Prostatic intra-epithelialneoplasia (PIN) is considered a precursor of invasive carcinoma, characterized by proliferation and anaplasia of cells lining Prostatic ducts and acini. In this study, we applied the PIN grading system on one-hundred cases of Prostatic carcinoma and one-hundred cases of benign Prostatic Hyperplasia, then compared the results. 74% of Prostatic carcinoma and 51% of Prostatic Hyperplasia cases showed PIN foci. Most of the Prostatic carcinomas (61%) showed foci of high-grade PIN including grade II (46%) and grade III (15%). In benign Prostatic Hyperplasia cases, only PIN grade I (26%) and grade II (25%) were seen.It is concluded that PIN and invasive adenocarcinoma of prostate are closely associated and the likelihood for coexistence is higher in patients with high grade PIN and especially if other factors such as prostate specific antigen and positive findings on sonography are also considered.

Background: Differentiation between Prostatic carcinoma and Hyperplasia may not be difficult in most cases, but sometime it is a problem even for expert pathologists. The method of AgNOR staining was applied for evaluating the usefulness of it in distinguishing between benign and malignant lesions. Methods: 50 cases of Prostatic carcinoma and 50 cases of nodular Prostatic Hyperplasia were selected and stained by the AgNOR (argirophilic nucleolar organizer region) method. These included prostatectomy (open/T.U.R.) or needle biopsy specimens of the prostate. Prostatic cancers were classified and graded according to Gleason's Histologic Grading System. Results: In Prostatic Hyperplasia the mean number of AgNOR count was 1.35 per cell and in Prostatic carcinoma it was 3.77. Prostatic hyperpla,sia showed one or two well defined NORs, but in Prostatic carcinoma there were many large irregular NORS. In Prostatic Hyperplasia the average percentage of cells exhibited three or more interphase AgNORs, which were 7.46% and in the Prostatic carcinoma 72.28%. Conclusions: AgNOR stair is useful for differentiation between Prostatic carcinoma and Hyperplasia, but this stain may not be used as a reliable index for grading of Prostatic adenocarcinoma, because overlapping was seen in some cases.

Introduction: We evaluated the efficacy and safety of radiofrequency-induced thermotherapy of the prostate in patients with benign Prostatic Hyperplasia (BPH). Materials and Methods: Radiofrequency-induced thermotherapy of the prostate was performed under local anesthesia in 24 patients (median age, 67 years) with BPH. The International Prostate Symptom Score (IPSS) score, maximum flow rate, postvoid residual urine volume, and prostate volume were measured preoperatively and 4 months postoperatively. Results: Nine patients (37.5%) had urinary retention preoperatively. One patient (4.2%) required transurethral resection of the prostate due to retention despite improved symptoms and 2 (8.3%) needed an alpha-blocker, postoperatively. The success rate was 87.5% after 4 months follow-up. All patients were catheter-free after the procedure. The mean IPSS score decreased from 26.08 ± 3.9 to 13.33 ±4.69 (P < .001), and the mean maximum flow rate increased from 4.63±4.4 mL/s to 13.21 ± 4.28 mL/s (P < .001). The mean prostate volume and mean residual urine volume were 46.38 ± 16.8 mL and 160±57 mL, which decreased to 39.6±16 mL (P = .009) and 61.46 ± 17.45 mL (P = .003), respectively. Fever, dysuria, and perineal pain (in 9 patients; 37.5%) were improved with conservative therapy. Retrograde ejaculation, erectile dysfunction, and urinary incontinence were not reported. Conclusion: Radiofrequency-induced thermotherapy of the prostate is a new, safe, and effective treatment for BPH. This technique is carried out under local anesthesia and mild sedation with little bleeding. It is especially appropriate for patients who present as high risk for general anesthesia.

Introduction: We examined the clinical effectiveness of prostate injection of botulinum A toxin in the treatment of BPH. Methods: In this descriptive study, 55 men with BPH, who had failed medical treatment and were poor risks for surgery, were treated by injection of botulinum A toxin into different parts of the transition zone. Amounts of prostate-specific antigen (PSA), prostate symptom scores, quality-of-life index, prostate volume, postvoid residual urine volume, and peak urinary flow rates were recorded and compared for all patients before injection and 3 and 6 months after the injection. Results: The mean patient age was 78 ±2.5 years. The mean symptom score and quality-of- life index significantly improved after3 months. Maximal urinary flow rate (Qmax) showed a significant increase after 3 and 6 months of treatment. Postvoid residual urine volume had a significant decrease after 3 and 6 months (P<0.05). Mean serum total PSA decreased from 5.1±1.5 ng/ml to 2.7±1=0.9 ng/ml within 3 months after the treatment (P>0.05). Prostate volume decreased from 65±8=m8l to 59±6 ml within 1 month and to 49±5 ml within 3 months (P<0.05). The maximal treatment effect was seen after 1 week. At the end of the 6- month follow up, 48patients had improved symptoms and in 32patients, medical treatments were discontinued. Only in 7patients, symptoms were remaining. Conclusion: The study showed that Prostatic injection of botulinum A toxin (BTX-A) leads to rapid reduction of prostate volume as well as reduction in urethral resistance in patients with bladder outlet obstruction due to enlargement of prostate and it can be regarded as a treatment for resistant urinary retention in patients with benign Prostatic Hyperplasia who are poor risks for surgery. This alternative treatment has the minimal side effects. It may even be considered as an adjuvant treatment in patients with prostate cancer.

Purpose: Thermobalancing therapy, provided by Therapeutic Device, which contains a natural thermoelement, and is applied topically in the projection ofthe prostate, was aimed to improve blood circulation in the affected organ. We evaluated the effectiveness of new Therapeutic Device for the treatment of patients with benign Prostatic Hyperplasia (BPH). Materials and Methods: We performed a clinical non-randomized controlled trial before and after 6-month treatment. Therapeutic Device was administered to 124 patients with BPH as mono-therapy. The dynamic of the patients’ condition was assessed by the International Prostate Symptom Score (IPSS), ultrasound measurement of prostate volume (PV) and uroflowmetry. The control-group comprised 124 men who did not receive any treatment. The IPSS score, maximum flow rate (Qmax), and PV were compared between the groups. Results: Baseline evaluation (pre-treatment) for both groups were comparable to each other with no clinically significant difference regarding age, IPSS score, Qmax and PV volume. Overall, thermobalancing therapy resulted in significant improvements from baseline to endpoint in IPSS (P =. 001), IPSS storage and voiding subscores (both P =. 001), and IPSS quality of life index (QoL) (P =. 001) compared with control group. Moreover, comparison of parameters after 6 months treatment showed that thermobalancing therapy also improved the Qmax (P =. 001), and PV (P =. 001). Conclusion: Two years clinical trial demonstrated that thermobalancing therapy administered for 6 months provides a marked improvement in patients presenting with symptomatic BPH not only on lower urinary tract symptoms (LUTS) but also in QoL and Qmax. Thus urologists should be aware about thermobalancing therapy as a non-invasive physiotherapeutic treatment option for treatment of BPH.