scholarly journals Transurethral Resection of Prostate Abscess: Is It Different from Conventional Transurethral Resection for Benign Prostatic Hyperplasia?

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Neeraj Kumar Goyal ◽  
Apul Goel ◽  
Satyanarayan Sankhwar ◽  
Divakar Dalela
Keyword(s):  
Transurethral Resection ◽  
Preoperative Imaging ◽  
Transurethral Resection Of Prostate ◽  
Modified Technique ◽  
Abscess Drainage ◽  
Postoperative Fever ◽  
Prostatic Enlargement ◽  
Secondary Procedures ◽  
Group 2 ◽  
Group 1

Purpose. To present our experience of prostate abscess management by modified transurethral resection (TUR) technique. Methods. Seventeen men with prostate abscess undergoing TUR between 2003 and 2011 were retrospectively analyzed. Details of demography, surgical procedures, complications, and followup were noted. Results. With a mean age of 61.53 ± 8.58 years, all patients had multifocal abscess cavities. Initially, 6 men underwent classical TUR similar to the technique used for benign prostatic enlargement (group 1). Next, 11 men underwent modified TUR (group 2) in which bladder neck and anterior zone were not resected. The abscess cavities resolved completely, and no patient required a second intervention. One patient in group 1 and three in group 2 had postoperative fever requiring parenteral antibiotics . Three patients in group 1 had transient urinary incontinence, whereas none of the patients in group 2 had this complication (). Four and five men in group 1 and 2 reported retrograde ejaculation, respectively . Conclusion. The modified technique of prostate resection edges over conventional TURP in the form of reduced morbidity but maintains its high success rate for complete abscess drainage. It alleviates the need for secondary procedures, having an apparent advantage over limited drainage techniques. Use of this technique is emphasized in cases associated with BPH and lack of proper preoperative imaging.

scholarly journals Outcome Comparison of Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Patients in Karawang General Referral Hospital

2019 ◽  
Vol 13 (3) ◽  
pp. 69
Author(s):  
Ramlan Halimi ◽  
Achmad Rizky Herda Pratama
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Prostatic Hyperplasia ◽  
Transurethral Resection Of Prostate ◽  
Significant Difference ◽  
Prostate Size ◽  
Group 2 ◽  
Group 1

Background: Benign Prostatic Hyperplasia (BPH) is the most common pathological condition in man that causes Lower Urinary Tract Syndrome (LUTS). The most popular therapeutic modality for BPH is Transurethral Resection of Prostate (TURP). This study describes the TURP outcome in BPH patient with prostate size > 75 grams compared to < 75 grams in Karawang General Referral Hospital.Methods: We performed a retrospective review of clinical outcome from BPH patient with LUTS who underwent TURP procedure between January 2017 – April 2018. Data was taken through patient medical records and processed descriptively to describe complications, quality of life, and clinical laboratory data. Qualitative data compared with Chi-Square test.Results: During this study, we evaluated 40 patients, 20 patients with prostate size > 75 grams (group 1) and 20 patients with prostate size < 75 grams (group 2). Mean age in group 1 was 65.6 ± 9.9 years and in group 2 was 65.3 ± 10.2 years. International Prostate Symptom Score (IPSS) after TURP between group 1 and group 2 showed a significant difference, while incomplete emptying was found mostly in group 2 (p < 0.05). There was no significant difference in Quality of Life Score between group 1 and group 2 (p > 0.05). From laboratory results, we found a reduction of hemoglobin in both groups with p-value < 0.05 or no significant difference.Conclusions: Transurethral Resection of Prostate (TURP) procedure for patient with prostate size > 75 grams is safe and effective with lower complications and there is no significant difference compared to patient with prostate size < 75 grams.

scholarly journals Outcomes of Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Comparing Prostate Size of more than 80 Grams to Prostate Size less than 80 Grams

2015 ◽  
Vol 12 (3) ◽  
pp. 163-167 ◽  
Author(s):  
HN Joshi ◽  
IJ De Jong ◽  
RM Karmacharya ◽  
B Shrestha ◽  
R Shrestha
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Prostate Gland ◽  
Prostatic Hyperplasia ◽  
Transurethral Resection Of Prostate ◽  
Prostate Size ◽  
The Mean ◽  
Group 2 ◽  
Large Prostate ◽  
Group 1

Background Benign prostatic hyperplasia is a condition occurring in elderly men in which the prostate gland is enlarged, hence the condition also known as benign enlargement of prostate. Benign hyperplasia can lead to both obstructive and irritative symptoms. Transurethral resection of prostate (TURP) still remains the gold standard modality of surgical treatment of obstructive lower urinary tract symptoms due to Benign hyperplasia.Objectives The objective of this study was to evaluate the outcomes of TURP in large prostate (>80 grams) in comparison to small prostate (<80 grams) in terms of efficacy, safety and complications.Methods A total of 65 cases included in this prospective study, which were operated by a single surgeon with conventional monopolar TURP using standard technique. Intra -operative and post-operative complications, pre and post- operative quality of life (QoL) and international prostate symptom score (IPSS), operative time, time to removal of catheter and hospital stay were evaluated between small and large prostate gland volumes.Results Out of 65 cases, 30 were with large prostate size i.e. 80 grams or more (group 1), and 35 cases were with small prostate size than 80 grams size (group 2). Mean age was 71.8 SD ± 6.9 years in group 1 and 68.2 SD ± 12.7 years in group 2. The mean preoperative volume of prostate was 88.8 grams (range 80-115 grams) in group 1 and 40.3 (range 20-65 grams) in group 2. The mean preoperative post void residual volume of urine (PVRU) was 244 ml SD ± 190.8 ml in group 1 and 117 ml ± 70.3 ml in group 2. Mean resection time in group 1 was 110 (range 90-130) minutes and in group 2 it was 90 minutes (range 55-115) minutes. There were quite satisfactory improvements in IPSS and QoL. No significant complications were observed except TUR syndrome in 2 cases from group 2, which were managed well in postoperative period.Conclusion With meticulous resection and intra-operative haemostasis using continuous out flow resectoscope, conventional monopolar TURP is equally safe and effective in large size prostate as compare in small size.Kathmandu University Medical Journal Vol.12(3) 2014; 163-167

scholarly journals Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients

2019 ◽  
Vol 6 (3) ◽  
pp. 270-274 ◽  
Author(s):  
Luca Carmignani ◽  
Maria Chiara Clementi ◽  
Claudia Signorini ◽  
Gloria Motta ◽  
Sebastiano Nazzani ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Transurethral Resection Of Prostate ◽  
Benign Prostatic Enlargement ◽  
Prostatic Enlargement

scholarly journals Low Intraprostatic DHT Promotes the Infiltration of CD8+ T Cells in BPH TissuesviaModulation of CCL5 Secretion

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yu Fan ◽  
Shuai Hu ◽  
Jie Liu ◽  
Fei Xiao ◽  
Xin Li ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Cd8 T Cells ◽  
Cell Subset ◽  
Transurethral Resection Of Prostate ◽  
Medication History ◽  
Group 2 ◽  
Prostatic Epithelial Cell ◽  
Group 1

Clinical studies suggested thatandrogen might be associated with infiltrating T cells in prostate of benign prostatic hyperplasia (BPH) patients, but detail of T-cell subset and mechanism still remained unclear. The present study tested the hypothesis that intraprostatic 5α-dihydrotestosterone (DHT) exerts effects on T cells recruitment by BPH epithelial cells. Prostate tissues from 64 cases of BPH patients after transurethral resection of prostate (TURP) were divided into 2 groups: (1) no medication history; (2) administration of 5α-reductase type II inhibitor-finasteride 5 mg daily for at least 6 months before surgery. Group 2 presented significantly higher CD8+ T cells infiltration than group 1, but no changes in CD4+ T cells (immunohistochemistry and flow cytometry).In vitrostudy more CD8+ T cell migrated to the prostate tissue lysates from group 2 and BPH-1 cells in low DHT condition. Transcription of chemokine (C-C motif) Ligand 5 (CCL5) mRNA in BPH-1 cells and chemokine (C-C motif) receptor 5 (CCR5) mRNA in CD8+ T cells were upregulated in low DHT condition (q-PCR). CCL5 expression was also identified to be higher in group 2 prostate tissues by IHC. This study suggested that intraprostatic DHT may participate in regulating inflammatory response which was induced by human prostatic epithelial cell, via modulating CCL5 secretion.

Examining the Potential Use of a Novel Radiographic Scoring System for Determining Surgical Intervention in Diabetic Charcot Arthropathy

2016 ◽  
Vol 10 (3) ◽  
pp. 198-203
Author(s):  
Rahul Bijlani ◽  
Laurie M. Lomasney ◽  
Michael Pinzur ◽  
Katherine Dux
Keyword(s):  
Scoring System ◽  
Preoperative Imaging ◽  
The Novel ◽  
Median Score ◽  
Charcot Arthropathy ◽  
Radiographic Findings ◽  
Numerical Characterization ◽  
Group 2 ◽  
Serial Images ◽  
Group 1

Introduction. Although Eichenholtz and the Schon systems are commonly used to evaluate foot Charcot arthropathy on radiographs, a novel system with expanded characterization may have added benefit. Methods. Patients with Charcot arthropathy and foot radiographs were grouped in nonsurgical group 1 (imaging sets at minimum 2-year interval) and surgical group 2 (imaging preceding fusion and/or amputation). Radiographs were scored with Eichenholtz and Schon systems, and a novel scoring system (summation of 0-3 rank for bone density, distention/swelling, debris, disorganization, and dislocation/subluxation). Summative scores of the 2 groups were compared. Differences in scores of each system from serial images of group 1 were compared and average scores from each of the systems for preoperative imaging sets of group 2 were compared. Results. A total of 111 patients were included (group 1, 19 patients; group 2, 92 patients). The novel system provided a broad numerical characterization of the radiographs (range 1-15). Summative scores of the novel system for groups 1 and 2 were statistically different with lower median score in the nonsurgical group (nonsurgical median score 6 vs surgical median score 9). Individual characteristic scores from 4 (distention, debris, disorganization, and dislocation) of 5 categories for the novel system were statistically different, with lower scores for the nonoperative group. The narrower numerical scores from the Eichenholtz and Schon systems did not yield statistically significant results. Conclusion. The novel scoring system provides a broad numerical description of radiographic findings in Charcot arthropathy of the foot and has potential advantage for surgical predictive value. Levels of Evidence: Level IV: Retrospective

scholarly journals A Modified Technique Reduced Operative Time of Laparoendoscopic Rendezvous Endoscopic Retrograde Cholangiopancreatography Combined with Laparoscopic Cholecystectomy for Concomitant Gallstone and Common Bile Ductal Stone

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Wei Liu ◽  
Qunwei Wang ◽  
Jing Xiao ◽  
Liying Zhao ◽  
Jiangsheng Huang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Operative Time ◽  
Modified Technique ◽  
Endoscopic Retrograde ◽  
Traditional Technique ◽  
Laparoendoscopic Rendezvous ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Laparoendoscopic rendezvous (LERV) endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC+ERCP/LERV) are considered an optimal approach for concomitant gallstones and common bile duct stones. The rendezvous technique is essential for the success of procedure. We applied two different LERV techniques, traditional technique and modified technique, in 60 consecutive cases from January 2011 to November 2012. 32 cases who underwent modified technique (group 1) from February 2012 to November 2012 were retrospectively compared to 28 cases (group 2) who underwent traditional technique from January 2011 to January 2012. There was no significant difference between two groups with respect to preoperative demographic features. Although the difference was not statistically significant, the procedure was successfully performed in 31 cases (96.9%) in group 1 and 24 cases (86.2%) in group 2. The mean operative time and time of endoscopic part were 82.6 ± 19.6 min and 26.5 ± 5.99 min in group 1 which were significantly shorter than those in group 2 (118.0 ± 23.1 min and 58.7 ± 13.3 min, resp.). There was no postoperative pancreatitis and mortality in both groups. The mean hospital stay, blood loss, incidence of complications, and residual stone were of no difference in both groups. This study proved that this modified technique can effectively reduce the operative time and time of endoscopic part of LC+ERCP/LERV compared with traditional technique.

scholarly journals A MODIFIED TECHNIQUE FOR SURGICAL REMOVAL OF THE CONGENITAL DUODENAL OBSTRUCTION

2019 ◽  
Vol 23 (3) ◽  
pp. 146-149
Author(s):  
M. G. Chepurnoy ◽  
G. I. Chepurnoy ◽  
V. B. Katsupeev ◽  
A. V. Leyga ◽  
Ya. I. Chilibiyskiy ◽  
...  
Keyword(s):  
Duodenal Obstruction ◽  
Surgical Removal ◽  
Initial Part ◽  
Modified Technique ◽  
Congenital Duodenal Obstruction ◽  
Barium Suspension ◽  
Group 2 ◽  
Treitz Ligament ◽  
Made In ◽  
Group 1

Purpose. To improve the duodenum function after Kimura surgery which is performed for the congenital duodenal obstruction by restoring the horseshoe-shaped duodenum. Material and methods. A comparative analysis of two groups of patients was made: In Group 1 (n = 31) , patients were operated with the mobilization of lower horizontal duodenal branch and duodenoduodenal anastomosis by Kimura without restoring the horseshoe-shape of the duodenum. In Group 2 (n = 11), children had similar surgeries but the horseshoe-shaped configuration of the duodenum was restored by fixing the initial part of the jejunum to the Treitz ligament. After surgery, the researchers radiographically compared time of barium suspension passage through the duodenum in patients of both groups. Results. In children from Group 1, passage of the contrast suspension via duodenum lasted for 43.9 ± 3.9 sec., what is approximately 2 times faster than in the norm. In patients from Group 2, this indicator was 3-4 times larger than in patients from Group 1 and was 158.2 ± 18.2 sec. Such a slowdown in the chyme passage along the duodenum prolongs exposure of food masses to pancreatic juice, bile and intestinal juice and, consequently, improves the duodenal function. Conclusion. The authors recommend to end the surgical intervention for eliminating congenital duodenal obstruction by Kimura technique with the restoration of horseshoe-shaped duodenum by fixing the initial part of the jejunum to the Treitz ligament.

scholarly journals Bladder perforation during transurethral resection of bladder tumour is not a result of deficient structure of the bladder wall

2020 ◽  
Author(s):  
Sławomir Poletajew ◽  
Tomasz Ilczuk ◽  
Wojciech Krajewski ◽  
Grzegorz Niemczyk ◽  
Agata Cyran ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Transurethral Resection ◽  
Bladder Wall ◽  
Bladder Tumour ◽  
Bladder Perforation ◽  
Cytokeratin 20 ◽  
Primary Mouse ◽  
Surgeon Experience ◽  
Group 2 ◽  
Group 1

Abstract Background Transurethral resection of the bladder tumour (TUR) is associated with a risk of bladder perforation. The underlying mechanisms and risk factors are unknown. The aim of this study was to describe the quality and architecture of urothelium and bladder submucosa in patients undergoing TUR complicated by bladder perforation. Methods Fifteen patients who underwent TUR complicated by a bladder perforation were retrospectively enrolled into this morphological analysis (group 1). As a control group, 15 patients, who had undergone uncomplicated TUR, were matched (group 2). Surgical specimens were collected from all participating patients. Immunohistochemical studies were performed with primary mouse anti-human E-cadherin, beta-catenin, type IV collagen, cytokeratin 20 and epithelial membrane antigen antibodies. The intensity of the immunohistochemical reaction was assessed using an immunoreactive score (IRS). Ultrastructural examinations were performed in transmission electron microscopy. The microscopic assessment was focused on the intensity of fibrosis in bladder submucosa and the presence of degenerative changes in the urothelium. Results Patients’ age, sex distribution, tumour diameters, surgeon experience or cancer stage did not differ between study groups. Immunohistochemical analysis did not reveal statistically significant differences between group 1 and group 2. From clinical point of view, ultrastructural analysis by electron microscopy showed higher rate of severe fibrosis in group 1 (63.6% vs. 38.5%), with no differences in the rate and degree of urothelial changes. However, these differences were not statistically significant (p = 0.32). Conclusions Bladder perforation during transurethral resection of bladder tumour is not a result of deficient structure of the bladder wall and surgical technique seems to play the most important role in its prevention.

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