PURPOSE: This study was performed to investigate whether the free to total PSA ratio(F/T PSA ratio) offers a better discriminant for the detection of patient with prostatic cancer(CaP) and those with benign prostatic hyperplasia(BPH) than serum total PSA alone. MATERIALS AND METHODS: From September 1996 to February 1999, free and total PSA levels were measured on frozen sera samples of 154 men with BPH and 46 with CaP using immunoradiometric assay. RESULTS: In all subjects, the mean total PSA was significantly higher in CaP group(72.59+/-66.58ng/ml) than BPH group(3.12+/-4.10ng/ml). The mean PSAD was significantly higher in CaP group(1.64+/-1.86) than BPH group(0.08+/-0.01). The mean F/T PSA ratio was significantly lower in CaP group(0.19+/-0.07) than BPH group(0.30+/-0.13). Among 41 subjects whose total PSA were between 4-20ng/ml, the mean PSAD was significantly higher in CaP group(0.37+/-0.16) than BPH group(0.17+/-0.07), but the mean F/T PSA ratio was not significantly different between CaP(0.19+/-0.10) and BPH group(0.25+/-0.13). By comparing the sensitivity and specificity of total PSA alone, PSAD and F/T PSA ratio on receiver operating characteristic(ROC) curve in all subjects and subjects with total PSA between 4-20ng/ml, F/T PSA ratio had no superiority than total PSA alone and PSAD for. discrimination between CaP and BPH. CONCLUSIONS: We suggest that the F/T PSA ratio is not superior to total PSA alone and PSAD in the detection of prostatic cancer, and further evaluation of the usefulness of F/T PSA ratio should be required.
Discrimination (Psychology) ; Humans ; Immunoradiometric Assay ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms* ; Sensitivity and Specificity

This study investigated the relationship of personality, depression, somatization, anxiety with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the International Prostate Symptom Score (IPSS), 44-item Big Five Inventory (BFI), the Patient Health Questionnaire-9 (PHQ-9), the PHQ-15, and 7-item Generalized Anxiety Disorder Scale (GAD-7). The LUTS/BPH symptoms were more severe in patients with depression (p=0.046) and somatization (p=0.024), respectively. Neurotic patients were associated with greater levels of depression, anxiety and somatisation (p=0.0059, p=0.004 and p=0.0095, respectively). Patients with high extraversion showed significantly low depression (p=0.00481) and anxiety (p=0.035) than those with low extraversion. Our exploratory results suggest patients with LUTS/BPH may need careful evaluation of psychiatric problem including depression, anxiety and somatization. Additional studies with adequate power and improved designs are necessary to support the present exploratory findings.
Anxiety Disorders ; Anxiety* ; Depression* ; Extraversion (Psychology) ; Humans ; Lower Urinary Tract Symptoms* ; Prostate ; Prostatic Hyperplasia*

PURPOSE: Several studies and papers have reported good short-term results for using 120W HPS laser PVP. Here we report the short-term and long-term clinical outcomes analysis with efficacy and safety of 120W HPS laser PVP for the treatment of BPH. MATERIALS AND METHODS: We performed a retrospective clinical analysis of 357 patients, who underwent 120W HPS laser PVP for the treatment of BPH from April, 2009 to Feb. 2011. The IPSS, Qmax and PVR values were evaluated preoperatively and postoperatively. RESULTS: The mean age at the surgery; 70.35+/-8.28, mean prostate size; 46.56+/-21.11 ml, and mean PSA was 4.16+/-4.35 ng/ml. Mean operation time was 41.8+/-34.1 min, and mean lasing time was 19.8+/-11.3 min. Mean applied energy was 134,294.9+/-225,211.5 J. Thirty cases of co-operation were done. Mean catheter indwelling time was 0.84+/-0.36 day, and mean hospital stay was 1.1+/-0.2 day. The blood loss was minimal so transfusions were not needed. The baseline IPSS-sum; 19.61+/-9.13, QoL score; 4.28+/-1.02, Qmax; 7.94+/-5.51 ml/sec, PVR; 101.62+/-102.58 ml, At 1 month, IPSS-sum; 8.64+/-7.34, QoL score; 2.19+/-1.48, Qmax; 13.32+/-8.94 ml/sec, PVR; 32.54+/-46.07 ml was noted. At 12 months, IPSS-sum; 8.33+/-5.04, QoL score; 1.33+/-1.08, Qmax; 15.75+/-2.90 ml/sec, PVR; 21.56+/-31.28 ml was noted. Within 1 month of operation, 18 cases of dysuria and 27 cases of retention were reported but these were resolved with medication and observation. Compared with preoperative values, there were statistical improvements after the operation. CONCLUSIONS: 120W HPS laser showed statistical improvements after 1 month operation and these results were sustained for 12 months. Although limitations, our long term experience suggest that significant improvements in symptomatic and urodynamic outcomes of 120W HPS laser PVP.
Catheters ; Dysuria ; Humans ; Laser Therapy ; Length of Stay ; Prostate ; Prostatic Hyperplasia ; Retention (Psychology) ; Retrospective Studies ; Urodynamics ; Volatilization

BACKGROUNDBenign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.

METHODSOne hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.

RESULTSAll patients were visited after 6 months, the mean volume of transitional zone was found to have increased by 1.6 ml (P < 0.01), International Prostate Symptom Score was increased by 0.8 (P < 0.01) and Quality of Life was increased by 0.2 (P < 0.01), and there was no statistical change in other data. Among these patients, 17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).

CONCLUSIONSAfter one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; psychology ; therapy ; Quality of Life

BACKGROUNDThe enlarged prostate leads to obstruction and lower urinary tract symptoms (LUTS), which comprise frequency, urgency, weak stream, straining and nocturia. This study was conducted in a large series of patients to evaluate the relationship between LUTS as stipulated in the International Prostate Symptom Score (IPSS) and the objective parameters related to benign prostatic hyperplasia (BPH).

METHODSWe enrolled 1295 BPH patients from seven centers. The patients were either at first diagnosis of BPH or had discontinued medical treatment for at least 3 months. Those with several other diseases that may be potential risk factors affecting urinary symptoms were excluded from the study. Age, IPSS, prostate volume, peak flow rate, urine volume and post-voiding residual urine volume were measured. The relationship between IPSS and objective parameters were quantified by means of Spearman correlation coefficients. The differences in these parameters between the groups with mild, moderate or severe symptoms were also evaluated.

RESULTSStatistically significant correlations were found between IPSS and objective parameters by means of Spearman correlation coefficients. When the patients were divided into three groups with different severities of symptoms, there were significant differences in peak flow rate, urine volume, prostate volume, residue urine volume and quality of life, whereas average age and prostate-specific antigen levels were similar. However, there was evident overlap of these parameters between the groups. The same results were found when the irritative or obstructive subscore of IPSS was considered.

CONCLUSIONSThe correlation between objective parameters of BPH and LUTS is significant. However, it is hard to predict the severity of symptoms by these parameters.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; diagnosis ; psychology ; Quality of Life ; Urination Disorders ; etiology

OBJECTIVESymptomatic benign prostate hyperplasia (BPH) affects both the patients' and their wives' quality of life (QOL) due to lower urinary tract symptoms (LUTS) and related events. This study was to investigate the QOL of the wives of symptomatic BPH patients being evaluated for surgical treatment.

METHODSWe included 50 couples in this study, in which the husbands were symptomatic BPH patients referred for surgical treatment. The patients were asked to fill in the forms of IPSS and BPH impact index ( BPHII), while their wives investigated with a 7-item questionnaire. The data obtained were subjected to statistic analyses.

RESULTSLUTS of the BPH patients caused sleep disturbance in 12% of their wives, decreased social activity in 12%, inadequate sexual life in 20%, psychological stress in 38%, fear of prostate cancer in 68%, fear of surgery in 40% and insufficiency for essential tasks in 14%. The decrease in the QOL of the patients' wives was not correlated with the patients' scores on IPSS and BPHII (P > 0.05).

CONCLUSIONLUTS and related events of symptomatic BPH patients obviously decrease the QOL of their wives, but the severity of the patients' symptoms is not correlated with the decrease of their wives' QOL.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; Quality of Life ; Spouses ; psychology ; Surveys and Questionnaires

OBJECTIVE: To develop a specific quality of life (QOL) scale for Chinese patients with benign prostatic hyperplasia (BPH). METHODS: The scale was developed with the programmed decision methods. The item pool was certified by experts. Five methods were used in item selection after a pilot study for which 256 BPH patients had been recruited. The scale was evaluated by its reliability and validity. RESULTS: We formed a 27-item quality of life scale specific for patients with benign prostatic hyperplasia prior test version (BPHSQL). The test-retest correlation coefficient and Cronbach's alpha coefficient of BPHSQL were 0. 774 and 0. 945. The structure of the scale was similar to the theory construction. The scale's correlation coefficients with criteria ranged from 0.531 to 0.700. BPHSQL could well discriminate the quality of life between BPH and non-BPH patients as well as patients with different degrees of symptoms, different sources and patients with or without urethral catheters. CONCLUSION BPHSQL is reliable, valid and sensitive, and will be a convenient tool in clinical research to provide advice on different treatments for different patients.
Adult ; Evaluation Studies as Topic ; Factor Analysis, Statistical ; Humans ; Male ; Prostatic Hyperplasia ; psychology ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires ; standards

PURPOSE: Urologists occasionally experience some cases of voiding failure after transurethral resection of prostate (TURP). Preoperative and postoperative factors attributable to acute urine retention (AUR) after catheter removal in post-TURP patients were evaluated and analyzed to determine the causative factors for AUR. MATERIALS AND METHODS: From June 2004 to May 2008, a total of 172 patients who underwent TURP due to symptomatic benign prostatic hyperplasia (BPH) were divided into the AUR group (n=21) and the control group (n=151). The AUR group was defined as patients with voiding difficulty within 24 hours and whose residual urine volume was above 400 ml after catheter removal. The control group was defined as patients without AUR. Age, duration of symptoms, International prostate symptom score (IPSS), Quality of life score (QoL), uroflowmetry, post-void residual urine volume, preoperative serum prostate specific antigen (PSA) level, preoperative prostate volume, resected prostate volume, rate of prostate resection [resected prostate volume/preoperative prostate volume x 100], operative time and duration of catheter were retrospectively analyzed to identify which of these were the factors related with AUR after catheter removal in post-TURP patients. RESULTS: Preoperative prostate volume was higher (90.7+/-50.4 vs 64.4+/-32.7, p=0.002) and rate of prostate resection was lower (38.8+/-8.1 vs 50.5+/-12.4, p<0.001) in AUR group compared to control group. And age, duration of symptoms, IPSS, QoL, uroflowmetry, post-void residual urine volume, preoperative serum PSA level, resected prostate volume, operative time and duration of catheter were not statistically significant in both groups. The multivariate analysis subsequently showed that preoperative prostate volume (p=0.010, OR=1.040) and rate of prostate resection (p=0.001, OR=0.901) were independent factors related with AUR after catheter removal in post-TURP patients. CONCLUSIONS: The incidence of AUR after catheter removal was higher in post-TURP patients with high preoperative prostate volume and low rate of prostate resection. Therefore the surgeon's effort to increase the rate of prostate resection, especially in patients with large prostate volume, may lower the incidence of postoperative AUR.
Catheters ; Humans ; Hyperplasia ; Incidence ; Multivariate Analysis ; Operative Time ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Retention (Psychology) ; Retrospective Studies ; Transurethral Resection of Prostate ; Urinary Retention

PURPOSE: This study was done to examine the relationship of low urinary tract symptoms (LUTS), depression, sexual function, and health-related quality of life (HRQoL), and to identify factors influencing HRQoL in patients with benign prostatic hyperplasia (BPH) living in the community. METHODS: A total of 218 patients with BPH were recruited into the study. The data were collected by personal interviews using questionnaires and were analyzed with SPSS (version 17.0) computer program, and included descriptive statistics, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis. RESULTS: The relationship between HRQoL and LUTS with depression had a significant negative correlation, whereas the relationship between HRQoL and sexual function had a significant positive correlation. Depression, age, LUTS, number of chronic disease, and excercise were found to be significant predictors (35.6%) of the Physical Component Summary of HRQoL. Depression, stress, smoking, LUTS, and sexual function were found to be significant predictors (48.2%) of the Mental Component Summary of HRQoL. CONCLUSION: To improve HRQoL of patients with BPH, nurses should focus on the factors identified in this study when doing nursing assessments, and should develop nursing intervention programs for BPH prevention and symptoms management in primary care settings.
Aged ; Aged, 80 and over ; Chronic Disease ; Depression ; Exercise ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Prostatic Hyperplasia/*psychology ; *Quality of Life ; Questionnaires ; Sexual Dysfunction, Physiological ; Smoking ; Urinary Tract Physiological Phenomena

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of conventional transurethral resection of the prostate (TUR-P), transurethral resection in saline (TURIS), and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19), or TURIS-V (15) for BPH were retrospectively analyzed. All procedures were carried out by a single surgeon between October 2007 and April 2010. The patients were assessed preoperatively and perioperatively and were followed at 1, 3, and 6 months postoperatively. Patient baseline characteristics, perioperative data, and postoperative outcomes were compared, and major complications were recorded. RESULTS: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (p=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration, and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between the groups in hemoglobin levels or serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications. CONCLUSIONS: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was not inferior to conventional TUR-P or TURIS in terms of safety.
Catheters ; Follow-Up Studies ; Hemoglobins ; Humans ; Length of Stay ; Male ; Pilot Projects ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Retention (Psychology) ; Retrospective Studies ; Sodium ; Transurethral Resection of Prostate ; Urologic Surgical Procedures ; Volatilization