Outcome of Surgery for Benign Prostatic Hyperplasia-Is It Predictable?

Suhani,; Gupta, Sanjay; Gupta, Arun; Saha, Sudipta; Mahapatra, Lalatendu; Srivastava, UK

doi:10.7860/jcdr/2013/7606.3888

Cited by 6 publications

(2 citation statements)

References 12 publications

(5 reference statements)

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“…16 These delays are not benign: Longer catheter duration is associated with repeated catheter/trial to void cycles (possibly facilitating ongoing bladder damage), increased urosepsis events, urethral injury and higher likelihood of failure once the intervention is attempted. 17 , 18 Up to half of all men with one episode of AUR will experience recurrent retention and 85% will proceed to surgical intervention within a year 5 ; a timely and effective intervention to relieve their obstruction is essential.…”

Section: Discussionmentioning

confidence: 99%

Prostatic urethral lift for subjects in urinary retention (PULSAR): 12‐Month results of a prospective controlled trial compared with real‐world outcomes

Rochester,

Doherty,

Page

et al. 2023

BJUI Compass

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ObjectiveTo examine the safety and efficacy of prostatic urethral lift (PUL) in acute urinary retention (AUR) patients within a controlled (PULSAR) and real‐world setting (Real‐World Retrospective study).Materials and methodsPULSAR was a 12‐month prospective study of PUL in AUR patients (n = 51) performed at six centres in the United Kingdom; enrolled BPH patients aged ≥50 years, with prostate volume of ≤100 cc. AUR was defined as being catheter dependent with at least one prior failed trial without catheter (TWOC) while on an alpha‐blocker. RWR consisted of 3226 consecutive PUL patients across 22 international sites treated between July 2017 and March 2020; 469 of whom were in urinary retention (RWRr), that is, catheter‐dependent at the time of their procedure. Symptom response, uroflow and catheter independence rates were compared between PULSAR and RWRr subjects. A logistical regression model was constructed to evaluate patient baseline and dynamic factors predicting success after the procedure.ResultsSeventy‐three percent of PULSAR subjects were catheter independent and free from surgical reintervention at 12 months post‐PUL. Success was associated with higher voiding efficiency during the perioperative period. Slightly higher catheter‐independent rates (80%) were seen in RWRr patients; variables that influenced success included age <70 years, lower baseline prostate‐specific antigen (PSA), lower baseline post‐void residual (PVR) and shorter pre‐procedural catheter duration. Logistic regression of the combined PULSAR and RWRr retention groups revealed that procedural age <70 years and higher bladder voiding efficiency (BVE) were associated with success.ConclusionsLower baseline PSA and PVR, younger age and shorter pre‐procedure catheter durations drove successful outcomes in AUR patients undergoing PUL. Post‐PUL voiding efficiencies may help ascertain long‐term response to treatment.

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Section: Discussionmentioning

confidence: 99%

Prostatic urethral lift for subjects in urinary retention (PULSAR): 12‐Month results of a prospective controlled trial compared with real‐world outcomes

Rochester,

Doherty,

Page

et al. 2023

BJUI Compass

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“…Patients with surgical indications underwent TURP by the same experienced doctor, and the urine flow rate was reviewed one month after the operation. According to the postoperative improvement of maximum urinary flow rate, the patients were divided into group A (Qmax improvement value greater than or equal to 50% or Qmax>15ml/s, and it is defined as a good surgical effect [7]) 79 cases and group B (Qmax improvement value less than 50% and Qmax<15ml/s) 42 cases.…”

Section: Materials and Methods 11 General Information：mentioning

confidence: 99%

The Predictive Value of Non-Invasive Urodynamic Parameters for the Curative Effect of TURP

et al. 2022

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Purpose: To explore the predictive value of non-invasive urodynamic parameters for the efficacy of transurethral resection of the prostate (TURP). Methods: 121 cases, Benign prostatic hyperplasia (BPH) patients were assessed retrospectively and were divided into good prognosis (group A) and poor prognosis (group B) according to the degree of improvement in maximum urinary flow rate, and the changes in ultrasound and non-invasive urodynamic parameters between the two groups were explored. Results: The PV, IPP, and PVR of group A were lower than those of group B (P＜0.05), and Qmax of group A was greater than group B (P＜0.05). The difference was statistically significant (P＜0.05); There was no significant difference in DWT, age, and IPSS(P＞0.05). The ROC curve analyzes the diagnostic efficacy of each parameter in the diagnosis of the efficacy of TURP, and the results are ranked in order of 1/Qmax (AUC=0.777), PV (AUC=0.715), PVR (AUC=0.642), IPP (AUC=0.629), Of which 1/Qmax has the best diagnostic efficiency, and it AUC=0.777, the best cutoff value is 0.12, the sensitivity is 0.81, and the specificity is 0.571. Conclusion: Preoperative application of non-invasive urodynamic parameters in BPH patients can better predict postoperative efficacy, especially Qmax has the best predictive effect.

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Are Histological Findings of Thulium Laser Vapo-Enucleation Versus Transurethral Resection of the Prostate Comparable?

Carmignani

Macchi

Ratti

et al. 2015

Pathol. Oncol. Res.

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We investigated if an adequate histological diagnosis can be made from tissue after Thulium laser vapo-enucleation of the prostate (ThuVEP) and whether it is comparable to transurethral prostate resection (TURP) tissue findings in patients with symptomatic benign prostatic hyperplasia. We analyzed 350 ThuLEP and 100 matched TURP tissue specimens from patients who underwent one of the two procedures between January 2009 and June 2014. Thulium Laser Enucleation of Prostate (ThuVEP) was combined with mechanical morcellation of the resected lobe. Each histological specimen was reviewed by two pathologists. Preoperative prostate ultrasound volume, total serum prostatic specific antigen and postoperative tissue weight were evaluated. Microscopic histological diagnosis was assessed by standard histological techniques and immunohistochemical evaluation. Patients were comparable in terms of age and preoperative total serum prostate specific antigen. Incidental adenocarcinoma and high grade PIN of the prostate were diagnosed in a comparable percent of specimens in the 2 groups (2.5 % in the ThuVEP group versus 3 % in the TURP group). Tissue thermal artifacts induced by the Thulium laser are mostly due to coagulation as that of the conventional monopolar diathermy in TURP. Tissue quality was maintained in the ThuVEP histological specimens. Tissue maintain histological characteristics and proprieties without modification for successive immunoistochemical analysis. The pathologist ability to detect incidental prostate cancer and PIN was maintained even if there is a quoted of vaporized tissue.

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Outcome of Surgery for Benign Prostatic Hyperplasia-Is It Predictable?

Cited by 6 publications

References 12 publications

Prostatic urethral lift for subjects in urinary retention (PULSAR): 12‐Month results of a prospective controlled trial compared with real‐world outcomes

Prostatic urethral lift for subjects in urinary retention (PULSAR): 12‐Month results of a prospective controlled trial compared with real‐world outcomes

The Predictive Value of Non-Invasive Urodynamic Parameters for the Curative Effect of TURP

Are Histological Findings of Thulium Laser Vapo-Enucleation Versus Transurethral Resection of the Prostate Comparable?

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