Analysis of causes of failure of medical treatment in patients undergoing surgery for benign prostate enlargement

2021 ◽  
pp. 039156032110376
Author(s):  
Ajay Anand ◽  
Narmada P Gupta ◽  
Prem Nath Dogra ◽  
Amlesh Seth
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Medical Management ◽  
Prostate Volume ◽  
Large Size ◽  
Prostate Enlargement ◽  
Urinary Tract Symptoms ◽  
Significant Difference ◽  
Benign Prostate ◽  
Causes Of Failure

Background: To analyse causes of failure of medical management in benign prostate enlargement (BPE) in patients who undergo surgery following medical treatment and to elucidate parameters which warrant for early surgical treatment. Methods: Records of 747 patients who underwent surgery for BPE were reviewed for prostate volume, median lobe enlargement, post void residual urine, duration and type of medical treatment given for BPE. We used univariate and multivariate analysis to find out significant parameters for medical treatment failure. Results: A total of 601 patients (80.45%) received medical treatment for their lower urinary tract symptoms (LUTS), for a duration ranging between 3 months and 2 years. Statistically significant difference was found between age, prostate volume, intravesical projection, PSA and acute urinary retention with failure of medical treatment. Conclusions: BPE patients with failure to respond with medical management within 3–6 months and/or associated with large size prostate, intravesical projection and raised serum PSA should better be offered surgical treatment.

scholarly journals Association between Hyperglycemia and Prostate Volume in Patients with Benign Prostate Enlargement : A Hospital Case-Control Study

2017 ◽  
Vol 3 (2) ◽  
pp. 46
Author(s):  
Eriawan Agung Nugroho ◽  
Rickky Kurniawan
Keyword(s):  
Benign Prostate Hyperplasia ◽  
Prostate Volume ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Prostate Hyperplasia ◽  
Increased Risk ◽  
Prostate Enlargement ◽  
Significant Difference ◽  
Spearman Test ◽  
Benign Prostate

Introduction: Prostate is a male organ which might enlarge mostly, either benign or malignant. Hyperglycemia is one of the factor that increase the risk of  benign prostate hyperplasia. There is lack of studies which assessed the relationship between benign prostate hyperplasia and isolated hyperglycemia. The aim of this study was to evaluate the association between hyperglycemia and prostate volume in patients with benign prostate enlargement in dr. Kariadi Hospital Semarang.  Method: We conducted a retrospective analysis of clinical data which obtained from 640 men between 2010 and 2012 who admitted to the hospital with diagnosis of benign prostate enlargement. By their medical records, these patients were evaluated of their plasma glucose level and prostate volume by trans rectal ultrasound. The  presence  of  hyperglycemia  was  determined  based  on  the  American  Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Patients have already been diagnosed with controlled diabetes mellitus by an internist. We allocated the subjects into two groups: patients with hyperglycemia and non-hyperglycemia. Logistic regression analysis was used to assess whether hyperglycemia was associated with the increased risk of benign prostate enlargement.Results: Significant difference of prostate volume found between groups. Prostate volume was  significantly greater in hyperglycemia group compared with non-hyperglycemia ones in all sub-groups based on age (in decades). Odds Ratio (OR) in patients with hyperglycemia was 2.25 (95% CI: 1.23-4.11). By non-parametric Spearman test it obtained  Group 1 (P1) p = 0.000 and r = 0.669, group 2 (P2) it obtained p = 0.000 and r = 0.672, group 3 (P3) it obtained p = 0.000 and r = 0.415 which implied strong positive associationConclusion: Hyperglycemia and prostate volume were significantly associated in patients with benign prostate enlargement. Hyperglycemia became a significant risk factor  for  prostate  enlargement  in  patients  with  benign  prostate  enlargement  in dr. Kariadi Hospital Semarang.

Effect of alpha-blocker use on morbidity and lower urinary tract symptoms in patients undergoing transrectal ultrasound-guided prostate biopsy

2021 ◽  
pp. 039156032110383
Author(s):  
Remzi Salar ◽  
Güven Erbay
Keyword(s):  
Prostate Biopsy ◽  
Voiding Dysfunction ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Maximum Flow ◽  
Control Group ◽  
Alpha Blocker ◽  
Urinary Tract Symptoms ◽  
Significant Difference

Objective: To evaluate voiding dysfunction and morbidity after transrectal ultrasound (TRUS)-guided prostate biopsy and to investigate whether pre-intervention alpha-blocker treatment had any effect on morbidity and voiding dysfunction. Material and methods: The study included 197 consecutive patients who underwent TRUS-guided prostate biopsy between January 2014 and January 2018. The patients were divided into two groups, those receiving alpha-blocker (silodosin) and those not receiving alpha-blocker treatment before the procedure (controls). All patients were evaluated before and one week after the procedure with the International Prostate Symptom Score (IPSS), measurements of maximum flow rate ( Qmax), post-void residual urine volume (PVR) and prostate volume, and procedure-related complications were also recorded. All analyzed parameters were compared by within-group and between-group evaluations. Results: There was no significant difference between the two groups in terms of IPSS, Qmax and prostate volume values before biopsy. In the follow-up evaluation performed on the seventh day after biopsy, IPSS, PVR and prostate volume were found to be increased, whereas Qmax was decreased in the control group ( p < 0.05). In the silodosin group, an increase in prostate volume was observed, but there were no significant changes in IPSS, Qmax and PVR values. Acute urinary retention (AUR) after the biopsy procedure developed in two patients (2%) in the silodosin group, and in nine patients (9.1%) in the control group ( p = 0.02). No significant difference was found between the two groups in terms of biopsy-related complications, except for AUR. Conclusion: We believe that alpha-blocker treatment initiated before biopsy may be advantageous in preventing voiding dysfunction that may develop after the procedure.

scholarly journals Medical management in locally advanced and metastatic prostate cancer: Does changes in treatment policy have any specific effect on PSA levels?

2017 ◽  
Vol 89 (4) ◽  
pp. 282 ◽  
Author(s):  
Murat Bagcioglu ◽  
Cristian Surcel ◽  
Serkan Ozcan ◽  
Cristian Mirvald ◽  
Mehmet Ali Karagoz ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Medical Management ◽  
Locally Advanced ◽  
Androgen Deprivation ◽  
Testosterone Levels ◽  
Management Protocol ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Objective: Androgen deprivation therapy (ADT) is commonly used as a first-line treatment for locally advanced and metastatic prostatic cancer (Pca). There is no consensus about which alternative treatment should be used after the failure of initial ADT. We aimed to investigate the effect of changes in treatment on PSA and testosterone levels. Material and methods: A total of 120 patients with an established diagnosis of either locally advanced or metastatic Pca in two different centers. Depending on the type of medical and/or surgical management protocol planned at initial presentation, all cases were divided into three main groups as follows. Group 1 (n: 80) included the patients who underwent medical management during whole follow-up period in whom the initial management protocol was later on switched to another medical treatment with different agents, Group 2 (n: 20) included patients who were initially treated with a medical management protocol and switched to surgical castration during follow-up evaluation and lastly Group 3 (n: 20) included the patients undergoing treated surgical castration as initial treatment modality without any further medical management protocol. Results: Evaluation of our data did clearly demonstrate a statistically significant difference between the initial and final PSA as well as testosterone levels in Group 1 cases. Mean PSA and testosterone levels increased significantly in these cases despite a change in hormonal therapy by using another agent for androgen deprivation. Cases in Group 2 and 3 cases did not show any statistically significant difference with respect to the mean PSA as well as testosterone values during the same follow-up period. Conclusions: Our data clearly indicated that in case of a biochemical progression, switching into another alternative medical treatment was not effective enough in limiting the rising PSA levels in a statistically significant manner when compared with the approaches of switching to surgical castration after initial medical treatment or continuing with regular and close follow-up after initial surgical castration alone.

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 Moxibustion as an adjunct for lower urinary tract symptoms associated with benign prostate enlargement

Medicine ◽  
2020 ◽  
Vol 99 (4) ◽  
pp. e18918
Author(s):  
Hye-Yoon Lee ◽  
Go-Eun Bae ◽  
Sang-Don Lee ◽  
Jong-Kil Nam ◽  
Young-Ju Yun ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Prostate Enlargement ◽  
Urinary Tract Symptoms ◽  
Benign Prostate ◽  
Lower Urinary

scholarly journals Genetic Determinants of Metabolism and Benign Prostate Enlargement: Associations with Prostate Volume

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0132028 ◽  
Author(s):  
Ayush Giri ◽  
Todd L. Edwards ◽  
Saundra S. Motley ◽  
Susan H. Byerly ◽  
Jay H. Fowke
Keyword(s):  
Prostate Volume ◽  
Genetic Determinants ◽  
Prostate Enlargement ◽  
Benign Prostate

scholarly journals iTIND: the second-generation temporary implantable nitinol device for minimally invasive treatment of benign prostatic hyperplasia

2020 ◽  
Vol 12 ◽  
pp. 175628722093435
Author(s):  
Dhivya Balakrishnan ◽  
Patrick Jones ◽  
Bhaskar K. Somani
Keyword(s):  
Minimally Invasive ◽  
Second Generation ◽  
Short Term ◽  
Invasive Treatment ◽  
Prostate Enlargement ◽  
Urinary Tract Symptoms ◽  
Current Guidelines ◽  
Benign Prostate ◽  
Lower Urinary

iTIND is the second-generation version of the temporary nitinol implantable device (TIND), which has emerged over the past decade as one of the latest additions to the library of minimally invasive surgeries now available to treat bothersome lower urinary tract symptoms (LUTS) caused by benign prostate enlargement. While the key procedural steps remain the same, it now carries specific modifications designed to improve its efficacy and safety profile further. With the option to perform implantation under local anaesthesia, it can be delivered on an ambulatory basis and in the office setting. While the formal position of iTIND in current guidelines is yet to be determined, 12-month data demonstrates that it can improve both objective and subjective outcome measures, which are sustained at short-term follow up.

scholarly journals Prolapse of the urethral mucosa in a prepubertal Indian girl

2018 ◽  
Vol 7 (8) ◽  
pp. 3397
Author(s):  
Sabita Pulavarthi ◽  
Sharmila Vijayan
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Medical Management ◽  
Mucosal Prolapse ◽  
Indian Girl ◽  
Primary Modality

Prolapse of urethral mucosa in prepubescent girls is an uncommon entity and most often seen among native Africans. Management of these cases is controversial. Some would adopt initial medical treatment and others prefer surgical treatment as primary modality with a very few recurrences. Though urethral mucosal prolapse has been managed successfully with surgery in many African girls, the role of medical management and its success cannot be overlooked. Authors present a case of urethral mucosal prolapse in a prepubescent Indian girl who was successfully treated with medical management with no recurrence on follow up.

scholarly journals RELATIONSHIP OF PERIURETHRAL FIBROTIC IN BPH PATIENT WITH LUTS AND URINARY RETENTION

2017 ◽  
Vol 24 (2) ◽  
Author(s):  
Zamroni Zamroni ◽  
Sunaryo Hardjowijoto ◽  
Soetojo Soetojo
Keyword(s):  
Urinary Retention ◽  
Prostate Volume ◽  
Basal Membrane ◽  
Transitional Epithelium ◽  
Test Results ◽  
Prostate Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Significant Difference ◽  
Average Patient ◽  
Relationship Of

Objective: Analyzing the differences between collagen thicknesses in periurethral region from transurethral resection of the prostate (TURP) specimens of Benign Prostate Hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS) and of those with urinary retention. Material & methods: This was an observation analytic study on 30 patients who underwent TURP. Patients who met the inclusion criteria were divided into 2 groups: BPH patients with LUTS and those with urinary retention. Each group consisted of 15 people. The first TURP specimen of proximal verumontanum resection were examined in anatomic pathology using mass on strichrome staining as an examination of periurethral collagen thickness. Collagen will be stained as blue. Periurethral collagen thickness was measured from the basal membrane of transitional epithelium to fibromuscle tissue. Data were then statistically analyzed using independent t-test. Results: The average patient age was 66 ± 7 years old and there was no significant difference between age and periurethral collagen thickness with p=0.175 (p>0.05). The mean prostate volume was 47.19 ± 13.2 ml and there was no significant difference between prostate volume and periurethral collagen thickness with p=0.148 (p>0.05). Average periurethral collagen thickness in BPH patients with urinary retention was 146.67 ± 39.80 micrometers and while in those with LUTS was 205.33 ± 85.6 micrometers. There were no significant differences between periurethral collagen thickness and the occurrence urinary retention with retention of urine with p=0.063 (p>0.05). Conclusion: There were no significant differences between periurethral collagen thickness patients in BPH patients with LUTS and in those with urinary retention. This suggests that periurethral collagen thickness is not associated with the occurrence of urinary retention or LUTS in BPH patients.

Sign in / Sign up

Export Citation Format

Share Document