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Histology and Histopathology Aug 2022Ductal epithelial changes (lympho-epithelial lesions-LEL) in prostatic chronic inflammation (CI) are not well studied so far.
OBJECTIVES
Ductal epithelial changes (lympho-epithelial lesions-LEL) in prostatic chronic inflammation (CI) are not well studied so far.
AIM
to investigate LEL immediately adjacent to prostatic CI.
METHODS
We studied LEL in 144 prostatic surgical and autopsy specimens in various types of prostatic CI: NIH-category IV prostatitis (histologic prostatitis-HP), nonspecific granulomatous prostatitis (NSGP), and the reactive lymphoid infiltrates in the vicinity of benign prostatic hyperplasia (BPH) and prostate adenocarcinoma (PCa). CI is scored as low and high grade (LG, HG) according to the severity of inflammation.
RESULTS
LEL was identified in all types of prostatic specimens and in all types of prostatic CI: in 70.9% of patients with HP; in 100% of cases with NSGP; in 68.7% and in 80% adjacent to BPH and PCa respectively. Statistical analysis showed a significant correlation of the presence of LEL with HG CI (p<0.001). LEL showed strong membranous PD-L1 expression.
CONCLUSIONS
The study presents the first attempt to examine LEL in inflammatory human prostate. PD-L1 positive LEL have no diagnostic organ specificity, although they are a constant histological finding in HG prostatic CI. LEL, inducible after birth by CI, are an integral part of prostate-associated lymphoid tissue (PALT) and of the inflammatory prostatic microenvironment.
Topics: B7-H1 Antigen; Humans; Inflammation; Male; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms; Prostatitis; Tumor Microenvironment
PubMed: 35670049
DOI: 10.14670/HH-18-479 -
Infectious Disease Clinics of North... Dec 1987Several distinct types of prostatitis, or prostatitis syndromes, are now recognized. The most common types include acute and chronic bacterial prostatitis, nonbacterial... (Review)
Review
Several distinct types of prostatitis, or prostatitis syndromes, are now recognized. The most common types include acute and chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia. Bacterial prostatitis, caused mainly by enterobacteria, is often difficult to cure, and chronic bacterial prostatitis is a common cause of relapsing recurrent urinary tract infection in men. Nonbacterial prostatitis, the most common syndrome, is an inflammation of the prostate of unknown cause. Patients with prostatodynia typically have sterile cultures and normal prostatic secretions but demonstrate an acquired voiding dysfunction on video-urodynamic testing. Since nonbacterial types of prostatitis have no recognized infectious cause, treatment using antimicrobial agents is ineffective and unwarranted.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Chronic Disease; Humans; Male; Prostate; Prostatitis; Urinary Tract Infections
PubMed: 3333662
DOI: No ID Found -
BJU International Mar 2008Category III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most commonly diagnosed prostatitis syndrome. CP/CPPS is characterized by lower urinary... (Meta-Analysis)
Meta-Analysis Review
Category III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most commonly diagnosed prostatitis syndrome. CP/CPPS is characterized by lower urinary tract symptoms (LUTS) of which pain (particularly perineal pain and pain on ejaculation) and dysfunctional voiding cause the greatest morbidity and poor quality of life. There is no standard treatment for CP/CPPS. Patients report only transient relief of symptoms from currently available therapies and are frequently required to change treatments. The origin of LUTS and possibly the pelvic pain (e.g. on ejaculation) is thought to be prolonged smooth muscle contraction in the bladder and prostate, caused by alpha(1)-adrenoceptor activation. alpha(1)-Blockers are not indicated in the treatment of CP/CPPS but clinical experience suggests that they might be of benefit, possibly by promoting smooth muscle relaxation. Encouraging results of three phase II, randomized, placebo-controlled trials evaluating (using a validated instrument) the efficacy of alfuzosin, tamsulosin and terazosin in alpha(1)-blocker-naïve patients with CP/CPPS, support this hypothesis. The National Institute of Health and the National Institute of Diabetes and Digestive and Kidney Diseases are currently conducting a large phase III trial in 272 newly diagnosed and alpha(1)-blocker-naïve CP/CPPS patients randomized to received alfuzosin 10 mg once daily or placebo for 12 weeks.
Topics: Adrenergic alpha-Antagonists; Anti-Infective Agents; Bacterial Infections; Chronic Disease; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Drug Therapy, Combination; Ejaculation; Humans; Male; Pelvic Pain; Prostatism; Prostatitis; Quality of Life; Quinazolines; Randomized Controlled Trials as Topic; Secondary Prevention; Syndrome
PubMed: 18307680
DOI: 10.1111/j.1464-410X.2008.07496.x -
The Urologic Clinics of North America Nov 2009The overlap of pain and urinary voiding symptoms is common for urologic patients. The etiology of these syndromes is frequently multifactorial and due to disorders of... (Review)
Review
The overlap of pain and urinary voiding symptoms is common for urologic patients. The etiology of these syndromes is frequently multifactorial and due to disorders of the bladder and/or prostate. The evaluation and treatment of these syndromes continues to evolve. Here we summarize the general approach to evaluation and treatment of these pain syndromes.
Topics: Chronic Disease; Diagnosis, Differential; Humans; Male; Pelvic Pain; Prostatism; Prostatitis; Surveys and Questionnaires; Syndrome; Urinary Bladder Diseases
PubMed: 19942050
DOI: 10.1016/j.ucl.2009.08.005 -
The Veterinary Clinics of North... Nov 1980
Review
Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Biopsy, Needle; Dog Diseases; Dogs; Ejaculation; Estrogens; Immunotherapy; Male; Physical Examination; Prostate; Prostatitis; Radiography
PubMed: 6996296
DOI: 10.1016/s0195-5616(79)50081-3 -
Chemotherapy Dec 2003In the present review article, the penetration of antimicrobial agents into prostatic fluid and tissue was examined. Three major factors determining the diffusion and... (Review)
Review
In the present review article, the penetration of antimicrobial agents into prostatic fluid and tissue was examined. Three major factors determining the diffusion and concentration of antimicrobial agents in prostatic fluid and tissue are the lipid solubility, dissociation constant (pKa) and protein binding. The normal pH of human prostatic fluid is 6.5-6.7, and it increases in chronic prostatitis, ranging from 7.0 to 8.3. A greater concentration of antimicrobial agents in the prostatic fluid occurs in the presence of a pH gradient across the membrane separating plasma from prostatic fluid. Of the available antimicrobial agents, beta-lactam drugs have a low pKa and poor lipid solubility, and thus penetrate poorly into prostatic fluid, expect for some cephalosporins, which achieve greater than or equal to the inhibitory concentration. Good to excellent penetration into prostatic fluid and tissue has been demonstrated with many antimicrobial agents, including tobramycin, netilmicin, tetracyclines, macrolides, quinolones, sulfonamides and nitrofurantoin.
Topics: Anti-Bacterial Agents; Humans; Hydrogen-Ion Concentration; Male; Prostate; Prostatitis
PubMed: 14671426
DOI: 10.1159/000074526 -
FEMS Immunology and Medical Microbiology Nov 2010Chronic bacterial prostatitis (CBP) is a long-lasting and crippling disease that strongly impacts the patient's quality of life. The diagnosis of CBP is difficult and... (Review)
Review
Chronic bacterial prostatitis (CBP) is a long-lasting and crippling disease that strongly impacts the patient's quality of life. The diagnosis of CBP is difficult and the treatment regimens are not always successful. Poor penetration of antibiotics to the prostate tissue, the drug resistance of uropathogens, the adverse events associated with antibiotic treatment, the persistence of prostatic calculi, and biofilm formation in the prostate gland are factors that contribute toward decreasing the cure rate of CBP. The phenomenon of increasing antibiotic resistance, which has also been called a clinical super-challenge, has revived interest in therapy using bacterial viruses (bacteriophages or phages). Because of their mechanism of action, which is completely different from those of all antibiotics, phages are effective even against multidrug-resistant bacteria. Here, we describe the current perspectives on the possible application of phage therapy (PT) in treating CBP. The advantages of therapeutic phages, including their interactions with bacterial biofilm, as well as the safety of PT are discussed.
Topics: Anti-Bacterial Agents; Bacterial Infections; Bacteriophages; Biofilms; Chronic Disease; Drug Resistance, Multiple, Bacterial; Humans; Male; Prostate; Prostatitis; Treatment Failure
PubMed: 20698884
DOI: 10.1111/j.1574-695X.2010.00723.x -
Nederlands Tijdschrift Voor Geneeskunde Nov 1983
Topics: Acute Disease; Adult; Aged; Chronic Disease; Humans; Male; Middle Aged; Prostate; Prostatitis
PubMed: 6656905
DOI: No ID Found -
World Journal of Urology Apr 2018Prostatic artery embolization (PAE) has seen a recent increase in interest as a treatment for men with benign prostatic obstruction (BPO). The appeal of this... (Review)
Review
PURPOSE
Prostatic artery embolization (PAE) has seen a recent increase in interest as a treatment for men with benign prostatic obstruction (BPO). The appeal of this intervention lies in reported reduction in morbidity and its minimally invasive nature. The purpose of this review is to assess the safety and efficacy of PAE as a new treatment in BPO and explore risks surrounding its performance.
METHODS
A review of the literature was performed. Medical databases searched included PubMed, EMBASE, and Cochrane databases, limited to English, peer-reviewed articles. Search terms included prostatic artery embolization, lower urinary tracts symptoms, minimally invasive therapies, interventional radiology prostate, and benign prostatic hyperplasia. Articles were screened by two independent reviewers for content on development, methods, outcomes, and complications of PAE.
RESULTS
Suitability of patients to undergo PAE depends on review of patient history, pre-procedure visualisation of appropriate vascular anatomy and clinical parameters. Despite this selection of candidates favourable for procedural success, PAE is not without risk of complications, some of which can significantly affect patient quality of life.
CONCLUSIONS
Although initial findings show promise regarding safety and efficacy of PAE in improving symptom and quality-of-life scores, further investigation is required to establish durability of effect and the appropriate use of this experimental modality. There is currently limited robust evidence for the beneficial outcomes of PAE. Long-term follow-up studies will add to the evidence base to help further assess the feasibility of this procedure as an alternative to TURP.
Topics: Arteries; Embolization, Therapeutic; Humans; Male; Prostate; Prostatic Hyperplasia; Prostatism; Risk Adjustment; Treatment Outcome
PubMed: 29445846
DOI: 10.1007/s00345-018-2220-z -
Current Urology Reports Sep 2014Transurethral resection of the prostate (TURP) continues to be the most common treatment in the operative management of benign prostatic hypertrophy (BPH). Several other... (Review)
Review
Transurethral resection of the prostate (TURP) continues to be the most common treatment in the operative management of benign prostatic hypertrophy (BPH). Several other modalities have shown equivalence to TURP. However, even after surgical treatment, up to one third of patients have bothersome lower urinary tract symptoms (LUTS). This review discusses the pathophysiology, evaluation, and management options for patients with LUTS after TURP.
Topics: Disease Management; Humans; Lower Urinary Tract Symptoms; Male; Prostate; Prostatic Hyperplasia; Prostatism; Transurethral Resection of Prostate
PubMed: 25037906
DOI: 10.1007/s11934-014-0434-1