patients. Of these, six proteins showed up-regulation, while two proteins showed down-regulation. Further bioinformatics analysis of the proteins that exhibited differential expression revealed their predominant involvement in cellular biological processes, cellular component formation, as well as endocytosis and phagocytosis Additionally, these proteins were found to possess the RING domain of E3 ubiquitin ligase. Conclusion: The iTRAQ proteomics technique was employed to analyze the variation in protein expression in serum samples from patients with PND and those without PND. This study successfully identified eight proteins that exhibited differential expression levels between the two groups. Bioinformatics analysis indicates that proteins exhibiting differential expression are primarily implicated in the biological processes associated with microtubules. Investigating the microtubule formation process as it relates to neuroplasticity and synaptic formation may offer valuable insights for enhancing our comprehension and potential prevention of PND. Clinical Trial Registration: Registered (ChiCTR2000028836). Date (20190306). [ABSTRACT FROM AUTHOR]

This study critically examines the impact of urination posture on bladder health and overall urinary function, focusing on three primary postures: standing, sitting, and squatting. Each posture is analyzed for its physiological implications, including bladder emptying efficiency, post-void residual volume, and pelvic muscle strain. The merits and demerits of each posture are discussed in relation to gender, age, and specific health conditions, such as prostate enlargement and lower urinary tract symptoms (LUTS). Scientific evidence highlights the sitting posture as the most beneficial overall, promoting complete bladder emptying, reducing residual urine, and supporting pelvic health. While standing offers convenience, particularly for men, it can contribute to incomplete bladder emptying and increase the risk of urinary tract infections (UTIs) and other complications. Squatting, although highly effective in promoting urinary and bowel function, may not be practical or accessible for all individuals. The findings suggest that sitting, particularly for individuals with bladder or prostate conditions, is the optimal posture for long-term urinary health. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the technical feasibility, safety, and patency results of a simultaneous surgical approach to repair urethral stricture and treat benign prostatic enlargement endoscopically in a highly selected group of patients at a tertiary referral center. We hypothesize that this is technically feasible, safe, and does not affect urethroplasty outcomes. Methods: A retrospective review of adult men who underwent simultaneous urethroplasty and endoscopic prostatic surgery between May 2017 and May 2024 at our institution was conducted. Patients with strictures < 15 French and prostates with adverse prognostic features of response to medical treatment were included. The primary outcome was technical feasibility and safety. The secondary outcome was stricture-free survival. Results: Twenty men were treated during the study period. The median length of the urethral stricture was 3.0 cm (IQR 2.0–5.0), and the median size of the prostate was 95.0 cc (IQR 63.3–128.3). All patients were treated successfully with a median operative time of 194.5 min (IQR 180.0–246.8), and no procedures required conversion to a staged procedure or open prostatectomy. There were seven Clavien–Dindo I–II complications and one Clavien–Dindo IIIb complication (hematuria requiring endoscopic clot evacuation). At 22 months follow-up, two cases of urethral re-stricture were diagnosed, with one case requiring redo urethroplasty, though none had previous major complications. Conclusion: The combination of urethroplasty and endoscopic surgery for benign prostatic enlargement at the same stage appears to be technically viable and safe, and it does not compromise medium-term urethral patency results in a carefully selected group of patients. [ABSTRACT FROM AUTHOR]

Chronic prostate inflammation in patients with benign prostate hyperplasia (BPH) correlates with the severity of symptoms. How inflammation contributes to prostate enlargement and/or BPH symptoms and the underlying mechanisms remain unclear. In this study, we utilize a unique transgenic mouse model that mimics chronic non-bacterial prostatitis in men and investigate the impact of inflammation on androgen receptor (AR) in basal prostate stem cells (bPSC) and their differentiation in vivo. We find that inflammation significantly enhances AR levels and activity in bPSC. More importantly, we identify interleukin 1 receptor antagonist (IL-1RA) as a crucial regulator of AR in bPSC during inflammation. IL-1RA is one of the top molecules upregulated by inflammation, and inhibiting IL-1RA reverses the enhanced AR activity in organoids derived from inflamed bPSC. Additionally, IL-1RA appears to activate AR by counteracting IL-1α's inhibitory effect. Furthermore, using a lineage tracing model, we observe that inflammation induces bPSC proliferation and differentiation into luminal cells even under castrate conditions, indicating that AR activation driven by inflammation is sufficient to promote bPSC proliferation and differentiation. Taken together, our study uncovers mechanisms through which inflammation modulates AR signaling in bPSC and induces bPSC luminal differentiation that may contribute to prostate hyperplasia. Inflammation enhances androgen receptor levels and activity in basal prostate stem cells via IL-1RA, promoting their proliferation and differentiation, potentially contributing to benign prostate hyperplasia in mice. [ABSTRACT FROM AUTHOR]

Benign prostatic hyperplasia (BPH) is a prevalent condition affecting the male urinary system, with its molecular mechanisms of pathogenesis remaining unclear. Y-27632, a non-isoform-selective Rho kinase inhibitor, has shown therapeutic potential in various diseases but its effects on static factors and fibrosis in BPH remain unexplored. This study investigated human prostate tissues, human prostate cell lines, and BPH rat model using immunofluorescence, flow cytometry, quantitative reverse transcription polymerase chain reaction, western blotting, and cell counting kit-8. ROCK1 and ROCK2 were significantly up-regulated in BPH tissues, correlating with clinical parameters. Y-27632 targeted the inhibition of ROCK1 & ROCK2 expression and inhibited cell proliferation, fibrosis, epithelial-mesenchymal transition (EMT), while induced cell apoptosis in a dose-dependent manner. Moreover, knockdown of either ROCK isoform inhibited fibrosis and EMT, induced apoptosis, while ROCK overexpression had the opposite effects. ROCK downregulation inhibited the β-catenin signaling pathway (such as C-MYC, Snail and Survivin) and decreased β-catenin protein stability, while inhibiting TGF-β/Smad2/3 signaling. At the in vivo level, Y-27632 reversed prostatic hyperplasia and fibrosis in BPH model rats to some extent. Our study sheds light on the therapeutic potential of Y-27632 in regulating prostate cell growth, fibrosis and EMT, and demonstrates for the first time the regulatory effect of ROCK isoforms on prostate cells, providing the basis for future research of ROCK isoform-selective inhibitors. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated short-term postoperative recovery in patients with benign prostatic hyperplasia (BPH), especially focusing on symptoms reduction and life quality enhancement. Methods: We prospectively enrolled 160 BPH patients who underwent surgery and were followed up regularly for 12 weeks, collecting the International Prostate Symptom Score (IPSS), Quality of Life (QoL), and Qmax. Regression analysis and mixed effect models were used to evaluate the tendency of symptoms on recovery from the perspective of quality of life. Results: At 12 weeks, all patients recovered well with conspicuous change in IPSS, QoL and Qmax, that were 4.80 ± 4.59, 1.34 ± 1.14,20.02 ± 8.61 mL/s respectively. Voiding symptoms were significantly reduced by 79.4% at 2 weeks, whereas storage symptoms recovered slowly until 12 weeks with residual lower urinary tract symptoms (LUTS), predominantly urinary frequency and nocturia. Improvements in incomplete emptying urination and urinary frequency were significantly associated with QoL. Conclusions: With regards to the comprehensive full-cycle treatment of LUTS patients, in addition to the objective results, more attention should also be focused on the change in following symptoms, that is, incomplete emptying urination, urine frequency and urination difficulty, which play key roles in the enhancement of patients' quality of life. [ABSTRACT FROM AUTHOR]

Background Materials and Methods Results Conclusions α‐1 blockers and dutasteride are widely used as agents to treat benign prostatic hyperplasia (BPH); the impact of these drugs on prostatic inflammation is still unclear. Herein, we investigated the impact of α‐1 blockers and dutasteride treatment of BPH in terms of the degree of prostatic inflammation.Tissue specimens were obtained from 143 BPH patients who were administered α‐1 blockers up until their operation. Thirty‐three of the patients had also been treated with dutasteride before the procedure. The degree of prostatic inflammation was quantified histologically by the ratio of high endothelial venule (HEV)‐like vessels. We divided this retrospective cohort into α‐1 blocker monotherapy and combination therapy (α‐1 blockers + dutasteride) groups and evaluated clinical parameters of the two groups in relation to the degree of chronic prostatic inflammation. At the same time, we assessed factors exacerbating chronic prostatic inflammation.Comparison of the monotherapy and combination therapy groups showed no significant differences in the parameters of the urodynamic study or degree of chronic prostatic inflammation, whereas the IPSS total score, voiding subscore, nocturia, intermittency, weak stream, and straining were significantly lower in the combination than the monotherapy group. The duration of α‐1 blockers administration was not correlated with the ratio of HEV‐like vessels, while that of dutasteride was strongly correlated (correlation coefficient = 0.595; p < 0.001). Multiple regression analysis demonstrated that the duration of dutasteride administration was a key factor exacerbating the degree of chronic prostatic inflammation.The present study showed that despite their ameliorating effect on prostatic hyperplasia, dutasteride contributed significantly to chronic prostatic inflammation. [ABSTRACT FROM AUTHOR]

Purpose: Existing literature lacks an analysis of factors predicting the achievement of minimum clinically important differences (MCID) after water vapor thermal therapy (WVTT) for prostatic hyperplasia. This study aims to identify these predictors over a 36-month post-WVTT period. Methods: This prospective single surgeon case series assessed male patients receiving WVTT. Eligibility criteria included being at least 45 years old, having an estimated prostate volume (EPV) of 30–80 cc, an International Prostate Symptom Score (IPSS) of 12 points or more, and a maximum urinary flow rate (Qmax) under 16 mL/sec. MCID, representing the smallest symptomatic improvement perceived by patients, was calculated using the distribution-based method, considering half a standard deviation of baseline IPSS scores. Correlation and linear regression analyses assessed MCID attainment. Multivariable logistic regression evaluated MCID achievement, considering multicollinearity, heteroskedasticity, and normality. Results: Of 206 men with a median 29.1-month follow-up (Range: 24–36), 13.6% didn't achieve MCID for IPSS, and 7.2% for QoL scores. Significant hindrances to MCID attainment for IPSS were a large median lobe (> 10 mm protrusion) (OR = 3.01, 95% CI: 2.3–3.72), increased median lobe treatments (OR = 1.73, 95% CI: 1.23–2.35), and high preoperative irritative IPSS scores (OR = 1.25, 95% CI: 1.13–1.38). Factors for QoL MCID non-achievement included age over 75 (OR = 1.25, 95% CI: 1.13–1.38), a large median lobe (OR = 1.87, 95% CI: 1.62–2.01), and EPV over 60 cc (OR = 1.55, 95% CI: 1.16–1.97). A 6.3% surgical re-intervention rate was noted. Conclusions: The characteristics of the median lobe as well as the severity of lower urinary tract symptoms are crucial for treatment success. These should be integral to preoperative assessments and patient discussions on treatment options. [ABSTRACT FROM AUTHOR]

This document is a response to a letter regarding the management of benign prostatic hyperplasia (BPH) after laser enucleation of the prostate (LEP). The authors agree with the importance of considering bladder health in patients with BPH and storage symptoms. They found that LEP significantly improved overactive bladder symptoms and urodynamic parameters. Patients with significant storage symptoms had higher total IPSS in the initial period after LEP, but no significant difference was observed 12 months after the procedure. The authors suggest that patients with significant storage symptoms may benefit from de-obstruction, although it may take longer for their symptoms to completely remit. They also acknowledge that some patients may require additional medical treatment to alleviate storage symptoms during the postoperative period. The authors advocate for comprehensive patient counseling and a tailored approach to optimize outcomes. [Extracted from the article]

Background: Benign prostatic hyperplasia (BPH) is common and presents as lower urinary tract symptoms (LUTS). Understanding patient concerns and treatment preferences is essential for effective management. This study aimed to investigate the attitudes, preferences, and expectations of Iranian patients with BPH, and compare them with those of urologists in addressing this condition. Methods: A cohort of patients diagnosed with BPH underwent assessment during their initial visit. Before any counseling, their attitudes, concerns, and expectations regarding benign prostate enlargement were evaluated using semi-structured interviews. Patient responses were analyzed based on educational levels and age. Additionally, correspondence was initiated with thirty urologists who graduated within the past twelve years to assess their attitudes toward BPH, concerns, and treatment approaches. Interview questions were constructed using the Delphi method, and their validity was confirmed. Responses from both groups were analyzed and compared. Descriptive statistics, independent t-test, Chi-squared test, Mann-Whitney U, and principal component analysis (PCA) with varimax rotation were used for statistical analysis. Results: The study comprised 261 patients and 30 urologists. Findings revealed that 86.2% of patients and 86.7% of urologists perceived a lack of sufficient patient knowledge about BPH. Patients across all educational levels and age groups expressed a desire for more information about their condition. Primary concerns among patients included exacerbation of urinary symptoms, potential malignancy, and sexual dysfunction. While patients generally preferred pharmacological treatments, those older than 75 years showed a significantly higher preference for surgical options. Conversely, urologists exhibited greater concern for long-term clinical complications associated with BPH. Results indicated significant parallels between the attitudes of urologists and patients in assessing the multifaceted impact of BPH on patient well-being. Conclusion: This study enhances our understanding of patient attitudes and concerns regarding BPH, thereby facilitating more effective treatment strategies. Our findings encourage urologists to enhance patient perspectives by delivering comprehensive information. Furthermore, the comparison between patient and urologist attitudes towards BPH underscores the importance of tailored care and patient-centered approaches in optimizing outcomes for individuals with BPH. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of chrysin on the ventral prostate of spontaneously hypertensive rats (SHR). Ten‐week‐old male Wistar and SHR rats received 100 mg/kg/day of chrysin (TW and TSHR) or 200 µL/day of the dilution vehicle (CW and CSHR) for 70 days. After the treatment, the animals were euthanized and the prostates were dissected out, fixed, and processed for further morphological, immunohistochemical, and biochemical analyses. Blood was collected for serological analysis. Chrysin did not interfere with the blood pressure. Morphologically, the epithelial height increased in TW and decreased in TSHR. Stereology showed an increase in the epithelial and stromal relative frequency, and a decrease in the lumen of TW, whereas the epithelium in TSHR was reduced. Normal alveoli decreased, and hyperplastic alveoli had an increment in TW, whereas in TSHR normal alveoli increased and intense hyperplasia decreased. The secretion area was reduced in TW. Immunohistochemical analysis showed a smaller number of PCNA‐positive cells in TW. Finally, the biochemical analysis showed a reduction in malondialdehyde, carbonylated proteins, superoxide dismutase, and catalase in TW and TSHR. We concluded that the chrysin effect is dependent on the context in which this flavonoid is employed. In normal conditions, the anabolic potential of the chrysin was favored, disrupting the morphology of the prostate. However, when used in animals predisposed to develop hyperplasia, this flavonoid attenuates the hyperplastic status, improving the morphology of the gland. [ABSTRACT FROM AUTHOR]

Näive CD4+T cells play a key role in the initiation and maintenance of immune response. In the effect of cytokines and costimulatory molecules, they differentiate into Th1, Th2, Treg and Th17. Increasing evidences indicated that Th17 and Treg cells produce a significant effect on immune stability, autoimmune disease and cancer. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common type of prostatitis, accounting for 90%~95%, which is closely correlated with the progression of be‑ nign prostatic hyperplasia and prostate cancer. Benign and malignant diseases of the prostate share much similarity in immune microen‑ vironment. Thus, this review summarizs the latest research progress on the mechanism of Th17/Treg cells in prostatic disease. [ABSTRACT FROM AUTHOR]

Modern research has shown that Cucurbitacin B (Cu B) possesses various biological activities such as liver protection, anti-inflammatory, and anti-tumor effects. However, the majority of research has primarily concentrated on its hepatoprotective effects, with limited attention devoted to exploring its potential impact on the prostate. Our research indicates that Cu B effectively inhibits the proliferation of human prostate stromal cells (WPMY-1) and fibroblasts (HPRF), while triggering apoptosis in prostate cells. When treated with 100 nM Cu B, the apoptosis rates of WPMY-1 and HPRF cells reached 51.73 ± 5.38% and 26.83 ± 0.40%, respectively. In addition, the cell cycle assay showed that Cu B had a G2/M phase cycle arrest effect on WPMY-1 cells. Based on RNA-sequencing analysis, Cu B might inhibit prostate cell proliferation via the p53 signaling pathway. Subsequently, the related gene and protein expression levels were measured using quantitative real-time PCR (RT-qPCR), immunocytochemistry (ICC), and enzyme-linked immunosorbent assays (ELISA). Our results mirrored the regulation of tumor protein p53 (TP53), mouse double minute-2 (MDM2), cyclin D1 (CCND1), and thrombospondin 1 (THBS1) in Cu B-induced prostate cell apoptosis. Altogether, Cu B may inhibit prostate cell proliferation and correlate to the modulation of the p53/MDM2 signaling cascade. [ABSTRACT FROM AUTHOR]

Objective: We aim to report the learning curve and experience performing holmium laser enucleation of the prostate (HoLEP) from a resident standpoint trained at a tertiary high-volume center. Methods: An electronic survey was distributed to 10 surveyees that included recently graduated chief residents trained at Indiana University in the past 3 years i.e., between 2020 and 2022 with a 100% response rate. The questionnaire focused on HoLEP training experience based on a recently established mentorship curriculum in training the residents through each individual step of the surgery. Results: The average learning curve for performing HoLEP was reported to be greater than 25 cases with 50% of the residents reporting >50 cases to master the technique. The surgical difficulty of steps of the HoLEP were rated on a subjective scale of 1–5: 1 = very easy, 2 = easy, 3 = neutral, 4 = hard, and 5 = very hard. The common challenging steps in decreasing the order of difficulty as reported are performing apical enucleation, joining anterior and posterior planes, and dividing anterior commissure with a mean rating of 3.5, 3.1, and 3.1, respectively. The most difficult aspect of the surgery to master was performing apical dissection (60%). Comparing operative parameters for HoLEP with transurethral resection of the prostate in aspects of resection volume and times, 70% of candidates reported it better for HoLEP whereas 20% had similar times for both procedures. A total of 90% of the residents felt confident to offer HoLEP as part of their practice without the need for any further training. Regarding the initial challenge of including HoLEP surgery in practice, the majority (60%) reported difficulty with equipment set up in their practice while 20% reported difficulty maintaining efficient operating room (OR) times and turnover. Conclusion: We believe HoLEP can be performed immediately after residency training and incorporated into practice with high volume, repeated exposure to HoLEP surgery throughout residency based on study results. The average learning curve reported for performing HoLEP was greater than 25 cases. [ABSTRACT FROM AUTHOR]

Background: Inguinal hernia repair (IHR) is a common surgical procedure worldwide. Although IHR can be performed by the minimally invasive method, which accelerates recovery, postoperative urinary retention (POUR) remains a common complication that significantly impacts patients. Thus, it is essential to identify the risk factors associated with POUR to diminish its negative impact. Methods: We conducted a single-center retrospective review of elective IHR from 2018 to 2021. POUR was defined as the postoperative use of straight catheter or placement of an indwelling catheter to relieve the symptoms. Adjusted multivariate regression analysis was performed to address the associations of clinicodemographic, surgical, and intraoperative factors with POUR. Results: A total of 946 subjects were included in the analysis after excluding cases of emergent surgery, recurrent hernia, or concomitant operations. The median age was 68.4 years, and 92.0% of the patients were male. Twenty-three (2.4%) patients developed POUR. In univariate analysis, POUR in comparison with non-POUR was significantly associated with increased age (72.2 versus 68.3 years, P = 0.012), a greater volume of intraoperative fluid administered (500 versus 400 ml, P = 0.040), and the diagnosis with benign prostate hypertrophy (34.8% versus 16.9%, P = 0.025). In the multivariate model, both increased age (odds ratio [OR] 1.04, 95% CI 1.01–1.08; P = 0.049) and a greater volume of intraoperative fluid administered (OR 1.12 per 100-mL increase, 95% CI 1.01–1.27; P = 0.047) were significantly associated with the occurrence of POUR. Conclusions: We found that increased age and a greater volume of intraoperative fluid administered were significantly associated with the occurrence of POUR. Limiting the administration of intraoperative fluid may prevent POUR. From the perspective of practical implications, specific guidelines or clinical pathways should be implemented for fluid management and patient assessment. [ABSTRACT FROM AUTHOR]

Transurethral resection of prostate (TURP) is the main method for retreating benign prostatic hyperplasia (BPH), and urethral stricture is the main reason for readmission after TURP. No matter what surgical method is used to treat BPH, urethral stricture cannot be completely avoided, which seriously affects the patient's urinary function and quality of life. Only by selecting reasonable and effective treatment strategies can patients improve their urinary function. At present, the treatment methods for urethral stricture after TURP for BPH is the same as that for urethral stricture caused by other causes, which can be divided into open surgery and endovascular treatment. The short-term and long-term effects of different types of surgery vary significantly, and there are also strict limitations on suitable population. This article summarizes the occurrence and surgical treatment for urethral stricture after prostate enlargement surgery, which has certain guiding significance for clinical doctors to choose surgical plans. [ABSTRACT FROM AUTHOR]

Background: The most widespread condition that affected on primarily the male population is Benign hyperplasia of the prostate benign prostatic hyper-plasia (BPH). Flax seeds have been reported to have antiproliferation properties and exhibit antitumor. Aim: We assessed the impact of flax seeds ethanolic excerpt on BPH within a testosterone propionate (TP)-induced model of rats. Methods: A pre-3-week daily injection of TP (3 mg/kg BW) was used to induce BPH. Twenty male rats (200–240 gm) were randomly divided into 4 equal groups (n = 5) negative Group under control was given PBS orally, corn oil S/C, BPH-induced rats received 3 mg/kg BW TP for 3 weeks, extract group received 50 mg/Kg extract twice daily for 2 weeks Finasteride group received standard drug 10 mg/Kg BW for 2 weeks. When the course of treatment is over, rats were sacrificed and the blood was collected and separated, the prostate of the rats was harvested for histological examination. Results: The results showed that flax seeds ethanolic extract could significantly (p < 0.05) reduce the prostate gland weight, prostate index, serum level of PAS, testosterone, and 5-a reductase enzyme in BPH-induced rats and improve the tissue morphology of the prostate. Conclusion: Based on our results, the extract suggested that have a promising role in the treatment of benign hyperplasia of the prostate. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is considered the most common malignant neoplasm in males worldwide and the 2nd important reason for cancer-related male deaths after bronchogenic carcinoma. Objective: The purpose of this research is to assess how diffusion weighted image (DWI) and apparent diffusion coefficient (ADC) value characterise prostatic cysts, senile prostatic hyperplasia, prostate cancer, and the normal prostatic gland. Patients and methods: We enrolled 60 cases with suspicious prostatic lesions,20 cases with benign prostatic hypertrophy, 20 cases prostate cancer and 20 with prostatic cyst along with 20 controls. All underwent magnetic resonance imaging (MRI) for prostatic assessment and Trans-rectal ultrasonography (TRUS) guided biopsy. Results: Prostate cancer had a considerably lower mean ADC value (p-value < 0.001) than normal central gland (CG), peripheral zone (PZ), and benign prostatic hyperplasia (BPH) nodules. The ADC value of the PZ tissue had been substantially higher than that of the normal central zone (CZ) (p<0.001). While the prostatic cyst's ADC value was much greater than CZ's (p < 0.001), the BPH lesion's ADC value had been significantly lower than CZ's (p < 0.001). Conclusions: DWI has been a useful tool for gathering information on the tissue properties of the prostate's various anatomical zones. In contrast to normal tissue, BPH, and prostate cysts, prostate carcinoma cause restricted diffusion of water, which may be used in the differential diagnosis of benign and malignant lesions. [ABSTRACT FROM AUTHOR]

Prostatic hyperplasia is very common in elderly men and is a typical disease that reduces quality of life. Histologically, hyperplasia of the prostate gland causes obstruction at the bladder outlet, resulting in symptoms such as a weak urine stream. Various factors have been considered to cause histological enlargement of the prostate, but the underlying cause is still unknown. The factors that cause prostate hyperplasia can be broadly classified into intrinsic and extrinsic ones. Extrinsic factors include things that we directly come into contact with such as bacteria and food. On the other hand, intrinsic factors are those that cause changes in functions originally provided in the body due to some cause, including extrinsic factors, such as chronic inflammation and an imbalance of sex hormones. A large number of reports have been made to date regarding the etiology of prostatic hyperplasia, although they have not yet clarified the fundamental cause(s). The various factors currently known should be outlined for future research. Should it be possible to prevent this highly prevalent prostatic hyperplasia which is mainly cause of dcreasing quality of life, there is no doubt that it would be a huge contribution to humanity. [ABSTRACT FROM AUTHOR]

To assess the practices, trends, and challenges associated with the use of endoscopic techniques in Africa related to the surgical treatment of benign prostatic hyperplasia The questionnaire, which was based on Google Forms, assessed several points related to the surgical management of benign prostatic hyperplasia. In 67.4% of the centers, BPH was the primary pathology requiring surgical management. In all 43 centers, approximately 1/3 of the urologists (n = 41) are able to perform an endoscopic procedure for the management of prostatic hypertrophy. Of the 43 centers, 30 had a block equipped with endourology equipment, and 56.6% (n = 17) performed endourological surgery exclusively for the surgical management of BPH. TURP is the most widely used endoscopic technique. Open prostatectomy was the only surgical technique used in 14 centers (32.5%). In the remaining centers, both procedures (endoscopy and open surgery) were used depending on the surgeon's skills. Twenty-six (60.5%) centers expressed the need for training in endoscopic management of BPH. The main challenges encountered relate to the lack of competent personnel, the unavailability of equipment and materials, and the high cost to patients. It is essential to develop modern urology in Africa, particularly in terms of endourological practices. [ABSTRACT FROM AUTHOR]

Purpose: To investigate various anatomical features of the prostate using preoperative MRI and patients' clinical factors to identify predictors of successful Holmium:YAG laser enucleation of the prostate (HoLEP). Methods: 71 patients who had received HoLEP and undergone a 3.0-T prostate MRI scan within 6 months before surgery were retrospectively enrolled. MRI features (e.g., total prostate and transitional zone volume, peripheral zone thickness [PZT], BPH patterns, prostatic urethral angle, intravesical prostatic protrusion, etc.) and clinical data (e.g., age, body mass index, surgical technique, etc.) were analyzed using univariable and multivariable logistic regression to identify predictors of successful HoLEP. Successful HoLEP was defined as achieving the Trifecta, characterized by the contemporary absence of postoperative complications within 3 months, a 3-month postoperative maximum flow rate (Qmax) > 15 mL/s, and no urinary incontinence at 3 months postoperatively. Results: Trifecta achievement at 3 months post-surgery was observed in 37 (52%) patients. Patients with Trifecta achievement exhibited a lower preoperative IPSS-quality of life score (QoL) (4.1 vs. 4.5, P = 0.016) and a thinner preoperative peripheral zone thickness (PZT) on MRI (7.9 vs.10.3 mm, P < 0.001). In the multivariable regression analysis, a preoperative IPSS-QoL score < 5 (OR 3.98; 95% CI, 1.21–13.07; P = 0.017) and PZT < 9 mm (OR 11.51; 95% CI, 3.51–37.74; P < 0.001) were significant predictors of Trifecta achievement after HoLEP. Conclusions: Alongside the preoperative QoL score, PZT measurement in prostate MRI can serve as an objective predictor of successful HoLEP. Our results underscore an additional utility of prostate MRI beyond its role in excluding concurrent prostate cancer. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate whether urinary glycosaminoglycans (GAG) levels reflect clinical status in men with lower urinary tract symptoms and if they could be used as a marker in management of overactive bladder (OAB). Methods: A total of 34 patients were recruited who were admitted with LUTS and diagnosed as having clinically bladder outlet obstruction (BOO) due to prostate enlargement. These newly diagnosed, never treated patients underwent routine investigation, consisting of history, physical examination, PSA, ultrasound, uroflowmetry, assessment of symptoms scored by both International Prostate Symptom Score (IPSS) and Marmara- Overactive Bladder Questionnaire (M-OBQ). The patients were divided into two groups as those with an initial M-OBQ score < 12 (group 1) and ≥ 13 (group 2). Alfa blocker was initiated in eligible patients. Further evaluations included prostate volume measurement, pre- and post-treatment urinary GAG levels, IPSS and M-QAOB values and maximum urine flow rate (Qmax). Results: Before treatment, urinary GAG level was 21.5 mg/gCr (6.1-45.5) in Group 1, and 23.35 mg/gCr (15.6-32.6) in Group 2 (p =0.845). After the treatment, the GAG level in Group 1 and Group 2 were found to be 19.8 mg/gCr (7.4-70.5) and 18 (7.6- 41.7), respectively (p = 0.511). No difference in GAG levels was found in subgroup analysis for patients with or without OAB. Conclusions: In recent years, there have been many studies investigating the relationship between LUTS and urinary markers. However, in our prospective study, no relationship was found between pre- and post- treatment urinary GAG levels in patients with LUTS with or without OAB. [ABSTRACT FROM AUTHOR]

Simple Summary: The contrast-enhanced ultrasound (CEUS) allows the evaluation of the vascularization of an organ, using contrast agents composed of gas microbubbles, such as sulfur hexafluoride. Prostate perfusion is increased in dogs with benign prostatic hyperplasia (BPH), due to the stimulation of dihydrotestosterone (DHT). In the present study, CEUS is applied for monitoring dogs with BPH, receiving osaterone acetate (OSA). Fifteen intact adult dogs are referred for BPH. A CPSE assay and B-mode ultrasound confirm the diagnosis. CEUS is performed before OSA treatment (D0) and highlights the rapid diffusion times of the contrast agent (length of the wash-in and wash-out phases). Prostatic cysts and parenchymal alteration are also detected. After treatment (D1), the CPSE and prostate volume are significantly reduced, while CEUS detects a significant increase in wash-in and wash-out times and a reduction in parenchymal abnormalities. These findings confirm the decrease in prostatic perfusion after OSA treatment and, although preliminary, are promising for the broader use of CEUS for the diagnosis and monitoring of dogs with BPH. The prostate is the only sexual gland of the male dog, and dihydrotestosterone (DHT) regulates its growth. In intact dogs, constant DHT stimulation results in benign prostatic hyperplasia (BPH) that can be treated with osaterone acetate (OSA). This study describes the effects of OSA treatment, detected by contrast-enhanced ultrasonography (CEUS), highlighting prostatic vascularization with a contrast agent composed of gas microbubbles. Fifteen dogs (2–8 years) of different sizes and breeds (4–30 kg) diagnosed with BPH are involved in the study. Before treatment (D0), CPSE is measured (294.05 ± 115.97 ng/mL), and a B-mode ultrasound is performed (Vratio = 2.80 ± 1.85), confirming BPH. CEUS highlights the length of the wash-in (11.93 ± 2.08 s) and wash-out (42.20 ± 6.99 s) phases of the contrast agent in the prostate and the presence of cysts and parenchymal alteration. Dogs are treated with OSA (0.5 mg/kg for 7 days) and reassessed after 21 days (D1): CPSE and prostate volume are significantly (p < 0.001) reduced. The length of the wash-in (14.73 ± 2.54 s) and wash-out (51.13 ± 6.03 s) phases are significantly (p < 0.001) increased. The results confirm the effectiveness of the treatment, particularly the reduction in prostatic perfusion, confirmed by the increase in diffusion times of the contrast. Although preliminary, these findings are promising for the use of CEUS in monitoring dogs with BPH. [ABSTRACT FROM AUTHOR]

An intact male terrier dog aged 6.25 years was referred with a history of dysuria and intermittent hematuria for the past 2 years. Clinical examination, abdominal radiography and ultrasonography revealed the presence of prostatomegaly and cystolithiasis. A large radio-opaque calculus was observed inside the urinary bladder and ultrasonographic size of the prostate gland was 5. 7 9 × 3. 5 5 cm 2 . The animal was diagnosed with benign prostatic hyperplasia based on anamnesis, physical examination findings and paraclinical investigations. The presence of a single large calculus within the urinary bladder was associated with incomplete voiding resulting from enlargement of the prostate. The bladder calculus which was removed by cystotomy was a mixed type of stone consisting of ammonium (10%), phosphate (20%), calcium (20%), oxalate (40%) and magnesium (10%). The enlargement of the prostate gland was also confirmed by intraoperative examination. Cystolithiasis associated with canine benign prostatic hyperplasia has not been previously reported in the literature. [ABSTRACT FROM AUTHOR]

This letter published in the Journal of General Internal Medicine discusses the use of medications listed in the Beers Criteria among older patients in the United States. The study analyzed data from the National Ambulatory Medical Care Survey from 2010 to 2019 and found that 45% of primary care patients over the age of 65 were taking at least one medication on the Beers list. The study also identified differences in the use of specific drug classes among older patients, with an increase in the use of antihistamines and antipsychotics over the decade analyzed. The authors acknowledged limitations in the study and suggested that future research should consider medical indications and comorbid conditions to better understand medication practices in the older population. [Extracted from the article]

Numerous animal models have demonstrated that caloric restriction (CR) is an excellent tool to delay aging and increase the quality of life, likely because it counteracts age-induced oxidative stress and inflammation. The aging process can affect the prostate in three ways: the onset of benign prostatic hyperplasia, prostatitis, and prostate cancer. In this study, we used 14 aged male Sprague Dawley rats, which were allocated into two groups, at the age of 18 months old. One group was fed ad libitum (a normal diet (ND)), and the other group followed a caloric restriction diet with a 60% decrease in intake. The rats were sacrificed at the age of 24 months. By immunohistochemical (IHC) and Western blot (WB) analyses, we studied the variations between the two groups in immune inflammation and fibrosis-related markers in aged prostate tissues. Morphological examinations showed lower levels of prostatic hyperplasia and fibrosis in the CR rats vs. the ND rats. The IHC results revealed that the prostates of the CR rats exhibited a lower immune proinflammatory infiltrate level and a reduced expression of the NLRP3 inflammasome pathway, together with significantly reduced expressions of mesenchymal markers and the profibrotic factor TGFβ1. Finally, by WB analysis, we observed a reduced expression of ERα, which is notoriously implicated in prostate stromal proliferation, and increased expressions of SOD1 and Hsp70, both exerting protective effects against oxidative stress. Overall, these data suggest that CR brings potential benefits to prostatic tissues as it reduces the physiological immune–inflammatory processes and the tissue remodeling caused by aging. [ABSTRACT FROM AUTHOR]

Benign prostatic hyperplasia (BPH) is a multifactorial disease in which abnormal growth factor activation and embryonic reawakening are considered important factors. Here we demonstrated that the aberrant activation of transforming growth factor β (TGF-β)/Rho kinase 1 (ROCK1) increased the stemness of BPH tissue by recruiting mesenchymal stem cells (MSCs), indicating the important role of embryonic reawakening in BPH. When TGF-β/ROCK1 is abnormally activated, MSCs are recruited and differentiate into fibroblasts/myofibroblasts, leading to prostate stromal hyperplasia. Further research showed that inhibition of ROCK1 activation suppressed MSC migration and their potential for stromal differentiation. Collectively, our findings suggest that abnormal activation of TGF-β/ROCK1 regulates stem cell lineage specificity, and the small molecule inhibitor GSK269962A could target ROCK1 and may be a potential treatment for BPH. [ABSTRACT FROM AUTHOR]

Introduction: The objectives of the study were to examine the opinions of urology specialists on whether there are actual differences in efficacy among α1-blockers and to identify the factors that should be considered when prescribing these medications according to age. Methods: We surveyed 50 South Korean urology specialists with over 3 years of clinical experience in secondary or tertiary hospitals in July-August 2021. The survey covered urologists' demographics, awareness of α1-blocker prescription differences, and key factors in α1-blocker selection based on LUTS severity and patient age. Results: Overall, 82% of the respondents believed that there were differences in the efficacy of α1-blockers in actual practice according to age. Over 90% of the respondents agreed on the need for head-to-head comparison studies to compare the effects of different α1-blockers. Regardless of the severity of LUTS, urologists prioritize cardiovascular side effects when prescribing α1-blockers to patients aged ≥70 years. Further, 19% of the urologists prioritized ejaculatory side effects for mild-to-moderate LUTS and 9% for severe LUTS (p < 0.001). Conclusions: This study shows that head-to-head studies comparing the efficacy of different α1-blockers are highly valuable for the real-world clinical application of α1-blockers. Notably, urologists prioritize cardiovascular and ejaculatory side effects in older and younger patients while prescribing α1-blockers, respectively. [ABSTRACT FROM AUTHOR]

Objectives: To study the functional and oncological results of minimally invasive treatment methods: cryoablation, brachytherapy, and high-intensity focused ultrasound (HIFU) therapy of localized prostate cancer in a single hospital. Methods: One hundred sixty patients with localized prostate cancer were treated with minimally invasive methods (53, 52, 55 patients with cryoablation, brachytherapy and HIFU therapy, respectively). Prostate-specific antigen and evaluation of post-procedure biopsies were used as an assessment. The review of functional indicators and quality of life was made with International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), quality of life (QoL) questionnaires. Results: Patients after cryoablation showed worse results of oncological control according to positive repeat biopsies, best indicators were observed after brachytherapy. When considering the IPSS results, there were statistically significantly worse scores in the brachytherapy group in the early postoperative period, these differences do not reach statistical significance in the late period in the brachytherapy and cryoablation groups. Patients in the cryoablation group showed worse indicators of IIEF-5; in the early postoperative period; in the late follow-up period, the indicators of erectile function in patients in the cryoablation group did not statistically significantly differ from those in patients after brachytherapy. Patients after HIFU therapy showed fewer cases of de novo erectile dysfunction during the follow-up period of 3 years, higher average IIEF-5 scores, lower IPSS scores and better QoL results. Conclusion: The recurrence of prostate cancer was statistically significantly higher in the International Society of Urological Pathology (ISUP) 3 grade group. HIFU therapy had better urination indicators compared to other groups, that can be associated with the laser enucleation of prostatic hyperplasia. The advantage was noted in patients after HIFU therapy when comparing the parameters to the IIEF-5 thus, HIFU treatment had a better impact on patients' QoL with localized prostate cancer. [ABSTRACT FROM AUTHOR]

Background The Qianlie Shule capsule is a classical Chinese medicine compound preparation frequently used in therapeutic settings to alleviate astringent pain in the urethra, prostatic hypertrophy, and chronic prostatitis or urinary frequency. However, a comprehensive analysis of the chemical composition of Qianlie Shule capsules has not been reported. Objective To establish a quick and effective analytical method based on hybrid quadrupole-orbitrap mass spectrometry ultrahigh-performance liquid chromatography (UPLC-Q-Orbitrap-MS/MS) for the identification and characterization of chemical components in Qianlie Shule capsules. Method Using ultrahigh-performance liquid chromatography with hybrid quadrupole-orbitrap mass spectrometry and data post-processing, the samples of Qianlie Shule capsules were examined. First, the whole extract of the Qianlie Shule capsules was separated using a UPLC machine, and the fragmentation data were collected in both positive and negative ion mode. The target molecule is then quickly identified by comparing the fragmentation information of the neutral loss (NLs) and characteristic fragments (CFs) reported in the literature. Results A total of 145 chemical components were identified. It includes flavonoids, triterpenoids, phenylpropanoids, organic acids, alkaloids, phenylethanoids, iridoids, and anthraquinones. Conclusions This study is a method for the rapid qualitative analysis of the chemical composition of Qianlie Shule capsules, which provides a method for the rapid, sensitive, and high-throughput identification of the prescription components of Chinese medicine. Highlights Systematic identification of the chemical composition of QLSL capsules provides a theoretical basis for studying the substance basis of QLSL capsules and the improvement of the quality control level. [ABSTRACT FROM AUTHOR]

This article explores how a group of 35 Japanese men comprehend and verbalize the somatic experience embedded in dealing with benign prostate enlargement, or disquiet/discomfort of developing prostate cancer. Grounded in an adaptation of the sexual scripts theorizing, a set of in-depth, semistructured individual interviews were conducted through a LINE-app videocall from 2021 to 2023. Outcomes of interview were analyzed through a conversational approach, and presented by using three axes: the body, gender, and sexuality. An understanding of the Japanese-civilized-self has rendered somatic knowing problematic and pretended ignorance a strategy to deal with conversations about a condition involving the genitals and body waste. The body refers to a cancer-self who copes with ignorance of the prostate's anatomy and physiology, the-mechanics-of-urine, and medication/treatment side-effects. Gender is concerned with a cancer-self who grapples with an ailment that "emasculates the self," and the feminization of care as well as infantilization at medical facilities. Sexuality implies a cancer-self who bears scripts related to asexuality, medication/treatments that affect libido and penile erections, and a tarnished sexual reputation as a "heterosexual man" because prostate stimulation has been associate with homosexuality. [ABSTRACT FROM AUTHOR]

Benign Prostate Hyperplasia (BPH) significantly impacts men's health and quality of life, with its prevalence rising with age. This review critically examines the cost-effectiveness of pharmacological interventions for BPH to optimize patient outcomes and healthcare resource utilization. This review explores the integration of cost-effectiveness analysis (CEA) into clinical practice, balancing clinical efficacy with economic efficiency in BPH management. We performed a critical literature search, including recent studies on the economic evaluation of BPH treatments, focusing on pharmacotherapies such as alpha-blockers and 5-alpha reductase inhibitors. Additionally, we discussed the concept of CEA and evaluated the role of medicinal reconciliation and the avoidance of polypharmacy in favor of optimal BPH treatment. Cost-effectiveness analysis is crucial for evaluating BPH treatments, with evidence suggesting a shift towards surgical interventions may offer greater long-term economic benefits. However, these models must be applied cautiously, considering clinical evidence and patient preferences to ensure equitable and patient-centric healthcare. [ABSTRACT FROM AUTHOR]

Background & Objective: Prostatic adenocarcinoma (PAC) is the second most prevalent cancer and the fifth leading cause of cancer death in men worldwide. Additionally, pathologists may face problems diagnosing it reliably and may need more than one marker. Thus, the search for new immunohistochemical biomarkers becomes mandatory. This study aims to investigate P4HB and SOX4 expression in prostatic carcinoma, their possible roles, and clinical significance. Methods: This retrospective study included fifty-six cases of PAC and an equal number of nodular prostatic hyperplasia (NPH) that were immunohistochemically stained by P4HB and SOX4. The results of expression were compared between PAC and NPH cases, followed by correlations with available clinicopathological parameters. Results: There was a highly significant difference between PAC and NPH regarding P4HB and SOX4 expressions in favor of PAC (both P<0.001). ROC curve analysis of the diagnostic power of P4HB showed 79% sensitivity, 76% specificity, and an area under the ROC curve of 0.845, while SOX4 showed (89%, 100%, and 0.946, respectively). P4HB and SOX4 expression showed a direct correlation (P<0.001). Moreover, the H-score of SOX4 expression showed a significant inverse relation with ERG expression (P=0.047). There was a significant correlation between P4HB and SOX4 and Gleason score (P<0.001). Moreover, P4HB expression was significantly associated with lymphovascular invasion (P=0.013), while SOX4 expression showed a significant association with perineural invasion (P=0.05). Conclusion: SOX4 and P4HB seem to have diagnostic and prognostic value in PAC. While there was a direct correlation between SOX4 and P4HB, an inverse relationship between SOX4 and ERG was detected. [ABSTRACT FROM AUTHOR]

Androgen deprivation therapy for prostate cancer was pioneered by Charles Huggins, laureate of the Nobel Prize in Medicine in 1966. The authors tried to understand the scientific context and how previous findings paved Huggins way to his discoveries. With the help of summary or review articles on androgen deprivation therapy, the authors identified key publications and used his Nobel Prize speech as a basis to understand his discoveries. Furthermore, they used a recording of the laboratory‐talk interview he gave about his findings to guide them to relevant publications. The authors found that the basis for Huggins' discoveries was the isolation of testosterone in 1935, not long before Huggins' 1941 hallmark publication. Huggins' work follows major experiments in the 19th century in orchiectomy done as a treatment for prostate hypertrophy. Researching the etiology of idiopathic hydrocele, Huggins analyzed the composition of prostate fluid. Further research led to the discovery of the influence of castration, testosterone, and estrogen on acid phosphatase. Recently developed methods facilitated the measurement of the phosphatases. He, therefore, had a biomarker for metastatic prostate cancer to measure treatment response. Very early on, he reported clinical improvements after castration in metastatic patients. Although the effect of orchiectomy on prostate hypertrophy was already known, Huggins was the first to show that testosterone stimulated and estrogen decreased the activity of prostate cancer. Huggins also established phosphatases as a tumor marker to measure disease response. Charles Huggins won the Nobel Prize in Medicine in 1966 for his discovery of the effect of castration on prostate cancer. The authors elucidate how he arrived at his findings and the contributions of prior researchers. [ABSTRACT FROM AUTHOR]

Context: Dutasteride is used in the treatment of benign prostate enlargement with reported many side effects. Aims: The purpose of this study is to examine how different doses of dutasteride (0.5 mg) in combination with tamsulosin affect the outcome of treatment of benign prostatic enlargement (BPE). Settings and Design: Prospective study (phase III trial). Subjects and Methods: Between April 2017 and March 2020, this randomized study was conducted on 300 patients with moderate-to-severe lower urinary tract symptoms attributable to BPE and a prostate volume of more than 40 cc. The patients were divided into three therapy groups at random (one-to-one randomization), each with 100 patients: (Group I) daily tamsulosin 0.4 mg plus dutasteride (0.5 mg). (Group II) every other day tamsulosin 0.4 mg plus dutasteride 0.5 mg. (Group III) once a week tamsulosin 0.4 mg plus dutasteride 0.5 mg. Statistical Analysis: Statistical analysis was carried out with the help of the SPSS program 22. (IBM, Armonk, NY, USA). The mean and standard deviation (SD) are used to express quantitative data (SD). When comparing two means, an independent-samples t-test of significance was used. To compare more than two means, a one-way analysis of variance was utilized. For multiple comparisons between distinct variables, a post hoc test was performed. Results: Patients were followed up every 3 months, with a 1-year follow-up to examine the medications' efficacy, prostate size reduction, and erectile function. After 1 year of treatment, all groups showed significant improvement in their symptom scores. However, Groups I and II experienced a considerable reduction in prostate size after therapy, but Group III experienced no meaningful reduction. In terms of sexual dysfunction, there was a considerable shift in Group I after 12 months. Conclusions: Dutasteride treatment on the other day schedule has the same efficacy as the daily dose on prostate size at the same time; the other day scheduled dose has better preservation of sexual function. [ABSTRACT FROM AUTHOR]

BACKGROUND & OBJECTIVE: Benign prostatic hyperplasia (BPH) is a prevalent condition in older males, primarily responsible for lower urinary tract symptoms (LUTS). Transurethral resection of the prostate (TURP), a frequently utilized surgical procedure for BPH management, has mixed effects on erectile function (EF). The objective of this study is to evaluate the changes in EF following TURP in patients with BPH. METHODOLOGY:This descriptive study was conducted at Bilawal Medical College for Boys, LUMHS Jamshoro, involving 261 male subjects between the ages of 50 and 70 who underwent TURP. Evaluation of EF was carried out before and after the surgical procedure using the International Index of Erectile Function (IIEF) scoring system. RESULTS:The average age of the participants was 60.47 years, and the mean duration of BPH prior to surgery was 15.83 months. The mean IIEF score prior to surgery was 16.72, which notably decreased to 11.50 after surgery. This decline was statistically significant (p < 0.001), and this trend remained consistent across variables such as age, duration of BPH, and prostate volume. CONCLUSION:The study concludes that TURP significantly correlates with a decline in EF among patients with BPH. These outcomes highlight the necessity for comprehensive preoperative counseling about the potential impacts on sexual health for patients considering TURP. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to forecast the core targets of formononetin through network pharmacology and to assess its potential anti-benign prostatic hyperplasia (BPH) effects using molecular docking and animal experimentation. Active compounds were filtered from the Swiss ADME database, while drug targets were extrapolated from TTD, GeneCards, and DrugBank databases. Targets overlapping between drug and disease were pinpointed, and PPI networks were subsequently developed. Both GO and KEGG enrichment analyses were executed. The AutodockVina software facilitated molecular docking to examine formononetin's estrogen activity. Mice diagnosed with BPH were grouped into control, TP, 2.5 mg/kg, 5 mg/kg, 10 mg/kg, 5 mg/kg + fulvestrant (20 mg/kg/week), and 10 mg/kg + fulvestrant (20 mg/kg/week) groups. Pathological deviations were discerned through H&E and Masson staining. Estrogen receptor and cell cycle gene expressions were quantified by qPCR. Our findings pinpointed 35 potential protein targets bridging formononetin and BPH, with ER-α, EGFR, ER-β, CYP19A1, AChE, and PPARA being the focal targets. The GO and KEGG enrichment analyses indicated that formononetin's targets predominantly revolved around cellular responses to estradiol stimulation, estrogen biosynthesis, steroid hormone receptor activity, steroid binding, and other related processes. These extended to pathways like steroid hormone biosynthesis and estrogen signaling. Molecular docking deduced a stronger affinity of formononetin for ER-β than for ER-α. Examination of pathological sections in formononetin-treated BPH mice demonstrated its significant inhibitory effect on BPH. Concurrently, the estrogen receptor inhibitor, fulvestrant, markedly dampened formononetin's therapeutic efficacy. qPCR assessments revealed that formononetin effectively curtailed ER-β expression within hyperplastic prostate tissues. Moreover, post-formononetin treatment led to a decline in expression levels of cell cycle-related genes, such as CDK1, cyclin A2, CDK2, and cyclin B1. However, this trend was notably stunted with the introduction of an estrogen receptor inhibitor. In summation, through the combined insights of network pharmacology and animal testing, we ascertained that formononetin mitigated cell cycle progression via the estrogen receptor when addressing prostatic hyperplasia. [ABSTRACT FROM AUTHOR]

Background: Lower urinary tract symptoms commonly occur in the elderly population and seriously constrain the quality of life. Glandular fibrosis is an important pathobiological process in benign prostatic hyperplasia and is also a main inducing factor for benign prostatic hyperplasia-associated lower urinary tract symptoms. Cistanches species is an important herbal medicine resource and is traditionally used in ameliorating renal and prostatic defects. Methods: This study was to investigate the potential protective function of echinacoside (a bioactive compound from Cistanches) against prostatic fibrosis in mice and human benign prostatic hyperplasia epithelial-1 cell models. Results: It was found that echinacoside attenuated testosterone-induced prostatic hyperplasia and collagen deposition in mice, relieved prostate local inflammation and oxidative damage, and ameliorated prostatic epithelial-mesenchymal transition. Additionally, echinacoside inhibited the activation of the MKK6/MK2 signaling pathway both in vivo and in vitro. Conclusion: This study added new evidence for the anti-fibrotic function of echinacoside on the prostate and provided new insights for understanding its possible pharmacological mechanisms. [ABSTRACT FROM AUTHOR]

Background: To summarize current evidence to report a comparative systematic review and meta-analysis of prostatic artery embolization (PAE) with transurethral resection of the prostate (TURP) and open simple prostatectomy (OSP) for the treatment of benign prostatic hyperplasia (BPH). Methods: A systematic literature search was performed to identify studies published from inception until August 2021. The search terms used were (prostate embolization OR prostatic embolization) AND (prostatic hyperplasia OR prostatic obstruction) as well as the abbreviations of PAE and BPH. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I) tool for observational studies. Random-effects meta-analysis was performed using Revman 5.4. Results: Seven studies were included with 810 patients: five RCTs and one observational study compared PAE with TURP, and one observational study compared PAE with OSP. The included studies had considerable risk of bias concerns. TURP and OSP were associated with more statistically significant improvements in urodynamic measures and BPH symptoms compared to PAE. However, PAE seems to significantly improve erectile dysfunction compared to OSP and improve other outcome measures compared to TURP, although not significantly. PAE appeared to reduce adverse events and report more minor complications compared with TURP and OSP, but it is unclear whether PAE is more effective in the long-term. Conclusion: PAE is an emerging treatment option for patients with symptomatic BPH who cannot undergo surgery or have undergone failed medical therapy. Overall, PAE groups reported fewer adverse events. Future ongoing and longer-term studies are needed to provide better insight into the benefit of PAE compared to other treatment options. [ABSTRACT FROM AUTHOR]

Background: To assess the value of tripartite magnetic resonance imaging model based on T2-weighted imaging (T2-WI), diffusion-weighted imaging (DWI) as well as dynamic contrast-enhanced imaging (DCE) for the diagnosis of prostatitis, prostatic hyperplasia and prostate cancer. Materials and Methods: A total of 100 patients with prostatic diseases were selected from our hospital from January 2020 to December 2022. All patients underwent T2-WI, DWI and DCE examination. Results: Among the 100 suspected patients, 40 were diagnosed with prostate cancer, 30 were prostatitis, and 30 were prostate hyperplasia. Apparent diffusion coefficient (ADC) value was reduced in prostate cancer patients compared to the prostatic hyperplasia as well as prostatitis groups (P<0.05). No difference was discovered in ADC value between the prostatic prostatic hyperplasia and prostatitis groups (P>0.05). Moreover, the diagnosis efficacy of the tripartite magnetic resonance imaging model was higher compared to those of prostate imaging reporting and data system version 2 (PI-RADS V2). Conclusion: The tripartite magnetic resonance imaging model based on T2-WI, DWI, as well as DCE has high diagnostic accuracy in prostatic diseases, with high sensitivity and low misdiagnosis rate, which might be valuable in clinical application. [ABSTRACT FROM AUTHOR]

Our aim was to investigate which features were associated with clinical successes at short- and mid-terms following prostate artery embolization (PAE) for symptomatic benign prostate hypertrophy (BPH). All adults treated by PAE for BPH at our referral center between January 2017 and March 2021, with pre-treatment MRI, technical success, and follow-up at 3 months and 2 years were included in this single-center retrospective study. Radiologists reviewed the prostatic protrusion index (PPI), adenomatous dominant BPH (adBPH), and Wasserman classification on pre-treatment MRI. Radiomics analysis was achieved on the transitional zone on pre-treatment T2-weighted imaging (WI) and ADC, and comprised reproducibility assessment, unsupervised classifications, and supervised radiomics scores obtained with cross-validated Elasticnet regressions. Eighty-eight patients were included (median age: 65 years), with 81.8% clinical successes at 3 months and 60.2% at 2 years. No feature was associated with success at 3 months, except the radiomics score trained on T2-WI and ADC (AUROC = 0.694). Regarding success at 2 years, no radiomics approaches provided significant performances; however, Wasserman type-1 and change in international prostate symptom score (IPSS) at 3 months ≤ −35% were associated with success in multivariable analysis (OR = 5.82, p = 0.0296, and OR = 9.04, p = 0.0002). Thus, while radiomics provided limited interest, Wasserman classification and early IPSS changes appeared predictive of mid-term outcomes. [ABSTRACT FROM AUTHOR]

Introduction This study aimed to compare the safety and efficacy of treatment using simple prostatectomy (SP) and using photoselective vaporization of the prostate (PVP) with a 180W GreenLight XPS laser in patients with high-volume prostate hypertrophy. Material and methods The study included 120 patients with LUTS symptoms caused by prostatic enlargement of more than 80 ml; 79 patients were treated with SP, while 41 were treated with PVP. The analysis included subjective the International Prostate Symptom Score (IPSS) and Quality of Life (QoL), and objective (Qmax), (Qave), and post-void residual volume (PVR) parameters before treatment and at an average of 38 months after surgical treatment. Early and late adverse effects and length of hospitalisation were assessed. Complication reports were performed according to the modified Clavien-Dindo system. Results The analysis independently showed the effectiveness of both methods. Subjective parameters (IPSS, QoL), showed no significant differences. Patients treated with SP scored slightly better on objective parameters (Qmax, Qave, and PVR). Analysis of adverse effects and hospitalisation time were more favourable after PVP. Conclusions SP and PVP were found to be comparable and highly effective in treating benign prostatic hyperplasia in terms of IPSS and QoL. Patients treated with the SP method obtained slightly better results of objective parameters such as Qmax, Qave, and PVR. Compared with SP, PVP has a more favourable safety profile. [ABSTRACT FROM AUTHOR]

The American Urological Association (AUA) has updated its guidelines for the management of benign prostatic hyperplasia (BPH) to include prostatic artery embolization (PAE) as a treatment option. PAE has been shown to be safe and effective in large cohort studies, randomized controlled trials, and sham studies. The inclusion of PAE in the guidelines is expected to increase awareness of the treatment, expand the population seeking treatment for lower urinary tract symptoms (LUTS), and lead to an increase in demand for well-trained interventional radiologists. The guidelines may also prompt insurance coverage for PAE and encourage further study of its applications. The European Association of Urology (EAU) guidelines have also accepted PAE as a treatment option, and the adoption of PAE in both sets of guidelines may help promote its use worldwide. However, the impact of the guidelines on the practice of PAE will ultimately depend on how interventional radiologists build their clinical practice and promote the treatment. [Extracted from the article]

The study aimed to investigate the underlying molecular mechanisms of prostate injury induced by 4,4′‐sulfonyldiphenol (BPS) exposure and propose a novel research strategy to systematically explore the molecular mechanisms of toxicant‐induced adverse health effects. By utilizing the ChEMBL, STITCH, and GeneCards databases, a total of 208 potential targets associated with BPS exposure and prostate injury were identified. Through screening the potential target network in the STRING database and Cytoscape software, we determined 21 core targets including AKT1, EGFR, and MAPK3. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses conducted through the DAVID database illustrated that the potential targets of BPS in prostatic toxicity were primarily enriched in cancer signaling pathways and calcium signaling pathways. These findings suggest that BPS may actively participate in the occurrence and development of prostate inflammation, prostatic hyperplasia, prostate cancer, and other aspects of prostate injury by regulating prostate cancer cell apoptosis and proliferation, activating inflammatory signaling pathways, and modulating prostate adipocytes and fibroblasts. This research provides a theoretical basis for understanding the molecular mechanism of underlying BPS‐induced prostatic toxicity and establishes a foundation for the prevention and treatment of prostatic diseases associated with exposure to plastic products containing BPS and certain BPS‐overwhelmed environments. This study aimed to investigate the mechanism of 4,4′‐sulfonyldiphenol (BPS)‐mediated prostate injury and explore a new approach to understanding the molecular mechanisms of toxicants based on network toxicology. Potential targets of BPS‐induced prostate injury were obtained from databases and core targets were screened using network analysis. The results showed that BPS mediated prostatic toxicity mainly through cancer and calcium signaling pathway. This research provides a theoretical basis for understanding BPS‐induced prostatic toxicity and lays foundation for its prevention and treatment. [ABSTRACT FROM AUTHOR]

Prostate enlargement, medically termed as benign prostatic hyperplasia (BPH), is a prevalent and frequently troublesome issue affecting older men. Research suggests that over 50% of males in their 60s may encounter symptoms associated with BPH. While BPH doesn't pose an immediate threat to life, its implications on urinary function can substantially diminish a man's quality of life. The aetiology of BPH involves complex hormonal and inflammatory mechanisms, leading to prostatic enlargement and obstructive symptoms. Traditional management strategies such as a-blockers and 5-a reductase inhibitors offer symptomatic relief but may cause adverse effects. In recent years, natural compounds have gained attention for their potential efficacy and safety in the management of prostate enlargement. This article reviews recent advancements in prevention and treatment of BPH, with a particular emphasis on the utilisation of herbal remedies, namely fireweed (Epilobium angustifolium L.) and nettle (Urtica dioica L.). These plants are a rich source of polyphenols, known for their anti-inflammatory properties. Moreover, they seem to positively influence hormonal balance. These two functions appear to be responsible for alleviating LUTS symptoms. The research was conducted using PubMed, Scopus, and Google Scholar databases to gather relevant studies and findings. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of thyroid nodules has been increasing, and there are few research data on the risk factors of thyroid nodules in the Chinese population. In this study, we aimed to determine the prevalence and risk factors of thyroid nodules by retrospectively investigating the physical examination records of a cohort of "healthy" individuals in Beijing, China. Methods: This was a retrospective cross-sectional study. The database of a Medical Examination Centre (MEC) was searched. Physical examination data, blood test data, and ultrasound examination data, etc., from 2015 to 2017 were accessed. Only those that recorded a thyroid ultrasound were included. Chi-square test and t-test were used to compare clinical features of individuals' age, gender, body mass index, blood pressure, blood glucose, blood lipids, uric acid, and presence of fatty liver. Risk factors for thyroid nodules were determined using multivariate logistic regression. Results: A total of 52,003 records, which included 19,901 cases with thyroid nodules, were examined. The overall prevalence rate was 38.3% (19,901/52,003): 30.2% (6,726/22,305) and 44.4% (13,175/29,698) in men and women, respectively. Of 52,003 cases, only 35,420 cases had records of all nodule-related metabolic abnormalities and were selected for cross-sectional determination of related risk factors of thyroid nodules. In male, relationships were found between thyroid nodules and increased age (p < 0.001), impaired fasting glucose (p = 0.044), diabetes (p = 0.047), decreased HDL-C (p = 0.018) and prostatic hyperplasia (p < 0.001). And in female, relationships were found between thyroid nodules and increased age (p < 0.001) and decreased HDL-C (p < 0.001). Conclusion: Thyroid nodules are common in China. This study found that thyroid nodules are associated with several metabolic indicators or metabolic diseases, although the mechanism is unclear. Further research is needed. [ABSTRACT FROM AUTHOR]

Introduction The International Prostate Symptoms Score (IPSS) may be used to measure the severity of lower urinary tract symptoms. To assess baseline patient pain, IPSS uses a seven-point questionnaire with a maximum total possible score of 35. IPSS is also used to monitor a patient's symptom improvement. Materials and Procedures: The current prospective investigation was carried out at our tertiary care hospital's Department of General surgery and department of radiodiagnosis. The research lasted six months, from January to June 2022. At 95% confidence interval and 5% acceptable margin of error, a sample size of 100 was computed. The research included patients with lower urinary tract complaints. Transabdominal ultrasonography was performed on all patients to determine prostate size/volume. The current research divides study participants into three groups based on the severity of their symptoms as determined by the IPSS score. 22% of the patients had mild symptoms, 40% had moderate symptoms, and 28% had severe symptoms. Prolate ellipsoid formula Antero-posterior x Transverse x Cranio-caudal x 0.52 was used to determine prostate volume. 12% of patients had a prostatic volume of 20 cc, 26% had a prostatic volume of 21-30 cc (Grade I), 34% had a prostatic volume of 31-50 cc (Grade II), 21% had a prostatic volume of 51-80 cc (Grade III), and 7% had an 80 cc (Grade IV). Conclusion We concluded from the current research that there was no association between age and international prostate symptom score, nor was there any correlation between prostate volume or prostate enlargement grade and IPSS score. [ABSTRACT FROM AUTHOR]