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The Urologic Clinics of North America Aug 2016Prostate development follows a common pattern between species and depends on the actions of androgens to induce and support ductal branching morphogenesis of buds... (Review)
Review
Prostate development follows a common pattern between species and depends on the actions of androgens to induce and support ductal branching morphogenesis of buds emerging from the urogenital sinus. The human prostate has a compact zonal anatomy immediately surrounding the urethra and below the urinary bladder. Rodents have a lobular prostate with lobes radiating away from the urethra. The human prostate is the site of benign hyperplasia, prostate cancer, and prostatitis. The rodent prostate has little naturally occurring disease. Rodents can be used to model aspects of human benign hyperplasia, but care should be taken in data interpretation and extrapolation to the human condition.
Topics: Animals; Diagnostic Techniques, Urological; Humans; Male; Prostate; Prostatic Hyperplasia
PubMed: 27476121
DOI: 10.1016/j.ucl.2016.04.012 -
Clinical Nutrition ESPEN Oct 2019and 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...
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.
Topics: Databases, Factual; Diet; Dietary Supplements; Humans; Inflammation; Life Style; Male; Micronutrients; Nutritional Status; Plant Extracts; Prostatic Hyperplasia; Serenoa; Vitamin D; Zinc
PubMed: 31451276
DOI: 10.1016/j.clnesp.2019.07.015 -
Primary Care Jun 2019Benign prostatic hyperplasia (BPH) is a common condition in aging men that is frequently associated with troublesome lower urinary tract symptoms (LUTS). The American... (Review)
Review
Benign prostatic hyperplasia (BPH) is a common condition in aging men that is frequently associated with troublesome lower urinary tract symptoms (LUTS). The American Urologic Association Symptom Index is a validated, self-administered tool that is used to diagnose LUTS, guide initial treatment, and assess treatment response. Watchful waiting is an option for men with mild symptoms. Pharmacologic treatment includes alpha-adrenergic blockers and 5-alpha reductase inhibitors. There is no evidence to support the use of herbal supplements in the treatment of LUTS. Surgical therapy is effective and indicated for men with complications from BPH or who fail medical therapy.
Topics: 5-alpha Reductase Inhibitors; Adrenergic alpha-Antagonists; Humans; Lower Urinary Tract Symptoms; Male; Prostatic Hyperplasia
PubMed: 31030823
DOI: 10.1016/j.pop.2019.02.003 -
BJU International Apr 2021To present historical and contemporary hypotheses on the pathogenesis of benign prostatic hyperplasia (BPH), and the potential implications for current medical therapies. (Review)
Review
OBJECTIVES
To present historical and contemporary hypotheses on the pathogenesis of benign prostatic hyperplasia (BPH), and the potential implications for current medical therapies.
METHODS
The literature on BPH was reviewed. BPH is a prevalent disease with significant health and economic impacts on patients and health organisations across the world, whilst the cause/initiation of the disease process has still not been fully determined.
RESULTS
In BPH, pathways involving androgens, oestrogens, insulin, inflammation, proliferative reawakening, stem cells and telomerase have been hypothesised in the pathogenesis of the disease. A number of pathways first described >40 years ago have been first rebuked and then have come back into favour. A system of an inflammatory process within the prostate, which leads to growth factor production, stem cell activation, and cellular proliferation encompassing a number of pathways, is currently in vogue. This review also highlights the physiology of the prostate cell subpopulations and how this may account for the delay/failure in treatment response for certain medical therapies.
CONCLUSION
BPH is an important disease, and as the pathogenesis is not fully understood it impacts the effectiveness of medical therapies. This impacts patients, with further research potentially highlighting novel therapeutic avenues.
Topics: Humans; Male; Prostatic Hyperplasia
PubMed: 32893964
DOI: 10.1111/bju.15229 -
Cell Death & Disease Jun 2022Benign prostate hyperplasia (BPH) is an age-related disease in men characterized by the growth of prostate cells and hyperproliferation of prostate tissue. This...
Benign prostate hyperplasia (BPH) is an age-related disease in men characterized by the growth of prostate cells and hyperproliferation of prostate tissue. This condition is closely related to chronic inflammation. In this study, we highlight the therapeutic efficacy of ellagic acid (EA) for BPH by focusing on the AR signaling axis and STAT3. To investigate the effect of EA on BPH, we used EA, a phytochemical abundant in fruits and vegetables, to treat testosterone propionate (TP)-induced BPH rats and RWPE-1 human prostate epithelial cells. The EA treatment reduced prostate weight, prostate epithelial thickness, and serum DHT levels in the TP-induced BPH rat model. In addition, EA improved testicular injury by increasing antioxidant enzymes in testis of the BPH rats. EA reduced the protein levels of AR, 5AR2, and PSA. It also induced apoptosis by regulating Bax, Bcl_xL, cytochrome c, caspase 9, and caspase 3 with increasing mitochondrial dynamics. Furthermore, EA reduced the expression of IL-6, TNF-α, and NF-κB, as well as phosphorylation of STAT3 and IκBα. These findings were also confirmed in TP-treated RWPE-1 cells. Overall, our data provide evidence of the role of EA in improving BPH through inhibition of AR and the STAT3 pathway.
Topics: Androgens; Animals; Ellagic Acid; Humans; Hyperplasia; Male; Plant Extracts; Prostate; Prostatic Hyperplasia; Rats; Rats, Sprague-Dawley; STAT3 Transcription Factor; Testosterone Propionate
PubMed: 35715415
DOI: 10.1038/s41419-022-04995-3 -
Technology in Cancer Research &... 2023Review efficacy and safety of minimally-invasive treatments for Low Urinary Tract Symptoms (LUTS) in patients affected by Benign Prostate Hyperplasia (BPH). We performed... (Review)
Review
Review efficacy and safety of minimally-invasive treatments for Low Urinary Tract Symptoms (LUTS) in patients affected by Benign Prostate Hyperplasia (BPH). We performed a systematic review of the literature from 1993 to 2022 leveraging original research articles, reviews, and case-studies published in peer-reviewed journals and stored in public repositories. Prostate artery embolization (PAE), transurethral needle ablation (TUNA), transurethral microwave thermotherapy (TUMT), high intensity focused ultrasound (HIFU), laser treatments and Cryoablation are valid and safe alternatives to the gold standard (surgery) in the treatment of LUTS in patients affected by BPH, with fewer undesired effects being reported.
Topics: Male; Humans; Prostatic Hyperplasia; Cryosurgery; Embolization, Therapeutic; Prostate; Pelvis; Treatment Outcome; Transurethral Resection of Prostate
PubMed: 36794408
DOI: 10.1177/15330338231155000 -
Annual Review of Medicine 2016Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) commonly affect older men. Age-related changes associated with metabolic... (Review)
Review
Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) commonly affect older men. Age-related changes associated with metabolic disturbances, changes in hormone balance, and chronic inflammation may cause BPH development. The diagnosis of BPH hinges on a thorough medical history and focused physical examination, with attention to other conditions that may be causing LUTS. Digital rectal examination and urinalysis should be performed. Other testing may be considered depending on presentation of symptoms, including prostate-specific antigen, serum creatinine, urine cytology, imaging, cystourethroscopy, post-void residual, and pressure-flow studies. Many medical and surgical treatment options exist. Surgery should be reserved for patients who either have failed medical management or have complications from BPH, such as recurrent urinary tract infections, refractory urinary retention, bladder stones, or renal insufficiency as a result of obstructive uropathy.
Topics: 5-alpha Reductase Inhibitors; Ablation Techniques; Adrenergic alpha-Antagonists; Digital Rectal Examination; Humans; Laser Therapy; Lower Urinary Tract Symptoms; Male; Phosphodiesterase 5 Inhibitors; Prostatic Hyperplasia; Transurethral Resection of Prostate; Watchful Waiting
PubMed: 26331999
DOI: 10.1146/annurev-med-063014-123902 -
Canadian Association of Radiologists... Feb 2017Prostate artery embolization has garnered much attention as a promising treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. We aim to... (Review)
Review
Prostate artery embolization has garnered much attention as a promising treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. We aim to provide an up-to-date review of this minimally invasive technique, including discussion of potential benefits and technical challenges. Current evidence suggests it is a safe and effective option for patients with medication-refractory urinary obstructive symptoms who are poor surgical candidates or refuse surgical therapy. Larger, randomized studies with long-term follow-up data are needed for this technique to be formally established in the treatment paradigm for benign prostatic hyperplasia.
Topics: Embolization, Therapeutic; Humans; Male; Prostate; Prostatic Hyperplasia; Treatment Outcome
PubMed: 27887933
DOI: 10.1016/j.carj.2016.06.003 -
Current Urology Reports Aug 2019The purpose of this review is to summarize the role and significance of inflammation as a putative additional factor contributing to lower urinary tract symptoms and the... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to summarize the role and significance of inflammation as a putative additional factor contributing to lower urinary tract symptoms and the progression of benign prostatic hyperplasia. We review (1) the histologic definition of prostatic inflammation and its prevalence, (2) the effects inflammation in the prostate including on risk of acute urinary retention, and (3) the effects of systemic inflammation on the prostate and on voiding.
RECENT FINDINGS
Inflammation is a highly prevalent finding in the prostate, both on a histological and biochemical level. Men with inflammation have higher IPSS scores and increased prostate size; however, these differences appear to be imperceptibly small. Men with inflammation do experience a significantly increased risk of developing acute urinary retention, an event that is associated with significant morbidity. Recently, attempts have been made to identify more specific biochemical markers of local inflammation, and to identify regional patterns of inflamed tissue within the prostate which may be associated with higher IPSS scores, accelerated progression, and AUR. The effects of systemic inflammatory states, most notably MetS, and their role in LUTS have also been examined. Inflammation is a common finding in prostates of aging men, but its contribution to lower urinary tract symptoms and benign prostatic hyperplasia progression appears to be small when considered as a clinically relevant entity. Advances in the understanding of different forms of inflammation, and their impact when experienced in different locations within the prostate, may refine this knowledge. Systemic inflammation affects voiding, including in the absence of a prostate, but again significant effects of systemic inflammation on the prostate itself are also difficult to demonstrate. Prostatic inflammation is associated with a significantly increased risk of acute urinary retention.
Topics: Acute Disease; Disease Progression; Humans; Inflammation; Lower Urinary Tract Symptoms; Male; Prostatic Hyperplasia; Prostatitis; Urinary Retention
PubMed: 31377881
DOI: 10.1007/s11934-019-0917-1 -
Seminars in Ultrasound, CT, and MR Aug 2020Prostate artery embolization (PAE) is a minimally invasive technique in managing men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia... (Review)
Review
Prostate artery embolization (PAE) is a minimally invasive technique in managing men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). BPH is one of the commonest causes of LUTS in men, associated with high morbidity and economic burden. Patients suffering from LUTS secondary to BPH, severe enough to warrant intervention traditionally underwent transurethral resection of the prostate or open prostatectomy. PAE is an emerging alterative technique with promising data. In this paper we review important elements to running a safe PAE practice including careful patient selection, exclusion criteria, complications, and efficacy of PAE compared to other techniques. This paper also reviews the basic anatomy and techniques relevant to PAE, including common anatomical variants.
Topics: Arteries; Embolization, Therapeutic; Humans; Lower Urinary Tract Symptoms; Male; Patient Selection; Prostate; Prostatic Hyperplasia
PubMed: 32620226
DOI: 10.1053/j.sult.2020.04.001