scholarly journals Perineal Urethrostomy: Surgical and Functional Evaluation of Two Techniques

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Nicolaas Lumen ◽  
Matthias Beysens ◽  
Charles Van Praet ◽  
Karel Decaestecker ◽  
Anne-Francoise Spinoit ◽  
...  

Introduction. PU is an option to manage complex and/or recurrent urethral strictures and is necessary after urethrectomy and/or penectomy. PU is generally assumed to be the last option before abandoning the urethral outlet.Methods. Between 2001 and 2013, 51 patients underwent PU. Mean age (± standard deviation) was60±15years. Only 13 patients (25.5%) did not undergo previous urethral interventions. PU was performed according to the Johanson(n=35)or Blandy(n=16)technique and these 2 groups were compared for surgical failure, maximum urinary flow (Qmax), urinary symptoms, and quality of life (according to the International Prostate Symptom Score).Results. Both groups were similar for patient’s and stricture characteristics. Only follow-up duration was significantly longer after Johanson PU (47.9 months versus 11.1 months;P=0.003). For the entire cohort, 11 patients (21.6%) were considered a failure (9 or 25.7% for Johanson group and 2 or 12.5% for Blandy group;P=0.248). There was a significant improvement ofQmaxin both groups. Quality of life after PU was comparable in both groups.Conclusions. PU is associated with a 21.6% recurrence rate and the patient should be informed about this risk.

2021 ◽  
Author(s):  
Seyed Reza Yahyazadeh ◽  
Seyed Shahaboddin Izadi

Abstract Purpose: To investigate the clinical significance of the intravesical prostatic protrusion (IPP) index in benign prostatic hyperplasia (BPH) patients to clarify its diagnostic value in predicting the clinical and structural abnormalities of the prostate. Materials and Methods: In this descriptive and analytical cross-sectional study, we include every man older than 50 years old with lower urinary tract symptoms (LUTS), predominantly voiding or obstructive, suggestive of BPH. The patients were evaluated to determine the following indices: IPSS (International Prostate Symptom Score) Index, QoL (quality of life), prostate volume (PV) and postvoid residual urine (PVR), serum PSA level, and the maximum urinary flow rate (Qmax) obtained by uroflowmetry. Subsequently, the assessment of the IPP index was undertaken by transabdominal ultrasonography. The categorization of the IPP index was done into 3 grades: grade one (below 5 mm), grade two (between 5 and 10 mm), and grade three (greater than 10 mm). Results: The significant direct correlation between the intravesical prostatic protrusion and international prostate symptom score, quality of life, prostate volume, postvoid residual urine, and serum PSA as well as inversely with the maximum urinary flow rate was confirmed both before and after the medical treatment. Also, the need for surgical intervention increased significantly with increasing IPP levels. Conclusion: The intravesical prostatic protrusion can be used to evaluate and predict the severity of symptoms and outcomes in patients with clinical BPH.


2015 ◽  
Vol 95 (3) ◽  
pp. 260-264 ◽  
Author(s):  
Keqin Zhang ◽  
Dingqi Sun ◽  
Hui Zhang ◽  
Qingwei Cao ◽  
Qiang Fu

Objective: To evaluate plasmakinetic vapor enucleation of the prostate (PVEP) with button electrode and plasmakinetic resection of the prostate (PKRP) in patients with urinary symptoms due to benign prostatic enlargement (BPE) >90 ml. Methods: A total of 112 patients with symptomatic BPE were randomly assigned to either PKRP or PVEP prospectively from August 2012 to May 2014 in our department. Perioperative and postoperative data were investigated during a 3-month follow-up. Results: PVEP was significantly superior to PKRP in terms of operation time (63.9 ± 7.7 vs. 78.1 ± 13.6 min, p < 0.001), hemoglobin loss (1.18 ± 0.30 vs. 1.63 ± 0.38 g/dl, p < 0.001), serum sodium decrease (2.9 ± 0.7 vs. 4.3 ± 0.8 mmol/l, p < 0.001), catheterization duration (49.3 ± 12.2 vs. 78.1 ± 14.8 h, p < 0.001) and hospital stay (100.2 ± 28.3 vs. 116.0 ± 29.2 h, p = 0.004). There were no statistical differences in blood transfusion between the two groups. In addition, there were no statistical differences in maximum urinary flow rate, International Prostate Symptom Score, postvoid residual urine volume, quality-of-life score, transient incontinence, and urethral stricture at 3 months postoperatively. Conclusions: PVEP with button electrode is an equally effective technique for treatment of large BPE with PKRP, with more safety and faster recovery. It may become the superior alternative to PKRP for patients with large BPE.


2015 ◽  
Vol 43 (8) ◽  
pp. 1561-1566 ◽  
Author(s):  
Giuseppe Mercante ◽  
Alessandra Masiello ◽  
Isabella Sperduti ◽  
Giovanni Cristalli ◽  
Raul Pellini ◽  
...  

2021 ◽  
pp. 1-5
Author(s):  
Ahmet Asfuroglu ◽  
Melih Balci ◽  
Yilmaz Aslan ◽  
Cagdas Senel ◽  
Ozer Guzel ◽  
...  

<b><i>Introduction:</i></b> It was aimed to show the relationship between benign prostatic hyperplasia and inflammation by measuring urinary C-reactive protein values before and after alpha-blocker treatment. <b><i>Methods:</i></b> A total of 71 patients with a total prostate-specific antigen &#x3c;3.5 ng/mL, International Prostate Symptom Score &#x3e;7, and maximum urinary flow rate &#x3c;15 mL/s were included in the study. Doxazosin 4 mg p.o. once daily was started orally as an alpha-blocker treatment. Serum and urine C-reactive protein values, International Prostate Symptom Score, maximum urinary flow rate, and the post-void residual volume of patients were recorded at the first admission and in the first month of alpha-blocker treatment. <b><i>Results:</i></b> The mean age of the patients was 59.2 ± 7.5 years. The mean serum C-reactive protein values of the patients at the first admission and follow-up were 2.62 ± 1.8 (range, 0–5) mg/L and 2.83 ± 1.6 (0–6) mg/L, respectively. The mean urine C-reactive protein values of the patients at the first admission and follow-up were 0.45 ± 0.11 (range, 0.28–0.99) mg/L and 0.14 ± 0.04 (range, 0.79–0.328) mg/L, respectively, which was statistically significantly different. In the subgroup analysis, the urine C-reactive protein level change was more prominent in severely symptomatic patients than in moderately symptomatic patients. <b><i>Conclusion:</i></b> Our results showed that C-reactive protein was detectable in urine, alpha-blocker treatment significantly reduced urine C-reactive protein levels, and the decrease was more prominent in severely symptomatic patients.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Pieter D’hulst ◽  
Michael S. Floyd ◽  
Fabio Castiglione ◽  
Kathy Vander Eeckt ◽  
Steven Joniau ◽  
...  

Background. Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are therefore of major importance. Objective. The objective of this study was to prospectively analyse functional outcomes and patient satisfaction. Design, Settings, and Participants. We prospectively evaluated 47 patients before and after EPA from August 2009 until February 2017. The first follow-up visit occurred after a median of 2.2 months (n = 47/47), with the second and third follow-ups occurring at a median of 8.5 months (n = 38/47) and 20.2 months (n = 31/47). Before surgery and at each follow-up visit, the patients received five questionnaires: the International Prostate Symptom Score (IPSS), the International Prostate Symptom Score with the Quality of Life (IPSS-QOL) score, the Urogenital Distress Inventory Short Form (UDI-6) score, the International Index of Erectile Function-5 (IIEF-5) score, and the ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTS-QOL) score. Surgical Procedure. Surgery was performed in all cases using the same standardized EPA technique. Outcome Measurements and Statistical Analysis. Voiding symptoms, erectile dysfunction, and quality of life were analysed using paired sample t-tests, with a multiple-testing Bonferroni correction. Any requirement for instrumentation after surgery was considered treatment failure. Results and Limitations. Patients with mild or no baseline erectile dysfunction showed significant decline in erectile function at first follow-up (mean IIEF-5 of 23.27 [standard deviation; SD: 2.60] vs. 13.91 [SD: 7.50]; p=0.002), but this had recovered completely at the third follow-up (IIEF-5: 23.25 [SD: 1.91]; p=0.659). Clinically significant improvements were noted in IPSS, IPSS-QOL-score, UDI-6-score, and ICIQ-LUTS-QOL-score at the first follow-up (p<0.0001). These improvements remained significant at the second and third follow-ups (p<0.0001) for all PROMs. Three of the patients experienced stricture recurrence. The main limitations of this study were incomplete questionnaires, loss to follow-up, and low number of patients. Conclusions. EPA results in an initial decline in erectile function, but full recovery occurred at a median of 20 months. Voiding improved significantly, and a major improvement in quality of life was noted, which persisted for up to 20 months after surgery. Patient Summary. This study showed the importance of patient-reported outcome measures in indicating the actual outcome of urethral stricture disease surgery.


2019 ◽  
Vol 5 (2) ◽  
pp. 143-147
Author(s):  
Md Abul Hossain ◽  
Md Akter Alam ◽  
Md Fazal Naser ◽  
Md Shafiqul Azam

Background: BPH is one of the most common cause of LUTS which significantly impairs the quality of life. TURP is minimally invasive surgical procedure for Benign Prostatic hyperplasia which has impact on quality of life. Impact on quality of life can be measured by QoL score and effect of TURP can be evaluated. Objective: The purpose of the present study was to evaluate the impact of transurethral resection of prostate (TURP) on Quality of Life (QoL) score. Methodology: This prospective study was carried out in the Department of Urology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, from July 2015 to June 2016. Total fifty patients between 50 to 72 years attending for the treatment of benign prostatic hypertrophy (BPH) with lower urinary tract symptoms (LUTS) were included for the study according to inclusion & exclusion criteria. All of them were evaluated with baseline international prostate symptoms score (IPSS), QoL score, peak urinary flow rate (Qmax), voided volume, voiding time and PVR and were recorded in a predesigned data sheet. Selected patients underwent Transurethral Resection of Prostate. They were followed after 1 month and 3 months with same parameter and compared with the baseline values. Results: The baseline international prostate symptoms score (IPSS) in this study was 25.18±1.45. At one month and three months follow up visits after TURP, the IPSS was decreased to 15.0±1.07 and 8.14±0.76 respectively. There was significant improvement of peak urinary flow rate (Qmax) in the postoperative period, at the 1st follow up visit after one month of TURP (15.78±1.42, p<0.001) and at the 2nd follow visit after three months of TURP (18.78, p <0.001). The mean QoL score was 5.30±0.46 before TURP. After one month of TURP it was 3.20±0.45 and after 3 months of TURP it was 1.86±0.57. Conclusion: There is a significant improvement of quality of after TURP. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 143-147


2020 ◽  
Vol 15 (2) ◽  
pp. 27-32
Author(s):  
Md Akter Alam ◽  
Md Abul Hossain ◽  
Md Fazal Naser ◽  
Md Shafiqul Azam ◽  
Md Nurul Hooda ◽  
...  

Objectives: Evaluation of the international prostate symptom score(IPSS) and quality of life score before and following TURP in BPH patients and correlation with objective parameters(Qmax and PVR). Methods: This purposive clinical trial was carried out in the Department of Urology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from January 2008 to December 2008. Total fifty patients between 50-72 years attending for the treatment of BPH with LUTS were included for the study according to inclusion & exclusion Patients with carcinoma prostate riteria. Selected patients underwent transurethral resection of prostate. All of them had baseline IPSS, QoL score, Qmax, voided volume, voiding time and PVR. They were followed after 1 month and 3 months with same parameter and compared with the baseline values. Correlation of IPSS and QoL score was done with Qmax and PVR. Results: The baseline IPSS in this study was 25.18±1.45. At one month and three months follow up visits after TURP, the IPSS was decreased to 15.0±1.07 and 8.14±0.76 respectively. The mean QoL score was 5.30± 0.46 before TURP. After one month of TURP it was 3.20± 0.45 and after 3 months of TURP it was 1.86 ± 0.57. There was significant negative correlation between the QoL score and Qmax in the preoperative period (r = -0.606, p=0.001), at the 1st follow up visit after one month of TURP (r = -0.171, p=0.235) and at the 2nd follow visit after three months of TURP (r = -0.680, p =0.001). There was positive correlation between the QoL score and PVR in the preoperative period (r = 0.394, p=0.005), at the 1st follow up visit after one month of TURP (r = 0.047, p =0.748) and at the 2nd follow up visit after three months of TURP (r = 0.471, p=0.235). Conclusion: There was significant improvement of quality of after TURP and There was significant negative correlation between the QoL score and Qmax and positive correlation between the QoL score and PVR. Bangladesh Journal of Urology, Vol. 15, No. 2, July 2012 p.27-32


2010 ◽  
Vol 76 (4) ◽  
pp. 428-435 ◽  
Author(s):  
Francesco Selvaggi ◽  
Guido Sciaudone ◽  
Paolo Limongelli ◽  
Crescenzo Di Stazio ◽  
Ilaria Guadagni ◽  
...  

Ileal pouch-anal anastomosis (IPAA) has become the procedure of choice for surgical treatment of intractable ulcerative colitis (UC). Surgical complications occurring in the short-term, like pelvic sepsis, are responsible for pouch dysfunction. We prospectively evaluated 118 patients with IPAA for UC operated on between 1987 and 2002. Follow-up intervals were at 3, 6, and 12 months in the first year, then every year for at least 5 years. Patients answered a questionnaire 1 and 5 years after ileostomy closure. One hundred and seventeen patients completed the early follow-up. Nine patients developed early pelvic sepsis (7.69%); six required pouch salvage procedure. In about 33.3 per cent of cases more than one procedure was necessary. Eighty-eight patients were available for 5-year functional evaluation. Patients developing early sepsis (n = 9) showed worse long-term functional results compared with the remaining study population (n = 79): stool frequency; night evacuation; perfect day/night continence; discrimination; antidiarrhoeals need; pad usage; and sexual restriction were significantly different ( P < 0.05). Quality of life and satisfaction after surgery were good in all patients. This observation did not correlate with function. Eighty-eight and 97 per cent would undergo IPAA again and would recommend it to others respectively, in septic group and controls. Functional outcome after IPAA may be influenced by early septic complications. Overall quality of life and satisfaction with surgery are comparable with those of controls.


2006 ◽  
Vol 175 (4S) ◽  
pp. 150-151
Author(s):  
Jeffrey S. Montgomery ◽  
Bishoy A. Gayed ◽  
Brent K. Hollenbeck ◽  
Stephanie Daignault ◽  
Martin G. Sanda ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document