Prostatitis and benign prostatic hyperplasia (BPH) are common prostatic diseases. Furthermore, the incidence of prostate cancer has recently shown a rapid increase, even in Korea. Pain caused by prostatitis may induce sexual dysfunction, including erectile dysfunction and ejaculatory disturbance. And BPH itself, or treatments for BPH, may affect sexual function. In addition, with increased detection of localized prostate cancer, surgical treatments and radiation therapy have also increased, and the treatments may cause sexual dysfunction. Aging is also an important factor in the deterioration of the quality of life of men. Deterioration of quality of life caused by prostate diseases may be affected not only by the prostate diseases themselves but also by the sexual dysfunction caused by the prostate diseases secondarily. Thus, consideration of these points at the time of treatment of prostate disease is required. Therapies suitable to each condition should be selected with an understanding of the close association of prostate diseases and associated sexual dysfunction with the quality of life of males.
Aging ; Erectile Dysfunction ; Humans ; Incidence ; Korea ; Male ; Prostate ; Prostatic Diseases ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Prostatitis ; Quality of Life

Prostatic diseases and erectile dysfunction (ED) are common diseases in urology and andrology. Basic and clinical studies have proved that there is a close relationship between the two. This article reviews the mechanism, diagnosis and treatment of ED caused by several prostatic diseases, such as acute prostatitis, chronic prostatitis, benign prostate hyperplasia and prostate cancer.
Chronic Disease ; Erectile Dysfunction ; diagnosis ; etiology ; therapy ; Humans ; Male ; Prostatic Diseases ; complications ; Prostatic Hyperplasia ; complications ; Prostatic Neoplasms ; complications ; Prostatitis ; complications

From its size, location and structure, the prostate is one of the most suitable organs for the diagnostic application of ultrasound. Transrectal ultrasonography with transrectal linear array probe was per. formed in 19 controls and 36 patients with prostatic disease to evaluate the size and morphology of prostate. The following results were obtained: 1. The average values of maximum anteroposterior, superiorinferior and transverse diameter obtained from ultrasonograms were 2.2O+/-0.30cm, 3.38+/-0.35cm, 4.18+0.35cm in control group; 3.16+/-0.78 cm, 4.79+/-0.84 cm, 5.13+/-0.62cm in BPH; 3.40+/-0.84cm, 5.25+ 1.95cm, 5.73+/-1.16cm in prostatic cancer. 2. In a comparison of sonography and x-ray for detecting prostatic calculi, the detection rate of sonography (54.5 %) was higher than x-ray (25.5%). 3. Diagnostic accuracy of sonography was 88% in BPH and 100% in prostatic cancer. 4. Ultrasonographic findings in BPH were enlarged in size, homogeneity in echo pattern and all capsular echoes are continuous. In prostatic cancers, which have mixed echo pattern and capsule is thick with discontinuity. 5. Transrectal sonography is especially useful in estimating prostatic size and in detecting pathology such as BPH, prostatic cancer, prostatitis and abscess.
Abscess ; Calculi ; Humans ; Pathology ; Prostate ; Prostatic Diseases* ; Prostatic Neoplasms ; Prostatitis ; Ultrasonography*

There have been much limitations and errors in evaluating prostatic conditions by traditional radiologic methods due to its location and anatomical structure. However recent introduction and improvement of the ultrasonography have been enabled us to visualize boundary of the prostate clearly and differentiate the variable findings within the prostate. Transrectal or transurethral ultrasonography of the prostate is popular nowadays, however we performed suprapubic ultrasonography of which merits are traumatic to the patients, easy to perform and it requires no adjustments or additions to basic ultrasound equipment. In order to evaluate ultrasonogram of the prostate in patients with prostatic diseases and normal adults and compare preoperative volume of the prostate on ultrasonographic estimation with postoperative volume, 31 patients with prostatic diseases and 40 normal adults under the age 60 were studied with suprapubic ultrasonography. The results obtained were as follows. 1. On ultrasonographic picture of the prostate, normal adults showed symmetrical or triangular or elliptical appearance and there were numerous fine homogenous spots within the prostate. BPH patients showed symmetric, round or oval shapes and its margin was smooth and numerous fine spots were seen within the prostate as normal adults. The prostatic size enlarged and elevated to the bladder base. Advanced prostatic cancer patients showed dyssymmetric irregular appearance. The prostate of acute prostatitis patients resembled normal prostate but prostatic size enlarged. 2. The mean prostatic volume of normal adults on ultrasonographic estimation was 21.30+/-24.80 cm3 and there were no differences of the prostatic volume between ages. 3. The mean prostatic volume of 21 BPH patients on ultrasonographic estimation was 46.2+/-17.2 cm3 and majority patients were in 33.49-61.56 cm3. 4. Comparisonal studies between preoperative ultrasonographic prostatic volume and resected prostatic volume showed correlation coefficient 0.98 (P<0.005) and mean error rate 17.58+/-8.1%. Most cases showed preoperative prostatic volume was larger than the postoperative volume which was probably due to inadequate removal of tissue and surgical capsule. As results of the above, the suprapubic ultrasonography was helpful in differential diagnosis of the prostatic diseases and estimation of the prostatic size.
Adult ; Diagnosis, Differential ; Humans ; Prostate ; Prostatic Diseases* ; Prostatic Neoplasms ; Prostatitis ; Ultrasonography ; Urinary Bladder

PURPOSE: Prostatic specific antigen (PSA) may be elevated in patients with benign prostatic diseases. We evaluated the causes of elevated serum prostatic specific antigen concentration in men without prostatic carcinoma by periodic determination of serum PSA. MATERIALS AND METHODS: From January 1996 to December 2000, of the 85 patients with elevated serum PSA (>4 ng/ml), 53 (62.4%) had clinical evidence of benign prostatic diseases such as BPH or acute prostatic inflammation. In 47 patients serum PSA was measured every 1-4 weeks until the PSA returned to base line level. RESULTS: In 42 (89.4%) patients the serum PSA concentration decreased to less than 4 ng/ml. within 3 months. The recovery rate of serum PSA within 4 weeks was high at 69% (29 of 42). The base line PSA was greater than 4 ng/ml during the follow-up period of 3 months in five patients. An elevation of PSA by acute prostatic inflammation (mean 34.1 40.0ng/ml) was abrupt and significantly greater than by prostatic hyperplasia (12.4 9.4 ng/ml, p=0.026). In patients with BPH, an initial elevation in serum PSA correlated with prostatic volume (r2=0.211, p=0.036), but no significant correlations between prostatic volume and elevated PSA levels were observed in patients with acute prostatic inflammation (r2=0.051, p=0.480). CONCLUSIONS: Benign prostatic hypertrophy and acute prostatic inflammation were main benign causes for serum PSA elevation. Majority of patients with elevated PSA by benign causes returned to base line less than 4 ng/ml in 4 weeks. However in some patients the serum PSA still remained elevated after 4 weeks, who should undergo TRUS guided biopsy of prostate to rule out the presence of malignancy. We recommended to wait at least 6 weeks for a repeat PSA determination.
Biopsy ; Follow-Up Studies ; Humans ; Inflammation ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Diseases* ; Prostatic Hyperplasia ; Prostatitis

Saw palmetto fruit extract (SPE), as a herbal product, is widely used for the treatment of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Recent studies show that SPE also has some therapeutic effects on chronic prostatitis, prostate cancer, sexual dysfunction, and so on. This article presents an overview on the application of SPE in the treatment of BPH, prostate cancer, and chronic prostatitis/chronic pelvic pain syndrome, with a discussion on its action mechanisms.
Chronic Disease ; Fruit ; chemistry ; Humans ; Lower Urinary Tract Symptoms ; drug therapy ; Male ; Pelvic Pain ; drug therapy ; Plant Extracts ; therapeutic use ; Prostatic Diseases ; drug therapy ; Prostatic Hyperplasia ; drug therapy ; Prostatic Neoplasms ; drug therapy ; Prostatitis ; drug therapy ; Syndrome

Adenocarcinoma ; metabolism ; pathology ; Atrophy ; Biomarkers ; metabolism ; Diagnosis, Differential ; Humans ; Male ; Prostate ; pathology ; Prostatic Diseases ; metabolism ; pathology ; Prostatic Hyperplasia ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology ; Prostatitis ; metabolism ; pathology ; Xanthomatosis ; metabolism ; pathology

From March 1982 to June 1985, Serum FSH, LH and prolactin were taken in 85 normal males, 37 benign prostatic hyperplasia and 7 prostatic carcinomas, Radioimmunoassay resulted in the following findings. 1. Serum FSH is seen to increase steadily with age in both normal subjects and patients with BPH. No difference was found in the value of the FSH between the 2 group. 2. Serum LH is seen to increase sharply after 70 years of age but level of LH in the benign prostatic hyperplasia do not reflect this age related increment. 3. Serum prolactin is seen to remain relatively unchanged in the normal male through adult life. No difference was observed between patients with BPH and normal age-matched control.
Adult ; Gonadotropins* ; Humans ; Male ; Prolactin* ; Prostatic Diseases* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Radioimmunoassay

PURPOSE: To investigate whether hospitalization influences serum prostate-specific antigen (PSA) values. MATERIALS AND METHODS: Transrectal ultrasound-guided prostate biopsies were performed for detecting prostate cancer in 2,017 patients between February 2001 and April 2011 at Ajou University Hospital. Of those patients, 416 patients who were hospitalized for prostate biopsies, whose serum PSA values were measured at the outpatient department within 1 month of admission and also just after admission, and who had negative prostate biopsy results were included in the present study. We retrospectively reviewed the data of the 416 patients and compared the serum PSA values measured in the outpatient department with those measured during hospitalization. RESULTS: Among all 416 patients, the interval between the two PSA measurements was 22.2 days (range, 3 to 30 days) and the prostate size measured by transrectal ultrasonography was 53.63 mL (range, 12.8 to 197.9 mL). Among all patients, mean serum PSA levels measured during hospitalization were significantly lower than those measured in the outpatient department (6.69 ng/mL vs. 8.01 ng/mL, p<0.001). When stratified according to age, the presence or absence of chronic prostatitis in the biopsy pathology, serum PSA levels, and prostate size, the serum PSA levels measured during hospitalization were significantly lower than those measured in the outpatient department in all subgroups, except in cases aged 20 to 39 years and those with PSA <4 ng/mL, in whom no significant differences were shown. CONCLUSIONS: Hospitalization decreases serum PSA values compared with those measured on an outpatient basis in patients with benign prostatic diseases. Therefore, serum PSA values should be checked on an outpatient basis for serial monitoring.
Aged ; Biopsy ; Hospitalization ; Humans ; Outpatient Clinics, Hospital ; Outpatients ; Prostate ; Prostate-Specific Antigen ; Prostatic Diseases ; Prostatic Neoplasms ; Prostatitis ; Retrospective Studies

We investigated a correlation of serum prostate specific antigen(PSA) and preoperative prostatic volume measured by transrectal ultrasonography (TRUS) in 66 patients with pathologically con- firmed benign prostatic hyperplasia (BPH), as aids in the early detection of prostate cancer and in the improvement of specificity in BPH. The preoperative serum PSA value was also measured in 18 patients with pathologically confirmed prostate cancer and 15 men without prostatic disease as normal control using Tandem-R PSA radioimmunometric assay. There was a highly significant correlation between natural logarithm transformed PSA(In PSA) and non-transformed prostatic volume by linear regression analysis(r=0.6668, p<0.0001). Given above data, we determined a volume adjusted 95th percentile upper confidence limit for n PSA as an appropriate cutoff between normal and abnormal PSA value, according to prostatic volume in BPH. In the patients with BPH and prostate cancer, sensitivity, specificity, diagnostic accuracy and positive predictive value were 94%, 72%, 68% and 48%, respectively. A statistical results by the volume-adjusted cutoff for in PSA was similar to that at 10 ng/ml as cutoff for PSA value. Above 40ml in prostatic volume, however, a false positive rate was decreased in inverse proportion to prostatic volume in BPH. In summary, the prostatic volume must be considered in BPH patients with elevated serum PSA value, negative digital rectal examination and negative TRUS of prostate. And when the volume adjusted PSA cutoff is clinically applied to BPH patients for the early detection of prostate cancer, we thought that the false positive rate can be decreased in BPH patients.
Diagnosis* ; Digital Rectal Examination ; Humans ; Linear Models ; Male ; Prostate* ; Prostatic Diseases ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Sensitivity and Specificity ; Ultrasonography*