Prognostic Value of a Combination of IPSS, Flow Rate and Residual Urine Volume Compared to Pressure-Flow Studies in the Preoperative Evaluation of Symptomatic BPH

Background: Benign Prostatic Hypertrophy (BPH) is common in older men. This study compared homeopathic treatment strategies using constitutional medicines (CM) or organopathic medicines (OM) alone or in combination (BCOM) in patients suffering from BPH.Methods: 220 men aged 30–90 years were recruited in Odisha, India. Patients presenting symptoms of prostatism, with or without evidence of bladder outflow obstruction were included in the study. Patients with serum prostate specific antigen (PSA)> 4 nmol/mL, malignancy, complete urine retention, stone formation and gross bilateral hydronephrosis were excluded. Patients were sequentially allocated to OM, CM or BCOM. The main outcome measure was the International Prostate Symptom Score (IPSS).Results: 73, 70 and 77 patients respectively were sequentially allocated to OM, CM or BCOM. 180 patients (60 per group) completed treatment and were included in the final analysis. Overall 85% of patients showed improvement of subjective symptoms such as frequency, urgency, hesitancy, intermittent flow, unsatisfactory urination, feeble stream, diminution of residual urine volume but there was no reduction in prostate size. Treatment response was highest with BCOM (38.24%) compared to OM (31.62%) and CM (30.15%). Effect sizes were highest for the decrease in IPSS, residual urine volume and urinary flow rate.

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POST-VOID RESIDUAL URINE VOLUME IN WOMEN WITH OVERACTIVE BLADDER SYMPTOMS

The Journal of Urology ◽

10.1097/01.ju.0000140502.34334.75 ◽

2004 ◽

Vol 172 (5) ◽

pp. 1911-1914 ◽

Cited By ~ 22

Author(s):

MARK MILLEMAN ◽

PETER LANGENSTROER ◽

MICHAEL L. GURALNICK

Keyword(s):

Overactive Bladder ◽

Urine Volume ◽

Residual Urine Volume ◽

Residual Urine ◽

Overactive Bladder Symptoms ◽

Bladder Symptoms

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A drug-coated balloon treatment for urethral stricture disease: Two-year results from the ROBUST I study

Canadian Urological Association Journal ◽

10.5489/cuaj.6661 ◽

2020 ◽

Vol 15 (2) ◽

Author(s):

Rachel A. Mann ◽

Ramon Virasoro ◽

Jessica M. DeLong ◽

Rafael E. Estrella ◽

Merycarla Pichardo ◽

...

Keyword(s):

Quality Of Life ◽

Adverse Events ◽

Urethral Stricture ◽

Flow Rate ◽

Erectile Function ◽

Urine Volume ◽

Urethral Stricture Disease ◽

Residual Urine ◽

Drug Coated Balloon

Introduction: Mechanical balloon dilation and direct visualization internal urethrotomy (DVIU) are the most widely used treatments for urethral stricture disease in the U.S., but recurrence rates are high, especially after re-treatment. This study investigates the safety and efficacy of the Optilume™ paclitaxel-coated balloon for the treatment of recurrent strictures. Methods: Men with recurrent bulbar strictures ≤2 cm with 1–4 prior endoscopic treatments were treated with the Optilume™ drug-coated balloon. Patients were evaluated within 14 days, three, six, 12, and 24 months post-treatment. The primary safety endpoint was serious urinary adverse events. The primary efficacy endpoint was ≥50% improvement in International Prostate Symptom Score (IPSS) at 24 months. Secondary outcomes included quality of life, erectile function, flow rate, and post-void residual urine volume. Results: A total of 53 subjects were enrolled and treated; 46 completed the 24-month followup. Forty-three percent of men had undergone >1 previous dilations, with a mean of 1.7 prior dilations. There were no serious adverse events related to treatment at two years. Success was achieved in 32/46 (70%), and baseline IPSS improved from a mean of 25.2 to 6.9 at 24 months (p<0.0001). Quality of life, flow rate, and post-void residual urine volumes improved significantly from baseline. There was no impact on erectile function. Conclusions: Two-year data indicates the Optilume™ paclitaxel-coated balloon is safe for the treatment of recurrent bulbar urethral strictures. Early efficacy results are encouraging and support further followup of these men through five years, as well as further investigation with a randomized trial.

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