COMPARACIÓN DE LOS RESULTADOS CLÍNICOS EN PACIENTES CON HIPERPLASIA PROSTÁTICA BENIGNA CON TRATAMIENTO INICIAL FARMACOLÓGICO, NO FARMACOLÓGICO Y QUIRÚRGICO, ATENDIDOS EN EL HOSPITAL PABLO ARTURO SUÁREZ DE ENERO 2014 A DICIEMBRE 2016.

2020 ◽  
Vol 31 (1) ◽  
Author(s):  
Esteban Noroña Vásconez ◽  
Patricia Páez Vargas
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Pharmacological Treatment ◽  
Clinical Signs ◽  
Clinical Results ◽  
Scientific Data ◽  
Prostatic Hyperplasia ◽  
Urinary Symptoms ◽  
Post Intervention ◽  
Significant Difference

Background: Currently there are few scientific data comparing the three therapeutic modalities of Benign Prostatic Hyperplasia to determine the best clinical outcome, considering that it is a pathology whose incidence increases as population life expectancy arise. Objective: To compare the clinical results between the initial pharmacological, non-pharmacological and surgical treatment, based on clinical signs of prostatism in patients with benign prostatic hyperplasia during the period between January 2014 and December 2016. Study Design: Retrospective Cohort Study. Methods: 399 patients were divided according to the modality of treatment received: non-pharmacological, pharmacological and surgical. The decrease of the symptoms was compared with the first post-treatment consultation by using a matrix of evaluation of urinary symptoms elaborated by the authors, based on SPSS International Score; this tool stratified the patients by the severity of the symptomatology. SPSS ® software was used. Results: Within the non-pharmacological treatment, there was a mean difference of 1.67 (95% CI 0.49 - 2.85, p <0.05); for the pharmacological it was 0.21 (95% CI 0.92 - 1.34, p = 0.713) and for the surgical was 8.23 (95% CI 7.19 - 9.27, p <0.05). Significant differences were found between the three groups during the pretreatment phase, after stratifying them according to the degree of severity. Post-intervention, the clinical results of each treatment were compared, finding that in patients with mild symptoms there were no significant differences (p = 0.087), not so for patients with moderate and severe symptoms where a statistically significant difference was found. Conclusion: In patients with urinary symptoms classified as moderate and severe within this sample, surgical treatment decreased urinary symptomatology in greater proportion compared to pharmacological and non-pharmacological treatment.

Evaluation of mid-term results of bipolar transurethral resection in the treatment of benign prostatic hyperplasia

2018 ◽  
pp. 1-9
Author(s):  
А.С. Векильян
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Blood Loss ◽  
Endoscopic Surgery ◽  
Transurethral Resection ◽  
Operating Time ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Surgical Methods

Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений. Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов. Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию. The clinical results of surgical treatment of benign prostatic hyperplasia (BPH) up to 100 cm3 by bipolar transurethral resection of the prostate (BTUR - 74 patients) in comparison with open transvesical prostatectomy (OPE - 96 patients), previously used for such clinical cases in the urological clinic "Railway hospital" in Volgograd are presented. With statistically equal operating time of both surgical methods, there was a significant decrease in intraoperative blood loss, the terms of postoperative catheterization and hospital stay, the minimum frequency of hemorrhagic and infectious-inflammatory complications. Observation of the urological status of patients during the first postoperative year showed the same clinical efficacy of the compared surgical methods. A significant reduction in the volume of blood loss during the operation, can be considered a great achievement, since the improvement of visibility in the area of surgical intervention allows to optimize the hemostasis, to prevent massive bleeding during and after surgery, to reduce the duration of postoperative bladder catheterization, which, in turn, reduces the incidence of infectious-inflammatory complications. Faster recovery of patients after endoscopic surgery of medical,social and economic importance, as the minimum number of postoperative complications and reduction of hospitalization can significantly reduce the cost of treatment and quickly normalize the quality of life of patients. The results demonstrate the prospects of the introduction of bipolar methods of endoscopic surgery for the treatment of BPH in the surgical practice of urological hospitals in order to improve the safety of surgical treatment and save costs for hospitalization.

The advantages of bipolar transurethral enucleation for the treatment of benign prostatic hyperplasia of large size

2018 ◽  
pp. 21-30
Author(s):  
А.В. Кузнецов ◽  
И.В. Ларичев ◽  
А.Ю. Попова
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Medium Term ◽  
Total Period ◽  
Large Size ◽  
The City

Представлена оценка среднесрочных клинических результатов внедрения биполярной техники выполнения трансуретральной энуклеации (ТУЭБ) доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом свыше 80 см3. Исследование проведено на базе урологического отделения «Дорожной клинической больницы на станции Воронеж-1 ОАО «РЖД» города Воронежа, где применение метода ТУЭБ для хирургического лечения ДГПЖ началось с 2016г. В исследование включено 67 пациентов (основная группа), оперированных методом ТУЭБ, и 79 – методом открытой чреспузырной простатэктомии (ОПЭ, контрольная группа). Применение ТУЭБ позволило в 3 раза сократить срок послеоперационной катетеризации и в 2 раза - объем кровопотери во время операции и общий срок госпитализации. При этом количество операционных осложнений было достоверно меньшим в сравнении с ОЧПЭ, а показатели эффективности оперативного лечения статистически равные. Полученные результаты позволили рекомендовать метод ТУЭБ к широкому применению в урологических клиниках в качестве стандарта хирургического лечения ДГПЖ крупных размеров. Эндоскопический аналог открытой операции следует активно внедрять в хирургическую практику лечения ДГПЖ, что позволит снизить инвазивность оперативного лечения за счет уменьшения риска развития массивных кровотечений и многих других осложнений, а также повысить эффективность использования профильного коечного фонда и экономить средства стационара за счет сокращения продолжительности госпитализации. The evaluation of the medium-term clinical results of the introduction of bipolar technique of transurethral enucleation (TUEB) of benign prostatic hyperplasia (BPH) with a volume of more than 80 cm3 is presented. A study conducted at the urology Department of the clinical hospital at the station Voronezh-1 JSC "RZD" of the city of Voronezh, where the application of the method of TWEB for surgical treatment of BPH began with 2016. The study included 67 patients (main group) were operated by TUEB and 79 by the method of open transvesical prostatectomy (OTP, control group). The use of TUEB made it possible to reduce the period of postoperative catheterization by 3 times and the volume of blood loss during the operation and the total period of hospitalization by 2 times. At the same time, the number of surgical complications was significantly lower in comparison with OTPE, and the indicators of the effectiveness of surgical treatment were statistically equal. The obtained results made it possible to recommend the TUEB method for wide application in urological clinics as a standard of surgical treatment of large-size BPH. The endoscopic analogue of open surgery should be actively introduced into surgical practice of treatment of BPH, which will reduce the invasiveness of surgical treatment by reducing the risk of massive bleeding and many other complications.

scholarly journals 1974 POPULATION BASED TRENDS IN THE SURGICAL TREATMENT OF BENIGN PROSTATIC HYPERPLASIA

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Florian R. Schroeck ◽  
John M. Hollingsworth ◽  
Samuel R. Kaufman ◽  
Rodney L. Dunn ◽  
Brent K. Hollenbeck ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Population Based ◽  
Prostatic Hyperplasia

scholarly journals Clinical significance of prostatic-urethral angulation on the treatment outcome of patients with symptomatic benign prostatic hyperplasia treated with tamsulosin hydrochloride

2015 ◽  
Vol 87 (3) ◽  
pp. 238
Author(s):  
Hassan El-Tatawy ◽  
Tarek Gameel ◽  
Mohammed Abo El-enen ◽  
Ayman Hagras ◽  
Ayman Mousa ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Clinical Significance ◽  
Treatment Efficacy ◽  
Specific Antigen ◽  
Prostatic Hyperplasia ◽  
Final Conclusion ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
The Impact

Objectives: To evaluate the impact of the prostatic-urethral angulation (PUA) on the treatment efficacy of selective alpha-1A receptor blocker in male patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). Materials and methods: A total of 80 patients with LUTS/BPH and with mean age 53.3 ± 6.3 (range 47-70) were included in our prospective comparative study. The patients were classified into 2 groups as a consecutive cases 40 in each one depending on the PUA either ≤ 35° (group A) or &gt; 35° (group B). PUA and different prostatic parameters were measured using transrectal ultrasound. Prostate-specific antigen (PSA), the International Prostate Symptom Score and quality of life score (IPSS/QoL score), maximum flow rate (Q<sub>max</sub>), and postvoid residual (PVR) volume were compared between the groups. The clinical significance of PUA was evaluated after 8 weeks of medical treatment with tamsulosin hydrochloride 0.4 mg daily. Results: Baseline evaluation (pre-treatment) for both groups were comparable to each other with no clinically significant difference regarding age, PSA, IPSS/QoL score, Qmax and PVR volume (P-value &gt; 0.05). Comparison of parameters after 8 weeks showed that tamsulosin hydrochloride improved the total IPSS and all subscores (P &lt; 0.001), QoL (P = 0.001), Q<sub>max</sub> (P = 0.002), and PVR (P = 0.04) in group A (Table 1). Conclusion: Tamsulosin hydrochloride appears to be less effective in improving IPSS/Qol score, Qmax and PVR in patients with lager PUA. The PUA might be a predictor for the treatment efficacy of α-blockers and more studies are warranted in the future before the final conclusion.

scholarly journals Impact of cyclin D1 and DJ-1 on diagnosis, clinico-pathological features and outcome in prostate cancer and benign prostatic hyperplasia

2020 ◽  
Vol 10 (2) ◽  
pp. 15-25
Author(s):  
Amrallah A. Mohammed ◽  
Hanna M. Ibrahim ◽  
Hanna A. Atwa ◽  
Ayman Elshentenawy ◽  
Amira Elwan
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Cyclin D1 ◽  
Tumor Stage ◽  
Prostatic Hyperplasia ◽  
Common Finding ◽  
Tissue Sampling ◽  
Benign Lesions ◽  
Significant Difference

AbstractBackgroundDisturbance in cell cycle regulatory genes is a common finding among many types of cancers. The aim of this study is to evaluate the role of cyclin D1 and DJ-1 in benign prostatic hyperplasia (BPH) and prostate cancer (PC).MethodThe current study enclosed 40 patients diagnosed with PC and 40 cases of BPH. The expression level of cyclin D1 and DJ-1 were evaluated by immunohistochemistry (IHC). Cyclin D1 scored depending on the percentage of stained nuclear tumor cells. While scoring of DJ-1 was based on intensity. The results were correlated with clinicopathological features and outcome.ResultsIn the PC group, cyclin D1 was detected in 95% and overexpressed in 42.5%, DJ-1 was positively stained in 85% and overexpressed in 47.5%. Meanwhile, in the BPH group, cyclin D1 was not detected and DJ-1 stained in only 2.5%. There was a statistically significant difference in Gleason score (GS), tumor stage, size, and treatment failure (p =< 0.001). In the terms of PC diagnosis prediction, although cyclin D1 was more specific (100%), DJ-1 is more sensitive than cyclin D1 (80%, 70%, respectively) (p = 0.000).ConclusionsCyclin D1 and DJ-1 may emerge as a promising way for diagnosis of PC in certain circumstances, as the presence of insufficient tissue sampling, small foci of carcinoma or benign lesions mimic PC. This is in addition to the known role of cyclin D1 and DJ-1 in PC prognosis.

scholarly journals Gambaran disfungsi ereksi pada pasien dengan benign prostatic hyperplasia (BPH) di Klinik Advent Tikala Manado

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Michael B. Tawale ◽  
Lydia Tendean ◽  
Lusiana Setiawati
Keyword(s):  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Clinical Signs ◽  
Sampling Technique ◽  
Descriptive Study ◽  
Prostatic Hyperplasia ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Post Surgery ◽  
Cross Sectional Design

Abstract: Erectile dysfunction (ED) is an inability to achieve an erection sufficient for intercourse with his partner which causes dissatisfaction for both of them. The etiology of ED is classified as psychogenic, organic, drug abuse, and also by post-surgery. Benign prostatic hyperplasia (BPH) is a disease caused by aging. BPH clinical signs usually appear in more than 50% of men aged ≥50 years. This was a survey-descriptive study with a cross sectional design. Samples were obtained by using purposive sampling technique. Respondents were patients at Efrata Adventist Clinic in Manado. The instrument in this study was modified IIEF-5 questionnaire. The results showed that based on the duration of BPH, respondents who suffered from BPH >3 years were as many as 75.0% and <1 year were 7.1%. Based on the ages, respondents of 61-70 years were 46.5 and of 41-50 years were 7.1%. The erectile dysfunction of respondents was classified as moderate 42.9%, mild-moderate 32.1%, severe 17.9%, and mild 7.1%. Conclusion: Most of the erectile dysfunction with BPH >3 years was classified as moderate.Keywords: erectile dysfunction, BPH Abstrak: Disfungsi ereksi (DE) yaitu suatu ketidakmampuan untuk mencapai ereksi yang cukup untuk melakukan senggama bersama pasangannya sehingga menimbulkan ketidakpuasan diantara keduanya. Etiologi DE diklasifikasikan menjadi psikogenik, organik, penyalahgunaan obat-obatan dan juga oleh pasca tindakan bedah. Benign prostatic hyperplasia (BPH) adalah penyakit yang disebabkan oleh penuaan. Tanda klinis BPH biasanya muncul pada lebih dari 50% laki-laki yang berusia 50 tahun ke atas. Jenis penelitian ialah survei deskriptif-observasional dengan desain potong lintang. Pengambilan sampel dilakukan dengan teknik purposive sampling pada seluruh pasien di Klinik Advent Efrata Tikala Manado. Variabel penelitian ialah pasien BPH di Klinik Advent Tikala Manado. Instrumen penelitian menggunakan kuesioner IIEF-5 yang telah dimodifikasi. Hasil penelitian mendapatkan berdasarkan lama menderita BPH, responden yang menderita BPH >3 tahun sebesar 75,0%; 1-2 tahun sebesar 17,9%; dan <1 tahun sebesar 7,1%. Berdasarkan usia responden berusia 61-70 tahun sebesar 46,5% dan 41-50 tahun sebesar 7,1%. DE pada BPH paling banyak termasuk klasifikasi sedang (42,9%), diikuti ringan-sedang (32,1%), berat (17,9%) dan ringan (7,1%). Simpulan: Sebagian besar pasien DE dengan BPH >3 tahun termasuk dalam klasifikasi sedang. Kata kunci: disfungsi ereksi, BPH

scholarly journals Nonsurgical Management of Acute Uncomplicated Appendicitis in Children: the Analysis of Treatment Outcome in Relationship with Antimicrobial Regimens and Adverse Prognostic Factors

2016 ◽  
Vol 16 (2) ◽  
pp. 12-16
Author(s):  
Elina Silina ◽  
Asnate Jurgele ◽  
Arturs Viksne ◽  
Zane Abola ◽  
Arnis Engelis ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Clinical Signs ◽  
Drug Combinations ◽  
Antimicrobial Drug ◽  
Nonsurgical Management ◽  
Unsuccessful Treatment ◽  
Significant Difference ◽  
Non Surgical Treatment

SummaryIntroduction.For acute appendicitis - the most frequent condition to perform an urgent abdominal operation in pediatric surgery - surgical appendectomy still remains the gold standard regarding treatment, nevertheless nonsurgical management has become more and more recognized as a treatment method for uncomplicated acute appendicitis (UAA). However there are still many unanswered questions regarding possible factors that could predict the treatment outcome as well as appropriate antimicrobial drug regimens.Aim of the Study.The aim was to investigate if there is a possible association between factors such as C-reactive protein (CRP) level, presence of appendicolith, the diameter of the appendix and treatment outcome; as well as to identify most successfully used antimicrobial drug combinations.Material and methods.A retrospective analysis of hospital cases, admitted to a single reference center during the time period from 2013 to 2015. Patients with clinical signs of acute appendicitis, elevated inflammatory markers and radiological findings suggestive for acute appendicitis were included in the study. Nonsurgical treated patients were divided in two groups based on the treatment outcome - successful or unsuccessful. Analysis of the three factors (CRP level, presence of appendicolith and the diameter of the appendix) and most commonly used antimicrobial drug regimen association with treatment outcome was performed.Results.Overall 384 children medical records with acute appendicitis were registered and non-surgical treatment was initiated in 147/384 (38 %) cases. Successful treatment outcome of nonsurgical management was identified in 114/147 (78 %) cases. Analyzing prognostic adverse factors results presents no statistically significant difference in association with CRP level >25 mg/l (p=0,479), presence of appendicolith (p=0,183) and the diameter of appendix >1 cm (p=0,183) with successful or unsuccessful treatment outcome. The two most commonly used antimicrobial drug combinations were - Ampicillin/Metronidazole for 49 patients and Ampicillin/Gentamicin for 44 patients. No relevance with treatment outcome and used antimicrobial agents was detected (p=0,597).The overall recurrence rate after initial presentation is 15 % (17/114). In 3 cases (3 %) recurrent appendicitis developed one month after discharge and in 14 cases (12 %) up to one year after discharge.Conclusions.Prognostic adverse factors - CRP, presence of appendicolith and diameter of appendix - were not statistically reliable in association with initial non-surgical treatment outcome. The success rate of conservative treatment with narrow spectrum antibiotics was 78 %, which is just as high as in cases treated conservatively with broad-spectrum antibiotics from previous studies. Therefore the question of which factors and antimicrobial drug combinations influence the course of treatment still remains unanswered and further studies are required.

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