Prostatic artery embolization (PAE) in catheter-dependent patients with large prostatic (BPH) glands (> 90 cc): early intervention essential.

CONCLUSION: PAE is very successful in allowing spontaneous voiding in men with obstructing BPH requiring a urethral catheter. However, the PAE should be performed as soon as possible after the urethral catheter is inserted. Direct referral from acute urology services or emergency departments once the catheter is inserted are warranted. PMID: 30845814 [PubMed - as supplied by publisher]
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research

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AbstractObjectiveTo investigate whether prostatic arterial embolization (PAE) could be recommended as a routine therapy for benign prostatic hyperplasia (BPH), we conducted an updated meta-analysis to assess the efficacy and safety of PAE compared with transurethral resection of the prostate (TURP).MethodsSystematic literature retrieval by searching data from Web of science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, CNKI, Wanfang and VIP databases was carried out to identify all related trials from the inception dates to June 2019. We also conducted subgroup analyses depending on the kind of study design, kind o...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
CONCLUSION: The current landscape of BPH surgical treatment should be individualized with a shared decision- making process based on prostatic anatomy and clinical parameters combined with patient's preferences to select the ideal treatment option for each patient. Aquablation is one such option that involves a robotically delivered hydroablation technique based on individualised real time ultrasonic prostatic mapping that can offer safe and effective treatment for symptomatic BPH while minimising sexual dysfunction. Larger trials with longer follow up data will be required to further validate the long term effectiveness o...
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
AbstractPurpose of ReviewTo review the prevalence and risks of sexual dysfunction associated with current treatment options for benign prostatic hyperplasia and to characterize techniques and methods to manage postoperative sexual dysfunction-related side effects.Recent FindingsCurrent surgical therapies available for the treatment of benign prostatic hyperplasia are associated with a substantial risk of both ejaculatory and erectile function. However, many of the novel minimally invasive treatment alternatives have demonstrated the ability to preserve postoperative sexual function to a better degree, all while providing s...
Source: Current Sexual Health Reports - Category: Sexual Medicine Source Type: research
Abstract Erectile dysfunction (ED) is a common male sexual dysfunction associated with a reduced quality of life for patients and their partners. ED is associated with increasing age, depression, obesity, lack of exercise, diabetes mellitus, hypertension, dyslipidaemia, cardiovascular disease and lower urinary tract symptoms related to benign prostatic hyperplasia. The evaluation of men with ED requires a full medical and personally and culturally sensitive sexual history, a focused clinical examination, fasting glucose levels, a fasting lipid profile and, in select cases, a total testosterone level and a prostate...
Source: Med J Aust - Category: General Medicine Authors: Tags: Med J Aust Source Type: research
This study compared the efficacy and safety of Aquablation to transurethral resection of the prostate (TURP) for the treatment of male lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).Recent FindingsThe WATER study compared Aquablation using the AquaBeam system to the current gold standard, TURP. It demonstrated that Aquablation was non-inferior to TURP when comparing the primary efficacy study endpoint of reduction in International Prostate Symptom Score at 6-month follow-up. Additionally, it proved superior for the primary safety endpoints at 3 and 6  months.SummaryAquablation has been s...
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research
Conclusions Aging leads to a progressive decrease in androgen production that, in turn, leads to the development of LOH, defined by significant low T serum levels (in the lowest quartile) in the presence of signs and symptoms of hypogonadism (51). LOH could be due to both testicular and hypothalamic-pituitary dysfunction (32), and ED is one of its main symptoms. ED in LOH is linked to increased oxidative stress, subclinical inflammation, and subsequent endothelial dysfunction (101). In elderly men, it has been shown that LOH is also linked to lower cAMP pool and to an alteration of the cGMP signaling pathway. PDE5 gene l...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
We report the first case of PFS in a long-standing (over 20 years) dermatotrichological practice with frequent finasteride prescription observed in a 25-year-old male following dutasteride treatment for male androgenetic alopecia. There was circumstantial evidence that PFS may represent a delusional disorder of the somatic type, possibly on a background of a histrionic personality disorder, which would explain the refractoriness of the condition and a high degree of suggestibility.Skin Appendage Disord
Source: Skin Appendage Disorders - Category: Dermatology Source Type: research
Authors: Andrade C Abstract Finasteride and dutasteride are 5α-reductase inhibitor drugs that are used to treat benign prostatic hyperplasia (BPH). Randomized controlled trials (RCTs) conducted in men with BPH show that these drugs impair libido and cause erectile dysfunction. Meta-analyses of the RCTs confirm the findings, estimating odds ratio (OR) values for these adverse effects at around 1.50. A problem with meta-analyses that do not report absolute risks with drug vs placebo and that extract ORs instead of relative risks (RRs) from RCT data is that it is hard for the reader to know how to interpret the ...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
CONCLUSION: Sexual dysfunction and SBAU/BPH are intimately linked by a cross-over effect in the population of men over 50, a possible common pathophysiology and treatments for BPH with sexual consequences. Evaluating the sexuality of patients in care for SBAU/BPH is therefore essential. Patients should be informed of potential adverse drug effects of BPH, including ejaculation disorders with alpha blockers and loss of libido and erectile dysfunction with 5 alpha reductase inhibitors. After BPH surgery, loss of antegrade ejaculation is common, although preservation possibilities exist. The improvement of urinary functi...
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
AbstractPurpose of ReviewReview how the various surgical treatments for benign prostatic hyperplasia and lower urinary tract symptoms impact on male sexual health and function.Recent FindingsThe interplay between benign prostatic hyperplasia and erectile function is complex, and the conditions seem linked. Most cavitating procedures to improve male voiding will degrade ejaculatory and possibly erectile function. Many of the newer minimally invasive therapies appear to preserve sexual function in the short term while sacrificing some of the voiding improvements realized with more complete removal of the prostate adenoma.Sum...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research
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