Storage Irritative) and Voiding Obstructive) Symptoms as Predictors of Benign Prostatic Hyperplasia Progression and Related Outcomes
|
|
- Conrad Evans
- 5 years ago
- Views:
Transcription
1 European Urology European Urology ) 1±6 Storage Irritative) and Voiding Obstructive) Symptoms as Predictors of Benign Prostatic Hyperplasia Progression and Related Outcomes Claus G. Roehrborn a,*, John D. McConnell a, Brian Saltzman b, Donald Bergner c, Todd Gray d, Perinchery Narayan e, Thomas J. Cook f, Amy O. Johnson-Levonas f, Wilson A. Quezada f, Joanne Waldstreicher f for the PLESS Study Group) a Department of Urology, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., J8-130, Dallas, TX , USA b Harvard Medical School, Beth Israel Hospital, Boston, MA, USA c Tampa Bay Medical, Clearwater, FL, USA d Lovelace Medical Center, Albuquerque, NM, USA e Department of Veterans Affairs, Gainesville, FL, USA f Merck Research Laboratories, Rahway, NJ, USA Accepted 26 April 2002 Abstract Objectives: To assess the utility of voiding and lling symptom subscores in predicting features of benign prostatic hyperplasia BPH) progression, including acute urinary retention AUR) and prostate surgery. Methods: The Proscar Long-termEf cacy and Safety Study PLESS) was a 4-year study designed to evaluate the effects of nasteride versus placebo in men with lower urinary tract symptoms LUTS), clinical evidence of BPH, and no evidence of prostate cancer. A self-administered questionnaire was employed to quantify LUTS at baseline. Receiver operating characteristics ROC) curves were used to assess baseline characteristics frompatients treated with placebo as predictors of outcomes. The characteristics assessed included the overall symptom score Quasi-AUA SI), separate voiding and lling subscores, prostate volume PV) and serum prostate-speci c antigen PSA) levels. Results: PV and PSA were superior to the symptom scores at predicting episodes of spontaneous AUR and all types of AUR. The Quasi-AUA SI and the lling and voiding subscores were effective at predicting progression to surgery; however, PSA was more effective at predicting this outcome. To better evaluate symptoms as predictors of surgery, patients who experienced a preceding episode of AUR were excluded fromthe surgery analysis. In the absence of preceding AUR, the best predictors of future surgery were the Quasi-AUA SI and the lling subscore. Conclusions: Among men with LUTS, clinical BPH and no history of AUR, the overall symptom score and storage subscore are useful parameters to aid clinicians in identifying patients at risk for future prostate surgery. PVand PSA were the best predictors of AUR, while PSA was the best predictor of prostate surgery for all indications). # 2002 Elsevier Science B.V. All rights reserved. Keywords: Benign prostatic hyperplasia; Acute urinary retention; Prostate surgery; BPH progression; Prostatespeci c antigen; AUA symptom score 1. Introduction Benign prostatic hyperplasia BPH) is a highly prevalent histological diagnosis in older men, and may * Corresponding author. Tel ; Fax: address: claus.roehrborn@utsouthwestern.edu C.G. Roehrborn). lead to progressive enlargement of the prostate gland and the development of lower urinary tract symptoms LUTS) [1]. Although many men with LUTS manage well without therapy, others experience a progressive worsening of their condition with the development of bladder outlet obstruction, which may ultimately result in acute urinary retention AUR) or require surgical intervention [2,3] /02/$ ± see front matter # 2002 Elsevier Science B.V. All rights reserved. PII: S )
2 2 C.G. Roehrborn et al. / European Urology ) 1±6 Clinical and epidemiological studies have identi ed numerous risk factors for BPH progression. A study based on a community cohort of men showed that, compared to younger men, the incidence of spontaneous AUR was three times higher in men aged 60 to 69, and eight times higher in men aged 70 to 79 years old [4]. In addition to age, increased incidence of AUR was associated with depressed urinary ow rates and prostate volume PV) >30 ml. Further supportive data come from the Proscar Long-term Ef cacy and Safety Study PLESS), which demonstrated that the incidence of AUR or prostate surgery in placebo-treated men increased from8.9% in patients with the smallest prostate volumes to 22.0% in patients with the largest volumes [5]. Similar data were obtained upon analyzing tertiles of serumprostate-speci c antigen PSA); the incidence of AUR or surgery increased from7.8% in the lowest tertile to 19.9% in the highest tertile. Data fromthis study demonstrated that PSA and PV are powerful predictors of the risk of AUR and surgery in men with LUTS and clinical BPH and no evidence of prostate cancer. The American Urological Association Symptom Index AUA SI) has been categorized into voiding obstructive) symptoms urinary hesitancy, diminished stream, straining, incomplete emptying, interruption of the urinary stream, and dribbling) thought to be associated with obstruction, and lling irritative) symptoms urgency, frequency, and nocturia) believed to arise frominvoluntary detrusor contractions detrusor overactivity). Despite the empiric validity of symptom subscores, there is little evidence supporting their clinical usefulness [6,7]. In this post-hoc analysis, we re-analyzed data frompless to assess whether separate voiding and lling subscores are predictive of BPH progression and related outcomes. 2. Patients and methods 2.1. Study design PLESS was a 4-year, placebo-controlled study evaluating 3040 patients with moderate to severe LUTS and enlarged prostates, with no evidence of prostate cancer. The present analysis includes only placebo-treated patients fromthis trial N ˆ Following a 1-month placebo run-in, patients were randomized to receive either nasteride 5 mg or placebo once daily for 4 years [8]. The primary endpoint, symptom score, was assessed by a self-administered questionnaire that queried subjects regarding the frequency of LUTS. Subsequent to the initiation of PLESS, the AUA SI was adopted as a standard for symptom assessment. The seven symptom components of the AUA SI nocturia, impairment in size and force of urinary stream, urinary frequency, delay, strained, or interrupted urination, and incomplete emptying of the bladder) were represented in the PLESS questionnaire. A pre-de ned linear transformation of the seven symptom components in the PLESS questionnaire was used togeneratethe Quasi-AUASI[8]. TheQuasi-AUASIwasdividedinto voidingandstorage lling)subgroupsaspublishedbywelchetal.[6]. Surgery and the occurrence of AUR during the 4-year period were prede ned secondary endpoints. An Endpoint Committee reviewed all the study documents for each man who underwent prostate surgery or who had AUR requiring catheterization of the bladder. The AUR was classi ed as spontaneous if there was no precipitating factor, or precipitated if there was a factor that may have contributed to the development of retention. PSA and symptom scores were measured in all patients. By design, PV was assessed in a subset of patients 10%) by magnetic resonance imaging Statistical analysis Receiver operating characteristics ROC) curves have been used to evaluate the ability of PV, PSA, and symptom score to predict the AUR and BPH-related surgery [5]. In this report, we used the same type of analysis to examine the ability of lling and voiding symptom subscores to predict BPH-related outcomes. Baseline symptom scores were used to plot ROC curves and the area under the curve AUC) was computed by the method of Hanley and McNeil [9]. The AUC for a particular population denotes the probability that a randomly chosen individual in the affected population has a higher value of a de ned parameter than a randomly chosen individual in the non-affected population. The area under the ROC curve is non-informative when AUC ˆ 0:5; therefore, values furthest from0.5, when statistically signi cant, are usually meaningful. An alpha level of 0.05 was used in the analyses. 3. Results 3.1. Patient accounting A total of 1516 men were randomized to placebo, and ef cacy data were available for 1503 men 99%). By the end of the study, 42% of patients discontinued treatment. Four-year follow-up data was available for 92% of all patients randomized, including those who discontinued treatment. In the remaining 8%, complete information was available until discontinuation of medication or until the 6-month follow-up after discontinuation. Over a 4-year period, AUR developed in 7% of placebo-treated patients, compared to 3% of patients receiving nasteride [8]. Approximately 10% of the patients in the placebo group versus 5% in the nasteride group underwent BPH-related surgery [8]. Among the placebo patients who had surgery, approximately 32% had a preceding episode of AUR either spontaneous or precipitated) Acute urinary retention PV and PSA were previously shown to be the best predictors of spontaneous and all types of AUR in PLESS. In contrast, the Quasi-AUA SI was a poor predictor of AUR [5]. In the present report, ROC curves were used to evaluate the performance of baseline lling and voiding subscores as predictors of all types
3 C.G. Roehrborn et al. / European Urology 42 (2002) 1±6 3 Table 1 Area under the ROC curve for several baseline parameters that may predict acute urinary retention and prostate surgery Outcome Baseline characteristic Filling symptoms Voiding symptoms Quasi-AUA SI score PV Serum PSA All AUR Spontaneous Precipitated * ** *** 0.703*** 0.632*** All surgery Excluding preceding AUR 0.588*** 0.615*** 0.558* 0.568* 0.587*** 0.608*** *** 0.564* * * p < 0:05. ** p < 0:01. *** p < 0:001. of AUR (Table 1; Fig. 1A) and spontaneous AUR (Table 1; Fig. 1B). For comparison, we also show the results from the ROC analyses of baseline PV, PSA and Quasi-AUA SI. The ROC curves for PV were discontinuous in nature due to the limited number of placebo patients who underwent prostate imaging at baseline. Relative to PV and PSA, the lling and voiding subscores were poor predictors of urinary retention (spontaneous, precipitated, and all kinds of AUR). The voiding subscore was numerically better at predicting future episodes of spontaneous AUR compared to the Quasi-AUA SI and the lling subscore. Fig. 1. The ROC curve analyses to measure the ability of baseline parameters, including serum PSA, PV, Quasi-AUA SI, and the separate lling and voiding symptom subscores, to predict (A) all episodes of AUR, and (B) spontaneous episodes of AUR in placebo-treated patients with LUTS and clinical BPH. Fig. 2. The ROC curve analyses to assess the ability of baseline parameters, including serum PSA, Quasi-AUA SI, and the separate lling and voiding symptom subscores, to predict (A) prostate surgery in the entire cohort of placebo-treated patients, or (B) in patients without a preceding episode of AUR.
4 4 C.G. Roehrborn et al. / European Urology ) 1±6 Fig. 3. Percent of patients needing surgery over a 4-year period, excluding all patients who experienced a preceding episode of AUR, strati ed by baseline response to two lling symptoms relating to nocturia and urinary frequency All prostate surgery As previously shown [5], PSA and PV were superior to the Quasi-AUA SI at predicting surgery Fig. 2A; Table 1). Despite the high AUC value for PV, this parameter did not show statistically signi cant predictive power for surgery due to the limited number of patients 10%) with prostate size measurements. The Quasi-AUA SI and the lling subscore were marginally better at predicting progression to surgery in placebotreated patients compared to the voiding subscore BPH-related surgery in the absence of AUR The ability of the Quasi-AUA SI and lling subscore to predict BPH-related surgery substantially improved when patients who had experienced a prior episode of AUR were excluded fromthe analysis Fig. 2B). The AUC values increased from0.587 p < 0:001 to p < 0:001 for the overall symptom score and from0.588 p < 0:001 to p < 0:001 for the lling subscore Table 1). While the voiding subscore remained nearly unchanged by this analysis, the predictive abilities of PV decreased from0.635 p ˆ 0:086 to p ˆ 0:490, and PSA from p<0:001 to p ˆ 0:03. Compared to the Quasi-AUA SI and the lling subscore, PVand PSA were relatively poor predictors of BPH-related surgery in men who did not have a preceding episode of AUR Predictive value of individual lling and voiding questions for surgery In order to explore the relationship between individual symptoms and risk of surgery, we plotted the percentage of patients needing surgery by baseline patient response to individual questions. None of the Quasi-AUA SI questions were predictive of surgery with the exception of two lling questions nocturia and increased urinary frequency) Fig. 3). Men reporting ve or more night time urinations at baseline had more than twice the risk of undergoing surgery than men reporting no night time urination. In addition, those men reporting urinary frequency from ``half the time'' to ``almost always'' at baseline had twice the risk of requiring surgery than patients experiencing less frequent urination. 4. Discussion In a previous analysis of PLESS data, we examined the ability of baseline characteristics to predict important BPH progression and related outcomes [5]. The ROC analyses were used to determine the predictive abilities of PSA, PV and the Quasi-AUA SI for AUR and prostate surgery for all indications including AUR-related prostatectomies). The results of this initial analysis demonstrated that PSA and PV were strong predictors of AUR and prostate surgery; however, the predictive value of PV did not reach statistical signi cance most likely due to the limited number of patients with prostate size measurements [5]. The similarity in the magnitude of the AUC values for PSA and PV most likely re ects the strong correlation between these two parameters [10]. Compared to PSA and PV, symptom severity, as measured by the
5 C.G. Roehrborn et al. / European Urology ) 1±6 5 Quasi-AUA SI, was a relatively poor predictor of AUR and prostate surgery for all indications [5]. In the present analysis, we sought to determine whether subdividing the Quasi-AUA SI score into its lling and voiding components would improve the predictive ability of symptom scores for long-term BPH-related outcomes. The results of this analysis con rm that compared to PV and PSA, symptom severity is a poor predictor of AUR and prostate surgery for all indications [5]. Of the symptom scores, the voiding subscore was the only signi cant predictor of spontaneous AUR p < 0:050, although it did not outperformpv and PSA. To explore whether symptom scores were useful at predicting surgery in the absence of a medical indication, we re-analyzed the symptom score data by excluding patients who developed spontaneous or precipitated AUR prior to undergoing surgery. The AUC values for the Quasi-AUA SI and the lling subscore increased substantially with this analysis, suggesting that lling/irritative and overall symptom scores are useful for assessing future risk of surgery in the absence of other indications. The AUC values for the Quasi-AUA SI and the lling subscore were similar in magnitude and signi cance, con rming that voiding symptoms were not predictive of BPH-related surgery. Two lling questions increased urinary frequency and nocturia) appeared to be driving the predictive ability of the symptom scores for BPH-related surgery. This nding supports the commonly held clinical belief that irritative symptoms are most bothersome to the patient, motivating doctor visits and ultimately leading to the decision to proceed with surgery in the absence of other medical indications. In comparison, the lling subscore was a relatively poor predictor of AUR, suggesting that the factors leading to AUR are clearly different fromthe sensory disturbances of irritative lling. Arrighi et al. [11] analyzed data fromthe Baltimore Longitudinal Study of Aging BLSA) to determine the ability of pre-surgical characteristics to predict subsequent prostatectomy in men with BPH. After controlling for age, ``diminished stream'', incomplete emptying, and increased PV by palpation had a signi cant positive association with the subsequent risk of having a prostatectomy [11]. Voiding symptoms and PV were found to be predictive of future prostatectomy, but nocturia, although prevalent in older men, was not. Unlike our analysis of PLESS, the importance of nocturia was not found in BLSA [11], but differences between the studies may account for such discrepancies. BLSA studied community men, not selected for age or for symptoms suggestive of prostate obstruction, while PLESS studied men of a restricted age range who had moderate-tosevere symptoms and enlarged prostates. Furthermore, BLSA included men with preceding AUR in analyzing symptoms predictive of future prostatectomy, while the PLESS analysis showed that, by excluding these patients, the predictive ability of the scores could be improved. Finally, BLSA examined the ability of presurgical variables assessed just prior to surgery) to predict prostatectomy, whereas PLESS analyzed baseline characteristics in a 4-year prospective clinical trial. Recently, Barry et al. re-examined data from the Veterans Administration Co-operative Study to determine the merit of calculating separate lling and voiding subscores [7]. Although these analyses con- rmed the empiric validity of subdividing the AUA SI into two symptom components, they did not establish the clinical usefulness of symptom subscores in the diagnosis of disease severity, or in identifying patients who may respond to speci c pharmacologic treatments. Our analysis indicates that lling symptoms may be useful in predicting prostate surgery among patients who do not have a speci c indication for surgery, such as AUR. Patients with advanced lling subscores who have not experienced AUR may bene t frommedical therapies proven to reduce the risk of surgery. Nevertheless, prostate volume and PSA are important considerations when weighing options for the treatment of bladder outlet obstruction secondary to BPH, as these measures are the best predictors of surgery for all causes AUR related or not). We recognize that clinical trials do not necessarily predict outcomes observed in clinical practice or in population based studies. General population studies have demonstrated a positive relationship between BPH symptoms and outcomes [4,12,13]; however, the relationships between separate voiding versus lling symptoms and individual outcomes have not been evaluated. This new analysis of PLESS demonstrated that the lling subscore and overall symptom score are useful predictors of BPH-related surgery in men who had not experienced a preceding episode of AUR. It is possible that in a broader sample population of patients with BPH, voiding and storage symptoms may demonstrate more usefulness in predicting BPH progression and related outcomes, especially AUR. It is also likely that baseline PV and PSA would still be the best predictors, since these parameters are more directly linked to the BPH disease process. Acknowledgements This study was sponsored by Merck Research Laboratories, Rahway, NJ. The authors would like to
6 6 C.G. Roehrborn et al. / European Urology ) 1±6 acknowledge the coordinators at the participating sites for their tremendous contribution to this study. The PLESS Study Group includes in alphabetical order): A. Aigen, P. Albertsen, R. Anderson, G. Andriole, S. Auerbach, M. Bamberger, J. Bannow, W. Barzell, D. Bergner, J. Bonilla, R.B. Bracken, W. Brannan, W. Bremner, T. Brown, R. Bruskewitz, R. Castellanos, S. Childs, K.S. Cof eld, T. Cook, C. Cox, E.D. Crawford, B. Dalkin, R.W. devere White, G. Drach, H. Epstein, C. Ercole, D. Falcone, D. Finnerty, W. Fitch, M. Flanagan, J. Fowler, H. Fuselier, D. Garvin, J. Geller, R. Gibbons, P. Gilhooly, M. Gittelman, S. Glickman, J. Gottesman, T. Gray, J. Grayhack, H. Guess, L. Harrison, R. Herlihy, G.B. Hodge Jr., H.L. Holtgrewe, R. Huben, P. Hudson, C.L. Jackson, E. Johnson, D. Kadmon, S. Kandzari, S. Kantor, S. Kaplan, M. Koppel, G. Kornitzer, D. Kozlowski, O. Kurzer, R. Labasky, J. Libertino, M. Lieber, R. Lund, S. Luttge, D. Lynch, G. Malek, N Mangelson, A. Matsumoto, J.D. McConnell, W.S. McDougal, A. Melman, D. Milam, R. Milsten, J. Mitchell, D. Mobley, P. Narayan, J.C. Nickel, L. Oppenheimer, F. Pappas, R. Parra, L. Peterson, J. Rajfer, P. Reddy, M. Resnick, O.F. Rigby, C.G. Roehrborn, N. Romas, S. Rosenberg, S. Rosenblatt, S. Rous, C. Rowe, J. Roy, B. Saltzman, W.P. Sawyer, P. Schellhammer, J. Schmidt, K. Short, T. Shown, D. Siegel, M. Soloway, T. Stanisec, B. Stein, E. Stoner, M. Sullivan, D. Sussman, A.M. Taylor, L. Tenover, J. Waldstreicher, P. Walsh, D. Wang, F. Wei, S. Weiner, G. Wells, H. Wessells, C. White, H. Wise, and G. Zhang. The authors gratefully acknowledge Dr. Michael J. Barry for his insight and comments on the analysis of BPH-related surgery. References [1] Garraway WM, Kirby RS. Benign prostatic hyperplasia: Effects on quality of life and impact on treatment conditions. Urology 1994;44:629±36. [2] Boyle P. Some remarks on the epidemiology of acute urinary retention. Arch Ital Urol 1998;LXX:77±82. [3] Girman CJ, Waldstreicher J. Prevention of the progression and longtermcomplications of benign prostatic hyperplasia. In: Resnick MI, Thompson IM, editors. Advanced Therapy of Prostate Disease. Hamilton BC): Decker Inc., p. 498±507. [4] Jacobsen SJ, Girman CJ, Guess HA, Rhodes T, Oesterling J, Lieber MM. Natural history of prostatism: Longitudinal changes in voiding symptoms in community dwelling men. J Urol 1996;155:595±600. [5] Roehrborn CG, McConnell JD, Lieber M, Kaplan S, Geller J, Malek GH et al. Serumprostate-speci c antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. Urology 1999;53:473±80. [6] Welch G, Kawachi I, Barry MJ, Giovannucci E, Colditz GA, Willett WC. Distinction between symptoms of voiding and lling in benign prostatic hyperplasia: Findings fromthe Health Professionals Followup Study. Urology 1998;51:422±7. [7] Barry M, Williford W, Fowler F, Jones KM, Lepor H. Filling and voiding symptoms in the American Urological Association Symptom Index: The value of their distinction in a veterans affairs randomized trial of medical therapy in men with a clinical diagnosis of benign prostatic hyperplasia. J Urol 2000;164:1559±64. [8] McConnell JD, Bruskewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL et al. The effect of nasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-TermEf cacy and Safety Study Group. New Engl J Med 1998;338:557±63. [9] Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic ROC) curve. Radiology 1982;143:29±36. [10] Roehrborn CG, Boyle P, Gould AL, Waldstreicher J. Serumprostatespeci c antigen as a predictor of prostate volume in men with benign prostatic hyperplasia. Urology 1999;53:581±9. [11] Arrighi HM, Guess HA, Metter EJ, Fozard JL. Symptoms and signs of prostatismas risk factors for prostatectomy. Prostate 1990;16: 253±61. [12] Girman CJ, Jacobsen SJ, Guess HA, Oesterling JE, Chute CG, Panser LA et al. Natural history of prostatism: Relationship among symptoms, prostate volume, and peak urinary ow rate. J Urol 1995;153:1510±5. [13] Barry MJ, Fowler Jr. FJ, Bin L, Pitts JC, Harris CJ, Mulley AG. The natural history of patients with benign prostatic hyperplasia as diagnosed by North American urologists. J Urol 1997;157:10±5.
The New England Journal of Medicine
The New England Journal of Medicine Copyright, 1998, by the Massachusetts Medical Society VOLUME 338 F EBRUARY 26, 1998 NUMBER 9 THE EFFECT OF FINASTERIDE ON THE RISK OF ACUTE URINARY RETENTION AND THE
More informationThe Hallmarks of BPH Progression and Risk Factors
European Urology Supplements European Urology Supplements 2 (23) 2 7 The Hallmarks of BPH Progression and Risk Factors M. Emberton * Institute of Urology and Nephrology, University College London, 48 Riding
More informationα-blocker Monotherapy and α-blocker Plus 5-Alpha-Reductase Inhibitor Combination Treatment in Benign Prostatic Hyperplasia; 10 Years Long-Term Results
www.kjurology.org http://dx.doi.org/10.4111/kju.2012.53.4.248 Voiding Dysfunction α-blocker Monotherapy and α-blocker Plus 5-Alpha-Reductase Inhibitor Combination Treatment in Benign Prostatic Hyperplasia;
More informationDepartment of Urology, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX
NEW PERSPECTIVES ON BPH 5- -Reductase Inhibitors Prevent the Progression of Benign Prostatic Hyperplasia Claus G. Roehrborn, MD Department of Urology, The University of Texas Southwestern Medical Center
More informationISSN: (Print) (Online) Journal homepage:
Archives of Andrology Journal of Reproductive Systems ISSN: 0148-5016 (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/iaan19 CHANGE IN INTERNATIONAL PROSTATE SYMPTOM SCORE AFTER TRANSURETHRAL
More informationREVIEW The utility of serum prostatic-specific antigen in the management of men with benign prostatic hyperplasia
(2008) 20, S19 S26 & 2008 Nature Publishing Group All rights reserved 0955-9930/08 $30.00 www.nature.com/ijir REVIEW The utility of serum prostatic-specific antigen in the management of men with benign
More informationIncreasing Awareness, Diagnosis, and Treatment of BPH, LUTS, and EP
Introduction to Enlarged Prostate E. David Crawford, MD Professor of Surgery (Urology) and Radiation Oncology Head, Urologic Oncology E. David Crawford Endowed Chair in Urologic Oncology University of
More informationTherapeutic Strategies for Managing BPH Progression
european urology supplements 5 (2006) 997 1003 available at www.sciencedirect.com journal homepage: www.europeanurology.com Therapeutic Strategies for Managing BPH Progression John M. Fitzpatrick a, *,
More informationLONG-TERM SAFETY AND EFFICACY OF TAMSULOSIN FOR THE TREATMENT OF LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA
0022-5347/03/1702-0498/0 Vol. 170, 498 502, August 2003 THE JOURNAL OF UROLOGY Printed in U.S.A. Copyright 2003 by AMERICAN UROLOGICAL ASSOCIATION DOI: 10.1097/01.ju.0000076140.68657.fd LONG-TERM SAFETY
More informationPRABHAKAR SINGH*, MANOJ INDURKAR, AMITA SINGH, PALLAVI INDURKAR
Academic Sciences International Journal of Current Pharmaceutical Research ISSN- 0975-7066 Vol 5, Issue 1, 2013 Research Article COMPARISON OF THE EFFICACY AND SAFETY OF TAMSULOSIN (0.4 V/S (and) FINASTERIDE
More informationLow Incidence of Acute Urinary Retention in the General Male Population: TheTriumph Project
European Urology European Urology 47 (2005) 494 498 Low Incidence of Acute Urinary Retention in the General Male Population: TheTriumph Project K.M.C. Verhamme a,b, *, J.P. Dieleman a, M.A.M. van Wijk
More informationDuring the past decade, numerous
Benign prostatic hyperplasia (BPH) is one of the most common diseases of aging men. It is estimated that by age 60 years, greater than 50% of men will have histologically documented evidence of the disease.
More informationRELATIONSHIPS BETWEEN AMERICAN UROLOGICAL ASSOCIATION SYMPTOM INDEX, PROSTATE VOLUME, PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA
American Urological Association symptom index for BPH RELATIONSHIPS BETWEEN AMERICAN UROLOGICAL ASSOCIATION SYMPTOM INDEX, PROSTATE VOLUME, AND DISEASE-SPECIFIC QUALITY OF LIFE QUESTION IN PATIENTS WITH
More informationMale LUTS, OAB, Sex: natural history. JR Sathiya
Male LUTS, OAB, Sex: natural history JR Sathiya Definitions Newer concepts of LUTs Natural history of BPH Prevalence of LUTs Definition BPH- represents a histologic diagnosis that refers to the proliferation
More informationDiagnostic approach to LUTS in men. Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center
Diagnostic approach to LUTS in men Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center Classification of LUTS Storage symptoms Voiding symptoms Post micturition
More informationa 1 -adrenoceptor antagonist on uro owmetric parameters in patients with benign prostatic hyperplasia
Single dose methodology to assess the in uence of an a 1 -adrenoceptor antagonist on uro owmetric parameters in patients with benign prostatic hyperplasia S. P. Curtis, 1 I. Eardley, 2 M. Boyce, 3 P. Larson,
More informationREPORTS. Clinical and Economic Outcomes in Patients Treated for Enlarged Prostate
Clinical and Economic Outcomes in Patients Treated for Enlarged Prostate Michael James Naslund, MD, MBA; Muta M. Issa, MD, MBA; Amy L. Grogg, PharmD; Michael T. Eaddy, PharmD, PhD; and Libby Black, PharmD
More informationShrestha A, Chalise PR, Sharma UK, Gyawali PR, Shrestha GK, Joshi BR. Department of Surgery, TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Original Article Intravesical Prostatic Protrusion is better than Prostate Volume in Predicting Symptom Severity in Benign Prostatic Hyperplasia: A Prospective Clinical Study Shrestha A, Chalise PR, Sharma
More informationNIH Public Access Author Manuscript J Urol. Author manuscript; available in PMC 2010 May 4.
NIH Public Access Author Manuscript Published in final edited form as: J Urol. 2009 December ; 182(6): 2819 2824. doi:10.1016/j.juro.2009.08.086. Intravesical Prostatic Protrusion in Men in Olmsted County,
More informationCan men with prostates sized 80 ml or larger be managed conservatively?
Original Article - Lower Urinary Tract Dysfunction Investig Clin Urol 2017;58:359-364. pissn 2466-0493 eissn 2466-054X Can men with prostates sized 80 ml or larger be managed conservatively? Alvin Lee,
More informationBenign Prostatic Hyperplasia (BPH):
Benign Prostatic Hyperplasia (BPH): Evidence Based Guidelines for Primary Care Providers Jeanne Martin, DNP, ANP-BC Objectives 1. Understand the pathophysiology and prevalence of BPH 2. Select the appropriate
More informationPHARMACEUTICALS ISSUE 2.0 APRIL 1996 FINASTERIDE: CLINICAL AND ECONOMIC IMPACTS
TECHNOLOGY OVERVIEW: PHARMACEUTICALS ISSUE 2.0 APRIL 1996 FINASTERIDE: CLINICAL AND ECONOMIC IMPACTS prepared by Dr. Nicolaas Otten, Pharm D. Coordinator, Pharmaceutical Assessment, CCOHTA This overview
More informationThe Journal of International Medical Research 2012; 40:
The Journal of International Medical Research 2012; 40: 899 908 Comparison of α-blocker Monotherapy and α-blocker Plus 5α-Reductase Inhibitor Combination Therapy Based on Prostate Volume for Treatment
More informationKey words: Lower Urinary Tract Symptoms (LUTS), Prostatic Hyperplasia, Alpha-1 Adrenoceptor Antagonists, Tamsulosin, Terazosin.
The Professional Medical Journal DOI: 10.17957/TPMJ/17.4102 ORIGINAL PROF-4102 PROSTATIC HYPERPLASIA; COMPARISON BETWEEN TAMSULOSIN AND TERAZOSIN FOR EFFICACY IN MEDICAL MANAGEMENT OF LOWER URINARY TRACT
More informationOffice Management of Benign Prostatic Enlargement
Focus on CME at McGill University Office Management of Benign Prostatic Enlargement Symptomatic benign prostate enlargement is a common medical problem encountered in our aging society. Watchful waiting,
More informationThe Evolution of Combination Therapy. US men eligible for BPH treatment * with projected population changes
The Management of BPH & The Impact of Combination Therapy Results Combination of Avodart and Tamsulosin (CombAT) Medical Therapy of Prostate Symptoms (MTOPS) Dr. Jack Barkin, md, fics, facs, dabu, Mcert
More informationBPH: a present and future perspective on health impact
BPH: a present and future perspective on health impact Burden of disease in men with moderate LUTS Dalibor Pacík This presentation is financially supported by GlaxoSmithKline. CZ/DUTT/0019/12 Men with
More informationThe Relationship between Prostate Inflammation and Lower Urinary Tract Symptoms: Examination of Baseline Data from the REDUCE Trial
european urology 54 (2008) 1379 1384 available at www.sciencedirect.com journal homepage: www.europeanurology.com Benign Prostatic Hyperplasia The Relationship between Prostate Inflammation and Lower Urinary
More informationHyoung Woo Kim, Dae Geun Moon, Hyun Min Kim, Jong Ho Hwang, Soon Chan Kim, Sam Geuk Nam, Jun Tag Park
www.kjurology.org http://dx.doi.org/10.4111/kju.2011.52.10.681 Voiding Dysfunction Effect of Shifting from Combination Therapy to Monotherapy of α-blockers or 5α-Reductase Inhibitors on Prostate Volume
More informationBenign Prostatic Hyperplasia. Jay Lee, MD, FRCSC Clinical Associate Professor University of Calgary
Benign Prostatic Hyperplasia Jay Lee, MD, FRCSC Clinical Associate Professor University of Calgary Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied,
More informationEVALUATION OF THE EFFICACY OF TADALAFIL IN IMPROVING LOWER URINARY TRACT SYMPTOMS IN PATIENTS WITH SYMPTOMATIC BENIGN PROSTATIC ENLARGEMENT
Basrah Journal Of Surgery EVALUATION OF THE EFFICACY OF TADALAFIL IN IMPROVING LOWER URINARY TRACT SYMPTOMS IN PATIENTS WITH SYMPTOMATIC BENIGN PROSTATIC ENLARGEMENT MB, ChB, FIBMS, Assistant Professor
More informationA SURVEY ON LOWER URINARY TRACT SYMPTOMS (LUTS) AMONG PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA (BPH) IN HOSPITAL UNIVERSITI SAINS MALAYSIA (HUSM)
Malaysian Journal of Medical Sciences, Vol. 14, No. 2, July 2007 (67-71) SHORT COMMUNICATION A SURVEY ON LOWER URINARY TRACT SYMPTOMS (LUTS) AMONG PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA (BPH) IN HOSPITAL
More informationBenign Prostatic Hyperplasia and Enlarged Prostate Guidelines: How They Can Be Useful to Primary Care
Volume 1, Number 1 Weill Medical College of Cornell University Reports on Men s Urologic Health 1 Editor: Steven A. Kaplan, MD, Professor of Urology, and Chief, Institute for Bladder and Prostate Health,
More informationSerum Prostate-Specific Antigen as a Predictor of Prostate Volume in the Community: The Krimpen Study
european urology 51 (2007) 1645 1653 available at www.sciencedirect.com journal homepage: www.europeanurology.com Benign Prostatic Hyperplasia Serum Prostate-Specific Antigen as a Predictor of Prostate
More informationINTEROBSERVER VARIATION OF PROSTATIC VOLUME ESTIMATION WITH DIGITAL RECTAL EXAMINATION BY UROLOGICAL STAFFS WITH DIFFERENT EXPERIENCES
Clinical Urology International Braz J Urol Official Journal of the Brazilian Society of Urology DIGITAL RECTAL EXAMINATION BY UROLOGICAL STAFFS Vol. 30 (6): 466-471, November - December, 2004 INTEROBSERVER
More informationThe Relationship Between Prostate Volume, Prostate- Specific Antigen and Age in Saudi Men with Benign Prostatic Conditions
African Journal of Urology 1110-5704 Vol. 16, No. 4, 2010 117-123 Original article The Relationship Between Prostate Volume, Prostate- Specific Antigen and Age in Saudi Men with Benign Prostatic Conditions
More informationGuideline for the primary care management of male lower urinary tract symptoms
review Article GUIDELINES FOR LUTS M.J. SPEAKMAN et al. As my Comment in the first section of the journal suggested, the MTOPS results have offered the possibility to general practitioners of reducing
More informationMedical Therapy for Benign Prostatic Hyperplasia Present and Future Impact
REPORTS Medical Therapy for Benign Prostatic Hyperplasia Present and Future Impact Muta M. Issa, MD, MBA; Timothy S. Regan, BPharm, RPh, CPh Abstract The purpose of this manuscript is to provide clinicians,
More informationBenign Prostatic Hyperplasia (BPH) Important Papers / Landmark. Vijayan Manogran
Benign Prostatic Hyperplasia (BPH) Important Papers / Landmark Studies Vijayan Manogran MTOPS & CombAT PLESS SMART ALTESS ALF-ONE VA PREDICT EPICS Landmark Studies MTOPS Medical Therapy of Prostatic Symptoms
More informationVOIDING DYSFUNCTION IN ELDERLY MALE CURRENT STATUS
VOIDING DYSFUNCTION IN ELDERLY MALE CURRENT STATUS DR. FRANCIS LEE Voiding dysfunction Storage Emptying Common voiding dysfunction in elderly male Emptying BPH Storage Incontinence Overactive bladder Post-prostatectomy
More informationOptimising the Medical Management of Benign Prostatic Hyperplasia
European Urology European Urology 45 (2004) 411 419 Review Optimising the Medical Management of Benign Prostatic Hyperplasia Michael Marberger a,*, Richard Harkaway b, Jean de la Rosette c a Department
More informationImpact of smoking on Lower Urinary Tract Symptoms (LUTS) - Single tertiary centre experience
International Journal of Scientific and Research Publications, Volume 6, Issue 5, May 2016 119 Impact of smoking on Lower Urinary Tract Symptoms (LUTS) - Single tertiary centre experience AUB Pethiyagoda
More informationMANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH
MANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH INTRODUCTION (1) Part of male sexual reproductive organ Size
More informationQuestioning questions about symptoms of benign prostatic hyperplasia
Family Practice Vol. 18, No. 3 Oxford University Press 2001 Printed in Great Britain Questioning questions about symptoms of benign prostatic hyperplasia Ejda Hassler, Ingvar Krakau, Lars Häggarth, Lars
More informationAbstract. Key words Trial without catheter, Acute urinary retention, Benign prostatic hyperplasia, Introduction
The role of sustained-released alfuzosin in the treatment of acute urinary retention Mohamed Fawzi Ahmed. Department of Surgery, Ninevah College of Medicine, University of Mosul. Abstract To see whether
More informationIndex. urologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Ablative therapies, transurethral needle ablation, Adverse events, sexual side effects of BPH Aging, and incidence of BPH associated with
More informationNOTE: This policy is not effective until April 1, Transurethral Water Vapor Thermal Therapy of the Prostate
NOTE: This policy is not effective until April 1, 2019. Medical Policy Manual Surgery, Policy No. 210 Transurethral Water Vapor Thermal Therapy of the Prostate Next Review: December 2019 Last Review: December
More informationChapter 4: Research and Future Directions
Chapter 4: Research and Future Directions Introduction Many of the future research needs listed in the 1994 Agency for Health Care Policy and Research (AHCPR) clinical practice guideline Benign Prostatic
More informationEvidence-based guidelines in lower urinary tract symptoms secondary to benign prostatic hyperplasia and variation in care
REVIEW C URRENT OPINION Evidence-based guidelines in lower urinary tract symptoms secondary to benign prostatic hyperplasia and variation in care Seth A. Strope Purpose of review Guidelines have been developed
More informationCombination Drug Therapy for Benign Prostatic Hyperplasia (BPH)
The Annals of African Surgery www.sskenya.org Combination Drug Therapy for Benign Prostatic Hyperplasia (BPH) Author: Oliech J.S. FRCS, Affiliation: Department of Surgery, University of Nairobi. P.O. Box
More informationCurrent drug management of BPH in primary care Claire Taylor MRCS, Charlotte Foley MRCS and Roger Kirby MA, MD, FRCS Urol
Drug review BPH Current drug management of BPH in primary care Claire Taylor MRCS, Charlotte Foley MRCS and Roger Kirby MA, MD, FRCS Urol Skyline Imaging Ltd The range of drug treatments for BPH, alone
More informationThe Enlarged Prostate Symptoms, Diagnosis and Treatment
The Enlarged Prostate Symptoms, Diagnosis and Treatment MAC00031-01 Rev G Financial support for this seminar has been provided by NeoTract, Inc., the manufacturer of the UroLift System. 1 Today s Agenda
More informationThe role of bladder diverticula in the prevalence of acute urinary retention in patients with BPH who are candidates
ORIGINAL ARTICLE Vol. 44 (x): 2018 March 3.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2017.0605 The role of bladder diverticula in the prevalence of acute urinary retention in patients with BPH who
More informationDrugTreatment of Benign Prostatic Hyperplasia and Hospital Admission for BPH-Related Surgery
European Urology European Urology 43 (2003) 528 534 DrugTreatment of Benign Prostatic Hyperplasia and Hospital Admission for BPH-Related Surgery P.C. Souverein a,*, J.A. Erkens b, J.J.M.C.H. de la Rosette
More informationManagement of LUTS. Simon Woodhams February 2012
Management of LUTS Simon Woodhams February 2012 The management of lower urinary tract symptoms (LUTS) in men Implementing NICE guidance May 2010 NICE clinical guideline 97 Background Lower urinary tract
More informationProstate Gland Volume and Its Relationship to Complications of Benign Prostatic Enlargement
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 14, Issue 6 Ver. II (Jun. 2015), PP 33-37 www.iosrjournals.org Prostate Gland Volume and Its Relationship
More informationPrevalence of Benign Prostatic Hyperplasia on Jeju Island: Analysis from a Cross-sectional Community-based Survey
pissn: 2287-4208 / eissn: 2287-4690 World J Mens Health 2012 August 30(2): 131-137 http://dx.doi.org/10.5534/wjmh.2012.30.2.131 Original Article Prevalence of Benign Prostatic Hyperplasia on Jeju Island:
More informationA unit of International Journal Foundation Page I 96
Occupational distribution of Patients with LUTS Single tertiary center experience. Part -4 (Medical Science) Chapter-III August/Vol.4.0/Issue-II ISSN NO : 2456-1045 ISSN CODE: 2456-1045 (Online) (ICV-MDS
More informationThe potential for NX-1207 in benign prostatic hyperplasia: an update for clinicians
Therapeutic Advances in Chronic Disease Review The potential for NX-1207 in benign prostatic hyperplasia: an update for clinicians Neal Shore and Barrett Cowan Ther Adv Chronic Dis (2011) 2(6) 377 383
More informationEffect of Transurethral Resection of the Prostate Based on the Degree of Obstruction Seen in Urodynamic Study
www.kjurology.org http://dx.doi.org/10.4111/kju.2013.54.12.840 Voiding Dysfunction/Female Urology Effect of Transurethral Resection of the Prostate Based on the Degree of Obstruction Seen in Urodynamic
More informationThe patient, your co-pilot in assessing LUTS
The patient, your co-pilot in assessing LUTS Frank Van der Aa Leuven, Belgium This symposium is supported by Astellas Pharma Europe Ltd., including speaker honoraria and production of materials the slides
More information50% of men. 90% of men PATIENT FACTSHEET: BPH CONDITION AND TREATMENTS. Want more information? What are the symptoms?
PATIENT FACTSHEET: BPH CONDITION AND TREATMENTS What is Benign Prostatic Hyperplasia (enlarged prostate)? Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate, the gland that
More informationchronic kidney disease in community-dwelling men
Kidney International, Vol. 67 (2005), pp. 2376 2382 The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men ANDREW D. RULE,DEBRA J. JACOBSON,ROSEBUD O.
More informationA Study of Relationship of Prostate Volume, Prostate Specific Antigen and age in Benign Prostatic Hyperplasia
ORIGINAL RESEARCH www.ijcmr.com A Study of Relationship of Prostate Volume, Prostate Specific Antigen and age in Benign Prostatic Hyperplasia Rupam Deori 1, Bijoyananda Das 2, Mustafa Abdur Rahman 3 ABSTRACT
More informationEvaluation of Recent Trends in Treatment Patterns Among Men With Benign Prostatic Hyperplasia
469245JMHXXX10.1177/1557988312469245A merican Journal of Men s HealthKruep et al. Article Evaluation of Recent Trends in Treatment Patterns Among Men With Benign Prostatic Hyperplasia American Journal
More informationHow Do New Data from Clinical Trials Allow Us to Optimise the Assessment and Treatment of Patients with Benign Prostatic Hyperplasia?
available at www.sciencedirect.com journal homepage: www.europeanurology.com How Do New Data from Clinical Trials Allow Us to Optimise the Assessment and Treatment of Patients with Benign Prostatic Hyperplasia?
More informationRecommended drug treatment of BPH in primary care Claire Taylor MRCS, Charlotte Foley MRCS and Roger Kirby MA, MD, FRCS Urol
Drug review BPH Recommended drug treatment of BPH in primary care Claire Taylor MRCS, Charlotte Foley MRCS and Roger Kirby MA, MD, FRCS Urol Skyline Imaging Ltd The development of safe and effective drugs
More informationGUIDELINES ON BENIGN PROSTATIC
European Association of Urology GUIDELINES ON BENIGN PROSTATIC HYPERPLASIA J. de la Rosette, S. Madersbacher, G. Alivizatos, C. Rioja Sanz, M. Emberton, J. Nordling 1 TABLE OF CONTENTS PAGE 1 BACKGROUND
More informationProstate Disease. Chad Baxter, MD
Prostate Disease Chad Baxter, MD Managing BPH and LUTS Chad Baxter, MD Department of Urology cbaxter@mednet.ucla.edu 33 nd Annual UCLA Intensive Course in Geriatric Medicine & Board Review Prevalence of
More informationUrodynamic Results of Sacral Neuromodulation Correlate with Subjective Improvement in Patients with an Overactive Bladder
European Urology European Urology 43 (2003) 282±287 Urodynamic Results of Sacral Neuromodulation Correlate with Subjective Improvement in Patients with an Overactive Bladder W.A. Scheepens a, G.A. van
More informationTABLE 1. Differential Diagnosis of Symptomatic BPH* Category Cause of BPH Comments Malignant Adenocarcinoma of the prostate, transitional Men should b
CONCISE BENIGN PROSTATIC REVIEW HYPERPLASIA FOR CLINICIANS Evaluation and Medical Management of Benign Prostatic Hyperplasia THOMAS J. BECKMAN, MD, AND LANCE A. MYNDERSE, MD Benign prostatic hyperplasia
More informationAlpha antagonists from initial concept to routine clinical practice
european urology 50 (2006) 635 642 available at www.sciencedirect.com journal homepage: www.europeanurology.com Editorial 50th Anniversary Alpha antagonists from initial concept to routine clinical practice
More informationH6D-MC-LVHR Clinical Study Report Synopsis Page LVHR Synopsis (LY450190)
H6D-MC-LVHR Clinical Study Report Synopsis Page 1 2. LVHR Synopsis H6D-MC-LVHR Clinical Study Report Synopsis Page 2 Clinical Study Report Synopsis: Study H6D-MC-LVHR Title of Study: A Randomized, Double-Blind,
More informationBPH with persistently elevated PSA 아주대학교김선일
BPH with persistently elevated PSA 아주대학교김선일 PSA in BPH: present status AUA & EAU BPH guideline: PSA: recommended test AUA practice guideline committee. J Urol 2003;170:530 Madersbacher. Eur Urol 2004;46:547
More informationBenign Prostatic Hypertrophy (BPH) is the most
Medical treatment of benign prostatic hypertrophy There is little doubt that medical therapy has transformed the treatment of benign prostatic hypertrophy (BPH). The medical treatment of BPH continues
More informationChanges in Surgical Strategy for Patients with Benign Prostatic Hyperplasia: 12-Year Single-Center Experience
www.kjurology.org DOI:10.4111/kju.2011.52.3.189 Voiding Dysfunction Changes in Surgical Strategy for Patients with Benign Prostatic Hyperplasia: 12-Year Single-Center Experience Yu Seob Shin 1, Jong Kwan
More informationInvoluntary Detrusor Contractions: Correlation of Urodynamic Data to Clinical Categories
Neurourology and Urodynamics 20:249±257 (2001) Involuntary Detrusor Contractions: Correlation of Urodynamic Data to Clinical Categories Lauri J. Romanzi, Asnat Groutz, Dianne M. Heritz, and Jerry G. Blaivas*
More informationKorean Urologist s View of Practice Patterns in Diagnosis and Management of Benign Prostatic Hyperplasia: A Nationwide Survey
Original Article DOI 10.3349/ymj.2010.51.2.248 pissn: 0513-5796, eissn: 1976-2437 Yonsei Med J 51(2):248-252, 2010 Korean Urologist s View of Practice Patterns in Diagnosis and Management of Benign Prostatic
More informationREVIEW The role of combination medical therapy in benign prostatic hyperplasia
(2008) 20, S33 S43 & 2008 Nature Publishing Group All rights reserved 0955-9930/08 $30.00 www.nature.com/ijir REVIEW The role of combination medical therapy in benign prostatic hyperplasia Department of
More informationTitle of Research Thesis:
Eastern Michigan University By Fatai Osinowo Adviser s Name: Dr. Stephen Sonstein, PhD Title of Research Thesis: A sub-analyses from the Benign Prostatic Hyperplasia (BPH) Registry and Patient survey:
More informationUrinary symptoms: prevalence and severity in British men aged 55 and over
Journal of Epidemiology and Conmntunity, Health 1994;48:569-575 Health Services Research Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel St, London
More informationLower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist
Lower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist Lower Urinary Tract Symptoms Storage Symptoms Frequency, urgency, incontinence, Nocturia Voiding Symptoms Hesitancy, poor flow, intermittency,
More informationAll about the Prostate
MEN S HEALTH Dr Nick Pendleton January 16 th 2018 All about the Prostate 1 What does it do? Functions of the Prostate 1. Secretes Prostatic Fluid slightly alkaline fluid, 30% of volume of seminal fluid,
More informationPATIENT INFORMATION 2017 NeoTract, Inc. All rights reserved. Printed in the USA. MAC Rev A
PATIENT INFORMATION OVER 70% OF MEN IN THEIR 60s HAVE SYMPTOMS OF BPH 1 BPH affects more than 500 million men worldwide, with many men suffering from symptoms of enlarged prostate. 1 You no longer have
More informationThe Evaluation of Bladder Symptoms in Patients With Lumbar Compression Disorders Who Have Undergone Decompressive Surgery
The Evaluation of Bladder Symptoms in Patients With Lumbar Compression Disorders Who Have Undergone Decompressive Surgery SPINE Volume 35, Number 17, pp E849 E854 2010, Lippincott Williams & Wilkins Chun-Hao
More informationAssociationbetweenSocieoeconomicVariablesSEVandBenignProstaticHyperplasiaBPHamongSudanesePatients
: I Surgeries and Cardiovascular System Volume 15 Issue 1 Version 1.0 Year 2015 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Online ISSN: 2249-4618
More informationPROSTATIC ARTERY EMBOLISATION (PAE) FOR BENIGN PROSTATIC HYPERPLASIA. A Minimally Invasive Innovative Treatment
PROSTATIC ARTERY EMBOLISATION (PAE) FOR BENIGN PROSTATIC HYPERPLASIA A Minimally Invasive Innovative Treatment What is the prostate? The prostate is an accessory organ of the male reproductive system.
More informationBenign prostatic hyperplasia (BPH) is a term that
42Clinical Pharmacist February 2012 Vol 4 For older men, benign prostatic hyperplasia is a common cause of lower urinary tract symptoms such as polyuria, incomplete bladder emptying, urinary urgency and,
More informationINTERNATIONAL PROSTATE SYMPTOM SCORE IPSS - AUA AS DISCRIMINAT SCALE IN 400 MALE PATIENTS WITH LOWER URINARY TRACT SYMPTOMS (LUTS)
Urological Neurology International Braz J Urol Official Journal of the Brazilian Society of Urology IPSS IN MALE PATIENTS WITH LUTS Vol. 30 (2): 135-141, March - April, 2004 INTERNATIONAL PROSTATE SYMPTOM
More informationCialis. Cialis (tadalafil) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.06.02 Subject: Cialis Page: 1 of 5 Last Review Date: September 18, 2015 Cialis Description Cialis (tadalafil)
More informationThe population of subjects which was statistically analyzed was the Intent-to-Treat population
Study No.: ARIB3003 (Year 1) Title: A Randomized, Double-Blind, Placebo-Controlled, Two-Year Parallel-Group Study of the Efficacy and Safety of GI198745 in the Treatment and Modification of Progression
More informationSubject: Temporary Prostatic Stent and Prostatic Urethral Lift
02-54000-21 Original Effective Date: 03/15/05 Reviewed: 09/27/18 Revised: 10/15/18 Subject: Temporary Prostatic Stent and Prostatic Urethral Lift THIS MEDICAL COVERAGE GUIDELINE IS NOT AN AUTHORIZATION,
More informationDIAGNOSED WITH BENIGN PROSTATIC HYPERPLASIA
Acta Poloniae Pharmaceutica ñ Drug Research, Vol. 74 No. 4 pp. 1247ñ1253, 2017 ISSN 0001-6837 Polish Pharmaceutical Society PHARMACOLOGY CLINICAL EVALUATION OF α-1-adrenolytics IN PATIENTS DIAGNOSED WITH
More informationVoiding Dysfunction Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU.
Voiding Dysfunction 2009 Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU. Objectives Understand and explain physiologic function and dysfunction of lower urinary tract.
More informationDo 5a-Reductase Inhibitors Alter Prostate Cancer Detection and What Are the Implications?
european urology supplements 5 (2006) 752 757 available at www.sciencedirect.com journal homepage: www.europeanurology.com Do 5a-Reductase Inhibitors Alter Prostate Cancer Detection and What Are the Implications?
More informationDichotomous Estimation of Prostate Volume: A Diagnostic Study of the Accuracy of the Digital Rectal Examination
pissn: 2287-4208 / eissn: 2287-4690 World J Mens Health 2013 December 31(3): 220-225 http://dx.doi.org/10.5534/wjmh.2013.31.3.220 Original Article Dichotomous Estimation of Prostate Volume: A Diagnostic
More informationEXPERIMENTAL AND THERAPEUTIC MEDICINE 4: , 2012
1112 Usefulness of total bladder capacity and post void residual urine volume as a predictor of detrusor overactivity with impaired contractility in stroke patients SANG HYUB LEE, JOONG GEUN LEE, GYEONG
More informationNON-Neurogenic Chronic Urinary Retention AUA White Paper
NON-Neurogenic Chronic Urinary Retention AUA White Paper Great Lakes SUNA Inside Urology March 16, 2018 Michelle J. Lajiness FNP-BC Nurse Practitioner DMC Urology Incidence Really unknown Lack consensus
More information