Minimally Invasive and Endoscopic Management of Benign Prostatic Hyperplasia

Fitzpatrick, John M.

doi:10.1016/b978-1-4160-6911-9.00093-1

Cited by 31 publications

(38 citation statements)

References 321 publications

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“…However, complications can be observed in up to 20 % of cases following a successful intervention. These complications include bleeding, TUR syndrome, urinary incontinence, and residual gland, especially for large glands [5][6][7]. Open surgery (prostatic adenoma enucleation) is effective with less residual gland, but is very difficult to coagulate and may result in more complications.…”

Section: Discussionmentioning

confidence: 99%

Benign Prostatic Hyperplasia Treatment by Transurethral Enucleation of the Prostate Using a 2-μm Laser

Zhou

et al. 2015

Indian J Surg

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This study investigates the efficacy of benign prostatic hyperplasia (BPH) treatment by prostate transurethral enucleation using a 2-μm laser. A total of 107 patients with BPH were treated by prostate transurethral enucleation using a RevoLix 2-μm laser surgery system. Bleeding volume, operation time, catheterization time, voiding situation, maximum urinary flow rate, and hospital stay were observed. The mean operation time was 74 min±12 min (range 45 to 150 min), the mean follow-up period was 2 to 6 months, the mean catheter time was 5 days, and the mean peak urinary flow rate increased from 6.3±0.6 to 17.5±1.5 mL/s. The International Prostate Symptom Score and quality of life significantly declined (p<0.01). No significant differences were observed in the hemoglobin and blood electrolytes before and after operation. Prostate transurethral enucleation using a 2-μm laser is safe and efficient for BPH treatment.

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Section: Discussionmentioning

confidence: 99%

Benign Prostatic Hyperplasia Treatment by Transurethral Enucleation of the Prostate Using a 2-μm Laser

Zhou

et al. 2015

Indian J Surg

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“…Even though TUR-P is efficient, there are developments of various alternative minimally invasive surgeries for BPH because of the morbidity rate of 18% in TUR-P procedures [8].…”

Section: Discussionmentioning

confidence: 99%

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Kılıç¹

2014

Ann Clin Anal Med

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ÖzetAmaç: Prostat'ın transüretral rezeksiyonundan (TUR-P) önce uygulanan tek doz goserelin' in, benign prostat hiperplazisi (BPH) olan hastalarda kan kaybı ve prostat subüretral dokunun mikrovasküler dansitesi (MVD) üzerine olan etkilerinin belirlenmesi amaçlandı. Gereç ve Yöntem: TUR-P planlanan hastalar iki gruba randomize edilerek ayrıldı. Ameliyattan 1 ay önce 3,6 mg subkütan goserelin asetat uygulanan 18 hasta Grup 1'i oluşturdu. Grup 2 ise goserelin verilmeyen 21 hastadan oluşturuldu. İntraoperatif kanama miktarı ölçüldü.Her hasta için toplam kan kaybı, toplam kan kaybı/ ameliyat süresi, toplam kan kaybı/ rezeke edilen doku gramı hesaplandı. Prostat subüretral doku kesitleri mikrovasküler dansitesi açısından incelendi. Bulgular: Ameliyattan hemen sonra yapılan kontrolde; grup 1'deki hemoglobin (Hb) düşüşü grup 2'ye göre daha fazlaydı ve ortalama Hb seviyesi grup 1'de grup 2'ye kıyasla istatistiksel olarak anlamlı derecede düşük bulundu (p=0.028). İstatistiksel olarak anlamlı olmamasına rağmen irrigasyon sıvısında Hb konsantrasyonu ve ameliyat süresince kan kaybı grup 1'de grup 2'ye oranla daha yüksekti, buna karşılık TUR-P süresine göre ve rezeke edilen prostat doku ağırlığına göre kan kaybı ise grup 1'de grup 2'ye gore daha düşüktü. Mikrovasküler dansite grup 2'de belirgin olarak daha azdı. Tartışma: Bir aylık tek doz goserelin tedavisi, TUR-P boyunca olan kan kaybını azaltmada etkili değildir ve prostat dokusunda mikrovasküler dansitesi üzerinde süpresif etkisi yoktur. Anahtar KelimelerBenign Prostat Hiperplazisi; Goserelin; Mikrovasküler Dansite; Kan Kaybı; Prostatın Transüretral Rezeksiyonu Abstract Aim: To determine the effects of one dose goserelin before transurethral resection of the prostate (TUR-P) on blood loss and microvessel density (MVD) of prostatic suburethral tissues in the patients with benign prostatic hyperplasia (BPH). Material and Method: The patients who planned to have a TUR-P were randomly divided into two groups. Group-1 consisted of 18 patients who were pretreated with 3,6 mgr subcutaneous injection of goserelin acetate one month before the operation. Group-2 was constructed from 21 patients without goserelin acetate pretreatment. The amount of intraoperative haemorrhage was calculated. Total blood loss, total blood loss/duration of surgery and total blood loss/gram of resected tissue were calculated for each patient. Sections from the prostatic suburethral tissues were examined for microvessel density. Results: Quantitative decreases in Hb were greater in group 1 than in group 2, and mean Hb level was statistically significantly lower in group 1 than in group 2 at the control just after the operation (p=0.028). Although all the differences were statistically insignificant, Hb concentration in irrigation fluid and total blood loss during surgery were higher in the group 1 than in the group 2, contrarily, blood loss by duration of TURP and blood loss by weight of resected prostate tissue were less in the group 1 than in the group 2. The MVD was significantly lower in group 2 than ...

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“…Svaka od teorija ne isključuje drugu već je učinak vrlo vjerojatno posljedica zajedničkog mehanizma. Komparativne studije su pokazale kako ova metoda nije uspješna kao TURP, ali rezultira poboljšanjem simptoma unatoč nedostatku objektivnih znakova poboljšanja 27 .…”

Section: Laserske Tehnikeunclassified

“…Uz pomoć optičkog instrumenta u uretru se uvede monopolarni kateter koji na vrhu ima dvije igle kojima se uz pomoć električne energije proizvodi toplina u tranzicionalnoj zoni, čuvajući sluznicu uretre, čime dolazi do koagulacijske nekroze. Pogodna je za pacijente kod kojih nije uspjela medikamentozna terapija, koji nisu skloni većem zahvatu te s prostatom do 60 g. To je zahvat koji ima sve pogodnosti dnevne kirurgije u smislu kratke hospitalizacije i niskog morbiditeta, ali mu nedostaje dugoročna efikasnost i dugotrajnost kao kod TURP-a 27,28 .…”

Section: Transuretralna Ablacija Iglomunclassified

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Surgical management of benign prostatic hyperplasia

et al. 2017

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Sažetak. Nekada smo benignu hiperplaziju prostate smatrali glavnim uzrokom problema s mokrenjem kod muškaraca. Danas koristimo naziv simptomi donjeg urinarnog trakta jer se pokazalo kako je benigna hiperplazija prostate samo jedan od etioloških čimbenika. Kvalitetna dijagnostička obrada simptoma uputit će nas u pravom smjeru kako bismo mogli individualizirati terapiju. Za pacijente koji imaju indikaciju za kirurško liječenje danas postoji nekoliko operativnih tehnika. Otvorena jednostavna prostatektomija najstariji je i dokazano učinkoviti zahvat. Transuretralna resekcija prostate je zlatni standard liječenja. Laserska tehnologija danas stoji uz bok zlatnom standardu, a pojavile su se i tehnike minimalno invazivne kirurgije koje pružaju prednosti niskog morbiditeta i kratkotrajne hospitalizacije.Ključne riječi: minimalno invazivna kirurgija; povećanje prostate; prostatektomija; transuretralna resekcija prostate Abstract. Benign prostatic hyperplasia was once considered the main reason for urinary symptoms in male patients. Today we are aware that many etiological factors cause these symptoms so a new term was coined: lower urinary tract symptoms. An adequate diagnostic work up will lead us onto the right path of individualized treatment for each patient. Those in need of surgery have various surgical procedures at their disposal. Open simple prostatectomy is the oldest procedure that has proven its efficacy. Transurethral resection of prostate is the current gold standard. Laser techniques are challenging the gold standard while minimally invasive surgical procedures offer all the benefits of low morbidity and short hospital stay.

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Minimally Invasive and Endoscopic Management of Benign Prostatic Hyperplasia

Cited by 31 publications

References 321 publications

Benign Prostatic Hyperplasia Treatment by Transurethral Enucleation of the Prostate Using a 2-μm Laser

Benign Prostatic Hyperplasia Treatment by Transurethral Enucleation of the Prostate Using a 2-μm Laser

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Surgical management of benign prostatic hyperplasia

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