Inflammation and BPH

Inflammation and BPH

What is the connection?(Inflammation in benign prostatic hyperplasia: a 282 patients’ immunohistochemical analysis)

Prostatic inflammation could be a key component in prostate enlargement and benign prostatic hyperplasia (BPH) progression. Our aim was to characterize inflammatory cells infiltrate within BPH tissue and to correlate inflammation and clinical data. Two of the major clinical studies on BPH (MTOPS and Reduce study) recently demonstrated a link between histological prostatic inflammation and prostate enlargement or symptoms scores 45.

Conclusion

We characterized inflammatory cells infiltrate in a large cohort of surgically treated BPH specimens. The role of inflammation in BPH development was highlighted by the strong correlation between histological inflammation, IPSS and prostate volume. Prostate enlargement due to chronic inflammatory process may progressively conduce to BPH progression. Therefore, inflammation is a therapeutic target for BPH.

What causes inflammation in the prostate? (https://andrologyaustralia.org/prostate-problems/prostatitis/))

Bacterial prostatitis. … Chronic bacterial Prostatitis is caused by an underlying problem in the prostate, such as prostate stones or BPH (enlarged prostate), which becomes the focus for bacteria in the urinary tract. Chronic bacterial prostatitis is a common cause of frequent urinary tract infections in men.

What is prostatitis? Prostatitis is inflammation of the prostate gland, which means the prostate can feel sore and irritated. Prostatitis can be caused by a bacterial infection or non-bacterial inflammation, and it can be very painful and have a major effect on quality of life.

How common is prostatitis? Prostatitis can affect men at any age and it is thought that one in every six men have this condition at some stage during their lives.

 

What are the symptoms of prostatitis?

There are many symptoms of prostatitis including:

  • dysuria (painful urination)
  • urgency, the feeling of urgently needing to urinate
  • frequent and painful urination
  • painful ejaculation
  • lower back pain
  • perineal pain (pain at the base of the scrotum and penis)
  • chills
  • fever
  • muscular pain
  • general lack of energy

What are the types of prostatitis?

The main types of prostatitis are bacterial and non-bacterial prostatitis.

 

Bacterial prostatitis

Acute bacterial prostatitis is caused by bacteria and is the easiest form of prostatitis to diagnose and treat, although serious complications may develop if it is not treated quickly. Acute bacterial prostatitis is the least common form of prostatitis and it can be life-threatening if the infection is not treated.

 

Chronic bacterial prostatitis is caused by an underlying problem in the prostate, such as prostate stones or BPH (enlarged prostate), which becomes the focus for bacteria in the urinary tract. Chronic bacterial prostatitis is a common cause of frequent urinary tract infections in men.

 

Non-bacterial prostatitis

Chronic non-bacterial prostatitis (chronic prostate pain syndrome) is an inflamed prostate without bacteria and is the form of prostatitis that is not well understood. Urinary tract infections do not happen with this form of prostatitis. Symptoms may disappear and come back later. Stress often makes symptoms of chronic non-bacterial prostatitis worse.

 

What causes prostatitis?

Sexually transmitted infections (STIs) can develop into bacterial prostatitis. Unprotected sexual intercourse can let bacteria into the urethra and the bacteria can move up to the prostate.

 

Other cases of bacterial prostatitis develop when there is a bladder outlet obstruction (BOO, blockage of the outlet of the bladder) that might be caused by an enlarged prostate gland. BOO can cause urinary tract infections that then spread to the prostate.

 

Prostatitis may also happen without bacterial infection; however the causes of non-bacterial prostatitis are not known. Other factors that can contribute to development of prostatitis include diabetes, a suppressed immune system or a viral illness that stresses the immune system.

Last modified: April 19, 2018

Does Inflammation cause prostate cancer?

(https://www.hopkinsmedicine.org/news/media/releases/chronic_inflammation_linked_to_high_grade_prostate_cancer)

FAST FACTS:

  • Men with chronic inflammation in non-cancerous prostate tissue may have nearly twice the risk of actually having prostate cancer.
  • Study shows association between prostate inflammation and prostate cancer, not proof that inflammation is a cause of prostate cancer. Apr 18, 2014

Researchers want to know more about what causes prostate inflammation, how it may contribute to prostate cancer, and whether this inflammation may be prevented. Ultimately, men with at least one tissue sample showing signs of chronic inflammation had 1.78 times higher odds of having prostate cancer, and 2.24 times higher odds of having an aggressive cancer, the researchers concluded. The association held firm even in men with low PSA levels at the time of their biopsies.

The Johns Hopkins team is studying the relationship between PSA levels and detailed measures of inflammation in men with no indications for a prostate biopsy, as well as a potential link between sexually transmitted disease history and the amount of inflammation in the prostate.

Does ibuprofen reduce prostate inflammation? (https://www.webmd.com/men/prostate-enlargement-bph/news/20060830/aspirin-cut-enlarged-prostate-risk#1)

Anti-inflammatory drugs, such as ibuprofen and naproxen, are often used to treatarthritis inflammation. Their anti-inflammatory effect may also help an enlargedprostate. Daily aspirin, which is also an anti-inflammatory drug, is commonly used to help decrease the risk of heart disease and heart attack.Aug 30, 2006

Inflammation Key?

Doctors don’t know exactly how BPH develops, but inflammation may be part of the process. Anti-inflammatory drugs, such as ibuprofen and naproxen, are often used to treat arthritis inflammation. Their anti-inflammatory effect may also help an enlarged prostate.

Daily aspirin, which is also an anti-inflammatory drug, is commonly used to help decrease the risk of heart disease and heart attack.

Enlarged Prostate Study

The study, published in the American Journal of Epidemiology, comes from the Mayo Clinic in Rochester, Minn.

St. Sauver and colleagues studied 2,447 Minnesota men aged 40-79 for 12 years.

Their study was purely observational. That is, the researchers checked the men’s medical records and drug use. But they didn’t ask the men to take aspirin or other anti-inflammatory drugs.

What medication is prescribed for enlarged prostate?

Your doctor might suggest one of these alpha blockers: (https://www.webmd.com/…/prostate-enlargement-bph/enlarged-prostate-types-medicatio..)

  1. Alfuzosin🙁Uroxatral) Uroxatral (alfuzosin) is an alpha-adrenergic (AL-fa ad-ren-ER-jik) blocker. Uroxatral helps relax the muscles in the prostate and bladder neck, making it easier to urinate.

Common side effects of Uroxatral include: dizziness, lightheadedness, headache, fatigue, tired feeling, or. cold symptoms such as stuffy nose, sneezing, or sore throat.

 

 

  1. Doxazosin: (Cardura) (https://www.drugs.com/doxazosin.html)

Doxazosin is an alpha-adrenergic (AL-fa ad-ren-ER-jik) blockers. It relaxes your veins and arteries so that blood can more easily pass through them. It also relaxes the muscles in the prostate and bladder neck, making it easier to urinate.

Doxazosin is used to treat hypertension (high blood pressure), or to improve urination in men with benign prostatic hyperplasia (enlarged prostate).

The extended-release form of doxazosin (Cardura XL) is for use only in treating benign prostatic hyperplasia and should not be used to treat hypertension.

Important information

Doxazosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using doxazosin. Do not stop using this medicine before surgery unless your surgeon tells you.

You should not use this medication if you are allergic to doxazosin or similar medicines such as alfuzosin (Uroxatral), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax), or terazosin (Hytrin). Doxazosin may cause dizziness or fainting, especially when you first start taking it or when you start taking it again. Be careful if you drive or do anything that requires you to be alert. Avoid standing for long periods of time or becoming overheated during exercise and in hot weather. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Tell your doctor about all other medications you use, especially other blood pressure medications including diuretics (water pills).

Before taking this medicine

You should not use this medicine if you are allergic to doxazosin or similar medicines such as alfuzosin (Uroxatral), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax), or terazosin (Hytrin).

To make sure doxazosin is safe for you, tell your doctor if you have:

  • a blockage in your digestive tract (stomach or intestines);
  • severe constipation;
  • liver disease; or
  • low blood pressure.

Doxazosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using this medication. Do not stop using this medicine before surgery unless your surgeon tells you to.

Commonly reported side effects of doxazosin include: dizziness, fatigue, vertigo, hypertension, symptomatic orthostatic hypotension, malaise, and orthostatic hypotension due to drug. Other side effects include: syncope, drowsiness, and edema.

 

 

3.Prazosin (Minipress) (https://www.rxlist.com/minipress-drug.htm#indications)

MINIPRESS is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes, including this drug.

Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetesmanagement, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake.

SIDE EFFECTS

Clinical trials were conducted on more than 900 patients. During these trials and subsequent marketing experience, the most frequent reactions associated with MINIPRESS therapy are: dizziness 10.3%, headache 7.8%, drowsiness 7.6%, lack of energy 6.9%, weakness 6.5%, palpitations5.3%, and nausea 4.9%. In most instances, side effects have disappeared with continued therapy or have been tolerated with no decrease in dose of drug.

Less frequent adverse reactions which are reported to occur in 1-4% of patients are:

Gastrointestinal: vomiting, diarrhea, constipation.

Cardiovascular: edema, orthostatic hypotension,dyspneasyncope.

Central Nervous System: vertigo, depression, nervousness.

Dermatologic: rash.

Genitourinary: urinary frequency.

EENT: blurred vision, reddened scleraepistaxisdry mouthnasal congestion.

 

 

4.Silodosin (Rapaflo)( https://www.drugs.com/rapaflo.html) Rapaflo (silodosin) is an alpha-adrenergic (AL-fa ad-ren-ER-jik) blocker. Rapaflo helps relax the muscles in the prostate and bladder neck, making it easier to urinate. Rapaflo is used to improve urination in men with benign prostatic hyperplasia(enlarged prostate).

Important information

You should not take Rapaflo if you have severe kidney or liver disease.

Do not take silodosin together with similar medicines such as alfuzosin, doxazosin, prazosin, tamsulosin, or terazosin.

Rapaflo may cause dizziness or fainting, especially when you first start taking it. Be careful if you drive or do anything that requires you to be alert. Avoid standing for long periods of time or becoming overheated during exercise and in hot weather. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Rapaflo can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using Rapaflo. Do not stop using Rapaflo before surgery unless your surgeon tells you to.

There are many other drugs that can interact with silodosin. Tell your doctor about all medications you use.

Before taking this medicine

You should not take Rapaflo if you are allergic to silodosin, or if you have:

  • severe liver disease; or
  • severe kidney disease.

Some medicines can interact with silodosin and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • imatinib;
  • isoniazid;
  • nefazodone;
  • an antibiotic – clarithromycin, telithromycin;
  • antifungal medicine – itraconazole, ketoconazole, posaconazole, voriconazole;
  • heart medication – nicardipine, quinidine;
  • antiviral medicine to treat hepatitis C or HIV/AIDS – atazanavir, boceprevir, cobicistat, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir, telaprevir; or
  • medicines similar to Rapaflo – alfuzosin, doxazosin, prazosin, tamsulosin, or terazosin.

To make sure Rapaflo is safe for you, tell your doctor if you have:

  • low blood pressure;
  • kidney disease (or if you are on dialysis);
  • heart disease;
  • a history of prostate cancer;
  • a condition for which you take a diuretic or “water pill”; or
  • if you are on a low-salt diet.

Rapaflo can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using this medicine.

SIDE EFFECTS

For the Consumer

Applies to silodosin: oral capsule

Along with its needed effects, silodosin (the active ingredient contained in Rapaflo) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking silodosin:

Less Common

  • Chills
  • cold sweats
  • confusion
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

Incidence Not Known

  • Abdominal or stomach pain
  • clay-colored stools
  • dark urine
  • fever
  • headache
  • itching
  • loss of appetite
  • nausea
  • pinpoint red or purple spots on the skin
  • rash
  • skin blisters
  • unpleasant breath odor
  • unusual tiredness or weakness
  • vomiting of blood
  • yellow eyes or skin

Some side effects of silodosin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Change or problem with discharge of semen

 

  1. Tamsulosin (Flomax) (https://www.drugs.com/tamsulosin.html)

Tamsulosin (Flomax) is an alpha-blocker that relaxes the muscles in the prostate and bladder neck, making it easier to urinate.

Tamsulosin is used to improve urination in men with benign prostatic hyperplasia(enlarged prostate).

Tamsulosin is not approved for use in women or children.

Important information

You should not use this medication if you are allergic to tamsulosin. Do not take tamsulosin with other similar medicines such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), or terazosin (Hytrin).

Tamsulosin may cause dizziness or fainting, especially when you first start taking it or when you start taking it again. Be careful if you drive or do anything that requires you to be alert. Avoid standing for long periods of time or becoming overheated during exercise and in hot weather. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

If you stop taking this medicine for any reason, call your doctor before you start taking it again. You may need a dose adjustment.

Tamsulosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using this medication. Do not stop using tamsulosin before surgery unless your surgeon tells you to.

There are many other drugs that can interact with this medicine. Tell your doctor about all medications you use.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use tamsulosin if you are allergic to it. Do not take tamsulosin together with similar medicines such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), or terazosin (Hytrin).

To make sure tamsulosin is safe for you, tell your doctor if you have:

  • liver or kidney disease;
  • a history of prostate cancer;
  • low blood pressure; or
  • an allergy to sulfa drugs.

Tamsulosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using this medicine. Do not stop using tamsulosin before surgery unless your surgeon tells you to.

Although this medicine is not for use in women, tamsulosin is not expected to harm an unborn baby. If you are a woman using this medication, tell your doctor if you are pregnant or breast-feeding.

This medicine is not approved for use by anyone younger than 18 years old.

SIDE EFFECTS

Applies to tamsulosin: oral capsule

Along with its needed effects, tamsulosin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking tamsulosin:

More Common

  • Cough or hoarseness
  • fever or chills
  • lower back or side pain
  • painful or difficult urination

Less Common

  • Chest pain

Rare

  • Dizziness or lightheadedness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fainting
  • the feeling of constant movement of self or surroundings
  • painful or prolonged erection of the penis
  • sensation of spinning

Incidence Not Known

  • Blistering, peeling, or loosening of the skin
  • blurred vision
  • confusion
  • diarrhea
  • difficult or labored breathing
  • fast, pounding, or irregular heartbeat or pulse
  • itching
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • a sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • sweating
  • tightness of the chest
  • unusual tiredness or weakness

Some side effects of tamsulosin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Abnormal ejaculation
  • back pain
  • body aches or pain
  • congestion
  • a headache
  • lack or loss of strength
  • sneezing
  • stuffy or a runny nose
  • tender, swollen glands in the neck
  • trouble swallowing
  • voice changes

Less Common

  • Decreased interest in sexual intercourse
  • decreased sexual drive or performance
  • drowsiness
  • inability to have or keep an erection
  • increased cough
  • the loss in sexual ability, desire, drive, or performance
  • nausea
  • pain or tenderness around the eyes and cheekbones
  • sleepiness or unusual drowsiness
  • tooth disorder
  • trouble sleeping

 

  1. )
  2. Terazosin (Hytrin) (https://www.drugs.com/terazosin.html)
  1. Terazosin is in a group of drugs called alpha-adrenergic blockers. Terazosin relaxes your veins and arteries so that blood can more easily pass through them. It also relaxes the muscles in the prostate and bladder neck, making it easier to urinate.
  2. Terazosin is used to treat hypertension (high blood pressure), or to improve urination in men with benign prostatic hyperplasia (enlarged prostate).
  3. Terazosin may also be used for other purposes not listed in this medication guide.

10.  Important information

  1. Terazosin may cause dizziness or fainting, especially when you first start taking it or when you start taking it again. You may wish to take this medication only at bedtime if it causes you to feel light-headed. Be careful if you drive or do anything that requires you to be alert. Avoid standing for long periods or becoming overheated during exercise and in hot weather. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
  2. You should not use this medication if you are allergic to terazosin.
  3. If you stop taking terazosin for any reason, call your doctor before you start taking it again. You may need a dose adjustment.
  4. Terazosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using terazosin. Do not stop using terazosin before surgery unless your surgeon tells you to.
  5. Tell your doctor about all other medications you use, especially other blood pressure medications including diuretics (water pills).

16.  Before taking this medicine

  1. You should not use this medication if you are allergic to terazosin.
  2. If you have a history of prostate cancer, you may need a dose adjustment or special tests to safely take terazosin.
  3. Terazosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using this medication. Do not stop using terazosin before surgery unless your surgeon tells you to.
  4. FDA pregnancy category C. It is not known whether terazosin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether terazosin passes into breast milk or if it could harm a nursing baby. Do not use terazosin without telling your doctor if you are breast-feeding a baby.
  1. SIDE EFFECTS

Applies to terazosin: oral capsule, oral capsule liquid filled, oral tablet

Along with its needed effects, terazosin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur while taking terazosin:

More Common

Less Common

  • Chest pain
  • dizziness or lightheadedness when getting up from a lying or sitting position
  • fainting (sudden)
  • fast or irregular heartbeat
  • pounding heartbeat
  • shortness of breath
  • swelling of feet or lower legs

Rare

  • Weight gain

Some side effects of terazosin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Headache
  • unusual tiredness or weakness

Less Common

9 Over-the-Counter Medications Enlarged Prostate

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