I-Hung Chen

Correlations Among Cardiovascular Risk Factors, Prostate Blood Flow, and Prostate Volume in Patients With Clinical Benign Prostatic Hyperplasia

OBJECTIVE To investigate the relationships among the cardiovascular risk factors, prostate blood flow, and prostate volume in patients with clinical benign prostatic hyperplasia (BPH). METHODS A total of 130 patients with the clinical diagnosis of BPH were recruited. The presence of 5 cardiovascular risk factors, including obesity, diabetes, hypertension, hyperlipidemia, and a history of cardiovascular events, was recorded. The urologic evaluation included digital rectal examination, serum prostate-specific antigen, International Prostate Symptom Score, and transrectal ultrasonography. Doppler spectrum analysis was performed with the patient in the right lateral decubitus position to measure the blood flow in the prostate capsular arteries, periurethral arteries, and neurovascular bundles. The correlations were analyzed between the resistive indexes of the prostatic branches and the cardiovascular risk factors, as well as the transrectal ultrasound findings. RESULTS The resistive indexes of the periurethral arteries and right neurovascular bundles showed positive correlations with the number of cardiovascular risk factors in the patients (r=.228, P=.01 and r=.225, P=.011, respectively). The periurethral artery resistive index also correlated positively with both prostate and transitional zone volumes, with the capsular artery correlating positively only with the latter. No significant correlations were noted between the resistive indexes and the International Prostate Symptom Score. CONCLUSION Prostate vascular resistance in patients with BPH has positive correlations with cardiovascular risk factors and prostate size. These findings suggest that prostate hypoxia might play a role in the pathogenesis of BPH.

Loperamide-induced rat prostate relaxation through activation of peripheral µ-opioid receptors.

The effect of µ‐opioid receptor (MOR) agonist, loperamide on prostate relaxation and the role of potassium channel in this action were studied in isolated Wistar rat prostate.

Metabolic Syndrome Enhances Prostate Contractility and In Vitro Phenylephrine-induced α1-Adrenoceptor Protein Expression in the Fructose-fed Rat

Objectives: To study the effects of metabolic syndrome on prostate α‐adrenergic contractile function using fructose‐fed rats (FR).

Urinary Bladder Relaxation through Activation of Imidazoline Receptors Induced by Agmatine is Increased in Diabetic Rats

The effect of agmatine on bladder contractility and the diabetes‐induced alteration of this action were studied in the rat.

Metabolic syndrome decreases tissue perfusion and induces glandular hyperplasia in the fructose-fed rat prostate.

The effects of metabolic syndrome on the prostate blood perfusion and histological structure were studied using fructose‐fed rats (FR).

Agmatine Induces Rat Prostate Relaxation through Activation of Peripheral Imidazoline I2‐Receptors

Objectives: The effect of agmatine on prostate contractility as well as the roles of imidazoline receptors and potassium channels in this action were studied using isolated Wistar rat prostate tissue.

Alteration of Loperamide-Induced Prostate Relaxation in High-Fat Diet-Fed Rats

Objective. To investigate the change of loperamide-induced prostate relaxation in rats fed with high-fat diet (HFD). Materials and Methods. Adult male Wistar rats were divided into 2 groups: (1) control rats fed with normal chow and (2) rats fed with HFD for 6 months. The prostate was removed for histology study. Isolated prostate strips were hung in organ bath and precontracted with 1 μmol/L phenylephrine or 50 mmol/L KCl. The relaxation responses to loperamide 0.1 to 10 μmol/L were recorded. Western blotting analyses were performed for prostate μ-opioid receptors (MOR) and ATP-sensitive potassium (KATP) channel proteins: sulfonylurea receptor (SUR) and inwardly rectifying potassium channel (Kir) 6.2 subunits. Results. Body weight, prostate weight, plasma levels of glucose, insulin, triglyceride, and cholesterol, as well as systolic blood pressure, were significantly increased in the HFD rats. Histology showed prostatic hyperplasia in the HFD rat prostate. Prostatic relaxation induced by loperamide was markedly reduced in HFD when compared to the control. Protein expressions of MOR, SUR, and Kir 6.2 were decreased in HFD-fed rats. Conclusion. Loperamide-induced prostate relaxation is decreased in HFD rats due to reduced MOR and KATP channel expressions.

Induction of apoptosis in prostate cancer by ginsenoside Rh2

The therapeutic action of ginsenoside Rh2 on several cancer models has been reported. This study aimed to evaluate its apoptotic effect on prostate cancer and the underlying mechanism. Cultured DU145 cells were treated with Rh2 (5 × 10–5 to 1 × 10–4 M), peroxisome proliferator-activated receptor-delta (PPAR-delta) antagonist GSK0660 (1 × 10–6 to 5 × 10–6 M); or small interfering RNA (siRNA) of PPAR-delta. The treatment effects were evaluated with cell viability assay, life/death staining and flow cytometry for apoptosis. Immunostaining was used for reactive oxygen species (ROS) and superoxide detection. Western blot analysis for PPAR-delta and signal transducer and activator of transcription 3 (STAT3) protein expression were performed. The results showed that Rh2 significantly decreased DU145 cell survival and increased cell apoptosis. ROS and superoxide induction, PPAR-delta up-regulation and phosphorylated STAT3 (p-STAT3) down-regulation by Rh2 were demonstrated. GSK0660 partially but significantly inhibited the Rh2-induced apoptosis and restored cell viability. Treatment with siRNA reversed the Rh2-induced apoptosis as well as changes in PPAR-delta and p-STAT3 expression. In conclusion, our findings have demonstrated that ginsenoside Rh2 induces prostate cancer DU145 cells apoptosis through up-regulation of PPAR-delta expression which is associated with p-STAT3 up-regulation and ROS/superoxide induction. Rh2 may be potentially useful in the treatment of prostate cancer.

Association of Prostate Blood Flow with Male Lower Urinary Tract Symptoms

Purpose: To investigate the association of prostate blood flow (PBF) with lower urinary tract symptoms (LUTS) in aged males using Doppler spectral waveform (DSW) analysis. Patients and Methods: We performed a prospective analysis involving 133 aged males with clinical diagnosis of LUTS. DSW parameters (peak-systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI)) were measured at bilateral neurovascular bundles (NVB), periurethral, and capsular branches by Doppler transrectal ultrasound with the patient in the right lateral decubitus position. The associations of PBF parameters and the International Prostate Symptom Score (IPSS) were analyzed. Results: Overall, total IPSS scores were significantly correlated with the RI of bilateral NVB vessels (r2 = 0.03, 0.04; p = 0.04, 0.02, respectively), and PSV of left NVB vessels. PSV of bilateral NVB vessels were associated with the storage score (p = 0.022 and p = 0.016), but not with the voiding score. The sum of the frequency and urgency score was also associated with EDV of both capsular and urethral branches (p = 0.043 and p = 0.009, respectively), and PSV of NVB vessels on both sides (p = 0.045 and p = 0.019, respectively). Conclusions: There is an association between PBF and LUTS, especially with storage symptoms. The findings may provide some insights in understanding the underlying pathophysiology of lower urinary tract dysfunction.

Microsurgical Subinguinal Varicocelectomy—An Experience of 327 Operations in 224 Patients

Objective Varicocele is associated with male infertility and/or scrotal pain. Microsurgical varicocelectomy provides advantages of reliable identification of spermatic vessels and has been advocated as the gold standard procedure for varicocele repair. The purpose of this study was to assess the outcome after microsurgical subinguinal varicocelectomy in patients with varicocele associated infertility or scrotal pain. Materials and Methods A total of 224 men underwent 327 operations of microsurgical subinguinal varicocelectomy at a single university hospital because of infertility or painful scrotum. The diagnosis of varicocele was based on the findings of physical examination. The vast majority of the surgeries were performed on an outpatient basis. All patients underwent pre- and postoperative semen analysis or pain scale evaluation. Results For the 114 infertile patients who underwent varicocelectomy, significant improvements were noted between pre- and postoperative mean sperm count and total motile sperm count. Patients who received bilateral surgery had greater improvement than patients who received unilateral surgery. Repair of larger varicocele was associated with postoperative sperm count changes. Induction of spermatogenesis was observed in at least two of 11 patients with nonobstructive azoospermia. The overall semen improvement rate (improvement index, >0.5) was 70.2% and the 1-year spontaneous pregnancy rate was 33.3%. Of the 102 patients with painful scrotum, 66 patients (64.7%) reported complete resolution of pain, 30 patients (29.4%) had partial resolution, and no change was claimed in six patients (5.9%). For all patients, the pre-and postoperative mean verbal pain scale were 5.8 ±0.4 and 1.2 ± 0.4, respectively ( p Conclusion Microsurgical subinguinal varicocelectomy provides a minimally invasive and effective therapy to varicocele repair with significant improvements in semen quality and scrotal discomfort, and a low incidence of morbidity.