Benign Prostatic Hyperplasia And Prostate Size Greater Than 90 Grams
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|Verified September 2019 by Tampa General Hospital. Recruitment status was: RecruitingFirst Posted : June 18, 2014Last Update Posted : September 10, 2019|
This is a phase II, single center, prospective, single arm, investigational study to evaluate the safety and efficacy of prostate artery embolization for treatment of severe lower urinary tract symptoms related to BPH in patients with prostate size greater than 90 grams that either refuse surgical treatment or are considered poor candidates for traditional surgical therapy.
30 patients will be enrolled in the single treatment arm with follow-up for no less than 12 months.
|Study Type :|
|Official Title:||Phase II, Single Arm Prospective Study to Evaluate Safety and Efficacy of Prostate Artery Embolization in Patients With Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia and Prostate Size Greater Than 90 Grams|
|Study Start Date :|
Which Is Better Turp Or Laser
Laser surgery. Laser procedures usually give you symptom relief and better urinary flow similar to TURP . However, some laser therapies produce fewer side effects than others and also reduce the risk of bleeding. Long-term studies are needed to find out whether laser treatments are as effective as TURP .
Treatments Options For High
The prostate is a walnut-sized organ that is part of the male reproductive system. It sits in front the bladder and above the rectum. The prostate is responsible for the production and supply of fluid that helps nourish sperm in the ejaculate. The urethra, where urine travels from the bladder to the penis, runs through the prostate.
As a result of family history, lifestyle, diet, and natural hormonal changes, the prostate begins to grow in size as men age, starting in their mid-30s. When the prostate becomes more enlarged over time, it might press against the urethra and block urine flow . This condition is called benign prostatic hyperplasia, or BPH.
Enlarged prostates differ in size. The size can be estimated on digital rectal exam or prostate imaging like an ultrasound. People with very enlarged prostates have several treatment options. However, size is not the only factor used to choose a treatment.
When doctors evaluate the prostate, symptoms are just as important as size. In addition, size and symptoms don’t always correspond. For example, one person might have a mildly enlarged prostate with noticeable symptoms, while another person could have a very large prostate with no symptoms.
All of this information is the basis of a personalized treatment plan. Here are the options for patients with very enlarged prostates, with or without symptoms.
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What Is Enlarged Prostate Size
The prostate size varies from person to person. Still, a large prostate has a volume of 40ml to 100 ml. When we talk about the weight then the weight will around 40 g to 125 g. Around the age of 40, the prostate gland begins to grow. Many of them dont know that the prostatic hyperplasia glands size may increase by 4 to 5 times.
Digital Rectal Examination Standardization For Inexperienced Hands: Teaching Medical Students
Leonardo Oliveira Reis
1Faculty of Medical Sciences, University of Campinas, Unicamp, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887 Campinas, SP, Brazil
2Faculty of Medicine, Center for Life Sciences, Pontifical Catholic University of Campinas, PUC-Campinas, 13060-904 Campinas, SP, Brazil
After anamnesis, clinical evaluation with physical examination is fundamental to proceed with patient investigation, determining the necessary complementary exams and even defining treatments.
Classically, the initial approach to men presenting with low urinary tract symptoms is accomplished by digital rectal examination , prostate specific antigen , international prostatic symptom score , and postvoid residue by ultrasonography .
The DRE technique is a simple and well-established maneuver however, this propaedeutic method and mainly its optimal quantification of prostate volume still remain empirical knowledge, with no scientific reasoning and standardization. PV has a direct correlation with natural history of prostate enlargement and subsequent risk of a poor outcome .
This preliminary study evaluates the impact of DRE standardization on inexperienced hands and sets how the designed method correlates with the comprehensive evaluation of men presenting with LUTS to assess the acquisition and validity of DRE skills, mainly PV assessment.
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How Can I Clean My Prostate
5 steps to better prostate health Drink tea. Both green tea and hibiscus tea are among the top drinks for prostate health. Exercise and lose weight. Exercising and losing weight are some of the best things you can do to promote prostate health. Follow a prostate-friendly diet. Take supplements. Reduce stress. Making changes.
Are There Any New Developments In The Treatment Of Prostate Cancer
Doctors often successfully treat prostate cancer. Sometimes, however, the disease returns . An FDA-approved radiotracer for PET/CT called Axumin® helps detect and locate cancer that recurs following radiation therapy or surgery.
Conventional imaging, such as MRI or ultrasound, cannot locate recurring prostate cancer when it is small. PET/CT with Axumin® can detect recurring cancer when PSA levels are low and when the cancer is small.
Identifying the exact location and extent of the disease at an early state is vital. It allows doctors to specifically target the cancer and limit exposure to healthy tissues.
Prostate-specific membrane antigen is a protein that helps develop prostate cancer. A PSMA scan uses PET imaging and a radiotracer to locate recurrent cancer. Doctors are studying Lutetium-177 PSMA therapy in clinical trials for use in treating prostate cancer. Neither of these procedures has FDA approval yet. For more information about the clinical trials, visit .
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What Is The Prostate
The prostate is a gland found in male mammals. In dogs, it is located behind the bladder and below the dogs rectum. The purpose of the prostate is to support and carry sperm cells. In healthy dogs, this gland reaches its maximum size when the dog reaches adulthood, which is around two years of age.
However, not all dogs have a prostate gland. If the dog gets neutered before he hits puberty, the prostate gland wont develop. The reason for this lies in the lack of testosterone, which is the male hormone that testicles normally produce.
How To Get The Benign Prostate Treatment Cost In India
Many of them dont know that benign prostatic hyperplasia is also known as prostate gland enlargement. If anyone is looking for benign prostate treatment cost in India then we will offer cost-saving treatment options. In case you have an enlarged prostate gland then you have these problems like blocking the flow of urine out of the bladder. It makes you feel very uncomfortable. Due to benign prostate, you have bladder, urinary tract, or kidney problems. Now we will tell you what is benign prostate enlargement treatment.
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What Is Benign Prostate Enlargement Treatment
If you were concerned about benign prostate treatment cost in India then we will also tell you. First, you have to know what exactly it is. Theprostate is found directly beneath the bladder and in front of the rectum. When we are talking about the treatment the doctor firstly uses some medicines. If there is no relief through medicines then they will decide to take surgery. There are various types of surgery that can be utilized to eliminate the prostate tissue that blocks the flow of urine, including:
Transurethral resection of the prostate : The urologist eliminates the tissue impeding the urethra with a unique instrument. It has some side-effect like infection, bleeding, impotence feebleness , incontinence, and retrograde ejaculation.
Transurethral incision of the prostate : The urologist makes two little cuts in the bladder neck and in the prostate to augment the urethra to improve urine flow.
Transurethral electrovaporization: This procedure utilizes electrical energy applied through a cathode to quickly warm prostate tissue, transforming the tissue cells into steam. This permits the specialist to disintegrate a space of the developed tissue and alleviate the urinary blockage.
GreenLight laser: This method will help to eliminate prostate tissue with a laser. It is associated with less bleeding during and after the method.
Anatomy Of The Prostate
The prostate is a small gland in the male reproductive system. It is situated in front of the rectum, below the bladder, and surrounds the urethra, which is the tube through which urine flows out of the body. The main function of the chestnut-sized prostate is to secrete part of the seminal fluid that combines with sperm to form semen.
Prostate Cancer Treatment Costs
One study found that the typical cost of treatment for a person with prostate cancer is about $2,800 per month after diagnosis. But these costs can be higher or lower, depending on if youâre insured or not, which type of insurance or government assistance you receive, and the specific kind of care you need. Costs can also vary in different parts of the country and by facilities.
You may already have an idea of some cancer care costs, but others might not be as obvious. You should consider:
Doctor visits. Your insurance might cover most of your appointment costs, but you may also have to cover a copay. This can vary, depending on your plan. In one study, the average copayment amount a month after a prostate cancer diagnosis was $37. That cost dropped to $31 a month 10 months after a diagnosis. If you have lab tests or radiology tests during your appointment, you might have to pay an extra cost as well. Talk to your doctor if youâre unable to pay fees or copays. They may be able to waive some of the charges or set up a payment schedule.
Medication. Like your doctor visits, you may have to cover a part of the cost of your medications. But there are many resources that can help lower these charges. Ask you doctor about the expected costs of your medications and if they recommend any resources to help with those expenses.
- Active surveillance
How Do Sex Hormones Affect Weight And Muscle
As we get older we lose muscle strength. Hormone treatment which lowers testosterone levels can also cause loss of muscle bulk in men. It can lead to:
- loss of muscle mass
- loss of muscle strength
Hormone treatment can also cause you to put on weight . This is usually around your waist. Hormone treatment can also make you feel tired and this can make you less active. This can then make the weight gain worse, as you might be less active.
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An Active Yet Noninvasive Therapy
âMany men on active surveillance are anxious about doing ânothingâ for their prostate cancer. This study has the potential to provide both patients and providers with an active yet noninvasive therapy that could benefit not only their prostate cancer, but also their overall health and quality of life,â Wright said.
âWe all have busy lives and priorities that make it difficult to stick to a diet and exercise regimen,â he said. âPart of our goal here is to prioritize a shift in lifestyle through a structured, supervised program that participants can sustain after the study concludes.â
This intervention, which is modeled on the National Institutes of Healthâs Diabetes Prevention Program, has a track record of success for participants keeping the weight off years later. âThe DPP has been shown to help participants â both men and women â lose up to 7 percent of their body weight after the six-month intervention and keep the weight off 10 years later,â Wright said. âThis is the first time, to our knowledge, that the intervention has been done solely in male cancer patients.â
Findings from this study, Wright said, will help researchers understand how obesity affects prostate cancer outcomes, and it could have âa profound impactâ on clinical practice by providing a lifestyle intervention as a therapy for men, like Asay, who opt for active surveillance.
Investigating The Role Of Glucose On Cancer Progression
With the help of study participants like Asay, Hutch oncologist Wright and colleagues are interested in investigating the role of impaired glucose regulation â commonly associated with obesity â in the progression of prostate cancer. They hypothesize that keeping glucose levels in check through weight loss will slow the growth of the cancer and improve long-term survival.
The National Cancer Instituteâfunded study is in the process of enlisting 200 Seattle-area men â about half of whom so far, like Asay, have been veterans enrolled in the local VA. These men are a particularly relevant group to study, said Wright, a joint associate member of the Prostate Studies Group in the Public Health Sciences Division at Fred Hutch and an associate professor of urology at UW School of Medicine. Wright also cares for patients at Seattle Cancer Care Alliance, Fred Hutchâs clinical care partner, and the VA Puget Sound Health Care System in Seattle.
âObesity and prostate cancer are both common diagnoses in older men,â he said, âbut in our veterans, the rates of these two diseases are even higher,â especially among those who served in the Vietnam War and were exposed to Agent Orange, an herbicide that has been linked to an increased risk of aggressive prostate cancer, among other malignancies.
Wrightâs father served a year in combat in the Vietnam War as an infantry soldier, he said, âmaking the importance of providing care to our veterans even more personal for me.â
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Reproductive Health Effects In Boys And Men
DDT compounds are thought to cause male reproductive health effects through anti-androgenic and/or oestrogenic effects on the hypothalamus-pituitary-gonadal axis . Impacts on the receptors located in the hypothalamus and/or pituitary would lead to an increased release of gonadal hormones in the case of an anti-androgenic effect and a decrease in the release of these hormones in the case of an estrogenic effect. The reduction in the release of testosterone resulting from an estrogenic response as well as the inhibition of the action of testosterone by anti-androgenic compounds acting on peripheral receptors can negatively impact early reproductive development and spermatogenesis.
Figure 1. Effect of anti-androgens and /or estrogens on the hypothalamus-pituitary-gonadal axis in males.
pp-DDE has been shown to result in reduced anogenital distance, a good measure of androgen action, at birth due to in-utero exposure, delayed puberty due to exposure during puberty and reduced androgen-dependent seminal vesicle and ventral prostate weights due to adult exposure in male rats. Additionally, in wildlife, DDT has been shown to be responsible for developmental effects that include demasculinisation of male alligators and super-feminisation of females and has been shown to impair reproduction and cause eggshell thinning in birds. DDT has also been linked to cryptorchidism, sperm abnormalities and sterility in Florida panthers.
Viiiasusceptible Populations Or Individuals
Evidence that individuals might show a different response to the same chemical exposure was first established in studies that showed a differential response in the prostate weight of mice following prenatal estradiol exposure the difference depended upon the intrauterine position of the developing mouse. Specifically, males situated in utero between two females showed a significantly greater increase in their adult prostate weight than those males situated between two males when exposed prenatally to estrogens. Minor differences in the local concentrations of intrauterine estradiol, which appeared to be gender-specific, were determined as the basis for different adult outcomes. This phenomenon should be taken into consideration when dealing with xenoestrogen exposure. For example, the positional effect has been shown to act additively with fetal BPA exposure in determining the age at which puberty initiates in female offspring. In this regard, one major issue that has arisen in the field of environmental endocrine disruption is that wildlife populations and outbred rodent strains are composed of nonidentical individuals and thus vary in their susceptibility to any particular noxious agent. This was made clear by a study showing that different strains of mice responded very differently to estradiol exposure.
Laura N. Vandenberg, in, 2014
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Study Design And Statistics
Two body imagers with 10 years of experience reading prostate MRIs were assigned the task of measuring total prostatic volume using T2-weighted MRI on the 140 patient cohort. They were provided with a spreadsheet showing only the patient hospital identification numbers. After determining the total prostate volumes, these spreadsheets were returned to the administrator. Intra-rater reliability was tested only on the experts data. Re-measurement of prostate volume was done between 3 and 9 months after primary measures. Inter-rater reliability for continuous variables for volumes was analyzed for actual paired case-to-case correlation using the Pearson product moment and Lins Coefficient of Concordance. Linear regression was calculated to find r2 values, Y intercepts, p values and 95% confidence intervals . These were calculated from the open access statistical programs at the National Institute of Water and Atmospheric Research and QI Macro Statistics® . Measurements of the administrator were used as a proxy for gross pathological specimen weight for the determination of rater accuracy. Correlations were analyzed by linear regression and graphed. A comparison of means was also done after the data was available to establish data normality. Significance was defined as p0.05.
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