• The Journal of Internal Korean Medicine
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• v.31 no.1
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• pp.166-176
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• 2010

Objective : Benign prostatic hyperplasia(BPH) is one of the most common diseases among elderly men. In BPH, dihydrotestosterone (DHT) acts as a potent cellular androgen and promotes prostate growth. Many reports conclude the component melittin in bee venom has the potential to treat various diseases including prostate cancer. In this study, we investigated the therapeutic effects and action mechanism of Bee venom herbal acupuncture with BPH induced by castration and testosterone treatment. Methods : Sprague-Dawley rats were treated with testosterone after castration for induction of experimental BPH. A total of 24 rats were equally divided into four groups: Group 1 was the model group; Group 2 served as control (sham-operated group); Group 3 animals were treated with Bee venom herbal acupuncture as an experimental specimen; Group 4 served as a positive control group and was treated with finasteride at a dose of 1 mg/kg. The drugs were administered orally. The prostates were evaluated by prostatic weight, volume, histopathological changes and testosterone levels. Results : While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation, the rats treated with Bee venom herbal acupuncture showed a diminished range of tissue damage and showed significant decrease in their prostatic weights, volume and histopathological examination. Conclusions : These results suggest that Bee venom herbal acupuncture may protect the glandular epithelial cells and also inhibit stromal proliferation. From theses results, we suggest that Bee venom herbal acupuncture could be a useful remedy agent for treating the benign prostatic hyperplasia.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.5
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• pp.361-369
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• 2015

Benign prostatic hyperplasia(BPH) is a common disease among male. However, its cause and treatment are not known and it is easy to relapse to the patients again after some treatment. Chinese has got an active research on BPH of traditional Chinese medicine. We researched the Chinese clinical papers from 2000 to 2014. After translating those papers, we analyzed total 45 papers by classifying those according to frequently used prescriptions, differentiation of symptoms, signs, addition and subtraction of each medicine and the quantity of frequently used medicines. Through this study it was to provide evidence in the diagnosis and treatment of BPH. The prescription of BPH was classified according to its stage. Mainly damp heat patterns(濕熱型) induce dysuria, Qi-stagnation and blood stasis patterns(氣滯血瘀型) induce pain, While Kidney deficiency patterns(腎虛型) induce sexual function disorder. This analysis report would be able to provide the basis of taking a research on BPH. In addition, it could be applied on a stereotype of BPH as well as a variety of symptoms with frequently used prescription and addition and subtraction of each medicine.

• Journal of Nutrition and Health
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• v.40 no.3
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• pp.249-258
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• 2007

Benign prostatic hyperplasia (BPH) is one the most common prostate diseases in middle aged and elderly men. This study was conducted to investigate diet and lifestyle risk factors for benign prostatic hyperplasia in a community-dwelling free-living population group. The dietary data were collected from the 601 male subjects aged 50-79 years using the 24-hour recall method. The mean age of the BPH group ($63.0{\pm}7.9$ years) was significantly higher than that of the non-BPH ($58.8{\pm}7.4$ years). Among many nutrients, the amount of animal fat intake was increased while that of carbohydrate intake decreased in subjects with BPH compared to those with non-BPH. In BPH subjects, the proportion of energy from fat was also greater than in subjects with non-BPH. The logistic regression analysis on the food consumption data showed that the consumption of total animal food was increased while that of mushrooms was decreased in patients with BPH compared to the subjects with non-BPH. The age-adjusted odds ratios and 95% confidences limits for BPH incidence in subjects whose milk and milk products, beverages and alcoholic liquors intake was greater than the median were 1.796 (1.167-2.782) and 1.738 (1.129-2.676) respectively, compared to those in subjects whose intakes were below the median. These results may be applicable in the development of a nutrition intervention and education program toward a reduction in the risk for benign prostatic hyperplasia.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.211-227
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• 1998

Benign Prostatic Hyperplasia(BPH) is the most common benign tumor seen in the western male, and it is found in 50% of men over 50 years of age. It is characterized by the formation of large discrete lesions in the periurethral region. As they enlarge, these nodules tend to compress the urethra and cause partial or almost complete obstruction of .urine flow. The etiology of BPH is uncertain, but the increasing incidence with advancing age suggests the possibility of an imbalance between male and female sex hormones. In the past, most patients have had multiple indications to support the decision to initiate therapy. But both the urologic surgeon and the patient must be clearly aware of the results that can be expected and the risks involved in achieving them. The aims of this study are to investigate and summarize the current trends of treatment for BPH so as to suggest the effective and available way to treat the disease. In Oriental medicine, the BPH is recognized as uroschesis and ischuria, and the etiology is mainly in stagnated blood and insufficiency of the kidneys. The point of treatment of BPH is recovery of urination, and the treatment can be approached in two ways through herb drugs and acupuncture. Some of the herb drugs have substances which reduce BPB. Acupuncture therapy stimulates the pelvic plexus and is reported to be effective for voiding. Suppository, massotherapy, rectal injection, locus injection and attachment of herb drugs to the navel or the acupoint are announced as the effective treatments. So, this study of the approach and application of these treatments on BPH would be necessary.

• The Journal of Internal Korean Medicine
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• v.31 no.3
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• pp.437-447
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• 2010

Obejectives : To investigate the clinical effect of electroacupuncture and bee venom acupuncture for benign prostatic hyperplasia(BPH) symptoms. Methods : Among 39 outpatients who were treated at a BPH clinic, 8 were finally selected for analysis by charts-review, retrospectively. They were treated by electroacupuncture and bee venom acupuncture more than 3 times. We estimated the effectiveness of the treatments by using the International Prostate Symptom Score (IPSS) questionnaire and checking their nocturia frequency. On the basis of these variables, we analyzed the statistical significations of symptom improvements. Results : Among 8 patients, the IPSS and nocturia frequency showed significant improvement after the final treatment compared with baseline (P = .0078, P = .0078). The IPSS significantly decreased even after the 1st treatment and also after the 2nd treatment compared with the baseline (P = .0078, P = .0078). The IPSS at post final-treatment, post 1st- and post 2nd treatment also showed significant improvement compared with IPSS at baseline in 6 severe symptomatic patients(P = .031, P = .031, P = .031). Nocturia frequency decreased after the 1st treatment compared with baseline and showed significant improvement between baseline and post 2nd treatment (P = .0078). Conclusions : In a retrospective and cross-sectional study investigating the clinical effects of electroacupuncture and bee venom acupuncture on BPH, these treatments proved to have significant therapeutic effects, particularly for various symptoms involving frequent nocturia.

• The Journal of Korean Medicine
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• v.31 no.1
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• pp.153-161
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• 2010

Objective: The primary objective of this study was to evaluate the effect of Paljung-san on lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). Methods: We researched four men with BPH and LUTS, who were treated 3 times a day for 10 days with Paljung-san. The International Prostate Symptom Score (IPSS) and post void residual urine (PVR) were evaluated. Results: The mean decrease in IPSS total score was 13 points (P=0.007, Mann-Whitney test). The reduction of IPSS was more prominent in the obstructive subscore but was not significant (P=0.057, Mann-Whitney test). Furthermore, Paljung-san reduced PVR. Conclusions: After the 10-day treatment period, Paljung-san improved total IPSS score, especially in the obstructive subscale score, and reduced post void residual urine.

• Quality Improvement in Health Care
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• v.3 no.2
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• pp.36-51
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• 1997

Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.355-364
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• 2009

Objectives : Benign prostatic hyperplasia (BPH) is one of the most common diseases among elderly men. Though medicines such as 5${\alpha}$-reductase inhibitor (finasteride) have recently been developed for treating BPH, their adverse effects and low efficacy should not be overlooked. Curcuma longa has a long history of use in traditional medicines of Asian countries. Many reports conclude the component curcumin in Curcuma lonfa, has the potential to treat various diseases including prostate cancer. In this study, we investigated the therapeutic effects and action mechanism of Curcuma longa with a BPH rat model. Methods : Sprague-Dawley rats were used with subcutaneous injection of testosterone after castration, which were histologically similar to human BPH. A total of 30 rats were equally divided into five groups: Group 1 served as control (sham-operated group): Group 2 was the model group: Group 3 and Group 4 animals were administered Curcuma longa at dose levels of 0.5g/kg and 1.0g/kg: Group 5 served as a positive control group and was treated with finasteride at a dose of 1 mg/kg. The drugs were administered orally once a day for 30 days consecutively. After 31 days, the prostates were removed, and analyzed for their prostatic weight and histological examination. Results : The oral Curcuma longa ingestion group showed statistically significant decreases in their prostatic weights compared with the BPH-induced group and the oral finasteride ingestion group (p<0.05). Curcuma longa is also very safe in liver and kidney up to a dose of lg/kg. Injected testosterone histologically led to prostatic hyperplasia in rats, but oral Curcuma longa ingestion decreased this change. Conclusions : These results suggest that Curcuma longa has a definite inhibitory effect on BPH and might be an alternative medicine for treatment and prevention of human BPH.

• Journal of Preventive Medicine and Public Health
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• v.39 no.2
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• pp.141-148
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• 2006

Objectives : We wanted to evaluate the medical underutilization for benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) among Korean elderly men and we wanted to determine their associated factors. Methods : This study was conducted on 239 men with LUTS and 116 men with BPH who were compatible with the diagnostic criteria from a total of 641 participants. These participants were over 50 years old and they were randomly chosen in a community-based study for estimating the prevalence of BPH. Using a self-reported questionnaire, we surveyed the sociodemographics, health status, quality of life, lower urinary tract symptoms, medical utilization and reasons for not seeking treatment. Results : Only 27.6% of the men with LUTS and 31.0% of the men with BPH reported having visited a doctor for urinary symptoms. The reasons for not visiting a doctor were, in order of responses from the group with LUTS: 'considered the symptoms as a part of the normal ageing process', 'not enough time to visit a doctor', 'financial difficulty' and 'the symptoms were not severe or bothersome'. Regarding BPH, the responses were the same as those of the group with LUTS however, 'financial difficulty' placed second. Among the men with experience of visiting a doctor for urinary symptoms, 33.3% of those with LUTS and 28.1% of those with BPH were not treated. The most common reason in both groups was 'the symptoms were not severe to be treated'. On a multiple logistic regression analysis, the larger size household (odds ratio (OR) 3.03, 95% confidence interval (CI)=1.40-6.54) and an unsatisfactory quality of life related with urinary symptoms (OR 2.98, 95% CI=1.23-7.21) were associated with medical utilization in the group of LUTS. For BPH, the current employment status was related with the medical utilization (OR 2.80, 95% CI=1.10-7.11), in addition to the larger size household (OR 3.24, 95% CI=1.14-9.21). Conclusions : Many men with urinary symptoms do not visit a doctor. This medical underutilization for people with LUTS and BPH may be associated with economic status in Korea.

• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.643-664
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• 1997

This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.