Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline

Foster, Harris E.; Barry, Michael J.; Dahm, Philipp; Gandhi, Manhar C.; Kaplan, Steven A.; Köhler, Tobias; Lerner, Lori B.; Lightner, Deborah J.; Parsons, J. Kellogg; Roehrborn, Claus G.; Welliver, Charles; Wilt, Timothy J; McVary, Kevin T.

doi:10.1016/j.juro.2018.05.048

Cited by 243 publications

(216 citation statements)

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“…A transurethral resection of the prostate (TURP) is currently the standard surgical procedure in the treatment of a bladder outlet obstruction caused by benign prostate enlargement . A rare but unfortunate complication is post‐TURP urinary incontinence .…”

Section: Introductionmentioning

confidence: 99%

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Noordhoff

Finazzi‐Agrò

Scheepe

et al. 2019

Neurourology and Urodynamics

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AimTo evaluate the outcome of adjustable continence balloons in the treatment of stress urinary incontinence (SUI) after transurethral resection of the prostate (TURP).MethodsIn two tertiary centers, adjustable continence balloons were implanted in 29 patients with post‐TURP SUI between 2007 and 2018. Endpoints of this retrospective multicenter study were patient‐reported changes in pad count and complications. Dry was defined as no pad or one security pad.ResultsPreoperative urinary incontinence was mild in 7 (24%), moderate in 12 (41%), and severe in 10 (35%) patients. The median follow‐up duration was 21 (interquartile range [IQR], 11‐43) months. Within 30 days postoperatively, a Clavien‐Dindo grade less than or equal to II complication occurred in 24% of the patients. Reintervention rate was 24%. Six and 12 months after implantation, the International Prostate Symptom Score (IPSS) quality‐of‐life item improved significantly from 5 (IQR, 5‐6) preoperatively to 3 (IQR, 1‐4.5) and 1 (IQR, 0‐3), respectively. At last visit (median 21 months after implantation), the outcome on continence had improved in 76% of the patients, including, 45% dry patients. After a median follow‐up of 28 months (IQR, 13‐63; N = 23), all but one patient reported improvement on the Patient Global Impression of Improvement (PGI‐I) scale. In detail, 10 patients reported “very much better” condition compared with before the implantation, 10 patients “much better,” two patients “a little better,” and one patient “no change.” Daily pad use decreased from three (IQR, 2‐5) to one (IQR, 0‐2) pads/day (P < 0.001).ConclusionsThis is hitherto, the first study reporting results of adjustable continence balloons in the treatment of post‐TURP SUI. The therapy was found to be safe and efficient. The majority of our study population reported improvement on their condition and greater than or equal to 50% reduction in daily pad use.

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Section: Introductionmentioning

confidence: 99%

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Noordhoff

Finazzi‐Agrò

Scheepe

et al. 2019

Neurourology and Urodynamics

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“…The Holmium laser has rapidly gained a lot of acceptance supported by well-designed randomized controlled trials and meta-analyses [2][3][4]. As a result, recent AUA and EAU guidelines now incorporate holmium laser enucleation of the prostate (HoLEP) as an alternative option for treatment of symptomatic BPH with a high level of evidence to support its efficacy and safety [5,6].…”

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The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

et al. 2019

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Introduction: The DrillCut^TM morcellator is marketed for its fast and highly efficient removal of prostatic tissue and a higher level of patient safety. However, a paucity of publications has looked into its actual efficacy and safety. The aim of our study was to evaluate its ex vivo and in vivo efficiency and to compare its results with other devices presented in the literature. Patients and Methods: We conducted a prospective pilot study on patients who underwent holmium laser enucleation of the prostate (HoLEP) from 2017 to 2018 using the Top-Down technique. Enucleated adenomas were morcellated using the DrillCut^TM morcellator. We collected both preoperative and operative data. Operative data included the enucleated adenoma weight and operative time. Various morcellator parameters were collected including morcellation time and efficiency. We recorded the encountered complications and device malfunction. Ex vivo characteristics were evaluated in terms of morcellation speed and aspiration power. Results: Sixty consecutive patients with a median age of 72.8 years were included. The enucleated adenoma was retrieved in 12.5 min (4–58). The median resected prostatic weight was 90 g (44–242). The DrillCut^TM efficiency was calculated as 6.46 g/min (2.7–15). Only one patient had a simple bladder mucosal injury. Device malfunction was encountered in 4 patients (6.6%) due to blockage of the morcellator blades. The ex vivo aspiration speed was 52 s/L, while the morcellation power was 14 g/2 min. Conclusion: Our results showed that the DrillCut morcellator was effective and safe in managing our patients post-HoLEP. The DrillCut^TM has better ex vivo morcellation power but modest aspiration speed in comparison to other morcellators.

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“…Transurethral resection of the prostate significantly improves BPH symptoms and uroflowmetry measurements; however, alternative treatment methods should be considered for treating patients with complications (e.g., patients receiving anti-coagulation therapy) and in men with prostate volumes >80 ml (Foster et al, 2018). The complications associated with TURP include the need for blood transfusion, surgical revision, urethral stricture, bladder neck contracture, urinary incontinence, erectile dysfunction and retrograde ejaculation (Ahyai et al, 2010;Cornu et al, 2015;Uygur, Gur, Arik, Altug, & Erol, 1998).…”

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confidence: 99%

Effect of bipolar radiofrequency thermotherapy on benign prostate hyperplasia

Diri

Gül

2019

Andrologia

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| INTRODUC TI ONBenign prostatic hyperplasia (BPH) is the most common type of benign neoplasms in the male population. It affects approximately 50% and 90% men >60 and at around 85 years of age respectively (Lim, 2017). BPH can have a major effect on the quality of life because of symptoms, such as urinary urgency, frequency, nocturia, incomplete voiding of urine, weak urinary flow and hesitancy. The treatment options for BPH include conventional medications, such as alpha-1 blockers, 5-alpha reductase inhibitors and transurethral resection of the prostate (TURP; Foster et al., 2018). Although medical treatment slows the progression of BPH, approximately one in 10 patient expe-Abstract This study aims to evaluate the safety and efficacy of the new bipolar radiofrequency thermotherapy device (TEMPRO) in treating patients with benign prostate hyperplasia (BPH). Between December 2017 and November 2018, 72 male patients with BPH were included. All patients completed the International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) questionnaires. Physical examinations were performed, and prostate volume, prostatic urethral length andpost-voiding residual urine (PVR) were measured using ultrasound. Uroflowmetry was used to calculate the maximum flow rate of urination (Qmax). Bipolar radiofrequency thermotherapy was applied with TEMPRO system containing a 16Fr applicator. All patients were re-evaluated at 6 months post-operatively. The mean age of the patients was 63.22 ± 6.68 years. All patients were treated with local anaesthesia, and three patients were unable to complete the procedure. The median (IQR) visual analogue scale score was 1 (0-3) at 6 hr post-operatively. After 6 months, significant improvements were observed in the IPSS, QoL, Qmax and PVR values of the patients (p < .001 for Qmax, IPSS and QoL; p = .03 for PMR). The success rate of the procedure was similar between patients with prostate volumes <70 and >70 ml. Due to its low rate of complication, the TEMPRO © treatment is effective in treating BPH, especially among aged patients and those with serious symptoms. K E Y W O R D Sbenign prostate hyperplasia, radiofrequency, thermotherapy, treatment How to cite this article: Diri MA, Gul M. Effect of bipolar radiofrequency thermotherapy on benign prostate hyperplasia.

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Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline

Cited by 243 publications

References 38 publications

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

Effect of bipolar radiofrequency thermotherapy on benign prostate hyperplasia

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Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline

Cited by 243 publications

References 38 publications

Outcome and complications of adjustable continence therapy (ProACTTM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Outcome and complications of adjustable continence therapy (ProACTTM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

Effect of bipolar radiofrequency thermotherapy on benign prostate hyperplasia

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Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study

Outcome and complications of adjustable continence therapy (ProACT^TM) in the treatment of urinary incontinence after transurethral resection of the prostate: A multicenter study