Urtica dioica in the Management of Benign Prostate Hyperplasia (BPH)

2020 ◽  
Vol 10 (5) ◽  
pp. 535-542
Author(s):  
Mohaddese Mahboubi
Keyword(s):  
Molecular Mechanisms ◽  
Life Quality ◽  
Urtica Dioica ◽  
Urinary Flow ◽  
Prostate Hyperplasia ◽  
Long Time ◽  
Tract Infections ◽  
Preclinical And Clinical Studies ◽  
Benign Prostate ◽  
Maximum Urinary Flow

Background:: Benign Prostatic hyperplasia (BPH) is known as a disease prevalent in men after the age of 50 years old. Ninety percent of men with the age of 80 years and over have BPH. BPH is associated with functional problems like dysuria, nocturia, polyuria, urinary incontinence and recurrent urinary tract infections. Urtica dioica or nettle is a popular medicinal plant for management of BPH in men. Objective:: This article evaluates the efficacy and safety of nettle and its related possible mechanisms in the management of BPH. Methods:: For the preparation of this manuscript, all the information was gathered from accessible and inaccessible resources (Web, Books, Thesis, etc.). Results:: The results of preclinical and clinical studies confirmed the efficacy of nettle roots extracts (methanol, ethanol, and petroleum ether) in the improvement of BPH in term of IPSS score, and patient's life quality. An increase in mean and maximum urinary flow rates and a reduction in prostate volume and residual urine level were observed after treatment with nettle extract. Nettle roots should be used for 6-12 months as its use is possible for a long time without any serious adverse effects. Conclusion:: Designing the clinical trials to compare the efficacy of different extracts from roots or leaves and investigation of molecular mechanisms of action could be the approaches for future.

Holmium laser enucleation of prostate for patients with acute urinary retention due to benign prostate hyperplasia: Efficacy and safety

2019 ◽  
Author(s):  
Pu Li(Former Corresponding Author) ◽  
Jun Tao ◽  
Chengming Wang ◽  
Min Tang ◽  
Xiaoxin Meng(New Corresponding Author)
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Benign Prostate Hyperplasia ◽  
Holmium Laser ◽  
Common Disease ◽  
Urinary Flow ◽  
Prostate Hyperplasia ◽  
Laser Enucleation ◽  
Benign Prostate ◽  
Holmium Laser Enucleation

Abstract Background Benign prostate hyperplasia (BPH) is a common disease in older men, and part of patients develop acute urinary retention (AUR) at the time of initial treatment. The aim of this study was to evaluate the effectiveness and safety of holmium laser enucleation of prostate (HoLEP) for patients with BPH in setting of AUR. Methods The clinical data of 88 patients with BPH who underwent HoLEP surgery in our center were retrospectively analyzed. AUR existed in 34 patients and the other 54 patients had no AUR. The general information, prostate volume, urodynamic parameters and intraoperative parameters were recoeded and compared. The outcome were recorded and analysed including the international prostate symptom score (IPSS), quality of life score (QoL), maximum urinary flow rate (Qmax), and post-voiding residual (PVR). Results In both groups, the preoperative parameters were equivalent except for the white blood cell in urinalysis. All the HoLEP procedures were smoothly carried out. The intr- and post-operative complications were low in both groups and no difference were detected. All the patients were followed up for at least 6 months. IPSS, QoL, Qmax and PVR were all improved in both groups. No statistical differences were obtained in these parameters between groups. Conclusion s HoLEP could be a safe and effective treatment for BPH patients either with or without AUR. The efficacy was immediate and sustained during the short-term follow-up session in both groups.

scholarly journals Research on Applications of Transurethral Plasmakinetic Enucleation of the Prostate in Elderly Patients Aged ≥80 Years

2021 ◽  
Vol 8 ◽  
Author(s):  
Wen Su ◽  
Ye Yi ◽  
Liang Zeng ◽  
Jin Tang
Keyword(s):  
Elderly Patients ◽  
Transurethral Resection ◽  
Benign Prostate Hyperplasia ◽  
Specific Antigen ◽  
Urinary Flow ◽  
Prostate Hyperplasia ◽  
Flushing Time ◽  
Benign Prostate

Objective: To evaluate the safety and efficacy of transurethral plasmakinetic enucleation of the prostate (PKERP) vs. transurethral resection of the prostate (TURP) in elderly patients aged ≥80 years with benign prostate hyperplasia.Materials and Methods: We conducted a retrospective analysis of the PKERP (n = 123) and TURP (n = 143) in patients aged ≥80 years at urology department of The Third Xiangya Hospital of Central South University from January 2016 to October 2019. Then the preoperative, intraoperative, and postoperative data of different indicators were compared between the two groups. The follow-up was done at 3 months, 1 year after surgical treatment.Results: No significant differences were observed between the two groups for the baseline characteristics, including age, prostate volume, prostate-specific antigen (PSA) level, concurrent disease, maximum urinary flow rate (MFR), international prostate symptoms score (IPSS), and quality of life (QoL) score. The operative time, hemoglobin decrease, and postoperative flushing time were significantly lower in the PKERP group compared with the TURP group. However, no significant differences were observed between both groups for postoperative hospital stay, incidence of transurethral resection syndrome (TURS), prostatic capsular perforation, and genuine urinary incontinence. The follow-up results showed that the MFR of the PKERP group was significantly higher than the TURP group at 1 year after surgery.Conclusion: Compared with TURP, PKERP is a safe and efficacious method for treating patients aged ≥80 years with benign prostate hyperplasia, and it may improve long-term urination symptoms.

scholarly journals Comparison of Penile Cuff Test and Conventional Urodynamic Study Prior to Photoselective Vaporization of Prostate for Benign Prostate Hyperplasia Using a 120 W GreenLight High Performance System Laser

2020 ◽  
Vol 9 (4) ◽  
pp. 1189
Author(s):  
Kang Sup Kim ◽  
Yong Sun Choi ◽  
Woong Jin Bae ◽  
Hyuk Jin Cho ◽  
Ji Youl Lee ◽  
...  
Keyword(s):  
Bladder Outlet Obstruction ◽  
Benign Prostate Hyperplasia ◽  
Outlet Obstruction ◽  
Urinary Flow ◽  
Urodynamic Study ◽  
Prostate Hyperplasia ◽  
Predictive Values ◽  
Number Of Patients ◽  
Photoselective Vaporization ◽  
Benign Prostate

Background: We compared the utility of the penile cuff test (PCT) and the conventional urodynamic study (UDS) for the preoperative assessment of patients undergoing scheduled photoselective vaporization of the prostate (PVP) for benign prostate hyperplasia (BPH). Methods: Fifty-nine patients with voiding lower urinary tract symptoms (LUTS) underwent a simultaneous PCT and conventional UDS before PVP. The modified International Continence Society (ICS) nomogram was used to confirm bladder outlet obstruction after measuring maximum urinary flow rate and highest pressure at flow interruption. The PCT and UDS results, in terms of modified ICS nomogram predictions, were compared. Their sensitivities, specificities, and positive and negative predictive values were calculated. Results: Thirty-six patients were diagnosed as obstructed and 23 as non-obstructed/equivocal using the modified ICS nomogram during the PCT. All 36 of the first group were confirmed as obstructed by UDS. Of the 23 diagnosed as non-obstructed/equivocal by the PCT, 14 were confirmed to be non-obstructed by UDS, with nine diagnosed as obstructed. The PCT showed a sensitivity of 80% and a specificity of 100%. The positive and negative predictive values were 100% and 60.9%, respectively. Conclusions: In conclusion, despite our small number of patients, the PCT’s high sensitivity and specificity suggest that it may provide diagnostic information about bladder outlet obstruction before PVP for patients with voiding LUTS. Evidently, the PCT has the potential to be used for some patients as a screening alternative to invasive UDS.

scholarly journals DOXAZOSIN AND MELOXICAM COMBINATION THERAPY FOR BPH TREATMENT WITH LUTS

2014 ◽  
Vol 21 (1) ◽  
Author(s):  
Wayan Suarsana ◽  
Sunaryo Hardjowijoto ◽  
Soetojo Wirjopranoto ◽  
Budiono Budiono
Keyword(s):  
Blood Flow ◽  
Combination Therapy ◽  
Benign Prostate Hyperplasia ◽  
Double Blind Study ◽  
Urinary Flow ◽  
Prostate Hyperplasia ◽  
Once Daily ◽  
Significant Difference ◽  
Grade Ii ◽  
Benign Prostate

Objective: To compare the efficacy of combination therapy of 4 mg doxazosin + 15 mg meloxicam with 4 mg doxazosin single therapy for benign prostate hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS). Materials & Methods: A prospective, randomized and double blind study with total of 22 BPH patients with LUTS were randomized to receive 4 mg doxazosin + placebo once daily for 6 weeks or a combination of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks. Inclusion criteria included IPSS ≥ 8, age > 50 years, prostate blood flow grade II. Therapeutic efficacy was assessed by comparing changes in IPSS, maximal urinary flow (Q-max) and changes in prostate blood flow between baseline and immediately after 6 weeks of therapy. Results: There was no significant difference in IPSS change between the two treatment groups (delta IPSS 4 ± 1.1 versus 3.7 ± 1.5, p = 0.630). There was a significant difference in Q-max changes between the two groups (delta Q-max 4 ± 1.5 versus 2.1 ± 0.7, p < 0.001). In group therapied with 4 mg doxazosin + 15 mg meloxicam prostate blood flow decreased from grade II to grade I in 9 of 11 patients (81%). Whereas, in the treatment group of 4 mg doxazosin + placebo no reduction was found in prostate blood flow. Conclusion: Combination therapy of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks is better than 4 mg doxazosin therapy alone in improving Q-max and decreasing prostate blood flow in BPH patients with LUTS.Keywords: Benign prostate hyperplasia, inflammation, COX-2 inhibitors.

scholarly journals Structure of human steroid 5α-reductase 2 with anti-androgen drug finasteride

2020 ◽  
Author(s):  
Qingpin Xiao ◽  
Lei Wang ◽  
Shreyas Supekar ◽  
Tao Shen ◽  
Heng Liu ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Structural Information ◽  
Conformational Dynamics ◽  
Dynamics Simulation ◽  
Structural Topology ◽  
Prostate Hyperplasia ◽  
Its Gene ◽  
Binding Cavity ◽  
Benign Prostate ◽  
Structural Insights

Abstract Human steroid 5α-reductase 2 (SRD5α2) as a critical integral membrane enzyme in steroid metabolism catalyzes testosterone to dihydrotestosterone. Mutations on its gene have been linked to 5α-reductase deficiency and prostate cancer. Finasteride and dutasteride as SRD5α2 inhibitors are widely used anti-androgen drugs for benign prostate hyperplasia, which have recently been indicated in the treatment of COVID-19. The molecular mechanisms underlying enzyme catalysis and inhibition remained elusive for SRD5α2 and other eukaryotic integral membrane steroid reductases due to a lack of structural information. Here, we report a crystal structure of human SRD5α2 at 2.8 Å revealing a unique 7-TM structural topology and an intermediate adduct of finasteride and NADPH as NADP-dihydrofinasteride in a largely enclosed binding cavity inside the membrane. Structural analysis together with computational and mutagenesis studies reveals molecular mechanisms for the 5α-reduction of testosterone and the finasteride inhibition involving residues E57 and Y91. Molecular dynamics simulation results indicate high conformational dynamics of the cytosolic region regulating the NADPH/NADP+ exchange. Mapping disease-causing mutations of SRD5α2 to our structure suggests molecular mechanisms for their pathological effects. Our results offer critical structural insights into the function of integral membrane steroid reductases and will facilitate drug development.

scholarly journals Structure of human steroid 5α-reductase 2 with the anti-androgen drug finasteride

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Qingpin Xiao ◽  
Lei Wang ◽  
Shreyas Supekar ◽  
Tao Shen ◽  
Heng Liu ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Transmembrane Domain ◽  
Structural Information ◽  
Conformational Dynamics ◽  
Dynamics Simulation ◽  
Structural Topology ◽  
Prostate Hyperplasia ◽  
Binding Cavity ◽  
Benign Prostate ◽  
Structural Insights

Abstract Human steroid 5α-reductase 2 (SRD5A2) is an integral membrane enzyme in steroid metabolism and catalyzes the reduction of testosterone to dihydrotestosterone. Mutations in the SRD5A2 gene have been linked to 5α-reductase deficiency and prostate cancer. Finasteride and dutasteride, as SRD5A2 inhibitors, are widely used antiandrogen drugs for benign prostate hyperplasia. The molecular mechanisms underlying enzyme catalysis and inhibition for SRD5A2 and other eukaryotic integral membrane steroid reductases remain elusive due to a lack of structural information. Here, we report a crystal structure of human SRD5A2 at 2.8 Å, revealing a unique 7-TM structural topology and an intermediate adduct of finasteride and NADPH as NADP-dihydrofinasteride in a largely enclosed binding cavity inside the transmembrane domain. Structural analysis together with computational and mutagenesis studies reveal the molecular mechanisms of the catalyzed reaction and of finasteride inhibition involving residues E57 and Y91. Molecular dynamics simulation results indicate high conformational dynamics of the cytosolic region that regulate NADPH/NADP+ exchange. Mapping disease-causing mutations of SRD5A2 to our structure suggests molecular mechanisms for their pathological effects. Our results offer critical structural insights into the function of integral membrane steroid reductases and may facilitate drug development.

HUBUNGAN USIA, OBESITAS DAN RIWAYAT PENYAKIT DIABETES MELLITUS DENGAN KEJADIAN BENIGN PROSTATE HYPERPLASIA (BPH) DERAJAT IV DI RSUD DR. M. HAULUSSY AMBON PERIODE 2012-2014

2017 ◽  
pp. 141-151
Author(s):  
Andrew Ruspanah
Keyword(s):  
Diabetes Mellitus ◽  
Benign Prostate Hyperplasia ◽  
Chi Square ◽  
Cross Sectional ◽  
Prostate Hyperplasia ◽  
Benign Prostate

Pendahuluan. Benign Postate Hiperplasia (BPH) adalah penyakit yang umumnya terjadi pada pria lansia yang disebabkan oleh penuaan. Hiperplasia prostat adalah pertumbuhan jaringan nodul fibroadenomatosa pada prostat. Pembesaran prostat jinak merupakan penyakit yang tersering kedua setelah batu saluran kemih didapatkan secara klinis di Indonesia. Tujuan. Penelitian ini bertujuan untuk mengetahui hubungan antara usia, obesitas dan riwayat diabetes mellitus dengan kejadian Benign Prostate Hyperplasia (BPH) grade IV di Rumah Sakit Dr. M. Haulussy Ambon periode 2012-2014. Metode. Jenis penelitian ini adalah penelitian analitik desain Cross-Sectional, dengan menggunakan catatan medis data di ruang operasi di Rumah Sakit Dr. M. Haulussy Ambon Tahun 2012-2014 dan memperoleh jumlah sampel yang memenuhi kriteria inklusi sebanyak 239, yang diambil dengan teknik total sampling. Analisis dilakukan dengan analisis univariat dan bivariat menggunakan uji Chi Square. Hasil yang di temukan dalam penelitian ini bahwa kejadian BPH lebih besar pada mereka yang berusia> 65 tahun dan 56-65 tahun dibandingkan dengan usia 46-55 dan <46 tahun dengan hasil tes menunjukkan adanya hubungan antara usia dengan BPH dengan nilai (p= 0,000), ada hubungan antara obesitas dengan nilai BPH (p=0,019) dan riwayat diabetes mellitus setelah menggunakan uji Chi-Square, hubungan antara riwayat diabetes mellitus dengan BPH dengan nilai (p = 0,000). Kesimpulan. Ada hubungan antara umur, obesitas dan riwayat diabetes mellitus dengan kejadian BPH.

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