vitamin-k-semiquinone-radical and Prostatic-Hyperplasia

To evaluate the safety of holmium laser enucleation of the prostate (HoLEP) in patients on oral anticoagulation (OA) with respect to intra- and postoperative bleeding complications.. Between January 2013 and October 2016, 2178 patients were included in this study, of whom 94 received direct oral anticoagulants (DOACs) and 151 received vitamin K antagonists (VKAs) before HoLEP. All patients either ceased OA (DOACs) or were bridged subtherapeutically (VKAs, international normalized ratio <2) during surgery. These patients were compared to a sample size of 1933 nonanticoagulated patients.. A significant longer postoperative stay was noted for the patients on DOACs (5.2 [4-6] days) and VKAs (5.3 [4-5] days) compared to the control group (4.5 [4-4] days). The mean drop in hemoglobin was significantly higher in the VKA group compared to the DOAC and control group. There was a significantly higher rate of postoperative bladder tamponades/secondary coagulation in patients on OA with 6 (7.9%)/3 (3.9%) patients in the DOAC group, 10 (7.4%)/6 (4.4%) patients in the VKA group compared to 37 (2.2%)/21 (2.1%) patients in the control group, respectively (p < 0.001). Eight patients required blood transfusions with a distribution of 1 (1.3%), 3 (2.2%), and 4 (0.2%) patients in the DOAC, VKA, and control group, respectively (p < 0.001).. Our findings indicate that bridged patients who's DOACs and VKAs were ceased before HoLEP are at higher risk of intra- and postoperative bleeding complications. Nonetheless, HoLEP appears to be a safe and effective procedure in those patients.

Topics: Administration, Oral; Aged; Aged, 80 and over; Anticoagulants; Blood Transfusion; Holmium; Humans; Laser Therapy; Lasers, Solid-State; Male; Middle Aged; Patient Safety; Perioperative Period; Postoperative Complications; Postoperative Hemorrhage; Prostatectomy; Prostatic Hyperplasia; Retrospective Studies; Transurethral Resection of Prostate; Vitamin K

Though age-related prostate enlargement is very common in Western societies, and the causes of benign prostate hyperplasia, BPH, have been diligently sought after, there is no biological, mechanistic explanation dealing with the root causes and progression of this very common disorder among men. All treatments to date are based on symptomatic relief, not a fundamental understanding of the cause of the disease. However, recent advances have shown that even subclinical varicoceles, which are more common than generally realized, cause retrograde blood flow from the testes past the prostate gland causing over a 130-fold increase in free testosterone in the veins near the prostate. By treating the varicoceles via embolization of the internal spermatic vein and its communicating and connected vessels the prostate enlargement can be reversed with corresponding symptomatic relief. So, varicose veins in the pampiniform venous plexus, varicoceles, are the direct cause of BPH. But what causes varicoceles? Recent research has uncovered the role of vitamin K in the calcification of varicose veins as well as a role in the proliferation of smooth muscle cells in the media layer of the vein wall. Vitamin K is intimately involved in the formation of varicose veins. The hypothesis is that poor prostate health is essentially a vitamin K insufficiency disorder. By providing vitamin K in the right form and quantity, along with other supporting nutrients and phytochemicals, it is likely that excellent prostate health can be extended much longer, and perhaps poor prostate health can be reversed. A protective role for vitamin K with respect to advanced prostate cancer was already found in the Heidelberg cohort of the EPIC study. This hypothesis can be further evaluated in studies examining the connection between vitamin K and varicoceles, and also by examining the connection between varicoceles and benign prostate hyperplasia. If this hypothesis is found to be true, management of prostate health will be radically altered. Rather than focusing on prostate health as a hormonal imbalance, prostate enlargement will be seen as a result of poor health of the veins in general and the internal spermatic veins in particular. Factors which promote the health of the veins will become a greater focus of research, including the role of vitamin K. Finally, the emerging understanding of the cause of BPH will empower men to take care of their bodies so they can enjoy much better health through

Topics: Humans; Male; Models, Biological; Prostate; Prostatic Hyperplasia; Testosterone; Varicocele; Veins; Vitamin K

Topics: Animals; Humans; Male; Mice; Mice, Nude; Neoplasms, Experimental; Prostatic Hyperplasia; Prostatic Neoplasms; Tritium; Vitamin K

Three groups of patients undergoing urological operations were given a prophylactic regimen of either subcutaneous heparin (n = 1143), antiprothrombics (n = 944) or no medication (n = 570). Results were deemed through simple clinical criteria. They were similar for the whole of patients and for some types of surgery, pecularly protatic: Anticoagulation induced a significant lowering of the frequency of thromboembolism, heparin being more efficient than antiprothrombics. It does not increase the percentage of haemorrhages. More, peridural anesthesia is not contre-indicated by heparin. However, parietal problems appear to be more frequent among heparinized patients.

Topics: Adolescent; Age Factors; Aged; Hemorrhage; Heparin; Humans; Male; Middle Aged; Postoperative Complications; Prostatic Hyperplasia; Retrospective Studies; Thromboembolism; Urinary Tract; Vitamin K

Topics: Humans; Hypertrophy; Male; Muscle, Smooth; Prostatic Hyperplasia; Seizures; Vitamin A; Vitamin K; Vitamins