How Reliable is a Single Measurement of Urinary Flow in the Diagnosis of Obstruction in Benign Prostatic Hyperplasia?

1993 ◽  
Vol 72 (2) ◽  
pp. 181-186 ◽  
Author(s):  
H. MATZKIN ◽  
R. VAN DER ZWAAG ◽  
Y. CHEN ◽  
LYNNE A. PATTERSON ◽  
Z. BRAF ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Single Measurement

scholarly journals Efficacy and safety of Finasteride (5 alpha-reductase inhibitor) monotherapy in patients with benign prostatic hyperplasia: A critical review of the literature

2020 ◽  
Vol 91 (4) ◽  
pp. 205-210
Author(s):  
Gian Maria Busetto ◽  
Francesco Del Giudice ◽  
Daniele D'Agostino ◽  
Daniele Romagnoli ◽  
Andrea Minervini ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Benign Prostatic Hyperplasia ◽  
Adverse Events ◽  
Clinical Efficacy ◽  
Critical Review ◽  
Reductase Inhibitor ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Efficacy And Safety

Background: Combination therapy with 5 alpha-reductase inhibitor (5-ARI) and alpha-blocker can be considered as a gold standard intervention for medical management of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS/BPH). On the other hand, 5-ARI monotherapy and in particular Finasteride alone is currently getting focus of attention especially due to lack of systematic reviews investigating efficacy outcomes and/or adverse events associated. Objectives: Aim of the present critical review was to analyze current knowledge of clinical efficacy and incidence of adverse events associated with 5-ARI treatment for LUTS/BPH. Materials and methods: A systematic review of clinical trials of the literature of the past 20 years was performed using database from PubMed, Cochrane Collaboration and Embase. A total of 8821 patients were included in this study and inclusion criteria for studies selection were: data from randomized clinical trials (RCTs) focusing their attention on the clinical role of Finasteride monotherapy for symptomatic BPH. Parameters of research included prostate specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPPS), postvoid residual urine (PVR), voiding symptoms of IPSS (voiding IPSS), maximum urinary flow rate (Qmax), and adverse events (AEs). Results: Overall 12 original articles were included and critically evaluated. Sample sizes of patient actively treated with finasteride varied from 13 to 1524 cases analyzed in a single study. Follow-up after treatments ranged from 3 to 54 months. The effect of finasteride in reducing prostate volume (PV) was moderate (standardized mean difference (SMD) effect between 0.5 to 0.8 for all trials evaluable) while the effect on IPSS score and Qmax was considered significant (SMD in the 0.2 to 0.5 variation range). No severe AEs and/or psychiatric disorders were retrieved among the studies. Sexual health dysfunctions were significantly influenced by finasteride therapy when compared with placebo treated patients. Conclusions: Although significant clinical benefits of finasteride monotherapy were demonstrated, the effective size of the available reports included in the analysis is limited. Additional head-to-head studies would be needed to re-evaluate clinical efficacy and safety of 5-ARI in combination or not with alpha blockers.

Relationship among symptom score, prostate volume, and urinary flow rates in 543 patients with and without benign prostatic hyperplasia

The Prostate ◽  
1998 ◽  
Vol 34 (2) ◽  
pp. 121-128 ◽  
Author(s):  
Alessandro Sciarra ◽  
Giuseppe D'Eramo ◽  
Paolo Casale ◽  
Andrea Loreto ◽  
Maurizio Buscarini ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Symptom Score ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Flow Rates

Monopolar vs. Bipolar Trans Urethral Resection of Prostrate (TURP) - A Comparative Outcome Analysis in Benign Prostatic Hyperplasia - A Single Centre Experience in Western Odisha

2021 ◽  
Vol 8 (31) ◽  
pp. 2875-2879
Author(s):  
Sucheta Panigrahi ◽  
Acharya Suryakanta Pattajoshi ◽  
Sanjay Kumar Mahapatra ◽  
Raja Kumar Subudhi P ◽  
Biswajit Sahu
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Operating Time ◽  
Prostatic Hyperplasia ◽  
Outcome Analysis ◽  
Symptom Improvement ◽  
P Value ◽  
Urinary Flow ◽  
Prostate Hyperplasia ◽  
Bipolar Group ◽  
Post Operative Period

BACKGROUND In this study we wanted to compare the clinical outcomes in terms of symptom improvement and perioperative results of monopolar and bipolar trans urethral resection of prostrate (TURP) for benign prostatic hyperplasia (BPH) and evaluate the advantages of bipolar transurethral resection over the monopolar resection. METHODS A total of 150 patients who underwent trans urethral resection of prostate (TURP) surgical procedure, (n = 75 for monopolar TURP) and (n = 75 for bipolar TURP) for BPH enrolled between December 2018 to November 2020 at the Department of Urology in VSSIMSAR, Burla, Odisha. RESULTS Significant differences were found in operating time in minutes (45.11 ± 4.029 vs 41.99 ± 5.020, P < 0.025) between monopolar and bipolar TURP. The mean sodium falls in post-operative period in bipolar and monopolar TURP was 7 Meq and 3 Meq respectively which was statistically significant (P - value less than 0.05). Bipolar TURP is equally effective as monopolar in reducing the international prostate symptom score (IPSS), improvement in quality of life, maximum urinary flow rate. Trans urethral resection (TUR) syndrome was reported in two patients who had undergone monopolar resection without any incidence in bipolar group. 3 patients in monopolar group developed clot retention compared to 1 in bipolar group in post-operative period. Fall in haemoglobin (Hb) and packed cell volume (PCV) was more with monopolar group but insignificant. CONCLUSIONS Bipolar TURP is safe and equally effective as monopolar TURP with advantage of shorter operative time and absence of dilutional hyponatremia and TUR syndrome, but needs large randomized trials with long follow up to confirm its efficacy and safety. KEYWORDS Monopolar TURP; Bipolar TURP; Benign Prostate Hyperplasia

scholarly journals Radial Extracorporeal Shock Wave Therapy as a Novel Agent for Benign Prostatic Hyperplasia Refractory to Current Medical Therapy

2019 ◽  
Vol 13 (1) ◽  
pp. 155798831983189 ◽  
Author(s):  
Dai Zhang ◽  
Yun-Lei Wang ◽  
Da-Xin Gong ◽  
Zhao-Xuan Zhang ◽  
Xiao-Tong Yu ◽  
...  
Keyword(s):  
Shock Wave ◽  
Benign Prostatic Hyperplasia ◽  
Medical Therapy ◽  
Safety Data ◽  
Extracorporeal Shock Wave Therapy ◽  
Current Medical ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

This study aimed to assess efficacy and safety data from pilot trials of the radial extracorporeal shock wave therapy (rESWT) to treat benign prostatic hyperplasia (BPH) refractory to current medical therapy. A total of 29 men with lower urinary tract symptoms (LUTS) suggestive of BPH who had responded poorly to medical therapy for at least 6 months and were poor surgical candidates were enrolled. Each participant was treated with rESWT once a week for 8 weeks, each by 2000 impulses at 2.0 bar and 10 hertz of frequency. International Prostate Symptom Score (IPSS), quality of life (QoL), and International Index of Erectile Function-5 (IIEF-5) were evaluated before treatment, after the fourth and eighth rESWT, and 3 months after the end of treatment. Peak urinary flow ( Qmax) and postvoid residual (PVR) were assessed. Safety was also documented. Statistically significant clinical improvements were reported for IPSS, QoL, and IIEF-5 after treatment, and those were sustained until 3 months follow-up. Qmax and PVR improved evidently at 8 weeks with a 63% and 70% improvement, respectively. The only adverse event was the occasional perineum pain or discomfort, which usually disappeared within 3 days. The rESWT may be an effective, safe, and noninvasive treatment for symptomatic BPH in selected patients whose medical treatment has faced failure and are poor surgical candidates.

Effects of Medical Therapy or Surgery on Prostatic and Bladder Resistive Indices in Patients with Benign Prostatic Hyperplasia

2014 ◽  
Vol 94 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Suleyman Bulut ◽  
Cuneyt Ozden ◽  
Binhan Kagan Aktas ◽  
Tagmac Deren ◽  
Suleyman Tagci ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Medical Therapy ◽  
Power Doppler ◽  
Urine Volume ◽  
Prostatic Hyperplasia ◽  
Doppler Imaging ◽  
Urinary Flow ◽  
Once Daily ◽  
Urinary Tract Symptoms ◽  
Posttreatment Period

Introduction: The effects of medical therapy or surgery on bladder and prostatic resistive indices (RIs) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) were evaluated in the present study. Patients and Methods: A total of 124 consecutive LUTS/BPH patients who were candidates for medical therapy (alfuzosin 10 mg once daily, n = 66) or surgery (transurethral prostatectomy (TUR-P), n = 58) were prospectively included. Baseline assessment of patients was performed with the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and prostatic and bladder RIs measured using power Doppler imaging (PDI). All patients were re-evaluated 3 months after treatment measuring the same parameters. Results: Following medical therapy, mean IPSS (17.2 ± 5.1 vs. 8.3 ± 5.3, p = 0.0001), postvoiding residual (PVR) urine (80.0 ± 80.5 vs. 40.3 ± 38.6, p = 0.0001), and prostatic RI (0.73 ± 0.1 vs. 0.70 ± 0.1, p = 0.0001) were decreased, Qmax (13.7 ± 4.2 vs. 16.9 ± 5.9, p = 0.0001) was increased, and bladder RI remained unchanged (0.70 ± 0.1 vs. 0.70 ± 0.1, p = 0.68). Mean IPSS (25.3 ± 5.6 vs. 6.0 ± 4.5, p = 0.0001), PVR urine volume (134.5 ± 115.5 vs. 35.7 ± 25.9, p = 0.0001), and prostatic (0.78 ± 0.1 vs. 0.67 ± 0.04, p = 0.0001) and bladder RIs (0.72 ± 0.1 vs. 0.64 ± 0.04, p = 0.005) were decreased, and Qmax (8.0 ± 4.5 vs. 17.2 ± 8.2, p = 0.0001) was increased after TUR-P. Conclusions: Our results demonstrated that TUR-P decreased both prostatic and bladder RIs, while α-blocker therapy did not change bladder RI in the early posttreatment period in LUTS/BPH patients.

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