OBJECTIVE: To observe the clinical efficacy of electroacupuncture (EA) at "four points of sacral region" for mild-to-moderate benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). METHODS: A total of 58 patients with BPH/LUTS were randomly divided into a sacral four-point EA group (29 cases, 1 case dropped out) and a conventional EA group (29 cases, 1 case dropped out). EA was applied at bilateral points 0.5 cun lateral to the sacrococcygeal joint and Huiyang (BL35) in the sacral four-point EA group; and was applied at Guanyuan (CV4), Zhongji (CV3), Qugu (CV2) and bilateral Shuidao (ST28), Sanyinjiao (SP6), Zusanli (ST36) in the conventional EA group. Both groups received continuous wave, 2 Hz in frequency, 30 min a time, once every other day, 3 times a week for 4 weeks. Before treatment, after 2 and 4 weeks of treatment, and in follow-up of 1 month after treatment completion, the international prostate symptom score (IPSS), the overactive bladder symptom score (OABSS), the quality of life (QOL) score were observed; before and after treatment, the prostate volume (PV) was measured by abdominal ultrasound; and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: Compared before treatment, the scores of IPSS, OABSS and QOL were decreased after 4 weeks of treatment and in follow-up in both groups (P<0.01, P<0.05). In the sacral four-point EA group, the scores of IPSS and QOL after 4 weeks of treatment and in follow-up were lower than those in the conventional EA group (P<0.05, P<0.01), and the OABSS score in follow-up was lower than that in the conventional EA group (P<0.05). After 4 weeks of treatment and in follow-up, the reductions of IPSS and OABSS scores compared before treatment in the sacral four-point EA group were larger than those in the conventional EA group (P<0.01, P<0.05); After 2, 4 weeks of treatment and in follow-up, the reductions of QOL score compared before treatment in the sacral four-point EA group were larger than those in the conventional EA group (P<0.01). No significant difference in PV was observed after treatment between the two groups (P>0.05). The total effective rate was 75.0% (21/28) in the sacral four-point EA group, which was higher than 39.3% (11/28) in the conventional EA group (P<0.01). CONCLUSION EA at "four points of sacral region" can effectively improve the LUTS, overactive bladder symptom and quality of life in patients with mild-to-moderate BPH, and has good short-term and long-term efficacy, although it can not reduce prostate volume.
Humans ; Male ; Electroacupuncture ; Prostatic Hyperplasia/complications* ; Aged ; Middle Aged ; Lower Urinary Tract Symptoms/physiopathology* ; Acupuncture Points ; Treatment Outcome ; Quality of Life

OBJECTIVE: To explore the impact factors and the clinical significance of the urination intermittences in benign prostatic hyperplasia (BPH) patients. METHODS: A retrospective study was performed in BPH patients who underwent urodynamic studies in Beijing Jishuitan Hospital form January 2016 to June 2021. The patients were aged 45 to 84 years with a median age of 63 years, and all the patients had no previous history of neurological disease and had no positive findings in neurological examinations. All the patients had free uroflometry followed by urethral catheterization and urodynamic tests. The voiding work of bladder was calculated using the detrusor power curve method, and the voiding power of bladder and the voiding energy consumption were also calculated. The frequency of urination intermittences generated in uroflometry was also recorded and the patients were divided into different groups according to it. The detrusor pressure at maximal flow rate (P_detQ_max), the maximal flow rate (Q_max), the bladder contractile index (BCI), the bladder outlet obstruction index (BOOI), the voiding work, the voiding power, and the voiding energy consumption were compared among the different groups. Multiva-riate analyses associated with presence of urination intermittences were performed using step-wise Logistic regressions. RESULTS: There were 272 patients included in this study, of whom, 179 had no urination intermittence (group A), 46 had urination intermittence for only one time (group B), 22 had urination intermittence for two times (group C), and 25 had urination intermittence for three times and more (group D). The BCI were 113.4±28.2, 101.0±30.2, 83.3±30.2, 81.0±30.5 in groups A, B, C, and D, respectively; The voiding power were (29.2±14.8) mW, (16.4±9.6) mW, (14.5±7.1) mW, (8.5±5.0) mW in groups A, B, C, and D, respectively, and the differences were significant (P < 0.05). The BOOI were 41.6±29.3, 46.4±31.0, 41.4±29.0, 42.7±22.8 in groups A, B, C, and D, respectively; The voiding energy consumption were (5.41±2.21) J/L, (4.83±2.31) J/L, (5.02±2.54) J/L, (4.39±2.03) J/L in groups A, B, C, and D, respectively, and the differences were insignificant (P>0.05). Among the patients, 179 cases were negative in presence of urination intermittences and 93 cases were positive. Step-wise Logistic regression analysis showed that bladder power (OR=0.814, 95%CI: 0.765-0.866, P < 0.001), BCI (OR=1.023, 95%CI: 1.008-1.038, P=0.003), and bladder work (OR=2.232, 95%CI: 1.191-4.184, P=0.012) were independent risk factors for urination intermittences in the BPH patients. CONCLUSION The presence of urination intermittences in the BPH patients was mainly influenced by bladder contractile functions, and was irrelevant to the degree of bladder outlet obstruction. The increase of frequency of urination intermittences seemed to be a sign of the decrease of the bladder contractile functions in the BPH patients.
Prostatic Hyperplasia/physiopathology* ; Humans ; Male ; Urodynamics ; Urination ; Retrospective Studies ; Middle Aged ; Aged ; Aged, 80 and over ; Urinary Bladder/physiopathology* ; Urination Disorders/etiology*

This study aimed to investigate perceived ejaculatory function/satisfaction before treatment for lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and to identify associations between specific categories of ejaculatory dysfunctions (EjDs) and LUTS. A total of 1574 treatment-naïve men with LUTS/BPH were included in this study. All patients underwent routine evaluation for LUTS/BPH including the International Index of Erectile Function and a 5-item questionnaire developed to assess ejaculatory volume/force/pain/satisfaction/latency time. Patients who had sexual intercourse over the past 4 weeks were classified as sexually active group. A total of 783 patients were categorized as sexually active group. Decreased ejaculatory volume and force were reported by 53.4% and 55.7% of 783 sexually active men, respectively. There was a strong correlation between ejaculatory volume and force. Ejaculatory pain/discomfort, premature ejaculation (PE), and delayed ejaculation (DE) were reported in 41.0%, 16.3%, and 41.4% of the patients, respectively. Over 40.0% of men without decreased ejaculation volume/force were satisfied with ejaculatory function, whereas approximately 6.0% of men with decreased volume/force were satisfied with ejaculatory function. About 30.0% of men with decreased volume/force had orgasmic dysfunction, while approximately 10.0% of men without decreased volume/force did. Decreased ejaculatory volume or force was associated with LUTS severity after adjusting for other influential factors including testosterone level, erectile function, and prostate size on ultrasonography, but PE or DE or ejaculatory pain/discomfort was not. In conclusion, a considerable portion of men with LUTS/BPH appear to have a variety of EjDs. Ejaculatory volume/force and satisfaction/orgasm do not always appear to be concordant. Ejaculatory volume or force is independently associated with LUTS severity, whereas PE or DE or ejaculatory pain/discomfort is not.
Aged ; Coitus ; Ejaculation ; Humans ; Lower Urinary Tract Symptoms/physiopathology* ; Male ; Middle Aged ; Orgasm ; Pain/etiology* ; Personal Satisfaction ; Premature Ejaculation/physiopathology* ; Prostate/diagnostic imaging* ; Prostatic Hyperplasia/physiopathology* ; Sexual Dysfunction, Physiological/physiopathology* ; Surveys and Questionnaires ; Testosterone/blood*

Benign prostatic hyperplasia (BPH) is an age-related disease of unknown etiology, characterized by prostatic enlargement coincident with distinct alterations in tissue histology. In the present study, we investigated whether triptolide can prevent testosterone-induced prostatic hyperplasia in rats. Castration was performed via the scrotal route after urethane aesthesia. BPH was induced in experimental groups by daily subcutaneous injections of testosterone propionate (TP) for two weeks. Triptolide was administered daily by oral gavage at a dose of 100 and 50 μg·kg for 2 weeks, along with the TP injections. On day 14, the animals were humanely killed by cervical dislocation after aesthesia. Prostates were excised, weighed, and used for histological studies. Testosterone and dihydrotestosterone (DHT) levels in serum and prostate were measured. The results showed that triptolide significantly reduced the prostate weight, and the testosterone and DHT levels in both the serum and prostate. Histopathological examination also showed that triptolide treatment suppressed TP-induced prostatic hyperplasia. In conclusion, triptolide effectively inhibits the development of BPH induced by testosterone in a rat model.
Androgens ; blood ; Animals ; Diterpenes ; administration & dosage ; Drugs, Chinese Herbal ; administration & dosage ; Epoxy Compounds ; administration & dosage ; Humans ; Male ; Phenanthrenes ; administration & dosage ; Prostate ; drug effects ; growth & development ; Prostatic Hyperplasia ; blood ; drug therapy ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Testosterone ; blood ; Tripterygium ; chemistry

ObjectiveTo evaluate the effect and safety of phloroglucinol combined with parecoxib on cystospasm after transurethral resection of the prostate (TURP).

METHODSWe conducted a prospective randomized case-control study on 98 patients treated by TURP. After operation, the patients were randomly assigned to a treatment (n=50) and a control group (n=48), the former treated by intravenous injection of 80 mg phloroglucinol qd plus 40 mg parecoxib bid while the latter given 80 mg phloroglucinol only, both for 3 successive days. Then we recorded the frequency and duration of cystospasm, visual analogue scales (VAS), adverse reactions, post-operative bladder irrigation time, catheter-indwelling time, and hospital stay and compared them between the two groups of patients.

RESULTSCompared with the controls, the patients in the treatment group showed a significantly lower frequency of cystospasm (［1.95±0.14］ vs ［0.70±0.65］ times, P<0.01), duration of cystospasm (［0.44±0.21］ vs ［0.12±0.14］ min, P<0.01), and VAS score (2.70±1.80 vs 1.90±1.30, P<0.01) at 48－72 hours after TURP, but no statistically significant differences were found between the control and treatment groups in the post-operative bladder irrigation time (［2.75±0.87］ vs ［2.64±0.83］ d, P>0.05), catheter-indwelling time (［3.52±0.32］ vs ［3.44±0.42］ d, P>0.05), and hospital stay (［5.23±0.81］ vs ［5.10±0.73］ d, P>0.05), and no obvious adverse reactions were observed in either of the two groups.

CONCLUSIONSPhloroglucinol combined with parecoxib is more effective and safer than phloroglucinol alone in relieving postoperative cystospasm after TURP.

Aged ; Case-Control Studies ; Drug Therapy, Combination ; Humans ; Isoxazoles ; administration & dosage ; therapeutic use ; Length of Stay ; Male ; Middle Aged ; Phloroglucinol ; administration & dosage ; therapeutic use ; Postoperative Period ; Prospective Studies ; Prostatic Hyperplasia ; Spasm ; drug therapy ; Therapeutic Irrigation ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder ; drug effects ; physiopathology

OBJECTIVETo assess the clinical effect and safety of the Chinese medicine Longbishu Capsule combined with mesylate doxazosin in the treatment of benign prostatic hyperplasia (BPH) of the kidney deficiency and blood stagnation type.

METHODSThis was a randomized, double-blind, double-simulation control study. We equally assigned 60 men diagnosed with BPH of the kidney deficiency and blood stagnation type to an experimental and a control group, the former treated with mesylate doxazosin plus Longbishu Capsule and the latter with mesylate doxazosin plus placebo. We compared the International Prostate Symptom Score (IPSS), quality of life (QOL), Chinese symptom score (CSS), maximal urinary flow rate (Qmax), and prostate volume between the two groups of patients before and after 6 months of medication.

RESULTSAfter treatment, there were 5 cured cases, 13 markedly effective cases, 9 effective cases, 1 ineffective case, and 2 eliminated cases in the experimental group, as compared with 2 cured cases, 8 markedly effective cases, 10 effective cases, 7 ineffective cases, and 3 eliminated cases in the control group. The total effectiveness rate was obviously higher in the former (96.4%) than in the latter (74.1%). IPSS, Qmax, and CSS were improved in both of the groups after medication, even more significantly in the experimental than in the control group (IPSS: 15.22 ± 2.98 vs 18.15 ± 5.88, P <0.05; Qmax: [13.56 ± 2.26] ml/s vs [11.78 ± 2.97] ml/s, P <0.05; CSS: 6.18 ± 2.13 vs 9.52 ± 3.15, P <0.05). Because of the difference in the QOL score between the two groups at the baseline (P = 0.038 <0.05), no more comparison was made in this aspect after treatment.

CONCLUSIONThe combination of Longbishu Capsule with mesylate doxazosin is safe and effective for the treatment of BPH.

Adrenergic alpha-Antagonists ; therapeutic use ; Capsules ; Double-Blind Method ; Doxazosin ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Prostatic Hyperplasia ; drug therapy ; physiopathology ; Quality of Life ; Treatment Outcome ; Urination

OBJECTIVETo identify the correlation of the volume of residual urine (VRU) with the severity of bladder outlet obstruction (BOO) and detrusor contractility in patients with benign prostatic hyperplasia (BPH).

METHODSA total of 152 patients with clinically diagnosed BPH underwent ultrasonography for measurement of the prostate volume and RVU, free uroflowmetry, and urodynamic examination for the severity of BOO and detrusor contractility. Using the software SPSS20. 0, we analyzed the correlation between the ultrasonographic results and urodynamic parameters and compared the two sample means by the t-test.

RESULTSThe prostate volume was correlated positively with BOO severity (r = 0.432, P < 0.01) and detrusor contractility (r = 0.343 , P < 0.01) while Qmax negatively with BOO severity (r = 0.327, P < 0.01) but not significantly with detrusor contractility (r = 0.123, P > 0.05). VRU showed a significantly negative correlation with detrusor contractility when > 150 ml (r = -0.490, P < 0.01), even more significantly when > 300 ml (r = -0.717, P < 0.01), but exhibited no significant correlation with it when ≤ 150 ml (r = 0.041, P > 0.05).

CONCLUSIONVRU can somehow predict the detrusor function. For patients with VRU > 150 ml, especially for those with VRU > 300 ml, the detrusor function should be evaluated and urodynamic examination is recommended for exact assessment of BOO severity and detrusor contractility.

Aged ; Humans ; Male ; Muscle Contraction ; Muscle Hypertonia ; diagnostic imaging ; physiopathology ; Organ Size ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; diagnostic imaging ; physiopathology ; Severity of Illness Index ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnostic imaging ; physiopathology ; Urine ; Urodynamics

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 observe the effectiveness and safety of Kangquan Recipe (康泉方, KQR) for benign prostatic hyperplasia (BPH) patients.

METHODSOne hundred and six BPH patients were randomly assigned to the treatment group (53 cases) and the control group (53 cases) according to a random number table. The treatment group was given KQR orally; the control group was given cernilton orally. After 24-week treatment, the clinical effect and safety were evaluated using the International Prostatic Symptom Score (I-PSS), quality of life (QOL), maximum flow rate (Qmax), average flow rate (Qave), residual urine volume (RUV), total prostatic volume (TPV), etc.

RESULTSAfter treatment, the score of I-PSS was decreased from 16.9±5.6 to 12.5±4.6 in the treatment group, significantly lower compared with the control group; the levels of Qmax and Qave were from 10.9±3.5 to 15.6±4.5 and 5.4±2.1 to 7.3±2.5 (mL/s) in the treatment group, significantly higher compared with the control group; the levels of RUV and TPV were from 70.8±28.2 to 35.2±21.8 and 37.2±16.9 to 30.1±10.8 (mL) in the treatment group, significantly lower compared with the control group (all P<0.05). The incidence rate of adverse reaction was similar between the two groups (P>0.05).

CONCLUSIONKQR is effective and safe for the treatment of BPH.

Aged ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Male ; Middle Aged ; Organ Size ; Prostate ; pathology ; Prostatic Hyperplasia ; drug therapy ; physiopathology ; urine ; Treatment Outcome ; Urination

We performed a retrospective, case-control study to evaluate whether the urine flow acceleration (UFA, mL/s(2)) is superior to maximum uroflow (Qmax, mL/s) in diagnosing bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH). In this study, a total of 50 men with BPH (age: 58±12.5 years) and 50 controls (age: 59±13.0 years) were included. A pressure-flow study was used to determine the presence of BOO according to the recommendations of Incontinence Control Society (ICS). The results showed that the UFA and Qmax in BPH group were much lower than those in the control group [(2.05±0.85) vs. (4.60±1.25) mL/s(2) and (8.50±1.05) vs. (13.00±3.35) mL/s] (P<0.001). According to the criteria (UFA<2.05 mL/s(2), Qmax<10 mL/s), the sensitivity and specificity of UFA vs. Qmax in diagnosing BOO were 88%, 75% vs. 81%, 63%. UFA vs. Omax, when compared with the results of P-Q chart (the kappa values in corresponding analysis), was 0.55 vs. 0.35. The prostate volume, post void residual and detrusor pressure at Qmax between the two groups were 28.6±9.8 vs. 24.2±7.6 mL, 60.4±1.4 vs. 21.3±2.5 mL and 56.6±8.3 vs. 21.7±6.1 cmH2O, respectively (P<0.05). It was concluded that the UFA is a useful urodynamic parameter, and is superior to Qmax in diagnosing BOO in patients with BPH.
Case-Control Studies ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; physiopathology ; Retrospective Studies ; Urinary Bladder Neck Obstruction ; diagnosis ; physiopathology ; Urine ; physiology