Review Article
Volume 5 Issue 6 - 2021
Treatment Modalities for the Management of Benign Prostatic Hyperplasia: Past, Present and Future Perspectives
Godswill J Udom1,2*, John A Udobang3, Nkechi J Onyeukwu2, Anwanabasi E Udoh2, Ikanke M Udoh4, Uduak P Ise2, Oluchi F Obilor5 and Omoniyi K Yemitan6
1Department of Pharmacology and Toxicology, Faculty of Pharmacy, Federal University Oye-Ekiti, Oye-Ekiti, Nigeria
2Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Uyo, Uyo, Nigeria
3Department of Clinical Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, University of Uyo, Uyo, Nigeria
4Department of Surgery, General Hospital, Ikot Okoro, Oruk Anam Local Government Area, Akwa Ibom State, Nigeria
5ManProject Foundation, Port-Harcourt, Rivers State, Nigeria
6Department of Pharmacology, Therapeutics and Toxicology, Lagos State University of College of Medicine, Ikeja, Nigeria
*Corresponding Author: Godswill J Udom, Department of Pharmacology and Toxicology, Faculty of Pharmacy, Federal University Oye-Ekiti, Oye-Ekiti, Nigeria.
Received: April 11, 2021; Published: May 17, 2021




Abstract

Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting men. BPH can lead to a number of symptoms for patients collectively tagged as lower urinary tract symptoms (LUTS). Over the last decade, increased modifiable risk factors, such as metabolic disease and obesity, have resulted in an increased incidence of BPH. We performed a comprehensive search using multiple databases (National Library of Medicine, ResearchGate, PubMed, Cochrane Library, Scopus, Google Scholar, MEDLINE, ScienceDirect ) and other sources of grey literature as well as conference proceedings published in English. Current therapies can first be divided into medical or surgical intervention. Pharmacotherapy for BPH includes 5-alpha-reductase inhibitors, alpha-blockers, Phosphodiesterase-5 inhibitors, anticholinergics or a combination of these agents. Surgical interventions include a conventional transurethral resection of the prostate (TURP), as well as newer modalities such as bipolar TURP, holmium laser enucleation of the prostate (HoLEP), GreenLight and thulium laser, and prostatic urethral lift (PUL). Emerging therapies in this field must also be further investigated for safety and efficacy. This narrative review attempts to consolidate past, current, emerging as well as alternative therapy options for BPH and highlights the need for additional investigation on optimizing treatment selection by clinicians.

Keywords: Benign Prostatic Hyperplasia; Pharmacotherapy of BPH; Future Therapies; Urologic Surgery; Phytotherapy of BPH

References

  1. Sembulingam K and Sembulingam P. “Essentials of medical physiology”. Jaypee Brothers Medical Publishers (2012): 486-469.
  2. Singh O and Bolla SR. “Anatomy, abdomen and pelvis, prostate”. StatPearls Publishing LLC (2020).
  3. Hall JE. “Guyton and Hall textbook of medical physiology”. Elsevier, Philadelphia (2016): 1024.
  4. Bloom W and Fawcett DW. “Textbook of histology”. W. B. Saunders, Philadelphia (1975): 805-855.
  5. Vos T., et al. “Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010”. Lancet 380 (2012): 2163–2196.
  6. Egan KB. “The epidemiology of benign prostatic hyperplasia associated with lower urinary tract symptoms: prevalence and incident rates”. Urologic Clinics of North America 43 (2016): 289-297.
  7. Patel ND and Parsons JK. “Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction”. Indian Journal of Urology 30 (2014): 170-176.
  8. Lokeshwar SD., et al. “Epidemiology and treatment modalities for the management of benign prostatic hyperplasia”. Translational Andrology and Urology5 (2019): 529-539.
  9. Parsons JK and Kashefi C. “Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms”. European Urology6 (2008): 1228-1235.
  10. Wu Y., et al. “Guidelines for the treatment of benign prostatic hyperplasia”. S. Pharmacist 41 (2016): 36-40.
  11. Sarma AV and Wei JT. “Clinical practice: benign prostatic hyperplasia and lower urinary tract symptoms”. New England Journal of Medicine3 (2012): 248-257.
  12. McVary KT., et al. “American Urological Association Guideline: Management of Benign Prostatic Hyperplasia (BPH). Linthicum, MD: American Urological Association (2010): 1-62.
  13. Yeo JK., et al. “Korean clinical practice guideline for benign prostatic hyperplasia”. Investigative and Clinical Urology1 (2016): 30-44.
  14. McConnell JD., et al. “The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia”. New England Journal Medicine 349 (2003): 2387-2398.
  15. Ahn HS., et al. “Long-term cost comparison between surgical and medical therapy for benign prostatic hyperplasia: a study using hospital billing data”. BJU International5A (2019): E79-E85.
  16. Khera M., et al. “Simple prostatectomy: overview, preparation, and technique”. Medscape (2018).
  17. Young MJ., et al. The changing practice of transurethral resection of the prostate”. Annals of the Royal College of Surgeons of England4 (2018): 326-329.
  18. Kumar V. et al. “TUR syndrome - a report”. Urology Case Reports 26 (2019): 100982.
  19. Barboza LE., et al. “Holmium Laser enucleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP)”. Revista do Colegio Brasileiro de Cirurgioes3 (2015): 165-170.
  20. Zhang X., et al. “Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis”. Scientific Reports 6 (2016): 23503.
  21. Chang CH., et al. “Safety and effectiveness of high-power thulium laser enucleation of the prostate in patients with glands larger than 80 mL”. BMC Urology8 (2019).
  22. Palmero-Martí JL., et al. “Comparative study between thulium laser (Tm: YAG) 150W and greenlight laser (LBO:ND-YAG) 120W for the treatment of benign prostatic hyperpplasia: Short-term efficacy and security”. Actas Urologicas Espanolas3 (2017): 188-193.
  23. Perera M., et al. “Prostatic urethral lift improves urinary symptoms and flow while preserving sexual function for men with benign prostatic hyperplasia: a systematic review and meta-analysis”. European Urology 67 (2015): 704-713.
  24. Altavilla D., et al. “Effects of flavocoxid, a dual inhibitor of COX and 5-lipoxygenase enzymes, on benign prostatic hyperplasia”. British Journal of Pharmacology 167 (2012): 95-108.
  25. Al-Trad B., et al. “Effect of gold nanoparticles treatment on the testosterone-induced benign prostatic hyperplasia in rats”. International Journal of Nanomedicine 14 (2019): 3145-3154.
  26. Penna G., et al. “The vitamin D receptor agonist elocalcitol inhibits IL-8-dependent benign prostatic hyperplasia stromal cell proliferation and inflammatory response by targeting the RhoA/Rho kinase and NF-kappaB pathways”. Prostate5 (2009): 480-493.
  27. Nitti VW., et al. “Mirabegron for the treatment of overactive bladder: a prespecified pooled efficacy analysis and pooled safety analysis of three randomised, double-blind, placebo-controlled, phase III studies”. International Journal of Clinical Practice 67 (2013): 619-632.
  28. Kaplan SA., et al. “Efficacy and safety of mirabegron versus placebo add-on therapy in men with overactive bladder symptoms receiving tamsulosin for underlying benign prostatic hyperplasia: a randomized, phase 4 study (PLUS)”. Journal of Urology 203 (2020): 1163-1171.
  29. Magistro G., et al. “New intraprostatic injectables and prostatic urethral lift for male LUTS”. Nature Reviews in Urology 12 (2015): 461-471.
  30. Denmeade SR., et al. “Phase 1 and 2 studies demonstrate the safety and efficacy of intraprostatic injection of PRX302 for the targeted treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia”. European Urology 59 (2011): 747-754.
  31. Shore N. “NX-1207: a novel investigational drug for the treatment of benign prostatic hyperplasia”. Expert Opinion on Investigational Drugs 19 (2010): 305-310.
  32. Bortnick E., et al. “Modern best practice in the management of benign prostatic hyperplasia in the elderly”. Therapeutic Advances in Urology (2020).
  33. Abt D., et al. “Comparison of prostatic artery embolization (PAE) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia: randomised, open label, non-inferiority trial”. BMJ 361 (2018): 2338.
  34. Taktak S., et al. “Aquablation: a novel and minimally invasive surgery for benign prostatic hyperplasia”. Therapeutic Advances in Urology6 (2018): 183-188.
  35. Zhang W., et al. “Acupuncture for benign prostatic hyperplasia: a systematic review and meta-analysis”. PLoS One 12 (2017): e0174586.
  36. Bae GE., et al. “Moxibustion for benign prostatic hyperplasia: a systematic review and meta-analysis”. Journal of Internal Korean Medicine3 (2018): 372-388.
  37. Nyamai DW., et al. “Herbal management of benign prostatic hyperplasia”. Journal of Cancer Science and Therapy5 (2016): 130-134.
  38. Sudeep HV., et al. “A phytosterol-enriched saw palmetto supercritical CO2 extract ameliorates testosterone-induced benign prostatic hyperplasia by regulating the inflammatory and apoptotic proteins in a rat model”. BMC Complementary and Alternative Medicine 19 (2019): 270.
  39. Pigat N., et al. “Combined Sabal and Urtica Extracts (WS® 1541) exert anti-proliferative and anti-inflammatory effects in a mouse model of benign prostate hyperplasia”. Frontiers in Pharmacology 10 (2019): 311.
  40. Ishola IO., et al. “Potential of Moringa oleifera in the treatment of benign prostate hyperplasia: role of antioxidant defence systems”. Medical Principles and Practice 27 (2018): 15-22.
  41. Choi YJ., et al. “Effect of Paecilomyces tenuipes extract on testosterone-induced benign prostatic hyperplasia in sprague–dawley rats”. International Journal of Environmental Research and Public Health 19 (2019): 3764.
  42. Wang CT., et al. “Rhodobacter sphaeroides extract lycogen™ attenuates testosterone-induced benign prostate hyperplasia in rats”. International Journal of Molecular Sciences 19 (2018): 1137.
  43. Park BK., et al. “Effects of Lespedeza cuneata aqueous extract on testosterone-induced prostatic hyperplasia”. Pharmaceutical Biology1 (2019): 90-98.
  44. Jin BR., et al. “HBX-6, standardized Cornus officinalis and Psoralea corylifolia L. extracts suppresses benign prostate hyperplasia by attenuating E2F1 activation”. Molecules9 (2019): 1719.
  45. Lee G., et al. “Cynanchum wilfordii ameliorates testosterone-induced benign prostatic hyperplasia by regulating 5α-reductase and androgen receptor activities in a rat model”. Nutrients 10 (2017): 1070.
  46. Lim S., et al. “Botanical formulation HX109 ameliorates TP-Induced benign prostate hyperplasia in rat model and inhibits androgen receptor signaling by upregulating Ca2+/CaMKKβ and ATF3 in LNCaP cells”. Nutrients 10 (2018): 1946.
  47. Choi HM., et al. “Cinnamomi cortex (Cinnamomum verum) suppresses testosterone-induced benign prostatic hyperplasia by regulating 5α-reductase”. Scientific Reports 6 (2016): 31906.
  48. Jeon WY., et al. “Inhibitory effects of Ponciri fructus on testosterone-induced benign prostatic hyperplasia in rats”. BMC Complementary and Alternative Medicine 17 (2017): 384.
  49. Asare GA, et al. “Shrinkage of prostate and improved quality of life: management of bph patients with Croton membranaceus ethanolic root extract”. Evidence-Based Complementary and Alternative Medicine (2015): 365205.
Citation: Godswill J Udom., et al. “Treatment Modalities for the Management of Benign Prostatic Hyperplasia: Past, Present and Future Perspectives”. EC Emergency Medicine and Critical Care 5.6 (2021): 10-24.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


October Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the October issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before November 01, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk