Benign prostatic hyperplasia : Part 1- diagnosis

Peer reviewedPublisher PD

Therapeutic Considerations Related to Finasteride Administration in Male Androgenic Alopecia and Benign Prostatic Hyperplasia

Finasteride has been used extensively until now as a relative efficient therapeutic option for male androgenic alopecia and benign prostatic hyperplasia. Unfortunately, over time several concerns appeared regarding the frequency and magnitude of adverse effects, which in some cases have been even irreversible. Herein we review the recent literature on this topic, trying to clarify the current safety profile of Finasteride for these two therapeutic indications. We concluded that Finasteride could be retained as a therapeutic approach for male androgenic alopecia, based on two important reasons. First, a synergistic action between a partial inhibitor of 5α-reductase (Finasteride) and another compound (like Minoxidil) are preferable to a complete suppression of 5α-reductase (see Dutasteride), in order to preserve the important physiological roles of dihydrotestosterone. Second, Finasteride side effects can currently be addressed in part prior to the onset of the therapy, by using information about the patient such as hand preference and sexual orientation to predict the risk of adverse effects

PERBEDAAN ANGKA KEJADIAN BENIGN PROSTATIC HYPERPLASIA PADA USIA ANTARA 50-59 TAHUN DENGAN USIA DIATAS 60 TAHUN PADA PEMERIKSAAN ULTRASONOGRAFI DI RS. PKU (PEMBINA KESEJAHTERAAN UMAT) MUHAMMADIYAH SURAKARTA

Farida kumala sari 2010. Perbedaan angka kejadian benign prostatic hyperplasia pada usia antara 50-59 tahun dengan usia diatas 60 tahun pada pemeriksaan ultrasonografi di RS. PKU (Pembina Kesejahteraan Umat) Muhammadiyah Surakarta. Latar Belakang. Pembesaran prostat jinak atau lebih dikenal sebagai BPH (benign prostatic hyperplasia) adalah kelainan prostat yang paling sering terjadi, terutama pada pria berusia > 50 th. Penyakit ini tidak mengenal status sosial, setiap pria yang memiliki prostat perlu waspada terhadap pembesaran prostat, karena sampai saat ini penyebab pasti dari pembesaran prostat jinak belum diketahui. Diperkirakan ada 2,5 juta laki-laki Indonesia yang menderita BPH. Tujuan. Tujuan penelitian ini adalah untuk mengetahui perbedaan antara angka kejadian benign prostatic hyperplasia pada usia antara 50-59 tahun dengan usia diatas 60 tahun pada pemeriksaan ultrasonografi. Metode. Penelitian ini menggunakan metode deskriptif dengan pengambilan data secara retrospektif dengan jumlah sampel 30 penderita benign prostatic hyperplasia di RS. PKU (Pembina Kesejahteraan Umat) Muhammadiyah Surakarta, yang telah melakukan pemeriksaan ultrasonografi mulai dari tanggal 1 Januari 2009 sampai 31 Mei 2010. Hasil. Berdasarkan kelompok usia didapatkan, dari 30 penderita yang menderita Benign Prostatic Hyperplasia, sebanyak 26 penderita atau 86,67% berusia diatas 60 tahun, sedangkan yang berusia antara 50-59 tahun sebanyak 4 penderita atau 13,33%. Kesimpulan. Berdasarkan penelitian ini dapat disimpulkan bahwa, ada perbedaan antara angka kejadian benign prostatic hyperplasia pada usia 50-59 tahun dengan usia diatas 60 tahun

Benign prostatic hyperplasia : Part 2-management

Peer reviewedPublisher PD

Effect of aging on endogenous level of 5 alpha-dihydrotestosterone, testosterone, estradiol, and estrone in epithelium and stroma of normal and hyperplastic human prostate.

associated with aging. Thus, the question arises whether or not a correlation exists between the well known prostatic androgen and estrogen accumulation and aging. To address this question, we measured 5a-dihydrotestosterone (DHT), testosterone, estradiol, and estrone in epithelium and stroma of six normal (NPR) and 19 BPH and correlated the values with the age of the donors (26-87 yr). The mean DHT level in NPR epithelium was significantly higher than in NPR stroma, and also significantly higher than in epithelium and stroma of BPH. The epithelial DHT level of NPR and BPH decreased with age, the correlation being statistically significant. The stromal DHT level of NPR and BPH showed no correlation with age. Concerning testosterone, generally rather low values were found which showed no correlation with age. The mean levels of estradiol and estrone were significantly higher in BPH stroma as compared to BPH epithelium as well as to NPR epithelium and stroma. In NPR, the mean levels of estradiol and estrone were significantly higher in epithelium than stroma. In NPR and BPH, the stromal estradiol and estrone levels increased significantly with age. In epithelium such a correlation between the estrogen levels and age was not found. Our results indicate that the prostatic accumulation of DHT, estradiol, and estrone is in part intimately correlated with aging, leading with increasing age to a dramatic increase of the estrogen/androgen ratio particularly in stroma of BPH

Interstitial laser therapy of benign prostatic hyperplasia

The objective of interstitial laser coagulation (ILC) of benign prostatic enlargement is to achieve a marked volume reduction and to decrease bladder outlet obstruction and lower urinary tract symptoms with minimal morbidity. Coagulation necrosis is generated well inside the adenoma by means of specifically designed laser applicators combined with either a Nd:YAG laser or a diode laser. Because the laser applicators can be inserted as deeply and as often as necessary, it is possible to coagulate any amount of tissue at any desired location while preserving adjacent structures such as the urethra. Postprocedural, the intraprostatic lesions result in secondary atrophy and regression of the prostate lobes, rather than sloughing of necrotic tissue. Several single-armed and randomized studies indicated the effectiveness of interstitial laser coagulation of BPH-syndrome. Marked improvements in AUA score, peak flow rate, residual urine volume and prostate volume were reported. Pressure-flow studies demonstrated a sufficient decrease of the intravesical/detrusor pressure, urethral opening pressure and urethral resistance. Long-term results demonstrating sustained success for up to 3 years were reported on a series of 394 patients. ILC is suitable to debulk even large prostates and to treat highly obstructive patients. Therefore, ILC can be seen as a true alternative to TURF with certain advantages, such as almost no serious morbidity and with certain disadvantages, such as the need for postoperative catheterization. However, ILC can be done under local anesthesia and does not require hospitalization

Cystic benign prostatic hyperplasia in a dog

Old intact male dogs are often predisposed to benign prostatic hyperplasia. Both hypertrophy and hyperplasia of prostate gland occur due to hormonal influences. Clinical signs such as haematuria, stranguria and tenesmus are often associated with benign prostatic hyperplasia. A seven year-old local breed intact male dog was presented with a primary complaint of haematuria and stranguria. Diagnostic work-up conducted inclusive of complete blood count, serum biochemistry, urinalysis, abdominal radiograph, cystourethrography and abdominal ultrasonography. The dog was diagnosed with cystic benign prostatic hyperplasia. Prostatic omentalisation and castration were performed in this case

The postfinasteride syndrome; an overview

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to the return of symptomatology for each condition. In addition, during the therapeutic phase, several adverse effects have been reported, some of which persist long or indefinitely after treatment cessation, known as “post-finasteride syndrome.” Herein we present and discuss the most common finasteride side effects, along with a psycho-neuroendocrine rationale that could explain the persistence of many adverse effects after treatment cessation. Moreover, we argue that finasteride adverse effects occurring during finasteride administration should be delineated from postfinasteride side effects (encountered after treatment cessation), suggesting the need to be addressed separately within a therapeutic perspective. Until a tailored therapeutic approach of postfinasteride syndrome becomes available, we have noted that hand preference and sexual orientation seem to be useful as possible predicting factors for finasteride side effects and postfinasteride syndrome. Finally, even though finasteride administration is considered relatively safe, literature data urges prudence. Specifically, recent studies report that some subjects receiving finasteride develop severe depressive episodes including suicidal thoughts, in part due to persistent sexual side effects

Correlation between Prostatic Calculi and Benign Prostatic Hyperplasia

Prostatic calculus is a common disease of the urinary system, Prostate stones are more common in middle-aged and elderly men, With the development of ultrasonic diagnosis, more and more patients with prostate stone were found in physical examination,According to research shows,The vast majority of patients with benign prostatic hyperplasia in the pathogenesis of examination was found to have prostate stones, but so far the correlation between prostate stones and benign prostatic hyperplasia is still not very clear,Benign prostatic hyperplasia is an important factor affecting the physical and mental health and quality of life of the elderly male, With an increasing trend of population aging in China more quickly, this problem is more and more outstanding, but also allows us to further study the relationship between prostate stones and benign prostatic hyperplasia