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Objective: To compare the efficacy and safety of 1470-nm diode laser enucleation of the prostate (DiLEP) with that of plasmakinetic resection of the prostate (PKRP) in treating patients with large benign prostatic hyperplasia (BPH > 80ml). Methods: The clinical data from 211 cases of BPH (>80 ml) were collected for analysis. The patients were divided into two groups: the PKRP group (n = 118) and the DiLEP group (n = 93), based on the surgical method used. Result: The DiLEP group demonstrated significantly lower surgical time (p < 0.001), intraoperative bleeding (p < 0.001), bladder flushing time (p = 0.003), indwelling catheter time (p < 0.005), and length of hospital stay (p = 0.018) compared to the PKRP group. However, the quality of the prostatectomy was significantly higher in the DiLEP group (p = 0.005). The Qmax for the DiLEP group was significantly higher than that of the PKRP group (p < 0.05). Compared to the PKRP group, the incidence of urinary incontinence in the DiLEP group increased significantly 4 weeks post-surgery (p = 0.026), although the need for blood transfusion during surgery was significantly reduced (p = 0.037). Conclusion: Both DiLEP and PKRP are safe and effective methods for treating large-volume BPH. However, DiLEP offers advantages such as more thorough glandular resection, shorter surgical time, reduced bleeding, quicker recovery, and fewer complications. [ABSTRACT FROM AUTHOR]

Introduction: Surgical treatment for Benign Prostatic Hyperplasia (BPH) has advanced significantly in recent years. Transurethral Resection of the Prostate (TURP) is a minimally invasive procedure associated with a low risk of complications and clinical limitations, including life-threatening Transurethral Resection (TUR) syndrome, as, well as higher costs due to longer hospital stays and challenges in managing large glands. Aim: To compare the safety and effectiveness of prostate enucleation using Holmium Laser Enucleation of the Prostate (HoLEP) with bipolar resection of the prostate in cases of BPH. Materials and Methods: A hospital-based prospective interventional study was conducted in the Department of Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, from January 2020 to July 2022. The study included 60 patients, divided into two groups of 30 each. Males aged ≥45 years with recurrent Lower Urinary Tract Symptoms (LUTS) secondary to BPH, with or without Acute Urinary Retention (AUR) (drug-refractory) or with failed medical therapy (alpha-blockers, 5-alpha reductase inhibitors), were included in the study. In the first group, HoLEP was performed (Group I), while in the second group (Group II), patients underwent bipolar resection. Data were analysed and statistically evaluated using Statistical Package for the Social Sciences (SPSS) software version 21.0. A p-value of less than 0.05 was considered statistically significant. Results: The mean age of patients in the HoLEP group was 60.25 years, while in the Bipolar TURP (B-TURP) group, it was 59.67 years. Both groups had similar proportions of patients with moderate urinary symptoms {International Prostate Symptom Score (IPSS)} and large prostates (>80 grams). The mean amount of irrigation fluid used (40.83±9 litres vs. 21.2±5.9 litres) and the duration of surgery (106.33±14.24 min vs. 67.4±9.73 minutes) were significantly higher in the HoLEP group compared to the B-TURP group (p-value

Simple Summary: Benign Prostatic Hyperplasia (BPH) is a prevalent condition among aging men, and recent research suggests it may be influenced by high cholesterol levels, especially oxidized LDL (OxLDL). However, how this happens is still not fully understood. This study aimed to explore how elevated OxLDL levels affect prostate cell growth and the release of small particles called extracellular vesicles (EVs), which cells use to communicate. By studying mice on a high-fat diet and human prostate cells exposed to OxLDL, we found that these conditions led to increased cell growth, potentially worsening BPH. We also discovered that OxLDL stimulated the production of EVs, further promoting cell proliferation. However, the drug metformin, commonly used to treat diabetes, was able to reduce this harmful growth. These findings provide new insights into how OxLDL may drive BPH progression and suggest that metformin could be a promising treatment to delay its development, potentially benefiting many men worldwide. Background: Clinical and experimental evidence has linked Benign Prostatic Hyperplasia (BPH) with dyslipidemic and hypercholesterolemic conditions, though the underlying cellular mechanisms remain unclear. This study investigates the impact of dyslipidemia, specifically oxidized LDL (OxLDL), on prostatic stromal cell proliferation and the release of extracellular vesicles (EVs). Methods: Mice were fed a high-fat diet, and human prostatic stromal cells (HPSCs) were treated with OxLDL. Proliferation assays and EV characterization were performed to assess the role of EVs in BPH progression. Results: Pro-atherogenic conditions significantly increased cell proliferation in both murine prostatic cells and HPSCs. Treatment with metformin effectively inhibited OxLDL-induced proliferation. Additionally, OxLDL stimulated the production and release of pro-proliferative EVs by HPSCs, which further promoted cellular proliferation. Conclusions: The findings suggest that dyslipidemia drives prostatic stromal cell proliferation and EV secretion, contributing to BPH progression. Metformin demonstrates potential as a therapeutic agent to mitigate these effects, offering insight into novel strategies for BPH management. This study highlights the complex interaction between dyslipidemia, cell proliferation, and extracellular communication in the context of BPH pathogenesis. [ABSTRACT FROM AUTHOR]

Introduction: Surgical treatment for Benign Prostatic Hyperplasia (BPH) has advanced significantly in recent years. Transurethral Resection of the Prostate (TURP) is a minimally invasive procedure associated with a low risk of complications and clinical limitations, including life-threatening Transurethral Resection (TUR) syndrome, as, well as higher costs due to longer hospital stays and challenges in managing large glands. Aim: To compare the safety and effectiveness of prostate enucleation using Holmium Laser Enucleation of the Prostate (HoLEP) with bipolar resection of the prostate in cases of BPH. Materials and Methods: A hospital-based prospective interventional study was conducted in the Department of Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, from January 2020 to July 2022. The study included 60 patients, divided into two groups of 30 each. Males aged =45 years with recurrent Lower Urinary Tract Symptoms (LUTS) secondary to BPH, with or without Acute Urinary Retention (AUR) (drug-refractory) or with failed medical therapy (alpha-blockers, 5-alpha reductase inhibitors), were included in the study. In the first group, HoLEP was performed (Group I), while in the second group (Group II), patients underwent bipolar resection. Data were analysed and statistically evaluated using Statistical Package for the Social Sciences (SPSS) software version 21.0. A p-value of less than 0.05 was considered statistically significant. Results: The mean age of patients in the HoLEP group was 60.25 years, while in the Bipolar TURP (B-TURP) group, it was 59.67 years. Both groups had similar proportions of patients with moderate urinary symptoms {International Prostate Symptom Score (IPSS)} and large prostates (>80 grams). The mean amount of irrigation fluid used (40.83±9 litres vs. 21.2±5.9 litres) and the duration of surgery (106.33±14.24 min vs. 67.4±9.73 minutes) were significantly higher in the HoLEP group compared to the B-TURP group (p-value<0.001). Postoperative catheterisation time (1.003±0.23 days vs. 2.38±0.52 days) (p<0.001) and length of hospital stay (3.2±0.65 days vs. 4.67±1.32 days) (p<0.001) were significantly longer in the B-TURP group compared to the HoLEP group. Both the HoLEP and bipolar resection of the prostate groups did not experience significant intraoperative or immediate postoperative complications; however, one patient in the HoLEP group developed urethral stricture as a late complication. Conclusion: The B-TURP procedure is an equally effective and feasible method for treating BPH patients, with a smaller learning curve and lesser financial burden. [ABSTRACT FROM AUTHOR]

Objective: The effect of Syzygium malaccense methanol leaf extract (SMLE) on some parameters of testosterone-estradiol valerate induced benign prostatic hyperplasia (BPH) in rats was assayed.Materials and Methods: Thirty male albino rats were used and they were grouped as: Control: received 1 mL/kg olive oil (oral and subcutaneous); BPH: received subcutaneously 9 mg/kg dihydrotestosterone (DHT)+0.9 mg/kg estradiol valerate (ESV) and orally 1 ml/kg olive oil; finasteride: received 9 mg/kg of DHT+0.9 mg/kg ESV (subcutaneously) and 5 mg/kg finasteride (orally) and test groups 1 and 2: received 9 mg/kg of DHT+0.9 mg/kg ESV (subcutaneously) and 200 and 400 mg/kg SMLE (orally). The duration of the treatment was 28 days.Results: The BPH group had increased prostatic total proteins, oxidative stress, interleukin 8, tumor necrosis factor-α, prostate weights, serum concentrations of prostate specific antigen, estradiol, follicle stimulating hormone, and C-reactive protein, dyslipidaemia, altered prostate histology and hormonal levels but had no significant change (p>0.05) in haematological indices relative to the control. Finasteride or S. malaccense modulated most of these parameters as corroborated by prostate histology. Acute toxicity study indicated the non-toxicity of SMLE. SMLE showed strong in vitro antioxidant activity which corroborated its in vivo antioxidant activity.Conclusion: The study showed that S. malaccense could be useful in the management of BPH.

Objective: The effect of Syzygium malaccense methanol leaf extract (SMLE) on some parameters of testosterone-estradiol valerate induced benign prostatic hyperplasia (BPH) in rats was assayed. Materials and Methods: Thirty male albino rats were used and they were grouped as: Control: received 1 mL/kg olive oil (oral and subcutaneous); BPH: received subcutaneously 9 mg/kg dihydrotestosterone (DHT)+0.9 mg/kg estradiol valerate (ESV) and orally 1 ml/kg olive oil; finasteride: received 9 mg/kg of DHT+0.9 mg/kg ESV (subcutaneously) and 5 mg/kg finasteride (orally) and test groups 1 and 2: received 9 mg/kg of DHT+0.9 mg/kg ESV (subcutaneously) and 200 and 400 mg/kg SMLE (orally). The duration of the treatment was 28 days. Results: The BPH group had increased prostatic total proteins, oxidative stress, interleukin 8, tumor necrosis factor-a, prostate weights, serum concentrations of prostate specific antigen, estradiol, follicle stimulating hormone, and C-reactive protein, dyslipidaemia, altered prostate histology and hormonal levels but had no significant change (p>0.05) in haematological indices relative to the control. Finasteride or S. malaccense modulated most of these parameters as corroborated by prostate histology. Acute toxicity study indicated the non-toxicity of SMLE. SMLE showed strong in vitro antioxidant activity which corroborated its in vivo antioxidant activity. Conclusion: The study showed that S. malaccense could be useful in the management of BPH. [ABSTRACT FROM AUTHOR]

Abstract Background Benign prostate hyperplasia (BPH) commonly affects aging men that can result in hematuria. For patients who are not suitable candidates for surgery, prostatic artery embolization (PAE) has emerged as a minimally invasive alternative. This study aimed to assess the safety and efficacy of PAE specifically for treating hematuria in BPH patients who cannot undergo surgery. Methods The study included n = 110 participants. PAE was performed, and outcomes of interest, including resolution of hematuria, improvement in lower urinary tract symptoms (LUTS), prostate volume (PV), and quality of life (QoL), were assessed. Adverse events were also analyzed. Results The study demonstrated a 100% clinical success rate in resolving hematuria at 3 months, with no recurrence observed during the 6-month follow-up. Mean hemoglobin levels increased, indicating successful resolution of bleeding. PAE also led to a significant reduction in LUTS severity, as measured by the International Prostate Symptom Score (IPSS). Improvement in the mean maximum urinary flow rate (Qmax) indicated enhanced urinary flow. Additionally, MRI measurements showed a reduction in prostate volume following PAE. These improvements contributed to enhanced QoL for the patients. Conclusions Prostatic artery embolization (PAE) was found to be a safe and effective treatment option for hematuria in BPH patients not suitable for surgery. PAE demonstrated a high success rate in resolving hematuria and resulted in significant improvements in LUTS, prostate volume, and QoL outcomes. These findings have important implications for clinical decision-making and improving patient care for BPH patients with hematuria. Further research and long-term follow-up studies are necessary to validate these findings and assess the durability of PAE outcomes in this patient population.

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Objective To investigate the intervention mechanism of Lingze Tablet on benign prostatic hyperplasia (BPH) rats based on the PI3K/Akt pathway・ Methods Forty SPF-grade SD rats were randomly divided into normal, model, finasteride, low-dose, and high・dose groups. Except for the normal group, all rats in the remaining groups were induced with non-castrated testosterone propionate to create a rat model of prostate hyperplasia. After the modeling, the normal and model groups were given saline, while the finasteride, low-dose, and high-dose groups were given the corresponding drugs by gavage for 28 days. After gavage, the rats were sacrificed, and the prostate tissues were collected to observe the changes in the prostate index, tissue structure, and PI3K/Akt signaling pathway-related proteins in each group. Results Compared with the nonnal group, the rats in the model group showed significant hyperplasia of prostate tissue, increased prostate index, and expression levels of PI3K, Akt, and Bcl-2 proteins (P <0・ 01), and decreased expression levels of Bax protein (P <0・01)・ Compared with the model group, the prostate index and Bcl-2, PI3K, and Akt protein expression levels decreased (P<0.01), and Bax protein expression levels increased (P <0・ 01) in the finasteride and Lingze tablet high-dose groups. The prostate index and PBK, Akt, and Bcl-2 protein expression decreased, and Bax protein expression increased in the Lingze tablet low-dose group. However, only the differences in the prostate index and Akt protein expression levels were statistically significant (P <0,05)< Conclusion Lingze Tablet can negatively regulate the PI3K/Akt signaling pathway, down-regulate PI3K, Akt, and Bcl-2 protein expression levels, and up-regulate Bax protein expression levels, inhibiting cell proliferation and promoting apoptosis, thus exerting therapeutic effects on BPH. The therapeutic effect is better when using Lingze Tablet at high doses. [ABSTRACT FROM AUTHOR]

Age‐induced erectile dysfunction (ED) is a convoluted medical condition, and restoring erectile function (EF) under geriatric conditions is highly complicated. Platelet‐rich plasma (PRP) treatment is an inexpensive cell‐based therapeutic strategy. We have aimed to restore EF in aged‐ED rats with PRP as a therapeutic tool. Male rats were grouped into aged and young according to age. The young rats were considered as normal control (NC) and treated with saline. Aged were further divided into 2 groups and treated with intracavernous (IC) PRP and saline. Treatment was scheduled at the 9th and 10th week for NC and 41th and 42th week for aged‐ED rats, with EF analysis scheduled on the 12th week for NC and 44th week for aged‐ED rats, respectively. Erectile response, immunofluorescence staining, and electron microscopic analyses were performed. IC PRP treatment effectively reduced prostate hyperplasia (PH). EF response indicated a significant increase in crucial EF parameters in PRP‐treated aged‐ED rats. Histological evidence denoted a rigid and restored development of tunica adventitia of the dorsal artery, decreased vacuolation of the dorsal penile nerve, and structural expansion of the epineurium. Masson's trichrome and immunostaining results affirmed an elevated expression of α‐smooth muscle actin (α‐SMA) in the corpus cavernosum (CC). Ultrastructure findings revealed that PRP effectively rejuvenated degenerating nerves, preserved endothelium and adherent junctions of corporal smooth muscle, and restored the axonal scaffolds by upregulating neurofilament‐H (NF‐H) expression. Finally, PRP enhanced neural stability by enhancing the axonal remyelination processes in aged‐ED rats. Hence, PRP treatment was proven to restore EF in aged‐ED rats, which was considered a safe, novel, cost‐effective, and hassle‐free strategy for EF restoration in geriatric patients. [ABSTRACT FROM AUTHOR]

Prostatic hyperplasia (PH) is an androgen-dependent condition associated with increased prostatic size that is common in intact dogs, and similar to the condition in men. In dogs, the increase in prostatic size is most prominent the first years, and after approximately four years (in beagles), a plateau is reached, and further growth is slower. Why the prostate continues to grow more in some individuals is not clear. Most testosterone in the circulation is bound to albumin or sex hormone binding globulin (SHBG) and only a minor part is unbound and biologically active. The binding to SHBG has higher affinity than that to albumin. In addition, SHBG has own biological functions, modifying testosterone action. The aim of the present study was to investigate if there is an association between relative prostatic size and the variables total testosterone concentration, SHBG concentration, an estimation of bioavailable testosterone: the ratio between testosterone and SHBG (free androgen index, FAI), estradiol concentration, the estradiol/testosterone ratio, dog age and dog weight. Hormone concentrations were measured in serum from 79 intact male dogs aged ≥ four years, weighing ≥ five kg. The size of the prostate was estimated using ultrasonography, and relative prostate size, S rel , was calculated as the estimated size related to the normal size for a 4-year-old dog of the same weight. There as a negative correlation between testosterone concentration and age (ρ = −0.27, P = 0.018) and a positive correlation between age and S rel (ρ = 0.27, P = 0.016) and between SHBG and weight (ρ = 0.38, P = 0.001). The FAI was negatively correlated with dog weight (ρ = −0.32, P = 0.004). There were no significant correlations between S rel and SHBG or FAI or between estradiol or estradiol/testosterone and S rel , age or weight. A multiple regression analysis showed significant associations between log S rel and log testosterone concentration, log age and log weight of the dog, with an adjusted R2 of 9.5%. Although the variables total testosterone concentration, age and weight of the dog were all significantly associated with S rel , the coefficient of determination was low, indicating that they only explained a minor part of the prostatic size. The results support the analysis of total testosterone in studies of prostatic growth in the dog. • Large dogs have relatively larger prostates - relative size increases with weight. • The prostatic size is positively associated with testosterone concentrations. • Factors other than age, weight and testosterone are important for prostatic size. • Analysis of total testosterone gives useful information. [ABSTRACT FROM AUTHOR]

Background and purpose: We aimed to describe the technique and outcomes of En-Bloc MOSES laser enucleation of the prostate (En-Bloc MoLEP) with early apical release comparing it to En-Bloc HoLEP (non-MOSES). Patients and methods: This is a single-arm prospective study, using a historical control. n = 80 patients were enrolled to the En Bloc MoLEP group and compared to a retrospective group of n = 137 patients treated by En Bloc HoLEP (non-MOSES), in total n = 217 patients. Results: En-Bloc MoLEP, showed to significantly improve the surgical time by 32% compared to non-MOSES HoLEP (32.16 ± 14.46 min, 47.58 ± 21.32, respectively; P = 0.003). Enucleation time, ablation rate and hemostasis time were also significantly improved (P < 0.001, for all three parameters). Enucleation time was 22.10 ± 9.27 min and 31.46 ± 14.85 min (P < 0.001), ablation rate 4.11 ± 2.41 and 2.54 ± 1.31 gr/min (P < 0.001), Hemostasis time 3.01 ± 2.50 and 8.35 ± 5.38 min (P < 0.001), for En Bloc MoLEP and En Bloc HoLEP, respectively. Q-max, PVR, PSA and IPSS showed significant improvement, however, at 12 months no significant differences were observed comparing both groups. Conclusions: En-Bloc MoLEP was significantly better than En-Bloc HoLEP in terms of surgical time, enucleation time, ablation rate and hemostasis time. However, large comparative RCT with long-term follow-up are needed. [ABSTRACT FROM AUTHOR]

This work analysed the expression of prostate polysaccharides in rats with age-related benign prostatic hyperplasia (BPH) for a better understanding of the possible relationship between prostate polysaccharides secretion and BPH onset. For this, prostatic glands from 1 month-old, 3 months-old, 6 months-old and 12 months-old Sprague-Dawley rats were processed in order to identify their overall polysaccharide content. Additionally, serum testosterone was also determined. One-month old rats showed significantly (P < 0.05) lower testosterone levels (0.77 ng/mL±0.12 ng/mL) compared with the other groups, which showed no significant difference among them. PAS staining showed positive polysaccharides markings in both the prostatic lumen and inside of luminal prostatic cells in all groups. Semiquantitative analysis of intraluminal PAS showed that one month-old rats had significantly (P < 0.005) lower PAS intensity when compared with all other groups (100.0 ± 0.5, arbitrary units vs. 107.3 ± 0.6, arbitrary units in 3 months-old ones), whereas 12 months-old ones showed significantly (P < 0.005) higher values when compared with all other groups (133.6 ± 3.5, arbitrary units in 12 months-old rats vs. 108.6 ± 1.4, arbitrary units in 6 months-old ones). The PAS + content practically disappeared when tissues were pre-incubated with either α-amylase or amyloglucosidase, regardless of a previous incubation with proteinase K. Incubation of prostate extracts from 12 months-old rats for 2 h with α-amylase yielded a significantly higher amount of free glucose (1.47 nmol/mg protein±0.23 nmol/mg protein vs. 0.32 nmol/mg protein±0.01 nmol/mg protein in untreated extracts). Similar results were obtained when extracts were pre-incubated with amyloglucosidase. Contrarily, pre-incubation with N -glycosidase induced a significantly (P < 0.05), much lower increase of free glucose. Pre-treatment with proteinase K did not significantly modify these results, which indicate that BPH is related to an increase in the secretion of low ramified ductal α-glycosydic polysaccharides that were not protected against lysis by any type of protein protective core. These changes seem to not be related with concomitant variations in serum testosterone levels. [Display omitted] • The onset of both rat age-related benign prostate hyperplasia (BPH) is concomitant with an increase in intraductal polysaccharide content. • The intraductal prostate polysaccharide content is, mainly composed by low ramified α-glycosydic chains. • The onset of rat BPH is concomitant with an increase of the polysaccharide metabolism of prostate ductal cells. [ABSTRACT FROM AUTHOR]

Abstract Background Enlargement of the prostate is associated with prostatic diseases in dogs, and an estimation of prostatic size is a central part in the diagnostic workup. Ultrasonography is often the method of choice, but biomarkers constitute an alternative. Canine prostate specific esterase (CPSE) shares many characteristics with human prostate specific antigen (PSA) and is related to prostate size. In men with clinical symptoms of prostatic disease, PSA concentrations are related to prostate growth. The aims of the present follow-up study were to evaluate if the concentration of CPSE is associated with future growth of the prostate, and if analysis of a panel of 16 steroids gives further information on prostatic growth. Owners of dogs included in a previous study were 3 years later contacted for a follow-up study that included an interview and a clinical examination. The prostate was examined by ultrasonography. Serum concentrations of CPSE were measured, as was a panel of steroids. Results Of the 79 dogs included at baseline, owners of 77 dogs (97%) were reached for an interview, and 22 were available for a follow-up examination. Six of the 79 dogs had clinical signs of prostatic disease at baseline, and eight of the remaining 73 dogs (11%) developed clinical signs between baseline and follow-up, information was lacking for two dogs. Development of clinical signs was significantly more common in dogs with a relative prostate size of ≥2.5 at baseline (n = 20) than in dogs with smaller prostates (n = 51). Serum concentrations of CPSE at baseline were not associated with the change in prostatic size between baseline and follow-up. Serum concentrations of CPSE at baseline and at follow-up were positively associated with the relative prostatic size (Srel) at follow-up. Concentrations of corticosterone (P = 0.024), and the class corticosteroids (P = 0.0035) were positively associated with the difference in Srel between baseline and follow-up. Conclusions The results support the use of CPSE for estimating present and future prostatic size in dogs ≥4 years, and the clinical usefulness of prostatic size for predicting development of clinical signs of prostatic disease in the dog. The association between corticosteroids and prostate growth warrants further investigation.

Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter.

Background: The purpose of this study was to assess the impact of coincidental radiotherapy on the volume of the non-malignant prostate gland in rectal cancer patients treated with neo-adjuvant radiotherapy. Materials and methods: In this retrospective analysis, thirty male patients with rectal cancer who had neoadjuvant radiotherapy met the inclusion criteria. These patients had pre-treatment magnetic resonance imaging (MRI) and at least one post-treatment MRI of the pelvis and the whole of their prostate volume received the full prescribed radiotherapy dose; 45 Gy in 25 fractions (n = 22), 45 Gy in 20 fractions (n = 4) and 25 Gy in 5 fractions (n = 4). Results: The median age of this patient cohort was 66 years (range: 30–87). With a median interval between pre-treatment MRI and first MRI post-treatment of 2 months (range: 1–11), the mean prostate volume reduced from 36.1 cm³ [standard deviation (SD) 14.2] pre-radiotherapy to 31.3 cm³ (SD 13.0) post radiotherapy and this difference was significant (p = 0.0004). Conclusion: Radiotherapy may cause shrinkage in volume of normal (non-malignant) prostate. Further research is required in this field, since these results may be of some comfort to men contemplating the consequences of radiotherapy on their quality of life. The authors suggest recording flow-rate and international prostate symptom score (IPSS) during rectal radiotherapy as a next step. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Thulium laser (Tm:YAG) prostate surgery is a safe and effective procedure with low morbidity and comparable clinical outcomes to those of transurethral resection of the prostate (TURP). However, the sexual function outcomes (erectile and ejaculatory function) have been scarcely studied. Aim: We aimed to assess the impact of Tm:YAG prostate surgery on sexual outcomes (erectile and ejaculatory function) and compare them with those patients undergoing TURP. Material and Methods: We searched digital databases like PUBMED, SCOPUS, CENTRAL and EMBASE using relevant keywords to identify comparative studies on TURP and non-comparative studies on Tm:YAG prostate surgery that assessed sexual outcomes. We performed qualitative and quantitative analyses with the extracted data. We carried out a meta-analysis to compare postoperative International Index of Erectile Function (IIEF-5) scores and incidences of retrograde ejaculation (RE) in patients undergoing either Tm:YAG or TURP. The pre-operative and post-operative IIEF-5 scores were pooled to estimate overall scores. Results: We included 5 comparative and 8 non-comparative studies in this review. We found the postoperative IIEF-5 score improvements to be significantly higher in the Tm:YAG prostate surgery group than in the TURP group with a significant mean difference (MD) of 0.45 (95% CI, 0.18 to 0.72; P = .001). We found no significant associations between the procedures. The pooled OR for the association of RE was estimated at 0.90 (95% CI, 0.50 to 1.60; P = .71; I2 = 0%). Conclusion: Tm:YAG prostate surgery improves erectile function more than TURP, according to our findings. Tm:YAG prostate aided surgery also outperforms TURP in terms of preserving sexual function following surgery.However, We found similar or no difference in incidence of RE between Tm:YAG prostate surgery and TURP.Bibo L, Hao L, Pang K, et al. Assessment of Sexual Outcomes in Patients Undergoing Thulium Laser Prostate Surgery for Management of Benign Prostate Hyperplasia: A Systematic Review and Meta-analysis. Sex Med 2022;10:100483.

Objective: Propionibacterium acnes has been implicated in the pathogenesis of prostate disease as acute and chronic prostatic inflammation, benign prostatic hyperplasia and prostate cancer although it should still be clarified if Propionibacterium acnes (P. acnes) is a commensal or accidental prostate pathogen. Aiming to evaluate the pathogenic potential for genitourinary tract of Propionibacterium acnes, we investigated the frequency of P. acnes genome in urine or semen samples from men with recurrent symptoms of urinary infection and negative testing for the most common urinary tract pathogens and sexually transmitted infections (STI) agents as Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum. Materials and methods: The DNA extracted from urine and semen samples was analyzed for evaluating the P. acnes genome presence by real-time polymerase chain reaction (PCR). Infections were treated with vancomycin and cephalosporins antibiotics and then the search for the P.acnes genome by realtime PCR was repeated. Results: The P. acnes qualitative real-time PCR revealed the genome in 73 out of 159 samples examined (108 urine and 51 semen). After antibiotic therapy, P. acnes was never detected. Conclusions: These results suggested that P. acnes genome determination should be performed in cases of chronic inflammation in the urinary tract to identify an unknown potential pathogen of genitourinary tract.

Introduction: Prostatic hyperplasia (BPH) is one of the most common diseases of elderly and senile men. Its natural "evolution" leads to an increase in deformity disorders, gradual decompensation of the bladder and the progression of CKD. If the morphogenesis of BPH, as well as the patterns of adaptive and pathological restructuring of the lower urinary tract are described in the literature, then there is practically no evidence of adaptive processes in the prostate itself against the background of the growth of hyperplasia nodes. The purpose of the work: to study the features of morphological restructuring of prostate tissue and its vascular system in persons suffering from benign prostatic hyperplasia, with different levels of compensation for bladder function., Material and Methods: Autopsy material of 82 men aged 60-80 years was studied, divided into 4 groups: 25 men without GPH who died from causes unrelated to urological pathology; 25 men with GPH without clinical and morphological signs of bladder decompensation; 22 men with decompensated BPH, which is the main disease, where the immediate cause of death was chronic urinary retention, bilateral ureterohydronephrosis, CKD, uremia; 10 people who died from various causes, however, having a pathological diagnosis of BPH complicated by acute urinary retention. Fragments of the prostate gland were subjected to morphological examination. Histological sections were stained with hematoxylin-eosin, according to Mason and Hart, and also performed: overview microscopy, vascular morphometry and stereometry of the structural components of the prostate. In addition, an immunohistochemical study (IHC) was performed using mouse monoclonal antibodies to SMA. The results of the study. The formation and progressive growth of prostate nodes in elderly and senile men leads to a compensatory restructuring of the tissue of this organ. Its manifestation is hypertrophy of the smooth muscles of the prostate and the restructuring of the arterial bed, which provides trophism to the overly developed smooth muscles of the stroma. Over time, sclerotic processes progress in the prostate tissue, which, on the one hand, have an inflammatory genesis, and, on the other, have a senile dyscirculatory character due to atherosclerosis of the extraorgan arteries and restructuring of the intraorgan arteries in connection with long-term arterial hypertension. As a result, the prostate gland becomes not only enlarged in volume due to hyperplasia nodes, but also rigid due to fibrosis, which, along with hypertrophy of the smooth muscle component of the stroma, contributes to a further increase in resistance to urine outflow. An increase in the size of nodes, inflammatory edema of the organ, its sclerosis and petrification, as well as progressive reduction of the arterial bed, lead to the development of venous hyperemia and lymph circulation disorders, being a morphological prerequisite for acute urinary retention., Conclusion: In GPH, compensatory and adaptive processes occur not only in the detrusor, but also in the prostate gland, as well as its vascular bed. At the same time, aimed at ensuring the normal functioning of the organ in conditions of formation of hyperplastic nodes, they eventually lead to its pathological restructuring, themselves becoming the cause of impaired urine outflow, predetermining the dynamics of the disease and the occurrence of its complications.

Objectives: The failure rate following prostate artery embolization (PAE) is around 20%, which may in part result from inadequate embolization. Prostate contrast retention (PCR) adequacy on immediate post-embolization cone-beam CT may provide better assessment of embolization completeness than arterial contrast stasis seen on fluoroscopy alone. The aim of this study was to evaluate outcomes of PAE using PCR adequacy as the procedural endpoint. Methods: A retrospective cohort study of all PAE cases using this technique at a single large volume center was conducted. Following initial embolization of the main prostatic arteries, if PCR was inadequate, additional embolization was performed. Technical success (adequate PCR) was defined as > 75% global prostate gland contrast staining. Clinical success was determined in accordance to CIRSE standards of practice. Results: One hundred sixty-five patients (mean age 68 ± 8.4 years) underwent PAE from June 2017 to March 2019. Technical and clinical success rates were 98.8% and 96.4% respectively. Clinical success rate was significantly higher in patients with adequate PCR. International Prostate Symptom Scores (IPSS) and Quality of Life (QoL) scores significantly improved at 1-, 3-, 6-, and 12-month follow-up when compared to baseline. Prostate volume (PV) and post-voiding residual bladder volume were significantly reduced at 3, 6, and 12 months in comparison to baseline. Mild (Clavien-Dindo grade I/II) and moderate (grade III) complication rates were 12.1% and 3.6% respectively. Conclusions: By using PCR adequacy as a guide to determine the procedure endpoint for PAE, it may be possible to achieve more complete embolization and thus higher clinical success rates. Key Points: • By using PCR adequacy as a guide to determine the procedure endpoint for PAE, it may be possible to achieve more complete embolization and thus higher clinical success rates. [ABSTRACT FROM AUTHOR]

Abstract Background To find out any association of urethral catheterisation with rise in serum PSA. Methods This study was conducted in 80 patients of BPH who had to undergo catheterisation because of acute urinary retention. Patients were divided into two groups: Group A (n = 43 patients), age group 40–60 years, and Group B (n = 47 patients), age group 60–75 years. Values of PSA, free/total PSA and PSA density were recorded in both age groups before catheterisation and one and three days after catheterisation. Results PSA, PSA density and free/total PSA were not statistically different before and after urethral catheterisation. Conclusions In the absence of urinary tract infection, urethral catheterisation does not elevate serum PSA. PSA, PSA density and free/total PSA were not statistically different before and after urethral catheterisation.

OBJECTIVE: A little is known about the role of miRNA-153 expression in prostate cancer (PCa), in this study we aimed to determine the prognostic value of miRNA-153 and PTEN expression in PCa, by correlating their expression with Gleason patterns, Gleason scores, and Grade groups. PATIENTS AND METHODS: In situ hybridization for miRNA-153 and immunohistochemical staining for PTEN were applied on microarray sections of 80 PCa, with different Gleason grades, and 20 benign prostate hyperplasia (BPH) cases. RESULTS: We found that miRNA-153 expression was significantly higher and PTEN was significantly lower in PCa compared to BPH. In PCa, high miRNA-153 expression and loss of PTEN expression were associated significantly with higher Gleason patterns, higher Gleason scores, and higher Grade groups. The expression of miRNA-153 showed a significant inverse correlation with PTEN expression. CONCLUSIONS: Increased miRNA-153 expression and lost PTEN expression in PCa may provide information on their role in the progression of this cancer, suggesting that miRNA-153 could affect PTEN directly in prostatic neoplastic and hyperplastic lesions, and therefore miRNA-153 can be considered a new tool to improve the treatment efficacy and prognosis of PCa patients. [ABSTRACT FROM AUTHOR]

Aims: To evaluate outcomes after benign prostate hyperplasia (BPH) surgery among men with lower urinary tract symptoms (LUTS) only versus those with urinary retention (UR). Methods: The protocol was registered in PROSPERO with ID#232253. Eligible studies identified from four electronic databases. Search, data extraction and quality assessment were performed independently by two reviewers. Studies with perioperative, functional, early and late complication outcomes included. Results: Twenty‐five studies, 14 593 patients including 1 randomized controlled trial, 11 prospective and 13 retrospective studies included for meta‐analysis. This showed higher risk of immediate transient recatherization (risk ratio [RR]: 5.29, p < 0.00001), longer days to trial‐off‐catheter (mean difference [MD]: 0.25, p < 0.00001), longer hospitalization stay in the UR group (MD: 0.35, p < 0.00001), and higher risk of intraoperative blood transfusions (RR: 1.90, p = 0.002), postoperative urinary tract infections (RR: 1.49, p < 0.00001) and sepsis (RR: 8.15, p = 0.009) too. Failure of surgery like permanent recatheterization (RR: 5.27, p < 0.00001) was more in preoperative UR group. Negligible differences seen in long term functional outcomes between the two groups (International Prostate Symptom Score at 12 months, MD: −0.06, p = 0.68; Quality of Life at 12 months, MD: 0.20, p < 0.00001; maximum urinary flow rate at 12 months, MD: −0.33, p = 0.10; and postvoid residual volume at 12 months, MD: 4.32, p < 0.00001). Conclusions: Preoperative UR patients undergoing surgery for BPH have higher risk of postoperative complications versus LUTS only group including the need for permanent catheterization. Both groups had similar long‐term functional outcomes. We could infer that patients with UR on whom surgery is successful, with time may recover bladder function akin to patients with LUTS alone. [ABSTRACT FROM AUTHOR]

Background: Enlargement of the prostate is associated with prostatic diseases in dogs, and an estimation of prostatic size is a central part in the diagnostic workup. Ultrasonography is often the method of choice, but biomarkers constitute an alternative. Canine prostate specific esterase (CPSE) shares many characteristics with human prostate specific antigen (PSA) and is related to prostate size. In men with clinical symptoms of prostatic disease, PSA concentrations are related to prostate growth. The aims of the present follow-up study were to evaluate if the concentration of CPSE is associated with future growth of the prostate, and if analysis of a panel of 16 steroids gives further information on prostatic growth. Owners of dogs included in a previous study were 3 years later contacted for a follow-up study that included an interview and a clinical examination. The prostate was examined by ultrasonography. Serum concentrations of CPSE were measured, as was a panel of steroids. Results: Of the 79 dogs included at baseline, owners of 77 dogs (97%) were reached for an interview, and 22 were available for a follow-up examination. Six of the 79 dogs had clinical signs of prostatic disease at baseline, and eight of the remaining 73 dogs (11%) developed clinical signs between baseline and follow-up, information was lacking for two dogs. Development of clinical signs was significantly more common in dogs with a relative prostate size of ≥2.5 at baseline (n = 20) than in dogs with smaller prostates (n = 51). Serum concentrations of CPSE at baseline were not associated with the change in prostatic size between baseline and follow-up. Serum concentrations of CPSE at baseline and at follow-up were positively associated with the relative prostatic size (Srel) at follow-up. Concentrations of corticosterone (P = 0.024), and the class corticosteroids (P = 0.0035) were positively associated with the difference in Srel between baseline and follow-up. Conclusions: The results support the use of CPSE for estimating present and future prostatic size in dogs ≥4 years, and the clinical usefulness of prostatic size for predicting development of clinical signs of prostatic disease in the dog. The association between corticosteroids and prostate growth warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Several techniques are used for laser enucleation of benign prostate hyperplasia, including two- and three-lobe enucleation, enucleation of all lobes in a single block (en-bloc), and enucleation of all nodes in a single block without longitudinal incisions (total en-bloc)., Aim: A prospective and retrospective analysis of the results of two-lobe, en-bloc, and total en-bloc using thulium fiber laser enucleation of the prostate (ThuFLEP) techniques was performed., Method: s. The study included a retrospective and prospective comparative analysis of the peri- and postoperative results of ThuFLEP using several techniques. Patients with benign prostatic hyperplasia causing bladder outlet obstruction (IPSS>20, Qmax<15) were undergone to ThuFLEP from January 2015 to May 2022. All patients were examined prior to and 1, 3, and 6 months after the procedure. In the pre- and postoperative period, the age of the patients, prostate volume, level of prostate-specific antigen, functional parameters (IPSS, post-void residual, Qmax, and QoL), the stress urinary incontinence were evaluated. In addition, the following intraoperative parameters were assessed: duration of the procedure, enucleation rate, morcellation rate, and mass of enucleated tissue., Results: We found 450 patients who underwent thulium fiber laser enucleation of prostate hyperplasia (ThuFLEP). Three laser enucleation techniques were used, including two-lobe (n=148; group A), en-bloc (n=150; group B), and total en-bloc without longitudinal incision (n=152; group C). The mean prostate volume was comparable between groups. The mean operation time for the total en-bloc technique (group C) was less compared to the other two techniques (58.9+/-30.1 vs. 68.8+/-30.6 for group A and 67.4+/-30.1 min for group B, respectively; p<0.005). The mean enucleation rate in group C was higher compared to groups A and B (2.3+/-0.78 vs. 1.9+/-0.74 and 1.9+/-0.69 g/min, respectively; p<0.005). The mean morcellation rate in all three groups was comparable (2.8+/-1.7, 3.0+/-1.1, and 2.9+/-2.1 g/min; p>0.05). After 6 months, there were no differences in functional results, according to the IPSS, PVR, Qmax, and QoL., Conclusion: The two-lobe, en-bloc, and total en-bloc techniques were comparable in functional results and the complication rate. Total en-bloc enucleation showed the higher enucleation efficiency.

To analyze the expressions of inflammatory factors nuclear transcription factor-κB (NF-κb) and hypoxia-inducible factor-1a (HIF-1a) in the prostate cancer tissues and its correlations with various clinicopathological characteristics, fresh prostate cancer tissues from 102 patients were taken as the experimental group, prostate hyperplasia tissues from 58 patients were taken as the control group, and normal tissues from 102 patients were taken as the blank group. Enzyme-linked immunosorbent assay (ELIA) was used to determine the concentrations of NF-κB and HIF-1a in the three groups. The fluorescence quantitative polymerase chain reaction (PCR) was used to detect the mRNA expression levels of NF-κB and HIF-1a in the three groups. The immunohistochemistry was used to detect the protein expressions of NF-κB and HIF-1a in the three groups. The variance was used to analyze the correlations between NF-κB, HIF-1a and clinicopathological characteristics. The results showed that the mRNA expression (4.27 = 1.14), protein positive expression rate (66.53%) and concentration (87.17 = 8.55pg/mL) of NF-κB in the experimental group were higher than those of the control group and the blank group (P< 0.05); the mRNA expression (3.62 = 1.06), protein positive expression rate (71.72%) and concentration (50.67 = 5.11ng/L) of HIF-1a in the experimental group were significantly higher than those in the control group and blank group (P< 0.05); the positive expressions of NF-κB and HIF-1a had obvious differences in age, and those in patient no younger than 50 years old were higher than those in patient younger than 50 years old (P< 0.05); the positive expressions of NF-κB and HIF-1a had observable differences in TNM stages, and those in patients at stage IV were significantly higher than those in patients at stage II and III (P< 0.05); the positive expressions of NF-κB and HIF-1a in level of specific antigen of prostate were greatly different, and those in patients with no less than 15ng/mL were higher than those in patients with less than 15ng/mL (P< 0.05). In conclusion, the expression levels of inflammatory factors NF-κB and HIF-1a in the prostate cancer tissues were higher than those in the prostatic hyperplasia tissues, and were significantly positively correlated with TNM stage, age, and level of specific antigen of prostate. [ABSTRACT FROM AUTHOR]

Several therapeutic approaches such as holmium laser enucleation of the prostate (HoLEP) have been introduced to relieve bladder outlet obstruction caused by benign prostatic hyperplasia (BPH). Compared with other techniques including the transurethral resection of the prostate (TURP) and simple open prostatectomy, HoLEP results in a shorter hospital stay and catheterization time and fewer blood loss and transfusions. HoLEP is a size-independent treatment option for BPH with average gland size from 36 g to 170 g. HoLEP is a safe procedure in patients receiving an anticoagulant and has no significant influence on the hemoglobin level. Also, HoLEP is an easy and safe technique in patients with a prior history of prostate surgery and a need for retreatment because of adenoma regrowth. The postoperative erectile dysfunction rate of patients treated with HoLEP is similar to TURP or open prostatectomy and about 77% of these patients experience loss of ejaculation. Patients with transitional zone volume less than 30 mL may suffer from persistent stress urinary incontinence following HoLEP so other surgical techniques like bipolar TURP are a good choice for these patients. In young patients, considering HoLEP with high prostate-specific antigen density and a negative standard template prostate biopsy, multiparametric MRI needs to be considered to exclude prostate cancer. [ABSTRACT FROM AUTHOR]

Objective: Propionibacterium acnes has been implicated in the pathogenesis of prostate disease as acute and chronic prostatic inflammation, benign prostatic hyperplasia and prostate cancer although it should still be clarified if Propionibacterium acnes (P. acnes) is a commensal or accidental prostate pathogen. Aiming to evaluate the pathogenic potential for genitourinary tract of Propionibacterium acnes, we investigated the frequency of P. acnes genome in urine or semen samples from men with recurrent symptoms of urinary infection and negative testing for the most common urinary tract pathogens and sexually transmitted infections (STI) agents as Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum. Materials and methods: The DNA extracted from urine and semen samples was analyzed for evaluating the P. acnes genome presence by real-time polymerase chain reaction (PCR). Infections were treated with vancomycin and cephalosporins antibiotics and then the search for the P.acnes genome by real-time PCR was repeated. Results: The P. acnes qualitative real-time PCR revealed the genome in 73 out of 159 samples examined (108 urine and 51 semen). After antibiotic therapy, P. acnes was never detected. Conclusions: These results suggested that P. acnes genome determination should be performed in cases of chronic inflammation in the urinary tract to identify an unknown potential pathogen of genitourinary tract. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND AND OBJECTIVES: The objective of this study was to correlate the level of anxiety presented in the preoperative period with the intensity of pain reported by elderly in the immediate postoperative period of transvesical prostatectomy. METHODS: Sixty-four elderly patients submitted to transvesical prostatectomy were studied, using the following instruments: the numeric pain scale and Hamilton anxiety rating scale in the preoperative; and the short-form McGill pain questionnaire (Portuguese version adapted) in the immediate postoperative period. The elderly divided into four groups, according to the level of anxiety presented in the preoperative period: absent, mild, moderate and intense. The Spearman correlation was established between preoperative anxiety levels and postoperative pain intensity. RESULTS: There was a significant positive correlation between the level of preoperative anxiety and pain intensity in the immediate postoperative period. The pain curves (sensitive and affective) presented a significant increase at moments 6, 18 and 24h in all groups. These curves were significantly higher in the elderly with moderate and intense anxiety than in those without anxiety and mild anxiety. The pain peak was recorded at 18h after surgery in all groups. CONCLUSION: In the elderly, the level of anxiety presented in the preoperative period was positively correlated with the pain response in the immediate postoperative of transvesical prostatectomy. The use of preoperative measures that reduce anxiety can improve analgesia in the immediate postoperative period of this surgery and, therefore, reduce the amount of analgesics used in this period. There was also a need for intervention with adequate analgesia at the postoperative pain peak which occurred 18h after surgery.

Objective: Despite high-grade intravesical prostatic protrusion (IPP) being closely related to bladder outlet obstruction (BOO), up to 21% of patients with low IPP remain obstructed. This study evaluates the characteristics and urodynamic findings of men with small prostates and low IPP. Methods: One hundred and fourteen men aged >50 years old with lower urinary tract symptoms (LUTS) were assessed with symptoms, uroflowmetry, serum prostate-specific antigen (PSA), transabdominal ultrasound measurement of prostate volume (PV), IPP and post-void residual urine (PVRU). All patients underwent pressure flow studies. Patients with PV

Benign prostatic hyperplasia (BPH) is one of the most common causes of bladder outlet obstruction in men. In this study we aimed to evaluate the elasticity of the bladder by Acoustic Radiation Force Impulse (ARFI) elastography in BPH patients. Fifty benign prostate patients were included in the study. After evaluation of patients in the outpatient clinic. ARFI elastography was performed with full bladder. Elastography was performed separately on the anterior, right and left walls of the bladder. Then the patient underwent uroflowmetry. The maximum flow rate and post -mix residual values in uroflowmetry were recorded. The mean age of the patients was 45.6 ± 3.77 The average of bladder anterior wall elasticity 3.39 ± 0.89, Bladder left wall elasticity 2,69 ± 0,82 and Bladder right wall elasticity was 3.69 ± 0.89.The mean prostate size 52.58 ± 24.16 The average of Qmax11.96 ± 4.85 The mean of PMR 77.8 ± 59.6 and mean of prostate elasticity was 2.97 ± 1.1. Urinary bladder wall elasticity with ARFI can be a diagnostic indicator for bladder outlet obstruction due to BPH. [ABSTRACT FROM AUTHOR]

Pueraria mirifica (PM) is a medicinal plant native to Thailand contained high amount of phytoestrogen and possesses anticancer activity. This study reports the effect of P. mirifica extract, phytoestrogen of diadzein and genistein for its benign prostate hyperplasia properties in testosterone-induced prostate hyperplasia in male Sprague Dawley rats. The P. mirifica extract was evaluated for its total phenols, flavonoid and antioxidant activity using DPPH, FRAP and metal chelating assay. The assessment of P. mirifica, diadzein and genistein against benign prostate hyperplasia was determined in testosterone-induced prostate hyperplasia in male Sprague Dawley rats. The total phenol was higher than flavonoid but showed low antioxidant activity of DPPH, FRAP and metal chelating. The aqueous PM extract at 1000 mg/kg significantly increased testosterone levels in testosterone-induced rats by 13% while diadzein and genistein increased it by 11% and 17% respectively. However, levels of FSH, LH, triglyceride and HDL are not affected by the oral administration of PM, diadzein and genistein to the rats. Similarly, total protein, albumin, globulin, total bilirubin, conjugated bilirubin, alkaline phosphatase, alanine aminotransferase, AST, and G-glutamyltransferase showed no significant difference as compared with negative control rats. The body weight of the rats, testis, kidney and liver showed no toxic effect. The zinc content increased significantly and the zinc transporter gen of ZnT4 and ZIP4 highly expressed suggesting that the PM, diadzein and genistein plays essential role in modulating prostate zinc homeostasis. Similarly, the expression of IL-6, AR and ER was significantly reduced indicating functioning in regulation of prostate growth and acts as anti-inflammatory role in preventing BPH. In conclusion, the results indicated that PM reduced BPH and contributed to the regulation in the zinc transport expression of the prostate cells in the benign prostate hyperplasia (BPH). [ABSTRACT FROM AUTHOR]

Purpose: Previously, we reported the presence of virus-encoded microRNAs (miRNAs) in the urine of prostate cancer (CaP) patients. In this study, we investigated the expression of two herpes virus-encoded miRNAs in prostate tissue. Methods: A total of 175 tissue samples from noncancerous benign prostatic hyperplasia (BPH), 248 tissue samples from patients with CaP and BPH, and 50 samples from noncancerous surrounding tissues from these same patients were analyzed for the expression of two herpes virus-encoded miRNAs by real-time polymerase chain reaction (PCR) and immunocytochemistry using nanoparticles as molecular beacons. Results: Real-time reverse transcription-PCR results revealed significantly higher expression of hsv1-miR-H18 and hsv2-miRH9- 5p in surrounding noncancerous and CaP tissues than that in BPH tissue (each comparison, P

Introduction: The aim of the study was to examine the percentage volume of epithelium, acini, and interstitial collagen in the nonhyperplastic canine prostate and in cases of epithelial and epithelial cystic hyperplasia. Material and Methods: A histomorphometric study of 39 prostates was performed using computer image analysis. Results: The highest percentage volume of epithelium was found in cases of epithelial hyperplasia (47.8 %) and epithelial cystic hyperplasia was the correlate for acini (48.97 %). Epithelium decreased with dogs’ age (P < 0.01), whereas acini increased (P < 0.01). Interstitial collagen varied only insignificantly across age groups, but collagen was higher (12.1 %) in the nonhyperplastic prostates. With age cystic formation progressed in the canine prostate, the percentage volume of epithelium decreased and that of acini increased, but this same parameter in prostatic collagen did not change distinctly. The epithelium percentage volume increased in cases of epithelial hyperplasia but the cystic variant caused an increase in acinar volume. Conclusion: As dogs age, cystic formation progresses in the prostate, therefore the volume of epithelium decreases and that of acini increases. The volume of prostatic collagen did not change distinctly with age, and was higher in normal prostates than in both epithelial and epithelial cystic hyperplastic glands.

Purpose: The authors evaluated the relationships between the clinical factors and resistive indexes (RIs) of prostate and urethral blood flows by using power Doppler transrectal ultrasonography (PDUS) in men with benign prostatic hyperplasia (BPH). Methods: The data of 110 patients with BPH and lower urinary tract symptoms (LUTS) treated between January 2015 and July 2015 were prospectively collected. PDUS was used to identify the capsular and urethral arteries of the prostate in order to measure RIs. International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), total prostate volume (TPV), transition zone volume (TZV), transition zone index (=TZV/TPV), presence of intravesical prostatic protrusion (IPP), and the RIs of capsular and urethral arteries were evaluated for all of the patients by one urologist. Results: The 110 patients were categorized according to IPSS (mild symptoms, 0–7; moderate symptoms, 8–19; and severe symptoms, 20–35), Qmax (

Objective: Men with benign prostate hyperplasia (BPH) with good urinary flow may still have bladder outlet obstruction (BOO). Intravesical prostatic protrusion (IPP) has been shown to be able to predict BOO. We aim to investigate the use of IPP to predict BOO in men with good urinary flow. Methods: One hundred and fourteen consecutive men (>50 years old) presenting with lower urinary tract symptoms suggestive of BPH were recruited in 2001 and 2002. They were evaluated with serum prostate specific antigen (PSA), uroflowmetry and transabdominal ultrasound measurement of IPP and prostate volume (PV). Pressure-flow urodynamic studies were performed on all men and BOO was defined by BOO index > 40. Men with Qmax ≥ 12.0 mL/s were considered to have good flow. Results: Among the 114 men, 61 patients had good urinary flow. Their median age, PV and Qmax were 66 years, 32.9 mm3 and 14.5 mL/s respectively. 14/61 (23.0%) patients had BOO and their distribution of IPP were as follows: Grade 1 – 0/20 (0%) obstructed, Grade 2 – 6/22 (27.3%) and Grade 3 – 8/19 (42.1%). Sensitivity of Grade 2/3 IPP for BOO was 100% while specificity of Grade 3 IPP was 76.6%. The area-under-curve (AUC) for IPP was greater than that for PV (0.757 vs. 0.696). Conclusion: Even in men with good flow, high grades of IPP were more likely to have BOO and hence, may be a useful adjunct to predict BOO.

Herein is a case report of a 70 years old man with a tenacious benign prostatic hyperplasia (BPH). The aim of this manuscript is to briefly discuss the usage and advantage of EmbozeneTM Microsphere in embolization of the prostate arteries in the treatment of failed medical and surgical therapy for BPH. [ABSTRACT FROM AUTHOR]

A 72-year-old Caucasian man incurring a prostate hypertrophy presented with a right forearm nodule, the growth of which appeared to parallel the rise in his blood prostatespecific antigen (PSA) level. Echographic examination was consistent with a median-nerve schwannoma, and was confirmed upon magnetic resonance imaging (MRI). Excision of the nodule was readily performed without significant neural damage, and its schwannoma nature was confirmed upon immunohistochemistry analysis. Importantly, blood PSA dropped abruptly from -13 to -5 ng/ml within 2 months postschwannoma resection, a swift drastic reduction unachievable with oral dutasteride alone. However, 6 weeks later, a new nodule became apparent on the back of the left knee and was identified as a second schwannoma, thereby suggesting that its growth could have been stimulated by the resection of the first schwannoma, as previously described for vestibular schwannomas. The second schwannoma was in fact two: the bigger one was in the common fibular nerve and the smaller one in the tibial nerve. Both echography and MRI results were confirmed upon surgical resection of the bigger knee schwannoma. Although the third schwannoma has not yet been resected and formally characterized, we face a schwannomatosis case with an unexpected potential exosome-mediated stimulating effect on PSA secretion (PSA immunohistochemistry was negative on both schwannomas). On the other hand, preliminary genomic analysis showed a deficient balance for chromosome 22, the very chromosome carrying the three main genes involved in schwannomatosis. This age-related schwannomatosis case is thus discussed in light of the following: age-related DNA repair deficiency culminating in loss of chromosome/heterozygosity; CpG methylation/demethylation-based epigenetic aging; age-related functional decline of the immune system responsible for inefficient elimination of abnormal cells and subsequent tumorigenic cell turn-over; exosome-mediated pathologic intercellular communications; and prostate-invading brain neural progenitors as pathologic peripheral nervous system (PNS) cells. [ABSTRACT FROM AUTHOR]

Abstract Aim Growth arrest and DNA-damage-inducible 45 beta (GADD45β) is a member of the gene family associated with cell growth control, apoptosis, and DNA damage repair. The aim of present study was to determine the potential effects of GADD45β deletion on prostate hyperplasia progression. Main methods LNCaP cells were incubated with testosterone propionate (1 μM) for 48 h and specific siRNA used to suppress GADD45β expression in vitro. For in vivo experiments, testosterone (3 mg/kg, IP) was injected into wild-type (WT) and GADD45β knockout (GADD45β−/−) C57BL/6J mice for 21 consecutive days, and serum and prostate tissues subjected to biological and histochemical analyses. Key findings GADD45β-silenced LNCaP cells showed suppressed testosterone-induced 5α-reductase 2 and androgen receptor expression compared to control LNCaP cells. Moreover, after 21 days of testosterone treatment, prostate weight and stromal tissue increment were relatively lower in GADD45β−/− than WT counterpart mice. Inhibition of testosterone-induced 5α-reductase 2 and proliferating cell nuclear antigen expression in the GADD45β−/− group was confirmed via immunohistochemistry analyses. Significance Although the exact correlation between GADD45β and prostate hyperplasia remains to be established, the present GADD45βdeletion suppressed testosterone-induced prostate hyperplasia which was accompanied by inhibition of 5α-reductase 2-related protein expression. [ABSTRACT FROM AUTHOR]

Objective: To report the largest comparative analysis of robotic vs open simple prostatectomy (OSP) for large-volume prostate glands. Materials and Methods: We retrospectively reviewed 103 patients that underwent open and 64 patients that underwent robotic simple prostatectomy from 2012 to 2016 at a single institution. A propensity score-matched analysis was performed with five covariates, including age, body mass index, race, Charlson comorbidity index, and prostate volume. Perioperative, postoperative, and functional outcomes were compared between groups. Results: After propensity score matching there were 59 patients in each group available for comparison. There was no statistically significant difference between groups for all preoperative demographic variables. Robotic compared with OSP demonstrated a significant shorter average length of stay (LOS) (1.5 vs 2.6 days, p < 0.001), but longer mean operative time (161 vs 93 minutes, p < 0.001). The robotic approach was also associated with a lower estimated blood loss (339 vs 587 mL, p < 0.001) and lower percentage hematocrit drop (12.3% vs 19.5%, p = 0.001). Two patients required blood transfusions in the robot group compared with four in the open group, but this was not significant ( p = 0.271). Improvements in maximal flow rate, International Prostate Symptom Score, quality of life, postvoid residual, and postoperative prostate-specific antigen levels were similar before and after surgery for both groups, but there was no difference between groups. There was no difference in complications between groups. Conclusion: Robotic simple prostatectomy is a safe and effective treatment for the surgical management of benign prostatic hyperplasia. It provides similar function outcomes to the open approach; however, offers the advantage of reduced LOS and reduced blood loss. [ABSTRACT FROM AUTHOR]

Currently, holmium laser enucleation of the prostate is a new technology for the treatment of obstructive urinary symptoms due to prostatic growth. This technique has been shown to have similar clinical results to TURP and is suitable for anticoagulated patients, as well as those with large prostates. It is a safe and effective technique, with a short learning curve, relieving the low obstructive urinary symptoms, but with much less perioperative morbidity, less bleeding and a more rapid recovery. An updated bibliographic review was conducted based on the AUA (American Urological Association)/EAU (European Association of Urology). We also reviewed indications, contraindications, technical limitations and surgical results as published in the literature. [ABSTRACT FROM AUTHOR]