scholarly journals Comparison of Nonspherical Polyvinyl Alcohol Particles and Microspheres for Prostatic Arterial Embolization in Patients with Benign Prostatic Hyperplasia

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Jin Ho Hwang ◽  
Sang Woo Park ◽  
Il Soo Chang ◽  
Sung Il Jung ◽  
Hae Jeong Jeon ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Polyvinyl Alcohol ◽  
Clinical Success ◽  
Arterial Embolization ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Prostatic Volume ◽  
Early Results ◽  
Significant Difference ◽  
Pva Particles

Purpose. To report early results following prostatic artery embolization (PAE) and compare outcomes between nonspherical polyvinyl alcohol (PVA) particles and microspheres to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Methods. PAE was performed in nine patients (mean age: 78.1 years) with symptomatic BPH. Embolization was performed using nonspherical PVA particles (250–355 μm) in four patients and microspheres (300–500 μm) in five patients. Results. PAE was technically successful in all nine patients (100%). During a mean follow-up of 10.1 months, improvements in mean International Prostate Symptom Score (IPSS), Quality of Life (QoL), prostatic volume (total volume and transition zone), and peak urinary flow (Qmax) were 9.8 points, 2.3 points, 28.1 mL, 17.8 mL, and 4.5 mL/s, respectively. Clinical success was obtained in seven of nine patients (78%). Patients in the microsphere group showed greater improvement in IPSS, QoL, prostatic volume, and Qmax compared to patients in the nonspherical PVA particle group. However, significant difference was noted only in the prostatic volume. Conclusion. PAE is a feasible, effective, and safe treatment option for BPH with LUTS. Use of microspheres showed greater prostatic volume reduction compared to nonspherical PVA particles.

Early results and complications of prostatic arterial embolization for benign prostatic hyperplasia

2015 ◽  
Vol 34 (5) ◽  
pp. 625-632 ◽  
Author(s):  
Souhil Lebdai ◽  
Nicolas Barry Delongchamps ◽  
Marc Sapoval ◽  
Grégoire Robert ◽  
Gregory Amouyal ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Arterial Embolization ◽  
Prostatic Hyperplasia ◽  
Prostatic Arterial Embolization ◽  
Early Results

A Comparative Study on the Safety and Efficacy of Tamsulosin and Alfuzosin in the Management of Symptomatic Benign Prostatic Hyperplasia: A Randomized Controlled Clinical Trial

2005 ◽  
Vol 33 (5) ◽  
pp. 562-573 ◽  
Author(s):  
MCM Lapitan ◽  
V Acepcion ◽  
J Mangubat
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Sexual Function ◽  
Prostatic Hyperplasia ◽  
Controlled Clinical Trial ◽  
Urinary Flow ◽  
Double Blind ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Once Daily ◽  
Treatment Regimens ◽  
Significant Difference

This randomized, double-blind, parallel-design trial compared the efficacy and safety of tamsulosin and alfuzosin in 76 men with symptomatic benign prostatic hyperplasia. Patients were randomized to receive 0.2 mg tamsulosin once daily orally ( n = 40) or 10 mg alfuzosin once daily orally ( n = 36), and changes in the International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax) and the Danish prostatic symptom sexual function score and morbidity rates were compared after 8 weeks of treatment. There was a mean overall decrease in the IPSS, with no significant difference between the treatment groups. There was an overall increase in the Qmax, which again was similar in the two groups. There was no significant change in the sexual function scores in either group. The incidence of adverse events was similar for tamsulosin (25%) and alfuzosin (19.4%) therapy. In conclusion, both treatment regimens similarly improved the IPSS and Qmax, did not alter sexual function and were well tolerated.

scholarly journals Intraprostatic Injection of Alcohol Gel for the Treatment of Benign Prostatic Hyperplasia: Preliminary Clinical Results

2006 ◽  
Vol 6 ◽  
pp. 2474-2480 ◽  
Author(s):  
Benjamin T. Larson ◽  
Nelson Netto ◽  
Christian Huidobro ◽  
Marcelo Lopez de Lima ◽  
Wagner Matheus ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Adverse Effects ◽  
Clinical Results ◽  
Prostatic Hyperplasia ◽  
Easy Access ◽  
Urinary Flow ◽  
Prostatic Volume ◽  
Urinary Tract Symptoms ◽  
Gel Injection

Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH.A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20–30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months.The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p< 0.0001) improvements in Qmax, IPSS, and QoL. The mean amount of gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment.This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an option for the treatment of BPH and LUTS. The viscosity of the gel allows for accurate imaging under ultrasound, no run back along the needle allowing for multiple methods of delivery, and the gel does not spread to extraprostatic tissue. This new technique could provide a simple and possibly less expensive clinic procedure for treating BPH, and warrants further study.

Photoselective Vaporization of the Prostate and Simultaneous Suprapubic Cystostomy for the Treatment of Benign Prostatic Hyperplasia in Patients with Mild to Severe Detrusor Underactivity

2015 ◽  
Vol 95 (3) ◽  
pp. 269-275 ◽  
Author(s):  
Zhenggang Yu ◽  
Jian Li ◽  
Zhaoyi Li ◽  
Ruipeng Hou
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Maximum Flow ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Detrusor Underactivity ◽  
Suprapubic Cystostomy ◽  
Bladder Compliance ◽  
Significant Difference ◽  
Photoselective Vaporization ◽  
Postvoid Residual Urine

Introduction: This study investigated the clinical efficacy and safety of photoselective vaporization of the prostate (PVP) and simultaneous suprapubic cystostomy for benign prostatic hyperplasia (BPH) in patients with mild to severe detrusor underactivity (DU). Subjects and Methods: Seventy-eight patients with BPH were divided into 3 groups according to the severity of DU: mild DU group, moderate DU group and severe DU group. The preoperative and postoperative data, including the detrusor pressure at maximum flow (Pdetmax), bladder compliance, maximum urinary flow (Qmax), postvoid residual urine (PVR) values, International Prostate Symptom Score (IPSS) and quality of life (QoL) were evaluated. Results: The therapeutic effectiveness including cure and improvement in mild and moderate DU group was significantly higher than that of the severe group. Compared to the preoperative values, Pdetmax, bladder compliance, Qmax, PVR, IPSS and QoL scores at 12 months postoperatively had significantly improved. In addition, the above parameters at 12 months postoperatively in the mild or moderate DU group had significant difference compared to the severe DU group. Conclusion: PVP and simultaneous suprapubic cystostomy seem to be an appropriate treatment modality in BPH patients with mild and/or moderate DU as well as in patients with severe DU and slightly reduced bladder compliance.

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.

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