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1.
Urol Int ; 104(11-12): 853-858, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32894859

RESUMO

PURPOSE: To investigate the effectiveness of benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS), which occur as a natural result of aging and androgen exposure, in predicting disease prognosis in male patients diagnosed with COVID-19. METHODS: The study was planned prospectively. The study included 63 male patients over 40 years of age diagnosed with COVID-19. The patients were diagnosed with COVID-19 based on the results of reverse transcription polymerase chain reaction tests of oropharyngeal and nasopharyngeal swabs obtained as per the World Health Organization guidelines. The presence of LUTS was assessed by the International Prostate Symptom Score (I-PSS), a subjective assessment, and the I-PSS was filled for the patients included in the study. The patients were divided into three groups based on their scores in the I-PSS survey: group 1: mild (0-7), group 2: moderate (8-19), and group 3: severe (20-35). The data of all three groups were statistically analyzed. RESULTS: In the assessment performed between the groups, it was identified that for patients in group 3, the length of hospital stay was longer, intensive care requirement was more frequent, and their mortality rates were numerically higher. In the evaluation made regarding the time to intensive care admittance, this was identified to be the shortest in group 3. CONCLUSION: As a result of our study, we think that in patients with COVID-19, BPH-related LUTS can guide clinicians in predicting prognosis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Sintomas do Trato Urinário Inferior/epidemiologia , Pneumonia Viral/epidemiologia , Hiperplasia Prostática/epidemiologia , Qualidade de Vida , Adulto , Comorbidade , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Prognóstico , Estudos Prospectivos
2.
Urologe A ; 59(10): 1195-1203, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32880664

RESUMO

Multimorbid older men are increasingly more common in daily practice and present a challenge because they are often affected by lower urinary tract symptoms (LUTS) and age-associated benign prostatic hyperplasia (BPH). In order to identify possible risks in diagnostics, therapy and counselling at an early stage, screening for functional deficits or risk factors with standardized procedures is helpful. An initial screening with subsequent assessment of everyday skills using the Barthel Index, Timed up & Go Test, and a cognitive test are recommended. If frailty syndrome is detected, it should be taken into account during the pre-, peri-, and postoperative management, as it may indicate increased morbidity and mortality. Noninvasive methods for reducing the prostate volume without anesthesia can be a therapy option in older multimorbid patients, and with individual planning and consideration of risk factors, up to 70% of individuals become symptom-free. However, there is currently no gold standard for this vulnerable patient group. Number of medications and concomitant diseases and higher need for help are per se risk factors for unsatisfactory results after transurethral resection of the prostate (TURP) or laser vaporization. With drug therapy, concomitant medications and their interactions, especially in the cytochrome system, an existing multimorbidity and adherence to therapy must be taken into account. Combination therapies may complement each other and may bridge the time until surgery. Minimally invasive methods that can be performed without general anesthesia are suitable for geriatric patients, especially those with recurrent retention. Studies with the Rezüm® system (NxThera Inc., Maple Grove, MN, USA) and UroLift® (NeoTract Inc., Pleasanton, CA, USA) show that about 70% of patients can be relieved from the permanent catheter.


Assuntos
Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Idoso , Idoso Fragilizado , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/terapia , Resultado do Tratamento
4.
Artigo em Inglês | MEDLINE | ID: mdl-32722374

RESUMO

(1) Background: Patients with benign prostatic hyperplasia (BPH) were questioned about quality of life and sleep. Most BPH patients were treated with alpha-1 adrenergic receptor antagonists, which could improve cerebral blood flow for 1-2 months. Patients with ischemic stroke (IS) could experience cerebral autoregulation impairment for six months. The relationship between BPH and recurrent IS remains unclear. The aim of this study was to determine the risk of one-year recurrent IS conferred by BPH. (2) Methods: We used data from the Taiwanese National Health Insurance Database to identify newly diagnosed IS cases entered from 1 January 2008 to 31 December 2008. Patients were followed until the recurrent IS event or 365 days after the first hospitalization. The risk factors associated with one-year recurrent IS were assessed using Cox proportional hazards regression. (3) Results: Patients with BPH had a higher risk of recurrent IS (12.11% versus 8.15%) (adjusted hazard ratio (HR): 1.352; 95% confidence interval (CI): 1.028-1.78, p = 0.031). Other risk factors included hyperlipidemia (adjusted HR: 1.338; 95% CI: 1.022-1.751, p = 0.034), coronary artery disease (adjusted HR: 1.487; 95% CI: 1.128-1.961, p = 0.005), chronic obstructive pulmonary disease (adjusted HR: 1.499; 95% CI: 1.075-2.091, p = 0.017), and chronic kidney disease (adjusted HR: 1.523; 95% CI: 1.033-2.244, p = 0.033). (4) Conclusion: Patients with BPH who had these risk factors had an increased risk of one-year recurrent IS. The modification of risk factors may prevent recurrent IS.


Assuntos
Isquemia Encefálica/epidemiologia , Hiperplasia Prostática/complicações , Qualidade de Vida/psicologia , Acidente Vascular Cerebral/epidemiologia , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Hiperplasia Prostática/tratamento farmacológico , Hiperplasia Prostática/epidemiologia , Receptores Adrenérgicos alfa 1 , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/psicologia
5.
PLoS One ; 15(4): e0232091, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324838

RESUMO

INTRODUCTION: Up-to-date statistics on prostate cancer incidence and causative risk factors are essential for the primary prevention of this disease. However, the incidence of Prostate cancer (ICD-10 code C61) (PCa), or cancers in general, are poorly documented in Eritrea. This study analyses the data available to produce an estimate of the incidence of PCa in Eritrea. METHODS: We conducted a retrospective study by identifying all incident cases of PCa captured between 2011-2018 in the National Health Laboratory pathology database (Polytech 8.37.C); Urology departments of Orotta Referral Hospital and Sembel Hospital. Crude incidence rates (CIRs), age-adjusted rates per 100,000 person years and associated trends were subsequently calculated. Joinpoint Regression Program, V.4.5.0.1 was employed in these analyses. RESULTS: A total of 1721 cases were reported, of which 1593 (92.5%) were benign prostatic hypertrophy cases and 128 (7.5%) were PCa cases. The mean (±SD) age of the patients with PCa was 73.49 (± 8.9), confidence interval (CI) (54-98) and the minimum and maximum ages were 54 and 98, respectively. The median age interquartile ranges (IQR) was 73 (13) years. The highest and lowest PCa incidence rates were in 2017 (4.51 per 100 000) and 2014 (2.69 per 100 000), respectively. The age standardised rates (ASIR) (World) over the study period (2011-2018) was 30.26 per 100 000. The annualized ASIR values over the study period was 3.78 per 100 000. The associated average annual percentage change (APC) (CI) over the study period was 5.4 (-1.4-12.7), P-value = 0.100, showing a static trend over the study period. CONCLUSION: This study suggests that previous reports have under-estimated the incidence of PCa in Eritrea. The study provides ample evidence on the need for research targeted at uncovering the true burden of PCa in Eritrea. Potential solutions will require the establishment of high-quality population-based cancer registries (PBCRs) and long-term commitment to improvements in research, training, screening, diagnosis, and the overall management of PCa in the country.


Assuntos
Hiperplasia Prostática/epidemiologia , Neoplasias da Próstata/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Eritreia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Análise de Regressão , Estudos Retrospectivos
6.
Prostate ; 80(7): 570-576, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32196725

RESUMO

BACKGROUND: We evaluated the optimal high-density lipoprotein cholesterol level for benign prostatic hyperplasia (BPH) prevention in men not taking statin medication using a large historical cohort. METHODS: We initially selected 130 454 men who underwent health checkups in 2009 from the National Health Information Database of the National Health Insurance Service. After excluding 36 854 men with BPH in 2009, and 45 061 men for statin use, 48 539 men were ultimately included in the analysis. A Kaplan-Meier analysis and multivariable Cox regression analysis was performed to assess the optimal high-density lipoprotein cholesterol level for preventing BPH. RESULTS: High-density lipoprotein cholesterol levels were less than 40 mg/dL in 7431 (15.3%) men, 40 to 49 in 15 861 (32.7%), 50 to 59 in 15 328 (27.5%), and greater than or equal to 60 in 11 919 (24.6%). The overall cumulative incidence of BPH was 4.4%, 8.7%, 13.0%, and 17.8% at the 1-, 2-, 3-, and 4-year follow-up periods, respectively. In multivariable analysis, high-density lipoprotein greater than or equal to 60 mg/dL were significantly associated with a decreased incidence of BPH, as were age, residence, income, body mass index, diabetes, hypertension, triglyceride, and increased annual clinic visits, especially in men in their 40s. CONCLUSION: Elevated serum high-density lipoprotein cholesterol levels were negatively associated with BPH incidence. In addition, maintaining high-density lipoprotein greater than or equal to 60 mg/dL was associated with a decreased BPH incidence compared with high-density lipoprotein less than 40 mg/dL, especially in men in their 40s.


Assuntos
HDL-Colesterol/sangue , Hiperplasia Prostática/sangue , Hiperplasia Prostática/prevenção & controle , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Bases de Dados Factuais , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Hiperplasia Prostática/epidemiologia , República da Coreia/epidemiologia
7.
Clin Lab ; 66(1)2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32013341

RESUMO

BACKGROUND: This study was performed to explore the total prostate-specific antigen (tPSA) concentration, free PSA (fPSA) concentration, free-to-total PSA ratio (% fPSA), tPSA density (tPSAD), and neutrophil-to-lymphocyte ratio (NLR) in blood in patients with concurrent benign prostatic hyperplasia (BPH) and histologic prostatitis, and to provide new ideas for the diagnosis of prostatitis. METHODS: Patients who underwent transurethral bipolar plasmakinetic prostatectomy from June 2017 to June 2018 were retrospectively divided into two groups according to the degree of pathological inflammation of the resected prostate tissue: group A (BPH with histologic acute and chronic inflammation), group B (BPH with histologic chronic inflammation). The preoperative PSA-related indexes and NLR in blood were respectively compared between two groups. RESULTS: Groups A and B comprised 59 and 41 cases, respectively. The values of tPSA, tPSAD, and NLR were all significantly higher in group A than B, and the value of % fPSA was significantly lower in group A than B (p < 0.05). There was no significant difference for the value of fPSA between the two groups (p > 0.05). CONCLUSIONS: Histologic acute prostatitis can cause changes of PSA-related indexes and NLR in blood, which has important clinical significance in diagnosis of prostatitis.


Assuntos
Linfócitos/citologia , Neutrófilos/citologia , Antígeno Prostático Específico/sangue , Hiperplasia Prostática , Prostatite , Idoso , Idoso de 80 Anos ou mais , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Próstata/patologia , Hiperplasia Prostática/sangue , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/patologia , Prostatite/sangue , Prostatite/epidemiologia , Prostatite/patologia , Estudos Retrospectivos
8.
Clin Lab ; 66(1)2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32013356

RESUMO

BACKGROUND: Increased evidence suggested the important role of microRNAs (miRNAs) in the tumorigenesis of prostate cancer (PCa). The aberrant expression of miRNA (miR)-374b-5p has been observed in various types of cancers. The purpose of the current study was to evaluate the relationship between miR-374b-5p expression levels and PCa and to assess the feasibility of using peripheral blood miR-374b-5p as a potential non-invasive biomarker for PCa. METHODS: Total RNA was isolated from the whole-blood samples of 42 PCa patients whole-blood samples, 42 benign prostatic hyperplasia (BPH) patients, and 42 healthy controls (HC). The expression of miR-374b-5p was assessed by reverse transcription quantitative polymerase chain reaction. Normalized data were subjected to the receiver operating characteristic (ROC) and Kaplan-Meier analysis. RESULTS: The expression of peripheral blood miR-374b-5p was significantly higher in PCa patients than in HC individuals and patients with BPH (p < 0.001). Upregulation of miR-374b-5p was observed to be related to certain parameters, including Gleason score > 7 (p < 0.001), and PSA > 20 ng/mL (p < 0.01). To further evaluate the role of miR-374b-5p in patients with PCa, ROC analysis was carried out. Our data showed that peripheral blood miR-374b-5p could screen PCa patients from HC individuals (area under the curve (AUC), 0.851; 95% CI, 0.766 - 0.936; p < 0.001) and patients with BPH (AUC, 0.831; 95% CI, 0.742 - 0.920; p < 0.001). CONCLUSIONS: Increased miR-374b-5p expression in peripheral blood may serve as a potential biomarker to distinguish PCa patients from healthy controls and BPH patients.


Assuntos
MicroRNAs/sangue , Neoplasias da Próstata/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Valor Preditivo dos Testes , Hiperplasia Prostática/sangue , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/epidemiologia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/epidemiologia
9.
Arch Ital Urol Androl ; 91(4): 245-250, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937085

RESUMO

OBJECTIVE: Overweight and low physical activity (PA) increase the risk of prostatic enlargement and erectile dysfunction (ED). Less clear is the role of these factors at young age on the lifelong risk. MATERIALS AND METHODS: During June 2018 the Italian Society of Urologists organized the month of Male Urologic Prevention "#Controllati". Men aged 18 years or more were invited to attend urologic centers for a visit and counselling about urologic/ andrologic conditions. Each participating man underwent a physical examination and was asked about urologic symptoms, sexual activity and possible related problems. RESULTS: We analyzed data from 2786 men, aged 55.1 years (SD 10.9, range 19-97). A total of 710 (25.5%) subjects had a diagnosis of prostatic enlargement and 632 (22.7%) of DE. Overweight/obese men were at increased risk of prostatic enlargement and ED with corresponding odds ratio (0R) in comparison with normal or underweight men, being respectively 1.18 (95% Confidence Interval (CI) 1.00-1.44) and 1.69 (95% CI 1.39-2.05). The OR of prostatic enlargement in comparison with men reporting at age 25 a BMI < 25.0 was 1.22 (95% CI 1.01-1.51) for men with a BMI at 25 years of age ≥ 25; the corresponding OR value for ED was 1.17 (0.92- 1.48). Considering total PA at diagnosis, the OR of prostatic enlargement in comparison with no or low PA, was 0.69 (95%CI 0.55-0.86) for men reporting moderate PA and 0.75 (95%CI 0.58-0.98) for those reporting intense PA. When we considered PA at 25 years of age, the OR of subsequent diagnosis of prostatic enlargement, in comparison with men reporting no/low PA at 25 years of age was 0.81 (95%CI 0.63-1.04) for men reporting moderate PA and 0.70 (95%CI 0.52-0.99) for those reporting intense PA. CONCLUSIONS: These findings underline the utility of encouraging healthy lifestyle habits among young men in order to reduce the subsequent risk of prostatic enlargement and ED.


Assuntos
Disfunção Erétil/epidemiologia , Obesidade/complicações , Sobrepeso/complicações , Hiperplasia Prostática/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Disfunção Erétil/etiologia , Exercício Físico/fisiologia , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Hiperplasia Prostática/etiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
10.
Reprod Domest Anim ; 55(3): 283-292, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31885111

RESUMO

Benign prostatic hyperplasia (BPH) is an age-dependent primarily non-inflammatory enlargement of the accessory gland in the intact dog. The aim of the present study was to control a previously raised suspicion of a breed-related higher incidence of BPH in dogs of the Rhodesian Ridgeback breed. For this, 18 Labrador Retrievers/LR and 20 Rhodesian Ridgebacks/RR were assigned to the age groups 18-24 months (n = 12), 25-48 months (n = 13) and 49-72 months (n = 13). Prostate gland status was determined by rectal palpation, B-mode ultrasound, calculation of the prostate gland volume and semen analysis regarding haemospermia and was classified according to blood plasma concentrations of canine prostate-specific arginine esterase (CPSE) (normal ≤ 60 ng/ml, increased ≥ 61 ng/ml; Pinheiro et al., 2017). Concentrations of testosterone, 5α-dihydrotestosterone and estradiol were analysed in peripheral blood serum or plasma for detecting breed-specific conditions regarding the endocrine metabolism. Prostatic volume was significantly larger in RR irrespective of the CPSE status. In RR, BPH occurred more frequently and started at an earlier age compared with the LR. Breed-related specificities in steroid metabolism in the RR were indicated by correlations of 5α-dihydrotestosterone and estradiol with age and of testosterone with prostate gland volume. Although the incidence of sonographic signs of BPH and haemospermia did not fit with normal and increased CPSE concentrations, a breed-specific higher incidence of BPH in the RR breed could be clearly verified.


Assuntos
Doenças do Cão/epidemiologia , Hiperplasia Prostática/veterinária , Animais , Hidrolases de Éster Carboxílico/sangue , Di-Hidrotestosterona/sangue , Di-Hidrotestosterona/metabolismo , Doenças do Cão/sangue , Doenças do Cão/diagnóstico , Cães , Estradiol/sangue , Estradiol/metabolismo , Hemospermia/veterinária , Masculino , Próstata/diagnóstico por imagem , Hiperplasia Prostática/sangue , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/epidemiologia , Análise do Sêmen , Especificidade da Espécie , Testosterona/sangue , Testosterona/metabolismo , Ultrassonografia/veterinária
11.
Mil Med Res ; 6(1): 34, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-31718713

RESUMO

BACKGROUND: Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide. Hence, this study aimed to investigate the association between periodontal disease and the risk of benign prostatic hyperplasia. METHODS: A total of 4930 participants were selected from an available health examination that was carried out in 2017, only males were considered for further analysis. All eligible males were divided into benign prostatic hyperplasia and normal groups, the benign prostatic hyperplasia group was then divided into prostate volume ≤ 60 g and > 60 g subgroups; all their periodontal status was extracted and then into normal (CPI score of 0), periodontal disease (CPI score between 1 and 4), and periodontitis (CPI score between 3 and 4) groups. The correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control analysis. Subgroup analysis based on prostate volume was also performed. All analyses were conducted with SAS 9.4 software. RESULTS: A total of 2171 males were selected for this analysis. The presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times (OR = 1.68, 95% CI: 1.26-2.24), and individuals with periodontitis showed a higher risk (OR = 4.18, 95% CI: 2.75-6.35). In addition, among matched cases and controls, this association remained robust (periodontal disease: OR = 1.85, 95% CI: 1.30-2.64; periodontitis: OR = 4.83, 95% CI: 2.57-9.07). Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well (for prostate volume ≤ 60 g: OR = 1.64, 95% CI: 1.22-2.20; for volume > 60 g: OR = 2.17, 95% CI: 1.04-4.53), and there was a higher risk in the group with a prostate volume greater than 60 g. CONCLUSION: Periodontal disease is significantly and positively associated with an increased risk of benign prostatic hyperplasia. Further validation studies should be performed to explore the relationship between periodontal treatment and benign prostate hyperplasia.


Assuntos
Doenças Periodontais/epidemiologia , Próstata/patologia , Hiperplasia Prostática/epidemiologia , Adulto , Idoso , Estudos de Casos e Controles , China/epidemiologia , Estudos Transversais , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada
12.
Niger J Clin Pract ; 22(11): 1600-1605, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31719283

RESUMO

Background: Findings from studies on obesity and benign prostatic enlargement (BPE) have been inconsistent. With a previous study done in our facility showing no correlation between anthropometric indices of obesity and BPE, this study aimed at reevaluating the association between obesity and BPE using sonographic indices of abdominal/central obesity. Materials and Methods: Ninety consenting subjects with clinically confirmed BPE had their height and weight [(to calculate body mass index (BMI)] as well as waist and hip circumference [to calculate waist-hip ratio (WHR)] done. The subcutaneous, preperitoneal, and visceral fat thicknesses (SFT, PFT, and VFT, respectively) of these subjects and their prostate volumes were measured on transabdominal Ultrasonography (USS). Transrectal USS was also done to measure the total prostate and transitional zone volumes. Data were analyzed using SPSS version 22. Results: WHR and waist circumference correlated positively with SFT (r = 0.325, P = 0.002 and r = 0.370, P = 0.000, respectively) and PFT (r = 0.209, P = 0.048 and r = 0.313, P = 0.003, respectively). While BMI correlated positively (r = 0.23, P = 0.029) with transrectal transitional zone volume, all three sonographic indices of adiposity correlated negatively (SFT: r = -0.223, P = 0.035; PFT: r = -0.321, P = 0.002; VFT: r = -0.242, P = 0.021) with transrectal total prostate volume. In addition, PFT correlated negatively with transabdominal prostate volume (r = -0.222, P = 0.037) and transrectal transitional zone volume (r = -0.211, P = 0.046). Conclusion: The relationship of BMI with transrectal transitional zone volume was a direct one, while that of SFT, PFT, and VFT with transrectal total prostate volume as well as PFT with transabdominal prostate volume and transrectal transitional zone volume was an inverse one.


Assuntos
Gordura Intra-Abdominal , Obesidade/complicações , Hiperplasia Prostática/diagnóstico por imagem , Gordura Subcutânea Abdominal , Ultrassonografia/métodos , Adiposidade , Adulto , Antropometria , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Obesidade/epidemiologia , Obesidade Abdominal , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/etiologia , Fatores de Risco , Centros de Atenção Terciária , Circunferência da Cintura , Relação Cintura-Quadril
13.
Medicine (Baltimore) ; 98(42): e17635, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626149

RESUMO

This study aimed to investigate the metabolic syndrome-related risk factors for the development of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) in healthy men.A total of 4880 healthy men who underwent transrectal ultrasonography at our hospital during routine health examinations were included in this study. Those who had undergone a prior biopsy or surgery for prostate disease, were suspected of having urinary tract infection, or were taking BPH/LUTS or metabolic syndrome medications were excluded. BPH/LUTS was defined as an International Prostate Symptom Score (IPSS) of ≥8 and a prostate volume (PV) of ≥30 cm.The subjects had a mean age of 54.1 years, PV of 29.2 cm, prostate-specific antigen (PSA) level of 1.20 ng/mL, and IPSS of 9.2. The annual PV growth rate was 0.48 cm/year. Age, body mass index (BMI), PSA, basal metabolic rate, apolipoprotein A-1, fasting blood glucose, high-density lipoprotein (HDL) cholesterol levels were significant predictive factors for PV. Age, PSA, apolipoprotein B, fasting blood glucose, cholesterol, HDL, and low-density lipoprotein (LDL) levels were predictors of BPH/LUTS at the initial health examination. A decreased fat mass and LDL level were a significant risk factor for the development of BPH/LUTS within 5 years in men without a BPH/LUTS diagnosis at the initial examination.Metabolic syndrome-related variables were strongly associated with BPH/LUTS and by decreasing fat mass and LDL levels, development of BPH/LUTS could be prevented within 5 years in healthy Korean men.


Assuntos
LDL-Colesterol/sangue , Sintomas do Trato Urinário Inferior/etiologia , Síndrome Metabólica/complicações , Hiperplasia Prostática/etiologia , Medição de Risco/métodos , Idoso , Biomarcadores/sangue , Biópsia , Glicemia/metabolismo , Índice de Massa Corporal , Progressão da Doença , Endossonografia , Seguimentos , Humanos , Incidência , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prognóstico , Próstata/diagnóstico por imagem , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/epidemiologia , Reto , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
14.
Transplant Proc ; 51(9): 2921-2926, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31627917

RESUMO

BACKGROUND: With the aging of recipients of renal transplantation (RT) one of the emerging issues is the incidence of low urinary tract symptoms (LUTS), which may have negative consequences on the graft survival and function. The aim of our study was to assess the influence of LUTS and the treatment with transurethral resection of the prostate (TURP) on the outcome of RT. MATERIALS AND METHODS: We collected data from men over 55 who underwent RT at our center from January 2007 to December 2016. We analyzed the incidence of LUTS; the rate of treatment with TURP; the eGFR (estimated glomerular filtration rate) at 6 months and 1, 3, and 5 years from transplantation; and graft survival. RESULTS: Fifty-five patients out of 268 experienced LUTS, and 19 of them had a bladder outlet obstruction (BOO). Patients experiencing BOO had a significantly higher hazard ratio (HR) of graft failure (HR 5.7, CI 1.56-21.4) compared to the other recipients. Of the 18 patients treated with TURP, 10 received the procedure within 6 months from the LUTS onset. They had a significantly absolute eGFR improvement at 6 months from the intervention (+14.25 mL/min ± 8.10) compared to the patients treated later (-8.4 mL/min ± 14.43). DISCUSSION: We showed the negative effects of LUTS on kidney graft function and survival. Although TURP is the standard therapy for such an issue, the best timing for it still has to be defined. Our experience supports the need for an early treatment of the LUTS for promoting the outcome of the RT.


Assuntos
Transplante de Rim , Hiperplasia Prostática/complicações , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata , Idoso , Sobrevivência de Enxerto , Humanos , Transplante de Rim/efeitos adversos , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/epidemiologia , Obstrução do Colo da Bexiga Urinária/epidemiologia , Obstrução do Colo da Bexiga Urinária/etiologia , Obstrução do Colo da Bexiga Urinária/cirurgia
15.
Clin Nutr ESPEN ; 33: 5-11, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31451276

RESUMO

BACKGROUND: and aims: Benign Prostatic hyperplasia (BPH) is an important public health problem. Roughly half of all men will suffer from BPH related symptoms later in life. The prostate gland, a hormone dependent part of the male reproductive system, is susceptible to internal and external disruptions of regulatory systems. We attempt in this paper to collect available evidence on influence of lifestyle modifications, and naturally occurring substances, plants, micronutrients and supplements on BPH symptoms. METHODS: Systematic review was performed within the MEDLINE database and Cochrane Library Central Search using a combination of Medical Subject Headings (MeSH) and keywords. RESULTS: Moderate exercise and the type and amount of protein intake have a considerable influence on BPH symptoms. The intake of zinc and vitamin D also positively influence BPH symptoms, and so do certain supplements, such as saw palmetto, cemilton and pygeum extracts. CONCLUSIONS: Lifestyle changes, diet modification and certain nutritional supplements can favorably influence BPH symptoms.


Assuntos
Dieta , Estado Nutricional , Hiperplasia Prostática/dietoterapia , Hiperplasia Prostática/etiologia , Hiperplasia Prostática/fisiopatologia , Bases de Dados Factuais , Suplementos Nutricionais , Humanos , Inflamação/dietoterapia , Estilo de Vida , Masculino , Micronutrientes , Extratos Vegetais , Hiperplasia Prostática/epidemiologia , Vitamina D , Zinco
16.
Eur Urol ; 76(5): 667-675, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31281024

RESUMO

BACKGROUND: Aquablation has emerged as a novel ablative therapy combining image guidance and robotics for targeted waterjet adenoma resection. OBJECTIVE: To describe a standardised technique of aquablation in the treatment of benign prostatic obstruction (BPO), and to report the perioperative and 1-yr functional outcomes obtained by multiple surgeons with no previous experience of the technique. DESIGN, SETTING, AND PARTICIPANTS: Between September 2017 and January 2018, patients referred to three different urological centres for BPO surgical management were prospectively enrolled to undergo an aquablation procedure. SURGICAL PROCEDURE: Aquablation was performed using the Aquabeam system (Procept BioRobotics, Redwood Shores, CA, USA) that combines transrectal prostatic image guidance and robotics bespoke tissue resection with a high-pressure saline jet. The surgeon defines the area of treatment, and the resection is executed automatically. MEASUREMENTS: The primary endpoint was the change in total International Prostate Symptom Score (IPSS) score at 6 and 12mo. Functional outcomes were assessed at 1, 3, 6, and 12mo with IPSS, International Index of Erectile Function (IIEF)-15, Sexual Health Inventory for Men, and Male Sexual Health Questionnaire questionnaires and uroflowmetry. RESULTS AND LIMITATIONS: Thirty patients were enrolled in the study. The median operative time and resection time were 30.5 (24-35) and 4 (3.1-4.9)min, respectively. The median catheterisation time was 43 (23-49)h. The median hospitalisation stay was 2 (2-4)d. The IPSS score improved to 3 (1-6) at the 6mo, with a mean change of 15.6 points (95% confidence interval 13-18.2). IPSS improvements persisted at month 12. The maximum urinary flow rate improved to 20.4 (17-26)ml/s at 12mo. The 6-mo rates of Clavien-Dindo grade 2 and 3 events were 13.3%. There were no reports of incontinence or de novo erectile dysfunction. Postoperative de novo ejaculatory dysfunction was observed in 26.7% of patients. CONCLUSIONS: This clinical registry confirmed that aquablation was feasible, safe, and effective, and provided immediate good functional results and similar outcomes to those of prior studies despite the lack of surgeons' previous experience with the technique. PATIENT SUMMARY: Aquablation is feasible, safe, and reproducible with promising outcomes for treating benign prostatic enlargement.


Assuntos
Técnicas de Ablação , Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Robótica/métodos , Técnicas de Ablação/efeitos adversos , Técnicas de Ablação/instrumentação , Técnicas de Ablação/métodos , Idoso , França/epidemiologia , Humanos , Tempo de Internação/estatística & dados numéricos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/fisiopatologia , Hiperplasia Prostática/cirurgia , Recuperação de Função Fisiológica , Sistema de Registros/estatística & dados numéricos , Resultado do Tratamento
17.
Sci Rep ; 9(1): 8261, 2019 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-31164686

RESUMO

This study was aimed to compare serial long-term postoperative changes in quality-of-life (QoL) between photoselective-vaporization (PVP) using 120W-High-Performance-System and holmium-laser-enucleation (HoLEP) in benign-prostatic-hyperplasia (BPH) patients and to identify factors influencing the QoL improvement at the short-term, mid-term and long-term follow-up visits after surgery. We analyzed 1,193 patients with a baseline QoL-index ≥2 who underwent PVP (n = 439) or HoLEP (n = 754). Surgical outcomes were serially compared between the two groups at up to 60-months using the International-Prostatic-Symptom-Score (I-PSS), uroflowmetry, and serum PSA. We used logistic regression analysis to identify predictors of QoL improvement (a reduction in the QoL-index ≥50% compared with baseline) at the short-term (12-months), mid-term (36-months), and long term (60-months) follow-up after surgery. In both groups, the QoL-index was decreased throughout the entire follow-up period compared with that at baseline. There were no significant differences in postoperative changes from the baseline QoL-index between the two groups during the 48-month follow-up, except at 60-months. The degree of improvement in QoL at 60-months after HoLEP was greater than that after PVP. A lower baseline storage-symptom-subscore and a higher bladder-outlet-obstruction-index (BOOI) were independent factors influencing QoL improvement at the short-term. No independent factor influences QoL improvement at the mid- or long-term.


Assuntos
Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Sintomas do Trato Urinário Inferior/cirurgia , Hiperplasia Prostática/cirurgia , Idoso , Humanos , Terapia a Laser/efeitos adversos , Lasers de Estado Sólido/efeitos adversos , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/patologia , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Próstata/patologia , Próstata/cirurgia , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/patologia , Qualidade de Vida , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento
18.
Int J Clin Pract ; 73(9): 1-15, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31120179

RESUMO

OBJECTIVES: Prior studies of erectile dysfunction (ED) tend to narrowly focus on relationships with specific comorbidities, rather than evaluating a more comprehensive array of risk factors and assessing naturalistic patterns among them. This study identifies natural clusters of male characteristics from a general population sample per country, quantifies ED dynamics in these profiles and compares profiles across the US, Italy, Brazil and China samples. METHODS: National Health and Wellness Survey 2015 and 2016 patient-reported data on men aged 40-70 years (USA n = 15,652; Italy n = 2,521; Brazil n = 2,822; China n = 5,553) were analysed. Hierarchical agglomerative clustering identified clusters where predictors included demographics, health characteristics/behaviours, ED risk factors and provider visits in the past 6 months. Multinomial logistic regression assessed the independent utility of variables in predicting cluster membership, compared with the healthiest control cluster per country. RESULTS: Different natural clusters were found across countries, with four clusters for the USA, Italy and China and three clusters for Brazil. Age, income, employment, health behaviours and ED risk factors predicted different cluster membership across countries. In the USA, Italy and Brazil, younger clusters were predicted by ED, unhealthy behaviours and ED risk factors. Unique cluster profiles were identified in China, with ED and ED risk factors (aside from hypertension) not predicting cluster membership, while socio-demographics and health behaviours were strongly predictive. CONCLUSIONS: Natural cluster profiles revealed notable ED rates among adult males of age 40-70 in four different countries. Clusters were mainly predicted by unhealthy behaviours, ED risk factors and ED, regardless of level or presence of positive health characteristics and behaviours. This analysis identified meaningful subgroups of men with heightened ED risk factors, which can help healthcare providers to better recognise specific populations with the greatest need for intervention.


Assuntos
Disfunção Erétil/epidemiologia , Comportamentos Relacionados com a Saúde , Comportamentos de Risco à Saúde , Adulto , Idoso , Brasil/epidemiologia , China/epidemiologia , Comorbidade , Inquéritos Epidemiológicos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia
19.
Medicine (Baltimore) ; 98(18): e15502, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045838

RESUMO

BACKGROUND: The aim of this meta-analysis was to understand the relationship between statin with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). METHODS: A systematic literature search was conducted using PubMed, Embase, Cochrane Library, Chinese Medical and Biological Literature Database, China HowNet, Vip, and Wanfang. We calculated pooled odds ratios (OR) and 95% CI and standardized mean difference (SMD). Using Stata 12.0 and Review 5.3 for meta-analysis. RESULTS: This meta-analysis included 11 articles and 49,128 participants. Results show statins could not reduce the incidence of BPH [OR = 0.77 (0.57, 1.03, P = .08]. For patients over 60 years old, statins could reduce the incidence of BPH [OR = 0.35 (0.22, 0.55), P < .0001]. Statins can slow down the progression of LUTS in BPH [SMD = -0.32 (-0.54, -0.10), P = .004], but there is no significant correlation between them in patients taking drugs for less than 1 year. CONCLUSION: Statins have no significant effect on the incidence of BPH, but statins can reduce the risk of BPH for patients over 60 years old. For patients with hyperlipidemia, the duration of medication is more than 1 year, which can slow down the progression of LUTS. However, more high-quality and large sample size studies are needed to further improve and verify.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Hiperlipidemias/tratamento farmacológico , Sintomas do Trato Urinário Inferior/induzido quimicamente , Hiperplasia Prostática/induzido quimicamente , Idoso , China/epidemiologia , Humanos , Incidência , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/epidemiologia , Fatores de Risco , Fatores de Tempo
20.
Sci Rep ; 9(1): 6077, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-30988330

RESUMO

Benign prostatic hyperplasia (BPH) results in a significant public health burden due to the morbidity caused by the disease and many of the available remedies. As much as 70% of men over 70 will develop BPH. Few studies have been conducted to discover the genetic determinants of BPH risk. Understanding the biological basis for this condition may provide necessary insight for development of novel pharmaceutical therapies or risk prediction. We have evaluated SNP-based heritability of BPH in two cohorts and conducted a genome-wide association study (GWAS) of BPH risk using 2,656 cases and 7,763 controls identified from the Electronic Medical Records and Genomics (eMERGE) network. SNP-based heritability estimates suggest that roughly 60% of the phenotypic variation in BPH is accounted for by genetic factors. We used logistic regression to model BPH risk as a function of principal components of ancestry, age, and imputed genotype data, with meta-analysis performed using METAL. The top result was on chromosome 22 in SYN3 at rs2710383 (p-value = 4.6 × 10-7; Odds Ratio = 0.69, 95% confidence interval = 0.55-0.83). Other suggestive signals were near genes GLGC, UNCA13, SORCS1 and between BTBD3 and SPTLC3. We also evaluated genetically-predicted gene expression in prostate tissue. The most significant result was with increasing predicted expression of ETV4 (chr17; p-value = 0.0015). Overexpression of this gene has been associated with poor prognosis in prostate cancer. In conclusion, although there were no genome-wide significant variants identified for BPH susceptibility, we present evidence supporting the heritability of this phenotype, have identified suggestive signals, and evaluated the association between BPH and genetically-predicted gene expression in prostate.


Assuntos
Predisposição Genética para Doença , Padrões de Herança , Hiperplasia Prostática/genética , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Estudos de Casos e Controles , Registros Eletrônicos de Saúde/estatística & dados numéricos , Perfilação da Expressão Gênica , Estudo de Associação Genômica Ampla , Técnicas de Genotipagem , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Próstata/patologia , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/patologia
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