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Steven A Kaplan

All articles from this author are listed below.

Volume 8, Number 1 Review Articles

Medical Therapy for Benign Prostatic Hyperplasia: New Terminology, New Concepts, Better Choices

Management Update

Steven A Kaplan

Benign prostatic hyperplasia Bladder outlet obstruction Overactive bladder Detrusor overactivity Medical Therapy of Prostatic Symptoms trial Muscarinic

Volume 9, Number 2 Review Articles

Phosphodiesterase Type 5 Inhibitors for the Treatment of Male Lower Urinary Tract Symptoms

Treatment Update

Ricardo R Gonzalez Steven A Kaplan

Both lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) and erectile dysfunction have a very high prevalence among aging men, and there is some clinical evidence that they may share a common pathophysiology. Consequently, several preliminary studies of phosphodiesterase type 5 inhibitors—sildenafil and tadalafil—have recently been conducted in men with concomitant erectile dysfunction and lower urinary tract symptoms to determine whether these agents are effective for the treatment of symptomatic BPH. These studies have demonstrated efficacy, both alone and in combination with an -blocker, in treating lower urinary tract symptoms along with sexual dysfunction. However, larger-scale randomized studies are necessary to determine long-term safety, efficacy, and cost effectiveness. [Rev Urol. 2007;9(2):73-77]

Benign prostatic hyperplasia Lower urinary tract symptoms Erectile dysfunction Tadalafil Sildenafil Phosphodiesterase type 5 inhibitors

Volume 11, Supplement 1 Review Articles

Side Effects of a-Blocker Use: Retrograde Ejaculation

Advances in the Pharmacologic Treatment of BPH

Steven A Kaplan

There are currently 5 α-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all α-blockers are equally effective. However, α-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available α-blockers being used to treat men with LUTS due to benign prostatic hyperplasia.[Rev Urol. 2009;11(suppl 1):S14–S18 doi: 10.3909/riu11S1S0001]© 2009 MedReviews®, LLC

Benign prostatic hyperplasia Lower urinary tract symptoms Blockers

Volume 13, Number 3 Review Articles

Role of Inflammation in Benign Prostatic Hyperplasia

Disease State Review

Richard Lee Bilal Chughtai Alexis E Te Steven A Kaplan

Inflammation of the prostate may represent a mechanism for hyperplastic changes to occur in the prostate. There are a variety of growth factors and cytokines that may lead to a proinflammatory process within the prostate. There are several proposed mechanisms that lead to both the intrinsic and extrinsic basis of inflammation. Prostatic inflammation may represent an important factor in influencing prostatic growth and progression of symptoms. This article reviews the recent literature on inflammation leading to chronic prostatic diseases, such as benign prostatic hyperplasia. [Rev Urol. 2011;13(3):147-150 doi: 10.3909/riu0535] © 2011 MedReviews®, LLC

Benign prostatic hyperplasia Inflammation Prostatitis Prostatic cytokines Vitamin D

Volume 14, Number 3 Review Articles

Update on Phosphodiesterase Type 5 Inhibitors for the Treatment of Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia

Treatment Update

Bilal Chughtai Alexis E Te Dean S Elterman Richard K Lee Steven A Kaplan

Many aging men will experience both erectile dysfunction (ED) and benign prostatic hyperplasia (BPH), resulting in lower urinary tract symptoms (LUTS). Basic and clinical evidence suggests common pathogenic mechanisms underlying both LUTS and ED. Decreases in the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway with age result in decreased levels of intracellular cGMP and calcium, leading to diminished smooth muscle relaxation of the bladder and prostate and worsening LUTS. Phosphodiesterase type 5 inhibitors as monotherapy in combination with a-blockers have shown efficacy in treating both LUTS and ED. Tadalafil has recently been approved by the US Food and Drug Administration for the treatment of LUTS secondary to BPH, with or without concomitant ED. [Rev Urol. 2012;14(3/4):79-86 doi: 10.3909/riu0559] © 2013 MedReviews®, LLC

Benign prostatic hyperplasia Lower urinary tract symptoms Erectile dysfunction Phosphodiesterase inhibitors Tadalafil Sildenafil Vardenafil

Volume 15, Number 3 Review Articles

Use of Herbal Supplements for Overactive Bladder

Management Update

Bilal Chughtai Richard Lee Alexis E Te Elizabeth Kavaler Franklin C Lowe Steven A Kaplan

Anticholinergics, specifically antimuscarinic agents, are the most common medications prescribed for overactive bladder (OAB). The most common side effects of these agents are dry mouth and constipation, although other more concerning effects include changes in blood pressure, pulse rate, or heart rhythm when treatment is initiated. Herbal treatments are an increasingly popular alternative for treating OAB. A 2002 survey of US adults aged ≥ 18 years conducted by the Centers for Disease Control and Prevention indicated that 74.6% of those with OAB had used some form of complementary and alternative medicine. The World Health Organization estimates that 80% of the world’s population presently uses herbal medicine for some aspect of primary health care. Women were more likely than men to use complementary and alternative medicine. The authors review the most commonly used herbal medications for OAB. [Rev Urol. 2013;15(3):93-96 doi: 10.3909/riu0587] © 2013 MedReviews®, LLC

Overactive bladder Herbal medicine Gosha-jinki-gan Hachi-mi-jio-gan Buchu (Barosma betuline)Cleavers (Galium aparine)Cornsilk (Zea mays)Horsetail (Equisetum)Ganoderma lucidum Resinferatoxin Capsaicin

Volume 15, Number 2 Review Articles

Conservative Treatment for Postprostatectomy Incontinence

Treatment Update

Alexis E Te Bilal Chughtai Steven A Kaplan Richard Lee

Postprostatectomy incontinence (PPI) is a bothersome complication of radical prostatectomy. Although most men recover from PPI, some men continue to have persistent urinary incontinence. The initial management of persistent PPI usually consists of conservative measures such as pelvic floor muscle exercises. Surgical treatments are usually not entertained for men with urinary incontinence until conservative treatments have failed. This article discusses risk factors for PPI and various options for its treatment, including biofeedback and pharmacotherapy. [Rev Urol. 2013;15(2):61-66 doi: 10.3909/riu0569] © 2013 MedReviews®, LLC

Radical prostatectomy Postprostatectomy incontinence Pelvic floor muscle training

Volume 17, Number 2 Review Articles

Relationship Between Depression and Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

Mangement Update

Bilal Chughtai Alexis E Te Steven A Kaplan Leanna Laor Claire Dunphy

This article provides an overview of current data on the relationship between depression and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), with a focus on pathophysiology and patient management implications. Review of the literature indicated a clear relationship between LUTS secondary to BPH and depression. It is unknown whether this relationship is bidirectional or unidirectional. Depression is associated with the impact of LUTS on quality of life in men with BPH. Research suggests that depression alters the experience of LUTS in this population. Medical and surgical treatments for BPH may impact quality of life and, therefore, depression. Results conflict on the exact nature of the relationship examined, and on the extent to which the relationship may be attributed to physiological factors such as inflammation. Practicing clinicians should consider using a brief self-administered scale to assess for depression in patients with BPH. There is a clear need for additional research to decisively determine the nature of the relationship between LUTS secondary to BPH and depression, as well as the extent to which change in either condition may be affected by the other. [Rev Urol. 2015;17(2):51-57 doi: 10.3909/riu0658] © 2015 MedReviews®, LLC

Benign prostatic hyperplasia Depression Lower urinary tract symptoms

Volume 17, Number 2 Review Articles

Diagnosis, Evaluation, and Treatment of Mixed Urinary Incontinence in Women

Diagnosis and Treatment Update

Bilal Chughtai Alexis E Te Steven A Kaplan Leanna Laor Claire Dunphy Richard Lee

Mixed urinary incontinence (MUI) is a common clinical problem in the community and hospital setting. The broad definition of the term makes it difficult to diagnose, as well as determine effective treatment strategies. There are no current guidelines recommended for physicians. The estimated prevalence of this condition is approximately 30% in all women with incontinence. It has also been suggested that patients with MUI report more bothersome symptoms than either stress or urge incontinence; approximately 32% of 40- to 64-year-olds with MUI report symptoms of depression. The authors examine the diagnosis, evaluation, and treatment of patients with MUI. [Rev Urol. 2015;17(2):78-83 doi: 10.3909/riu0653] © 2015 MedReviews®, LLC

Mixed urinary incontinence Detrusor overactivity Stress incontinence Urge incontinence Urodynamic stress incontinence Pelvic organ prolapse Transvaginal tape

Volume 21, Number 4 Review Articles

Long-term Consequences of Medical Therapy for Benign Prostatic Hyperplasia

Management Update

Vannita Simma-Chiang Steven A Kaplan Eric M Bortnick

Benign prostatic hyperplasia (BPH) is a common disease in men. Although transurethral resection of the prostate (TURP) is the gold standard therapy for treatment of BPH and associated lower urinary tract symptoms (LUTS), many patients choose to avoid surgery and instead choose medical therapy. Until recently, medical therapy for BPH has been thought to be both safe and effective. However, new studies have shown that some of these medications can have significant neurocognitive, psychiatric, and sexual side effects, including dementia and depression. As most patients taking these medications will continue them for the long term, it is vital for physicians to explain these potential risks to the patient prior to prescribing them for a quality-of-life condition. [Rev Urol. 2019;21(4):154–157] © 2020 MedReviews®, LLC

Benign prostatic hyperplasia Medical therapy Depression Dementia 5-Alpha-reductase inhibitors alpha-blockers