Concentrations of Norfloxacin in prostatic tissues following oral administration in patients with benign prostatic hyperplasia

For assessing plasma and tissue concentrations of norfloxacin after oral administration, twelve patients with benign prostatic hypertrophy (BPH) were given two doses of 400 mg norfloxacin approximately 12 hours apart prior to transurethral resection of the prostate (TURP). Prostatic tissue samples and blood samples were collected and assayed for norfloxacin content by HPLC. The mean peak norfloxacin concentration in plasma was 1.63 μg/ml (range 0.63 to 3.38 μg/ml). The mean peak concentration in prostatic tissue was 1.63 μg/g (range 0.75 to 3.30 μg/g). The plasma and prostatic tissue levels of norfloxacin exceeded the MIC's of most urinary tract pathogens. The data suggest that norfloxacin may be useful in the treatment of chronic bacterial prostatitis.     

Prostatic stents for benign prostatic hyperplasia

Treatment options for benign prostatic hyperplasia (BPH) have developed rapidly over the past several years. These options include surgical intervention, medical therapy, and minimally invasive modalities such as prostatic stents. Prostatectomy remains the treatment of choice for symptoms that are the result of bladder outflow obstruction, with success rates of 85-90%. Medical therapy with selective alpha-1 antagonists, 5 alpha-reductase inhibitors, LHRH antagonists, antiandrogens, and aromatase inhibitors have increased in popularity and are mainly used to treat patients with mild to moderate prostatic obstruction. Prostatic urethral stents have recently emerged as an alternative treatment for BPH throughout Europe and Asia, but few investigators have used prostatic stents in the United States because of strict regulatory forces and a debate concerning the indications for these devices. The possibility of providing a treatment option for BPH to patients who are frail and elderly, as well as to patients with multiple medical problems, has prompted enthusiasm toward prostatic stents in the urologic community. The focus of this review will be an up-to-date discussion of the types of prostatic stent available, including a review of recent clinical trials involving the use of each available stent.     

前列腺动脉栓塞术治疗良性前列腺增生

目的评价前列腺动脉栓塞术(PAE)治疗良性前列腺增生(BPH)的可行性、有效性。方法对7例BPH患者行PAE,术后1、6个月复查并收集临床结果,观察比较手术前后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、前列腺体积(PV)、最大尿流率(Q_(max))、剩余尿(RU)的变化。结果 7例患者共完成12支较大前列腺动脉(PA)的栓塞治疗,其中膀胱下动脉发出7支,闭孔动脉2支,阴部内动脉2支,臀下动脉1支。单侧栓塞2例,双侧栓塞5例。与术前比较,术后6个月IPSS显著改善[平均提高(24.00±3.90)分],QOL改善[平均降低(4.00±1.40)分],Q_(max)显著改善[平均改善(8.45±1.90)ml/s],PV显著缩小[平均减少(42.86±21.20)ml],RU显著下降[平均减少(122.86±74.80)ml]。结论PAE治疗BPH有效、可行,具有良好的应用前景。     

Randomized crossover comparison of tamsulosin and alfuzosin in patients with urinary disturbances caused by benign prostatic hyperplasia

Purpose  

The aim of this study was to compare the efficacy and safety of alfuzosin (Alf) and tamsulosin (Tam) in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).     

Urinary flow rates in patients with benign prostatic hypertrophy following treatment with alfuzosin. DUALF Group.

In order to document further the onset of action of alfuzosin, a selective alpha-1 blocker, 93 symptomatic patients with benign prostatic hypertrophy were randomly allocated to a single oral dose of either alfuzosin 1.25 mg or 2.5 mg, or placebo, after a 1-week placebo lead-in period. The effects on flow rates were assessed 1 h 30 min after administration. Peak and mean flow rates were significantly increased in the alfuzosin groups, as compared with placebo, in a dose-dependent manner. After a single intake of placebo, the mean values of these 2 parameters showed little change. The effect on the cardiovascular system (heart rate and blood pressure) was mild. This study indicates that the action of alfuzosin is already present 1 h 30 min after administration.     

Prostatic anatomical parameters correlate with clinical characteristics suggestive of benign prostatic hyperplasia

We conducted the present study to assess the correlation of the prostatic anatomical parameters,especially the ratio of peripheral zone thickness and transition...     

Sexual dysfunction in patients with benign prostatic hyperplasia

Two of the most common problems presenting to urologists are benign prostatic hyperplasia and sexual dysfunction, with an increasing number of patients presenting for treatment as a result of the proliferation of less invasive therapies. How such therapies for lower urinary tract symptoms affect sexual function in men is important to both urologists and their patients, and is the focus of this review.     

Sexual function in patients with benign prostatic hyperplasia

Sexual health has significant impact on quality of life among men with benign prostatic hyperplasia (BPH). The degree of sexual dysfunction matches the severity of lower urinary tract symptoms (LUTS). Treatment of BPH affects not only LUTS, but sexual function as well. Medical, surgical, and minimally invasive therapies differ in their effect on erectile function, ejaculation, and sexual satisfaction. Choice of treatment modality takes into account baseline sexual function and patient expectations. This review outlines the relationship between LUTS and sexual function and how they change with the currently available treatments.     

Levels of carbenicillin in serum and prostatic tissue after intravenous administration in patients with benign prostatic hyperplasia

Carbenicillin (CB-PC) was administered intravenously (5 gm over one-half hour) to 25 patients suffering form benign prostatic hyperplasia. Prostatic biopsies and sera were obtained one, two, three, four, and five hours later for histology and biochemical analyses of the serum and prostatic tissue levels of CB-PC. The serum and prostatic tissue levels of carbenicillin attained were sufficient to eradicate gram-negative bacteria within the five time intervals studied. The ratio of prostatic tissue level of CB-PC to the serum level of this agent increased in proportion to the grading of round cell infiltration of the prostatic tissue. The results of this study point to the clinical usefulness of CB-PC in the treatment of chronic and acute prostatitis.     

Serum proteins in patients with benign prostatic hyperplasia

Studies of serum protein patterns done in a group of 42 patients with benign prostatic hyperplasia (PBH) revealed the following: (1) prior to the operation significant hypalbuminaemia and increase of alpha 2-, beta- and gamma-globulins, IgG, IgA, IgM and CRP levels; (2) 12 days after operation a marked decrease of albumin concentration, increase of alpha 2-globulin and a sharp rise of CRP; (3) after 1 year a decrease of hypalbuminaemia and increase of alpha 2- and beta-globulins and CRP; in contrast to that, there was further increase of gamma-globulin concentration expressed also in the IgG, IgA and IgM levels.     

Bladder compliance in patients with benign prostatic hyperplasia

Factors influencing bladder compliance were examined in 116 patients with benign prostatic hyperplasia (BPH), by evaluating patients' histories, response of isolated bladder strips to acetylcholine, and the effect of prostatic urethral anesthesia. Patients' age, frequency of micturition, and duration of voiding difficulty were not correlated with bladder compliance. Bladder compliance was significantly low in patients within 30 days after urinary retention, as compared with bladder compliance in patients without an episode of retention. More than 30 days after retention, however, there was a tendency toward increased bladder compliance. Restricted to patients without an episode of retention, bladder compliance in the overactive detrusor group was found to be significantly lower than in the normal group. The responses to acetylcholine of bladder strips were compared between patients with low and normal-compliance bladders. The dose-response curve of patients with low-compliance bladders did not differ from that of those with normal compliance bladders, even when patients with an episode of retention were excluded. After prostatic urethral anesthesia, a significant increase of bladder compliance was observed in patients with an overactive detrusor, while the increase was not significant in patients with a normal detrusor. Our results strongly suggest that easy irritability of the anatomically altered prostatic urethra, as well as bladder overdistension caused by urinary retention, are important factors affecting bladder compliance in BPH patients.     

Obstructive uropathy in patients with benign prostatic hyperplasia

In an attempt to determine the role of obstructive prostatic hyperplasia as a cause of irreversible renal function the records of 32 men with a diagnosis of benign prostatic hyperplasia and renal failure were reviewed. Patients were classified as either having a serum creatinine of more than or less than 4 mg.per 100 ml. when they were discharged from the hospital. Admission serum creatinine levels were comparable in both groups. Characteristics of the group with permanently impaired renal function included a longer mean duration of symptoms, higher incidence of urinary tract infection, lower average volume of residual urine and greater incidence of small kidneys with increased parenchymal echogenicity. These data assist in the objective prediction of patients who will have irreversible renal dysfunction when presenting with obstructive benign prostatic hyperplasia.     

良性前列腺增生患者尿流动力学检查前预防性应用抗生素的研究

目的:探讨良性前列腺增生(BPH)患者行尿流动力学检查前预防性应用抗生素的有效性及安全性。方法:选取2010年10月至2012年10月行尿流动力学检查的BPH患者256例,随机分为两组,对照组(n=118)检查前不用预防性抗生素应用,试验组(n=138)检查前30 min用头孢西丁钠1.0 g静滴后由同一名医生行全套尿流动力学检查。对比两组患者尿路感染发生率。结果:对照组患者中发生尿路感染24例(20.3%),试验组10例(7.3%),两组结果有统计学意义(P<0.01)。合并糖尿病患者感染率试验组6.7%(3/45),对照组23.5%(8/34),两组对比有统计学意义(P<0.05);合并残余尿(>50 ml)患者感染率试验组5.4%(3/56),对照组18.5%(10/54),两组对比有统计学意义(P<0.05);合并糖尿病及残余尿患者感染率试验组9.5%(2/21),对照组44.4%(8/18),两组对比有统计学意义(P<0.05);试验组中仅有3例出现药物不良反应(2.2%)。结论:BPH患者,特别是合并糖尿病及残余尿患者,行尿流动力学检查前预防性应用抗生素能有效预防尿路感染的发生,且具有良好的安全性。     

前列腺动脉栓塞治疗高龄高危良性前列腺增生患者的疗效观察

目的:探讨前列腺动脉栓塞(PAE)治疗高龄高危良性前列腺增生(BPH)患者的安全性和疗效。方法:分析21例高龄高危BPH患者采用PAE治疗的临床资料。结果:21例患者PAE均顺利完成,操作时间90~200 min,术后2周、3个月、6个月和1年随访,IPSS分别为(18.3±3.1)、(9.8±2.7)、(9.4±2.5)、(10.1±2.2)分,QOL分别为(4.6±1.4)、(4.3±1.2)、(4.6±1.1)、(4.9±0.6)分,最大尿流率分别为(12.5±2.5)、(15.8±2.4)、(16.6±2.2)、(16.3±1.8)ml/s,残余尿量分别为(35.0±3.4)、(13.0±3.3)、(10.0±3.0)、(8.0±2.5)ml,与术前[IPSS(24.5±3.7)分、QOL(5.7±1.6)分、最大尿流率(8.3±2.1)ml/s、残余尿量(98.0±11.0)ml]相比,均有明显改善(P均0.05);彩色多谱勒显示前列腺内血流信号明显减弱,前列腺体积分别为(74.4±4.8)、(42.5±4.4)、(38.3±4.0)、(36.7±3.5)cm3,与术前前列腺体积(84.3±5.4 cm3)相比明显缩小(P均0.05)。结论:PAE对于高龄高危BPH患者是一种可选择的安全有效的治疗方法。