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Benign Prostatic Hyperplasia

Benign Prostate Hyperplasia

Benign prostatic hyperplasia is defined as a common age-related, nonmalignant enlargement of the prostate gland.


Presentation

  • This study reports for the first time that post-coital gross hematuria is one of the clinical presentations of BPH, which can be successfully treated with 5alpha-reductase inhibitor.[ncbi.nlm.nih.gov]
  • The two current classifications are presented, and management of this condition is reviewed.[ncbi.nlm.nih.gov]
  • The purpose of the present was to describe a surgical technique and early post-operative results of the first successful laparoscopic retropubic simple prostatectomy (LRSP) in Thailand.[ncbi.nlm.nih.gov]
  • If a nodular abnormality is present there is around a 50% chance of a diagnosis of prostate cancer being made on biopsy.[ncbi.nlm.nih.gov]
  • The present study aimed to investigate the protective effects and regulatory mechanisms of URG11 in benign prostatic hyperplasia (BPH).[ncbi.nlm.nih.gov]
Recurrent Urinary Tract Infection
  • Surgery should be reserved for patients who either have failed medical management or have complications from BPH, such as recurrent urinary tract infections, refractory urinary retention, bladder stones, or renal insufficiency as a result of obstructive[ncbi.nlm.nih.gov]
  • Chronic urologic conditions, including benign prostatic hyperplasia, recurrent urinary tract infections, and urinary incontinence, are common in older adults.[ncbi.nlm.nih.gov]
Abdominal Mass
  • A 60-year old female pseudohermaphrodite with congenital adrenal hyperplasia presented with acute retention of urine and a lower abdominal mass. At laparotomy a large uterus with multiple leiomyomas was removed.[ncbi.nlm.nih.gov]
Urinary Retention
  • This therapy is exemplified by the case of a sixty-six-year-old man with hemophilia B and urinary retention.[ncbi.nlm.nih.gov]
  • KEYWORDS: Acute urinary retention; Benign prostatic hyperplasia; Chronic urinary retention; Lower urinary tract symptoms; Voiding dysfunction[ncbi.nlm.nih.gov]
  • We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was treated with endoscopic transurethral resection of the prostate (TUR-P).[ncbi.nlm.nih.gov]
  • Abstract Purpose: We determined the effect of long-term treatment with finasteride on the incidence of acute urinary retention (AUR) and benign prostatic hyperplasia (BPH) related surgery in men with BPH.[doi.org]
  • Steps in making the diagnosis include a focused neurologic examination, urinalysis, serum creatinine determination and, possibly, catheterization to detect urinary retention.[ncbi.nlm.nih.gov]
Enlargement of the Prostate
  • Benign prostatic hyperplasia is defined as a common age-related, nonmalignant enlargement of the prostate gland. About 33% of the men older than 50 years suffer from BPH. As the age advances, almost 90% of the men are affected with this disease.[symptoma.com]
  • Benign prostatic hyperplasia is a progressive, androgen-dependent disease resulting in enlargement of the prostate gland and urinary obstruction.[ncbi.nlm.nih.gov]
  • By age 60, half of all men have an enlarged prostate. By age 80, about 80 percent of all men have an enlarged prostate. The prostate forms part of the male reproductive system and helps produce semen. It is located at the base of the male bladder.[uwhealth.org]
  • BACKGROUND: Benign prostatic hyperplasia (BPH), nonmalignant enlargement of the prostate, can lead to obstructive and irritative lower urinary tract symptoms (LUTS).[ncbi.nlm.nih.gov]
Nocturia
  • The possibility that the monthly period of nocturia is a general phenomenon and is coupled to a monthly menstrual period, and the implications for more accurate diagnosis and new modes of therapy, are discussed.[ncbi.nlm.nih.gov]
  • This indicates that Pygeum africanum resulted in a statistically significant moderate to large improvement in nocturia.[doi.org]
  • At 10 weeks after treatment, the frequency of nocturia had decreased from once every 1.5 hours to once per night, urinary peak flow rates had increased from 5.1 mL/s to 10.3 mL/s, and postvoid residual urinary bladder volume had decreased from 187 mL[ncbi.nlm.nih.gov]
  • Secondary outcomes included changes in nocturia and urodynamic measures. The main outcome measure for side effects was the number of men reporting side effects.[ncbi.nlm.nih.gov]
  • Secondary outcomes included changes in nocturia and urodynamic measures. The main outcome measure for harms was the number of men reporting side effects.[ncbi.nlm.nih.gov]
Urinary Incontinence
  • Chronic urologic conditions, including benign prostatic hyperplasia, recurrent urinary tract infections, and urinary incontinence, are common in older adults.[ncbi.nlm.nih.gov]
  • Surgery is sometimes required, but is associated with risks such as erectile dysfunction and urinary incontinence.[pharmaceutical-journal.com]
  • Most Transient SUI After HoLEP Resolves Within 6 Weeks Of patients who had transient stress urinary incontinence after holmium laser enucleation of the prostate, 88.6% experienced resolution of the incontinence within 6 weeks after the procedure.[renalandurologynews.com]
  • Urodynamic effects of volume-adjustable balloons for treatment of postprostatectomy urinary incontinence. Urology. 2013; 81 :1308–14. [ PubMed ] [ Google Scholar ][ncbi.nlm.nih.gov]
  • ., nocturia, increased urinary frequency, urinary incontinence, and urgency issues with voiding e.g., weak urinary stream, hesistancy, straining to void, and post-void dribbling exacerbated by alpha-1 agonists irritative issues e.g., urgency and increased[medbullets.com]
Prostatic Disease
  • An increase in immunoreactive CK-BB or CK-BB activity in patients with prostatic disease has been proposed as an indication of prostatic adenocarcinoma.[ncbi.nlm.nih.gov]
  • However, the question whether the presence of OS-related parameters and drugs could be used for the diagnosis or management of prostatic diseases, needs to be addressed in future larger and better studies with a more rational basis.[ncbi.nlm.nih.gov]
  • Despite the fact that BPH is very rare in childhood, one should keep it in mind in the differential diagnosis of acute urinary retention and malignant prostate diseases. The endoscopic method is the treatment of choice in BPH.[ncbi.nlm.nih.gov]
  • Uroselectivity Revisited Subject Categories Medicine, Dentistry, Nursing & Allied Health Medicine Urology Prostatic Disease BISAC Subject Codes/Headings: MED088000 MEDICAL / Urology[routledge.com]
  • Thermal ablation of prostate diseases: advantages and limitations. International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group. Nov 2004;20(7):679-697.[urology.ucsf.edu]

Workup

  • Primary care physicians are uniquely positioned to screen for BPH, conduct a timely diagnostic workup, and if indicated, initiate medical therapy.[mdedge.com]
  • In addition, peak urinary flow, voided volume, and symptoms may worsen over time in men with untreated BPH (see Workup ). The risk of AUR and the need for corrective surgery increases with age.[emedicine.medscape.com]
Bladder Trabeculation
  • The false passage will disappear also on cystoscopy and IC can be safely restarted. 77 Other complications such as hydronephrosis, vesico-ureteral reflux, and bladder cancer seem to relate rather to infection, bladder trabeculation, detrusor pressure[doi.org]

Treatment

  • Nevertheless, the timeliest moment for a possible treatment has not been fully established.[ncbi.nlm.nih.gov]
  • After cessation of alfuzosin treatment thrombocytopenia improved and thrombocyte count reached to normal on week 2 following the discontinuation of treatment.[ncbi.nlm.nih.gov]
  • Recent studies have sought to further elucidate the relationship between surgical treatment of benign prostate hyperplasia and sexual outcomes, and a number of studies have demonstrated that treatment of benign prostate hyperplasia can actually result[ncbi.nlm.nih.gov]
  • Medical aspects of the treatment of LUTS/BPH: 5-alpha reductase inhibitors 10. Medical aspects of the treatment of LUTS/BPH: anti-cholinergic 11. Medical aspects of the treatment of LUTS/BPH: combination therapies 12.[worldcat.org]

Prognosis

  • Conclusion: In this study, we discussed important genetic markers in benign prostatic hyperplasia patients which may, in the future, be used as markers for diagnosis and prognosis, as well as targets for therapeutic intervention.[ncbi.nlm.nih.gov]
  • Report to the Nation on Prostate Cancer 2004, Chapter 1: Detection, Diagnosis, and Prognosis of Prostate Cancer CME. Medscape Today, Clinical Update [On-line CME]. Available online at . (2004 August 17, Reviewed).[labtestsonline.org]
  • MRI enlarged transition zone heterogeneous signal with an intact low signal pseudocapsule in the periphery Treatment and prognosis Medical management for early disease typically commences with an alpha blocker such as tamsulosin given in combination with[radiopaedia.org]
  • […] stream Epidemiology demographics men 45 years of age Pathogenesis unclear; however, chronic inflammation and hormonal and vascular mechanisms may play a role Associated conditions obesity and metabolic syndromes hypertension type 2 diabetes mellitus Prognosis[medbullets.com]

Etiology

  • Little is known about their etiologies except that studies have suggested a substantial heritable component. Our objective is to provide a comprehensive, genome-wide evaluation of inherited risks and possible mechanisms of etiology in BPH.[ncbi.nlm.nih.gov]
  • Owing to the limited number of cases, the etiology and management of BPH in the first two decades is not clear.[ncbi.nlm.nih.gov]
  • Although the etiology remains unclear, nutritional factors may have an effect on the disease.[ncbi.nlm.nih.gov]
  • In order to investigate the endocrine etiology of benign prostatic hyperplasia (BPH), we conducted a case-control study in Athens, Greece using 52 patients with histologically confirmed BPH and 52 healthy controls matched according to age and town of[ncbi.nlm.nih.gov]
  • Although age and genetics play important roles in the etiology of BPH and LUTS, recent insights at the population level have revealed that modifiable risk factors are likely key components as well.[ncbi.nlm.nih.gov]

Epidemiology

 About 33% of the men older than 50 years suffer from BPH. As the age advances, almost 90% of the men are affected with this disease. It is estimated that worldwide, approximately 30 million men are affected by symptoms related to this disease.

The occurrence of the histologic BPH and Symptomatic BPH in the fifth decade is 50% and 26% respectively which rises to 70% and 33% in the sixth decade. In the eighth decade of the life of the men, the occurrence of histologic BPH and Clinical BPH becomes 90% and 46% respectively. Obesity has been proven to increase the predisposition of males to BPH due to the decrease in physical activity [2].

In the developed countries such as the USA, the serious complications such as urosepsis, renal failure and acute urinary retention is only less than 10%.

Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology is a complex interrelated sequence of events involving stromal and epithelial growth changes.[ncbi.nlm.nih.gov]
  • In this study, we propose a novel and tested pathophysiological mechanism for the evolution of BPH and suggest a tested and effective treatment.[ncbi.nlm.nih.gov]
  • This work intends to review the proposed pathophysiology behind the sexual side effects resulting from the surgical treatment of benign prostate hyperplasia and review the literature regarding both established and emerging surgical techniques.[ncbi.nlm.nih.gov]
  • Further research is warranted to validate our results and elucidate the association of the pathophysiology of these 2 diseases.[ncbi.nlm.nih.gov]
  • A clinical evaluation of potent dual 5alpha-reductase inhibitors may help to define the relative roles of human type 1 and 2 5alpha-reductase in the pathophysiology of benign prostatic hyperplasia and other androgen-dependent diseases.[ncbi.nlm.nih.gov]

Prevention

  • Consequently, EGCG might be useful in the prevention and treatment of diseases characterized by excessive cell proliferation such as BPH. Copyright 2017 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • Preventing the conversion of testosterone to its tissue-active form, dihydrotestosterone, by inhibiting the enzyme 5 alpha-reductase could decrease the action of androgens in their target tissues; in the prostate the result might be a decrease in prostatic[ncbi.nlm.nih.gov]
  • Assessing the oxidative stress in these patients may assist in the future prevention, diagnosis and also treatment.[ncbi.nlm.nih.gov]
  • Their long term effectiveness, safety and ability to prevent BPH complications are not known.[ncbi.nlm.nih.gov]
  • Strategies to prevent or delay the need for surgery, such as regular examinations, testing, and use of pharmacotherapy where indicated, may further reduce the need for surgical intervention.[ncbi.nlm.nih.gov]

Patient Information

BPH is the condition in which the patient suffers from nocturia, dysuria and trouble in passing out the urine. If untreated, this disease can cause severe infections in the urinary tract. Though advanced age is the most important cause of the disease, there are some modifiable causes such as diabetes; high BMI and high waist circumference which can help decrease the chances of BPH many-fold.

References

Article

  1. Chen AC; Waterboer T; Keleher A; Morrison B; Jindal S; McMillan D; Nicol D; Gardiner RA; McMillan NA; Antonsson A. Human papillomavirus in benign prostatic hyperplasia and prostatic adenocarcinoma patients. Pathol Oncol Res. 2011; 17(3):613-7 (ISSN: 1532-2807).
  2. Parsons JK; Sarma AV; McVary K; Wei JT. Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigms and future directions. J Urol. 2013; 189(1 Suppl):S102-6 (ISSN: 1527-3792)
  3. Zhang NZ; Chen J; Ma L; Xu ZS. Clinical characteristics of bladder urothelial tumors in male patients--the influences of benign prostatic hyperplasia/benign prostatic enlargement. Urol Oncol. 2012; 30(5):646-51 (ISSN: 1873-2496)
  4. De Nunzio C; Kramer G; Marberger M; Montironi R; Nelson W; Schröder F; Sciarra A; Tubaro A. The controversial relationship between benign prostatic hyperplasia and prostate cancer: the role of inflammation. Eur Urol. 2011; 60(1):106-17 (ISSN: 1873-7560)
  5. American Cancer Society. 2009. American Cancer Society - Learn About Prostate Cancer. Accessed 1/29/2009.
  6. Parsons JK; Palazzi-Churas K; Bergstrom J; Barrett-Connor E. Prospective study of serum dihydrotestosterone and subsequent risk of benign prostatic hyperplasia in community dwelling men: the Rancho Bernardo Study. J Urol. 2010; 184(3):1040-4 (ISSN: 1527-3792).
  7. Zeng R; Liu ZY; Sun YH; Xu CL; Gao X; Jiao L. Expressions of the androgen receptor in normal prostate, benign prostatic hyperplasia and prostate cancer.Zhonghua Nan Ke Xue. 2010; 16(11):967-72 (ISSN: 1009-3591)
  8. Kaplan SA; Lee JY; Meehan AG; Kusek JW; Long-term treatment with finasteride improves clinical progression of benign prostatic hyperplasia in men with an enlarged versus a smaller prostate: data from the MTOPS trial.J Urol. 2011; 185(4):1369-73 (ISSN: 1527-3792)
  9. Rick FG; Szalontay L; Schally AV; Block NL; Nadji M; Szepeshazi K; Vidaurre I; Zarandi M; Kovacs M; Rekasi Z. Combining growth hormone-releasing hormone antagonist with luteinizing hormone-releasing hormone antagonist greatly augments benign prostatic hyperplasia shrinkage. J Urol. 2012; 187(4):1498-504 (ISSN: 1527-3792).
  10. Parsons JK. Lifestyle factors, benign prostatic hyperplasia, and lower urinary tract symptoms.Curr Opin Urol. 2011; 21(1):1-4 (ISSN: 1473-6586).

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Last updated: 2018-06-21 20:03