Medical therapy for benign prostatic hyperplasia: the road ahead

1997 ◽  
Vol 79 (S1) ◽  
pp. 92-96 ◽  
Author(s):  
R.S. KIRBY
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Medical Therapy ◽  
Prostatic Hyperplasia ◽  
The Road

The first experience of bipolar transurethral operations in surgery of benign prostatic hyperplasia

2018 ◽  
pp. 10-20
Author(s):  
Н.А. Глотов ◽  
Н.Е. Соколов ◽  
Ю.Б. Смоляков
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostatic Hyperplasia ◽  
Medium Term ◽  
Significance Level ◽  
The Road ◽  
Surgical Methods ◽  
The Comparative Study ◽  
Endoscopic Methods ◽  
Qualitative Characteristics

Представлены результаты внедрения в хирургическую практику урологического отделения Дорожной клинической больницы г. Ярославль биполярной техники трансуретральной резекции (БТУР) и энуклеации простаты (ТУЭБ) для лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) средних и больших размеров. В сравнительное исследование включено 164 пациента, разделенных по методам операции на 2 основные группы (ТУЭБ - 33 человека, БТУР - 49) и 2 контрольные (открытая простатэктомия - ОПЭ - 38 и монополярная ТУР - 44). Для новых эндоскопических методов установлено значимое снижение объема кровопотери, частоты геморрагических осложнений, сроков послеоперационной катетеризации и госпитализации. Для количественной оценки различий средних и относительных показателей использо-вали непараметрический критерий Манна-Уитни, оценка качественных признаков проводилась с применением критерия Пирсона (χ2), уровень значимости различий для исследования выбран р ≤ 0,05. Анализ послеоперационной динамики клинических показателей в среднесрочной перспективе показал сходную радикальность и эффектив-ность сравниваемых методов. Установленные меньшая инвазивность, большая безопасность и лучшая переносимость биполярных эндоскопических операций демонстрируют перспективность их внедрения взамен бывших стандартных хирургических методов, что позволит повысить качество оперативного лечения и сократить затраты стационара. The results of the introduction into surgical practice of the urological Department of the road clinical hospital of Yaroslavl bipolar technique of transurethral resection (BTTR) and enucleation of the prostate (EOTP) for the treatment of benign prostatic hyperplasia (BPH) of medium and large sizes are presented. The comparative study included 164 patients, divided by the methods of surgery into 2 main groups (EOTP - 33 people, BTTR - 49) and 2 control (open prostatectomy - OPE - 38 and monopolar TTR - 44). For new endoscopic methods, a significant reduction in the volume of blood loss, the frequency of hemorrhagic complications, the timing of postoperative catheterization and hospitalization was established. Nonparametric Mann-Whitney test was used to quantify the differences in mean and relative indicators, qualitative characteristics were evaluated using Pearson test (χ2), the significance level of the differences for the study was chosen p ≤ 0.05. Analysis of postoperative dynamics of clinical parameters in the medium term showed similar radicality and effectiveness of the compared methods. The lower invasiveness, greater safety and better tolerability of bipolar endoscopic operations demonstrate the prospects of their implementation instead of the former standard surgical methods, which will improve the quality of surgical treatment and reduce the costs of the hospital.

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.

2009 THE IMPACT OF CHANGING TRENDS IN MEDICAL THERAPY ON SURGERY FOR BENIGN PROSTATIC HYPERPLASIA OVER TWO DECADES

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Seung Hyun Ahn ◽  
In Ho Chang ◽  
Kyung Do Kim ◽  
Young Tae Moon ◽  
Soon Chul Myung ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Medical Therapy ◽  
Prostatic Hyperplasia ◽  
Changing Trends ◽  
The Impact

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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