A Novel Intraurethral Prostatic Bridge Catheter for Prevention of Temporary Prostatic Obstruction Following High Energy Transurethral Microwave Thermotherapy in Patients With Benign Prostatic Hyperplasia

Djavan, Bob; Fakhari, Mitra; Shariat, Shahrokh F.; Ghawidel, Keywan; Marberger, Michael

doi:10.1016/s0022-5347(01)62085-8

Cited by 32 publications

(4 citation statements)

References 36 publications

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“…Previously Dahlstrand and Pettersson [21] reported the use of biodegradable stents after TUMT, and Devonec and Dahlstrand [22], and Djavan et al. [23] reported the use of the ‘Trestle’ stent. This is an interesting development, as it obviates some of the complaints caused by an indwelling catheter and should reduce the incidence of UTI, increasing the patient's comfort immediately after treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of a new 30‐min algorithm for transurethral microwave thermotherapy: initial results

et al. 2000

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Objective To assess the ef®cacy of a new 30-min algorithm for high-energy transurethral microwave thermotherapy (TUMT, Prostasoft 3.5) in the treatment of men with lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia. Patients and methods A total of 108 men (mean age 66 years) with bothersome LUTS were treated with the new TUMT protocol. All patients were evaluated using a standard assessment at baseline, 6, 12, 26 and 52 weeks after TUMT. The evaluation included the assessment of objective and subjective outcome measures, with a urodynamic evaluation using pressure-¯ow analysis, and the occurrence of adverse events. Results The treatment was well tolerated. In general, the International Prostate Symptom Score improved from a mean of 20.0 at baseline to a mean of 9.3 at 6 months after treatment. The maximum urinary¯ow improved from 9.4 mL/s to 14.6 mL/s at 6 months. The mean duration of catheterization was 17.9 days. The urodynamic evaluation showed a change from the obstructed to the equivocal zone on the Abrams± Grif®th nomogram. There were no serious complications. Urgency and frequency were the most frequent side-effects after treatment; these all resolved within 3 months. Conclusion High-energy TUMT using the new high-dose Prostasoft 3.5 protocol appears to be a safe and effective treatment. The faster procedure improves the tolerance of the treatment. The subjective and objective improvements were signi®cant and the treatment-related morbidity low. A longer follow-up is needed to assess the durability of this new treatment protocol.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of a new 30‐min algorithm for transurethral microwave thermotherapy: initial results

et al. 2000

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“… 13 , 14 Meanwhile, both temporary placement of an intraurethral prostatic bridge catheter and neoadjuvant or adjuvant alpha-blocker treatment were shown to be effective in alleviating symptoms and improving quality of life. 17 , 18 The improved energy targeting systems are better tolerated under topical local anesthesia and are associated with fewer sexual complications, such as erectile dysfunction and/or ejaculation disorders. 19 Potent systemic sedoanalgesic medications were necessary when using the oldest systems.…”

Section: Devices For Delivery Of Thermal Treatmentmentioning

confidence: 99%

Minimally invasive devices for treating lower urinary tract symptoms in benign prostate hyperplasia: technology update

Aoun

Marcelis

Roumeguère

2015

RRU

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Benign prostatic hyperplasia (BPH) represents a spectrum of related lower urinary tract symptoms (LUTS). The cost of currently recommended medications and the discontinuation rate due to side effects are significant drawbacks limiting their long-term use in clinical practice. Interventional procedures, considered as the definitive treatment for BPH, carry a significant risk of treatment-related complications in frail patients. These issues have contributed to the emergence of new approaches as alternative options to standard therapies. This paper reviews the recent literature regarding the experimental treatments under investigation and presents the currently available experimental devices and techniques used under local anesthesia for the treatment of LUTS/BPH in the vast majority of cases. Devices for delivery of thermal treatment (microwaves, radiofrequency, high-intensity focused ultrasound, and the Rezum system), mechanical devices (prostatic stent and urethral lift), fractionation of prostatic tissue (histotripsy and aquablation), prostate artery embolization, and intraprostatic drugs are discussed. Evidence for the safety, tolerability, and efficacy of these “minimally invasive procedures” is analyzed.

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“…Studies have shown that these patients have improved symptomatology early on over those not on alphablockade (9), and also have a lower incidence of retention. Another option includes the placement of a temporary prostatic bridge catheter, which is effective and well-tolerated option that provides a better immediate peak flow, IPSS, and quality of life compared to no stent if the patient has adequate detrusor contraction (10,11).…”

Section: Postoperative Detailsmentioning

confidence: 99%

Transurethral microwave thermotherapy for benign prostatic hyperplasia

Rubeinstein

McVary

2003

Int. braz j urol.

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Transurethral resection of the prostate (TURP) remains the gold standard for treatment of benign prostatic hyperplasia (BPH). In general, while this procedure is safe, patients require a spinal, epidural, or general anesthesia and often several days of hospital stay; the potential morbidity and mortality limits the use of TURP in high-risk patients. Pharmacotherapy has been recommended as a first-line therapy for all patients with mild to moderate symptoms. Patients are often times enthusiastic if they are offered a one-time method to treat lower urinary tract symptoms secondary to BPH, provided that the method offers reduced risk and allows an efficacy equal to that of medical therapy. One such method is transurethral microwave thermotherapy (TUMT). TUMT involves the insertion of a specially designed urinary catheter with a microwave antenna, which heats the prostate and destroys hyperplastic prostate tissue. TUMT allows the avoidance of general or regional anesthesia, and results in minimal blood loss and fluid absorption. In this review, the authors discussed the current indications and outcome of TUMT, including the history of the procedure, the mechanism of action, the indications for TUMT, the pre-operative considerations, the patient selection, the results in terms of efficacy, by comparing TUMT vs. Sham, TUMT vs. Alpha-blocker and TUMT vs. TURP. Finally, the complications are presented, as well as other uses and future directions of the procedure. The authors concluded that TUMT is a safe and effective minimally invasive alternative to treatment of symptomatic BPH.

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A Novel Intraurethral Prostatic Bridge Catheter for Prevention of Temporary Prostatic Obstruction Following High Energy Transurethral Microwave Thermotherapy in Patients With Benign Prostatic Hyperplasia

Cited by 32 publications

References 36 publications

Clinical efficacy of a new 30‐min algorithm for transurethral microwave thermotherapy: initial results

Clinical efficacy of a new 30‐min algorithm for transurethral microwave thermotherapy: initial results

Minimally invasive devices for treating lower urinary tract symptoms in benign prostate hyperplasia: technology update

Transurethral microwave thermotherapy for benign prostatic hyperplasia

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