Determining the Utility of Recalled Lower Urinary Tract Symptoms

Helfand, Brian T.; Fought, Angela J.; Manvar, Ankur; McVary, Kevin T.

doi:10.1016/j.urology.2009.12.052

Cited by 10 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A limitation of this registry study includes the absence of thorough baseline assessments in some patients that would assist evaluation of comparative changes in urinary symptom scores and quality of life measures (i.e., I-PSS). In addition, in men whose retention has lasted many months prior to effective thermal therapy treatment, the validity of a recalled I-PSS score is known to be inaccurate muting the impact of a lack of baseline I-PSS in this cohort [25]. While these baseline evaluations are expected in a clinical trial, our observations with limited data may represent the reality in the clinical setting.…”

Section: Discussionmentioning

confidence: 87%

Water vapor thermal therapy to alleviate catheter-dependent urinary retention secondary to benign prostatic hyperplasia

McVary

Holland

Beahrs

2019

Prostate Cancer Prostatic Dis

Self Cite

View full text Add to dashboard Cite

Background Water vapor thermal therapy utilizes convectively delivered thermal energy to target ablation of obstructive prostatic tissue. We report results of this thermal therapy for relief of nonneurogenic complete urinary retention associated with BPH. Patients and methods We conducted a retrospective analysis of 38 catheter-dependent men with complete urinary retention consecutively enrolled in a registry in two centers: median age 75.5 years and multiple comorbidities, median prostate volume 58.5 cc (23-153), median 2 failed trials without catheter (TWOCs), and median catheter dependency 3 months (0.3-35). The Rezūm™ System thermal therapy procedure was performed in an ambulatory surgery center with conscious sedation or an office procedure room with a modified periprostatic block. Water vapor injections were customized to the configuration of the hyperplastic gland, including median lobe and/or enlarged central zone. Results Of the 38 treated patients, one was lost to follow-up and 26 of 37 (70.3%) voided spontaneously (mean of 1.6 ± 0.8 TWOCs) and were catheter free a median of 26 days (range 4-65) after the procedure; 18 of these 26 (69%) patients discontinued BPH medications. No significant differences in age, prostate volume, number of water vapor injections, or presence of the median lobe were associated with predicting a successful treatment outcome. Duration of follow-up for 20 catheter-free patients was a median of 475 days or 15.8 months (140-804 days); six patients were followed a median of 31.5 days (0-60). Adverse events were infrequent, mild, and resolved quickly including dysuria in five patients (13%), gross hematuria in four (10.5%), and UTIs in two (2.6%) with indwelling catheters. Conclusions Water vapor thermal therapy may provide an effective and safe alternative to surgical treatment in this group of catheter-dependent patients in complete urinary retention.

show abstract

Section: Discussionmentioning

confidence: 87%

Water vapor thermal therapy to alleviate catheter-dependent urinary retention secondary to benign prostatic hyperplasia

McVary

Holland

Beahrs

2019

Prostate Cancer Prostatic Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Alternatively, the high rate of alpha-antagonist utilization in this study may have hidden the true incidence of patient reported obstructive voiding symptoms with SBRT. In addition, most late obstructive voiding symptoms were transient and associated bother may have been missed due to the timing of questionnaire administration [51]. …”

Section: Discussionmentioning

confidence: 99%

“…The recall period for the IPSS is one month [51]. The IPSS includes four question related to obstructive symptoms (incomplete emptying, intermittency, weak stream and straining).…”

Section: Methodsmentioning

confidence: 99%

Obstructive voiding symptoms following stereotactic body radiation therapy for prostate cancer

et al. 2014

View full text Add to dashboard Cite

BackgroundObstructive voiding symptoms (OVS) are common following prostate cancer treatment with radiation therapy. The risk of urinary retention (UR) following hypofractionated radiotherapy has yet to be fully elucidated. This study sought to evaluate OVS and UR requiring catheterization following SBRT for prostate cancer.MethodsPatients treated with SBRT for localized prostate cancer from February 2008 to July 2011 at Georgetown University were included in this study. Treatment was delivered using the CyberKnife® with doses of 35 Gy-36.25 Gy in 5 fractions. UR was prospectively scored using the CTCAE v.3. Patient-reported OVS were assessed using the IPSS-obstructive subdomain at baseline and at 1, 3, 6, 9, 12, 18 and 24 months. Associated bother was evaluated via the EPIC-26.Results269 patients at a median age of 69 years received SBRT with a median follow-up of 3 years. The mean prostate volume was 39 cc. Prior to treatment, 50.6% of patients reported moderate to severe lower urinary track symptoms per the IPSS and 6.7% felt that weak urine stream and/or incomplete emptying were a moderate to big problem. The 2-year actuarial incidence rates of acute and late UR ≥ grade 2 were 39.5% and 41.4%. Alpha-antagonist utilization rose at one month (58%) and 18 months (48%) post-treatment. However, Grade 3 UR was low with only 4 men (1.5%) requiring catheterization and/or TURP. A mean baseline IPSS-obstructive score of 3.6 significantly increased to 5.0 at 1 month (p < 0.0001); however, it returned to baseline in 92.6% within a median time of 3 months. Late increases in OVS were common, but transient. Only 7.1% of patients felt that weak urine stream and/or incomplete emptying was a moderate to big problem at two years post-SBRT (p = 0.6854).ConclusionsSBRT treatment caused an acute increase in OVS which peaked within the first month post-treatment, though acute UR requiring catheterization was rare. OVS returned to baseline in > 90% of patients within a median time of three months. Transient Late increases in OVS were common. However, less than 10% of patients felt that OVS were a moderate to big problem at two years post-SBRT.

show abstract

“…A significant or meaningful change in AUASI score was defined as a 3-point change as previously described. 20,21 For some analyses the total AUASI score (questions 1 to 7) was used. To assess the effects of urinary symptoms other than nocturia, subdomains of the AUASI score (questions 1 to 6) were used.…”

Section: Methodsmentioning

confidence: 99%

Associations Between Improvements in Lower Urinary Tract Symptoms and Sleep Disturbance Over Time in the CAMUS Trial

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

Determining the Utility of Recalled Lower Urinary Tract Symptoms

Cited by 10 publications

References 15 publications

Water vapor thermal therapy to alleviate catheter-dependent urinary retention secondary to benign prostatic hyperplasia

Water vapor thermal therapy to alleviate catheter-dependent urinary retention secondary to benign prostatic hyperplasia

Obstructive voiding symptoms following stereotactic body radiation therapy for prostate cancer

Associations Between Improvements in Lower Urinary Tract Symptoms and Sleep Disturbance Over Time in the CAMUS Trial

Contact Info

Product

Resources

About