Prostate最新文献

{"title":"Assessing Predictors of Failure After Bladder Neck Incision in Patients Who Developed Bladder Neck Stenosis Following Transurethral Surgery for Benign Prostatic Enlargement.","authors":"Leonardo Quarta, Marco Bandini, Christian Corsini, Francesco Cattafi, Paolo Zaurito, Federico Belladelli, Donato Cannoletta, Alfonso Santangelo, Umberto Capitanio, Vincenzo Scattoni, Andrea Salonia, Alberto Briganti, Francesco Montorsi","doi":"10.1002/pros.70027","DOIUrl":"10.1002/pros.70027","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder neck stenosis (BNS) is a known complication following surgery for benign prostatic enlargement (BPE). While endoscopic bladder neck incision (BNI) is considered a viable treatment option, factors leading to success or failure remain not clearly elucidated.</p><p><strong>Methods: </strong>Patients receiving BNI for BNS after BPE surgery were included. International Prostate Symptoms Score (IPSS) was assessed 3 months after BNI. Failure after treatment was defined as IPSS between 8 and 35 points (pts). Logistic regression analyses tested association between BNI failure and predicting factors such as Charlson Comorbidity Index (CCI), time from BPE surgery to onset of BNS symptoms (< 6 vs. ≥ 6 months), prostate volume and BPE surgery technique (holmium [ho] laser enucleation of the prostate [HoLEP] vs. transurethral resection of the prostate [TURP]).</p><p><strong>Results: </strong>Overall, 110 patients underwent BNI. The majority (91.8%) received ho-laser BNI. Three months after BNI, 64.0%, 30.7% and 5.3% patients reported mild (0-7 pts), moderate (8-19 pts), and severe (20-35 pts) symptoms according to IPSS, respectively. A time < 6 months from BPE surgery to the onset of BNS symptoms (OR: 3.87; 95%CI:1.25-13.00; p = 0.02) and prostate volume < 50 g at BPE surgery (OR: 3.47; 95%CI:1.14-11.59; p = 0.03) were statistically significantly associated with BNI failure.</p><p><strong>Conclusions: </strong>BNI for BNS following BPE surgery is associated with satisfactory outcomes, not influenced by comorbidities and technique for BPE surgery. Short time interval between BPE surgery and onset of BNS symptoms, as well as small prostate volume at BPE surgery seem to increase risk of BNI failure.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1424-1431"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There Any Association Between Periodontitis and Prostatic Alterations? A Systematic Review.","authors":"Beatriz Rodrigues Risuenho Peinado, Rayssa Maitê Farias Nazário, Deborah Ribeiro Frazão, Yago Gecy de Sousa Né, Leonardo Oliveira Bittencourt, Nathália Carolina Fernandes Fagundes, Caio Melo Mesquita, Cassiano Kuchenbecker Rösing, Renata Duarte de Souza-Rodrigues, Luiz Renato Paranhos, Lucianne Cople Maia, Rafael Rodrigues Lima","doi":"10.1002/pros.70029","DOIUrl":"10.1002/pros.70029","url":null,"abstract":"<p><strong>Background: </strong>The prostate plays a crucial role in male reproduction but is susceptible to diseases such as prostate cancer. Periodontitis, as an inflammatory disease, has the potential to modulate systemic conditions. This systematic review aimed to evaluate the association between periodontitis and prostatic alterations.</p><p><strong>Methods: </strong>The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines and registered in the PROSPERO database (CRD42024614333). Observational studies comparing the presence of periodontitis in men with and without prostatic alterations were included. The search strategy was applied to databases such as PubMed, Scopus, Embase, Web of Science and Lilacs, as well as gray literature (OpenGrey and Google Scholar). The selection of studies and data extraction were carried out independently by two reviewers. Methodological quality was assessed using the tools of the Joanna Briggs Institute, and confounding factors were analyzed using multivariate models, where applicable.</p><p><strong>Results: </strong>A total of 769 references were identified, and 14 studies were included. Most studies indicated a significant association between periodontitis and prostate cancer, with a higher risk in patients with periodontal disease. Associations with BPH and chronic prostatitis were also observed in fewer studies. However, methodological limitations, such as inadequate control of confounding factors (e.g. smoking, genetics and age), heterogeneity in diagnostic criteria and reliance on self-reported data, increased the risk of bias. Many studies did not adequately adjust for confounding factors, compromising the robustness of the evidence.</p><p><strong>Conclusion: </strong>Thus, the findings suggest a potential association between periodontitis and prostatic alterations, especially prostate cancer.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1369-1385"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to Onal et al. Primary Analysis of (NCT03380806) a Phase II Randomized Trial of Stereotactic Body Radiotherapy Boost Versus Conventional Fractionation External Beam Radiotherapy Boost in Unfavorable-Intermediate and High-Risk Prostate Cancer.","authors":"Andre Gouveia, Ian Dayes, Theodoros Tsakiridis","doi":"10.1002/pros.70023","DOIUrl":"10.1002/pros.70023","url":null,"abstract":"","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1451-1452"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in the Use of MRI and PET Scan Among Medicare Beneficiaries With Prostate Cancer.","authors":"Hanna Zurl, Klara K Pohl, Stephan M Korn, Andrea Piccolini, Zhiyu Qian, Boyuan Xiao, Jianyi Zhang, Caroline M Moore, Timothy R Rebbeck, Kerry L Kilbridge, Marianne Leitsmann, Sascha Ahyai, Adam S Kibel, Quoc-Dien Trinh, Alexander P Cole","doi":"10.1002/pros.70022","DOIUrl":"10.1002/pros.70022","url":null,"abstract":"<p><strong>Background: </strong>Despite recent advances in imaging technologies for prostate cancer (PCa) staging, unequal access to new technologies may aggravate racial disparities. We aim to investigate racial disparities in the utilization of Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) scans in a sample of 100% Medicare beneficiaries.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, we analyzed 100% Medicare insurance claims from 2018 to 2023. We included male beneficiaries aged 66 and above diagnosed with PCa between January 1, 2019 and December 31, 2023. The primary outcome measure was the receipt of advanced imaging within 1 year after PCa diagnosis. Patient characteristics included race/ethnicity, age, U.S. region, county type, year of diagnosis, comorbidities, dual eligibility for Medicare, and disability status. Chi-squared tests and clustered multivariable regression analyses were conducted to assess differences in the utilization of advanced imaging among patient subgroups.</p><p><strong>Results: </strong>We identified a total of 749,202 Medicare beneficiaries diagnosed with PCa in the study period. The study cohort was 84.0% White, 8.7% Black, 4.1% other, and 3.2% unknown race/ethnicity. Black men were less likely to receive MRI (OR 0.84,95% CI 0.80-0.89, p < 0.0001) and PET scan (OR 0.87,95% CI 0.84-0.91, p < 0.0001) compared to White men. Absolute utilization of MRI for PCa staging remains low, while PET scan utilization increased from 6% in 2019% to 21% in 2023.</p><p><strong>Conclusions: </strong>Utilization of advanced imaging in men with newly diagnosed PCa is significantly lower among Black men compared to White men. Improving equal access to new technologies is essential to reducing racial disparities in PCa care.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1386-1394"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"Impact of Holmium Laser Enucleation of the Prostate on Active Surveillance for Prostate Cancer in Patients With Lower Urinary Tract Symptoms\".","authors":"Ahmet Burak Yilmaz","doi":"10.1002/pros.70012","DOIUrl":"10.1002/pros.70012","url":null,"abstract":"","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1449-1450"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Prostate Cancer Care: Clinical Utility of the Prostate Health Index.","authors":"I-Ta Lee, Chun-Ming Hou, Thi Thuy Tien Vo, Jian-Hua Hong, Chao-Yuan Huang, Yung-Li Wang, Yuh-Lien Chen, Chih-Hung Chiang","doi":"10.1002/pros.70025","DOIUrl":"10.1002/pros.70025","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is one of the most common malignancies among men worldwide. Current diagnostic methods, such as digital rectal examination (DRE) and prostate-specific antigen (PSA), often lack specificity and lead to overdiagnosis. The Prostate Health Index (PHI), a composite of total PSA, free PSA, and [-2]proPSA, has emerged as a promising biomarker for improving PCa detection and risk stratification.</p><p><strong>Methods: </strong>This narrative review synthesizes evidence from clinical trials and meta-analyses evaluating the diagnostic and prognostic performance of PHI. Studies on its use in initial and repeat biopsy settings, ethnic variation, integration with multiparametric MRI (mpMRI), and its role in predicting clinically significant PCa were analyzed to provide a comprehensive overview.</p><p><strong>Results: </strong>PHI consistently demonstrates superior accuracy compared to PSA alone, particularly in the PSA \"gray zone\" (2-10 ng/mL), reducing unnecessary biopsies while enhancing detection of clinically significant PCa. PHI also shows added value when used in conjunction with mpMRI and risk stratification tools. Ethnic-specific variations suggest the need for population-adjusted reference ranges. Moreover, PHI has shown clinical relevance in predicting Gleason score upgrades and reclassification during active surveillance.</p><p><strong>Conclusions: </strong>PHI is a clinically valuable, noninvasive tool that improves diagnostic precision for PCa, aids in therapeutic decision-making, and may reduce overtreatment. Incorporating PHI into routine clinical practice could optimize PCa management, though further studies are needed to establish standardized thresholds and integrate it into multiparametric diagnostic pathways.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1357-1368"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Anatomical Findings in Robot-Assisted Prostatectomy and Optimal Dissection Layer Selection for Preserving Urethral Support Structures.","authors":"Satoru Muro, Sunao Shoji, Meiko Aoki, Suthasinee Tharnmanularp, Akimoto Nimura, Keiichi Akita","doi":"10.1002/pros.70030","DOIUrl":"10.1002/pros.70030","url":null,"abstract":"<p><strong>Background: </strong>The role of preserving the superior fascia of the pelvic diaphragm in the context of urinary function remains unclear. This study aimed to investigate the anatomical relationship between the superior fascia of the pelvic diaphragm and the external urethral sphincter in terms of preventing postoperative urinary incontinence. We hypothesized that the external urethral sphincter would be supported by the fascia, smooth muscle, and levator ani muscle.</p><p><strong>Methods: </strong>Three cadavers were used, and the pelvis was dissected to explore the superior fascia of the pelvic diaphragm, levator ani muscle, and external urethral sphincter. Tissue samples underwent wide-range serial sectioning, Masson's trichrome staining, and immunohistochemical staining for smooth muscle actin. Serial histological sections were reconstructed three-dimensionally.</p><p><strong>Results: </strong>Macroscopic examination revealed the superior fascia of the pelvic diaphragm as a fibrous membrane covering the levator ani muscle. Histology identified interposing smooth muscle tissue between the levator ani muscle, superior fascia, and the external urethral sphincter. Three-dimensional reconstruction revealed this smooth muscle filling the space between the superior fascia and external urethral sphincter, extending medially and laterally, and connecting with surrounding structures.</p><p><strong>Conclusions: </strong>This study clarified the anatomical details of smooth muscle tissue interposed between the superior fascia of the pelvic diaphragm, external urethral sphincter, and levator ani muscle. This smooth muscle, continuous with the superior fascia, likely forms a supportive structure stabilizing the external urethral sphincter, playing a crucial role in urinary continence. During robot-assisted radical prostatectomy, selection of the dissection plane should consider preservation of these supportive structures to maintain postoperative urinary function.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1440-1448"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probenecid and Eugenol Mitigate Testosterone Induced Benign Prostatic Hyperplasia by Targeting Uric Acid-Induced Inflammation and Pro-Survival Pathways.","authors":"Nibrass Taher Abdali, Yasmin S Mohamed, Hala F Zaki, Laila A A Ramadan, Hassan Afify","doi":"10.1002/pros.70026","DOIUrl":"10.1002/pros.70026","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a prevalent condition among aging males, significantly impacting their quality of life. Emerging evidence links elevated uric acid (UA) levels to prostatic inflammation and hyperplasia, potentially through oxidative stress and activation of proliferative pathways. However, the role of UA in BPH pathogenesis remains poorly defined. The study aims to investigate the potential protective effects of a natural phenolic compound, eugenol, and/or probenecid against testosterone-BPH in rats, along with the possible underlying mechanisms.</p><p><strong>Methods: </strong>BPH was induced by administering testosterone (3 mg/kg; s.c.) for 2 weeks, either alone or following a 1-week pretreatment with probenecid (200 mg/kg/day; i.p.), eugenol (10 mg/kg/day; p.o.), or their combination.</p><p><strong>Results: </strong>The results demonstrated a significant increase in prostate index, cell survival markers such as cyclin D1 expression, and histopathological features indicative of BPH following testosterone administration. Furthermore, testosterone led to elevated uric acid levels, oxidative stress, inflammatory markers, and activation of pro-survival pathways including PI3-K/Akt/mTOR and NFκB. However, treatment with probenecid, eugenol, or their combination effectively attenuated these alterations, demonstrating their anti-inflammatory, antioxidative, and anti-hyperproliferative effects. Notably, combination therapy exhibited superior efficacy compared to individual treatments. These findings suggest that probenecid and eugenol may mitigate testosterone-induced BPH by targeting the uric acid-induced inflammation and pro-survival pathways.</p><p><strong>Conclusions: </strong>This study provides novel insights into the therapeutic potential of probenecid and eugenol as adjunctive treatments for BPH, offering promising avenues for further clinical investigation.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1412-1423"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Oncological Outcomes of Robot-Assisted Radical Prostatectomy for Clinically Localized Grade Groups 4 and 5 Prostate Cancers Diagnosed on Prostate Biopsy.","authors":"Victor Sandoval, Thomas Osinski, Kamil Malshy, Changyong Feng, Jean Joseph","doi":"10.1002/pros.70028","DOIUrl":"10.1002/pros.70028","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the long-term oncological outcomes of Grade Group (GG) 4 and 5 Prostate Cancer (PCa) diagnosed by prostate biopsy who underwent robotic-assisted radical prostatectomy (RARP).</p><p><strong>Methods: </strong>We retrospectively reviewed our database for those who had clinically localized GG 4 and 5 PCa discovered on prostate biopsy who underwent RARP before January 1, 2018. Demographic and clinical data was collected. Primary outcomes included overall survival (OS) and PCa-specific survival (CSS). Secondary outcomes covered biochemical recurrence-free survival (BCR-FS), need for adjuvant or salvage radiotherapy (aRT/sRT), and final specimen pathological features. Kaplan-Meier analyses assessed 5-, 10-, and 15-year OS and BCR-FS.</p><p><strong>Results: </strong>98 patients met our inclusion criteria, with a median age of 63.7 years (IQR: 59.7-69.3) and a median preoperative PSA level of 6.9 ng/mL (IQR: 4.9-10.9). Most patients were GG 4 (77.6%), and 22.4% were GG 5. Pathology at prostatectomy revealed the following ISUP Grade Groups: 19 patients (19.4%) with Grade Group 2, 36 (36.7%) with Grade Group 3, 27 (27.6%) with Grade Group 4, and 16 (16.3%) with Grade Group 5. 64.2% had pT3 (or greater?) disease, 21.4% with pN+, and 22.4% with positive margins. 26.5% of patients received post-RARP radiotherapy (14.3% adjuvant, 12.5% salvage). After a median follow-up of 132 months, 12 deaths occurred (none from prostate cancer; CSS = 100%]). OS estimates were 95% at 5 years, 88% at 10 years, and 86% at 15 years. The estimated BCRFS rates were 90%, 80%, and 78% at 5, 10, and 15 years respectively.</p><p><strong>Conclusions: </strong>In our cohort, RARP for clinically localized GG 4 and 5 PCa discovered on prostate biopsy achieved high OS, CSS, and BCFRS rates with mostly single-modality treatment. RARP remains a valid first-line treatment for clinically localized GG 4 and 5 PCa.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1432-1439"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to \"Inhibition of Signaling Downstream of Beta-2 Adrenoceptor by Propranolol in Prostate Cancer Cells\".","authors":"","doi":"10.1002/pros.70033","DOIUrl":"10.1002/pros.70033","url":null,"abstract":"","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1453"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}