Diabetes Mellitus in Patients with Benign Prostatic Hyperplasia

Of 51 patients submitted to operation for benign prostatic hyperplasia three (5.9%) were knwon, diabetics and two others had undergone surgery for peptic ulcer. Of the remaining patients half (23 out of 46) were found to be diabetic; 40% (20 patients) had a history of previous cardiac infarction or electrocardiograph evidence of myocardial ischaemia.It is suggested that these findings add further support to the hypothesis that benign prostatic hyperplasia is one manifestation of a relative increase of oestrogen secretion with advancing age.     

Urology: Management of Benign Prostatic Hyperplasia

The Council on Scientific Affairs of the California Medical Association presents the following inventory of items of progress in urology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, and scholars to stay abreast of these items of progress in urology that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Urology of the California Medical Association, and the summaries were prepared under its direction.     

良性前列腺增生与代谢综合征相关性研究

目的:探讨代谢综合征在老年良性前列腺患者病程中的作用.方法:选择湖南师范大学第二附属医院老年病科2010年1月至2012年1月门诊及住院的男性良性前列腺增生合并代谢综合征患者88例,同时选择同期的单纯良性前列腺增生患者90例,分析体重指数、血压、腰围、空腹血糖、胰岛素抵抗指数、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、前列腺特异性抗原等对及前列腺体积的影响.结果:BPH合并MS组PV为(39.7±21.1)mL,明显高于单纯BPH组,且PV与BMI、收缩压、空腹血糖、PSA呈正相关,与高密度脂蛋白呈负相关.结论:BPH与MS具有相关性,BMI、收缩压、PSA、FBG、低密度脂蛋白是BPH发生发展的危险因素.     

原发性高血压对良性前列腺增生病程发展的影响研究

目的：探讨原发性高血压与良性前列腺增生（BPH）发生与-临床进展的相关性。方法：将确诊为良性前列腺增生的78例BPH患者分为单纯性BPH组和BPH合并有高血压组两组,其中BPH组33例,BPH合并有高血压组45例。对两组患者的尿流率、残尿量、血清前列腺特异性抗原（PSA）、血尿发生率、前列腺体积、国际前列腺症状（tPSS）评分、尿潴留次数及不稳定膀胱发生率指标进行对比分析。结果：两组患者间在年龄、尿流率、残尿量、PSA、最大膀胱容量及最大逼尿肌压力指标差异无统计学意义（P〉0．05）。而BPH合并高血压患者在血尿发生率、前列腺体积、IPSS评分、尿潴留次数及不稳定膀胱发生率指标上明显大于单纯良性前列腺增生组,差异有统计学意义（P〈0．05）。结论：原发性高血压患者发生前列腺增生的病例报道越来越多,高血压状态能够促进BPH的发生以及临床进展。     

前列腺选择性光汽化术治疗良性前列腺增生

良性前列腺增生症(BPH)是中老年男性泌尿系统最普遍的病症之一.药物治疗存在一定局限性,而传统手术治疗存在高危病人手术风险大、术后并发症多等缺陷.在过去的十几年中,大量对于BPH微侵袭外科手术治疗的研究正在开展,其中使用绿激光(green laser)的前列腺选择性光汽化术(PVP)以其出血少、留置导尿和住院时间短、术后并发症少等优点,有望逐步取代传统经尿道前列腺电切术(TURP),成为新一代BPH治疗的有效方法.通过对PVP手术的原理、方法、优点、术中护理配合、目前研究成果等相关内容的讨论,对该手术进行简要综述.     

The QT Interval and Selection of Alpha-Blockers for Benign Prostatic Hyperplasia

The QT interval is the electrocardiographic manifestation of ventricular depolarization and repolarization. Drug-induced long QT syndrome is characterized by acquired, corrected QT (QTc) interval prolongation that is associated with increased risk of torsade de pointes. Every physician must recognize if the drugs he or she prescribes prolongs the QTc interval, especially if the drug is prescribed for a chronic condition in older patients who are on polypharmacy. The evolution of alpha-blockers for the treatment of benign prostatic hyperplasia has allowed the development of drugs that are easier to administer and better tolerated. Because alpha-blockers generally have equivalent efficacy, this class of drugs is typically differentiated by safety and side effects. Studies suggest that alpha-blockers may vary in regard to their effect on the QT interval, and, therefore, on their predisposition to cause potentially life-threatening ventricular arrhythmias.     

5-alpha-Reductase Inhibitors Prevent the Progression of Benign Prostatic Hyperplasia

Lower urinary tract symptoms (LUTS) associated with clinical benign prostatic hyperplasia (BPH) are a common occurrence in aging men, causing bother and interference with daily activities and affecting disease-specific quality of life. There is increasing evidence to suggest that, in many patients, the signs and symptoms of BPH are progressive. Progression can be measured as continued growth of the prostate gland; worsening of symptoms, bother, or quality of life; deterioration of urinary flow rate; episodes of acute urinary retention (AUR); and need for prostate-related surgery. Furthermore, it has become clear that the risk of disease progression increases with age as well as with increasing prostate volume and serum prostate-specific antigen (PSA) level. The 5-alpha-reductase inhibitor finasteride has been shown not only to improve symptoms, bother, and quality of life but also to prevent progression to AUR and surgery, with a relative risk reduction of over 50%. As the risk for such progression is higher in patients with larger glands or higher serum PSA values at baseline, it is in those patients that finasteride induces an even greater risk reduction, making it a cost-effective treatment choice for patients with LUTS associated with prostatic enlargement.     

Combination of Autoantibody Signature with PSA Level Enables a Highly Accurate Blood-Based Differentiation of Prostate Cancer Patients from Patients with Benign Prostatic Hyperplasia

Although an increased level of the prostate-specific antigen can be an indication for prostate cancer, other reasons often lead to a high rate of false positive results. Therefore, an additional serological screening of autoantibodies in patients’ sera could improve the detection of prostate cancer. We performed protein macroarray screening with sera from 49 prostate cancer patients, 70 patients with benign prostatic hyperplasia and 28 healthy controls and compared the autoimmune response in those groups. We were able to distinguish prostate cancer patients from normal controls with an accuracy of 83.2%, patients with benign prostatic hyperplasia from normal controls with an accuracy of 86.0% and prostate cancer patients from patients with benign prostatic hyperplasia with an accuracy of 70.3%. Combining seroreactivity pattern with a PSA level of higher than 4.0 ng/ml this classification could be improved to an accuracy of 84.1%. For selected proteins we were able to confirm the differential expression by using luminex on 84 samples. We provide a minimally invasive serological method to reduce false positive results in detection of prostate cancer and according to PSA screening to distinguish men with prostate cancer from men with benign prostatic hyperplasia.     

Relationship Between Depression and Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

This article provides an overview of current data on the relationship between depression and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), with a focus on pathophysiology and patient management implications. Review of the literature indicated a clear relationship between LUTS secondary to BPH and depression. It is unknown whether this relationship is bidirectional or unidirectional. Depression is associated with the impact of LUTS on quality of life in men with BPH. Research suggests that depression alters the experience of LUTS in this population. Medical and surgical treatments for BPH may impact quality of life and, therefore, depression. Results conflict on the exact nature of the relationship examined, and on the extent to which the relationship may be attributed to physiological factors such as inflammation. Practicing clinicians should consider using a brief self-administered scale to assess for depression in patients with BPH. There is a clear need for additional research to decisively determine the nature of the relationship between LUTS secondary to BPH and depression, as well as the extent to which change in either condition may be affected by the other.Key words: Benign prostatic hyperplasia, Depression, Lower urinary tract symptomsThe prevalence of benign prostatic hyperplasia (BPH) increases with age.¹ Approximately half of men over age 40 are diagnosed with BPH. Of these men, approximately 50% will develop significant and bothersome lower urinary tract symptoms (LUTS) secondary to BPH, which increase in prevalence between ages 40 and 80 years. LUTS secondary to BPH is associated with decreased quality of life and may include urgency/frequency, incontinence, and nocturia. Symptom severity is impacted by the degree of prostatic enlargement, which is highly variable.¹Depression is another common condition that severely and negatively impacts quality of life, with an estimated lifetime prevalence of 16.5% according to the National Institute of Mental Health.² Depression plays a role in the pathogenesis of a number of chronic diseases, including inflammatory bowel disease, arthritis, asthma, and diabetes³; a relationship has also been identified between depression and urologic diagnoses such as incontinence.⁴ Symptoms of BPH are associated with decreased quality of life and depression, and the literature strongly suggests that there may also be a pathophysiologic relationship between BPH and depression^5,6; in addition, depressive symptoms are also associated with treatments for BPH.^7–9Research has suggested that psychiatric parameters such as depression may have a putative role in the development of LUTS secondary to BPH.⁶ Furthermore, depression may pose an impediment to effective treatment for these patients. Improved understanding of the relationship between BPH and depression could lead to improved management. This area of research is important because clinical depression is associated with a significant increase in mortality, and early detection, intervention, and treatment of clinically relevant depressive symptoms are key factors in patient care.¹⁰Fewer studies have focused on the relationship between depressive symptoms or depressive disorders and BPH, or the nature and direction of this relationship. Thus, a systematic review of the relationship between depression and BPH is needed. We provide a comprehensive summary of contemporary published reports on LUTS secondary to BPH and depression to improve understanding of the relationship between these two conditions and provide a framework for future investigation.     

中国老年科门诊良性前列腺增生患者就诊需求研究

目的:研究中国老年科门诊老年良性前列腺增生(benign prostatic hyperplasia,BPH)患者的不同就诊需求.方法:采用自行设计的,对中国南、北方11个城市(北方:兰州、北京、沈阳;南方:成都、长沙,武汉、济南、南京、杭州、上海、广州)33所三级甲等医院2027例60岁及以上BPH门诊患者与医务人员沟通、采用的检查项目需求、采用的治疗方案和健康指导方面的需求进行调查.结果:本调查问卷克朗巴哈系数为0.845,表明该问卷具有较好的信度.南方北方城市患者沟通需求、诊断需求、治疗需求和健康指导需求评分差异无统计学意义.下尿路症状越严重的患者其沟通需求和健康指导需求更强烈.结论:BPH患者在其就诊中对于沟通、诊断、治疗和健康指导方面具有普遍需求.BPH患者沟通需求、诊断需求、治疗需求和健康指导需求在南北城市间无差异.且下尿路症状越严重的患者其沟通需求和健康指导需求更强烈.     

Nutritional Status of Adult Patients with Pulmonary Tuberculosis in Rural Central India and Its Association with Mortality

Under-nutrition is a known risk factor for TB and can adversely affect treatment outcomes. However, data from India are sparse, despite the high burden of TB as well as malnutrition in India. We assessed the nutritional status at the time of diagnosis and completion of therapy, and its association with deaths during TB treatment, in a consecutive cohort of 1695 adult patients with pulmonary tuberculosis in rural India during 2004 - 2009.Multivariable logistic regression was used to obtain adjusted estimates of the association of nutritional status with deaths during treatment. At the time of diagnosis, median BMI and body weights were 16.0 kg/m²and 42.1 kg in men, and 15.0 kg/m²and 34.1 kg in women, indicating that 80% of women and 67% of men had moderate to severe under-nutrition (BMI<17.0 kg/m²). Fifty two percent of the patients (57% of men and 48% of women) had stunting indicating chronic under-nutrition. Half of women and one third of men remained moderately to severely underweight at the end of treatment. 60 deaths occurred in 1179 patients (5%) in whom treatment was initiated. Severe under-nutrition at diagnosis was associated with a 2 fold higher risk of death. Overall, a majority of patients had evidence of chronic severe under-nutrition at diagnosis, which persisted even after successful treatment in a significant proportion of them. These findings suggest the need for nutritional support during treatment of pulmonary TB in this rural population.     

Inflammatory Responses in a Benign Prostatic Hyperplasia Epithelial Cell Line (BPH-1) Infected with Trichomonas vaginalis

Trichomonas vaginalis causes the most prevalent sexually transmitted infection worldwide. Trichomonads have been detected in prostatic tissues from prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Chronic prostatic inflammation is known as a risk factor for prostate enlargement, benign prostatic hyperplasia symptoms, and acute urinary retention. Our aim was to investigate whether T. vaginalis could induce inflammatory responses in cells of a benign prostatic hyperplasia epithelial cell line (BPH-1). When BPH-1 cells were infected with T. vaginalis, the protein and mRNA of inflammatory cytokines, such as CXCL8, CCL2, IL-1β, and IL-6, were increased. The activities of TLR4, ROS, MAPK, JAK2/STAT3, and NF-κB were also increased, whereas inhibitors of ROS, MAPK, PI3K, NF-κB, and anti-TLR4 antibody decreased the production of the 4 cytokines although the extent of inhibition differed. However, a JAK2 inhibitor inhibited only IL-6 production. Culture supernatants of the BPH-1 cells that had been incubated with live T. vaginalis (trichomonad-conditioned medium, TCM) contained the 4 cytokines and induced the migration of human monocytes (THP-1 cells) and mast cells (HMC-1 cells). TCM conditioned by BPH-1 cells pretreated with NF-κB inhibitor showed decreased levels of cytokines and induced less migration. Therefore, it is suggested that these cytokines are involved in migration of inflammatory cells. These results suggest that T. vaginalis infection of BPH patients may cause inflammation, which may induce lower urinary tract symptoms (LUTS).     

Increased Serum C-Reactive Protein Level Is Associated with Increased Storage Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia

Objective

Chronic inflammation is considered as one of the contributing mechanisms of lower urinary tract symptoms (LUTS). Serum C-reactive protein (CRP) level is the widely used biomarker of inflammatory status. This study investigated the association between serum CRP level in men with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) before and after medical treatment.

Methods

A total of 853 men with BPH and LUTS were enrolled. All patients completed the International Prostate Symptoms Score (IPSS) questionnaire and urological examinations. The parameters of uroflowmetry (maximum flow rate, Qmax; voided volume, VV), post-void residual (PVR), total prostate volume (TPV) and transition zone index (TZI), serum prostate specific antigen (PSA), and serum CRP levels were obtained. All patients were treated with alpha-blocker or antimuscarinic agent based on the IPSS voiding to storage subscore ratio (IPSS-V/S). Correlation analyses were performed between serum CRP levels with age, IPSS, TPV, TZI, Qmax, PVR, VV, PSA and between baseline and post treatment.

Results

The mean age was 66.9±11.6 years old and the mean serum CRP levels were 0.31±0.43 mg/dL. Univariate analyses revealed serum CRP levels were significantly associated with age (p<0.001), PSA levels (p = 0.005) and VV (p = 0.017), but not significantly associated with TPV (p = 0.854) or PVR (p = 0.068). CRP levels were positively associated with urgency (p<0.001) and nocturia (p<0.001) subscore of IPSS, total IPSS (p = 0.008) and storage IPSS (p<0.001) and negatively associated with IPSS- V/S ratio (p = 0.014). Multivariate analyses revealed that serum CRP levels were significantly associated with age (p = 0.004) and storage IPSS subscore p<0.001). Patients with IPSS-V/S<1 and treated with tolterodine for 3 months had significant decrease of CRP levels after treatment.

Conclusion

Serum CRP levels are associated with storage LUTS and sensory bladder disorders, suggesting chronic inflammation might play a role in the patients with storage predominant LUTS.     

Renal Capsule Xenografting and Subcutaneous Pellet Implantation for the Evaluation of Prostate Carcinogenesis and Benign Prostatic Hyperplasia

New therapies for two common prostate diseases, prostate cancer (PrCa) and benign prostatic hyperplasia (BPH), depend critically on experiments evaluating their hormonal regulation. Sex steroid hormones (notably androgens and estrogens) are important in PrCa and BPH; we probe their respective roles in inducing prostate growth and carcinogenesis in mice with experiments using compressed hormone pellets. Hormone and/or drug pellets are easily manufactured with a pellet press, and surgically implanted into the subcutaneous tissue of the male mouse host. We also describe a protocol for the evaluation of hormonal carcinogenesis by combining subcutaneous hormone pellet implantation with xenografting of prostate cell recombinants under the renal capsule of immunocompromised mice. Moreover, subcutaneous hormone pellet implantation, in combination with renal capsule xenografting of BPH tissue, is useful to better understand hormonal regulation of benign prostate growth, and to test new therapies targeting sex steroid hormone pathways.     

Influence of Cadmium on the Antioxidant Status with in vitro Cultures of Rhododendron japonicum

Biology Bulletin - The effect of different concentrations of cadmium (Cd, 42–126 µM) on the antioxidant system of in vitro cultures of Rhododendron japonicum was studied. A decrease in...     

前列腺增生的膀胱尿道系统流场仿真研究

测量排尿过程中的声音信号来诊断膀胱出口梗阻BOO。建立了一个三维的CFD模型,用来研究漩涡与梗阻的关系。通过计算都得到了各种情况下尿道内部的流场分布。比较计算结果可知,漩涡的大小主要由阻塞程度决定,其次还受膀胱压力的影响。计算结果对于完善这种声学无侵入诊断方法具有参考意义。     

热作用致良性前列腺增生组织对KTP/Nd:YAG激光的吸收和散射特性变化

研究了热作用下的良性前列腺增生(BPH)组织对532 nm的KTP和1064 nm的Nd:YAG激光的吸收和散射特性的变化及其差异,实验采用双积分球测量系统以及反向倍增法获取BPH组织的吸收和散射特性。结果表明:热作用下的BPH组织对532 nm和1064 nm的吸收系数和约化散射系数都是随着加热温度的变化而变化的,在20℃到80℃的温度范围内,BPH组织对532 nm的吸收系数和约化散射系数都分别显著地较其对1064 nm的吸收系数和约化散射系数要大,其对532 nm和1064 nm的吸收系数的最大值都在20℃,其值分别为1.663 mm-1和0.127 mm-1,最小值分别在50℃和70℃,其值分别为0.864 mm-1和0.034 mm-1,其对532 nm和1064 nm的吸收系数的最大差异在70℃,其值为2647%,其对532 nm和1064 nm的约化散射系数的最大值都在80℃,其值分别为2.036 mm-1和1.421 mm-1,最小值分别在50℃和70℃,其值分别为1.499 mm-1和0.246 mm-1,其对532 nm和1064 nm的约化散射系数的最大差异在70℃,其值为555%,在70℃的热作用下BPH组织达到完全热凝固,其对532 nm和1064 nm的吸收和散射特性的差异达到最大值。