Monopolar versus Plasmakinetic™ Energy Effect on Prostatic Tissue Damage in Terms of PSA Levels: A Prospective Randomized Trial

2015 ◽  
Vol 95 (3) ◽  
pp. 265-268 ◽  
Author(s):  
Aslan Demir ◽  
Mert Ali Karadag ◽  
Kursat Cecen ◽  
Mehmet Uslu ◽  
Omer Erkam Arslan
Keyword(s):  
Tissue Damage ◽  
Statistical Difference ◽  
Operation Time ◽  
Maximum Flow ◽  
Energy Effect ◽  
Free Psa ◽  
Bipolar Energy ◽  
Resected Tissue ◽  
Group 2 ◽  
Total Psa

Introduction: We investigated the monopolar and bipolar energy effects on prostate and correlated the results with the type of pathology, thus determining the relationship between tissue damage and the PSA level. Material and Methods: One hundred and twenty four patients underwent TURP and according to the energy source, 2 groups were designed as monopolar (Group 1) and bipolar energy (Group 2). Hemoglobin and free and total PSA were measured preoperatively and 6 hours postoperatively, and differences were calculated. The weight of resected tissue and operation time were also recorded. Two groups were also formed later according to the pathology as chronic prostatitis (CP) and BPH. The findings were analyzed. Results: There were no statistical differences between the groups in terms of age; prostate volumes; resected tissue; operation times; pre- and postoperative Hb, total-free PSA, IPSS, PVR, and quality of life scores; or postoperative maximum flow rates. Changes in total-free PSA (25.7 and 10.8 ng/dl for PSA; 13.2 and 5.76 ng/dl for free PSA for Groups 1 and 2, respectively) were significantly different between Groups 1 and 2. There was a statistical difference in total PSA between the groups among CP patients (28.18 and 11.73 ng/dl for Groups 1 and 2, respectively). But no statistical difference existed among BPH patients. The change in Hb differed based on pathological results. Conclusion: Bipolar TURP is less invasive than monopolar TURP on the basis of postoperative PSA levels. In addition, bleeding during TURP is affected not by the kind of energy, but by the pathology.

scholarly journals Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

2014 ◽  
Vol 8 (9-10) ◽  
pp. 595 ◽  
Author(s):  
Mert Ali Karadag ◽  
Kursat Cecen ◽  
Aslan Demir ◽  
Ramazan Kocaaslan ◽  
Fatih Altunrende
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Statistical Difference ◽  
Preoperative Evaluation ◽  
Operation Time ◽  
Maximum Flow ◽  
Prostatic Hyperplasia ◽  
Group 2 ◽  
Hemoglobin Drop ◽  
Group 1

Introduction: We evaluate the efficacy and outcomes of plasmakinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH).Methods: A total of 183 patients with BPH underwent plasmakinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization.Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 ± 3.819 and Group 2 had a 18.15 ± 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 ± 1.049 days, and in Group 2 it was 2.64 ± 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR).Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year.

scholarly journals Incidence of Meniscal Tears Accompanying ACL Ruptures

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0012
Author(s):  
Mehmet Hasan Tatari ◽  
Vugar Guliyev
Keyword(s):  
Statistical Difference ◽  
Meniscal Tear ◽  
Operation Time ◽  
Variance Analysis ◽  
Meniscal Tears ◽  
Chi Square ◽  
Group 3 ◽  
Group 2 ◽  
Bucket Handle ◽  
Group 1

Objectives: Anterior cruciate ligament (ACL) injury is a common disorder in athletes and in most cases, meniscal tears accompany. These meniscal tears can be the result of the initial trauma or the consecutive injuries in the unoperated patients. The aim of the study was to compare the incidence of meniscal tears in the patients operated because of ACL defficiency in the early or late period after the initial trauma. The age of the patient and meniscal tear pattern were the other subjects compared. Methods: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236). Results: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236) Conclusion: We can say that the incidence of meniscal tears can be decreased if the patients with ACL injury are operated early after the initial trauma. Earlier ACL reconstruction means less meniscal tear.

Effect of Marathon Running on Total and Free Serum Prostate-Specific Antigen Concentrations

2003 ◽  
Vol 127 (3) ◽  
pp. 345-348 ◽  
Author(s):  
Alexander Kratz ◽  
Kent B. Lewandrowski ◽  
Arthur J. Siegel ◽  
Patrick M. Sluss ◽  
Kelly Y. Chun ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Physical Exertion ◽  
The United States ◽  
Marathon Running ◽  
Reliable Determination ◽  
Free Psa ◽  
Sporting Event ◽  
Exercise Induced ◽  
Total Psa

Abstract Context.—Prostate-specific antigen (PSA) is an important tumor marker for the most frequently diagnosed cancer in the United States. A major limitation of this marker is falsely elevated results in patients who are found not to have prostate cancer. The effects of vigorous physical exertion on PSA concentrations are controversial. Objective.—To determine the effects of marathon running on PSA levels. Design.—Measurement of total and free PSA levels in the sera of participants in a marathon before and within 4 and 24 hours after the race. Results.—None of the participants had elevated total PSA levels before the race. Although we found no statistically significant changes in average total or free PSA concentrations at either time point, after the marathon, 2 (11%) of 18 runners had total PSA concentrations outside the standard reference range. Changes in total PSA levels did not correlate with age or prerace PSA concentrations. Free PSA levels were not statistically significantly changed after the race and did not allow a reliable determination of exercise-induced PSA elevations. Conclusions.—Although it may not be necessary for men to abstain from exercise involving running before blood draws for PSA analysis, elevated PSA concentrations may be observed in some individuals after participation in a major sporting event. In these cases, repeat measurements should be considered at a time significantly removed from such exercise.

scholarly journals Usefulness of the prostate health index in predicting the presence and aggressiveness of prostate cancer among Korean men: a prospective observational study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae Yoon Kim ◽  
Ji Hyeong Yu ◽  
Luck Hee Sung ◽  
Dae Yeon Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Specific Antigen ◽  
Significant Proportion ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

Abstract Background We aimed to evaluate the usefulness of the Beckman Coulter prostate health index (PHI) and to compare it with total prostate-specific antigen (PSA) levels and related derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in the Korean population. Methods A total of 140 men who underwent their first prostate biopsy for suspected PCa were included in this prospective observational study. The diagnostic performance of total PSA, free PSA, %free PSA, [–2] proPSA (p2PSA), %p2PSA, and PHI in detecting and predicting the aggressiveness of PCa was estimated using the receiver operating characteristic curve (ROC) and logistic multivariate regression analyses. Results Of 140 patients, PCa was detected in 63 (45%) of participants, and 48 (76.2%) of them had significant cancer with a Gleason score (GS) ≥ 7. In the whole group, the area under the curve (AUC) for ROC analysis of tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.63, 0.57, 0.69, 0.69, 0.72, and 0.76, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p = 0.005). For PCa with GS ≥ 7, the AUCs for tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.62, 0.58, 0.41, 0.79, 0.86, and 0.87, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p < 0.001). In the subgroup with tPSA 4–10 ng/mL, both %p2PSA and PHI were strong independent predictors for PCa (p = 0.007, p = 0.006) and significantly improved the predictive accuracy of a base multivariable model, including age, tPSA, fPSA and %fPSA, using multivariate logistic regression analysis. (p = 0.054, p = 0.048). Additionally, at a cutoff PHI value > 33.4, 22.9% (32/140) of biopsies could be avoided without missing any cases of aggressive cancer. Conclusions This study shows that %p2PSA and PHI are superior to total PSA and %fPSA in predicting the presence and aggressiveness (GS ≥ 7) of PCa among Korean men. Using PHI, a significant proportion of unnecessary biopsies can be avoided.

scholarly journals Comparison of Inflammatory Reactions Following Two Different Cesarean Section Techniques: The Modified Misgav-Ladach Versus the Pfannenstiel-Kerr; A Prospective Randomized Trial

2018 ◽  
pp. 1
Author(s):  
Baris Buke ◽  
Hatice Akkaya ◽  
Cigdem Karakukcu
Keyword(s):  
Cesarean Section ◽  
Inflammatory Reaction ◽  
Operation Time ◽  
Blood Samples ◽  
Inflammatory Reactions ◽  
Tnf Α ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
Group 1

<p><strong>Objectives:</strong> There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels.<br />To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique.</p><p><strong>Study Desıgn:</strong> The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-α levels, and these percentages were then compared between the groups.</p><p><strong>Results:</strong> There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001).</p><p><strong>Conclusions:</strong> The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.</p>

scholarly journals Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877089 ◽  
Author(s):  
Cen Tao Liu ◽  
Heng an Ge ◽  
Rui Hu ◽  
Jing Biao Huang ◽  
Yi Chao Cheng ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Pain Score ◽  
Operation Time ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Single Row ◽  
Repair Technique ◽  
Randomized Controlled Studies ◽  
Group 2 ◽  
Group 1

Background: The comparison of clinical outcomes of arthroscopic footprint-preserving knotless single-row repair with the tear completion repair technique for articular-sided partial-thickness rotator cuff tears (PTRCTs) remains unclear. Methods: A total of 68 patients diagnosed with articular-sided PTRCTs who underwent rotator cuff repair between December 2014 and June 2015 were included. Of the 68 patients, 30 received footprint-preserving knotless single-row repair (group 1) and 38 received the tear completion repair technique (group 2). Preoperative and postoperative assessments were compared. Results: Both groups had significantly improved American Shoulder and Elbow Surgeons (ASES) scores (group 1: 48.2 preoperatively to 81.9 postoperatively, p < 0.001; group 2: 47.1 preoperatively to 84.9 postoperatively, p < 0.001) and visual analog scale (VAS) pain score (group 1: 6.0 preoperatively to 0.93 postoperatively, p < 0.001; group 2: 6.1 preoperatively to 1.1 postoperatively, p < 0.001), showing that the two procedures significantly improved postoperative shoulder function. No significant differences were shown in ASES score or VAS pain score between the two groups ( p > 0.05). The mean operation time was significantly shorter in group 1 with an average of 48.1 min than in group 2 with an average of 60.4 min ( p < 0.001). Conclusions: Footprint-preserving knotless single-row repair obtains similar clinical results compared to tear completion repair in the treatment of articular-sided PTRCTs. Footprint-preserving knotless single-row repair may be a convenient choice for the treatment of articular-sided PTRCTs. Randomized controlled studies are needed to investigate whether the footprint-preserving knotless single-row repair yields better long-term outcomes through the protection of the bursal cuff and restoration of the healthy footprint.

Modifield Desarda Repair and Hernioplastia Lichtenstein Repair for Inguinal Hernia

2021 ◽  
Vol 2 (3) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
The Mean ◽  
Group 2 ◽  
Location Type ◽  
Mean Time

Introduction: The objective of this study is to compare the outcomes of Modified Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 1342 patients having 1394 hernias operated from January 2008 to December 2020. 690 patients were operated using Lichtenstein repair and 652 using Desarda repair. The demographie data (Age,Sex) , hernia type and location , anesthetic , operative time , postoperative pain and complications were analysed. Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 52 minutes in Modified Desarda group and 42 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.0 % in Modified Desarda group and 0.28 % in Lichtenstein group. But, there were 9 cases of infection to the polypropylene mesh in the Lichtenstein group, 2 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7,6 %) as compared to Modified Desarda group (3.8 %). The mean time to return to work in the Modified Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. in Modified Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: The modified Desarda repair scores significantly on Lichtenstein repair in most of all aspects, including reexplorations and morbidity. Modified Desarda repair is a better option compared to Lichtenstein repair.

Repair of Esophageal Atresia With Trache Esophageal Fistula Through Modified Transpleural Approach by Delivering Lung Out of Main Wound

2018 ◽  
Vol 32 (4) ◽  
pp. 106-111
Author(s):  
Pramod Kumar Mohanty ◽  
Pravat Kumar Majumdar ◽  
Hiranya Kishor Mohanty ◽  
Pradeep Kumar Jena ◽  
Prasant Kumar Tripathy ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Esophageal Atresia ◽  
Tertiary Care ◽  
Operation Time ◽  
Anastomotic Site ◽  
Care Hospital ◽  
Co Morbidity ◽  
Group 2 ◽  
Surgery Department ◽  
Approach Group

Objectives: To assess the morbidity, mortality, operation time, and postoperative complications in the present modified transpleural (MTP) approach with the conventional extrapleural (EP) approach in esophageal atresia (EA) with tracheoesophageal fistula (TEF). Design: Longitudinal randomized case control study. Setting: Pediatrics Surgery Department of a tertiary care hospital. Study period: November 2009 to December 2011. Participants: Neonates above 1.5 kg body weight with EA and TEF. Results: Sex ratio is 7:3 (male and female). In total, 40% had associate anomalies. Duration of operation in MTP approach from 90 to 110 min (mean duration 98.6 min) where as in EP approach from 120 to 130 min (mean duration 121.4 min). All 3(15% wound infections were in EP group. A total of 3 develops right sided pneumothorax with 2 in MTP and 1 in EP approach group. In total, 10% (2) in MTP approach group and 5% (1) in EP group expired. Leakage in anastomotic site was seen in 2(10%) each in both the groups. Six developed stricture, out of which 4 in EP group, 2 in MTP group. Conclusion: MTP approach is less time consuming, possess less hindrance during operation. Postoperative complications are comparable. Mortality is higher in MTP group than EP group, may be because of associated lethal co morbidity.

scholarly journals The Combination of Human Glandular Kallikrein and Free Prostate-specific Antigen (PSA) Enhances Discrimination Between Prostate Cancer and Benign Prostatic Hyperplasia in Patients with Moderately Increased Total PSA

1999 ◽  
Vol 45 (11) ◽  
pp. 1960-1966 ◽  
Author(s):  
Angeliki Magklara ◽  
Andreas Scorilas ◽  
William J Catalona ◽  
Eleftherios P Diamandis
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Prostate Specific Antigen ◽  
Prostatic Carcinoma ◽  
Specific Antigen ◽  
Area Under The Curve ◽  
Prostatic Hyperplasia ◽  
Free Psa ◽  
Glandular Kallikrein ◽  
Total Psa

Abstract Background: Prostate-specific antigen (PSA) is the most reliable tumor marker available and is widely used for the diagnosis and management of prostate cancer. Unfortunately, PSA cannot distinguish efficiently between benign and malignant disease of the prostate, especially within the range of 4–10 μg/L. Among the refinements developed to enhance PSA specificity is the free/total PSA ratio, which is useful in discriminating between the two diseases within the diagnostic “gray zone”. Recent data indicate that human glandular kallikrein (hK2), a protein with high homology to PSA, may be an additional serum marker for the diagnosis and monitoring of prostate cancer. Methods: We analyzed 206 serum samples (all before treatment was initiated) from men with histologically confirmed benign prostatic hyperplasia (n = 100) or prostatic carcinoma (n = 106) with total PSA in the range of 2.5–10 μg/L. Total and free PSA and hK2 were measured with noncompetitive immunological procedures. Statistical analysis was performed to investigate the potential utility of the various markers or their combinations in discriminating between benign prostatic hyperplasia and prostatic carcinoma. Results: hK2 concentrations were not statistically different between the two groups of patients. There was a strong positive correlation between hK2 and free PSA in the whole patient population. hK2/free PSA ratio (area under the curve = 0.69) was stronger predictor of prostate cancer than the free/total PSA ratio (area under the curve = 0.64). At 95% specificity, the hK2/free PSA ratio identified 30% of patients with total PSA between 2.5–10 μg/L who had cancer. At 95% specificity, the hK2/free PSA ratio identified 25% of patients with total PSA between 2.5 and 4.5 μg/L who had cancer. Conclusions: Our data suggest that hK2 in combination with free and total PSA can enhance the biochemical detection of prostate cancer in patients with moderately increased total PSA concentrations. More specifically, the hK2/free PSA ratio appears to be valuable in identifying a subset of patients with total PSA between 2.5 and 4.5 μg/L who have high probability of cancer and who should be considered for biopsy.

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