European Journal of Molecular & Clinical Medicine

Prostatic specimens have a wide histological spectrum of benign and malignant lesions. With benign mimickers of prostatic adenocarcinoma, it can be diagnostically challenging in some cases. The present study was conducted to observe the histomorphological spectrum of prostatic lesions, and to evaluate the usefulness of basal cell specific anti-cytokeratin antibody for HMWCK (34ßE12) immunostaining in differentiating benign mimickers from prostatic adenocarcinoma.
Materials and Methods: Histomorphology of 229 consecutive prostatic specimens received over a period of six months was studied in this retrospective study. Immunohistochemical staining using basal cell specific antibody high molecular weight cytokeratin HMWCK (34ßE12) was done on 33 cases. Prostatic adenocarcinoma cases were graded according to ISUP 2014 Modified Gleason grading system.
Results: Both benign and malignant lesions had a peak incidence in seventh decade of life. Benign lesions accounted for majority of cases (88.21%), of which benign prostatic hyperplasia was the commonest lesion (84.71%). The incidence of prostatic adenocarcinoma was 11.79%. In cases of adenocarcinoma, maximum number of cases were of grade group 5 (40.8%). IHC using HMWCK was useful in 90.9% cases where it either confirmed (81.8%) or changed (9.1%) the diagnosis, thereby improving overall diagnostic efficacy.
Conclusion: Morphological spectrum of prostatic lesions is wide. Histopathology remains the cornerstone of diagnosis in most cases. Immunohistochemistry with basal cell specific marker HMWCK is valuable as an adjuvant to histopathology in diagnostically challenging cases.

Background: There are various prostate pathologies. Among all, Benign Prostatic Hyperplasia (BPH) is a common health issue among ageing men globally. The present study was conducted to assess correlation of various prostate pathologies with serum prostate specific antigen.
Materials & Methods: 58 male patients with various prostate pathologies presenting with LUTS underwent DRE and were worked up with USG KUBP, Serum PSA and biopsy. A trans-abdominal ultrasound examination was done to assess the size of the prostate gland. Patients with suspicious DRE finding or increased Serum PSA levels (defined as more than 4 ng/ml) underwent prostate biopsy
Results: Age group 50-60 years had PSA level 3.5 ng/ml, 61-70 years had 15.4 ng/ml and 71-80 years had 11.9 ng/ml. The difference was significant (P< 0.05). IPSS was mild in 29, moderate in 23 and severe in 6 patients. PSA (ng/ml) level in mild patients was 4.7, in moderate was 6.2 and in severe was 13.7. PSA (ng/ml) level in prostate grade I patients was 4.16, in grade II was 12.3 and in grade III was 31.5 and in grade IV was 42.6. The difference was significant (P< 0.05).
Conclusion: The mean serum PSA levels rises with increasing age. Serum PSA levels has a significant correlation with international prostate symptom severity scoring wherein mean serum PSA level rises with severity of LUTS. Prostate-specific antigen is specific for prostatic tissue and is raised in both benign and malignant lesions of prostate.

Background: The incidence of prostatic lesions increases with increasing age. The present study was conducted to assess correlation between increasing PSA levels and neoplastic lesions of prostate.
Materials & Methods: 80 patients of prostate pathologies were included. In all patients, prostate-specific antigen (PSA) values were recordedusing chemiluminescent assay. Transurethral resection of prostate (TURP) biopsies was fixed in 10% formalin, processed and stained with Haematoxylin and Eosin for histopathological examination.
Results: BPH was seen in 48, HGPIN in 6, LGPIN in 4, prostatitis in 10 and adenocarcinoma in 12 cases. Age group 40-50 years had 12, 2, 2, 2 and 4 cases respectively. Age group 50-60 years had 18, 2, 1, 3 and 2, 60-70 years had 10,1,1,3,3 and >70 years had 8, 1,0,2 and 3 patients respectively. The difference was significant (P< 0.05).PSA 0-7 ng/ml had 32 cases of BPH, 9 cases of prostatitis, 7 cases of HGPIN, 5 cases of LGPIN. 7-14 ng/ml had 6, 2, 3, 1, 14-21 ng/ml had 4, 21-28 ng/ml had 2 cases of BPH and 5 cases of adenocarcinoma and >35 ng/ml had 12 cases of adenocarcinoma respectively. The difference was significant (P< 0.05).
Conclusion: Prostate-specific antigen is specific for prostatic tissue and is raised in both benign and malignant lesions of prostate. In males, benign prostatic hyperplasia is the most common pathology encountered.

Background:In inguinal hernia (IH) the most terrible event is that intestines are trapped and pinched in the groin or scrotum and cannot be moved back into the abdomen, leading to an incarcerated or even strangulated inguinal hernia. The present study was conducted to assess correlation between the presence of inguinal hemias and lower urinary tract symptoms related to BPH.
Materials & Methods: 80 subjects were divided into 2 groups of 40 each. Group I had inguinal hernia and group II had no inguinal hernia. LUTS were quantified using the 7 question IPSS, Uroflowmetry - peak urinary flow rate (Qmax), post-void residual (PVR) and measurement of prostate volume (PV) by transrectal ultrasound was performed.
Results: IPSS score was 21.4 in group I and 17.2 in group II, Qmax was 12.5 ml/sec in group I and 13.6 ml/sec in group II. PVR was 55.6 ml in group I and 38.2 ml in group II and PV was 49.2 ml in group I and 52.4 ml in group II. Symptoms severity score was mild seen in 12 in group I and 14 in group II, moderate 15 in group I and 18 in group II and severe in 23 in group I and 18 in group II. The difference was significant (P< 0.05).
Conclusion: Higher IPSS was observed in patients with inguinal hemias in contrast to patients without inguinal hemias

Background: Benign prostatic hyperplasia (BPH) is the most frequent cause of lower urinary tract symptoms (LUTS) in the aging male. The present study compared intrathecal dexmedetomidine with low-dose bupivacaine spinal anaesthesia versus a higher dose of bupivacaine in patients undergoing transurethral resection of the prostate (TURP).
Materials & Methods: 60 male patients undergoing transurethral resection of the prostatewere divided into 2 groups of 30 each. Group I received 7.5 mg of 0.5% hyperbaric bupivacaine hydrochloride and group II received 3 µg of dexmedetomidine hydrochloride along with 6 mg of 0.5% hyperbaric bupivacaine hydrochloride. Parameters such as regression time from peak sensory block level, assessment of the motor block scales, haemodynamic alterations were recorded.
Results: Time to reach T10 sensory block was 12.6 minutes in group I and 10.2 minutes in group II. Modified Bromage score at the end of surgery 1 was seen in 7 in group I, 2 in 8 in group I and 17 in group II, 3 seen 15 in group I and 13 in group II. VAS score at 1 hours was 3.4 and 2.6, at 2 hours was 2.1 and 2.0, at 3 hours was 1.9 and 1.5 and at 4 hours was 1.1 and 1.3. The difference was significant (P< 0.05). Common side effects werenausea seen in 4 in group I and 3 in group II, vomiting 3 in group I and 2 in group II, pruritis 3 in group I and 1 in group II and hypotension 1 in group I and 2 in group II.
Conclusion: Authors found that addition of 3 µg of dexmedetomidine added to 6 mg bupivacaine resulted prolonged perioperative analgesia and a faster onset and longer duration of sensory and motor block.

Background: BPH is characterised by the non-malignant overgrowth of prostatic tissue surrounding the urethra, ultimately constricting the urethral opening and giving rise to associated LUTS.
Materials & Methods: 86 patients with benign prostate hyperplasia with with LUTS were clinically diagnosed by per rectal digital examination. All underwent transrectal ultrasonography. IPSS score evaluation was done in the first month, the second month, the fourth month, and in the sixth month. The QOL score was calculated and recorded
Results: The mean basal QOL score was 4.6, mean prostate volume was 51.2ml, BMI was 26.2kg/m2, basal IPSS score was 19.4. The mean IPSS at 1 month was 5.8, at 2 months was 4.2, at 4 months was 3.5 and at 6 months was 2.7. The mean QOL at 1 month was 1.8, at 2 months was 1.4, at 4 months was 1.1 and at 6 months was 0.7. The difference was significant (P< 0.05).
Conclusion: There was improvement in quality of life in patients undergoing transurethral resection of the prostate for benign prostate hyperplasia

Background: Benign prostatic hyperplasia (BPH) is a common progressive disease in the male aging population. The present study assessed relationship between prostate volume and lower urinary tract symptoms.
Materials & Methods: 80 male patients of lower urinary tract symptoms were selected and International Prostate Symptom Score (IPSS) was used for the evaluation of benign prostatic hyperplasia (BPH). All underwent ultrasonography of lower abdomen and the prostate volume of each patient was estimated.
Results: Age group age group 30-40 years had 8, 40-50 years had 11, 50-60 years had 26, 60-70 years had 22 and >70 years had 10 patients. The difference was significant (P< 0.05). Prostrate volume (in cc) 20-30 was seen among 15, 30-40 cc in 22, 40-50 cc in 16, 50-60 cc in 5, 60-70 cc in 12, 70-80 cc in 7 and 80-90 cc in 3 patients. The difference was significant (P< 0.05). IPSS revealed mild cases in 26, moderate in 34 and severe in 20. Prostrate volume 20-30 cc had 5, 10 and 0, 30-40 cc had 6, 11 and 5, 40-50 cc had 5, 5 and 6, 50-60 cc had 1, 3 and 3, 60-70 cc had 3, 1 and 8, 70-80 cc had 4, 2 and 0 and 80-90 cc had 2, 1 and 0 respectively.
Conclusion: Males with severe burden of lower urinary tract symptoms (LUTS) often have measurable decrements in overall health-related quality of life. IPSS total score and prostate volume showed a significant positive relationship.

Background: Benign prostatic hyperplasia (BPH) is highly prevalent in elderly men and often results in lower urinary tract symptoms (LUTS). The present study was conducted to compare the efficacy of tadalafil with tamsulosin in the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).
Materials & Methods: 78 patients of diagnosed with LUTS secondary toBPHwere divided into 2 groups. Group I were given tadalafil 5 mg and group II tamsulosin 0.4 mg. Maximum flow rate (Qmax), Postvoid residual urine (PVR), International Prostate Symptom Score (IPSS), International Prostate Symptom Score Quality of life (IPSS QoL) and Sexual Health Inventory for Men (SHIM) scoring were compared.
Results: mean prostate size in group I was 32.5 gram and in group II was 30.1 gram. Qmax was 13.6 ml/sec in group I and 12.8 ml/sec in group II. PVR was 51.4 ml in group I and 83.2 ml in group II. IPSS was 12.7 in group I and 14.9 in group II, IPSS QoL was 2.3 in group I and 3.0 in group II. The difference was significant (P< 0.05).
Conclusion: Once daily tadalafil 5 mg is well tolerated and can be considered for the treatment of LUTS secondary to BPH when associated with ED