Evaluation of the Transurethral Ethanol Ablation of the Prostate (TEAP) for Symptomatic Benign Prostatic Hyperplasia (BPH): A European Multi-Center Evaluation

Grise, P.; Plante, Mark; Palmer, John H.; Martínez-Sagarra, J.M.; Hernández, Carlos; Schettini, M.; González-Martín, M.; Castiñeiras, J; Ballanger, P.; Teillac, P.; Rolo, F.; Baena, V.; Erdmann, J.; Mirone, Vincenzo

doi:10.1016/j.eururo.2004.06.001

Cited by 47 publications

(23 citation statements)

References 7 publications

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“…The median (interquartile range, IQR) IPSS was 19 (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) and QoL score was 3 (3)(4). All the implantations were successful, with no intraoperative complications recorded.…”

Section: Resultsmentioning

confidence: 93%

“…For functional results, significant improvements in the postoperative IPSS and Q max compared with baseline were recorded. Notably, this improvement was recorded early, within 3 weeks of the procedure, presenting an important positive aspect of this procedure, as the vast majority of other minimally invasive techniques can require several weeks before improvement [5,19]. Moreover, the IPSS remained stable during the entire follow-up period.…”

Section: Discussionmentioning

confidence: 97%

“…In addition, the technique has not been standardised and finally, severe adverse events have been reported [19]. For these reasons, TEAP is still considered experimental and should be used only in trials [5,20].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, some Authors have reported that LUTS have a lower impact on QoL than sexual dysfunction or incontinence [1,[13][14][15]. To reduce the invasiveness of TURP, many minimally invasive surgical options have been proposed during recent decades (Table 4) [16][17][18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

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Temporary implantable nitinol device (TIND): a novel, minimally invasive treatment for relief of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH): feasibility, safety and functional results at 1 year of follow‐up

et al. 2015

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ObjectivesTo report the first clinical experience with a temporary implantable nitinol device (TIND; Medi-Tate â ) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Patients and MethodsIn all, 32 patients with LUTS were enrolled in this prospective study, which was approved by our Institutional Ethics Committee. Inclusion criteria were: age >50 years, International Prostate Symptom Score (IPSS) of ≥10, maximum urinary flow rate (Q max ) of ≤12 mL/s, and prostate volume of <60 mL. The TIND was implanted within the bladder neck and the prostatic urethra under light sedation, using a rigid cystoscope. The device was removed 5 days later in an outpatient setting. Demographics, perioperative results, complications (according to the Clavien system), functional results and quality of life (QoL) were evaluated. Follow-up assessments were made at 3 and 6 weeks, and 3, 6 and 12 months postoperatively. The Student's t-test, analysis of variance (ANOVA), Kruskall-Wallis test, and simple and multiple linear regression models were used in the statistical analyses. ResultsThe mean patient age was 69.4 years, the mean (standard deviation, SD) prostate volume was 29.5 (7.4) mL and the Q max was 7.6 (2.2) mL/s. The median (interquartile range, IQR) IPSS was 19 (14-23) and QoL score was 3 (3-4). All the implantations were successful, with no intraoperative complications recorded. The mean operative time (SD) was 5.8 (2.5) min and the median (IQR) postoperative stay was 1 (1-2) day. All but one of the devices (96%) was removed 5 days at after implantation in an outpatient setting. Four complications (12.5%) were recorded, including urinary retention (one, 3.1%), transient incontinence due to device displacement (one, 3.1%), prostatic abscess (one, 3.1%), and urinary tract infection (one, 3.1%). Multiple regression analysis failed to identify any independent prognostic factor for complications. There were statistically significant differences in the IPSS, QoL score and Q max when comparing pre-and postoperative results at every time point. After 12 months, the median (IQR) IPSS and QoL score were 9 (7-13) and 1 (1-2), respectively, and the mean (SD) Q max was 12 (4.7) mL/s. The mean variations with respect to baseline conditions at the same time points were À45% for the IPSS and +67% for Q max . At 12 months after surgery (last followup visit), no patients required medical therapy or surgical procedures for BPH. ConclusionTIND implantation is a feasible and safe minimally invasive option for the treatment of BPH-related LUTS. The functional results are encouraging and the treatment significantly improved patient QoL. Further studies are required to assess durability of TIND results and to optimise the indications of such a procedure.

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Section: Resultsmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Temporary implantable nitinol device (TIND): a novel, minimally invasive treatment for relief of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH): feasibility, safety and functional results at 1 year of follow‐up

et al. 2015

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“…This allows in-situ delivery of pure ethanol to produce chemical ablation and tissue necrosis in the prostate. Ethanol has been shown to ablate all cellular elements within the human prostate including nerves 13 . Immunohistochemical review shows complete destruction of nerve cells and nerve endings.…”

Section: Transurethral Ethanol Ablation Of Prostatementioning

confidence: 99%

The Minimally Invasive Treatments for Benign Prostrate Hyperplasia

Lim

Tay

2014

Proceedings of Singapore Healthcare

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The prevalence of benign prostatic hyperplasia (BPH) increases with age, affecting more than 50% of men above the age of 50 to varying degrees. As it enlarges, it compresses onto the urethra causing bladder outlet obstruction. This can cause a spectrum of problems ranging from irritative and obstructive lower urinary tract symptoms (LUTS) to retention of urine with obstructive uropathy. Transurethral resection of prostate (TURP) is the standard for surgical intervention, however with the advent of an ageing population, there is an increasing number of patients who have ischaemic heart disease who require long-term anticoagulation and have multiple co-morbidities that put them at an increased risk of general anaesthesia. This review aims to critically appraise the effectiveness and evidence for use of these minimally invasive techniques.Both PubMed and Ovid were used to search for randomised control trials (RCT) comparing the various minimally invasive techniques against TURP. In cases where there were no RCTs, the results of the respective trial were compiled. This was later compiled in a summary table.An effective minimally invasive treatment modality will play a complimentary role to TURP which remains the standard of surgical treatment for BPH. Technologies progressing towards rapid re-creation of prostatic channel, minimal blood loss and non-urethral instrumentation will bridge the divide between pharmacotherapy and surgery.

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