Abstract:
:The development of human benign prostatic hyperplasia (BPH) clearly requires a combination of testicular androgens and the ageing process. Although the role of androgens as the causative factor for human benign prostatic hyperplasia is debated, they undoubtedly play, at least, a permissive role. The principal prostatic androgen is dihydrotestosterone. Although not elevated in human benign prostatic hyperplasia, dihydrotestosterone levels in the prostate remain at a normal level with ageing, despite a decrease in the plasma testosterone. Dihydrotestosterone (DHT) is generated by a reduction in testosterone. Two isoenzymes of 5alpha-reductase have been discovered. Type 1 is present in most tissues in the body where 5alpha-reductase is expressed, and is the dominant form in sebaceous glands. Type 2 5alpha-reductase is the dominant isoenzyme in genital tissues, including the prostate. Finasteride is a 5alpha-reductase inhibitor that has been used to treat BPH and male-pattern baldness. At doses used clinically, its major effect is to suppress type 2 5alpha-reductase, because it has a much lower affinity for the type 1 isoenzyme. Finasteride suppresses DHT by about 70% in serum and by as much as 85%-90% in the prostate. The remaining DHT in the prostate is likely to be the result of type 1 5alpha-reductase. The suppression of both 5alpha-reductase isoenzymes with GI198745 results in greater and more consistent containment of serum dihydrotestosterone than that observed with a selective inhibitor of type 2 5alpha-reductase. Physiological and clinical studies comparing dual 5alpha-reductase inhibitors, such as GI198745, with selective type 2, such as finasteride, will be needed to determine the clinical relevance of type 1 5alpha-reductase within the prostate. There have been two large, international multicentre, phase III trials published documenting the safety and efficacy of finasteride in treating human benign prostatic hyperplasia. Combining these two studies, randomised, controlled data are available for 12 months. Non-controlled extension of these data from a subset of patients, who elected to continue on the drug for 3, 4 and 5 years, are also available. Long-term medical therapy with finasteride can reduce clinically significant endpoints, such as acute urinary retention or surgery. According to the meta-analysis of six randomised, clinical trials with finasteride, finasteride is most effective in men with large prostates. A more effective dual inhibitor of type 1 and 2 human 5alpha-reductase may lower circulating dihydrotestosterone to a greater extent than finasteride and show advantages in treating human benign prostatic hyperplasia and other disease states that depend on dihydrotestosterone. A clinical evaluation of potent dual 5alpha-reductase inhibitors may help to define the relative roles of human type 1 and 2 5alpha-reductase in the pathophysiology of benign prostatic hyperplasia and other androgen-dependent diseases.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Bartsch G,Rittmaster RS,Klocker Hdoi
10.1007/s00345-002-0248-5keywords:
subject
Has Abstractpub_date
2002-04-01 00:00:00pages
413-25issue
6eissn
0724-4983issn
1433-8726journal_volume
19pub_type
杂志文章,评审abstract:PURPOSE:Given that the tumor-promoting inflammation has been previously established in squamous cell carcinoma of the bladder but its contribution to development of urothelial carcinoma (UC) still remains elusive, our aim was to study changes in expression and activity of inflammation-mediating NF-κB and STAT3 transcri...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-014-1237-1
更新日期:2014-12-01 00:00:00
abstract::The diagnosis of prostate cancer is based on histology. Prostate biopsies are obtained based on the triad of prostate specific antigen (PSA), digital rectal examination (DRE) and transrectal ultrasound. Because prostate biopsies still have a large percentage of negative outcomes, patient selection and biopsy direction...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-007-0189-0
更新日期:2007-08-01 00:00:00
abstract:PURPOSE:Oxidative stress is believed to be one of the important etiologies in carcinogenesis that has not been systemically investigated in urothelial carcinoma (UC). Through data mining from a published transcriptomic database of UC of urinary bladders (UBUCs) (GSE31684), glutathione peroxidase 2 (GPX2) was identified...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-015-1522-7
更新日期:2015-11-01 00:00:00
abstract:PURPOSE:To evaluate renal function and to identify factors associated with renal dysfunction in the elective indications setting of nephron-sparing surgery (NSS). METHODS:We retrospectively reviewed operative data and glomerular filtration rate (GFR) of 519 patients treated by NSS in an elective indications setting be...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-014-1292-7
更新日期:2015-01-01 00:00:00
abstract::A once-daily (o.d.) formulation of alfuzosin has recently been developed in order to improve the convenience of dosing and to provide optimal pharmacokinetic coverage over a 24-h period. The results of two double-blind, placebo-controlled phase III studies of similar design that included 983 patients with LUTS that su...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-002-0244-9
更新日期:2002-04-01 00:00:00
abstract:PURPOSE:To evaluate for the first time the prognostic significance of female invasive patterns in stage pT4a urothelial carcinoma of the bladder in a large series of women undergoing anterior pelvic exenteration. PATIENTS AND METHODS:Our series comprised of 92 female patients in total of whom 87 with known invasion pa...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-014-1308-3
更新日期:2015-03-01 00:00:00
abstract:PURPOSE:To evaluate the present human-based evidence that diet is related to the risk and outcome of prostate cancer. METHODS:Review of major case-control and cohort studies, and experimental trials evaluating the effect of diet or dietary constituents on the risk of prostate cancer. RESULTS:Although non-experimental...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-011-0810-0
更新日期:2012-04-01 00:00:00
abstract::A low-pressure reservoir for urine is created by antimesenteric splitting and side-to-side anastomosis of the rectosigmoid, the expectation being to obtain better continence rates and better protection of the upper tract than are achievable by ureterosigmoidostomy. Between 1990 and August 1993 the procedure was perfor...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/BF00182560
更新日期:1996-01-01 00:00:00
abstract::Nephrolithiasis is a highly prevalent disease worldwide with rates ranging from 7 to 13% in North America, 5-9% in Europe, and 1-5% in Asia. Due to high rates of new and recurrent stones, management of stones is expensive and the disease has a high level of acute and chronic morbidity. The goal of this study is to rev...
journal_title:World journal of urology
pub_type: 杂志文章,评审
doi:10.1007/s00345-017-2008-6
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:To investigate pathological and oncological outcomes of obese patients who underwent robot-assisted radical prostatectomy (RARP) compared with laparoscopic radical prostatectomy (LRP) or open retropubic radical prostatectomy (RRP) since limited comparative data exist with regard to oncological and survival o...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-014-1326-1
更新日期:2015-03-01 00:00:00
abstract::Percutaneous nephrolithotomy (PCNL) remains the treatment of choice for staghorn renal calculi. Many reports suggest that laparoscopy can be an alternative treatment for large renal stones. We wished to evaluate the role and feasibility of laparoscopic extended pyelolithotomy (REP) for treatment of staghorn calculi. T...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-006-0099-6
更新日期:2006-06-01 00:00:00
abstract::The purpose of this study was to assess the ability of [(18)F]FDG-PET, CT/MRI and serum tumor marker (TM) to predict the viability of residual masses after high-dose chemotherapy (HD-Ctx) in patients with metastatic germ cell tumors (GCT). In a prospective study, 60 residual tumors in 28 GCT patients were classified a...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-003-0392-6
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Imaging of the urinary tract and its surrounding tissue still remains challenging, since standard imaging in the urological operation room consists of fluoroscopy and plain X-rays. The combination of a ceiling-mounted X-ray system and a new urological intervention table now allows cross-sectional imaging and...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-012-0951-9
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:To present current evidence supporting the vessel sparing technique to reconstruct bulbar urethral strictures via primary anastomosis. METHODS:English literature review of presented series of transecting and non-transecting bulbar urethroplasty from 2000 to 2018. RESULTS:Since its introduction in 2007, vessel...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02867-8
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:Previous studies examining the management of urinary tract infections (UTI) showed marked variability in the economical burden of care, with a tenfold increase in costs when patients require admission to the hospital. We sought to examine the patient and emergency department (ED) characteristics associated with...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-013-1167-3
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Numerous recent studies have shown that concomitant carcinoma in situ (CIS) can be closely associated with the prognosis of patients with bladder cancer (BCa). However, the prognostic value of CIS in BCa is still not conclusive. Hence, we performed a systematic review and meta-analysis to explore the associa...
journal_title:World journal of urology
pub_type: 杂志文章,meta分析
doi:10.1007/s00345-019-02738-2
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:To investigate the impact of gender differences on treatment success, intraoperative and postoperative complications in patients undergoing ureteroscopy (URS). MATERIALS AND METHODS:A prospectively maintained database of 927 consecutively performed ureteroscopies on solitary ureteral stones in four different c...
journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-014-1435-x
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:Investigate the short-term effect of sildenafil on microcirculation, especially the velocity, the pattern of the flow and the recruitment of the leukocyte in postcapillaries. METHODS:In male Sprague-Dawley rats, the microcirculatory consequences of 60 min experimental testicular torsion, followed by 240 min of...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-018-2340-5
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Previous study compared limited number of parameters post the treatment of cold knife and laser urethrotomy for urethral stricture and controversy about the superiority of those two techniques still remains. This study aims to update the evidence and provide better clinical guidance. METHOD:We systematicall...
journal_title:World journal of urology
pub_type: 杂志文章,meta分析
doi:10.1007/s00345-019-02729-3
更新日期:2019-12-01 00:00:00
abstract::Upon feeling the urge to urinate, the urinary bladder contracts, the urethral sphincters relax and urine flows through the urethra. These actions are mediated by the micturition reflex. We investigated the hypothesis that vesical contraction is maintained by positive feedback through continuous flow of urine through t...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-003-0340-5
更新日期:2003-08-01 00:00:00
abstract:PURPOSE:Decreased vitamin D levels have been associated with prostate cancer, but it is unclear whether this association is causal. A functional single-nucleotide polymorphism (SNP) in the group-specific component (GC) gene (T > G, rs2282679) has been associated with 25-hydroxy (25-OH) vitamin D and 1.25 dihydroxy (1.2...
journal_title:World journal of urology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00345-015-1646-9
更新日期:2016-04-01 00:00:00
abstract:PURPOSE:To assess the long-term patient-reported outcomes following TO-TVT as a secondary continence procedure in women with recurrent stress urinary incontinence (R-SUI). METHODS:A secondary analysis of the 9-year follow-up of the E-TOT study was performed: 341 women with predominant SUI symptoms were randomised to u...
journal_title:World journal of urology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00345-016-1969-1
更新日期:2017-07-01 00:00:00
abstract:PURPOSE:To compare prognostic performance of MSKCC and IMDC risk models in patients with synchronous mRCC. METHODS:Retrospective analysis of pre-therapeutic MSKCC and IMDC prognostic factors and outcomes in patients with synchronous mRCC treated at a single institute in the targeted therapy era was performed. Cytoredu...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-016-1769-7
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:To study microscopic patterns of remaining peripheral nerves (PN) after nerve-sparing (NS) radical prostatectomy (RP) and possible consequences for nerve preparation. METHODS:Specimens from 27 patients (7 = non-NSRP, 20 = unilateral NS) were examined. Sections were investigated for PN content by immunoassaying...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-011-0791-z
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:To review the United States National Cancer Database (NCDB) from 2004 to 2015 and analyze survival outcomes of invasive non-urachal adenocarcinoma based on treatment modality. METHODS:The NCDB 2004-2015 bladder dataset was queried for adenocarcinoma histology, excluding urachal variant, and limited to patients...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-018-2411-7
更新日期:2019-03-01 00:00:00
abstract::It has been brought to our attention that the first sentence of the Conclusion in the original publication [1] is incorrect. We have removed this sentence and the correct version can be found in this Erratum. ...
journal_title:World journal of urology
pub_type: 已发布勘误
doi:10.1007/s00345-019-02929-x
更新日期:2020-09-01 00:00:00
abstract:PURPOSE:Chronic inflammation has been considered a potential risk factor for prostate cancer. Toll-like receptors (TLRs) are important in the innate immune response to pathogens and in cross talk between innate immunity and adaptive immunity. In this study, sequence variants in the TLR4 gene were investigated to determ...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-011-0690-3
更新日期:2012-04-01 00:00:00
abstract:PURPOSE:Rectal culture screening for fluoroquinolone (FQ)-resistant Enterobacteriaceae before transrectal ultrasound guided prostate (TRUSPB) biopsy and targeted antibiotic prophylaxis (TAP) may decrease post-TRUSPB infection rates compared to empiric (EAP) regimens. The objective of this study was to evaluate the effe...
journal_title:World journal of urology
pub_type: 杂志文章,meta分析
doi:10.1007/s00345-018-2217-7
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. PATIENTS AND METHODS:Male patients with urethral stricture disease participated in a choice-base...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-017-2066-9
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:To explore the role of prostate biopsy core length on prediction of index tumor clinical significance and localization on radical prostatectomy (RP) and time to recurrence, hypothesizing 10-, 10-12-, or > 12-mm minimum core as potential biopsy quality control. METHODS:Assessed 2424 prostate biopsy cores and co...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-018-2242-6
更新日期:2018-07-01 00:00:00