Are all procedures for benign prostatic hyperplasia created equal? A systematic review on post-procedural PSA dynamics and its correlation with relief of bladder outlet obstruction

Bhat, Abhishek; Blachman‐Braun, Ruben; Herrmann, Thomas; Shah, Hemendra N.

doi:10.1007/s00345-021-03771-w

Cited by 17 publications

(6 citation statements)

References 71 publications

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“…We next investigated the effect of MIX on the expression of PSA, which is closely related to the pathogenesis of BPH and prostate cancer [ 7 28 ]. As shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Hence, these results indicate that the reduction of 5α-reductase type 2 might play a critical role in the ameliorating effect of MIX on prostate weight gain and histologic changes. Furthermore, the expression and serum concentration of PSA, a biomarker for prostate cancer and BPH [ 7 28 ], and the expression of PCNA were increased in the TP-induced BPH group, but markedly decreased by MIX ( Fig. 4 ).…”

Section: Discussionmentioning

confidence: 99%

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Mixture of Corni Fructus and Schisandrae Fructus improves testosterone-induced benign prostatic hyperplasia through regulating 5α-reductase 2 and androgen receptor

Hwangbo

Kim

et al. 2023

Nutr Res Pract

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BACKGROUND/OBJECTIVES Benign prostatic hyperplasia (BPH) characterized by an enlarged prostate gland is common in elderly men. Corni Fructus (CF) and Schisandrae Fructus (SF) are known to have various pharmacological effects, including antioxidant and anti-inflammatory activities. In this study, we evaluated the inhibitory efficacy of CF, SF, and their mixture (MIX) on the development of BPH using an in vivo model of testosterone-induced BPH. MATERIALS/METHODS Six-week-old male Sprague-Dawley rats were randomly divided into seven groups. To induce BPH, testosterone propionate (TP) was injected to rats except for those in the control group. Finasteride, saw palmetto (SP), CF, SF, and MIX were orally administered along with TP injection. At the end of treatment, histological changes in the prostate and the level of various biomarkers related to BPH were evaluated. RESULTS Our results showed that BPH induced by TP led to prostate weight and histological changes. Treatment with MIX effectively improved TP-induced BPH by reducing prostate index, lumen area, epithelial thickness, and expression of BPH biomarkers such as 5α-reductase type 2, prostate-specific antigen, androgen receptor, and proliferating cell nuclear antigen compared to treatment with CF or SF alone. Moreover, MIX further reduced levels of elevated serum testosterone, dihydrotestosterone, and prostate-specific antigen in BPH compared to the SP, a positive control. BPH was also improved more by MIX than by CF or SF alone. CONCLUSIONS Based on the results, MIX is a potential natural therapeutic candidate for BPH by regulating 5α-reductase and AR signaling pathway.

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“…We next investigated the effect of MIX on the expression of PSA, which is closely related to the pathogenesis of BPH and prostate cancer [ 7 28 ]. As shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mixture of Corni Fructus and Schisandrae Fructus improves testosterone-induced benign prostatic hyperplasia through regulating 5α-reductase 2 and androgen receptor

Hwangbo

Kim

et al. 2023

Nutr Res Pract

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“…Zhu et al examined the influence of DU severity on patients' postoperative results and showed limited efficacy of TUR-P in patients with severe DU (BCI < 82) in the 20 ≤ bladder outlet obstruction index < 40 group [19]. These heterogeneous outcomes lead to the question of whether a gold standard with an indefinite template and sizeable discrepancies regarding performance markers, like PSA reduction in large-volume randomized trials, is sufficient for this patient collective [20]. Indeed, in the few studies on AEEP in DU/DA, very promising results were observed.…”

Section: Discussionmentioning

confidence: 99%

Early Results after Thulium Laser Enucleation of the Prostate in Patients with Urodynamically Proven Detrusor Underactivity

Trotsenko,

Wetterauer,

Haydter

et al. 2024

SIUJ

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Objectives: Benign prostatic hyperplasia is one of the most common urological diseases. Among these patients, the presence of detrusor underactivity or acontractility represents a challenging condition since no medical treatment is available. Our objective is to evaluate early term outcomes following transurethral anatomical enucleation of the prostate with Tm:YAG support. Methods: In a retrospective analysis of 115 patients who underwent this procedure between January 2019 and March 2022 due to lower urinary tract symptoms, 8 patients with urodynamic evidence of detrusor underactivity secondary to a non-neurogenic aetiology were identified. Detrusor underactivity was defined as a bladder contractility index of <100. Results: Median age, prostate volume and bladder contractility index were 73.2 years, 78.5 cm3 and 63.9, respectively. Median International Prostate Symptom Score/quality of life, Qmax and post-void residual volume were 15/3.5 points, 4.4 mL/s and 189 mL, respectively. Postoperatively, immediate catheter-removal success rate was 87.5% (7/8), at 2 months all patients were catheter-free and remained so at 1-year follow-up. Significant improvements for quality of life, Qmax and post-void residual volume were detected. Median postoperative International Prostate Symptom Score/Quality of life, Qmax and post-void residual volume were 7/2, 21.6 mL/s and 0 mL, respectively. Conclusions: This surgical approach offers high catheter-free rates, significantly improves functional voiding parameters and increases patient satisfaction in patients with benign prostatic hyperplasia and concomitant detrusor underactivity. Therefore, it can be regarded as an effective approach for such patients.

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“…If a modified template preserves more areas of adenoma, that can entail increased risk of re-growth, requiring another procedure down the line. Different treatment modalities and templates have been evaluated with several variables, including PSA reduction, questionnaires like the International Prostate Symptom Score, the maximum urinary flow rate and postvoid residuals [27]. Using PSA decrease as a proxy for amount of prostatic tissue removed, performance differences between extraanatomical templates are evident.…”

Section: Ejaculation Preservation Approachestemplatesmentioning

confidence: 99%

Antegrade ejaculation preservation in surgical treatment for benign prostatic hyperplasia: quest for balance between voiding and sexual function

Lopategui,

Shah,

Herrmann

2024

Current Opinion in Urology

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Purpose of review Surgical treatment of benign prostatic hyperplasia (BPH) carries a significant risk of ejaculation dysfunction. Preservation of antegrade ejaculation while providing effective, well tolerated, and durable treatment of BPH is a paramount component of physical and sexual well being for significant number of men. We reviewed available literature with an aim of providing status on antegrade ejaculation preserving BPH surgical therapies. Recent findings Minimally invasive surgical therapies for BPH have been developed over the last decade, with significant marketing emphasis on their potential for preservation of antegrade ejaculation. However, the question about durability of relief of bladder outlet obstruction remains. Parallel to this technological development, the understanding of anatomical structures involved in ejaculation have resulted in technical modifications of well established surgical treatments modalities like transurethral resection of prostate, endoscopic enucleation of prostate and simple prostatectomy, thereby providing safe and durable relief of bladder outlet obstruction secondary to BPH with a satisfactory preservation of antegrade ejaculation. Summary Preservation of antegrade ejaculation is an important goal for significant number of men needing BPH surgery. Novel minimally invasive surgical technologies have been developed for this purpose; but understanding of the anatomical structures essential for antegrade ejaculation have allowed technical modification of existing surgical techniques with excellent preservation of antegrade ejaculation.

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Are all procedures for benign prostatic hyperplasia created equal? A systematic review on post-procedural PSA dynamics and its correlation with relief of bladder outlet obstruction

Cited by 17 publications

References 71 publications

Mixture of Corni Fructus and Schisandrae Fructus improves testosterone-induced benign prostatic hyperplasia through regulating 5α-reductase 2 and androgen receptor

Mixture of Corni Fructus and Schisandrae Fructus improves testosterone-induced benign prostatic hyperplasia through regulating 5α-reductase 2 and androgen receptor

Early Results after Thulium Laser Enucleation of the Prostate in Patients with Urodynamically Proven Detrusor Underactivity

Antegrade ejaculation preservation in surgical treatment for benign prostatic hyperplasia: quest for balance between voiding and sexual function

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