scholarly journals First Multi-Center All-Comers Study for the Aquablation Procedure

2020 ◽  
Vol 9 (2) ◽  
pp. 603 ◽  
Author(s):  
Thorsten Bach ◽  
Peter Gilling ◽  
Albert El Hajj ◽  
Paul Anderson ◽  
Neil Barber
Keyword(s):  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Procedure Time ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Real World Evidence ◽  
The Mean ◽  
Maximum Urinary Flow

Waterjet-based prostate resection (Aquablation procedure) is an increasingly recognized treatment for symptomatic benign prostatic hyperplasia (BPH). We confirmed the safety and effectiveness of the Aquablation procedure in the commercial setting in 178 men at five sites. The mean prostate volume was 59 cc. The procedure time averaged 24 min and total anesthesia duration was 50 min. The International Prostate Symptom Score (IPSS) decreased from 21.6 at the baseline to 6.5 at the 12-month follow-up, a 15.3-point improvement (p < 0.0001). The maximum urinary flow rate increased from 10 cc/s at the baseline to 20.8 cc/s at month 12 (increase of 11.8 cc, p < 0.0001). Ejaculatory function was relatively preserved. Prostate volume assessed with transrectal ultrasound decreased 36% by month three. Five patients (2.7%) underwent a transfusion in the first week after the procedure. Real-world evidence shows that Aquablation is safe and effective for the treatment of BPH.

What Is the Interaction between Urine C-Reactive Protein, Prostatic Inflammation, and Doxazosin Treatment in Patients with Benign Prostatic Hyperplasia? A Pilot Study

2021 ◽  
pp. 1-5
Author(s):  
Ahmet Asfuroglu ◽  
Melih Balci ◽  
Yilmaz Aslan ◽  
Cagdas Senel ◽  
Ozer Guzel ◽  
...  
Keyword(s):  
International Prostate Symptom Score ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
C Reactive Protein ◽  
Alpha Blocker ◽  
Reactive Protein ◽  
The Mean ◽  
Maximum Urinary Flow ◽  
First Admission

<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.

scholarly journals Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253083
Author(s):  
Carolina Bebi ◽  
Matteo Turetti ◽  
Elena Lievore ◽  
Francesco Ripa ◽  
Lorenzo Rocchini ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Postoperative Complications ◽  
Prostate Volume ◽  
Symptom Relief ◽  
Urinary Flow ◽  
Complication Rates ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Sexual Symptoms ◽  
First Choice

Background Bipolar Transurethral Enucleation of the Prostate (B-TUEP) is recommended as a first-choice treatment for benign prostatic obstruction in prostates >80 ml. Differently, B-TUEP is only considered as an alternative option after TURP for smaller prostates (30–80 ml). The aim of our study is to assess the relation between prostate size and surgical outcomes after B-TUEP. Methods We performed a retrospective analysis of data collected from 172 patients submitted to B-TUEP. Patients were segregated according to tertiles of prostate volume (PV) (≤60 ml, 61–110 ml, >110 ml). For each group we evaluated enucleation efficacy (enucleated weight/enucleation time), complication rates, urinary and sexual function parameters. Functional and sexual parameters were compared between groups at baseline, 1 and 3 months follow up. Descriptive statistics and linear and logistic regression models tested the association between PV and postoperative complications/outcomes. Results Operative time and weight of enucleated adenomas increased along with prostate volumes (all p≤0.01). Enucleation efficacy was higher in men with PV >110 ml compared to other groups (p≤0.001). Length of hospital stay, catheterization time and rates of postoperative complications, such as transfusion and clot evacuation rates and bladder neck/urethral strictures, were comparable between groups. Urinary symptoms improved at 1-and 3-months in each group as compared to baseline evaluation (all p<0.01) but they did not differ according to PV. In each group maximum urinary flow and post-void residual volume significantly improved at 3 months compared to baseline (all p≤0.01), without differences according to PV. Sexual symptoms were similar between groups at each follow up assessment. At multivariable linear and logistic regression analysis, prostate volume was not associated with postoperative functional outcomes and complications. Conversely, patient’s comorbid status and antiplatelet/anticoagulation use were independently associated with postoperative complications. Conclusion According to our findings, B-TUEP should be considered a “size independent procedure” as it can provide symptom relief in men with prostates of all sizes with the same efficacy and safety profile.

scholarly journals Transurethral Intraprostatic Botulinum Toxin-a Injection in Patients with Benign Prostatic Hyperplasia: A Case Series and Literature Review

2022 ◽  
Vol 16 (1) ◽  
pp. 9-16
Author(s):  
Mahmoud Tavakkoli ◽  
◽  
Hamidreza Ghorbani ◽  
Amin Nobahar ◽  
Maryam Emadzadeh ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Botulinum Toxin A ◽  
Specific Antigen ◽  
Case Series ◽  
Optimal Number ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Pubmed Database ◽  
The Mean

Background: We aimed to assess the efficacy of Intraprostatic Onabotulinumtoxin-A (BTA) on the International Prostate Symptom Score (IPSS) and other objective measures of patients with Benign Prostatic Hyperplasia (BPH). Methods: Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion. Results: The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up. Conclusion: Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.

scholarly journals Body Mass Index and Risk of Prostate Volume, International Prostate Symptom Score, Maximum Urinary Flow Rate, and Post-Void Residual in Benign Prostatic Hyperplasia Patients

2019 ◽  
Vol 13 (4) ◽  
pp. 155798831987038 ◽  
Author(s):  
Bing-Hui Li ◽  
Tong Deng ◽  
Qiao Huang ◽  
Hao Zi ◽  
Hong Weng ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Benign Prostatic Hyperplasia ◽  
Body Mass ◽  
Flow Rate ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Increased Risk ◽  
Maximum Urinary Flow

The objective of this study was to evaluate association between body mass index (BMI) and prostate volume (PV), international prostate symptom scores (IPSS), maximum urinary flow rate ( Qmax), and post-void residual (PVR) of Chinese benign prostatic hyperplasia (BPH) patients. All newly diagnosed BPH patients between September 2016 and August 2018 were selected and 788 patients were included. According to BMI, the patients were categorized into four groups, while according to PV, IPSS, Qmax, and PVR, they were categorized into two groups based on clinical significant cutoffs. Univariable and multivariable logistic regressions and a restricted cubic spline (RCS) were applied to explore the relationship of BMI with categorical PV, IPSS, Qmax, and PVR. Compared with normal BMI, obesity presented significant association with increased risk of larger PV (>80 ml) in both unadjusted and adjusted models (unadjusted odds ratio [OR] = 1.772, 95% CI [1.201, 2.614], p = .004; adjusted OR = 1.912, 95% CI [1.212, 3.017], p = .005); however, underweight or overweight did not present a significant connection with such risk. No significant effect was identified for BMI on IPSS, Qmax, or PVR in either unadjusted or adjusted model. Nonlinear test including BMI using RCS and adjusting for confounders showed no significance ( p > .05); however, a significant linear relationship was ascertained between BMI and the risk of larger PV ( p < .001). In conclusion, there was a significant linear association between BMI and the risk of larger PV in BPH patients. Hence, this suggests urologists should consider both BMI and PV when providing surgical treatment for BPH patients.

Ultrasound-guided transperineal laser ablation for percutaneous treatment of benign prostatic hyperplasia: a new minimally invasive interventional therapy

2021 ◽  
pp. 028418512110032
Author(s):  
Huai-Jie Cai ◽  
Jian-Hua Fang ◽  
Fan-Lei Kong ◽  
Chen-Ke Xu ◽  
Chuang-Hua Chen ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Laser Ablation ◽  
Minimally Invasive ◽  
Prostate Volume ◽  
Interventional Therapy ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Ultrasound Guided ◽  
Prostate Hyperplasia

Background Although there are different treatments for benign prostate hyperplasia, their efficacy and safety differ. We are currently exploring a new minimally invasive interventional therapy for benign prostatic hyperplasia (BPH). Purpose To determine the feasibility, effectiveness, and safety of ultrasound-guided transperineal laser ablation (US-TPLA) for the treatment of BPH. Material and Methods Twenty patients with BPH (mean age = 73.9 ± 9.2 years) who underwent US-TPLA from June 2018 to January 2020 with a subsequent six-month follow-up were retrospectively reviewed. After local anesthesia, a 21-G trocar was inserted into the prostate tissue under ultrasound monitoring, followed by 1064 nm diode laser irradiation. Changes in international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume, and complications were evaluated six months after surgery. Results All patients underwent the operation successfully without serious complications. After six months, the average IPSS improved from 22.7 ± 5.3 to 9.1 ± 3.2 ( P < 0.001), the QoL improved from 4.9 ± 1.7 to 2.3 ± 1.3 ( P < 0.001), the Qmax improved from 8.5 ± 3.0 to 15.2 ± 4.8 mL/s ( P < 0.001), the PVR increased from 78.7 ± 58.8 to 30.3 ± 34.2 ( P < 0.05), and the mean prostate volume ranged from 70.8 ± 23.8 to 54.7 ± 20.9 mL ( P < 0.05). Conclusion US-TPLA is safe and feasible for the treatment of BPH. An evaluation at the six-month follow-up is effective.

scholarly journals Prostatic artery embolization for giant prostatic hyperplasia: a single-center experience

2021 ◽  
Vol 54 (4) ◽  
pp. 219-224
Author(s):  
André Moreira de Assis ◽  
Airton Mota Moreira ◽  
Francisco Cesar Carnevale ◽  
José Ramón Lanz-Luces
Keyword(s):  
Prostate Volume ◽  
Specific Antigen ◽  
Specific Treatment ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Single Center Experience ◽  
Prostatic Artery

Abstract Objective: To describe the safety and efficacy of prostatic artery embolization (PAE) in patients with a markedly enlarged prostate. Materials and Methods: This was a retrospective study including 18 consecutive patients (mean age, 74 years) with benign prostatic hyperplasia, all with a prostate volume ≥ 200 cm3, who were enrolled to receive PAE for the treatment of moderate-to-severe lower urinary tract symptoms. Results: The PAE procedure was technically successful in 17 patients (94.4%). During follow-up, clinical failure (defined as an International Prostate Symptom Score [IPSS] ≥ 8) was observed in two (11.1%) of those 18 patients. At 3 months of follow-up, there was significant improvement over baseline in all relevant outcome measures: total IPSS (from 15.7 to 2.9); IPSS quality of life score (from 5.2 to 1.0); prostate specific antigen (from 11.4 to 1.82 ng/mL); peak urinary flow rate (from 7.45 to 18.6 mL/s); prostate volume (from 252.4 to 151.6 cm3); and post-void residual volume (from 143.7 to 28.3 mL)-p < 0.05 for all. Of the 18 patients, one (5.6%) presented detachment of prostate tissue and self-limited hematuria, which did not require specific treatment. Conclusion: In patients with a markedly enlarged prostate, PAE proved to be safe and effective, resulting in significant improvements in clinical, imaging, and urodynamic parameters.

scholarly journals The correlation between obesity and prostate volume in patients with benign prostatic hyperplasia at Charlotte Maxeke Johannesburg Academic Hospital

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Eshely Mampa ◽  
Mohamed Haffejee ◽  
Pascaline Fru
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Health Care Systems ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
High Body Mass Index ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Academic Hospital ◽  
Subsequent Increase ◽  
The Mean

Abstract Background Benign prostatic hyperplasia (BPH) is on the increase placing a substantial burden on health care systems. Recent studies have shown that men with high body mass index (BMI) and central obesity, as denoted by waist circumference (WC) have bigger prostate volumes (PV) with subsequent increase in lower urinary tract symptoms (LUTS) than men with normal BMI. The purpose of this research was to investigate the correlation between Obesity and PV in patients with BPH. Methods The study included 178 men aged between 50 and 75 years with BPH seen at Charlotte Maxeke Johannesburg academic hospital (CMJAH) Urology Outpatient Department between September 2018 and February 2019. Weight and height measurements were obtained to calculate BMI. Furthermore, WC was measured using a measuring tape, while a transrectal ultrasound (TRUS) was used to measure PV. Patient demographics, clinical characteristics such as hypertension, diabetes, smoking and prostate specific antigen (PSA) were also noted. Results Patients in the study had a mean age of 64.87 ± 6.526 years and the mean BMI was 27.31 ± 3.933 kg/m2. The mean PV of each BMI group were 52.92 ± 38.49, 61.00 ± 33.10 and 64.86 ± 37.46 cm3 for normal, overweight and obese groups, respectively, and the average PV score was 59.36 ± 36.507 cm3. The mean PSA score was 4.30 ± 3.126 with a range of 1.3–6.4, while the mean WC was 98.67 cm. There was no correlation between BMI and PV (p value = 0.195) as well as between PV and WC, hypertension, diabetes or smoking. The results revealed that the relationship between PV with PSA level as well as age was significant (p value = 0.001, p value = 0.009, respectively). Conclusion The results showed no correlation between BMI and PV. Diabetes and hypertension as well had no positive correlation with PV. A follow-up study may be indicated to look at the correlation between obesity, LUTS and urinary flow rates to establish whether aggressive management of obesity would have significant impact on the management of BPH.

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.

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