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1.
Zhonghua Yi Xue Za Zhi ; 99(31): 2435-2439, 2019 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-31434423

RESUMO

Objective: To compare the efficacy of prostatic artery embolization (PAE) in the treatment of patients with benign prostatic hyperplasia (BPH) with different prostatic volume (PV). Methods: In this single-center, retrospective study, 137 patients, mean age (70±11) years, range 50-89 years, undergoing PAE for BPH between January 2015 and May 2017 in Chinese PLA General Hospital were involved and divided into three groups according to the PV (group A, >80 ml; group B, 40-80 ml; group C, <40 ml). The changes of international prostate symptoms (IPSS) score, quality of life (QoL) score, and maximum urinary flow rate (Q(max)) were compared among the three groups at 1, 6, and 12 months post-PAE. Correlation between the proportion of prostate ischemia at 1 month post-PAE and the proportion of PV reduction at 12 month post-PAE were analyzed, also the correlation between both of them with IPSS and QoL score were analyzed, respectively. Results: Mean baseline prostate volumes were 110 ml in group A (n=62), 67 ml in group B (n=47) and 33 ml in group C (n=28). At 12 months post-PAE, the outcomes of IPSS score and Q(max) in group A were better than those in group B and C (all P<0.05).The proportion of prostate ischemia at 1 month post-PAE and proportion of PV reduction at 12 month post-PAE in group A, B, and C were 61.4%, 49.3%, 38.0%, and 47.3%, 29.3%, 24.6%, respectively. The proportion of prostate ischemia in group A was larger than that in group B and C (P=0.049, 0.004), also the proportion of PV reduction in group A was greater than that in group B and C (P<0.01). The proportion of prostate ischemia at 1 month post-PAE in all three groups were positively correlated with the proportion of PV reduction at 12 month post-PAE (r=0.699, P=0.024; r=0.719, P=0.019; r=0.821, P=0.004), and there were positive correlations between both of them and the improvement of IPSS score at 12 month post-PAE (0.5

Assuntos
Embolização Terapêutica , Hiperplasia Prostática , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
2.
Anticancer Res ; 39(8): 4171-4177, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366502

RESUMO

BACKGROUND/AIM: Identification of prostatic stem cells in primary prostate tissue sections, organ cultures of prostate and cell lines requires a range of techniques that allows characterization of stem cells for their potential use in the treatment of patients. Isolated cells usually round-up and develop changes in shape, size and cellular characteristics. The aim of this study was to provide a range of methods for identifying prostatic stem cells and characterizing them with regard to ultrastructure, nuclear morphology, cytoplasmic organelles, and/or expression stem cell marker CD133. MATERIALS AND METHODS: Prostate biopsy and prostatectomy specimens were used for studying prostatic stem cells and their known marker CD133 in tissue sections by light and/or electron microscopy. Inverted capsule embedding was used to study archival metastatic prostate in pelvic nodes and Du145 cell line in a monolayer culture. RESULTS: Staining for CD133 positively identified stem cells that were found in benign prostatic hyperplasia, benign prostate, and prostate cancer cells. Paraffin embedded sections showed a single type of stem cells, whereas methylene blue-stained Epon sections showed both light and dark stem cells. Electron microscopy showed that both basal and stem cells were closely associated with the basement membrane (basal lamina). Stem cells had smooth plasma and nuclear membranes, a prominent nucleolus, small mitochondria, and few ribosomes. Du145 cells were separated by intercellular spaces in monolayer culture. CONCLUSION: The inverted capsule embedding method allowed the study of metastasized prostate cancer in pelvic lymph nodes. Our approach enabled the assessment of stem cells in tissue sections by light and electron microscopy.


Assuntos
Antígeno AC133/genética , Membrana Basal/ultraestrutura , Hiperplasia Prostática/genética , Neoplasias da Próstata/genética , Membrana Basal/patologia , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Masculino , Microscopia Eletrônica , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Células-Tronco Neoplásicas/ultraestrutura , Próstata/metabolismo , Próstata/patologia , Próstata/ultraestrutura , Hiperplasia Prostática/metabolismo , Hiperplasia Prostática/patologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/ultraestrutura
3.
Zhongguo Zhong Yao Za Zhi ; 44(9): 1953-1959, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31342726

RESUMO

In this study,mouse models of benign prostatic hyperplasia induced by subcutaneous injection of testosterone propionate was used to investigate the therapeutic effect and mechanism of Urtica hyperborean( UW) extracts on prostate hyperplasia in mice. The effects of UW extracts on prostate index,serum epidermal growth factor( EGF) and dihydrotestosterone( DHT) in model mice were observed,and the EGF and anti-apoptotic factor( Bcl-2) mRNA expression levels were detected as well as pathological changes in prostate tissue. The results showed that the ethyl acetate extraction and alcohol soluble fraction of the UW could significantly reduce the prostate index,reduce the serum DHT and EGF levels( P<0. 01),and significantly decrease the EGF and Bcl-2 mRNA expression( P<0. 01),significantly improved the morphological structure of prostate tissue. The above results confirmed that ethyl acetate extract and alcohol-soluble parts of UW have a good preventive effect on mice prostatic hyperplasia model,and its mechanism may be to reduce androgen levels by regulating polypeptide growth factors and/or inhibiting cell hyperproliferation and promoting apoptosis. This study laid the foundation for the further research on UW.


Assuntos
Medicina Tradicional Tibetana , Extratos Vegetais/farmacologia , Hiperplasia Prostática/tratamento farmacológico , Urticaceae/química , Animais , Di-Hidrotestosterona/sangue , Fator de Crescimento Epidérmico/sangue , Masculino , Camundongos , Hiperplasia Prostática/induzido quimicamente , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Propionato de Testosterona
5.
Curr Urol Rep ; 20(8): 47, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31278441

RESUMO

INTRODUCTION: In the last decade, there has been a growing interest in minimally invasive treatment for benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS). In this field, one of the options currently available is the temporary implantable nitinol device (iTIND) (Medi-Tate®; Medi-Tate Ltd., Or Akiva, Israel). PURPOSE OF THE WORK: To review the recent data available in the literature regarding the role of the first-generation (TIND) and second-generation (iTIND) devices for the management of BPH with LUTS, especially focusing on follow-up of functional outcomes. EVIDENCE ACQUISITION: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were screened for clinical trials on this topic. EVIDENCE SYNTHESIS: Literature evidences regarding implantation of TIND and iTIND for PBH with LUTS are limited. There are only three studies available, one with a medium-term follow-up. The results of these studies suggested that both the TIND and iTIND implantations are safe, effective, and well-tolerated procedures, allowing spare ejaculation in sexually active patients. CONCLUSIONS: Current evidences emphasize that the temporary implantable nitinol devices are promising alternatives to the standard minimally invasive surgical options for BPH-related LUTS. Further studies are needed to confirm the effectiveness over a long-term follow-up.


Assuntos
Sintomas do Trato Urinário Inferior/cirurgia , Hiperplasia Prostática/cirurgia , Stents , Ligas , Materiais Biocompatíveis , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Hiperplasia Prostática/complicações , Implantação de Prótese
6.
Urologiia ; (2): 59-63, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162903

RESUMO

The article presents a description of the clinical case. Surgical treatment by plasma transurethral enucleation of the prostate was performed in patients with benign prostatic hyperplasia of giant size - 530 cm3. Observation in the short term showed the absence of functional and organic complications. Comparison with the results of surgical treatment of giant prostate adenoma by classical transurethral enucleation of the prostate, obtained in our urological clinic in 2015, showed a reduction in operating time by 1 hour without a significant increase in blood loss during surgery and without operational complications. The results demonstrate the prospects of the widespread introduction of plasma methods of transurethral operations in urological practice.


Assuntos
Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Humanos , Masculino , Tamanho do Órgão , Hiperplasia Prostática/patologia , Resultado do Tratamento
7.
Urologiia ; (2): 67-72, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162905

RESUMO

Benign prostatic hyperplasia commonly is the most common cause of bladder outlet obstruction and can result in storage and micturition symptoms in men older than 40 years. Nowadays the 1-adrenoreceptor antagonists are the first-line drug for treatment of the lower urinary tract symptoms (LUTS). However, 1-adrenoreceptors are known to be present in other tissues and this fact could be a reason of potential risk of adverse events, associated with changes in peripheral vascular tone, such as orthostatic hypotension, syncopal states, dizziness, etc., especially in patients of advanced age, and those affected by cardiovascular diseases and taking essential drugs. A highly selective -adrenergic blocker silodosin is characterized by a lower rate of mentioned adverse events, comparable with placebo. Silodosin is also highly effective in treating of both types of LUTS in these patients, both as monotherapy and in combination with other drugs. A detailed analysis of clinical data confirming the high efficacy and safety of silodosin is presented in this review of the literature.


Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Indóis/uso terapêutico , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Hiperplasia Prostática/tratamento farmacológico , Agentes Urológicos/uso terapêutico , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/complicações
8.
Urologiia ; (2): 73-81, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162906

RESUMO

Prostate cancer (PCa) is the 4th most commonly diagnosed cancer in the male population and incidence of different stages is increasing every year. The efficiency of PCa treatment is strongly dependent on the its stage. Prostate Specific Antigen (PSA) is the most widely used and universal biomarker of PCa worldwide. Considering its limited predictive value, particularly in patients older than 50 with PSA level ranging from 4.5 to 10 ng/ml, there is a need to introduce new serum biomarkers of PCa. Current data on different PCa biomarkers are reviewed in the article as well as a role of angiotensin-converting enzyme (ACE) as a novel PCa biomarker.


Assuntos
Biomarcadores Tumorais/sangue , Peptidil Dipeptidase A/sangue , Hiperplasia Prostática/sangue , Neoplasias da Próstata/sangue , Humanos , Masculino , Próstata/metabolismo , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/diagnóstico
12.
Adv Exp Med Biol ; 1124: 195-215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31183828

RESUMO

Spontaneous myogenic contractions have been shown to be significantly upregulated in prostate tissue collected from men with Benign Prostatic Hyperplasia (BPH), an extremely common disorder of the ageing male. Although originally thought likely to be involved in 'housekeeping' functions, mixing prostatic secretions to prevent stagnation, these spontaneous myogenic contractions provide a novel opportunity to understand and treat BPH. This treatment potential differs from previous models, which focused exclusively on attenuating nerve-mediated neurogenic contractions. Previous studies in the rodent prostate have provided an insight into the mechanisms underlying the regulation of myogenic contractions. 'Prostatic Interstitial Cells' (PICs) within the prostate appear to generate pacemaker potentials, which arise from the summation of number of spontaneous transient depolarisations triggered by the spontaneous release of Ca2+ from internal stores and the opening of Ca2+-activated Cl- channels. Pacemaker potentials then conduct into neighbouring smooth muscle cells to generate spontaneous slow waves. These slow waves trigger the firing of 'spike-like' action potentials, Ca2+ entry and contraction, which are not attenuated by blockers of neurotransmission. However, these spontaneous prostatic contractions can be modulated by the autonomic nervous system. Here, we discuss the mechanisms underlying rodent and human prostate myogenic contractions and the actions of existing and novel pharmacotherapies for the treatment of BPH. Understanding the generation of human prostatic smooth muscle tone will confirm the mechanism of action of existing drugs, inform the identification and effectiveness of new pharmacotherapies, as well as predict patient outcomes.


Assuntos
Sinalização do Cálcio , Células Intersticiais de Cajal/fisiologia , Canais Iônicos/fisiologia , Contração Muscular , Músculo Liso/fisiologia , Animais , Cálcio/fisiologia , Humanos , Masculino , Hiperplasia Prostática
13.
Curr Urol Rep ; 20(8): 45, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31218458

RESUMO

PURPOSE OF REVIEW: To provide an economic context within which to consider treatment options for benign prostatic hyperplasia (BPH). To this end, this review provides a comparison of the costs of combination medical therapy, operative treatment, and office-based therapies for BPH from a payer perspective. RECENT FINDINGS: Analysis of Medicare charges from the authors' institution, as well as local retail costs of medication, demonstrated a wide range in costs of commonly used BPH treatments. In this study, interventions for BPH reached cost equivalence with combination medical therapy within 6 months to 8 years. A myriad of options for managing men with symptomatic BPH exist. It is prudent not only to consider surgeon preference and patient-specific factors when selecting a treatment but also to understand the economic impact different BPH therapies confer.


Assuntos
Hiperplasia Prostática/economia , Hiperplasia Prostática/terapia , Terapia Combinada/economia , Custos e Análise de Custo , Humanos , Masculino , Medicare/economia , Estados Unidos , Procedimentos Cirúrgicos Urológicos Masculinos/economia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Agentes Urológicos/economia , Agentes Urológicos/uso terapêutico
14.
Curr Urol Rep ; 20(8): 46, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31227924

RESUMO

PURPOSE OF REVIEW: To explore the potential applicability of a novel, heat-free, and robotically controlled ablative therapy for surgical management of benign prostatic enlargement. RECENT FINDINGS: With the emergence of new technology to provide personalized care and overcome the complications associated with options such as TURP, holmium laser enucleation of the prostate, GreenLight laser, or simple prostatectomy, Aquablation has been studied across a variety of prostate volumes. The functional outcome of Aquablation seems to be uncompromised by prostate volume. The sexual profile seems superior to TURP and the risk of retrograde ejaculation is lower. The robotic system provides a reproducible ablation, independent of prostate volume, without requiring extensive training for performing the procedure. The mean ablation time in the prostate as large as 150 ml does not exceed 9.1 min, and the blood transfusion rates do not seem to be higher than open prostatectomy.


Assuntos
Técnicas de Ablação/métodos , Sintomas do Trato Urinário Inferior/cirurgia , Prostatectomia/métodos , Hiperplasia Prostática/cirurgia , Humanos , Hidroterapia/métodos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/complicações
15.
Curr Urol Rep ; 20(7): 39, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31152253

RESUMO

PURPOSE OF REVIEW: Rezum is a new minimally invasive treatment for benign prostate enlargement using thermal transurethral water vapour therapy. We review the evidence with advantages and disadvantages of this technique. RECENT FINDINGS: There are five studies reported including a randomised control trial looking at the outcomes of Rezum. The outcomes show an IPSS reduction by 45-60%, QoL improvement with a score reduction of 37-59%, the Qmax improvement by 44-72% and the PVR reduction by 20-38%. Convective water vapour therapy using the Rezum system has been shown to have successful outcomes in the treatment of LUTS resulting from BPH. The reported complications are infrequent and often minor, and it seems to be relatively cost-effective.


Assuntos
Hiperplasia Prostática/terapia , Vapor , Ressecção Transuretral da Próstata/métodos , Humanos , Masculino , Hiperplasia Prostática/complicações , Resultado do Tratamento
16.
Urologiia ; (1): 5-15, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31184011

RESUMO

INTRODUCTION: In this study an attempt was made to determine some reasons that prompted the urologist to make a choice in favor of particular drug or combination from a wide variety of available drugs. The prescribing habits and subjective evaluation of efficiency and safety of the drugs for the treatment of lower urinary tract symptoms/benign prostatic hyperplasia by the urologists in Russia was analyzed. MATERIALS AND METHODS: a prospective multicenter epidemiological study "LUTS/BPH - who treats?" was carried out in 12 centers using data obtained from May 1 to July 31, 2018 with anonymous survey of 500 urologists living in 9 cities of the Russian Federation. The survey consisted of 46 questions reflecting a level of education, involvement in scientific life of urologic community, membership in various professional organizations, and subjective assessment of safety and efficiency of drugs used in Russian Federation for the treatment of urinary disorders. The obtained data was analyzed for a whole group and further in the subgroups. RESULTS: Alpha-blockers are the most commonly prescribed drugs. These drugs constitute 63.4% of all appointments, followed by the 5-a-reductase inhibitors (23.98%) and combined therapy by the both drugs (24.68%). The most frequently used alpha-blocker is tamsulosin, but professors, MD and urologists, who read special literature at a regular basis, prescribed tamsulosin and silodosin equally. In primary cases and in patients with concomitant cardiac pathology, silodosin was prescribed more commonly in comparison with other alpha-blockers. CONCLUSION: the results of the study indicate a concordance with global trends in the treatment of these patients. Our data reflect a significant influence of the level of education, work experience and involvement in scientific professional life of urologic community on the choice of a particular drug for the treatment of LUTS/BPH and prove the feasibility of further work which should be aimed at popularization of the modern medical knowledges among the urologists and organization of a process of continuous medical education.


Assuntos
Sintomas do Trato Urinário Inferior , Padrões de Prática Médica , Hiperplasia Prostática , Tomada de Decisões , Estudos Epidemiológicos , Humanos , Masculino , Estudos Prospectivos , Hiperplasia Prostática/tratamento farmacológico , Federação Russa
17.
Urologiia ; (1): 40-46, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31184016

RESUMO

INTRODUCTION: Benign prostatic hyperplasia (BPH) is the most common proliferative disease of the prostate gland in the elderly. MATERIALS AND METHODS: The results of an open, randomized comparative study of the effectiveness of Serenoa repens in the combination with Urtica dioiccus (Prostagut-forte) are presented in the article. All patients were divided into two groups, depending on the therapy. In group I (n=51) Serenoa repens in combination with Urtica dioiccus 160/120 mg twice daily for 3 months was given, while in Group II (n=51) patients were prescribed to Serenoa repens 320 mg once a day, for 3 months. RESULTS: According to the results, herbal preparations, like Serenoa repens, are effective for the medical treatment of BPH, which is confirmed by a decrease in LUTS severity, an increase in Qmax, a decrease in postvoid residual urine volume and an intensity of the inflammatory process in the prostatic tissue. However, in patients with BPH associated with chronic inflammation, it is preferable to use Serenoa repens in combination with Urtica dioiccus.


Assuntos
Fitoterapia , Extratos Vegetais , Hiperplasia Prostática , Serenoa , Idoso , Humanos , Inflamação , Masculino , Extratos Vegetais/uso terapêutico , Hiperplasia Prostática/tratamento farmacológico , Serenoa/química
18.
Urologiia ; (1): 52-55, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31184018

RESUMO

AIM: For a long time, benign prostatic hyperplasia (BPH) was considered as only cause of lower urinary tract symptoms (LUTS) in elderly men. More than 30% of patients underwent surgery by the age of 80. Unsatisfactory outcome of surgical treatment of BPH are observed in 9-27% of cases. Various irritative symptoms, which are typical for detrusor overactivity, persist especially often. Currently, anticholinergic drug therapy (m-cholinoblockers) is the main treatment for detrusor overactivity. The aim of our study was to assess the effectiveness of m-cholinoblockers for the treatment of persisted LUTS in men with BPH who had undergone transurethral resection of prostate (TURP). MATERIALS AND METHODS: The study included 60 patients with BPH who underwent TURP. All patients were divided into two groups. In Group 1, anti-inflammatory therapy for 10 days with 1-month follow-up was prescribed. In Group 2, anti-inflammatory therapy was combined with the drug Toviaz for 1 month. Evaluation of the treatment effectiveness was carried out 3-5 days, 14-15 days and 1 month after TURP, respectively and included voiding diary, IPSS score, QOL, uroflowmetry, adverse events and acute urinary retention. RESULTS: At baseline, in the Group 1 and 2, average urination frequency was 12.6 and 12.7 times per day, the number of urgency episodes was 9.2 and 9.0 times and number of nocturnal voiding episodes was 5,2 and 5.3 times, respectively. The average IPSS score was 19.8 and 19.7 points and Qmax was 6.5 and 6.7 ml/sec, respectively. By the 14th-15th day of therapy, in both groups positive changes were found. There was a significant decrease (p<0.05) in the urination frequency and nocturnal voiding episodes according to voiding diaries, an increase in Qmax and average IPSS and QOL score. The adverse events rate in group 2 was 16.7%. By the 30th day of therapy in the group 1 there were no significant changes. However, in group 2, urination frequency, number of urgency episodes, average IPSS and QOL score decreased to an average of 5.7 times a day, 0.4 times, 1.2 times, 9.3 points and 1.6 points, respectively. Average Qmax increased to 15.5 ml/sec. No adverse events were detected. CONCLUSION: According to the results of our study, the use of m-cholinoblockers, in particular Fesoterodine (Toviaz), in combination with standard therapy in patients with detrusor overactivity after TURP is reasonable and allows to effectively and safely alleviate irritative symptoms.


Assuntos
Compostos Benzidrílicos , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Agentes Urológicos , Idoso , Compostos Benzidrílicos/uso terapêutico , Humanos , Masculino , Hiperplasia Prostática/cirurgia , Resultado do Tratamento , Agentes Urológicos/uso terapêutico
19.
Urologiia ; (1): 119-124, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31184029

RESUMO

Tadalafil is a drug from the phosphodiesterase-5 inhibitors (PDE-5) group, which is used to treat erectile dysfunction (ED), lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) and ED with LUTS in patients with BPH. The efficacy and safety of tadalafil were reviewed. The focus was on cardiovascular safety of tadalafil due to frequent cardiovascular comorbidities in patients with ED. We concluded that tadalafil is well tolerated and safe in patients with cardiovascular comorbidities and, in addition, has a beneficial effect on the cardiovascular system.


Assuntos
Doenças Cardiovasculares , Sistema Cardiovascular , Disfunção Erétil , Sintomas do Trato Urinário Inferior , Tadalafila , Doenças Cardiovasculares/complicações , Sistema Cardiovascular/efeitos dos fármacos , Disfunção Erétil/complicações , Disfunção Erétil/tratamento farmacológico , Humanos , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Masculino , Inibidores da Fosfodiesterase 5/efeitos adversos , Inibidores da Fosfodiesterase 5/uso terapêutico , Hiperplasia Prostática/complicações , Tadalafila/efeitos adversos , Tadalafila/uso terapêutico , Resultado do Tratamento
20.
Curr Urol Rep ; 20(7): 40, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31168725

RESUMO

PURPOSE OF REVIEW: In this article, we review why patients may fail medical therapy for benign prostatic hyperplasia (BPH) and by doing so, gain a better understanding of the disease process and how to optimize the care of these patients. RECENT FINDINGS: A growing body of literature has attempted to better characterize the various mechanisms by which patients develop BPH as well as identify predictors of disease progression and treatment failure. BPH is a heterogenous disease process. A more personalized approach to treatment, including patient selection for medical or surgical management, would allow us to optimize patient care.


Assuntos
Resistência a Medicamentos , Hiperplasia Prostática/tratamento farmacológico , Falha de Tratamento , Inibidores de 5-alfa Redutase/uso terapêutico , Antagonistas Adrenérgicos alfa/uso terapêutico , Fatores Etários , Ensaios Clínicos como Assunto , Progressão da Doença , Quimioterapia Combinada , Humanos , Masculino , Obesidade/complicações , Inibidores da Fosfodiesterase 5/uso terapêutico , Antígeno Prostático Específico/análise , Prostatite/complicações
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