OBJECTIVETo compare therapeutic effects of elongated needle therapy and routine acupuncture therapy on dysuria induced by benign prostatic hyperplasia (BPH).

METHODSRandomized, controlled, multi-central method was adopted and 150 cases confirmed to the enrolled criteria were divided into two groups by odd or even number, an elongated needle group (n = 72) and a routine acupuncture group (n = 78). Acupuncture was given at bilateral Zhibian (BL 54) and Zhongji (CV 3) in the two groups, once daily, 5 sessions constituting one course, with a 2-day interval between two courses. The treatment was given for 2 courses. Changes of I-PSS symptom cumulative score, urine flowing rate, residual urine in bladder before and after the treatment were observed.

RESULTSThe effective rate was 83.3% in the elongated needle group and 44.9% in the routine acupuncture group. There were significant differences between the two groups in improvemet of I-PSS score, increase of urine flowing rate and reduction of residual urine in bladder (all P < 0.05).

CONCLUSIONThe elongated needle therapy has a definite therapeutic effect on dysuria induced by benign prostatic hyperplasia.

Acupuncture Therapy ; Aged ; Humans ; Male ; Meridians ; Middle Aged ; Prostatic Hyperplasia ; physiopathology ; therapy ; Urinary Bladder ; physiopathology ; Urination

OBJECTIVE: To evaluate urinary dynamics in the diagnosis, differential diagnosis, disease grades, complications, prognosis, and curative effect on benign prostatic hyperplasia (BPH) patients accompanied with diabetic mellitus (DM), and to investigate the clinical significance of urodynamic studies. METHODS: A total of 106 BPH patients with lower urinary tract symptoms were studied, aged 53-92(63.21+/-7.18) years. The mean duration of voiding symptoms was 3-12 years. These patients were divided into 2 groups: Group A consisted of 59 BPH patients while Group B consisted of 47 BPH patients combined with DM. Both groups were evaluated the international prostate symptom score(IPSS), urine flow rate, and residual urine volume. All patients underwent urodynamic examination. Correlation analysis was conducted to determine the correlation among the patients. The urodynamic results in different groups were compared. RESULTS: The IPSS in Group A was higher than Group B, while the Qmax was lower than Group B. The unsatisfactory results of Group A was higher than Group B. There was significant difference between the 2 groups (P<0.05). There was no significant difference in residual urine volume between the 2 groups (P>0. 05). There was significant difference between the 2 groups in detrusor instability of the bladder, low compliance bladder, and damaged detrusor function (P<0.05). CONCLUSION The influence of DM on the function of the bladder in BPH patients is significant. Urodynamics can provide objective basis for the selection of therapeutic methods, and forecast the postoperative effect. It has an important reference value in BPH patients accompanied with DM.
Aged ; Aged, 80 and over ; Diabetes Complications ; physiopathology ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; physiopathology ; Urinary Bladder ; physiopathology ; Urodynamics

OBJECTIVETo investigate the expression and significance of Clusterin in normal prostate, benign prostate hyperplasia (BPH) and prostate cancer.

METHODSClusterin expression in samples of 12 normal prostate, 15 BPH, and 56 prostate cancer were studied by immunohistochemical stain.

RESULTSOf 83 cases, 67 are positive or weak positive (81%). The rate of positive or weak positive for normal prostate, BPH and prostate cancer was 17% (2/12), 73% (11/15), and 96% (54/56) respectively. The expression level of Clusterin in prostate cancer was much higher than in normal prostate (t = 8.82, P < 0.01). BPH (t = 7.63, P < 0.01) was related positively with pathological grade (r = 0.649, P < 0.01) and stage (r = 0.609, P < 0.01) of prostate cancer.

CONCLUSIONClusterin may play an important role in the biological characteristics of prostate cancer by the anti-apoptosis pathway.

Apoptosis ; Clusterin ; metabolism ; physiology ; Female ; Humans ; Immunohistochemistry ; Male ; Prostate ; metabolism ; Prostatic Hyperplasia ; metabolism ; Prostatic Neoplasms ; metabolism ; pathology ; physiopathology

OBJECTIVETo compare the difference in the clinical efficacy on benign prostatic hyperplasia (BPH) between the acupuncture-moxibustion therapy and the medication of Qianliekang tablets.

METHODSOne hundred and twenty-eight patients were randomized into an acupuncture-moxibustion group and a Qianliekang group, 64 cases in each one. In the acupuncture-moxibustion group, acupuncture was applied to Shenshu (BL 23), Pangguangshu (BL 28), Zhongji (CV 3), Guanyuan (CV 4) and Shuidao (ST 28), and the warm moxibustion therapy with moxa stick was used at Shenshu (BL 23), Guanyuan (CV 4) and Shenque (CV 8), once every day. In the Qianliekang group, Qianliekang tablets were prescribed for oral administration, 4 tablets each time, three times a day, for 3 months. The International Prostate Symptom Score (I-PSS) and the changes in residual urine (Ru) and maximal urine flow rate (Qmax) determined with the ultrasonic B test were compared before and after treatment in the two groups.

RESULTSThe results of I-PSS, Qmax and Ru were improved obviously after treatment as compared with those before treatment in the two groups (all P < 0.05). The improvements in the acupuncture-moxibustion group were much more obvious than those in the Qianliekang group [8.62 +/- 2.18 vs 15.26 +/- 2.81, (16.04 +/- 4.33) mL/s vs (12.47 +/- 2.13) mL/s, (10.43 +/- 2.14) mL vs (32.13 +/- 3.24) mL, all P < 0.01]. The total effective rate was 89.1% (57/64) in the acupuncture-moxibustion group, which was better than 68.7% (44/64) in the Qianliekang group.

CONCLUSIONAcupuncture-moxibustion therapy achieves the significant efficacy on BPH, which is better than the oral administration of Qianliekang tablets.

Acupuncture Therapy ; Aged ; Humans ; Male ; Middle Aged ; Moxibustion ; Prostatic Hyperplasia ; physiopathology ; therapy ; Treatment Outcome ; Urination

OBJECTIVETo study the factors that affect the prognosis of the patients with benign prostatic hypertrophy (BPH) after prostatectomy.

METHODSUsing urodynamic methods, we studied 50 BPH patients with embarrassing outcomes after prostatectomy.

RESULTSDetrusor instability (Dl) appeared in 20 (40%) patients. Twelve (24%) patients suffered from weak contractility of the detrusor and 18 (36%) patients had bladder outlet obstruction.

CONCLUSIONSDl, weak contractility of the detrusor and bladder outlet obstruction are the most frequent causes affecting the prognosis of BPH patients after prostatectomy. Urodynamics may play a significant role in the identification of the causes of unsatisfied prognosis of BPH patients.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatectomy ; Prostatic Hyperplasia ; physiopathology ; surgery ; Urodynamics

Benign prostate obstruction(BPO) means bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH), which concerns BPH, and lower urinary tract symptoms(LUTS). To treat the BPO is the main purpose of therapy on BPH in clinic. This review includes recent advances in study of changes on urodynamics(UDS), morphology, prostatic composition, which occur in BPO.
Humans ; Male ; Prostatic Hyperplasia ; complications ; Urinary Bladder Neck Obstruction ; etiology ; physiopathology ; therapy ; Urodynamics

OBJECTIVETo compare suprapubic puncture and transurethral catheterization for pressure-flow determination during voiding in BPH patients.

METHODSBoth suprapubic puncture and transurethral catheterization were used for pressure-flow determinations during voiding in 23 BPH patients at the mean age of 69.3 years (range 57-77 years) and the related parameters were compared by t-test.

RESULTSCompared with transurethral catheterization, suprapubic puncture increased Qmax by 1.19 mn/s (P <0.05) and MMC by 66.61 ml (P <0.01) , and reduced the pressure of detrusor at Qmax (Pdet, Qmax) by 10.57 cmH2O (P < 0.05), URA by 11.39 cmH2O (P < 0.01) and AG by 12.94 (P < 0.01). Either according to the Schäfer diagram or with AG > 40 as the diagnostic standard, there were 16 (69.6%) cases of bladder outlet obstruction (BOO) in the suprapubic puncture group and 20 (87.0%) in the transurethral catheterization group.

CONCLUSIONIn pressure-flow determination during voiding, suprapubic puncture and transurethral catheterization each have its own advantages and disadvantages, but the former is preferred for BPH patients. As for other patients, it all depends on specific conditions.

Aged ; Cystostomy ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; physiopathology ; surgery ; Urinary Catheterization ; Urination ; physiology ; Urodynamics

OBJECTIVETo explore the correlation between the Traditional Chinese Medicine (TCM) syndrome differentiation and urodynamic parameters in benign prostate hyperplasia (BPH).

METHODSUrodynamic examination was conducted for 152 BPH patients, who were divided by TCM syndrome differentiation into seven types, namely, kidney-yin deficiency, kidney-yang deficiency, aqueduct stagnancy, spleen-qi deficiency, lung-heat and qi stagnancy, wetness-heat down-flow and phlegm-wetness stagnancy.

RESULTSOf the total number of the BPH cases, 71 (46.71%) were differentiated as the type of kidney-yang deficiency, 40 (26.31%) as aqueduct stagnancy, and 14 (9.21%) as kidney-yin deficiency. Fifty-eight cases of Grade III-IV bladder outflow obstruction fell into the type of kidney-yang deficiency, and another 38 cases of the same grade along with 26 cases of Grade V-VI came under the type of aqueduct stagnancy. Of the 12 patients with very weak contractility of detrusor urine, 4 (33.33%) were attributed to the type of kidney-yang deficiency and 7 (58.33%) the type of aqueduct stagnancy. Among the 48 with weak contractility of detrusor urine, 27 (56.25%) fell under the type of kidney-yang deficiency and 17 (35.42%) the type of aqueduct stagnancy.

CONCLUSIONThe TCM syndrome differentiation of BPH is correlated with bladder outflow obstruction and detrusor urine contractility, which has provided corresponding evidence for the quantization and objectification of the TCM syndrome differentiation of BPH.

Aged ; Diagnosis, Differential ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prostatic Hyperplasia ; diagnosis ; physiopathology ; Urodynamics

OBJECTIVE: To determine the relationship between uroflowmetry and age, the course of disease, premicturition volume, transition zone index and proportion of stroma-to-epithelium in benign prostate hyperplasia (BPH) patients. METHODS: Eighty-nine BPH patients in our hospital from 2000 to 2003 were evaluated. With the CMM3 pathology image analysis system, transrectal ultrasound and Dantec 2000 urodynamic instrument, the value of influence factors was determined. A linear regression was applied to analyze all the data by SPSS software. RESULTS: The flow rate was correlated to premicturition volume ( r = 0. 477, P < 0.01) and proportion of stroma-to-epithelium significantly ( r = - 0.437, P < 0.05) , but was not correlated to the age, the course of disease and transition zone index significantly. The parameter of flow rate/premicturition volume had no difference in 3 micturitions in all patients. CONCLUSION The parameter (flow rate/premicturition volume)could be used to evaluate the micturition status of the BPH patients whose bladder volume is less than 200 ml. We should pay more attention to receptor blockers when we treat BPH patients.
Aged ; Circadian Rhythm ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; physiopathology ; Urination ; physiology ; Urodynamics ; physiology

Prostates of the same volumes were found to have very variable shapes, that is, combinations of variably elongated width, height, and lengths. These were believed to be possible causes of the differences in the severity of both the obstructions and symptoms in the prostates even when their volumes were similar. We measured the transverse (width), anterior-posterior (height) and longitudinal (length) diameters of the prostates and the transition zone, and their calculated volumes using transrectal ultrasonography. To establish the relationship between the International Prostate Symptom Score (IPSS) and each of the dimensional parameters of the transition zone and the total prostate, 105 consecutive patients (mean age 66.43 +/- 9.24 years with a range o6f 46 to 90) who had voiding dysfunctions that were presumably related to BPH were analyzed using the t-test. Patients with conditions other than BPH were excluded. The results were as follows: 1. There was no significant correlation between the IPSS and any prostate volume parameter in the constant prostate volume conditions, because of the small numbers in each group. However, in the analysis of the total number of cases in all the volume categories, a significant correlation was found between the IPSS and some prostate dimensions; i.e., the longitudinal parameters in the total prostates (p < 0.01), and the transverse (p < 0.05) and longitudinal parameters (p < 0.05) in the transition zones. 2. Further investigations of the statistics of these significant parameters showed that prostates that were longer than 4 cm had significantly more severe symptoms than prostates shorter than 4 cm (p < 0.05), and that prostates with a ratio of length in the transition zone to the length in the total prostate ratio that was greater than 0.8 had significantly higher symptom scores than those with lower ratios (p < 0.05). When evaluating patients who have BPH, it is important to consider the shape of prostate. More aggressive treatment may be indicated in cases where the transition zone lengths exceeds 4 cm and the transition zone to total prostate length ratio exceeds 0.8.
Aged ; Aged, 80 and over ; Human ; Male ; Middle Age ; Prostate/*physiopathology/*ultrasonography ; Prostatic Hyperplasia/*physiopathology/*ultrasonography ; Questionnaires ; Severity of Illness Index