scholarly journals Characterizing ProstivaTMRF Treatments of the Prostate for BPH with Gadolinium-Enhanced MRI

2009 ◽  
Vol 9 ◽  
pp. 10-16 ◽  
Author(s):  
Christian Huidobro ◽  
Benjamin Larson ◽  
Samuel Mynderse ◽  
James J. Myers ◽  
David Busel ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Bladder Neck ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Enhanced Mri ◽  
Urinary Tract Symptoms ◽  
Mri Sequences ◽  
The Mean ◽  
Lower Urinary

Transurethral needle ablation (TUNA) is an accepted and effective therapy for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). ProstivaTM(Medtronic, Shoreview, MN) is the newest-generation device, which includes a new needle design and radio frequency (RF) generator. This device creates temperatures of 120°C and necrotic lesions in less than 2.5 min. Using previously described techniques, we analyzed dynamic, gadolinium-enhanced MRIs to characterize the ablative properties of the new ProstivaTMRF device.Ten men with LUTS due to BPH were treated with the standard ProstivaTMmanufacturer–recommended protocol. The bladder neck and lateral lobes received treatment based on prostate volume and prostatic urethral length. Gadolinium-enhanced MRI sequences were obtained prior to and 1 week post-treatment. Analyze® software (Mayo Clinic Biomedical Imaging Resource, Rochester, MN) was used to evaluate MRIs. New gadolinium defects were seen in all patients following ProstivaTMtreatments. All lesions coalesced within the prostate. No defects were seen beyond the prostate, and the urethra was spared in all patients. The mean volume of necrosis was 7.56 cc, representing a mean of 11.28% of total prostate volume.Dynamic, gadolinium-enhanced MRIs demonstrate new vascular defects representing necrosis caused by ProstivaTMRF therapy of the prostate. The standard ProstivaTMRF protocol produces lesions that coalesce to create larger lesions in the bladder neck and lateral lobes. Compared to the TUNA® Precision PlusTMdevice, the ablative lesions appear comparable while produced with a shorter burn time.

scholarly journals Correlation of prostate volume with severity of lower urinary tract symptoms as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mudi Awaisu ◽  
Muhammed Ahmed ◽  
Ahmad Tijjani Lawal ◽  
Abdullahi Sudi ◽  
Musliu Adetola Tolani ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Flow Rate ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urine Flow ◽  
Urine Flow Rate ◽  
Urinary Tract Symptoms ◽  
The Mean ◽  
Lower Urinary

Abstract Background The aim of the study is to find the correlation between the prostate volume and severity of lower urinary tract symptoms (LUTS) as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia (BPH). Methods The study was a prospective correlational study conducted between June 2016 and November 2017. A total of 290 patients who presented with LUTS suggestive of BPH and satisfied the inclusion criteria were consecutively recruited. Clinical evaluation including digital rectal examination of the prostate was done. Symptoms severity was assessed using the self-administered international prostate symptoms score (IPSS) questionnaire. Prostate volume was determined by transrectal ultrasound scan, and the urine flow rate was measured using uroflowmeter. Data were analyzed using SPSS version 20.0, and p value < 0.05 was taken to be statistically significant. Results The mean age of the patients was 64.22 ± 9.04 years with a range of 40 to 95 years. Most of the patients had moderate symptoms (55%) on IPSS with the mean IPSS value of 16.41 ± 7.43. The mean Qmax value was 16.55 ± 7.41 ml/s, and the median prostate volume (IQR) was 45.05 (35, 59). There was a positive significant correlation between prostate volume and IPSS (r = 0.179, p = 0.002) and a negative significant correlation between prostate volume and Qmax (r = − 0.176, p = 0.003). Conclusion This study showed a significant correlation between the prostate volume and IPSS, and also between prostate volume and maximum flow rate (Qmax).

scholarly journals Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexander S. Somwaru ◽  
Stephen Metting ◽  
Laura M. Flisnik ◽  
Michael G. Nellamattathil ◽  
Arjun Sharma ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Term Efficacy ◽  
Urinary Tract Symptoms ◽  
Surgical Treatments ◽  
Lower Urinary

Abstract Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort. Methods Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100–250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred. Conclusions PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

scholarly journals Effect of preoperative prostate volume on the improvement of lower urinary tract symptoms in patients with benign prostatic hyperplasia undergoing transurethral resection of prostate

2019 ◽  
Vol 9 (2) ◽  
pp. e18-e18
Author(s):  
Behzad Lotfi ◽  
Sajjad Farazhi ◽  
Mohammadreza Mohammadi Fallah ◽  
Mansour Alizadeh ◽  
Rohollah Valizadeh ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Significant Difference ◽  
Lower Urinary

Introduction: Benign prostate hyperplasia, pathophysiology contributes to bladder outlet obstruction due to functional obstruction caused by gland size enlargement resulting in the lower urinary tract symptoms (LUTS). Objectives: To determine the correlation of the prostate volume with surgical outcomes and postoperative LUTS in patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection of the prostate (TURP). Patients and Methods: Patients with BPH who were refractory for medical treatment enrolled in the study. Patients divided into three groups with attention to their prostate volume conducted by transabdominal ultrasonography. To evaluate patients’ LUTS, the International Prostate Symptom Score (IPSS) questionnaire was filled for all patients preoperatively and during the first and third months follow up sessions. Results: In the current study, mean age of the patients was 66.92 ± 1.08 years. Of 111 patients, eight patients (7.2%) had prostate volume less than 30 cc, 59 patients (53.2%) had prostate volume between 30-60 cc, and 44 patients (39.6%) had prostate volume more than 60 cc. During first month postoperative, mean decrease in IPSS scores in patients with prostate volume less than 30 cc, prostate volume between 30–60 cc and prostate volume more than 30 cc were 27.72 ± 3.53, 27.32 ± 3.37 and 27.45 ± 2.87, respectively. The ANOVA test showed no significant difference between the groups (P= 0.93). Mean decrease in IPSS score during third month postoperative, had no significant difference between the three groups, too (P=0.71). Symptoms alleviation observed in 94.6% and 95.5% of the patients, during first and third months follow-up, respectively. Conclusion: There was no correlation between the IPSS scores decrease and patients’ symptoms recovery and preoperative prostate volume in patients with BPH who underwent TRUP.

scholarly journals Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

2020 ◽  
Author(s):  
Alexander S. Somwaru ◽  
Stephen Metting ◽  
Laura M. Flisnik ◽  
Venkat S. Katabathina
Keyword(s):  
Urinary Tract ◽  
Treatment Option ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Term Efficacy ◽  
Urinary Tract Symptoms ◽  
Surgical Treatments ◽  
Lower Urinary

Abstract Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume larger than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective study examined the safety and long-term efficacy of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large cohort of patients. Methods 72 patients with GPH and severe LUTS who underwent PAE were retrospectively evaluated. PAE was performed bilaterally with two embolic agents in sequence: 100 µm to 250 µm embolic particles followed by 2 mm and 3 mm coils. Clinical assessment was performed by collecting international prostate symptoms score (IPSS), quality of life (QoL), and post-void residual volume (PVR) before PAE and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before PAE and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, PVR, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < .0.01) at 12 months and to 10.5 (P < .0.01) at 24 months. Mean QoL decreased from 6.0 to 4.0 (P < 0.01) at 12 months and to 2.0 (P < 0.01) at 24 months. Mean PVR decreased from 198.0 mL to 152.0 mL (P < 0.01) at 12 months and to 90 mL (P < 0.01) at 24 months. Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) at 12 months and to 209.0 mL (P < 0.01) at 24 months. There were no major complications. Conclusions PAE is a safe treatment option with long term efficacy in patients with severe LUTS due to GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

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