Double-Blind Placebo-Controlled Study of PR-2000 in the Management of Benign Prostatic Hyperplasia
|
|
- Juniper Turner
- 5 years ago
- Views:
Transcription
1 [The Antiseptic (2002): (99), 1, 8-11] Double-Blind Placebo-Controlled Study of PR-2000 in the Management of Benign Prostatic Hyperplasia Garg, S.K., M.S., D.N.B. (Surgery), M.Ch., D.N.B. (Urology) Bombay Urologist and Transplant Surgeon, Garg Urological Clinic, B-51, Brij Enclave Colony, Varanasi , Uttar Pradesh, India and Kala Suhas Kulkarni*, M.D., Medical Advisor, R&D Center, The Himalaya Drug Company, Makali, Bangalore, India [*Correspondence author] ABSTRACT A double-blind placebo controlled study was planned in 40 patients with symptomatic benign prostatic hyperplasia (BPH). The patients were in the age group. The patients were subjected to pelvic ultrasonography to measure at the prostatic weight. The symptoms were evaluated according to the American Urological Association (AUA) symptom score. The PSA value was also estimated. They were dispensed a polyherbal preparation known as PR-2000 at a dose of 2 tablets, twice a day for 6 months. After 6 months, when these patients were evaluated, it was found that the AUA symptom score was reduced significantly in 90% of the patients in the PR-2000 group, with a moderate reduction in 10%, while in the placebo group, there was a significant reduction in 6.7% and a moderate reduction in 6.7%, and no effect in 86.4%. In the PR-2000 group, the prostatic weight reduced in 80% and moderately reduced in 20%, while in placebo group, it was significantly reduced in 6.7% and moderately reduced in 6.7%, no effect in 86.4%. The post-void residual volume was reduced in 50%, moderately reduced in 35% and hardly reduced in 15% in the PR-2000 group, while in the placebo group, only 10% showed reduction and 90% were not effected. The PSA values also showed reduction on an average of 0.31 mg/ml. Thus, PR-2000 provided a significant medical therapy in patients with BPH. Key words: PR-2000, ultrasonography, AUA symptom score, PSA value INTRODUCTION The prostate gland is an accessory male sex organ situated between the base of bladder and the external striated urethral sphincter. A benign enlargement of the prostate associated with voiding dysfunction has been recognized for centuries. Eight percent of men of years of age or older have benign prostatic hyperplasia (BPH). Benign prostatic hyperplasia is not necessarily a progressive process, and not all patients required immediate surgery. The causative factors of BPH in man have been studied and several theories have been putforth. In general, the 2 most important factors are aging and the presence of functional testes. These factors are the key to development of BPH, although they appear to be nonspecific 1.
2 The prostate consists of a network of glandular elements embedded in stroma, with androgen being the most important factor for prostatic growth. Free plasma testosterone enters prostatic cells, where at least 90% is converted into dihydrotestosterone (DHT) by 5α-reductase. The process of androgen conversion to DHT is irreversible and is followed by DHT binding to receptors on the nucleus. The breakthrough discovery that DHT is the active factor in the prostate is the rationale for the use of 5α-reductase inhibitors in the treatment of BPH, particularly the static component of the disease caused by the prostate mechanically obstructing the bladder neck. The paradox of continuing prostatic growth with declining androgen levels suggests that other factors, secreted by the testis, can stimulate prostate growth or perhaps sensitize prostatic cells to androgen 2. Estrogen androgen synergism as well as the role of other steroidal hormones have also been suggested as mechanisms for BPH. The final treatment for symptomatic BPH may be surgery. But in few patients, who are very high-risk cases, the desired line of treatment is medical therapy. The medical treatment includes blockade of α-adrenergic receptors by Phenoxybenzamine, Prazocin, Terazocin, Doxazocin etc. and hormonal manipulation by androgen deprivation, i.e. Estrogen and α 1 -reductase inhibiter like finastride. Mainly α 1 -antagonist and finastride were found effective in symptomatic treatment of BPH, but these drugs have a number of side effects also. So naturally occurring plant extracts have come into the forefront of research to treat BPH. With aging, there is a gradual accumulation of prostate mass as a result of continuing glandular stromal interactions, which may be enhanced by various growth factors provided systemically via the circulation or locally via the urethra. The effect of androgen is mediated through the stromal cells and results in proliferation. The impact of stromal cells on epithelial growth and function is mediated through production of specific growth factors 3-5. Another theory suggests a disturbance of the balance between the rate of prostate cell death and the rate of replication caused by hormonal factors, growth factors and oncogenes. PR-2000 also has 5α-reductase activity and has been documented in experimental studies to reduce the prostatic weight in experimentally-induced prostatic hyperplasia 6. Clinical studies of PR-2000 in patients with prostate hyperplasia have shown results that after PR-2000 treatment, there was a reduction in the American Urological Association (AUA) symptom score, prostatic weight and PSA values 7. In this double-blind study, the PR-2000 drug has been compared with placebo and PR-2000 has been found effective in symptomatic BPH. PR-2000 is a polyherbal formulation manufactured by The Himalaya Drug Company, Bangalore, India. MATERIALS AND METHODS A double-blind placebo controlled trial was carried out at Garg Urological Clinic and Heritage Hospital, Varanasi, India. Forty patients, diagnosed with symptomatic BPH, were
3 included in study after a thorough physical examination and complete urological history. The patients were between years of age. The efficacy parameters were subjective evaluation as per AUA symptom scoring index and objective evidence in the form of changes in prostate volume measured by ultrasonography and post-void residual urine. Assessment and follow-up was done every month. These included history with AUA scoring and digital rectal examination (DRE). Ultrasonography of the bladder (USG) was done to measure the prostate weight and post-void residual urine was measured initially and after 6 months. The serum PSA was also done initially and after 6 months. PR-2000 was administered at a dose of 2 tablets, thrice times a day, in 20 patients with a similarly looking placebo in another 20 patients. Both drug treatments continued for six months. RESULTS All patients of both the drug and placebo groups were followed every month and the final analyses were done after 6 months. The criteria of improvement was as follows: Significant improvement in AUA score 7. Average improvement in AUA score = Poor improvement in AUA score >14. Results showed that in the PR-2000 group, 10 patients (50%) showed significant improvement, while 4 (20%) showed average improvement and 6 (30%) showed poor improvement. In the placebo group, 1 patient (5%) each showed significant and average improvement and 18 patients (90%) displayed poor improvement (Table 1). Improvement with respect to severity of symptoms indicated that out of 20 patients in the PR-2000 group, 10 patients were severely symptomatic with AUA score 30 and another 10 patients were less symptomatic with AUA score < 30. Less symptomatic patients with AUA score <30 showed a significant improvement in 90% of cases, while only 10% of severely symptomatic patients showed a significant improvement. In the placebo group, 7 patients were severely symptomatic with AUA score 30 and 17 patients were less symptomatic with AUA score < 30. Less symptomatic patients with AUA score <30 displayed significant improvement in 7.7% of cases and none of the patients of the severely symptomatic patients shown significant improvement (Table 2). Abdominal ultrasonography showed that in the PR-2000 group, 80% of patients with prostate weight <80 gm displayed significant reduction while only 20% Improvement Improvement Table 1: Overall improvement PR-2000 group No. of patients Percentage Placebo group No. of patients Percentage Significant 10 50% 1 5% Average 4 20% 1 5% Poor 6 30% 18 90% Total % % Table 2: Improvement with respect to severity of symptoms Less symptomatic (AUA score < 30) PR-2000 group Severely symptomatic group (AUA score 30) Less symptomatic group (AUA score < 30) Placebo group Severely symptomatic group (AUA score 30) Significant 9 (90%) 1 (10%) 1 (6.7%) - Average 1 (10%) 3 (30%) 1 (6.7%) - Poor - 6 (60%) 11 (86.4%) 7 (100%) Total
4 patients with prostate weight 80 gm displayed significant improvement. In the placebo group, 6.7% of patients with prostate weight 80 gm showed a significant improvement and none of the patients with prostate weight <80 gm showed any improvement (Table 3). In all the patients in the PR-2000 group, ultrasonography showed a decrease in prostate weight, ranging from 4 to 20 gm with an average of 9.8 gm. In the placebo group, the weight of the prostate increased in most patients with an average of 8.3 gm in 16 patients while in 4 cases, weight decreased with an average of 8 gm. There was an improvement in respect to post-void residual volume in the treated group. In the PR-2000 group, 50% patients showed a significant decrease in post-void residue and 35% patients had average improvement whereas Improvement Significant (Final AUA score <7) Average (Final AUA score 8-14) Poor (Final AUA score >14) 15% had poor improvement. In the placebo group, 10% patients showed a significant decrease in post-void residue and 90% patients a poor improvement (Table 4). In PR-2000 group, serum PSA levels were reduced in all the cases ranging from mg/ml with an average of 0.31 mg/ml. In the placebo group, no significant changes in serum PSA levels were found. Table 3: Improvement in respect to prostatic weight Prostate weight <80 gm PR-2000 group Prostate weight 80 gm Prostate weight <80 gm Placebo group Prostate weight 80 8 (80%) 2 (20%) 1 (6.7%) - 2 (20%) 2 (20%) 1 (6.7%) (60%) 13 (86.4%) 5 (100%) Total Table 4: Improvement in respect to post-void residue Improvement Significant (PVR <40 ml) Average (PVR ml) Poor (PVR >60 ml) PR-2000 group No. of patients Percentage Placebo group No. of patients Percentage 10 50% 2 10% 7 35% % 18 90% Total % % DISCUSSION The idea of triphasic evolution of bladder behavior in BPH has been reviewed with traditional grouping of the associated symptoms as irritative (frequency; nocturia; urgency; and urge incontinence) or obstructive (hesitancy; difficulty of voiding; weak urinary stream; postvoiding dribble; sensation of incomplete emptying; and residual urine) In this clinical trial, it was found that there was a significant reduction in 9 patients who were less symptomatic and the one patient who was severely symptomatic as assessed by AUA symptoms score when compared to the placebo group, which showed that there was only one patient who responded out of 20 patients.
5 Post-voiding (post-void) residual urine (PVR) has been a time-honored measure of the degree of prostatism, and the traditional indicator of detrusor decompensation that presumably progresses to the end-stage of urinary retention 13,14. Post-void residual urine volume is considered significantly (ie, abnormally) elevated if it is >25% of the normal adult physiologic bladder capacity (after normal, ie, not overfill voiding), >10% of premicturitional bladder volume, or >50 to 100 ml 15,16. In this clinical trial, it was found that 50% had significant improvement (PVR<40 ml), 35% had average improvement (PVR ml) and there was poor improvement in 15% (PVR >60 ml). In the placebo group, 10% had significant improvement (PVR<40 ml) and there was no improvement in 90% (PVR >60 ml). In prostatic weight there was significant reduction in 10 patients, average reduction in 4 patients and poor reduction in 6 patients in the PR-2000 group. In the placebo group, only one patient each displayed significant and average reduction, while 18 patients showed no reduction of the prostatic weight. The anatomic location of the prostate at the bladder neck enveloping the urethra plays an important role in the pathophysiology of BPH, but it is known that the severity of obstructive voiding symptoms is not correlated only with the size of the prostate. Two prostatic components play a role in bladder outlet obstruction (BOO) and development of lower urinary tract symptoms: dynamic and static. The static component of BPH is related to increased prostate tissue mass. Progressive nodular proliferation leads to increased prostatic size and consequent boo. The result is symptomatic BPH with its classic symptoms such as weak stream, post-void dribbling, frequency and nocturia, which might affect the upper urinary tract if not properly managed. The ratio of stroma to epithelium increases from 2:1 in the healthy prostate to 5:1 in BPH The dynamic component of BPH is related to prostatic smooth muscle tone. Smooth muscle accounts for 39% of the cellular volume and 51% of the total stromal volume in BPH. Alpha 1 -adrenoceptors are the main receptors of stromal cells whereas α 2 -adrenoceptors are localized to the epithelium and blood vessels: 98% of α 1 -adrenoceptor binding sites may be in the prostatic stroma, which expresses 6-fold as much of this receptor as glandular cells. The predominance of α 1 -adrenoceptors in the prostate and the recognition of the role of neuromuscular tone in the prostate in BOO is the basis for the use of α-adrenergic receptor inhibitors in the treatment of voiding dysfunction. Failure to respond or poor response to α-adrenergic receptor inhibitors suggests variable mechanisms of autonomic activity 20. Post-void residual urine is the measurement of the urine volume remaining in the bladder immediately after completion of micturition. However, it is a helpful tool that can be used for follow-up and evaluation of response to therapy. Medical therapy is the first-line management option preferred by both physicians and patients due to its reversibility, less invasive nature, and the significant symptomatic improvement
6 and safety demonstrated in several studies of both α-blockers and 5α-reductase inhibitors. Medical therapy has the potential to prevent retention and obviate the need for surgery. Open prostatectomy is the oldest, most invasive, most efficient BPH treatment and produces a reported 98% symptom improvement. Compared with transurethral resection of the prostate (TURP) and transurethral incision of the prostate (TUIP), strictures and retrograde ejaculations are more common after open prostatectomy, but the mortality is lower than with TURP. However, TURP is the gold standard surgical treatment, although it should not be performed in patients who want to remain fertile. Side effects include incontinence (approximately 3% of patients), impotence (5 10%), retrograde ejaculation (60 80%), and bladder neck contracture (3 5%). The symptom improvement rate is % and the mortality risk is 2% PR-2000 is also useful in the treatment of BPH. CONCLUSION In this double-blind trial, the use of PR-2000 showed a significant improvement in 70% of patients according to the AUA score, while according to post-void residue 85% showed a significant improvement. In all the patients, serum PSA levels reduced with an average of 0.31 mg/ml and prostate weight decreased significantly with an average of 9.8 gm, while there was no change in placebo-treated patients. ACKNOWLEDGEMENT We are thankful to The Himalaya Drug Company, Bangalore, India for arranging the trial drug. REFERENCES 1. Partin A.W., Page W.F. and Lee B. et al. (1994). Concordance rates for benign prostatic hyperplasia among twins suggests hereditary influence. Urology, 44, Grayhack J.T. (1961). Changes with aging in human seminal vesicle fluid fructose concentration and seminal vesicle weight. Journal of Urology, 86, Cunha G.R. and Lung B. (1979). The importance of stroma in morphogenesis and functional activity of urogenital epithelium. In Vitro, 15, Cunha G.R., Chung L.W.K. and Shannon J.M. et al. (1983). Hormone induced morphogenesis and growth: role of mesenchymal epithelial interactions. Recent Progress in Hormone Research, 39, Steiner M.S. (1993). Role of peptide growth factors in the prostate. A review. Urology, 42, Sundaram R., Mohan A.R., Gopumadhavan S., Venkataranganna M.V., Venkatesha Udupa, Seshadri S.J., Anturlikar S.D. and Mitra S.K. (1999). Protective effect of Prostane in experimental prostatic hyperplasia in rats. Asian Journal of Andrology, 1(4), 175.
7 7. Lokesh Upadhyay and Tripathi, K. (2001). A study of Prostane in the treatment of benign prostatic hyperplasia. Phytotherapy Research, 15, Riehman M. and Bruskewitz R.C. Benign prostatic hyperplasia: clinical manifestations and indications for intervention. In: Lepo H. and Lawson R.K. (Eds.). Prostate Diseases. Philadelphia, WB Saunders. 1993, pp Madsen F.A. and Bruskewitz R.C. (1995). Clinical manifestations of benign prostatic hyperplasia. Urologic Clinics of North America, 22, Hinman F Jr. Overview Basis for clinical management. In: Rodgers CH, Coffey DS, Cunha G, Grayhack JT, Hinman F Jr. and Horton R (Eds). Benign prostatic hyperplasia, Vol. II, Bethesda, MD, USPHS, NIH Publiccation, No , 1987, pp Coolsaet B. and Elbadawi A. (1989). Urodynamics in the management of benign prostatic hypertrophy. World Journal of Urology, 6, Cockett A.T., Aso Y., Denis L., Murphy G., Khoury S., Abrams P., Barry M.J., Carlton G.E., Fitzpatrick J., Gibbons R., Griffiths K., Hald T., Holtgrewe L., Jardin A., McConnell J.D., Mebust W., Roehrborn C.G., Smith P., Steg A. and Walsh P. (1993) Recommendations of the International Consensus Committee concerning: 1. Prostatic symptom score (I-PSS) and quality of life assessment, 2. Diagnostic work-up of patients presenting with symptoms suggestive of prostatism, 3. Standardization of the evaluation of treatment modalities, 4. BPH treatment recommendations. In: Cockett A.T.K., Khoury S., Aso Y., Chatelain C., Denis L., Griffiths K. and Murphy G. (Eds.) The 2 nd International Consultation on Benign Prostatic Hyperplasia (BPH), Paris, June 27 30, 1993, Proceedings. (pp ) Jersey, Channel Islands: Scientific Communication International. 13. Abrams P.H. and Griffiths D.J. (1979). The assessment of prostatic obstruction from urodynamic measurements and from residual urine. British Journal of Urology, 51, Schoenberg H.W. and Burke H. Correlation of flow rate and residual urine with symptomatology. In: Hinman F. Jr (Eds.) Benign Prostatic Hypertrophy, New York: Springer-Verlag., 1983, pp Abrams P., Bruskewitz R., de la Rosette J., Griffiths D., Koyanagi T., Nordling J., Park Y.-C., Schäfer W. and Zimmern P. (1996) The diagnosis of bladder outlet obstruction: urodynamics. In: Cockett A.T.K., Khoury S., Aso Y., Chatelain C., Denis L., Griffiths K. and Murphy G. (Eds.) The 3 rd International Consultation on Benign Prostatic Hyperplasia (BPH), Monaco June 26 28, 1995, Proceedings. (pp ) Jersey, Channel Islands: Scientific Communication International. 16. George N.J.R., Feneley R.C. and Roberts J.B.M. (1986). Identification of the poor risk patient with prostatism and detrusor failure. British Journal of Urology, 58,
8 17. Caine M. (1986). The present role of alpha adrenergic blockers in the treatment of benign prostatic hypertrophy. Journal of Urology, 136, McNeal J.E. (1990). Pathology of benign prostatic hyperplasia. Urologic Clinics of North America, 17, Bartsch G., Muller H.R. and Oberholzer M. et al. (1979). Light microscopic stereological analysis of the normal human prostate and of benign prostatic hyperplasia. Journal of Urology, 122, James S., Chapple C.R. and Phillips M.I. et al. (1989). Autoradiographic analysis of alpha-adrenoceptors and muscarinic cholinergic receptors in hyperplastic human prostate. Journal of Urology, 142, Madsen F.A. and Bruskewitz R.C. (1995). Clinical manifestations of benign prostatic hyperplasia. Urolic Clinics of North America, 22, Griffiths D.A. Pressure flow studies of micturition. Urologic Clinics of North America, 23,
Role of herbal drugs in the management of benign prostatic hyperplasia: Clinical trial to evaluate the efficacy and safety of Himplasia
[Medicine Update (2003): 11(2), 55-58] Role of herbal drugs in the management of benign prostatic hyperplasia: Clinical trial to evaluate the efficacy and safety of Himplasia Arora, R.P., CMO, Rajiba L.
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 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 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 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 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 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 informationMODULE 3: BENIGN PROSTATIC HYPERTROPHY
MODULE 3: BENIGN PROSTATIC HYPERTROPHY KEYWORDS: Prostatic hypertrophy, prostatic hyperplasia, PSA, voiding dysfunction, lower urinary tract symptoms (LUTS) At the end of this clerkship, the medical student
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 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 informationSome prostatic diseases
Some prostatic diseases Benign Prostatic Hyperplasia (Nodular Hyperplasia) Extremely common Present in a significant number of men by the age of 40 & its frequency rises progressively with age, reaching
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 informationEAU GUIDELINES POCKET EDITION 3
EAU GUIDELINES POCKET EDITION 3 CONTENTS: BENIGN PROSTATIC HYPERPLASIA URINARY INCONTINENCE UROLITHIASIS 2 3 EAU POCKET GUIDELINES POCKET EDITION 3 This is one of a series of convenient pocket size books
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 informationProstate Health PHARMACIST VIEW
Prostate Health PHARMACIST VIEW Prostate Definition Prostate is a gland made of fibromuscular tissue. It is about 4 cm and surrounds the neck of the bladder and the urethra. It produces seminal fluid.
More informationManagement of LUTS after TURP and MIT
Management of LUTS after TURP and MIT Hong Sup Kim Konkuk University TURP & MIT TURP : Gold standard MIT TUIP TUNA TUMT HIFU LASER Nd:YAG, ILC, HoLRP, KTP LUTS after TURP and MIT Improved : about 70% Persistent
More informationLower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics. Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital
Lower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital 01/02/2018 Lower Urinary Tract Symptoms LUTS - one of
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 informationVictoria Sharp, MD, MBA, FAAFP. Clinical Professor of Urology and Family Medicine
Victoria Sharp, MD, MBA, FAAFP Clinical Professor of Urology and Family Medicine Victoria Sharp, MD, MBA, FAAFP Market Chief Medial Officer AmeriHealth Caritas Family of Companies Office phone: (515) 330-3740
More informationEvaluating the efficacy and safety of Himplasia (PC-27) in the medical management of benign hyperplasia
[Indian Journal of Clinical Practice (2004): (14), 11, 31-36] Evaluating the efficacy and safety of Himplasia (PC-27) in the medical management of benign hyperplasia Ketan Shukla, M.S., M.Ch (Urology),
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 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 informationDOWNLOAD OR READ : TREATMENT OF BENIGN PROSTATIC HYPERPLASIA PDF EBOOK EPUB MOBI
DOWNLOAD OR READ : TREATMENT OF BENIGN PROSTATIC HYPERPLASIA PDF EBOOK EPUB MOBI Page 1 Page 2 treatment of benign prostatic hyperplasia treatment of benign prostatic pdf treatment of benign prostatic
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 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 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 informationWhat should we consider before surgery? BPH with bladder dysfunction. Inje University Sanggye Paik Hospital Sung Luck Hee
What should we consider before surgery? BPH with bladder dysfunction Inje University Sanggye Paik Hospital Sung Luck Hee Diagnostic tests in three categories Recommendation: there is evidence to support
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 informationA Comparative Study of Trans Urethral Resection Versus Trans Urethral Incision for Small Size Obstructing Prostate
ORIGINAL ARTICLE A Comparative Study of Trans Urethral Resection Versus Trans Urethral Incision for Small Size Obstructing Prostate ABSTRACT Rafique Ahmed Sahito, Abdul Jabbar Pirzada, Masood Ahmed Qureshi,
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 informationOverview. Urology Dine and Learn: Erectile Dysfunction & Benign Prostatic Hyperplasia. Iain McAuley September 15, 2014
Urology Dine and Learn: Erectile Dysfunction & Benign Prostatic Hyperplasia Iain McAuley September 15, 2014 Overview Review of the most recent guidelines for ED and BPH ED Guidelines CUA 2006 AUA 2011
More informationBenign Prostatic Hyperplasia. Shahideh Amini Pharm.D clinical pharmacy resident Tehran university of medical science Department of pharmacotherapy
Benign Prostatic Hyperplasia Shahideh Amini Pharm.D clinical pharmacy resident Tehran university of medical science Department of pharmacotherapy Definition BPH is a common disorder that increases in frequency
More informationTransurethral incision versus transurethral resection of the prostate in small prostatic adenoma: Long-term follow-up
African Journal of Urology (2012) 18, 29 33 Pan African Urological Surgeons Association African Journal of Urology www.ees.elsevier.com/afju www.sciencedirect.com Transurethral incision versus transurethral
More informationOriginal Policy Date
MP 7.01.39 Transurethral Microwave Thermotherapy Medical Policy Section Surgery Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013 Return to Medical
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 informationCHAPTER 6. M.D. Eckhardt, G.E.P.M. van Venrooij, T.A. Boon. hoofdstuk :49 Pagina 89
hoofdstuk 06 19-12-2001 09:49 Pagina 89 Urethral Resistance Factor (URA) Versus Schäfer s Obstruction Grade and Abrams-Griffiths (AG) Number in the Diagnosis of Obstructive Benign Prostatic Hyperplasia
More informationMEDICAL THERAPY. Endocrine Approaches. Página 1 de 5.
Página 1 de 5 MEDICAL THERAPY Part of "32 - BENIGN PROSTATIC HYPERPLASIA" Use of pharmacologically defined and a variety of so-called alternative medications to attempt to improve BPH voiding dysfunction
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 informationManagement of Voiding Problems in Older Men. Dr. John Fenn Consultant, QEH 10 th October, 2005
Management of Voiding Problems in Older Men Dr. John Fenn Consultant, QEH 10 th October, 2005 Voiding Problems Poor stream Hesitancy Straining Incomplete emptying Intermittent micturition Terminal dribbling
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 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 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 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 informationManaging urinary morbidity after brachytherapy. Kieran O Flynn Department of Urology, Salford Royal Foundation Trust, Manchester
Managing urinary morbidity after brachytherapy Kieran O Flynn Department of Urology, Salford Royal Foundation Trust, Manchester Themes Can we predict urinary morbidity? Prevention of urinary morbidity
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 informationAs man draws near the common goal Can anything be sadder Than he who, master of his soul Is servant to his bladder LUTS 2. Prevalence of BPH LUTS 5
BPH / LUTS Dr Jonny Coxon MA MD MRCS MRCGP DRCOG Beaconsfield Medical Practice, Brighton As man draws near the common goal Can anything be sadder Than he who, master of his soul Is servant to his bladder
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)
Benign Prostatic Hyperplasia (BPH) Definition Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH), prostate gland enlargement can cause bothersome
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 informationJMSCR Vol 04 Issue 10 Page October 2016
www.jmscr.igmpublication.org Impact Factor 5.244 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v4i10.40 Combined Bladder Stones Removal: In
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 informationLasers in Urology. Sae Woong Choi, Yong Sun Choi, Woong Jin Bae, Su Jin Kim, Hyuk Jin Cho, Sung Hoo Hong, Ji Youl Lee, Tae Kon Hwang, Sae Woong Kim
www.kjurology.org http://dx.doi.org/10.4111/kju.2011.52.12.824 Lasers in Urology 120 W Greenlight HPS Laser Photoselective Vaporization of the Prostate for Treatment of Benign Prostatic Hyperplasia in
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 informationThe Egyptian Journal of Hospital Medicine (January 2019) Vol. 74 (6), Page
The Egyptian Journal of Hospital Medicine (January 2019) Vol. 74 (6), Page 1377-1386 Evaluation of Silodosin in Comparison to Tamuslosin in Treatment of Benign Prostatic Hyperplasia with lower Urinary
More informationWhen to worry, when to test?
Focus on CME at the University of Calgary Prostate Cancer: When to worry, when to test? Bryan J. Donnelly, MSc, MCh, FRCSI, FRCSC Presented at a Canadian College of Family Practitioner s conference (October
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 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 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 information(2) Assistant Professor of Pathology
The Association between (Serum prostatic specific antigen and Dihydrotestosterone) and Efficacy of Solifenacin Therapy for Benign prostatic hypertrophy Patient in Salahalddin (1) Mohammed Mohsin Abdul-Aziz,
More informationThe Journal of International Medical Research 2005; 33:
The Journal of International Medical Research 2005; 33: 562 573 A Comparative Study on the Safety and Efficacy of Tamsulosin and Alfuzosin in the Management of Symptomatic Benign Prostatic Hyperplasia:
More informationProstate surgery. What is the prostate? What is a TURP? Why is a TURP operation necessary? Deciding to have a TURP operation.
What is the prostate? The prostate is a gland about the size of a walnut that is only present in men. It is located just below the bladder and surrounds the urethra, the tube through which urine flows
More informationOriginal Article. J Fac Med Baghdad 119. Nibbras I. AL-Hamdani* Ali W. Zeki*** Introduction:
Original Article The Efficacy of Solifenacin Added to Α-Adrenergic Antagonists in the Treatment of Lower Urinary Tract Symptoms in Males with Benign Prostate Hyperplasia (The Iraqi Experience) Nibbras
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 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 informationThe ICS- BPH Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction
British Journal of Urology (1998), 82, 619 623 The ICS- BPH Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction J.M. REYNARD1, Q. YANG2, J.L. DONOVAN3,T.J. PETERS3, W. SCHAFER4,
More informationBenign Prostatic Hyperplasia. Management of Benign Prostatic Hyperplasia. Goals of Therapy
Benign Prostatic Hyperplasia Management of Benign Prostatic Hyperplasia Goals of Therapy Improve or abolish lower urinary tract symptoms (LUTS) Prevent or delay clinical progression of benign prostatic
More informationCanadian Undergraduate Urology Curriculum (CanUUC): Prostate Diseases
Canadian Undergraduate Urology Curriculum (CanUUC): Prostate Diseases LUTS/Benign Prostate Hyperplasia Objectives 1. List the lower urinary tract symptoms (LUTS) found in men with BPH. 2. List the differential
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 informationWhat is Benign Prostatic Hyperplasia (BPH)?
What is Benign Prostatic Hyperplasia (BPH)? Benign prostatic hyperplasia (BPH) is an enlarged prostate. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty,
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 informationMale LUTS. Dr. Brian Ho. Division of Urology Department of Surgery Queen Mary Hospital
Male LUTS Dr. Brian Ho Division of Urology Department of Surgery Queen Mary Hospital Mr. Siu M/78 Known to have HT & DM since 2008 on follow up with General ut-patient Clinic (GPC) Noticed to have worsening
More informationBPH / LUTS. Prevalence. Prevalence of BPH. It is abnormal NOT to have benign growth of the prostate with increasing age. Prevalence.
BPH / LUTS Dr Jonny Coxon MA MD MRCS MRCGP DRCOG FECSM Beaconsfield Medical Practice, Brighton & Brighton & Sussex Universities NHS Trust As man draws near the common goal Can anything be sadder Than he
More informationEarly-Stage Clinical Experiences of Holmium Laser Enucleation of the Prostate (HoLEP)
JRural Med 2007 ; 2 : 93 97 Original article Early-Stage Clinical Experiences of Holmium Laser Enucleation of the Prostate (HoLEP) Shuzo Hamamoto 1,TakehikoOkamura 1,HideyukiKamisawa 1,KentaroMizuno 1,
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 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 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 informationDr. Aso Urinary Symptoms
Haematuria The presence of blood in the urine (haematuria) is always abnormal and may be the only indication of pathology in the urinary tract. False positive stick tests and the discolored urine caused
More informationINJINTERNATIONAL. Original Article INTRODUCTION
Official Journal of Korean Continence Society / Korean Society of Urological Research / The Korean Children s Continence and Enuresis Society / The Korean Association of Urogenital Tract Infection and
More informationPROSTATIC EMBOLIZATION FOR BENIGN HYPERPLASIA
St. Louis Hospital PROSTATIC EMBOLIZATION FOR BENIGN HYPERPLASIA INITIAL CLINICAL RESULTS Faculty of Medical Sciences New University of Lisbon JOÃO PISCO LUÍS CAMPOS PINHEIRO TIAGO BILHIM HUGO RIO TINTO
More informationÉZER A. MELO, DEMERVAL MATTOS JR., LUIS A. S. RIOS. Division of Urology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
Clinical Urology Brazilian Journal of Urology Official Journal of the Brazilian Society of Urology Vol. 28 (1): 25-32, January - February, 2002 A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED STUDY, TO
More informationTrans Urethral Resection of Prostate (TURP)
Trans Urethral Resection of Prostate (TURP) Patient Information Author ID: SF Leaflet Number: Urol 010 Version: 6 Name of Leaflet: Trans Urethral Resection of Prostate (TURP) Date Produced: March 2018
More informationElements for a Public Summary
VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Benign prostatic hyperplasia (BPH), also called benign prostatic hypertrophy or benign prostatic obstruction, is a condition in
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 informationName of Policy: Transurethral Microwave Thermotherapy
Name of Policy: Transurethral Microwave Thermotherapy Policy #: 449 Latest Review Date: September 2013 Category: Surgery Policy Grade: B Background/Definitions: As a general rule, benefits are payable
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 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 informationClinical Studies with Speman in Cases of Benign Enlargement of Prostate
[The Indian Practitioner (1971): 6, 281] Clinical Studies with Speman in Cases of Benign Enlargement of Prostate Agarwal, V.K., M.S., F.I.C.S., Professor of Surgery, and Gupta, R.K., M.B.,B.S., Research
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 informationPROSTATE ENLARGEMENT A GUIDE TO URINARY SYMPTOMS IN MEN A BOOKLET IN THE SERIES OF CONSUMER GUIDES ON MALE REPRODUCTIVE HEALTH FROM
PROSTATE ENLARGEMENT A GUIDE TO URINARY SYMPTOMS IN MEN A BOOKLET IN THE SERIES OF CONSUMER GUIDES ON MALE REPRODUCTIVE HEALTH FROM AT A GLANCE First published in March 2004 by Andrology Australia 5th
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 informationPatient Information. Lower Urinary Tract Symptoms (LUTS) and Diagnosis of BPE
Patient Information English 32 Lower Urinary Tract Symptoms (LUTS) and Diagnosis of BPE Symptoms The underlined terms are listed in the glossary. Benign prostatic enlargement (BPE) can affect the way you
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 informationNew Modification of Transurethral Incision of the Prostate in Surgical Treatment of Bladder Outlet Obstruction: Prospective Study
43(5):61-614,2 CLINICAL SCIENCES New Modification of Transurethral Incision of the Prostate in Surgical Treatment of Bladder Outlet Obstruction: Prospective Study Boris Ru iæ, Davor Trnski, Ognjen Kraus,
More informationUrodynamics and Benign Prostatic Hyperplasia
Urodynamics and Benign Prostatic Hyperplasia Alexis E. Te, MD Associate Professor of Urology Director of the Brady Prostate Center and Urodynamic Laboratory Weill Medical College of Cornell University
More informationDIAGNOSING and treating
CME CREDIT ' REVIEW Benign prostatic hyperplasia: an approach for the internist CRAIG D. ZIPPE, MD In benign prostatic hyperplasia, urodynamic testing and the many available drugs and surgical procedures
More informationUrodynamic Assessments of Bladder Outflow Obstruction Associated with Benign Prostatic Hyperplasia
Original Article Urodynamic Assessments of Bladder Outflow Obstruction Associated with Benign Prostatic Hyperplasia Kun Dou, MD; QiGui Liu, MD; Xin Li, MD; QingYu Zhou, MD; XiaoLu Han, MD Kun Dou is a
More informationEjaculation. Emission. Ejection. Orgasm
Ejaculation Emission Ejection Orgasm Ejaculation sc T10-L2 S2-4 Emission: vas deferens, prostate, bladder neck Post. Urethra distention Ejection: Pelvic Floor / bulbocavernous muscle contraction Orgasm:
More informationProstate Artery Embolization: A Minimally Invasive Option for the Treatment of BPH
Prostate Artery Embolization: A Minimally Invasive Option for the Treatment of BPH Farrah J. Wolf, MD Diagnostic Radiology, Board Certified Vascular & Interventional Radiology fwolf@bocaradiology.com Educational
More information