Supervisors info:
Κακλαμάνος Ιωάννης, Καθηγητής Νοσηλευτικής Σχολής Ε.Κ.Π.Α.
Γιαννακοπούλου Μαργαρίτα, Καθηγήτρια Νοσηλευτικής Σχολής Ε.Κ.Π.Α.
Μπίρμπας Κωνσταντίνος, Αναπλ. Καθηγητής Νοσηλευτικής Σχολής Ε.Κ.Π.Α.
Summary:
Background: Multiple methods are used (surgical and pharmaceutical) to relieve lower urinary tract symptoms in combination with many other factors (such as prostate tumor, elevated prostate-specific-PSA) and side effects daily routine of patients with benign prostatic hyperplasia. In particular, there is a need to apply methods for treating the disease by non-invasive or minimally invasive therapies, as well as for non-pharmacological methods, which can be used as complementary or alternative therapies.
Purpose: The purpose of the present study is to investigate the comparison of medical-conservative therapy with surgical- invasive intervention in benign prostatic hyperplasia and the role of PSA in the above-mentioned disease.
Method: A critical review of research articles was carried out using the electronic databases Medline, Embase, Cinahl και HEAL-Link, και το Google Scholar (1985-2008), PubMed, MEDLINEL, EMBASE, ISI Web Knowledge, Scopus και Science Direct, with the following keywords:
“PSA”, “FREE PSA”, “PSA Levels”, “Total PSA”, “PSA concentration”, “Prostate specific antigen”, “Benign Prostate Hyperplasia”, “Prostate Volume”, “Patients”, “Patients with Benign Prostate Hyperplasia”, “Prostate hypertrophia”, “Prostate volume”, “pharmaceutical therapy for patients with BPH”, “Surgery treatment for patients with BPH”, “comparison medical and surgical treatment of benign prostate hyperplasia”, “surgical treatment for patients with BPH”, “surgical management for patients with BPH”, “pharmaceutical management for patients with BPH”, “moderate obstructive Symptoms of prostate” ,“ Bladder outlet obstruction”.
A bibliographic review was carried out which included articles in English that concerned the subject of work and included studies with randomized clinical trials. Only researched scientific articles have been reviewed.
These studies were validated according to the inclusion and exclusion criteria (eg p-value estimation of statistically significant studies) and the probability of a bias (eg, the studies rejected only prostate levels in prostate cancer or prostate inflammation without including benign hyperplasia or prostate therapies not involving benign hyperplasia at all) that were either used for analysis or were rejected.
Results: PSA density has a positive correlation with prostate histology and can detect prostate cancer patients (PSA) with "gray zone PSA". The PSA/α1 specificity of Alpha 1-antichymotrypsin-PSA (ACT-PSA) to total PSA (t-PSA) is a useful tool for avoiding unnecessary prostate biopsy in patients with a total PSA of>10 ng/ml enhances the specificity for detecting prostate cancer. The use of empiric antibiotic therapy reduced blood serum PSA levels in patients with PSA>2.5 ng/ml blood serum and improved lower urinary tract symptoms. Alfuzosin (α-inhibitor) is associated with a low incidence of acute urinary retention and surgery due to benign prostatic hyperplasia. Patients treated with alpha-blocker had higher risk for benign prostatic hyperplasia -related surgery compared with patients treated with 5-ARIs. Fewer patients with benign prostatic hyperplasia have undergone surgery when they have previously been receiving drug therapy for a longer period of time. Patients initiating care with urologists are more likely to continue treatment than those initiating treatment with primary care physicians. For men with moderate symptoms of benign prostatic hyperplasia, surgery is more effective than careful waiting-follow-up. Dried cranberries improve prostate health very effectively in both men with elevated PSA in histologically proven prostatitis as well as in improving lower urinary tract symptoms. Lycopene in a study of patients with benign prostatic hyperplasia inhibited the progression of benign prostatic hyperplasia.
Conclusions: The presently available options of a pharmaceutical, invasive and non-invasive method of treatment and treatment of the symptoms of benign prostatic hyperplasia are based primarily on the severity of the patient's symptomatology, the objective examinations, prostate volume based on medical assessment and evaluation. Also, the blood serum prostate specific antigen enhances the specificity for the detection of prostate cancer in men with histologically proven benign prostatic hyperplasia and plays a key role in monitoring the course of the above disease in these patients.
Keywords:
PSA”, “FREE PSA”, “PSA Levels”, “Total PSA”, “PSA concentration”, “Prostate specific antigen”, “Benign Prostate Hyperplasia”, “Prostate Volume”, “Patients”, “Patients with Benign Prostate Hyperplasia”, “Prostate hypertrophia”, “Prostate volume”, “pharmaceutical therapy for patients with BPH”, “Surgery treatment for patients with BPH”, “comparison medical and surgical treatment of benign prostate hyperplasia”, “surgical treatment for patients with BPH”, “surgical management for patients with BPH”, “pharmaceutical management for patients with BPH”, “moderate obstructive Symptoms of prostate” ,“ Bladder outlet obstruction”.
