Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia

McVary, Kevin T.; Roehrborn, Claus G.; Avins, Andrew L.; Barry, Michael J.; Bruskewitz, Reginald C.; Donnell, Robert F.; Foster, Harris E.; Gonzalez, Christopher; Kaplan, Steven A.; Penson, David F.; Ulchaker, James; Wei, John T.

doi:10.1016/j.juro.2011.01.074

Cited by 1,202 publications

(896 citation statements)

References 37 publications

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“…Bei Symptomen die auf eine Pathologie der Prostata hinweisen ist gegebenenfalls eine PSA Wert-Bestimmung zu empfehlen [47][48][49]. Eine Kontrolle der Nierenretentionsparameter ist gegebenenfalls bei einer Überlaufinkontinenz durchzuführen.…”

Section: Blutanalyseunclassified

Urininkontinenz beim Mann – ein Tabuthema

Kozomara-Hocke

Hermanns

Poyet

2016

Praxis

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Male urinary incontinence is an underestimated and frequently not broached issue. The urinary incontinence is divided into stress-, urge incontinence and hybrid forms as well as overflow incontinence. The fact that there are increasingly more men over 60 means that the prevalence of the urinary incontinence is up to 40%, and urinary incontinence will increasingly gain importance in daily routine practice. Many investigations and therapies can be realized by the general practitioner. Already simple therapy approaches can lead to a considerable clinical improvement of male urinary incontinence. If the initial therapy fails or pathological results (i. e. microhaematuria, recurrent urinary tract infections, raised residual urine and so on) are found, the patient should be referred to a urologist. Si la thérapie primaire ne réussit pas à résoudre l'incontinence urinaire ou on trouve des résultats pathologique (hématurie microscopique, infection urinaire récidivé, urine résiduelle augmenté etc.) le patient doit être envoyé chez le spécialiste d'urologie.4

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Section: Blutanalyseunclassified

Urininkontinenz beim Mann – ein Tabuthema

Kozomara-Hocke

Hermanns

Poyet

2016

Praxis

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“…Evidence suggests that HoLEP provides superior outcomes compared to TURP and open simple prostatectomy in men with BPH, regardless of prostate size [2][3][4][5] . Additionally, a recent study found that HoLEP is associated with decreased hospital costs compared to open prostatectomy.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

Monn

Tayeb

Bhojani

et al. 2015

Urology

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Objectives: To examine predictors of enucleation and morcellation time within a large cohort of men undergoing HoLEP for benign prostatic hypertrophy.Methods: Pre-operative, peri-operative, and post-operative clinical characteristics were available from men treated with HoLEP between 1998 and 2013 at Indiana University Health Methodist Hospital. Stepwise linear regression was performed to determine clinical variables which are associated with enucleation and morcellation times. Results:We identified 960 patients who underwent HoLEP. Average (range) enucleation time was 65.7 (11-245) minutes and morcellation time was 19.7 (3-260) minutes. History of anticoagulation was associated with a small decrease in enucleation time (p=0.013) while increasing HoLEP specimen weight was associated with increasing enucleation time (p<0.001).History of intermittent catheterization, urinary tract infections, presence of dense prostatic tissue (colloquially referred to as "beach balls"), and increasing specimen weight were associated with increasing morcellation time (p<0.05 each). Having HoLEP performed by a less experienced urologist was associated with longer enucleation and morcellation times. Conclusions:Prostate volume is significantly associated with increased enucleation and morcellation times during HoLEP. Additionally, history of UTI and CIC are associated with modest increases in enucleation and morcellation times. Dense enucleated prostate tissue significantly impacts the ability to morcellate effectively. Increasing surgeon experience can significantly improve both enucleation and morcellation efficiency.3

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“…The latest version of the guidelines on the management of BPH from the American Urological Association [4] and the guidelines on the management of male LUTS from the European Urological Association [5] refer to alfuzosin, doxazosin, tamsulosin and terazosin, while the Japanese guidelines for BPH also recommend naftopidil and silodosin [6] . The reports submitted to the US Food and Drug Administration Adverse Event Reporting System between 1997 and 2011 assessed the safety profiles of alfuzosin, doxazosin, tamsulosin, terazosin, naftopidil, silodosin and urapidil [7] .…”

Section: Introductionmentioning

confidence: 99%

(−)Doxazosin is a necessary component for the hypotensive effect of (±)doxazosin during long-term administration in conscious rats

Zhao

Kong

et al. 2013

Acta Pharmacol Sin

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Aim: Doxazosin is a racemic mixture of (-)doxazosin and (+)doxazosin that is currently used as an add-on therapy for hypertension. In this study we investigated the contribution of each enantiomer to the hypotensive action of long-term administration of (±)doxazosin in conscious rats. Methods: Blood pressure of conscious SD rats was measured using a volume pressure recording system. The rats were orally administered (-)doxazosin, (+)doxazosin, or (±)doxazosin (8 mg·kg -1 ·d -1 ) for 12 weeks. Plasma concentrations of the agents were analyzed with HPLC. The effect of the agents on α 1 -adrenoceptor was examined in isolated rat caudal artery preparations. Results: Treatment of conscious rats with a single dose of (±)doxazosin (8 mg/kg) did not affected DBP and MBP, but significantly decreased SBP by 11.9% 4 h after the administration. Long-term treatment of conscious rats with (±)doxazosin significantly decreased SBP, DBP and MBP with a maximal decrease of SBP by 29.3% 8 h after the last administration. The rank order of the hypotensive actions caused by long-term treatment in conscious rats was (±)doxazosin>(+)doxazosin>>(-)doxazosin. However, the pK B values for inhibiting NA-induced contraction of isolated rat caudal artery were (+)doxazosin (8.995)>(±)doxazosin (8.694)>(-)doxazosin (8.032). The plasma concentrations of (-)doxazosin, (+)doxazosin, and (±)doxazosin were 18.26±3.55, 177.11±20.66, and 113.18±13.21 ng/mL, respectively, 8 h after the last administration of these agents. Conclusion: Long-term treatment with (±)doxazosin produces potent hypotensive action in conscious rats that seems to result from synergic interaction of the two enantiomers.

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Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia

Abstract: New pharmacotherapies and technologies have emerged which have impacted treatment algorithms. The management of LUTS/BPH continues to evolve.

Cited by 1,202 publications

References 37 publications

Urininkontinenz beim Mann – ein Tabuthema

Urininkontinenz beim Mann – ein Tabuthema

Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

(−)Doxazosin is a necessary component for the hypotensive effect of (±)doxazosin during long-term administration in conscious rats

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