No abstract

Purpose: Cyclooxygenase-2 (COX-2) is expressed in human BPH tissue and displays either a pro-inflammatory effect or a proliferative effect on prostate cells. The aim of this study is to analyze whether combination therapy with rofecoxib, a COX-2 inhibitor, and finasteride offers an advantage compared to finasteride monotherapy in patients with BPH. Materials and Methods: This is a single centre unblinded trial. Forty-six consecutive men with LUTS and BPH were entered into the study and were randomized to receive rofecoxib 25 mg/day plus finasteride 5 mg/day (group B) versus finasteride 5 mg/day alone (group A) for 24 weeks. Inclusion criteria included also a prostate size greater than 40 cc. The efficacy and safety of treatments were assessed at baseline and at week 4, 12 and 24. Results: In our population, both treatments (groups A and B) produced statistically significant improvements in total IPSS and Q max from baseline during follow-up, although they were very low in particular for the finasteride alone group at 4 weeks. We found that finasteride monotherapy produces very little improvement at the 1 month interval. In comparing group A with group B, a significantly higher improvement in IPSS (p = 0.0001) and Q max (p = 0.03) was obtained in group B at 4 weeks interval (% cases with IPSS reduction >4 points: group B = 34.7, group A = 0; % cases with Q max improvement >3 ml/s: group B = 8.7, group A =0), whereas at week 24, the differences between the two treatments were not significant (p > 0.05). Conclusions: In our population, the advantage of the combination therapy compared to finasteride alone is significant in a short-term interval (4 weeks). It can be hypothesized that the association of rofecoxib with finasteride induces a more rapid improvement in clinical results until the effect of finasteride becomes predominant.

Objective: Transurethral resection of the prostate (TURP) is the current optimal therapy for the relief of bladder outflow obstruction, with subjective and objective success rate of 85 to 90%. Aim of this study was to evaluate efficacy and safety of Plasmakinetic energy (Gyrus electro surgical system), which produces vaporization of tissue immersed in isotonic saline against standard monopolar transurethral resection of the prostate. Results: Comparative data on IPSS symptom score, IIEF-5, Qol, PSA, peak urinary flow rate and post-void residual urine volume were similar in the two groups but showed a significant improvement respect to baseline values. The postoperative haemoglobin levels, postoperative catheterization time, hospital stay and 3-year overall surgical re-treatment-free rate were significantly better in the bipolar group. Conclusions: Bipolar TURP has a comparable outcome to standard monopolar TURP at short and medium term regard to subjective and objective outcome measurements. Its impact on bladder outlet function is also similar to that of monopolar TURP. Improvement in IPSS, Qol index, IIEF-5, Q max and post-void residual urine volume were comparable in both group denoting similar efficacy of the techniques.

No abstract

No abstract