145 Serum prostate antigen as a predictor of prostate volume in patients with symptomatic benign prostatic hyperplasia

2004 ◽  
Vol 3 (2) ◽  
pp. 39
Author(s):  
H.S. Chang ◽  
C.H. Park ◽  
C.I. Kim ◽  
T.G. Kwon ◽  
D.Y. Kim ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Prostate Antigen

scholarly journals Changing patients’ profile presenting for surgical management of benign prostatic hyperplasia over the past 16 years: A single-centre perspective

2015 ◽  
Vol 9 (11-12) ◽  
pp. 372 ◽  
Author(s):  
Mohamed A Elkoushy ◽  
Ahmed M Elshal ◽  
Mostafa M Elhilali
Keyword(s):  
Urinary Incontinence ◽  
Benign Prostatic Hyperplasia ◽  
Operative Time ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Complication Rates ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

<p><strong>Introduction:</strong> We assessed the change of patients’ profile presenting for symptomatic benign prostatic hyperplasia (BPH) over 16 years and its impact on surgical outcomes over this time.</p><p><strong>Methods:</strong> We reviewed a prospectively maintained database of patients treated with laser for symptomatic BPH since March 1998. Patients were divided into 3 consecutive time-based groups: Group 1 for patients who underwent surgery before April 2004; Group 2, between April 2004 and March 2009; and for Group 3 from April 2009 to August 2014. We reviewed demographic and preoperative data, including prostate volume; international prostate symptoms score (IPSS), quality of life (QoL), and peak flow rate (Qmax). We also recorded any perioperative and long-term complications.</p><p><strong>Results:</strong> A total of 1835 patients were included in our study, including 542 (29.5%) in Group 1, 614 (33.5%) in Group 2, and 679 (37%) in Group 3. Preoperative prostate volume was positively correlated with age at surgery (r = 0.62, p &lt; 0.001), total energy used (r = 0.47, p &lt; 0.001), and total operative time (r = 0.47, p &lt; 0.001). Patients in Group 3 were significantly older (75.28 ± 8.47 in Group 3 vs. 71.11 ± 8.9 in Group 2 vs. 65.3 ± 9.04 years in Group 1, p 72 years), prostate volume (&gt;80 cc), operative time (&gt;95 minutes), and preoperative PSA (&gt;6 ng/dL) were significantly associated with postoperative urinary incontinence.</p><strong>Conclusions:</strong> Patients presenting for surgery due to symptomatic BPH over the last 16 years were significantly older, more morbid, and had larger prostates and more abnormal voiding parameters. Over time, patients used prostatic medications more frequently. Despite the changes in patient profiles, perioperative safety and complication rates between groups were comparable, likely due to advancements in laser technology and techniques. Age (&gt;72 years), prostate volume (&gt;80 cc), operative time (&gt;95 minutes), and preoperative PSA (&gt;6 ng/dL) were significantly associated with reversible postoperative urinary incontinence.

Initial Canadian Experience of Prostate Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: Midterm Outcomes

2020 ◽  
pp. 084653712093993
Author(s):  
Neeral R. Patel ◽  
Dean S. Elterman ◽  
Narayanan Thulasidasan ◽  
Rachel Altman ◽  
Elizabeth Tai ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Artery Embolization ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Prostate Artery Embolization ◽  
Prostate Imaging ◽  
Canadian Experience ◽  
Post Procedure ◽  
Male Patients

Introduction: This study aimed to assess the midterm outcomes and safety of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH). Methods: A single-center, retrospective review of PAE performed for BPH was performed. Validated International Prostate Symptom Score (IPSS), quality of life (QoL) index, and International Index for Erectile Function (IIEF-5) questionnaires were completed at baseline and at least 12 months post-procedure. Prostate imaging was performed preprocedure as well as 3 months and 12 months post-procedure to assess prostate volume (PV). Uroflowmetry was also performed at baseline and 12 months post-procedure to assess urine flow rate (Qmax) and post-void residual (PVR) volume. Adverse events were graded according to Society of Interventional Radiology (SIR) guidelines. Results: Eighty male patients underwent the PAE procedure (mean age 69 years). Prostate volume decreased significantly from a mean volume 156 to 107 mL after 12 months post-procedure, commensurate with a mean reduction of 27.5% ( P < .05). Significant improvements were seen in IPSS (21.8 vs 10.5) and QoL (4.5 vs 2.0) from baseline to 12 months post-procedure ( P < .05). There was no significant change in IIEF-5 score. There was a significant reduction in PVR (202 vs 105 mL) and improvement in Qmax (5.9 vs 10.0 mL/s) between baseline and 12 months post-procedure ( P < .05). No major complications occurred; 4 minor complications occurred (SIR grade A or B). Conclusion: Prostate artery embolization achieved a clinically and statistically significant prostate volume reduction, symptom and QoL improvement, and enhanced uroflowmetry parameters in patients with BPH.

Superselective prostatic artery embolization in the treatment of large benign prostatic hyperplasia

2021 ◽  
pp. 039156032199359
Author(s):  
Alexander Izrailevich Neymark ◽  
Andrey Anatoljevich Karpenko ◽  
Boris Alexandrovich Neymark ◽  
Mikhail Alexandrovich Tachalov ◽  
Denis Dmitrievich Arzamastsev ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Urine Volume ◽  
Symptom Burden ◽  
Prostatic Hyperplasia ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Prostatic Artery

Purpose: To evaluate the use of prostatic artery embolization (PAE) as a treatment option for patients with symptomatic benign prostatic hyperplasia (BPH) with prostate volumes of 80 cc and more. Materials and Methods: The study included 75 patients with high anesthesia-related risks for conventional surgery (TURP). All patients were surveyed for symptom burden, using IPSS and quality of life score. The prostate volume was determined by transrectal ultrasonography (TRUS). At baseline, prostate-specific antigen (PSA) level was obtained in all patients. Urodynamics was evaluated using uroflowmetry. Clinical outcomes were assessed at follow-up 1, 3, 6, 12, and 24 months after PAE. Results: The prostate volume decreased significantly at months 1 and 3 post-treatment; the prostate continued shrinking until month 12, and the size was then stabilized. At month 24, prostate volume decreased by 40.82%, from 134.0 ± 8.3 mL at baseline to 79.3 ± 6.6 mL. Postvoid residual (PVR) urine volume was significantly decreased from 55.9 ± 5.3 mL to 22.0 ± 1.8 mL 1 month after PAE ( p < 0.001). Qmax increased from 9.2 ± 0.3 mL/s to 15.7 ± 0.4 mL/s. IPSS score following PAE decreased from 28.2 ± 0.7 to 9.7 ± 0.8 ( p < 0.001). QoL improvement was observed from 4.8 ± 0.2 at baseline to 1.8 ± 0.2 at month 24 ( p < 0.001). Decreased activity and density of adenomatous tissue resulted in decreased total PSA levels: from 5.9 ± 1.1 ng/mL to 2.6 ± 0.2 ng/mL ( p < 0.001). TURP became feasible in 35 patients due to reduction of prostate volumes below 80 mL after PAE. Conclusions: PAE was effective in relieving LUTS and reducing prostate size, and may be considered as a preoperative approach for patients with large prostate.

scholarly journals Safety and efficacy of prostatic artery embolization for large benign prostatic hyperplasia in elderly patients

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098628
Author(s):  
Chen Xu ◽  
Gang Zhang ◽  
Jin-jin Wang ◽  
Chun-xian Zhou ◽  
Min-jun Jiang
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Elderly Patients ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Urine Volume ◽  
Prostatic Hyperplasia ◽  
Antigen Level ◽  
Residual Urine Volume ◽  
Safety And Efficacy ◽  
Total Prostate Specific Antigen

Objective To assess the safety and efficacy of prostatic arterial embolization (PAE) for elderly patients with lower urinary tract symptoms secondary to large benign prostatic hyperplasia. Methods Twenty-eight patients (>80 years of age) with prostate volume >80 mL were enrolled from October 2016 to October 2019. PAE was performed using microspheres and functional results were evaluated at 1, 3, 6, and 12 months postoperatively. The following data were recorded: International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume, prostate volume and total prostate-specific antigen level. Results Selective prostatic arterial catheterization and embolization were achieved in 27 of 28 patients. Follow-up data were available for those 27 patients until 12 months postoperatively. Significant improvements were found at all postoperative time points in terms of the mean IPSS, mean QoL score, mean Qmax, mean post-void residual urine volume, mean total prostate-specific antigen level, and mean prostate volume. The overall complication rate was 46.4%. Conclusions PAE is an efficacious and safe treatment for elderly patients with large prostate volume; it may offer an effective approach for patients who are not candidates for open or endoscopic surgical procedures because of comorbidities.

scholarly journals Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saira Khan ◽  
K. Y. Wolin ◽  
R. Pakpahan ◽  
R. L. Grubb ◽  
G. A. Colditz ◽  
...  
Keyword(s):  
Body Size ◽  
Benign Prostatic Hyperplasia ◽  
Life Course ◽  
Early Life ◽  
Prostate Volume ◽  
Late Life ◽  
Later Life ◽  
Normal Weight ◽  
Prostatic Hyperplasia ◽  
The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

scholarly journals Efficacy and safety of Finasteride (5 alpha-reductase inhibitor) monotherapy in patients with benign prostatic hyperplasia: A critical review of the literature

2020 ◽  
Vol 91 (4) ◽  
pp. 205-210
Author(s):  
Gian Maria Busetto ◽  
Francesco Del Giudice ◽  
Daniele D'Agostino ◽  
Daniele Romagnoli ◽  
Andrea Minervini ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Benign Prostatic Hyperplasia ◽  
Adverse Events ◽  
Clinical Efficacy ◽  
Critical Review ◽  
Reductase Inhibitor ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Efficacy And Safety

Background: Combination therapy with 5 alpha-reductase inhibitor (5-ARI) and alpha-blocker can be considered as a gold standard intervention for medical management of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS/BPH). On the other hand, 5-ARI monotherapy and in particular Finasteride alone is currently getting focus of attention especially due to lack of systematic reviews investigating efficacy outcomes and/or adverse events associated. Objectives: Aim of the present critical review was to analyze current knowledge of clinical efficacy and incidence of adverse events associated with 5-ARI treatment for LUTS/BPH. Materials and methods: A systematic review of clinical trials of the literature of the past 20 years was performed using database from PubMed, Cochrane Collaboration and Embase. A total of 8821 patients were included in this study and inclusion criteria for studies selection were: data from randomized clinical trials (RCTs) focusing their attention on the clinical role of Finasteride monotherapy for symptomatic BPH. Parameters of research included prostate specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPPS), postvoid residual urine (PVR), voiding symptoms of IPSS (voiding IPSS), maximum urinary flow rate (Qmax), and adverse events (AEs). Results: Overall 12 original articles were included and critically evaluated. Sample sizes of patient actively treated with finasteride varied from 13 to 1524 cases analyzed in a single study. Follow-up after treatments ranged from 3 to 54 months. The effect of finasteride in reducing prostate volume (PV) was moderate (standardized mean difference (SMD) effect between 0.5 to 0.8 for all trials evaluable) while the effect on IPSS score and Qmax was considered significant (SMD in the 0.2 to 0.5 variation range). No severe AEs and/or psychiatric disorders were retrieved among the studies. Sexual health dysfunctions were significantly influenced by finasteride therapy when compared with placebo treated patients. Conclusions: Although significant clinical benefits of finasteride monotherapy were demonstrated, the effective size of the available reports included in the analysis is limited. Additional head-to-head studies would be needed to re-evaluate clinical efficacy and safety of 5-ARI in combination or not with alpha blockers.

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