Echinacoside attenuates glandular fibrosis in benign prostatic hyperplasia via inhibiting MKK6/MK2 signaling pathway

Background:Lower urinary tract symptoms commonly occur in the elderly population and seriously constrain the quality of life.Glandular fibrosis is an important pathobiological process in benign prostatic hyperplasia and is also a main inducing factor for benign prostatic hyperplasia-associated lower urinary tract symptoms.Cistanches species is an important herbal medicine resource and is traditionally used in ameliorating renal and prostatic defects.Methods:This study was to investigate the potential protective function of echinacoside(a bioactive compound from Cistanches)against prostatic fibrosis in mice and human benign prostatic hyperplasia epithelial-1 cell models.Results:It was found that echinacoside attenuated testosterone-induced prostatic hyperplasia and collagen deposition in mice,relieved prostate local inflammation and oxidative damage,and ameliorated prostatic epithelial-mesenchymal transition.Additionally,echinacoside inhibited the activation of the MKK6/MK2 signaling pathway both in vivo and in vitro.Conclusion:This study added new evidence for the anti-fibrotic function of echinacoside on the prostate and provided new insights for understanding its possible pharmacological mechanisms.

Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction surgeries.Methods:A 36-item survey was developed with a Delphi method.Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included.Urologists were invited globally to complete the online survey.Consensus was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative continence.Consensus in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery feasibility.Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 mL.Conclusion:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining MIST.Urolift®,Rezum®,and EEP were regarded as MIST by most urologists.

Alleviatory effect of isoquercetin on benign prostatic hyperplasia via IGF-1/PI3K/Akt/mTOR pathway

We evaluated the effect of isoquercetin(quercetin-O-3-glucoside-quercetin,IQ)as a functional component of Abeliophyllum disistichum Nakai ethanol extract(ADLE)on prostate cell proliferation and apoptosis and its effects on the IGF-1/PI3K/Akt/mTOR pathway in benign prostatic hyperplasia(BPH).Metabolites in ADLE were analyzed using UHPLC-qTOF-MS and HPLC.IQ was orally administered(1 or 10 mg/kg)to a testosterone propionate-induced BPH rat model,and its effects on the prostate weight were evaluated.The effect of IQ on androgen receptor(AR)signaling was analyzed in LNCaP cells.Whether IGF-1 and IQ affect the IGF-1/PI3K/Akt/mTOR pathway in BPH-1 cells was also examined.The metabolites in ADLE were identified and quantified,which confirmed that ADLE contained abundant IQ(20.88 mg/g).IQ significantly reduced the prostate size in a concentration-dependent manner in a BPH rat model,and significantly decreased the expression of AR signaling factors in the rat prostate tissue and LNCaP cells in a concentration-dependent manner.IQ also inhibited the PI3K/AKT/mTOR pathway activated by IGF-1 treatment in BPH-1 cells.In BPH-1 cells,IQ led to G0/G1 arrest and suppressed the expression of proliferation factors while inducing apoptosis.Thus,IQ shows potential for use as a pharmaceutical and nutraceutical for BPH.

Alterations of gut microbiota diversity, composition and metabonomics in testosterone-induced benign prostatic hyperplasia rats

Background: Studies had shown many diseases affect the stability of human microbiota, but how this relates to benign prostatic hyperplasia(BPH) has not been well understood. Hence, this study aimed to investigate the regulation of BPH on gut microbiota composition and metabonomics.Methods: We analyzed gut samples from rats with BPH and healthy control rats, the gut microbiota composition and metabonomics were detected by 16S rDNA sequencing and liquid chromatography tandem mass spectrometry(LC–MS/MS).Results: High-throughput sequencing results showed that gut microbiota beta-diversity increased(P<0.01) in the BPH group vs. control group. Muribaculaceae(P<0.01), Turicibacteraceae(P<0.05), Turicibacter(P<0.01) and Coprococcus(P<0.01) were significantly decreased in the BPH group, whereas that of Mollicutes(P<0.05) and Prevotella(P<0.05)were significantly increased compared with the control group. Despite profound interindividual variability, the levels of several predominant genera were different. In addition, there were no statistically significant differences in several bacteria. BPH group vs. control group: Firmicutes(52.30% vs. 57.29%, P>0.05), Bacteroidetes(46.54% vs. 41.64%,P>0.05), Clostridia(50.89% vs. 54.66%, P>0.05), Ruminococcaceae(25.67% vs. 20.56%, P>0.05). LC–MS/MS of intestinal contents revealed that differential metabolites were mainly involved in cellular processes, environmental information processing, metabolism and organismal systems. The most important pathways were global and overview maps, lipid metabolism, amino acid metabolism, digestive system and endocrine system. Through enrichment analysis, we found that the differential metabolites were significantly enriched in metabolic pathways, steroid hormone biosynthesis,ovarian steroidogenesis, biosynthesis of unsaturated fatty acids and bile secretion. Pearson correlation analysis(R=0.94) showed that there was a strong correlation between Prevotellaceae, Corynebacteriaceae, Turicibacteraceae,Bifidobacteriaceae and differential metabolites.Conclusions: Our findings suggested an association between the gut microbiota and BPH, but the causal relationship between the two groups is unclear. Thus, further studies are warranted to elucidate the potential mechanisms and causal relationships between BPH and gut microbiota.

Metformin:A promising clinical therapeutical approach for BPH treatment via inhibiting dysregulated steroid hormones-induced prostatic epithelial cells proliferation

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.However,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive relationship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met’s anti-proliferative effects were blocked by AMPK inhibitor or YAP1 overexpression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Targeted anti-tumor synergistic effects of Myc decoy oligodeoxynucleotides-loaded selenium nanostructure combined with chemoradiotherapy on LNCaP prostate cancer cells

In the present study,we investigated the synergistic effects of targeted methotrexate-selenium nanostructure containing Myc decoy oligodeoxynucleotides along with X-irradiation exposure as a combination therapy on LNCaP prostate cancer cells.Myc decoy ODNs were designed based on the promoter of Bcl-2 gene and analyzed by molecular docking and molecular dynamics assays.ODNs were loaded on the synthesized Se@BSA@Chi-MTX nanostructure.The physicochemical characteristics of nanostructures were determined by FTIR,DLS,UV-vis,TEM,EDX,in vitro release,and hemolysis tests.Subsequently,the cytotoxicity properties of them with and without X-irradiation were investigated by uptake,MTT,cell cycle,apoptosis,and scratch assays on the LNCaP cell line.The results of DLS and TEM showed negative charge(−9 mV)and nanometer size(40 nm)for Se@BSA@Chi-DEC-MTX NPs,respectively.The results of FTIR,UV-vis,and EDX showed the proper interaction of different parts and the correct synthesis of nanoparticles.The results of hemolysis showed the hemocompatibility of this nanoparticle in concentrations less than 6 mg/mL.The ODNs release from the nanostructures showed a pH-dependent manner,and the release rate was 15%higher in acidic pH.The targeted Se@BSA@Chi-labeled ODN-MTX NPs were efficiently taken up by LNCaP cells by targeting the prostate-specific membrane antigen(PSMA).The significant synergistic effects of nanostructure(containing MTX drug)treatment along with X-irradiation showed cell growth inhibition,apoptosis induction(~57%),cell cycle arrest(G2/M phase),and migration inhibition(up to 90%)compared to the control.The results suggested that the Se@BSA@Chi-DEC-MTX NPs can potentially suppress the cell growth of LNCaP cells.This nanostructure system can be a promising approach for targeted drug delivery and chemoradiotherapy in prostate cancer treatment.

Management of urethral strictures and stenosis caused by the endo-urological treatment of benign prostatic hyperplasiad-a single-center experience

Objective:Urethral stricture disease after endo-urological treatment of benign prostatic hyperplasia(BPH)is a sparsely described complication.We describe management of five categories of these strictures in this retrospective observational case series.Methods:One hundred and twenty-one patients presenting with symptoms of bladder outflow obstruction after endo-urological intervention for BPH from February 2016 to March 2019 were evaluated.Among them,76 were eligible for this study and underwent reconstructive surgery.Preoperative and postoperative assessments were done with symptom scores,uroflowmetry,ultrasound for post-void residue,and urethrogram.Any intervention during follow-up was classed as a failure.The recurrence and 95%confidence interval for recurrence percentage were calculated.Results:The following five categories of patients were identified:Bulbo-membranous(33[43.4%]),navicular fossa(21[27.6%]),penile/peno-bulbar(8[10.5%]),bladder neck stenosis(6[7.9%]),and multiple locations(8[10.5%]).The average age was 69 years(range:60-84 years).Overall average symptom score,flow rate,and post-void residue changed from 21 to 7,6 mL/s to 19 mL/s,and 210 mL to 20 mL,respectively.The average follow-up was 34 months(range:12-58 months).Overall recurrence and complication rates were 10.5%and 9.2%,respectively.The recurrence in each category was seen in 3,1,2,1,and 1 patient,respectively.Overall 95% confidence interval for recurrence percentage was 4.66-19.69.Conclusion:Urethral stricture disease is a major long-term complication of endo-urological treatment of BPH.The bulbo-membranous strictures need continence preserving approach.Navicular fossa strictures require minimally invasive and cosmetic consideration.Peno-bulbar strictures require judicious use of grafts and flaps.Bladder neck stenosis in this cohort could be treated with endoscopic measures.Multiple locations need treatment based on their sites in single-stage as far as possible.

Fournier’s gangrene after insertion of thermo-expandable prostatic stent for benign prostatic hyperplasia:A case report

BACKGROUND Thermo-expandable urethral stent(Memokath 028)implantation is an alternative treatment for older patients with lower urinary tract symptoms and benign prostatic obstruction.Following prostatic urethral stent implantation,minor complications such as urinary tract infection,irritative symptoms,gross hematuria,and urethral pain have been observed;however,there are no reports of life-threatening events.Herein,we report a critical case of Fournier’s gangrene that occurred 7 years after prostatic stenting.CASE SUMMARY An 81-years-old man with benign prostatic hyperplasia(volume,126 ccs;as measured by transrectal ultrasound)had undergone insertion of a thermoexpandable urethral stent(Memokath 028)as he was unfit for surgery under general anesthesia.However,the patient had undergone a suprapubic cystostomy for recurrent acute urinary retention 4 years after the insertion of prostatic stent(Memokath 028).We had planned to remove the Memokath 028;however,the patient was lost to follow-up.The patient presented to the emergency department 3 years after the suprapubic cystostomy with necrotic changes from the right scrotum to the right inguinal area.In digital rectal examination,tenderness and heat of prostate was identified.Also,the black skin color change with foulsmelling from right scrotum to right inguinal area was identified.In computed tomography finding,subcutaneous emphysema was identified to same area.He was diagnosed with Fournier’s gangrene based on the physical examination and computed tomography findings.In emergency room,Fournier’s gangrene severity index value is seven points.Therefore,he underwent emergent extended surgical debridement and removal of the Memokath 028.Broad-spectrum intravenous antibiotics were administered and additional necrotic tissue debridement was performed.However,the patient died 14 days after surgery due to multiorgan failure.CONCLUSION If Memokath 028 for benign prostatic hyperplasia is not working in older patients,its rapid removal may help prevent severe complications.

Top 50 most cited articles on prostatic artery embolization for benign prostatic hyperplasia:A bibliometric review

BACKGROUND Bibliometric analysis can be used to assess the current state of the literature and publication trends on a given topic.There has not been a review of this kind on prostatic artery embolization(PAE)for benign prostatic hyperplasia(BPH).PAE is a relatively new and somewhat controversial treatment option for BPH.Given the novelty and controversy,there has been much research published on the topic recently.AIM To survey the current state of research on PAE for BPH by using bibliometric analysis to analyze the top 50 most highly cited articles.METHODS A cross-sectional study was performed using the Web of Science database to identify the most cited articles published on PAE for BPH as of June 2022.Articles that did not primarily focus on PAE or BPH as an indication were eliminated.The 50 most cited articles were carried forward for analysis.RESULTS All but 6 articles were published in the last decade with contributions from 15 countries.Fifty-two percent of the studies had a C level of evidence.The majority were published in the Journal of Vascular and Interventional Radiology and Cardiovascular and Interventional Radiology.Twenty percent(n=10)of the articles were published in urologic journals.On average,articles published in urologic journals tended to be more recent.The mean year of publication for an article in a urological journal was 2016.6 compared to 2013.9 in a non-urologic journal(P=0.02).Seventy percent of the articles focused on clinical outcomes,while only 2%focused on practice guidelines.Self-citations accounted for 11.4 citations perarticle on average,corresponding to 14.7%of all citations analyzed.CONCLUSION The most influential papers on this topic represent a fairly recent body of work with contributions from a wide variety of countries and journals.The fact that articles in urologic journals were published significantly more recently than articles on the list in non-urologic journals may suggest that the field of urology is starting to accept PAE for a wider range of indications.Finally,while there has been much high-quality research published,more influential studies on practice guidelines and technique may be beneficial.

Medical therapy for clinical benign prostatic hyperplasia:α1 Antagonists,5α reductase inhibitors and their combination

Medical therapy for clinical benign prostatic hyperplasia(BPH)has advanced significantly in the last 2 decades.Many new a1 antagonists and 5a reductase inhibitors(5ARi)are now commercially available.The practicing urologist must decide on the most appropriate medication for his patients,taking into consideration various factors like efficacy,dosing regime,adverse effects,cost,patient’s socioeconomic background,expectations,drug availability and his own clinical experience.The use of combination therapy added further to the complexity in clinical judgment when prescribing.We highlight some of the key points in prescribing a1 antagonists,5ARi and their combination,based on our viewpoints and experience as urologists in an Asian clinical setting.

Preclinical therapy of benign prostatic hyperplasia with neuropeptide hormone antagonists

Benign prostatic hyperplasia(BPH)is a pathologic condition of the prostate described as a substantial increase in its number of epithelial and stromal cells.BPH may significantly reduce the quality of life due to the initiation of bladder outlet obstruction and lower urinary tract syndromes.Current medical therapies mostly consist of inhibitors of 5α-reductase orα1-adrenergic blockers;their efficacy is often insufficient.Antagonistic analogs of neuropeptide hormones are novel candidates for the management of BPH.At first,antagonists of luteinizing hormone-releasing hormone(LHRH)have been introduced to the therapy aimed to reduce serum testosterone levels.However,they have also been found to produce an inhibitory activity on local LHRH receptors in the prostate as well as impotence and other related side effects.Since then,several preclinical and clinical studies reported the favorable effects of LHRH antagonists in BPH.In contrast,antagonists of growth hormone-releasing hormone(GHRH)and gastrin-releasing peptide(GRP)have been tested only in preclinical settings and produce significant reduction in prostate size in experimental models of BPH.They act at least in part,by blocking the action of respective ligands produced locally on prostates through their respective receptors in the prostate,and by inhibition of autocrine insulin-like growth factors-Ⅰ/Ⅱand epidermal growth factor production.GHRH and LHRH antagonists were also tested in combination resulting in a cumulative effect that was greater than that of each alone.This article will review the numerous studies that demonstrate the beneficial effects of antagonistic analogs of LHRH,GHRH and GRP in BPH,as well as suggesting a potential role for somatostatin analogs in experimental therapies.

Clinical study of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia with overactive bladder

Objective To evaluate the efficacy and safety of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia ( BPH) with overactive bladder ( OAB) . Methods 82 patients with OAB and coexisting BPH were randomly divided into tamsulosin group ( n

Prostate-specific antigen reduction after capecitabine plus oxaliplatin chemotherapy:A case report

BACKGROUND Prostate cancer(PC)is currently the most common malignant tumor of the genitourinary system in men.Radical prostatectomy(RP)is recommended for the treatment of patients with localized PC.Adjuvant hormonal therapy(AHT)can be administered postoperatively in patients with high-risk or locally advanced PC.Chemotherapy is a vital remedy for castration-resistant prostate cancer(CRPC),and may also benefit patients with PC who have not progressed to CRPC.CASE SUMMARY A 68-year-old male was admitted to our hospital because of urinary irritation and dysuria with increased prostate-specific antigen(PSA)levels.After detailed examination,he was diagnosed with PC and treated with laparoscopic RP on August 3,2020.AHT using androgen deprivation therapy(ADT)was performed postoperatively because of the positive surgical margin,extracapsular extension,and neural invasion but lasted only 6 mo.Unfortunately,he was diagnosed with rectal cancer about half a year after self-cessation of AHT,and was then treated with laparoscopic radical rectal resection and adjuvant chemotherapy using the capecitabine plus oxaliplatin(CapeOx)regimen.During the entire treatment process,the patient's PSA level first declined significantly after treatment of PC with laparoscopic RP and ADT,then rebounded because of self-cessation of ADT,and finally decreased again after CapeOx chemotherapy.CONCLUSION CapeOx chemotherapy can reduce PSA levels in patients with high-risk locally advanced PC,indicating that CapeOx may be an alternative chemotherapy regimen for PC.

Effect of two different extracts of red maca in male rats with testosterone-induced prostatic hyperplasia

Aim： To determine the effect of two different extracts of red maca in male rats. Methods： Prostatic hyperplasia was induced in male rats with testosterone enanthate （TE）. The study comprised six groups： one control group （group 1）, one group treated with TE （group 2）, two groups treated with TE and aqueous extract of red maca （groups 3 and 4）, one group treated with hydroalcoholic extract of red maca （group 5） and one group treated with finasteride （0.1 mg, group 6）. Differences in the aqueous extract dependent on the length of time of boiling, whether for 2 or 3 hours, for groups 3 and 4 was assessed. Extracts of red maca contained 0.1 mg of benzylglucosinolate. Thereafter, a doseresponse effect of different doses of benzylglucosinolates （0.02-0.08 mg） in red maca extracts was assessed. Results： Prostate weight was similar in rats treated with freeze-dried aqueous extract of red maca prepared after 2 and 3 hours of boiling. Freeze-dried aqueous extract of red maca, hydroalcoholic extract of red maca and finasteride reduced prostate weight in rats with prostatic hyperplasia. No difference was observed between the data obtained from aqueous extract or hydroalcoholic extract of red maca. A dose dependent reduction of prostate weight was observed with the increase of the dose of benzylglucosinolates in red maca extracts. Conclusion： The present study showed that hydroalcoholic or aqueous extract of red maca containing 0.1 mg of benzylglucosinolate can reduce prostate size in male rats in which prostatic hyperplasia had been induced by TE.

Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia

Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia （BPH） and to evaluate their clinical and voiding outcome. Methods： A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score （IPSS）, quality of life score （QoL）, uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results： All patients got through the perioperative period safely. The chief advantages of PVP were： short operative time （25.6 ± 7.6 min）, little bleeding loss （56.8 ± 14.3 mL） and short indwelling catheterization （1.6 ± 0.8 d）. The IPSS and QoL decreased from （29.6 ± 5.4） and （5.4 ± 0.6） to （9.5 ± 2.6） and （1.3 ± 0.6）, respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data （P 〈 0.05）. No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion： PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.

nfluence of immune inflammation on androgen receptor expression in benign prostatic hyperplasia tissue

This study was designed to investigate the association between immune inflammation and androgen receptor （AR） expression in benign prostatic hyperplasia （BPH）. We retrospectively analyzed 105 prostatectomy specimens. An immune inflammation score for each specimen was defined by combining three immunohistochemical markers （CD4, CD8 and CD20）. The immunohistochemical markers were CD4 and CD8 for T lymphocytes, CD20 for B lymphocytes and AR antibody for the AR in BPH samples. Rates of CD4, CD8, CD20 and AR expression in BPH were 20 （19.0%）, 21 （20.0%）, 101 （96.2%） and 48 （45.7%）, respectively. Total prostate volume （TPV） was higher in the immune inflammation group than in the non-immune inflammation group （62.7 ml vs. 49.2 ml, t=-2.482, P〈0.05）. Patients in the immune inflammation group had a higher serum prostate-specific antigen （PSA） than those in the non-inflammation group （7.5 ng m1-1 vs. 5.4 ng m1-1, t=-2.771, P〈0.05）. Specifically, the immune inflammation group showed a higher rate of AR expression than the non-inflammation group （56.1% vs. 28.2%, χ2=7.665, P〈0.05）. Our study revealed a strong association between immune inflammation and TPV, serum PSA and AR expression in BPH tissue. Prostate hyperplasia caused by an immune inflammatory process may contribute to BPH progression over time. Therefore, the inflammatory response involved in BPH may be a prime therapeutic target.

The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function： a systematic review

A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia （BPH） on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy （TUMT）, transurethral needle ablation of the prostate （TUNA）, transurethral ethanol ablation of the prostate （TEAP） and high-intensity frequency ultrasound （HIFU）, in comparison with traditional transurethral resection of the prostate （TURP） or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction （EjD） is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies （〉 33.6%）. TUMT, TUNA and neodymium：yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.

Human benign prostatic hyperplasia heterotransplants as an experimental model

Benign prostatic hyperplasia is a nonmalignant adenomatous enlargement of the pefiurethral prostate gland. It is a common disease in older men. In addition to man,spontaneous benign prostatic hyperplasia occurs in chimpanzee and the dog. Alternatives to these spontaneous models are induced benign prostatic hyperplasia,xenografts and in vitro models. Xenografts may be induced by cells cultured in vitro or by the heterotransplantation of primary surgical specimens into immunosuppressed mice. The purpose of this review is to integrate data from more than 30 years of heterotransplantation research in the study of benign hyperplasia of the prostate. Heterotransplantation has provided data regarding the histopathology,morphology,tissue markers,androgen receptor expression,tissue kinetics,take rate and tissue vasculature for this prostate disease.There are advantages,as well as limitations,that have been identified for human prostate disease heterotransplants versus xenotransplantation of cultured cells.Overall,heterotransplanted tissue is better at retaining tissue morphology,pathology,secretory activity,expression of tissue markers and human vasculature of the patient＇s original specimen. Furthermore,heterotransplanted tissue preserves the three-dimensional tissular architecture of the prostate to maintain critical stromal-epithelial cell interactions.

Evaluation for Madigan's prostatectomy in patients with benign prostatic hyperplasia

Aim: To comparatively evaluate the efficacy and post-operative complications of the Madigan's prostatectomy(MPC) and suprapubic prostatectomy (SPPC). Methods: A total of 43 patients with benign prostatic hyperplasiawere divided into two groups: 21 underwent MPC and 22, SPPC. In all the patients, the international prostate symp-tom score (IPSS) and urinary pressure-flow studies were assessed before and 6 months after operation. The InternationalContinence Society (ICS) nomogram, Abrams-Griffiths (AG) number and linear passive urethral resistance relationanalysis (L-PURR) were used to diagnose and grade bladder outlet obstruction (BOO). The IPSS and the urodynamicparameters before and after operation, as well as the advantages and post-operative complications were recorded andcompared. Results: Patients of both the MPC and SPPC groups had a significant improvement in IPSS and urody-namic parameters. Obstruction was relieved in 81.0% of MPC and 86.4% of SPPC patients. MPC has the advantagesof the absence of postoperative hematuria and post-catheter stricture, a shorter period of hospitalization, and lower inci-dence of retrograde ejaculation and erectile dysfunction. Conclusion: Both MPC and SPPC can effectively relieveBOO. MPC has certain advantages and a lower incidence of complications as compared with SPPC. (Asian J Androl2001 Mar; 3: 33-37)

KAI1/CD82 gene expression in benign prostatic hyperplasia and late-stage prostate cancer in Chinese

Aim: To evaluate KAII/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and late-stage carcinoma of prostate (CaP). Methods: Thirty Chinese patients with benign prostatic hyperplasia and 34 withCaP (adenocarcinoma clinical stage C and D) were analyzed by means of immunohistochemical methods. Results:The KAII/CD82 expression in BPH tissue was all positive, which was uniformly located on the glandular cell mem-brane at the cell-to-cell borders, but KAII/CD82 expression in metastasis CaP tissues was either significantly lower thanthat of BPH or negative, and the immunostaining pattern was not continuous. In late-stage CAP KAII/CD82 expressionwas correlated inversely to the pathological grade ( P < 0.05), but not to clinical stage ( P > 0.05). Conclusion:The authors believe that decreased and negative KAII/CD82 expression in late-stage CaP may be related to tumor pro-gression and metastasis, and appears to be a prognostic marker.