Risk Stratification for Benign Prostatic Hyperplasia

2017 ◽  
Vol 84 (3) ◽  
pp. 153-157
Author(s):  
Fabio Zattoni ◽  
Vincenzo Ficarra ◽  
Giacomo Novara
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Risk Stratification ◽  
Symptom Control ◽  
Public Health Problem ◽  
Prostatic Hyperplasia ◽  
Important Public Health Problem ◽  
Urinary Tract Symptoms ◽  
Patients At Risk

Benign prostatic hyperplasia (BPH) represents an important public health problem in ageing men due to frequently associated lower urinary tract symptoms (LUTS), which may impair quality of life. BPH is also a progressive disease, mainly characterized by a worsening of LUTS over time, and in some patients by the occurrence of serious outcomes such as acute urinary retention and need for BPH-related surgery. The management of BPH and LUTS in men should move forward its focus on symptom control only. Indeed, the goals of therapy for BPH are not only to improve bothersome LUTS but also to identify those patients at risk of unfavourable outcomes in order to optimize their management and reduce complications. Risk stratification and tailored treatment should improve the reductions in both symptoms and the long-term consequences of BPH and BPH treatments. To do this, clinicians need to know possible factors that may support the develop of PBH and possible risks due to the BPH itself.

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.

Long-Term Effects of Doxazosin, Finasteride and Combination Therapy on Quality of Life in Men with Benign Prostatic Hyperplasia

2013 ◽  
Vol 190 (1) ◽  
pp. 187-193 ◽  
Author(s):  
Chyng-Wen Fwu ◽  
Paul W. Eggers ◽  
Steven A. Kaplan ◽  
Ziya Kirkali ◽  
Jeannette Y. Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Prostatic Hyperplasia ◽  
Long Term Effects

Is Early Benign Prostatic Hyperplasia (BPH) Treatment Worthwhile?

2017 ◽  
Vol 84 (3) ◽  
pp. 142-147 ◽  
Author(s):  
Fabrizio Presicce ◽  
Cosimo De Nunzio ◽  
Andrea Tubaro
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Ad Hoc ◽  
Perioperative Complications ◽  
Evidence Synthesis ◽  
Surgical Techniques ◽  
Prostatic Hyperplasia ◽  
Treatment Result ◽  
Urinary Tract Symptoms ◽  
Patients At Risk ◽  
Risk Of Disease

Background The medical armamentaria for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) have been extensively implemented over the past decade. Nevertheless, the timeliest moment for a possible treatment has not been fully established. Evidence Acquisition A systematic literature search in January 1996 until June 2016 was performed to answer the following question: in men with LUTS due to BPH, does early treatment result in better outcome? An ad hoc Population/patient Intervention/indicator Comparator/control Outcome (PICO) was developed. The Medline, PubMed and Scopus databases were searched. Each article title and abstract were reviewed for relevance and appropriateness with regard to the topic of this review. Evidence Synthesis Overtime, the introduction of novel medications and the implementation of surgical techniques have significantly improved the treatment outcomes and markedly reduced the rate of BPH surgery. Early treatments in patients at risk of disease progression may result in better clinical outcomes than a delayed approach. However, the evidence to support early intervention remains weak and criteria to identify the patient phenotype that could best benefit from immediate treatment remain ill-defined. On the contrary, the patients who ultimately undergo surgery following prolonged pharmacological treatment present with larger prostates, older age and comorbidities. At the same time, the technological progress has partly compensated this critical scenario, and commonly, a nonpejorative trend has been recorded in perioperative complications. Conclusions The ideal moment to begin a treatment in LUTS/BPH patients is still uncertain, and surprisingly, rare good quality studies are available on this topic.

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.

Long-term dutasteride therapy in men with benign prostatic hyperplasia alters glucose and lipid profiles and increases severity of erectile dysfunction

2017 ◽  
Vol 30 (3) ◽  
Author(s):  
Abdulmaged Traish ◽  
Karim Sultan Haider ◽  
Gheorghe Doros ◽  
Ahmad Haider
Keyword(s):  
Blood Glucose ◽  
Benign Prostatic Hyperplasia ◽  
Specific Antigen ◽  
Term Treatment ◽  
Prostatic Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Long Term Treatment

AbstractBackgroundDutasteride has been successfully used in treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). However, dutasteride inhibits 5α-reductase type 1 and type 2 enzymes and may compromises glucocorticoids and androgen metabolism and alters metabolic function resulting in undesirable metabolic and sexual adverse side effects.AimThe aim of this study was to investigate the long-term adverse effects of dutasteride therapy in men with BPH on: i) blood glucose, ii) glycated hemoglobin (HbAMethodsA retrospective registry study, with a cohort of 230 men aged between 47 and 68 years (mean 57.78 ± 4.81) were treated with dutasteride (0.5 mg/day) for LUTS, secondary to BPH. A second cohort of 230 men aged between 52 and 72 years (mean 62.62 ± 4.65) were treated with tamsulosin (0.4 mg). All men were followed up for 36–42 months. At intervals of 3–6 months, and at each visit, plasma glucose, HbAResultsLong-term treatment with dutasteride therapy is associated with significant improvements in LUTS, as assessed by reduction in prostate volume, IPSS and prostate specific antigen (PSA). Long-term dutasteride therapy, however, resulted in increased blood glucose, HbAConclusionOur findings suggest that long-term dutasteride therapy produces worsening of ED, reduced T levels and increased glucose, HbA

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.

Sign in / Sign up

Export Citation Format

Share Document