Plasmakinetic Vapor Enucleation of the Prostate with Button Electrode versus Plasmakinetic Resection of the Prostate for Benign Prostatic Enlargement >90 ml: Perioperative and 3-Month Follow-Up Results of a Prospective, Randomized Clinical Trial

2015 ◽  
Vol 95 (3) ◽  
pp. 260-264 ◽  
Author(s):  
Keqin Zhang ◽  
Dingqi Sun ◽  
Hui Zhang ◽  
Qingwei Cao ◽  
Qiang Fu
Keyword(s):  
Urine Volume ◽  
Operation Time ◽  
Urinary Flow ◽  
Benign Prostatic Enlargement ◽  
Effective Technique ◽  
Prostatic Enlargement ◽  
Postvoid Residual Urine ◽  
Maximum Urinary Flow

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.

scholarly journals Diode laser vaporization of prostate as treatment for benign prostatic enlargement: Initial results of 73 patients with 1 year follow-up

2014 ◽  
Vol 61 (1) ◽  
pp. 21-24
Author(s):  
Miodrag Acimovic ◽  
Dragutin Rafailovic ◽  
Uros Bumbasirevic ◽  
Uros Babic ◽  
Veljko Santric ◽  
...  
Keyword(s):  
Diode Laser ◽  
Intraoperative Complications ◽  
Urine Volume ◽  
Laser Vaporization ◽  
Urinary Flow ◽  
Benign Prostatic Enlargement ◽  
Prostatic Enlargement ◽  
Initial Results

Objective: Our objective is to evaluate the efficacy, safety and 12 month outcome of a 980 nm diode laser with Twister fiber in the treatment of benign prostatic enlargement. Materials and methods: Between February 2011 and January 2013, 73 patients with benign prostatic enlargement had undergone diode laser vaporization of prostate at our institution. The following parameters were assessed at baseline, and after a follow-up period of 3 and 12 months: International Prostate Symptom Score, peak urinary flow rate, post-void residual urine volume, and quality of life score. Results: The procedure was completed successfully in all patients with no intraoperative complications. At 12 months postoperatively the percentage improvements in IPSS was-69.09%, Qmax +197%, PVR-88.54%, and QoL-68.29%. Conclusion: Diode laser vaporization of prostate is safe and effective method for treatment of benign prostatic enlargement.

scholarly journals Vaginal apical and anterior reconstruction using ultralight weight mesh: two-year follow-up

2018 ◽  
Vol 67 (3) ◽  
pp. 55-63
Author(s):  
Dmitry D. Shkarupa ◽  
Nikita D. Kubin ◽  
Eduard N. Popov ◽  
Ekaterina A. Shapovalova ◽  
Gleb V. Kovalev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
De Novo ◽  
Urine Volume ◽  
Operation Time ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Apical Prolapse ◽  
Pelvic Floor Reconstruction

Introduction. Anterior and apical prolapse is the most common type of pelvic organ prolapse. The insufficient  effectiveness of native tissue repair in the pelvic organs leads to the search of new methods of the pelvic floor reconstruction. Objective. The current analysis was undertaken to evaluate the efficiency of the use of the Pelvix anterior mesh system (Lintex) with sacrospinous fixation of the apex in the treatment of anterior and apical prolapse. Methods. This study involved 150 women suffering from anterior-apical prolapse (stages III and IV). Reconstruction with the use of the mesh was performed in all the patients. To evaluate the results of surgical treatment, data of a vaginal examination (POP-Q), uroflowmetry, bladder ultrasound, and validated questionnaires (PFDI-20, PFIQ-7, PISQ-12) were used. All the listed parameters were determined before the surgery and on follow-up visits in 1, 6, 12, and 24 months after the treatment. Results. Mean operation time was 47 minutes. No cases of intraoperative clinically significant bleeding were reported. Anatomical cure rate (< stage II / asymptomatic stage II, according to the Baden-Walker system) at 12 months was found to be 94.4%, and at 24 months — 92.7%. Within the first month of follow-up, de novo stress urinary incontinence and de novo urgency occurred in 8.0% and 7.2% of patients, respectively. Statistically significant (p < 0.05) improvement in uroflowmetry parameters and decreased post-voiding urine volume were achieved after the surgery and did not change by 24 months. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period. Conclusion. The use of the Pelvix anterior mesh system in the surgical correction of the anterior and apical prolapse is a safe uterus-sparing technique. At two-year follow-up, it provides a high anatomical efficiency, normalizes urodynamic parameters and improves quality of life.

scholarly journals Value of the visual prostate symptom score in evaluation of symptomatic benign prostatic enlargement: prospective study in a Nigerian population

2019 ◽  
Vol 7 (5) ◽  
pp. 1658
Author(s):  
Victor E. Onowa ◽  
Samaila I. Shuaibu ◽  
Idorenyin C. Akpayak ◽  
Chimaobi G. Ofoha ◽  
Christian A. Agbo ◽  
...  
Keyword(s):  
Symptom Score ◽  
University Teaching ◽  
P Value ◽  
Urinary Flow ◽  
Benign Prostatic Enlargement ◽  
Time Period ◽  
Urinary Tract Symptoms ◽  
Prostatic Enlargement ◽  
Nigerian Population ◽  
Maximum Urinary Flow

Background: To evaluate the correlation of Visual Prostate Symptom Score (VPSS) with International Prostate Symptom Score (IPSS) and Maximum Urinary Flow (Qmax). To investigate the effect of educational level on the ability to independently complete the VPSS versus the IPSS and time taken to do so.Methods: Bio data was taken from men with lower urinary tract symptoms (LUTS) due to Benign Prostatic Enlargement (BPE) who presented at the Urology clinic of Jos University Teaching Hospital. They were administered the IPSS questionnaire and VPSS pictogram, which they completed with or without physician assistance and the time taken to do so was noted. They subsequently had uroflowmetry done on same visit and the data was recorded in a structured proforma. Statistical analysis was done using SPSS(R) version 20. Correlation test was done for VPSS, IPSS and Qmax while the paired t-test was used for the average time spent in completing both questionnaires. A p-value <0.05 was considered as significant.Results: Eighty-five men (aged 42 to 94 years) were enrolled in the study. The VPSS correlated significantly with the IPSS in terms of total score (r = +0.684, p<0.001) and QoL (r = +0.570, p<0.001), as well as with the Qmax (r = -0.222, p = 0.041). A greater proportion (21.2%) of men with limited education could complete the VPSS without physician assistance as compared to the IPSS (6.0%) and the average time taken to complete the VPSS (170.51 seconds) was significantly shorter than the time taken to complete the IPSS (406.42 seconds).Conclusions: The VPSS correlates significantly with the IPSS and Qmax. It can be completed without physician assistance by a greater proportion of men with limited education within a shorter time period.

scholarly journals A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach

2021 ◽  
Vol 8 ◽  
Author(s):  
Yifeng Jing ◽  
Qian Sun ◽  
Wenhuan Guo ◽  
Dapeng Zhou ◽  
Yiping Zhu ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Urine Volume ◽  
Operation Time ◽  
Bladder Injury ◽  
Thulium Laser ◽  
Modified Technique ◽  
Total Operation Time ◽  
Postvoid Residual Urine ◽  
Laser Enucleation

Background: Until recently, most enucleation techniques of the prostate were performed with the application of morcellator. We introduce a modified enucleation technique of thulium laser with non-morcellator approach, which is about incising and vaporizing remaining prostate tissue instead of a morcellator.Methods: A retrospective evaluation of 223 patients undergoing ThuLEP from January 2014 to December 2015 was performed in our institution. One hundred five of the patients used morcellator while the other 118 used non-morcellator approach. All patients were assessed with the International Prostate Symptom Score (IPSS), quality of life (Qol), ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR). We reassessed these parameters at 1-, 3-, 6-, and 12-months after operation. Operative time, perioperative, and postoperative complications were also recorded.Results: Significant improvement was noted in the IPSS, QoL, Qmax, and PVR in both groups at the 12-month follow-up, and assessment showed no differences in these parameters between the two groups. Comparisons of the total operation time and enucleation time demonstrated no significant differences between the two groups. Our non-morcellator approach needed more time to incise and vaporize the enucleated tissue compared to morcellation when the prostate volume was about 40–80 ml (p &lt; 0.05), while it showed a significant lower rate of superficial bladder injury than using morcellator (p &lt; 0.05). There were no significant differences in other complications between the two groups (p &gt; 0.05).Conclusions: Our modified technique is a safe and effective procedure for the treatment of BPH avoiding the potential complications caused by morcellator.

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 ◽  
...  
Keyword(s):  
Quality Of Life ◽  
International Prostate Symptom Score ◽  
Urinary Flow ◽  
Functional Evaluation ◽  
Entire Cohort ◽  
Urethral Strictures ◽  
Surgical Failure ◽  
Maximum Urinary Flow

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.

scholarly journals Clinical Significance of Intravesical Prostatic Protrusion Index in Patients with Clinical Diagnosis of Benign Prostatic Hyperplasia. 

2021 ◽  
Author(s):  
Seyed Reza Yahyazadeh ◽  
Seyed Shahaboddin Izadi
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
International Prostate Symptom Score ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Postvoid Residual Urine ◽  
Intravesical Prostatic Protrusion ◽  
Maximum Urinary Flow

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.

scholarly journals An Indigenous Method of Securing Ventriculoperitoneal Shunt Tube in Peritoneal Cavity

2021 ◽  
Author(s):  
Samir Kumar Kalra ◽  
Krishna Shah ◽  
Sneyhil Tyagi ◽  
Suviraj John ◽  
Rajesh Acharya
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Operation Time ◽  
Complication Rates ◽  
Effective Technique ◽  
Common Procedure ◽  
Shunt System ◽  
Shunt Tube ◽  
Csf Diversion ◽  
Median Operation Time

Abstract Introduction Ventriculoperitoneal shunt (VPS) is the most common procedure used for cerebrospinal fluid (CSF) diversion in hydrocephalus. Over the years, many technical, procedural, and instrument-related advancements have taken place which have reduced the associated complication rates. Shunt block is a very common complication irrespective of the shunt system used. The abdominal end of the shunt tube gets blocked usually due to plugging of omentum onto the shunt catheter. We describe a technique of catheter fixation and placement under vision coupled with omentopexy done laparoscopically to prevent this complication. Materials and Methods This technique was used in 23 patients (11 female, 12 male; range 16–73 years) afflicted with hydrocephalus from June 2016 and December 2019 after obtaining an informed consent, and the outcomes were noted in terms of shunt patency, complications, if any, and the need for revision. Results The median operation time was 90 minutes (range 35–160 minutes). All shunt catheters were still functional after a mean follow-up of 16.5 months (range 1–34 months) and none required revision. Conclusion Laparoscopic placement of shunt tube along with omental folding is a safe and effective technique for salvaging the abdominal end of VPS and may be helpful in reducing shunt blockage.

Analysis of Voiding Impairment after Prostate Biopsy and the Effect of Doxazosin Treatment: Outcomes from a Regional Cancer Center

2021 ◽  
pp. 1-6
Author(s):  
Yi Zheng ◽  
Fuding Bai ◽  
Nan Zhang ◽  
Huifeng Wu
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Cancer Center ◽  
Control Group ◽  
Urinary Flow ◽  
Voiding Difficulty ◽  
Male Patients ◽  
Baseline Values

<b><i>Introduction:</i></b> The aim of this study was to investigate the association of transrectal ultrasound (TRUS)-guided prostate biopsy with voiding impairment and the efficacy of doxazosin treatment. <b><i>Methods:</i></b> A prospective observational study including 200 male patients undergoing TRUS-guided prostate biopsy was performed between May 2020 and December 2020. One hundred patients underwent biopsy with doxazosin (doxazosin group). The remaining 100 patients underwent biopsy without doxazosin (control group). All patients were questioned regarding post-biopsy voiding difficulty and acute urinary retention. The International Prostate Symptom Score (IPSS), maximal urinary flow rate (Q<sub>max</sub>), and residual urine volume were recorded before biopsy and at 7 and 30 days after biopsy. <b><i>Results:</i></b> There were no significant differences in baseline parameters between the two groups. The rate of post-biopsy voiding difficulty in the doxazosin group was significantly lower than that in the control group. Compared with baseline values, doxazosin treatment significantly improved IPSS, quality of life scores, and Q<sub>max</sub> after biopsy (<i>p</i> &#x3c; 0.05). The baseline values of IPSS and prostate size may be risk factors for post-biopsy voiding difficulty. <b><i>Conclusion:</i></b> TRUS-guided prostate biopsy causes transient voiding impairments, which may be improved by doxazosin treatment.

PD33-01 QUALITY OF LIFE WITH PHARMACOLOGICAL TREATMENT IN PATIENTS WITH BENIGN PROSTATIC ENLARGEMENT

2020 ◽  
Vol 203 ◽  
pp. e704
Author(s):  
Nikita Bhatt* ◽  
Niall F. Davis ◽  
Wim P. Witjes ◽  
Anders Bjartell ◽  
Christien Caris ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pharmacological Treatment ◽  
Benign Prostatic Enlargement ◽  
Prostatic Enlargement
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