Previous studies have showed that men suffering from diabetes mellitus, metabolic syndrome （MetS） and obesity have a higher risk of benign prostatic hyperplasia （BPH）. The present study aimed to examine the associ...Previous studies have showed that men suffering from diabetes mellitus, metabolic syndrome （MetS） and obesity have a higher risk of benign prostatic hyperplasia （BPH）. The present study aimed to examine the association between BPH, obesity, and features of MetS among men of the Hunan area of China. For this cross-sectional study, 904 males （aged 50-59 years） were included. MetS parameters, International Prostate Symptom Score （IPSS）, prostate-specific antigen （PSA） levels, total prostate volume （TPV）, postvoid residual volume （PVR） and maximum urine flow rate （Qmax） were measured. Results showed that MetS was associated with TPV （P = 0.048）, PVR （P = 0.004） and IPSS （P = 0.011）, but not with other indicators of BPH progression such as PSA levels or Qmax. MetS was associated with the voiding symptoms score （P〈 0.05）, but not with the storage symptom score. In addition, body mass index and fasting blood glucose positively correlated with TPV （r= 0.416, P〈 0.001; and r= 0.310, P= 0.011, respectively）. In conclusion, results suggest that MetS is associated with higher prostatic volume, prostate symptom score and voiding symptoms, but not with other features of prostatic hyperplasia such as PSA levels or Qmax. Changes in lifestyle factors, including physical activity and prevention of MetS, might be useful to prevent BPH and its progression, but further studies are needed.展开更多
Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and ...Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.展开更多
The use of testosterone to treat the symptoms of late-onset hypogonadal men has increased recently due to patient and physician awareness. However, concerns regarding the effect of testosterone on the prostate, in par...The use of testosterone to treat the symptoms of late-onset hypogonadal men has increased recently due to patient and physician awareness. However, concerns regarding the effect of testosterone on the prostate, in particular any possible effect on the risk of prostate cancer have prompted further research in this regard. Surprisingly, numerous retrospective or small, randomized trials have pointed to a possible improvement in male lower urinary tract symptoms （LUTS） in patients treated with testosterone. The exact mechanism of this improvement is still debated but may have a close relationship to metabolic syndrome. For the clinician, the results of these studies are promising but do not constitute high levels of evidence. A thorough clinical examination （including history, examination and laboratory testing of testosterone） should be undertaken before considering the diagnosis of late-onset hypogonadism or instigating treatment for it. Warnings still remain on the testosterone supplement product labels regarding the risk of urinary retention and worsening LUTS, and these should be explained to patients.展开更多
目的 :探讨经尿道前列腺电切术(transurethral resection of prostate,TURP)与经尿道双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)疗效、并发症及安...目的 :探讨经尿道前列腺电切术(transurethral resection of prostate,TURP)与经尿道双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)疗效、并发症及安全性差异。方法:收集2009年1月至2011年12月接受TURP和PKRP的BPH患者560例,其中TURP组210例,PKRP组350例,比较2组基线资料、疗效、并发症及安全性差异。结果:PKRP组与PKRP组比较,2组基线资料差异无统计学意义(P>0.05);PKRP组手术时间(t=8.046,P=0.000)、术中出血量(t=16.653,P=0.000)、留置尿管时间(t=7.701,P=0.000)均少于TURP组;TURP组术后较术前:国际前列腺症状评分(international prostate symptom score,IPSS)(t=62.092,P=0.000)、生活质量指数(quality of life,QOL)(t=72.355,P=0.000)、最大尿流率(maximum flow rate,Qmax)(t=73.993,P=0.000)均有改善,PKRP组术后较术前:IPSS(t=77.777,P=0.000)、QOL(t=82.038,P=0.000)、Qmax(t=89.860,P=0.000),均有明显改善,但2组间比较差异无统计学意义(P>0.05);TURP组前列腺电切综合征、血流动力学波动、术中大出血等13项发生率明显高于PKRP组(P<0.05)。结论:TURP和PKRP均为BPH的有效治疗手段。PKRP比较TURP,具有手术时间短、出血量少、并发症少、安全性更高等优点,但其长期疗效需进一步随访观察。展开更多
文摘Previous studies have showed that men suffering from diabetes mellitus, metabolic syndrome （MetS） and obesity have a higher risk of benign prostatic hyperplasia （BPH）. The present study aimed to examine the association between BPH, obesity, and features of MetS among men of the Hunan area of China. For this cross-sectional study, 904 males （aged 50-59 years） were included. MetS parameters, International Prostate Symptom Score （IPSS）, prostate-specific antigen （PSA） levels, total prostate volume （TPV）, postvoid residual volume （PVR） and maximum urine flow rate （Qmax） were measured. Results showed that MetS was associated with TPV （P = 0.048）, PVR （P = 0.004） and IPSS （P = 0.011）, but not with other indicators of BPH progression such as PSA levels or Qmax. MetS was associated with the voiding symptoms score （P〈 0.05）, but not with the storage symptom score. In addition, body mass index and fasting blood glucose positively correlated with TPV （r= 0.416, P〈 0.001; and r= 0.310, P= 0.011, respectively）. In conclusion, results suggest that MetS is associated with higher prostatic volume, prostate symptom score and voiding symptoms, but not with other features of prostatic hyperplasia such as PSA levels or Qmax. Changes in lifestyle factors, including physical activity and prevention of MetS, might be useful to prevent BPH and its progression, but further studies are needed.
文摘Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.
文摘The use of testosterone to treat the symptoms of late-onset hypogonadal men has increased recently due to patient and physician awareness. However, concerns regarding the effect of testosterone on the prostate, in particular any possible effect on the risk of prostate cancer have prompted further research in this regard. Surprisingly, numerous retrospective or small, randomized trials have pointed to a possible improvement in male lower urinary tract symptoms （LUTS） in patients treated with testosterone. The exact mechanism of this improvement is still debated but may have a close relationship to metabolic syndrome. For the clinician, the results of these studies are promising but do not constitute high levels of evidence. A thorough clinical examination （including history, examination and laboratory testing of testosterone） should be undertaken before considering the diagnosis of late-onset hypogonadism or instigating treatment for it. Warnings still remain on the testosterone supplement product labels regarding the risk of urinary retention and worsening LUTS, and these should be explained to patients.
文摘目的 :探讨经尿道前列腺电切术(transurethral resection of prostate,TURP)与经尿道双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)疗效、并发症及安全性差异。方法:收集2009年1月至2011年12月接受TURP和PKRP的BPH患者560例,其中TURP组210例,PKRP组350例,比较2组基线资料、疗效、并发症及安全性差异。结果:PKRP组与PKRP组比较,2组基线资料差异无统计学意义(P>0.05);PKRP组手术时间(t=8.046,P=0.000)、术中出血量(t=16.653,P=0.000)、留置尿管时间(t=7.701,P=0.000)均少于TURP组;TURP组术后较术前:国际前列腺症状评分(international prostate symptom score,IPSS)(t=62.092,P=0.000)、生活质量指数(quality of life,QOL)(t=72.355,P=0.000)、最大尿流率(maximum flow rate,Qmax)(t=73.993,P=0.000)均有改善,PKRP组术后较术前:IPSS(t=77.777,P=0.000)、QOL(t=82.038,P=0.000)、Qmax(t=89.860,P=0.000),均有明显改善,但2组间比较差异无统计学意义(P>0.05);TURP组前列腺电切综合征、血流动力学波动、术中大出血等13项发生率明显高于PKRP组(P<0.05)。结论:TURP和PKRP均为BPH的有效治疗手段。PKRP比较TURP,具有手术时间短、出血量少、并发症少、安全性更高等优点,但其长期疗效需进一步随访观察。
