Prostate International最新文献

{"title":"Extracorporeal shockwave therapy of the perineum for male patients with chronic pelvic pain syndrome: a pilot study","authors":"Joe K.C. Lee ,&nbsp;Terence Y.X. Law ,&nbsp;Liang Shen ,&nbsp;Gregory X.W. Pek ,&nbsp;Qi Y. Lim ,&nbsp;Yi Q. Tan ,&nbsp;Jun Y. Chia ,&nbsp;Man K. Li","doi":"10.1016/j.prnil.2023.11.001","DOIUrl":"10.1016/j.prnil.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Chronic pelvic pain syndrome (CPPS) is a complex condition that is often difficult to treat and may sometimes require a multidisciplinary team. Among the wide array of treatment options is extracorporeal shockwave therapy (ESWT). However, its role in CPPS remains controversial. The purpose of our study is to assess the efficacy and safety of ESWT of the perineum in male patients with CPPS.</p></div><div><h3>Methods</h3><p>Fourteen patients aged between 21 and 85 years were recruited in this single-center, single-arm prospective trial from October 2018 to October 2020. ESWT was delivered to the perineum weekly for up to 8 weeks. Assessment was done via International Index for Erectile Function, International Prostate Symptom Score, King's Health Questionnaire, National Institutes of Health – Chronic Prostatitis Symptom Index, Visual Analogue Scale, Analgesic Questionnaire, and UPOINT (urinary symptoms [U], psychosocial dysfunction [P], organ-specific symptoms [O], infection-related symptoms [I], neurological/systemic conditions [N], tenderness of skeletal muscles [T]) phenotype system. The parameters are assessed before the start and end of treatment as well as at regular time points on follow-up appointments up to 20 weeks.</p></div><div><h3>Results</h3><p>Thirteen patients completed the study. There was improvement in the Visual Analogue Scale pain score, Tenderness domain on UPOINT, King's Health Questionnaire, and National Institutes of Health – Chronic Prostatitis Symptom Index scores. In terms of erectile function, improvement in the erectile function domain of International Index for Erectile Function was observed. There was also significant improvement in lower urinary tract symptoms assessed on International Prostate Symptom Score. There were no adverse events reported post treatment and during the follow-up period.</p></div><div><h3>Conclusions</h3><p>ESWT improved pain and quality of life of male patients with CPPS. It can be a safe and effective treatment modality in the armamentarium of CPPS.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000582/pdfft?md5=0d0aff0a76ba5b5b7c5ffd3a9c50c91c&pid=1-s2.0-S2287888223000582-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting to transperineal prostate biopsy: A narrative review","authors":"Younsoo Chung ,&nbsp;Sung Kyu Hong","doi":"10.1016/j.prnil.2023.11.003","DOIUrl":"10.1016/j.prnil.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><p>To address the limitations and challenges associated with transrectal (TR) biopsy and to present transperineal (TP) biopsy as a viable and potentially safer alternative to TR biopsy.</p><p>Prostate cancer (PCa) is a significant global health concern. The prevalence of advanced-stage prostate cancer in Asia is higher than that in the United States, emphasizing the need for effective screening and diagnosis methods. The gold standard of diagnosis is a TR biopsy. However, it has limitations due to the risk of infection and potential complications, such as injury to the rectal artery. Efforts have been made to address issues such as false-negative biopsies, under-sampling, and over-sampling through MRI-guided biopsies. However, the TR approach makes it difficult to access the apical and anterior regions of the prostate. TP biopsy has emerged as an alternative to address the limitations of TR biopsy. Nevertheless, a TP biopsy is a painful procedure, requiring the use of general anesthesia and expensive equipment. As a result, it has been perceived as costly and time-consuming. In addition, it requires a steep learning curve. The introduction of local anesthesia such as pudendal nerve block and the adoption of freehand techniques have contributed to the feasibility of performing TP biopsy. Recent research indicates that freehand TP biopsy can yield comparable diagnostic results to template-guided approaches. The diagnostic performance, cancer detection rates, and complication rates of TP biopsy have demonstrated its potential as a safe and effective diagnostic method.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000600/pdfft?md5=3949cfa29cc3221a6f5a0b7f792ae2c7&pid=1-s2.0-S2287888223000600-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138519691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel anterior approach that involves Retzius space development between the umbilical ligaments is associated with a lower incidence of postoperative inguinal hernia in robotic radical prostatectomy","authors":"Satoshi Washino,&nbsp;Shozaburou Mayumi,&nbsp;Kimitoshi Saito,&nbsp;Kai Yazaki,&nbsp;Yuhki Nakamura,&nbsp;Tomoaki Miyagawa","doi":"10.1016/j.prnil.2023.12.003","DOIUrl":"10.1016/j.prnil.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>To facilitate robotic radical prostatectomy (RP), we developed a novel anterior approach that utilizes a peritoneal incision between the umbilical ligaments to develop the Retzius space without contacting the internal inguinal rings, followed by closure of this space prior to prostatectomy and vesicourethral anastomosis. This approach could decrease the incidence of postoperative inguinal hernia (IH), similar to a Retzius-sparing RP (RS-RP). We compared the incidence of IH following this novel approach with that following conventional anterior RP and RS-RP.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed 532 patients who underwent robotic RP from September 2017 to August 2022. We compared the incidence of IH following novel anterior RP (<em>n</em> = 153) to that following conventional anterior RP (<em>n</em> = 284) and RS-RP (<em>n</em> = 95). We also assessed the independent factors associated with postoperative IH using Cox hazard models.</p></div><div><h3>Results</h3><p>The 12- and 24-month cumulative incidences of postoperative IH following novel anterior RP were 1.3% and 1.3%, significantly lower than those associated with conventional anterior RP (8.0% and 12.6%, <em>p</em> = 0.009) but not significantly different from those following RS-RP (1.1% and 2.1%, <em>p</em> = 0.782). In multivariate analysis, use of the novel anterior RP approach, RS-RP, and body mass index were independent factors negatively associated with the occurrence of postoperative IH.</p></div><div><h3>Conclusions</h3><p>This novel anterior approach involves developing the Retzius space between the umbilical ligaments and closure of this space following prostatectomy and vesicourethral anastomosis. It can decrease the incidence of IH compared to the conventional anterior approach. Prospective comparative studies are necessary to confirm the benefits of this approach.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000740/pdfft?md5=c1b9d89214c2f6fc3fd026d5d0d8aec7&pid=1-s2.0-S2287888223000740-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis after radical prostatectomy in men older than 75 years: long-term results from a single tertiary center","authors":"Jaewon Lee ,&nbsp;Jungkeun Song ,&nbsp;Gyoohwan Jung ,&nbsp;Sang Hun Song ,&nbsp;Sung Kyu Hong","doi":"10.1016/j.prnil.2023.09.004","DOIUrl":"10.1016/j.prnil.2023.09.004","url":null,"abstract":"<div><h3>Background</h3><p>Despite longer lifespans, guidelines for prostate cancer treatment recommend surgery for those with over 10 years of life expectancy, potentially leaving older patients undertreated. This study examines the outcomes of radical prostatectomy (RP) in a large cohort of men older than 75 years.</p></div><div><h3>Materials and methods</h3><p>We retrospectively analyzed 636 patients from a pool of 4,500 RP cases at a single tertiary institution from 2004 to 2022. Patients younger than 75 years or with incomplete records were excluded. Baseline clinical variables, including PSA and biopsy grade group (GG), as well as postoperative pathology and oncological outcomes, were assessed. Achievement of continence based on no pads and ≤1 pad at last follow-up were evaluated.</p></div><div><h3>Results</h3><p>Mean age and PSA were 76.4 years and 15.3 ng/ml, respectively. At biopsy, GG1 and 2 were found in 18.1% and 31.5%, respectively, with 28.5% harboring GG4-5 tumors. After RP, 41.5% had GG upgrade compared to biopsy results, with 46.5% with ≥pT3 tumors. In a mean follow-up of 41.5 months, 82.3% were able to attain total continence of 0 pads, and 89.5% used ≤1 pads at the last follow-up. Overall and cancer-specific mortality was observed in 4.3% and 0.9%, respectively, and biochemical recurrence (BCR) occurred in 20.3% after a median of 154 months. At multivariate analysis, age was not a significant factor for BCR, whereas preoperative PSA, biopsy GG, margin positivity, and lymph node invasion were significant.</p></div><div><h3>Conclusion</h3><p>RP is feasible in men older than 75 years with decent oncological outcome, with absolute age insignificant within this age group. Risk of undertreatment should be acknowledged, and definite treatment must be considered.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000545/pdfft?md5=fdabba6e5f1e13373e64deb0daec31b6&pid=1-s2.0-S2287888223000545-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134993681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious complications of transrectal prostate biopsy in patients receiving targeted antibiotic prophylaxis after urethral and rectal swab versus standard prophylaxis: A prospective comparative study","authors":"Sotirios Gatsos ,&nbsp;Nikolaos Kalogeras ,&nbsp;Georgios Dimakopoulos ,&nbsp;Michael Samarinas ,&nbsp;Anna Papakonstantinou ,&nbsp;Efi Petinaki ,&nbsp;Vassilios Tzortzis ,&nbsp;Stavros Gravas","doi":"10.1016/j.prnil.2023.11.002","DOIUrl":"10.1016/j.prnil.2023.11.002","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the role of targeted antibiotic prophylaxis (TAP) after rectal and urethral swab cultures compared to empiric antibiotic prophylaxis (EAP) for the prevention of infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx).</p></div><div><h3>Methods</h3><p>We conducted a prospective comparative study on 141 patients who underwent TRUS-Bx and were allocated in two groups. The first group (n = 71) received EAP with ciprofloxacin and the second (n = 70) received TAP according to rectal and urethral cultures. Post-biopsy infectious complications rates were compared between the two groups. Fluoroquinolone resistance (FQ-R) in the urethral and rectal swabs was recorded. Baseline characteristics were analyzed to assess their relationship with infectious complications and antibiotic resistance.</p></div><div><h3>Results</h3><p>A total of 8 infectious complications were observed, 7 of them in the EAP group (9.85%) and 1 in the TAP group (1.4%). There was a statistically significant difference in febrile UTIs between the two groups (6 vs 0, <em>P</em> = 0.028). FQ-R rate was 4.3% and 12.9% for rectal and urethral samples, respectively. Recent antibiotic exposure was associated with higher post-biopsy infection rates for EAP group and FQ-R rates for TAP group.</p></div><div><h3>Conclusion</h3><p>Combination of rectal and urethral swab cultures for TAP was able to detect FQ-R bacteria carriers and was associated with fewer infectious complications compared to EAP.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000594/pdfft?md5=5ddf202cc8adf9f4d3e705c722e7c76e&pid=1-s2.0-S2287888223000594-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138519702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Pelvic Lymph Node Dissection and Survival Among Patients with Prostate Cancer Treated with Radical Prostatectomy","authors":"Isaac E. Kim, Aaron H. Wang, George S. Corpuz, Preston C. Sprenkle, Michael S. Leapman, Joseph M. Brito, Joseph R Renzulli, Isaac Yi Kim","doi":"10.1016/j.prnil.2024.01.002","DOIUrl":"https://doi.org/10.1016/j.prnil.2024.01.002","url":null,"abstract":"","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139888555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the efficiency of transurethral enucleation with bipolar energy according to prostate volume for patients with benign prostate hyperplasia","authors":"Byeongdo Song ,&nbsp;Sang Hun Song ,&nbsp;Seong Jin Jeong","doi":"10.1016/j.prnil.2023.08.001","DOIUrl":"10.1016/j.prnil.2023.08.001","url":null,"abstract":"<div><h3>Background</h3><p>This study evaluated the efficiency and safety of transurethral enucleation with bipolar energy (TUEB) using a spatula loop according to prostate volume.</p></div><div><h3>Methods</h3><p>We retrospectively evaluated 398 patients who underwent TUEB for benign prostatic hyperplasia at a single tertiary hospital between August 2018 and December 2022. The patients were divided into three groups according to estimated prostate volume (ePV): ≤40 mL (n = 67), 40–80 mL (n = 200), and ≥80 mL (n = 131). To compare the efficiency of TUEB, perioperative parameters including TUEB and enucleation efficiencies, were calculated as enucleated tissue weight per operation time and enucleated tissue weight per enucleation time, respectively. Preoperative and postoperative functional outcomes such as the International Prostate Symptom Score (IPSS), quality-of-life (QoL) score, maximum flow rate (Qmax), and post-void residual urine volume (PVR), were also compared.</p></div><div><h3>Results</h3><p>The IPSS total score, voiding sub-score, Qmax, and PVR improved after TUEB in all groups (all <em>p</em> &lt; 0.05). The TUEB and enucleation efficiencies increased with increasing ePVs (all <em>P</em> &lt; 0.001). When comparing the three prostate volume groups, there were no significant differences in functional outcomes within 12 months after TUEB (all-Bonferroni adjusted <em>P</em> &gt; 0.017). A total of 57 patients experienced adverse events after TUEB, with no significant differences between the three groups (<em>p</em> = 0.507)</p></div><div><h3>Conclusion</h3><p>As prostate volume increases, the perioperative efficiency of TUEB is enhanced. Meanwhile, small prostates did not show significant differences in the improvement of functional outcomes and complications in comparison with larger prostates.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000387/pdfft?md5=0127699501eb4db2b03c943b578b0ee8&pid=1-s2.0-S2287888223000387-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48529366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility of distance to the tumor of biopsy cores to estimate the extracapsular extension","authors":"Chang Lim Hyun ,&nbsp;Kyung Kgi Park","doi":"10.1016/j.prnil.2023.10.001","DOIUrl":"10.1016/j.prnil.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>To investigate the predictive capability of a new parameter, the distance between the fibromuscular capsule and the tumor as measured using a prostate biopsy core (referred to as “distance to the tumor” [DTT]), for the presence of extracapsular extension (ECE).</p></div><div><h3>Materials and methods</h3><p>We analyzed specimens obtained from 246 patients diagnosed with prostate cancer. All patients underwent prebiopsy, prostate magnetic resonance imaging (MRI), and subsequent prostatectomy. DTT measurements were obtained for each prostate biopsy core, and the minimum (min) DTT was extracted. We assessed the relationship between min DTT, MRI-estimated ECE, and pathological ECE, considering factors such as the PI-RADS score and tumor location.</p></div><div><h3>Results</h3><p>In this study of 246 patients, the mean age was 65.8 years, and the mean prostate-specific antigen (PSA) level was 18.9 ng/ml. Patients with suspicious lesions in the peripheral zone and pathological ECE displayed higher rates of positive digital rectal examination (DRE), elevated PSA levels, and shorter DTT values in the biopsy cores. DTT demonstrated an accurate estimation of the presence of ECE, similar to MRI findings. Min DTT exhibited higher accuracy for peripheral zone masses, with a cutoff value of 1.0 mm for min DTT predicting ECE (AUC: 0.84, sensitivity: 72.23%, specificity: 77.78%, <em>P</em> &lt; 0.01). Of the 246 patients, 66 had no ECE on MRI; however, 18 of these patients displayed pathological ECE, with 14 having DTT values &lt;1.0 mm.</p></div><div><h3>Conclusions</h3><p>Min DTT, positive DRE results, and a higher Gleason grade were significantly associated with ECE. DTT measurements of &lt;1 mm can provide a more accurate prediction of ECE in the peripheral zone of the prostate than MRI-based assessments.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000557/pdfft?md5=7100e4c12f4028ece8a0c9005215e082&pid=1-s2.0-S2287888223000557-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate-specific antigen doubling time predicts the efficacy of site-directed therapy for oligoprogressive castration-resistant prostate cancer","authors":"Taketo Kawai ,&nbsp;Satoru Taguchi ,&nbsp;Keina Nozaki ,&nbsp;Naoki Kimura ,&nbsp;Takahiro Oshina ,&nbsp;Takuya Iwaki ,&nbsp;Hotaka Matsui ,&nbsp;Aya Niimi ,&nbsp;Jun Kamei ,&nbsp;Yoshiyuki Akiyama ,&nbsp;Yuta Yamada ,&nbsp;Yusuke Sato ,&nbsp;Daisuke Yamada ,&nbsp;Tomoyuki Kaneko ,&nbsp;Subaru Sawayanagi ,&nbsp;Hidetsugu Nakayama ,&nbsp;Ryogo Minamimoto ,&nbsp;Hideomi Yamashita ,&nbsp;Hideyo Miyazaki ,&nbsp;Tetsuya Fujimura ,&nbsp;Haruki Kume","doi":"10.1016/j.prnil.2023.10.002","DOIUrl":"10.1016/j.prnil.2023.10.002","url":null,"abstract":"<div><h3>Background</h3><p>In recent years, site-directed therapies (SDTs) targeting progressive lesions in patients with oligometastatic prostate cancer have attracted attention. However, whether they effectively treat oligoprogressive castration-resistant prostate cancer (CRPC) remains unclear. Here, we investigated the efficacy of SDT in patients with oligoprogressive CRPC and identified prognostic factors.</p></div><div><h3>Methods</h3><p>We reviewed 59 patients with oligoprogressive CRPC who underwent SDT targeting prostate or metastatic lesions between April 2014 and March 2022. We evaluated the associations between several pretreatment clinical variables and treatment procedures and a &gt;50% prostate-specific antigen (PSA) response, progression-free survival (PFS), and time to next treatment (TTNT).</p></div><div><h3>Results</h3><p>A PSA response of &gt;50% was observed in 66% of patients. The median PFS and TTNT were 8.3 months and 9.9 months, respectively. Patients with PSA doubling time ≥6 months showed a higher &gt;50% PSA response rate (87% vs. 45%; <em>P</em> &lt; 0.001), longer PFS (median, 15.0 vs. 5.0 months; <em>P</em> &lt; 0.001), and longer TTNT (median, 16.3 vs. 5.9 months; <em>P</em> &lt; 0.001) than patients with PSA doubling time &lt;6 months. In multivariate analyses, a PSA doubling time of ≥6 months independently predicted a &gt;50% PSA response, favorable PFS, and TTNT (<em>P</em> = 0.037, 0.025, and 0.017, respectively).</p></div><div><h3>Conclusion</h3><p>PSA doubling time of ≥6 months may be a key indicator of the favorable efficacy of SDT for oligoprogressive CRPC.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000569/pdfft?md5=fc52a964e0d32452ba3d67a5945fb814&pid=1-s2.0-S2287888223000569-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136009400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervi Parvum Cornu complex for men with lower urinary tract symptoms: a multicenter, randomized, double-blind, placebo-controlled trial","authors":"Dongho Shin ,&nbsp;Byung Il Yoon ,&nbsp;Soomin Kim ,&nbsp;JunJie Piao ,&nbsp;Kyung-Hwa Jeon ,&nbsp;Youngjoo Kwon ,&nbsp;Sang-Hyuck Park ,&nbsp;Young Tae Koo ,&nbsp;Jin-Soo Kim ,&nbsp;Dong Sup Lee ,&nbsp;U-Syn Ha ,&nbsp;Sae Woong Kim ,&nbsp;Hoon Jang ,&nbsp;Woong Jin Bae","doi":"10.1016/j.prnil.2023.09.002","DOIUrl":"10.1016/j.prnil.2023.09.002","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the efficacy and safety of <em>Cervi Parvum Cornu</em>, Angelicae Gigantis Radix and Glycyrrhizae Radix complex (CAG) in men with moderate lower urinary tract symptoms (LUTS).</p></div><div><h3>Materials and methods</h3><p>From November 2020 to January 2022, participants with International Prostate Symptom Score (IPSS) of 12–19 in two centers were recruited and randomize into three groups: a CAG 500 mg/day group (CAG 500), a CAG 1000 mg/day group (CAG 1000), and a placebo group (PG). They were treated for 12 weeks. The primary endpoint was change of IPSS at the end of study from baseline. Secondary end points included change of prostate specific antigen (PSA), testosterone, dihydrotestosterone (DHT), maximum urinary flow rate (Q max), post-void residual volume (PVR), International Index of Erectile Function (IIEF), and drug safety.</p></div><div><h3>Results</h3><p>A total of 103 patients were able to finish the study according to the study protocol. Total IPSS and sub-scores (residual urine sensation, frequency, weak stream, hesistancy, nocturia, and quality of life) in CAG 500 and CAG 1000 were significantly improved at the 12^th week compared to those of the PG. Changes of serum PSA, DHT, and testosterone levels at the 12^th week from baseline did not show significant differences among the three groups. Q max and PVR changes did not show significant differences among the three groups either. Total IIEF and sub-scores (erectile function, orgasmic function, sexual desire, intercourse satisfaction) in CAG 1000 were significantly improved at 12^th week compared to those in PG. No significant adverse events were found.</p></div><div><h3>Conclusions</h3><p>CAG is well tolerated in patients with moderate LUTS. Treatment with CAG for 12 weeks has a therapeutic effect on moderate LUTS.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000417/pdfft?md5=7a5bc39f39dedbfad71178229af7e742&pid=1-s2.0-S2287888223000417-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}