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Benign prostatic hyperplasia

All articles from this key word are listed below.

Volume 8, Supplement 4 Review Articles

Alpha-Blockers for the Treatment of Prostatitis-Like Syndromes

Advances in Alpha-Blocker Therapy in the Management of Urological Disorders

J Curtis Nickel

Prostatitis is a common medical diagnosis. The etiology of this symptomatic syndrome can be an acute or chronic bacterial infection, a noninfectious initiator (the most common cause), or iatrogenic heat or radiation; the syndrome may coexist with benign prostatic hyperplasia. Alpha-blockers have a role in the treatment of the prostatitis syndromes. In Category I, acute bacterial prostatitis, a-blockers have been shown to possibly ameliorate obstructive and irritative voiding symptoms. In Category II, chronic bacterial prostatitis, a-blockers seem to reduce the risk of clinical and bacteriological recurrence. In Category III, chronic pelvic pain syndrome, a-blockers improve symptoms and quality of life. Alpha-blockers also seem to ameliorate the symptoms and reduce the risk of acute urinary retention in patients who suffer from either heat- or radiation-induced prostatic inflammation. Alpha-blockers improve lower urinary tract symptoms, including pain, in patients who are diagnosed with both prostatitis and benign prostatic hyperplasia. Evidence has proven there is definitely a role for a-blockers in the management of the prostatitis syndromes. [Rev Urol. 2006;8(suppl 4):S26-S34]

Benign prostatic hyperplasia Lower urinary tract symptoms Blockers Prostatitis syndromes CP/CPPS

Volume 8, Number 4 Review Articles

The Role of Gonadotropin- Releasing Hormone Antagonists for the Treatment of Benign Prostatic Hyperplasia

Treatment Update

Medical therapy is the preferred first-line approach in the management of lower urinary tract symptoms in men with benign prostatic hyperplasia. The magnitude of the improvement in lower urinary tract symptoms observed in response to combination therapy (-blocker plus 5- reductase inhibitors) does not approach that achieved with prostatectomy. Various drugs have been under consideration, including BXL628, lonidamine, and phosphodiesterase inhibitors, all of which have had unacceptable side effects. The gonadotropinreleasing hormone antagonist cetrorelix is associated with dose-dependent symptom improvement and reduction of prostate volume. Elucidating the mechanism for cetrorelix-mediated improvement in lower urinary tract symptoms will likely contribute to unraveling the pathophysiology of lower urinary tract symptoms in men. [Rev Urol. 2006;8(4):183-189]

Benign prostatic hyperplasia Blockers 5-reductase inhibitors LH-RH antagonists Cetrorelix

Volume 8, Number 4 Meeting Reviews

Advances in the Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

Meeting Review

Claus G Roehrborn

Highlights from the 21st European Association of Urology Congress, April 5–8, 2006, Paris, France [Rev Urol. 2006;8(4):216-225]

Benign prostatic hyperplasia Nocturia Lower urinary tract symptoms Alfuzosin Prostatectomy PDE-5 inhibitors TURP Dutasteride Sexual dysfunction Acute urinary retention Chronic inflammatory infiltrates PVP High-energy transurethral microwave thermotherapy

Volume 8, Supplement 3 Review Articles

The Next Generation In Laser Treatments and the Role of the GreenLight High-Performance System Laser

Photoselective Vaporization of the Prostate

Lasers have evolved over the past decade, with technical refinements that have resulted in a procedure that can achieve transurethral-like results in a safe and efficacious manner. The physics and characteristics of the laser light, such as wavelength and power densities, influence efficiency of treatment and safety profiles of various laser techniques and systems. The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate gland in men with lower urinary tract symptoms and benign prostatic hyperplasia has been shown to be a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Refinements based on clinical experience as well as progress in available technologies have produced an advanced system with improvements in beam quality and an increase in power to provide an increase in vaporization efficiency and flexibility in technique. The refinements require adjustments to current technique. The advanced technological developments enhance the utility of this laser for application in benign prostatic hyperplasia and urology. [Rev Urol. 2006;8(suppl 3):S24-S30]

Benign prostatic hyperplasia Lower urinary tract symptoms Laser prostatectomy Potassium-titanyl-phosphate laser Transurethral resection of the prostate

Volume 8, Supplement 3 Review Articles

Safety and Efficacy of the Potassium-Titanyl-Phosphate Laser and Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia

Photoselective Vaporization of the Prostate

Claus G Roehrborn

The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate in men with lower urinary tract symptoms and benign prostatic hyperplasia (BPH) is a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Efficacy data from multicenter prospective studies, comparative studies against other interventions, and single-center long-term outcomes suggest the efficacy to be at least equivalent to that of transurethral resection of the prostate, with a very good safety profile. New technological developments promise to further enhance the utility of this laser for application in BPH and urology. [Rev Urol. 2006;8(suppl 3):S16-S23]

Benign prostatic hyperplasia Lower urinary tract symptoms Potassium-titanyl-phosphate laser Laser prostatec-tomy Photoselective vaporization of the prostate

Volume 8, Supplement 3 Review Articles

Economic Impact of Surgical Intervention in the Treatment of Benign Prostatic Hyperplasia

Photoselective Vaporization of the Prostate

John T Wei John M Hollingsworth

The economic burden of benign prostatic hyperplasia (BPH) on our health care system is significant and likely to continue to grow given the burgeoning elderly population. Coincident with the rising number of annual physician office visits and expenditures for BPH has been a dramatic shift in the disease’s management, from surgical to medical care. However, long-term cost data call into question the appropriateness of medical therapy as the initial treatment approach for all men with BPH, particularly those with moderate to severe symptoms. Although there has been a paradigm shift away from traditional BPH surgery, there has been renewed interest in the treatment of BPH with novel surgical techniques and minimally invasive surgeries. The economics of surgical interventions for BPH are discussed. [Rev Urol. 2006;8(suppl 3):S9-S15]

Benign prostatic hyperplasia Economics Surgical procedures, minimally invasive Transurethral resection of prostate

Volume 8, Number 3 Meeting Reviews

Best of the 2006 AUA Annual Meeting

Meeting Review

Michael K Brawer Shachi Tyagi Li-Ming Su Michael E Aldridge Tobias Klatte John P Mulhall John P Stein Arie S Belldegrun Danil V Makarov Claus G Roehrborn Jacob Rajfer J Curtis Nickel Victor W Nitti Michael B Chancellor Alan W Partin Ellen Shapiro

Highlights from the 2006 Annual Meeting of the American Urological Association May 20–25, 2006 Atlanta, GA

Prostate cancer Infertility Benign prostatic hyperplasia Bladder cancer Kidney cancer Lower urinary tract symptoms Bladder exstrophy Overactive bladder Interstitial cystitis Stress urinary incontinence Peyronie’s disease Spina bifida Neurogenic bladder Erectile dysfunction Chronic pelvic pain syndrome Chronic prostatitis Tumor markers Androgen replacement therapy Ejaculatory dysfunction Anorectal malformations Renal stones Robotic-assisted radical prostatectomy

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 4 Review Articles

Alpha Blockers for the Treatment of Benign Prostatic Hyperplasia

Treatment Update

The evolution of alpha blocker therapy for benign prostatic hyperplasia (BPH) has focused on improving convenience and tolerability. Indications for treating BPH include reversing signs and symptoms or preventing progression of the disease. The indication that most commonly drives the need for intervention is relief of lower urinary tract symptoms (LUTS) with the intent of improving quality of life. Alpha blockers are the most effective, least costly, and best tolerated of the drugs for relieving LUTS. Four long-acting alpha 1 blockers are approved by the Food and Drug Administration for treatment of symptomatic LUTS/BPH: terazosin, doxazosin, tamsulosin, and alfuzosin. All are well tolerated and have comparable dose-dependent effectiveness. Tamsulosin and alfuzosin SR do not require dose titration. Alfuzosin, terazosin, and doxazosin have all been shown to be effective in relieving LUTS/BPH independent of prostate size. [Rev Urol. 2007;9(4):181-190]

Benign prostatic hyperplasia Lower urinary tract symptoms Quality of life Tamsulosin Alfuzosin Doxazosin Terazosin

Volume 9, Number 4 Review Articles

Extending the Rationale of Combination Therapy to Unresponsive Erectile Dysfunction

Treatment Update

Christopher Reece Diedre Nienow Ajay Nehra Rajeev Kumar

Combination therapies aim to overcome the limitations of individual drugs by selecting diverse targets of action to enhance effectiveness synergistically. This article reviews the principles of combination therapy and its applications for benign prostatic hyperplasia and overactive bladder. It then examines pathophysiological, pharmacological, and clinical evidence for currently available drug and device combinations for erectile dysfunction that has not responded to first-line, single-agent therapy. [Rev Urol. 2007;9(4):197-206]

Benign prostatic hyperplasia Overactive bladder Erectile dysfunction Combination therapy Intracavernosal therapy Intraurethral therapy