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Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (20 October 2022) | Viewed by 12627

Special Issue Editor

Dr. Petros Sountoulides

E-Mail Website
Guest Editor
1st Department of Urology, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, GR-55134 Thessaloniki, Greece
Interests: prostate cancer; bladder cancer; benign prostatic obstruction

Special Issue Information

Dear Colleagues,

It is with great pleasure that I invite you to submit your original work for inclusion in this Special Issue of the Journal of Clinical Medicine, titled “Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia”.

Lower urinary tract symptoms related to benign prostatic obstruction afflict the majority of men over 50 and are associated with worsening of urinary, sexual function, and quality of life. Until recently, therapy was mainly pharmacological with varying degrees of success and questionable compliance, while surgical options were limited to the “gold standard” transurethral resection of the prostatic adenoma, literally irrespective of prostate size.

As new, minimally invasive, day case, surgical treatments have emerged, the game in LUTS/BPH is certainly changing as many patients who were unwilling to stay on long-term medication or withstand the sexual side effects of it will opt for minimally invasive therapies promising to better preserve sexual function providing equal, if not better, relief from symptoms.

On the other hand, the management of the large prostate is currently shifting toward anatomical enucleation of the prostate, using a variety of energy sources and techniques, offering a definitive and lasting solution to lower urinary tract obstruction with minimal morbidity even in the outpatient setting.

Last but not least, lower urinary tract symptoms are often a result of previous procedures for benign or malignant indications, as in the case of urethral strictures and bladder neck stenosis. This Special Issue will also focus on emerging techniques for the prevention and management of urethral stricture disease.

Dr. Petros Sountoulides
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • benign prostatic obstruction
  • lower urinary tract symptoms
  • minimally invasive surgical treatments
  • urethral stricture
  • anatomical enucleation
  • lasers
  • HoLEP
  • BipolEP

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Published Papers (5 papers)

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Editorial

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4 pages, 143 KiB  
Editorial
Editorial for Special Issue: “Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia”
by Eliophotos Savvides, Georgios Langas and Petros Sountoulides
J. Clin. Med. 2024, 13(9), 2453; https://doi.org/10.3390/jcm13092453 - 23 Apr 2024
Viewed by 899
Abstract
Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) constitute a significant health concern worldwide, particularly among aging male populations [...] Full article
(This article belongs to the Special Issue Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia)

Review

Jump to: Editorial, Other

14 pages, 326 KiB  
Review
Role of Phytotherapy in the Management of BPH: A Summary of the Literature
by Vaki Antoniou, Vineet Gauhar, Sachin Modi and Bhaskar Kumar Somani
J. Clin. Med. 2023, 12(5), 1899; https://doi.org/10.3390/jcm12051899 - 28 Feb 2023
Cited by 8 | Viewed by 3899
Abstract
Benign prostatic hyperplasia (BPH) describes the non-malignant enlargement of the prostate. It is both common and growing in incidence. Treatment is multimodal, involving conservative, medical, and surgical interventions. This review aims to examine the evidence base for phytotherapies, specifically analyzing their role in [...] Read more.
Benign prostatic hyperplasia (BPH) describes the non-malignant enlargement of the prostate. It is both common and growing in incidence. Treatment is multimodal, involving conservative, medical, and surgical interventions. This review aims to examine the evidence base for phytotherapies, specifically analyzing their role in treating lower urinary tract symptoms (LUTS) attributable to BPH. A literature search was completed, specifically looking for randomized control trials (RCTs) and systematic reviews involving phytotherapy treating BPH. Specific emphasis was placed on exploring substance origin, the proposed mechanism of action, evidence of efficacy, and the side-effect profile. Several phytotherapeutic agents were evaluated. These included serenoa repens, cucurbita pepo, and pygeum Africanum, among others. For most of the reviewed substances, only modest effectiveness was reported. Generally, though, all treatments were tolerated well with minimal side effects. None of the treatments discussed in this paper form part of the recommended treatment algorithm in either European or American guidelines. We, therefore, conclude that phytotherapies, in the treatment of LUTS attributable to BPH, do provide a convenient option for patients, with minimal side effects. At present, however, the evidence for the usage of phytotherapy in BPH is inconclusive, with some agents having more backing than others. This remains an expansive field of urology whereby there is still more research to be done. Full article
(This article belongs to the Special Issue Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia)
15 pages, 565 KiB  
Review
A Novel Insight into the Immune-Related Interaction of Inflammatory Cytokines in Benign Prostatic Hyperplasia
by Xiaokaiti Naiyila, Jinze Li, Yin Huang, Bo Chen, Mengli Zhu, Jin Li, Zeyu Chen, Lu Yang, Jianzhong Ai, Qiang Wei, Liangren Liu and Dehong Cao
J. Clin. Med. 2023, 12(5), 1821; https://doi.org/10.3390/jcm12051821 - 24 Feb 2023
Cited by 10 | Viewed by 2985
Abstract
Benign prostatic hyperplasia (BPH) is a common male condition that impacts many men’s quality of life by generating lower urinary tract symptoms (LUTS). In recent years, inflammation has become very common in the prostate, and BPH with inflammation has a higher International Prostate [...] Read more.
Benign prostatic hyperplasia (BPH) is a common male condition that impacts many men’s quality of life by generating lower urinary tract symptoms (LUTS). In recent years, inflammation has become very common in the prostate, and BPH with inflammation has a higher International Prostate Symptom Score (IPSS) score and an enlarged prostate. Chronic inflammation leads to tissue damage and the release of pro-inflammatory cytokines, which play an important role in the pathogenesis of BPH. We will focus on current advancements in pro-inflammatory cytokines in BPH, as well as the future of pro-inflammatory cytokine research. Full article
(This article belongs to the Special Issue Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia)
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11 pages, 1579 KiB  
Review
The Role of Combination Therapy with α-Blockers and Hexanic Extract of Serenoa repens in the Treatment of LUTS/BPH
by Cosimo De Nunzio, Andrea Salonia, Mauro Gacci and Vincenzo Ficarra
J. Clin. Med. 2022, 11(23), 7169; https://doi.org/10.3390/jcm11237169 - 2 Dec 2022
Cited by 5 | Viewed by 2292
Abstract
The hexanic extract of Serenoa repens (HESr) has been in use for decades as an effective, safe and well-tolerated therapy for relieving bothersome lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). This manuscript gives an overview of HESr as monotherapy [...] Read more.
The hexanic extract of Serenoa repens (HESr) has been in use for decades as an effective, safe and well-tolerated therapy for relieving bothersome lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). This manuscript gives an overview of HESr as monotherapy for LUTS/BPH treatment and focuses on the currently available literature investigating the possible clinical benefits of HESr combination therapy with α-blockers. Combination therapy of HESr with α-blockers has been gaining significant interest in recent years, as an increasing body of evidence shows the beneficial pharmacological effects that HESr treatment can add to standard first-line treatment with α-blockers. By reducing persistent Prostatic Inflammatory Status (PIS), commonly present in LUTS/BPH patients, HESr complements the relaxation of prostate smooth muscle induced by α-blockers, thus providing additional symptom relief. Data suggest that patients harbouring PIS and having a specific clinical profile might especially benefit from the combination therapy. Future therapeutic efforts may take advantage of more personalised strategies for LUTS/BPH management. Full article
(This article belongs to the Special Issue Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia)
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Other

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14 pages, 1329 KiB  
Systematic Review
Concomitant Endoscopic Surgery for Bladder Tumors and Prostatic Obstruction: Are We Safely Hitting Two Birds with One Stone? A Systematic Review and Meta-Analysis
by Eliophotos Savvides, Nikolaos Pyrgidis, Georgios Langas, Evangelos N. Symeonidis, Georgios Dimitriadis and Petros Sountoulides
J. Clin. Med. 2022, 11(20), 6208; https://doi.org/10.3390/jcm11206208 - 21 Oct 2022
Cited by 1 | Viewed by 1732
Abstract
Background: Lower urinary tract symptoms (LUTS) caused by benign prostatic obstruction (BPO) and bladder tumors may co-exist, especially among elderly patients. Transurethral resection of bladder tumors (TURBT) and endoscopic surgery for benign prostatic obstruction in the same setting are avoided by many surgeons [...] Read more.
Background: Lower urinary tract symptoms (LUTS) caused by benign prostatic obstruction (BPO) and bladder tumors may co-exist, especially among elderly patients. Transurethral resection of bladder tumors (TURBT) and endoscopic surgery for benign prostatic obstruction in the same setting are avoided by many surgeons due to concerns for tumor cell seeding and recurrences in the prostatic urethra. Aim: The aim of this study was assess the effect of concomitant TURBT and endoscopic BPO surgery on oncological safety and patient quality of life via systematic review and meta-analysis. Methods: We searched the PubMed, Cochrane Library, EMBASE, Scopus, and Clinicaltrials.gov databases and sources of grey literature published before June 2021 for relevant studies. We performed a random-effects meta-analysis of odds ratios (ORs) or weighted mean differences (WMD) to compare concomitant TURBT and BPO surgery versus TURBT alone in terms of recurrence and progression rates. Accordingly, we undertook multiple subgroups and sensitivity analyses (PROSPERO: CRD42020173363). Results: Three randomized and twelve retrospective observational studies with 2421 participants were included. Across studies with good methodological quality, no statistically significant differences were demonstrated regarding overall bladder tumors recurrence rates between concomitant endoscopic BPO surgery and TURBT versus TURBT alone (OR: 0.81, 95% CI: 0.60–1.09, I2 = 42%). Similarly, no significant differences were observed in recurrences located at the bladder neck and/or prostatic urethra (OR: 1.06, 95% CI: 0.76–1.47, I2 = 0%), time to first recurrence (WMD: −0.2 months, 95% Cl: −2.2–1.8, I2 = 48%), and progression rate (OR: 1.05, 95% CI: 0.67–1.64, I2 = 0%). Subgroup analyses based on tumor grade, number of tumors, and utilization of single-instillation chemotherapy post-TURBT did not detect any significant differences in overall bladder tumor recurrence. The level of evidence was estimated as low for all outcomes. Concomitant surgery improved lower urinary tract symptoms. Conclusion: Concomitant endoscopic BPO surgery and TURBT are oncologically safe and improve LUTS-related quality of life. Full article
(This article belongs to the Special Issue Current and Emerging Therapies for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia)
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