scholarly journals Intraprostatic Injection of Alcohol Gel for the Treatment of Benign Prostatic Hyperplasia: Preliminary Clinical Results

2006 ◽  
Vol 6 ◽  
pp. 2474-2480 ◽  
Author(s):  
Benjamin T. Larson ◽  
Nelson Netto ◽  
Christian Huidobro ◽  
Marcelo Lopez de Lima ◽  
Wagner Matheus ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Adverse Effects ◽  
Clinical Results ◽  
Prostatic Hyperplasia ◽  
Easy Access ◽  
Urinary Flow ◽  
Prostatic Volume ◽  
Urinary Tract Symptoms ◽  
Gel Injection

Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH.A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20–30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months.The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p< 0.0001) improvements in Qmax, IPSS, and QoL. The mean amount of gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment.This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an option for the treatment of BPH and LUTS. The viscosity of the gel allows for accurate imaging under ultrasound, no run back along the needle allowing for multiple methods of delivery, and the gel does not spread to extraprostatic tissue. This new technique could provide a simple and possibly less expensive clinic procedure for treating BPH, and warrants further study.

scholarly journals Pharmacological Effects and Potential Clinical Usefulness of Polyphenols in Benign Prostatic Hyperplasia

Molecules ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 450
Author(s):  
Kensuke Mitsunari ◽  
Yasuyoshi Miyata ◽  
Tomohiro Matsuo ◽  
Yuta Mukae ◽  
Asato Otsubo ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Molecular Mechanisms ◽  
Prostatic Hyperplasia ◽  
Pathological Conditions ◽  
Urinary Tract Symptoms ◽  
Anti Inflammatory ◽  
Lower Urinary

Benign prostatic hyperplasia (BPH) is arguably the most common benign disease among men. This disease is often associated with lower urinary tract symptoms (LUTS) in men and significantly decreases the quality of life. Polyphenol consumption reportedly plays an important role in the prevention of many diseases, including BPH. In recent years, in addition to disease prevention, many studies have reported the efficacy and safety of polyphenol treatment against various pathological conditions in vivo and in vitro. Furthermore, numerous studies have also revealed the molecular mechanisms of the antioxidant and anti-inflammatory effects of polyphenols. We believe that an improved understanding of the detailed pharmacological roles of polyphenol-induced activities at a molecular level is important for the prevention and treatment of BPH. Polyphenols are composed of many members, and their biological roles differ. In this review, we first provide information regarding the pathological roles of oxidative stress and inflammation in BPH. Next, the antioxidant and anti-inflammatory effects of polyphenols, including those of flavonoids and non-flavonoids, are discussed. Finally, we talk about the results and limitations of previous clinical trials that have used polyphenols in BPH, with particular focus on their molecular mechanisms of action.

Saw Palmetto and Benign Prostatic Hyperplasia

2004 ◽  
Vol 32 (03) ◽  
pp. 331-338 ◽  
Author(s):  
Edward M. Gong ◽  
Glenn S. Gerber
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Prostatic Hyperplasia ◽  
Placebo Effects ◽  
Urinary Function ◽  
First Line ◽  
Saw Palmetto ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Benign prostatic hyperplasia (BPH) is a common health issue that affects 8% of all men at the age of 40, 60% of men in their 70s, and 90% of those greater than 80 years of age. One-fourth of these men will develop moderate to severe lower urinary tract symptoms that greatly affect their quality of life. Recent evidence suggests that the use of saw palmetto leads to improvements in urinary function for those suffering from BPH. The favorable comparison of saw palmetto with tamsulosin, a well-known first line agent in the treatment of urinary tract symptoms, demonstrates promise towards a beneficial effect of this herbal agent, with very few, if any, adverse effects. However, what degree of this beneficial activity is due to placebo effects is yet to be determined. In addition, the precise mechanism of action of saw palmetto in men with BPH remains unclear.

Effects of Medical Therapy or Surgery on Prostatic and Bladder Resistive Indices in Patients with Benign Prostatic Hyperplasia

2014 ◽  
Vol 94 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Suleyman Bulut ◽  
Cuneyt Ozden ◽  
Binhan Kagan Aktas ◽  
Tagmac Deren ◽  
Suleyman Tagci ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Medical Therapy ◽  
Power Doppler ◽  
Urine Volume ◽  
Prostatic Hyperplasia ◽  
Doppler Imaging ◽  
Urinary Flow ◽  
Once Daily ◽  
Urinary Tract Symptoms ◽  
Posttreatment Period

Introduction: The effects of medical therapy or surgery on bladder and prostatic resistive indices (RIs) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) were evaluated in the present study. Patients and Methods: A total of 124 consecutive LUTS/BPH patients who were candidates for medical therapy (alfuzosin 10 mg once daily, n = 66) or surgery (transurethral prostatectomy (TUR-P), n = 58) were prospectively included. Baseline assessment of patients was performed with the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and prostatic and bladder RIs measured using power Doppler imaging (PDI). All patients were re-evaluated 3 months after treatment measuring the same parameters. Results: Following medical therapy, mean IPSS (17.2 ± 5.1 vs. 8.3 ± 5.3, p = 0.0001), postvoiding residual (PVR) urine (80.0 ± 80.5 vs. 40.3 ± 38.6, p = 0.0001), and prostatic RI (0.73 ± 0.1 vs. 0.70 ± 0.1, p = 0.0001) were decreased, Qmax (13.7 ± 4.2 vs. 16.9 ± 5.9, p = 0.0001) was increased, and bladder RI remained unchanged (0.70 ± 0.1 vs. 0.70 ± 0.1, p = 0.68). Mean IPSS (25.3 ± 5.6 vs. 6.0 ± 4.5, p = 0.0001), PVR urine volume (134.5 ± 115.5 vs. 35.7 ± 25.9, p = 0.0001), and prostatic (0.78 ± 0.1 vs. 0.67 ± 0.04, p = 0.0001) and bladder RIs (0.72 ± 0.1 vs. 0.64 ± 0.04, p = 0.005) were decreased, and Qmax (8.0 ± 4.5 vs. 17.2 ± 8.2, p = 0.0001) was increased after TUR-P. Conclusions: Our results demonstrated that TUR-P decreased both prostatic and bladder RIs, while α-blocker therapy did not change bladder RI in the early posttreatment period in LUTS/BPH patients.

scholarly journals A comparative clinical evaluation of outcome of medical and surgical management of symptoms due to benign prostatic hyperplasia

2020 ◽  
Vol 7 (9) ◽  
pp. 3032
Author(s):  
Bhushan Kumar Gnana ◽  
Sanjeeva Rao Matlapudi
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Surgical Management ◽  
Benign Neoplasm ◽  
Prostatic Hyperplasia ◽  
Single Drug ◽  
Urinary Tract Symptoms ◽  
Rectal Digital Examination ◽  
The Mean ◽  
Lower Urinary

Background: Benign hypertrophy of prostate is common disorder and benign neoplasm of man above 50 years of age. Around 30% patients with benign hypertrophy of prostate lower urinary tract symptoms (LUTS) but all symptoms may not be due to benign hypertrophy of prostate (BHP). Present study has been designed for comparative evaluation of the outcome of medical and surgical management of symptoms, due to benign prostatic hyperplasia by using IPSS (international prostate score) and quality of life score as tool.Methods: In present study patients with LUTS, clinically diagnosed by per rectal digital examination and transrectal ultrasonographically confirmed cases of enlargement of prostate are enrolled for this study. Patients enrolled were divided equally in three groups.Results: After six month the mean IPSS score in silodosin (Sd) group was 6.55±0.86 and in Sd+Dutasteride (Dt) group it was 5.09±1.12. After six months mean IPSS score in Sd+Dt group was 5.09±1.12 and in TURP group it was 2.44±0.59.Conclusions:  Single drug treatment with silodosin is associated with slow and less improvement in IPSS score in comparison with silodosin and dutasteride. But the response to TURP was better and faster than medical management.

scholarly journals Efficacy and Safety of 12-week Monotherapy With Once Daily 5 mg Tadalafil for Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia: Evidence-based Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianwei Cui ◽  
Dehong Cao ◽  
Yunjin Bai ◽  
Jiahao Wang ◽  
Shan Yin ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Lower Urinary Tract ◽  
Prostatic Hyperplasia ◽  
Evidence Based ◽  
Efficacy And Safety ◽  
Once Daily ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background: Tadalafil has been approved for the treatment of benign prostatic hyperplasia (BPH) for nearly 10 years. However, there are insufficient evidence-based studies of the efficacy and safety of tadalafil in treating lower urinary tract symptoms of BPH (LUTS/BPH).Objective: To evaluate the therapeutic effect and clinical safety of tadalafil monotherapy (5 mg once daily for 12 weeks) for LUTS/BPH.Methods: A total of 13 studies (15 randomized clinical trials [RCTs]) were extracted from the following databases: PubMed, Cochrane Central Register of Controlled Trials, Embase, and Web of Science for the period up to July 2021. The quality of the included RCTs was evaluated independently by two authors, who, respectively, extracted data according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses principles. Conflicts were settled by a discussion with two-third of senior authors. All data analyses were conducted by the Review Manager, version 5.4.Results: Regarding efficacy, 12-week trials indicated that 5 mg once daily tadalafil showed a significantly lower and, consequently, better total International Prostate Symptom Score (IPSS) than the placebo did (mean difference [MD]: −1.97, 95% CI: −2.24 to −1.70; P &lt; 0.00001). In addition, significant differences were found between the tadalafil regimen and the placebo in the IPSS voiding subscore (MD: −1.30, 95% CI: −1.48 to −1.11; P &lt; 0.00001), the IPSS storage subscore (MD: −0.70, 95% CI: −0.82 to −0.58; P &lt; 0.00001), the IPSS quality of life (MD: −0.29, 95% CI: −0.35 to −0.22; P &lt; 0.00001), and BPH impact index (MD: −0.58, 95% CI: −0.76 to −0.40; P &lt; 0.00001). The safety analysis did not show a significant difference in serious adverse events between the two groups (risk ratio: 1.27, 95% CI: 0.80–2.01; P = 0.31), although the adverse events occurred at a higher incidence in the tadalafil group than in the placebo.Conclusions: This study demonstrates that once daily 5 mg tadalafil is a potentially effective and safe treatment choice with excellent tolerability for patients with LUTS/BPH.Systematic Review Registration: Identifier (CRD42021228840).

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