Cordyceps militaris Fruit Body Extract Decreases Testosterone Catabolism and Testosterone-Stimulated Prostate Hypertrophy

The androgens testosterone and dihydrotestosterone (DHT) are essential for a variety of systemic functions in mature males. Alteration of these hormones results in late-onset hypogonadism (LOH) and benign prostate hyperplasia (BPH). The fruit bodies of fungi of the genus Cordyceps have been regarded as folk medicine or health food with tonic and antifatigue effects. The extract from the fruit body of Cordyceps militaris parasitizing Samia cynthia ricini (CM) was evaluated as a novel-candidate natural product for ameliorating male andropause symptoms. To explore the effects of CM on LOH and BPH, CM was applied to rat models and cultured testicular cells and prostate cells. The concentrations of androgens in the serum and culture media were determined by ELISA. Expression of steroidogenic enzymes and androgen-related genes was evaluated by qPCR, and prostatic cell proliferation was assessed with the cell-viability assay. CM maintained the serum levels of testosterone and DHT, but inhibited testosterone-induced prostate hypertrophy. CM also increased the secretion of testosterone and DHT by primary testicular cells, with no changes in the mRNA expression of steroidogenic enzymes, but decreased the growth of prostatic cell lines. Our data suggest that CM could improve both LOH and BPH in males.     

经尿道前列腺气化术治疗前列腺增生症（附60例报道）

目的：观察经尿道气化术治疗前列腺增生症（BPH）的近期疗效。方法：应用经尿道前列腺气化术治疗BPH60例。结果：60例患手术均成功。手术时间20－＃120min。术中心电图、血压无改变。结论：认为经尿道前列腺气化术（TUVP）损伤小、安全性高、疗效确切且并发症少,尤其适用于有严重并发症的高危患,TUVP治疗BPH近期效果好,其远期效果有待进一步随访观察。     

前列腺增生症伴有神经源性排尿功能障碍的处理

目的：提高对前列腺增生症伴有神经源性排尿功能障碍的认知和处理水平。方法：回顾分析14例前列腺增生症伴有神经源性排尿功能障碍患者的临床资料、尿动力学检查、诊断、处理及预后情况。结果：14例中行前列腺电气化9例,趾骨上经膀胱前列腺摘除术1例,膀胱永久造瘘2例,药物保守治疗2例。电气化患者1例出现永久性尿失禁,1例术后1年又出现增生,经再次气化治疗后痊愈,其余患者排尿均明显改善,残余尿减少或消失。结论：前列腺增生症伴有原性尿功能障碍并不少见,通过细致的检验和尿动力学检查,明确神经性排尿功能障碍的严重程度,选择恰当的治疗方案能够改善排尿症状,减少永久膀胱造瘘,最大限度地提高病人的生活质量。     

Nonalcoholic fatty liver disease and risk of prostatic diseases: Roles of insulin resistance

Nonalcoholic fatty liver disease (NAFLD), the liver component of metabolic syndrome, is considered to be associated with high risk of prostatic diseases but a systematic review has not been conducted. Under a comprehensive review of the eligible clinical studies, a potential positive association between NAFLD and benign prostatic hyperplasia/prostate cancer (BPH/PCa) has been postulated. Insulin resistance and metabolic aberrations are considered to be the potential mechanism for such association. However, the relationship between NAFLD and other prostatic diseases, that is, prostatic inflammation and lower urinary tract symptoms, seems vague due to limited relevant studies in the literatures. The present review highlights that clinicians should be conscious of the detrimental effect of NAFLD on the development of BPH and PCa.     

Is ‘Omega Sign’ anatomical endoscopic enucleation of the prostate technique reproducible?

We aimed to evaluate the learning curve of the surgically standardised ‘Omega Sign’ anatomical endoscopic enucleation (AEEP) of the prostate surgery technique for junior surgeons. This study is a retrospective comparison of cases that underwent AEEP by a mentor surgeon and three junior surgeons who have completed their learning curve. A video-based laser enucleation of the prostate assessment tool (LEAT) composed of 8 steps of the technique was used to assess a senior surgeon and junior surgeons’ surgical compatibility and consistency. The surgeon who defined Omega Sign technique was determined as group 1, and cases by three junior surgeons were identified as group 2. The end points were to assess the reproducibility and repeatability and operative post-operative outcomes of the technique. 55 patients’ videos were rated by five experienced endourologists. There was no significant difference in LEAT scores between the groups among all steps. The most symmetry was found in the 1st and 3rd steps. Inter-rater consistency was also high for each step, with no statistically significant difference between the evaluators. The standardised anatomical ‘Omega Sign’ technique is reproducible for the junior surgeons. The operative steps can be performed with high consistency, and the functional and perioperative outcomes are comparable with the senior surgeon.     

Outcomes and complications of naftopidil versus tamsulosin for elderly men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: A systematic review and meta-analysis

We conducted a systematic review and meta-analysis to assess the outcomes and complications of naftopidil in treating elderly men with lower urinary tract symptoms secondary to benign prostatic hyperplasia and compared them with those administered with tamsulosin. A literature review was performed to identify the available randomised controlled trials concerning the comparison between naftopidil and tamsulosin for men with LUTS/BPH. We searched the following databases: the Cochrane Library Database, PubMed, Embase and Web of Science. Eleven publications involving 1,114 men (557 in the naf group and 557 in the tam group) were pooled in our analysis. We found no significant differences in the total IPSS, IPSS storage score, IPSS voiding score, quality of life index, peak urinary flow rate, average flow rate and post-void residual volumes. We assessed cardiovascular and sexual adverse events, acute urinary retention, surgical intervention, withdrawals due to any reason and withdrawals due to adverse events. The incidence of adverse events was similar among patients in naf and tam groups. In conclusion, naftopidil shared comparable efficacy and similar incidence of adverse events with tamsulosin and appears to be a promising agent for and alternative to tam. However, more prospective trials with high quality and long-term treatment duration are needed to verify this observation.     

经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生的临床体会

目的探讨经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生患者的安全性、有效性和远期并发症情况。方法回顾性研究2017年10月至2018年9月我院45例<30g小体积前列腺增生患者的临床资料,其中TURP组20例,1470 nm激光组25例。详细记录两组患者的临床资料、围手术期并发症和随访情况。结果45例患者手术均成功,术后平均随访时间12.6个月(9~16个月)。两组患者年龄、前列腺体积和IPSS、RUV、Qmax和QOL基线资料差异无统计学意义(P>0.05)。TURP组和1470 nm激光组患者术后3个月IPSS、RUV、Qmax和QOL均较术前改善(P<0.05),组间比较差异无统计学意义(P>0.05)。1470 nm激光组患者手术时间([48.6±13.6)min vs(56.8±11.7)min,P=0.038]、术后膀胱持续冲洗时间[(0.8±0.5)d vs(1.5±0.9)d,P=0.001]、导尿管留置时间([2.7±0.6)d vs(4.7±0.9)d,P<0.001]和住院时间([4.2±1.2)d vs(5.2±1.9)d,P=0.036]较TURP组患者明显缩短,术前术后血红蛋白浓度变化更小([5.5±2.4)g/L vs(11.6±2.7)g/L,P<0.01]。随访发现TURP组有2例出现尿道狭窄,1470 nm激光组无尿道狭窄病例发生。结论经尿道国产1470 nm激光汽化术治疗<30 g小体积前列腺增生安全有效,与传统TURP比较术中出血少,术后恢复时间更短,无尿道狭窄并发症发生,为BPH的个体化治疗提供了新的思路。     

Association of TERT gene polymorphisms with clinical benign prostatic hyperplasia in a Chinese Han population of the Northwest region

BackgroundTo investigate the association between single nucleotide polymorphisms (rs10078761, rs12696304, rs2853669, rs16847897, rs2736100, rs10069690) of telomerase gene (TERT) and the risk clinical benign prostatic hyperplasia (BPH) in a Chinese Han population of the Northwest region.MethodsA total of 150 BPH patients and 150 healthy older males from the northwest Chinese Han population were included in this study. The sample size for this unmatched case-control study was estimated by the look-up table method. Meanwhile, the general information and disease data of patients were collected. Age was only collected in healthy control subjects for statistical correction. Genotypes were detected using a multiplex PCR + ligase detection reaction (LDR). Typing results and clinical data were statistically analyzed using multiple linear regression and logistic regression. Pearson correlation was used for Hardy-Weinberg equilibrium.ResultsThe included population is in Hardy-Weinberg equilibrium. There was no significant association between SNP and the risk of BPH by correlation analysis. However, 4 haplotypes (TCTGGT, TCTGTC, TGCCTC, and TGTGTC) were identified as risk factors of BPH by haplotype analysis. The SNP rs2853669 is an independent risk factor for smooth muscle type of hyperplasia. Besides, rs2736100, rs10078761, and rs10069690 which are in linkage disequilibrium are associated with the severity of BPH.ConclusionsPolymorphism of the TERT gene determines the different disease development and pathological manifestations of BPH in the Chinese Han population the Northwest region.