ergoline and Prostatic-Hyperplasia

Prolactinomas are the most frequent pituitary tumors and their frequency varies with age and sex, occurring most frequently in females between 20-50 yr-old. In men, hyperprolactinaemia is often present for many years without symptoms, as generally the most important symptoms are the decrease in libido and/or sexual potency both underestimated by the majority of the patients. Prolactin (PRL) plays a role in the process of spermatogenesis, and normal serum PRL levels are required for normal testicular function. On the other hand, hyperprolactinaemia has multiple negative effects on the gonadal axis. As a consequences hyperprolactinemic males show alteration of sexual potency and seminal fluid quality. Cabergoline treatments is able to induce normalization of PRL levels and a reduction of tumor mass in the majority of patients and consequently restoring the normal semen quality and ameliorating the quality of life of men with pituitary PRL-secreting adenoma.

Topics: Age Factors; Cabergoline; Dopamine Agonists; Ergolines; Humans; Libido; Male; Pituitary Neoplasms; Prevalence; Prolactin; Prolactinoma; Prostatic Hyperplasia; Semen; Sex Factors; Spermatogenesis; Testis

In experimental models, prolactin (PRL) displays independent hypertrophic effects on the prostate. To investigate whether hyperprolactinemia is associated with prostate enlargement in humans, we designed this open, prospective, case-control study enrolling 20 men with prolactinoma (aged 34 +/- 10 yr) and 20 age-matched healthy men. The endocrine profile and prostate transrectal ultrasonography were performed before and after 12 and 24 months of cabergoline treatment in the patients and at study entry and after 24 months in the controls. The patients had lower serum testosterone, dihydrotestosterone (DHT), and IGF-I levels and prostate volume (15.4 +/- 3.5 vs. 19.6 +/- 5.1 ml; P < 0.001) and higher PRL levels and prostate-specific antigen density than controls. There was no difference in prostate and transitional zone volumes between patients with normoandrogenemia (n = 8) or hypoandrogenemia (n = 12). After 12 and 24 months of treatment, PRL, testosterone, and DHT levels were normal in all cases, as were IGF-I and IGF-binding protein-3 levels. After 24 months, prostate volume was comparable to that in controls (21.7 +/- 4.5 vs. 22.5 +/- 4.7 ml). There were no changes in prostate structure throughout the study period in either the patients or the controls. In conclusion, in young men with prolactinoma PRL excess is unlikely to have effects on the prostate per se, because it is accompanied by low testosterone and DHT levels that produce the major effects.

Topics: Adult; Cabergoline; Case-Control Studies; Dihydrotestosterone; Dopamine Agonists; Ergolines; Humans; Male; Middle Aged; Pilot Projects; Pituitary Neoplasms; Prolactin; Prolactinoma; Prospective Studies; Prostate; Prostatic Hyperplasia; Testosterone; Ultrasonography

An urodynamic survey and an E.M.G. of the striated sphincters were performed in 20 patients presenting with prostatism, before and after infusion of either nicergoline or placebo, under double-blind conditions. Statistical analysis was performed and demonstrated a significant decrease in the tone of the bladder neck, the prostate, the striated sphincter and the bladder; impoverished electromyographic activity of the striated sphincters; increased maximal and mean urine flow and decreased post-voiding residue. The authors stress the efficacy of nicergoline in cervico-prostato-sphincteric syndromes.

Topics: Clinical Trials as Topic; Double-Blind Method; Drug Evaluation; Electromyography; Ergolines; Humans; Male; Nicergoline; Placebos; Prostate; Prostatic Hyperplasia; Urinary Bladder; Urinary Bladder Neck Obstruction

A double blind trial of bromocriptine in the treatment of 14 patients with the symptoms of benign prostatic hypertrophy is reported. 5 patients did not complete the trial mainly because of side-effects due to an overdosage of bromocriptine. In the remaining 9 patients there was symptomatic improvement in 6, with objective evidence of improvement in 3 patients on flow rate measurements. The possible modes of action of bromocriptine in this condition are discussed.

Topics: Aged; Bromocriptine; Clinical Trials as Topic; Ergolines; Humans; Male; Middle Aged; Placebos; Prostatic Hyperplasia; Urinary Tract; Urination; Urination Disorders

Lisuride hydrogen maleate (LHM, SH-1072), a dopaminergic agonist and therefore an inhibitor of prolactin (PRL) secretion, were administered to 12 patients with mild to moderate BPH in order to evaluate the clinical effectiveness. LHM was administered 75 or 150 mcg/day, po, for 20 weeks on the average. The status of micturition evaluated by score points and nocturnal frequency of urination was significantly improved, whereas objective responses such as on the amount of residual urine, size of the prostate gland, findings of urethrocystography and the length of prostatic urethra measured on the film were minimal. Serum PRL level have been reduced significantly through the therapy, and testosterone were unchanged. The mechanism of action of the agent on BPH and the surrounding tissue was discussed; reduced androgen effect on the prostate through lowering of PRL and anti-alpha-adrenergic activity or the effect through prostaglandin on the gland, the bladder neck and the posterior urethra would mitigate the symptoms.

Topics: Aged; Drug Administration Schedule; Drug Evaluation; Ergolines; Humans; Lisuride; Male; Middle Aged; Prolactin; Prostatic Hyperplasia

A double-blind crossover study of the alpha-blocker Nicergoline was carried out in sixteen patients affected by benign prostatic bladder outflow obstruction. The "irritative" symptoms of prostatic hypertrophy, including nocturnal frequency and dysuria, were improved after Nicergoline significantly more than after placebo. In 10 further patients with prostatic hypertrophy, peak and mean flow rates increased by 50% and 77% respectively after the acute administration of Nicergoline. No side effects were detected. In conclusion Nicergoline seems to be active and well tolerated in the treatment of benign prostatic obstruction.

Topics: Adult; Aged; Double-Blind Method; Ergolines; Humans; Male; Middle Aged; Nicergoline; Prostatic Hyperplasia; Random Allocation; Urinary Bladder Neck Obstruction; Urodynamics

Topics: Bromocriptine; Ergolines; Humans; Male; Prostatic Hyperplasia